bluuebunny/crossref_metadata_2025 huggingface dataset:
Macroscopical contact pressure and microscopic leakage performance analysis of rubber seal considering thermal oxygen aging effect
Authors: Sun Heng-Chao , Hao Yan-Yan , Wang Li-Na
Published: March 2022

Leakage performance of rubber seal is a key factor of spacecraft system, which is required long life. But the degradation law of the rubber seal performance in long service period is limited to qualitative analysis for its macro contact performance, and the quantitative research of rubber seal leakage performance is rarely involved considering thermal oxygen aging effect. Therefore, the thermal oxygen aging mathematical model is firstly established to predict the life of rubber material by aging tests. Secondly, the finite element model (FEM) of rubber seal performance analysis considering thermal oxygen aging effect is built to obtain the degradation law of its macroscopic contact performance with the increase of service time. Thirdly, the micro-leakage model of rubber seal considering thermal oxygen aging effect is established based on the material surface microstructure, contact pressure, and contact width, and the leakage rate of rubber seal is calculated by the model. Finally, the micro-leakage model of rubber seal is modified based on the experimental results, so the calculation accuracy of leakage rate is improved.
The Role of Cultural Values in National-Level Innovation: Evidence from 106 Countries
Authors: Bonetto Eric , Pichot Nicolas , Adam-Troïan Jaïs
Published: March 2022

Innovation constitutes a key factor for the economy and the competitiveness of societies. Using the Hofstede model of national culture, previous studies investigated the influence of different cultural dimensions on national-level innovation. These studies provided for mixed evidence regarding the influence and weight of each cultural dimension in innovation. By considering possible explanations for these inconsistent results, the present study ( N = 106 countries) showed that only two cultural dimensions seem to be consistently associated with innovation. Cultures that view change as necessary (long-term oriented) and are more accepting of norm violations (displaying low uncertainty avoidance) tend to promote innovation. These results shed new light on the way cultural tightness and social regulation processes can affect innovative behaviors.
Prospective Results of the Modified Glide Path Technique for Improved Syndesmotic Reduction During Ankle Fracture Fixation
Authors: Harris Mitchell C. , Lause Gregory , Unangst Alicia , Arthur Jacob , Song Daniel , Lustik Michael , Lindell Kenneth K. , Ryan Paul
Published: March 2022

Background:

Malreduction after syndesmotic stabilization occurs in as many as 52% of cases and has been shown to detrimentally affect clinical outcomes. We propose that the modified Glide Path technique reduces the occurrence of syndesmotic malreduction.

Methods:

This study is a prospective series comparing 16 patients reduced with the modified Glide Path technique with a retrospectively reviewed series of 25 patients reduced with a traditional technique using fluoroscopy and a clamp. The modified Glide Path technique consists of manual reduction of the fibula and placement of a Kirschner wire through the fibula and tibia along the transmalleolar axis. The syndesmosis can then be reduced along the glide path created by the Kirschner wire to prevent posterior or anterior malreduction. Computed tomographic scans of the repaired and contralateral ankles were obtained postoperatively to assess reduction.

Results:

We found a statistically significant decrease of syndesmotic malreductions using the modified Glide Path technique when compared with technique that did not use a glide path. In our study, 2 of 16 patients (12.5%) had syndesmotic malreductions using the modified Glide Path technique, compared with 11 of 25 patients (44%) with syndesmotic malreductions in the historical cohort.

Conclusion:

The modified Glide Path technique is a simple method for ankle syndesmotic reduction. The technique has lower rates of malreduction compared with historical methods and may be useful for most operative syndesmotic injuries.

Level of Evidence:

Level II, prospective cohort study.
Children’s experiences of stress and coping during hospitalization: A mixed-methods examination
Authors: Claridge Amy M , J Powell Olivia
Published: March 2022

Children often experience hospitalization as stressful. To better understand children’s experiences, this current study involved interviews with and assessments of 17 children who were currently admitted at a U.S. children’s hospital. On average, they reported low levels of distress on the Facial Affective Scale (FAS) ( M = .34) and moderate levels of anxiety on the Child Drawing: Hospital ( M = 107.01). Results revealed themes in children’s experiences including stressors in the hospital, such as pain, disruptions to normalcy, and uncertainty. Children also reported factors that contributed to coping, including social support from parents and peers, and distractions from the medical routine such as leaving their hospital room. When children were grouped into clusters based on coping, those who were younger and who had received child life specialist services tended to be coping well. Regardless of understanding of diagnosis, those who demonstrated high levels of stress (distress and anxiety) in assessments tended to be categorized as not coping well. The findings inform interventions to support children’s coping during hospitalization.
Pre-hospital trauma triage: Outcomes of interfacility transferred trauma patients meeting pre-hospital triage criteria
Authors: Li Winny , Mok Garrick , Nolan Brodie
Published: March 2022

Introduction

In Ontario, Canada, paramedics use the Field Trauma Triage Standard to identify patients at risk for severe injury. These triage criteria encompass physiologic, anatomic, mechanism of injury, and special considerations to identify patients that should be transported directly to a trauma center. Patients meeting any one of these criteria mandate direct transfer to a trauma center. This study evaluated whether severely injured trauma patients that underwent an interfacility transfer met these triage criteria. The secondary objective was to assess the impact of failed triage application on in-hospital mortality.

Methods

This is a retrospective cohort study of interfacility trauma transfers to an adult trauma center over a 3-year period that were either admitted to the intensive care unit, received an operation within 4 h of arrival, or died within 48 h of arrival. Data were abstracted from the hospital’s trauma registry and chart review of electronic medical records. Frequency of patients meeting pre-hospital triage criteria and which specific criteria were collected. Multivariable logistic regression was performed to assess the impact of missed pre-hospital triage on in-hospital mortality.

Results

There were 1008 interfacility patients during the study period, of which 340 patients met inclusion criteria; 78.5% ( n = 267) of interfacility transports had met at least one triage criteria. Most frequent criteria met were: Glasgow Coma Scale <14 (42.4%), high risk motor-vehicle collision (22.1%), and systolic blood pressure <90 mmHg (19.4%). When adjusted for injury severity score and age, patients who met triage criteria were not at increased odds of death (OR 2.38, 95% CI: 0.87–6.46) compared to interfacility patients that did not meet criteria. Conclusion: A majority of critically injured interfacility transfers met initial trauma triage criteria. These patients are at high risk for preventable morbidity and mortality. This study indicates the need to understand the barriers to pre-hospital adherence to trauma triage guidelines.
Transformational learning and identity shift: Evidence from a campus behind bars
Authors: Lerman Amy E , Sadin Meredith
Published: March 2022

Identity-driven theories of desistance provide a useful model for understanding change in a carceral context. However, these theories often are not grounded in specific programmes or practices that might catalyze identity shift, and tend to focus narrowly on recidivism as the sole outcome of interest. In this study, we examine the role of prison higher education in identity-driven change through the process of transformative learning. Using administrative information on college-level course completion and an original longitudinal survey of prison college students, we show evidence of both between- and within-subjects shifts in individuals’ sense of self-efficacy, as well as their broader civic orientation. We further explore the role of identity using a survey experiment that randomly assigns individuals to a “student” versus “prisoner” identity label. We find that identity labelling has significant effects on both confidence in accomplishing one's goals and perceived likelihood of recidivism. We supplement these quantitative findings with qualitative interviews of prison college alumni. Our study suggests that access to higher education can be consequential for those in prison, and provides a broader framework through which to analyze the effects of prison programming that extends beyond recidivism.
‘Making Strange’: Discourse Analysis Tools for Teaching Critical Development Studies
Authors: Gasper Des
Published: March 2022

Critical development studies require not just a critical attitude, but also usable tools. This article suggests some forms of discourse analysis that can add substance to critical development studies’ aspirations and that can yet be learnt and used by students without specialist background. Central are tools for ‘making strange’ (defamiliarization), so that we view both texts and social realities in a fresh independent way and start to discern better their blindspots, and our own. The article presents accessible yet helpful forms of text analysis, argumentation analysis and content analysis that contribute in required processes of defamiliarization and reconstruction.
Cleft complications: Severely rotated maxillary permanent central incisors
Authors: Hameed Othman , Good Sarah
Published: March 2022

The maxillary permanent central incisor (MPCI) has been reported to be rotated in up to 96% of cleft patients. A severely rotated MPCI is highly visible when smiling, drawing attention to a repaired cleft lip, and is often the main presenting complaint of a patient with cleft lip and palate attending for orthodontic treatment. The benefit of interceptive orthodontic treatment to alleviate these concerns must be weighed up against the consequences of adding to the already substantial orthodontic burden likely to be faced by these patients.

Despite the high prevalence of this dental abnormality among cleft patients, there is little published in the literature regarding this type of malocclusion. This paper explores the aetiology, presentation and management of this condition, using examples from cases treated within our department. In addition, the commonly found pre-existing anomaly of a short root length is discussed, in combination with the implications this may have upon orthodontic treatment planning for a rotated MPCI.
Endovascular Treatment of Abdominal Aortic Aneurysm With Severe Angulation of Infrarenal Aortic Neck by Gore Conformable Endograft
Authors: Mascoli Chiara , Faggioli Gianluca , Goretti Martina , Gallitto Enrico , Pini Rodolfo , Logiacco Antonino Maria , Vacirca Andrea , Gargiulo, Prof Mauro
Published: March 2022

Introduction:

The aim of the study is to report a single-center experience with the Gore Excluder conformable endograft with active control system (CEXC Device, W.L. Gore and Associates, Flagstaff, AZ, USA) in abdominal aortic aneurysms (AAAs) with severe infrarenal neck angulation.

Methods:

All patients underwent EVAR with CEXC Device between September 2018 and 2020, were prospectively enrolled, and retrospectively analyzed. Anatomical details of the proximal aortic neck were evaluated. Early endpoints were the use of repositionability and angulation system, intraoperative unplanned cuff, technical success (TS), 30-day morbidity/mortality, and reintervention. Follow-up endpoints were type-I endoleaks, endograft migration, aortic neck dilatation, aneurismal sac shrinkage, survival (S), and freedom from reintervention (FFR).

Results:

Twenty-five patients were enrolled (median age: 80 [range = 60-90] years, median AAA diameter: 60 [range = 52-90] mm). All patients had severe infrarenal neck angulation (beta angle ≧ 60°), and 11 (44%) of those had neck beta angle ≧ 90°. Median infrarenal neck angle, length, and diameter were 70° (range = 60°-90°), 22 (range = 13-42) mm and 22 (range = 18-31) mm, respectively. Endograft repositioning system was employed in 15 (60%) cases and the median number of repositioning maneuvers was 1 (range:0-4). Active angulation system was used in 17 (68%) patients. The median proximal diameter of the main-body and oversize were 28 (range = 23-36) mm and 28% (range = 21%-38%), respectively. Proximal cuff was positioned in 1 (4%) patient. Technical success was achieved in all cases. Intraoperative and perioperative morbidity and mortality were 12% and 0%, respectively. Perioperative type-I/III and II endoleaks were observed in 0 and 4 (16%) patients, respectively. The median follow-up was 12 months (range: 3-30). One patient died at 12-month for AAA-unrelated causes. Abdominal aortic aneurysm-sac shrinkage and stability were observed in 9 (36%) and 15 (60%) cases, respectively. No type-I/III endoleak and reintervention occurred during the follow-up. One persistent type-II endoleak was observed. Estimated survival at 24 months was 92%.

Conclusion:

According to the present data, the CEXC Device allows an excellent rate of TS in severe angulated aortic neck. This preliminary data, could increase the rate of patients eligible for EVAR.
Mother’s Eyes
Authors: Giorgio Grace
Published: March 2022

This autoethnography pays homage to my mother and all the women who supported each other through the act of abortion. Coming of age in the era of Roe v. Wade, I accessed a legal and safe abortion with my mother’s help. My mother who became a nurse during the era of illegal abortions witnessed young women dying at the hands of the state. My mother, like many women before her, acted to help another woman terminate an unwanted pregnancy, an act of resistance to a system that devalues women by privileging the fetus over the body that supports its existence.
Toward A New Political Economy of Human Resource Development
Authors: Ardichvili Alexandre , Harmon Brian
Published: March 2022

To promote human development and flourishing and the creation of just and sustainable workplaces, HRD professionals need a better understanding of the political and economic forces shaping organizational realities. We need new models, grounded in an updated understanding of the political economy of labor and workforce development. This essay offers a brief critique of the current models and discusses alternative ways of thinking about political and economic mechanisms that can promote human flourishing, equity, and sustainability. We offer suggestions for how HRD researchers and practitioners can use this new lens to develop interventions and advance scholarship.
‘You Game Like a Girl’: Perceptions of Gender and Competence in Gaming
Authors: Kelly Danielle , Nic Giolla Easpaig Brona , Castillo Paola
Published: March 2022

While there is an abundance of research concerning the gendered dimensions of video gaming and online communities, there is a limited focus on gameplay competence. This study examined the relationship between sexism and gendered perceptions of competence in gaming. Three hundred and 85 participants volunteered to take part. Participants were randomly allocated to one of three gendered conditions (female, male or neutral). Participants watched two video game clips within each condition (novice and expert playthroughs). Participants rated the competence and warmth of the players, estimated the number of errors made and completed the Ambivalent Sexism Inventory. The findings indicated that female and neutral clips were perceived as less competent than male clips in both skill levels. This difference was more pronounced in the expert level. Warmth ratings varied significantly across conditions. Hostile sexism predicted lower perceptions of warmth. The study demonstrates the need for inclusive and safe online gaming environments.
The Effect of Upper Extremity Tourniquet Time on Postoperative Pain and Opiate Consumption
Authors: Ruckle David E. , Chang Alexander C. , Wongworawat Montri Daniel
Published: March 2022

Background:

There is widespread use of pneumatic tourniquet for both upper and lower extremity orthopedic surgeries. Tourniquet use improves visualization, decreases blood loss, and as a result, decreases operative time. Exceeding a certain amount of tourniquet time can cause lasting neuromuscular damage. Orthopedic procedures cause significant pain, and the perioperative narcotic prescriptions after orthopedic surgery have been identified as one of the major contributors to the opioid epidemic. Our aim was to determine whether increasing tourniquet time had a negative impact on immediate postoperative opiate usage in the upper extremity, and to determine other factors associated with increased immediate postoperative opiate usage.

Methods:

A retrospective medical record review was performed on patients who underwent volar pleading for fracture fixation between January 2014 and December 2019 at a single institution. Postoperative pain, morphine equivalent dose (MED) usage, and demographic variables were collected. Multivariable analysis was performed, with P < .05 considered significant.

Results:

Immediate postoperative MED consumed was not correlated with operative time, tourniquet time, preoperative substance usage, or sex. However, postoperative MED consumed was correlated with preoperative narcotic use, high body mass index (BMI), and fracture surgery complexity.

Conclusions:

Tourniquet usage under current guidelines does not appear to have an effect on postoperative pain and narcotic usage. Preoperative narcotic usage, BMI, and surgery complexity are significant factors for postoperative opiate consumption.
Radiographic Thumb Metacarpal Subsidence Following Ligament Reconstruction With Tendon Interposition and Suture-Only Suspension Arthroplasty in the Treatment of Basal Joint Arthritis
Authors: Munsch Maria A. , Suszynski Thomas M. , Fowler John R. , Balk Marshall L. , Hagberg William C. , Buterbaugh Glenn A. , Imbriglia Joseph E.
Published: March 2022

Background:

The thumb carpometacarpal (CMC) joint is a common source of osteoarthritis. Following trapeziectomy, ligament reconstruction with tendon interposition (LRTI) is considered a “gold standard” treatment, but suture-only suspension arthroplasty (SSA) has recently emerged as a simpler alternative. Currently, there is no objective radiographic study comparing subsidence following these 2 techniques.

Methods:

This study is a retrospective review of 23 patients (10 LRTI, 13 SSA) that had at least 6 months of radiographic follow-up following thumb CMC arthroplasty. Posteroanterior radiographs at a preoperative timepoint, and at the 2-week and greater than 6-month postoperative timepoints were evaluated for actual trapezial height, as well as trapezial height normalized to capitate, thumb metacarpal, and proximal phalangeal heights. Normalized trapezial heights were calculated, and preoperative values were compared with greater than 6-month postoperative values. In addition, actual and normalized trapezial heights following LRTI and SSA were compared at each timepoint.

Results:

Mean trapezial height decreased from approximately 12 to 5 mm (reduction of ~60%, P < .05) in both groups with no differences when comparing LRTI and SSA at each timepoint. All normalized trapezial heights revealed differences from preoperative to greater than 6-month postoperative timepoints, but no differences between LRTI and SSA.

Conclusions:

Ligament reconstruction with tendon interposition and SSA exhibit equivalent actual and normalized trapezial heights over a greater than 6-month postoperative time course.
Sevoflurane Preconditioning Increases Stress Resistance via IMB-2/DAF-16 in Caenorhabditis Elegans
Authors: Cao Yue , Cui Yongchen , Liao Junling , Gao Chente , Zhao Zhe , Zhang Junfeng
Published: March 2022

Sevoflurane preconditioning has been proved to possess therapeutic effects on stress. However, the mechanism by which sevoflurane preconditioning protects against stress remains unclear. In this study, an acute model of heat stress in C.eleans was established. We investigated the dose-response of sevoflurane exposure on coordinated movement in C.elegans and time course for protection against heat stress of sevoflurane preconditioning to determine the optimal concentration and time point in the following experiments. EC99 of sevoflurane is 1.7% (1.3EC50) and sevoflurane preconditioning exerts the maximal protection at 6 hours after incubation, and these 2 parameters were used in our following experiments. We found that sevoflurane preconditioning increased DAF-16 nuclear translocation and enhanced the expression of DAF-16 during heat stress in N2 strain of C.elegans. DAF-16 mutation abolished the sevoflurane preconditioning-induced protection for heat stress. Furthermore, suppression of IMB-2 by RNAi prevented the upregulation of DAF-16 and enhancement of stress resistance caused by sevoflurane preconditioning. Overall, this work reveals that sevoflurane preconditioning increases the expression of DAF-16 via IMB-2 to enhance the stress resistance of C.elegans.
Primary balloon angioplasty of venous Sinus stenosis in idiopathic intracranial hypertension
Authors: Carlos Martinez-Gutierrez Juan , Kole Matthew J , Lopez-Rivera Victor , Inam Mehmet Enes , Tang Rosa , Al-Zubidi Nagham , Adesina Ore-Ofeoluwatomi , Lekka Elvira , Engstrom Allison C. , Sheth Sunil , Pedroza Claudia , Day Arthur L. , Chen Peng Roc
Published: March 2022

Background

Venous sinus stenosis (VSS) stenting has emerged as an effective treatment for patients with Idiopathic Intracranial Hypertension (IIH). However, stenting carries risk of in-stent stenosis/thrombosis and cumulative bleeding risk from long-term dual antiplatelet (DAPT) use. Thus, we investigated the potential safety and efficacy of primary balloon angioplasty as an alternative to stenting in IIH.

Methods

A prospectively maintained single-center registry of IIH patients undergoing endovascular procedures was queried. Inclusion criteria included patients with confirmed IIH and angiographically demonstrable VSS who underwent interventions from 2012- 2021. Patients were dichotomized into primary balloon angioplasty (Group A) and primary stenting (Group S), comparing clinical outcomes using bivariate analyses.

Results

62 patients were included with median age of 33 [IQR 26-37], 74% females. Group A (9/62) and Group S (53/62) had similar baseline characteristics. Papilledema improvement was higher in Group S at 6 weeks and 6 months (44 vs. 93, p = 0.002 and 44 vs. 92%, p = 0.004), with similar improvements across all symptoms. Group S had higher mean post-procedure venous pressure gradient change (8 vs. 3 mmHg, p = 0.02) and a lower CSF opening pressure at 6 months (23 vs. 36 cmH2O, p < 0.001). VPS rescue rate was higher in Group A (44 vs. 2%, p = 0.001). There was only one procedural complications; a subdural hematoma in Group A.

Conclusions

Primary VSS balloon angioplasty provides a marginal and short-lived improvement of IIH symptoms compared to stenting. These findings suggest a cautious and limited role for short-term rescue angioplasty in poor shunting and stenting candidates with refractory IIH.
Condition monitoring of water pump bearings using ensemble classifier
Authors: Irfan Muhammad , Althobiani Faisal , Alwadie Abdullah Saeed , Zaffar Maryam , Abbass Ali , Glowacz Adam , Ghonaim Saleh Mohammed , Abdushkour Hesham , Rahman Saifur , Alshorman Omar , Asif Khan Mohammad Kamal , Alqhtani Samar , Alkahtani Fahad Salem
Published: March 2022

The bearings faults are reported to be the major reason for centrifugal pump (CPs) failures. Limited literature is available to diagnose the minor scratches in the bearing surface through non-intrusive condition monitoring techniques. Recent research on the analysis of bearing scratches through non-intrusive motor current analysis (MCA) has shown encouraging results where the comparison of machine learning and convolutional neural networks (CNNs) was performed in the classification of healthy bearings and faulty bearings (holes and scratches). The fault classification accuracy of 89.26% through MCA combination with machine learning and CNN algorithm was reported which is very low. The key factors of low accuracies were identified as low amplitudes of the harmonics in the MCA spectrum, the magnitude of environmental noise, and utilization of conventional feature extraction techniques. This problem has been tackled in this paper by developing a novel feature extractor (NFE) that extracts powerful features from the integrated current and voltage sensors data. The NFE has been derived using the threshold-based decision mechanism which has the capability to identify the location of the feature harmonic, feature extraction, measure the amplitude of the fault component, and compare it with the derived threshold. The experimental data has been collected for the bearing balls (BB), bearing cage (BC), inner race (IR) and the outer race (OR) faults, and the performance of the NFE has been tested on an ensemble classifier (CatBoost) and the better classification accuracy (99.2% for an individual feature and 100% with the combination of two or more features) of NFE has been achieved as compared to previously reported methods.
Impact of the COVID-19 pandemic on the management and outcomes of emergency surgical patients: A retrospective cohort study
Authors: Montauban Pierre , Balakumar Charannya , Rait Jaideep , Zarsadias Prizzi , Shahzad Faisal , Ogbuagu Nnenna , Iqbal Sara , Chowdhury Ashim , Pangeni Anang , Shah Ankur , Imtiaz Mohammad R
Published: March 2022

Introduction

The COVID-19 pandemic has led to drastic measures being implemented for the management of surgical patients across all health services worldwide, including the National Health Service in the United Kingdom. It is suspected that the virus has had a detrimental effect on perioperative morbidity and mortality. Therefore, the aim of this study was to assess the impact of the COVID-19 pandemic on these outcomes in emergency general surgical patients.

Methods

Emergency general surgical admissions were included in this retrospective cohort study in one of the COVID-19 hotspots in the South East of England. The primary outcome was the 30-day mortality rate. Secondary outcomes included the length of stay in hospital, complication rate and severity grade and admission rates to the ITU.

Results

Of 123 patients, COVID-19 was detected in 12.2%. Testing was not carried out in 26%. When comparing COVID-positive to COVID-negative patients, the mean age was 71.8 + 8.8 vs. 50.7 + 5.7, respectively, and female patients accounted for 40.0 vs. 52.6%. The 30-day mortality rate was 26.7 vs. 3.9 (OR 6.49, p = 0.02), respectively. The length of stay in hospital was 20.5 + 22.2 vs. 7.7 + 9.8 ( p < 0.01), the rate of complications was 80.0 vs. 23.7 (OR 12.9, p < 0.01), and the rate of admission to the ITU was 33.3 vs. 7.9% (OR 5.83, p = 0.01).

Conclusion

This study demonstrates the detrimental effect of COVID-19 on emergency general surgery, with significantly worsened surgical outcomes.
Social barriers influence inflammatory bowel disease (IBD) outcomes and disproportionally affect Hispanics and non-Hispanic Blacks with IBD
Authors: Damas Oriana M. , Kuftinec Gabriela , Khakoo Nidah S. , Morillo Diana , Quintero Maria A. , Leavitt James , Lopez Joanna , Kerman David H. , Abreu Maria T. , Deshpande Amar R. , Schwartz Seth J. , Palacio Ana
Published: March 2022

Background:

The impact of social determinants of health in inflammatory bowel disease (IBD) remains understudied. We evaluated the impact of social barriers on IBD outcomes within a diverse cohort of patients.

Methods:

We performed a cross-sectional study on adult IBD patients and assessed known social determinants of health. We calculated the total prevalence of these barriers in the sample as a whole and within each ethnic group. We summed the number of barriers present for each individual to create a cumulative social barrier score (SBS), and we evaluated the relationship of each barrier and of the cumulative SBS with IBD outcomes, including disease activity and depressive symptoms.

Results:

A total of 316 patients were included in the study. Disparities in the prevalence of social barriers emerged by ethnicity: non-Hispanic Blacks reported the greatest number of social barriers, followed by Hispanic patients. Prevalent social barriers included financial strains (38.4%), (such as food insecurity), medical care delays (~30%), and low educational attainment (26.8%). Social barriers associated with poor IBD outcomes included low educational attainment, poor health literacy, and financial insecurity. High SBS was associated with greater depressive symptoms [odds ratio (OR) 1.94, 95% confidence interval (CI) 1.21–2.9, p = 0.001] and lower reported use of medications. Greater ulcerative colitis (UC) disease activity was observed in patients with greater SBS. No associations were identified between SBS and IBD surgeries, hospitalizations, or disease location.

Conclusion:

Our study identifies social barriers that may impact IBD care and are disproportionately higher in non-Hispanic Blacks and Hispanics in the United States. Future studies should focus on implementing interventions to reduce these barriers and improve delivery of care.
Hybrid CFD/low-order modeling of thermoacoustic limit cycle oscillations in can-annular configurations
Authors: Haeringer Matthias , Polifke Wolfgang
Published: March 2022

We propose a hybrid strategy for modeling non-linear thermoacoustic phenomena, e.g. limit-cycle (LC) oscillations, in can-annular combustion systems. The suggested model structure comprises a compressible CFD simulation limited to the burner/flame zone of one single can, coupled to a low-order model (LOM) representing the remaining combustor. In order to employ the suggested strategy for modeling non-linear phenomena like LC oscillations, the LOM must capture non-linear flame dynamics in the cans, which are not resolved by CFD. Instead of identifying such non-linear flame models in preliminary simulations, we aim at learning the non-linear dynamics “on-the-fly”, while simulating the self-excited system under consideration. Based on the observation of flame dynamics in the CFD domain, the parameters of the employed non-linear models are estimated during run time. The present study reveals that block-oriented models, which comprise a linear dynamic part followed by a static non-linear function, are well suited for this purpose.

The proposed hybrid model is applied to a laminar can-annular combustor. Results agree well with the monolithic CFD simulation of the entire combustor, while the computational cost is drastically reduced. The employed flame models, whose parameters are identified during the simulation of the self-excited LC oscillation, represent well the relevant non-linear dynamics of the considered flame.
Politics – Simply Explained? How Influencers Affect Youth’s Perceived Simplification of Politics, Political Cynicism, and Political Interest
Authors: Schmuck Desirée , Hirsch Melanie , Stevic Anja , Matthes Jörg
Published: March 2022

Social media influencers promote not only products and brands but also their opinions on serious topics like party politics or climate change. These so-called digital opinion leaders may exert a powerful impact on their followers’ political attitudes. Accordingly, we explore new directions to explain how influencers’ communication is related to political outcomes by proposing the concept of perceived simplification of politics (PSP). We argue that PSP may fuel political cynicism but also stimulate youth's interest in politics. We also explore important boundary conditions of these associations. We use data from three studies, a two-wave panel survey of adolescents ( NT2 = 294), a cross-sectional survey of young adults ( N = 632), and a two-wave panel survey of young adults ( NT2 = 496) in Germany between 2019 and 2020. Findings of all three studies show that the frequency of exposure to social media influencers’ content increases PSP. In Studies 1 and 2, PSP is related to higher political cynicism, while in Study 3, this relationship is restricted to influencers’ communication about environmental topics and gender equality. Furthermore, Studies 2 and 3 suggest that PSP also increases political interest—yet this association requires a certain level of parasocial interaction (PSI) with the influencer and is contingent on specific political topics.
Does Femoroacetabular Impingement Syndrome Affect Self-Reported Burden in Football Players With Hip and Groin Pain?
Authors: Scholes Mark J. , Kemp Joanne L. , Mentiplay Benjamin F. , Heerey Joshua J. , Agricola Rintje , Semciw Adam I. , Souza Richard B. , Link Thomas M. , Majumdar Sharmila , King Matthew G. , Lawrenson Peter R. , Crossley Kay M.
Published: March 2022

Background:

It is unknown if football players with femoroacetabular impingement (FAI) syndrome report worse burden than those with other causes of hip/groin pain, and to what extent this is mediated by cartilage defects and labral tears.

Hypothesis:

Football players with FAI syndrome would report worse burden than other symptomatic players, with the effect partially mediated by cartilage defects and/or labral tears.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Football (soccer and Australian football) players (n = 165; 35 women) with hip/groin pain (≥6 months and positive flexion–adduction–internal rotation test) were recruited. Participants completed 2 patient-reported outcome measures (PROMs; the International Hip Outcome Tool–33 [iHOT-33] and Copenhagen Hip and Groin Outcome Score [HAGOS]) and underwent hip radiographs and magnetic resonance imaging (MRI). FAI syndrome was determined to be present when cam and/or pincer morphology were present. Cartilage defects and labral tears were graded as present or absent using MRI. Linear regression models investigated relationships between FAI syndrome (dichotomous independent variable) and PROM scores (dependent variables). Mediation analyses investigated the effect of cartilage defects and labral tears on these relationships.

Results:

FAI syndrome was not related to PROM scores (unadjusted b values ranged from −4.693 ( P = 0.23) to 0.337 ( P = 0.93)) and cartilage defects and/or labral tears did not mediate its effect ( P = 0.22-0.97).

Conclusion:

Football players with FAI syndrome did not report worse burden than those with other causes of hip/groin pain. Cartilage defects and/or labral tears did not explain the effect of FAI syndrome on reported burden.

Clinical Relevance:

FAI syndrome, cartilage defects, and labral tears were prevalent but unrelated to reported burden in symptomatic football players.
The Value and Impact of a Health Café Organized by Primary Care Physician, On Visitors, Clinics, and the Community: A Qualitative Study
Authors: Oishi Yuta , Son Daisuke , Hotta Satoko
Published: March 2022

Introduction:

Reflecting the rapidly aging society, there has been a worldwide increase in the number of health cafés and dementia cafés which can provide a variety of support to people with illnesses and their families in the community. Nevertheless, health cafés organized by primary care physicians are rarely reported, and the social value of these activities has not yet been fully elucidated.

Objectives:

This study was aimed to investigate the value and impact that the health café organized by the primary care physician, brings to the visitors, the clinic, and the community.

Methods:

Conversations between the author (YO), who belongs to a medical clinic that has been operating for many years in Shizuoka City, and visitors of the health café were qualitatively analyzed using Steps for Coding and Theorization (SCAT), which is a sequential and thematic qualitative analysis technique consisting of 4 steps.

Results:

Sixteen people participated in the study. The values and impacts of holding a health café were social support, opportunities for cognitive and behavioral changes, complementary functions to outpatient care, advantages for medical care, the creation of encounters with diverse individuals, connections with local community organizations, and motivating visitors to become proactive actors.

Conclusion:

It was considered valuable for physicians in community-based medical clinics to have opportunities to interact with patients and local residents outside the clinical settings. Because they can potentially enhance their role as primary care physicians in the community. In addition, the impact on the community is that local residents can receive social support, increase community ties, and make people more proactive about their health.
The Most-Cited Publications in Gender-Affirming Surgery: A Cross-Sectional Bibliometric Analysis
Authors: Oleru Olachi O. , Rohde Christine H.
Published: March 2022

Background: Gender-affirming surgery is becoming more common among reconstructive surgeons. Bibliometric analyses are statistical evaluations of published scientific correspondence and are a validated method of measuring influence in the scientific community. As no such bibliometric analysis has been done as of yet, the purpose of this study is to identify the characteristics of the 50 most-cited peer-reviewed articles on gender-affirming surgery. Methods: The Scopus abstract and citation database was utilized in April 2020 to search for English-language publications related to gender-affirming surgery. The 50 most-cited publications that met inclusion criteria were reviewed for various metric tabulations. Results: The 50 publications have been cited a total of 4402 times. Thirty-one (62%) were published in 2000 or later. Phalloplasty was the most discussed surgical technique, and 18 of the articles focused on female-to-male (FtM) patients. Case series (46%) and review articles (24%) were most common and there were no Level I or Level II studies. The Netherlands contributed the most, with 13 articles. Among the most frequent keywords in the 50 abstracts were “flap” and “complication”. The earliest author keywords used were “transsexual” and “sex reassignment”. Conclusions: The keyword usage in these abstracts over time seems to follow the trend of a more socially inclusive lexicon. A focus on studies with a higher level of evidence may optimize surgeon education and more appropriately guide clinical practice. This study reveals that the most influential and commonly referenced studies may not be sufficient to appropriately guide clinical practices.
Incidence of Injury for Professional Soccer Players in the United States: A 6-Year Prospective Study of Major League Soccer
Authors: Forsythe Brian , Knapik Derrick M. , Crawford Matthew D. , Diaz Connor C. , Hardin David , Gallucci John , Silvers-Granelli Holly Jacinda , Mandelbaum Bert R. , Lemak Lawrence , Putukian Margot , Giza Eric
Published: March 2022

Background:

Despite an abundance of injury research focusing on European professional soccer athletes, there are limited injury data on professional soccer players in the United States.

Purpose:

To describe the epidemiology of injury across multiple years in Major League Soccer (MLS) players.

Study Design:

Descriptive epidemiology study.

Methods:

A web-based health management platform was used to prospectively collect injury data from all MLS teams between 2014 and 2019. An injury was defined as an incident that required medical attention and was recorded into the health management platform anytime over the course of the 2014-2019 seasons. Injuries and exposure data were recorded in training and match settings to calculate injury incidence.

Results:

A total of 9713 injuries were recorded between 2014 and 2019. A mean 1.1 injuries per year per player were identified, with midfielders sustaining the largest number of injuries. The most common injuries were hamstring strains (12.3%), ankle sprains (8.5%), and adductor strains (7.6%). The mean time missed per injury was 15.8 days, with 44.2% of injuries resulting in no days missed. Overall injury incidence was 8.7 per 1000 hours of exposure, declining over the course of the investigation, with a 4.1-times greater mean incidence during matches (14.0/1000 h) than training (3.4/1000 h).

Conclusion:

Between 2014 and 2019, the most commonly reported injuries in MLS players were hamstring strains, ankle sprains, and adductor strains. Injury incidence during matches was 4.1 times greater when compared with training, while overall injury incidence was found to decline during the course of the study period.
Benefits of Patch Augmentation on Rotator Cuff Repair: A Systematic Review and Meta-analysis
Authors: de Andrade André Luís Lugnani , Garcia Thiago Alves , Brandão Henrique de Sancti , Sardeli Amanda Veiga , Mouraria Guilherme Grisi , Belangero William Dias
Published: March 2022

Background:

Despite technological advances, the overall retear rate on rotator cuff repair is still high. Patches have shown significant reduction in retear rate and pain scores; however, this is not a universal finding and conflicting results have been shown among functional shoulder scales.

Purpose:

To analyze previous controlled trials of the literature to bring a consensus about the effectiveness of patch use on rotator cuff repair.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

The search was conducted in PubMed, Web of Science, EMBASE, Scopus, and Cochrane in April 2020. The results of rotator cuff repair with patch augmentation versus without augmentation (control) were compared through odds ratio (OR), raw mean difference (RMD), and standardized mean difference (SMD) of retear rate; functional shoulder scales; strength; and range of motion (ROM).

Results:

Of 733 initial studies, 7 of them met the criteria to be included in the analysis. Compared with the control group, the patch augmentation group had a significantly lower retear rate (OR, 0.32 [95% CI, 0.18 to 0.55]; P < .001), lower pain (SMD, –0.42 [–0.71 to –0.12]; P < .01), a higher University of California Los Angeles Shoulder Rating Scale (RMD, 0.87 [0.15 to 1.60], P = .017), and a trend toward higher strength (SMD, 0.95 [–0.03 to 1.94], P = .05) and lower forward elevation ROM (RMD, –10.50 [–21.86 to 0.67]; P = .06), while no changes were noted for other functional scales or for internal and external rotation ROM.

Conclusion:

The results point to benefits of patch augmentation in rotator cuff repair, particularly a reduction in retear rate. More interventional studies with better methodological quality should be conducted to confirm the results of this initial review.
Comparison of Biomechanical Failure Loads Between Tape-Type and Conventional Sutures in Internal Knotless Anchor–Based Constructs
Authors: Chuang Hao-Chun , Yen Joe-Zhi , Hong Chih-Kai , Hsu Kai-Lan , Kuan Fa-Chuan , Chen Yueh , Chang Hao-Ming , Su Wei-Ren
Published: March 2022

Background:

Despite the increasing prevalence of tape-type sutures, whether internal knotless anchors can consistently affix tape-type sutures has not been thoroughly investigated.

Purpose:

To evaluate whether substituting tape-type sutures for conventional sutures influences the suture-holding strength of internal knotless anchors.

Study Design:

Controlled laboratory study. Level of evidence, 5.

Methods:

A total of 3 internal knotless anchors were tested: a spiral core clamping anchor (Footprint Ultra PK), a winged clamping anchor (PopLok), and a spooling anchor (ReelX STT). Four constructs were compared for each type of anchor, with the anchor double or quadruple loaded with tape-type sutures or conventional sutures. The testing protocol comprised preloading suture tension to 10 N; cyclic loading, in which tension increased in increments of 10 N from 10 to 90 N; and a load-to-failure stage set at a speed of 0.5 mm/s. The clinical failure load (CFL) was defined as suture slippage of ≥3 mm. Also, 1-way analysis of variance and power analysis were used to compare the CFLs of the constructs.

Results:

For the quadruple-loaded spiral core clamping anchors, a significant reduction in CFLs was seen with conventional sutures over tape-type sutures (138.10 ± 4.73 vs 80.00 ± 12.25 N, respectively; P < .001). This reduction was not observed under the double-loaded condition (conventional vs tape type: 76.00 ± 5.48 vs 80.00 ± 10.00 N, respectively). Substitution of the suture materials did not significantly reduce the CFLs for the winged clamping anchors (conventional vs tape type: 40.00 ± 10.00 vs 30.00 ± 7.07 N for double loaded, respectively, and 64.00 ± 13.41 vs 50.00 ± 10.00 N for quadruple loaded, respectively) or the spooling anchors (conventional vs tape type: 62.00 ± 19.23 vs 56.32 ± 20.20N for double loaded, respectively, and 72.00 ± 21.68 vs 84.00 ± 13.42 N for quadruple loaded, respectively).

Conclusion:

Substituting tape-type sutures for conventional sutures increased the CFLs of some internal knotless anchors. With specific suture-anchor combinations, quadruple-loaded conventional suture anchors had CFLs higher than those of double-loaded conventional suture anchors.

Clinical Relevance:

When multiple tape-type sutures are used in conjunction with a clamping anchor, clinicians should note a possible reduction in CFLs and resultant early suture slippage.
Sarcoidosis Illuminations on Living During COVID-19: Patient Experiences of Diagnosis, Management, and Survival Before and During the Pandemic
Authors: Saketkoo Lesley Ann , Jensen Kelly , Nikoletou Dimitra , Newton Jacqui J. , Rivera Frank J. , Howie Mike , Reese Rodney K. , Goodman Melanie , Hart Patricia B. , Bembry Whitney , Russell Adam , Lian Isabelle , Lammi Matthew R. , Scholand Mary Beth , Russell Anne-Marie
Published: March 2022

Background: Inspired by intense challenges encountered by patients and clinicians, we examined the experiences of living with sarcoidosis in three of the hardest impacted English-speaking cities during the early COVID-19 pandemic: London, New Orleans, and New York. Methods: A multi-disciplinary, multi-national research team including 6 patient leaders conducted qualitative investigations with analyses rooted in grounded theory. Recruitment occurred by self-referral through patient advocacy groups. Results: A total of 28 people living with sarcoidosis participated. The majority of patients had multi-system and severe sarcoidosis. Dominant themes were consistent across groups with differences expressed in spirituality and government and health systems. Racial, gender, and able-bodied inequity were voiced regarding healthcare access and intervention, societal interactions, and COVID-19 exposure and contraction. Agreement regarding extreme disruption in care and communication created concern for disability and survival. Concerns of COVID-19 exposure triggering new sarcoidosis cases or exacerbating established sarcoidosis were expressed. Pre-COVID-19 impediments in sarcoidosis healthcare delivery, medical knowledge, and societal burdens were intensified during the pandemic. Conversely, living with sarcoidosis cultivated personal and operational preparedness for navigating the practicalities and uncertainties of the pandemic. Optimism prevailed that knowledge of sarcoidosis, respiratory, and multi-organ diseases could provide pathways for COVID-19-related therapy and support; however, remorse was expressed regarding pandemic circumstances to draw long-awaited attention to multi-organ system and respiratory conditions. Conclusion: Participants expressed concepts warranting infrastructural and scientific attention. This framework reflects pre- and intra-pandemic voiced needs in sarcoidosis and may be an agent of sensitization and strategy for other serious health conditions. A global query into sarcoidosis will be undertaken.