bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Technique of Medial Displacement Calcaneal Osteotomy Using the Intramedullary Fixation of a Conventional Low-Profile Locking Wedge Plate
Authors: Choi Jun Young , Yu Oh Jun , Suh Jin Soo
Published: February 2024

Background:

Postoperative heel pain arising from prominent screw heads is a common complication following medial displacement calcaneal osteotomy (MDCO). This study aims to present the clinicoradiographic outcomes of a novel MDCO technique, wherein intramedullary fixation of a conventional low-profile locking wedge plate is employed.

Methods:

A retrospective analysis, involving a comparison of clinical and radiographic parameters among consecutive patients who underwent MDCO was conducted. The patients were subjected to either intramedullary wedge plate fixation through the osteotomy site (IWPF group, n = 45 cases) or conventional cannulated screw fixation from the heel (CCSF group, n = 51 cases). Radiographic evaluation included measurement of hindfoot alignment angle, alignment ratio, and moment arm. Clinical outcomes were measured with the American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and the Foot and Ankle Ability Measure (FAAM) activities of daily living and sports subscales, before and at 6, 12, and ≥24 months postoperatively. The presence of heel pain was evaluated at the postoperative 6 and 12 months in both groups.

Results:

For both groups, a marked enhancement in all 3 radiographic parameters was observed. The extent of correction for all clinicoradiographic parameters demonstrated no statistically significant divergence between the 2 groups. However, the FAAM-Sports scores at the 6-month postoperative juncture exhibited a significant elevation in the IWPF group relative to the CCSF group. Importantly, no patient reported heel pain at postoperative 6 and 12 months in the IWPF group whereas the rates of patients having heel pain at postoperative 6 and 12 months were 56.8% (29 cases) and 33.3% (17 cases), respectively, in the CCSF group.

Conclusion:

Both techniques yield analogous postoperative clinical and radiographic enhancements. However, the utilization of IWPF promotes a swifter clinical improvement with respect to sports activities when juxtaposed with the CCSF from the calcaneal tuberosity.

Level of Evidence:

Level III, retrospective comparative study.
A Novel Nomogram for Predicting Warfarin-Related Bleeding: A Retrospective Cohort Study
Authors: Yang Shaohua , Yao Wensen
Published: February 2024

Warfarin is a widely used anticoagulant, and bleeding complications are the main reason why patients discontinue the drug. Currently, there is no nomogram model for warfarin-associated bleeding risk. The aim of this study was to develop a risk-prediction nomogram model for warfarin-related major and clinically relevant non-major (CRNM) bleeding. A total of 280 heart disease outpatients taking warfarin were enrolled, 42 of whom experienced major or CRNM bleeding at the one-year follow-up. The Least Absolute Shrinkage and Selection Operator regression model was employed to identify potential predictors. Backward stepwise selection with the Akaike information criterion was used to establish the optimal predictive nomogram model. The receiver operating characteristic (ROC) curve, calibration plot, Hosmer–Lemeshow goodness-of-fit test, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. The nomogram consisted of four predictors: female (OR = 1.85; 95% CI: 0.91-3.94), TIA (OR = 6.47; 95% CI: 1.85-22.7), TTR (OR = 0.99; 95% CI: 0.97-1.00), and anemia (OR = 2.30; 95% CI: 1.06-4.84). The model had acceptable discrimination (area under the ROC curve = 0.68, 95% CI: 0.59-0.78), and was significantly better than the existing nine warfarin-related bleeding prediction scoring systems. The calibration plot and Hosmer–Lemeshow test (χ² = 7.557; P = .478) indicated well-calibrated data in the model. The DCA demonstrated good clinical utility. In this study, we developed a nomogram to predict the risk of warfarin-related major or CRNM bleeding. The model has good performance, allows rapid risk stratification of warfarin users, and provides a basis for personalized treatment.
Double trouble in DMEK surgery: Learning experience and review of the literature
Authors: Romano Vito , Passaro Maria Laura , Airaldi Matteo , Ancona Chiara , Pagano Luca , Semeraro Francesco , Pineda Roberto
Published: February 2024

Purpose

To report a challenging Descemet Membrane Endothelial Keratoplasty (DMEK) case, complicated by intraoperative aqueous misdirection and spontaneous anterior chamber fibrin reaction.

Methods

A 70-year-old female affected by corneal edema due to Fuchs endothelial dystrophy underwent a triple procedure (cataract extraction - IOL implantation - DMEK surgery) in her left eye. This report illustrates the management of the intraoperative complications of aqueous misdirection syndrome and anterior chamber fibrin reaction.

Results

Despite the optimal management of the posterior pressure and the thorough removal of the fibrinous reaction during the case, the DMEK graft was not completely unfolded and centred at the end of the surgical procedure. Nonetheless, the patient showed good long-term anatomical and functional recovery: at the last follow-up (2 years after surgery), central corneal thickness was 526 µm with a best corrected visual acuity of 20/25 and an endothelial cell density of 1112 cell/mm2.

Conclusion

Early recognition and prompt management of intraoperative aqueous misdirection syndrome and anterior chamber fibrin reaction during DMEK surgery is essential to ensure good functional and anatomical outcomes.
Rotational stability and capsular bag performance of a hydrophobic acrylic open-loop single-piece intraocular lens
Authors: Ullrich Marlies , Fisus Andreea D. , Palkovits Stefan , Hienert Julius , Hirnschall Nino , Findl Oliver
Published: February 2024

Purpose

To evaluate the rotational stability and capsular bag performance of a blue light-absorbing hydrophobic acrylic open-loop single-piece intraocular lens (IOL) with a blast-finished anchor wing haptic design during the first 6 postoperative months.

Methods

In this prospective clinical study, patients with age-related cataract and potential postoperative corrected distance visual acuity (CDVA) of 0.2 logMAR or better were included. The patients received a non-toric hydrophobic acrylic single-piece IOL with an axis mark (YST0.00; Nidek Co. Ltd, Japan). Surgeries were video-taped. Retroillumination images were acquired 1 h, 1 week and 6 months postoperatively. Rotational stability was assessed by precise image overlay. At 6 months, Purkinje meter measurements were performed to evaluate tilt and decentration.

Results

In total, 100 eyes of 77 patients were included in the analysis. Mean absolute rotation was 2.1 ± 1.7° (median 1.7, range: 0–7.9) at 6 months (1 h – 6 months postoperatively). IOL rotation was ≤3° and ≤6° in 74 (74%) and 98 (98%) eyes, respectively. Mean absolute IOL rotation from the end of surgery to 6 months was 2.5 ± 2.2° (median 2.3, range: 0–15.6; n = 78). Mean tilt (pupillary axis) and decentration were 4.1 ± 1.9° (median 4.0, range: 0.5–8.2) and 0.35 ± 0.17 mm (median 0.32, range: 0.06–0.91) respectively (n = 84). Postoperatively, 98 (98%) eyes achieved a CDVA of 0.2 logMAR or better, 95 (95%) of ≤0.1 and 81 (81%) of ≤0.0.

Conclusions

This hydrophobic acrylic single-piece IOL showed an excellent rotational stability and capsular bag position with low tilt and decentration values.
Clinical evaluation of tear substitute utility after anti-VEGF intravitreal injection
Authors: Carlo Cagini , Poddi Maria , Mocini Stefano , Boni Niccolò , Damiani Francesco , Battini Michele Apponi , Mirabella Giuseppe , Tataranno Mario
Published: February 2024

Purpose

The purpose of this study is to evaluate the role of a polyethylene glycol 400 - propylene glycol - hydroxypropyl guar - hyaluronic acid eye drops in relieving the symptoms of dry eye syndrome after anti-VEGF intravitreal injection.

Methods

In this randomized, parallel-group study, patients were randomized to receive standard therapy alone or study eye drops plus standard therapy. Patients enrolled were older than 50 with exudative age-related macular degeneration, who have never had intravitreal injections, and without severe dry eye condition or severe ocular or systemic conditions. Patients had baseline preoperative evaluation (V0), and successively after 15 (V1) and 30 (V2) days. At VO and V1 T-BUT, Schirmer's test, fluorescein staining, DEQ5 and OSDI questionnaires were performed and at V2 (30) the OSDI questionnaire was administered.

Results

80 patients were included in the study, of them 40 received standard therapy plus study eye drops. DEQ5 questionnaire showed an increase in the control group between the values at V0 and V1, while in the study group a decrease was observed. No changes in T-BUT, Schirmer, and fluorescein staining values between V0 and V1 were observed in both groups. OSDI data in the control group showed no statistically significant differences, while in the study group they showed a statistically significant difference.

Conclusions

In our study patients undergoing for the first time intravitreal treatment presented dry eye symptoms in the postoperative period: in this group of patients the use of a tears substitute reduces postoperative ocular discomfort.
Magnitude and factors associated with delay in treatment-seeking among new pulmonary tuberculosis patients in public health facilities in Habro district, eastern Ethiopia
Authors: Getiye Assefa , Zakaria Hamdi Fekredin , Deressa Alemayehu , Mamo Galana , Gamachu Mulugeta , Birhanu Abdi , Eyeberu Addis , Debela Adera , Hawulte Behailu , Tesfaye Gezahegne , Mussa Ibsa
Published: February 2024

Background:

In developing nations, almost two-thirds of people with active tuberculosis (TB) remain undetected and untreated. Delays in seeking treatment increase the severity of the illness, the likelihood of mortality, and the risk of the infection spreading to others in the community. Thus, this study aimed to assess the magnitude of delay in treatment-seeking and its associated factors among new adult pulmonary tuberculosis patients attending public health facilities in Habro District, West Harerge Zone, Oromia Region, Eastern Ethiopia.

Methods:

A health facility-based cross-sectional study design was conducted among 420 randomly selected patients with pulmonary tuberculosis who visited public health facilities in Habro District from September 5 to October 5, 2022. Binary logistic regression analysis was used to determine the relationship between the dependent and independent variables, and a 95% confidence interval was used to select significant variables.

Result:

Twenty-one days after the start of their illness, 62.38% (95% CI: 57.4%, 66.6%) of the patients sought an initial consultation. Being female (AOR = 2.14, 95% CI: 1.26, 3.65), having poor knowledge about TB (AOR = 3.10, 95% CI: 1.77, 5.43), having no contact history with TB patients (AOR = 3.52, 95% CI: 1.29, 9.58), having clinically diagnosed pulmonary tuberculosis (AOR = 2.16, 95% CI: 1.26, 3.67), and living a long distance from the nearest health facility (AOR = 2.87, 95% CI: 1.31, 6.23) were important predictors contributing to TB patient treatment delay.

Conclusion:

In the current study, more than three-fifths of TB patients delayed seeking treatment. Thus, awareness of tuberculosis should be created, especially targeting females and communities found at a distance from the health facility. Additionally, health professionals should emphasise the importance of getting medical attention early and knowing how to suspect and identify tuberculosis symptoms.
AI techniques for evaluating misaligned journal bearing performance: An approach beyond the Sommerfeld number
Authors: Rossopoulos Georgios N , Papadopoulos Christos I
Published: February 2024

This paper presents two novel artificial intelligence-based approaches for evaluating the performance of heavily loaded marine journal bearings including shaft misalignment. Traditionally, the Sommerfeld number has been used as a key parameter to evaluate the performance similarity between different bearings. However, this method has limitations, particularly when dealing with complex elastic geometries, heavily loaded journal bearings and shaft misalignment. The first proposed approach leverages neural networks to analyze key bearing performance parameters and provide a more accurate and comprehensive assessment of bearing performance similarity, including additional parameters beyond the Sommerfeld number limitations. The second method utilizes artificial intelligence convolutional networks to assess the bearing similarity based on their simulated pressure profiles under isoviscous and isothermal hydrodynamic lubrication regime. The effectiveness of the proposed methods is demonstrated and compared to the traditional Sommerfeld number method, discussing various potential applications and extensions of this concept.
Cross-domain dynamics: How geopolitical and climate policy uncertainties shape tourism patterns in the United States
Authors: Hamida Hela B
Published: February 2024

Predicting tourism demand is crucial for policymakers and stakeholders in the tourism industry, enabling them to enhance promotional strategies, optimize marketing efforts, align investments, and achieve operational efficiency. While existing research has highlighted the negative impact of global risk factors such as geopolitical risks, economic policy uncertainty, and climate changes on tourism demand, the specific influence of climate policy changes and their differential impact on tourist arrivals has been less explored. Addressing this gap, our study employs bivariate, multiple, and partial wavelet methods to analyze the differential impact of climate policy uncertainty and geopolitical risk on tourism arrivals in the United States. Utilizing recent monthly data from January 1996 to August 2022, we uncover significant time-frequency varying dependencies between these factors and tourism demand. Our causality analysis reveals that both geopolitical risk and climate policy uncertainty are key determinants of tourism demand in the U.S. Furthermore, the Nonlinear Autoregressive Distributed Lag model corroborates the findings of the wavelet analysis, highlighting asymmetrical interactions in the long run. These findings offer valuable insights and have significant implications for policymakers and industry stakeholders, suggesting the need for adaptive and responsive tourism strategies that consider the evolving landscape of geopolitical and climate policy uncertainties.
A qualitative study of mental health problems among children living in New Delhi slums
Authors: Martin Prerna , Haroz Emily E. , Lee Catherine , Bolton Paul , Martin Kiran , Meza Rosemary , McCarthy Elizabeth , Dorsey Shannon
Published: February 2024

Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of children living in Indian slums, including local descriptions, perceived causes, impact, and coping behavior. Local Hindi-speaking interviewers conducted 77 free-list interviews and 33 key informant interviews with children and adults (N = 107) from two slums in New Delhi. Results identified a range of internalizing and externalizing symptoms consistent with depression, anxiety, and conduct problems in children. Findings included both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., “madness or anger,” “pain in the heart and mind”) not typically included on western standardized measures of psychopathology. Mental health problems appeared to be highly interconnected, with experiences such as harassment and fighting often described as both causes and impacts of mental health symptoms in children. Community perspectives indicated that even in the face of several unmet basic needs, mental health problems were important to the community and counseling interventions were likely to be acceptable. We discuss implications for adapting mental health interventions and assessing their effectiveness to reduce the burden of mental illness among children living in urban slums in India.
Goffman, Chicago sociology, and the classical canon
Authors: Shalin Dmitri
Published: February 2024

The present study starts with the premise that corpus classicus is a font of ideas irreducible to a neat formula and marked by the ambivalence toward reigning theories. The founder’s disciples and adherents often lose this perspective, fighting to suppress alternative readings and undermining the theoretical synthesis attempted by a classic thinker. To flesh out this thesis, the paper examines the place of Erving Goffman in Chicago sociology and the ingenious way he blended various strands comprising this tradition. The discussion starts with the debate on what constitutes the Chicago school, after which it moves to the knotty relationship between Goffman and symbolic interactionism and his determined effort to accommodate structuralist premises within process-oriented sociology. An argument is made that Goffman followed the lead of his mentor, Everett Hughes, in casting social institutions as “going concerns” that run the gamut from large scale formal organizations to taken-for-granted collective enterprises which are honored in the breach. Several empirical studies developing Goffman’s theory of total institutions are reviewed to flesh out his brand of structural interactionism. The paper concludes with reflections on the retroactive nature of reconstructing a school’s origins, problematic practice of assigning sociologists to a specific paradigm, and the affinity of Goffman’s sociology with the classical inquiry into a dialectical relationship between agency and structure. The case is made that Goffman’s research on the institutional moorings of human subjectivity places him firmly in the classic sociological canon and forms the core of his intellectual legacy.
Proton Therapy in Breast Cancer: A Review of Potential Approaches for Patient Selection
Authors: Wu Xiao-Yu , Chen Mei , Cao Lu , Li Min , Chen Jia-Yi
Published: February 2024

Proton radiotherapy may be a compelling technical option for the treatment of breast cancer due to its unique physical property known as the “Bragg peak.” This feature offers distinct advantages, promising superior dose conformity within the tumor area and reduced radiation exposure to surrounding healthy tissues, enhancing the potential for better treatment outcomes. However, proton therapy is accompanied by inherent challenges, primarily higher costs and limited accessibility when compared to well-developed photon irradiation. Thus, in clinical practice, it is important for radiation oncologists to carefully select patients before recommendation of proton therapy to ensure the transformation of dosimetric benefits into tangible clinical benefits. Yet, the optimal indications for proton therapy in breast cancer patients remain uncertain. While there is no widely recognized methodology for patient selection, numerous attempts have been made in this direction. In this review, we intended to present an inspiring summarization and discussion about the current practices and exploration on the approaches of this treatment decision-making process in terms of treatment-related side-effects, tumor control, and cost-efficiency, including the normal tissue complication probability (NTCP) model, the tumor control probability (TCP) model, genomic biomarkers, cost-effectiveness analyses (CEAs), and so on. Additionally, we conducted an evaluation of the eligibility criteria in ongoing randomized controlled trials and analyzed their reference value in patient selection. We evaluated the pros and cons of various potential patient selection approaches and proposed possible directions for further optimization and exploration. In summary, while proton therapy holds significant promise in breast cancer treatment, its integration into clinical practice calls for a thoughtful, evidence-driven strategy. By continuously refining the patient selection criteria, we can harness the full potential of proton radiotherapy while ensuring maximum benefit for breast cancer patients.
Partners in Care: Consumer Experiences With Professional Services
Authors: Dean Evan E. , Patten Kristie , Dunn Winnie
Published: February 2024

Consumer experience is a key driver of successful health and education outcomes. Yet, the key factors influencing consumer experiences with care are not fully understood. The aim of this study was to understand, from the perspective of people receiving health care or education services, factors that determine positive and negative experiences with care. We interviewed people who received services, including occupational therapists, and analyzed recordings of the interviews using content analysis. Themes emerged from positive experiences with care on a continuum from “Acknowledges Me” to “Shares Problem Solving.” Themes from negative experiences were also on a continuum from “Lacks Curiosity” to “Disregards.” A fifth theme emerged from occupational therapists, describing “transformational insights” regarding how their personal experiences receiving care affected their practice. The findings from this study align with core OT constructs and advances understanding of authentic partnerships with people receiving professional services.
Inclusive Description in the Glasgow School of Art Library’s Published Catalog
Authors: Chew Carissa
Published: February 2024

This case study provides an overview of two guidance packs that the author created for the GSA Library, the first of which concerns advisory notices and the second of which concerns subject indexing and classifications. In an effort to share good praxis, this article includes real examples of item-level advisory notice text as well as a set of flowcharts that were designed to help GSA Library staff with the tasks of inclusive description.
Effects of perceptual redundancy, conceptual redundancy and self-relatedness on categorical responses
Authors: Patchitt Joel , Sherman Maxine T , Critchley Hugo
Published: February 2024

A redundancy gain occurs when perceptually identical stimuli are presented together, resulting in quicker categorization of these paired stimuli than lone stimuli. Similar effects have been reported for paired stimuli within the same conceptual category, particularly if the category is self-related. We recruited 528 individuals across three related studies to investigate whether, during perceptual and conceptual redundancy, such self-bias effects on foreground stimuli are modulated by natural versus urban backgrounds. Here, we highlight our observations pertaining to perceptual and conceptual redundancy effects of the foreground stimuli. In our first experiment, response options were randomised per trial. Results showed reaction time gains for perceptually identical stimuli, but this advantage was not modulated by self/other categorization. However, slower reaction times were observed for conceptually-related stimulus pairs and were influenced by self/other categorization. The second experiment replicated the methods of earlier studies of redundancy and observed comparable results to Experiment 1: a perceptual redundancy gain unmodulated by self/other categorization, yet for conceptual redundancy, no gain/cost but effects of self/other categorization. In the third experiment, self/other categories were substituted with arbitrary A/B categories: Once more, there was a perceptual redundancy gain and no conceptual redundancy gain. Notably, A/B categorisation produced effects equivalent to self/other categorisation. Overall, these findings challenge previous research on the facilitated early processing of conceptually-related stimuli and suggest that self-relatedness may not exert a unique effect on stimulus processing beyond attentional and response preferences during categorization. Our study motivates further research to understand conceptual categorization and redundancy gain effects.
A large multicenter Ralstonia pickettii outbreak in critically ill patients during the COVID-19 pandemic: Epidemiological and clinical characteristics of 66 cases
Authors: Viana-Cárdenas Erika , Triana Abel , Cárdenas-Álvarez Jorge , Carvajal-Diaz Edwin , Mendoza Humberto , Viasus Diego
Published: February 2024

Objective

To describe a multicenter outbreak of R. pickettii that occurred in a large number of critically ill patients in a city in Colombia, during the COVID-19 pandemic.

Methods

In April 2021, the National Institute for Food and Drug Surveillance (INVIMA) reported an outbreak of R. pickettii infection associated with contaminated intravenous medications. The Municipal Health Department began collecting data for all cases identified by the hospitals and the results of microbiological studies. Medical records and death certificates of included cases were reviewed.

Results

Between March and May 2021, 66 cases of R. pickettii bloodstream infections from nine hospitals were documented. The median age of the patients was 60 years (IQR 51–72), and most of them had comorbidities (78.8%), mainly arterial hypertension and diabetes mellitus. At the time of the R. pickettii bloodstream infection, 89.4% had COVID-19, 86.4% were on mechanical ventilation, and 98.5% were receiving corticosteroids. The overall mortality was 81.8%. Nearly 60% of the deaths were related to R. pickettii bloodstream infections. R. pickettii was identified in the cultures from intravenous medications.

Conclusions

This large multicenter outbreak caused by intravenous medications contaminated with R. pickettii mainly affected critically ill COVID-19 patients. Mortality was high and largely related to R. pickettii bloodstream infection.
Critiquing Journal Articles in Writing Classrooms and Its Effect on English Major Students’ Argumentative Writing Development
Authors: Gordani Yahya , Ezhdehakosh Mahnaz
Published: February 2024

Despite all the attempts to convince teachers and school authorities to support critical thinking (CT) skills in school settings, the application of CT skills has not reached a satisfactory point. Using a quasi-experimental design, the present study attempted to examine the effect of critiquing journal articles on English major students’ argumentative writing abilities. To develop CT skills among language learners and improve their argumentative writing abilities, the strategy of critiquing journal articles was applied to a semester of foreign language writing classroom instruction of the experimental group for the results to be compared later with the performance in a control group. This comparison was made through the analysis of covariance, which revealed that the experimental group performed significantly better than the control group in writing argumentatively. This, in turn, demonstrated that critiquing journal articles as a pedagogical strategy in classrooms could significantly affect English as a foreign language learners’ argumentative writing performance.
The Needle Shield Size and Applied Force of Subcutaneous Autoinjectors Significantly Influence the Injection Depth
Authors: Staples Anne-Sofie Madsen , Poulsen Mette , Præstmark Kezia Ann Friis , Sparre Thomas , Sand Traberg Marie
Published: February 2024

Background:

This study examines how shield-triggered autoinjectors (AIs), for subcutaneous drug delivery, affect injection depth. It focuses on shield size and applied force, parameters that could potentially lead to inadvertent intramuscular (IM) injections due to tissue compression.

Method:

A blinded ex-vivo study was performed to assess the impact of shield size and applied force on injection depth. Shields of 15, 20, and 30 mm diameters and forces from 2 to 10 N were investigated. The study involved 55 injections in three Landrace, Yorkshire, and Duroc (LYD) pigs, with injection depths measured with computed tomography (CT). An in-vivo study, involving 20 injections in three LYD pigs, controlled the findings, using fluoroscopy (FS) videos for depth measurement.

Results:

The CT study revealed that smaller shield sizes significantly increased injection depth. With a 15 mm diameter shield, 10 N applied force, and 5 mm needle protrusion, the injection depth exceeded the needle length by over 3 mm. Injection depth increased with higher applied forces until a plateau was reached around 8 N. Both applied force and size were significant factors for injection depth (analysis of variance [ANOVA], P < .05) in the CT study. The FS study confirmed the ex-vivo findings in an in-vivo setting.

Conclusions:

The study demonstrates that shield size has a greater impact on injection depth than the applied force. While conducted in porcine tissue, the study provides useful insights into the relative effects of shield size and applied force. Further investigations in humans are needed to confirm the predicted injection depths for AIs.
Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial
Authors: Okaforcha Emmanuel Ikechukwu , Eleje George Uchenna , Ikechebelu Joseph Ifeanyichukwu , Ezeama Chukwuemeka Okwudili , Igbodike Emeka Philip , Ugwu Emmanuel Onyebuchi , Okpala Boniface Chukwuneme , Mbachu Ikechukwu Innocent , Umeononihu Osita Samuel , Ogabido Chukwudi Anthony , Onwusulu Daniel Nnaemeka , Oguejiofor Charlotte Blanche , Okafor Chidinma Charity , Olisa Chinedu Lawrence , Ikwuka David Chibuike , Ofor Ifeanyichukwu Jude , Okafor Chigozie Geoffrey
Published: February 2024

Objectives:

To compare the efficacy and safety of intravenous and intramuscular oxytocin in preventing atonic primary postpartum haemorrhage in the third stage of labour.

Methods:

A double-blind randomised clinical study on consenting women without risk factors for primary postpartum haemorrhage in labour at term. Two hundred and thirty-two women were randomly allotted into intravenous ( n = 115) and intramuscular ( n = 117) oxytocin groups in the active management of the third stage of labour. All participants received 10 IU of oxytocin, either IV or IM, and 1 ml of water for injection as a placebo via a route alternate to that of administration of oxytocin within 1 min of the baby’s delivery. The primary outcome measures were mean postpartum blood loss and haematocrit change. Trial Registration No.: PACTR201902721929705.

Results:

The baseline socio-demographic and clinical characteristics were similar between the two groups ( p > 0.05). There was no statistically significant difference between the two groups with regards to the mean postpartum blood loss (254.17 ± 34.85 ml versus 249.4 ± 39.88 ml; p = 0.210), haematocrit change (2.4 (0.8%) versus 2.1 (0.6%); p = 0.412) or adverse effects ( p > 0.05). However, the use of additional uterotonics was significantly higher in the intravenous group (25 (21.73%) versus 17 (14.53%); p = 0.032).

Conclusion:

Although oxytocin in both study groups showed similar efficacy in terms of preventing atonic primary postpartum haemorrhage, participants who received intravenous oxytocin were more likely to require additional uterotonics to reduce their likelihood of having an atonic primary postpartum haemorrhage. However, both routes have similar side effect profiles.
Internationalization and Organizational Resilience to COVID-19 Crisis: The Moderating Effect of Digitalization
Authors: Wang Yueqi , Chen Shouming , Hu Yuanyuan
Published: February 2024

Organizational resilience is a company’s ability to quickly recover and adapt when it encounters sudden and unexpected challenges. Our study looks at how a company’s level of international involvement before such challenges can influence its resilience, particularly when faced with the global disruptions caused by the COVID-19 pandemic. We also examine whether a company’s prior investment in digital technologies can help soften any negative impacts. From January 20 to June 10, 2020, we analyzed data from 2,363 Chinese companies that are traded on stock exchanges. We assessed their organizational resilience based on how their stock prices fluctuated and how quickly they returned to their pre-shock performance levels. Our findings indicate that companies with more international activities before the pandemic were generally slower to recover. However, companies with advanced digital capabilities before the pandemic demonstrated greater resilience, overcoming the negative repercussions more effectively. This research contributes new insights to the understanding of how international business activities affect a company’s ability to withstand and bounce back from global crises. Additionally, it underscores the importance of digitalization in enhancing organizational resilience.
Return-to-Golf Rate After Shoulder Arthroplasty: A Systematic Review and Meta-analysis
Authors: Galal Youssef , Sheth Mihir , Lederman Evan , Shah Anup
Published: February 2024

Background:

With advancements in the technology, techniques, and biomechanical understanding of shoulder arthroplasty, higher rates of postoperative return to various sports have been seen in the past decade.

Purpose:

To observe the return-to-golf rate after various types of shoulder arthroplasty (anatomic total shoulder arthroplasty [TSA], hemiarthroplasty [HA], and reverse total shoulder arthroplasty [RSA]) and also to review the protocols for return to golf.

Study Design:

Scoping review; Level of evidence, 4.

Methods:

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed in a search of PubMed, JSTOR, Google Scholar, ScienceDirect, and CORE using the keywords “return to sport,”“shoulder arthroplasty,”“golf,”“TSA,”“shoulder arthroplasty,”“hemiarthroplasty,”“reverse shoulder arthroplasty,”“RSA,”“sports,” and “athlete.” Of 145 preliminary results, 10 retrospective studies (n = 178 patients) published between 1998 and 2021 were included in the final analysis.

Results:

The mean patient age was 65 years. Of the 172 patients with reported return-to-sport rates, the mean return-to-golf rate was 75.8% for all types of shoulder arthroplasty. Of these 172 patients, 107 patients were categorized by type of procedure: Anatomic TSA had the highest return-to-golf rate at 77.6% (49/107), followed by HA at 64.3% (14/107) and RSA at 59.1% (44/107). Four studies commented on return to the full 18 holes of golf, with a return-to-sport timeline ranging from 5 to 6 months postoperatively. One study specified the return-to-golf timeline based on the type of shot and reported the mean number of weeks before putting, chipping, and returning to the course as 20, 22, and 27 weeks, respectively. Two studies that reported on golf playing frequency noted an increase from before to 1 year after TSA, from a mean of 1.6 and 0.7 times per week to 2.0 and 1.7 times per week, respectively. Only 1 study, published in 1998, provided a comprehensive return-to-golf protocol.

Conclusion:

The return-to-golf rate after shoulder arthroplasty was highest after anatomic TSA (78%) compared with HA (64%) and RSA (59%). The most commonly reported duration before returning to a full 18 holes was 5 to 6 months, but patients returned to putting and chipping earlier.
Assessing the Impact of Cannabis Decriminalization on Racial Disparities in Chicago’s Cannabis Possession Arrests
Authors: Owusu-Bempah Akwasi , Wallace Danielle , Gaston Shytierra , Eason John , Sevell Eric
Published: February 2024

Black and Hispanic neighborhoods have suffered the most severe consequences of the “war on drugs.” As the war on drugs waned, cannabis legalization/decriminalization efforts increased across America. A prime example of decriminalization occurred in August of 2012 as the City of Chicago introduced a new law providing officers with option to ticket, rather than arrest, individuals caught in possession of 15 grams of cannabis or less. As cannabis policy continues evolving, it remains to be seen whether or not the trend toward decriminalization will produce equitable changes in drug arrest outcomes across racial/ethnic groups. We employ data tracking cannabis arrests over time by neighborhood to assess the impact of cannabis decriminalization in Chicago and estimate racial disparities in the likelihood of arrest (v. ticket) using two sets of models: within-neighborhood models and hierarchical logistic regressions with random effects. We find that Blacks and non-White Hispanics are more likely to be arrested than ticketed for minor cannabis possession in Chicago following the introduction of the Alternative Cannabis Enforcement (ACE) program, regardless of the neighborhood where the arrest took place. In addition, Black neighborhoods did not experience the same reduction in arrests after the law changed in comparison with racially mixed, White, or predominantly Hispanic neighborhoods. Our findings draw attention to the differential deployment of discretionary policing strategies across neighborhoods of different racial/ethnic composition. Although Chicago’s ACE program has lowered the overall rate of cannabis arrests, major racial/ethnic disparities in those arrests remain and become exacerbated when examining macro neighborhood-level trends.
College Is Not the Great Equalizer in Japan
Authors: Fujihara Sho , Ishida Hiroshi
Published: February 2024

This study represents the first systematic account to test the hypothesis of college as the great equalizer in Japan by analyzing the three-way association among class origin, destination, and education. The authors use data from the Social Stratification and Social Mobility surveys and the Japanese Life Course Panel Surveys. By applying the entropy balancing technique, the authors estimate the heterogeneous causal effect of college education on occupational attainment by the father’s occupation. The results indicate that college education does not function as a great equalizer in Japan. There is no clear evidence to suggest that the occupational returns to a college education are greater among those from less advantaged families than those from more advantaged families. The authors argue that the equalizing effect of a college education is not apparent, because of the specific institutional arrangements of the educational system and the labor market in society.
Early Childhood Caries and Dental Care Utilization in Mangalore, India: Parents’ Perceptions
Authors: Suprabha B.S. , Shenoy R. , Mahabala K.Y. , Nayak A.P. , Rao A. , D’Souza V.
Published: February 2024

Background:

Parents often underuse dental care services for their children with early childhood caries (ECC), resulting in a high burden of untreated dental caries.

Aim:

To describe parental perceptions and challenges in dental care utilization for their children with ECC.

Design:

A descriptive qualitative study was conducted with parents of children with ECC seeking dental care in Mangalore, India. Data were collected through focus group discussions using an interview guide. Manual line-by-line coding and content analysis methods were used for data analysis.

Results:

Three categories were generated from data obtained through 5 focus groups of 27 participants: dental care visiting patterns, the significance of dental visits, and challenges to dental care utilization. Parents would only visit the dentist when they perceived their children’s tooth problems. The challenges faced include time constraints, misinformation, lack of awareness and motivation, costs, fear, and anxiety of the children and the parents themselves. Parents perceived improvements in the awareness of their children’s oral health and quality of life after dental visits.

Conclusion:

Attending dental services to treat their children’s tooth problems was the primary way of attaining awareness about prevention among the parents of children with ECC. Increased oral health awareness and improved quality of life can motivate parents to seek further dental care for their children. Collaboration with multidisciplinary stakeholders is required to improve oral health awareness among parents of children with ECC.

Knowledge Transfer Statement:

The study’s results will help plan targeted preventive programs for children with ECC. The study suggests dental care utilization by children with ECC is based on parental perceptions of their children’s tooth problems. It outlines the challenges that affect dental visits of children with ECC and the role of multidisciplinary stakeholders. Improved oral health awareness and quality of life following dental treatment can facilitate further dental visits.
Long-Term Outcomes of Vitrectomy for Idiopathic Epiretinal Membrane With Internal Limiting Membrane Removal in Patients With Good Preoperative Visual Acuity
Authors: Drummond Sean C. , Crosson Jason N. , Mason John O.
Published: February 2024

Purpose: To evaluate the long-term visual results of vitrectomy with epiretinal membrane (ERM) and internal limiting membrane (ILM) removal for idiopathic ERM in eyes with a preoperative visual acuity (VA) of 20/50 or better. Methods: This retrospective review of a consecutive case series comprised 337 patients. Of these, 36 eyes of 36 patients had ERM and ILM removal from 2017 to 2018. Inclusion criteria included a subjective decrease in VA, a preoperative VA of 20/50 or better, vitrectomy with ERM and ILM removal for ERM, and a minimum 6-month follow-up. Paired t tests were used to determine the statistical significance ( P < .05) of VA changes postoperatively. Results: The mean (±SD) best-corrected logMAR VA improved to a maximum of 0.125 ± 0.09 (Snellen equivalent 20/26.4) at a mean of 11.1 months postoperatively ( P < .001). The VA continued to significantly improve over the long term (mean, 41.6 months; range, 6-63; P < .001). Overall long-term data trended heavily toward VA improvement (25/36 patients [69.4%]) and stability (10/36 patients [27.7%)] after ERM and ILM removal, with only 1 patient (2.8%) having worse VA. There were no intraoperative or postoperative complications related to ERM and ILM removal. Conclusions: Surgery to remove idiopathic ERM and ILM for patients with significant symptoms and good preoperative VA may result in excellent long-term visual results.
Strain softening observed during nanoindentation of equimolar-ratio Co–Mn– Fe–Cr–Ni high entropy alloy
Authors: Owhal Ayush , Belwanshi Vinod , Roy Tribeni , Goel Saurav
Published: February 2024

This research article presents an atomistic study on the cyclic nanoindentation of an equimolar-ratio Co–Mn–Fe–Cr–Ni high-entropy alloy (HEA) using molecular dynamics simulation. The study investigated the effects of indentation depth on the cyclic load versus the indentation depth of the HEA. The results showed that the cyclic response exhibits a pronounced shift towards plasticity with pile-up formation instead of sinking behavior at higher indentation depths. Within the realm of molecular dynamics simulations, the simulated hardness value reached up to 16 GPa for the initial indentation cycle. A steep drop in the load–displacement curve was observed during the elastic–plastic transition, signifying substantial strain softening of the substrate. It was found that the densely clustered stacking faults undergo a reverse transition during cyclic loading, contributing to the backpropagation phase responsible for elastic recovery despite subsequent strain hardening. The study provides important insights into the underlying mechanisms governing the cyclic mechanical behavior of HEAs to guide their improved micromanufacturing.
Preparing school leaders for social justice: An analysis of educational leadership preparation programs in Jamaica
Authors: Jackson Mario , Von Dohlen Heidi , Black-Chen Marsha
Published: February 2024

The purpose of this study was to explore the extent to which the curricula across three educational leadership preparation programs in Jamaica are addressing issues of social justice and social justice leadership in their preparation of aspiring school leaders. The methodological approach used was content analysis to determine the presence or absence of specific concepts within leadership preparation programs’ curricula. Increasingly, several scholars in education have been using this technique to explore how different concepts are addressed across leadership preparation programs. Findings revealed that the three leadership preparation programs gave minimal attention to preparing current and aspiring school leaders to engage in social justice leadership. Implications are offered for local policymakers and their reconceptualization of the job requirements of principals, leadership preparation programs, and faculty teaching in these programs.
How a broken vertebra can lead to a fatal hemorrhage: a case report
Authors: Ploumen Roxanne A. W. , van Wezenbeek Martin R. , Willems Paul C. P. H. , Gerretsen Suzanne C. , Ten Bosch Jan A.
Published: February 2024

Background

Unintentional falls are common among the elderly and given the expected increase of the aging population, these falls contribute to a high number of admissions to the emergency department. Relatively low-energy trauma mechanisms can lead to serious injuries in the elderly, with contributing factors being comorbidities, medication use and degenerative abnormalities.

Case presentation

A 94-year-old female suffered an unintentional fall at home. Upon arrival of the ambulance at her house she was hemodynamically stable and mobilized to the gurney with assistance. During primary survey at the emergency department, her blood pressure and oxygen saturation decreased, she was not able to move her legs anymore and lost consciousness. A full-body CTA was performed, which showed a fracture through the vertebral body of L2 with significant dislocation and a large active bleeding of the corpus, extending to the retroperitoneum and the epidural space. Despite resuscitation, her vital signs deteriorated and given the severe abnormalities on CTA, it was decided to discontinue further treatment, after which she deceased. The performed CTA and an x-ray from 2016 suggested diffuse idiopathic skeletal hyperostosis, which might have contributed to the severity and instability of the vertebral fracture. Mobilization after the fall might have increased the dislocation of the fracture. The use of oral anticoagulants worsened the subsequent bleeding and the extension to the epidural space caused the paralysis of the legs.

Conclusions

It is important to be aware of the possible serious consequences of unintentional falls in the elderly population and to provide strict immobilization of the spinal column until proper imaging.