bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety over privacy: Family violence, information sharing and mental health care
Authors: Sougias Kathy , Fernbacher Sabin , Lim Izaak
Published: August 2022

Objective

This article aims to provide an update on information sharing practices in mental health services, in light of recent inter-sectoral family violence reforms in Victoria. We hope that this article will help increase familiarity with this contemporary best practice and improve clinician confidence in its application.

Method

We use three case scenarios to illustrate the application of these relatively new family violence frameworks in mental health services, with a focus on approaches to information sharing.

Results

The duty to respect the privacy of patients and their families sometimes comes into conflict with the duty to protect patients and their families from the risk of harm. Our case scenarios highlight situations where these conflicting duties need to be weighed and balanced, among other ethical considerations.

Conclusions

Mental health services have an ethical and legal responsibility to share information where it will enhance the safety of victim survivors of family violence, whether they are the primary client of the service or not.
The Americans with Disabilities Act and the Individuals with Disabilities Education Act: Intersection, Divergence, and the Path Forward
Authors: West Jane E. , McLaughlin Virginia L. , Shepherd Katharine G. , Cokley Rebecca
Published: August 2022

The 30th anniversary of the Americans with Disabilities Act (ADA) offered an opportunity for reflection on ways that ADA has influenced—and might further shape—the provision of special education under the Individuals with Disabilities Education Act (IDEA), now in its 47th year of implementation. After reviewing the purposes, provisions, and contexts of the two laws, the authors discuss the interplay between IDEA and ADA within several important areas, including the delivery of student services, creation of system-wide frameworks, focus on postsecondary outcomes, and programs in higher education. The authors then consider three factors that create tensions for the ways in which IDEA currently defines disability and addresses student needs: changing demographics in public schools, standards-based reform in education, and the growth of disability rights and activism. The article concludes with recommendations for moving ahead by deepening and expanding the dialogue between special education and the disability rights communities; amplifying the voices of graduates of IDEA; engaging leadership of independent federal advisory agencies to infuse ADA principles into IDEA; and exploring international thinking, scholarship, and practice related to serving all students effectively and inclusively.
Modeling and optimization of concurrent execution process of coupled design-construction tasks under design-build mode
Authors: Wang Ting , Feng Jingchun
Published: August 2022

Concurrent execution of design and construction tasks is an important way to realize the integration of them in design-build (DB) mode, but it may bring about period risk due to multiple rework and frequent information transfer in local scope. To solve this problem, this study constructs a concurrent execution strategy model from the perspective of quantitative analysis with the decision goal of minimizing the total execution duration. The results show that: first, when the probability of information change between design and construction tasks decreases gradually, the optimal overlap degree increases and the optimal parallelism decreases. Second, learning effect can effectively shorten the minimum duration corresponding to the optimal overlap degree under any degree of parallelism. Thirdly, with the decrease of the probability of information change between design and construction tasks and the strengthening of learning effect, the shortening rate of the actual execution duration corresponding to the optimal parallelism will be gradually greater than the increasing rate of the actual execution duration. The findings of the study provide suggestions for exploring the mechanism of concurrent execution in DB mode, and also provide countermeasures for better realization of integration of design and construction in DB mode.
Reconstruction With a 3D-Printed Megaprosthesis With Ankle Arthrodesis After Distal Tibial Tumor Resection
Authors: Liang Haijie , Wang Jichuan , Yang Yi , Niu Tianli , Du Zhiye , Zang Jie , Wei Ran , Yan Taiqiang , Tang Xiaodong , Guo Wei
Published: August 2022

Background:

Reconstruction after en bloc resection of the distal tibia has remained an unsettled issue despite many attempts with bone grafts or prostheses in the past. Failures of the previous methods have been attributed to inadequate mechanical strength, poor articular stability, failed osseointegration, and poor soft tissue coverage. To overcome these shortcomings, we designed and applied a 3D-printed megaprosthesis with ankle arthrodesis.

Methods:

A total of 13 patients underwent resection of a distal tibial tumor and reconstruction with a 3D-printed distal tibial megaprosthesis between January 2017 and November 2020. Mean age was 14.9±6.5 years. Diagnoses included 11 cases of osteosarcoma and 1 case each of low-grade phosphaturic mesenchymal tumor and rhabdomyosarcoma. Baseline characteristics, operative data, complication profiles, and oncologic, and functional outcomes were reviewed and analyzed.

Results:

All 13 cases attained a wide or marginal resection. During a mean follow-up of 26.8±10.6 months, 1 patient experienced local recurrence and distant metastasis, whereas 3 other patients only developed distant metastasis. Periprosthetic infection subsequent to paronychia occurred in 1 patient 24 months after the operation. No other complications were observed. By the last follow-up, the mean MSTS-93 score was 28.0±1.5.

Conclusion:

In this relatively small cohort with short-term follow-up, reconstruction with the 3D-printed megaprosthesis with ankle arthrodesis was found to be a safe and efficacious method after resection of a distal tibial malignancy.
“Complicated” Grief
Authors: Ludwin Katherine
Published: August 2022

In an autoethnographic journey through two losses that occurred months apart, I explore my own sense of disbelief, pain, shock, and horror while accompanying each of my parents through their final months of illness that were anything but peaceful and calm. In a twin set of poems, the pieces problematize the pathologizing label of “complicated” grief by asking how—and if—loss can be experienced as anything other than complicated with all the mess, tension, and conflict it brings.
A Visual Representation of Kalpaka Bulvāris in Riga, Latvia Following the Invasion of Ukraine
Authors: Queen Courtney , Benfer Brian
Published: August 2022

Russia launched an unprovoked full-scale invasion of the sovereign country of Ukraine. This movement was historic as people around the world watched the events unfold, and before our eyes, the world watched a country be destroyed and civilians lose their homes, schools, hospitals, and lives. The invasion on February 24, 2022, was particularly emotional feeling incredibly close to home in countries like Latvia that also lost its independence in a similar manner just generations before. This is the visual representation of the events by the people of Latvia for the people of Ukraine during the first 2 weeks following the invasion.
Mā’ohi methodologies and frameworks for conducting research in Mā’ohi Nui
Authors: Reynolds Pauline , Wheeler Vehia
Published: August 2022

Historically, scholarship of and about Mā’ohi Nui (French Polynesia) has been conducted using western methods, methodologies, and frameworks which has, to a large extent, resulted in inaccurate and degrading representations of the people and the islands. In accordance with the empowering trends of Critical Pacific Studies, this article proposes a new way forward by advocating for the creation of Mā’ohi (French Polynesian) methodologies and frameworks and the incorporation of values and protocols in an effort to re-centre and de-centralise the historical inaccuracies of European scholarship, encouraging scholarship founded within the principles of for Mā’ohi researchers, by Mā’ohi researchers, or for Mā’ohi, by Mā’ohi.
Multiple Myeloma: Bioinformatic Analysis for Identification of Key Genes and Pathways
Authors: Saadoune Chaimaa , Nouadi Badreddine , Hamdaoui Hasna , Chegdani Fatima , Bennis Faiza
Published: August 2022

Multiple myeloma (MM) is a hematological malignancy in which monoclonal plasma cells multiply in the bone marrow and monoclonal immunoglobulins are overproduced in older people. Several molecular and cytogenetic advances allow scientists to identify several genetic and chromosomal abnormalities that cause the disease. The comprehension of the pathophysiology of MM requires an understanding of the characteristics of malignant clones and the changes in the bone marrow microenvironment. This study aims to identify the central genes and to determine the key signaling pathways in MM by in silico approaches. A list of 114 differentially expressed genes (DEGs) is important in the prognosis of MM. The DEGs are collected from scientific publications and databases ( https://www.ncbi.nlm.nih.gov/ ). These data are analyzed by Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) software ( https://string-db.org/ ) through the construction of protein-protein interaction (PPI) networks and enrichment analysis of the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, by CytoHubba, AutoAnnotate, Bingo Apps plugins in Cytoscape software ( https://cytoscape.org/ ) and by DAVID database ( https://david.ncifcrf.gov/ ). The analysis of the results shows that there are 7 core genes, including TP53; MYC; CDND1; IL6; UBA52; EZH2, and MDM2. These top genes appear to play a role in the promotion and progression of MM. According to functional enrichment analysis, these genes are mainly involved in the following signaling pathways: Epstein-Barr virus infection, microRNA pathway, PI3K-Akt signaling pathway, and p53 signaling pathway. Several crucial genes, including TP53, MYC, CDND1, IL6, UBA52, EZH2, and MDM2, are significantly correlated with MM, which may exert their role in the onset and evolution of MM.
Redistributive State in Iran, Fiscal Sociology, and the Attitude of Two Generations of Students Toward State Revenue and Expending
Authors: Nozari Hamzeh
Published: August 2022

The Iranian state is the state of redistribution of oil and gas resources by a wide bureaucracy. Inequitable redistribution of resources and bureaucratic corruption have caused drastic movements in Iran over the past decade and raised the issue of public attitudes toward state funding and spending. Although previous studies in the literature have extensively addressed the rentier Iranian government, the issue of the public attitudes toward redistribution has been largely neglected. Therefore, this study aimed to investigate the attitudes of two generations of students toward state financing and expenditure practices in Iran. The data were collected by conducting two surveys in 2003 and 2016. The findings demonstrated that from the perspective of Iranian students, economic corruption is the most important factor leading to economic crisis.
Establishing optimal illuminance for pedestrian reassurance using segmented regression
Authors: Portnov BA , Fotios S , Saad R , Kliger D
Published: August 2022

The optimal illuminance from road lighting for pedestrian reassurance after dark is that beyond which further increase in illuminance has no significant effect on reassurance. Previous studies have not revealed a precise estimate of optimal illuminance. The current study investigates the use of segmented regression for defining optimal illuminance, applied to 25 662 reassurance evaluations by 380 test participants who recorded their reassurance assessments in 253 locations in three cities in Israel. Segmented regression led to models which better fit the empirical data than their unsegmented counterparts and offered precise estimates of optimal illuminance, these ranging from 8.9 lx to 26 lx, depending on location.
Socioeconomic status is associated with healthcare seeking behaviour and disease burden in young adults with asthma – A nationwide cohort study
Authors: Håkansson Kjell Erik Julius , Backer Vibeke , Ulrik Charlotte Suppli
Published: August 2022

Introduction

Specialist management of asthma has been shown to associate with socioeconomic status (SES). However, little is known about the influence of SES on care burden in universal healthcare settings.

Methods

Patients aged 18–45 years using inhaled corticosteroids (ICS) were followed in national databases. Impact of asthma was investigated using negative binomial regression adjusted for age, sex, comorbidity, and GINA 2020 Step. Uncontrolled asthma was defined as >600 annual SABA puffs, ≥2 prednisolone courses and/or ≥1 hospitalization.

Results

A total of 60,534 (55% female, median age 33 (IQR 25–39)) patients were followed for 10.1 years (IQR 5.2–14.3)). Uncontrolled asthma resulted in 6.5 and 0.51 additional annual contacts to primary care and pulmonologists, respectively. Unscheduled and primary care burden was dependent on SES, increasing with rural residence, lower education, income and receiving welfare. Differences in planned respiratory care were slight, only seen among divorced, low income- or welfare recipients. Lower SES was consistently associated with an increased utilization of SABA and prednisolone. No dose–response relationship between ICS use and SES could be identified.

Conclusion

Lower SES in asthma is a risk factor for a predominance of unscheduled care and adverse outcomes, warranting further attention to patients’ background when assessing asthma care.
Recent advances in nanotechnology-enabled biosensors for detection of exosomes as new cancer liquid biopsy
Authors: Hsu Chang-Chieh , Wu Yun
Published: August 2022

Cancer liquid biopsy detects circulating biomarkers in body fluids, provides information that complements medical imaging and tissue biopsy, allows sequential monitoring of cancer development, and, therefore, has shown great promise in cancer screening, diagnosis, and prognosis. Exosomes (also known as small extracellular vesicles) are cell-secreted, nanosized vesicles that transport biomolecules such as proteins and RNAs for intercellular communication. Exosomes are actively involved in cancer development and progression and have become promising circulating biomarkers for cancer liquid biopsy. Conventional exosome characterization methods such as quantitative reverse transcription polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) are limited by low sensitivity, tedious process, large sample volume, and high cost. To overcome these challenges, new biosensors have been developed to offer sensitive, simple, fast, high throughput, low sample consumption, and cost-effective detection of exosomal biomarkers. In this review, we summarized recent advances in nanotechnology-enabled biosensors that detect exosomal RNAs (both microRNAs and mRNAs) and proteins for cancer screening, diagnosis, and prognosis. The biosensors were grouped based on their sensing mechanisms, including fluorescence-based biosensors, colorimetric biosensors, electrical/electrochemical biosensors, plasmonics-based biosensors, surface-enhanced Raman spectroscopy (SERS)-based biosensors, and inductively coupled plasma mass spectrometry (ICP-MS) and photothermal biosensors. The future directions for the development of exosome-based biosensors were discussed.
Assessment of Neurological Impairment and Recovery Using Statistical Models of Neurologically Healthy Behavior
Authors: Scott Stephen H. , Lowrey Catherine R. , Brown Ian E. , Dukelow Sean P.
Published: August 2022

While many areas of medicine have benefited from the development of objective assessment tools and biomarkers, there have been comparatively few improvements in techniques used to assess brain function and dysfunction. Brain functions such as perception, cognition, and motor control are commonly measured using criteria-based, ordinal scales which can be coarse, have floor/ceiling effects, and often lack the precision to detect change. There is growing recognition that kinematic and kinetic-based measures are needed to quantify impairments following neurological injury such as stroke, in particular for clinical research and clinical trials. This paper will first consider the challenges with using criteria-based ordinal scales to quantify impairment and recovery. We then describe how kinematic-based measures can overcome many of these challenges and highlight a statistical approach to quantify kinematic measures of behavior based on performance of neurologically healthy individuals. We illustrate this approach with a visually-guided reaching task to highlight measures of impairment for individuals following stroke. Finally, there has been considerable controversy about the calculation of motor recovery following stroke. Here, we highlight how our statistical-based approach can provide an effective estimate of impairment and recovery.
Termination versus operation extension for degrading systems
Authors: Finkelstein Maxim , Cha Ji Hwan , Langston Amy
Published: August 2022

Optimal cost-wise termination of operation for degrading engineering systems is considered that maximizes the expected profit for the infinite horizon. Termination reduces probability of the future failure that usually results in substantial loss. The cases of non-repairable and minimally repairable systems are discussed. The black-box scenario without additional information on stochastic process of degradation and that with additional information are considered. The novel sequential optimal inspection policy is described. It is proved that the termination time can be postponed in an optimal way if the degradation observed at inspection is smaller than the defined level. The developed approach allows for optimal usage of system’s “resource.” The detailed numerical examples illustrate the findings.
Expression of p53 as a biomarker of pazopanib efficacy in solitary fibrous tumours: translational analysis of a phase II trial
Authors: Napolitano Andrea , Moura David S. , Hindi Nadia , Mondaza-Hernandez José L , Merino-Garcia José A. , Ramos Rafael , Dagrada Gian Paolo , Stacchiotti Silvia , Graziano Francesco , Vincenzi Bruno , Martin-Broto Javier
Published: August 2022

Background:

Solitary fibrous tumours (SFT) are soft tissue sarcomas molecularly defined by the presence of the NAB2::STAT6 intrachromosomal fusion gene. Recently, a prospective phase II trial evaluating the role of the antiangiogenic tyrosine kinase inhibitor pazopanib in SFT has been conducted (NCT02066285).

Methods:

Here, we analysed the mRNA and protein expression levels of the tumour suppressor and angiogenesis regulator p53 ( TP53) in pre-treatment tumour samples from 22 patients with low aggressive (or typical) SFT and 28 patients with high aggressive (26 malignant and 2 dedifferentiated) SFT enrolled in the aforementioned pazopanib phase II trial. These results were correlated with radiological progression-free survival (PFS) and objective response. Univariate and multivariate Cox regression analyses were also performed, including known clinic-pathological prognostic factors.

Results:

Diffuse immunohistochemistry (IHC) expression of p53 was only found in patients with aggressive SFT and was associated with significantly shorter PFS [hazard ratio (HR): 4.39, 95% confidence interval (CI): 1.19–16.14). TP53 mRNA levels were significantly higher in the low aggressive SFT group. Only in the high aggressive SFT group, relatively higher levels of TP53 were significantly associated with shorter PFS (HR: 4.16, 95% CI: 1.46–11.89) as well as to a lower rate of disease control following treatment with pazopanib. In the multivariate analysis, the only independent prognostic factor in the whole cohort was mitotic count.

Conclusion:

Diffuse p53 IHC expression and higher TP53 mRNA levels are associated with worse prognosis in the subset of aggressive SFT patients treated with pazopanib.
Clinical Outcomes of Revision Surgery Using a Dorsal Approach After Failed Primary Interdigital Neuroma Excision
Authors: Rajan Lavan , Mizher Rami , Srikumar Syian , Fuller Robert , Ellis Scott J.
Published: August 2022

Background

Revision neurectomy may be approached with either a dorsal or a plantar incision. Although a plantar approach is more commonly described, few studies have investigated outcomes following a dorsal revision neuroma excision. In this study, we performed a case series on a group of patients who underwent revision neuroma excision through a dorsal approach and reported complications and outcomes using validated patient-reported outcome measures (PROMs).

Methods

This retrospective case series included 10 patients who underwent a dorsal-approach revision neuroma excision and had preoperative and minimum 1-year postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores. Complications including neuroma recurrence and continued unresolved pain were obtained from the electronic medical record. Preoperative and postoperative PROMIS scores were compared to assess improvement in PROMs.

Results

There were significant improvements in the PROMIS pain interference (P = .026), pain intensity (P = .008), and global physical health (P = .017) domains. One patient experienced recurrence of their neuroma 4 years after surgery.

Conclusion

This case series provides preliminary data indicating that revision neurectomy using a dorsal approach leads to satisfactory outcomes in pain-related PROMs. Further research with comparative study designs is necessary to determine if one approach is superior to the other.

Levels of Evidence:

Level IV: Retrospective
Trans-Posterior Cruciate Ligament All-Inside Root Repair Versus Partial Meniscectomy for Medial Meniscus Posterior Root Tears: Comparison of Semiquantitative and Quantitative MRI Outcomes in Cartilage Degeneration and Osteoarthritic Progression
Authors: Su Jiarong , Wan Hongyan , Pang Yingchang , Lu Yanli , Liang Jiaming , Yan Zhigang , Xu Sibo , Sun Tiezheng
Published: August 2022

Objective

To perform conventional, morphological, and T2 mapping compositional MRI imaging to assess the cartilage degeneration and osteoarthritic progression in patients with medial meniscus posterior root tears (MMPRTs) who underwent trans-posterior cruciate ligament (PCL) all-inside repair or partial meniscectomy.

Design

Patients with MMPRTs after trans-PCL all-inside repair (group AR) or partial meniscectomy (group PM) between 2015 and 2018 were retrospectively identified. Preoperative and postoperative conventional MRI were collected to assess medial meniscus extrusion (MME) and the whole-organ magnetic resonance imaging score (WORMS). Postoperative morphological MRI and T2 mapping compositional MRI were collected to evaluate the quantitative cartilage thickness/volume and cartilage composition.

Results

The final cohort consisted of 21 patients in group AR and 22 patients in group PM, with no differences in demographic data and baseline patient characteristics between the 2 groups. Group AR demonstrated less progression of articular cartilage wear ( P < 0.05) and decreased meniscal extrusion ( P = 0.008) than group PM at the final follow-up. In addition, group AR demonstrated less extracellular matrix degeneration in the cartilage subregion of the medial compartment ( P < 0.05) than group PM with lower T2 relaxation times in the superficial layer of the articular cartilage.

Conclusion

Trans-PCL all-inside repair of MMPRTs could delay the initial cartilage deterioration and morphological cartilage degeneration compared with partial meniscectomy. However, the amount of residual meniscal extrusion is clinically important, and an improved root repair fixation method should be investigated.
Aspect-Level Personality Characteristics of U.S. Presidential Candidate Supporters in the 2016 and 2020 Elections
Authors: Xu Xiaowen , Plaks Jason E.
Published: August 2022

With two studies ( N=1,257), we examined the aspect-level personality predictors of support for major U.S. presidential candidates in 2016 and 2020. U.S. residents completed measures of aspect-level personality, overall political orientation, and support for each candidate. The profile that predicted support for each candidate diverged from the profile that predicted generic liberalism/conservatism. Moreover, differences emerged between supporters of different candidates within the same party. For example, preference for Clinton was predicted by higher Openness, but lower Intellect, Politeness, and Volatility, whereas preference for Sanders was predicted only by higher Openness and lower Volatility. Preference for Trump was predicted by lower Openness and higher Volatility in 2016, but lower Compassion and higher Industriousness in 2020. Support for Biden was predicted by higher Compassion, Intellect, and Withdrawal. This work provides a more nuanced understanding of how the psychology of generalized political orientation may deviate from the psychology behind support for specific candidates.
Screening for neglected tropical diseases and other infections in refugee and asylum-seeker populations in the United Kingdom
Authors: Cinardo Paola , Farrant Olivia , Gunn Kimberlee , Ward Allison , Eisen Sarah , Longley Nicky
Published: August 2022

Asylum-seekers and refugees have an increased burden of infections compared with the general population. This has been widely recognised by countries welcoming those fleeing conflict and persecution; however, there are no screening standardised guidelines and regulatory processes. Identification of certain neglected tropical diseases (NTDs) and other infections is important for the health and well-being of the individual in addition to public health and biosecurity. In the United Kingdom, screening for infections at port of entry or after arrival is not mandatory. Those on refugee resettlement programmes will have infection screening as part of their pre-entry health assessment, but no such system exists for those claiming asylum in the United Kingdom. In this article, we have reviewed published, peer-reviewed articles looking at the approaches to screening for NTDs and infectious diseases in the United Kingdom. In addition to this, we have reviewed the literature looking at the acceptability, barriers and facilitators of these screening practices. We found that there is a heterogeneous approach to screening practices in the United Kingdom and a paucity of data to support a single ‘best practice’ approach. Based on our findings, we have made recommendations and consideration for NTD screening strategies and highlighted important areas for future research.
Diagnostic and therapeutic dilemma in orofacial pain: A rare case of bilateral Eagle syndrome
Authors: Pradhan Umesh , Adhikari Tika Ram
Published: August 2022

Eagle’s syndrome is a collection of symptoms due to abnormal and/or elongated styloid process. This can irritate the various neurovascular structures that lie in its close proximity, mainly the glossopharyngeal nerve, leading to odynophagia, dysphagia, foreign body sensation, cervicofacial pain, and headache. It is a diagnosis of exclusion and needs high degree of clinical suspicion. It is a rare condition with no reported incidence in the Bhutanese population so far. In this article, we present a case of elongated styloid process that was causing persistent and troublesome orofacial pain in a patient, which was not relieved by medication. The patient underwent trans-oral styloidectomy, which helped cure his symptoms.
Spontaneous clival meningocele
Authors: El Ouali Ibtissam , Behyamet Onka , Elkettani Najwa , Fikri Meriem , Jiddane Mohamed , Touarsa Firdaous
Published: August 2022

The occipital bone is an uncommon location for meningoceles protrusion. This condition occurs generally after a severe traumatism or surgical procedure. However, in some rare cases, the herniation can happen spontaneously. Nontraumatic clival meningoceles present an extremely rare entity and correspond to a herniating pachymeningeal collection containing cerebrospinal fluid through a zone of fragility in the clivus. Clinical presentation ranges from simple headache or rhinorrhea to severe complications such as recurrent bacterial meningitis or nerve compression. Computed tomography provides an analysis of the bone and magnetic resonance imaging provides a superior contrast resolution, helping to distinguish among the various types of clival lesions. We report the case of a young woman with a long history of idiopathic intracranial hypertension, who presented with a worsening headache. Magnetic resonance imaging confirmed a clival meningocele without other complications and the patient was put under medical surveillance.
Intramedullary Nail or Primary Arthroplasty? A System Review and Meta-Analysis on the Prognosis of Intertrochanteric Femoral Fractures Based on Randomized Controlled Trials
Authors: Wang Zhaojun , Gu Fei , Xu Shizhuang , Yue Yang , Sun Kefu , Nie Wei
Published: August 2022

Introduction

There is no consensus regarding the superiority between intramedullary nailing and primary arthroplasty in the management of intertrochanteric femoral fractures. This systematic review was performed to investigate and compare the clinical efficacy of intertrochanteric femoral fractures treated with these 2 methods.

Materials and methods

We systematically searched PubMed, Embase, Cochrane, Web of science core collection and ClinicalTrials.gov for randomized controlled trials which compared the clinical outcomes of intertrochanteric fractures treated with either intramedullary nails or primary arthroplasty. Relevant data of the postoperative complications, reoperations, mortality and functional assessment, were pooled and presented graphically.

Results

A total of 6 trials with 427 participants were identified and included in the analyses. The pooled estimates suggested these 2 techniques have comparable risks in terms of overall complications (pooled risk ratio [RR] .80; 95% confidence interval [CI] .43 to 1.43; I2 = 79.94%), the rate of patients with orthopedic complications (RR .71, 95% CI .40 to 1.27; I2 = .00%), reoperations (RR 1.33, 95% CI .48 to 3.71; I2 = .00%), the overall mortality (RR .52; 95%CI .26 to 1.02; I2 = 31.35%) and 1-year mortality (RR .67; 95%CI .38 to 1.19; I2 = .00%). Primary arthroplasty associated with higher HHS at 3 months postoperatively (MD -21.95, 95% CI -28.29 to −15.60; I2 = 70.44%). While the difference was not significant at 6 months (MD 2.32, 95% CI -1.55 to 6.18; I2 = .00%), and even reversed at 12 months postoperatively (MD 13.02, 95% CI 8.14 to 17.90; I2 = 73.42%).

Conclusions

Meta-analytic pooling of current evidences demonstrated that primary arthroplasty is related to a better early functional recovery at the early stage postoperatively, but the long-term result tends to favor to intramedullary nailing. The differences in overall complications, the rate of patients with orthopedic complications, reoperations, overall and 1-year mortality did not reach a significant level.
Exploring University EFL Teachers’ Technological Pedagogical Content Knowledge and Teacher Efficacy in Technology-integrated Flipped Classroom
Authors: Zhang Meng , Fang Xiaotian
Published: August 2022

This qualitative study explored teachers’ knowledge and teacher efficacy about implementing technology-integrated flipped classroom (FC) in higher education. Using the technological pedagogical content knowledge (TPACK) framework and teacher efficacy theories, the study probed the experiences and perceptions reported by 12 university teachers of English as a foreign language. Six themes emerged from the study. Themes 1 to 3 depicted how the EFL teachers practiced the three essential teaching tasks of technology-integrated FC. By incorporating the instructional design of FC into TPACK constructs, the study developed a new FC-situated TPACK framework. Themes 4 to 6 revealed that the teachers’ sense of efficacy increased overall but fluctuate slightly. Factors improving teacher efficacy included positive changes in student performance, supportive leadership and climate, effective group work among colleagues, and open-mindedness toward technology. While factors decreasing teacher efficacy encompassed adherence to a unified teaching model imposed by the department, technology’s non-user-friendly, and impersonal characteristics. This study provides a comprehensive view of how the sampled teachers applied FC-situated TPACK. Its findings also enhance the understanding of teacher efficacy, particularly in relation to FC instruction.
Evaluation of the move to remote delivery of drug and alcohol services during the COVID-19 pandemic: A study protocol
Authors: Lloyd Nigel , Wills Wendy , Bartington Suzanne , Bontoft Charis , Breslin Gavin , Fakoya Olujoke , Freethy Imogen , Garcia-Iglesias Jaime , Howlett Neil , Jones Julia , Newby Katie , Smeeton Nigel , Wagner Adam , Wellings Amander , Wellsted David , Brown Katherine
Published: August 2022

Background:

Substance misuse is a significant global health concern. In the UK, the prevalence of substance misuse has increased over the past decade and the number of alcohol and drug related deaths are increasing. Individuals with substance dependency issues are entitled to access treatment services. However, the COVID-19 pandemic created significant challenges for public services, including drug and alcohol treatment, and resulted in significant service reconfiguration and a shift from in-person to remote delivery. This study aims to evaluate the delivery of drug and alcohol services in a large metropolitan area in Northern England during the COVID-19 pandemic. It aims to understand the impact of service reconfiguration for services, staff and service users, and to use this understanding to inform the future optimised design of services.

Design and methods:

The study has five workstreams within a mixed methods framework: (1) Systematic review of literature; (2) Qualitative process evaluation with service providers (digital timelines, focus groups and interviews); (3) Qualitative process evaluation with service users (interviews, focus groups, text based conversations and case studies); (4) Quantitative outcomes and health economic analysis; and (5) Data synthesis and dissemination.

Expected Impact of the study for Public Health:

The breadth of the study, its novel nature, and the importance of substance misuse as a public health issue, mean that this study will provide valuable findings for those who commission, deliver and use drug and alcohol treatment services nationally and internationally. There will also be important learning for the effective remote delivery of services in sectors beyond drug and alcohol treatment.
Variation in the Use of Basic Behavioral Management Techniques in General and Pediatric Dental Practice: A Cross-sectional Study
Authors: Felemban Osama , Baamer Ruba , Bukhari Zuhor , Baghlaf Khlood , Aldajani Mariam , Sijini Ohoud
Published: August 2022

Aim:

Basic guidance on nonpharmacological behavioral management techniques in dental practice is fundamental for the effective treatment of pediatric patients. The aim of this study was to compare the use of basic nonpharmacological behavior guidance in general and specialist pediatric dentists and to evaluate the perceived difference in their effectiveness across hospital clinics in Jeddah, Saudi Arabia.

Material and Methods:

A cross-sectional study with a nonpurposive sample of 179 registered general and pediatric dentists in the Saudi Dental Society based in Jeddah in 2019. Participants were contacted and asked to complete a validated questionnaire. The first section of the questionnaire comprised questions on demographic data and the second section investigated the frequency of the use of various behavioral management techniques. Descriptive statistics (frequency and percentages) and inferential statistics were used.

Results:

A total of 109 participants completed the survey; 52 were general dentists and 57 were pediatric dentists. The techniques tell–show–do ( P = .018), positive reinforcement ( P = .004), distraction ( P = .001), and nonverbal communication ( P = .001) were used more frequently by pediatric dentists than general dentists, and there were statistically significant differences. Also, pediatric dentists reported that the techniques tell–show–do ( P = 0.035), positive reinforcement ( P = .026), distraction ( P = .011), and nonverbal communication ( P = .007) were highly effective more often than general dentists did.

Conclusions:

Statistically significant differences were found between general and pediatric dentists in the use of basic behavioral management techniques. Broadly, general dentists used fewer behavior guidance techniques compared to pediatric dentists. More pediatric dentists reported that behavioral management techniques were effective in comparison to general dentists.
Tracking plan implementation using elected officials’ social media communications and votes
Authors: Han Albert Tonghoon , Laurian Lucie
Published: August 2022

Plans can only impact practice when elected officials adopt, enact, and approve funding for specific strategies. We explore ways to track implementation from the planning documents to elected officials’ priorities and to their voting patterns to identify the consistencies and gaps that may limit the impact of plans. We use Twitter data mining, text content analysis, and voting records from the digitized council minutes in Calgary, Alberta, between the 2017 municipal election and the last quarter of 2020. We connect the expressed preferences to votes for each councilor over the study period. On the two most salient topics—transit and affordable housing—those who expressed support on Twitter also supported investments. With one exception of an anti-tax councilor, over time, the rest of the councilors reached agreements on public investments (supra-local funding lightened the financial burdens for the city facilitating “yes” votes). Planners can derive meaningful information from the elected officials’ social media communication, such as concerns and support for specific planning initiatives, to promote successful plan implementation. This information can also enhance voters’ awareness of local officials’ views and actions on planning initiatives.
Book review: Sunaina Arya and Aakash Singh Rathore, ed., Dalit Feminist Theory: A Reader
Authors: Mukherjee Srirupa
Published: August 2022

Sunaina Arya and Aakash Singh Rathore, ed., Dalit Feminist Theory: A Reader. New York: Routledge, 2020, 245 pp., $8,315.92 (Hardback). ISBN: 978-0-367-43841-8.
Effect of the Reversed L-Shaped Osteotomy on the Round Sign: Not All Hallux Valgus Deformities May Need Proximal Derotation to Correct the Radiographic Appearance of Metatarsal Pronation
Authors: Weigelt Lizzy , Wild Linda , Winkler Elin , Torrez Carlos , Jentzsch Thorsten , Wirth Stephan H.
Published: August 2022

Background:

Metatarsal pronation has been claimed to be a risk factor for hallux valgus recurrence. A rounded shape of the lateral aspect of the first metatarsal head has been identified as a sign of persistent metatarsal pronation after hallux valgus correction. This study investigated the derotational effect of a reversed L-shaped (ReveL) osteotomy combined with a lateral release to correct metatarsal pronation. The primary hypothesis was that most cases showing a positive round sign are corrected by rebalancing the metatarsal-sesamoid complex. We further assumed that the inability to correct the round sign might be a risk factor for hallux valgus recurrence.

Methods:

We retrospectively evaluated 266 cases treated with a ReveL osteotomy for hallux valgus deformity. The radiologic measurements were performed on weightbearing foot radiographs preoperatively, at an early follow-up (median, 6.2 weeks), and the most recent follow-up (median, 13 months). Univariate and multivariate logistic regression analyses identified risk factors for hallux valgus recurrence (hallux valgus angle [HVA] ≥ 20 degrees).

Results:

A preoperative positive radiographic round sign was present in 40.2% of the cases, of which 58.9% turned negative after the ReveL osteotomy ( P < .001). Hallux valgus recurred in 8.6%. Risk factors for recurrence were a preoperative HVA >30 degrees (odds ratio [OR] = 5.3, P < .001), metatarsus adductus (OR = 4.0, P = .004), preoperative positive round sign (OR = 3.3, P = .02), postoperative HVA >15 degrees (OR = 74.9; P < .001), and postoperative positive round sign (OR = 5.3, P = .008). Cases with a positive round sign at the most recent follow-up had a significantly higher recurrence rate than those with a negative round sign (22.7% vs 5.9%, P < .001).

Conclusion:

The ReveL osteotomy corrected a positive round sign in 58.9%, suggesting that not all hallux valgus deformities may need proximal derotation to negate the radiographic appearance of the round sign. A positive round sign was found to be an independent risk factor for hallux valgus recurrence. Further 3-dimensional analyses are necessary to better understand the effects and limitations of distal translational osteotomies to correct metatarsal pronation.

Level of Evidence:

Level IV, case series.
Can modeling soil heterogeneity in 2D site response analyses improve predictions at vertical array sites?
Authors: de la Torre Christopher A , Bradley Brendon A , Stewart Jonathan P , McGann Christopher R
Published: August 2022

This study uses a database of 21 vertical borehole arrays in California to examine whether a two-dimensional (2D) site response analysis framework that accounts for soil heterogeneity via spatially correlated random fields can explain misfits observed from prior one-dimensional (1D) ground response modeling. The main hypothesis is that the overprediction of ground motion at site modal frequencies, consistently observed in many site response validation studies, is caused by soil heterogeneity and 2D/three-dimensional (3D) wave propagation effects that cannot be captured by 1D analyses. We apply classical “within” boundary conditions for borehole input motion along with equivalent incident wave motions derived using a framework developed here to help elucidate the effects of the down-going wave on observed fundamental mode resonances. Results from 2D and 1D analyses are compared to observations using a transfer-function-based taxonomy and residuals of other intensity measures (IMs) including response spectra. The uncertainty in predicted IMs is estimated from the many realizations of 2D models. This 2D approach was found capable of scattering seismic waves and producing transfer function variability resembling the observed event-to-event variability in empirical transfer functions (ETFs). For several sites that exhibit less down-going wave effects in ETFs (i.e. flatter peaks) and/or higher variability in ETFs, median transfer functions from 2D analyses provide a significantly better estimate of the median ETF than conventional 1D deterministic analyses, especially at fundamental modes. In contrast, for some of the sites that are well represented by 1D methods (e.g. Wildlife Liquefaction Array and Treasure Island), 2D methods with generic levels of spatial variability may over-represent the heterogeneity and consequently underpredict amplifications at higher mode frequencies.
Empirical nonlinear site effects in Japanese megathrust earthquakes
Authors: Campbell Kenneth W , Bozorgnia Yousef , Kuehn Nicolas , Gregor Nicholas
Published: August 2022

In the course of developing ground-motion models (GMMs) of peak ground acceleration (PGA) for Japanese megathrust earthquakes, we discovered that empirical nonlinear site effects from these events are very different from those found for shallow crustal earthquakes in California and other global active tectonic regions. In particular, nonlinearity in site response is much less prominent in Japan than these other regions, which is consistent with other empirical and theoretical ground-response studies using recordings from both crustal and subduction earthquakes. In this study, we used the residuals from Japanese megathrust GMMs that account for linear site response to develop a nonlinear site-response term that uses the value of PGA on rock as a measure of ground-motion severity and the value of time-averaged shear-wave velocity in the top 30 m of a site ( VS30) as a measure of site properties. The resulting residuals are unbiased and trendless over all PGA values of interest. We also investigated whether soil nonlinearity can be modeled using proxies for shear stress and shear strain. We found deviations from expected linearity unrelated to nonlinear site effects at small values of strain—believed to be due to network accelerograph trigger thresholds—and at large earthquake magnitudes, believed to be due to the shape of the source spectrum.
The application of custom-made 3D-printed titanium augments designed through surgical simulation for severe bone defects in complex revision total hip arthroplasty
Authors: Zhang Yanchao , Gao Zhisen , Zhang Bohan , Du Yinqiao , Ma Haiyang , Tang Yuyu , Liu Yang , Zhou Yonggang
Published: August 2022

Background

With the development of radiology and three-dimensional (3D) printing technology, custom-made 3D-printed titanium augments have been more widely used. However, the radiological and clinical outcomes of custom-made augments lack reports. To better understand the clinical effect of using 3D-printed titanium augments and the significance of accurate placement, the aim of this study was to assess the outcomes when using custom-made 3D-printed titanium augments and to validate the idea that surgical simulation should be done before designing custom-made augments.

Methods

A retrospective review was conducted on 31 surgical simulations and revision total hip arthroplasties using custom-made 3D-printed titanium augments. The safe zone, cup position, and hip rotation center were measured on anteroposterior radiographs. Clinical outcomes were assessed with a mean 21.1 months of follow-up.

Results

All patients were positioned within the safe zone, and none of the acetabular cups nor the custom-made augments had any evidence of migration at the latest follow-up. A strong correlation was found between the planned cup position and the postoperative position. The average vertical position of the center of rotation was significantly increased from 3.55 cm to 2.35 cm. The mean Harris Hip Score was increased from 40.81 preoperatively to 65.46 postoperatively. Complications included gait abnormality, groin pain, fracture of the greater trochanter, and partial palsy of the sciatic nerve. However, patient satisfaction reached 92.3%.

Conclusion

Surgical simulations help to design custom-made augments accurately and improve surgical plans. Acetabular components supported with custom-made 3D-printed augments is a useful method to bridge severe bone deficiencies. In this study, both the radiologic results and clinical outcomes were favorable.

Level of evidence

Level 4.