bluuebunny/crossref_metadata_2025 huggingface dataset:
Pseudoaneurysm Repair With a Septal Occluder
Authors: Vogel Julia , Räber Lorenz , Makaloski Vladimir
Published: April 2022

Introduction

New treatment options, like endovascular aortic repair, reduced the mortality rate of patients suffering from complications after an acute type A aortic dissection repair. Nevertheless, initial successful treatment of an aortic dissection does not fully eliminate the risk of later adverse aortic events like anastomotic pseudoaneurysm. Pseudoaneurysm of the anastomosis between the ascending and the arch graft could initiate complications like peripheral embolization, dysphagia or compression of mediastinum organs. Re-operation via re-sternotomy bears enormous morbidity and mortality for these patients. There is a high unmet need for percutaneous therapeutic options to treat pseudoaneurysms.

Case Presentation

A 59-year-old-man treated 15 years ago for type A aortic dissection, was hospitalized due to intermittent abdominal pain. A detailed examination revealed 2 pseudoaneurysms: 1 symptomatic at the level of the reimplanted celiac trunk and 1 asymptomatic at the anastomosis between the brachiocephalic trunk and the aortic arch graft. Due to multiple co-morbidities and previous operations, the risk for surgery was considered too high. Both pseudoaneurysm were treated percutaneously, the symptomatic 1 with covered stent and the asymptomatic with Amplatzer™ septal-occluder.

Discussion

We present an alternative percutaneous therapy approach for treatment of pseudoaneurysm using a septal-occluder. A follow-up computed tomography 3 months later showed successfully excluded pseudoaneurysm.
Allostatic Load, Income, and Race Among Black and White Men in the United States
Authors: Tavares Carlos D. , Bell Caryn N. , Zare Hossein , Hudson Darrell , Thorpe Roland J.
Published: April 2022

Research indicates that income is significantly associated with allostatic load (AL) and that this association may differ between White and Black Americans. Most existing income–AL link work focuses on women and less is known about this association among men. Using data from the National Health and Nutrition Examination Survey (NHANES), we examined whether race moderates the association between income and AL among Black and White men in the United States ( n = 5,685). We find that, regardless of income levels, Black men have significantly higher prevalence of being in the high-AL group compared with high-income White men. Our findings suggest that Black men do not receive the same health benefits for increased income relative to their White counterparts.
Family Support for (Increasingly) Older Adults with Down Syndrome: Factors Affecting Siblings’ Involvement
Authors: Lemoine Lise , Benoît Schneider
Published: April 2022

Background

Life expectancy for people with Down syndrome is increasing, but older adults with Down syndrome are at greater risk of developing certain pathologies associated with ageing. When ageing parents can no longer look after their child with Down syndrome, their other children are often expected to shoulder this responsibility.

Method

We asked 120 adult siblings of a person with Down syndrome to complete a questionnaire on their current and anticipated relationships.

Results

Most respondents considered these relationships to be positive, but they expressed concerns about the effects of ageing and about having to organise their sibling with Down syndrome’s future life. We investigated the impact of factors relating to the respondents and to their sibling with Down syndrome (age, gender, social inclusion, protection regime) on these general tendencies.

Conclusion

Siblings need to be given support, for example, via discussion groups, to facilitate the transition to becoming caregivers.
The Ever-Expanding Scope of Animation Historiography: A Discussion of Interdisciplinary Approaches and Methods
Authors: Bieberstein Rada , Feyersinger Erwin
Published: April 2022

Accounting for animation’s pervasiveness, heterogeneity and intermediality, this article reflects conceptions of animation historiography. It brings together contemporary perspectives and methods in the research of animation history/historiography, and considers tangible approaches outside animation studies. Particular attention is paid to materials and aspects that are overlooked and non-canonical. The authors conceptualize animation historiography in the shape of a rhizome, enabling a better understanding of the relations between canonical aspects and fringes, and enriching the dialogue between the various disciplines, actors and institutions writing the histories of animation. Following a look at the current state of debate about animation history/histories and historiography in animation studies, the article surveys pertinent debates in film studies, art history and media art history. It then discusses historical research in performance studies and in the history of science, both concerned with fields where animation is often marginalized, as well as animation-related research on motion graphics and useful cinema, themselves under-researched topics, for perspectives to reconceptualize animation history. Media archaeology, its approaches and methodology, will be addressed repeatedly from the perspectives of the different disciplines and areas. The article is conceived as an ‘open paper’, understood as an invitation to further discuss animation historiography on a metalevel.
Discovering Animation Manuals: Their Place and Role in the History of Animation
Authors: Lamotte Coralie
Published: April 2022

This article explores the history of animation manuals in the United States from the 1940s to the present. It argues that this history can be divided into three major periods that correspond to changes in technique, profession and industry. From the post-War period until the 1980s, manuals reflected the hegemony of hand-drawn animation, closely bound to studio production and an apprenticeship training system. At the end of the 1970s, the rise of computer animation led to a new type of guidebook, addressing a growing convergence of computational training and new requirements introduced by the animation industry. Finally, since the turn of the century, manuals have sought to combine hand-drawn skills with digital tools, re-negotiating tradition and novelty in a diversified professional environment. Therefore, manuals are situated at a changing nexus of professional identity and training, techniques and technology, aesthetics and modes of production. In this article, the author argues that their integration within the history of animation will prove beneficial to researchers. Nevertheless, manuals are not innocent sources, but reflect discursive positions that shape the very history in which they take part.
Reanimating the History and the Forgotten Characteristics of the Zoetrope
Authors: Veras Christine
Published: April 2022

This article aims to reanimate and expand on the often-neglected details of the zoetrope’s history, offering new insightful evidence from archival sources about this 19th-century optical toy’s genealogy. From its theorizing by William G. Horner in 1834 to its commercialization in 1867, this new study of the zoetrope’s original patents and archival materials suggests that all the three patents, filed in the same year, months apart from one another, in England, the United States, and France, are connected to the Milton Bradley Company. The historical investigation extends to the forgotten characteristics of the zoetrope, bringing them to light in combination with a hands-on approach through the lens of experimental media archaeology. This includes experiments with ‘zoetropic editing’, allowing for a recontextualization of its imaginative potential and playability through the combination of two different strips. From this animation practitioner and researcher’s point of view, the contributions shared in this article can expand and challenge the way we play with, teach about, and produce animations for the zoetrope today.
The effect of contextual arousal on the integration of emotional words during discourse comprehension
Authors: Zhang Qian , Mou Cong , Yang Xiaohong , Yang Yufang , Li Lin
Published: April 2022

This event-related potential (ERP) study examined the effect of contextual arousal on emotional word integration during discourse comprehension. We used two-sentence discourses as experimental materials. The first sentence served as an emotional context and described a high-arousal positive event, a low-arousal positive event, a high-arousal negative event, or a low-arousal negative event. The second sentence contained one negative word as the critical word, which was identical among different conditions. Thus, four conditions were included in the present study: high-arousal inconsistent, low-arousal inconsistent, high-arousal consistent, and low-arousal consistent. The ERP results showed that inconsistent emotional words elicited larger P200 and LPC than consistent words in the high-arousal context. However, only a P200 effect was observed for inconsistent emotional words in the low-arousal context. Our results indicate that a high-arousal context could lead to more elaborated emotional evaluation in the later stage of emotional word integration and suggest an important role of contextual arousal on the processing of emotional words during discourse processing.
The differentiation of single and dual career athletes falls short: A person-oriented approach to characterize typical objective life situations of elite athletes
Authors: Örencik Merlin , Schmid Michael J. , Schmid Jürg , Conzelmann Achim
Published: April 2022

Research concerning athletic career development in high-performance sport typically uses demographic data, sport characteristics or pursuing a dual career (i.e. having an educational or vocational career simultaneous to the athletic career) to identify developmental processes. In defiance of these attempts, considerable heterogeneity remains within these subgroups of the elite athlete population. In line with the person-oriented approach, the objective of this study was to develop a comprehensive typology of athletes with similar objective life situations by considering both sport-related as well as non-sport related aspects. To this end, data were collected about athletic performance level, weekly amount of working time (i.e. sport-related activities, education, and vocation), and financial information (i.e. gross annual income and income generated from sport). Based on a sample of 733 elite athletes, a cluster analysis was performed to divide the sample into groups of similar patterns on the aforementioned factors. Five different athlete patterns were found: (1) working dual career athletes, (2) high-income professional athletes, (3) medium-income professional athletes, (4) family-supported athletes, and (5) student dual career athletes. These findings support the dual career literature of separating dual career ( Cluster 1 and Cluster 5) from single career athletes, which, in turn, should also not be regarded as a single population, but further divided ( Cluster 2, Cluster 3, and Cluster 4). This typology may aid federations and practitioners within athletic career development in providing individual assistance for elite athletes.
Efficacy and safety of endoscopic papillectomy: a multicenter, retrospective, cohort study on 227 patients
Authors: Gondran Hannah , Musquer Nicolas , Perez-Cuadrado-Robles Enrique , Deprez Pierre Henri , Buisson François , Berger Arthur , Cesbron-Métivier Elodie , Wallenhorst Timothee , David Nicolas , Cholet Franck , Perrot Bastien , Quénéhervé Lucille , Coron Emmanuel
Published: April 2022

Background:

Endoscopic papillectomy is a minimally invasive treatment for benign tumors of the ampulla of Vater or early ampullary carcinoma. However, reported recurrence rates are significant and risk factors for recurrence are unclear.

Objective:

The aims of this study were to evaluate the efficacy and safety of endoscopic papillectomy and to identify risk factors for recurrence and adverse events.

Methods:

All patients who underwent endoscopic papillectomy at five tertiary referral centers between January 2008 and December 2018 were included. Recurrence was defined as the detection of residue on one of the follow-up endoscopies. Treatment success was defined as the absence of tumor residue on the last follow-up endoscopy.

Results:

A total of 227 patients were included. The resections were en bloc in 64.8% of cases. The mean lesion size was 20 mm (range: 3–80) with lateral extension in 23.3% of cases. R0 resection was achieved in 45.3% of cases. The recurrence rate was 30.6%, and 60.7% of recurrences were successfully treated with additional endoscopic treatment. Finally, treatment success was achieved in 82.8% of patients with a median follow-up time of 22.3 months. R1 resection, intraductal invasion, and tumor size > 2 cm were associated with local recurrence. Adverse events occurred in 36.6% of patients and included pancreatitis (17.6%), post-procedural hemorrhage (11.0%), perforation (5.2%), and biliary stenosis (2.6%). The mortality rate was 0.9%.

Conclusion:

Endoscopic papillectomy is an effective and relatively well-tolerated treatment for localized ampullary tumors. In this series, R1 resection, intraductal invasion, and lesion size > 2 cm were associated with local recurrence.
The EU to the rescEU? Assessing the geopolitics of the EU’s medical stockpile
Authors: Glencross Andrew
Published: April 2022

This article uses a geopolitical lens to assess the EU’s response to COVID-19 by exploring the Commission’s creation of an emergency medical stockpile, dubbed rescEU. The article describes the creation, financing and distribution of this stockpile, which comes under the aegis of the Civil Protection Mechanism, in its first year of operation, 2020–1. What the analysis shows is how the creation and distribution of medical assistance was justified by the need to adapt to a changing international environment, one in which Russia and China contested the EU’s solidarity, both within the EU27 and towards its neighbours. The EU has committed to investing large sums to develop pandemic resilience via stockpiling. However, what remains to be seen is how far such a policy can strengthen solidarity and counteract anti-EU narratives in the global context of the increasing strategic competition facing the EU.
The EU’s chair was missing at the Ukraine table
Authors: Howorth Jolyon
Published: April 2022

The crisis in Ukraine has highlighted the weaknesses of the EU as an international actor. Although the EU is an economic, commercial and regulatory giant, it has not succeeded in emerging as a significant military or security actor—despite having announced a ‘common foreign and security policy’ 30 years ago. In particular, it is deeply divided over policy towards Russia. Moreover, attempts to devise an overall policy for its neighbourhood, and in particular an ‘Eastern Partnership’ focused on the borderline states between the Union and Russia, have been widely judged as failures. In the showdown between Russia and the West over Ukraine, the EU per se has been marginalised by both Moscow and Washington. Various EU member states have embraced different preferences with respect to the potential resolution of the Ukraine crisis. In the context of potential discussions, demanded by Vladimir Putin, on a ‘new security order’ for Eurasia, the EU’s absence is tragic.
The Coordinated Maritime Presences concept and the EU’s naval ambitions in the Indo-Pacific
Authors: Nováky Niklas
Published: April 2022

Since the launch of the first-ever EU naval operation in 2008, the ongoing Operation Atalanta off the Horn of Africa, EU naval forces have operated primarily in Europe’s vicinity or in regions in which great-power tensions have been low. Yet, the Union has also begun to seek a naval role for itself in more sensitive regions, namely the Indo-Pacific, via the new Coordinated Maritime Presences concept. This article analyses the EU’s plans to play a more visible naval role in the Indo-Pacific, and argues that the extension of this concept to the region would raise the EU’s level of ambition as a naval actor. However, the EU’s ability to be a meaningful maritime security provider in the Indo-Pacific depends on the EU countries coming closer to seeing eye-to-eye on how the Union should approach China, and on their willingness to send vessels to the Indo-Pacific.
Bonhoeffer’s Account of the Conscience and How it Can Inform Formation Today
Authors: Burkholder Benjamin J.
Published: April 2022

In contemporary discourse, different conceptions of the conscience abound. Aquinas and Calvin had similar yet distinct accounts of the conscience and its role in Christian ethical formation. Upon close inspection, both struggle to account fully and consistently for the effects of the fall and its impact on human reason. In response to some of the weaknesses observed in these accounts, Bonhoeffer’s reflections on the conscience offer a more helpful way forward that accounts for the Fall’s effects on human rationality. In addition, his work also offers guidelines for navigating the internal voices and concerns of fallen humanity, ultimately pointing the Christian to the Word of Christ as the final judge and justifier. Finally, his formulations can provide a fuller set of instructions for people doing the spiritual disciplines and navigating their internal world in prayer.
Chronic Effects of Pitching on Muscle Thickness and Strength of the Scapular Stabilizers in Professional Baseball Players
Authors: Valle Ohsana , Sheridan Scott S. , Rauch Joseph J. , Sarver Joseph J. , Paul Ryan W. , Thomas Stephen J.
Published: April 2022

Background:

The posterior scapular muscles eccentrically contract to disperse the high forces observed in the deceleration phase of pitching. Muscular adaptations often occur following chronic eccentric loading, however, no study has evaluated the adaptations of the posterior scapular muscles with regard to throwing and their relationship with humeral retroversion (HR) in professional pitchers.

Hypothesis:

Significant chronic adaptations in muscle thickness (MT) and strength of the trapezius and rhomboids would be observed in healthy professional baseball pitchers, and there would be a significant relationship between humeral adaptations (ie, HR) and posterior scapular muscle adaptations (ie, strength and MT).

Study Design:

Cross-sectional; Level 3.

Methods:

A total of 28 healthy male professional baseball pitchers (age, 22 ± 2 years; mass, 95 ± 17 kg; height, 190 ± 7 cm) were included in the study. Bilateral isometric muscle strength of the upper trapezius (UT), middle trapezius, lower trapezius (LT), and rhomboids was measured during a maximum voluntary isometric contraction. Diagnostic ultrasound images of the UT, middle trapezius, LT, rhomboid major, and rhomboid minor muscles were collected bilaterally to measure MT. HR was also quantified bilaterally with ultrasound. Paired sample t tests were used to compare dominant and nondominant strength and MT. Pearson correlation coefficients were used to assess the relationship between HR, isometric strength, and MT.

Results:

A significantly increased MT of the LT was found on the dominant arm compared with the nondominant arm (5.4 ± 1.1 mm vs 4.4 ± 1.5 mm; P = 0.00). The Pearson correlation coefficient demonstrated a significant weak negative relationship between HR and rhomboid major MT ( P = 0.03; R = −0.36), and a significant weak negative correlation between HR and middle trapezius isometric strength ( P = 0.03; R = −0.37).

Conclusion:

LT thickness was greater in the throwing arm compared with the nonthrowing arm of pitchers, suggesting a positive adaptation of the LT. Interestingly, there was a weak negative relationship between HR and both rhomboid major MT and middle trapezius isometric strength. This negative relationship suggests that since increased HR leads to decreased internal rotation range of motion during deceleration, the scapula may be forced into anterior tilt and protraction, which can place excessive eccentric load on the rhomboid major and middle trapezius.
Introducing NASN’s Medication Administration in Schools Implementation Toolkit
Authors: DuChateau Teresa , Carr Bette
Published: April 2022

Evidence-based practice is an increasingly used term in health care. Clinical guidelines are evidence-based, incorporating the strongest research available and clinical expertise to make recommendations for practice prioritizing patient safety and improved patient outcomes. NASN recently published clinical guidelines for medication administration in schools. Subsequently, NASN published a toolkit—School Nursing Evidence-based Clinical Practice Guideline: Medication Administration in Schools Toolkit—to assist school nurses in applying the clinical guidelines to practice. Review and implementation of clinical guidelines and companion toolkits assist school nurses in maintaining current standards of practice as well as quality improvement measures.
A recovery mechanism for flap system of large aircraft with actuator failure
Authors: Zhou XC , Xue P , Luo YB , Lu JG , Zhang C
Published: April 2022

High-lift devices of transport aircraft reshape the wing in order to increase the lift of the aircraft during certain portions of flight. In order to increase its reliability, large transport aircrafts usually install the inter connection strut (ICS) as security devices. However, there are very limited publications on how to design the ICS, and how it works. There is a strong motivation for modeling and simulating the behavior of high-lift devices with ICS once failure happens and resulting design parameters. In this study, based on rigid-flexible coupling multi-body modeling technique, and dynamic response analysis of flap system under normal operation and failure state, a design method of ICS is proposed and the key parameters, that is, freely moving range and the mean crushing load of the energy absorber, are identified. The mitigation effect of ICS for actuator failure of flap system is clarified by analyzing the dynamic response of flap system with ICS. The results show that the ICS can reduce the peak driving torque of drive strut by 45.3%, and the unexpected rotation of the flap decreases by 66.2% after actuator failure happened.
Overall patient experience with a virtual hybrid hospital at home program
Authors: Maniaci Michael J , Torres-Guzman Ricardo A , Garcia John P , Avila Francisco R , Maita Karla C , Forte Antonio J , Paulson Margaret R
Published: April 2022

Objectives:

Traditional hospital at home models often have high patient experience scores. The purpose of this study is to look at the patient experience of a new virtual hybrid model of hospital at home called Advanced Care at Home.

Methods:

Patients in Mayo Clinic’s Advanced Care at Home program received a survey via email from 1 January–31 May 2021. Each survey consisted of 20 questions divided into 18 multiple-choice and two open-ended questions.

Results:

Ninety-nine surveys were sent and 41 partially or completely finished surveys were returned for a response rate of 41.4%. Patients responded positively, denoted by answering “strongly agree or somewhat agree,” with regard to the ability to reach the team right away 100% of the time, being kept informed 92% of the time, the command center responding promptly to their needs 95% of the time, the team providing comfort and support 98% of the time, feeling comfortable with interacting with their provider by phone or tablet 95% of the time, the ease of use from the equipment 97% of the time, the virtual and in-person staff working well together 98% of the time, the staff treating patients with courtesy and respect 100% of the time, and the ease of understanding the discharge process and feeling ready to leave the program 100% of the time. All providers received positive responses on listening ⩾88% of the time. Patients gave a top rating in likelihood to recommend the program 100% of the time.

Conclusion:

Overall, the Advanced Care at Home model of hospital at home was highly recommended by patients. Patients scored the program high on responsiveness, staff engagement and communication, ease of equipment use, and readiness for discharge, strengthening the overall confidence in this novel program.
Hematological abnormalities among adults with type 1 diabetes mellitus at the University of Gondar Comprehensive Specialized Hospital
Authors: Getawa Solomon , Adane Tiruneh
Published: April 2022

Objective:

Changes in the blood cell function, metabolism, and the coagulation system were associated with diabetes mellitus. This study aimed to determine the magnitude and associated factors of hematological abnormalities in adults with type 1 diabetes mellitus.

Methods:

A total of 204 medical charts of adults with type 1 diabetes mellitus who registered for follow-up at the University of Gondar Comprehensive Specialized Hospital were reviewed from June to August 2021. Data were collected using a structured data extraction checklist. To identify factors associated with hematological abnormalities, both bivariate and multivariate logistic regression analyses were done. Statistical significance was defined as a p-value of <0.05.

Results:

The overall magnitude of leukocytosis and anemia in adults with type 1 diabetes mellitus was 76.0% (95% confidence interval: 70.07–81.89) and 30.90% (95% confidence interval: 24.49–37.28), respectively. Neutrophilia and lymphocytosis were the common white blood cell abnormalities detected in 53.43% (95% confidence interval: 46.53–60.33) and 43.63% (95% confidence interval: 36.76–50.49) of the patients, respectively. Besides, thrombocytosis and thrombocytopenia were observed in 5.4% (95% confidence interval: 2.27–8.52) and 10.3% (95% confidence interval: 6.09–14.5) of the patients, respectively. Only being male (adjusted odds ratio = 2.28 (95% confidence interval: 1.46–5.29)) and duration of diabetes mellitus (⩾3 years) (adjusted odds ratio = 8.41 (95% confidence interval: 2.49–28.29)) were significantly associated with anemia and leukocytosis, respectively.

Conclusion:

Hematological abnormalities, particularly anemia and leukocytosis, are common in patients with type 1 diabetes mellitus. Therefore, preventive and control strategies for hematological abnormalities are essential in patients with type 1 diabetes mellitus particularly for male and patients with a long duration on diabetes mellitus to reduce the burden and related complications.
Determinants of long-acting reversible contraceptive use among women in Jawi woreda, North West Ethiopia: A case-control study
Authors: Asres Abiyot Wolie , Tiruneh Ayele Almaw , Ferede Addisu Gasheneit , Hunegnaw Woldeamilak Adamu
Published: April 2022

Objectives:

The utilization of long-acting reversible contraceptive methods is one of the key factors in protecting women and couples against unwanted pregnancies. The study aimed to assess the determinants of long-acting reversible contraceptive use among women in Northwest Ethiopia.

Methods:

A community-based unmatched case-control study was conducted from 1 February to 8 March 2017 in Northwest Ethiopia. The cases were women who used long-acting reversible contraceptive methods, and the controls were women who used short-acting contraceptives. Both of them were selected using a systematic sampling method. An interviewer-administered questionnaire was used to collect the data. Epi info and SPSS version 23 were used for data entry and analysis, respectively. Descriptive statistics and association measures were done and presented in texts, tables, and figures.

Results:

A total of 882 women were interviewed, with a response rate of 99.3%. Women who were between 15 and 24 years old were two times more likely to use long-acting reversible contraceptive methods than those whose age was ⩾35 (adjusted odds ratio = 2, 95% confidence interval: (1.20, 3.50)). A good level of knowledge about long-acting reversible contraceptive methods (adjusted odds ratio = 11.6, 95% confidence interval: (5.42, 24.80)), a negative attitude toward long-acting reversible contraceptive methods (adjusted odds ratio = 0.31, 95% confidence interval: (0.21, 0.46)), membership in the health development army (adjusted odds ratio = 2.8, 95% confidence interval: (2.12, 3.78)), no discussion with a partner about long-acting reversible contraceptive methods (adjusted odds ratio = 2.3, 95% confidence interval: (1.54, 3.49)), and more than 2 years of desire to wait before another pregnancy (adjusted odds ratio = 23.7, 95% confidence interval: (11.63, 48.55)) were determinants of long-acting reversible contraceptive methods use.

Conclusion:

This study revealed that attitude toward long-acting reversible contraceptive method use, being a member of the women’s health development army, and the desire to space children were determinants of long-acting reversible contraceptive method use. More actions should be taken to increase the utilization of long-acting reversible contraceptive methods by promoting discussion between partners about modern contraceptives and increasing women’s participation in being a member of the health development army.
The impact of the COVID-19 pandemic on the primary definitive management of ureteric stones
Authors: Lee Charlotte , Whitehurst Lily , Masani Alisha , Mackie Simon , Watson Graham
Published: April 2022

Objective:

To assess the management pathways of ureteric stones within our department and any impact on this as a result of the pandemic.

Patients and methods:

Retrospective data were collected at two different time points defined as ‘pre-COVID-19’, during April and May 2019, and ‘peri-COVID-19’, during April and May 2020 of all patients with ureteric stones.

Results:

Similar patient numbers presented with ureteric stones pre-COVID-19 (63) and during the pandemic (75). Pre-COVID-19, 31 patients were admitted, of which 48% had primary ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL). The average time to theatre was 1.2 days. During the pandemic, there were 34 admissions with 56% of these patients receiving primary URS/PCNL. The average time to theatre was 1.5 days. Of the patients referred to the virtual stone clinic, pre-COVID-19, 38% were listed for urgent-elective surgery which was performed at an average of 62 days. During the pandemic, 49% were listed for surgery, waiting 144 days for their procedure.

Conclusion:

Patients who underwent primary surgery during their first admission had their definitive treatment quicker during the pandemic. However, patients listed for elective procedures waited longer in the peri-COVID-19 period.

Level of evidence:

(Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009)): 2c
Picturing Opaque Power: How Conspiracy Theorists Construct Oppositional Videos on YouTube
Authors: Grusauskaite Kamile , Harambam Jaron , Aupers Stef
Published: April 2022

Conspiracy theories were once perceived as delusions of individuals on the fringes of society, but have become commonplace in mainstream culture. Today, they are produced, consumed, and circulated on various online media environments. From memes on 4chan, QAnon influencers on Instagram, to flat earth or antivaxx videos on YouTube, modern-day conspiracy culture embodies compelling mediated images and narratives that are composed of various audiovisual materials. Building on Stuart Hall’s encoding/decoding model, and Henry Jenkins’ notion of “participatory culture,” we analyze these audiovisual conspiracy theories as “oppositional readings” of hegemonic truths. More concretely, we analyze how conspiracy theorists reconstruct various audiovisual (mass-media) materials into streamlined narratives on YouTube videos to picture opaque power. Based on an in-depth qualitative analysis of 24 conspiracy theory videos, strategically selected from a larger sample of 200, we present three major categories of audiovisual narrative construction in conspiracy videos on YouTube: (1) Simulating: using fiction, religious and cultural images and narratives to render images of events otherwise invisible; (2) Deciphering: decoding hidden messages by “closely reading” images and looking for hidden symbolism; (3) Exhibiting: exposing information, research, and images that are “hidden in plain sight” but point to conspiracy. This article contributes to the growing body of literature on conspiracy theories by showing how they are not just texts, but should better be seen as media practices involving the recontextualizing of (mass)media material into new audiovisual conspiracy theory narratives. This shapes not just their content and form, but also their place in public discourse.
Three Social-Mediated Publics in Digital Activism: A Network Perspective of Social Media Public Segmentation
Authors: Ma Lingyan , Zhang Yueqian
Published: April 2022

This study provides a network perspective to segment social-mediated publics in digital activism based on social media users’ influence on the information dissemination process. We used social network analysis to segment publics based on their information sharing behaviors in the case of the Chinese #MeToo movement in 2018 on Sina Weibo. Besides, we conducted a content analysis to reveal the characteristics of each type of publics. We have identified three meaningful social-mediated publics in the Chinese #MeToo movement on Sina Weibo: (1) the provoking public, who plays an essential role in initiating the discussion; (2) the bridging public, which contributes to spreading the discussion to various groups of people; and (3) the powerful public, who has the advantages of the first two segments of publics and is the most powerful one in the formation and development of the online discussion. Three publics have different characteristics. The provoking public (e.g., media and internet celebrities) typically has many followers and is interested in various social issues. The bridging public has fewer followers (e.g., grassroots individuals) but tends to have a special interest in the issue and actively uses social media. The powerful public has a large number of followers, a particular interest in this issue, and is active on social media. This public segmentation provides a relatively new perspective to understand publics in digital activism in societies with strict social norms and media censorship. Limitations and future research are discussed.
The Effects of Cannabinoids on Sleep
Authors: Kolla Bhanu Prakash , Hayes Lisa , Cox Chaun , Eatwell Lindy , Deyo-Svendsen Mark , Mansukhani Meghna P.
Published: April 2022

The use of cannabis products to help with sleep and various other medical conditions by the public has increased significantly in recent years. Withdrawal from cannabinoids can lead to sleep disturbance. Here, we describe a patient who developed significant insomnia leading to worsening anxiety, mood, and suicidal ideation in the setting of medical cannabis withdrawal, prompting presentation to the Emergency Department and inpatient admission. There is a limited evidence base for the use of cannabis products for sleep. We provide a comprehensive review evaluating the literature on the use of cannabis products on sleep, including an overview of cannabis and related psychoactive compounds, the current state of the law as it pertains to the prescribing and use of these substances, and potential side effects and drug interactions. We specifically discuss the impact of cannabis products on normal sleep and circadian sleep-wake rhythms, insomnia, excessive daytime sleepiness, sleep apnea, parasomnias, and restless legs syndrome. We also describe the effects of cannabis withdrawal on sleep and how this increases relapse to cannabis use. Most of the studies are observational but the few published randomized controlled trials are reviewed. Our comprehensive review of the effects of cannabis products on normal sleep and sleep disorders, relevant to primary care providers and other clinicians evaluating and treating patients who use these types of products, shows that cannabis products have minimal to no effects on sleep disorders and may have deleterious effects in some individuals. Further research examining the differential impact of the various types of cannabinoids that are currently available on each of these sleep disorders is required.
Prevalence and Incidence of Patients With Fibromyalgia in Catalonia Between 2010 and 2017: A Descriptive Observational Study
Authors: Sauch Valmaña Glòria , Miró Catalina Queralt , Vidal-Alaball Josep
Published: April 2022

Objective:

To measure the prevalence and cumulative incidence of individuals diagnosed with fibromyalgia (FM) in Catalonia between 2010 and 2017.

Methods:

A retrospective observational study of the population of Catalonia between 2010 and 2017, both included, was designed to describe the incidence, prevalence, and sociodemographic characteristics of individuals diagnosed with fibromyalgia. A total of 56 098 patients were included in the study. The scope of the study were the 283 Primary Care Teams (PCT), all managed by the Instituto Catalán de la Salud [Catalan Institute of Health] (ICS).

Results:

The diagnosis of FM is higher in females (95.4%) than males (4.55%), with a mean age of 53.0 [45.0-61.0] years. The prevalence of FM in the total population was 0.4% in 2010 and 1.4% in 2017. The highest prevalence was found in the 55 to 65 age group (1.05% in 2010, and 2.46% in 2017). A relationship was found between the prevalence of FM and the degree of socioeconomic deprivation in urban areas: the greater the deprivation, the greater the prevalence of FM. The cumulative incidence of FM in the population remained constant over time (0.11% in 2010 and 0.10% in 2017), being more prevalent in women than men (0.18% women, 0.01% men in 2017).

Conclusions:

Our study confirms that FM is a prevalent disease in Catalonia, with an upward trend in recent years and it is more prevalent in women.
Clinical, Laboratory, and Ultrasound Related Diagnoses of Thyroid Disorders: Using a Family Medicine Center Data to Assess Thyroiditis and Thyroid Nodules in the Eastern Province of Saudi Arabia
Authors: Al-Shammari Malak A. , Abdel Wahab Moataza M. , AlShamlan Nouf A. , AlOmar Reem S. , Althunyan Abdullatif K. , Alghamdi Layla M. , Aldhawyan Adam Fahad , AlAmer Naheel A. , Elmaki Sara A. , Al Dandan Omran
Published: April 2022

Introduction/Objectives:

The prevalence of thyroid disorders is high in Saudi Arabia. Among the disorders, goiter and thyroiditis are the most common and have unique ultrasound (US) features, underscoring the need for US screening for thyroid pathologies. This study aimed to determine the prevalence of thyroiditis and thyroid nodules in patients attending the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University.

Methods:

This registry-based cross-sectional study analyzed laboratory and US data from 240 patients who attended the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University from January 2020 to December 2021. Abnormalities of the thyroid gland were categorized according to laboratory and US data. Associations between different types of thyroid pathology and clinical and laboratory findings were assessed using appropriate statistical methods.

Results:

The majority of participants were Saudi women. The prevalence of thyroiditis in the study population was 43%. Approximately 25% of these patients had more than 1 nodule, and fine-needle aspiration biopsy showed that most nodules were benign. Most nodules were found in clinically euthyroid patients. Thyroiditis might be associated with abnormal thyroid function.

Conclusions:

Thyroiditis and thyroid nodules were common in our cohort. Vitamin D deficiency, other autoimmune diseases, and a family history of thyroid disorders were associated with thyroiditis and thyroid nodules. US is useful for identifying the type of thyroid disease.
Comparison of Highly Intensive Home-Based Post-acute Care to Inpatient Program for Patients With Fragility Fractures After Surgery
Authors: Lee Min-Chang , Woung Lin-Chung , Tsauo Jau-Yih , Shih Shih-Liang , Chen Hung-Ming , Chu Da-Chen , Huang Sheng-Jean
Published: April 2022

Introduction

Evidence suggests that patients with fragility fractures would benefit from post-acute care (PAC); however, they have been subjected to varying PAC programs. This study aimed to compare the effectiveness of home-based PAC (HPAC) to inpatient PAC (IPAC) programs for patients with fragility fractures in Taiwan.

Materials and methods

This is a retrospective study that reviewed the medical records of patients who received HPAC or IPAC within three weeks after hip, knee, or spine fragility fractures in the Taipei City Hospital from September 1, 2017, to August 31, 2018.

Results

The mean age (78.9 ± 10.8 years) showed significant difference between the HPAC (age = 80.6 ± 11.1, n = 83) and the IPAC (age = 78.2 ± 10.6, n = 185) groups ( P = .049). After PAC, both HPAC and IPAC groups showed improvement on Barthel index, numerical pain rating scale, and Harris hip score (all P < .001). Patients in the HPAC group displayed greater improvement than the IPAC group on Barthel Index for activities of daily living (ADLs) by 5.8 (95% confidence interval, 3.0 to 8.5). The IPAC group had a significant longer length of PAC than the HPAC group (12.4 ± 3.0 vs. 11.1 ± 2.7, P < .001).

Conclusion

Both PAC programs could significantly improve functional performance and reduce pain in patients with fragility fractures. Patients treated in the HPAC group had better ADLs, and less length of PAC.
Epidemiology of Fragility Pubic Ramus Fractures in the United States
Authors: Suneja Nishant , Kong Ryan M , Tracey Olivia C , Mallon Zachary , Tischler Eric H.
Published: April 2022

Introduction

Previous studies illustrate significant increases in pelvic fracture incidence; however, there is a paucity of information on the incidence of osteoporotic pelvic ring injuries based on large-scale examinations of geographically and ethnically diverse populations. This study addresses the epidemiology of osteoporotic pubic ramus fractures in the United States and details differences in incidence rates with respect to age, gender, and race.

Materials and Methods

National Electronic Injury Surveillance System (NEISS) data between 2002 and 2019 was gathered for individuals aged 60 and above presenting to U.S. emergency departments with ramus fractures. Incidence rates for ramus injuries were calculated using adjusted U.S. Census Bureau estimates of population. Fracture incidences were calculated for age, gender, and race strata.

Results

The overall incidence rate of pubic ramus fractures in the United States between 2002 and 2019 was 13.47 per 1,000,000 people 60 years and older (95% confidence limit: 9.92-17.01). The incidence of pubic ramus fractures for females in the US was 21.71 (16.08-27.34). Rates of ramus fracture increased overall ( P < .001) and for both genders between the ages of 60 and 100, though the rate increase was significantly greater in females than in males ( P < .001). In terms of race, incidence was highest Asian females and lowest in Native American and Pacific Islander men.

Discussion/Conclusion

: As the first national study addressing the epidemiology of ramus injuries in the United States, this work reveals these injuries comprise a significant fracture risk in the elderly. In addition, it highlights gender and ethnic strata that are more susceptible to these injuries.
The Covid 19 Pandemic Effect on the Epidemiology of Thoracolumbar Fractures Presenting to the Emergency Department in Patients Above 65 years Old
Authors: Lotan Raphael , Prosso Ilia , klatzkin Lev , Hershkovich Oded
Published: April 2022

Introduction

Studies investigating the Covid-19 Pandemic’s orthopedic aspects are accumulating, including reports on a 10-33% decrease in hip fracture incidence alongside shorter times to surgery. Osteoporotic vertebral compression fractures (VCF) have not yet been discussed. This study evaluated the effect of the Covid-19 pandemic’s first wave on VCF in the elderly.

Method

A retrospective cohort of elderly patients diagnosed with VCF between 2018-19 (Pre-Covid-19 pandemic) to 2020.

Results

The cohort included 172 patients above 65 years with VCF during 2018-2020. Patients’ age and gender were similar between the two study groups. We found a higher proportion of high-energy VCF during 2020 (10.5% vs 6.7%). Incidence of recurrent fractures was 7.5 times higher during 2020 (5.3% vs .7%, P =.06), and significantly higher rates of Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis in 2020 (7.9% vs 1.5%, P=.04). VCF ED admission rates were similar, with 60% treated conservatively. Admitted patients underwent more surgeries in 2020 (66.7% vs 60%, P =.71) and a tendency towards Precoutaneus Balloon Kyphoplasty (BKP) + fixation compared with BKP alone (15.8% in 2020 vs 7.5% in 2018-19, P =.29). RR for BKP + fixation vs BKP alone was 1.95, suggesting higher odds for a more complex surgery during the Covid-19 pandemic. The complication rate was significantly higher during 2020 (18.4% vs 3.7%, P <.001). Admission length was slightly longer during 2020 (12.2 days vs 9.9 days, P = .27), and time to surgery was marginally longer, 6.25 vs 5.3 days ( P = .55). Many patients chose home over institutional rehabilitation during the Covid-19 pandemic (72.2% vs 58.8%).

Conclusion

The Covid-19 pandemic did not alter VCF incidence, but patients’ characteristics changed, affecting admissions, institutional rehabilitation, and a tendency towards complex surgery rather than BKP alone. It is still unclear if Covid-19 will remain an issue in the upcoming years, but its impact and lessons are still worthwhile.
Trajectories of Self-Esteem Development for Adolescence Based on China Family Panel Studies: A Piecewise Growth Mixture Model Analysis
Authors: Huang Jiaqin , Xie Xin , Pan Yuxi , Li Guangming , Zhang Fadi , Cui Ningjing
Published: April 2022

Self-esteem has always been a hot research object in the field of adolescent mental health. But in longitudinal research, using a single slope to describe the trajectory of adolescent self-esteem is unrealistic. The piecewise growth mixture model (PGMM) was used to fit the data in this study. Selecting from China Family Panel Studies database, a total of 1,759 individuals were selected and their self-esteem (RSES) scores over the years were used as the tracking index. Based on the characteristics of the development trajectories of three latent classes, class 1 was referred to as “stable low level group,” class 2 was named “rapidly rising group,” and class 3 was referred to as “rapidly decrease group.” And there were two stages in the development process of self-esteem in the adolescent group. The slope of the stable low level group showed a significant downward trend in the first stage and a significant upward trend in the second stage, with a relatively flat development trajectory and relatively low self-esteem on the whole. The slope of the rapidly rising group showed an insignificant upward trend in the first stage and a significant rapid upward trend in the second stage. The rapidly decrease group showed a significant and rapid downward trend in the first stage and a significant and rapid upward trend in the second stage. In the development of self-esteem in adolescence, there were three latent classes in which the characteristics of development trajectories were different. Age of 14 is the turning point between the two stages of development.