bluuebunny/crossref_metadata_2025 huggingface dataset:
Mothers’ experience of being involved with the transfer of the CO-OP approach: A qualitative study
Authors: Gharebaghy Soraya , Rassafiani Mehdi , Vameghi Roshanak , Akbarfahimi Malahat , Cameron Debra , Polatajko Helene J , Shafaroodi Narges
Published: September 2021

Introduction

Since mothers are the best persons to facilitate transfer in their children, it is important to understand their experience with implementing the cognitive orientation to daily occupational performance approach at home. Therefore, this study aims to explore mothers’ experiences in facilitating transfer during implementing cognitive orientation to daily occupational performance approach at the home in children with specific learning disorder.

Method

A semi-structured interview was applied for mothers of children receiving cognitive orientation to daily occupational performance. The interviews were transcribed verbatim and the data were analyzed using a continuous comparison technique and inductive content analysis.

Results

Five themes emerged which described the mothers’ experiences of being involved with the transfer of cognitive orientation to daily occupational performance approach at home including (1) mothers’ feelings toward themselves; (2) supportive therapist; (3) supportive social settings; (4) multidimensional educational content; and (5) educational methods.

Conclusion

Mothers expressed that cognitive orientation to daily occupational performance approach was simple, but they needed deeper information and skills. They provided suggestions for increasing the involvement during cognitive orientation to daily occupational performance intervention to increase transfer.
Post-Crack Flexural and Joint Performance Behaviors of Fiber-Reinforced Concrete for Pavements
Authors: Barman Manik , Hansen Bryce
Published: September 2021

This study investigated the influence of fiber properties on the post-crack flexural and joint performance behaviors of fiber-reinforced concrete (FRC) for thin concrete overlays. The study included a literature review, an online survey, and laboratory testing. It was found that the majority (almost 93%) of the FRC overlays in the United States of America were constructed with synthetic macro fibers. In the laboratory study, a total of 46 different FRC mixes were prepared with 11 different types of fibers. Fiber dosage, stiffness, and geometry significantly influenced the residual strength ratio (RSR) and residual strength (RS). In general, stiffer fibers with geometry like embossed, twisted, and crimped shapes showed higher post-crack flexural strength on average than the low-stiffness straight synthetic fibers. From the joint performance testing, it was found that fibers can improve the load transfer efficiency (LTE). A nomogram was developed so that agencies can select fiber dosage and type based on the target values of RSR, RS, and/or LTE.
#MeToo Online Disclosures: A Survivor-Informed Approach to Open Science Practices and Ethical Use of Social Media Data
Authors: O’Callaghan Erin , Douglas Hannah M.
Published: September 2021

With social media data widely available, researchers are increasingly incorporating tweets, posts, and blogs in their work. While easily accessible, the use of “public” posts raises important questions about the ethics of mining, storing, analyzing, and reporting publicly available social media data—especially when gathering sensitive information such as sexual violence disclosures. Online movements including #MeToo and #WhyIDidntReport emerged to shed light on gender-based violence. These movements generate large quantities of data with little consistency and oversight across research groups, disciplines, and review boards on data ethics. With the recent push in social science to publish data to open science databases, the concerns of feminist psychologists and ethical concerns of social media research with survivors have become more salient. In this article, we describe and address these ethical issues by reviewing existing social media sexual assault disclosure research and make concrete recommendations for authors seeking to use social media data. We also seek to address these ethical concerns by noting the work of some feminist researchers, but also by pushing researchers to do more for survivors through a survivor-informed approach to this research in an open science context. We propose four survivor-informed recommendations for research with this vulnerable population: (a) get input from survivors, (b) update ethics review boards, (c) maximize benefits to participants, and (d) utilize study-appropriate datasets with informed consent.
Environmental assessment of amending the Amager Bakke incineration plant in Copenhagen with carbon capture and storage
Authors: Bisinella V. , Nedenskov J. , Riber Christian , Hulgaard Tore , Christensen Thomas H.
Published: September 2021

Amending municipal solid waste incineration with carbon capture and storage (CCS) is a new approach that can reduce the climate change impacts of waste incineration. This study provides a detailed analysis of the consequences of amending the new Amager Bakke incinerator in Copenhagen (capacity: 600,000 tonnes waste per year) with CCS as a post-combustion technology. Emphasis is on the changes in the energy flows and outputs as well as the environmental performance of the plant; the latter is assessed by life cycle assessment. Amending Amager Bakke with CCS of the chosen configuration reduces the electricity output by 50% due to steam use by the capture unit, but introducing post-capture flue gas condensation increases the heat output utilized in the Copenhagen district heating system by 20%. Thus, the overall net energy efficiency is not affected. The CCS amendment reduces the fossil CO2 emissions to 40 kg CO2 per tonne of incinerated waste and stores 530 kg biogenic CO2 per tonne of incinerated waste. Potential developments in the composition of the residual waste incinerated or in the energy systems that Amager Bakke interacts with, do not question the benefits of the CCS amendment. In terms of climate change impacts, considering different waste composition and energy system scenarios, introducing CCS reduces in average the impact of Amager Bakke by 850 kg CO2-equivalents per tonne of incinerated waste. CCS increases the environmental impacts in other categories, but not in the same order of magnitude as the savings introduced within climate change.
Expression of caveolin family proteins in serum of patients with systemic lupus erythematosus
Authors: Li Ming , Zhang Yi-Jing , Liu Dong-Xia , Liu Zhi , Fu Min , Yang Qing-Rui , Sun Hong-Sheng
Published: September 2021

Objectives

Caveolin family proteins, including caveolin-1 (Cav-1), caveolin-2 (Cav-2), and caveolin-3 (Cav-3), are identified as the principal protein components of caveolae in mammalian cells. Circulating form of caveolin family proteins can be used as a good potential biomarker for predicting disease.

Methods

To investigate the clinical significance of the serological levels of caveolin family proteins in patients with systemic lupus erythematosus (SLE), we evaluated the soluble serum levels of caveolin family proteins in patients with SLE by enzyme-linked immunosorbent assay (ELISA) and assessed their associations with various known clinical variables.

Results

The major findings of our study are as follows: Cav-2 was not detected in serum of SLE patients and normal controls (NCs). Serum Cav-1 and Cav-3 levels were higher in SLE patients compared with NCs. There were no significant correlations between serum Cav-1 and Cav-3 levels and SLE disease activity. Further analysis showed that serum Cav-3 may be more valuable as a marker than serum Cav-1 in SLE patients.

Conclusion

Serum levels of Cav-1 and Cav-3 might have a diagnostic role in patients with SLE. However, their predictive and prognostic value was not determined. Further studies are necessary to determine the potential clinical significance of these assays in SLE.
Platelet-Derived Biomaterials Inhibit Nicotine-Induced Intervertebral Disc Degeneration Through Regulating IGF-1/AKT/IRS-1 Signaling Axis
Authors: Lo Wen-Cheng , Chiou Chi-Sheng , Tsai Feng-Chou , Chan Chun-Hao , Mao Samantha , Deng Yue-Hua , Wu Chia-Yu , Peng Bou-Yue , Deng Win-Ping
Published: September 2021

Apart from aging process, adult intervertebral disc (IVD) undergoes various degenerative processes. However, the nicotine has not been well identified as a contributing etiology. According to a few studies, nicotine ingestion through smoking, air or clothing may significantly accumulate in active as well as passive smokers. Since nicotine has been demonstrated to adversely impact various physiological processes, such as sympathetic nervous system, leading to impaired vasculature and cellular apoptosis, we aimed to investigate whether nicotine could induce IVD degeneration. In particular, we evaluated dose-dependent impact of nicotine in vitro to simulate its chronic accumulation, which was later treated by platelet-derived biomaterials (PDB). Further, during in vivo studies, mice were subcutaneously administered with nicotine to examine IVD-associated pathologic changes. The results revealed that nicotine could significantly reduce chondrocytes and chondrogenic indicators (Sox, Col II and aggrecan). Mice with nicotine treatment also exhibited malformed IVD structure with decreased Col II as well as proteoglycans, which was significantly increased after PDB administration for 4 weeks. Mechanistically, PDB significantly restored the levels of IGF-1 signaling proteins, particularly pIGF-1 R, pAKT, and IRS-1, modulating ECM synthesis by chondrocytes. Conclusively, the PDB impart reparative and tissue regenerative processes by inhibiting nicotine-initiated IVD degeneration, through regulating IGF-1/AKT/IRS-1 signaling axis.
Electoral Systems and the Substantive Representation of Marginalized Groups: Evidence from Women’s Issue Bills in South Korea
Authors: Kweon Yesola , Ryan Josh M.
Published: September 2021

How do electoral rules shape the substantive representation of traditionally underrepresented groups? Using an original dataset of introduced and passed bills in the Korean National Assembly, which has both single-member districts and proportional representation, we examine the extent to which institutions condition the relationship between lawmaker gender and the substantive representation of women. While women lawmakers engage in higher levels of substantive representation of women, proportional representation allows both women and men to introduce more women’s issue bills than their counterparts elected through single-member districts. Furthermore, legislators elected through proportional representation are more effective at achieving passage of women’s issue legislation when compared with those elected in single-member districts, and this effect is especially pronounced for men. Our findings show that electoral systems matter for the representation of marginalized groups and that proportional representation systems allow both female and male politicians to increase their substantive representation of women.
A sub-domain adaptive transfer learning base on residual network for bearing fault diagnosis
Authors: Wang Chongyu , Zhu Guangya , Liu Tianyuan , Xie Yonghui , Zhang Di
Published: September 2021

Bearing fault diagnosis is an important research field for rotating machinery health monitoring. Recently, many intelligent fault diagnosis methods driven by big data, such as transfer learning, have been studied. However, there are two shortcomings for the prior transfer learning method in industry application. First, it is necessary to design a complex loss function to enhance the similarity between the two domains further. Second, previous studies required big data both in source and target task, without considering the lack of sufficient training samples. Inspired by relevant research work, this article proposes a local joint distribution discrepancy to increase similar features. A sub-domain adaptive transfer learning is designed to detect bearing faults based on the residual network. Two kinds of transfer experiments are designed to verify the method effectiveness. After that, the impact of small training samples and noise on the results is explored. The proposed method reaches high accuracy.
“It ain’t a compliment”: Feminist data visualisation and digital street harassment advocacy
Authors: Fileborn Bianca , Trott Verity
Published: September 2021

In an era of datafication, data visualisation is playing an increasing role in civic meaning-making processes. However, the conventions of data visualisation have been criticised for their reductiveness and rhetoric of neutrality and there have been recent efforts to develop feminist principles for designing data visualisations that are compatible with feminist epistemologies. In this article, we aim to examine how data visualisation is used in feminist activism and by feminist activists. Drawing on the example of digital street harassment activism, we analyse how street harassment is visualised in and through a selection of prominent activist social media accounts. We consider the platform affordances utilised by activists, and how these are harnessed in making street harassment ‘knowable'. Moreover, we critically interrogate which and whose experiences are ‘knowable’ via digital techniques, and what remains obscured and silenced. In analysing digital feminist activists’ practices, we argue that what constitutes ‘data visualisation’ itself must be situated within feminist epistemologies and praxis that centre lived experience as the starting point for knowledge production. Such an approach challenges and disrupts normative constructions of what constitutes data visualisation. Our findings demonstrate how feminist activists are adopting ‘traditional’ practices of speaking out and consciousness-raising to the digital sphere in the creation of a range of visualisations that represent the issue of street harassment. We consider the efficacy of these visualisations for achieving their intended purpose and how they might translate to policy and government responses, if this is indeed their goal. Further, we document a tension between feminist epistemologies and the prevailing logic of datafication or dataism and note how in an attempt to unite the two, some digital feminist activism has contributed to reproducing existing power structures, raising concerning implications at the policy level.
Propensity-matched analysis does not support angiosome-guided revascularization of multilevel peripheral artery disease (PAD)
Authors: Kurianov Pavel , Lipin Alexandr , Antropov Alexey , Atmadzas Kirill , Gruzdev Nikita , Tankaeva Zaynab , Atmadzas Alisa , Orlov Anton , Borisov Alexey , Sobolev Roman , Eminov Yanis
Published: September 2021

Background:

This retrospective comparative cohort study evaluated the clinical outcome of angiosome-guided endovascular arterial reconstructions in chronic limb-threatening ischemia (CLTI) due to multilevel peripheral artery disease (PAD).

Methods:

Patients treated in an endovascular fashion for CLTI with tissue loss due to multilevel PAD were analyzed. Limbs were classified as having undergone either angiosome-guided (direct) revascularization (DR) or nonangiosomic (indirect) revascularization (IR). DR was defined as uninterrupted in-line flow to the affected angiosome, revascularization through the pedal arch was also considered direct. Groups were adjusted with propensity score (PS) matching and compared for amputation-free survival (AFS), freedom from major adverse limb events (MALE), and healing rate at 12 months.

Results:

A total of 174 patients (81 men, mean age 70.0 ± 10.4 y) were included. PS matching produced two groups of 55 patients each: DR (24 men, mean age 71.7 ± 10.7 y) and IR (26 men, mean age 72.0 ± 9.4 y). The matched groups had no significant differences in baseline variables. At 12 months there were no significant differences in AFS (73.2% vs 71.6%; p = 0.841), freedom from MALE (71.7% vs 66.1%; p = 0.617), and healing rate (72.7% vs 72.0%; p = 1.000) between DR and IR, respectively.

Conclusion:

This study failed to support the use of angiosome concept in CLTI due to multilevel disease.
Platforms, sex work and their interconnectedness
Authors: Swords Jon , Laing Mary , Cook Ian R
Published: September 2021

This article examines the interconnectedness of sex work with the platform economy. It does this by mobilizing two concepts from the platform economy literature: the platform stack (which captures the structure of platforms) and interpenetration (which describes the processes through which platforms intersect). Exploring these concepts, the article draws on a dataset of linked platforms used by 54 cam workers and documented observations of 55 different platforms. These platforms include those designed for sex workers as well as those with a more generalist function. In mapping this platform ecology, the article highlights some of the opportunities, barriers and risks that platform interpenetration presents for sex workers.
Patient reported side-effects of prednisone and methotrexate in a real-world sarcoidosis population
Authors: Kahlmann Vivienne , Moor Catharina C , Veltkamp Marcel , Wijsenbeek Marlies S
Published: September 2021

Currently prednisone is the first-line pharmacological treatment option for pulmonary sarcoidosis. Methotrexate is used as second-line therapy and seems to have fewer side-effects. No prospective comparative studies of first-line treatment with methotrexate exist. In this study, we evaluated patient reported presence and bothersomeness of side-effects of prednisone and methotrexate in a sarcoidosis population to guide the design of a larger prospective study. During a yearly patient information meeting 67 patients completed a questionnaire on medication use; 11 patients never used prednisone or methotrexate and were excluded from further analysis. Of the remaining 56 patients, 89% used prednisone and 70% methotrexate (present or former). Significantly more side-effects were reported for prednisone than for methotrexate, 78% versus 49% ( p = 0.006). In conclusion, methotrexate seems to have fewer and less bothersome side-effects than prednisone. These findings need to be confirmed in a prospective study.
Social Support Received and Provided in the Adjustment of Parents of Children With Cancer
Authors: Melguizo-Garín Anabel , Hombrados-Mendieta Isabel , José Martos-Méndez Mª , Ruiz-Rodríguez Iván
Published: September 2021

Objective:

The aim of the present study is to determine the relation between the satisfaction of parents of children with cancer with the social support received and provided from a multidimensional perspective (sources and types of support) and the disruptions that take place in different areas of their lives (partner, children, family, social relations, and economic and employment situation)

Method:

One hundred twelve parents of children diagnosed with cancer who received treatment at the Mother and Child Hospital of Málaga (Spain) were recruited. Data were gathered through self-reporting measures. The instrument used includes a questionnaire about socio-demographic variables, a questionnaire about parents’ adjustment to the situation and a questionnaire about social support received and provided based on the different sources and types of support.

Results:

There is a negative and significant relation between satisfaction with support received and provided and the magnitude of disruptions in parents’ lives.

Conclusion:

Satisfaction with emotional support received from the partner and family, and support provided to these sources, relate to lower disruption in different areas of parents’ lives. These results can have significant practical implications for the psychosocial care provided to parents of children with cancer.
Osteopontin as a biomarker for COVID-19 severity and multisystem inflammatory syndrome in children: A pilot study
Authors: Reisner Andrew , Blackwell Laura S , Sayeed Iqbal , Myers Hannah E , Wali Bushra , Heilman Stacy , Figueroa Janet , Lu Austin , Hussaini Laila , Anderson Evan J , Shane Andi L , Rostad Christina A
Published: September 2021

This study sought to evaluate the candidacy of plasma osteopontin (OPN) as a biomarker of COVID-19 severity and multisystem inflammatory condition in children (MIS-C) in children. A retrospective analysis of 26 children (0–21 years of age) admitted to Children’s Healthcare of Atlanta with a diagnosis of COVID-19 between March 17 and May 26, 2020 was undertaken. The patients were classified into three categories based on COVID-19 severity levels: asymptomatic or minimally symptomatic (control population, admitted for other non-COVID-19 conditions), mild/moderate, and severe COVID-19. A fourth category of children met the Centers for Disease Control and Prevention's case definition for MIS-C. Residual blood samples were analyzed for OPN, a marker of inflammation using commercial ELISA kits (R&D), and results were correlated with clinical data. This study demonstrates that OPN levels are significantly elevated in children hospitalized with moderate and severe COVID-19 and MIS-C compared to OPN levels in mild/asymptomatic children. Further, OPN differentiated among clinical levels of severity in COVID-19, while other inflammatory markers including maximum erythrocyte sedimentation rate, C-reactive protein and ferritin, minimum lymphocyte and platelet counts, soluble interleukin-2R, and interleukin-6 did not. We conclude OPN is a potential biomarker of COVID-19 severity and MIS-C in children that may have future clinical utility. The specificity and positive predictive value of this marker for COVID-19 and MIS-C are areas for future larger prospective research studies.
Formyl peptide receptor 1 promotes podocyte injury through regulation of mitogen-activated protein kinase pathways
Authors: Zhang Jun , Ding Ting , Tang Dongxing , Wang Jianping , Huang Peng
Published: September 2021

Podocyte injury contributes to glomerular injury and is implicated in the pathogenesis of diabetic nephropathy. Formyl peptide receptor (FPR) 1 is abundantly expressed in neutrophils and mediates intracellular transport of Ca 2+. Intracellular Ca 2+ regulates pathological process in renal podocyte and plays a role in diabetic nephropathy. However, the role of formyl peptide receptor 1 in podocyte injury of diabetic nephropathy has not been reported yet. Firstly, a rat model with diabetic nephropathy was established by streptozotocin injection, and a cell model was established via high glucose treatment of mouse podocytes (MPC5). Formyl peptide receptor 1 was enhanced in streptozotocin-induced rats and high glucose-treated MPC5. Secondly, streptozotocin injection promoted the glomerular injury with decreased nephrin and podocin. However, tail injection with adenovirus containing shRNA for silencing of formyl peptide receptor 1 attenuated streptozotocin-induced glomerular injury and the decrease in nephrin and podocin. Moreover, silencing of formyl peptide receptor 1 repressed cell apoptosis of podocytes in diabetic rats and high glucose-treated MPC5. Lastly, protein expression levels of p-p38, p-ERK, and p-JNK protein were up-regulated in streptozotocin-induced rats and high glucose-treated MPC5. Silencing of formyl peptide receptor 1 attenuated high glucose-induced increase in p-p38, p-ERK, and p-JNK in MPC5, and over-expression of formyl peptide receptor 1 aggravated high glucose-induced increase in p-p38, p-ERK, and p-JNK. In conclusion, inhibition of formyl peptide receptor 1 preserved glomerular function and protected against podocyte dysfunction in diabetic nephropathy.
Distinguishing between Fatigue and Fatigability in Multiple Sclerosis
Authors: Enoka Roger M. , Almuklass Awad M. , Alenazy Mohammed , Alvarez Enrique , Duchateau Jacques
Published: September 2021

Fatigue is one of the most common debilitating symptoms reported by persons with multiple sclerosis (MS). It reflects feelings of tiredness, lack of energy, low motivation, and difficulty in concentrating. It can be measured at a specific instant in time as a perception that arises from interoceptive networks involved in the regulation of homeostasis. Such ratings indicate the state level of fatigue and likely reflect an inability to correct deviations from a balanced homeostatic state. In contrast, the trait level of fatigue is quantified in terms of work capacity (fatigability), which can be either estimated (perceived fatigability) or measured (objective fatigability). Clinically, fatigue is most often quantified with questionnaires that require respondents to estimate their past capacity to perform several cognitive, physical, and psychosocial tasks. These retrospective estimates provide a measure of perceived fatigability. In contrast, the change in an outcome variable during the actual performance of a task provides an objective measure of fatigability. Perceived and objective fatigability do not assess the same underlying construct. Persons with MS who report elevated trait levels of fatigue exhibit deficits in interoceptive networks (insula and dorsal anterior cingulate cortex), including increased functional connectivity during challenging tasks. The state and trait levels of fatigue reported by an individual can be modulated by reward and pain pathways. Understanding the distinction between fatigue and fatigability is critical for the development of effective strategies to reduce the burden of the symptom for individuals with MS.
Investigation of Health Behavior on Burnout Scores in Women Physicians who Self-Identify as Runners: A Cross-Sectional Survey Study
Authors: Uhlig-Reche Hannah , Larson Allison R. , Silver Julie K. , Tenforde Adam , McQueen Alisa , Verduzco-Gutierrez Monica
Published: September 2021

As the proportion of women in the physician workforce increases, burnout in this population warrants further investigation. Exercise is an often-proposed strategy to combat burnout. Evaluating physical activity across a cohort of women physicians can assess associations of health behaviors with burnout. Cross-sectional study of women attending physicians in the United States who are actively engaged in a social media group for runners. An electronic survey comprised of 60 questions covering demographics, health behaviors, and burnout was administered. A healthy lifestyle subgroup (HLS) was defined based on American Heart Association physical activity and nutrition recommendations. We determine the prevalence of burnout and investigate associations between health behavior factors and burnout.

Of the 369 included surveys, most respondents were at least six years out from medical training (85.9%) and White (74.5%). Forty-two percent experienced burnout symptoms. Time exercising was significantly associated with fruit/vegetable consumption ( P=.00002). There was no significant difference in burnout between the HLS compared to others ( P = .37).

This group of self-reported physically active women physicians was found to have a lower prevalence of burnout when compared to other women physicians. Exercise and nutrition may be protective against burnout in women physicians but deserve further investigation.
Qualitative Study Protocol: Augmented Reality Technology to Deliver Asthma Inhaler Technique Training for Children and Adolescents With Asthma
Authors: O'Connor Antonia , Tai Andrew , Kopsaftis Zoe , Carson-Chahhoud Kristin
Published: September 2021

Asthma is a chronic inflammatory condition of the airways with a heterogenous symptom profile. When symptoms are poorly controlled and frequent, asthma sufferers are impacted regularly, with limitations on physical activities and sleep disturbances, significantly impairing quality of life. Asthma is highly prevalent and the leading cause of disease burden in young people. Those aged 0–14 contribute to over half of the asthma hospitalisations within Australia. Asthma education and self-management remains a key component of care; however, challenges remain in the paediatric population with difficulties of engagement. Augmented reality (AR) may provide a novel and effective solution with its ability to superimpose virtual objects into a real-world setting. Using a smartphone or tablet to deliver AR makes this modality accessible to much of the population. AR is a growing field in technology and has already established uses in education and training. The ability to increase motivation, enhance enjoyment and encourage faster concept understanding in the educational setting is encouraging and supports our proposal that AR technology can provide a generation appropriate education delivery modality for young people with asthma. To ensure successful implementation of an AR asthma educational resource on a large scale, the usability, acceptability, barriers and enablers of its use must be investigated. Using an iterative co-design process, an asthma resource utilising AR to deliver education on inhaler technique will be created. Qualitative research will be undertaken using semi-structured interviews with moderator guides to obtain mixed-method data on the AR resource. Participants will be key members of the asthma community including children and adolescents with asthma (8–17 years old), caregivers of children and adolescents with asthma, and health professionals. Understanding the usability, acceptability, barriers and enablers of the AR resource will enable us to improve our alpha version and test an optimal version in a planned feasibility study.
Direct oral anticoagulants decrease treatment failure for acute lower extremity deep venous thrombosis
Authors: Hekman Katherine E , Chao Calvin L , Morgan Courtney E , Helenowski Irene B , Eskandari Mark K
Published: September 2021

Objective

Optimal medical therapy for acute lower extremity deep venous thrombosis (DVT) remains an enigma. While clinical trials demonstrate non-inferiority with an oral anti-Xa inhibitor, or direct oral anticoagulant (DOAC), versus combined low–molecular weight heparin (LMWH) and oral vitamin K antagonist (VKA), the most effective regimen remains to be determined.

Methods

This study is a single-center retrospective cohort study from October 2014 to December 2015 of patients with a diagnosis of acute DVT and subsequent serial lower extremity venous duplex. Demographics, medical history, medications, serial ultrasound findings, as well as the primary anticoagulant used for treatment were collected and analyzed by two independent data extractors. Treatment failure was defined as any new DVT or progression of an existing DVT within 3 months of diagnosis of the index clot. Risk factors for treatment failure were assessed using standard odds ratios and Fischer’s exact test.

Results

Among 496 patients with an acute lower extremity DVT, 54% ( n = 266) were men, mean age was 61 years, 35% ( n = 174) involved the popliteal or more proximal segments, and 442 had documentation of the primary treatment for DVT: 20% ( n = 90) received nothing; 20% ( n = 92) received an oral VKA; 34% ( n = 149) received a DOAC; 20% ( n = 90) received LMWH; and 5% ( n = 21) received another class of anticoagulant. Within 3 months, 21% ( n=89 out of 427) had treatment failure defined as any new DVT or progression of prior DVT. Patients treated with a DOAC were less likely to experience treatment failure when compared with any other treatment (odds ratio 0.43; 95% confidence intervals [0.23, 0.79]; p = 0.0069) and when compared with traditional oral VKA (OR 0.44; 95% CI [0.21, 0.92]; p = 0.029). None of prior history of DVT, pulmonary embolism, thrombophilia, renal insufficiency, hepatic insufficiency, cancer, or antiplatelet therapy correlated with treatment failure. Treatment outcome did not correlate with being on any anticoagulation versus none ( p = 0.74), nor did it correlate with the duration of treatment (<3 months versus ≥3 months) ( p = 0.42). Proximal and distal DVTs showed no difference in treatment failure (19% versus 22%, respectively; p = 0.43).

Conclusion

In summary, the use of a DOAC for acute lower extremity DVT yielded better overall outcomes and fewer treatment failures at 3 months as compared to traditional oral VKA therapy based on serial duplex imaging.
A case report: An increased oxygen extraction fraction in remote ischemic lesions after revascularization for moyamoya disease with a progression of posterior cerebral artery stenosis
Authors: Kawanami Kanako , Kokubo Yasuaki , Sato Shinji , Itagaki Hiroshi , Sonoda Yukihiko
Published: September 2021

The cerebral metabolism, such as the oxygen extraction fraction (OEF), in remote ischemic lesions following revascularization for moyamoya disease (MMD) has not yet been fully elucidated. We herein report a patient with an increased OEF in a remote ischemic lesion after revascularization in a case of adult-onset MMD. A 21-year-old woman suffered from a left parietal lobe infarction due to MMD. At 2 months after onset, left superficial temporal artery (STA)–middle cerebral artery (MCA) bypass and encephalo-myo-synangiosis (EMS) were performed. The postoperative course was uneventful. 15O-positron emission tomography (PET) performed at 2 months after the first operation revealed an increased OEF in the contralateral (right) frontal lobe that was suspected of being possible remote ischemia. The patient underwent right STA-MCA bypass and EMS. 15O-PET at 14 days after the second operation revealed an increased OEF in the contralateral (left) occipital lobe that was suspected of potentially being remote ischemia caused by a watershed shift. Two years after the second surgery, left occipital artery (OA)–posterior cerebral artery (PCA) anastomosis and EMS were performed due to transient right hemianopsia. Neither rebleeding nor ischemic complications occurred 2 years after the third surgery. We need to be alert for the possible progression of PCA stenosis in MMD after revascularization. It might induce remote ischemia after revascularization. OA–PCA bypass is therefore considered to be an effective treatment option in such cases.
Gastrointestinal symptoms in COVID-19 could be associated with severe lung involvement and increased readmission rates
Authors: Bozkurt Hüseyin S , Bilen Ömer
Published: September 2021

Introduction

SARS-CoV-2 virus manifests itself with primary lung damage but also has intestinal involvement. In this study, we aimed to investigate the frequency of gastrointestinal symptoms (GIS) and the relationship of GIS with readmission to the hospital within 30 days in SARS-CoV-2 infected patients who were hospitalized in a specified pandemic hospital.

Materials and Methods

Symptomatic patients diagnosed with rapid antibody positivity with real-time polymerase chain reaction and typical thorax computed tomography findings were included in this retrospective cohort observational study. Demographic and clinical data were obtained from electronic medical records. Hospital-associated GIS were considered as experiencing at least one of the GIS such as gas, bloating, diarrhea, and constipation developing within72 h after hospital admission.

Results

The mean age of the patients was 58 ± 14.4 years and 60.7% were men. 82% of hospitalizations were a moderate and severe disease. 71.4% of patients without GIS had at least one of the GIS after hospitalization. As the severity of the disease increased, the frequency of the severity of gastrointestinal symptom increased. GIS bowel disorders were more prominent in patients with moderate and severe disease. Antibiotic and specific treatment (anti-Il-1, anti-Il-6) contributed to the occurrence of gastrointestinal symptom in SARS-CoV-2 inpatients.

Conclusion

According to our observations of the second wave of the pandemic, the presence, frequency, and severity of gastrointestinal symptom in inpatient is associated with severity of lung disease and increased readmission rate after discharge.
A Long-Term Follow-Up of Post-Operative Periprosthetic Humeral Fracture in Shoulder Arthroplasty
Authors: Novi Michele , Porcellini Giuseppe , Donà Alessandro , Tarallo Luigi , Micheloni Gianmario , Giorgini Andrea , Paladini Paolo , Catani Fabio
Published: September 2021

Background

During the last decades, the growing number of shoulder replacement has increased the associated complications. Periprosthetic fractures have a low incidence but can be a severe clinical condition, especially in elderly population. There are still no guidelines to define the best treatment protocol for post-operative periprosthetic humeral fractures. Factors associated to these fractures and consequently the decision-making for the best treatment seem to be patient-related but also correlated with the type of implant. The aim of this study is to analyze the patient’s risk factors, fracture pattern, implant type and treatment, evaluating the outcome with a long-term follow-up.

Methods

A retrospective study was performed on more than 2700 shoulder prostheses implanted over 10 years in two specialized centers, identifying 19 patients who underwent surgery for post-operative periprosthetic fracture. Gender, age, comorbidities, type of prosthetic implant, type of fracture, and cortical index of each patient were evaluated. All patients underwent surgery and were evaluated with a mean follow-up of 5 years with radiographic controls and functional assessment with the Constant–Murley score.

Results

Complete healing was achieved in 18 of 19 patients. All patients presented a lower Constant–Murley score than the pre-fracture score, there were no significant differences between prosthetic implants, and the cortical index was lower than the threshold level in more than 60% of cases.

Conclusion

The results of this study showed that a correct preoperative planning is essential to evaluate the type of implant and possible signs of stem mobilization. With a stable stem, it is preferable to maintain it and proceed to a synthesis. The decision process is more complex in periprosthetic fractures with a reduced cortical index, when some radiolucency lines are present in stems with high primary stability, because it is not always indicative of an unstable stem.

Level of Evidence

Therapeutic III
Effect of Comorbidity Burden on the Risk of Venous Thromboembolic Events after Total Knee Arthroplasty
Authors: Bala Abiram , Oladeji Kingsley , Amanatullah Derek F.
Published: September 2021

Background

Venous thromboembolic events (VTEs) are common after total knee arthroplasty (TKA). The rate of VTEs has improved with early mobilization, mechanical prophylaxis, and appropriate chemoprophylaxis. The aim of this study was to analyze the contribution of medical comorbidities to the risk of VTE after TKA

Method

Medicare claims from 2005 to 2014 were queried. International Classification of Diseases, Ninth revision (ICD-9), and Current Procedural Terminology codes were used to identify the diagnoses, procedures, and complications. 157,200 primary TKAs were age, sex, and Elixhauser Comorbidity Index (ECI) matched with 157,200 osteoarthritis controls. First instances of deep venous thrombosis (DVT) and pulmonary embolism were tracked at 90 days and 2 years. Odds ratios (ORs), confidence intervals, and P-values (p) were calculated and used to investigate the contribution of comorbidities.

Results

90 days after TKA or OA diagnosis, comorbidities were associated with 45% of the DVT risk, 38% of the PE risk. 1 in 92 patients would be expected to be diagnosed with VTE after TKA and 1 in 136 patients after only the diagnosis of osteoarthritis. After 90 days, medical comorbidities were associated with 70% of the DVT risk, 68% of the PE risk.

Conclusion

Nearly 50% of DVTs and 40% of PEs within 90 days of TKA may be related to the baseline health of OA patients. Venous thromboembolic events after TKA are a “never” event according to Center of Medicare and services that appropriate VTE prophylaxis likely cannot be neutralized.
A Pilot Study of Radiculopathy Following Osteoporotic Vertebral Fracture in Elderly Patients: An Algorithmic Approach to Surgical Management
Authors: Lin Guang-Xun , Sun Li-Wei , Jhang Shang-Wun , Ou Su-Wei , Chang Kai-Sheng , Tsai Ru-Yin , Hu Bao-Shan , Rui Gang , Chen Chien-Min
Published: September 2021

Background: Osteoporotic vertebral compression fractures (OVCF) due to severe and refractory back pain or neurological complications require surgical treatment. In this study, patients with radiculopathy due to foraminal stenosis following OVCF were surgically managed by performing transforaminal full-endoscopic lumbar foraminoplasty and/or discectomy (FELFD). Methods: From May 2015 to November 2019, fifteen patients underwent transforaminal FELFD. Patient data, Charlson comorbidity index (CCI), and American Society of Anesthesiologists (ASA) score were collected. Clinical outcomes, including pre- and postoperative Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI), and MacNab criteria of response to surgical treatment, were evaluated. Results: Mean of age, bone mineral density (T-score), CCI, ASA, and follow-up duration were 69.5 ± 6.6 years, −2.6 ± 0.8, 5.2 ± 2.3, 2.4 ± 0.5, and 24.5 ± 8.8 months, respectively. Mean VAS for leg pain significantly decreased from 6.9 ± 0.8 preoperatively to 2.9 ± 1.1 ( P < .05). Mean ODI decreased from 39.9 ± 3.2 preoperatively to 19.3 ± 4.6 postoperatively ( P < .05). The satisfaction rate is 86.7% (based on Macnab criteria), showed six patients had excellent outcomes and seven had good outcomes. Conclusions: Transforaminal FELFD is an effective treatment option for patients with radiculopathy due to lumbar OVCF, including those with severe osteoporosis and elderly patients.
Secondary School Teachers’ Views of Gender Differences in School Achievement and Study Choices in Spain
Authors: Sáinz Milagros , Solé Jordi , Fàbregues Sergi , García-Cuesta Sara
Published: September 2021

This study examines Spanish secondary school teachers’ views of gender differences in academic achievement and study choices. Thirty-six secondary school teachers participated in semi-structured interviews. Most teachers acknowledged that girls had better school performance, particularly in reading comprehension. Some were also acquainted with a higher predisposition to underachieve in boys. However, the teachers used different biology-centered arguments to explain these gender disparities. For many of the participants, that girls matured earlier than their male counterparts facilitates their adaptation to school demands. Likewise, a few teachers argued that the feminization of school favors girls’ adjustment to school demands, whereas a number of them discussed that male adolescents do not consider school to be part of their gender identity. The usual attribution of intellectual abilities and effort to boys and girls was also discussed. In addition, socio-cultural and biological factors were accounted for gender differences in study choices.
An autologous culture model of nodal B-cell lymphoma identifies ex vivo determinants of response to bispecific antibodies
Authors: Roider Tobias , Brinkmann Berit J. , Kim Vladislav , Knoll Mareike , Kolb Carolin , Roessner Philipp M. , Bordas Marie , Dreger Peter , Müller-Tidow Carsten , Huber Wolfgang , Seiffert Martina , Dietrich Sascha
Published: September 2021

Bispecific antibodies (BsAbs) can induce long-term responses in patients with refractory and relapsed B-cell lymphoma. Nevertheless, response rates across patients are heterogeneous, and the factors determining quality and duration of responses are poorly understood. To identify key determinants of response to BsAbs, we established a primary, autologous culture model allowing us to mimic treatment with CD3xCD19 and CD3xCD20 BsAbs within the lymph node microenvironment ex vivo. T cell–mediated killing of lymphoma cells and proliferation of T cells varied significantly among patients but highly correlated between BsAbs targeting CD20 or CD19. Ex vivo response to BsAbs was significantly associated with expansion of T cells and secretion of effector molecules (eg, granzyme B, perforin) but not with expression of T-cell exhaustion (eg, PD1, TIM3) or activation markers (eg, CD25, CD69) or formation of intercellular contacts. In addition, we identified a distinct phenotype of regulatory T cells that was linked to ex vivo response independently from T-cell frequency at baseline. High expression levels of Aiolos (IKZF1), ICOS, and CXCR5 were positively associated with ex vivo response, whereas strong expression of Helios (IKZF2) had an unfavorable impact on ex vivo response to BsAbs. We further showed that lenalidomide, nivolumab, and atezolizumab improved ex vivo response to BsAbs by potentiating T-cell effector functions. In summary, our ex vivo study identified a distinct regulatory T-cell phenotype as a potential contributor to treatment failure of BsAbs and suggests drug combinations of high clinical relevance that could improve the efficacy of BsAbs.
Interhospital transfer of COVID-19 patients treated with high-flow nasal oxygen therapy
Authors: Dubie Elophe , Morin François , Savary Dominique , Serruys Amaury , Usseglio Pascal
Published: September 2021

At the start of the COVID-19 pandemic, early intubation was recommended on the basis of worldwide observations of severe hypoxemia. However, some patients were ultimately able to benefit from high-flow nasal cannula (HFNC) and thus avoid intubation. During the “second wave” (September to December 2020 in France), some emergency departments implemented HFNC in patients with severe COVID-19. The question then arose regarding the transfer of these most serious patients to intensive care units (ICU) and of the respiratory modalities to be used during this transfer. To assess the feasibility of interhospital transfers of COVID-19 patients needing HFNC, we conducted a bi-centric prospective observational study of all medical transfers of patients needing HFNC with the Chambéry and Angers (France) mobile emergency and intensive care service (SMUR) during the “second wave” of the COVID-19 pandemic in France. Analysis of these 42 patients showed no significant variation in the respiratory requirements during the transfer. Overall, 52% of patients were intubated during their stay in ICU, including three patients intubated before or during transfer. Interhospital transfer with HFNC is very high-risk, and intubation remains indicated in the most unstable patients. However, 48% of patients benefited from HFNC and were thus able to avoid intubation during their transfer and ICU stay; for these patients, intubation would probably have been indicated in the absence of available HFNC techniques.
A data-driven analysis of the potential of public transport for German commuters using accessibility indicators
Authors: Mocanu Tudor , Joshi Jigeeshu , Winkler Christian
Published: September 2021

Background

A significant mode shift will be required in order to meet the ambitious greenhouse gas emissions reduction targets in Germany and elsewhere. Such a mode shift can only be achieved by a combination of drastic push and pull measures. Getting commuters to switch modes might be particularly difficult and have a negative impact on their access to employment and welfare.

Methodology

We investigate the potential for a mode shift from car to public transport for German commuters using a data-driven approach based mainly on open data sources that avoids complex transport model runs. Different datasets on the home and workplace location of all employees in Germany are consolidated to create an origin-destination commuter matrix at traffic analysis zone level. The commuter matrix is merged with travel time data for car and public transport to calculate a spatially disaggregated and mode-specific measure of accessibility. The comparison of accessibility by car and public transport is used to derive the potential for a mode shift and identify potential challenges and barriers.

Results

Public transport accessibility to workplaces is poorer across the country compared to access by car. On average, public transport travel times are almost three times higher than the corresponding car travel times. The differences in accessibility are largely independent of the region type. Results are validated by an independent dataset from a household travel survey. Based on these results, the potential for a mode shift appears to be very low.