bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexural capacity enhancing of notched steel beams by combining shape memory alloy wires and carbon fiber-reinforced polymer sheets
Authors: Deng Jun , Fei Zhongyu , Li Junhui , Huang Haifan
Published: March 2023

Combining shape memory alloy (SMA) and carbon fiber-reinforced polymer (CFRP) sheet can achieve a self-stressing SMA-CFRP composite, providing an innovative prestressing method for steel elements. This study applied SMA(Ni–Ti–Nb) wires and CFRP sheets to achieve composite strengthening for notched steel beams. The effectiveness of SMA-CFRP composite for flexural strengthening of notched steel beams was evaluated, and the formula for the maximum allowable moment of the strengthened beams with SMA-CFRP composites was proposed. The four-point bending test results showed that the ultimate load and flexural stiffness of the strengthened beams with SMA-CFRP composites increased by 79.2% and 57.9% more than those of the unstrengthened beams. By comparison, the CFRP-only and SMA-only strengthened beams merely achieved half the ultimate load and flexural stiffness over the strengthened beams with SMA-CFRP composite. Besides, compared to the unstrengthened beams, the notch tip yield load for the strengthened beam with SMA-CFRP composite was increased by 230%, while the notch tip yield load for strengthened beams with CFRP-only and SMA-only just increased by 70% and 125%. These indicate that the SMA-CFRP composite strengthening can significantly delay crack propagation and improve the load capacity and stiffness of notched steel beams. Moreover, the analytical results of the maximum allowable moment were in good agreement with experimental results, indicating the accuracy of the proposed analytical equations.
Quality and readability of online information on hand osteoarthritis
Authors: Hong Seok Woo , Kang Jeong-Hyun , Park Jun Hyoung , Park Hee Jin , Kim Eugene
Published: March 2023

Objectives: This study aimed to evaluate the quality and readability of web pages providing information about hand osteoarthritis using several authorized methods.

Methods: A web page exploration was performed using the Google internet search engine. The three search terms, “hand osteoarthritis,” “finger osteoarthritis,” and “hand OA,” were used and the top 100 ranked websites were selected and divided into six categories. The Health on the Net Foundation (HON) grade scale, an instrument for judging the quality of written consumer health information on treatment choice (DISCERN instrument), and the Ensuring Quality Information for Patients (EQIP) score were used to evaluate the quality of each website. The Flesch-Kincaid reading ease (FRE) score, Flesch-Kincaid grade (FKG) level, Gunning-Fog index, and Simple Measure of Gobbledygook grade level were used to evaluate website readability.

Results: Among 300 websites, 57 websites were selected following exclusion criteria. News portal websites, including the online version of newspapers and periodicals, showed the highest score in all three quality evaluation tools. Only four websites were regarded as high-quality websites based on the HON grade scale ( n = 3) and the EQIP score ( n = 1). Each type of website showed an average FKG level higher than 7th grade and obtained an average FRE score of less than 80 points, indicating an inappropriate level for a layperson to read.

Conclusions: The online information about hand osteoarthritis is low quality and difficult to read for the general public. There is a need to enhance the quality and readability of web-based information related to hand osteoarthritis for patients to obtain credible information and receive proper treatment for the disease.
On the defence of antifascist Italy in Alcide De Gasperi’s 1946 speech to the Paris Peace Conference
Authors: Brambilla Emanuele
Published: March 2023

Faced with the gradual rise of neofascist parties in Europe, the present paper looks back at the past to analyse a speech delivered by one of the founding fathers of the European Union, namely Alcide De Gasperi. The investigation is part of a broader project on the analysis of Italian antifascist discourse. The speech that De Gasperi delivered at the 1946 Paris Peace Conference is reconstructed with the help of the pragma-dialectical model of a critical discussion, focusing on the passages in which the speaker dealt with Italy’s non-fascist identity and its wrong perception by the audience. Emphasis is laid on the argumentative pattern underlying De Gasperi’s discourse and the argumentative style characterising his address. Moreover, reference is made to the notion of argumentative equivalence to examine the translation of De Gasperi’s speech into English; published in the New York Times the day after he delivered his address, it cast a shadow over the impartiality of the drafters of the English version of the speech, which nevertheless managed to go down to history as an argumentative classic.
Persistent Sciatic Artery in Right Lower Extremity Complicated by Thrombosis: A Case Report
Authors: Liu Boyang , Hu Bingbing , Li Fang , Min Zhenqi , Yuan Supeng , Dai Xianpeng
Published: March 2023

Purpose:

Persistent sciatic artery (PSA) is a rare congenital vascular malformation with an incidence of approximately 0.025% to 0.04%. Persistent sciatic artery has major complications, such as aneurysms, thrombosis, and occlusion. Complications may lead to a range of serious clinical problems, and a timely diagnosis of this vascular variant is crucial to avoid life-threatening complications.

Case:

A 65-year-old man was admitted to the hospital with pain and chills in the right lower extremity for 2 months, which gradually worsened. This was accompanied by numbness in the right foot for the last 10 days. Computed tomography angiography showed that the right inferior gluteal artery and right popliteal artery of the right internal iliac artery were connected, which is considered a congenital developmental variant. This was complicated by multiple thromboses of the right internal and external iliac arteries, and the right femoral artery. After admission to the hospital, the patient underwent endovascular staging surgery to relieve numbness and pain in the lower extremities.

Conclusion:

Treatment strategies can be selected based on the anatomical characteristics of PSA and superficial femoral artery. Asymptomatic patients with PSA can be closely monitored. Surgery or individualized endovascular treatment plans should be considered for patients with aneurysm formation or vascular occlusion.

Clinical Impact

For the rare vascular variation of the PSA, clinicians must make a timely and accurate diagnosis. Ultrasound screening is essential, which requires experienced ultrasound doctors to be aware of vascular interpretation and develop personalized treatment plans for each patient. In this case, we adopt staged a minimally invasive intervention to solve the problem of lower limb ischemic pain for patients. This operation has the advantages of rapid recovery and less trauma, which has important reference significance for other clinicians.
Effect of combining motivational interviewing with cognitive remediation on personal recovery in patients with schizophrenia
Authors: Kunita Koji , Morimoto Takafumi , Kotake Reiko , Sato-Nakamura Seika , Nakamura-Kukuminato Naoko
Published: March 2023

Background/objective

We have been practising the Neuropsychological and Educational Approach to Remediation (NEAR) as cognitive remediation (CR) in a psychiatric hospital and have implemented it in combination with regular interviews based on Motivational Interviewing (MI) approximately 2 years after launching NEAR. In this study, we investigated whether combining MI with CR affected completion of the programme, cognitive functions, global functioning, and personal recovery of patients with schizophrenia by analysing medical records.

Methods

In this retrospective observational study, 14 participants were assigned to the NEAR group and 12 participants were assigned to the NEAR + MI group. Fifteen participants in the NEAR group ( n = 6) and NEAR + MI group ( n = 9) completed the programme. First, the difference in the completion rate between the groups was examined using the chi-squared test. Second, measures of cognitive functions, global functioning, and personal recovery pre-and post-intervention were examined using the Wilcoxon signed-rank tests for those in each group who completed the programme. Third, therapeutic responses for each group were compared using the Mann–Whitney U tests.

Results

There were no statistically significant differences in completion rates between the groups. In the NEAR group, verbal memory and overall cognition improved after the intervention. On the other hand, not only cognitive functions but also global functioning and personal recovery improved in the NEAR + MI group. Moreover, changes in global functioning and personal recovery were significantly higher in the NEAR + MI group.

Conclusion

Study findings indicated that combining MI with CR improves cognitive functions, global functioning, and personal recovery in patients with schizophrenia.
Managing unintended consequences of algorithmic decision-making: The case of Robodebt
Authors: Rinta-Kahila Tapani , Someh Ida , Gillespie Nicole , Indulska Marta , Gregor Shirley
Published: March 2023

In 2016, the Australian welfare agency Centrelink implemented an information system to automate the identification and recollection of welfare overpayments. Such algorithmic decision-making systems are increasingly leveraged to improve the efficiency of public administration. However, Centrelink’s scheme went horribly wrong: the system, branded as “Robodebt” by the popular media, generated debt notices that were inaccurate and based on insufficient evidence. Numerous vulnerable citizens who received the debt notices suffered a great deal of distress. While public controversy ensued, the ruling government continued to defend the flawed system until a court decision ruled it unlawful in 2019. This teaching case challenges one to analyze what went wrong in the implementation and management of the Robodebt system through the lens of sociotechnical systems.
Mobile app for personalized sleep–wake management for shift workers: A user testing trial
Authors: Murray Jade M. , Magee Michelle , Giliberto Emma S. , Booker Lauren A. , Tucker Andrew J. , Galaska Beth , Sibenaller Sara M. , Baer Sharon A. , Postnova Svetlana , Sondag Thijs A.C. , Phillips Andrew J.K. , Sletten Tracey L. , Howard Mark E. , Rajaratnam Shantha M.W.
Published: March 2023

Objective

Development of personalized sleep–wake management tools is critical to improving sleep and functional outcomes for shift workers. The objective of the current study was to test the performance, engagement and usability of a mobile app ( SleepSync) for personalized sleep–wake management in shift workers that aid behavioural change and provide practical advice by providing personalized sleep scheduling recommendations and education.

Methods

Shift workers ( n = 27; 20 healthcare and 7 from other industries) trialled the mobile app for two weeks to determine performance, engagement and usability. Primary outcomes were self-reported total sleep time, ability to fall asleep, sleep quality and perception of overall recovery on days off. Secondary performance outcomes included sleep disturbances (insomnia and sleep hygiene symptoms, and sleep-related impairments) and mood (anxiety, stress and depression) pre- and post-app use. Satisfaction with schedule management, integration into daily routine and influence on behaviour were used to determine engagement, while the usability was assessed for functionality and ease of use of features.

Results

Total sleep time ( P = .04), ability to fall asleep ( P < .001), quality of sleep ( P = .001), insomnia ( P = .02), sleep hygiene ( P = .01), sleep-related impairments ( P = .001), anxiety ( P = .001), and stress ( P = .006) were all improved, with non-significant improvements in recovery on days off ( P = .19) and depression ( P = .07). All measures of engagement and usability were scored positively by the majority of users.

Conclusions

This pilot trial provides preliminary evidence of the positive impact of the SleepSync app in improving sleep and mood outcomes in shift workers, and warrants confirmation in a larger controlled trial.
The Impact of Mobile Payment Application Design and Performance Attributes on Consumer Emotions and Continuance Intention
Authors: Rahardja Untung , Sigalingging Claudia Teresa , Putra Panca O. Hadi , Nizar Hidayanto Achmad , Phusavat Kongkiti
Published: March 2023

This study examines a chain of impact of a mobile payment user experience on consumers’ emotions and, consequently, on continuance intention. The examined factors influencing user experience include application design attributes (i.e., user interface attractiveness, privacy and security, and convenience) and application performance attributes (i.e., compatibility, ease of use, relative advantage, and service quality). The study is conducted in the context of a popular mobile payment application named Go-Pay in a developing country, Indonesia. Data are obtained via an online survey of 1,275 mobile payment users that are then analyzed using covariance based-structural equation modeling. The analysis shows that application design attributes, such as privacy and security as well as convenience, are factors that shape users’ negative emotions; conversely, the performance attributes of compatibility, relative advantage, and service quality affect users’ positive emotions. Both negative and positive emotions contribute to increasing continuance intention in using mobile payment services. In this regard, the positive emotion is the most significant factor influencing users to continue using mobile payment services. Research in the field of mobile payment has mostly assessed consumer acceptance of mobile payment technology, whereas research focusing on continuous intention to use mobile payment is still limited. Our findings provide a new perspective on the loyalty in using mobile payment by examining the part of the user experience represented by the design and performance of applications, which affect positive and negative emotions, and have also been shown to influence user loyalty behavior.
Land Tenure and Land Acquisition Enforcement in Vietnam
Authors: Tuan Nguyen Tran
Published: March 2023

Land tenure is an individual relationship to the land. Vietnam applies a regime of universal ownership of land. The land belongs to all the people of Vietnam, but the State represents the owner. Land ownership in Vietnam includes three fundamental rights: the right to possess, use, and dispose of land. When the State allocates land to land users, it only assigns them the right to own and use land. This article evaluated one out of eight rights to dispose of land by the State, land acquisition. Data was collected from a survey with 100 land-expropriated households, five interviews with authorities at all levels, and five interviews with households living next to the study area. The results show that land acquisition does not ensure fairness for families who lose land. Compensation rates are six to eight times lower for agricultural land. The right to access land information is also not appreciated when people do not know their household compensation details. Another inequity was also seen between households who lost land and those living around the land acquisition project.
A Pilot to Implement Chronic Care Management Services at an Academic Medical Center
Authors: Jamshed Namirah , Miller Jessica , Rubin Craig
Published: March 2023

Objective: Chronic Care Management (CCM) for patients requires care coordination. Our aim was to describe a pilot to implement CCM services within our house call program. We aimed to identify processes and verify reimbursement. Design: Pilot study and retrospective review of patients participating in CCM. Setting and Participants: Non-face-to face delivery of CCM services at an academic center. Sixty-five and over with two or more chronic conditions expected to last at least 12 month or until the death of the patient from July 15th, 2019 to June 30, 2020. Methods: We identified patients using a registry. If consent given, a care plan was documented in the chart and shared with the patient. The nurse would then call the patient during the month to follow up on the care plan. Results: Twenty-three patients participated. Mean age was 82 years. Majority were white (67%). One thousand sixty-six dollars ($1,066) were collected for CCM. Co-pay for traditional MCR was $8.47. Most common chronic disease diagnoses were hypertension, congestive heart failure, chronic kidney disease, dementia with behavior and psychological disturbance, and type 2 diabetes mellitus. Conclusion and Implications: CCM services offer additional revenue source for practices that provide care coordination for chronic disease management.
Performance feedback and firms search behaviors: Role of corporate governance in companies around the world
Authors: DasGupta Ranjan , Mishra Sibanjan
Published: March 2023

Research on firm’s motivation to undertake search behaviors in situations of positive and negative performance feedback is limited in empirical literature. In addition, the role of institutionalized corporate governance mechanisms in mediating firm’s aspiration-driven search behaviors is yet to be explored. Therefore, this study aims at examining whether firms around the world facing positive and negative performance feedback undertake different search behaviors. Furthermore, we test whether firm’s corporate governance mechanisms strengthen such search behaviors. This study reports that negative performance feedback positively influences firm problem-driven search behaviors, whereas positive performance feedback positively impacts its innovative search behaviors. Furthermore, we find a significant negative moderating influence of board strength, while a mixed positive influence of board effectiveness on firm performance feedback to carry out distinctive search behaviors. Therefore, we think that these findings would help the regulators and policy makers to strengthen their existing corporate governance mechanisms and regulations.

JEL CLASSIFICATION: G30, G32, G34
The Reverse Shoulder Arthroplasty Angle in MRI: Impact of the Articular Cartilage in the Estimated Inclination of the Inferior Glenoid
Authors: de Marinis Rodrigo , Contreras Julio J. , Vidal Catalina , Palma Cristóbal , Angulo Manuela , Valenzuela Alfonso , Jaña Ricardo , Calvo Claudio , Liendo Rodrigo , Soza Francisco
Published: March 2023

Purpose

To describe the reverse shoulder arthroplasty angle (RSA angle) in magnetic resonance imaging (MRI) and compare the angle formed using bony landmarks (Bony RSA angle or B-RSA angle) with another angle formed using the cartilage margin as reference (Cartilage RSA angle or C-RSA angle).

Methods

Adult patients with a shoulder MRI obtained in our hospital between July 2020 and July 2021 were included. The C-RSA angle and B-RSA angle were measured. All images were independently assessed by 4 evaluators. Intraclass correlation coefficient (ICC) was determined for the B-RSA and C-RSA to evaluate interobserver agreement.

Results

A total of 61 patients were included with a median age of 59 years (17-77). C-RSA angle was significantly higher than B-RSA (25.4° ± 0.7 vs 19.5° ± 0.7, respectively) with a P-value <.001. The overall agreement was considered “good” for C-RSA (ICC = 0.74 [95% CI 0.61-0.83]) and “excellent” for B-RSA angle (ICC = 0.76 [95% CI 0.65-0.85]).

Conclusions

C-RSA angle is significantly higher than B-RSA angle. In cases without significant glenoid wear neglecting to account for the remaining articular cartilage at the inferior glenoid margin may result in superior inclination of standard surgical guides.
Is the right way to go in between?
Authors: Gantenbein Andreas R. , Kleinschmidt Andreas
Published: March 2023

In the study by Johnston et al., gepants were meant to be taken to treat emergent migraine. It is tempting to speculate what the effect would be if patients were instructed to take a gepant as needed (PRN) or even prior to headache onset. While the latter sounds irrational at first glance, several studies have shown that a significant proportion of patients are quite proficient in predicting (or simply due to premonitory symptoms noting) their migraine attacks prior to the onset of actual headache. The study by Johnston et al. provides food for thought along these lines and should encourage us to further investigate flexible patient-controlled CGRP blocking as a third, intermediate and potentially cost-effective avenue between acute/rescue treatment and prevention/prophylaxis.
Study on the relationship between obesity and complications of Pediatric Epilepsy surgery
Authors: Shen Lei , Wang Mengyang , Zhao Jingwei , Ruan Yuanyuan , Yang Jingyi , Chai Songshan , Dai Xuan , Yang Bangkun , Cai Yuankun , Zhou Yixuan , Mei Zhimin , Zheng Zhixin , Xu Dongyuan , Guo Hantao , Lei Yu , Cheng Runqi , Yue Chuqiao , Wang Tiansheng , Zhao Yunchang , Liu Xinyu , Chai Yibo , Chen Jingcao , Du Hao , Xiong Nanxiang
Published: March 2023

Objective

Studies have shown that obesity has a significant impact on poor surgical outcomes. However, the relationship between obesity and pediatric epilepsy surgery has not been reported. This study aimed to explore the relationship between obesity and complications of pediatric epilepsy surgery and the effect of obesity on the outcome of pediatric epilepsy surgery, and to provide a reference for weight management of children with epilepsy.

Methods

A single-center retrospective analysis of complications in children undergoing epilepsy surgery was conducted. Body mass index (BMI) percentiles were adjusted by age and used as a criterion for assessing obesity in children. According to the adjusted BMI value, the children were divided into the obese group (n = 16) and nonobese group (n = 20). The intraoperative blood loss, operation time, and postoperative fever were compared between the two groups.

Results

A total of 36 children were included in the study, including 20 girls and 16 boys. The mean age of the children was 8.0 years old, ranging from 0.8 to 16.9 years old. The mean BMI was 18.1 kg/m2, ranging from 12.4 kg/m2 to 28.3 kg/m2. Sixteen of them were overweight or obese (44.4%). Obesity was associated with higher intraoperative blood loss in children with epilepsy (p = 0.04), and there was no correlation between obesity and operation time (p = 0.21). Obese children had a greater risk of postoperative fever (56.3%) than nonobese children (55.0%), but this was statistically nonsignificant (p = 0.61). The long-term follow-up outcomes showed that 23 patients (63.9%) were seizure-free (Engel grade I), 6 patients (16.7%) had Engel grade II, and 7 patients (19.4%) had Engel grade III. There was no difference in long-term seizure control outcomes between obese and nonobese groups (p = 0.682). There were no permanent neurological complications after surgery.

Conclusion

Compared with nonobese children with epilepsy, obese children with epilepsy had a higher intraoperative blood loss. It is necessary to conduct early weight management of children with epilepsy as long as possible.
Maternal health equity in Georgia: a Delphi consensus approach to definition and research priorities
Authors: Hernandez Natalie D. , Aina Angela D. , Baker L. Joy , Blake Sarah C. , Dunn Amore Alexis B. , Franklin Cheryl G. , Henderson Zsakeba T. , Kramer Michael R. , Jackson Fleda Mask , Mosley Elizabeth , Nunally Lauren , Sylvester Shirley
Published: March 2023

Background

Pregnancy-related mortality in the United States is the greatest among all high-income countries, and Georgia has one of the highest maternal mortality rates—almost twice the national rate. Furthermore, inequities exist in rates of pregnancy-related deaths. In Georgia, non-Hispanic Black women are nearly 3 times more likely to die from pregnancy-related complications than non-Hispanic White women. Unlikehealth equity, a clear definition ofmaternal health equityis lacking, overall and in Georgia specifically, but is needed to reach consensus and align stakeholders for action. Therefore, we used a modified Delphi method to define maternal health equity in Georgia and to determine research priorities based on gaps in understanding of maternal health in Georgia.

Methods

Thirteen expert members of the Georgia Maternal Health Research for Action Steering Committee (GMHRA-SC) participated in an iterative, consensus-driven, modified Delphi study comprised of 3 rounds of anonymous surveys. In round 1 (web-based survey), experts generated open-ended concepts of maternal health equity and listed research priorities. In rounds 2 (web-based meeting) and 3 (web-based survey), the definition and research priorities suggested during round 1 were categorized into concepts for ranking based on relevance, importance, and feasibility. Final concepts were subjected to a conventional content analysis to identify general themes.

Results

The consensus definition of maternal health equity created after undergoing the Delphi method is: maternal health equity is the ultimate goal and ongoing process of ensuring optimal perinatal experiences and outcomes for everyone as the result of practices and policies free of interpersonal or structural bias that tackle current and historical injustices, including social, structural, and political determinants of health impacting the perinatal period and life course. This definition highlights addressing the current and historical injustices manifested in the social determinants of health, and the structural and political structures that impact the perinatal experience.

Conclusion

The maternal health equity definition and identified research priorities will guide the GMHRA-SC and the broader maternal health community for research, practice, and advocacy in Georgia.
Title page: psychometric properties of literacy of suicide scale (LOSS) in iranian population: long form
Authors: Jafari Alireza , Moshki Mahdi , Mokhtari Ali Mohammad , Ghaffari Amirarsalan , Nejatian Mahbobeh
Published: March 2023

Introduction

Suicide and suicide attempts are among the most important indicators of mental health in the world. In this research, the validity and reliability of Literacy of Suicide Scale (LOSS) was examined in general people over the age of 18.

Methods

This cross-sectional psychometric study was conducted in 2022 among 952 general population in Iran. Participants were selected by two methods of proportional stratified sampling and simple random sampling. The internal consistency of the tools was assessed using Cronbach’s alpha coefficient, and McDonald omega coefficient. Also, test-retest reliability was checked by Intraclass Correlation Coefficient (ICC).

Results

In the confirmatory factor analysis section, the factor loading of all questions were above 0.4 and one questions were deleted and final model with four factors and 25 questions was confirmed (Some of goodness-of-fit indexes: AGFI = 0.910, RMSEA = 0.050, IFI = 0.901, and χ2/df = 3.333). For all questions, the Cronbach’s alpha coefficient was 0.859, McDonald omega coefficient was 0.866, and ICC was 0.895. Finally, the Persian long version of LOSS was approved with 25 items and four subscales: causes/triggers (9 items), risk factors (7 items), signs and symptoms (5 items) and treatment/prevention (4 items).

Conclusion

The Persian long version of LOSS with four subscales and 25 items is an appropriate tool to investigate the state of suicide literacy in the public population.
The application of a hollow trephine in femoral retrograde intramedullary nailing technique
Authors: Yao Xiang , Liu Hongyuan , Hu Minjie , Wang Chong , Liu Dejun , Hu Jianping , Tang Jilei
Published: March 2023

Purpose

The purpose of this study was to describe and evaluate the use of a specially designed hollow trephine to create the entry point through the femoral condyle during retrograde interlocking intramedullary nailing for femoral fractures.

Methods

From June 2019 to December 2021, we treated 11 patients (5 men, 6 women; mean age, 64 years; age range 40–77 years) with mid-distal femoral fractures by retrograde intramedullary femoral nailing using a self-designed hollow trephine for femoral condyle reaming and cancellous bone harvesting. The mode of all the nails is static. Patients were followed up at 1, 4, 8, and 12 weeks and for at least 6 months after surgery. The healing process and heterotopic ossification were evaluated by imaging. Partial weight bearing was permitted during the recovery period and complete weight bearing was permitted after clinical healing of the fracture displayed by X-ray.

Results

The operation was successful in all patients. Over mean follow-up of 9.3 months (range, 6.0–12.0 months), all patients achieved clinical healing within three months. There were no complications such as knee joint infection, heterotopic ossification, knee joint adhesion and wedge effect.

Conclusion

The use of the hollow trephine during femoral retrograde intramedullary nailing helps avoid postoperative complications such as heterotopic ossification, knee joint adhesions, and wedge effect. It also facilitates bone graft harvesting.
A retrospective study on application of a classification criterion based on relative intervertebral tension in spinal fusion surgery for lumbar degenerative diseases
Authors: Hou Yang , Shi Hongyang , Zhao Tianyi , Shi Haoyang , Shi Jiangang , Shi Guodong
Published: March 2023

Background

As an important part of spinal fusion procedure, the selection of fusion cage size is closely related to the curative effect of the surgery. It mainly depends on the clinical experience of surgeons, and there is still a lack of objective standards. The purpose of this study is to propose the concept of relative intervertebral tension (RIT) for the first time and its grading standards to improve the surgical procedures of lumbar interbody fusion.

Methods

This retrospective study was conducted from January 2018 to July 2019. A total of 83 eligible patients including 45 men and 38 women with lumbar degenerative disease underwent transforaminal lumbar interbody fusion (TLIF) were included in this study. A total of 151 fusion segments were divided into group A, group B and group C according to the grading standards of RIT. In addition, parameters of intervertebral space angle (ISA), intervertebral space height (ISH), intervertebral space foramen (IFH), fusion rates, cage-related complications and cage heights were also compared among the three groups.

Results

The ISA in group A was the smallest among three groups in contrast with group C with largest ISA at the final follow-up(P < 0.05). The group A presented the smallest ISH and IFH values(P < 0.05), compared with group B with the largest ISH and IFH values(P < 0.05). These two parameters in the group C were in-between. The fusion rates of group A, group B and group C were 100%, 96.3% and 98.8% at the final follow-up, respectively. No statistical difference in fusion rates and cage-related complications occurred among the three groups(P > 0.05), and a certain correlation between ISH and RIT was also observed.

Conclusions

The concept of RIT and the application of its clinical grading standards could simplify the surgical procedures of spinal fusion and reduce cage-related complications.
Migrated Hem-o-Lok clips in the neobladder with giant stone formation: a case report
Authors: Xu Shang , Wang Xin-Ning , Wang Zi-Jie , Zhang Tian-Wei , Zhang Yu-Hao , Cao Yuan-Chao , Jiao Wei
Published: March 2023

Introduction

Neobladder urolithiasis is a rare but important delaying complication of orthotopic urinary diversion. We report a case of Hem-o-Lok (HOLC) migration into the neobladder with giant stone formation after orthotopic neobladder cystectomy.

Case report

We report a case of a 57-year-old man with frequent urination and occasional discharge of stones 3 years after a laparoscopic orthotopic neobladder cystectomy. Computed tomography revealed a large round 3.5 cm calculus. An endoscopic neocystolitholapaxy was performed, and a Hem-o-Lok was found in the center of the stone.

Conclusion

We described the case presentation, treatment and analysis of etiology of stone formation to avoid such complication.
Comparing the shear bond strength of veneering materials to the PAEKs after surface treatments
Authors: Kiliç Mustafa , Dede Doğu Ömür , Küçükekenci Ahmet Serkan
Published: March 2023

Background

This study aimed to evaluate the impact of various surface treatments on the shear bond strength (SBS) of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) polymers to indirect laboratory composite (ILC) and lithium disilicate ceramic (LDC) veneering materials.

Methods

Polymer specimens (7 × 7x2 mm) were sectioned from PEEK and PEKK discs (N = 294) and randomly allocated to 7 groups (n = 20); untreated (Cnt), plasma (Pls), 98% sulfuric acid (Sa), sandblasting with 110 µm Al2O3 (Sb), tribochemical silica coating with 110 µm silica modified Al2O3 (Tbc), Sb + Sa, Tbc + Sa. Scanning electron microscopy assessments were performed on one sample of each treatment group, and veneering materials were applied to the remaining specimens (n = 10). The specimens were subjected to the SBS test after being soaked in distilled water (24 h, 37 °C). Three-way ANOVA, independent sample t-test, and Tukey HSD test were performed for statistical analyses (α = .05).

Results

The surface treatment, polymer, veneering material types, and their interactions were significant on SBS results according to the 3-way ANOVA (p < 0.001). The SBS values of ILC veneered groups were significantly higher than LDC groups, regardless of surface treatment and polymer type (p < 0.05). The highest SBS values were obtained for Sa-applied ILC veneered PEEK (21.55 ± 1.45 MPa) and PEKK (17.04 ± 1.99 MPa) polymer groups (p < 0.05).

Conclusion

The effect of surface treatment and veneering materials may be significant on the SBS values of PAEKs. Therefore, the application parameters of surface treatments should be more specified for the applied veneering material and polymer type.
Influence of cold atmospheric-pressure-plasma in combination with different pretreatment methods on the pull-off tensile load in two-piece abutment-crowns: an in-vitro study
Authors: Görgen Carolin-Isabel , Sagheb Kawe , Lehmann Karl Martin , Schmidtmann Irene , Wentaschek Stefan
Published: March 2023

Background

In implant prosthetic dentistry, the adhesive connection of individualized ceramic crowns and prefabricated titanium bases leads to several benefits. However, the durability of the bonding could be a weak point and especially depends on sufficient surface pretreatment. Cold atmospheric-pressure plasma (CAP) is a pretreatment method that should improve the surface properties without physical damage. Thus, the purpose of this study was to investigate the influence of CAP treatment on pull-off tensile load in two-piece abutment crowns.

Methods

Eighty zirconia crowns and titanium bases were divided into eight groups (n = 10) according to their surface pretreatment prior to cementation with Panavia V5: no treatment (A); sandblasting (B); 10-MDP primer (C); sandblasting and primer (D); CAP (AP); sandblasting and CAP (BP); CAP and primer (CP); sandblasting, CAP and primer (DP). The specimens were thermocycled (5°/55°, 5000 cycles), and then the pull-off tensile load (TL) was measured. Statistical analyses were performed using three-way ANOVA with Tukey post-hoc and Fisher’s exact tests.

Results

The results showed that the TL was highest in group D (p < 0.0001). Some combinations of different treatments led to effects that were greater than the sum of the individual effects. These effects were modified by interactions. Only in combination with primer, CAP treatment had a small but positive significant effect (group CP vs. C and CP vs. AP, p < 0.0001) which however did not come close to the strong interaction effect that resulted from the combination of sandblasting and primer.

Conclusion

Within the limitations of this study, CAP treatment cannot be recommended in this specific field of indication due to its unreliable influence on TL in combination with other pretreatment methods.
Rubric vs. numeric rating scale: agreement among evaluators on endodontic treatments performed by dental students
Authors: Escribano Nuria , Belliard Virginia , Baracco Bruno , Da Silva Dayana , Ceballos Laura , Fuentes M. Victoria
Published: March 2023

Background

Students´ assessment should be carried out in an effective and objective manner, which reduces the possibility of different evaluators giving different scores, thus influencing the qualification obtained and the consistency of education. The aim of the present study was to determine the agreement among four evaluators and compare the overall scores awarded when assessing portfolios of endodontic preclinical treatments performed by dental students by using an analytic rubric and a numeric rating scale.

Methods

A random sample of 42 portfolios performed by fourth-year dental students at preclinical endodontic practices were blindly assessed by four evaluators using two different evaluation methods: an analytic rubric specifically designed and a numeric rating scale. Six categories were analyzed: radiographic assessment, access preparation, shaping procedure, obturation, content of the portfolio, and presentation of the portfolio. The maximum global score was 10 points. The overall scores obtained with both methods from each evaluator were compared by Student’s t, while agreement among evaluators was measured by Intraclass correlation coefficients (ICC). The influence of the difficulty of the endodontic treatment on the evaluators´ scores was analyzed by one-way ANOVA. Statistical tests were performed at a pre-set alpha of 0.05 using Stata 16.

Results

Difficulty of canal treatment did not influence the scores of evaluators, irrespective of the evaluation method used. When the analytic rubric was used, inter-evaluator agreement was substantial for radiographic assessment, access preparation, shaping procedure, obturation, and overall scores. Inter-evaluator agreement ranged from moderate to fair with the numeric rating scale. Mean higher overall scores were achieved when numeric rating scale was used. Presentation and content of the portfolio showed slight and fair agreement, respectively, among evaluators, regardless the evaluation method applied.

Conclusions

Assessment guided by an analytic rubric allowed evaluators to reach higher levels of agreement than those obtained when using a numeric rating scale. However, the rubric negatively affected overall scores.
The impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease
Authors: Lin Ling , Song Qing , Duan Jiaxi , Liu Cong , Cheng Wei , Zhou Aiyuan , Peng Yating , Zhou Zijing , Zeng Yuqin , Chen Yan , Cai Shan , Chen Ping
Published: March 2023

Purpose

Study the impact of impaired sleep quality on symptom change and future exacerbation of chronic obstructive pulmonary disease (COPD) patients.

Methods

This was a prospective study. Patients with COPD were recruited into the study and followed up for one year. Pittsburgh sleep quality index (PSQI) was collected at baseline. Symptom change was assessed with Minimum clinically important difference (MCID) in COPD Assessment Test (CAT) at 6-month visit, which is an indicator to assess symptom improvement. Exacerbation was recorded during the one-year visit. PSQI score > 5 was defined as poor sleep quality, whereas PSQI score ≤ 5 was defined as good sleep quality. MCID was defined as attaining a CAT decrease ≥ 2.

Results

A total of 461 patients were enrolled for final analysis. Two hundred twenty-eight (49.4%) patients had poor sleep quality. Overall, 224 (48.6%) patients attained MCID at 6-month visit and the incidence of exacerbation during the one-year visit was 39.3%. Fewer patients with impaired sleep quality achieved MCID than patients with good sleep quality. Good sleepers were significantly more likely to attain MCID (OR: 3.112, p < 0.001) than poor sleepers. Fewer poor sleepers in GOLD A and D groups attained MCID with ICS/LABA, and fewer poor sleepers in the GOLD D group attained MCID with ICS/LABA/LAMA than good sleepers. Poor sleep quality was a greater risk factor of future exacerbation in Cox regression analysis. The ROC curves showed that PSQI score had a predictive capacity for future exacerbation. More patients with poor sleep quality experienced future exacerbation in GOLD B and D group with treatment of ICS/LABA/LAMA compared to good sleepers.

Conclusions

COPD patients with impaired sleep quality were less likely to achieve symptom improvement and were at increased risk of future exacerbation compared to patients with good sleep quality. Besides, sleep disturbance may affect the symptom improvement and future exacerbation of patients with different inhaled medication or in different GOLD groups.
Effects of air pollution on restricted activity days: systematic review and meta-analysis
Authors: Orellano Pablo , Reynoso Julieta , Quaranta Nancy
Published: March 2023

Background

The adverse effects of air pollution on human health include many diseases and health conditions associated with mortality, morbidity and disability. One example of these outcomes that can be translated into economic costs is the number of days of restricted activity. The aim of this study was to assess the effect of outdoor exposure to particulate matter with an aerodynamic diameter less than or equal to 10 and 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and ozone (O3), on restricted activity days.

Methods

Observational epidemiological studies with different study designs were included, and pooled relative risks (RR) with 95% confidence intervals (95%CI) were calculated for an increase of 10 μg/m3 of the pollutant of interest. Random-effects models were chosen because of the environmental differences between the studies. Heterogeneity was estimated using prediction intervals (PI) and I-Squared (I2) values, while risk of bias was assessed using a tool developed by the World Health Organization specifically designed for air pollution studies, and based on different domains. Subgroup and sensitivity analyses were performed where possible. The protocol for this review was registered with PROSPERO (CRD42022339607).

Results

We included 18 articles in the quantitative analysis. Associations between pollutants and restricted activity days in time-series studies of short-term exposures, measured as work-loss days, school-loss days, or both were significant for PM10 (RR: 1.0191; 95%CI: 1.0058–1.0326; 80%PI: 0.9979–1.0408; I2: 71%) and PM2.5 (RR: 1.0166; 95%CI: 1.0050–1.0283; 80%PI: 0.9944–1.0397; I2: 99%), but not for NO2 or O3. Some degree of heterogeneity between studies was observed, but sensitivity analysis showed no differences in the direction of the pooled relative risks when studies with a high risk of bias were excluded. Cross-sectional studies also showed significant associations for PM2.5 and restricted activity days. We could not perform the analysis for long-term exposures because only two studies analysed this type of association.

Conclusion

Restricted activity days and related outcomes were associated with some of the pollutants under evaluation, as shown in studies with different designs. In some cases, we were able to calculate pooled relative risks that can be used for quantitative modelling.
SARS-CoV2 mutations and impact on mortality: observational study in a sub-saharan Africa hospital
Authors: Makulo Jean-Robert , Wumba Roger , Mandina Madone Ndona , Mbala Placide , Aziza Adrienne Amuri , Nlandu Yannick Mayamba , Kabwe Benjanmin , Mangala Donatien , Bepouka Ben Izizag , Odio Jerome Ossam , Longokolo Murielle , Mukenge Eric , Kamwiziku Guyguy , Kingand Eddy Lusamaki , Bashengezi Constantin , Kabanda Gilbert , Longo-Mbenza Benjamin
Published: March 2023

Background

One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves.

Method

The present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct < 25 to ensure the chances to generate complete genome sequence. RNA extraction was performed using the Viral RNA Mini Kit (Qiagen). Depending on the platform, we used the iVar bioinformatics or artic environments to generate consensus genomes from the raw sequencing output in FASTQ format.

Results

During the study period, the original strain of the virus was no longer circulating. The Delta VOC was predominant from June (92%) until November 2021 (3rd wave). The Omicron VOC, which appeared in December 2021, became largely predominant one month later (96%) corresponding the 4th wave. In-hospital mortality associated with COVID-19 fell during the 2nd wave (7% vs. 21% 1st wave), had risen during the 3rd (16%) wave before falling again during the 4th wave (7%) (p < 0.001).

Conclusion

The Delta (during the 3rd wave) and Omicron VOCs (during the 4th wave) were very predominant among patients followed for Covid-19 in our hospital. Contrary to data in the general population, hospital mortality associated with severe and critical forms of COVID-19 had increased during the 3rd wave of the pandemic in Kinshasa.
Epithelioid and spindle rhabdomyosarcoma with TFCP2 rearrangement in abdominal wall: a distinctive entity with poor prognosis
Authors: Li Yuan , Li Dan , Wang Jingyu , Tang Jinlong
Published: March 2023

Background

Epithelioid and spindle rhabdomyosarcoma (ES-RMS) with TFCP2 rearrangement is a recently discovered rare variant of rhabdomyosarcoma composed of epithelioid and spindle cells, because it shows extraordinarily adverse prognosis and is easily misdiagnosed as other epithelioid or spindle cell tumors.

Methods

A rare case of ES-RMS with TFCP2 rearrangement was presented and English literatures in Pubmed online up to 01 July 2022 were gathered by two authors for a systematic review according to the inclusion and exclusion criteria.

Case presentation/results

We report a case of ES-RMS in an early 30s-years-old female, the neoplastic cells are remarkably immunoreactive with CK(AE1/AE3), and partially with ALK protein. Unexpectedly, the tumor shows TFCP2 rearrangement with coexistence of increased copy numbers of EWSR1 and ROS1 gene and MET gene mutation. Besides, Next-generation sequencing for genetic mutational profiling revealed frequent MET exon14 mutations in chromosome 7, most of which are C > T nonsynonymous SNV, and exon42 of ROS1 in chromosome 6 showed frequent G > T mutation up to 57.54%. In addition, neither MyoD1 mutation nor gene fusions were detected. Moreover, the patient shows high tumor mutational burden (TMB) up to 14.11 counts/Mb. Finally, as many cases of ES-RMS including our case had local progression or metastasis, we find, similar to epithelioid rhabdomyosarcoma (median survival time is 10 month), ES-RMS shows a more aggressive behavior and adverse prognosis (median survival time is 17 month) than spindle cell/sclerosing rhabdomyosarcoma (median survival time is 65 month) according previous studies.

Conclusions

ES-RMS with TFCP2 rearrangement is a rare malignant tumor and easily confused with other epithelioid or spindle cell tumors, it may harbor additional gene alteration in addition to TFCP2 rearrangement, such as MET mutation, increased copy numbers of EWSR1 and ROS1 gene, high TMB. Most importantly, it may show very poor outcome with extensive metastasis.