bluuebunny/crossref_metadata_2025 huggingface dataset:
Porridge and misogyny: Rationalising inconspicuous misogyny in morning television shows
Authors: Ridley Anna , Humă Bogdana , Walz Linda
Published: October 2023

While in the last decade we made strides in the pursuit of gender equality, women's rights, dignity, and safety continue to be under threat around the world. There is a growing body of research documenting contemporary misogyny, mainly focused on extreme manifestations found in online environments. Conversely, we know less about how misogyny features in other spheres of our daily lives. The current study focuses on such an environment, namely segments from the British show This Morning in which guests are invited to take opposing stances on a variety of topics related to women's appearance, behaviour, competencies, and experiences with sexual harassment. Using discursive psychology, we identified two sets of argumentative discursive practices employed by guests who espoused misogynist views. First, when guests were prompted to present their controversial views, they constructed them as reasonable, strategically differentiating them from established misogynist tropes. By contrast, when guests’ views were challenged, they doubled down on their positions by drawing on scientific explanations for human behaviour that ostensibly justified bigoted views. This study sheds light onto the discursive mechanisms through which misogyny escapes eradication, and through which it mutates into subtler forms that are increasingly difficult to identify and denounce.
The clinical results of bi-cruciate vs posterior stabilized total knee arthroplasty for flexion contracture in osteoarthritic knee
Authors: Inoue Atsuo , Arai Yuji , Nakagawa Shuji , Yoshihara Yasushi , Kobayashi Masashi , Takahashi Kenji
Published: October 2023

Background

The improvement of flexion contracture is important in knee arthroplasty since residual flexion contracture postoperatively is associated with decreased quality of life and patient satisfaction. In this study, we investigated the effect of bi-cruciate stabilized (BCS)-type total knee arthroplasty (TKA) as compared to posterior stabilized (PS)-type TKA on osteoarthritic primary knees with flexion contractures.

Methods

59 TKAs from January 2014 to December 2020, of which 30 were PS-type TKAs (NexGen LPS-flexⓇ; 76.3 years, BMI 27.5) and 29 BCS-type TKAs (Journey IIⓇ; 72.5 years, BMI 28.6), were performed for knee osteoarthritis with preoperative flexion contracture of 15° or greater. Full extension was obtained intraoperatively during all TKAs. Clinical outcomes, radiological evaluations, and the amount of additional distal femoral osteotomy during TKA were evaluated in a retrospective study design.

Results

The range of motion improved in the both groups. Postoperative flexion contracture was significantly improved in the BCS group. Knee Society Score improved significantly in both groups, with no difference between the two groups. The amount of additional distal femoral osteotomy was 2.5 ± 1.3 mm for the PS group, and 1.8 ± 1.5 mm for the BCS group, showing a significant difference ( p = 0.04).

Discussion

The BCS-type TKA significantly improved preoperative flexion contracture and reduced the amount of additional distal femoral osteotomy compared to PS-type TKA. This is attributed to the anterior cam in the BCS-type TKA, which leads to a smaller amount of protrusion of the posterior femoral condyle from the posterior margin of the tibial component in the BCS-type in knee extension, as compared to the PS-type.
Evaluation of the osteoconductivity and the degradation of novel hydroxyapatite/polyurethane combined with mesoporous silica microspheres in a rabbit osteomyelitis model
Authors: Wang Qi , Du Jialei , Sun Quanbo , Xiao Shanwen , Huang Wei
Published: October 2023

Bone defects caused by osteomyelitis can lead to severe disability. Surgeons still face significant challenges in treating bone defects. Nano-hydroxyapatite (n-HA) plays an important role in bone tissue engineering due to its excellent biocompatibility and osteoconductivity. Levofloxacin (Levo) was encapsulated in mesoporous silica nanoparticles (MSNs) via electrostatic attraction to serve as a drug delivery system. MSNs were incorporated with n-HA and polyurethane (PU). The degradation and osteoconductivity properties of these novel composite scaffolds and their effectiveness in treating chronic osteomyelitis in a rabbit model were assessed. Gross pathology, radiographic imaging, micro-computed tomography, Van Gieson staining, and hematoxylin and eosin staining were conducted at 6 and 12 weeks. The group of composite scaffolds combining n-HA/PU with MSNs containing 5 mg Levo (n-HA/PU + Nano +5 mg Levo) composite scaffolds showed superior antibacterial properties compared to the other groups. At 12 weeks, the n-HA/PU + Nano +5 mg Levo composite scaffolds group exhibited significantly greater volume of new trabecular bone formation compared to the other three groups. The surface of the novel composite scaffolds exhibited degradation after 6 weeks implantation. The internal structure of the scaffolds collapsed noticeably after 12 weeks of implantation. The rate of material degradation corresponded to the rate of new bone ingrowth. This novel composite scaffold, which is biodegradable and osteoconductive, has potential as a drug delivery system for treating chronic osteomyelitis accompanied by bone defects.
Music performance anxiety in Portuguese higher education: Contextual factors, perceptions, and strategies
Authors: Barros Samuel , Marinho Helena , Pereira Anabela
Published: October 2023

Music performance anxiety (MPA) affects health, wellbeing, and performance quality. The characteristics of MPA are multifaceted and mainly caused by psychophysiological factors that generate a sense of loss of control. The aims of the present study were to understand MPA in the context of higher music education in Portugal through the individual and collective thoughts and perceptions reported by teachers and students; identify the strategies employed both by teachers during the teaching-learning process for students to cope with the effects of MPA and by the students themselves; and portray the extent of institutional support for students experiencing MPA. We carried out semistructured interviews with 24 students and 12 teachers from four higher education institutions in Portugal and analyzed the data thematically. We identified four overarching themes (perceptions of MPA, strategies, contextual factors, and institutional support) from which 10 subthemes emerged. In addition to confirming the presence of psychophysiological factors experienced before, during, and after performances, the findings suggest that MPA may decrease with years of experience and that teachers’ strategies to counter MPA are limited. Contextual factors, institutional culture, teaching methodology, and lack of institutional support all contribute to the high levels of MPA that continue to be found in higher education institutions. One implication of the study is that there is a clear need for MPA to be discussed in educational institutions with teachers, students, and psychologists.
Tracking auditory attention in group performances: A case study on Éliane Radigue’s Occam Delta XV
Authors: Majeau-Bettez Emanuelle , Golvet Aliénor , Canonne Clément
Published: October 2023

While the empirical study of the processes and mechanisms underlying joint musical performance has gained a lot of traction in the past few decades, surprisingly little attention has been paid to the study of musicians’ listening strategies in what remains a mainly audio-centric medium. Yet, understanding how musicians listen to each other is particularly crucial for more open-ended, improvised, or indeterminate musical practices, as it plays a crucial role in shaping how the performance will unfold. In this article, we report on an exploratory study that was designed to investigate the dynamics of musicians’ auditory attention in such settings, using Quatuor Bozzini’s performance of Éliane Radigue’s Occam Delta XV (2018) as a case study. Using a post hoc annotation procedure, we found striking differences between musicians’ overall auditory attention, with each musician’s listening orientation relating differently to the general narrative of Occam Delta XV. We also found that joint listening between musicians was more likely to emerge when coordination was more challenging, suggesting that attentional focus was used strategically by the performers as a way of enhancing coordination within the group. Taken together, our findings shed important light on musicians’ listening and interactional strategies in collective music-making.
Missing Moments and Requesting Encouragement: The Experiences and Consequences of Having an Incarcerated Loved One
Authors: Tadros Eman , Presley Sarah
Published: October 2023

The consequences of incarceration extend far beyond the individual incarcerated. This article aims to understand the needs, thoughts, feelings, and experiences of incarcerated loved ones through the uses-and gratifications theory. Posts derived from the Facebook group entitled, “Incarcerated Loved Ones” and were coded using thematic analysis. The posts highlighted two themes: negative emotional experiences and criminal justice consequences. The theme negative emotional experiences included feelings of discomfort, requesting encouragement, and venting. The theme criminal justice consequences included difficulty navigating the system, visitation, financial burden, and missing moments. The discussion includes clinical and policy implications as well as future research directions.
Safety and Outcomes With Combination Therapy With Sarilumab and Baricitinib for Severe COVID-19 Respiratory Infection in Cancer Patients
Authors: Velez Ana Paula , Handley Guy , Morison Austin , Katzman Ju Hee , kinkhova Olga , Quiltz Rod , Greene John , Pasikhova Yanina
Published: October 2023

Objectives

This study aims to describe the clinical outcomes of combination therapy with sarilumab and baricitinib for severe novel Coronavirus-19 (COVID-19) infection in cancer patients. With this study, we aim to evaluate the role of expanded immunotherapy for severely ill patients with COVID-19 respiratory infections with limited options. The secondary objective is to assess the safety of combination therapy with sarilumab and baricitinib for severe COVID-19 infection.

Methods

This was a retrospective cohort study of patients admitted to Moffitt Cancer Center with COVID-19 infection between January 2020 and April 2022. Our research received a waiver to sign consent by the patients according to our institutional IRB because it was free of any risk for the patients and respected the patient’s privacy. Following the Institutional IRB approval and relevant Equator guidelines, we collected information on patients with severe COVID-19 infection and received sarilumab and baricitinib. We evaluated the survival rate and safety of combination therapy. All the patient’s information was de-identified to protect their information according to Health Insurance Portability and Accountability Act (HIPAA).

Results

Four patients were included in the data analysis. Two survived, and two of them died (Table 1). All the patients that survived were previously vaccinated. Among the two patients who died, one was vaccinated, and the other was unvaccinated. All the patients tolerated the combination therapy well, and none of the patients who survived developed secondary infections or COVID-19-associated complications beyond 12 months of discharge.

Conclusion

Our study explores the potential safe combination use of different immune modulators targeting multiple pathways of the inflammatory cascade for severe and refractory COVID-19 respiratory infections in high-risk oncology patients. The small number of patients in our observational study was a limitation. A larger sample of patients will be needed to conclude more precisely the efficacy of the combination therapy of sarilumab and baricitinib for refractory cases of severe COVID-19 respiratory infection. Moreover, exploring other cytokine release signaling pathway targets may be the key to significantly reducing inflammation and further pulmonary fibrosis with chronic unbearable respiratory sequela.
Explorations in Non-Binary Poiesis: A Sartorial Path to Wholeness in Queer Body
Authors: Cheverie Calder
Published: October 2023

The path toward coming home to an embodied sense of wholeness in queer identity is often a long journey marked by personal severance. For trans and non-binary people, the arts have become an invaluable space for reclamative wayfinding and liberation. Artistic pathways offer processes to (re)presence the severed parts of ourselves that were laid down to survive in a binary framework that collapses wholeness. Here, I offer forward a sartorial expression of non-binary poiesis as a reclamative act of (re)weaving the lost threads of self. In the disassembling of my adopted aesthetic, sewing and sartorial expressions become a pathway home to wholeness in queer body, where (re)stitching binary endpoints gestures toward a third space for belonging.
Expanding the Spectrum of EWSR1::CREM Fusion Tumors: An Unusual Pediatric Intranasal Myxoid Tumor
Authors: Koh Shamen , Punjabi Lavisha S. , Chang Kenneth Tou En , Wei Yang Teo Neville , Ee Hoon Teo Constance , Soh Shui Yen , Kun Kiaang Tan Henry
Published: October 2023

EWSR1::CREM gene fusions are increasingly being recognized in a diverse number of soft tissue tumors, including well-defined entities such as angiomatoid fibrous histiocytoma or clear cell sarcoma, and other unclassifiable tumors. As a group, EWSR1::CREM fused tumors often demonstrate primitive spindle or epithelioid cells, myxoid stroma, and a broad immunophenotype. Herein we present an unusual case of a child diagnosed with an intranasal malignant myxoid tumor harboring an EWSR1::CREM gene fusion. To the best of our knowledge, this is the first case of intranasal myxoid tumor with this particular fusion. Diagnosis and management of the case is discussed.
The experiencescape of integrated resorts in Macao: Scale development and validation
Authors: Ji Chunli , Yan Libo
Published: October 2023

Based on the conception and dimensions of experiencescape proposed in a recent work, this study develops and validates a six-dimension scale of experiencescape in the context of integrated resorts in Macao. The validated dimensions include hospitality, the natural element, cultural proximity, social interaction, the multisensory element, and amenity. In contrast to previous studies focusing on certain aspects of integrated-resort experiences, this study provides a holistic understanding of the experiencescape. The scale of the integrated-resort experiencescape facilitates future research into the relationship between guests’ comprehensive experiences of integrated resorts and their corresponding behaviours and intentions. The theoretical and practical implications of the integrated-resort experiencescape scale are discussed.
Harnessing welfare state theories to explain the emergence of eco-social policies
Authors: Mandelli Matteo
Published: October 2023

As complex challenges such as climate change and social inequality become more and more politically salient, eco-social policies are emerging as suitable public policy tools to pursue integrated environmental and social objectives. In spite of this, the sustainable welfare literature has been, at least until now, dominated by prescriptive studies, paying little attention to the politico-institutional conditions required for these policies to emerge. Against this background, this article aims to help filling this gap, by proposing a set of four theoretical expectations pointing to possible causal drivers and mechanisms behind the adoption of this particular kind of policies. It does so by harnessing the most established welfare state theories and reflecting on their potential and limitations when applied to the study of eco-social policies. Selected theoretical strands – functionalism, historical institutionalism, interest-based and ideas-based theories – are first reviewed and then applied to the specific object of the study, with a view to deriving the four expectations by deduction. The ultimate aim is to generate a politico-institutional theory of eco-social policies, which can guide future empirical research. The article argues that eco-social policies can be expected to emerge in strong environmental states and/or in weak welfare states, in which equally powerful labour and green interests engage in political exchanges, or where advocacy coalitions form around ambiguous ideas, such as ‘just transition’. The article concludes by arguing that only an actor-centred approach based on empirically observable policy preferences can help us to craft minimally sufficient causal inferences about the emergence of eco-social policies.
Physical activity levels before and after the COVID-19 restrictions among Danish adolescents: a retrospective cohort study
Authors: Eilertsen Martin , Riis Allan , Nielsen Anne , Riel Henrik
Published: October 2023

Aims:

It has been suggested that the COVID-19 restrictions may have negatively impacted physical activity (PA) levels, especially among adolescents, who often use organised sports to support their intrinsic motivation for staying active. This study aimed to investigate whether adolescents were less physically active after the COVID-19 restrictions compared with before and examine whether participation in organised sports has changed since the COVID-19 restrictions.

Methods:

This was a retrospective cohort study of Danish adolescents aged 15 to 19 years. Data was collected using a questionnaire in SurveyXact. The primary variable of interest was moderate or high-intensity PA frequency before and after COVID-19 restrictions (from March 11, 2020, to September 10, 2021). Secondary variables of interest included whether the PA was self-organised (e.g. running, hiking, going to a gym or cycling) or part of an organised sport delivered by a club or other association, before versus after the restrictions.

Results:

A total of 324 participants responded to the questionnaire. The relative risk of not performing PA at least twice per week after COVID-19 restrictions compared with before was significantly larger (1.44; 95%CI: 1.19 to 1.85, p = 0.005). Before the lockdowns, 190 (59%) were engaged in organised sports compared with 152 (47%) after the restrictions (relative risk: 1.51, 95%CI: 1.19 to 1.92, p < 0.001).

Conclusions:

Compared with activity levels before the pandemic, adolescents became significantly less physically active following the COVID-19 restrictions, beyond what is typically observed during adolescence. These results emphasise a need for strategies to increase PA levels among adolescents to minimise the long-term negative effects of physical inactivity during adolescence.
Conducting ethnographic research in male-dominated environments: Reflections of a(n) (emotional) female researcher
Authors: O’Hanlon Rebecca , Mackintosh Chris , Holmes Hannah , Meek Rosie
Published: October 2023

This article contributes to the field of qualitative research by shining a light on the additional and invisible work demanded of female ethnographers undertaking research in male-dominated spaces. It draws on an 18-month ethnographic study exploring the potential of sport and physical activity as a tool to support the transition of male veterans from the military into civilian life. Previous literature has explored the experiences of female ethnographers, hinting at some of this additional necessary work. This study builds upon this, to highlight the invisible and additional management processes required of female ethnographers in male-dominated spaces, including the management of events, managing image and gender performance and the multi-layered demands of managing emotions. This article argues that a greater degree of effort and labour is demanded of female ethnographers, which should be acknowledged in academic writing alongside the provision of support when entering male-dominated research spaces.
Risk and Protective Factors for Sexual Exploitation in Male and Female Youth From a Cross-Cultural Perspective: A Systematic Review
Authors: Mercera Gabriëlle , Kooijmans Roel , Leijdesdorff Sophie , Heynen Evelyn , van Amelsvoort Thérèse
Published: October 2023

Youth are at elevated risk of becoming victims of sexual exploitation, which has a detrimental impact on their physical and psychological well-being. Understanding factors associated with sexual exploitation is key for prevention efforts and adequate and timely treatment. This systematic review sheds more light on this by providing an overview of both risk and protective factors for sexual exploitation in male and female youth from a cross-cultural perspective. In all, 65 studies were selected meeting the inclusion criteria: qualitative or quantitative peer-reviewed studies in English, Dutch, or German with findings on risk and protective factors associated with sexual exploitation in youth aged up to 24 years. Results show that there are common risk factors in male and female youth worldwide (e.g., adverse childhood experiences, lack of a social network, substance use, and running away). Positive and supportive relationships are an important protective factor in mitigating the risk of sexual exploitation. Geographic differences were found. In non-Western continents, more environmental factors (e.g., economic vulnerabilities, residential instability) were cited. Research in countries outside the United States is limited and protective factors and males are underexamined. To fully understand vulnerabilities in youth, their interactions, and possible gender differences and to address the needs of diverse populations, more insight should be gained into the broader range of risk and protective factors worldwide. This systematic review has made a valuable contribution to this by providing practice, policy, and research guidance in the establishment of more targeted prevention efforts, adequate treatment, and areas to address in future research.
Digital Violence and Abuse: A Scoping Review of Adverse Experiences Within Adolescent Intimate Partner Relationships
Authors: Torp Løkkeberg Stine , Ihlebæk Camilla , Brottveit Gudrun , Del Busso Lilliana
Published: October 2023

International research in the past 2 decades has suggested that intimate partner violence among adolescents is a significant public health concern. Both are commonly understood as a pattern of behavior that is intended to establish and maintain control over a partner. Recently, a plethora of digital applications and social networking sites have presented new opportunities for adolescents to initiate, develop, and conduct intimate partner relationships. However, research exploring adverse experiences related to digital interactions in the context of adolescents’ intimate partner relations is limited. This scoping review aims to identify and describe the nature and range of difficult experiences in the current published research relating to digital interactions between intimate adolescent partners, from digitalized violence to less severe adverse experiences. Systematic and manual searching resulted in the identification of 1,876 potential articles for inclusion in this review. A total of 18 articles were ultimately included based on the following predefined inclusion criteria. The article must: (a) be an empirical study that has used quantitative, qualitative, mixed, or review methods; (b) include young adolescents and adolescents of 18 years or younger as participants; (c) include accounts of young adolescents and young people’s experiences and/or consequences of digital interactions within intimate partner relationships; and (d) be published in a peer-reviewed journal. Examples of less severe experiences could be different kinds of digital harassment, such as electronic intrusiveness, excessive texting, insults, unpleasant messages, and the spreading of rumors. Other adverse experiences related to digital interactions included being controlled by a partner, verbal abuse, experiences of aggression, sexual pressure, and coercion. Common consequences of adverse experiences included emotional and mental health-related difficulties, self-restricting behaviors, relationship difficulties, and risk behaviors.
The Table and the Tomb: Positioning Trans Power and Play Amid Fantasy Realism in Dungeons & Dragons
Authors: Berge PS
Published: October 2023

This article contends with the transphobic logics perpetuated by the “world's greatest roleplaying game,” Dungeons & Dragons (D&D). Bringing together game texts and scraped social media data from reactionary D&D fans, I argue that despite cursory improvements in official representation, D&D's hostility to trans play is inscribed in the game's engagement of fantasy realism—a culturally sculpted “common sense” that rearticulates the logics of established fantasy media. From sex-swap curses in Gygax's “Tomb of Horrors” (1978) to the shapechanging “blessed elves of Corellon” (2017), D&D's approach to fantasy realism mechanically and narratively excludes trans bodies, vilifies trans stories, and diminishes trans power. Drawing on the work of analog game and trans media scholars, I use this case study to center trans power in tabletop gaming and explore D&D's relationship with fantasy realism by asking Whose fantasy? and Whose reality?
Consequential Issues of Censoring Curriculum: Who Has the Right to Ban What’s Read?
Authors: Johnson Detra D. , Roberts LaSonja , Wong Lok-Sze , Ebejer Mary
Published: October 2023

Ms. Sampson, a White eighth-grade teacher in a predominately White suburban school district in the southern United States, decided to include several books in her lesson plan. Selected books were from the school’s library and had been previously approved by stakeholders as instructional resources for the district. One parent, a school board member, became enraged when he heard about the readings during a Parent Teacher Organization (PTO) back-from-spring-break celebration and contacted the district superintendent. A book was subsequently removed from the library and Ms. Sampson was placed on administrative leave without pay. This case centers on the critical race debate in public schools and how school leaders and other stakeholders address a teacher’s decision to diversify curriculum and instructional resources amid stakeholder pushback.
Vertical interference: video, drone witnessing, and the myth of precision targeting
Authors: Ljungbäck Hugo
Published: October 2023

Artists and filmmakers frequently problematize drone warfare through their creative practices, contesting military surveillance and violence by appropriating, parodying, and turning the drone’s gaze back at itself. Challenging and subverting the myth of ‘precision targeting’ – the military’s claim to perfect accuracy in aiming their weapons only at ‘bad guys’ – is central to artists’ engagement with drone warfare. By looking at recent work by Nicolas Brynolfson, George Barber, and eteam, the author argues that these artists pose drone vision – how and what drones see and look at – as a site of compromised looking, where the indexical and objective is rarely just that, but always layered by and interpreted through discourse, ideology, compression, and noise. By performing ‘drone witnessing’, these artists tease out the connective tissue between state surveillance and remote warfare, raising key questions about sovereignty and autonomy in the age of operational images.
YouTube discourse of the Oting massacre in Nagaland: investigating affiliations, sentiments and Naga identity negotiation in YouTube comments
Authors: Muinao A Blessing , Ratnamala V
Published: October 2023

Personae identification and understanding the social bonds shared in online interactions are found to be key to combating misinformation and conspiratorial discourse as well as aiding in developing solutions for specific communities. The 2021 Oting massacre in Nagaland that killed 14 civilians sparked public outrage and widespread protests calling for justice and the repeal of the Armed Forces (Special Powers) Act in northeast India. The massacre received a lot of attention, including YouTube videos, and reignited discussion on militarization, Naga identity and a backlash over the botched operation. A close qualitative analysis of 500 randomly extracted comments from 10 selected YouTube videos identified 15 personae with unique linguistic patterns that reveal specific ideational targets and their affiliation strategies in the discourse. A sentiment analysis of 11,294 comments shows a higher negative score linked to condemnation, hate speech and conspiracy than a positive score linked to solidarity and empathy. ‘Nagaism’ as being a Naga is reimagined and reinforced via YouTube, countering misconceptions about Naga identity.
A Choice-Based Design Approach to Influence Beneficial Use of a Green Space by Family Caregivers at a Tertiary Care Hospital in India
Authors: Phatak Sanat , Parikh Avani , Saraf Shashank , Mehta Jyoti , Garda Laila , Wadia Shirin
Published: October 2023

Objectives, Purposes, and Aims:

Principles of behavioral economics are now being used across fields in changing human behavior toward perceived benefit. We studied the effectiveness of simple, cost-effective design cues based on these principles, in encouraging use of a neglected outdoor space in a hospital.

Background:

Benefits of access to nature and green spaces are established in healthcare; however, we found utilization of an outdoor space to be suboptimal. Presenting choices in different ways is known to influence user choice.

Methods:

We designed four design interventions based to nudge relative-caregivers waiting outside the operation theater toward utilizing an adjoining outdoor balcony. These included making the terrace prominent, reducing indoor sensory stimulation, adding stereotypical elements, and improving usability. We measured usage via video camera data and satisfaction using questionnaires.

Results:

The number of users and average time per person spent on the balcony increased over the consecutive intervention periods as compared to baseline (trend p < .01 for both), mainly driven by the addition of stereotypical elements. There were no adverse events in the balcony. There was no difference in the satisfaction related outcomes on questionnaire; a larger percentage of positive comments tended to be related to the balcony in the final intervention.

Conclusions:

Cost-effective design cues nudged patient-caregivers toward spending more time with nature, thus changing behavior toward that with perceived benefits.
Surgical Options for Diabetic Toe Ulcers and Osteomyelitis Technical Tips and a Decision-Making Algorithm
Authors: Yammine Kaissar
Published: October 2023

Introduction. Diabetic foot ulcers (DFUs) reflect a pivotal event that could lead to serious complications such as amputation and death. Although conservative surgery was reported to have better outcomes when compared to nonsurgical standard of care of forefoot wounds, the surgical management of diabetic toe ulcers (DTUs) is hardly researched. Methods. The aim of this study is to describe the types and techniques of surgical procedures that could be needed when managing DTU. The proposed surgical techniques were based on their outcomes following an evidence-based search of the literature. Results. Six major types of procedures could be used to treat DTUs; (1) interphalangeal joint resection arthroplasty, (2) phalangectomy or internal pedal amputation, (3) distal Syme amputation, (4) percutaneous toe flexor tenotomy, (5) toe fillet flap, and (6) toe amputation. Details on technical tips are described. Conclusion. Based on the location, ulcer grade of the ulcer and the status of the surrounding soft tissue, a surgical decision-making algorithm is proposed to assist surgeons when managing such prevalent conditions.

Levels of Evidence: Level V: Expert review
Generative Knowing Doesn’t Leave Anything Behind: An Interview With Aliki Nicolaides
Authors: Nicolaides Aliki , Barefield Trisha , Cox Alexandra B. , Herr Neal C. , Lim Ahreum , Lindell Heather , Perry Shannon A. B.
Published: October 2023

This article features an interview between Dr. Aliki Nicolaides, Professor of Adult Learning, Leadership, and Adult Development at the University of Georgia, and a group of her current and former graduate students whose scholarly works draw on Nicolaides’ generative knowing theory in various ways. After co-interviewers gathered to discuss Nicolaides’ first book, Generative Knowing: Principles, Methods, and Dispositions of an Emerging Adult Learning Theory, and its implications for their work, they interviewed her about how this book and generative knowing theory came into being. The interview also explores the wide implications of this emerging theory for adult learning research and practice.
Limbic Encephalitis Associated with Human Herpesvirus-7 Infection in an Immunocompetent Adolescent
Authors: Lynch Megan , Nedjat-Haiem Matthew , Abeson Kylie , Chang Celia
Published: October 2023

Despite the ubiquitous nature of human herpesvirus-7 (HHV-7) infection, its clinical significance in the central nervous system (CNS) is poorly understood. However, the related human herpesvirus-6 (HHV-6), which has remarkable genomic similarity to HHV-7, is linked to encephalitis. We present the case of a 17-year-old immunocompetent male with remote history of seizure who arrived in status epilepticus. Upon resolution, he required hospitalization for worsening encephalopathy. Electroencephalogram (EEG) revealed bilateral temporal lobe dysfunction and magnetic resonance imaging (MRI) showed increased signaling in bilateral medial temporal lobes with hippocampal microhemorrhages. Empiric intravenous (IV) acyclovir was initiated despite initially negative cerebrospinal fluid (CSF) studies due to concern for herpes simplex virus (HSV) encephalitis. The patient improved and was discharged on hospital day 13 (HD13). After discharge, a human metagenomics CSF panel resulted positive only for HHV-7, making a case for possible etiology and empiric treatment of HHV-7 despite delayed CSF and serum studies.
The Effect of Breathy Vocal Quality on Speech Intelligibility and Listening Effort in Background Noise
Authors: Shen Jing , Heller Murray Elizabeth , Kulick Erin R.
Published: October 2023

Speech perception is challenging under adverse conditions. However, there is limited evidence regarding how multiple adverse conditions affect speech perception. The present study investigated two conditions that are frequently encountered in real-life communication: background noise and breathy vocal quality. The study first examined the effects of background noise and breathiness on speech perception as measured by intelligibility. Secondly, the study tested the hypothesis that both noise and breathiness affect listening effort, as indicated by linear and nonlinear changes in pupil dilation. Low-context sentences were resynthesized to create three levels of breathiness (original, mild-moderate, and severe). The sentences were presented in a fluctuating nonspeech noise with two signal-to-noise ratios (SNRs) of −5 dB (favorable) and −9 dB (adverse) SNR. Speech intelligibility and pupil dilation data were collected from young listeners with normal hearing thresholds. The results demonstrated that a breathy vocal quality presented in noise negatively affected speech intelligibility, with the degree of breathiness playing a critical role. Listening effort, as measured by the magnitude of pupil dilation, showed significant effects with both severe and mild-moderate breathy voices that were independent of noise level. The findings contributed to the literature by demonstrating the impact of vocal quality on the perception of speech in noise. They also highlighted the complex dynamics between overall task demand and processing resources in understanding the combined impact of multiple adverse conditions.
Building Collaborative Teams to Include Students With Extensive Support Needs in General Education Contexts
Authors: Taub Deborah , Lansey Kirsten , Burnette Kristin , Hartmann Elizabeth
Published: October 2023

Including students with extensive support needs (ESN) in general education schools and classes across a district and school can be challenging. To be successful and sustainable, students with ESN need education teams with a wide range of expertise and, at minimum, a district-wide system of inclusion. This article demonstrates how one district and their school teams used a scaffolded tool (5-15-45 Tool) and a five-step implementation process to increase the inclusion of students with ESN at the school and district levels. The tool was designed to support collaborative teams to implement evidence-based practices in general education contexts. Using vignettes, completed examples from the 5-15-45 Tool, and an external link to a grade-level lesson, this article illustrates how education teams, schools, and districts can use the 5-15-45 Tool and five-step process to include students with ESN in general education contexts and to enhance inclusive education across a district.
Testicular torsion in Sub-Saharan Africa: a scoping review
Authors: Nedjim Saleh Abdelkerim , Biyouma Marcella D. C. , Mahamat Mahamat Ali , Douglas Arthur , Mbwambo Orgeness Jasper , Mbarouk Mohamed , Hervé Remadji Yanhdet , Salissou Mahamane , Gallouo Messian , Traoré Aboubacar , Ouima Justin Dieudonné ZIBA , Djoua Yannick Joël , Oyibo Ugbede , Rimtebaye Kimassoum , Ouchemi Choua , Angwafor Fru Fobuzshi
Published: October 2023

Testicular torsion is a surgical emergency caused by rotation of the vascular pedicle of the testicle around its axis. If left untreated, testicular necrosis can set in, necessitating orchiectomy and loss of the testicle. The authors of this article reviewed articles on testicular torsion published in sub-Saharan Africa. The aim of this work is to establish the patient profile, consultation delay and orchiectomy rate in the sub-Saharan context. Data from the review will be compared with large non-sub-Saharan series and journals. Twenty-three articles were selected for review. All these articles were published between 1985 and 2022. A total of 1410 patients were included in the review. The average age was 19.7 years. The majority of patients were from urban areas. Risk factors for torsion were identified in 9 publications. The mode of hospital admission varied. Acute scrotal pain was the main symptomatology reported. The mean time in hours between onset of symptoms and consultation was 52.5 h. The left side was affected in 46.04% and the right in 49.81%. Four authors reported referral to a health center, and 8 authors reported scrotal ultrasonography. The rate of orchiectomy performed was found in 21 publications, the mean for the review as a whole was 46.4% with extremes of 13.2 and 72%. The orchiectomy rate was 52.4% in studies that reported an initial referral to a health center (patient transfer), versus 36.9% in studies that did not. In studies reporting ultrasound, the orchiectomy rate was 52.5%, compared with 36.9% in those not reporting ultrasound. On the basis of these results, we can formulate the following recommendations and actions: (i) further study of this pathology in sub-Saharan countries; (ii) raise public awareness of this pathology; (iii) train and retrain community workers and health center managers; and (iv) train general practitioners and surgeons in emergency scrototomy, orchidopexy and orchidectomy.
MSXFGP: combining improved sparrow search algorithm with XGBoost for enhanced genomic prediction
Authors: Zhou Ganghui , Gao Jing , Zuo Dongshi , Li Jin , Li Rui
Published: October 2023

Background

With the significant reduction in the cost of high-throughput sequencing technology, genomic selection technology has been rapidly developed in the field of plant breeding. Although numerous genomic selection methods have been proposed by researchers, the existing genomic selection methods still face the problem of poor prediction accuracy in practical applications.

Results

This paper proposes a genome prediction method MSXFGP based on a multi-strategy improved sparrow search algorithm (SSA) to optimize XGBoost parameters and feature selection. Firstly, logistic chaos mapping, elite learning, adaptive parameter adjustment, Levy flight, and an early stop strategy are incorporated into the SSA. This integration serves to enhance the global and local search capabilities of the algorithm, thereby improving its convergence accuracy and stability. Subsequently, the improved SSA is utilized to concurrently optimize XGBoost parameters and feature selection, leading to the establishment of a new genomic selection method, MSXFGP. Utilizing both the coefficient of determination R2 and the Pearson correlation coefficient as evaluation metrics, MSXFGP was evaluated against six existing genomic selection models across six datasets. The findings reveal that MSXFGP prediction accuracy is comparable or better than existing widely used genomic selection methods, and it exhibits better accuracy when R2 is utilized as an assessment metric. Additionally, this research provides a user-friendly Python utility designed to aid breeders in the effective application of this innovative method. MSXFGP is accessible at https://github.com/DIBreeding/MSXFGP.

Conclusions

The experimental results show that the prediction accuracy of MSXFGP is comparable or better than existing genome selection methods, providing a new approach for plant genome selection.
The clinical utility of circulating cell division control 42 in small-vessel coronary artery disease patients undergoing drug-coated balloon treatment
Authors: Wu Lei , Li Hui , Chen Huanzhen , Fan Chunyu , Lu Yan , Wei Ruipeng , Yang Guangzhao , Jia Yongping
Published: October 2023

Background

Cell division control 42 (CDC42) regulates atherosclerosis, blood lipids, and inflammation and thus affects coronary artery disease (CAD), but its utility in drug-coated balloon (DCB)-treated small-vessel CAD (SV-CAD) patients is unclear. This study intended to evaluate the change and prognostic role of CDC42 in SV-CAD patients underwent DCB.

Methods

Serum CDC42 was measured by enzyme-linked immunosorbent assay in 211 SV-CAD patients underwent DCB at baseline, day (D) 1, D3, and D7, as well as in 50 healthy controls (HCs).

Results

CDC42 was decreased in SV-CAD patients compared to HCs (P < 0.001), and it was negatively associated with total cholesterol (P = 0.015), low-density lipoprotein cholesterol (P = 0.003), C-reactive protein (P = 0.001), multivessel disease (P = 0.020), and American college of cardiology/American heart association type B2/C lesions (P = 0.039) in SV-CAD patients. Longitudinally, CDC42 decreased from baseline to D1 and then gradually increased to D7 (P < 0.001) in SV-CAD patients after DCB. Interestingly, high CDC42 (cut-off value = 500 pg/mL) at baseline (P = 0.047), D3 (P = 0.046), and D7 (P = 0.008) was associated with a lower accumulating target lesion failure (TLF) rate; high CDC42 at D3 (P = 0.037) and D7 (P = 0.041) was related to a lower accumulating major adverse cardiovascular event (MACE) rate in SV-CAD patients underwent DCB. Importantly, CDC42 at D7 (high vs. low) independently predicted lower accumulating TLF (hazard ratio (HR) = 0.145, P = 0.021) and MACE (HR = 0.295, P = 0.023) risks in SV-CAD patients underwent DCB.

Conclusions

Circulating CDC42 level relates to milder disease conditions and independently estimates lower risks of TLF and MACE in SV-CAD patients underwent DCB, but further validation is still needed.
Development and validation of a prediction model for in-hospital death in patients with heart failure and atrial fibrillation
Authors: Yan Meiyu , Liu Huizhu , Xu Qunfeng , Yu Shushu , Tang Ke , Xie Yun
Published: October 2023

Background

To develop a prediction model for in-hospital mortality of patients with heart failure (HF) and atrial fibrillation (AF).

Methods

This cohort study extracted the data of 10,236 patients with HF and AF upon intensive care unit (ICU) from the Medical Information Mart for Intensive Care (MIMIC). The subjects from MIMIC-IV were divided into the training set to construct the prediction model, and the testing set to verify the performance of the model. The samples from MIMIC-III database and eICU-CRD were included as the internal and external validation set to further validate the predictive value of the model, respectively. Univariate and multivariable Logistic regression analyses were used to explore predictors for in-hospital death in patients with HF and AF. The receiver operator characteristic (ROC), calibration curves and the decision curve analysis (DCA) curves were plotted to evaluate the predictive values of the model.

Results

The mean survival time of participants from MIMIC-III was 11.29 ± 10.05 days and the mean survival time of participants from MIMIC-IV was 10.56 ± 9.19 days. Simplified acute physiology score (SAPSII), red blood cell distribution width (RDW), beta-blocker, race, respiratory rate, urine output, coronary artery bypass grafting (CABG), Charlson comorbidity index, renal replacement therapies (RRT), antiarrhythmic, age, and anticoagulation were predictors finally included in the prediction model. The AUC of our prediction model was 0.810 (95%CI: 0.791–0.828) in the training set, 0.757 (95%CI: 0.729–0.786) in the testing set, 0.792 (95%CI: 0.774–0.810) in the internal validation set, and 0.724 (95%CI: 0.687–0.762) in the external validation set. The calibration curves of revealed that the predictive probabilities of our model for the in-hospital death in patients with HF and AF deviated slightly from the ideal model. The DCA curves revealed that the use of our prediction model increased the net benefit than use no model.

Conclusion

The prediction model had good discriminative ability, and might provide a tool to timely identify patients with HF complicated with AF who were at high risk of in-hospital mortality.
Relationship between fear of falling and fall risk among older patients with stroke: a structural equation modeling
Authors: Chen Yuanyuan , Du Hui , Song Mi , Liu Ting , Ge Pei , Xu Yue , Pi Hongying
Published: October 2023

Background

With reduced balance and mobility, older patients with stroke are more susceptible to fear of falling (FOF). A maladaptive form of FOF can cause excessive activity restriction, poor balance, and recurrent falls, forming a self-reinforcing vicious cycle. This study applied and adapted the FOF model to investigate the interaction between FOF and fall risk in older stroke patients.

Methods

A cross-sectional study was conducted among 302 older stroke patients aged 60 and over. All participants were invited to complete the FOF, fall risk, physical activity, and balance tests, which were measured by the Falls Efficacy Scale International (FES-I), Self-Rated Fall Risk Questionnaire (FRQ), the long-form International Physical Activity Questionnaire (IPAQ-LF) and the Four-Stage Balance Test (FSBT) respectively. Data were analyzed using structural equation modeling.

Results

The mean age of the respondents was 68.62 ± 7.62 years; 8.94% reported a high level of FOF, and 18.21% reported a moderate level of FOF. The structural equation model showed that FOF was directly associated with fall risk (β=-0.38, p < 0.001), and was indirectly associated with fall risk via physical activity (β=-0.075, p < 0.05) and balance ability (β=-0.123, p < 0.05). Depression (β=-0.47, p < 0.001), fall history (β=-0.13, p < 0.05), and female sex (β=-0.16, p < 0.05) affected FOF, while anxiety was not associated with FOF.

Conclusions

The increased risk of falling in older stroke patients results from a maladaptive FOF affected by depression, fall history, poor balance ability, and limited physical activity. Our results suggest that greater attention should be paid to FOF during stroke recovery and fall prevention. A multifaced intervention program encompassing physiological and psychological factors should be designed to address FOF and prevent falls.