bluuebunny/crossref_metadata_2025 huggingface dataset:
Are All Gay Men at Risk of Developing HIV/AIDS? Why China’s Mass HIV Testing Has Majorly Targeted Gay Men in the Era of Biomedicalization
Authors: Yang Lei , Sun Zhipeng
Published: February 2024

Global HIV/AIDS responses have been increasingly biomedically dominated over the past years. In line with this shifting paradigm, China has prioritized mass HIV testing as a practical approach to controlling its HIV/AIDS epidemics among at-risk populations, especially gay men and other men who have sex with men (MSM). This study analyzed why China’s mass HIV testing mainly targeted gay men by understanding the perspectives of public health professionals, community-based organization (CBO) workers, and gay men. In addition, this study revealed the tensions and unintended consequences of HIV/AIDS prevention and the representation of gay men in China. The study involved fieldwork conducted in a major city in Eastern China from 2015 to 2019. Semi-structured interviews were held with participants from the three abovementioned groups ( N = 25). The study identified four processes concerning why gay men are mainly targeted for HIV testing. Some public health professionals believe that being a gay man is equivalent to having HIV/AIDS risks. In addition, this study particularly noted tensions between public health professionals and gay men, including gay men–identified CBO workers, over whether mass HIV testing should target gay men or anyone who engaged in sexual risk behaviors. This study argued that a particular focus on gay men due to pursuing biomedical advances in HIV/AIDS prevention seems to have unintendedly stereotyped gay men based on the presumptions that they are at risk of developing HIV/AIDS. In addition, this study corresponded to the broader social scientific discussion concerning whether HIV/AIDS intervention should target specific sexual risk practices or sexual identity/population.
Experimental evaluation of the plunger technique: A method of cyclic manual aspiration thrombectomy for treatment of acute ischemic stroke
Authors: Poulos Demitria A , Keith James S , Froehler Michael T , Good Bryan C
Published: February 2024

Background

Mechanical thrombectomy via direct aspiration is a rapid treatment for acute ischemic stroke. This method often results in the partial ingestion of the clot or “corking” of the catheter tip. Cyclic aspiration may take advantage of the mechanical properties of the clot, resulting in greater clot ingestion and overall procedure success.

Methods

An in vitro analysis was performed comparing static and cyclic (plunger technique) aspiration. Embolus analogs were used to create occlusions in a mock circulatory flow loop, and one aspiration attempt (first pass effect) using either a static or plunger technique was performed. The percent ingestion of each embolus analog was recorded for each trial.

Results

Static aspiration for 0% and 50% hematocrit embolus analogs resulted in ingestions of 12.8 ± 4.6% and 15.1 ± 10.0%, respectively, while plunger technique (cyclic) aspiration resulted in 15.8 ± 7.3% and 34.4 ± 19.5% ingestion. Complete ingestion was observed only with 50% hematocrit analogs, occurring in 30% of plunger and 10% of static cases. Statistical differences were determined between the two aspiration techniques for the 50% hematocrit samples, with the plunger technique yielding significantly more ingestion. In addition, the plunger technique was shown to maintain a negative vacuum pressure throughout the duration of cyclic plunging.

Conclusions

The plunger technique for manual cyclic aspiration resulted in higher rates of complete ingestion and greater average % ingestions when compared to static aspiration. Increased clot ingestion can result in a higher rate of complete reperfusion during the first aspiration attempt, maximizing the number of patients with good clinical outcomes.
Synthesis of curcumin derivatives for suppression of castration-resistant prostate cancer
Authors: Gong Shunze , Yuan Chixiang , Hu Hang , Xu Defeng
Published: February 2024

In this work, 20 curcumin derivatives containing halogen atoms or nitrogen atoms were synthesized for suppression of castration-resistant prostate cancer. These curcumin derivatives were prepared by aldol condensation between the substituted benzaldehydes and acetylacetone or ethyl 3-acetyl-4-oxopentanoate. All synthesized compounds were characterized by 1H nuclear magnetic resonance, 13C nuclear magnetic resonance, high resolution mass, ultraviolet–visible spectroscopy, fluorescence spectroscopy, and high-performance liquid chromatography. The in vitro cytotoxicity of the prepared compounds against 22Rv1 cells was evaluated by the standard MTT assay. The compounds with good inhibitory activity against 22Rv1 cells were further tested for androgen receptor suppression effect. The results show that all compounds were successfully prepared and the purities are all over 90%. Among all synthesized compounds, compound p and s exhibit better inhibitory activity against 22Rv1 cells as compared to dimethylcurcumin, compound q and r display similar inhibitory activity against 22Rv1 cells as compared to dimethylcurcumin. Compounds p-s also demonstrate enhanced androgen receptor suppression effect against 22Rv1 cells as compared to dimethylcurcumin. This work indicates that compounds p-s show promising inhibitory activity against castration-resistant prostate cancer cells by suppression of androgen receptor.
Prognostic relevance of MRI in early relapsing multiple sclerosis: ready to guide treatment decision making?
Authors: Hoffmann Olaf , Gold Ralf , Meuth Sven G. , Linker Ralf A. , Skripuletz Thomas , Wiendl Heinz , Wattjes Mike P.
Published: February 2024

Magnetic resonance imaging (MRI) of the brain and spinal cord plays a crucial role in the diagnosis and monitoring of multiple sclerosis (MS). There is conclusive evidence that brain and spinal cord MRI findings in early disease stages also provide relevant insight into individual prognosis. This includes prediction of disease activity and disease progression, the accumulation of long-term disability and the conversion to secondary progressive MS. The extent to which these MRI findings should influence treatment decisions remains a subject of ongoing discussion. The aim of this review is to present and discuss the current knowledge and scientific evidence regarding the utility of MRI at early MS disease stages for prognostic classification of individual patients. In addition, we discuss the current evidence regarding the use of MRI in order to predict treatment response. Finally, we propose a potential approach as to how MRI data may be categorized and integrated into early clinical decision making.
Randomized trial of mechanotherapy for the treatment of stress urinary incontinence in women
Authors: Nakib Nissrine , Sutherland Suzette , Hallman Kevin , Mianulli Marcus , R Boulware David
Published: February 2024

Background:

Stress urinary incontinence (SUI) presents as unintentional urine leakage associated with activities. It significantly affects quality of life (QoL) and is the most common type of incontinence in women. Current treatment options, particularly non-surgical therapies, are lacking.

Objective:

To assess the efficacy of mechanotherapy provided by the Flyte® intra-vaginal device during pelvic floor muscle training (PFMT).

Design:

This was a randomized, controlled, double-blinded trial.

Materials and methods:

Flyte is a repeat use device for conditioning and strengthening the pelvic floor muscles (PFMs). It provides two-part mechanotherapy. Part 1 is the stretching and preloading of the PFM from the internal wand. Part 2 integrates mechanical pulses which elicit muscle cellular and tissue level responses that trigger cellular regeneration, improve neuromuscular facilitation and motor learning. Subjects used the device for 5 min/day for 12 weeks. Subjects (144) were randomized and evaluated at 6 and 12 weeks. Arm A (72) received both Part 1 and Part 2 mechanotherapy for 12 weeks, whereas Arm B (72) received Part 1 therapy for 6 weeks, then crossed over to full therapy. Mean age was 50, 49, respectively, prior pelvic/abdominal surgery 26%, 46%, and previous incontinence treatments 13%, 22%. The primary endpoint was 24-h pad weight (24-HR PW) at 6 weeks. Secondary endpoints were 24-HR PW at 12 weeks and QoL [International Consultation on Incontinence Questionnaire (ICIQ), Urinary Incontinence Quality of Life (IQOL)].

Results:

Part 1 therapy had a greater than anticipated therapeutic effect. Thus, the study was underpowered to identify differences between study arms. Therefore, data were pooled to assess the effects of mechanotherapy. Twenty four-HR PW was significantly reduced at 6 weeks ( p = <0.0001), with further reduction from 6 to 12 weeks ( p = <0.0001). Data were stratified based on 24-HR PW severity. Significant reductions were noted in all severity groups (mild p = <0.0001, moderate p = <0.0001, severe p = <0.01). QoL was similarly improved at 6 weeks (ICIQ p = <0.0001, IQOL p = <0.0001), and 12 weeks (ICIQ p = <0.0001, IQOL p = <0.0001). Compliance was >80% at 6 weeks and 70% at 12 weeks.

Conclusion:

Two-part mechanotherapy significantly improved 24-HR PW and QoL across all severities of SUI. Improvements were noted in as little as 2 weeks and appeared to be sustained through 2-year follow up.

Trial registration:

Registered on ClinTrials.gov (NCT02954042).
Curcumin Delivery Systems: How Far from Clinical Application in Tumor Therapy?
Authors: Wang Yuanru , Liang Lubiao , Zhao Yajin
Published: February 2024

Curcumin, a natural polyphenol compound found in turmeric, exhibits significant anti-cancer activity in preclinical studies. However, its clinical application is limited by poor bioavailability and low solubility in aqueous media. To overcome these challenges, various curcumin delivery systems (CDSs) have been developed to enhance the pharmacokinetics and pharmacodynamics of curcumin, aiming to improve its solubility, stability, and targeted delivery to tumor cells. Preclinical studies have shown that CDSs can improve pharmacokinetics, enhance anti-tumor efficacy, and reduce toxicity in various cancers. Several CDSs have also advanced into clinical trials, demonstrating safety and efficacy in cancer patients. Despite the promising results, challenges remain, such as optimizing formulation and dosage, investigating curcumin's influence on the carriers in drug delivery and release, evaluating long-term safety and toxicity, and conducting large-scale clinical trials. Understanding the effect of gut microbiota on CDSs metabolism and bioavailability is critical for enhancing their clinical effectiveness in tumor therapy. Further research and development are necessary to fully exploit the potential of CDSs in cancer treatment. This review summarizes recent progress in CDSs research and their potential application in tumor therapy, encompassing formulation strategies, delivery routes, as well as preclinical and clinical evaluations. It not only provides valuable insights into the future rational design and development of curcumin dosage forms and their cancer therapeutic potential but also facilitates the clinical translation of curcumin and CDSs.
Preparation, Characterization, and Sub-Chronic Toxicity of Carvacrol-Self-Nano-Emulsifying Drug Delivery System Towards Healthy Sprague Dawley Rats
Authors: Maarouf Fenk Bakir , Rahman Heshu Sulaiman
Published: February 2024

Background: Carvacrol (CAR) is the active component in essential oils (EOs) of many fragrant plants, including oregano and thyme; however, its high toxicity restricts its usage in biomedical fields, and the self-nano-emulsifying drug delivery system (SNEDDS) was suggested to overcome this issue. Objective: To prepare and characterize the CAR-loaded SNEDDS and to assess its toxicity profile towards healthy rats using the in vivo sub-chronic study. Methods: SNEDDS was prepared from olive oil, dimethyl sulfoxide, Tween-80, and distilled water, then CAR-SNEDDS was prepared by adding 0.5% CAR to SNEDDS and both composites were gently agitated for 72 h at room temperature. Later on, both composites were physiochemically characterized for size/charge (Zetasizer), shape (TEM), crystallinity (XRAD), composition (FTIR), and quantitated (UV–Vis). Additionally, the sub-chronic toxicity of both composites at different doses was conducted by orally treating healthy Sprague Dawley for 4 weeks. Then, the treated rats were checked for toxicological symptoms, food/water intake, and behavioral abnormality. In addition, the blood samples were tested for hematologic/biochemical changes, while vital organs (liver and kidney) were assessed for histopathological alterations. Results: The average globule size, zeta potential, and polydispersity index of CAR-SNEDDS were 158.93 ± 22.18 nm, −22.56 ± 1.77 mV, 0.553 ± 0.31, respectively. All treated animal tissues, serum biochemical profiles, and total hemograms were normal. At 30-90 mg/kg oral doses, CAR-SNEDDS was not toxic and did not cause mortality. Conclusions: CAR-SNEDDS was successfully synthesized and characterized, and the results from sub-chronic oral toxicity studies showed that the CAR-SNEDDS were non-toxic and safe for biomedical fields.
Explicating Women’s Career Transitions: Propositions and a Conceptual Model
Authors: Greer Tomika W. , Norman Joanna F. , Aiken Leah E.
Published: February 2024

In this conceptual article, we present an HRD model of career transitions. We used findings from extant literature to show how this model can be applied to women’s careers, which are characterized as nonlinear and complex due to the influence family life has on a woman’s career. The proposed model includes five propositions that explain how the career transition occurs in two phases: career preparation and career identity formation. These career transition phases are influenced by the individual characteristics of the woman in transition and the HRD interventions that are available and used by her. The entire process is sustained with the help of contextual supports, including workplace flexibility and inclusive organizational cultures. Future research can test this model in additional populations. This model highlights the practical role of HRD interventions and furthers theory and research related to career transitions in HRD.
Cellular Enhancement of Frozen Meniscus Allograft Combining Native Meniscus and Mesenchymal Stromal Cell Injections
Authors: Struijk Caroline , Lydon Katherine L. , Husen Martin , Verdonk Peter , Michielsen Jozef , van Wijnen Andre J. , Krych Aaron J. , Saris Daniel B.F.
Published: February 2024

Objective

This proof-of-concept study investigated an improved cell-based injection therapy combining mesenchymal stem cells (MSCs) and meniscus cells (MCs) to support superior meniscus allograft repopulation and early revival compared to injecting MSCs alone.

Design

In this controlled laboratory study, frozen meniscus allograft samples were injected vertically with a cell suspension containing different ratios of MSCs and MCs or control (lactated ringers) and cultured for 28 days. Samples were analyzed weekly for cell viability, migration, and metabolism using histological and biochemical assays. Tissue medium was analyzed for matrix metalloproteinase (MMP) expression using zymography.

Results

Cellular repopulation of frozen allografts injected with different cell suspensions was validated by immunohistochemistry. Significant higher DNA content was evidenced in grafts treated with suspensions of MCs or MC:MSC (1:4 ratio). Cell metabolic activity was significantly different between all treated groups and control group after 1 week. Allografts injected with MCs showed significantly more cell proliferation than injections with MSCs. MMP2 activity was detected in medium of all grafts cellularized with MCs with or without MSCs. Scanning electron microscopy (SEM) analysis showed resolution of the needle puncture, but not in the control group. Cell labeling of MCs upon injection of mixed MC:MSC suspensions revealed a gradual increase in the cell ratio.

Conclusions

The findings of this study establish that injection of MCs with or without MSCs enhances the cellularity of meniscus allograft to support early graft revival and remodeling.
Re-estimation of the burden of serious fungal diseases in Uganda
Authors: Bongomin Felix , Kwizera Richard , Namusobya Martha , van Rhijn Norman , Andia-Biraro Irene , Kirenga Bruce J. , Meya David B. , Denning David W.
Published: February 2024

Background:

It is of utmost importance to monitor any change in the epidemiology of fungal diseases that may arise from a change in the number of the at-risk population or the availability of local data.

Objective:

We sought to update the 2015 publication on the incidence and prevalence of serious fungal diseases in Uganda.

Methods:

Using the Leading International Fungal Education methodology, we reviewed published data on fungal diseases and drivers of fungal diseases in Uganda. Regional or global data were used where there were no Ugandan data.

Results:

With a population of ~45 million, we estimate the annual burden of serious fungal diseases at 4,099,357 cases (about 9%). We estimated the burden of candidiasis as follows: recurrent Candida vaginitis (656,340 cases), oral candidiasis (29,057 cases), and esophageal candidiasis (74,686 cases) in HIV-infected people. Cryptococcal meningitis annual incidence is estimated at 5553 cases, Pneumocystis pneumonia at 4604 cases in adults and 2100 cases in children. For aspergillosis syndromes, invasive aspergillosis annual incidence (3607 cases), chronic pulmonary aspergillosis (26,765 annual cases and 63,574 5-year-period prevalent cases), and prevalence of allergic bronchopulmonary aspergillosis at 75,931 cases, and severe asthma with fungal sensitization at 100,228 cases. Tinea capitis is common with 3,047,989 prevalent cases. For other mycoses, we estimate the annual incidence of histoplasmosis to be 646 cases and mucormycosis at 9 cases.

Conclusion:

Serious fungal diseases affect nearly 9% of Ugandans every year. Tuberculosis and HIV remain the most important predisposition to acute fungal infection necessitating accelerated preventive, diagnostic, and therapeutic interventions for the management of these diseases.
Isolated cryptococcal osteomyelitis in the setting of immune reconstitution inflammatory syndrome
Authors: Horton Embrey Pamela , Long Alexandra , Alfattal Rasha , Qiu Suimin , Hornak Joseph Patrik
Published: February 2024

Cryptococcal infections, though rare, must be considered in all immunocompromised patients. Patients with HIV/AIDS on antiretrovirals may have a treatment course complicated by immune reconstitution inflammatory syndrome. Here we present a case of a 38-year-old woman with HIV/AIDS with knee pain who only began to experience severe pain after induction of antiretroviral therapy. She was found to have cryptococcal osteomyelitis without dissemination to the central nervous system, an unusual presentation for immunocompromised patients. She was treated with oral fluconazole with a resolution of symptoms. This case report suggests conservative management of isolated cryptococcal infection with fluconazole, regardless of immune status.
Coeliac lymph node abscess: A case report of a rare manifestation of extrapulmonary tuberculosis
Authors: Goonetilleke Asitha , Nandasena Malith , Fernandopulle Nilesh , Matthias Anne Thushara
Published: February 2024

Tuberculosis is a leading cause of death worldwide, especially in developing countries. It can affect any site in the body and have a myriad of presentations making diagnosis challenging. Tuberculous lymphadenitis in the abdomen is rare. We present a case of a 42-year-old man who presented with non-specific abdominal symptoms and was found to have an intraabdominal abscess on computed tomography scan of the abdomen. Endoscopic ultrasound-guided aspiration was performed, and tuberculosis was confirmed. This case highlights the importance of having a high clinical suspicion of tuberculosis even with vague symptoms in tuberculosis endemic countries. This would prevent unnecessary surgery as tuberculosis is responsive to anti-tuberculosis drugs.
Social Media and Perceived Political Polarization: Role of Perceived Platform Affordances, Participation in Uncivil Political Discussion, and Perceived Others’ Engagement
Authors: Mak Macau K. F. , Li Mengyu , Rojas Hernando
Published: February 2024

This research applies a perceived affordance approach to examine the distinctive role of social media technologies in shaping (mis)perceptions of political polarization. We argue that users’ perceptions of platform affordances influence both (a) their self-participation in uncivil political discussion on social media and (b) perceptions of others’ engagement, which eventually shape their perceptions of polarization. Our analysis of US survey data found that perceptions of lower privacy and stronger network association on Facebook are related to perceptions of a higher level of uncivil discussion by other users, which in turn predicts greater perceived polarization. Perceptions of higher anonymity relate to higher self-participation in uncivil discussion, which is surprisingly associated with perceptions of reduced polarization. Our follow-up experimental study illustrated that participants with more frequent engagement in uncivil discussion, irrespective of interacting with civil or uncivil comments, showed consistently higher levels of intrapersonal reflection, which reduces perceived polarization.
Critical Illness-Related Corticosteroid Insufficiency (CIRCI) After Pediatric Cardiac Surgery
Authors: Ahmed Aziez , Kesman Russell , Lee Madonna E.
Published: February 2024

Although current studies do not support the routine use of corticosteroids after cardiopulmonary bypass in pediatric patients, there is incomplete understanding of the potential hemodynamic contribution of postoperative critical illness-related corticosteroid insufficiency in the intensive care unit. By reviewing the available studies and underlying pathophysiology of these phenomena in critically ill neonates, we can identify a subset of patients that may benefit from optimal diagnosis and treatment of receiving postoperative steroids. A suggested algorithm used at our institution is provided as a guideline for treatment of this high-risk population.
Determinants of the Quality of Tax Audits for Content Creation Tax and Tax Compliance: Evidence From Egypt
Authors: Tawfik Omar Ikbal , Elmaasrawy Hamada Elsaid
Published: February 2024

This study aims to examine the effect of determinants of the quality of tax audits for content creation tax on formal tax compliance and actual tax compliance. We used the questionnaire tool to collect data for a sample of 179 tax auditors, also we used partial least squares (PLS) to test the hypotheses. The result showed each of the regulations and laws, the quality of communication between the tax authority and taxpayers and the determinants associated with organizations have a positive effect on formal tax compliance. Meanwhile, the regulations and laws have a positive effect on actual tax. Also, there is no effect for both the quality of communication between the tax authority and taxpayers and the determinants associated with organizations on actual tax compliance. This study focused on the income tax on the profits of content creators and did not address the value-added tax on content creation. This study was also limited to the opinions of tax auditors and did not address the opinions of content creators.
Impact of Recovery Colleges in Postsecondary Institutions in Canada – Preliminary Findings
Authors: Paul Sayani , Battistelli Rachael , Arbour Simone
Published: February 2024

This paper describes the preliminary findings of the implementation of recovery colleges - a strengths-based, peer-driven, mental health learning model in five postsecondary institutions in Canada. Using exploratory methods and a sample of 124 participants completing a pre-participation and 72 completing a post-participation survey we aimed to answer two research questions; (1) Who is accessing the postsecondary recovery college? and (2) How is recovery college participation impacting students individually and interpersonally? Addressing the first research question, 80% were female students, between the ages of 18–25 years (73%), and 73% were in their second year of study. With regards to the second research question, recovery college participation improved students’ knowledge of coping and life skills and supported their mental health and wellbeing. Results provide evidence of impact of recovery college in postsecondary settings and may contribute to mental health system transformation to explore novel ways to support emerging adults’ mental health.
Expert Opinion, Real-World Classification, and Decision-Making in Thoracolumbar Burst Fractures Without Neurologic Deficits?
Authors: Camino-Willhuber Gaston , Bigdon Sebastian , Dandurand Charlotte , Dvorak Marcel F. , Öner Cumhur F. , Schnake Klaus , Muijs Sander , Benneker Lorin M. , Vialle Emiliano , Tee Jin W. , Keynan Ory , Chhabra Harvinder S. , Joaquim Andrei F. , Popescu Eugen C. , Canseco Jose A. , Holas Martin , Kanna Rishi M. , Aly Mohamed M. , Fallah Nader , Schroeder Gregory D. , Spiegl Ulrich , El-Skarkawi Mohammad , Bransford Richard J. , Rajasekaran Shanmuganathan , Vaccaro Alexander R.
Published: February 2024

Study Design

Retrospective analysis of prospectively collected data.

Objectives

To compare decision-making between an expert panel and real-world spine surgeons in thoracolumbar burst fractures (TLBFs) without neurological deficits and analyze which factors influence surgical decision-making.

Methods

This study is a sub-analysis of a prospective observational study in TL fractures. Twenty two experts were asked to review 183 CT scans and recommend treatment for each fracture. The expert recommendation was based on radiographic review.

Results

Overall agreement between the expert panel and real-world surgeons regarding surgery was 63.2%. In 36.8% of cases, the expert panel recommended surgery that was not performed in real-world scenarios. Conversely, in cases where the expert panel recommended non-surgical treatment, only 38.6% received non-surgical treatment, while 61.4% underwent surgery. A separate analysis of A3 and A4 fractures revealed that expert panel recommended surgery for 30% of A3 injuries and 68% of A4 injuries. However, 61% of patients with both A3 and A4 fractures received surgery in the real world. Multivariate analysis demonstrated that a 1% increase in certainty of PLC injury led to a 4% increase in surgery recommendation among the expert panel, while a .2% increase in the likelihood of receiving surgery in the real world.

Conclusion

Surgical decision-making varied between the expert panel and real-world treating surgeons. Differences appear to be less evident in A3/A4 burst fractures making this specific group of fractures a real challenge independent of the level of expertise.
Understanding Decision Making as It Influences Treatment in Thoracolumbar Burst Fractures Without Neurological Deficit: Conceptual Framework and Methodology
Authors: Dandurand Charlotte , Öner Cumhur F. , Hazenbiller Olesja , Bransford Richard J. , Schnake Klaus , Vaccaro Alexander R. , Benneker Lorin M. , Vialle Emiliano , Schroeder Gregory D. , Rajasekaran Shanmuganathan , El-Skarkawi Mohammad , Kanna Rishi M. , Aly Mohamed , Holas Martin , Canseco Jose A. , Muijs Sander , Popescu Eugen Cezar , Tee Jin Wee , Camino-Willhuber Gaston , Joaquim Andrei Fernandes , Keynan Ory , Chhabra Harvinder Singh , Bigdon Sebastian , Spiegel Ulrich , Dvorak Marcel F.
Published: February 2024

Study Design

This paper presents a description of a conceptual framework and methodology that is applicable to the manuscripts that comprise this focus issue.

Objectives

Our goal is to present a conceptual framework which is relied upon to better understand the processes through which surgeons make therapeutic decisions around how to treat thoracolumbar burst fractures (TL) fractures.

Methods

We will describe the methodology used in the AO Spine TL A3/4 Study prospective observational study and how the radiographs collected for this study were utilized to study the relationships between various variables that factor into surgeon decision making.

Results

With 22 expert spine trauma surgeons analyzing the acute CT scans of 183 patients with TL fractures we were able to perform pairwise analyses, look at reliability and correlations between responses and develop frequency tables, and regression models to assess the relationships and interactions between variables. We also used machine learning to develop decision trees.

Conclusions

This paper outlines the overall methodological elements that are common to the subsequent papers in this focus issue.
Using Equipoise to Determine the Radiographic Characteristics Leading to Agreement on Best Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficits
Authors: Dandurand Charlotte , Dvorak Marcel F. , Hazenbiller Olesja , Bransford Richard J. , Schnake Klaus J. , Vaccaro Alexander R. , Benneker Lorin M. , Vialle Emiliano , Schroeder Gregory D. , Rajasekaran Shanmuganathan , El-Skarkawi Mohammad , Kanna Rishi M. , Aly Mohamed M. , Holas Martin , Canseco Jose A. , Muijs Sander , Popescu Eugen C. , Tee Jin Wee , Camino-Willhuber Gaston , Joaquim Andrei Fernandes , Keynan Ory , Chhabra Harvinder Singh , Bigdon Sebastian , Spiegel Ulrich , Öner Cumhur F.
Published: February 2024

Study Design

Retrospective analysis of prospectively collected data.

Objectives

Our goal was to assess radiographic characteristics associated with agreement and disagreement in treatment recommendation in thoracolumbar (TL) burst fractures.

Methods

A panel of 22 AO Spine Knowledge Forum Trauma experts reviewed 183 cases and were asked to: (1) classify the fracture; (2) assess degree of certainty of PLC disruption; (3) assess degree of comminution; and (4) make a treatment recommendation. Equipoise threshold used was 77% (77:23 distribution of uncertainty or 17 vs 5 experts). Two groups were created: consensus vs equipoise.

Results

Of the 183 cases reviewed, the experts reached full consensus in only 8 cases (4.4%). Eighty-one cases (44.3%) were included in the agreement group and 102 cases (55.7%) in the equipoise group. A3/A4 fractures were more common in the equipoise group (92.0% vs 83.7%, P < .001). The agreement group had higher degree of certainty of PLC disruption [35.8% (SD 34.2) vs 27.6 (SD 27.3), P < .001] and more common use of the M1 modifier (44.3% vs 38.3%, P < .001). Overall, the degree of comminution was slightly higher in the equipoise group [47.8 (SD 20.5) vs 45.7 (SD 23.4), P < .001].

Conclusions

The agreement group had a higher degree of certainty of PLC injury and more common use of M1 modifier (more type B fractures). The equipoise group had more A3/A4 type fractures. Future studies are required to identify the role of comminution in decision making as degree of comminution was slightly higher in the equipoise group.
Prediction Model and Risk Factor Analysis of Adjacent Segment Disease After L4-5 Transforaminal Lumbar Interbody Fusion Through Preoperative Radiographic Features
Authors: Zhang Zi-Jian , Chen Lu , Zhu Lei , Shi Hang , Zhang Fu-Yu , Jiang Zan-Li , Wu Xiao-Tao
Published: February 2024

Study Design

A retrospective study.

Objective

To investigate the risk of adjacent segment disease (ASD) after L4-5 transforaminal lumbar interbody fusion (TLIF) in patients diagnosed with lumbar spinal stenosis (LSS), a prediction model for ASD is established and validated.

Methods

A retrospective study was carried out on a sample of 290 patients who underwent L4-5 TLIF at Zhongda Hospital, Southeast University, from January 2015 to January 2021. The study collected baseline data and preoperative radiographic features of L3-4 and L5-S1. The determination of the outcome variable was based on X-ray results spanning over 24 months and JOA scores. Multivariate logistic regression was used to identify the risk factors in constructing a nomogram.

Results

Independent risk factors for L3-4 degeneration after TLIF included osteoarthritis of L3-4 facet joints, L3-4 foraminal stenosis, L4 upper endplate osteochondritis, L3-4 local lordosis angle, and L3-4 spinal stenosis. Independent risk factors for L5-S1 degeneration after TLIF included osteoarthritis of L5-S1 facet joints, L5-S1 intervertebral disc degeneration, L5-S1 spinal stenosis, L5-S1 coronal imbalance, and S1 upper endplate osteochondritis. A predictive model was developed. The AUC for the prediction models at L3-4 and L5-S1 were .945 and .956. The calibration curve demonstrated good consistency between the predicted and actual probabilities. The DCA curve indicated the clinical benefit and practical value of this predictive model.

Conclusion

This study established nomograms for postoperative degeneration at L3-4 and L5-S1 based on selected preoperative radiographic features. These models provide a valuable auxiliary decision-making system for clinicians and aid in early surgical decisions.
Roger Felix V. Salditos and Agrarian Class Struggles in Panay Island, Philippines
Authors: Mongaya Karlo Mikhail I.
Published: February 2024

Roger Felix V. Salditos was among seven Filipino revolutionaries who were summarily executed by police and military forces in San Jose town, Antique, in the central Philippine island of Panay in 2018. Better known by the pen names Mayamor and Maya Daniel, which he used to sign his paintings and poetry, Salditos was a revolutionary intellectual who spent the better part of his life as a cadre of the Communist Party of the Philippines (CPP) since he left the seminary in 1979. This article examines the underground literary and political writings of Salditos to help illuminate the long history of agrarian class struggles of peasants and Tumandok indigenous peoples in one of the Philippines’ top food-producing regions. His narratives highlight the role of Panay as the only place where the Huk peasant rebellion took root outside Luzon in the 1950s, recalling important episodes of revolutionary contestations in the island amid changing conditions under the Marcos dictatorship and the class offensive of neoliberalism. Despite their partisan character and focus on the local and the superstructural, Salditos’s writings provide an important perspective on the persistence of one of the world’s longest-running rural-based insurgencies, notwithstanding the end of the classical era of peasant wars of the twentieth century and shifting spaces for agrarian contestations in the new century.
Challenges and opportunities of tele-speech therapy: Before and during the COVID-19 pandemic
Authors: Farmani Elahe , Fekar Gharamaleki Fatemeh , Nazari Mohammad Amin
Published: February 2024

In 2020, with the onset of the COVID-19 pandemic, the treatment and rehabilitation process faced problems and challenges. One of the most efficient therapy approaches in this period was telerehabilitation. Telepractice in speech therapy presents many challenges and opportunities. In this article, we review published articles up to June 2023 and summarize the challenges and opportunities of the COVID-19 pandemic for speech therapy. Researchers and clinicians have found that tele-speech therapy is an effective tool for improving access to high-quality services and a viable mechanism for delivering speech and language interventions. The results of teletherapy or telepractice during the COVID-19 pandemic were divided into opportunities and challenges. Speech therapy has moved toward telerehabilitation to improve treatment competence during the pandemic. Finally, teletherapy methods were more suitable for speech and language pathology.
Concurrence of Intracranial Injuries with Facial Trauma: A Retrospective Nationwide Analysis
Authors: Kim Erin J. , C. Lee Theodore , Bustos Valeria P. , Xun Helen , Lee Bernard T.
Published: February 2024

Introduction: The current literature exploring the association between facial and intracranial injuries is limited, as it primarily focuses on the association with facial fractures. This study aims to broaden the epidemiologic association between facial and intracranial trauma by expanding the scope of studied facial injuries. The secondary aim of this study will be to identify the most common setting of injury, diagnosis, and mechanism of injury. Methods: The National Electronic Injury Surveillance System database, which captures consumer goods-related injuries, was queried from 2019 to 2021. Inclusion criteria included encounters with cranial, facial, and both cranial and facial injuries. Outcome variables included the number of encounters, diagnosis, location of injury, associated consumer products, and patient disposition. Predictor variables included patient demographic information. Descriptive analyses were conducted, and all analyses were done on weighted national estimates. Results: A total of 10 939 340 weighted encounters were analyzed. Facial injuries had concurrent cranial injuries in approximately 1 in 4 encounters, and cranial injuries had concurrent facial injuries in approximately 1 in 6 encounters. Intracranial head injuries occurred with lower acuity facial injuries and without facial fractures in 91.1% of the encounters. The most common location across all groups was at home (66.9%), and building structures (28.8%) were the most common products resulting in injury. Conclusion: There is an understudied burden of associated intracranial injuries with lower acuity facial trauma across all ages, specifically in the home setting. Thus, in evaluating facial trauma, providers should consistently assess for potential head trauma, even when not immediately evident.
Immediate and Short-Term Effects of In-Shoe Heel-Lift Orthoses on Clinical and Biomechanical Outcomes in Patients With Insertional Achilles Tendinopathy
Authors: Alghamdi Nabeel Hamdan , Pohlig Ryan T. , Seymore Kayla D. , Sions Jaclyn Megan , Crenshaw Jeremy R. , Grävare Silbernagel Karin
Published: February 2024

Background:

Physical therapists frequently employ heel lifts as an intervention to reduce Achilles tendon pain and restore function.

Purpose:

To determine the short-term effect of heel lifts on clinical and gait outcomes in participants with insertional Achilles tendinopathy (IAT).

Study Design:

Case series; Level of evidence, 4.

Methods:

Participants with IAT underwent eligibility screening and completed assessments at baseline and 2 weeks later. Primary outcomes included symptom severity (Victoria Institute of Sports Assessment-Achilles [VISA-A]), gait analysis with the 10-m walk-test at 2 speeds (normal and fast), and pain during walking. Pain and gait analysis were assessed under 3 conditions: before fitting 20-mm heel lifts, immediately after heel-lift fitting, and after 2 weeks of wearing heel lifts. Ultrasound images and measurements at the Achilles insertion were obtained from prone and standing positions (with and without heel lifts). Spatiotemporal gait parameters and tibial tilt angles were evaluated at normal speed using inertia measurement units during the 3 study conditions. Differences between the conditions were analyzed using paired t test or analysis of variance.

Results:

Overall, 20 participants (12 female, 13 with bilateral IAT; mean age, 51 ± 9.3 years; mean body mass index 31.6 ± 6.8 kg/m2) completed all assessments. Symptom severity (VISA-A) of the more symptomatic side significantly improved at 2 weeks (60 ± 20.6) compared with baseline (52.2 ± 20.4; P < .01). Pain during gait (Numeric Pain Rating Scale) was significantly reduced immediately after heel-lift fitting (0.7 ± 2.0) when compared with baseline (2.2 ± 2.7, P = .043). Spatiotemporal gait parameters and tibial tilt angle before and after using heel lifts at normal walking speed were not significantly different; however, gait speed, stride length, and tibial tilt angle on both sides increased significantly immediately after using heel lifts and were maintained after 2 weeks of wear.

Conclusion:

Using heel lifts not only improved symptom severity after 2 weeks but also immediately reduced pain during gait and had a positive impact on gait pattern and speed.
An Analysis of Online Perceptions in Response to Microsoft’s and Google’s Sexual Harassment Scandals
Authors: Maiorescu Roxana D.
Published: February 2024

This study contributes to the literature on corporate diversity and crisis management by analyzing stakeholder perceptions in the aftermath of Google’s and Microsoft’s sexual harassment scandals. The results reveal that both scandals were construed from the perspective of activism, an inherent feature of social media communication. While users made demands for additional corrective action from both companies, Google’s scandal was predominantly defined from the frames of controllability and perceived injustice, possibly eroding corporate reputation. By contrast, the frame of severity prevailed in the online discourse around Microsoft and showed a delineation between perceptions of senior leadership and HR. The findings have implications for the practice of communication management with respect to scandals.
Social Network, Trust, Approval of President Biden, Risk Perception, and Annual COVID-19 Booster Intention
Authors: Hao Feng , Neely Stephen R.
Published: February 2024

The aim of this study is to understand the American public’s attitudes toward the annual coronavirus disease booster vaccination, administered beginning in the fall of 2023. The authors carried out a national survey in the spring of 2023, with 40 percent of respondents saying that they are “very likely” to receive the regular booster when it becomes available. Several underlying predictors are identified through structural equation modeling analyses. People with more vaccine takers in their social circles, greater trust in others, higher approval of President Biden’s performance, and greater perceived risk of the pandemic are more likely to receive regular boosters. The social network has the most considerable influence, with the largest coefficient size after comparing all standardized coefficients. The effect of trust is enhanced through social networks, and there is a combined effect of President Biden’s approval and risk perception. These findings contribute to the literature and have policy implications for leveraging interventions and optimizing the vaccination campaign.
Pediatric Intersession: An Upfront Flipped-Classroom Curriculum to Promote Pediatric Clerkship Readiness
Authors: Congdon Morgan , Goldstein Laura , Maletsky Kristin D. , Craven Meghan , Rose Stacey , Devon Erin Pete
Published: February 2024

OBJECTIVES

Best practices for content selection, mode of delivery, and timing of pediatric clerkship readiness curricula for medical students have, by and large, not been established. Capitalizing on changes in structure of the clinical clerkships during the COVID-19 pandemic, we created an upfront clerkship readiness curriculum, termed Pediatric Intersession (PI), to replace the existing weekly lecture-based clerkship didactics.

METHODS

Our goal was to develop an interactive curriculum with innovative instructional design methodology intended to promote broad foundational pediatric knowledge and clerkship preparedness using case-based learning. We first conducted a needs assessment and crafted curriculum content using guiding principles from the 2019 Council on Medical Student Education in Pediatrics (COMSEP) curriculum. We then organized material into four daily modules prior to the start of the clerkship and employed flipped classroom (FC) methodology.

RESULTS

Sixty-six percent of students completed course evaluations, and >90% of the 100 respondents reported that the PI enhanced their clinical learning. Pre-/post-testing demonstrated some knowledge gain following the small-group sessions and there was no change on the National Board of Medical Examiners (NBME) Subject Exam mean scores compared to prior cohorts of students.

CONCLUSIONS

The global pandemic provided an opportunity to re-envision our pediatric clerkship didactics content, while also incorporating instructional design methodology preferred by students. Our curriculum promotes a small group-based, interactive approach to clerkship readiness that fosters learning in the clinical environment that can be adapted for various settings. Our evaluation suggests that the transition to a FC readiness curriculum can be done successfully while effectively preparing students for their pediatric clerkship.
Influence of oxygen functional groups on the crack growth behavior of graphene with edge and middle crack: A molecular dynamics study
Authors: Salehi Arman , Rash-Ahmadi Samrand
Published: February 2024

In the last decade, graphene has found a wide role and application in nanocomposites and nanodevices for its extraordinary properties. However, due to its low fracture toughness and brittleness, graphene is brittle, and crack growth occurs rapidly. As a result, crack growth behavior and control of its progression are important. In this study, molecular dynamics modeling was used to investigate the crack growth behavior and mechanical properties in functionalized graphene (with middle and edge crack) with different oxide groups (hydroxyl, epoxide, and carboxyl) at different percentages of graphene oxide (0–3 wt. %). The results show that functionalized graphene with oxide groups changes the properties of graphene, effectively reducing the crack growth in crack length (4.9 Å), crack opening displacement (1.4 Å), tensile strength for edge crack (74 to 54 Gpa), and middle crack (128 to 63 Gpa). Also, carboxyl and epoxide groups have a greater reduction in crack growth rate, opening displacement growth rate, and stress concentration. In addition, increase in the number of atoms in oxide groups around the initial crack (with radius 13 Å) reduces crack growth rate, opening displacement growth rate, and stress concentration. This study provides a broader insight into crack growth behavior in functionalized graphene with oxide groups.
Calculating Repeated-Measures Meta-Analytic Effects for Continuous Outcomes: A Tutorial on Pretest–Posttest-Controlled Designs
Authors: Skvarc David R. , Fuller-Tyszkiewicz Matthew
Published: February 2024

Meta-analysis is a statistical technique that combines the results of multiple studies to arrive at a more robust and reliable estimate of an overall effect or estimate of the true effect. Within the context of experimental study designs, standard meta-analyses generally use between-groups differences at a single time point. This approach fails to adequately account for preexisting differences that are likely to threaten causal inference. Meta-analyses that take into account the repeated-measures nature of these data are uncommon, and so this article serves as an instructive methodology for increasing the precision of meta-analyses by attempting to estimate the repeated-measures effect sizes, with particular focus on contexts with two time points and two groups (a between-groups pretest–posttest design)—a common scenario for clinical trials and experiments. In this article, we summarize the concept of a between-groups pretest–posttest meta-analysis and its applications. We then explain the basic steps involved in conducting this meta-analysis, including the extraction of data and several alternative approaches for the calculation of effect sizes. We also highlight the importance of considering the presence of within-subjects correlations when conducting this form of meta-analysis.