bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidents relating to paediatric regional anaesthesia in the first 8000 cases reported to webAIRS
Authors: Mistry Manisha M , Endlich Yasmin
Published: October 2023

Regional anaesthesia is an essential tool in the armamentarium for paediatric anaesthesia. While largely safe and effective, a range of serious yet preventable adverse events can occur. Incidence and risk factors have been described, but few detailed case series exist relating to paediatric regional anaesthesia. Across Australia and New Zealand, a web-based anaesthesia incident reporting system enables voluntary reporting of detailed anaesthesia-related events in adults and children. From this database, all reports involving paediatric regional anaesthesia (age less than 17 years) were retrieved. Perioperative events and their outcomes were reviewed and analysed. When offered, the reported contributing or alleviating factors relating to the case and its management were noted. This paper provides a summary of these reports alongside an evidence review to support safe practice. Of 8000 reported incidents, 26 related to paediatric regional anaesthesia were identified. There were no deaths or reports of permanent harm. Nine reports of local anaesthetic systemic toxicity were included, seven equipment and technical issues, six errors in which regional anaesthesia made an indirect contribution and four logistical and communication issues. Most incidents involved single-shot techniques or a neuraxial approach. Common themes included variable local anaesthetic dosing, cognitive overload, inadequate preparation and communication breakdown. Neonates, infants and medically complex children were disproportionately represented, highlighting their inherent risk profile. A range of preventable incidents are reported relating to patient, systems and human factors, demonstrating several areas for improvement. Risk stratification, application of existing dosing and administration guidelines, and effective teamwork and communication are encouraged to ensure safe regional anaesthesia in the paediatric population.
My Tribute to Herb Gintis
Authors: Weisskopf Thomas E.
Published: October 2023

This is a tribute to Professor Herbert Gintis, a highly original social scientist who passed away in January 2023. Professor Gintis—often together with his lifelong friend and colleague Professor Samuel Bowles—authored numerous pathbreaking articles and books that have contributed greatly to our understanding of human behavior under various social, political, and economic conditions.

JEL Classification: B3, B5
An introduction to György Márkus’s aesthetics: Transformation from praxis aesthetics to theory of aesthetic modernity
Authors: Qilin Fu
Published: October 2023

György Márkus, as a leading member of the Budapest School led by György Lukács in Hungary, is closely concerned with aesthetics. His final unfinished writings in political exile in Sydney were focused on the question of modern cultural autonomy. From the 1960s to the new century, from Budapest to Sydney in Australia, he established a new form of Neo-Marxist aesthetics on the basis of critical theory drawn from Lukács to the Frankfurt School. His aesthetics includes three dimensions: an aesthetics of praxis, a reconstruction of Lukács’s aesthetics and a theory of aesthetic modernity. His aesthetics is characteristic of analytic philosophy, especially ‘categorical analysis’. It shifts from philosophical aesthetics in the Hungarian period, which is based on an ontological foundation, that is, materialist phenomenology, to social or sociological aesthetics in the Australian period concerning social modernity, institution, constitution, culture, and so on. This is a turn from a philosophical paradigm to a structural one as regards aesthetics, which indicates a break with Lukács’s late return in the early 1960s to Hegelian inspired Ontology of Social Being. Márkus is strictly and essentially an essayist in fragments, who distinguishes himself from the other members of the Budapest School in this way. Ironically, this genre is once again influenced by the young Lukács’s aesthetics.
Measuring Civic Engagement in Young Children
Authors: McLoughlin Shane , Polizzi Gianfranco , Harrison Tom , Moller Francisco , Maile Andrew , Picton Irene , Clark Christina
Published: October 2023

There is a dearth of studies exploring how younger children engage in civic life, what may be expected of them given their age, and what instruments may be used to capture their levels of civic engagement. Addressing these questions, this article presents key findings from a pilot study that aimed to create a validated instrument designed to measure the civic engagement of primary school children. Based on a survey administered to 655 primary school children aged 9–11 across England, this article focuses on the new measure that was specifically designed, and then tested and validated through both exploratory and confirmatory analyses. The findings validate a tripartite measure of civic engagement that assesses the civic attitudes, actions and awareness of 9–11-year-olds. This measure was found to be both practical and efficient in its administration, and it has been shown to be easily comprehensible by this age group. This new measure addresses an important gap in the literature on civic engagement in children, providing researchers with a validated tool to effectively measure civic engagement in 9–11-year-olds. The findings have implications for both researchers and educators interested in designing and evaluating interventions aimed at promoting civic engagement among younger children.
The Impact of Puzzle-Based Game With Scaffolding-Aid on Cultural Heritage Learning: Evidence From Eye Movements
Authors: Ye Li , Wang Ruoyan , Hang Yongxin
Published: October 2023

The pedagogical value and global relevance of heritage education regarding the safeguarding of global tradition and practice for future generations is indisputable. This research aims to investigate the efficacy of integrating a puzzle-based game, with scaffolding strategies, to enhance students’ understanding and appreciation of cultural heritage content. In the activity, students are tasked with reconstructing art patterns from cultural heritage artifacts, a process which is designed to bolster their performance in recognizing and appreciating such patterns. A control group, utilizing a non-interactive instructional video with the same content, was also established to contrast and evaluate the benefits of the game-based approach. The evaluation of knowledge acquisition and transfer was conducted through pattern tests, with the participants’ eye movements recorded during the testing process. The results show that the participants in the game group exhibited significant advantages in terms of efficiently recognizing fundamental content and effectively transferring pattern recognition. Furthermore, the examination of the visual behavior within the game reveals that the integration of the jigsaw puzzle (game mechanic) and scaffolding (instructional strategy) can enhance the efficacy and cognitive strategies employed by participants in comprehending heritage content. This study develops design methodologies for cultural heritage games that enhances learning and appreciation.
Intimate Partner Homicide: Comparison Between Homicide and Homicide-Suicide in Portugal
Authors: Gonçalves Mariana , Gomes Eduardo , Matos Marlene
Published: October 2023

Intimate partner homicide (IPH) is a tragic event. Studies involving the comparison between IPH and intimate partner homicide-suicide (IPH-S) are scarce, with few studies in Portugal about this issue. The current study aims to compare IPH and IPH-S perpetrators, the victim–perpetrator relationships dynamics, and homicide circumstances. The data was collected through the analysis of 78 judicial processes of IPH that occurred in Portugal, between 2010 and 2015. Of the cases, 51 were IPH, 20 were IPH-S cases, and seven were attempted suicide cases, being perpetrated in 84.6% ( n = 66) for male perpetrators. Suicide after intimate homicide were all committed by men. All judicial processes analyzed refer to heterosexual relationships. Bivariate and multivariate analyses were performed to compare the groups concerning perpetrator and victim sociodemographic characteristics, victim-perpetrator dyadic dynamics, and crime circumstances. The results show mostly common trends between the two groups with some differentiating factors when compared individually (e.g., perpetrator professional status, criminal records). Regression logistic analysis showed no differences between IPH and IPH-S.
Personality and mental disorders: sensitive character, melancholic type, and addenda
Authors: Daker Mauricio Viotti
Published: October 2023

A traditional view in psychiatry is that personality disorders or traits are intimately related to primary mental disorders. Psychic functions with common roots might be constitutive of personality and psychosis or other disorders. Hoche held that paranoia, mania and melancholia lie in the normal psyche, and Kraepelin conceded such a view, explicitly implying personality. According to Carl Schneider, endogenous symptom complexes or associations and normal functional associations are fuzzy. Many other psychopathologists emphasize personality characteristics in connection with endogenous or functional psychoses, such as the sensitive and melancholic types. When adopting a continuum view of mental disorders, they behave in a unitary or systemic configuration, corresponding to endogenous-functional dispositions interacting with the milieu and composing personality.
Syngas production from aqueous phase reforming of glycerol–water mixture for compression ignition engine
Authors: Kandasamy Vetrivel Kumar , Munimathan Arunkumar , Rajendran Silambarasan , Dhairiyasamy Ratchagaraja
Published: October 2023

Syngas produced from glycerol using aqueous phase reforming for nickel-based catalysts with different support materials were tested in a compression ignition (CI) engine. Experiments were conducted using nickel–alumina, nickel–lanthanum (NL), and nickel–ceria catalysts at 1:1, 1:2, 1:3, and 1:4 glycerol–water ratios and temperatures of 240°C, 260°C, and 280°C. The NL catalyst showed the highest syngas and hydrogen yield of 90.58% and 76.42%, respectively, at 1:3 ratio and 260°C. The optimized NL syngas and diesel were tested in a CI engine at 6 to 30 lpm flow rates. At 30 lpm flow, brake thermal efficiency increased by 3.15%, NOx emission was reduced by 21.22%, and smoke lowered significantly compared to diesel. The faster hydrogen combustion in syngas increased the heat release rate and cylinder peak pressure. CO and HC emissions increased at lower loads due to diluted combustion but reduced at higher loads. NL showed the best performance and emissions among the syngases due to higher hydrogen content. In summary, the NL syngas at 30 lpm showed great potential in CI engines by improving combustion and performance and reducing emissions.
Energy and exergo-economic analysis of a parallel feed multi-effect system integrated with humidification–dehumidification system for brine recovery
Authors: Shamet Osman , Qureshi Bilal A. , Antar Mohamed
Published: October 2023

Desalination technologies reject large amounts of brine with significant value back to sea. The concept of hybridization of different desalination technologies has proven that it can be effective in terms of reducing rejected brine and increasing the freshwater production rate as well as reducing the freshwater cost. In this work, brine recovery to improve water production through a simple modified configuration of integrating a multi-effect desalination (MED) system with humidification–dehumidification system (HDH). The rejected brine of the MED system is used as the feed for the HDH system without the need for preheating the rejected brine since it leaves the MED at a suitable temperature for HDH application. The study focuses on investigating the effect of different operating conditions on the increase in system freshwater production rate and recovery ratio as well as the exergetic efficiency. Parameters investigated include steam temperature, feed salinity, number of brine streams, cooling water flow rate, and ambient temperature. An exergo-economic analysis has also been conducted using the cost flow method to evaluate the freshwater production cost for the modified system. Results indicate that the integration of HDH can increase the water production rate by a maximum of 7.82% and produce fresh water at 2.08 $/m3 compared to 2.094 $/m3 when using the standalone system under the same conditions.
Family Ownership After Going Public: Exploring Nonlinear Effect on Innovation Inputs and the Role of Institutional Investors
Authors: Battaglia Francesca , Ossorio Mario , Fiorillo Paolo , Salerno Dario
Published: October 2023

Understanding the drivers of innovation in family firms is essential for their survival. While previous studies have mainly investigated innovation behaviours in private or public family firms, we focus on their R&D investment in the year following an IPO. Observing family firms in this context is crucial because it allows to analyse their propensity to innovate when financing constraints are relaxed. This work aims to investigate whether a relationship exists between R&D expenditures and family ownership in the setting of Initial Public Offerings (IPOs). Using a sample of IPOs in the period 2013–2018 by 132 French and Italian family and non-family firms, results reveal the existence of a U-shaped relationship in this regard. In addition, the curvilinear relationship is positively influenced by institutional investors. This study contributes to the debate around family firms’ innovation propensity, as well as to the literature on the heterogeneity among family firms.
Does Public Sentiment Impact Stock Price Movements? Evidence from India
Authors: Banerjee Aditya , Kundu Sayantan
Published: October 2023

This study analyses the impact of a weighted measure of public sentiment about firms on their stock price movement using a sample of 5.4 million tweets from the official Twitter handles of the 437 largest Indian firms. This article contributes to the literature by finding that general public discussion about firms and the resulting sentiment impact firms’ stock price movement in India. Moreover, the impact is greater during trading hours than off-market hours due to immediate action by traders in the former. It is also found that negative public sentiment has a more significant impact than positive sentiment on returns and volatility.

JEL Codes: G14, G40, G41
Multiomics Approach Reveal Novel Insights in FUS Driven Juvenile Amyotrophic Lateral Sclerosis: A Family Quartet Analysis
Authors: Verma Sagar , Khurana Shiffali , Gourie-Devi Mandaville , Anand Ish , Vats Yuvraj , Singh Arpita , Jothiramajayam Manivannan , Kshetrapal Pallavi , Sharma Ankkita , Wajid Saima , Ganguly Nirmal Kumar , Chakraborti Pradip , Taneja Vibha
Published: October 2023

Background

Juvenile amyotrophic lateral sclerosis (JALS) is a rare and severe form of motor neuron disease characterized by progressive loss of upper and lower motor neurons with an early onset (<25 years).

Purpose

Due to complex etiology and clinical heterogeneity, it is indispensable to unravel molecular mechanisms underlying JALS pathology. The study aimed to identify disease-specific signatures in a 14-years-old sporadic JALS patient.

Methods

Genomic, transcriptomic, and metabolomic analysis of proband and first-degree relatives (FDR).

Results

Exome sequencing identified a novel de novo frameshift variation (c.1465dupG: p.D490Gfs*26) in the fused in sarcoma (FUS) gene in proband. Interestingly, rare and potentially deleterious, disease-modifying variations in DDHD domain containing 1 (DDHD1) and fibrillin 2 (FBN2) were observed. Differentially expressed genes (DGEs) enriched in neuromuscular transmission and inflammatory response were identified by RNA-sequencing. In addition, alterations in purine and pyrimidine, vitamin B6, and sphingolipid metabolism reflect the involvement of inflammatory process in disease pathobiology.

Conclusion

Our findings suggest the involvement of multiple genetic factors coupled with hampered neuromuscular transmission and systemic inflammation in the onset and disease course of JALS.
Apocrine carcinoma-and-malignant myoepithelioma in a dog: a case of simultaneous malignant progression of both luminal epithelium and myoepithelium
Authors: Matsumoto Kana , Kishimoto Takuya Evan , Yamamoto Masami , Michishita Masaki , Takahashi Kimimasa , Yoshimura Hisashi
Published: October 2023

A 9-y-old male Boxer dog developed a mandibular skin tumor, which histologically had a locally invasive growth pattern composed of bilayered structures of inner eosinophilic cuboidal tumor cells and outer clear polygonal tumor cells with cytoplasm containing glycogen granules. Both cell populations gradually changed from low-grade morphologic features to highly anaplastic ones. Immunohistochemically, the eosinophilic tumor cells were positive for cytokeratin 8, a useful marker for luminal epithelial cells. In contrast, the clear tumor cells expressed several myoepithelial markers, including α-smooth muscle actin, p63, and cytokeratin 14. Based on these histologic and immunohistochemical characteristics, we diagnosed this apocrine sweat gland tumor as a carcinoma-and-malignant myoepithelioma with high-grade transformation of both luminal and myoepithelial cells. Our case may be a helpful reference for the histogenesis of carcinoma-and-malignant myoepithelioma, in which both the luminal epithelial and myoepithelial components are malignant.
Measuring the Unilateral Cleft Lip Nasal Deformity: Lateral Deviation of Subnasale Is a Clinical and Morphologic Index of Unrepaired Severity
Authors: Tse Raymond W. , Sitzman Thomas J. , Allori Alexander C. , Ettinger Russell E. , Fisher David M. , Bezuhly Michael , Samson Thomas D. , Beals Stephen P. , Matic Damir B. , Mercan Ezgi
Published: October 2023

Objective

Objective measurement of pre-operative severity is important to optimize evidence-based practices given that the wide spectrum of presentation likely influences outcomes. The purpose of this study was to determine the correlation of objective measures of form with a subjective standard of cleft severity.

Design

3D images were ranked according to severity of nasal deformity by 7 cleft surgeons so that the mean rank could be used as the severity standard.

Patients

45 patients with unilateral cleft lip and 5 normal control subjects.

Interventions

Each image was assessed using traditional anthropometric analysis, 3D landmark displacements, and shape-based analysis to produce 81 indices for each subject.

Main Outcome

The correlation of objective measurements with the clinical severity standard.

Results

Lateral deviation of subnasale from midline was the best predictor of severity (0.86). Other strongly-correlated anthropometric measurements included columellar angle, nostril width ratio, and lateral lip height ratio (0.72, 0.80, 0.79). Almost all shape-based measurements had tight correlation with the severity standard, however, dorsum deviation and point difference nasolabial symmetry were the most predictive (0.84, 0.82).

Conclusions

Quantitative measures of severity transcend cleft type and can be used to grade clinical severity. Lateral deviation of subnasale was the best measure of severity and may be used as a surrogate of uncoupled premaxillary growth; it should be recorded as an index of pre-operative severity with every cleft lip repair. The correlation of other measures evaluated clarify treatment priorities and could potentially be used to grade outcomes.
Unraveling the Patterns of Complexity in Transnational Corporate Bribery
Authors: Chan Fiona , Boratto Rachel , Gibbs Carole , Speers Mark
Published: October 2023

Scholarship on white-collar and corporate crime often notes that these crimes are complex due to their scale, longevity, and hidden, layered, and global nature. Embedded in these discursive descriptions is the assumption that complexity is unidimensional and operates solely in a linear fashion. Yet, corruption and transnational bribery are the results of a complex system that involves diverse actors interacting in dynamic environments, which can produce multiple classes of outcomes that may include different patterns of complexity in crime. In this paper, we empirically explore potential variability in patterns of complexity in transnational corporate bribery using official data from cases prosecuted under the Foreign Corrupt Practices Act in the United States. Our findings indicate that crime “complexity” can take different forms, suggesting that the relationship between variables can unfold in dynamic ways. Implications for theory and practice are discussed.
Corruption, Elite Contestation, and Parliaments: Why Do Legislatures Become Stronger in Authoritarian Regimes?
Authors: Wiebrecht Felix
Published: October 2023

A growing body of literature studies the personalization of power in authoritarian regimes. Yet, how institutions can become a credible constraint to dictatorial rule is less widely studied. I theorize that corruption is a key factor associated with stronger legislatures in authoritarian regimes. By engaging in corruption, authoritarian elites in ruling coalitions can build up networks of support and influence and ultimately, use their elevated position to impel more legislative powers vis-à-vis the executive. Examining panel data on the strength of legislatures in authoritarian regimes between 1946 and 2010, I show empirically that authoritarian parliaments are stronger when levels of corruption in a given regime are high. The link between corruption and legislative strength is especially strong in the Middle East and Africa, and primarily applies to party-based and military dictatorships. More competitive electoral and legislative processes, however, do not uniformly affect parliaments’ strength. These findings contribute to our understanding of institutional changes in autocracies and highlight the centrality of elite contestations in determining institutional trajectories.
Coagulation Factors and Natural Anticoagulants as Surrogate Markers of Preeclampsia and Its Subtypes: A Case–Control Study in a Ghanaian Population
Authors: Mintaah Selina , Anto Enoch Odame , Boadu Wina Ivy Ofori , Sackey Benedict , Boateng Lilian Antwi , Ansah Ezekiel , Korsah Emmanuel Ekow , Frimpong Joseph , Tamakloe Valentine Christian Kodzo Tsatsu , Selleh Peter Kuugemah , Afrifa David Amoah , Saasi Abdul-Razak , Senu Ebenezer , Duah Lawrence Agyemang , Opoku Stephen , Amoah John Paul , Adu Patrick , Boachie Joseph , Nyamekye Dorcas Asamoah , Sackey David Sebbie , Wiafe Yaw Amo , Addai-Mensah Otchere
Published: October 2023

Preeclampsia (PE) is associated with endothelial injury and hemostatic abnormalities. However, the diagnostic role of coagulation parameters and natural anticoagulants in predicting PE has not been explored in Ghana. This study assessed plasma levels of these factors as surrogate markers of PE and its subtypes. This case–control study included 90 women with PE (cases) and 90 normotensive pregnant women (controls). Blood samples were drawn for the estimation of complete blood count and coagulation tests. The prothrombin time (PT), activated partial thromboplastin time (APTT), and the calculation of the international normalized ratio (INR) were determined by an ACL elite coagulometer while the levels of protein C (PC), protein S (PS), antithrombin III (ATIII), and D-dimers were also measured using the solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) method. All statistical analyses were performed using the R Language for Statistical Computing. Results showed significantly ( p < .05) shortened APTT (28.25 s) and higher D-dimer levels (1219.00 ng/mL) among PE women, as well as low levels of PC (1.02 µg/mL), PS (6.58 µg/mL), and ATIII (3.99 ng/mL). No significant difference was found in terms of PT and INR. From the receiver operating characteristic analysis, PC, PS, and ATIII could significantly predict PE and its subtypes at certain cutoffs with high accuracies (area under the curve [AUC] ≥0.70). Most women with PE are in a hypercoagulable state with lower natural anticoagulants. PC, PS, and ATIII are good predictive and diagnostic markers of PE and its subtypes (early-onset PE [EO-PE] and late-onset PE [LO-PE]) and should be explored in future studies.
Industry Culture Matters: Sexual Harassment in the South Korean Film Industry
Authors: Lee Heeyoung , Moon Soo-Yeon , Lee Na-Young
Published: October 2023

This study analyzes factors of sexual harassment in the workplace based on sample survey data on women working in the Korean film industry ( n = 449) using logistic regression analysis. It finds higher education, younger age, and union membership increase harassment risk, suggesting backlash against feminism post-#MeToo. A higher proportion of men at shooting locations raises harassment likelihood, reflecting the industry's unique conditions. Longer work hours also increase harassment probability. The findings highlight the importance of considering industrial context in addressing workplace harassment. They emphasize the need for policies improving gender representation in film.
CIAP1/2 can regulate the inflammatory response and lung injury induced by apoptosis in septic rats
Authors: Liu Xiaoyu , Chen Jie , Li Zhonghao , Gao Nan , Zhang Guoqiang
Published: October 2023

Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), induced by sepsis, is predominantly caused by inflammation injury. However, there is no clear consensus on how to regulate the inflammatory response. The TNF pathway is one of the primary inflammatory pathways activated in sepsis. cIAP1/2, an essential E3 ubiquitin ligase in the TNF pathway, plays a pivotal role in positively regulating the activation of nuclear factor κB (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways to promote inflammation while inhibiting apoptosis. We found that Birc2 is the only differential expression gene in TNF pathway, and both cIAP1/2 upregulated in lung lysate with worsen lung injury. However, upon inhibiting cIAP1/2 using AZD5582, lung cell apoptosis was reactivated, and a significant improvement in lung injury was observed. Our study shows that cIAP1/2 expression increased in the lung tissue of a CLP rat ALI model. Inhibiting cIAP1/2 with AZD5582, a second mitochondria-derived activator of caspases (SMAC) mimetic, induced increased apoptosis and reduced lung injury. Therefore, inhibiting cIAP1/2 can alleviate sepsis-induced ALI, providing a new target for regulating organ damage induced by sepsis-induced inflammatory responses.
Neovascularization against autologous SLET donor grafts despite successful corneal epithelialization and graft adherence
Authors: Pan Warren , Nallasamy Nambi
Published: October 2023

Purpose

To report a case of neovascularization against autologous grafts after simple limbal epithelial transplantation (SLET) despite successful corneal epithelialization, as well as its subsequent regression without intervention.

Methods

A case report and review of the literature.

Results

A 52-year-old woman underwent uncomplicated autologous SLET for asymmetric limbal stem cell deficiency (LSCD) in the left eye. One month after the surgery, the patient had successful adherence of the graft and corneal epithelialization; however, new neovascularization developed in the left eye towards the graft sites. With only a slow taper of topical prednisolone acetate and polymyxin b/trimethoprim, the neovascularization regressed to ghost vessels over the following three months with improvement of her LSCD symptoms and increased clarity of her cornea.

Conclusion

The limbus does not enjoy relative immune privilege like other parts of the eye; therefore, autologous limbal stem cell transplantation (along with the minimal immune response generated) is valuable for restoration of the ocular surface. Here, we describe neovascularization against autologous donor grafts despite an otherwise uncomplicated surgery and expected epithelialization course. Inflammation-mediated angiogenesis likely initiated the neovascularization, suggesting that immune mediators of inflammation may be inadvertently part of the graft tissue in bilateral LSCD.
Bilateral evolution of OCT biomarkers in dry AMD: Long-term follow up study
Authors: Samanta Anindya , Arora Supriya , Jhingan Mahima , Singh Sumit , Amarasekera Sohani , Tucci Davide , Cagini Carlo , Lupidi Marco , Chhablani Jay
Published: October 2023

Purpose

To report the emergence and progress of four late-stage characteristics: incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) and complete RPE and outer retinal atrophy (cRORA), drusen ooze and drusen collapse in eyes with dry age-related macular degeneration (AMD) using Spectral Domain Optical Coherence Tomography (SD-OCT).

Methods

This was a retrospective analysis of eyes with non-exudative AMD. Multimodal imaging was done at follow up visits ≤ 12 months. OCT volume scan was used to assess and identify the 4 characteristics. Univariate analysis was done for the various demographic and clinical characteristics. Patients with a mean age of 76.7 ± 10 years were followed up for 69.9 ± 20.6 months. iRORA, cRORA, drusen ooze was present in 15.6%, 15.6% and 15.6% of patients at baseline, respectively, and 25.0%, 40.6% and 53.1% of patients at the final follow-up, respectively. At baseline 9.1%, 0% and 9.1% of patients had bilateral drusen ooze, iRORA and cRORA, respectively. By the final follow-up, drusen collapse occurred in 46.9% and 18.8% patients in unilateral and bilateral eyes, respectively. For bilateral cases, the mean interval of time between emergence inthe two eyes for drusen ooze, drusen collapse, iRORA, and cRORA was 5 ± 1.4 years, 2.2 ± 2.2 years, 3.5 ± 0.7 and 1.7 ± 0.6 years, respectively.

Conclusions

Late-stage OCT biomarkers are seen bilaterally at 21.9% at baseline and at 56.3% at 5.8 years follow-up. Once present in one eye, cRORA had the shortest mean interval before appearance in the other eye.
Spontaneous Pneumomediastinum in a 15-Year-Old Adolescent After Unintended Overexposure to Paint Diluent (Thinner) Fumes: First Reported Case
Authors: Barzallo Tania P , Marchan Claudia A , Salgado Octavio J , Espinosa Hermel M
Published: October 2023

Spontaneous pneumomediastinum (SPM) is the presence of air in the mediastinal interstices in the absence of any surgical or medical procedure, chest trauma, or mechanical ventilation. SPM can occur during vigorous Valsalva maneuvers, such as weight lifting, coughing fits, hyperemesis gravidarum, and so on, or during inhalation of illicit substances or toxic agents, as a result of an abrupt increase in pressure in the tracheal tree. Preexisting underlying lung disease may be a contributing factor. In the present case, we report for the first time an SPM due to accidental overexposure to paint thinner in a 15-year-old male from a low-income rural family. He was offered a job painting the inside of a house, which he accepted to earn some money for the family household. However, due to his inexperience, he overdosed on a can of paint with thinner. About 2 h after starting work, he began to feel increasingly severe chest pain and had to be rushed to the local level one basic hospital by his parents. Physical examination revealed subcutaneous emphysema over the supraclavicular area and crackles in the precordial area. Chest radiographs showed a pneumomediastinum. In retrospect, the patient denied coughing or sneezing attacks after exposure. He was transferred to a regional tertiary hospital for further diagnostic evaluation to rule out airway/esophageal perforation. Chest computed tomography confirmed underlying SPM and subcutaneous emphysema. The oesophagogram and bronchoscopy were unremarkable. SPM, possibly secondary to overexposure to thinner vapors, a hydrocarbon-based compound, was the final diagnosis. The patient was discharged asymptomatic on day 5.
Safety of anti-varicella zoster virus vaccination in patients with multiple sclerosis treated with natalizumab: A case series
Authors: Lapucci Caterina , Boccia Vincenzo Daniele , Sirito Tommaso , Cellerino Maria , Mikulska Malgorzata , Sticchi Laura , Inglese Matilde
Published: October 2023

The vaccination with live attenuated vaccines is generally not recommended during natalizumab (NTZ), as it is included among immunosuppressive/immunomodulating therapies. Nevertheless, considering the lack of evidence of a non-Central Nervous System (CNS) immunosuppressive effect of NTZ, after a risk/benefit evaluation, we decided to vaccinate four multiple sclerosis (MS) patients (three with an indication to switch to ocrelizumab for high-risk Progressive Multifocal Leukoencephalopathy (PML) and one for pregnancy planning). No vaccine-related adverse events of any type nor varicella zoster virus (VZV) infections were observed. To the best of our knowledge, these case series represent the first description of the good safety profile of anti-VZV vaccination in MS patients during NTZ treatment.
Preservice classroom teachers’ views and experiences of teaching physical education: Does taking a physical education specialization matter?
Authors: Tsangaridou Niki , Charalambous Charalambos Y , Kyriakides Ermis
Published: October 2023

Although in recent years there has been growing attention on how preservice classroom teachers (PCTs) learn to teach physical education (PE), it is still unclear if there are differences between PCTs who choose a PE specialization and those who do not. Investigating such differences could provide insights about the potential role of a PE specialization in PCTs’ learning. In this context, the purpose of this study was to explore the views and experiences of teaching PE of two groups of PCTs—one with a PE specialization and another without—during their student teaching. Data gathered through semi-structured interviews with 14 Cypriot PCTs, seven with a PE specialization and seven with no such specialization, were analyzed inductively. Although this analysis yielded similarities in the participants’ views on motor, cognitive, and affective domains, notable differences were also identified between participants’ views. PCTs in the PE specialization group emphasized more the correct performance and application of skills in games, seemed to feel more confident regarding their practices in teaching PE, and were largely concerned with the content being appropriate to students’ level. Conversely, participants in the no-specialization group raised more concerns about the task selection, sequencing, and time allocation. To the extent these differences are related to PCTs’ specialization, we suggest that a PE pathway be developed as a choice in teacher education. Alternatively, if this is not feasible, the study findings suggest that PCTs should at least be provided with opportunities to take more PE courses.
Patient and provider perspectives on telemedicine use in an outpatient gynecologic clinic serving a diverse, low-income population
Authors: Kulkarni Amita , Monu Ngozi , Ahsan Muhammad D , Orakuwue Chimsom , Ma Xiaoyue , McDougale Auja , Frey Melissa K , Holcomb Kevin , Cantillo Evelyn , Chapman-Davis Eloise
Published: October 2023

Objective

To evaluate patient and provider experiences using telemedicine for gynecologic visits among a diverse, low-income population.

Methods

Patients attending telemedicine visits at a resident-run gynecology clinic completed a modified Telemedicine Usability Questionnaire and providers completed a survey addressing satisfaction and barriers for each visit. The Telemedicine Usability Questionnaire included six subscales to assess telemedicine usability with 1–5 Likert-scale responses. Statistical analyses included Chi-square, Fisher's exact, Wilcoxon rank sum, Wilcoxon signed-rank, and two-sample t-test.

Results

Of 192 patients enrolled, 157 (82%) completed the surveys (87% video visits, 13% telephone visits). Most patients were ethnic minorities (non-Hispanic White—16%, Hispanic—32%, Black—28%, Asian—10%), median age was 40 years (range 18–69), and 63% reported income under $40,000. The total mean Telemedicine Usability Questionnaire score was 4.3/5. The reliability subscale score (3.72/5) was lower compared to all other subscales ( p < 0.001). Older respondents were more likely to find telemedicine unreliable (mean age >44 vs <39, p = 0.02). Without telemedicine, 54% would have traveled ≥1 h to appointments, with 46% spending over $35 on travel, and 27% missing ≥ 1 workday. Patients preferred telemedicine for follow-up rather than initial visits (81% vs 33%, p < 0.01). Among providers, residents felt less adequately trained in telemedicine compared to nurse practitioners and fellows (54% vs 46%, p = 0.039).

Conclusion

Low-income women utilizing telemedicine for outpatient gynecologic care report positive experiences with improved access to healthcare, cost, and time savings compared to in-person visits. Provider experiences were also positive; however, teaching hospitals must evaluate whether trainee providers feel adequately trained to deliver telemedicine visits.
Assessing the early influence of COVID-19 in an analysis of the immediate implementation of Minimum Pricing for Alcohol on drinkers in Wales
Authors: Holloway Katy , Buhociu Marian , Murray Shannon , Livingston Wulf , Perkins Andy
Published: October 2023

Background: The Welsh Government has commissioned a number of projects to consider the influence their implementation of Minimum Pricing for Alcohol (MPA) legislation in March 2020 had on the alcohol consumption and related behaviours of drinkers. Given the MPA's overlap with the COVID-19 pandemic and its related lockdown measures and restrictions, this rapidly became a story about the early impact of COVID-19 as it did MPA. This paper captures the core thematic messages from this specific strand of work, and in doing so reflects on (1) how early experiences of COVID-19 and the first lockdown influenced consumption and purchasing of alcohol behaviours and, in turn, (2) how relevant the introduction of MPA was for any of these. Methods: Semi-structured interviews were conducted by telephone with 32 drinkers 9 months after the implementation of the legislation in March 2020. The sample was recruited from three sources: the National Survey for Wales; a third sector organisation offering housing support to the homeless; and through an online survey on MPA. Results: COVID-19 had more relevance than MPA to drinkers. Furthermore, when MPA did have an influence on their behaviour, it was felt most keenly by the harmful drinkers in the study. These drinkers described spending more on alcohol, switching to other potentially more harmful substances, such as crack cocaine and synthetic cannabinoids, and more involvement in acquisitive crime and begging after the price increase. While our results might be an early indication of the influence of MPA on harmful drinkers, the small sample of this group in our study limits the generalisability of the findings. Conclusion: To date, the implementation of MPA has had little influence on the drinking patterns or lives of the drinkers in our sample. It is important that future research examines the longer-term influences of MPA before any conclusions on its effectiveness can be drawn.
Short-term results after robot-assisted surgery for primary rectal cancers requiring beyond total mesorectal excision in multiple compartments
Authors: Thorgersen Ebbe B. , Solbakken Arne M. , Strøm Tuva K. , Goscinski Mariusz , Spasojevic Milan , Larsen Stein G. , Flatmark Kjersti
Published: October 2023

Aim:

Rectal cancers requiring beyond total mesorectal excision (bTME) are traditionally operated using an open approach, but the use of minimally invasive robot-assisted procedures is increasing. Introduction of minimal invasive surgery for complex cancer cases could be associated with compromised surgical margins or increased complication rates. Therefore, reporting results both clinical and oncological in large series is important. Since bTME procedure reports are heterogeneous, comparing results is often difficult. In this study, a magnetic resonance imaging (MRI) classification system was used to describe the bTME surgery according to pelvic compartments.

Methods:

Consecutive patients with primary rectal cancer operated with laparoscopic robot-assisted bTME were prospectively included for 2 years. All patients had tumors that threatened the mesorectal fascia, invaded adjacent organs, and/or involved metastatic pelvic lateral lymph nodes. Short-term clinical outcomes and oncological specimen quality were registered. Surgery was classified according to pelvic compartments resected.

Results:

Clear resection margins (R0 resection) were achieved in 95 out of 105 patients (90.5%). About 26% had Accordion Severity Grading System of Surgical Complications grade 3–4 complications and 15% required re-operations. About 7% were converted to open surgery. The number of compartments resected ranged from one to the maximum seven, with 83% having two or three compartments resected. All 10 R1 resections occurred in the lateral and posterior compartments.

Conclusions:

The short-term clinical outcomes and oncological specimen quality after robot-assisted bTME surgery were comparable to previously published open bTME surgery. The description of surgical procedures using the Royal Marsden MRI compartment classification was feasible.
Can digital platforms support moralized markets? An analysis of affordances that matter to moralization
Authors: Bentsen Kristin , Pedersen Per Egil
Published: October 2023

The affordances offered by digital platforms may support the formation and maintenance of moralized markets – defined as markets that are undergirded with explicit moral principles that guide the interactions between market actors. In this paper, we draw on key tenets from recent advances in affordance theory, identifying social media platform affordances that support the moralization of digital markets. We develop insights based on qualitative data from the context of Norwegian digital local food markets, with focus on the role of digital affordances. We theorize particular ‘moral affordances’ that matter in the moralization of markets. We conclude by considering the possible outcomes that the increasing use of digital platforms may have for the moralization of contemporary markets.
Surface gravity wave interaction with a submerged tunnel in the presence of a submerged wavy porous plate
Authors: Mohapatra Amar K , Sahoo Trilochan
Published: October 2023

The present study deals with the surface gravity wave interaction of a submerged composite wavy porous plate in the presence of a tunnel placed at a finite distance under the assumption of small amplitude theory and a two-dimensional framework. To solve the boundary value problem, a numerical method using the multi-domain boundary element method (MDBEM) is implemented. Hydrodynamic characteristics of interest such as reflection coefficient and transmission coefficient are computed and studied for a wide range of dimensionless wavenumber and relative plate lengths. Various parametric studies are conducted to emphasize the effect of structural parameters like the number of relative ripple wavelengths, relative ripple amplitude, and relative submergence depth. Dimensionless wave force coefficients acting on the plate and the tunnel are calculated and investigated. The study reveals that the presence of composite wavy porous plate has a significant effect in the mitigation of wave-exerted force on the tunnel. Optimized results are shown for the efficient design of coupled breakwater and tunnel models, which can be used beneficially to protect against the severity of wave action in similar applications of ocean engineering in marine environments.
What’s Wrong With Extreme Wealth?
Authors: Axelsen David V , Nielsen Lasse
Published: October 2023

The expansion in the wealth of the extremely wealthy has received much attention in recent public and academic debate. In political theory, the phenomenon has only recently begun to be scrutinized. This article builds on these preliminary steps, exploring the normative reasons we have to worry about extreme wealth. Looking at the issues, first, through a distributive lens, we reveal that the excess wealth of the extremely wealthy compounds the injustice of inequality and insufficiency, making the situation distinctly unjust. Through a relational lens, we see that extreme wealth may create societal segregation, which poses distinct threats to solidarity. Finally, when the two previous perspectives interact, the particular ways in which the wealthy can influence society, change rules and norms and bend existing regulation to their advantage open up the possibility of vicious societal feedback loops.
Structural design and mechanical properties of glass fiber weft-knitted biaxial tubular fabrics
Authors: Zhou Mengmeng , Jiang Gaoming
Published: October 2023

In order to design glass fiber weft-knitted biaxial tubular (WKBT) fabric with the excellent dimensional stability and outstanding mechanical properties, six kinds of WKBT fabrics were prepared by four kinds of knitting structures (1 + 1 rib structure, face plating structure, back plating structure and face and back plating structure) and two kinds of stitch yarns (polyester and polytetrafluoroethylene fiber). The tensile properties, tearing properties and bursting tearing properties of WKBT fabrics with different binding tightness were investigated. The results showed that the failure of WKBT fabric was composed of the breakage of insertion yarns and the breakage of knitting structures. The tightness of knitting structures have significant effect on the mechanical properties of WKBT fabric. Compared with 1 + 1 rib structure, the plating structure affects the mechanical properties of WKBT fabrics by improving the weft density, binding tightness and dimensional stability. The kind of stitch yarn is another factor that affects the mechanical properties of WKBT fabrics.
Alteration of endothelial permeability ensures cardiomyocyte survival from ischemic insult in the subendocardium of the heart
Authors: Chu Qing , Song Xin , Xiao Ying , Kang Y James
Published: October 2023

Previous studies have shown that cardiomyocytes in the subendocardial region of myocardium survive from ischemic insult. This study was undertaken to explore possible mechanisms for the survival of these cardiomyocytes, focusing on changes in endothelial cells (ECs) and blood supply. C57/B6 mice were subjected to permanent ligation of left anterior descending (LAD) coronary artery to induce myocardial ischemia (MI). The hearts were harvested at 1, 4, and 7 days post MI and examined for histological changes. It was found that the survival of cardiomyocytes was associated with a preservation of ECs in the subendocardial region, as revealed by EC-specific tdTomato expression transgenic mice ( Tie2tdTomato). However, the EC selective proteins, PECAM1 and VEGFR2, were significantly depressed in these ECs. Consequently, the ratio of PECAM1/tdTomato was significantly decreased, indicating a transformation from PECAM1+ ECs to PECAM1− ECs. Furthermore, EC junction protein, VE-cadherin, was not only depressed but also disassociated from PECAM1 in the same region. These changes led to an increase in EC permeability, as evidenced by increased blood infiltration in the subendocardial region. Thus, the increase in the permeability of ECs due to their transformation in the subendocardial region allows blood infiltration, creating a unique microenvironment and ensuring the survival of cardiomyocytes under ischemic conditions.