bluuebunny/crossref_metadata_2025 huggingface dataset:
Short- and long-term outcomes of aortic root-sparing repair and replacement in acute type A aortic dissection repair
Authors: Tarkas Tillana Nirav , Stoicescu Carla , Munir Wahaj , Bashir Mohamad , Adams Benjamin
Published: May 2021

Acute type A aortic dissection is a surgical emergency with a high mortality rate if left untreated. Management of the aortic root in this setting constitutes an intricate decision-making framework, further complicated by the emergent nature of the dissection. There exists much controversy regarding pursuit of the aggressive aortic root replacement versus a conservative root-sparing repair, alongside considerations for valve-sparing root replacement. In this review, we critically appraise the current controversy in the literature considering the fate of the aortic root, discussing the aforementioned root interventions for which provides better outcomes for mortality and risk of re-intervention. Literature search was performed using electronic database through PubMed, Google scholar, and Embase focussing on studies reporting outcomes and re-intervention rates for these approaches. Limited by the heterogeneity in surgical strategy, with most studies being single-centred retrospective experiences, further fuel this ongoing debate. The literature reveals rather contrasting results whilst comparing root-sparing repair, versus the extensive root replacement; whilst some studies report no statistically significant difference, others show one superior over the other. There is greater consensus when considering risk of re-operation, with studies showing higher rates of re-operation in root-sparing group compared to replacement; however, many others show no statistically significant difference. In conclusion, the conflicting outcomes reported in the literature, with their inherent limitations, results in the current inability to reach a definitive answer. There remains support in the current literature for both approaches with much of the decision-making being surgeon-bound with many significant influencing factors on a case-by-case basis.
Early safety performance of a modified technique of aorta replacement with sinotubular stabilization
Authors: Moscarelli Marco , Di Bari Nicola , Nasso Giuseppe , Fattouch Khalil , Athanasiou Thanos , Bonifazi Raffaele , Speziale Giuseppe
Published: May 2021

Background

We sought to determine if a modified technique for ascending aorta replacement with sinotubular junction reduction and stabilization was safe.

Methods

This technique was performed by suspension of the three commissures, invagination of the aortic Dacron graft and advancing the graft into the ventricles. We included patients with dilatation of the ascending aorta, normal sinuses of Valsalva dimension (<45 mm), with or without aortic annulus enlargement (>25 mm) and with various degree of aortic insufficiency (from grade 1 to 3).

Results

From April to October 2019, 20 patients were recruited from two centers; mean age was 66.9 ± 12.8 years, 13 were male; grade 1, 2 and 3 was present in 12, 2 and 6 patients, respectively. All patients underwent ascending aorta replacement with modified technique; an additional open subvalvular ring was used in 8 patients with aortic insufficiency ≥ 2; cusps repair was performed in 6 patients (5 plicating central stitches/1 shaving); concomitant coronary artery bypass grafting was performed in 10 patients. There was no 30-day mortality. One patient was re-explored for bleeding. All patients completed six-month follow-up; at the transthoracic echocardiography, there was no aortic insufficiency ≥ 1 except one patient with aortic insufficiency grade 1 who underwent ascending aorta replacement and subvalvular ring; no patients underwent reintervention.

Conclusions

This modified technique for ascending aorta replacement and sinotubular junction stabilization was safe. It could be associated with other aortic valve sparing techniques. However, such remodeling approach has to be validated in a larger cohort of patients with longer follow-up.
The Poetics of Detachment in Medieval Ka-vya: Anthologies and the Path of Literary Sanskrit in the Second Millennium
Authors: Knutson Jesse Ross
Published: May 2021

This essay explores the dialectic of form, content and social life in the new poetry of the medieval Sanskrit anthologies. Did the seeming anarchy of content evinced in unfamiliar tables of contents produce genuine newness of aesthetic effect or affect, new possibilities for social value judgement—a critical and self-critical perspective—in response to changing sociopolitical conditions and the rise of the vernacular? Or else did this poetry simply do what it always did best: to be everything for everyone at the royal court, everywhere and nowhere? This article argues that the anthology may have spawned a contradictory dynamic: crafting a new sociological immediacy for the form, and yet reconciling the courtly ka-vya tradition to a future in which it no longer figured so centrally. Finally, in a methodological annex, the aforementioned case study spawns higher-order reflections on the mutual determination of art and social life in early medieval South Asia, and the materialist analysis of premodern cultural form. Thinking through premodern sociocultural change from the point of view of capitalist modernity fundamentally challenges the historical imagination, revealing self-reflexivity as both its first and last resort.
Targeting versus social protection in cash transfers in the Philippines: Reassessing a celebrated case of social protection
Authors: Dadap-Cantal Emma Lynn , Fischer Andrew M. , Ramos Charmaine G.
Published: May 2021

This article provides a corrective to the dominant celebratory narrative about the conditional cash transfer programme in the Philippines, the Pantawid, and its associated social registry, the Listahanan. Based on extensive documentary analysis and fieldwork in the Philippines in 2017 and 2018, we argue that the targeting system has in fact been unable to function according to its primary purpose of identifying the poor and providing them social protection, despite being celebrated precisely for this purpose. This has been partly – but not only – due to the increasingly obsolescent data of the registry, which the political system has been incapable of correcting, leading to stasis at a fairly low level of coverage, at a peak of about 19 percent of national households in 2014 and since subsiding to about 17 percent by 2020, with transfer amounts at a fraction of the food poverty line. This dysfunction has resulted in a quasi-permanent group of cash payment recipients, with little or no reflection of evolving poverty profiles. This revised reading of the Pantawid and Listahanan, in what might be considered as a strong case to examine social protection performance, brings us back to the perennial problems associated with poverty targeting in even best-case social protection programmes promoted by international donors and organisations.
When do parties put Europe in the centre? Evidence from the 2019 European Parliament election campaign
Authors: Maier Michaela , Jalali Carlos , Maier Jürgen , Nai Alessandro , Stier Sebastian
Published: May 2021

European elections have been described as second-order phenomena for voters, the media, but also parties. Yet, since 2009, there exists evidence that not only voters, but also political parties assign increasing significance to European elections. While initially ‘issue entrepreneurs’ were held responsible for this development, the latest campaigns have raised the question of whether mainstream parties are finally also campaigning on European issues. In this article, we examine European Union (EU) salience in the 2019 European Parliament (EP) campaigns of government and opposition parties and the predictors of their strategic behaviours. We test the relevance of factors derived from the selective emphasis and the co-orientation approach within an integrated model of strategic campaign communication based on expert evaluations of 191 parties in 28 EU member states. Results show that the traditional expectation that government parties silence EU issues does not hold anymore; instead, the average EU salience of government and opposition parties is similar on the national level. The strongest predictors for a party’s decision to campaign on EU issues are the co-orientation towards the campaign agendas of competing parties, and party’s EU position.
Support for a COVID-19 vaccine mandate in the face of safety concerns and political affiliations: An Australian study
Authors: Smith David T , Attwell Katie , Evers Uwana
Published: May 2021

COVID-19 vaccine development has been widely awaited, but concerns around acceptance and political polarisation prevail. We sought to determine the willingness of Australians to take a (then prospective) COVID-19 vaccine, compared with their previously recorded opinions about other vaccines. We also sought to determine reasons for hesitancy, levels of support for possible government mandates, and the political basis of support. We surveyed 1200 Australians, including 898 participants in a panel previously asked in 2017 about vaccines and mandates. In all, 66% of respondents indicated they would take a coronavirus vaccine, less than the 88% who in 2017 agreed that vaccines are safe, effective, and necessary. Also, 70% of the respondents who indicated hesitancy were concerned about the safety of the vaccine if it was developed too quickly, and 73% of all respondents agreed that the government should require a coronavirus vaccine for work, travel, and study. This is lower than the 85% who agreed with the childhood vaccine mandate in 2017, but slightly higher than the number of respondents who indicated that they would definitely be willing to take the coronavirus vaccine themselves. Older respondents, higher income respondents, and respondents who vote for major parties were all significantly more likely to take a coronavirus vaccine and to support government requirements.
E-learning adoption in higher education: A review
Authors: Baig Maria Ijaz , Shuib Liyana , Yadegaridehkordi Elaheh
Published: May 2021

In recent years, e-learning has become pivotal in higher education sectors. Researchers are correlating novel approaches with e-learning to facilitate education. However, despite the increase in e-learning research, there is still a lack of comprehensive literature analysis of e-learning in the higher education sector. Thus, this study aims to conduct a systematic literature review of the literature on e-learning in higher education. This study classifies the selected studies according to the focus of the study, utilizes a theoretical model and framework, and research methods. Also, it presents limitations and future research directions of e-learning in the higher education sector. A systematic approach is conducted, and a total of 47 relevant articles published between the year 2011 and 2019 were selected based on the inclusion and exclusion criteria. The findings on selected studies focus on the adoption, acceptance, readiness, and user insight, as well as e-learning expansion and challenges in the higher education sector. This study also classified theoretical models and frameworks based on their usage in the pre-adoption, adoption, and post-adoption stages. The findings revealed that most of the theoretical models and frameworks were used at the post-adoption stage. Nevertheless, this study revealed that most of the current studies in this domain were conducted using a quantitative research approach. Finally, this study highlighted limitations and presented possible future research directions as a guide for further enhancement in e-learning and higher education studies.
Sounds without borders: Exploring the cross-national expansion of commercial European Radio Groups
Authors: Bonet Montse , Fernández-Quijada David
Published: May 2021

This article aims to study how private European radio is becoming commercially international through the expansion of radio brands beyond their national market. It is the first ever analysis of the expansion strategies of radio groups across Europe, including their footprint in each market in which they operate, from the political economy of cultural industries. The article maps the main radio groups in Europe, analyses cross-national champions in depth and establishes three main types. This study shows that, thanks to the possibilities of a deregulated market, strengthening the role of the brand and the format, and the agreements with other groups, broadcasting radio has overcome the obstacles that, historically, hindered its cross-border expansion.
Digital infrastructure evolution as generative entrenchment: The formation of a core–periphery structure
Authors: Rodon Modol Joan , Eaton Ben
Published: May 2021

This article empirically investigates the process by which a digital infrastructure evolved and took the architectural form of a digital platform as a core–periphery structure over a 20-year period. Our study pays special attention to the developmental dependencies of the components of the infrastructure’s installed base and how the interdependencies between the platform core and periphery evolve over time. We use the notion of ‘generative entrenchment’ to provide an account of the formation and unfolding of a core–periphery structure from an evolving digital infrastructure that highlights three aspects of the process. First, the process of architectural evolution that our study depicts comprises three phases showing a gradual reversal of the entrenchment relationship of the platform core and periphery: (1) entrenchment of the periphery, (2) mutual entrenchment of the core and periphery, and (3) entrenchment of the core. Second, we show how the generatively entrenched infrastructure’s installed base shaped the decisions and choices regarding the initial platform core. Third, we identify three architectural practices (creating redundancy in the core, augmenting the core with novelty, and reducing the heterogeneity of an entrenched peripheral component and later integrating it into the core) that weakened the entrenchment of the peripheral components, amplified the role of the core, and consolidated the core–periphery structure.
Evaluating New York raw fiber-to-retail
Authors: Trejo Helen X , Lewis Tasha L
Published: May 2021

Inspired by the slow fashion movement, this is an exploratory case study focused on New York’s raw fiber-to-retail value chain for local clothing and textiles. New York has over 470 diverse sheep, alpaca, goat farms, fiber processing mills for product development, and fiber festivals for retail. A survey with farmers presents their motives for establishing a fiber farm business, diverse fibers available, fiber products, income, and their multiple retail venues. Interviews were conducted with farmers, fiber mill owners, and artisan designers. Primary research objectives included: (1) determining how fiber farms, mills, artisans, fiber festivals, and fiber agro-tourism intersect to sustain the current fiber community; (2) evaluating the major challenges the fiber community faces; (3) determining if stakeholders of the fiber community have benefited from any policies; and (4) understanding future goals New York raw fiber-to-fashion stakeholders have to sustain the local fiber community. Interviews reveal several leadership initiatives developed by fiber farmers to address challenges of finding a market, limited income, and fiber mill closures. This study uses the five key dimensions of slow fashion as a framework to evaluate New York raw fiber-to-retail.
A vision of the farming sector’s future: What is in there for farmers in the time of the Second Machine Age?
Authors: Rizov Marian
Published: May 2021

Recent technological advances both on the farm and in the lab are boosting not only the efficiency of modern farming but have made it also more independent from nature than ever before. Increasingly affordable and accessible new technologies are helping us to better understand and ‘manage’ nature and thus, for first time in history farming is becoming as any other industry – susceptible to specialisation and economies of scale. This in turn, besides increases in productivity and the minimum efficient scale, leads to fundamental organisational change, away from traditional family farms and towards corporate forms with the associated implications for employment and rural livelihoods. Recent evidence from the digitalisation in agriculture suggests that new technologies require developing capabilities in abstract and analytical skills substituting skills in routine tasks. However, this is not the end game for farmers; new partnerships between technology providers and agribusiness players emerge as digitalisation and connectivity become a strategic issue. Thus, while the first Industrial Revolution led to machines replacing ‘muscles’ the new Digital Revolution is leading to machines replacing ‘brains and souls’, and it may eventually end family farming as we know it.
Local development through the foundational economy? Priority-setting in Danish municipalities
Authors: Nygaard Birgitte , Hansen Teis
Published: May 2021

The foundational economy perspective suggests that industries, which provide services essential to all citizens’ well-being and participation in everyday life, should be placed centrally in economic development policy. This article studies the extent to which local governments put emphasis on foundational industries in their strategies for development. Moreover, drivers behind priority-setting are examined. Based on an analysis of all 98 Danish municipalities’ planning strategies and semi-structured interviews with relevant actors from two rural municipalities, we find that foundational industries are to a great extent emphasised, even if they are not characterised as the foundation for economic development. Rather, foundational industries are prioritised in the absence of other options or when municipalities are not compelled to put local job creation as a crucial focus to attract and maintain inhabitants.
The epidemiology of mescaline use: Pattern of use, motivations for consumption, and perceived consequences, benefits, and acute and enduring subjective effects
Authors: Uthaug Malin Vedøy , Davis Alan K , Haas Trevor Forrest , Davis Dawn , Dolan Sean B , Lancelotta Rafael , Timmermann Christopher , Ramaekers Johannes G
Published: May 2021

Background:

Mescaline is a naturally occurring psychoactive phenethylamine found in several cacti and historically used ceremonially by Indigenous and Latin American populations. Broader recognition of its possible therapeutic value in Western science began in the 1950s; however, knowledge of the safety profile of mescaline and the extent of its use remains limited. The primary aim of this study is to examine the epidemiology of mescaline use among English-speaking adults.

Methods:

About 452 respondents completed a web-based survey designed to assess their previous experience with mescaline (subjective effects, outcome measures, and mescaline type used).

Results:

Most respondents reported that they had consumed mescaline infrequently (⩽once/year), for spiritual exploration or to connect with nature (74%). A small number of respondents reported drug craving/desire (9%), whereas very few reported legal (1%), or psychological problems (1%) related to its use, and none reported seeking any medical attention. Overall, respondents rated the acute mystical-type effects as “ moderate,” ego-dissolution and psychological insight effects as “ slight,” and challenging effects as “ very slight.” Most respondents reported that they used Peyote and San Pedro in their most memorable mescaline experience. Overall, the intensity of acute mescaline effects did not differ between mescaline types. About 50% of the sample reported having a psychiatric condition (i.e. depression, anxiety, etc.), and most (>67%) reported improvements in these conditions following their most memorable experience with mescaline.

Conclusion:

Findings indicate that the mescaline in any form may produce a psychedelic experience that is associated with the spiritual significance and improvements in the mental health with low potential for abuse.
Frequency selective neuronal modulation triggers spreading depolarizations in the rat endothelin-1 model of stroke
Authors: Bazzigaluppi Paolo , Mester James , Joo Illsung L , Weisspapir Iliya , Dorr Adrienne , Koletar Margaret M , Beckett Tina L , Khosravani Houman , Carlen Peter , Stefanovic Bojana
Published: May 2021

Ischemia is one of the most common causes of acquired brain injury. Central to its noxious sequelae are spreading depolarizations (SDs), waves of persistent depolarizations which start at the location of the flow obstruction and expand outwards leading to excitotoxic damage. The majority of acute stage of stroke studies to date have focused on the phenomenology of SDs and their association with brain damage. In the current work, we investigated the role of peri-injection zone pyramidal neurons in triggering SDs by optogenetic stimulation in an endothelin-1 rat model of focal ischemia. Our concurrent two photon fluorescence microscopy data and local field potential recordings indicated that a ≥ 60% drop in cortical arteriolar red blood cell velocity was associated with SDs at the ET-1 injection site. SDs were also observed in the peri-injection zone, which subsequently exhibited elevated neuronal activity in the low-frequency bands. Critically, SDs were triggered by low- but not high-frequency optogenetic stimulation of peri-injection zone pyramidal neurons. Our findings depict a complex etiology of SDs post focal ischemia and reveal that effects of neuronal modulation exhibit spectral and spatial selectivity.
Bayesian versus Empirical Calibration of Microsimulation Models: A Comparative Analysis
Authors: Chrysanthopoulou Stavroula A. , Rutter Carolyn M. , Gatsonis Constantine A.
Published: May 2021

Calibration of a microsimulation model (MSM) is a challenging but crucial step for the development of a valid model. Numerous calibration methods for MSMs have been suggested in the literature, most of which are usually adjusted to the specific needs of the model and based on subjective criteria for the selection of optimal parameter values. This article compares 2 general approaches for calibrating MSMs used in medical decision making, a Bayesian and an empirical approach. We use as a tool the MIcrosimulation Lung Cancer (MILC) model, a streamlined, continuous-time, dynamic MSM that describes the natural history of lung cancer and predicts individual trajectories accounting for age, sex, and smoking habits. We apply both methods to calibrate MILC to observed lung cancer incidence rates from the Surveillance, Epidemiology and End Results (SEER) database. We compare the results from the 2 methods in terms of the resulting parameter distributions, model predictions, and efficiency. Although the empirical method proves more practical, producing similar results with smaller computational effort, the Bayesian method resulted in a calibrated model that produced more accurate outputs for rare events and is based on a well-defined theoretical framework for the evaluation and interpretation of the calibration outcomes. A combination of the 2 approaches is an alternative worth considering for calibrating complex predictive models, such as microsimulation models.
The Multifocal Approach to Sharing in Shared Decision Making: A Critical Appraisal of the MAPPIN’SDM
Authors: Forner David , Noel Christopher W. , Boland Laura , Pieterse Arwen H. , Borkhoff Cornelia M. , Hong Paul
Published: May 2021

Objective

Shared decision making integrates health care provider expertise with patient values and preferences. The MAPPIN’SDM is a recently developed measurement instrument that incorporates physician, patient, and observer perspectives during medical consultations. This review sought to critically appraise the development, sensibility, reliability, and validity of the MAPPIN’SDM and to determine in which settings it has been used.

Methods

This critical appraisal was performed through a targeted review of the literature. Articles outlining the development or measurement property assessment of the MAPPIN’SDM or that used the instrument for predictor or outcome purposes were identified.

Results

Thirteen studies were included. The MAPPIN’SDM was developed by both adapting and building on previous shared decision making measurement instruments, as well as through creation of novel items. Content validity, face validity, and item quality of the MAPPIN’SDM are adequate. Internal consistency ranged from 0.91 to 0.94 and agreement statistics from 0.41 to 0.92. The MAPPIN’SDM has been evaluated in several populations and settings, ranging from chronic disease to acute oncological settings. Limitations include high reading levels required for self-administered patient questionnaires and the small number of studies that have employed the instrument to date.

Conclusion

The MAPPIN’SDM generally shows adequate development, sensibility, reliability, and validity in preliminary testing and holds promise for shared decision making research integrating multiple perspectives. Further research is needed to develop its use in other patient populations and to assess patient understanding of complex item wording.
Intravoxel incoherent motion magnetic resonance imaging in predicting IDH1 gene mutations in high-grade gliomas
Authors: Wang Chaochao , Dong Haibo
Published: May 2021

Background

Intravoxel incoherent motion (IVIM) magnetic resonance imaging (MRI) has been applied to gliomas; however, the relationships between its parameters and isocitrate dehydrogenase 1 (IDH1) mutations in gliomas remain to be investigated.

Purpose

To investigate the value of IVIM in predicting IDH1 mutations in high-grade gliomas before surgery.

Material and Methods

A total of 72 patients with pathologically confirmed high-grade gliomas underwent conventional brain MRI and IVIM from September 2016 to May 2020. Among them, 22 cases were IDH1 mutant and 50 cases were IDH1 wild type. The independent samples t test (normal distribution and homogeneity of variance) or Mann–Whitney rank-sum test (non-normal distribution or heterogeneity of variance) was conducted, and receiver operating characteristic curves were generated to determine parameters for distinguishing IDH1-mutated from IDH1 wild-type high-grade gliomas. These parameters included apparent diffusion coefficient (ADC), true diffusivity (D), pseudo-diffusivity (D*), and perfusion fraction ( f).

Results

ADC, D, and f were significantly higher in IDH1-mutated gliomas than in IDH1 wild-type gliomas ( P < 0.05 for all). There was no significant difference in the D* value between the two groups ( P = 0.053). The areas under the curve of ADC, D, and f in predicting IDH1 mutations in gliomas were 0.798, 0.810, and 0.823, respectively. The specificity of ADC was highest (80.0%), and the sensitivity of the f value was the highest (100.0%).

Conclusion

IVIM can be used for the quantitative prediction of IDH1 mutations in high-grade gliomas before surgery, and the f value is the most effective.
Perioperative safety and short-term efficacy of functional minimally invasive esophagectomy
Authors: Liu Huibing , Jin Defeng , Wang Qian , Cui Zhaoqing , Zhang Luchang , Wei Yutao
Published: May 2021

Background

Standard minimally invasive McKeown three-field esophagectomy (SMIE) results in high perioperative risk and poor postoperative quality of life owing to considerable surgical damage and numerous postoperative complications. We created a modified procedure, functional minimally invasive esophagectomy (FMIE), which preserves the azygos arch, bronchial artery, pulmonary branch of the vagus nerve, and the mediastinal pleura. Our aim was to evaluate the efficacy and safety of FMIE and to determine whether it has limited invasiveness.

Methods

Between 2018 and 2020, FMIE was performed for 48 patients who were compared with 76 SMIE cases; 44 paired cases were matched using propensity score matching.

Results

Operation time, extubation time, and postoperative hospital stay were significantly lower in the FMIE group. FMIE was also associated with fewer pulmonary infections. Postoperative drainage volume on postoperative day (POD) 1 and POD 2, and white blood cell counts on POD 2 and POD 4 were also significantly lower in the FMIE group. There was no statistically significant difference in the number of dissected lymph nodes, short-term recurrence, metastasis rates, or survival rate between the two groups.

Conclusions

FMIE is a less invasive procedure and may be a suitable alternative for lower and early middle esophageal carcinoma.
Uterine necrosis, infection, and subinvolution: complications observed after combined application of modified B-Lynch suture and vascular ligation
Authors: Luo Linfeng , Wan Junhui , Chen Xinping , Zhang Huan , Zhang Minjie , Chen Qi
Published: May 2021

Compression sutures are primarily used to treat atonic postpartum hemorrhage. We herein describe three cases of selective arterial ligation combined with B-Lynch or modified B-Lynch suture for the treatment of intractable postpartum hemorrhage unresponsive to available conservative interventions. Three pregnant women underwent a cesarean section for a macrosomic fetus, fetal distress, and oligohydramnios, respectively. All three women developed intractable postpartum hemorrhage due to uterine atony with no chance of embolization therapy. B-Lynch or modified B-Lynch suture and additional selective arterial ligation were performed using braided absorbable suture. The first woman developed postoperative hematometra and infection without response to drainage and antibiotic therapy. Although laparoscopic exploration was performed to loosen the suture line and drain the hematometra and pyometra, the necrosis and infection could not be controlled. Subtotal hysterectomy was therefore conducted, and the necrotic uterine adnexa was removed. The other two women developed subinvolution of the uterus resulting in prolonged menstruation and amenorrhea, although the uterus was preserved and the bleeding was controlled. Modified B-Lynch suture combined with vascular ligation is an invaluable technique for women with severe intractable postpartum hemorrhage. However, it can lead to serious complications such as uterine necrosis, infection, and subinvolution.
Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children
Authors: Wang Jie , Dang Pan-hong , Chang Huan-huan , Wang Zi-han
Published: May 2021

Objective

To investigate the effect and prognosis of subtotal intracapsular tonsillectomy.

Methods

All children (n=162) with tonsillar hypertrophy and chronic tonsillitis were randomly divided into two groups: tonsillectomy (n=75) and subtotal intracapsular tonsillectomy (n=87). Tonsillectomy: the tonsillar tissue was completely removed along with the tonsillar capsule. Subtotal intracapsular tonsillectomy: 80% to 90% of the tonsils and the complete epithelium of the tonsillar crypts were removed without damaging the tonsillar capsule. The Face, Legs, Activity, Cry, and Consolability (FLACC) and parents’ postoperative pain measure (PPPM) scales were used to evaluate postoperative pain, and the obstructive sleep apnea (OSA)-18 questionnaire was used to assess the children’s postoperative quality of life. The patients were followed-up for 2 years.

Results

1. The FLACC and PPPM scales indicated that the children’s postoperative pain after subtotal intracapsular tonsillectomy was significantly less than that of children undergoing tonsillectomy. 2. The OSA-18 scale scores indicated that subtotal intracapsular tonsillectomy significantly improved the children’s quality of life. 3. Two years after subtotal intracapsular tonsillectomy, no patients required reoperation.

Conclusion

Subtotal intracapsular tonsillectomy may be the first choice for tonsillar hypertrophy and chronic tonsillitis patients.
Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study
Authors: Liu Wenlu , Lin Huanyi , Zeng Xianshang , Chen Meiji , Tang Weiwei , Zhou Ting , Yu Weiguang , Liu Qilong , Xu Guixing
Published: May 2021

Objective

To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C).

Methods

Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter.

Results

The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR).

Conclusion

In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.
Single-dose administration of a short-acting gonadotropin-releasing hormone agonist does not affect cycle outcome in frozen–thawed embryo transfer cycles
Authors: Wang Hanbi , Tang Xian , Bukulmez Orhan , Deng Chengyan , Yu Qi , Zhou Yuanzheng , Sun Zhengyi , Zhen Jingran , Wang Xue , Liu Meizhi
Published: May 2021

Objective

This prospective study aimed to assess the effect of short-acting gonadotropin-releasing hormone agonist (GnRHa) administration on pregnancy outcomes in frozen–thawed embryo transfer (FET) cycles.

Methods

Patients who planned to have FET in Peking Union Medical College Hospital (China) were recruited for this study and randomly assigned into two groups. Patients in the experimental group (n = 460) received triptorelin acetate on the day of embryo transfer along with routine luteal support. Patients in the control group (n = 433) only received luteal support. One dose (0.1 mg) of a short-acting GnRHa was administered on the day of blastocyte transfer. The rates for clinical pregnancy, biochemical pregnancy, implantation, miscarriage, and ectopic pregnancy were compared between the groups.

Results

There were no significant differences in the number and quality of blastocytes transferred between the two groups. In the experimental and control groups, the clinical pregnancy rate was 56.3% and 50.58%, the biochemical pregnancy rate was 15.78% and 18.94%, and the median implantation rate was 39.98% and 38.01%, respectively, with no significant difference between the groups. Biochemical pregnancy and abortion and the ectopic pregnancy rate were not significantly different between the two groups.

Conclusion

In FET cycles, a GnRHa does not affect the pregnancy outcome.
Pathogen distribution and risk factors for urinary tract infection in infants and young children with retained double-J catheters
Authors: Wang Jianfeng , Cao Yu , Zhang Li , Liu Guoqing , Li Chunjing
Published: May 2021

Objectives

To investigate the pathogens and potential risk factors for urinary tract infection (UTI) in patients with retained double-J catheters (DJCs).

Methods

In total, 107 infants and young children with DJCs were included in this retrospective analysis. Patients were included in the infection group (n = 30) or non-infection group (n = 77), according to UTI presence or absence. The species and characteristics of pathogens were investigated, and the clinical features of the patients were recorded for further analysis.

Results

Gram-negative bacilli were the most common causative pathogens (69.2%), among which Escherichia coli was most frequent (38.5%). The second most common causative pathogens were Gram-positive cocci (28.2%), among which Enterococcus faecalis was most frequent (10.3%). UTIs among patients in this study were associated with the following factors: catheter retention (long-term) (odds ratio [OR] = 2.514, 95% confidence interval [CI] = 1.176–5.373), sex (male) (OR = 2.966, 95% CI = 1.032–8.529), DJC retention (long-term) (OR = 1.869, 95% CI = 1.194–2.926), and DJC number (unilateral) (OR = 0.309, 95% CI = 0.103–0.922).

Conclusions

Infants and young children with DJCs were likely to experience UTIs, mainly caused by Gram-negative bacilli. Long-term catheter retention or DJC retention, male sex, and bilateral DJC retention were risk factors for UTI.
Outcomes of late Kasai portoenterostomy in biliary atresia: a single-center experience
Authors: Khayat Ammar , Alamri Aisha M. , Saadah Omar I.
Published: May 2021

Objectives

To describe the clinical, histopathologic, and outcomes data for a cohort of patients with biliary atresia (BA), and to identify the factors affecting survival.

Methods

This was a cross-sectional study of all BA patients diagnosed between 1999 and 2017. Clinical, biochemical, imaging, and histopathologic data were analyzed, and Kaplan–Meier survival rates were compared to identify potential prognostic factors.

Results

We evaluated 23 patients. The median age at the Kasai procedure was 77 ± 34 days, and the median overall survival was 12.5 ± 65 months. Thirteen (56%) patients survived with their native livers, 3 (13%) received a transplant, and 6 died (26%) while awaiting a transplant. Cholangitis and the use of ursodeoxycholic acid were associated with longer survival, while impaired synthetic function was associated with shorter survival.

Conclusions

Most patients presented late for the Kasai procedure. The survival rate with the native liver was comparable to other cohorts. Therefore, clinicians are encouraged to refer for the Kasai procedure even with late presentation (between 60 and 90 days), provided there is no hepatic decompensation.
Expression of Torque and Its Effect on Various Biological Structures Caused by Varying Archwire Material: A 3D FEM Study
Authors: Kothari Ridhi , Gupta Seema , Bhambri Eenal , Ahuja Sachin , Bharadwaj Ankit
Published: May 2021

Objective:

Studying torque expression and biomechanical effects of various wires on giving palatal root torque, using finite element (FE) method (FEM).

Conclusion:

TMA wires are most favourable for torquing, in terms of torque expression and susceptibility to root resorption.

Materials and Method:

Geometric model of maxillary right central incisor was developed, using computed tomography (CT) scan. 0.022" × 0.028" Standard edgewise brackets and 10-mm-long stainless steel (SS), titanium molybdenum (TMA) and titanium niobium (TiNb) archwires of dimension 0.019" × 0.025" were modeled and a palatal root torque of 25 degrees was applied on all wires. The angular displacement of the crown and root and nodal displacement at the incisal edge and root apex in y and z axis were analyzed along with stresses on periodontal ligament (PDL), bone, cementum, enamel, and bracket.

Results:

Buccal crown and palatal root movement was seen, which was maximum for SS and least for TMA. Angular displacement was also highest for SS. Compressive stresses were concentrated at the bucco-cervical and linguo-apical regions in the PDL, cementum, and bone and tensile stresses were concentrated in the linguo-cervical regions. In the enamel, the bracket attachment site showed maximum stresses, and slot base showed higher values of stresses than wings. All stress values were highest for SS and least for TMA.
Measurement and Comparison of Bracket Transfer Accuracy With Different Indirect Bonding Techniques: An In Vitro Study
Authors: Rastogi Sonam , Goyal Manish , Kumar Mukesh , Shaha Kalpit Shitalkumar , Yadav Ekta , Kaur Amandeep
Published: May 2021

Objective:

To measure and compare bracket transfer accuracy of 3 indirect bonding (IDB) techniques.

Material and Methods:

Three IDB techniques were studied using polyvinyl siloxane (PVS) putty, vacuum-form (VF), and glue gun (GG). A total of 120 orthodontic stone models were fabricated with die stone, out of which bonding was done on 60 working models and transferred to other 60 patient models. One quadrant was selected for each technique. Digital photography was used to measure the mesiodistal ( X-axis), occlusogingival ( Y-axis), and faciolingual ( Z-axis) position of each bracket on the working and patient models.

Results:

All the 3 IDB techniques have a very good bracket transfer accuracy. On comparing individual planes, greatest accuracy was seen in GG on X-axis, VF on Y-axis, and VF/PVS on Z-axis. Points A and B were compared for bracket rotation and the mean differences were insignificant indicating that there was no significant amount of rotation in 3 IDB techniques.

Conclusions:

We can say that all 3 IDB techniques had a very high bracket transfer accuracy. Out of the 3 IDB techniques VF was the most accurate, whereas PVS was the least accurate technique. The selection of technique should be based on tray cost and fabrication time.
What makes practice perfect? How tertiary piano students self-regulate play and non-play strategies for performance success
Authors: Suzuki Akiho , Mitchell Helen F
Published: May 2021

Self-regulated practice is critical to musicians’ development, but it is unclear what components of practice contribute to performance quality. This study aimed to explore tertiary music students’ practice using performance evaluations as indicators of practice efficacy. Five tertiary piano students prepared a quick study task of two pieces for a mock performance, in 2 hours over 2 days. An expert panel evaluated the mock performances and performers were ranked accordingly. Practice session recordings and interview transcripts were analysed according to the three phases of Self-Regulated Learning (forethought, performance, self-reflection) and linked to the pianists’ final performance evaluations. Successful pianists planned their practice and set interpretative goals, while their less successful peers practiced reactively without planning. The highest-ranked pianist’s self-regulation was facilitated by non-play practice which involved taking long pauses and using strategies such as score study, mark score, and listen to own recording. The lowest-ranked pianist failed to identify problems or self-evaluate effectively. Future studies should explore the use and content of non-play practice strategies, especially self-recording, to empower music students to develop and self-regulate their practice. The quick study task provided an effective practice assessment tool and could be used to diagnose and track practice approaches.
Alien Internment in John Galsworthy’s ‘The Bright Side’ and ‘The Dog It was that Died’
Authors: Durey Jill Felicity
Published: May 2021

This article illuminates two short stories by John Galsworthy through examining them with the help of his diaries and letters, a handful of unpublished letters by his nephew from an internment camp and secondary historical sources. It argues that the stories, when read in conjunction with these sources, are highly revealing about human nature during Second World War and also about Galsworthy’s prescient fears concerning a second twentieth-century world war, which he did not live to see.
Authors and Artemus Jones: Libel Reform in England, 1910–52
Authors: Hilliard Christopher
Published: May 2021

This article argues that the novel was collateral damage in English law’s reaction to mass-market newspapers. A 1910 court decision made the writer’s intention irrelevant in libel cases. As a result, publishers became vulnerable to defamation suits from people unknown to a novelist but who happened to share a name with a fictional character. Drawing on the Society of Authors archive and the records of the Porter Committee on the Law of Defamation, the article reconstructs the campaign to exempt fiction from liability in cases of unintentional defamation.
Factors of Recidivism among Individuals with Co-occurring Conditions in Rural Mental Health Jail Interventions
Authors: Victor Grant A. , Comartin Erin , Willis Tamarie , Kubiak Sheryl
Published: May 2021

Estimates indicate that nearly half of rural jail detainees meet the criteria for co-occurring disorders (COD). It is critical to examine factors of recidivism among detainees with COD in rural communities. This exploratory study aimed to examine factors of recidivism among adults in rural jails. Administrative data sources were utilized to assess postyear recidivism among 191 individuals with COD who participated in a jail-based intervention. Results indicated that a greater number of previous jail bookings and not receiving continuity of care were the strongest associations of overall recidivism, and a greater number of previous jail bookings was associated with of multiple recidivism events. The protective effect of receiving continuity of care was diminished in reducing recidivism 4- to 12-months following jail release. Re-entry services should consider developing or further expand specialized psychiatric care parole and connections to evidence-based integrated dual diagnosis treatment with a focus on programs with adaptability for rurality.
Study of environmental factors and quality of life in children with cerebral palsy based on international classification of functioning, disability and health
Authors: Rezaei Amin , Raji Parvin , Mousavi Seyedeh Tahmineh , Mahmoodian Mahmoud , Baghestani Ahmad Reza
Published: May 2021

Introduction

Identification of environmental barriers is an important factor for improving quality of life. The aim was to investigate the relationship between environmental factors and quality of life of children with cerebral palsy and to prioritize environmental factors affecting the quality of life.

Method

In this cross-sectional study, participants were children with cerebral palsy ( n = 67) 8–12 years. The European Child Environment Questionnaire and cerebral palsy quality of life questionnaire were used. In order to prioritize environmental codes, each of the items in the European Child Environment Questionnaire was linked to environmental codes of the cerebral palsy ICF Core Set. Data were analyzed using SPSS and Pearson correlation and regression tests.

Results

There was a significant negative relationship between quality of life and environmental barriers ( p < 0.05, r = −0.36). The European Child Environment Questionnaire covered 75% of the environmental codes of cerebral palsy ICF Core Set. Also, e5 (services, systems and policies) was identified as the main priority of environmental factors affecting the quality of life.

Conclusion

Occupational Therapists should devote part of the interventional plan to reduce environmental barriers. On the other hand, decision-making organizations have to make supportive laws to improve the physical environment of the home, community, school, and work.