bluuebunny/crossref_metadata_2025 huggingface dataset:
An elasto-plastic damage accumulation model for fatigue life predication of ductile metals at the yield stress
Authors: Huo Jindong , You Xiaochuan , Hu Jianan , Zhuang Zhuo
Published: September 2021

From the analysis of massive fatigue test data, we find a mismatch between the fatigue life predictions done by stress-life method (SN) and those by strain-life method (εN) around the yield stress of ductile metals. Since the SN and εN methods are widely used in engineering applications, this work aims to explain such mismatch and thereby to address the fatigue life prediction at material’s yield stress, at which the material’s elastic damage and plastic damage are comparable. Based on a normalized damage concept, we propose an elasto-plastic damage accumulation model, a data-driven approach, to evaluate the fatigue damage at the yield stress. By differentiating the damage caused by the elastic from the plastic, the damage of each loading cycle is formulated as a function of both stress and strain amplitudes to accurately capture the material’s response state. With introducing the strain-energy-density based weighting factor, the proposed model can accord well with the classical methods from low-cycle fatigue to high-cycle fatigue. When it comes to the yield stress, the fatigue life estimated by the proposed model compares favorably with the fatigue test data. Therefore, beyond clarifying the mismatch between the classical approaches, the proposed model is expected to improve the accuracy in fatigue damage evaluation of ductile metals at the yield stress.
Liposomal Bupivacaine Versus Immediate-Release Bupivacaine for Postoperative Pain Control
Authors: Dilawri Atul , Wyman Marcia , Shah Sneha
Published: September 2021

Background

Liposomal bupivacaine (LB) is increasingly being used for postoperative pain control, but there are conflicting efficacy data when compared with immediate-release bupivacaine (IRB).

Objective

To evaluate the comparative efficacies of LB and IRB for postoperative pain control in order to assess the formulary status of LB at our institution.

Methods

A single-center, retrospective, institutional review board–approved, noninferiority matched cohort study at a tertiary care academic medical center. Adult surgical patients admitted for >24 hours who received LB or IRB were included. The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes included total opioid consumption within 72 hours postoperatively, nonopioid analgesic use within 24 and 72 hours postoperatively, time to rescue analgesic use, and postoperative length of stay (LOS).

Results

A total of 326 patients were included in the matched cohort. Median 24-hour opioid consumption was significantly lower in the IRB group compared with the LB group (81 mg [30, 153] vs 103 mg [46, 241]; P = 0.01). Patients receiving IRB compared with LB also had a decrease in total opioid consumption 72 hours postoperatively (110 mg [45, 258] vs 165 mg [68, 402]; P = 0.005) and shorter postoperative LOS (2.8 days [1.7, 4] vs 3.3 days [2, 5.1]; P < 0.001). There was no difference in time to rescue analgesic use.

Conclusion and Relevance

Across a variety of surgical procedures, administration of IRB compared with LB was associated with a reduction in total opioid consumption within 24 and 72 hours postoperatively and shorter LOS in adult surgical patients.
A Critical Analysis of the Specific Pharmacist Interventions and Risk Assessments During the 12-Month TRANSAFE Rx Randomized Controlled Trial
Authors: Gonzales Haley M. , Fleming James N. , Gebregziabher Mulugeta , Posadas Salas Maria Aurora , McGillicuddy John W. , Taber David J.
Published: September 2021

Background

Medication safety issues have detrimental implications on long-term outcomes in the high-risk kidney transplant (KTX) population. Medication errors, adverse drug events, and medication nonadherence are important and modifiable mechanisms of graft loss.

Objective

To describe the frequency and types of interventions made during a pharmacist-led, mobile health–based intervention in KTX recipients and the impact on patient risk levels.

Methods

This was a secondary analysis of data collected during a 12-month, parallel-arm, 1:1 randomized clinical controlled trial including 136 KTX recipients. Participants were randomized to receive either usual care or supplemental, pharmacist-driven medication therapy monitoring and management using a smartphone-enabled app integrated with telemonitoring of blood pressure and glucose (when applicable) and risk-based televisits. The primary outcome was pharmacist intervention type. Secondary outcomes included frequency of interventions and changes in risk levels.

Results

A total of 68 patients were randomized to the intervention and included in this analysis. The mean age at baseline was 50.2 years; 51.5% of participants were male, and 58.8% were black. Primary pharmacist intervention types were medication reconciliation and patient education, followed by medication changes. Medication reconciliation remained high throughout the study period, whereas education and medication changes trended downward. From baseline to month 12, we observed an approximately 15% decrease in high-risk patients and a corresponding 15% increase in medium- or low-risk patients.

Conclusion and Relevance

A pharmacist-led mHealth intervention may enhance opportunities for pharmacological and nonpharmacological interventions and mitigate risk levels in KTX recipients.
Factors Affecting Turnover and Turnaway Intention of Journalists in South Korea
Authors: Song Haeyeop , Jung Jaemin
Published: September 2021

This study examined the factors affecting turnover and turnaway intention of newspaper journalists in South Korea through the lens of the push–pull–mooring framework. Survey results of 899 journalists showed that traffic boosting practices push journalists away from organizations. Particularly, senior journalists were more frustrated with the prevalence of traffic boosting practices, while juniors were more sensitive to growth potential and job security. Furthermore, ideological conflict between journalists and their organizations regarding political orientation was positively related to turnover intention. Meanwhile, regardless of the career length, journalists who enjoyed their coworkers were less likely to leave their jobs.
The Acceptability and Effectiveness of Videos Promoting Smoking Cessation Among Australians Experiencing Mental Illness
Authors: Sharma-Kumar Ratika , Puljević Cheneal , Morphett Kylie , Meurk Carla , Gartner Coral
Published: September 2021

There are high rates of tobacco smoking among people who experience mental illness (MI). While videos are an effective method of disseminating health-related information, there is limited research investigating the effectiveness of video-delivered education promoting smoking cessation among people living with MI. This formative study aimed to investigate the effectiveness and acceptability of targeted video resources providing smoking cessation information and advice to smokers with MI. This study used a mixed-method design; 29 Australian smokers living with MI completed a preinterview survey including 12 questions assessing knowledge about smoking cessation, watched six videos developed by the research team providing information about smoking cessation, took part in semistructured interviews about the videos’ quality, content, and format, and then completed a postinterview survey identical to the preinterview survey to assess changes in smoking cessation-related knowledge. A Wilcoxon signed rank test was used to calculate changes in cessation-related knowledge, and thematic analysis was used to identify common themes in qualitative data. We found a statistically significant increase in participants’ smoking cessation-related knowledge scores after watching the videos. Participants indicated an overall high level of acceptability of the videos’ quality, content, and format, and findings from the semistructured interviews reflected these favorable views. This study’s findings provide a new understanding of the effectiveness and acceptability of customized video-based education to promote smoking cessation among people living with MI, and can be used to inform the content and focus of video resources aimed at increasing knowledge about smoking cessation for people experiencing MI.
Eculizumab monotherapy for NMOSD: Data from PREVENT and its open-label extension
Authors: Pittock Sean J , Fujihara Kazuo , Palace Jacqueline , Berthele Achim , Kim Ho Jin , Oreja-Guevara Celia , Nakashima Ichiro , Levy Michael , Shang Shulian , Yountz Marcus , Miller Larisa , Armstrong Róisín , Wingerchuk Dean M ,   the PREVENT Study Group
Published: September 2021

During PREVENT (a phase 3, randomized, double-blind, placebo-controlled, time-to-event study) and its open-label extension (interim analysis), 33 adults with aquaporin-4 immunoglobulin G-positive neuromyelitis optica spectrum disorder (AQP4-IgG + NMOSD) received eculizumab monotherapy for a median of 2.8 years (range, 14 weeks–5.2 years). At 192 weeks (~4 years), 96% of these patients were free from adjudicated relapses (Kaplan–Meier analysis; 95% confidence interval, 75.7–99.4). During PREVENT, 95% (20/21) of patients receiving eculizumab monotherapy had no disability worsening. Eculizumab monotherapy provides effective long-term relapse prevention, relieving the chronic immunosuppression burden in patients with AQP4-IgG + NMOSD. ClinicalTrials.gov; PREVENT: NCT01892345; open-label extension: NCT02003144.
Risk factors for peripartum depression in women with multiple sclerosis
Authors: Krysko Kristen M , Anderson Annika , Singh Jessica , McPolin Kira , Rutatangwa Alice , Rowles William , Sadovnick A Dessa , Houtchens Maria K , Bove Riley
Published: September 2021

Background:

Peripartum depression (PPD) is underexplored in multiple sclerosis (MS).

Objective:

To evaluate prevalence of and risk factors for PPD in women with MS.

Methods:

Retrospective single-center analysis of women with MS with a live birth. Prevalence of PPD was estimated with logistic regression with generalized estimating equations (GEE). GEE evaluated predictors of PPD (e.g. age, marital status, parity, pre-pregnancy depression/anxiety, antidepressant discontinuation, sleep disturbance, breastfeeding, relapses, gadolinium-enhancing lesions, and disability). Factors significant in univariable analyses were included in multivariable analysis.

Results:

We identified 143 live births in 111 women (mean age 33.1 ± 4.7 years). PPD was found in 18/143 pregnancies (12.6%, 95% CI = 7.3–17.8). Factors associated with PPD included older age (OR 1.16, 95% CI = 1.03–1.32 for 1-year increase), primiparity (OR 4.02, CI = 1.14–14.23), pre-pregnancy depression (OR 3.70, CI = 1.27–10.01), sleep disturbance (OR 3.23, CI = 1.17–8.91), and breastfeeding difficulty (OR 3.58, CI = 1.27–10.08). Maternal age (OR 1.17, CI = 1.02–1.34), primiparity (OR 8.10, CI = 1.38–47.40), and pre-pregnancy depression (OR 3.89, CI = 1.04–14.60) remained significant in multivariable analyses. Relapses, MRI activity, and disability were not associated with PPD.

Conclusion:

The prevalence of PPD in MS appeared similar to the general population, but was likely underestimated due to lack of screening. PPD can affect MS self-management and offspring development, and prospective studies are needed.
Benchmarks of meaningful improvement on neurocognitive tests in multiple sclerosis
Authors: Wojcik Curtis , Jaworski Michael , Dwyer Michael G , Youngs Margaret , Unverdi Mahmut , Weinstock-Guttman Bianca , Benedict Ralph HB
Published: September 2021

Background:

Previous studies have established benchmarks of clinically meaningful decline on neuropsychological tests. However, little is known about meaningful testing benchmarks based on gains in function.

Objective:

Investigate neuropsychological changes in multiple sclerosis (MS) patients with work gains and calculate benchmarks of meaningful improvement on neuropsychological tests.

Methods:

A total of 323 people with MS were monitored longitudinally with neuropsychological testing and the Buffalo Vocational Monitoring Survey.

Results/Conclusions:

Those with work gains showed significant improvement (~3 points) on the Symbol Digit Modalities Test (SDMT) over time, p = 0.01. Benchmarks for clinically meaningful improvement on the SDMT are similar to those previously established for clinically meaningful decline.
How to deliver an effective primary survey report for the trauma CT: A radiological and surgical perspective
Authors: Davies Joseph , Johnson Rowena , Kashef Elika , Khan Mansoor , Dick Elizabeth
Published: September 2021

Whole body contrast-enhanced multidetector CT (WB-CE MDCT) is integral to the assessment of the severely injured patient with stable haemodynamic parameters or in those who respond to resuscitation with blood products. WB-CE MDCT is able to identify the number and severity of injuries sustained by the patient and enable time critical intervention.

In this narrative review article we discuss how communication within the trauma team, including the radiologists and appropriate clinicians is crucial in optimizing the effectiveness of WB-CE MDCT. We review the time critical imaging findings and their clinical relevance, which should be included in a succinct CT primary survey report.

We also discuss the process through which the effectiveness of the trauma report may be maximised and how non technical factors including teamwork may be optimised to facilitate decision making in this high pressure environment.
Predictive Factors for Limb Salvage and Foot Ulcer Recurrence in Patients with Chronic Limb-Threatening Ischemia After Multidisciplinary Team Treatment: A 6-Year Japanese Single-Center Study
Authors: Fujii Miki , Yamada Akitoshi , Yamawaki Kohei , Tsuda Shigeyasu , Miyamoto Naokazu , Gan Kunio , Terashi Hiroto
Published: September 2021

Chronic limb-threatening ischemia (CLTI) is associated with a short-term risk of limb loss. Multidisciplinary teams are often involved in CLTI treatment; however, in Asian countries, multidisciplinary teams that include podiatrists specializing in foot wounds and vascular surgeons who can perform distal bypass surgery are lacking. We investigated predictive factors for limb salvage and foot ulcer recurrence in patients with CLTI treated by a Japanese single-center intensive multidisciplinary team over 6 years. We retrospectively investigated 84 patients with CLTI and foot ulcers who had undergone revascularization and wound treatment between October 2013 and December 2019. Following postrevascularization treatment, including undertaking minor amputations, the healing rate was 77.8%, and the average wound healing time was 75 ± 68 days. To achieve adequate blood supply, 17.7% of patients were treated using a combination of endovascular revascularization and bypass surgeries. Thirty-three (44%) patients had wound recurrence and there was wound recurrence within 6 months in 58.9% of these patients. Multivariate logistic regression analysis showed that postrevascularization skin perfusion pressure was significantly associated with wound healing (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.033-1.243, P = .0078). Diabetes mellitus (OR 9.72, 95% CI 1.855-50.937, P = .0071), and heart disease (OR 3.51, 95% CI 1.052-11.693, P = .0411) were significantly associated with wound recurrence ( P < .05). Treatment within a single-center intensive multidisciplinary team resulted in good patient outcomes. Our study indicates that the revascularization endpoint of CLTI treatment should be marked by attainment of adequate blood supply and wound healing. The timing of revascularization and debridement is of utmost importance for the successful treatment of CLTI wounds.
Effects of Low-Intensity Conflicts on Farming Communities in Mindanao, Philippines
Authors: Pergis-Lozada Hazel , Valdez-Bayogan Emma Ruth , Orbeta Marvin Louie Gamaya , Fuentes Anne Shangrila Ysulat
Published: September 2021

Low-intensity conflicts have often been afforded lesser importance than high-intensity conflicts. Yet, low-intensity conflicts can have impacts on the ability to farm, productivity, and income. We studied the effects of low-intensity conflicts on the farming communities in two conflict vulnerable areas in Mindanao, Southern Philippines. Following a review of the economic effects of conflict with a focus on Mindanao, we surveyed farmers in low-conflict areas to assess its impact on livelihood. In 2018, farmers in “peaceful” situation differed in income from those who are in “low-conflict” situations. The mean total household income for the “low conflict” (PHP8,360 or $US155) group was significantly lower by PHP13,060 ($US242) from the “peaceful” group (PHP24,433 or $US453). This findings suggest the need for further research regarding how villages resolve conflicts informally as a way of improve government-sponsored conflict resolution efforts.
Photo-Elicited Interviews: A Method to Create Open Communication for Mothers Raising Children With Foetal Alcohol Spectrum Disorder
Authors: Drotsky Lian-Marie , Sonday Amshuda , Gretschel Pam
Published: September 2021

Photo-elicited interviewing (PEI) can make a valuable contribution to understand the lived realities of mothers raising children with foetal alcohol spectrum disorder (FASD), when used as a methodological tool. This article offers an explanation to some of the challenges experienced by these mothers who are often marginalised by a perception of causing wilful harm. PEI was used in a Master’s thesis that described the ways in which mothers promoted the occupational engagement of their children with FASD in the Pixley Ka Seme District in Northern Cape Province, South Africa. The study served as an example of how PEI shifted the power balance between the researcher and the mothers to create a space that encouraged mothers as participants to talk openly and freely about the challenges in their daily lives. PEI promoted the agency of participants and enabled the researcher to learn from them as experts in raising their children. The images discussed during PEI opened valuable doorways to conversation, helping participants prioritise what they want to share, while images acted as reminders during the conversation. Photographs added a visual layer to the verbal data gained through semi-structured interviews, offering a deeper level of insight into the contributions mothers make towards the development of children with FASD.
Safety inspection system and comprehensive evaluation method for concrete structure of gas pipeline tunnel based on fuzzy mathematics
Authors: Li Songhui , Zhang Yan , Han Shasha
Published: September 2021

Regular safety inspections are an important guarantee to ensure the high-quality operation of concrete structures of tunnels. The Chinese West-east Gas Pipeline Project is large in scale and complex in construction environment. These tunnels are equipped with gas pipelines, and the concrete structural defects of the tunnels are continuously exacerbated during the long-term operation. There are few studies on the safety evaluation methods of concrete structures of gas tunnels. Based on the characteristics of the operation of the gas tunnels, this paper proposes the establishment of a structural safety comprehensive inspection system from the following seven aspects, that is, the void between the concrete lining and surrounding rock, the strength of the concrete lining, the thickness of the protective layer of the reinforced concrete lining, the carbonization depth of the concrete lining, the deformation of the tunnel section, the cracks in the concrete lining, and the auxiliary concrete structure of the tunnel. In addition, a corresponding quantitative determination method and safety level classification standard are established. Based on the fuzzy mathematics theory and a structural safety comprehensive inspection system, a five-level safety evaluation method for tunnel concrete structures is proposed. Finally, a comprehensive inspection and evaluation were carried out for a tunnel running across the mountain.
Toward a Harm-Based Account of Microaggressions
Authors: Freeman Lauren , Stewart Heather
Published: September 2021

In this article, we critique the dominant understanding of microaggressions introduced by Derald Wing Sue and his colleagues—what we call the act-based account of microaggressions—by identifying its theoretical and practical shortcomings. On the basis of this critique, we introduce and defend an alternative, ameliorative account of microaggressions, what we call the harm-based account of microaggressions. Instead of understanding microaggressions on the basis of the acts committed by the microaggressing agent, we call for a reorientation of the concept so that the recipients of microaggressions and the harms they experience become the focal point.
Racial Incivility in Everyday Life: A Conceptual Framework for Linking Process, Person, and Context
Authors: Ong Anthony D.
Published: September 2021

Psychologists use the term racial microaggressions to describe subtle forms of everyday racial incivility and discrimination reported by members of historically underrepresented groups. Growing evidence links self-reported experiences of racial microaggressions to health. Drawing on life-course perspectives on stress, biopsychosocial models of racism, and daily-process research, I propose a conceptual framework for investigating daily stress processes (e.g., reactivity, recovery, appraisal, coping), cumulative stressor exposures (e.g., race-related traumas, major life events, nonevents, chronic stressors), and social structural factors (e.g., institutions, social roles, statuses) that may affect the experience of racial microaggressions in everyday life. An underlying assumption is that microaggressions are dynamic in character, can vary across individuals, and are shaped by the interplay of stressor exposures across multiple timescales and levels of analysis. The article concludes by inviting researchers to use methods that account for dynamic features of everyday racialized experiences, giving sufficient attention to process, person, and context.
Racial and Language Microaggressions in the School Ecology
Authors: Steketee Anne , Williams Monnica T. , Valencia Beatriz T. , Printz Destiny , Hooper Lisa M.
Published: September 2021

The growth trajectory of ethnically and linguistically diverse individuals in the United States, particularly for youth, compels the education system to have urgent awareness of how diverse aspects of culture (e.g., Spanish-speaking, Black Latina student) are implicated in outcomes in American school systems. Students spend a significant amount of time in the school ecology, and this experience plays an important role in their well-being. Diverse ethnic, racial, and linguistic students face significant challenges and are placed at considerable risk by long-observed structural inequities evidenced in society and schools. Teachers must develop the capacity to be culturally sensitive, provide culturally responsive pedagogy, and regularly self-assess for biases implicated in positive academic outcomes for students in kindergarten through Grade 12. Research and practice have suggested that racism and discrimination in the form of racial microaggressions are observed daily in schools and classrooms. This article provides an overview of racial microaggressions in the school context and their damaging effects on students. We provide specific examples of microaggressions that may be observed in the U.S. classroom environment and how schools can serve as a positive intervention point to ameliorate racism, discrimination, and racial and language microaggressions. This comprehensive approach blends theory with practice to support the continued development of cultural humility, culturally sustaining pedagogy, and an equity-responsive climate.
Impaired selection of a previously ignored singleton: Evidence for salience map plastic changes
Authors: Turatto Massimo , Valsecchi Matteo
Published: September 2021

Spatial suppression of a salient colour distractor is achievable via statistical learning. Distractor suppression attenuates unwanted capture, but at the same time target selection at the most likely distractor location is impaired. This result corroborates the idea that the distractor salience is attenuated via inhibitory signals applied to the corresponding location in the priority map. What is less clear, however, is whether lingering impairment in target selection when the distractor is removed are due to the proactive strategic maintenance of the suppressive signal at the previous most likely distractor location or result from the fact that suppression has induced plastic changes in the priority map, probably changing input weights. Here, we provide evidence that supports the latter possibility, as we found that impairment in target selection persisted even when the singleton distractor in the training phase became the target of search in a subsequent test phase. This manipulation rules out the possibility that the observed impairments at the previous most likely distractor location were caused by a signal suppression maintained at this location. Rather, the results reveal that the inhibitory signals cause long-lasting changes in the priority map, which affect future computation of the target salience at the same location, and therefore the efficiency of attentional selection.
Players at home: Physical activity and quality of life in 12–17 years-old football (soccer) players during the Covid-19 lockdown
Authors: Zago Matteo , Lovecchio Nicola , Galli Manuela
Published: September 2021

Background

Aggressive preventive actions were required to face the Covid-19 outbreak. However, from March 2020 on, many healthy youth football players have seen their sporting activities disrupted by the restrictions on outdoor exercise. This study describes physical activity and quality of life during April 2020 lockdown of young people participating in organized football.

Methods

1163 young football players aged 12–17 years (185 girls) completed a web-based questionnaire including the Youth Physical Activity and the Youth Quality of Life-Short Form Questionnaires; information on lifestyle and football-specific activity were also collected. Differences according to sex, urban/rural context and élite/non-élite club level were tested using a 2 [Formula: see text] 2 [Formula: see text] 2 MANOVA (age considered as a covariate).

Results

We found that: (i) on average, exposure to football accounted for 3.2 hours/week, was higher in élite clubs and changed in nature, being mainly performed individually; 19% of participants practiced football <1 hour/week; (ii) only 56% of the participants reported 7 or more hours/week of moderate-to-vigorous physical activity, which decreased with age and changed according to the geographical context; (iii) perceived quality of life was lower in youth playing for non-elite clubs and in older girls; (iv) coaches, rather that official initiatives, were the primary source of football exercises practiced at home.

Conclusion

A status of limited physical activity emerged; this might lead to deconditioning and susceptibility to injuries when football could restart. Governing bodies, football Associations and clubs could exploit these results to take informed decisions and support evidence-based interventions during and after the Covid-19 pandemic.
Anakinra and canakinumab for patients with R92Q-associated autoinflammatory syndrome: a multicenter observational study from the AIDA Network
Authors: Gaggiano Carla , Rigante Donato , Hernández-Rodríguez José , Vitale Antonio , Tarsia Maria , Soriano Alessandra , Lopalco Giuseppe , Iannone Florenzo , Abdel Jaber Masen , Giacomelli Roberto , Wiȩsik-Szewczyk Ewa , Cattalini Marco , Frassi Micol , Piga Matteo , Ragab Gaafar , Sota Jurgen , Zunica Fiammetta , Floris Alberto , Sabato Vito , Hegazy Mohamed Tharwat , Araújo Olga , Pelegrín Laura , Fabbiani Alessandra , Renieri Alessandra , Grosso Salvatore , Fabiani Claudia , Frediani Bruno , Cantarini Luca
Published: September 2021

Background:

This study aims at describing the therapeutic outcome of patients carrying the R92Q variant in the TNFRSF1A gene treated with anakinra (ANA) or canakinumab (CAN) and identifying any factors predictive of complete response to IL-1 inhibition.

Methods:

Clinical data of patients treated with ANA or CAN for recurrent inflammatory attacks due to the presence of the R92Q variant were retrospectively collected and analysed.

Results:

Data about 20 treatment courses with IL-1 inhibitors (16 with ANA and 4 with CAN) from 19 patients were collected. Mean age at disease onset was 20.2 ± 14.8 years. In 5 cases (26%) the R92Q variant was found in a family member affected by recurrent fever. The therapeutic response was complete in 13(68%) and partial in 2 patients (11%); treatment failure was observed in 4 cases (21%). Median AIDAI decreased from 10 (interquartile range [IQR] = 28) to 0 (IQR = 1) at the 12-month follow-up visit ( p < 0.001). Mean ESR and median CRP dropped respectively from 40.8 ± 24.8 to 9.1 ± 4.5 mm/h ( p < 0.001) and from 3.0 (IQR = 1.9) to 0.3 (IQR = 0.3) mg/dl ( p < 0.001) after 12 months of treatment. A steroid-sparing effect was observed from the third month of treatment ( p < 0.01). Thirteen patients (65%) were still on treatment at the last follow-up visit (median duration of treatment 17 (IQR = 38) months). The presence of R92Q mutation in a symptomatic relative ( p = 0.022), the relapsing remitting disease course ( p < 0.001) and the presence of migratory erythematous skin rashes during fever attacks ( p = 0.005) were associated with complete efficacy of IL-1 inhibitors.

Conclusions:

R92Q patients showed a favourable response to ANA and CAN, particularly when the mutation segregated in a family member and when a relapsing-remitting disease course or TNF-α receptor-associated periodic syndrome (TRAPS) typical skin rash were observed. In the subgroup of patients not taking advantage of IL-1 blockage different molecular mechanisms underlying the autoinflammatory picture are likely to exist.
Effect of Silver Nitrate Application on the Success of Endoscopic Dacryocystorhinostomy
Authors: Çetin Yaser S. , Akın Ramazan , Düzenli Ufuk , Turan Mahfuz , Bozan Nazım
Published: September 2021

Objectives

To compare the clinical outcomes of patients undergoing additional procedures in endoscopic endonasal dacryocystorhinostomy (End-DCR) surgery and discuss the factors affecting the success of End-DCR surgery in light of relevant literature.

Methods

The study included 155 patients who underwent End-DCR surgery in our clinic due to epiphora. This was a prospective randomized, single-blind, controlled trial. Group I (control) included 54 patients who did not undergo silicone stent insertion or silver nitrate application, group II included 51 patients who underwent silicone stent insertion only, and group III included 50 patients who underwent silver nitrate application only. Statistical analysis was performed on follow-up data regarding anatomic and functional success rates.

Results

Revision surgery was performed in 16 patients who developed persistent epiphora in the postoperative period, including 6 in group I, 7 in group II, and 3 in group III ( P = .4). The most common reason for revision surgery was stenosis of the neo-ostium ( n = 8), followed by granulation tissue formation ( n = 5) and synechia formation ( n = 3). Granuloma formation was the most common postoperative complication, and a significant difference was found among the groups with regard to granuloma formation ( P = .04). At postoperative month 12, the functional success rate was estimated to be 88%, 86%, and 94%, and the anatomic success rate was estimated to be 94%, 92%, and 96% in groups I, II, and III, respectively, with no significant difference, found among the 3 groups with regard to both rates ( P = .79 and P = .76, respectively).

Conclusion

The results indicated that stenting and silver nitrate application did not affect surgical success. Our preliminary results on silver nitrate cauterization showed that it is an effective, inexpensive, and practical method to reduce granulation formation in the postoperative period.
Has the Product Patent Regime Impacted Mergers and Acquisitions? Unveiling with a Systematic Literature Review
Authors: Verma Ashima , Agrawal Rachna
Published: September 2021

Mergers and acquisitions (M&As) are one of the most practised inorganic strategies to multiply economic profits, acquire new product capabilities, expand markets, diversify risk and bring synergistic gains. The purpose of the study is to review the literature related to companies’ financial analysis, pre and post-M&A after the Patents (Amendment) Act, 2005. The study follows a systematic literature review (SLR) process where 128 research publications from 2005–2020 are examined after applying the required review protocols. SLR found a deficient practical contribution of the limited literature on the three perspectives, namely, from accounting, productivity and managerial perspectives at the international level. Furthermore, there is also a dearth of studies from the three perspectives for the Indian Pharmaceutical Industry (IPI) post the Patents (Amendment) Act, 2005. This review finds that there is a need for a unified approach for evaluating the success of M&A in IPI. Future studies can encourage research that ties these three perspectives to a common thread and furnishes a holistic approach for analysis. It will further bolster the research to provide practical insights to companies’ rooting for a robust financial analysis.
Risk Factors for Injuries in Runners: A Systematic Review of Foot Strike Technique and Its Classification at Impact
Authors: Burke Aoife , Dillon Sarah , O’Connor Siobhán , Whyte Enda F. , Gore Shane , Moran Kieran A.
Published: September 2021

Background:

It has been suggested that foot strike technique (FST) at initial contact is related to running-related injuries (RRIs).

Purpose:

To explore the relationship between FST and RRIs.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic electronic search was performed using MEDLINE, PubMed, SPORTDiscus, Scopus, and Web of Science databases. Included were studies published in the English language that explored the relationship between FST and RRIs between January 1960 and November 2020. Results were extracted and collated. The Grading of Recommendations, Assessment, Development and Evaluation approach was applied to synthesize the quality of evidence.

Results:

We reviewed 13 studies exploring the relationship between FST and RRIs. Of these, 6 studies reported FST categorically (foot strike pattern [FSP]), and 7 reported continuous measures (foot contact angle, ankle flexion angle, and strike index). Three of the 6 studies looking at categorical FSP found rearfoot strikers have a significantly greater retrospective injury rate than do non– rearfoot strikers, with 1 other study noting a greater risk associated with midfoot and forefoot strike. Regarding the continuous measures of FST, only 1 of the 7 studies reported a significant relationship with RRIs.

Conclusion:

There was low evidence to suggest a relationship between FST (or its subcategories of categorical FSP and continuous measures) and RRIs. While two-thirds of the categorical studies found a relationship between FSP and RRIs, these studies were very low quality, with limitations such as retrospective study design, low participant numbers, and poor FSP assessment methods. More large-scale prospective studies are required.
Linking Features of Structural and Process Quality Across the Landscape of Early Education and Care
Authors: Hanno Emily C. , Gonzalez Kathryn E. , Jones Stephanie M. , Lesaux Nonie K.
Published: September 2021

Commonly regulated structural quality features, like educator education levels and group size, are thought to be foundational to the quality of children’s everyday experiences in early education and care settings. Yet little is known about how these features relate to the day-to-day interactions and activities that occur in these settings—or process quality features—across the landscape of early education and care. In this study, we examine the association between structural quality features and process quality features in a diverse sample of classrooms (n = 672) participating in a statewide study of early education and care. Using a permutation test approach, we found that group size and child-to-adult ratio were most consistently linked to children’s experiences but educator education, experience, and curriculum usage were largely unrelated. Implications of these findings for quality improvement initiatives are discussed.
Prevalence of Eight or More Antenatal Care Contacts: Findings From Multi-Country Nationally Representative Data
Authors: Ekholuenetale Michael
Published: September 2021

Optimal antenatal care is an important service required by women and babies. To promote healthy motherhood and for positive pregnancy outcomes, World Health Organization recently recommended a minimum of 8 ANC contacts. We aim to explore the prevalence of 8 or more ANC contacts using multi-country data. Urban dwellers, mothers with secondary or higher education, women from high household wealth, early birth order, and older mothers at childbirth had higher prevalence of 8 or more ANC contacts respectively. The pooled prevalence of 8 or more ANC contacts was 13.0%. Jordan had the leading prevalence of 8 or more ANC contacts (74.0%), followed by Ghana (43.0%) and Albania (30.0%). On the other hand, Senegal, Uganda, and Zambia had very low prevalence of 8 or more ANC contacts. There was heterogeneity in the prevalence of 8 or more ANC contacts across countries. There was low prevalence of 8 or more ANC contacts.
Parental Child Rearing Practices in Palestine: A Cross-Sectional Study
Authors: Atout Maha , Alrimawi Intima , Dreidi Mutaz , Rajeh Saifan Ahmad , Abusalameh Eman , Al-Yateem Nabeel
Published: September 2021

The objectives of this study were to explore parenting practices from the perspectives of Palestinian parents and their children, and concordance between parents and children in their reports of parenting practices, in a culture that is underrepresented in the literature. A descriptive cross-sectional design was used. The Alabama Parenting Questionnaire (APQ) was administered to 120 parents and 120 children drawn from 4 districts in Palestine. Children had higher scores on parental involvement, positive parenting, poor monitoring, inconsistent discipline, and corporal punishment. Three significant parent–child relationships were obtained1: parental involvement ( r = .276, P = .003), positive parenting ( r = .0301, P = .001), and poor parental monitoring ( r = −.241, P = .008). The findings of this study might be used by Palestinian authorities and policy-makers to formulate guidelines and training to aid parental decision-making about child rearing.
Prenatal Diagnosis Leads to Early Diagnosis of Transfusion-Dependent Thalassemia and Better Growth Outcomes
Authors: Asawasudsakorn Natthida , Lauhasurayotin Supanun , Poparn Hansamon , Chiengthong Kanhatai , Sosothikul Darintr , Chaiyasit Noppadol , Techavichit Piti
Published: September 2021

Thalassemia is the most common hematological transfusion-dependent disease in Thailand. Even though prenatal diagnosis (PND) can detect the condition, many new cases are diagnosed in pediatric practice. This study assessed the clinical outcome of patients with thalassemia who did PND. One hundred and six participants (53 female, 50%), with a median age of 8.5 years (Interquartile range [IQR] 8.00), were enrolled in the study. Twenty-one participants (19.8%) were prenatally diagnosed with thalassemia, with a median age of 8 years (IQR 9.00), 16 were diagnosed with transfusion-dependence thalassemia (TDT), and 5 participants were diagnosed with non-TDT. Another 80.2% did not prenatally diagnose, with a median age of 9 years (IQR 8.00). The PND group found early diagnosis compared with a non-PND group, at a median age of 6 months versus 15 months. There was a significant early diagnosis ( P < .001). Furthermore, the participants’ height for age z-score was significantly superior in the PND group ( P = .018). Even though the result of PND was abnormal, the parents still willing to continue with the pregnancy. The reason was they wanted to have a child. However, their child may require lifelong transfusion therapy.
Endoscopically Assisted Reconstruction of the Achilles Tendon Using Semitendinosus Graft
Authors: Carmont Michael R. , Saha Arunansu , Rhind John-Henry , Nilsson Niklas , Karlsson Jón , Nilsson-Helander Katarina
Published: September 2021

Background:

Chronic ruptures of the Achilles tendon may lead to symptomatic weakness, despite rehabilitation. Open reconstruction yields good outcome but has a high complication rate, notably wound problems. Endoscopically assisted free semitendinosus transfer restores ankle and preserves first metatarsophalangeal joint (MTPJ) function.

Indications:

The main indication for the procedure is symptomatic chronic rupture of the Achilles tendon with a palpable tendon gap.

Technique Description:

The procedure can be split into 4 stages: graft harvest, calcaneum and tunnel preparation, proximal graft attachment, and finally graft passage and screw insertion.

Discussion/Conclusion:

Following reconstruction, patients use a cast in full plantar flexion for 2 weeks, then a graduated walker for full weight-bearing.
HLFexpression defines the human hematopoietic stem cell state
Authors: Lehnertz Bernhard , Chagraoui Jalila , MacRae Tara , Tomellini Elisa , Corneau Sophie , Mayotte Nadine , Boivin Isabel , Durand Aurélie , Gracias Deanne , Sauvageau Guy
Published: September 2021

Hematopoietic stem cells (HSCs) sustain blood cell homeostasis throughout life and can regenerate all blood lineages after transplantation. Despite this clear functional definition, highly enriched isolation of human HSCs can currently only be achieved through combinatorial assessment of multiple surface antigens. Although several transgenic HSC reporter mouse strains have been described, no analogous approach to prospectively isolate human HSCs has been reported. To identify genes with the most selective expression in human HSCs, we profiled population and single-cell transcriptomes of unexpanded and ex vivo cultured cord blood–derived hematopoietic stem and progenitor cells as well as peripheral blood, adult bone marrow, and fetal liver. On the basis of these analyses, we propose the master transcription factor HLF (hepatic leukemia factor) as one of the most specific HSC marker genes. To directly track its expression in human hematopoietic cells, we developed a genomic HLF reporter strategy, capable of selectively labeling the most immature blood cells on the basis of a single engineered parameter. Most importantly, HLF-expressing cells comprise all stem cell activity in culture and in vivo during serial transplantation. Taken together, these results experimentally establish HLF as a defining gene of the human HSC state and outline a new approach to continuously mark these cells with high fidelity.
Abnormal B-cell development in TIMP-deficient bone marrow
Authors: Weiss Ashley , Saw Sanjay , Aiken Alison , Aliar Kazeera , Shao Yang W. , Fang Hui , Narala Swami , Shetty Ronak , Waterhouse Paul D. , Khokha Rama
Published: September 2021

Bone marrow (BM) is the primary site of hematopoiesis and is responsible for a lifelong supply of all blood cell lineages. The process of hematopoiesis follows key intrinsic programs that also integrate instructive signals from the BM niche. First identified as an erythropoietin-potentiating factor, the tissue inhibitor of metalloproteinase (TIMP) protein family has expanded to 4 members and has widely come to be viewed as a classical regulator of tissue homeostasis. By virtue of metalloprotease inhibition, TIMPs not only regulate extracellular matrix turnover but also control growth factor bioavailability. The 4 mammalian TIMPs possess overlapping enzyme-inhibition profiles and have never been studied for their cumulative role in hematopoiesis. Here, we show that TIMPs are critical for postnatal B lymphopoiesis in the BM. TIMP-deficient mice have defective B-cell development arising at the pro-B-cell stage. Expression analysis of TIMPless hematopoietic cell subsets pointed to an altered B-cell program in the Lineage−Sca-1+c-Kit+ (LSK) cell fraction. Serial and competitive BM transplants identified a defect in TIMP-deficient hematopoietic stem and progenitor cells for B lymphopoiesis. In parallel, reverse BM transplants uncovered the extrinsic role of stromal TIMPs in pro- and pre-B-cell development. TIMP deficiency disrupted CXCL12 localization to LepR+ cells, and increased soluble CXCL12 within the BM niche. It also compromised the number and morphology of LepR+ cells. These data provide new evidence that TIMPs control the cellular and biochemical makeup of the BM niche and influence the LSK transcriptional program required for optimal B lymphopoiesis.
Systemic bevacizumab for refractory bleeding and transfusion-dependent anemia in Heyde syndrome
Authors: Song Andrew B. , Sakhuja Rahul , Gracin Nancy M. , Weinger Ronald , Kasthuri Raj S. , Al-Samkari Hanny
Published: September 2021

Heyde syndrome, the co-occurrence of aortic stenosis and bleeding gastrointestinal (GI) angiodysplasia, is managed with aortic valve replacement. However, severe bleeding and anemia can preclude safe use of the antiplatelet or anticoagulant therapy required for this intervention. We present a case of the novel and successful treatment of severe, refractory bleeding and transfusion dependence with antiangiogenic therapy in a patient with Heyde syndrome. After systemic bevacizumab was initiated, the patient achieved durable hemostasis with normalization of hemoglobin and liberation from red cell transfusion and dependence on iron infusion; aspirin therapy was successfully initiated where it had previously failed. This durable hemostasis facilitated her subsequent successful transcatheter aortic valve replacement. Plasma vascular endothelial growth factor levels, which were monitored during therapy, paradoxically rose after bevacizumab was initiated but normalized after it was discontinued. Given the angiogenic dysregulation of Heyde syndrome, systemic bevacizumab may be an effective and safe targeted therapy for managing refractory GI bleeding, which thereby facilitates antiplatelet therapy and aortic valve replacement in these challenging cases. Additional investigation into the therapeutic role of inhibiting angiogenesis as a hemostatic modality in Heyde syndrome is warranted.