bluuebunny/crossref_metadata_2025 huggingface dataset:
The Medium Matters! In Defense of Medium-Specificity in Classical Film Theory
Authors: Turvey Malcolm
Published: September 2022

The doctrine of medium specificity holds that a medium can do something that other media cannot, or that they cannot do as well, and it has a long history in the theory, criticism, and practice of the arts. The first film theorists, who today are often referred to as classical film theorists, embraced medium specificity in their attempt to demonstrate that film is a legitimate art as great as, or perhaps greater than, the other arts. They believed that, in order for cinema to be accepted as a genuine art, they had to show that cinema can do certain things better than the other arts or that the other arts couldn’t do at all. Thus they set about identifying specific features of film that putatively distinguished it as a medium from other media. Today, medium specificity is a controversial doctrine, and has been subjected to powerful, sustained criticism by Noël Carroll, who has targeted its use in classical film theory. Yet, medium specificity has recently enjoyed a resurgence in film theorizing due, in part, to the advent of digital filmmaking. In this chapter, I claim that Carroll’s hostility to medium specificity in classical film theory is due to the unwarranted conflation of medium specificity with a related but logically distinct doctrine, namely, medium essentialism. Once the two are untangled, I show, medium specificity can be defended against its detractors such as Carroll, whose real and legitimate target, I suggest, is medium essentialism.
The Affective Turnabout’s Fair Play
Authors: Keller Sarah
Published: September 2022

This chapter considers the affective turn in cinema and its validation of a wider range of film experiences and modes of production than the dominant cinema tends to offer. It focuses on a recognition of the mutable nature of cinematic affect, then examines the dynamics of a set of recent films made by a handful of female filmmakers working in a range of forms (Céline Sciamma, Barbara Hammer, Chloe Zhao and Kirsten Johnson) to demonstrate their films’ diverse inclusivity and (relatedly) their emphasis on empathy. Paying attention to empathy offers a radical way of reading form, with the films’ affective underpinnings guiding not just narrative meaning but the act of engaging meaningfully with moving images more generally.
Introduction
Authors: Gable Philip A. , Miller Matthew W. , Bernat Edward M.
Published: September 2022

This chapter provides background knowledge and definitions for readers who may be unfamiliar with foundational knowledge in this area. Specifically, the chapter provides a physiological framework of what EEG frequency measures reflect in human participants. It outlines methodological commonalities that cut across most measures of frequency analyses in EEG research, with an emphasis on EEG equipment, recording techniques, and experimental design. It highlights recommended practices for achieving reproducible results, such as adequately powering studies as well as pre-registering data collection and processing plans. Readers who are new to EEG frequency research, as well as EEG researchers who seek to brush-up on EEG methods will benefit from this introductory chapter before venturing into later chapters focusing on specific areas of EEG frequency research.
Developmental Research on Time-Frequency Activity in Adolescence and Early Adulthood
Authors: Malone Stephen M. , Harper Jeremy , Iacono William G.
Published: September 2022

This chapter discusses developmental research on time-frequency activity implicated in psychological processes of importance to cognitive and clinical scientists, such as attention, feedback monitoring, decision making, and cognitive control. We review what the existing work with older children and adolescents reveals about age-related differences in time-frequency activity and the attentional and cognitive processes such activity appears to reflect. We describe how a developmental perspective offers a unique lens through which to understand time-frequency phenomena. Such a perspective is concerned with mechanisms underlying features of time-frequency activity (and the psychological process they reflect) and asks how these features come about, in addition to what they are. We discuss advantages and disadvantages of a longitudinal approach, which is uniquely suited for characterizing change in addition to mean differences in level among individuals, and we include new empirical work as an example of what can be gained from using longitudinal designs. Finally, we consider the kinds of questions a developmental perspective might motivate us to ask and what answers to these questions might teach us about time-frequency activity as well as relevant psychological processes.
Theta-Beta Power Ratio
Authors: Schutter Dennis J. L. G. , Kenemans J. Leon
Published: September 2022

Rhythmic activity plays a vital role in the organization and physical realization of functions in the brain. Following earlier observations of an increased ratio of theta (4–7 Hz) and beta (13–30 Hz) electroencephalogram (EEG) activity in attention-deficit hyperactivity disorder, both clinical and basic research have studied the functional nature of the theta-beta power ratio. A quantitative and qualitative review of the available scientific literature presented in this chapter shows that the theta-beta power ratio reflects a balance between the subcortical motivational and cortical cognitive control systems. Relative higher anterior theta-beta power ratios are indicative for dominant seeking motivation coupled to lower top-down attentional control, while relative lower anterior theta-beta power ratios signal top-down attentional control over the brain’s motivational systems. Although the applicability of the theta-beta power ratio in routine clinical settings should be considered complementary tool in the diagnosis of attention-related disorders, the EEG power ratio is able to capture functional aspects of normal and abnormal human behavior.
Bivariate Functional Connectivity Measures for Within- and Cross-Frequency Coupling of Neuronal Oscillations
Authors: Palva J. Matias , Palva Satu
Published: September 2022

Rhythmic brain activity fluctuations, neuronal oscillations, are ubiquitous in spontaneous brain activity in electrophysiological recordings at all measurable scales and in all species. Oscillations and their dynamics are produced by various synaptic and cellular mechanisms, which shape the temporal properties of neuronal activity at the brain circuit level. At the systems level, the dynamics of neuronal oscillations and correlations in their activity time series—functional connectivity (FC)—play a fundamental role in behavior and cognitive functions in humans and animal models. The accurate estimation of the dynamics and FC of neuronal oscillations in electrophysiological recordings, is hence of critical importance. This chapter provides an overview of the essential features of the local (univariate) oscillatory signals and the corresponding analysis methods for estimating their dynamics. It outlines methods for estimating dynamics and bivariate (pairwise) FC of brain oscillations among electrophysiological time series. Finally, it discusses the limitations posed by the typical confounders in MEG and EEG data.
The Environmental State and Its Limits
Authors: Meadowcroft James
Published: September 2022

The evolution of air pollution governance provides a useful way to approach the accomplishments and shortcomings of contemporary environmental states. Despite many failings, there has been a gradual strengthening of controls and an improvement in air quality across the developed countries over the past half century. Increasing scientific understanding of the damage caused by air pollution, a shifting technological frontier, and intervention by activist coalitions has driven a political process of “ratcheting up” of environmental standards that has been mediated and institutionalized through the environmental state. Despite the structural barriers that militate against more consequent engagement with environmental problems and the failure of governments so far to get to grips with meta problems such as climate change and biodiversity loss, the potential of actually existing environmental states is far from exhausted. Nothing is written in stone, and the capacity to engage in coming years with more transformative agendas will depend on the practical evolution of political forces.
The Latin American Novel and New Technology
Authors: Fitch Melissa A.
Published: September 2022

This chapter highlights some of the challenges connected to new technologies related to the use of terms that scholars of Latin American literature have long taken as self-evident. This includes what constitutes a novel, an author, and even the concept of a specific “Latin American” literature in a time in which so many authors from the region are transnationals. The chapter underscores the malleability of these concepts within the digital realm, while highlighting some additional problems that are unique to the creation of hypermedia narratives, among them, those related to accessibility of the texts and ethical questions regarding the production, consumption, and disposal of the laptops, tablets, and cellphones that are required to read or experience them. It argues that fluidity is the defining characteristic of this new field within Luso-Hispanic cultural studies, and that digital literature requires a change of focus on the part of scholars, one that departs from the interpretation of a strictly literary dimension of a work and, instead, factors in these myriad other elements, including the incorporation of insights derived in part from the multisensorial experience of accessing the work. It discusses at length two different hypermedia texts Amor de Clarice by Rui Torres and Hotel Minotauro by Doménico Chiappe, both of which can be experienced by readers while following along with the chapter. The chapter closes with an appraisal of both how, and why, analyses of digital narratives are of critical importance in contemporary Latin American cultural and literary studies.
Buddhist Magic and Vajrayāna
Authors: van Schaik Sam
Published: September 2022

Key elements of the Vajrayāna, or tantric Buddhism, can be traced back to some of the earliest Buddhist scriptures, typically texts that give instructions for practices that culminate in worldly results, such as protection from supernatural beings, healing illness and curing poison, bringing rain, or ensuring the safe birth of children. These magical aspects of Buddhist practice include the recitation of spells (mantra and dhāraṇī), along with other techniques such as the delimitation of sacred space with magical items and the use of ritual gestures (mudrā). In Vajrayāna texts, these techniques are adapted to the purpose of the ultimate Buddhist goal, awakening, though their power to achieve worldly ends is also taught in many tantras.
Acceptance and Commitment Therapy for Substance Use
Authors: Stavrinaki Maria , Kelly Megan M. , Karekla Maria
Published: September 2022

Global incidence for legal and illegal substance abuse is increasing, with marginalized groups and adolescents bearing the brunt. Substance use disorders (SUDs) are linked with serious and enduring physical health consequences, persistent psychological problems, criminality, homelessness, unemployment, and diminished educational opportunities. The issue of SUD prevention and treatment is therefore considered to be of the utmost importance worldwide. Current evidence-based treatments, though effective, present with mediocre abstinence rates, leaving room for improvement in the treatment of these conditions. Newer cognitive-behavioral therapy (CBT) approaches, such as acceptance and commitment therapy (ACT), acknowledge the inevitability of attempting to control internal states, which has been shown to ameliorate abstinence rates. ACT cultivates psychological flexibility, experiential acceptance, distress tolerance, and behavior change, with the aim of living a more fulfilled, valued life. More specifically, ACT for SUDs openly aims to increase awareness of contextual and internal substance cues, while simultaneously identifying and following personally relevant, valued directions. The evidence in support of ACT, in the context of SUDs, as well as the specifics of how to apply openness, awareness, and valued activity in treatment, are detailed in this article.
Technology
Authors: Lappalainen Raimo , Keinonen Katariina , Lappalainen Päivi
Published: September 2022

With the increase in demand for mental health services globally, the need for technology-based interventions (e.g., mobile applications, self-help websites) has risen. Evidence suggests that guided online interventions can be as effective as in-person interventions, along with greater accessibility for populations that may otherwise struggle to receive evidence-based mental health care (e.g., lower income, rural populations). This article provides a detailed overview of and rationale for technology-based methods of psychological intervention, specifically acceptance and commitment therapy (ACT). The effectiveness of technology-based ACT interventions, with and without support, is reviewed. Suggestions for how to implement ACT over technology is discussed, along with challenges and future directions. Additionally, the wide evidence base, both outcome and process research, for technological implementations of ACT is reviewed across disorders and populations. Although the development of technology-based ACT interventions is still modest among some populations, the current evidence suggests that they are effective across various mental health concerns and are improving psychological flexibility and well-being.
Acceptance and Commitment Therapy Inside Behavior Analysis
Authors: Tarbox Jonathan , Chastain Amanda N. , Szabo Thomas G.
Published: September 2022

Acceptance and commitment therapy (ACT) is a widely adopted and well-supported contemporary approach to psychotherapy. However, the basic research and learning principles that ACT is based on originated in the science of behavior analysis; therefore, ACT remains linked to behavior analysis at the conceptual level. In recent years, a flurry of interest in ACT among applied behavior analytic practitioners has developed, and research on the application of ACT inside of behavior analysis has been flourishing as well. This chapter discusses the conceptual foundations for ACT inside behavior analysis, including a brief conceptual analysis of the six core ACT processes in terms of behavior analytic principles of learning and motivation. The chapter reviews research on ACT inside of behavior analysis, especially as it has been applied to individuals with autism, their caregivers and staff. Also discussed are the extent to which the research reviewed adheres to the defining characteristics of applied behavior analysis, as well as directions for the future research that could both enhance the precision of the ACT literature, as well as expand the scope of applied behavior analysis.
Optical IFU observations of GOALS sample with KOOLS-IFU on Seimei Telescope: Initial results of nine U/LIRGs at z < 0.04
Authors: Toba Yoshiki , Yamada Satoshi , Matsubayashi Kazuya , Terao Koki , Moriya Aoi , Ueda Yoshihiro , Ohta Kouji , Hashiguchi Aoi , Himoto Kazuharu G , Izumiura Hideyuki , Joh Kazuma , Kato Nanako , Koyama Shuhei , Maehara Hiroyuki , Misato Rana , Noboriguchi Akatoki , Ogawa Shoji , Ota Naomi , Shibata Mio , Tamada Nozomu , Yanagawa Anri , Yonekura Naoki , Nagao Tohru , Akiyama Masayuki , Kajisawa Masaru , Matsuoka Yoshiki
Published: September 2022

We present ionized gas properties of nine local ultra/luminous infrared galaxies (U/LIRGs) at z < 0.04 through Integral Field Unit (IFU) observations with KOOLS-IFU on the Seimei Telescope. The observed targets are drawn from the Great Observatories All-sky LIRG Survey (GOALS), covering a wide range of merger stages. We successfully detect emission lines such as Hβ, [O iii]λ5007, Hα, [N ii]λλ6549, 6583, and [S ii]λλ6717, 6731 with a spectral resolution of R = 1500–2000, which provides (i) a spatially resolved (∼200–700 pc) moment map of ionized gas and (ii) diagnostics for an active galactic nucleus (AGN) within the central ∼3–11 kpc in diameter for our sample. We find that the [O iii] outflow that is expected to be driven by an AGN tends to be stronger (i) towards the galactic center and (ii) as a sequence of the merger stage. In particular, the outflow strength in the late-stage (stage D) mergers is about 1.5 times stronger than that in the early-state (stage B) mergers, which indicates that galaxy mergers could induce AGN-driven outflow and play an important role in the co-evolution of galaxies and supermassive black holes.
Effective two-body ΛN → NN weak potentials deduced from three-body ΛNN → NNN interactions and hypernuclear non-mesonic weak decay rates
Authors: Itonaga Kazunori , Motoba Toshio , Rijken Thomas A
Published: September 2022

We intend to study the role of the three-body weak ΛNN → NNN interaction in two-nucleon induced hypernuclear non-mesonic weak decay. The three-body weak interactions are constructed on the basis of the meson-pair exchange (MPE) model and then we derive the effective two-body ΛN → NN weak potentials from the three-body interactions based on the Loiseau–Nogami–Ross approximation. The strong coupling constants of MPE are taken from the Nijmegen ESC and GESC models and the weak ones of MPE are evaluated in the weak Λ–n mixing model by Dalitz and Von Hippel [Phys. Lett. 10, 153 (1964)]. The effective two-body ΛN → NN weak potentials are applied to evaluate hypernuclear non-mesonic decay rates, which should give a certain additional contribution to the two-nucleon induced decay rate Γ2N. Calculations of $\Gamma ^{({\text{eff.2B}})}_{nm}$ are done for $^5_\Lambda {\rm He}$, $^{11}_\Lambda {\rm B}$, and $^{12}_\Lambda {\rm C}$ and the results are compared with experimental data $\Gamma ^\mathrm{exp}_{2N}$. We have demonstrated the possibility of accounting for the two-nucleon induced non-mesonic decays of light and p-shell hypernuclei by introducing the effective two-body potentials deduced from the three-body weak interactions, though the calculated $\Gamma ^{(\text{eff.2B})}_{nm}$ still includes uncertainties. Discussions and limitations of our “effective two-body ΛN → NN model” are given.
Autophagy Enhances Longevity of Induced Pluripotent Stem Cell-Derived Endothelium via mTOR-Independent ULK1 Kinase
Authors: Hekman Katherine E , Koss Kyle M , Ivancic David Z , He Congcong , Wertheim Jason A
Published: September 2022

Stem cells are enabling an improved understanding of the peripheral arterial disease, and patient-specific stem cell-derived endothelial cells (ECs) present major advantages as a therapeutic modality. However, applications of patient-specific induced pluripotent stem cell (iPSC)-derived ECs are limited by rapid loss of mature cellular function in culture. We hypothesized that changes in autophagy impact the phenotype and cellular proliferation of iPSC-ECs. Endothelial cells were differentiated from distinct induced pluripotent stem cell lines in 2D culture and purified for CD144 positive cells. Autophagy, mitochondrial morphology, and proliferation were characterized during differentiation and over serial passages in culture. We found that autophagy activity was stimulated during differentiation but stagnated in mature iPSC-ECs. Mitochondria remodeled through mitophagy during differentiation and demonstrated increasing membrane potential and mass through serial passages; however, these plateaued, coinciding with decreased proliferation. To evaluate for oxidative damage, iPSC-ECs were alternatively grown under hypoxic culture conditions; however, hypoxia only transiently improved the proliferation. Stimulating mTOR-independent ULK1-mediated autophagy with a plant derivative AMP kinase activator Rg2 significantly improved proliferative capacity of iPSC-ECs over multiple passages. Therefore, autophagy, a known mediator of longevity, played an active role in remodeling mitochondria during maturation from pluripotency to a terminally differentiated state. Autophagy failed to compensate for increasing mitochondrial mass over serial passages, which correlated with loss of proliferation in iPSC-ECs. Stimulating ULK1-kinase-driven autophagy conferred improved proliferation and longevity over multiple passages in culture. This represents a novel approach to overcoming a major barrier limiting the use of iPSC-ECs for clinical and research applications.
Rapid evolution of SARS-CoV-2 in domestic cats
Authors: Bashor Laura , Gagne Roderick B , Bosco-Lauth Angela , Stenglein Mark , VandeWoude Sue
Published: September 2022

SARS-CoV-2 (SARS2) infection of a novel permissive host species can result in rapid viral evolution. Data suggest that felids are highly susceptible to SARS2 infection, and species-specific adaptation following human-to-felid transmission may occur. We employed experimental infection and analysis of publicly available SARS2 sequences to observe variant emergence and selection in domestic cats. Three cohorts of cats (N = 23) were inoculated with SARS-CoV-2 USA-WA1/2020 or infected via cat-to-cat contact transmission. Full viral genomes were recovered from RNA obtained from nasal washes 1–3 days post-infection and analyzed for within-host viral variants. We detected 118 unique variants at ≥3 per cent allele frequency in two technical replicates. Seventy of these (59 per cent) were nonsynonymous single nucleotide variants (SNVs); the remainder were synonymous SNVs or structural variants. On average, we observed twelve variants per cat, nearly 10-fold higher than what is commonly reported in human patients. We observed signatures of positive selection in the spike protein and the emergence of eleven within-host variants located at the same genomic positions as mutations in SARS2 variant lineages that have emerged during the pandemic. Fewer variants were noted in cats infected from contact with other cats and in cats exposed to lower doses of cultured inoculum. An analysis of ninety-three publicly available SARS2 consensus genomes recovered from naturally infected domestic cats reflected variant lineages circulating in the local human population at the time of sampling, illustrating that cats are susceptible to SARS2 variants that have emerged in humans, and suggesting human-to-felid transmission occurring in domestic settings is typically unidirectional. These experimental results underscore the rapidity of SARS2 adaptation in felid hosts, representing a theoretical potential origin for variant lineages in human populations. Further, cats should be considered susceptible hosts capable of shedding virus during infections occurring within households.
Into the Unknown: Experiences of Social Newcomers Entering Medical Education
Authors: Sims Lillian R.
Published: September 2022

Purpose

Amid efforts to diversify the medical profession, research has yet to fully explore the role of early social ties to the field. This study examined diversity through the experiences of students without early ties to medicine through family members working in health care (i.e., “newcomers”) in comparison with more-connected peers (i.e., “insiders”), examining how social newcomers to medicine negotiate challenges stemming from their outsider status.

Method

The author conducted an exploratory qualitative study from 2018 to 2021 using a constructivist grounded theory approach. Following a voluntary preliminary survey of 2 cohorts of first-year medical students about their social connections in health care, the author conducted interviews over the next 2 years with students who had indicated their willingness to participate. Interviews addressed how social context shaped—and continued to influence—their journeys into medicine. Eighty second- and third-year students participated in 94 interviews, including some follow-up interviews for longitudinal insight into outsider status. Interviews from the second year (58 new, 14 follow-up) provided the foundation of the qualitative results.

Results

Students experienced outsider status primarily on the basis of being newcomers to medicine, often compounded by intersectional characteristics, including first-generation college status, rural or low-income background, race or ethnicity, and nontraditional status. For some, an early shortage of social capital became internalized, continuing to influence confidence and belonging well into training, in line with social reproduction theory. However, newcomers also experienced benefits associated with diverse backgrounds which helped them find a sense of belonging in medicine, as suggested by community cultural wealth and antideficit perspectives.

Conclusions

Newcomer status proved to be a central cause of outsiderness for students from all backgrounds and warrants greater attention from stakeholders, perhaps mirroring the undergraduate focus on first-generation college-goers. Findings suggest institutions that provide robust networking and community-building opportunities are best positioned to support newcomers.
Chinese Guideline for Percutaneous Coronary Intervention in Patients with Left Main Bifurcation Disease
Authors:   Chinese Society of Cardiology, Chinese Medical Association; Editorial Board of Chinese Journal of Cardiology
Published: September 2022

The coronary left main (LM) artery is characterized by large caliber, length varying from <8 to >15 mm, and 2 large daughter vessels branching from it; it supplies blood to a large area (>75%) of the myocardium. LM bifurcation lesion is defined as the presence of atherosclerosis involving either or both of the 2 daughter vessels. Thus, the optimal strategy of revascularization for diseased LM has been an interesting research topic for a long time. With developments in percutaneous techniques, design, and materials of drug-eluting stents; intravascular imaging; new generation of antiplatelet medications; and particularly recent pooled evidence from randomized clinical trials comparing percutaneous coronary intervention with coronary artery bypass grafting, implantation of a drug-eluting stenting with or without other approved techniques is considered an important therapeutic approach for LM bifurcation lesions. Mirroring the anatomical complexity of the LM, stenting LM bifurcations is technically demanding, and intraprocedural complications can be catastrophic given the large amount of jeopardized myocardium. Therefore, the Chinese Society of Cardiology designed a writing committee with members from 3 working groups (ie, clinical research, intravascular imaging and physiology, and interventional cardiology) for the first time, to write a guideline on percutaneous treatment for LM bifurcation lesions, with view to improve the procedural quality and clinical outcomes. This guideline consists of introduction, anatomical description of the LM tree, risk stratification, strategies of revascularization, antiplatelet strategy, follow-up, and long-term management for patients with LM bifurcation lesions.
A calculated risk: Evaluating HIV resistance to the broadly neutralising antibodies10-1074 and 3BNC117
Authors: Zacharopoulou Panagiota , Ansari M. Azim , Frater John
Published: September 2022

Purpose of this review

Broadly neutralising antibodies (bNAbs) are a promising new therapy for the treatment of HIV infection. However, the effective use of bNAbs is impacted by the presence of preexisting virological resistance and the potential to develop new resistance during treatment. With several bNAb clinical trials underway, sensitive and scalable assays are needed to screen for resistance. This review summarises the data on resistance from published clinical trials using the bNAbs 10-1074 and 3BNC117 and evaluates current approaches for detecting bNAb sensitivity as well as their limitations.

Recent findings

Analyses of samples from clinical trials of 10-1074 and 3BNC117 reveal viral mutations that emerge on therapy which may result in bNAb resistance. These mutations are also found in some potential study participants prior to bNAb exposure. These clinical data are further informed by ex-vivo neutralisation assays which offer an alternative measure of resistance and allow more detailed interrogation of specific viral mutations. However, the limited amount of publicly available data and the need for better understanding of other viral features that may affect bNAb binding mean there is no widely accepted approach to measuring bNAb resistance.

Resistance to the bNAbs 10-1074 and 3BNC117 may significantly impact clinical outcome following their therapeutic administration. Predicting bNAb resistance may help to lower the risk of treatment failure and therefore a robust methodology to screen for bNAb sensitivity is needed.
The Impact of Senior Author Profile on Publication Level of Evidence in Plastic and Reconstructive Surgery
Authors: Blum Jessica D. , Kota Anchith , Villavisanis Dillan F. , Cho Daniel Y. , Swanson Jordan W. , Bartlett Scott P. , Taylor Jesse A.
Published: September 2022

Background:

Plastic and Reconstructive Surgery (PRS) incorporated the level of evidence (LOE) pyramid in 2011 to highlight evidence-based medicine in plastic surgery. This study aimed to assess the relationship between the profile of senior authors publishing in PRS and the LOE of publications.

Methods:

All accepted publications by American senior authors to PRS between January 2018 and March 2020 were classified by LOE. Demographic, educational, and career data on all senior authors were collected using publicly available online resources.

Results:

A total of 1030 articles were screened‚ of which 266 (25.8%) were eligible for LOE classification with the following distribution: I, 0.8%; II, 14.3%; III, 45.1%; IV, 33.1%; and V, 7.1%. Senior author demographic factors, including gender and race/ethnicity, did not significantly impact LOE (P > 0.05 for all). An advanced degree was associated with more publications per year, and only a PhD (P = 0.022) and board certification (P = 0.012) were associated with a higher LOE of publications (P = 0.022). Physicians working in an academic setting were significantly more likely to publish level III evidence than their private/community-based counterparts (P = 0.006). Breast papers constituted the highest proportion of level III evidence (41.4%; P < 0.001).

Conclusions:

Most publications in PRS contain level III-IV evidence. Senior author gender, race, and ethnicity did not impact LOE of publications. Plastic surgery board certification, possession of a PhD, and academic practice setting were associated with higher LOE of publications.
Beauty and Function: The Use of Trimmed Great Toe in Thumb and Finger Reconstruction
Authors: Troisi Luigi , Mazzocconi Luca , Mastroiacovo Alessandro , Vizcay Macarena , Zanchetta Francesco , Stucchi Sara , Pajardi Giorgio Eugenio
Published: September 2022

Background:

Finger amputations are one of the most common traumas of daily life. Regularization of the digital stump is the most widely used option in the literature today. The aim of this study was to evaluate a valid functional and aesthetic alternative to amputation.

Methods:

We retrospectively investigated our prospective database‚ selecting the patients who underwent trimmed great toe flap reconstruction for the amputation of a digit from September 2019 to November 2021. All the operations were performed by the first author (L.T.) in the Reconstructive Microsurgery Service of the University Department of Hand Surgery and Rehabilitation of MultiMedica Group.

Results:

No flap required anastomosis revision or had major complications. The length of the amputated finger was maintained, with a high functional and aesthetic result achieved.

Conclusions:

The trimmed great toe flap has proven to be a viable alternative to finger amputation in the reconstruction of thumb and long finger defects, leading to high aesthetic results. The morbidity of the donor site is reduced compared with the classic great toe flap, allowing a direct closure in most cases.
Duplex Sequencing Uncovers Recurrent Low-frequency Cancer-associated Mutations in Infant and Childhood KMT2A-rearranged Acute Leukemia
Authors: Pilheden Mattias , Ahlgren Louise , Hyrenius-Wittsten Axel , Gonzalez-Pena Veronica , Sturesson Helena , Hansen Marquart Hanne Vibeke , Lausen Birgitte , Castor Anders , Pronk Cornelis Jan , Barbany Gisela , Pokrovskaja Tamm Katja , Fogelstrand Linda , Lohi Olli , Norén-Nyström Ulrika , Asklin Johanna , Chen Yilun , Song Guangchun , Walsh Michael , Ma Jing , Zhang Jinghui , Saal Lao H. , Gawad Charles , Hagström-Andersson Anna K.
Published: September 2022

Infant acute lymphoblastic leukemia (ALL) with KMT2A-gene rearrangements (KMT2A-r) have few mutations and a poor prognosis. To uncover mutations that are below the detection of standard next-generation sequencing (NGS), a combination of targeted duplex sequencing and NGS was applied on 20 infants and 7 children with KMT2A-r ALL, 5 longitudinal and 6 paired relapse samples. Of identified nonsynonymous mutations, 87 had been previously implicated in cancer and targeted genes recurrently altered in KMT2A-r leukemia and included mutations in KRAS, NRAS, FLT3, TP53, PIK3CA, PAX5, PIK3R1, and PTPN11, with infants having fewer such mutations. Of identified cancer-associated mutations, 62% were below the resolution of standard NGS. Only 33 of 87 mutations exceeded 2% of cellular prevalence and most-targeted PI3K/RAS genes (31/33) and typically KRAS/NRAS. Five patients only had low-frequency PI3K/RAS mutations without a higher-frequency signaling mutation. Further, drug-resistant clones with FLT3

D835H
or NRAS

G13D/G12S
mutations that comprised only 0.06% to 0.34% of diagnostic cells, expanded at relapse. Finally, in longitudinal samples, the relapse clone persisted as a minor subclone from diagnosis and through treatment before expanding during the last month of disease. Together, we demonstrate that infant and childhood KMT2A-r ALL harbor low-frequency cancer-associated mutations, implying a vast subclonal genetic landscape.
Implementation of an Evidence-Based Prenotification Process for Patients With Stroke to Improve Neurological Outcomes
Authors: Gross Katharine , Gusler Bobbi , Londy Karen , Buterakos Roxanne , Keiser Megan
Published: September 2022

BACKGROUND: Endovascular mechanical thrombectomy can improve clinical outcomes in eligible patients with acute ischemic stroke (AIS), but its efficacy is time dependent. This quality improvement project aimed to examine whether a revised evidence-based neurological deficit algorithm initiated in the emergency department could reduce door-to-groin puncture time to less than 90 minutes and improve neurological outcomes in AIS patients who received mechanical thrombectomy. METHODS: Retrospective chart reviews occurred between September 2020 and April 2021, which included 25 patients. Clinical and time data were collected from AIS patients who were 18 years and older, presented for care with AIS symptoms, and deemed candidates for thrombectomy for a period of 6 months. A revised neurological deficit algorithm was initiated, and education was presented to appropriate staff. Postintervention chart reviews occurred from August 2021 to January 2022, which included 25 patients. RESULTS: Door-to-groin puncture time did not improve to less than 90 minutes; however, there was a slight improvement in time from 106 minutes in the preintervention to 98 minutes in the postintervention (P = .534). Although the outcome measures were not clinically significant, there was a statistically significant decrease in response time to acute stroke call down (P < .01). Door-to-computed tomography also improved, which was 14.42 minutes for the preintervention group and 5.25 minutes for the postintervention group (P < .001). Finally, the mean National Institutes of Health Stroke Scale on discharge for the preintervention group was 11.92, and that of the postintervention group was 6.05 on discharge (P < .01). CONCLUSIONS: Implementation of the revised neurological deficit algorithm did not decrease the door-to-groin puncture time to less than 90 minutes. After implementation of the revised neurologic deficit algorithm, there were single variable improvements in several benchmarks, and this is a starting point for future quality improvement projects.
Usefulness of preoperative Short Form-36 Mental Component Score as a prognostic factor in patients who underwent decompression surgery for degenerative lumbar spinal stenosis
Authors: Ko Sangbong , Choi Wonkee
Published: September 2022

Physical factors such as frequency of low back pain, sensory abnormalities in the lower extremities, smoking history before surgery, and preoperative mental health status as predictors of operative outcomes have been growing as areas of interest in the field of degenerative lumbar spinal stenosis (DLSS). This study aimed to investigate the correlation between the preoperative Short Form-36 Mental Component Score (SF-36 MCS) and long-term prognosis after decompression surgery for DLSS. In total, 198 patients were enrolled in this study. The Oswestry Disability Index (ODI) and Rolland Morris Disability Questionnaire (RMDQ) were used to evaluate spinal functional outcomes. The SF-36 questionnaire was used and analyzed by classifying it into physical component score (PCS) and mental component score (MCS). The SF-36 MCS was divided into role limitations caused by emotional problems, social functioning, vitality, and emotional well-being. In the correlation between preoperative MCS and ODI improvement, the r value was −0.595 (P < .05) at 12 months postoperatively. ODI improvement at 12 months after decompression surgery showed a statistically significant and strong negative correlation with preoperative MCS. In the correlation between preoperative MCS and RMDQ improvement, the r value was −0.544 (P < .05) at 12 months postoperatively. Therefore, RMDQ improvement 12 months after decompression surgery showed a strong negative correlation with preoperative MCS. Regarding the correlation between preoperative MCS and SF-36 PCS improvement, the r values were 0.321 (P < .05) at 6 months postoperatively and 0.343 (P < .05) at 12 months postoperatively. Therefore, SF-36 PCS improvement at 6 and 12 months after decompression surgery showed a strong positive correlation with preoperative SF-36 MCS scores. Preoperative SF-36 MCS is a factor that can predict the prognosis of patients who underwent decompression surgery for lumbar spinal stenosis for at least 1 year postoperatively.
A prediction model for 30-day mortality of sepsis patients based on intravenous fluids and electrolytes
Authors: Wang Yan , Feng Songqiao
Published: September 2022

To establish a prediction model for the 30-day mortality in sepsis patients. The data of 1185 sepsis patients were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) and all participants were randomly divided into the training set (n = 829) and the testing set (n = 356). The model was established in the training set and verified in the testing set. After standardization of the data, age, gender, input, output, and variables with statistical difference between the survival group and the death group in the training set were involved in the extreme gradient boosting (XGBoost) model. Subgroup analysis was performed concerning age and gender in the testing set. In the XGBoost model with variables related to intravenous (IV) fluid management and electrolytes for the 30-day mortality of sepsis patients, the area under the curve (AUC) was 0.868 (95% confidence interval [CI]: 0.867–0.869) in the training set and 0.781 (95% CI: 0.779–0.782) in the testing set. The sensitivity was 0.815 (95% CI: 0.774–0.857) in the training set and 0.755 (95% CI: 0.686–0.825) in the testing set. The specificity was 0.761 (95% CI: 0.723–0.798) in the training set, and 0.737 (95% CI: 0.677–0.797) in the testing set. In the XGBoost forest model without variables related to IV fluid management and electrolytes for the 30-day mortality of sepsis patients, in the training set, the AUC was 0.830 (95% CI: 0.829–0.831), the sensitivity was 0.717 (95% CI: 0.669–0.765), the specificity was 0.797 (95% CI: 0.762–0.833), and the accuracy was 0.765 (95% CI: 0.736–0.794). In the testing set, the AUC was 0.751 (95% CI: 0.750–0.753), the sensitivity was 0.612 (95% CI: 0.533–0.691), the specificity was 0.756 (95% CI: 0.698–0.814), and the accuracy was 0.697(95% CI: 0.649–0.744). The prediction model including variables associated with IV fluids and electrolytes had good predictive value for the 30-day mortality of sepsis patients.
Clinical efficacy of different shoulder joint drug injections for rotator cuff injuries: A network meta-analysis
Authors: Zhi Fang , Cai Feiyan , Zhang Wei , Xiong Liming , Hu Jinglin , Lin XingZhen
Published: September 2022

Background:

Rotator cuff injury is a common clinical disorder of the musculoskeletal system. It is one of the most common causes of shoulder pain and shoulder joint dysfunction. Intra-articular injection therapy is one of the common conservative treatments for rotator cuff injury in clinical practice, but scholars have been controversial about the different drugs used for injection therapy and their clinical effectiveness, and there is no complete agreement on the choice of different injectables, and the existing original studies are mostly direct comparisons in 1 arm, lacking indirect comparisons, making it difficult to have a clear and comprehensive understanding.

Objective:

A network Meta-analysis was used to comprehensively compare the effectiveness of drug injection therapies for rotator cuff injuries.

Methods:

The PubMed, The Cochrane Library, EMbase, Chinese national knowledge infrastructure, Chinese BioMedical Literature on disc, China Science and Technology Journal Database, and Wan-Fang databases were searched for randomized controlled trials on the effectiveness of steroid injections for the comparative treatment of rotator cuff injury for the period April 19, 2013 to April 19, 2022 (the last decade). Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in efficacy of each treatment measure and rank the efficacy using the ratio and 95% confidence interval (CI) as the effect indicator.

Results:

10 RCTs with a total of 861 patients with rotator cuff injury were included, involving 4 therapeutic measures: corticosteroid injection therapy (COR), platelet-rich plasma injection therapy (PRP), Hyaluronic acid injection therapy (HA), and prolotherapy therapy (PRO).Meta-analysis results showed that the ranking results of the 4 therapeutic measures were: corticosteroid injection + hyaluronic acid injection > platelet-rich plasma injection + corticosteroid injection > corticosteroid injection > platelet-rich plasma injection > PRO > platelet-rich plasma injection + hyaluronic acid injection > hyaluronic acid injection.

Conclusion:

we recommend that corticosteroid injections combined with hyaluronic acid injections can be used for the non-surgical conservative clinical management of rotator cuff injuries.
Comparing the short-term results of the improved triangular anastomosis technique for complete laparoscopic radical resection of sigmoid colon cancer and laparoscopic-assisted small incision colon reconstruction: A CONSORT study
Authors: Cheng Wenjie
Published: September 2022

The laparoscopic approaches using the triangular anastomosis technique for sigmoid colon cancer (SCC) are rare. This CONSORT study explored the short-term effects of laparoscopic radical resection of SCC with modified triangular anastomosis technique and laparoscopic-assisted small incision colon cancer reconstruction surgery. From April 2019 to January 2021, a total of 86 patients with SCC who were admitted to Luopu County People’s Hospital were selected and received radical resection. Patients were divided into 2 groups using a random number table method: in the control group, patients underwent laparoscopic-assisted small-incision reconstruction surgery, and patients in the observation group underwent complete laparoscopic surgery with modified triangular anastomosis technique. The 2 groups were compared in perioperative related indicators and postoperative complications. After 3 months follow-up, local tumor recurrence and metastasis, abdominal wall puncture and implantation, and death were observed. Compared to the control group, shorter operation time, gastrointestinal reconstruction time, postoperative exhaust time, hospitalization time, and less intraoperative blood loss, and lower probability of complications were observed in the observation group (P < .05). However, there was no significant difference in the number of lymph node dissections between the 2 groups (P > .05). After 3 months of follow-up, no local tumor recurrence, distant tumor metastasis, abdominal wall puncture implantation, and death were found in the 2 groups of patients. It is indicated that the improved triangular anastomosis technique for complete laparoscopic radical resection of SCC is effective in treatment for SCC.
Can intravenous lidocaine definitely attenuate propofol requirement and improve outcomes among colonoscopic patients under intravenous sedation?: A double-blinded, randomized controlled trial
Authors: Nongnuang Krisana , Limprasert Natirat , Munjupong Sithapan
Published: September 2022

Background:

Propofol-sparing effect of lidocaine has not been fully elucidated because propofol is usually mixed with many medications in anesthetic practice. Therefore, the study aimed to verify the additive effect of intravenous lidocaine to propofol without other sedative medications and control the depth of anesthesia using the bispectral index (BIS) during colonoscopy in a prospective, randomized, double-blinded controlled trial.

Methods:

Sixty-eight patients scheduled and undergoing colonoscopy were randomly allocated to receive intravenous lidocaine (1.5 mg/kg then 4 mg/kg/h) (Group L) or a similar volume of normal saline (Group C) with propofol administration guided by BIS monitoring. The primary outcome was total propofol requirements between group comparisons. The secondary outcomes included the number of hypoxemic periods, hemodynamic changes, duration in returning of BIS > 85, sedation scores, pain scores, postoperative opioid requirement, and patient satisfaction between group comparisons.

Results:

Intravenous lidocaine showed significantly reduced total propofol use (151.76 ± 50.78 mg vs 242.06 ± 50.86 mg, Group L vs Group C, respectively, P < .001). Duration in returning to BIS > 85, sedation scores, and patient satisfaction scores were significantly superior in Group L (P < .05). The number of hypoxemic episodes, changes of hemodynamic response, pain scores, and postoperative opioid requirement were similar in both groups. No adverse effects were detected in both groups.

Conclusion:

Intravenous lidocaine produced a definitely effective reduced propofol requirement without other sedative agents and improved outcomes including patient satisfaction, duration in returning to BIS > 85, and sedation score during colonoscopy without adverse effects.