bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of application status and development prospect of environmental chambers: A review
Authors: Xie Dong , Zhou Haixia , Zhou Lifeng , Yu Chuck Wah
Published: November 2022

Environmental chambers are a kind of equipment to simulate various conventional and extreme environments, which are usually applied to create various environmental conditions and conduct various studies related to environmental parameters. Through our review of literature of the past 30 years, environmental chambers have been mainly used in the following four aspects: pollutants’ emission characterization, human thermal comfort research, products and materials development and transformation and the reaction and behaviour of other living bodies such as animals and plants. In this paper, the current application of environmental chambers is summarized based on the research objectives, conditions and technical means. The purpose of this paper is to provide a review of the use of environmental chambers for research and analyze the current application of environmental chambers for the future application of environmental chambers and explore the direction of its future transformation and application.
Signaling news outlet trust in a Google Knowledge Panel: A conjoint experiment in Brazil, Germany, and the United States
Authors: Masullo Gina M , Wilhelm Claudia , Lee Taeyoung , Gonçalves João , Riedl Martin J , Stroud Natalie J
Published: November 2022

Using data from a conjoint experiment in three countries (Brazil, n = 2038; Germany, n = 2012, and the United States, n = 2005), this study demonstrates that journalistic transparency can cue trust at the level of the entire news outlet—or domain level—using a Google Knowledge Panel that comes up when people search for a news outlet. In Brazil and the United States, two pieces of information in a Knowledge Panel provided the strongest heuristics that a news outlet was trustworthy: a description of the news outlet and a description of other sites accessed by people who frequent that news outlet’s website. In Germany, information about journalists and the description of the news outlet were the strongest cues. Results offer insights into how people heuristically process online news and are discussed in relation to the heuristic-systematic model of information processing.
Metamaterials: Design, modelling, simulation and implementation
Authors: Sedighi Hamid M , Lallart Mickaël , Zhuang Xiaoying
Published: November 2022

Metamaterials are a new class of man-made compound materials with exceptional properties which are not found in nature. Thanks to their superior features, they are used in a variety of fields and industries such as microwave engineering, dispersion compensation, smart antennas, sensor identification, high-frequency battlefield communications, improved ultrasonic sensors, solar energy management for high-gain antennas, remote aerospace applications, vibration control, acoustic wave guiding, and energy harvesting. The microstructures in acoustic metamaterials are locally alternating. Over the past decade, acoustic metamaterials have gained increasing attention because of the ability to modify the sound wave field or vibration at inputs in ways that cannot be achieved using ordinary materials. In the meantime, acoustic metamaterials can possess negative modulus of elasticity, negative density, or anisotropic mass. These capabilities greatly increase the choice of materials and provide an unprecedented way to manipulate/attenuate wave propagation and vibrational and acoustic behavior of structures. Physiomechanical property improvements yielded major interests in metamaterials and thereby exploring the physics of such mechanisms, leading to excellent essential investigations related to the synthesis, development, and characterization of such advanced materials.
Aerodynamic noise characteristics of non-circular cylinders in subcritical flow regime
Authors: MG Arun , TJ Sarvoththama Jothi
Published: November 2022

The present study experimentally investigates the aerodynamic noise from the flow around cylinders of square and equilateral triangle cross-sections at different angles of incidence ( α). The cylinder models have a side dimension of 10 mm and a span of 300 mm. The free stream velocity ( U 0) is in the range of 12–36 m/s, and the corresponding Reynolds numbers are 7.8 × 103 to 2.3 × 104, which is in the subcritical flow regime. The characteristic acoustic tones are generated at α = 30° and 45° for square and triangular cylinders. The frequency of acoustic tones linearly increases with the free stream velocity, and the corresponding Strouhal numbers are found to be in the range of 0.13–0.16. Depending on the angle of incidence, the overall sound pressure level is higher than the background noise by 4–24 dB for the square cylinder and 3–15 dB for the triangular cylinder at U 0 = 36 m/s. The highest noise level of the square cylinder is 90 dB at α = 45° and 79 dB at α = 30° for the triangular cylinder. The spectral scaling with the sixth power of the free stream velocity indicates the dipole behaviour of the acoustic tones. The mean and root-mean-square velocity profiles in the wake region characterise the noise emissions at different angles of incidence. The comparative acoustic study of the non-circular cylinders with a circular counterpart showed that the highest noise level is from the square cylinder at α = 45°. The directivity study shows that the noise level of the square cylinder at α = 45° at 90° angular location ( θ) is higher by 6.5 dB than that at θ = 30°.
Revisions of evidence-based governance: The case of the Austrian quality management system SQA
Authors: Altrichter Herbert , Ettl Karin , Grinner Karin , Kolleritsch Kornelia , Kopp-Sixt Silvia , Leeb-Brandstetter Renate , Pöschko Heidemarie , Postlbauer Alexandra
Published: November 2022

Throughout the last 30 years, many European countries have ‘modernized’ their governance of education. For the Central European school systems of Austria and the German Bundesländer it has been claimed that this ‘modernization’ was characterised by a sequence of reform ‘waves’ which culminated in introducing ‘evidence-based governance’ models characterised by nation-wide comparative performance testing, new school inspections, etc. This paper argues that we recently see the emergence of revisions of the original ‘evidence-based governance’ models which may be understood as a new ‘wave of modernization’ of school governance. These models aim to react to increasing criticism of the evidence-based philosophy, in particular to its ambivalent attitude to teacher professionalism. The paper at hand analyses the specific aspirations and features of ‘revised evidence-based governance instruments’ to discuss their potential as a policy future. In a second step, we take the Austrian quality management system SQA as an example for these new governance models. In an explorative study, we use case data to understand how teachers and school leaders evaluate this reform and its impact on their work. In particular, we are interested whether or not educational professionals feel that this reform conveys appreciation of and trust in their professional capacities.
Substitution Effects and the Transnational Demand for European Soccer Telecasts
Authors: Nalbantis Georgios , Pawlowski Tim , Schreyer Dominik
Published: November 2022

European soccer leagues’ internationalization efforts have significantly increased the number of available telecasts abroad. In the US, this has fueled discussions about the degree of audience overlap between networks broadcasting international soccer. However, whether and to what extent telecasts of different leagues indeed constitute substitutes has never been explored empirically. Drawing on US audience data for Bundesliga telecasts, we analyze the impact of scheduling clashes with Premier League, La Liga, and Serie A games. Econometric demand models reveal sizeable substitution effects caused primarily by overlapping Premier League games, suggesting significant competition for the soccer audience in the US market.
An Exploration of Yoga in Occupational Therapy Practice for Multiple Sclerosis
Authors: Candray Haylee A. , Kinkel Charla L. , Fox Anna L. , Atler Karen E. , Fling Brett W. , Van Puymbroeck Marieke , Crowe Brandi M. , Schmid Arlene A.
Published: November 2022

The purpose of this exploratory qualitative study was to provide insight on the use of yoga in occupational therapy (OT) for people with multiple sclerosis (PwMS). This study aimed to answer how and why OT practitioners (OTPs) integrate yoga into clinical practice for PwMS. Eight OTPs, half of whom have also completed yoga teacher training, participated in a semi-structured telephone interview. Interviews were transcribed verbatim, inductively open-coded, and analyzed using thematic data analysis. Themes that emerged were: (a) OT and yoga are a natural fit; (b) improved performance and participation; (c) leveraging personal ties to yoga; and (d) influenced by client factors and clinical environment. The qualitative data provide valuable information about OTPs’ justification for, and unique application of, yoga in clinical practice for PwMS. Future researchers should further explore the use of yoga for OT-related outcomes and the experience of PwMS.
Assessing the determinants of Myanmar government employees’ job satisfaction through Herzberg’s two-factor theory
Authors: Thant Zaw Min
Published: November 2022

Studies on Myanmar public employees’ job satisfaction are very limited. To understand which factors affect these employees’ job satisfaction, this study adopted Herzberg’s two-factor theory and tested its applicability in assessing self-administered survey data ( N = 1,225). Results showed that Herzberg’s original sets of motivators and hygiene factors can measure government employees’ job satisfaction and that both motivators and factors are important in explaining job satisfaction. Specifically, public service motivation and religiosity contribute to job satisfaction, and family orientation’s negative effect on job satisfaction is statistically significant. Formulating flexible work schedules and dependent care programs can reduce employees’ work-family conflicts.
Two Cases of Delayed Flexor Tendon Rupture Decades After Reconstruction
Authors: Dieterich James D. , Frechette Gregory M. , Bernstein Zach , Melamed Eitan , Hausman Michael R.
Published: November 2022

Two patients are presented with late-term ruptures of their flexor tendon grafts 10 and 40 years, respectively, after reconstruction. Both occurred from low-energy mechanisms. Their ruptures were intratendinous and not at the proximal or distal insertions. Electron microscopy demonstrated degeneration and increased matrix deposition. Immunohistology showed viable tenocytes, but no clear vascular organization to the disrupted grafts. Even after clinically successful flexor tendon autograft, tendons may still be at risk of degeneration and rupture a decade or more after reconstruction.
A novel reliability index approach and applied it to cushioning packaging design
Authors: An Xue , Huang Bowen , Shi Dongyan
Published: November 2022

This paper is aimed at proposing a new approach to Reliability-based Design Optimization (RBDO) and applying it to cushioning packaging design with a highly nonlinear system. The problem is formulated as an RBDO problem, which is included a minimizing cost function and probabilistic constraints. Here, the thickness of the cushion material is dealt with uncertainty and uncontrolled parameters. The traditional reliability index approach (RIA) has evolved as a powerful tool to solve the RBDO problem; however, due to its convergence problem, the modified reliability index approach (MRIA) is proposed. Although the MRIA method solves the problems of the traditional RIA, it inherits the low efficiency of searching for the most probability point (MPP). Thus, we developed a novel RIA based on MRIA to improve the efficiency and robustness during the RBDO process. The innovation active set strategy is developed in reliability assessment, which is a strict inequality to determine whether the current constraint is active or inactive. An application example is presented, and the results are compared with MRIA to assess cost-effectiveness and efficiency. Results indicate the proposed method is feasible to solve the uncertainty problem of packaging materials in the processing process and is also an efficient RBDO method.
Adverse events are not increased with trainee participation in transcarotid revascularization
Authors: Husman Regina , Tanaka Akiko , Saqib Naveed U , Mirza Aleem , George Mitchell J , Keyhani Arash , Keyhani Kourosh , Wang S Keisin
Published: November 2022

Objective

To determine whether a vascular surgery trainee’s participation in transcarotid revascularization (TCAR), a new technology, affects patient safety and outcomes.

Design

Retrospective, institutional review of our carotid database was performed. Patients who underwent TCAR were stratified based on whether a vascular trainee was present during the procedure. Relevant demographics, comorbidities, anatomical indication, perioperative courses, and adverse events in the postoperative period were captured for statistical analysis.

Setting

Data were obtained from affiliated Memorial Hermann Hospitals in Houston, Texas.

Participants

All patients who underwent TCAR from September 2017 to January 2022 were included.

Results

Of 486 patients who underwent TCAR, 173 (35.6%) were performed in the presence of a trainee, and 313 (64.4%) were performed without a trainee. Subjects in the trainee cohort had more challenging anatomy, defined as a higher rate of carotid bifurcation above C2, restenotic disease, previous ipsilateral neck dissection, and neck radiation. The trainee cohort had higher rates of estimated blood loss (61.1 ± 66 vs. 35.5 ± 39 mL, p < 0.01), longer operative time (64.8 ± 30.3 vs. 57.9 ± 20.4 min, p < .01), longer cerebral blood flow reversal time (8.9 ± 6.1 vs. 7.9 ± 6.6 min, p = .01), and higher contrast administration (25.7 ± 12.0 vs. 21.1 ± 9.4 mL, p < .01). The ability to achieve technical success was similar between the two cohorts. There was no difference in the rates of cranial nerve palsy, ipsilateral stroke, hematoma, and stent thrombosis. Hospital length of stay, death (0% vs. 1.6%, p = .10), and stroke (1.1% vs. 2.8%, p = .22) were also similar between the two cohorts.

Conclusion

Vascular surgery trainee’s involvement during TCAR did not increase adverse outcomes, such as stroke and death, in the perioperative period. The results presented herein should encourage other teaching institutions to provide surgical trainees with supervised, hands-on experience during TCAR.
Operationalising a modified Delphi study to progress quality care process nursing metrics for acute care
Authors: O’Connor Laserina , McAuliffe Eilish , Casey Mary , Rogers Lisa , Gallen Anne , Finnegan Leonie , Glasgow Mary Ellen , White Mark , White Ciara , Kavanagh Paula , Bell Miriam , Killeen Angela , Barnard Marlize
Published: November 2022

Background

Despite representing the largest occupational group within the healthcare workforce, evidence suggests that due to the complexity of nursing practice, nurses’ contribution remains ‘invisible’. Quality Care Metrics aligned to standards can offer valuable numerical information that quantify input, output and dimensions of nursing care processes in complex clinical and interprofessional milieus.

Aims and objectives

Progress an evidence-based metric system to measure the quality and clinical safety of nursing care within acute care in Ireland. The objectives were to: classify quality care process nursing metrics and corresponding indicators pertinent to acute care; reach agreement on a selected set of robust metrics and corresponding indicators; and implement the findings of the study.

Design

A modified four-round Delphi study.

Methods

The modified Delphi study integrated a four-round survey of 422 nurses, face-to-face meetings with a patient representative and key stakeholders within acute services with a final consensus meeting inclusive of a panel of 26 expert nurse clinicians.

Results

There was consensus on 11 quality care process nursing metrics and 53 corresponding indicators for the acute care setting. Despite the rating of ‘critical’ in the Delphi rounds, a concern was reported by participants on the subjective nature of three of the developed metrics: ‘patient experience’, ‘patient engagement’ and ‘professional and ethical approach to care’ based on the absence of objective measurement tools that include patient input. Conversely, this led to the conundrum for the panel of experts at the final consensus meeting who were divided in their views on objectively observing, recording and subsequent auditing of those three developed metrics in real-time clinical practice.

Conclusion

This paper describes the operationalisation of a modified Delphi technique that progressed a set of 11 quality care process metrics and 53 corresponding indicators. The challenge now is the implementation of these quality care process metrics so that nurses’ contribution to patient-centred care is tangible in acute care.
Binding time: Investigations on the integration of visual stimulus duration
Authors: Köllnberger Katrin , Bogon Johanna , Dreisbach Gesine
Published: November 2022

The perception of and reaction to objects creates bindings of (object) features and responses, also called event files. In this context, time is a so far understudied feature. We conducted four experiments to investigate whether the duration of visual stimuli is also integrated into such event files. Experiments 1, 2, and 4 used a simple colour classification task and in Experiment 3 the location of a stimulus had to be classified. In all Experiments, the presentation duration of the stimuli (coloured circles) was either short (20 ms) or long (300 ms). We expected partial repetition costs as an indicator of binding. That is, performance should be better when both colour (Experiment 3: location) and duration repeat or alternate relative to partial repetitions. Results showed no partial repetition costs in Experiments 1 and 3, indicating no integration of duration into visual event files. Experiments 2 and 4 revealed partial repetition costs. Performance was better when Colour and Duration repeated compared with a partial repetition. What distinguishes the latter two experiments from the former is that the coloured stimuli could change their presentation location. The results of all four experiments show a pattern that duration can be integrated into visual event files depending on two criteria: The experimental context holds the possibility of a location change of the target stimulus (Experiments 2 and 4) and the location itself is not response relevant (Experiment 3). The role of location changes for the integration of temporal stimulus features into visual event files is discussed.
On the perception of movement vigour
Authors: Labaune Ombeline , Deroche Thomas , Castanier Carole , Berret Bastien
Published: November 2022

It is common to get the impression that someone moves rather slowly or quickly in everyday life. In motor control, the natural pace of movement is captured by the concept of vigour, which is often quantified from the speed or duration of goal-directed actions. A common phenomenon, here referred to as the vigour law, is that preferred speed and duration idiosyncratically increase with the magnitude of the motion. According to the direct-matching hypothesis, this vigour law could thus underlie the judgement of someone else’s movement vigour. We conducted a series of three experiments ( N = 80) to test whether the vigour law also exists in perception and whether it is linked to that of action. In addition to measuring participants’ vigour, we also asked them to judge the quickness of stimuli representing horizontal arm reaching movements varying through amplitudes, speeds, and durations. Results showed that speed and duration of movements perceived as neither fast nor slow (i.e., natural pace) increased with amplitude, thereby indicating that the vigour law holds when an observer judges the natural pace of others’ movements. Results also revealed that this judgement was population-based (related to the average vigour of all participants) rather than individual-based (participant’s own vigour).
Clip-assisted endoloop ligation of the mucosal defect after resection of colorectal polyps decreased postprocedural delayed bleeding
Authors: Xu Jian-hua , Gao Peng , Zhou Min , Gao Shuang , Dong Zhi-qi , Shen Yu-cui , Zhang Qi-sheng
Published: November 2022

Background:

Postprocedural delayed bleeding (PDB) remains the most common major complication of colorectal polypectomy. Incomplete clip closure of mucosal defect and unclosed injured blood vessels in gaps between clips may be the risk factors for PDB.

Objectives:

To observe whether completely no-gap closure of mucosal defect after polypectomy can reduce PDB occurrence.

Design:

Single-center, retrospective case-control study.

Methods:

In this study based on historical comparisons of patients in 2 time periods, only the patients with polyps sized between 6 and 15 mm were included. A new clip-assisted endoloop ligation (CAEL, treatment group) method was used between January 2019 and December 2020, and a traditional simple clip closure (SCC, control) was used Between January 2017 and December 2018 to prevent PDB after polypectomy. The rate of PDB of two groups and risk factors for PDB were evaluated.

Results:

Totally 4560 patients were included in the study; 2418 patients belong to CAEL group, and 2142 patients belong to SCC group. The overall rate of PDB was significantly lower in CAEL group compared to SCC group (0.6% versus 1.5%, p < 0.00). On multivariate logistic analysis, CAEL was a significant independent preventive factor for PDB (odds ratio (OR), 0.092; 95% confidence interval (CI), 0.029–0.3335; p = 0.000). Polyps located at rectum (colon versus rectum) represented a significant independent risk factor for PDB (OR, 11.888; 95% CI, 3.343–42.269; p = 0.001).

Conclusion:

Completely no-gap closure of mucosal defect after polypectomy further reduced the rate of PDB for polyps sized between 6 and 15 mm. CAEL may be a significant independent preventive factor for PDB. Polyps located at the rectum may be a significant independent risk factor for PDB.
Adjunctive PD-1 inhibitor versus standard chemotherapy in recurrent or metastatic nasopharyngeal carcinoma: a systematic review and meta-analysis
Authors: Polintan Edgar Theodore , Canicula Stephanie Krystel , Catahay Jesus Alfonso , Lo Kevin Bryan , Villalona-Calero Miguel , Loong Herbert Ho-fung
Published: November 2022

Objective:

To investigate whether Adjunctive PD-1 inhibitors have improved clinical outcomes compared to chemotherapy alone in platinum-pretreated and platinum-naive recurrent or metastatic nasopharyngeal carcinoma (R/M NPCA).

Methods:

The study involved a literature search from PubMed, Cochrane CENTRAL, and Google Scholar for randomized clinical trials (RCTs) on the use of PD-1 inhibitors versus chemotherapy alone in patients with R/M NPCA. Bias was assessed using Cochrane collaboration’s risk of bias tool. Overall Survival (OS) was examined as the primary endpoint. Secondary endpoints were Progression-Free Survival (PFS), Objective Response Rate, Disease Control Rate (DCR), Duration of Response, and Serious/Grade ⩾3 Adverse Events. Outcomes were measured with either Mean Difference, Risk ratio (RR), or Hazard ratios (HRs) at 95% confidence interval.

Results:

Four RCTs were included in the meta-analysis and systematic review. OS for the monotherapy subgroup was a HR of 0.87 [0.67, 1.13] ( p = 0.30) while the combination subgroup had 0.64 [0.45, 0.90] ( p = 0.01). The monotherapy subgroup exhibited significantly worse outcomes in PFS (HR 1.31 [1.01, 1.68]) ( p = 0.04) and DCR (RR 1.52 [1.12, 2.05]) ( p = 0.007) but no significant difference in other outcomes. For combination therapy, a statistically significant benefit can be seen in all outcomes except DCR (RR 0.62 [0.38, 1.01]) ( p = 0.06) which was a non-significant benefit favoring PD-1 inhibitors.

Conclusion:

Combination PD-1 inhibitor + chemotherapy followed by maintenance PD-1 inhibitor therapy is superior to chemotherapy alone in the first-line treatment of R/M NPCA, implying a potential benefit with the use of PD-1 inhibitors + chemotherapy with maintenance PD-1 inhibitors as first-line in R/M NPCA compared to standard chemotherapy alone.
Comparison of comorbidities of stroke collected in administrative data, surveys, clinical trials and cohort studies
Authors: Kilkenny Monique F , Dalli Lachlan L , Sanders Ailie , Olaiya Muideen T , Kim Joosup , Ung David , Andrew Nadine E
Published: November 2022

Background

Administrative data are used extensively for research purposes, but there remains limited information on the quality of these data for identifying comorbidities related to stroke.

Objective

To compare the prevalence of comorbidities of stroke identified using International Classification Diseases, Australian Modification (ICD-10-AM) or Anatomical Therapeutic Chemical codes, with those from (i) self-reported data and (ii) published studies.

Method

The cohort included patients with stroke or transient ischaemic attack admitted to hospitals (2012–2016; Victoria and Queensland) in the Australian Stroke Clinical Registry (N = 26,111). Data were linked with hospital and pharmaceutical datasets to ascertain comorbidities using published algorithms. The sensitivity, specificity, and positive predictive value of these comorbidities were compared with survey responses from 623 patients (reference standard). An indirect comparison was also performed with clinical data from published stroke studies.

Results

The sensitivity of hospital ICD-10-AM data was poor for most comorbidities, except for diabetes (93.0%). Specificity was excellent for all comorbidities (87–96%), except for hypertension (70.5%). Compared to published stroke studies (3 clinical trials and 1 incidence study), the prevalence of diabetes and atrial fibrillation in our cohort was similar using ICD-10-AM codes, but lower for dyslipidaemia and anxiety/depression. Whereas in the pharmaceutical dispensing data, the sensitivity was excellent for dyslipidaemia (94%) and modest for anxiety/depression (77%). In the pharmaceutical data, specificity was modest for hypertension (78%) and anxiety or depression (76%), but specificity was poor for dyslipidaemia (19%) and heart disease (46%).

Conclusion

Variation was observed in the reporting of comorbidities of stroke in administrative data, and consideration of multiple sources of data may be necessary for research. Further work is needed to improve coding and clinical documentation for reporting of comorbidities in administrative data.
Effects of NGF and Photobiomodulation Therapy on Crush Nerve Injury and Fracture Healing: A Stereological and Histopathological Study in an Animal Model
Authors: Şen Esengül , Özkan Nilüfer , Önger Mehmet Emin , Kaplan Süleyman
Published: November 2022

Study Design

A stereological and histopathological study in an animal model

Objective

This study explores the effects of the nerve growth factor and photobiomodulation therapy on the damaged nerve tissue and fracture healing.

Methods

A total of 24 rabbits were divided into 4 groups: control group (n = 5), nerve growth factor (NGF) group (n = 7), photobiomodulation (PBMT) group (n = 6), and nerve growth factor and photobiomodulation therapy (NGF+PBMT) group (n = 6). The vertical fracture was performed between the mental foramen and the first premolar, and the mental nerve was crushed for 30 seconds with a standard serrated clamp with a force of approximately 50 N in all groups. The control group received an isotonic solution (.02 mL, .09% NaCl) to the operation site locally. The NGF group received 1 μg human NGF-β/.9% .2 mL NaCl solution for 7 days locally. The PBMT group received PBMT treatment (GaAlAs laser, 810 nm, .3 W, 18 J/cm2) every 48 hours for 14 sessions following the surgery. The NGF+PBMT group received both NGF and PBMT treatment as described above. After 28 days, the bone tissues and mental nerves from all groups were harvested and histologically and stereologically analyzed.

Results

According to the stereological results, the volume of the new vessel and the volume of the new bone were significantly higher in the PBMT group than in other groups (P < .001). According to the histopathological examinations, higher myelinated axons were observed in experimental groups than in the control group.

Conclusions

As a result, PBMT has beneficial effects on bone regeneration. Based on the light microscopic evaluation, more regenerated axon populations were observed in the NGF group than in the PBMT and PBMT + NGF groups in terms of myelinated axon content.
Strongyloidiasis: what every gastroenterologist needs to know
Authors: Yeung Sabrina , Bharwada Yashvi , Bhasker Shveta , Boggild Andrea
Published: November 2022

Strongyloidiasis is caused by the intestinal roundworm, Strongyloides stercoralis, which has the potential for fatal outcome. It may present with vague gastrointestinal symptoms and mimic gastrointestinal diseases such as inflammatory bowel disease, and as such, it should be in the purview of the gastroenterologist. While strongyloidiasis is generally asymptomatic or produces mild symptoms in patients with an intact immune system, individuals who are immunocompromised may develop life-threatening disease through hyperinfection syndrome and disseminated disease. The worm has a complex lifecycle and is able to autoinfect its host, thereby allowing indefinite persistence even decades after initial infection. This leads to cases where travelers, and those who lived in endemic countries, may present years after travel. With its features of prolonged infection, relatively high global prevalence, and potential for fatal outcomes, it is imperative for all clinicians to be aware of this disease. Owing to its involvement with the gastrointestinal system, however, we will outline salient points about strongyloidiasis for the gastroenterologist.
Determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age attending health facilities in Ethiopia, 2019
Authors: Dirirsa Dejene Edosa , Awol Salo Mukemil , Gudeta Mogos Beya , kelbessa Merga Eticha , Lammi Mengistu Bekele
Published: November 2022

Objective:

This study aimed to identify the determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age in Ethiopia, 2019.

Methods:

The institutional-based case–control study design was implemented from June to August 2019. Eligible study participants were sampled using systematic random sampling technique. Data were collected using structured and pre-tested questionnaire and entered into Epi Info and exported to SPSS version 20 for further analysis. All variables with a p value of <0.05 at odds ratio of 95% confidence interval in multivariable logistic regression analysis were considered as determinants of early discontinuation of long-acting and reversible contraceptive methods.

Results:

A total of 825 study participants (206 cases and 619 controls) were included in the study. Decision-making on the use of contraception (adjusted odds ratio: 4.8, 95% confidence interval: 1.4–16.8 and adjusted odds ratio: 5.6, 95% confidence interval: 1.7–18.8), the women who got counseled about side effects of contraceptive methods being 84% less likely to discontinue long-acting and reversible contraceptive methods compared to the women of their counterpart (adjusted odds ratio: 0.16, 95% confidence interval: 0.15–0.4), having two or more children (adjusted odds ratio: 10, 95% confidence interval: 3.7–28), and desire to be pregnant (adjusted odds ratio = 0.15 95% confidence interval: 0.06–0.4) were determinants of early discontinuation of long-acting and reversible contraceptive methods.

Conclusion:

According to the findings of this study, decision-maker on utilization of contraceptive methods, being counseled on side effects of contraception, number of children, and desire of woman to be pregnant were found to be determinants of discontinuation of long-acting and reversible contraceptive methods. Health care providers should strengthen providing pre-insertion counseling in accordance with the national guideline for family planning services, with an emphasis on potential contraceptive side effects and consideration of counseling on decision-making.
Effects of Competition Level on the Prevalence and Incidence of Lumbar Disk Degeneration in Japanese Collegiate Gymnasts
Authors: Koyama Koji , Nakazato Koichi , Kubo Yoshiaki , Gushiken Koji , Hatakeda Yoshiaki , Seo Kyoko , Nakase Takuya , Hiranuma Kenji
Published: November 2022

Background:

Lumbar disk degeneration (LDD) occurs frequently in athletes. Researchers have found that LDD occurs mainly in the lower disks (L4/L5 and L5/S1) in the general and athletic populations. However, a retrospective study showed a high prevalence of LDD in the upper lumbar disks (L1/L2), especially in elite gymnasts.

Purpose:

To investigate the effect of competition level on the prevalence and incidence of LDD in the upper lumbar disks (L1/L2).

Study Design:

Cross-sectional study; Level of evidence, 3; and cohort study; Level of evidence, 2.

Methods:

We conducted 2 studies to evaluate the effect of competition level on the prevalence and incidence of LDD in Japanese collegiate gymnasts. In study 1, a cross-sectional study of 298 collegiate gymnasts was conducted between 2011 and 2015. Competition levels were categorized as regional, national, and international, and T2-weighted magnetic resonance imaging (MRI) was used to evaluate LDD. Chi-square testing was applied to assess differences in the prevalence of LDD and spinal levels among the 3 competition levels. In study 2–-a prospective cohort study–-LDD progression and its related risk factors were investigated in 51 collegiate gymnasts. Baseline lumbar MRI scans and measurements of physical function (generalized joint laxity and finger-floor distance test) were performed in March 2014. Follow-up lumbar MRI scans were obtained 2 years later, in February 2016. Logistic regression analyses were performed to investigate the relationship between competition level and LDD progression.

Results:

In study 1, the prevalence of at least 1 degenerated disk in the regional, national, and international groups was 44.2% (19/43), 44.7% (98/219), and 52.8% (19/36), respectively ( P = .655). The prevalence of LDD at L1/L2 in the international group was significantly higher than that in the other 2 groups ( P = .018). In study 2, the presence of LDD at L1/L2 was associated significantly with international-level competition (adjusted odds ratio, 47.8; 95% CI, 2.75-830.50).

Conclusion:

In Japanese collegiate gymnasts, competing at the international level was found to be a risk factor for LDD at L1/L2.
Risk Factors for Increase in Posterior Slope After Medial Open-Wedge High Tibial Osteotomy
Authors: Song Ju-Ho , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Park Jun-Gu , Lee Sang-Min
Published: November 2022

Background:

Whether lateral hinge fracture (LHF) after open-wedge high tibial osteotomy (OWHTO) is associated with the change in tibial posterior slope (PS) has not been determined. Risk factors for PS increase are still unknown.

Hypothesis:

There will be no difference in patient characteristics and radiographic factors when stratified by change in tibial PS (ΔPS).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We reviewed the records of 148 patients who underwent OWHTO with locking-plate fixation from 2010 to 2016. Included were those with a minimum 2-year follow-up and true lateral radiographs before and at 1 year after surgery. ΔPS was defined as a difference between preoperative and 1-year postoperative PS, with positive values indicating PS increase. ΔPS was classified into <3°, 3° to <6°, and ≥6°. Any LHFs were grouped by Takeuchi classification as stable (type 1) or unstable (types 2 and 3). Risk factors for PS increase were evaluated using ordinal logistic regression analyses. Clinical outcomes according to ΔPS were evaluated using the Hospital for Special Surgery score.

Results:

There were 79 (53.4%) patients with ΔPS <3°, 44 (29.7%) with 3° ≤ ΔPS < 6°, and 25 (16.9%) with ΔPS ≥6°. LHFs were observed in 41 (27.7%) patients: 32 with type 1 and 7 and 2 with types 2 and 3, respectively. Results of the multivariate ordinal logistic regression analysis indicated that ΔPS was associated with unstable LHF ( P = .005, exp[β] = 6.34), preoperative PS ( P = .028, exp[β] = 0.90), and correction angle ( P = .037, exp[β] = 1.09). ΔPS ≥6° was seen in 4 of 9 (44.4%) patients with unstable LHF, 9 of 32 (28.1%) with stable LHF, and 12 of 107 (11.2%) with no LHF ( P = .017). The mean correction angle was 11.3° ± 3.6° in patients with ΔPS ≥6°, 9.4° ± 4.6° in cases of 3° ≤ ΔPS < 6°, and 8.8° ± 3.6° in cases of ΔPS <3° ( P = .019). Hospital for Special Surgery scores did not differ according to ΔPS.

Conclusion:

LHF type and correction angle were associated with ΔPS after OWHTO, and unstable LHF and large correction angle were risk factors for PS increase. There was no significant difference in clinical outcomes according to ΔPS.
Interrogating the Cultural Diversity and Livelihood of Tribal People on YouTube: A Case Study of ‘Original Village Cooking’
Authors: Khatun Nadira
Published: November 2022

The article seeks to examine the role of ‘Original Village Cooking’, a YouTube channel, in upholding the diversity of particularly those Scheduled Tribe people whom they represent and their culture by highlighting the selective lifestyle of those people as cultural diversity. Moreover, this study examines the role of YouTube in empowering the marginalised section of India, and it looks particularly at the living conditions of tribal people. This article deploys McKenzie Wark’s (2021) concept of the vectoralist class and how these new emerging classes are changing the already established structures within ruling class dynamics. The article adopts the textual analysis method (that is, it reads YouTube videos as texts) as well as uses in-depth interviews. In the current article, tribal people’s depiction on YouTube can be divided into two broad sections: (a) Schedule Tribes of India: the question of diversity and inclusion on YouTube; and (b) digital labour and tribal empowerment: YouTube as a source of livelihood.
Success Rate of Non-Operative Treatment of Insertional Achilles Tendinopathy
Authors: Kunkle Bryce F. , Baxter Nicholas A. , Hoch Caroline P. , Caughman Alexander , Barcel John , Scott Daniel J. , Gross Christopher E.
Published: November 2022

Category:

Other

Introduction/Purpose:

Non-operative treatment of Insertional Achilles tendinopathy (IAT) is historically thought to be effective in 50-70% of cases, the success rate of modern non-operative treatment is not well defined in the current literature. The purpose of this study is to define the success rate of modern non-operative treatment of IAT.

Methods:

A retrospective chart review was performed to identify 133 patients (137 ankles) who received either surgical or non- surgical treatment of IAT at an academic medical center between September 2015 and June 2019. The success rates of various non-operative treatment strategies were recorded in order to determine which, if any, had the highest success rate. Patient factors including demographic factors, comorbidities, modifiable risk factors, patient-reported outcome measures (PROMs), physical exam findings, and radiographic parameters were recorded to determine those that are associated with the failure of conservative management of IAT.

Results:

The overall success rate of non-operative treatment was 82.5% and the average time from initial diagnosis to surgery was 198.83 (range, 28-486) days. There was no difference in treatment method between those successfully treated conservatively and those who went on to require surgery. At first encounter, patients who later received surgery were significantly more likely to be female (91.7% vs. 66.4%; p=.013) and have higher VAS pain scores (6.54 vs. 5.10; p=.045), lower SF-12 physical scores (25.16 vs. 35.61; p<.001), hypertension (79.2% vs. 52.2%; p=.015), Haglund's Deformity on physical exam (95.7% vs. 71.3%; p=.014), and greater cross-sectional tendon disease involvement on MRI (43.5% vs. 28.0%; p=.001). (Table 1)

Conclusion:

The success rates of non-operative treatment for IAT may be higher than historical reports, at just over 80%. Several patient factors were shown to be associated with the failure of conservative management of IAT. Orthopaedic surgeons should use this information to provide more accurate patient-specific counseling on the most appropriate treatment strategies for IAT.
Long-Term Survival of Hintegra Revision Ankle Arthroplasty in 116 Patients
Authors: Kvarda Peter , Susdorf Roman , Horn-Lang Tamar , Peterhans Ursina , Ruiz Roxa , Hintermann Beat
Published: November 2022

Category:

Ankle; Ankle Arthritis; Hindfoot

Introduction/Purpose:

Total ankle replacement (TAR) became a popularly utilized surgical solution for end-stage ankle osteoarthritis (OA). Consequent to the increased number of primary implantations, failed ankles are evermore challenge for foot and ankle surgeons. Historically, if the ankle failed, salvage was preferably fusion. Nowadays however, maintenance of the ankle and hindfoot functionality is first and foremost for the expanded patient group. Despite revision arthroplasty has been described as a viable option, the available literature on long-term outcomes is scarce. The aim of this study was to investigate the long-term survival of revision ankle arthroplasty in a uniquely large cohort using the mobile-bearing HINTEGRA prosthesis.

Methods:

We conducted a single-center retrospective cohort study included 116 patients (117) ankles following revision ankle arthroplasty for failed primary TAR from July 2000 to March 2010. Survival analysis was performed. Clinical outcomes including pain on visual analog scale (VAS), American Foot and Ankle Ankle-Hindfoot Score (AOFAS), ankle range of motion (ROM), and patient`s satisfaction were assessed preoperatively and at the last follow-up.

Results:

The mean follow-up time from initial revision arthroplasty to the latest follow-up was 15.0+-3.0 years (range 11.2 - 20.5). The cumulative survival of the revised ankles at 5, 10 and 15 years was 81+-4%, 74+-4%, and 70+-4%, respectively. Clinical outcomes including pain on VAS declined from median 6 (0 - 10) to 2 (0 - 10) (p<.0001)), and the AOFAS ankle-hindfoot score improved from 43+-17 to 70+-20 (p<.0001)) from preoperatively to the last follow-up.

Conclusion:

Despite difficult surgical challenge, revision ankle arthroplasty yields an acceptable survival rate and results on long- term, however lower than primary TAR. Careful preoperative planning is crucial to achieve the desired results. Fusion is may not anymore the state-of-the-art solution for failed ankles. The study provides unique information for foot and ankle surgeons improving patient-care and possibly influence decision-making process.
A Radiographic Analysis of Hallux Valgus Interphalangeus and Biplanar Proximal Phalanx Closing Wedge “MoAkin” Osteotomy in Hallux Rigidus Treated with a Synthetic Cartilage Implant
Authors: Lee Jong Min , Cristofaro Caroline , Kayum Shahin , Khan Ryan , Pinsker Ellie , Halai Mansur , Daniels Timothy R.
Published: November 2022

Category:

Midfoot/Forefoot

Introduction/Purpose:

'MoAkin' biplanar proximal phalanx closing wedge osteotomy with dorsal cheilectomy has been described as an effective procedure for treatment of hallux rigidus with hallux valgus interphalangeus (HVI). Its role as an adjunct procedure to first metatarsophalangeal joint hemiarthroplasty using a synthetic cartilage implant has not been well described. The purpose of this radiographic analysis was to examine radiographic changes associated with the MoAkin osteotomy performed in patients who underwent first MTPJ hemiarthroplasty using the Cartiva implant.

Methods:

A retrospective study of all patients with hallux rigidus and HVI treated with a synthetic cartilage implant and MoAkin osteotomy between 2009 and 2020 was conducted. Radiographs were performed preoperatively and at six- and/or twelve-month postoperatively, and evaluated using standardized measurement techniques. Hallux valgus angle (HVA), interphalangeal angle (IPA), and intermetatarsal angle (IMA) were measured.

Results:

Fifty-four patients were included in the study (37 male; 17 female). Mean preoperative HVA, IPA, and IMA were 11.7+- 4.2 degrees, 15.8+-4.6 degrees, and 8.2+-2.4 degrees, respectively. Mean six-month postoperative HVA, IMA, IPA were 7.7+-4.2 degrees, 15.7+-5.7 degrees, and 8.2 +- 3.0 degrees. Mean twelve-month postoperative HVA, IMA, IPA were 8.0+-4.5 degrees, 15.2+-6.1 degrees, and 8.1+-2.9 degrees. No statistical differences were found between the six-month and twelve-month radiographic analysis (p>=0.59). There was a statistically significant reduction in the hallux valgus angle at six and twelve-month follow up compared to the preoperative angles (p<0.001, d=0.73-1.16). No statistically significant differences were noted in terms of IPA and IMA (p>=0.31).

Conclusion:

MoAkin osteotomy improves the hallux valgus angle in patients with hallux rigidus and HVI undergoing first MTPJ hemiarthroplasty with the Cartiva implant. Further studies are warranted to evaluate the impact of these radiographic findings on patient-reported outcomes and other clinical outcomes.
Distribution of Bone Mineral Density in the Ankle Joint: Correlation with Hindfoot Alignment
Authors: Lintz Francois , Welck Matthew J. , Buedts Kristian , Fernando Céline , Netto Cesar de Cesar , Bernasconi Alessio
Published: November 2022

Category:

Ankle; Basic Sciences/Biologics; Hindfoot

Introduction/Purpose:

Abnormal Hindfoot Alignment (HA) has been correlated with increased complication rates in ankle fusion or replacement. Altered Bone Mineral Density (BMD) due to abnormal stress distribution could be predisposing factor for those unwanted outcomes. The objective of this study was to assess spatial distribution of BMD around the ankle joint in patients with normal or abnormal HA using cone beam Weight Bearing CT.

Methods:

Retrospective comparative study including 81 ankles allocated into 3 groups based on the Foot Ankle Offset (FAO): 27 normal (0%5%). groups were comparable by age (p=0.967), Body Mass Idex (p=0.669), sex (p=0.820) and side (p=0.708). Semi- automatic segmentation (BoneLogic, Disior) was applied to identify bones. Tibia and talus were digitally compartmented in medial (M) and lateral (L) volumes relative to the median sagittal plane. Mean Hounsfield Unit (HU) value per compartment was used to assess BMD and to calculate the Medial over Lateral HU ratio (M/L-HU). Comparisons among the three groups were performed using one-way ANOVA, Kruskal-Wallis and Chi2 tests.

Results:

Mean +- standard deviation HU values in the compartments in normal cases were 495.2+-110 (medial tibia), 495.6+- 108.1 (lateral tibia), 368.9+-80.3 (medial talus), 448.2+-90.6 (lateral talus) and 686.7+-120.4 (fibula). Upon comparison of the mean BMD value for each compartment in the three groups, the difference did not achieve statistical significance. Conversely, the tibia HU-M/L ratio (0.88+-0.14 in valgus cases, 0.99 +- 0.08 in normally-aligned cases and 1.04+-0.08 in varus cases) and the talar HU- M/L ratio (0.68+-0.18 in valgus cases, 0.82+-0.08 in normally-aligned cases and 0.96+-0.20 in varus cases) were significantly different in the three groups (p<0.001).

Conclusion:

We found that the BMD in distal tibia, fibula and the talus varies with hindfoot alignment. The increased HU medio- lateral ratio in varus cases was consistent with a greater medial bone density in the tibia and talus, while the decreased ratio found in valgus cases suggested a more lateral concentration in both bones. This data supports the role of WBCT in analyzing BMD distribution. This method could be clinically useful in ankle OA to evaluate bone quality for such considerations as surgical indications or implant positioning.