bluuebunny/crossref_metadata_2025 huggingface dataset:
Material philosophy and the adaptability of materials
Authors: Mol Annemarie
Published: January 2021

This reflection on Erik Rietveld’s The Affordances of Art for Making Technologies addresses, first, what it is to engage in material philosophy and make material propositions and then, second, what different materialities, or rather different ways of handling materialities, allow material philosophers to say. It notes that solidity is not an intrinsic property of any stuff. If only they are handled with care, and loved enough, even wood, concrete and metal turn out to be adaptable.
Show Me The Money…Saved! Cost Savings From Acute Asthma Care in the School-Based Health Center
Authors: Goddard Anna , Konesky Andrew , Borkowski Vera , Etcher LuAnn
Published: January 2021

Chronic school absenteeism directly affects educational outcomes while reducing school funding and reimbursement. Asthma is a prevalent disease associated with chronic absenteeism. This quality improvement project demonstrated classroom seat time preserved through use of school-based health centers (SBHC). The project also highlights the educational benefits, reduced emergency department utilization, potential cost savings to hospitals, and lower overall health care costs. Visit summary data were collected and analyzed to show quality asthma care and cost savings. Of 44 acute asthma visits that returned to class, an average classroom time of 3:42 hours were saved per student during the 2017–2018 academic year, resulting in a combined total of 166:07 hours saved. A minimum potential cost savings was estimated to be $67,770 for all 44 visits. Data analysis of structural, process, and outcome measures through quality improvement tools can demonstrate cost savings of SBHC care, which advocates funding for this pediatric care model.
Endothelial Function in Patients With Von Willebrand Disease
Authors: Noone Stephanie , Schubert Ralf , Fichtlscherer Stephan , Hilberg Thomas , Alesci Sonja , Miesbach Wolfgang
Published: January 2021

In patients with von Willebrand disease (vWD) the interest in age-related comorbidities has grown, because the life expectancy of these patients has increased. The research question of this study was whether patients with vWD show a different endothelial function compared to the general population. A total of 37 patients with type 1 (n = 23), type 2 (n = 10) and type 3 (n = 4) vWD, 14 controls and 38 patients with coronary artery disease (CAD) were included in this study. Five markers of endothelial dysfunction (MOED) were determined. Moreover, the endothelial function was examined using the Itamar Endo-PAT. The reactive hyperemia index (RHI) was calculated from the results. The markers soluble intercellular adhesion molecule-1 (p = 0.171), P-Selectin (p = 0.512), interleukin-6 (p = 0.734) and monocyte chemoattractant protein-1 (p = 0.761) showed higher levels in patients with vWD, but were not significantly different compared to the control group. RHI was impaired in CAD-patients (1.855), whereas vWD patients had mean results of 1.870 and controls 2.112 (p = 0.367). In this study, the endothelial function measurements of patients with von Willebrand disease were not significantly different compared to healthy controls.
Sharing Is Caring? Conflict and Value Codestruction in the Case of Sharing Economy Accommodation
Authors: Apostolidis Chrysostomos , Brown Jane
Published: January 2021

Using the context of sharing economy accommodation in London, the current research adopts a stakeholder causal scope approach, to explore conflictual relationships between guests, hosts, and locals and support the development of effective conflict management strategies. The means-end chain analysis method is combined with the critical incident technique to investigate the causes of conflict and its consequences on the value cocreated during stakeholder interactions. Our findings indicate that interest, relationship, values, information, and structural issues can cause conflict, leading to a loss of personal, financial, environmental, material, and social resources. Unless resolved successfully, this may result in further loss of resources and value codestruction. This can negatively influence the environmental, social, and economic sustainability of sharing economy accommodation. Effective conflict management strategies, such as development of consistent policies and effective communication channels, are required to enable value corecovery and cocreation, through the recovery of lost resources.
End-user perspectives on the development of an online intervention for parents of children on the autism spectrum
Authors: Hermaszewska Susannah , Sin Jacqueline
Published: January 2021

Strong evidence suggests that parents of children on the autism spectrum face increased stressors to their physical and mental wellbeing due to the demands of caregiving and paucity of support. The disparity between the services currently offered and unmet needs indicates that accessible and flexible support through online delivery is needed for parents. This study presents the ideas and perspectives collected from five focus groups of 17 parents of autistic children, on the optimal content and implementation strategy of an online intervention. Using thematic framework analysis, we derived themes under the categories: the need for online interventions; content and design; and implementation. Parents supported the development of a multicomponent online intervention which combines psychoeducation with peer-support and access to healthcare professionals.

Lay abstract

Parent caregivers play an essential role in the lives of individuals on the autism spectrum. The demands of caregiving can have negative effects on the mental and physical wellbeing of parents. Different types of formal support have been developed to help parents to cope with caregiving; however, many parents struggle to access services due to limited availability and busy schedules. The Internet could offer parents more accessible and flexible support. We asked 17 parents what content they would like to include in an online resource. Parents told us about their experiences trying to access and use existing formal support and websites. They overwhelmingly supported the development of an online resource informed by their suggestions. Parents emphasised the need for easier access to information through educational components and direct access to healthcare professionals online. Parents also wanted help with finding existing services and reliable, locally relevant information. Parents stressed the need for a safe environment to meet and chat with other parents online. This research forms the first stage in the development process of an online health resource for parents.
Uncanny Babushka: Migration, aging and the search for a new sexual Self
Authors: Cvajner Martina , Sciortino Giuseppe
Published: January 2021

Geographical mobility may have a powerful influence on sexual change. The sexual dimension of migration has mostly been studied in reference to its role in shaping aspiration for mobility. It has been documented how the promise of an erotically desirable future plays often an important role in many migration subcultures. Mobility, moreover, has been recognized as one of the ways in which many types of sexual minorities have escaped repression or pursued greater autonomy. In this paper, we argue that the same phenomena may be observed in the migration of older people. For some mature persons, particularly women, migration provides an alternative to de-sexualization and stigmatization. In many of these cases, however, the subjective process of sexual change is triggered indirectly, and sometimes serendipitously, by the experience of geographical dislocation. In fact, the experience of re-sexualization may be utterly independent from any pre-emigration aspiration to change one’s sexual Self. The paper – on the basis of two longitudinal research projects on the women pioneers of the Eastern European migration to Italy – explores the role played in their settlement by the discovery that, in the new environment, their age did not disqualify them from romance. The different reactions to these opportunities have created a strong differentiation among migratory trajectories. For the women pioneers who have decided to explore it, this unexpected lovescape has made possible to draw some crucial social boundaries and to trigger the birth of a distinctive sexual field.
Comparison of seismic performance between typical structural steel buildings designed following the Chinese and United States codes
Authors: Lu Xinzheng , Zhang Chi , Liao Wenjie , Lin Yuanqing , Lin Xuchuan , Xue Hongjing
Published: January 2021

In this study, comparative investigations of a typical steel moment frame and a steel frame-braced core-tube structure, designed following different seismic codes, are conducted to evaluate the significant differences between the Chinese and the United States (US) seismic codes for steel buildings. The study outcomes can enhance the understanding of the differences in steel structure design between two countries, especially the differences in seismic performance. Specifically, the design outputs of the structural components, material consumptions, dynamic characteristics, and seismic loads were analyzed. Subsequently, finite element (FE) models based on the design outputs were established to assess the seismic performance and collapse margin. Furthermore, the local buckling effect of the steel components can be considered in the FE model, which can effectively predict the buckling-induced strength deterioration under excessive deformation. The comparison results reveal that, under the same design conditions in this study, both the strength requirement and deflection limit are critical factors that control the typical buildings design following the Chinese codes. However, the strength requirement is the primary factor that controls the design outcomes following the US codes. Moreover, the collapse resistance of the steel moment frames from both codes are similar, but the material consumption based on the Chinese design code is comparatively higher. In contrast, the material consumption of the steel frame-braced core-tube structures are comparable, but the collapse resistance of the US design code is better. Furthermore, the collapse analyses indicate that the local buckling effect could significantly reduce the collapse resistance.
Web-based education of the elderly improves drug utilization literacy: A randomized controlled trial
Authors: Qvarfordt Maria , Throfast Victoria , Petersson Göran , Hammar Tora , Hellström Lina
Published: January 2021

The aim of this study was to explore the effects of web-based education in the field of drug utilization on elderly individuals’ knowledge of, concerns about and self-assessed understanding of drug utilization. The 260 included participants were randomized to a control group or an intervention group. To assess drug utilization literacy, we used a questionnaire containing 20 multiple-choice questions on drug utilization and ten statements about drug utilization (to which participants graded their response using a Likert scale: two about common concerns and eight about their self-assessed understanding of drug utilization). The Beliefs about Medicines Questionnaire-General was also used. The intervention group scored higher on the knowledge questions ( p < 0.001) and on six of the eight statements about self-assessed understanding of drug utilization at the first check after 2 weeks ( p < 0.05). At a second check 6 months later, the difference remained for the knowledge questions, but there was no difference in self-assessed understanding of drug utilization between the groups. There were no differences in the concerns about drug utilization or beliefs about medication at any time. We conclude that a web-based education can improve drug utilization literacy in elderly individuals and might contribute to the safer use of medications.
IWSHM 2019: Perturbation-based Bayesian damage identification using responses at vibration nodes
Authors: Huang Tianxiang , Schröder Kai-Uwe
Published: January 2021

One important topic for structural health monitoring is to achieve accurate damage detection with a small number of noisy sensors and without the requirement of a high-fidelity finite element model. This article adopts the Bayesian probabilistic approach combined with a perturbation model using responses at a few vibration nodes for damage monitoring. First, the node displacement, or the response at vibration node, is adopted in this study for real-time damage assessment with a relatively small number of sensors. Then, the construction method of the node displacement response curves based on the perturbation model is proposed to replace the expensive finite element model. After that, a Bayesian framework integrated the node displacement measurement and the response curves are adopted to acquire the probability distribution of the damage parameter. In this article, the accuracy of the node displacement–based Bayesian framework with the perturbation method is evaluated. The proposed method is applied to a supporting structure of a sailplane under different noise levels.
Investigation of the mechanical and forming behaviour of 3D warp interlock carbon woven fabrics for complex shape of composite material
Authors: Korkmaz Mehmet , Okur Ayşe , Labanieh Ahmad Rashed , Boussu François
Published: January 2021

Composite materials which are reinforced with 3D warp interlock fabrics have outstanding mechanical properties such as higher delamination resistance, ballistic damage resistance and impact damage tolerance by means of their improved structural properties. Textile reinforcements are exposed to large deformations in the production stage of composite materials which have complex shape. Although good formability properties of 3D warp interlock fabrics in forming process were already proven by recent studies, further information is needed to elucidate forming behaviours of multi-layer fabrics which is produced with high stiffness yarns like carbon. In this study, 3D warp interlock carbon fabrics were produced on a prototype weaving loom and the same carbon yarn was used in two fabric directions with equal number of yarn densities. Fabrics were differentiated with regard to the presence of stuffer warp yarn, weave pattern and parameters of binding warp yarn which are angle and depth. Therefore, the effect of fabric architecture on the mechanical and formability properties of 3D warp interlock carbon fabrics could be clarified. Three different breaking behaviours of fabrics were detected and they were correlated with crimp percentages of yarn groups. In addition, the bending and shear deformations were analysed in view of parameters of fabric architectures. Two distinct forming behaviours of fabrics were determined according to the distribution of deformation areas on fabrics. Moreover, the optimal structure was identified for forming process considering the fabric architecture.
Experimental evaluation of the compression garment produced from elastic spacer fabrics through real human limb
Authors: Mousavi Golnaz , Varsei Mehdi , Rashidi Abosaeed , Ghazisaeidi Reza
Published: January 2021

Spacer fabrics found vast applications as medical textile due to their intrinsic and unique properties such as good air permeability, breathability, compressibility and comfort. The aim of this study is to utilize weft knitted spacer fabric as pressure garment to apply more uniform interface pressure on limb than common commercial fabrics. Initially, different weft knitted spacer fabrics by varying the spacer fabric thickness (0.8, 1.2 and 1.8 mm) and elastane yarn content (25, 30, 35 and 40%) were produced. Then, mean interface pressure was obtained through conducting the Mannequin test. Based on the Mannequin test results, spacer fabrics with similar applied interface pressure to commercial one were selected to perform human limb test. According to the results, the spacer fabric with the thickness of 1.8[Formula: see text] and elastane yarn content of 25% not only applied interface pressure comparable to commercial fabric, but also exhibited the most uniform interface pressure mapping on human limb among those studied. Also experimental results showed the superior performance of spacer knitted fabrics with elastane yarn than the single jersey knitted fabrics as pressure garments.
Unifying Theory and Research on Intimate Partner Violence: A Feminist Perspective
Authors: De Coster Stacy , Heimer Karen
Published: January 2021

This paper shows how theorizing gender as a social system and a situational accomplishment provides a broad perspective that helps to synthesize many strands of theoretical and empirical research on IPV. We first address generalist claims that gendered explanations of IPV are not necessary. We next present a unifying feminist theoretical framework to explain IPV experiences and discuss how this framework can be extended to consider how gender and race systems intersect to influence IPV. We call for future theoretical development and empirical research that takes seriously a variety of intersecting systems and dimensions of oppression.
Proposal of a stage-by-stage design method and its application on a multi-stage multiphase pump based on numerical simulations
Authors: Shi Yi , Zhu Hongwu
Published: January 2021

Rotodynamic multiphase pumps are usually equipped with many compression units to provide sufficient boosting pressure for the transportation of production fluid in gas oil field. It is a challenge to maintain pump performance while flow parameters in each stage vary due to the compressibility of gas-liquid phase. In this article, a stage-by-stage design method is proposed to improve the boosting capability of a multiphase pump. Variations of flow parameters in each stage are investigated based on computational fluid dynamics (CFD) numerical simulation. Available methods to determinate main impeller geometry parameters of impeller are discussed. The stage-by-stage design method is applied on a five-stage multiphase pump when the inlet gas volume fraction (GVF) are 30% and 50% separately. The second stage is modified base on its corresponding inlet flow parameters when inlet GVF is 30% while the second and third stage are modified when inlet GVF is 50%. Flow parameters, pressure distribution and velocity distribution are compared between the original pump and modified pump. Differential pressure of the modified pump increases by 53.72 kPa and 58.57 kPa respectively when inlet GVFs are 30% and 50%. The feasibility of the stage-by-stage design method is verified through the comparison results.
Tenecteplase in wake-up ischemic stroke trial: Protocol for a randomized-controlled trial
Authors: Roaldsen Melinda B , Lindekleiv Haakon , Eltoft Agnethe , Jusufovic Mirza , Søyland Mary-Helen , Petersson Jesper , Indredavik Bent , Tveiten Arnstein , Putaala Jukka , Christensen Hanne , Kõrv Janika , Jatužis Dalius , Engelter Stefan T , Marco De Marchis Gian , Wilsgaard Tom , Werring David J , Robinson Thompson , Mathiesen Ellisiv B , Berge Eivind
Published: January 2021

Background

Patients with wake-up ischemic stroke who have evidence of salvageable tissue on advanced imaging can benefit from intravenous thrombolysis. It is not known whether patients who do not fulfil such imaging criteria might benefit from treatment, but studies indicate that treatment based on non-contrast CT criteria may be safe. Tenecteplase has shown promising results in patients with acute ischemic stroke. The aim of the Tenecteplase in Wake-up Ischemic Stroke Trial (TWIST) is to compare the effect of thrombolytic treatment with tenecteplase and standard care versus standard care alone in patients with wake-up ischemic stroke selected by non-contrast CT.

Methods/design

TWIST is an international, investigator-initiated, multi-centre, prospective, randomized-controlled, open-label, blinded end-point trial of tenecteplase ( n = 300) versus standard care ( n = 300) in patients who wake up with an acute ischemic stroke and can be treated within 4.5 h upon awakening. Seventy-seven centres in 10 countries (Denmark, Estonia, Finland, Latvia, Lithuania, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom) participate. The primary outcome is the modified Rankin Scale on the ordinal scale (0–6) at three months.

Discussion

TWIST aims to determine the effect and safety of thrombolytic treatment with tenecteplase in patients with wake-up ischemic stroke selected by non-contrast CT.

Trial registration

ClinicalTrials.gov NCT03181360. EudraCT Number 2014-000096-80.
Absence of susceptibility vessel sign is associated with aspiration-resistant fibrin/platelet-rich thrombi
Authors: Darcourt Jean , Garcia Cédric , Phuong Do M , Michelozzi Caterina , Bellanger Guillaume , Adam Gilles , Roques Margaux , Januel Anne C , Tall Philippe , Albucher Jean F , Olivot Jean M , Bonneville Fabrice , Payrastre Bernard , Cognard Christophe
Published: January 2021

Background

The composition of the thrombus influences its retrievability by mechanical thrombectomy.

Purpose

Our study aimed to report on thrombi resistant to aspiration, regarding susceptibility vessel sign and histologic composition.

Methods

This observational study was based on a prospective database of acute anterior circulation ischemic strokes treated by mechanical thrombectomy. Endovascular first-line strategy was aspiration and in case of failure, combined therapy-rescue was performed. The positivity of susceptibility vessel sign (SVS+) or its negativity (SVS−) was assessed on T2* sequences. The thrombus composition was analyzed with hematoxylin eosin staining.

Results

Histological analysis was performed on 102 clots. Thrombi with SVS− were significantly richer in fibrin/platelets, p = 0.04. Out of 210 mechanical thrombectomy, aspiration first pass strategy was performed in 131/210 (62%) patients. Combined therapy-rescue was needed in 37% of aspiration first pass strategy cases ( n = 131). Clots retrieved combined therapy-rescue were richer in fibrin/platelets 63.9% versus 50.8% for aspiration first pass strategy, p = 0.03. Logistic regression analysis showed that fibrin/platelet-poor clots (<60%) were significantly more likely to be recanalized by aspiration first pass strategy compared to fibrin/platelet-rich clots (>60%) that were more likely recanalized by combined therapy-rescue after aspiration first pass strategy failure (OR = 3.5; 95% CI = 1.2–10.8; p = 0.0054).

Conclusions

Our results confirm that SVS− clots are rich in fibrin/platelets and suggest that these “white clots” are less likely to be retrieved by aspiration alone and more often require the use of combined therapy.
Coaches’ internal model of the tennis serve technique: Knowing or understanding?
Authors: Fetisova Yulia , Zois James , Spittle Michael , Dawson Andrew
Published: January 2021

The understanding of coaches’ knowledge plays a critical role in coach development. This study aimed to examine the internal models of expert and novice tennis coaches and to identify the key distinguishing characteristics between levels. Data was captured by in-depth interviews and analysed using a combination of qualitative and quantitative methodologies. The results revealed that the internal model consisted of seven components including the “functionality” component that has not been reported previously. A significant difference was detected only in three components of the internal model: “reasoning chains”, “concepts” and “key flexion points”. The findings led to the conclusion that the main attribute of tennis coaching expertise is not pure technical knowledge but rather the perception of technique as a whole movement and the ability to understand the connection between technical elements. The findings provide a valuable contribution to tennis coach development as it can be applied in coach education to facilitate novice coach development processes.
Matching comparisons of therapeutic efficacy suggest better clinical outcomes for patients treated with peginterferon beta-1a than with glatiramer acetate
Authors: Scott Thomas F. , Su Ray , Xiong Kuangnan , Altincatal Arman , Castrillo-Viguera Carmen , Naylor Maria L.
Published: January 2021

Background:

Peginterferon beta-1a and glatiramer acetate (GA) are approved first-line therapies for the treatment of relapsing forms of multiple sclerosis, but their therapeutic efficacy has not been compared directly.

Methods:

Clinical outcomes at 2 years, including no evidence of disease activity (NEDA), for patients receiving peginterferon beta-1a 125 mcg every 2 weeks (Q2W) or GA 20 mg/ml once daily (QD) were compared by propensity score matching analysis using individual patient data from ADVANCE and CONFIRM phase III clinical trials. In addition, clinical outcomes at 1–3 years for patients receiving peginterferon beta-1a Q2W or GA 40 mg/ml three times a week (TIW) were evaluated using a matching-adjusted comparison analysis of individual patient data from ADVANCE and the ADVANCE extension study, ATTAIN, and aggregate patient data from the phase III GALA and the GALA extension studies.

Results:

Propensity-score-matched peginterferon beta-1a patients ( n = 336) had a significantly lower annualized relapse rate [ARR (0.204 versus 0.282); rate ratio = 0.724; p = 0.045], a significantly lower probability of 12-week confirmed disability worsening (10.0% versus 14.6%; hazard ratio = 0.625; p = 0.048), and a significantly higher rate of NEDA (20.3% versus 11.5%; p = 0.047) compared with GA 20 mg/ml QD patients after 2 years of treatment. Matching-adjusted peginterferon beta-1a patients (effective n = 276) demonstrated a similar ARR at 1 year (0.278 versus 0.318; p = 0.375) and significantly lower ARR at 2 years (0.0901 versus 0.203; p = 0.032) and 3 years (0.109 versus 0.209; p = 0.047) compared with GA 40 mg/ml TIW patients ( n = 834).

Conclusion:

Results from separate matching comparisons of phase III clinical trials and extension studies suggest that peginterferon beta-1a 125 mcg Q2W may provide better clinical outcomes than GA (20 mg/ml QD or 40 mg/ml TIW).
Compression gloves for patients with hand arthritis (C-GLOVES): A feasibility study
Authors: Hammond Alison , Prior Yeliz
Published: January 2021

Introduction

Compression gloves are frequently provided to patients with hand arthritis. Evidence for effectiveness is limited. The aim of this study was to determine feasibility of recruitment, assessment and treatment procedures, in preparation for a future compression glove trial.

Methods

A non-randomised feasibility study with out-patients with either undifferentiated inflammatory arthritis, rheumatoid arthritis or hand osteoarthritis, with moderate to severe hand pain. All received Isotoner™ compression gloves provided by rheumatology occupational therapists. The main outcomes were feasibility of recruitment, assessment and treatment procedures, trial outcome selection and sample size calculation. Participants were assessed at baseline and four weeks. Assessments included: numeric rating scales (0–10) of hand pain (on activity, at rest, at night) and stiffness; hand joint swelling; finger flexion; and hand function (Grip Ability Test).

Results

Of 318 patients screened, 86/204 (42%) of inflammatory and 68/114 (60%) of hand osteoarthritis patients were eligible. Of these, 41 (48%: age: 59.10 (SD 12.54) years) and 32 (47%: age: 60.75 (SD 8.64) years) respectively, consented. All completed four-week follow-up. Assessment and treatment protocols were feasible. Hand pain on activity and at night, stiffness, joint swelling, finger flexion and hand function improved: e.g. hand pain on activity: inflammatory arthritis change = −0.95 (SD 2.26; p = 0.01); osteoarthritis −1.57 (SD 1.78; p = 0.001). Participants reported improved hand pain, stiffness and hand function as main benefits.

Conclusion

Procedures tested were feasible. The most relevant primary outcome was hand pain on activity. Future trials would need 161 participants (Inflammatory arthritis) and 151 (hand osteoarthritis). Trial registration: Clinical Trials.Gov: NCT01874067
Digital Diabetes Management: A Literature Review of Smart Insulin Pens
Authors: Heinemann Lutz , Schnell Oliver , Gehr Bernhard , Schloot Nanette C. , Görgens Sven W. , Görgen Christoph
Published: January 2021

Digital health management is increasingly pivotal in the care of patients with diabetes. The aim of this review was to evaluate the clinical benefits of using smart insulin pens with connectivity for diabetes management. The search was performed using PubMed and PubMed Central on May 15, 2019, to identify publications investigating the use of insulin pens. Studies evaluating insulin pens with connectivity via Bluetooth/Near Field Communication, with an associated electronic device enabling connectivity, or with a memory function were included in the review. Nine studies were identified in the search. Overall, these studies lacked data on smart insulin pens with a connectivity function, with eight of the available studies investigating only pens with a memory function. The studies focused primarily on assessing patient preference, usability, and technical accuracy. The number of studies assessing clinical outcomes was small ( n = 3). However, the majority of studies ( n = 8) reported that patients preferred smart insulin pens because they increased confidence with regard to diabetes self-management. These results suggest a lack of published data regarding smart insulin pens with connectivity for the management of diabetes. However, the available published data on usability and patient preference suggest that the use of smart insulin pens holds promise for improving and simplifying diabetes self-management.
Lower Extremity Compartment Syndrome in National Football League Athletes
Authors: Lamplot Joseph D. , Wang Dean , Weiss Leigh J. , Baum Michael , Zeidler Kristina , Mack Christina , Barnes Ronnie P. , Warren Russell F. , Taylor Samuel A. , Rodeo Scott A.
Published: January 2021

Background:

The purpose of this study was to evaluate the incidence of lower extremity compartment syndrome in National Football League (NFL) athletes and report the mechanisms of injury, methods of treatment, and subsequent days missed. We review the existing literature on lower extremity compartment syndrome in athletic populations.

Hypothesis:

Lower extremity compartment syndrome occurs with a low incidence in NFL athletes, and there is a high return-to-play rate after surgical management of acute compartment syndrome.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

A retrospective review of recorded cases of lower extremity compartment syndrome from 2000 to 2017 was performed using the NFL Injury Surveillance System and electronic medical record system. Epidemiological data, injury mechanism, rates of surgery, and days missed due to injury were recorded.

Results:

During the study period, 22 cases of leg compartment syndrome in 21 athletes were recorded. Of these injuries, 50% occurred in games and 73% were the result of a direct impact to the leg. Concomitant tibial fracture was noted in only 2 cases (9.1%) and there was only 1 reported case of chronic exertional compartment syndrome. Surgery was documented in 15 of 22 cases (68.2%). For acute nonfracture cases, the average time missed due to injury was 24.2 days (range, 5-54 days), and all were able to return to full participation within the same season.

Conclusion:

NFL athletes with acute leg compartment syndrome treated with surgery exhibited a high rate of return to play within the same season.

Clinical Relevance:

Although compartment syndrome is a relatively rare diagnosis among NFL players, team physicians and athletic trainers must maintain a high index of suspicion to expediently diagnose and treat this potentially limb-threatening condition.
Polyurethane Versus Chitosan-Based Polymers Nasal Packs After Functional Endoscopic Sinus Surgery: A Prospective Randomized Double-Blinded Study
Authors: Khafagy Ahmed Gamal , Maarouf Ahmed Mahmoud
Published: January 2021

Background

Different packing materials are applied to the nose at the end of surgery to maintain drainage and sinus ventilation of the paranasal sinuses and avoid some complications such as bleeding, infection, crustations, adhesions in the middle meatus and lateralization of the middle turbinate.

Objective

The study aims to compare the clinical outcomes of two absorbable packing materials, the synthetic polyurethane, and the naturally occurring Chitosan-based polymers (CBP) nasal packs, after functional endoscopic sinus surgery.

Methods

Fifty patients with bilateral chronic rhinosinusitis with nasal polypi were operated with 100 surgical cavities. At the end of the surgery, one side was randomly packed with synthetic polyurethane and the opposite side with CBP nasal pack. Measure their outcomes at week 1, 2, 4, 8 and 12 as the presence of remnants materials in the middle meatus, crustations, adhesions, bleeding, granulations, infection, and general satisfaction of patients.

Results

CBP nasal pack shows a statistically significant advantage only in the first two weeks as regard remnants material, crusting and bleeding. All over the 12 weeks, there was no statistically significant difference between the two types of packs as regard granulations, adhesions and infection. In the first month, eight patients of the CBP group experienced bad smell and two patients had watery rhinorrhea as adverse reaction without a statistically significant difference. Patients were generally satisfied without a statistically significant difference between the two types of packs.

Conclusion

Synthetic polyurethane and Chitosan-based polymers nasal packs are safe and efficient regarding; the mucosal healing, bleeding control, and the overall satisfaction of patients. The CBP showed a higher statistically significant advantage in the first two weeks only regarding the amount of the retained material, crusting as well as bleeding. Patients packed with CBP experienced fish-like smelly odor and watery rhinorrhea but there is no statistically significant difference.
Mucosal Eosinophilia and Neutrophilia Are Not Associated With QOL or Olfactory Function in Chronic Rhinosinusitis
Authors: Farrell Nyssa F. , Mace Jess C. , Sauer David A. , Thomas Andrew J. , Geltzeiler Mathew , Detwiller Kara Y. , Smith Timothy L.
Published: January 2021

Background

Chronic rhinosinusitis (CRS) is often differentiated by histopathologic phenotypes (eosinophilic versus neutrophilic), which may impact disease severity measures and outcomes. As such, it has been suggested that counts of cellular elements be included as part of a standard pathological report following endoscopic sinus surgery (ESS).

Objectives

This cross-sectional study evaluated associations of mucosal eosinophilia and neutrophilia with measures of quality-of-life (QoL) and olfactory function.

Methods

Patients with medically refractory CRS completed the SNOT-22 survey and Brief Smell Identification Test (BSIT) at enrollment. In addition, baseline Lund-Mackay computed tomography (CT) and Lund-Kennedy endoscopy scores were collected. Ethmoid mucosa was biopsied during ESS and reviewed using microscopy to quantify densest infiltrate of eosinophils or neutrophils per high-powered-field (HPF). Eosinophilic CRS (eCRS) and neutrophilic CRS (nCRS), both with and without nasal polyposis (NP), were compared across SNOT-22 and BSIT scores.

Results

77/168 patients demonstrated mucosal eosinophilia (eCRS) while a total of 42/168 patients demonstrated mucosal neutrophilia (nCRS). After adjusting for polyp status, 35/168 had eCRSsNP, 42/168 eCRSwNP, 75/168 non-eCRSsNP, 16/168 non-eCRSwNP. Additionally, 22/161 were noted to have nCRSsNP, 20/161 nCRSwNP, 84/161 non-nCRSwNP, and 35/161 non-nCRSsNP. A small subset of patients demonstrated both eosinophilia and neutrophilia: 14 CRSwNP and 7 CRSsNP. When evaluating average Lund-Mackay Scores (LMS), significant differences existed between non-eCRSsNP and eCRSsNP (p = 0.006). However, after controlling for nasal polyps, eosinophilia did not significantly associate with differences in the Lund-Kennedy Score. Neutrophilia did not significantly associate with any changes in LMS or LKS after controlling for NP. Eosinophilic and neutrophilic histopathologic subtypes did not significantly associate with differences in baseline SNOT-22 or BSIT measures after controlling for NP.

Conclusion

Neither the presence of mucosal eosinophilia nor mucosal neutrophilia demonstrated significant associations with SNOT-22 quality-of-life or BSIT olfactory function scores when controlling for comorbid nasal polyposis.
Predictors of Chemotherapy Safe-Handling Precautions and Knowledge Among a Sample of Jordanian Oncology Nurses: A Model-Building Approach
Authors: Abu Sharour Loai. , Subih Maha , Bani Salameh Ayman , Malak Malakah
Published: January 2021

Background:

There are adverse side effects associated with handling chemotherapy; however, using safe-handling precautions can minimize or prevent these potential effects. Despite availability of international guidelines for chemotherapy handling, adherence to precautions is below expectations. This study examined knowledge of safe-handling precautions among a sample of oncology nurses in Jordon.

Methods:

A cross-sectional study was employed that included a convenience sample of 153 oncology nurses. Oncology nurses from two hospitals completed the Chemotherapy Handling Questionnaire. Descriptive analysis, Spearman rank correlation coefficients, and regression analyses were performed to determine the predictors of precaution use when handling hazardous drugs among participants.

Findings:

We observed that age, number of patients for whom the worker administered chemotherapy per day, the number of patients receiving chemotherapy per day in the participant’s work unit, nurses’ knowledge about safe-handling precautions, perceived risk, perceived barriers, self-efficacy, organization influence/workplace safety climate, conflict of interest, and interpersonal influences were predictors of use of safe-handling precautions (adjusted R2 = .66, p < .001).

Conclusion/Application for Practice:

Several predictors for using safe-handling precautions were identified. Clinically, chemotherapy handling procedures should be evaluated frequently to identify barriers to safe practices and to improve worker safety.
Factors Associated With Major Complications and Mortality During Hospitalization in Patients With Ankylosing Spondylitis Undergoing Surgical Management for a Spine Fracture
Authors: Ull Christopher , Yilmaz Emre , Hoffmann Martin F. , Reinke Charlotte , Aach Mirko , Schildhauer Thomas Armin , Kruppa Christiane
Published: January 2021

Study design:

Retrospective study.

Objectives:

To analyze factors associated with major complications (MC) in patients with ankylosing spondylitis (AS) undergoing surgical management for a spine fracture.

Methods:

Included were all persons with spine fractures and AS in a teriary health care center between 2003 and 2019. Clinical data and MC were characterized with descriptive characteristics. Multivariable analyses were used to find factors associated with MC.

Results:

In total, 174 traumatic fracture incidents in 166 patients with AS were included, with a mean patient age of 70.7 ± 13.1 years. The main reason for spine fracture was minor trauma (79.9%). Spinal cord injuries (SCI) were described in 36.7% of cases. The majority of patients (54.6%) showed more than one fracture of the spine, with cervical fractures being the most common (50.5%). Overall, the incidences of surgical site infection, implant failure, nosocomial pneumonia (NP), and mortality were 17.2%, 9.2%, 31%, and 14.9%, respectively. ICU stay > 48 hours was associated with MC (including death). Posterior approach for spondylodesis, ICU stay > 48 hours and cervical SCI were related to MC (excluding death). Age > 70 years, NP and Charlson comorbidity index > 5 points were associated with in-hospital mortality.

Conclusions:

Patients with AS and surgical treatment of spine fractures are at high risk for MC. Therefore, our results might give physicians better insight into the incidence and sequelae of major complications and therefore might improve patient and family expectations.
Allogeneic Umbilical Cord Blood–Derived Mesenchymal Stem Cell Implantation Versus Microfracture for Large, Full-Thickness Cartilage Defects in Older Patients: A Multicenter Randomized Clinical Trial and Extended 5-Year Clinical Follow-up
Authors: Lim Hong-Chul , Park Yong-Beom , Ha Chul-Won , Cole Brian J. , Lee Beom-Koo , Jeong Hwa-Jae , Kim Myung-Ku , Bin Seong-Il , Choi Chong-Hyuk , Choi Choong Hyeok , Yoo Jae-Doo ,   for the Cartistem Research Group, Yoon Jung-Ro , Chung Jun-Young
Published: January 2021

Background:

There is currently no optimal method for cartilage restoration in large, full-thickness cartilage defects in older patients.

Purpose:

To determine whether implantation of a composite of allogeneic umbilical cord blood–derived mesenchymal stem cells and 4% hyaluronate (UCB-MSC-HA) will result in reliable cartilage restoration in patients with large, full-thickness cartilage defects and whether any clinical improvements can be maintained up to 5 years postoperatively.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A randomized controlled phase 3 clinical trial was conducted for 48 weeks, and the participants then underwent extended 5-year observational follow-up. Enrolled were patients with large, full-thickness cartilage defects (International Cartilage Repair Society [ICRS] grade 4) in a single compartment of the knee joint, as confirmed by arthroscopy. The defect was treated either with UCB-MSC-HA implantation through mini-arthrotomy or with microfracture. The primary outcome was proportion of participants who improved by ≥1 grade on the ICRS Macroscopic Cartilage Repair Assessment (blinded evaluation) at 48-week arthroscopy. Secondary outcomes included histologic assessment; changes in pain visual analog scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) score from baseline; and adverse events.

Results:

Among 114 randomized participants (mean age, 55.9 years; 67% female; body mass index, 26.2 kg/m2), 89 completed the phase 3 clinical trial and 73 were enrolled in the 5-year follow-up study. The mean defect size was 4.9 cm2 in the UCB-MSC-HA group and 4.0 cm2 in the microfracture group ( P = .051). At 48 weeks, improvement by ≥1 ICRS grade was seen in 97.7% of the UCB-MSC-HA group versus 71.7% of the microfracture group ( P = .001); the overall histologic assessment score was also superior in the UCB-MSC-HA group ( P = .036). Improvement in VAS pain, WOMAC, and IKDC scores were not significantly different between the groups at 48 weeks, however the clinical results were significantly better in the UCB-MSC-HA group at 3- to 5-year follow-up ( P < .05). There were no differences between the groups in adverse events.

Conclusion:

In older patients with symptomatic, large, full-thickness cartilage defects with or without osteoarthritis, UCB-MSC-HA implantation resulted in improved cartilage grade at second-look arthroscopy and provided more improvement in pain and function up to 5 years compared with microfracture.

Registration:

NCT01041001, NCT01626677 (ClinicalTrials.gov identifier).
Simulation-based site amplification model for shallow bedrock sites in Korea
Authors: Aaqib Muhammad , Park Duhee , Adeel Muhammad Bilal , Hashash Youssef M A , Ilhan Okan
Published: January 2021

A new simulation-based site amplification model for shallow sites with thickness less than 30 m in Korea is developed. The site amplification model consists of linear and nonlinear components that are developed from one-dimensional linear and nonlinear site response analyses. A suite of measured shear wave velocity profiles is used to develop corresponding randomized profiles. A VS30 scaled linear amplification model and a model dependent on both VS30 and site period are developed. The proposed linear models compare well with the amplification equations developed for the western United States (WUS) at short periods but show a distinct curved bump between 0.1 and 0.5 s that corresponds to the range of site natural periods of shallow sites. The response at periods longer than 0.5 s is demonstrated to be lower than those of the WUS models. The functional form widely used in both WUS and central and eastern North America (CENA), for the nonlinear component of the site amplification model, is employed in this study. The slope of the proposed nonlinear component with respect to the input motion intensity is demonstrated to be higher than those of both the WUS and CENA models, particularly for soft sites with VS30 < 300 m/s and at periods shorter than 0.2 s. The nonlinear component deviates from the models for generic sites even at low ground motion intensities. The comparisons highlight the uniqueness of the amplification characteristics of shallow sites that a generic site amplification model is unable to capture.
Interaction between intensity and duration of acute exercise on neuronal activity associated with depression-related behavior in rats
Authors: Morikawa Ryoko , Kubota Natsuko , Amemiya Seiichiro , Nishijima Takeshi , Kita Ichiro
Published: January 2021

We examined the activities of serotonin (5-HT) neurons in the dorsal raphe nucleus (DRN) and corticotropin-releasing factor (CRF) neurons in the hypothalamic paraventricular nucleus (PVN) during acute treadmill running at different speeds (control, low, high) and durations (15, 30, 60 min) in male Wistar rats using c-Fos/5-HT or CRF immunohistochemistry. We also performed elevated plus maze test (EPM) and forced swim test (FST) after acute treadmill running in rats. Acute treadmill running at low speed, regardless of exercise duration, significantly increased c-Fos expression in 5-HT neurons in the DRN compared with controls, whereas high-speed running significantly activated 5-HT neurons only at 60-min duration. In contrast, c-Fos expression in CRF neurons in the PVN was enhanced in an intensity-dependent manner, regardless of exercise duration. c-Fos expression in 5-HT neurons in the DRN induced by the acute treadmill running for 30 or 60 min, but not 15 min, was positively correlated with the time spent on the open arms in the EPM and was negatively correlated with the immobility time in the FST. These results suggest an interaction between exercise intensity and duration on the antidepressant effects of acute physical exercise.