bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of three methods of Müller type C2 and C3 distal femoral fracture repair
Authors: Zhang Yadi , Xing Baorui , Hou Xiuxiu , Li Yunmei , Li Guoliang , Han Guangpu , Li Dongyue
Published: May 2021

Background

We compared the outcomes of three fixation techniques for Müller type C2 and C3 distal femoral fractures.

Methods

We retrospectively analyzed patients undergoing internal fixation for Müller type C2 and C3 distal femoral fractures via locking plate (Group A), lateral locking condylar plate and medial contoured reconstruction plate (Group B), and lateral locking condylar plate and anterior reconstruction plate (Group C). Knee joint functional recovery and functional outcomes were evaluated 12 months postoperatively.

Results

Patients included 34 men and 24 women aged 25 to 74 years (mean, 50.3 ± 10.73 years). Operating times were longest in Group B and similar in Groups A and C. Bleeding volume in Group A was smaller than in Group B and similar to that of Group C. Functional outcomes were excellent in 18 (31%) fractures, good in 24 (41%), moderate in 11 (19%), and poor in 5 (9%). Good-to-excellent results were achieved in 56%, 82%, and 83% of patients (Groups A, B, and C, respectively). Groups B and C's outcomes were superior to Group A's outcomes. No significant difference in postoperative complications between the groups existed.

Conclusion

Lateral locking condylar and anterior reconstruction plating was useful for complex type C distal femoral fractures.
Identification of miRNA-34a and miRNA-155 as prognostic markers for mantle cell lymphoma
Authors: He Jianxia , Xi Yanfeng , Gao Ning , Xu Enwei , Chang Jin , Liu Jie
Published: May 2021

Objective

MicroRNAs (miRNAs) with functional relevance have not been previously identified in mantle cell lymphoma (MCL). Here, we aimed to evaluate the relationships between miR-34a and miR-155-5p and MCL clinicopathology and prognosis.

Methods

Seventy-five paraffin-embedded tissue samples from patients with MCL who completed at least four cycles of chemotherapy from January 2006 to October 2016, and 27 samples from control patients with reactive lymphoid hyperplasia (RLH), were collected. MiRNA expression levels were measured by qRT-PCR.

Results

The miR-155-5p levels were significantly higher in patients with MCL than in the controls. The Eastern Cooperative Oncology Group (ECOG) ≥ 2 and Sex-Determining Region Y-Box transcription factor 11 (SOX11) < median value (M) groups presented lower miR-34a expression than the ECOG < 2 and SOX11 ≥ M groups, respectively. MiR-155-5p expression differed between low, intermediate, and high MCL International Prognostic Index risk groups. The AUCs of miR-34a and miR-155-5p were 0.5819 and 0.7784, respectively. The median survival times of the miR-34a ≤ 0.2150 and miR-155-5p > 2.11 groups were shorter than those of the miR-34a > 0.2150 and miR-155-5p ≤ 2.11 groups, respectively.

Conclusions

Low miR-34a and elevated miR-155-5p levels may be correlated with poor prognosis in MCL.
A Müllerian cyst in a male adolescent: a case report and literature review
Authors: He Jun , Tang Kaifa
Published: May 2021

Müllerian duct cyst is a congenital anomaly that originates from an abnormality in the degradation of the Müllerian system and remnants of the Müllerian duct. Müllerian cyst is rarely reported in male adolescents younger than 18 years of age. In this case report, a 17-year-old male adolescent presented with a scrotal mass of 6 years’ duration. Ultrasonography and computed tomography revealed a left scrotal mass, and the patient underwent open surgical resection of the cyst. Histologically, the cyst consisted of tall columnar cells and was consistent with a Müllerian duct cyst. We discuss the presentation and imaging findings in this case, drawing attention to the diagnosis and treatment.
Size selection of the Ambu AuraOnce laryngeal mask in Chinese men weighing >70 kg: a pilot study
Authors: Chen Jiahui , Chen Chunhuan , Xu Wei , Zhang Xiaoguang
Published: May 2021

Objective

To collect computed tomography data of the laryngeal anatomy of Chinese men and to determine the feasibility of using the size 4 Ambu AuraOnce laryngeal mask (Ambu A/S, Copenhagen, Denmark) in Chinese men weighing >70 kg.

Methods

This prospective study involved men who underwent surgery from May 2018 to January 2019 at Jinshan Hospital. Pharyngeal and laryngeal parameters were measured by computed tomography. The laryngeal mask insertion success rate, requirement for tracheal tube insertion, laryngeal mask insertion time, fiberoptic bronchoscopy grading, air leakage pressure, and pharyngeal complications were analyzed.

Results

In a comparison of the size 4 and 5 Ambu AuraOnce devices, the first insertion success rate was 100% and 87% and the three-times insertion success rate was 100% and 93%, respectively, with no significant differences. However, the insertion time was significantly different at 19.6 ± 5.9 versus 31.1 ± 11.2 s, respectively, and the proportions of fiberoptic grading levels were also significantly different. There were no significant differences in the air leakage pressure or pharyngeal complications.

Conclusion

The size 4 Ambu AuraOnce is more adequate than the size 5 for Chinese men weighing >70 kg, with a shorter insertion time and higher fiberoptic bronchoscopic grading.
Buccal swabs as non-invasive specimens for detection of severe acute respiratory syndrome coronavirus-2
Authors: Gaur Ritu , Verma Dipesh Kumar , Mohindra Ritin , Goyal Kapil , Gupta Shipra , Singla Vidhi , Sahni Vaibhav , Ghosh Arnab , Soni Roop Kishor , Bhalla Ashish , Gauba Krishan , Singh Mini P.
Published: May 2021

Introduction

The current gold standard for detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) RNA involves subjecting nasopharyngeal or oropharyngeal swabs to reverse transcription quantitative PCR (RT-qPCR). However, both sample types need to be collected by trained professionals. Using self-collected buccal swabs as an alternative could simplify and accelerate diagnosis of coronavirus disease 2019 (COVID-19).

Objective

To assess self-collected buccal swab samples as an alternative method for SARS-CoV-2 detection in patients with COVID-19.

Methods

Buccal swab samples were self-collected by 73 patients with COVID-19. Total RNA was extracted using Qiagen kits. RNA encoding the SARS-CoV-2 Env protein and human RNase P as an internal control was amplified using the TRUPCR® SARS-CoV-2 RT-qPCR kit version 2.1 and a Bio-Rad CFX96 Real-Time Detection System.

Result

The sensitivity of RT-qPCR from buccal swabs was 58.9% (43/73; 95% confidence interval [CI] 46.77%–70.27%) and that of RT-qPCR from saliva was 62.90% (39/62; 95% CI 49.69%–74.84%) taking positive SARS-CoV-2 RT-qPCR from nasopharyngeal swabs as the gold standard.

Conclusion

Self-collected buccal swabs are promising alternatives to nasopharyngeal or oropharyngeal swabs for SARS CoV-2 detection.
The effectiveness of an activity to practise communication competencies: A case study across five European engineering universities
Authors: Cruz Mariana Leandro , Sá Sofia , Mesquita Diana , M Lima Rui , Saunders-Smits Gillian
Published: May 2021

Although accreditation bodies emphasise communication competencies development in engineering curricula due to its importance for future engineers, the focus is often mainly on oral presentation and written reports. A communication activity was created to practice and reflect on students’ communication competencies including describing information in a short time, listening skills, and ask and respond to questions. This activity was implemented at five different European engineering universities involving 393 students. This study explores the effectiveness of this activity as a case-study of game-based learning to practise and reflect on engineering students’ communication competencies. A mixed-method approach measuring students’ communication performance, their perceived communication competencies, and the benefits of this activity to students was used to explore the game characteristics that make the activity effective. The findings of the scoring rubric and the questionnaire used showed that this activity is effective. Because it is engaging and set by rules, students actively participated during the activity, reflected on their effective and ineffective communication competencies, the existing communication barriers and styles, gained awareness, experienced communication in teams, and cooperated with different people. This study highlights the effectiveness of a small intervention using a proven communication activity, which is freely available as OpenCourseWare through TU Delft for anyone to use.
Machine Learning Solutions for Bridge Scour Forecast Based on Monitoring Data
Authors: Yousefpour Negin , Downie Steve , Walker Steve , Perkins Nathan , Dikanski Hristo
Published: May 2021

Bridge scour is a challenge throughout the U.S.A. and other countries. Despite the scale of the issue, there is still a substantial lack of robust methods for scour prediction to support reliable, risk-based management and decision making. Throughout the past decade, the use of real-time scour monitoring systems has gained increasing interest among state departments of transportation across the U.S.A. This paper introduces three distinct methodologies for scour prediction using advanced artificial intelligence (AI)/machine learning (ML) techniques based on real-time scour monitoring data. Scour monitoring data included the riverbed and river stage elevation time series at bridge piers gathered from various sources. Deep learning algorithms showed promising in prediction of bed elevation and water level variations as early as a week in advance. Ensemble neural networks proved successful in the predicting the maximum upcoming scour depth, using the observed sensor data at the onset of a scour episode, and based on bridge pier, flow and riverbed characteristics. In addition, two of the common empirical scour models were calibrated based on the observed sensor data using the Bayesian inference method, showing significant improvement in prediction accuracy. Overall, this paper introduces a novel approach for scour risk management by integrating emerging AI/ML algorithms with real-time monitoring systems for early scour forecast.
The microbiological profile of patients with Fournier’s gangrene: A retrospective multi-institutional cohort study
Authors: Cipriani Chiara , Iacovelli Valerio , Sandri Marco , Bertolo Riccardo , Maiorino Francesco , Antonucci Francesco , Micali Salvatore , Rocco Bernardo , Puliatti Stefano , Ferrarese Paolo , Benedetto Giuseppe , Minervini Andrea , Cocci Andrea , Pastore Antonio Luigi , Al Salhi Yazan , Antonelli Alessandro , Morena Tonino , Volpe Alessandro , Poletti Filippo , Celia Antonio , Zeccolini Guglielmo , Leonardo Costantino , Proietti Flavia , Finazzi Agrò Enrico , Bove Pierluigi
Published: May 2021

Objectives:

To evaluate the role of the microbiological profile and of disease-related factors in the management of patients affected with Fournier’s gangrene (FG).

Patients and methods:

Data regarding patients admitted for FG at nine Italian Hospitals (March 2007–June 2018) were collected. Patients were stratified according to the number of microorganisms documented: Group A – one microorganism; Group B – two microorganisms; Group C – more than three microorganisms. Baseline blood tests, dedicated scoring systems, predisposing risk factors, disease’s features, management and post-operative course were analyzed. UpSet technique for visualizing set intersections in a matrix layout and Cuzick’s nonparametric test for trend across ordered groups were used.

Results:

Eighty-one patients were available for the analysis: 18 included in Group A, 32 in Group B, 31 in Group C. The most common microorganism isolated was Escherichia coli. In Group B-C, Escherichia coli was often associated to Enterococcus faecalis, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Statistically significant positive association was highlighted among the number of pathogens (Group A vs B vs C) and serum C-reactive Protein ( p < 0.001), procalcitonin ( p = 0.02) and creatinine ( p = 0.03). Scoring systems were associated with the number of microorganisms detected ( p < 0.02). A significant association between the number of microorganisms and the use of VAC therapy and need of a fecal diversion was found ( p < 0.02). The number of microorganisms was positively associated with the length of stay (LOS) ( p = 0.02). Ten weeks after initial debridement, wound closure was achieved in 11 (91.7%), 22 (84.6%) and 20 (80%) patients in Group A, B, and C, respectively, with no differences in overall survival.

Conclusion:

Polymicrobial infections in FG are positively associated with inflammatory scores, the need for fecal diversion and the LOS. This results may help the counseling and the clinical management of this rare niche of patients.
Every nephron deserves a second chance before nephrectomy in obstructed uropathy due to urolithiasis
Authors: Tonyali Senol , Ortac Mazhar , Dursun Murat
Published: May 2021

Objective:

In this case report, we aimed to present our clinical experience in a patient with hydronephrotic and atrophic kidney due to impacted lower ureteral stone.

Case description:

A 56-year-old male was admitted to our emergency department with flank pain and nausea. A computed tomography scan revealed a 3 cm stone at the distal ureter, causing severe hydroureteronephrosis. Right kidney parenchyma was extremely thin at the medial zone, and some parenchyma was apparent at the upper and lower poles. We planned renal scintigraphy, but it was impossible to perform quickly due to the active appointment list. The patient’s kidney was assumed to be atrophic/non-functioning; however, given the long waiting list for renal scintigraphy and the patient’s intractable pain, we decided to relieve the patient’s pain with urinary drainage. Nephrostomy insertion was denied because of the extra thin parenchyma. About 40 days later, the patient underwent semi-rigid ureterorenoscopy under spinal anesthesia. It was impossible to place a double J stent to the ureter because of the kinked and extremely dilated ureter. So, we decided to place an open-end 6Fr ureter catheter. DMSA renal scintigraphy showed 33% right kidney and 67% left kidney function.

Conclusion:

Intractable flank pain might be a predictor of functioning renal parenchyma in hydronephrotic/atrophic kidneys. Renal split function lower than 10% on DMSA scintigraphy might not be an absolute indication of nephrectomy, especially in the obstructed renal unit. Evaluation of renal function after eliminating obstruction might be more reliable.
A Qualitative Review of What Forensic Mental Health Nurses Include in Their Documentation
Authors: Martin Krystle , Ricciardelli Rosemary
Published: May 2021

Background

Documentation of mental health care is a critical component of nursing practice. Despite being identified as playing a critical role, researchers continue to question the quality of nursing documentation and missing and/or inaccurate information.

Purpose

Our aim is to explore the content of nursing documentation among mental health nurses providing care to forensic inpatients.

Methods

Using a constructed semi-grounded emergent theme approach for data analysis, we reviewed the types of activities, subjects, and interactions described within nursing notes and identified themes of the content.

Results

Our results demonstrate that nursing documentation could be categorized into one of seven themes: interactions, food, activities, sleep, mental health, physical health and hygiene. These areas were not consistent with the recommendations from nursing bodies in Canada, specifically the areas of assessment, planning, implementation, and evaluation. Furthermore, missing in the nursing notes is context.

Conclusions

The discussion highlights the importance of nursing documentation within the context of best practice, bias, and the impact on patient care. We also discuss missing information (context, clinical relevance, and case conceptualization), and suggest that nurses are not injecting this expertise in patient notes. Clinical implications for documentation practices are presented in relation to education and reflective practice.
Assessment of mechanical and biocompatible performance of ultra-large nitinol endovascular devices fabricated via a low-energy laser joining process
Authors: Elsisy Moataz , Shayan Mahdis , Chen Yanfei , Tillman Bryan W , Go Catherine , Chun Youngjae
Published: May 2021

Nitinol is an excellent candidate material for developing various self-expanding endovascular devices due to its unique properties such as superelasticity, biocompatibility and shape memory effect. A low-energy laser joining technique suggests a high potential to create various large diameter Nitinol endovascular devices that contain complex geometries. The primary purpose of the study is to investigate the effects of laser joining process parameters with regard to the mechanical and biocompatible performance of Nitinol stents. Both the chemical composition and the microstructure of the laser-welded joints were evaluated using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). In vitro study results on cytotoxicity demonstrated that the joining condition of 8 Hz frequency and 1 kW laser power showed the highest degree of endothelial cell viability after thermal annealing in 500°C for 30 min. Also, in vitro study results showed the highest oxygen content at 0.9 kW laser power, 8 Hz frequency, and 0.3 mm spot size after the thermal annealing. Mechanical performance test results showed that the optimal condition for the highest disconnecting force was found at 1 Hz frequency and 1 kW power with 0.6 mm spot size. Two new endovascular devices have been fabricated using the optimized laser joining parameters, which have demonstrated successful device delivery and retrieval, as well as acute biocompatibility.
Prevalence and Risk Factors of Peer Victimization in a National Sample of Chilean Children and Youth
Authors: Pinto-Cortez Cristián , Moya-Vergara Rodrigo , Espinoza-Tapia Ricardo , Guerra Cristóbal
Published: May 2021

This research aimed to determine the prevalence and risk factors of peer victimization (PV) in a national sample of Chilean children and youth. We worked with secondary data of Encuesta Nacional de Polivictimización (2017). The sample was probabilistic and included 19,684 participants between 12 and 18 years ( M = 14.7, SD = 1.59) from all Chilean regions. The participants answered an adapted version of the Juvenile Victimization Questionnaire to assess different violence forms. However, for the present study, only five items related to PV were considered. The results showed that a lifetime and the last 12 months’ prevalence of PVwerevery high. More than half of the adolescents (60.3%) reported at least one type of victimization by peers throughout a lifetime. Gender differences were found; females have the highest rates of PV than males. These results have discussed the magnitude of this issue and promote the generation of prevention strategies.
Domestic Violence Victimization among South Asian Immigrant Men and Women in the United States
Authors: Rai Abha , Choi Y. Joon
Published: May 2021

Domestic violence is a pernicious social problem in the United States and a cause of national concern. The South Asian culture disempowers individuals experiencing domestic violence from recognizing and reporting victimization. Structural inequities may also discourage reporting victimization. These issues have led to inconsistent findings of domestic violence prevalence rates. Additionally, domestic violence studies with South Asians in the United States have predominantly focused on women, omitting men from this purview of research. The purpose of this study was to examine domestic violence victimization rates as well as their correlates among South Asian immigrant men and women. The sample for this cross-sectional study included 468 South Asians across the 50 U.S. states. Descriptive statistics were used to establish rates of domestic violence victimization. Hierarchical logistic regression was used to examine the correlates of domestic violence victimization. All of the sociodemographic information was added in step 1, and acculturation and gender-role attitudes were added as covariates in step 2.

The most prevalent type of domestic violence victimization was physical violence (48%), followed by emotional (38%), economic (35%), verbal (27%), immigration-related (26%), in-laws related (19%), and ultimately sexual abuse (11%). Prevalence rates were higher for women than for men in each type of violence. According to the logistic regression results, education, generational position, family type, and employment were significant correlates of domestic violence victimization. Prior to development of prevention programs by community agencies, it is essential to understand the nature and prevalence of domestic violence experiences among South Asians. The victimization of men in addition to women adds to the novelty of this research study and paves the way for practitioners and scholars to engage in conversations about providing both male and female victims of domestic violence with the needed resources and support. The article will discuss implications for research, practice, and policy.
Cognitive Impairment and the Trajectory of Loneliness in Older Adulthood: Evidence from the Health and Retirement Study
Authors: Lee Ji Hyun , Luchetti Martina , Aschwanden Damaris , Sesker Amanda A. , Strickhouser Jason E. , Terracciano Antonio , Sutin Angelina R.
Published: May 2021

Objective: To examine whether the trajectory of facets of loneliness—emotional and social—varied by cognitive impairment status in older adulthood. Methods: Data came from the Health and Retirement Study 2008–2018 waves ( N = 15,352). Cognitive impairment was assessed using standard cutoffs for cognitive impairment no dementia (CIND) and dementia. The 11-item UCLA loneliness scale was used to measure emotional and social loneliness. Results: Using multilevel modeling, we found that CIND and dementia status were associated with higher overall, emotional, and social loneliness, controlling for physical health, social contact, and depressive symptoms. The trajectory of loneliness did not vary by cognitive status. There were modest variations by sociodemographic factors. Discussion: Persons with CIND and dementia experience heightened emotional and social loneliness, but cognitive impairment does not contribute to the worsening of loneliness. Older adults' social integration may be maintained early in cognitive impairment.
The Effects of the BAILAMOSTM Dance Program on Physical Activity Levels and Cognition of Older Latino Adults: A Pilot Study
Authors: Balbim Guilherme M. , Aguiñaga Susan , Ajilore Olusola A. , Bustamante Eduardo E. , Erickson Kirk I. , Lamar Melissa , Marquez David X.
Published: May 2021

Objective: To investigate the effects of the BAILAMOSTM dance program on physical activity (PA), cardiorespiratory, and cognitive health. Methods: A parallel, two-armed pilot study was conducted with 57 older Latinos randomized to the BAILAMOSTM dance program ( n = 28) or health education (HE) ( n = 29). We conducted two- and three-way repeated-measures ANOVAs. Results: BAILAMOSTM participants increased participation in leisure moderate-to-vigorous PA (LMVPA) ( F[1,53] = 3.17, p = .048, η2 G = .01) and performance in global cognition relative to HE participants ( F[1,52] = 4.19, p = .045, η2 G = .01). Attendance moderated increases in moderate PA, MVPA, LMVPA, and total PA ( p < .05). Participants of both groups with ≥75% attendance increased participation in PA. Among participants with <75% attendance, BAILAMOSTM participants increased PA relative to HE. Discussion: BAILAMOSTM positively impacted self-reported PA and global cognition in older Latinos. Even smaller doses of dance appear to impact self-reported PA levels.
A method and apparatus for determination of the ultrasonic-assisted forming limit diagram
Authors: Najafizadeh Nima , Rajabi Majid , Hashemi Ramin , Amini Saeid
Published: May 2021

It was recently demonstrated that ultrasonic vibrations could result in lower forming forces and a better surface finish in a wide range of metal forming processes. The Nakazima stretch-forming test is a long-established experimental procedure for the formability evaluation of sheet metals. Today, the development of a standard test is critical for assessing sheet metals’ formability enhancement due to ultrasonic vibrations, which can potentially unlock the material selection limit in various manufacturing applications. This study aims to present a method and apparatus for effectuating the forming limit diagram (FLD). At the same time, high-frequency ultrasonic vibrations are combined with the movement of the forming tool. Taking St14 steel as an example, the mechanical and microstructural properties such as formability, Micro-Vickers hardness, and grain sizes were systematically investigated. Furthermore, the conventional FLD, as well as the novel “Ultrasonic-Assisted Forming Limit Diagram” (UA-FLD), were attained and compared with a nonlinear regression-based approach. The results have indicated that superimposing ultrasonic vibrations with the amplitude of 15µm at the frequency of 20 kHz to the tool would cause a notable enhancement in forming limit diagram, a maximum of 28% increase in hardness, and a 23% reduction in average grain size of the specimens.
Wheel–rail dynamic interaction caused by wheel out-of-roundness and its transmission between wheelsets
Authors: Tao Gongquan , Liu Mengqi , Xie Qinglin , Wen Zefeng
Published: May 2021

High-order and low-order wheel out-of-roundness (OOR) often occur on metro train wheels, which can intensify the wheel–rail dynamic interaction. A vehicle–track rigid-flexible coupled dynamics model is built through combining the dynamics software SIMPACK with the finite element software ANSYS, which is validated by field vibration measurement results of vehicle and track. Two adjacent vehicles with two two-axle bogies for each one are considered in the model. The wheel–rail interactions caused by high-order and low-order wheel OOR are investigated. The influence of the wheel–rail interaction caused by wheel OOR on one wheelset on wheel–rail interactions at other 7 wheelsets is explored. The results show that the wheel OOR can excite the first bending vibration of the wheelset and the P2 resonance at a normal operating speed, which can result in a considerable increase of the wheel–rail dynamic interaction and wheelset vibration. The wheel–rail dynamic interaction can be transmitted from the polygonised wheelset to another wheelset of the same bogie through the rail. However, the transmission is negligible from the path of the bogie. The amplitude of wheel OOR has no effect on the transmission ratio of wheel–rail dynamic interaction, but the vertical stiffness and damping coefficient of fasteners greatly influence the transmission. The two wheelsets on the same bogie should be re-profiled simultaneously if the radial run-out for one wheelset exceeds the limit and for the other does not. The effects of vibration transmission between wheelsets and track flexibility need to be taken into account in a model for predicting the development of wheel OOR.
Development of a finite element neck model for head-first compressive impacts: Toward the assessment of motorcycle neck protective equipment
Authors: Nasim Mohammad , Cernicchi Alessandro , Galvanetto Ugo
Published: May 2021

Head-first compressive impacts occur in motorcycle crashes and may result in serious to fatal neck injuries to riders. Equipment to protect the riders’ necks from these injuries are available in the market; however, their effectiveness in reducing injury risk is not clear, either due to the lack of scientific evidences or assessment with any prevalently accepted standard. This paper presents a finite element ligamentous neck model, developed as a computationally efficient tool, for future use in the computational phase of assessment process of neck protective equipment. The 3D cervical spine was generated using the mean statistical dimensions of vertebrae and proposed constitutive models, provided in the scientific literature. Ligaments, for the vertebra-vertebra and Hybrid III head–vertebra ligamentous joints, were introduced with the aid of published anatomical descriptions. For validation, the response of the head-neck system under compressive loadings and the flexion-extension bending stiffness of the neck at the segment level were compared against experimental data. The advanced CORrelation and Analysis (CORA) algorithm was applied on the validation responses to assess biofidelity of the model. The results indicate that the model is functional and meets ISO/TR9790 standard as a “good” biofidelic model.
Using a saddle-assistive device equipped with mechanical orthosis for walking of the person with incomplete spinal cord injury
Authors: Hojjati Najafabadi Akbar , Amini Saeid , Farahmand Farzam
Published: May 2021

The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.
Energy security through diversification of non-hydro renewable energy sources in developing countries
Authors: Seriño Moises Neil V
Published: May 2021

The increasing diversity of renewable energy sources in developing countries is receiving attention in discussions about the future of energy security and climate change. Given the strong relationship between energy demand and economic growth, this paper explores the factors that influence the diversification of non-hydro renewable energy sources across 117 developing countries covering more than 30 years. We contribute to the literature by using a new measure capturing diversification of non-hydro renewable energy sources and explore several estimation techniques in investigating determinants of diversification. Controlling for regional variations, results show that higher per capita income, implementation of policies promoting renewable energy, technological innovations and human capital improvement encourage diversification. In addition, the squared term of income was included to capture nonlinear effects. The results depict a U-shaped kind of relationship suggesting non-monotonic changes in renewable energy diversification in relation to increasing affluence. This implies that greater environmental concern in terms of energy use can be expected as countries developed. Other determinants suggest that high dependence on imported fuels and increasing world market price for crude oil will motivate developing countries to diversify non-hydro renewable energy sources. In contrast, the local abundance of hydropower and the availability of natural resources like oil impede diversification. Finally, we conclude that the progressive integration of renewable energy in developing countries energy mix can be hastened with environmental awareness, relevant policy, and favorable economic conditions.
Don’t they understand climate science? Reflections in times of crisis in science and politics
Authors: García Casañas Cristina
Published: May 2021

During the 2016 US presidential election, the majority of discussion on the social website ‘I fucking love science’ claimed that ‘climate change is a matter of science, truth and facts but “they”, the deniers, do not understand the science’, invoking a polarized version of the modern model of legitimation, entangled with the deficit model. This article challenges this narrative to open a dialogue space and identify criteria for dealing with the climate issue under conditions of high uncertainty and complexity. Analysis reveals how the dialogue might experience a stalemate when criticisms against this narrative are based on the need to show an inflicted harm for which this narrative can be blamed. Simultaneously, the same condition of uncertainty disarms a core principle from the modern model—that legimate action is to be based on predicting catastrophe in climate change. At stake is an essential part of the present: our praxis.
Role of Ventromedial Hypothalamus in Sucrose-Induced Obesity on Metabolic Parameters
Authors: Gaur Archana , Pal G.K. , Pal Pravati
Published: May 2021

Background:

Obesity is because of excessive fat accumulation that affects health adversely in the form of various diseases such as diabetes, hypertension, cardiovascular diseases, and many other disorders. Our Indian diet is rich in carbohydrates, and hence the sucrose-induced obesity is an apt model to mimic this. Ventromedial hypothalamus (VMH) is linked to the regulation of food intake in animals as well as humans.

Purpose:

To understand the role of VMHin sucrose-induced obesity on metabolic parameters.

Methods:

A total of 24 adult rats were made obese by feeding them on a 32% sucrose solution for 10 weeks. The VMH nucleus was ablated in the experimental group and sham lesions were made in the control group. Food intake, body weight, and biochemical parameters were compared before and after the lesion.

Results:

Male rats had a significant weight gain along with hyperphagia, whereas female rats did not have a significant weight gain inspite of hyperphagia. Insulin resistance and dyslipidemia were seen in both the experimental and control groups.

Conclusion:

A sucrose diet produces obesity which is similar to the metabolic syndrome with insulin resistance and dyslipidemia, and a VMH lesion further exaggerates it. Males are more prone to this exaggeration.
Educating Post-Partum Women: Interventions to Improve Engagement
Authors: Spigelmyer Pamela C. , Winberg Austin , Heyd Michael
Published: May 2021

Women giving birth in in-patient maternity units are required to complete certain education. The aim of this study was to investigate the effects of prompting on post-partum women’s education engagement (time from assignment to completion) while testing the feasibility of staff nurses assisting in research. A quasi-experimental design was used with 141 women allocated by admission date to one of three groups (usual care and two intervention) between September 2014 and December 2015. Intervention group I women were quickest to engage in their education and had the shortest length of stay. Significance was found for academic attainment ( df = 1, F = 6.218, p = .014), partial eta squared = 0.053 and R2 = 0.124. Women who had attended college engaged more quickly in all groups than those who had not. This statistically significant finding indicates how nurses can identify patients needing more assistance. Nurses reported no adverse effects on care.
Evaluation of Serum Sodium Correction Rates for Management of Hyponatremia in Hospitalized Patients
Authors: Pham Christine T. , Kassab Hagar S. , Johnston Jackie P.
Published: May 2021

Background:

Appropriate correction of hyponatremia can reduce complications such as osmotic demyelination syndrome (ODS).

Objective:

To evaluate rates of serum sodium correction in hyponatremic hospitalized patients and identify factors associated with higher rates of overcorrection.

Methods:

This is an institutional review board–approved single-center, retrospective chart review of patients ≥18 years of age with at least 1 serum sodium <130 mEq/L during hospitalization. The primary end point was percentage of patients appropriately corrected for hyponatremia. Appropriate correction was defined as a sodium change ≤12 mEq/L over 24 hours and 18 mEq/L over 48 hours, and overcorrection was defined as an increase in serum sodium exceeding these cutoffs. Secondary end points included incidence of ODS, poor neurological outcome, intensive care unit (ICU) and hospital lengths of stay (LOSs), and in-hospital mortality.

Results:

Of 234 patients evaluated, 100 were included. Mean age was 72 ± 16 years, and 47% were male. Overcorrection occurred in 14 patients. There was no incidence of ODS. Rates of poor neurological outcome ( P = 0.77), ICU ( P = 0.09) and hospital LOS ( P = 0.13), and in-hospital mortality ( P = 0.20) were similar between appropriately corrected and overcorrected patients. Using a logistic regression analysis, severe hyponatremia (serum sodium < 120 mEq/L; P = 0.0122) and history of alcohol use disorder ( P < 0.001) were risk factors found to be associated with overcorrection.

Conclusion and Relevance:

Overcorrection of hyponatremia occurred in 14% of patients in this study. To minimize this risk, further caution should be taken when managing patients presenting with identified risk factors.
Sex-Specific Differences Following Lateral Ankle Ligament Repair
Authors: Goodrich Ezra , Vopat Matthew L. , Baker Jordan , Tarakemeh Armin , Templeton Kimberly , Mulcahey Mary K. , Schroeppel J. Paul , Mullen Scott , Vopat Bryan G.
Published: May 2021

Background:

Chronic ankle instability is a common condition that can be treated with lateral ankle ligament repair. These procedures have a reported success rate greater than 85% in the literature, but little has been reported about the differences in postoperative outcomes between males and females. The purpose of this study was to evaluate sex-specific outcomes following lateral ankle ligament repair.

Methods:

In this systematic review and meta-analysis, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to search for articles on electronic databases and included studies in which study participants underwent primary lateral ligament repair and sex-specific outcomes were evaluated. Functional postoperative outcomes for males and females were recorded and statistically analyzed.

Results:

Out of 2768 studies, 7 (0.25%) met inclusion criteria and were analyzed in this review. These studies included 618 patients (402 males [65%] and 216 females [35%]) who underwent primary lateral ligament repair for ankle instability. Karlsson score ( P = .1582) and American Orthopaedic Foot & Ankle Society (AOFAS) score ( P = .1586) analyses found no statistically significant difference between males and females. Postoperative success rate—defined as a “good” or “excellent” Karlsson score (>81)—was not found to be significantly different between males and females ( P = .9374).

Conclusion:

There was no difference in postoperative mean Karlsson scores, AOFAS scores, or success rates between males and females who underwent primary lateral ankle ligament repair.

Level of Evidence:

Level IV, therapeutic.
Two-Year Outcomes After Total Ankle Replacement With a Novel Fixed-Bearing Implant
Authors: Kooner Sahil , Kayum Shahin , Pinsker Ellie B. , Al Khalifa Ahmed , Khan Ryan M. , Halai Mansur , Daniels Timothy R.
Published: May 2021

Background:

The Integra Cadence total ankle replacement (TAR) is a fourth-generation anatomic, fixed-bearing implant requiring minimal tibial and talar resection, which has been in clinical use since June 2016. The primary purpose of this study is to assess its short-term clinical and radiographic outcomes after TAR using this prosthesis.

Methods:

This is a prospective case series of consecutive patients that underwent TAR using this novel fourth-generation prosthesis between June 2016 and November 2017. The primary outcome of interest was the Ankle Osteoarthritis Scale (AOS). Secondary outcomes included Short Form Health Survey–36 (SF-36) scores, radiographic alignment, complications, reoperations, and revisions.

Results:

In total, 69 patients were included in our study. Fifty-one patients (73.9%) required a total of 91 ancillary procedures. Postoperatively, AOS pain scores decreased significantly by an average of 17.8±30.1 points from 45.9±18.2 to 28.4±27.3 ( P < .001). AOS disability scores also decreased significantly following surgery by an average of 22.0±30.5 points from 53.9±18.5 to 32.5±27.9 ( P < .001). The SF-36 physical component summary score improved 10.4±9.8 points from 33.1±9.1 to 42.6±9.1 ( P < .001). Radiographic analysis demonstrated significant improvement to neutral coronal plane alignment, which was achieved in 97% of patients ( P < .01) with no cyst formation at 2 years. There was 1 reported complication, 9 reoperations, and no metal or polyethylene component revisions. Overall, the 2-year implant survivorship was 100% in our cohort. Eighteen patients (26.1%) demonstrated fibrous ingrowth of the tibial component. However, outcome scores for these patients did not demonstrate any negative effects.

Conclusion:

In our hands, this TAR system demonstrated excellent early clinical and radiographic outcomes. Patients reported improved physical health status, pain, and disability in the postoperative period. Total ankle instrumentation allowed for accurate and reproducible implantation with correction of coronal and sagittal plane deformities. Early results for the clinical use of this TAR system are promising, but further long-term prospective outcome studies are necessary.

Level of Evidence:

Level IV, case series.
International Society of Oncology Pharmacy Practitioners (ISOPP) position statement: Role of the oncology pharmacy team in cancer care
Authors: Holle Lisa M , Bilse Tegan , Alabelewe Ramatu Masud , Kintzel Polly E , Kandemir Esin Aysel , Tan Chia Jie , Weru Irene , Chambers Carole R , Dobish Roxanne , Handel Evelyn , Tewthanom Karunrat , Saeteaw Manit , Dewi Luh Komang Mela , Schwartz Rowena , Bernhardt Brooke , Garg Manju , Chatterjee Ashraf , Manyau Pinky , Chan Alexandre , Bayraktar-Ekincioglu Aygin , Aras-Atik Elif , Harvey R Donald , Goldspiel Barry R
Published: May 2021

The Oncology Pharmacy Team (OPT), consisting of specialty-trained pharmacists and/or pharmacy technicians, is an integral component of the multidisciplinary healthcare team (MHT) involved with all aspects of cancer patient care. The OPT fosters quality patient care, safety, and local regulatory compliance. The International Society of Oncology Pharmacy Practitioners (ISOPP) developed this position statement to provide guidance on five key areas: 1) oncology pharmacy practice as a pharmacy specialty; 2) contributions to patient care; 3) oncology pharmacy practice management; 4) education and training; and 5) contributions to oncology research and quality initiatives to involve the OPT. This position statement advocates that: 1) the OPT be fully incorporated into the MHT to optimize patient care; 2) educational and healthcare institutions develop programs to continually educate OPT members; and 3) regulatory authorities develop certification programs to recognize the unique contributions of the OPT in cancer patient care.
Nutrient Intake During School Lunch in Title I Elementary Schools With Universal Free Meals
Authors: Adams Elizabeth L. , Raynor Hollie A. , Thornton Laura M. , Mazzeo Suzanne E. , Bean Melanie K.
Published: May 2021

Background

The National School Lunch Program (NSLP) provides >30 million meals to children daily; however, the specific nutrient composition of NSLP-selected and consumed meals for students from lower income and racial/ethnic minoritized backgrounds is unknown.

Aims

To quantify the nutrients in school lunch selection and consumption among students participating in the NSLP and compare these values to nutrient recommendations.

Method

Students (1st–5th graders; 98.6% from racial/ethnic minoritized backgrounds; 92.5% NSLP participation) from six Title I elementary schools serving universal free meals participated. Digital images of students’ lunch meal selection and consumption were obtained ( n = 1,102 image pairs). Plate waste analyses quantified portions consumed. Nutrient composition of students’ lunch selection and consumption were calculated and compared with the 2010 Healthy Hunger-Free Kids Act and 2009 Institute of Medicine recommendations.

Results

Most lunches selected (59%–97%) met recommendations for all nutrients except for total calories (23%), vitamin C (46%), and dietary fiber (48%). Based on lunch consumption, most students’ lunches met recommendations for sodium (98%), protein (55%), calories from fat (82%), and saturated fat (89%); however, few met recommendations for total calories (5%), calcium (8%), iron (11%), vitamin A (18%), vitamin C (16%), and fiber (7%).

Discussion

Meals selected met most nutrient recommendations for the majority of children; yet overall consumption patterns reflect suboptimal nutrient intake.

Conclusion

Meals served under the NSLP policy mandates align with recommended nutrient patterns, highlighting the importance of maintaining these standards. Strategies to optimize children’s intake of nutrient-rich portions of these meals are needed to optimize policy impact.
In-vitro assessment of release of silicone oil droplets with the use of variety of syringes and needles used in intravitreal injections
Authors: da Cruz Natasha Ferreira Santos , Agra Lydianne Lumack do Monte , Probst Christine , Lima Luiz Henrique , Carpenter John F. , Maia Mauricio , Farah Michel Eid , Melo Gustavo Barreto
Published: May 2021

Purpose:

To assess the variability of silicone oil (SO) particles released across syringes from the same lot and the role of different needle gauges.

Materials and methods:

Four syringe models and six needle models were assessed for SO release. About 50 microliters of a buffer solution were loaded into the syringe, needle or syringe/needle setup. The data were analyzed by imaging flow cytometry with fluorescently labeling for SO.

Results:

All syringe models had a high coefficient of variation in SO release across syringes from the same lot. The amount of SO was significantly greater in the syringe when the needle was attached. SO particles with the BD 30G needle attached to the syringe were statistically greater than the 27G counterpart ( p = 0.005). None of the other comparisons was statistically different. Finally, the number of SO particles was higher in the syringe/needle setup than in needles only ( p = 0.0024).

Conclusion:

We found a high variability in SO content across syringes from the same lot. Additionally, there was no clear association between needle gauge and the number of SO particles, as well as their coefficient of variation. Finally, the needles accounted for a small number of SO particles in comparison to the combined syringe-needle setup.