bluuebunny/crossref_metadata_2025 huggingface dataset:
The Clinical Efficacy of Double Plasma Molecular Absorption System Combined with Plasma Exchange in the Treatment of Acute-on-Chronic Liver Failure: A Systematic Review and Meta-Analysis
Authors: Bai Wenjie , Yao Chun , Mao Dewen , Wu Jinyu , Wang Kejing , Wei Huazhu , Huang Zuhong , Shi Qinglan , Wang Na
Published: March 2022

Objective. This study aims to investigate the clinical efficacy of plasma exchange in treating acute-on-chronic liver failure (ACLF) through meta-analysis. Method. PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched using a computer for all relevant Chinese and English literature from 2000 to 2021 in each database. At the same time, a large number of related papers and materials were manually consulted. Randomized controlled trials of plasma exchange (PE, control group) and combined double plasma molecular absorption system (DPMAS + PE, observation group) for the treatment of ACLF were collected. Meta-analysis was performed with Stata16.0 software. Result. A total of 474 articles were retrieved, and 11 papers were finally included for research after screening. Meta-analysis results showed that the effective rate of treatment in the experimental group was significantly higher than that in the control group. At the same time, the observation group’s prothrombin activity (PTA) level was better than that of the control group after treatment. After treatment, there was no significant difference in prothrombin time (PT) and international normalized ratio (INR) between the two groups. In addition, after treatment, the alanine aminotransferase (ALT) level of the observation group was significantly lower than that of the control group. However, TBIL levels and albumin (ALB) levels did not change significantly between the two groups. Regarding blood routine indexes, there were no significant changes in creatinine (Cr) levels and platelet counts (PLT) in the two groups after treatment, but hemoglobin (HGB) levels in the observation group were significantly lower than those in the control group. Conclusion. DPMAS combined with plasma exchange therapy can improve liver function, coagulation function, and blood routine level of ACLF patients and increase the effective rate of treatment. It is an effective treatment for acute-on-chronic liver failure.
A New Method for WebShell Detection Based on Bidirectional GRU and Attention Mechanism
Authors: Liu Zhiqiang , Li Daofeng , Wei Lulu
Published: March 2022

With the rapid development of hacker technology, network security issues have become increasingly serious. Uploading WebShell is one of the most common attack methods used by network intruders. WebShell escape technology is changing with each passing day, and the traditional method based on feature matching is difficult to accurately detect. In order to detect WebShell more accurately and mitigate the threat caused by WebShell attacks, a WebShell detection method combining bidirectional GRU (gated recurrent unit) and attention mechanism is proposed for the first time. First, the sample is preprocessed to remove useless information such as annotations. Then, the sample is divided into a series of words, the word2vec model is used to obtain the word vector, and finally, the word vector is input into the network for prediction. According to the experimental results, compared with peer methods, the method in this study performs better in performance indicators such as accuracy rate, recall rate, and F1 value. The model not only detects the PHP-type WebShell but also has a good performance on the WebShell written in JSP, ASPX, or ASP languages. The detection accuracy of PHP-type, JSP-type, and ASP-type WebShell reached 99.36%, 99.23%, and 99.87%, respectively, and the recall rate was 98.6%, 99.13%, and 99.56%, respectively.
Emotional Experience and Psychological Intervention of Depression Patients Based on SOM
Authors: Zou Yuanyuan
Published: March 2022

Depression is a severe mental illness with an unknown pathogenesis. Clinical diagnosis is based primarily on symptoms and does not include objective biological markers. Finding objective markers for diagnosis and treatment from imaging, on the contrary, is becoming increasingly important. The SOM (self-organizing feature mapping) model was used to identify the depression tendency of users in order to investigate the emotional experience and psychological intervention of patients with depression. On this foundation, the concept of depression index is developed further, and the relationship between depression index and the severity of depression in patients is thoroughly investigated. The system can accurately and quickly identify the depression state by applying it directly to the original EEG signals, without any preprocessing or feature extraction. When combined with traditional classifiers, the analysis and comparison results show that SOM can not only effectively select features but also improve the accuracy of depression classification. This research proposes a new research direction for deep learning in the context of large-scale big data analysis.
Curative Effect of Foraminal Endoscopic Surgery and Efficacy of the Wearable Lumbar Spine Protection Equipment in the Treatment of Lumbar Disc Herniation
Authors: Meng ZhaoWu , Zheng JinYang , Fu Kai , Kang YiZhao , Wang Liang
Published: March 2022

Lumbar disc herniation is a common and frequently-occurring disease in pain clinics. The incidence rate of affliction is increasing with every passing year. Besides the aged, young people also suffer from long-term pain, which not only affects their daily routines but may also lead to serious impairment. The causes of chronic low back and leg pain caused by lumbar disc herniation are mainly related to mechanical compression, the adhesion of epidural space, intervertebral space, and aseptic inflammatory reaction. The treatment of lumbar disc herniation should follow the principle of step-by-step treatment. An appropriate treatment scheme needs to be adopted according to the patient's condition. About 80% of patients received nonsurgical treatment to get relief from the pain symptoms. However, 10% to 15% of patients still need traditional open surgery. Spinal foraminal surgery is a new method for the treatment of lumbar disc herniation, lumbar surgery failure syndrome, and lumbar spinal stenosis. However, there are only scattered clinical reports on the efficacy of spinal foraminal surgery. Based on it, this paper proposes a method to explore the efficacy of spinal foraminal mirror surgery in the treatment of lumbar disc herniation. Besides, postoperative wearable lumbar protective equipment is proposed to ensure a seamless rehabilitation effect on the patients. Statistical analysis performed using a t-test revealed that there was a significant difference between the visual analog scales (VAS) scores of the two groups after 3 and 6 months of treatment (P < 0.05). The paper analyzes and summarizes the cases with definite and poor curative effects, which not only provides the basis for clinical practice but also paves the way to multicenter clinical research.
Image Recognition and Extraction of Students’ Human Motion Features Based on Graph Neural Network
Authors: Liu Jianguo , Ji Kai , Jing Yan
Published: March 2022

In order to improve students’ overall subhealth behavior, teenagers’ physical health problems have attracted more and more attention. The state clearly requires students to increase the number and frequency of exercise in school. In order to study the physical changes in the process of students’ sports and the impact on their health caused by a sports injury, a student human motion feature image recognition based on a graph neural network is proposed in this paper. This paper combines image recognition technology with graphic neural network management and uses image recognition technology to detect and track targets. It also analyzes the health changes of students in sports and the influencing factors of physical subhealth in classroom learning. The results show that image recognition technology can accurately analyze the process of cervical spine injury and sports injury in students’ classroom activities. It provides accurate experimental data for analyzing students’ physical health and effective suggestions for promoting students’ healthy development. Compared with the traditional image recognition and analysis results, the advantage of using a graph neural network to manage the detection and tracking results is that a graph neural network is used to manage the detection and tracking results, and the visual expression of students’ physical health test data is completed.
Double-Expressor Appendiceal Burkitt’s Lymphoma: A Case Report and Literature Review
Authors: Dukmak Osama N. , Abugharbieh Hamzeh M. I. , Emar Mohammad Farid , Khamayseh Iman , M. Tos Salem , Salhab Rafiq
Published: March 2022

Background. Appendiceal lymphoma is a very rare entity accounting for 0.015% of all gastrointestinal lymphoma cases. Acute appendicitis is the most common presentation of primary appendix neoplasms. Burkitt’s lymphoma presenting as an acute appendicitis is a rare entity with around 21% of the cases presenting as a lower iliac fossa mass. Case Presentation. A 23-year-old male was admitted to the surgical ward as a case of acute appendicitis with localized tenderness in the right iliac fossa, positive rebound tenderness, a positive Rovsing’s sign, and ultrasound findings of suspected complicated appendicitis. Appendectomy was performed. Histopathological examination of the appendectomy specimen revealed a double-expressor non-Hodgkin diffuse large cell lymphoma with Burkitt’s-like morphology. He was sent for chemotherapy treatment. Conclusion. Only 34 cases of Burkitt’s lymphoma have been reported to present as acute appendicitis. Histological examination following appendectomy for an apparent appendicitis is essential. Furthermore, complete blood count and a computed tomography scan aid the diagnosis of lymphoma. Double-expressor lymphoma has been shown to have poor outcomes. Therefore, prompt and aggressive treatment is vital.
The Construction of Big Data Computational Intelligence System for E-Government in Cloud Computing Environment and Its Development Impact
Authors: Ma Shengqing , Hao Fei , Lin Youwu , Liang Yinjing
Published: March 2022

The traditional E-government big data system fills and classifies algorithms with low accuracy and poor work efficiency. With the development and wide application of big data, the internet of things, and other technologies, the integration of information resources has become the key to information construction. In the process of information resource integration, there are still outstanding problems such as incomplete government information resource system, different standards of government information resource management system construction, and serious threats to network and information security. In order to solve this problem, a new E-government big data system filling and classification algorithm is studied in the cloud computing environment; E-government big data filling is carried out on the basis of complete compatibility theory; and the E-government big data computing intelligence system in the cloud computing environment is constructed and its development impact, so as to parallelize the data, classify the data through decision trees, and realize incremental update decision forest parallelization processing. To verify the effectiveness of the method, comparative experiments are set, and the results demonstrate that experiment one is randomly built into the classification model, and according to the decision forest algorithm, the optimal number of decision trees is 24.
Visual Health Analysis of Print Advertising Graphic Design Based on Image Segmentation and Few-Shot Learning
Authors: Hu Sen
Published: March 2022

Graphics innovation must adapt to the changing trends of the times in order to stay ahead of the curve. This article investigates the use of graphic vision in print advertising design, using image segmentation as a starting point and examines the current state of visual innovation in print advertising graphic design and its various expressions and applications. A series of homogeneous regions are generated and outlined using an image segmentation algorithm based on adaptive local threshold. The user then paints different colors on the area sets that make up the various targets. Finally, the image segmentation is completed by merging the color mark region sets. Automatic extraction of the initial curve of an active contour model, construction of an active contour model based on saliency and level set solution, automatic selection of training samples when a classifier is used for image segmentation, and so on are all problems that this method effectively solves. Experiments show that this algorithm not only satisfies users’ demands for more intuitive input and more accurate interactive image segmentation results but also enables multiregion and multitarget image segmentation with ease.
Improvement Study on Blood Test Investigation by Nanoparticle‐Coated Colour‐Coded Sample Paper
Authors: Jayakumar P. , Padmanabhan S. , Rani B. Sheela , Balamugundan B. , Mulugeta Lijalem
Published: March 2022

Nanobiotechnology is a growing branch of research that combines biology and nanotechnology to study and create unique, functionalized nanobiosystems. This interdisciplinary study subject has significant promise for improving medical engineering. Finding the exact blood category is a coercive test for blood transfer and other incalculable health checkups. The pandemic has accelerated these test frequencies in an exponential fashion. It is usually the job of the practitioners working in the laboratory to name the types of blood samples. Depending on the blood type and its cross‐matching fitness, recommendations are offered for blood transfer. In many places, this type of testing is done manually, and it is done through a microplate and test tube. These tests usually take longer, and the chances of errors are high, which can lead to fatalities. Polymer‐based paper sample collection has been shown to be ideal instruments for conducting blood tests in response to this requirement because of their capacity to do quick and low‐cost diagnostics and analyses. In this paper, a novel nanocoated blood polymer sample paper with unique coding was proposed and investigated for its operational simplicity and effectiveness. A unique coded polymer sample paper has prevented complications during blood tests and provides expected results without errors.
Establishment and Application of Bed-Separation Water Inrush Coefficient Method Considering Water Resistance of Fractured Rock Mass
Authors: He Jianghui , Li Wenping , Qiao Wei , Wang Qiqing , Yang Zhi , Li Liangning
Published: March 2022

Deep mining in Ordos Basin faces the threat of bed-separation water inrush (BWI), so it is necessary to carry out BWI risk assessment before mining. However, the existing BWI risk assessment methods fail to provide a universal risk classification standard. In this paper, taking three coal mines in Ordos Basin as research cases, the water resistance of fractured rock mass was analyzed, and a BWI coefficient (BWIC) method for BWI risk assessment was established. Firstly, by comparing the weight of each BWI-related factor, the formula for calculating the thickness of equivalent water-resisting layer of fractured rock mass was derived. The weight of each BWI-related factor was obtained by entropy weight method. Secondly, based on the stress arch theory, the overall BWIC in bed separation zone corresponding to different excavation lengths was obtained. BWIC was expressed by the ratio of the Cretaceous water pressure to the total thickness of the unbroken water-resisting layer and the equivalent water-resisting layer of the fractured rock mass. Finally, by comparing the value range of the overall BWIC in the bed separation zone corresponding to the excavation length with and without BWI, the standard of BWI risk classification was determined. The application results verified the scientificity of BWIC method and the universality of the BWI risk classification standard proposed in this paper.
[Retracted] Artesunate Suppresses the Growth of Lung Cancer Cells by Downregulating the AKT/Survivin Signaling Pathway
Authors: Zhang Weiwei , Ning Ning , Huang Jie
Published: March 2022

NSCLC (non‐small‐cell lung cancer) is the deadliest cancer in the world. Artesunate is one of the most potent and rapidly acting antimalarial agents. Recently, emerging evidence has suggested the anticancer function of artesunate. In our work, we aimed to investigate the molecular mechanism of artesunate‐induced growth inhibition in human lung adenocarcinoma cells and reported that the anticancer effects of artesunate is related to its ability in downregulating AKT/Survivin signaling in A549 cells. The effect of artesunate on the proliferation of A549 cells was determined by CCK‐8 assay and colony formation assay; its effect on A549 cell apoptosis was evaluated by lactate dehydrogenase (LDH) release assay. The role of artesunate on the activation of AKT/Survivin signaling was analyzed by western blot and quantitative QPCR. Finally, we used two mouse tumor models to investigate the function of artesunate on the in vivo growth of lung cancer cells. Artesunate treatment caused significant growth inhibition and apoptosis in A549 cells. Mechanistically, artesunate downregulated the activation of AKT/Survivin signaling. In agreement, hyperactivation of AKT signaling restored artesunate‐induced growth inhibition in A549 cells. In mouse lung cancer models, artesunate administration significantly reduced the growth of A549 cells and LLC cells in nude mice and immunocompetent mice, respectively. Our findings suggest that artesunate serves as a potential tumor suppressor in lung cancer and hopefully can provide new insight into the development of therapeutic strategies in the clinical lung cancer treatment.
Multi-Objective Optimal Design of Dropping Shock of Series Cushioning Packaging System
Authors: Xue Yang , Song Wei-Sheng , Miao Hong-Tao , Wang Jing , Li Yu
Published: March 2022

The product bears the shock load during the circulation process. The cushioning materials need to absorb the energy generated during the shock to prevent damage to the product. The cushion packaging system generally consists of products, cushioning materials, and an outside packaging carton. Therefore, it is necessary to study the factors affecting the cushion performance of the system. This paper adopts a BP neural network to develop a more precise constitutive relationship. Based on the trained constitutive network model, the dynamic equation of the system is established, and the Runge-Kutta algorithm is utilized to resolve it. The multi-objective optimization (MOP) model of the series cushioning system is established for the first time. The model considers more factors, such as the stability of the cushioning material and whether to use local cushioning. The factors affecting the performance of the cushioning system are deeply studied, and a variety of evolutionary algorithms (PESA2, SPEA2, MOPSO, MOEA/D, and NSGA-II) are utilized to solve the multi-objective optimization problem. The performances of the solution sets obtained by the evolutionary algorithms are studied based on several performance indicators. The results show that these solution sets have good convergence, and the all-around performance of NSGA-II ranks first. Finally, comparing the knee point of the non-dominated solution set calculated by NSGA-II with the parameters in the literature, it is found that the former has better defense performance and less material consumption, which can be used for future product design. Therefore, the evolutionary algorithm can favorably resolve the multi-objective optimization of the series cushioning packaging system under the dropping shock.
Aqueous Lumican Correlates with Central Retinal Thickness in Patients with Idiopathic Epiretinal Membrane: A Proteome Study
Authors: Chang Wei-Cheng , Lee Cho-Hao , Chiou Shih-Hwa , Liao Chen-Chung , Cheng Chao-Wen
Published: March 2022

Idiopathic epiretinal membrane (iERM) is a pathological fibrocellular change in the vitreoretinal junction over the macular area; however, possible pathogenic mechanisms remain unclear. Changes in the differential protein composition of the aqueous humor (AH) may represent potential molecular changes associated with iERM. To gain new insights into the molecular mechanisms of iERM pathology, a sensitive label-free proteomics analysis was performed to compare AH protein expressions in patients with cataracts with or without iERM. This study employed nanoflow ultra-high-performance liquid chromatography-tandem mass spectrometry to investigate protein compositions of the AH obtained from individual human cataract eyes from 10 patients with iERM and 10 age-matched controls without iERM. Eight proteins were differentially expressed between the iERM and control samples, among which six proteins were upregulated and two were downregulated. A gene ontology (GO) analysis revealed that iERM was closely associated with several biological processes, such as immunity interactions, cell proliferation, and extracellular matrix remodeling. Additionally, multiple proteins, including lumican, cyclin-dependent kinase 13, and collagen alpha-3(VI) chain, were correlated with the central retinal thickness, indicating a multifactorial response in the pathogenic process of iERM. Changes in the AH level of lumican between iERM and control samples were also confirmed by an enzyme-linked immunosorbent assay. In conclusion, several pathological pathways involved in iERM were identified in the AH by a proteomic analysis, including immune reactions, cell proliferation, and remodeling of the extracellular matrix. Lumican is a potential aqueous biomarker for predicting iERM development and monitoring its progression. More clinical parameters also need to be identified to complete the analysis, and those could provide additional targets for treating and preventing iERM.
Niketche: um romance sobre colonialidade e luta das mulheres
Authors: Silva Renato Kerly Marques
Published: March 2022

Niketche: uma história de poligamia, escrito por Paulina Chiziane,coloca em evidência relações sociais marcadas pela Colonialidade do Poder (QUIJANO, 2005), em Moçambique. O romance apresenta uma crítica à interdição do casamento poligâmico e à hipocrisia de líderes políticos que oficialmente defendiam a monogamia, mas viviam em poligamia. A narrativa sugereque a opressão das mulheres é acentuada pelo entroncamento de patriarcados (PAREDES, 2017), estabelecido entre colonizados e colonizadores, exemplificados a partir das interdições impostas pelo Estado e pela cultura ocidental que intensificam a opressão a que as mulheres moçambicanas estão submetidas. O textopropõe o estabelecimento da devoluçãoda história (SEGATO, 2012) para as mulheres do romance. Ao construírem uma rede de apoio, elas conseguem implementar seu próprio projeto histórico e, dessa forma, têm a possibilidade de conquistar melhores condições de vida.
Para além dos contos de fadas: representações de gênero no ensino de leitura e de escrita para estudantes de 3º ano do ensino fundamental
Authors: Weber Sabrine , Silva Leonardo da , Lemos Quézia Delgado Caleffi
Published: March 2022

Este artigo objetiva analisar representações de gênero de crianças do 3º ano do Ensino Fundamental, a partir de atividades envolvendo contos de fadas e suas reinvenções. O estudo desenvolveu-se como uma intervenção pedagógica, realizada com a participação dos discentes de uma escola estadual de Santa Catarina. Para o desenvolvimento das atividades, foram mobilizadas concepções bakhtinianas de leitura e escrita enquanto processos, conceitos da formação do imaginário da criança pelos contos de fadas e a importância do desenvolvimento da conscientização crítica. As coleções Antiprincesas e Anti-heróis foram utilizadas para apresentar às crianças outras configurações de representação de príncipe e princesa. Nas produções discentes de textos e de desenhos, foi possível observar que, ao mesmo tempo que os estudantes introduziram representações que se aproximam dos estereótipos de gênero presentes em muitos contos de fadas, também evidenciaram elementos de recontextualização e ressignificação, a partir do trabalho com as coleções Antiprincesas e Anti-heróis.
Building Bridges and Widening Gaps
Authors: Bütikofer Aline , Løken Katrine V. , Willén Alexander
Published: March 2022

By exploiting the opening of the Öresund Bridge between Denmark and Sweden, we examine the impact of access to larger labor markets on wages and employment. We show that the bridge generated a substantial increase in the cross-country commuting behavior of Swedes and a 13.5% increase in the average wage of workers in the region. We further show that the wage gains are unevenly distributed: the effect is largest for high-educated men and smallest for low-educated women. Thus, the wage gains come at the cost of increased income inequality and a widening of the gender wage gap, both within and across households.
Mahechadendron puntecascarillo (Vochysiaceae), a new genus and forest tree species from Colombia
Authors: ARIZA-CORTÉS WILLIAM , CORTÉS-B. ROCIO , FERNÁNDEZ-ALONSO JOSÉ LUIS
Published: March 2022

The new genus and species Mahechadendron puntecascarillo are described based on specimens first collected in the ‘60s but only recently found with flowers and fruits. It grows in the moist forests of the Middle Magdalena River in Colombia. The highly durable wood of this forest tree species is still used intensively for construction. Morphological and rbcL sequence data place this genus in the Vochysiaceae, most likely closely related to Callisthene. Mahechadendron shows inflorescences in compound dichasia, compact, only developed laterally, traits not previously recorded in this family. Mahechadendron  puntecascarillo exhibits the tiniest flowers known in the Vochysiaceae, with the fourth sepal basally sacciform, and copious villous-lanose indumentum in the internal portions of the fourth sepal, petal, filament, and ovary; the flowers also have the single petal non-clawed, a feature not very common in Vochysiaceae. In addition, the capsular fruit has a thick and persistent central column, and the exocarp is fused to the endocarp even at maturity, with seeds unilaterally winged. Moreover, this species bears mirror-image flowers, indicating enantiostyly, a sexual polymorphism already known in some Vochysiaceae. The conservation status suggested for the new species is Endangered (EN). A key to the genera of Vochysiaceae is provided.
Solid State Electrochemical Phosphorus Sensor for Carbon-Saturated Iron Melts
Authors: Kang Xue , Teng Fei , Hou Jian-Feng , Tan Xi-Han
Published: March 2022

Phosphorus in steel is typically recognized as a harmful element for high-quality steel, so monitoring phosphorus content is important for iron- and steel-making processes. The solid electrolyte 4CaO·P2O5 is incorporated into a phosphorus sensor with a Sn–P
alloy reference electrode. The cell configuration is written as: Mo|[P]Sn|4CaO·P2O5|[P]Fe|Mo cermet. The sensor is tested on standard on C/Fe solutions at 1633 K. Even with fluctuating temperatures, the phosphorus probe shows consistent measured
values and the developed calibration curves calculate the wt% of phosphorus based on measured voltage difference in the sensor with good stability and rugged construction.
Prediction and Analysis of Conduction Electromagnetic Interference in Communication Power
Authors: Zhou Yan
Published: March 2022

Conducted electromagnetic interference (EMI) in power electronic equipment is an important factor restricting the development of power electronics technology, and the research is of great hot and difficulty. The prediction of conducted EMI is to effectively guide the design of EMI filters.
On the one hand, the selection of commonmode capacitance and inductance values can be guided by the analysis of propagation path impedance; on the other hand, various passive devices are analyzed by simulation the influence of parasitic parameters on conducted EMI can guide the selection of
filter capacitors and inductors. In this paper, we take the widely used switching power supply as an example, a novel EMI conduction modelling is proposed, the impedance analysis method is used to model the high-frequency parasitic parameters, the model was built for predicting the conducted
EMI accurately of switching power supply.
What Is a Cloud? Toward a More Precise Definition
Authors: Spänkuch Dietrich , Hellmuth Olaf , Görsdorf Ulrich
Published: March 2022

There are a couple of reasons to stimulate a discussion about the definition of clouds. One reason is that the American Meteorological Society (AMS) and the World Meteorological Organization (WMO) define clouds differently, and that in two aspects. AMS defines clouds as visible objects, and WMO as perceivable objects. Furthermore, AMS includes all minute particles independent of their nature and composition whereas WMO considers only such minute particles that consist of water, ice, or a mixture of both. Additionally, the so-called invisible or subvisible clouds are perceivable objects in the definition of WMO but not of AMS. Clouds can be observed by humans and be detected by active and passive sensors from ground and space. The detection limits of instruments span more than two orders of magnitude in visible optical thickness ranging from about 0.001 from satellite lidar (in case of horizontal and vertical averaging or 0.07 for single lidar shots) to about 0.3 to 0.45 for multispectral satellite imaging spectrometers. Human observers see clouds when their optical thickness is larger than about 0.03 at day and 0.05 at night. This paper gives a brief overview of cloud detection from ground and space and of the occurrence, characteristics, and impacts of subvisible clouds. Pros and cons of these definitions are discussed, followed by a proposal for a more precise definition. This definition is, like those of AMS and WMO, a one-parametric definition and does not cover all aspects of clouds.
Comparison of Omental Patch Closure Versus Simple Closure for Laparoscopic Repair of Perforated Peptic Ulcer: A Systematic Review and Meta-Analysis
Authors: Mohamedahmed Ali Yasen y , Albendary Mohamed , Patel Kamlesh , Ayeni Adewale Adeoba , Zaman Shafquat , Zaman Osama , Ibrahim Rashid , Mobarak Dham
Published: March 2022

Aims

To evaluate comparative outcomes of laparoscopic repair of perforated peptic ulcer with omental patch versus without omental patch.

Methods

A systematic search of multiple electronic data sources was conducted, and all studies comparing laparoscopic repair of perforated peptic ulcer (PPU) with and without omental patch were included. Operative time, postoperative complications, re-operation and mortality were the evaluated outcome parameters for the meta-analysis. Revman 5.3 was used for data analysis.

Results

Four observational studies reporting a total number of 438 patients who underwent laparoscopic repair of PPU with (n = 268) or without (n = 170) omental patch were included. Operative time was significantly shorter in no-omental patch group (NOP) when compared to omental patch group ( P = .02). There was no significant difference in the risk of postoperative ileus (Odd ratio (OR) .76, P = .61), leakage (OR 1.17, P = .80), wound infection (OR 1.89, P = .34), intra-abdominal abscess (OR 1.17, P = .87), re-operation (OR .00, P = .94) and mortality (OR .55, P = .48). Moreover, length of hospital stay was comparable between the two groups ( P = .81).

Conclusion

Laparoscopic repair of PPU with or without omental patch have comparable postoperative complications and mortality rate. However, considering the shorter operative time, no-omental patch approach is an attractive and more favourable choice. Well-designed randomized controlled trials are needed to investigate this comparison.
Geriatric Trauma Patients: Outcomes Before and After Addition of a Hospitalist Consultation
Authors: Milburn Rebecca , Quinn Karson R. , Helmer Stephen D. , Reyes Jared , Mallick Maria , Haan James M.
Published: March 2022

Background

Research has shown improvements in patient care and outcomes with addition of a rounding geriatrician. The purpose of this study was to determine if addition of a hospitalist consultation improved patient outcomes.

Methods

A retrospective review was conducted of all trauma patients, ≥65 years, before (n=481) and after (n=430) addition of a hospitalist consultant. Data included were demographics, comorbidities, injury severity, blood pressure, laboratory levels, pain control methods, ICU and ventilator requirements, complications, hospital length of stay, mortality, preexisting wishes, and 30-day readmission.

Results

Adding a hospitalist consultation did not improve blood glucose or blood pressure control. It decreased narcotics-only use (36.0% vs 73.8%) while increasing multimodal pain control use (51.8% vs 14.8%, P<.001) and testing of HbA1c (7% vs .6%, P<.001). There was also increased knowledge of patient resuscitation status preferences (29.1% vs 12.9%, P<.001).

Conclusions

This article does not support use of routine hospitalist consultation in the geriatric trauma population. However, with study limitations, we continue to evaluate hospitalist utility and will adjust our daily rounds to more closely match prior studies.
Keep it SIMPL: Improved Feedback After Implementation of an App-Based Feedback Tool
Authors: Abdou Hossam , Kidd-Romero Sarah , Brown Rebecca F. , Kavic Stephen M. , Kubicki Natalia S.
Published: March 2022

Background

Data defining the utility of the system for improving and measuring procedural learning (SIMPL) in surgical education is limited. The aim of this pilot study is to describe the impact of SIMPL on resident and faculty perspectives regarding operative feedback.

Methods

Residents and faculty were surveyed prior to and 6 months after SIMPL implementation. Associations were analyzed using [Formula: see text] for categorical and Student’s t-test for continuous variables. Statistical significance was defined as P-value < .05.

Results

The proportion of residents receiving intraoperative feedback at least once/day increased significantly (35% to 73%, P = .025); there was a trend toward increased postoperative feedback (15% to 33%, P = .201). Faculty reported an increase in intraoperative (55% to 91%, P = .041) and postoperative feedback (21% to 64%, P = .020). Satisfaction with intraoperative feedback improved from a score of 3.50 ± 1.05 to 3.93 ± .62, although not statistically significant ( P = .181). Satisfaction with postoperative feedback improved significantly from 2.85 ± .93 to 3.50 ± .65 ( P = .032). The proportion of faculty who felt they were providing effective feedback increased (53% to 91%, P = .032). The proportion of residents who perceived that feedback enhanced their surgical skill increased as well (65% to 93%, P = .048).

Discussion

Despite a modest increase in frequency of postoperative feedback, perceived quality of feedback improved substantially after implementation of SIMPL. Introduction of SIMPL also increased the amount of feedback provided by faculty intraoperatively. SIMPL, via direct and indirect effects, has a positive impact on the resident operative learning environment. Further work is necessary to examine the influence this may have on resident operative skill and patient outcomes.
Antivenom Does Not Cause Snakebite Complications, Withholding It Does
Authors: J Gerardo Charles , Godfrey Andrew W , Greene Spencer
Published: March 2022

We read with interest the retrospective chart review “Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admission for Snakebites” by Bowden, et al. The efficacy of US snake antivenoms has been well established for decades. A randomized double-blind placebo-controlled clinical trial (RCT) has demonstrated Fab antivenom efficacy using patient-centered outcomes such as return of functionality and other patient-reported outcomes. These benefits occurred in a predominantly mildly envenomated patient population in a time-dependent manner. The cost-effectiveness of snake antivenom has been demonstrated globally, but no US cost-effectiveness studies have been published. Based on the evidence hierarchy of evidence-based medicine, the discordance between this study and the RCT merits discussion.
Who are hikikomori? Demographic and clinical features of hikikomori (prolonged social withdrawal): A systematic review
Authors: Nonaka Shunsuke , Takeda Tomoya , Sakai Motohiro
Published: March 2022

Objective:

This review, which was registered with PROSPERO (CRD42021237988), aimed to systematically extract common elements in the hikikomori definition or criteria applied by researchers and examine cultural differences and chronological changes in the demographic characteristics of hikikomori individuals such as age, gender and hikikomori duration.

Method:

For inclusion in the review, the hikikomori criteria, age and gender of the hikikomori individuals had to be specified, and the article had to be peer-reviewed and written in Japanese or English, focusing on hikikomori individuals or their families. Case studies, reviews and qualitative studies were excluded.

Results:

The total sample size for the 52 studies included in the review was 4744. Over 80% of the studies included the elements ‘not working or attending school’, ‘not socializing outside one’s home’ and ‘duration of hikikomori’ in their hikikomori criteria, and many studies included the element ‘staying at home on most days except solitary outings’. A cross-temporal meta-analysis showed the possibility that the age of hikikomori individuals increased chronologically (β = 0.44, B = 0.50, 95% confidence interval = [0.16, 0.84]). Comparisons weighted by sample size between Japan and other countries showed the possibility that the age of hikikomori individuals was higher ( d = 0.32), the percentage of males was lower ( d = 0.91) and the hikikomori duration was shorter ( d = 2.06) in studies conducted in countries other than Japan. However, many of the included studies had a high risk of selection bias, and this bias may have influenced the results obtained. Thus, the results of this study may represent the researcher’s perception of hikikomori rather than accurately representing the actual condition of hikikomori.

Conclusion:

Researchers should specifically identify similarities and differences in the clinical picture of hikikomori and compare the studies to organize the findings derived from studies focusing on hikikomori.
Who Leaves and Who Enters? Flow Measures of Neighborhood Change and Consequences for Neighborhood Crime
Authors: Hipp John R. , Chamberlain Alyssa W.
Published: March 2022

Objectives

Longitudinal studies of the relationship between neighborhood change and changes in crime typically focus exclusively on the net level of change in key socio-demographic characteristics.

Methods

We instead propose a demographic accounting strategy that captures the composition of neighborhood change: our measures capture which types of people are more likely to leave, stay, or enter the neighborhood. We use data for 3,325 tracts in the Southern California region over nearly two decades of 2000–2010 and 2010–2017 and construct flow measures based on race/ethnicity; the length of residence of owners and renters; the age structure.

Results

These flow measures improve the predictive power of the models—implying important theoretical insights. Neighborhoods with higher percentages of middle-aged residents who recently entered the neighborhood exhibit larger increases in violent and property crime. The relative stability of those in the highest crime-prone ages (aged 15–29) is associated with the largest increases in violent and property crime. The greater loss of Black and Asian residents decreased crime while moderate outflows of Latinos increased crime. The mobility of long- and short-term renters was related to crime changes.

Conclusions

This new technique will likely encourage further theoretical innovation for the neighborhoods and crime literature.
Does Interpersonal Vulnerability Mediate the Association Between Parental Bereavement and Mental Health?
Authors: Ifrah Kfir , Tsipper Itay
Published: March 2022

The current study examined the role of interpersonal vulnerability, that is, self-perceived threats to one’s interpersonal domain, in the mental health of bereaved parents. Israeli bereaved parents in older adulthood ( N = 105, aged 48–88, M = 64.06, SD = 9.93) were pair-matched with equivalent 105 non-bereaved parents. Participants completed questionnaires assessing interpersonal vulnerability, satisfaction with life, and depressive symptoms. The results showed higher levels of interpersonal vulnerability among bereaved parents compared to their non-bereaved counterparts. Additionally, parental bereavement and interpersonal vulnerability were associated with worse mental health. Finally, interpersonal vulnerability mediated the association of parental bereavement with worse mental health. This study reveals interpersonal vulnerability as an important vulnerability factor among a significant minority in older adulthood.
The Effect of First Language Transfer on Second Language Acquisition and Learning: From Contrastive Analysis to Contemporary Neuroimaging
Authors: Perkins Kyle , Zhang Lawrence Jun
Published: March 2022

The effect of first language transfer on second language acquisition and learning has been a major theoretical concept in second language research and pedagogy since the 1950s. In order to give a historical perspective, the authors offer a brief presentation of some of the major topics from the broad spectrum of issues that have been examined by the applied linguistics research community during the past six decades and some significant developments in neuroimaging and cognitive science that have allowed researchers to investigate the role that first language plays in transfer to second language during neural activity and cognitive processing. The paper concludes with some pedagogical implications for second language instructors.
Biological autologous excised varicose vein dressing compared to conservative dressing on the ulcer bed during endovenous ablation
Authors: Avrahami Ram , Silverberg Daniel , Kolvenbach Ralph , Elias Steven , Sivak Galit
Published: March 2022

Objective

To compare the use of biological autologous excised varicose vein dressing ( VenoDress) compared to conservative dressing on the ulcer bed during endovenous ablation

Methods

This retrospective non-blinded study included all consecutive patients with primary or recurrent venous leg ulcers (VLU) with superficial varices treated in one center between September 2019 and October 2020. They all underwent venous ablation, wound debridement, and when needed phlebectomy. On the study group, the excised veins were incised, formed into a sheet, and applied onto the debrided wound bed with the endothelial side facing the wound bed. Adhesion was assessed weekly for 3 weeks. The study group was compared to a control group that underwent similar procedures but with the debrided wound bed treated with low-adherent paraffin dressing. The primary outcome was complete wound healing at 1 and 3 months, and the secondary outcomes were wound-related pain and leg edema.

Results

Complete wound closure was documented in 17/26 study group patients at 1 month (65%) and in 25/26 (96%) at 3 months. Complete wound closure was documented in 37/82 patients in the control group (45%) and in 67/82 (82%) at 3 months. The 1-month healing rates were significantly in favor of the VenoDress group when adjusted to sex and diabetes: odds ratio = 2.81 (1.05–7.532), p = .04. The preoperative pain level of the study group (as measured by a visual analog scale VAS (0–10) decreased from 4.96 ± 2.71 to 0.73 ± 1.36 at 1 week and that of the control group from 4.8 ± 2 to 1.35 ± 1.38 at 1 week ( p < .001).

Conclusion

the use of autologous varicose veins as dressing effectively reduced pain in VLU patients compared to conventional techniques. Although its effects on wound closure appear highly promising, further validation is warranted in a randomized comparative study.
P3 latency as a biomarker for the complexity of migraine with aura: Event-related potential study
Authors: Petrusic Igor , Jovanovic Vojislav , Kovic Vanja , Savic Andrej M
Published: March 2022

Background

This study aimed to compare the P3 component between patients who have migraines with aura and healthy subjects, and to compare different subtypes of migraine with aura relative to the complexity of migraine aura.

Methods

Average Migraine Aura Complexity Score was calculated for each MwA patient. Visual oddball paradigm was used to elicit the P3 component. P3 amplitudes and latencies elicited from frequent and rare stimuli, as well as from difference wave, were compared with healthy subjects. Subsequently, subtypes of migraine with aura were compared and Average Migraine Aura Complexity Score was used to explore the connection between features of the P3 and complexity of migraine with aura.

Results

37 patients who have migraine with aura (16 with simple aura and 21 with complex aura) patients and 28 healthy subjects were studied. Patients who have migraine with aura had significantly prolonged latencies compared to healthy subjects (411 ± 39 ms vs 372 ± 34 ms, p < 0.001) relative to a rare condition. Patients who have complex aura significantly differs from patients who have simple aura (427 ± 34 ms vs 389 ± 35 ms, p = 0.004) and healthy subjects (372 ± 34 ms, p < 0.001) relative to P3 latency in a rare condition and the patients who have complex aura significantly differs from healthy subjects (442 ± 37 ms vs 394 ± 33 ms, p < 0.001) relative to P3 latency in difference wave. P3 latency from rare condition positively correlated with the Average Migraine Aura Complexity Score (p < 0.001).

Conclusions

Visual oddball paradigm, particularly rare stimuli, could serve as a potential new tool for deep profiling of different clinical complexities among patients who have migraine with aura. Also, the present pattern of P3 components provided new evidence for the cognitive dysfunctions in patients who have migraine with aura.
An Appraisal of Narcissistic Rage Through Path Modeling
Authors: Théberge David , Gamache Dominick
Published: March 2022

Pathological narcissism and borderline traits have been consistently associated with interpersonal aggression. Shame has been identified as an important trigger of aggressive behaviors in individuals with pathological personality traits, especially for narcissistic vulnerability and borderline traits. This is in line with Kohut’s theory on narcissistic rage, that is, aggression, anger, and destruction that act as a protection for a grandiose self. The present study aims to investigate the interrelations between pathological narcissism, borderline traits, shame, and trait aggression, concepts that are parts of the narcissistic rage phenomenon introduced by Kohut, using path models. A total of 399 participants completed self-report questionnaires assessing personality traits (narcissistic grandiosity and vulnerability, and borderline traits), shame, and aggression. Three path models including these variables were tested and compared to one another on fit indices. Results show that shame acts as a mediator between pathological traits (narcissistic vulnerability and borderline traits) and trait aggression, whereas the relationship between narcissistic grandiosity and aggression was direct (i.e., shame was not involved). Results expand the narcissistic rage theory by suggesting that it might represent an internalizing type of aggression that manifests in the context of narcissistic vulnerability and borderline traits, which is not the case for narcissistic grandiosity that exerts a direct effect on trait aggression.