bluuebunny/crossref_metadata_2025 huggingface dataset:
‘I code as much as I can because you never know what they might ask for’. The role of the coach in Performance Analysis: The view of the analyst
Authors: Mulvenna Claire , Bloyce Daniel , Twist Craig , Thomson Edward
Published: August 2024

Performance Analysis (PA) is viewed as an integral feature of soccer; however, the processes underpinning such practice are often described as simple, linear procedures. This fails to acknowledge the dynamism of PA and given increased investment and employment of analysts in professional soccer, scrutiny of the current processes and duties associated with the role would seem timely. To this purpose, eight full-time analysts in the English Football League (EFL) and English National League (National League) participated in in-depth semi-structured interviews and transcripts were subjected to inductive reflective thematic analysis. The data analysis revealed two higher-order categories (Flying solo / Coach control) and four themes classified as lower-order ( PA pragmatism / Identifying indicators / The reticent coach / Autocratic presentations). The findings of this study highlight that the responsibilities of the performance analyst range from acting on their own initiative to responding to requests and instructions from the coach. Subsequently, the responsibility for individual actions/activities related to PA is dependent on what aspects of analysis are to be used, who is the recipient of the data/video/presentation, when in the relationship between analyst and coach the activities are developed and when in the match-play process they are carried out.
“I made the change for me”: Theorizing Desistance for Life Sentenced Youth
Authors: Abrams Laura S
Published: August 2024

Building on the work of Professor Joanna Shapland, this exploratory, phenomenological study theorizes contexts that ground desistance for people sentenced to life in prison for crimes committed as youth. The investigation draws from 28 interviews conducted with 10 formerly incarcerated youth lifers, all male, who were imprisoned for an average of 27 years in California. The major themes are presented along three phases in the desistance journey: life in prison as a barrier to desistance, the will to change, and policy changes and the process of parole. The analysis finds that despite a harsh and violent prison environment, all located sources of support (i.e. spiritual, family, and peers) that facilitated desistance and hope to create a meaningful life inside of prison. While the work of desistance was ultimately externally validated by a parole board, all participants asserted agency to take behavioral and attitudinal steps toward desistance long before they had hope for freedom.
The effects of the war in Ukraine on the environment of Ukrainian artists: An evaluation by a diagnostic survey
Authors: Ober Józef , Rusakov Serhii , Matusevych Tetiana
Published: August 2024

The 2022 invasion of Ukraine by the Russian Federation has triggered many socioeconomic changes, not only in the countries directly affected by the hostilities but also in the global economy. It should be noted that there has been considerable academic interest in various aspects of international security and stability. This study seeks to address the lacuna in research by evaluating the effects of the war in Ukraine on the environment of Ukrainian artists. By conducting a diagnostic survey, the study aims to assess the socio-economic and cultural challenges faced by artists in conflict-affected areas. Through this investigation, the study attempts to shed light on the unique struggles and resilience of Ukrainian artists amidst the turmoil of war. The results of the research indicate that artists working in the audiovisual arts sector are more likely than other groups distinguished by the cultural sector to perceive a consequence of the war for producers of Ukrainian cultural products internationally in the form of increased financial assistance from international partners, investors and the diaspora. On the contrary, artists working in the performing arts sector are less likely than other groups to see the breaking of partnerships with lobbyists of Russian aggression in Ukraine because of the war for producers of Ukrainian cultural products in Ukraine. Furthermore, the need for Ukrainian artists to relocate after Russian military aggression has not affected their cultural and artistic initiatives for war-related purposes.
De-dollarization and global sovereignty: BRICS’ quest for a new financial paradigm
Authors: Arnold Theryn D.
Published: August 2024

This paper argues that the Brazil, Russia, India, China, and South Africa (BRICS) de-dollarization movement represents a significant shift away from the hegemonic influence of American finance, which is crucial for empowering liberation movements in the Global South. Historically, the dominance of the U.S. dollar as a global currency has restricted collective action by centralizing economic power. By reducing reliance on the dollar, BRICS nations aim to foster a new financial paradigm that supports left-wing revolutionary projects, enhancing their financial sovereignty, and enabling more equitable economic frameworks. This shift could potentially redefine global financial interactions, offering a fresh model for economic transactions that bypass traditional Western financial systems.
Metabolic syndrome and its associated factors among adults with cardiac diseases: A cross-sectional comparative group study
Authors: Abera Alemayehu , Shifeta Mekdes , Tesfaye Sisay , Addisu Bedasa , Hirigo Agete Tadewos
Published: August 2024

Objective

There is limited information about the extent of metabolic syndrome (MetS) among subjects with cardiac diseases in Ethiopia. Therefore, this study aimed to determine the prevalence and associated factors of MetS among adults with cardiac diseases.

Methods

A cross-sectional study was conducted at Hawassa University Comprehensive Specialized Hospital in southern-Ethiopia between May 2021 and August 2021. Data pertaining to the study were collected from 319 participants (153 cardiac and 166 non-cardiac groups) using the WHO stepwise approach. The International Diabetes Federation (IDF) and the revised National Cholesterol Education Program: Adult Treatment Panel III (ATP) were used to define MetS.

Results

The prevalence of MetS was 44.2% and 50.2% in IDF and ATP III, respectively. Among the cardiac group, 54.9% had MetS in IDF criteria, compared to 34.3% in the non-cardiac group ( p < .001); whereas, it was 60.1% in the cardiac group and 41% in non-cardiac group ( p < .001) by ATP III. Age >60 years, waist–height ratio ≥5, high waist–hip ratio, body mass index 25–29.9 and ≥30 kg/m2 were significantly associated with higher odds of MetS in both IDF and ATP III. Also, smoking history and monthly income were associated with MetS by ATP III, while being female was associated with higher odds of MetS by IDF.

Conclusion

More than half of the subjects with cardiac diseases developed MetS as compared to non-cardiac controls. Periodic screening and focusing on the identified modifiable high-risk factors such as body weight, smoking, and central adiposity is important to effectively mitigate the risk of further comorbidity and complications in this high-risk population.
Epilepsy associated with Graves’ disease: Report of two cases
Authors: Nagaki Shigeru , Osawa Makiko , Nagata Satoru
Published: August 2024

We present two cases of epilepsy associated with Graves’ disease. Case 1 is a 22-year-old woman. She had three epileptic seizures and was diagnosed with idiopathic generalized epilepsy. She was treated with valproic acid (VPA). She was later diagnosed with Graves’ disease, and treated with antithyroid medication (thiamazole). We added a thyroid medication (levothyroxine) because of a decrease in free thyroxine observed with antithyroid medication. Case 2 is an 18-year-old woman. She had three epileptic seizures and was diagnosed with juvenile myoclonic epilepsy and treated with VPA. Then, she was diagnosed with Graves’ disease and was treated with thiamazole. Levothyroxine was added due to low fT4 induced by thiamazole. Due to poor compliance with antithyroid medication, the thyroid functional status was not stable. Both patients became seizure-free and euthyroid after VPA and thiamazole treatments.
Evaluating cognitive performance: Traditional methods vs. ChatGPT
Authors: Fei Xiao , Tang Ying , Zhang Jianan , Zhou Zhongkai , Yamamoto Ikuo , Zhang Yi
Published: August 2024

Background

NLP models like ChatGPT promise to revolutionize text-based content delivery, particularly in medicine. Yet, doubts remain about ChatGPT's ability to reliably support evaluations of cognitive performance, warranting further investigation into its accuracy and comprehensiveness in this area.

Method

A cohort of 60 cognitively normal individuals and 30 stroke survivors underwent a comprehensive evaluation, covering memory, numerical processing, verbal fluency, and abstract thinking. Healthcare professionals and NLP models GPT-3.5 and GPT-4 conducted evaluations following established standards. Scores were compared, and efforts were made to refine scoring protocols and interaction methods to enhance ChatGPT's potential in these evaluations.

Result

Within the cohort of healthy participants, the utilization of GPT-3.5 revealed significant disparities in memory evaluation compared to both physician-led assessments and those conducted utilizing GPT-4 ( P < 0.001). Furthermore, within the domain of memory evaluation, GPT-3.5 exhibited discrepancies in 8 out of 21 specific measures when compared to assessments conducted by physicians ( P < 0.05). Additionally, GPT-3.5 demonstrated statistically significant deviations from physician assessments in speech evaluation ( P = 0.009). Among participants with a history of stroke, GPT-3.5 exhibited differences solely in verbal assessment compared to physician-led evaluations ( P = 0.002). Notably, through the implementation of optimized scoring methodologies and refinement of interaction protocols, partial mitigation of these disparities was achieved.

Conclusion

ChatGPT can produce evaluation outcomes comparable to traditional methods. Despite differences from physician evaluations, refinement of scoring algorithms and interaction protocols has improved alignment. ChatGPT performs well even in populations with specific conditions like stroke, suggesting its versatility. GPT-4 yields results closer to physician ratings, indicating potential for further enhancement. These findings highlight ChatGPT's importance as a supplementary tool, offering new avenues for information gathering in medical fields and guiding its ongoing development and application.
The many histories of Alibaba: Theories and practices of the political economy in China
Authors: Yuan Jingyan Elaine
Published: August 2024

This essay provides brief accounts of some critical historical moments of Alibaba, one of China’s leading platforms, against the backdrop of the country’s accelerated market-oriented reforms since the 1990s. These accounts illustrate three theoretical approaches to explain the political-economic prerequisite of Alibaba’s growth: the neoliberal model, the developmental state, and the market transition theories. The essay concludes with challenges to the systematic conceptualization of the state–market relation in which Chinese platforms are embedded.
Predictive Processing within Music Form: Analysis of Uncertainty and Surprise in Different Sections of Sonata Form
Authors: Tsai Chen-Gia
Published: August 2024

Predictive coding has emerged as a key framework for analyzing music listeners’ behavior and experiences. However, the simplicity of stimuli in empirical research frequently fails to reflect the multifaceted complexity of real-world music, potentially limiting the applicability of the predictive coding model within the broader sphere of music perception. To address this shortcoming, this study explores how principles of predictive processing manifest across different sections of sonata form. The analysis suggests that the tonal uncertainty encountered at the start of Beethoven's Symphony No. 1 may lead listeners to activate diverse hidden states, thereby enriching their listening experience. Sequential modulations in the development section prompt listeners to frequently revise their internal model of tonality, while concurrently reinforcing melodic predictability through consistent repetition of motifs/phrases. Conversely, the transitions within the exposition and recapitulation, as well as the retransition within the development, display unexpected changes in rhythm, dynamics, texture, timbre, melodic contour, motif, and figuration against a relatively predictable harmonic background. Such interactions between multiple musical aspects embody a compositional principle: balancing uncertainty or surprise in some musical aspects with predictability in others to enhance listeners’ engagement. By examining how this balancing principle unfolds in various sections of sonata form, this study offers fresh insights into the integration of large-scale structural considerations with predictive processing in music cognition.
Practical Considerations and Implementation of Sodium-Glucose Co-Transporter-2 Inhibitors in Chronic Kidney Disease: Who, When, and How? A Position Statement by Nephrologists
Authors: Rastogi Anjay , Collins Ashté , Kelepouris Ellie , Kotzker Wayne , Middleton John P. , Rajpal Minesh , Roy-Chaudhury Prabir , Chertow Glenn M.
Published: August 2024

Introduction:

There remains an unmet need to reduce kidney and cardiovascular risk in patients with chronic kidney disease (CKD). This report is therefore intended to provide real-world clinical guidance to primary care providers on sodium-glucose co-transporter-2 (SGLT2) inhibitor use in patients with CKD, focusing on practical considerations. Initially developed as glucose-lowering drugs, SGLT2 inhibitors preserve kidney function and reduce risks of cardiovascular events and mortality. Clinical benefits of SGLT2 inhibitors in CKD have been demonstrated in multiple clinical trials, yet utilization in practice remains relatively low, likely due to the complexity of labeled indications (past and present) and misconceptions about SGLT2 inhibitors as a class.

Methods:

A panel of 8 US-based nephrologists convened in August 2022 to develop consensus guidance for the primary care community surrounding risk assessment as well as initiation and implementation of SGLT2 inhibitors in patients with CKD. Here, we provide an adapted version of the Kidney Disease: Improving Global Outcomes (KDIGO) heatmap and a treatment-decision algorithm.

Conclusions:

We advocate SGLT2 inhibitors as co-first-line therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors, where RAAS inhibitor dose titration need not be completed before initiation of an SGLT2 inhibitor. In fact, SGLT2 inhibitor therapy may facilitate up-titration or maintenance of optimal RAAS inhibitor dosing. We describe potential strategies to aid implementation of an SGLT2 inhibitor in clinical practice, including improving education and awareness among care providers and patients and dispelling misconceptions about the safety of SGLT2 inhibitors. In summary, we support the use of SGLT2 inhibitors with RAAS inhibitors as co-first-line therapy in most patients with CKD.
The Impact of Digital Competence and Personal Innovativeness on the Learning Behavior of Students: Exploring the Moderating Role of Digitalization in Higher Education Quality
Authors: Pan Ling , Haq Shamsheer ul , Shi Xiaohua , Nadeem Muhammad
Published: August 2024

The integration of digitalization in higher education is a key to increasing the number of students getting access to education in the developing world. Inspired by the fast digitalization in higher education institutes and the lack of relevant empirical studies about the impact of this rapid digitalization on the learning behavior of students, we investigated: how does digital competence, along with personal innovativeness and attitudes toward digital learning, affect the learning behavior of students in China? This study also aims to examine the moderating role of the level of digitization at higher educational institutions between students’ personality traits and their learning behavior. For this purpose, cross sectional data were collected from 1,569 Chinese students through purposive and random sampling through a face-to-face survey. The data were analyzed using the partially least square structural equation model. The findings indicate that digital competence (β = .688, p < .01) exerts a robust positive influence on students’ learning behavior. The personal innovativeness had a significant impact on learning behavior (β = .720, p < .01). The study found that the attitude toward digital learning had a significant impact on students’ learning behavior (β = .573, p < .01). The results also indicated that digitalization at higher education institutes moderated positively between student personality traits and their learning behavior. Thus, the enables individuals to cultivate creativity, explore novel concepts, and acquire fresh insights that enhance their intellectual skills. Ultimately, DHEI also cultivates their attitude toward formal as well as informal digital learning, which significantly influences their learning behavior.
Ten Essential Pillars in Artificial Intelligence for University Science Education: A Scoping Review
Authors: Deroncele-Acosta Angel , Bellido-Valdiviezo Omar , Sánchez-Trujillo María de los Ángeles , Palacios-Núñez Madeleine Lourdes , Rueda-Garcés Hernán , Brito-Garcías José Gregorio
Published: August 2024

Although Artificial Intelligence (AI) is notable in education, the studies on its specific application in university science education are still incipient. At the same time, the research demonstrates a critical need to systematize AI pillars to provide a coherent and clear structure to guide the development, implementation, and understanding of this technology in various fields, but very little progress has been made in the field of university science education. Therefore, the present study was aimed at exploring the essential pillars of AI for university science education. This scoping review followed the Arksey and O’Malley methodology, which unfolds five stages; based on established criteria 89 texts were finally selected and included in the study. Ten pillars were found: (1) AI Ethics, (2) AI Didactic Integration (AI-DI), (3) Machine Learning (ML), (4) Deep Learning (DL), (5) Active Learning (AL), (6) Intelligent Prediction (AI-IP), (7) Natural Language Processing (NLP), (8) Augmented reality and Virtual reality (AR/VR), (9) Artificial Neural Network (ANN), and (10) Intelligent Tutoring System (ITS). The study provides a comprehensive synthesis of current trends and advances in this field, highlighting good practices that provide empirical evidence, highlighting ethical, pedagogical, and technical challenges associated with the application of AI in science education, which can contribute to the formation of an aware and ethical educational community in the use of AI.
Mitochondrial HMG-CoA Synthase Deficiency: A Cyclic Vomiting Mimic Without Reliable Biochemical Markers
Authors: Niehaus Annie D. , Cooper Holly , Lee Chung U.
Published: August 2024

Here, we report an individual, eventually diagnosed with HMG-CoA synthase deficiency, who presented with a cyclic vomiting phenotype. HMG-CoA synthase deficiency is a rare disorder affecting ketone body synthesis in which affected individuals typically present at a young age with hypoketotic hypoglycemia, lethargy, encephalopathy, and hepatomegaly, usually triggered by catabolism (e.g., infection or prolonged fasting). This individual presented with recurrent episodes of vomiting and lethargy, often associated with hypoglycemia or hyperglycemia, at 3 years of age. Metabolic labs revealed nonspecific abnormalities in her urine organic acids (showing mild elevation of dicarboxylic acids with relatively low excretion of ketones) and a normal acylcarnitine profile. Given her clinical presentation, as well as a normal upper gastrointestinal series, esophagogastroduodenoscopy with biopsies, and abdominal ultrasound, she was diagnosed with cyclic vomiting syndrome at 3 years of age. Molecular testing completed at 7 years of age revealed a previously reported pathogenic sequence variant (c.1016+1G>A) and a novel likely pathogenic deletion (1.57 kB deletion, including exon 1) within HMGCS2 consistent with HMG-CoA synthase deficiency. This individual’s presentation, mimicking cyclic vomiting syndrome, widens the clinical spectrum of HMG-CoA synthase deficiency. In addition, this case highlights the importance of molecular genetic testing in such presentations, as this rare disorder lacks specific metabolic markers.
Poster 239: Chondrocyte Response to Fresh Autologous Conditioned Serum Versus Freeze-Dried Allogenic Conditioned Serum
Authors: Credille Kevin T. , Elias Tristan J. , Allahabadi Sachin , Wang Zachary , Hakimiyan Arnavaz , Chubinskaya Susan , Frisbie David , Yanke Adam B.
Published: August 2024

Objectives:

Traditionally, knee injections for the treatment of knee osteoarthritis (OA) have included corticosteroid with local anesthetic and hyaluronic acid (HA), but more recent investigations have delved into the potential benefits of biologic injections such as platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and autologous conditioned serum (ACS). While positive clinical results have been seen with the clinical use of commercial ACS products, there are limitations currently precluding its widespread acceptance and use. These challenges include the preparation time and storage requirements, patient variability in both pro- and anti-inflammatory cytokine profiles, and lack of regulatory approval of a commercial product in the United States. The development of an allogenic freeze-dried ACS product with an unaltered cytokine profile that remains stable at room temperature and would allow for easy storage, transport, and delivery to clinical settings. The purpose of the present study is to (1) compare the composition of freeze-dried allogenic conditioned serum (FD-CS) to fresh ACS and (2) to investigate the response of human knee cartilage after exposure to FD-CS and ACS to determine whether freeze-drying (lyophilization) affects the biological activity of conditioned serum products.

Methods:

Cartilage explants were collected from 6 patients undergoing total knee arthroplasty. ACS and FD-CS were created from patient serum samples. Cartilage samples were divided into 6 groups: (1) untreated control, (2) control + ACS, (3) control + FD-CS, (4) IL-1β (5 ng/ml), (5) IL-1β + ACS, and (6) IL-1β + FD-CS. After 10 days of incubation, samples were analyzed and compared for DNA normalized glycosaminoglycan (GAG) content, cytokine contents, and histological characterization (Figure 1).

Results:

There was a significant decrease in pathology scoring for ACS (p = 0.0368) or FD-CS (p = 0.0368) in the presence of IL-1 compared to the control (Figure 2). Both ACS and FD-CS significantly mitigate the IL-1β induced increase in FGF (p = 0.0009 and p = 0.0002, respectively) (Figure 3). FD-CS showed a significant increase in IL-1Ra (Figure 4) and decrease in the IL-1β concentration in the presence of IL-1β compared to the control (p < 0.0001 and p < 0.0001). ACS treated samples had significantly higher concentration of TNF-α independent of IL-1 (p = 0.0053).

Conclusions:

Explanted osteoarthritic cartilage responds favorably and equivalently to treatment with ACS and FD-CS from a histological perspective. Both ACS and FD-CS were able to mitigate the IL-1β induced increases in FGF, and FD-CS lowers IL-1β concentration while increasing IL-1Ra concentration. While the cytokine profile of the FD-CS was slightly altered when compared to ACS, it does not affect its biologic activity.
Poster 285: Two-Year KOOS Improvement after Unloading Treatment With Implantable Shock Absorber in Post-Meniscectomy Patients
Authors: Flanigan David C. , Gomoll Andreas H. , Crawford Dennis , Ranawat Anil S. , Sherman Seth L. , Diduch David R.
Published: August 2024

Objectives:

Meniscectomy is a common orthopaedic procedure designed to improve symptoms. However, partial or full meniscectomy can reduce the structure’s ability to absorb and distribute normal joint load, which can result in post-meniscectomy pain. Subjects with and without previous meniscectomy and knee OA were treated with an implantable shock absorber (ISA) to unload the medial compartment. The purpose of this study was to compare subjects with and without previous meniscectomy who were treated with the ISA to evaluate if prior meniscectomy impacted outcomes scores. The objective was to determine if prior meniscectomy impacted two-year KOOS outcomes for patients treated with an implantable shock absorber.

Methods:

Eighty-one (81) subjects had the ISA implanted, and 23 subjects (28%) previously underwent partial (22) or full (1) medial meniscectomy. Subjects in the medial meniscectomy arm were 50.9 years old compared to 51.4 years old in the non-meniscectomy arm (p=0.8). The two arms were comparable for other baseline demographics, such as BMI, OA disease severity and duration of symptoms. Baseline and 2-year improvements in KOOS subscales were recorded.

Results:

Subjects with and without previous meniscectomy reported similar improvements in KOOS scores at two years. The post-meniscectomy group reported KOOS Pain improvement of 41.3 points from baseline, compared to a 47.3 point improvement in the non-meniscectomy group (p=0.2584) at two years. Similarly, the meniscectomy group reported a 43.6 improvement in KOOS ADL, compared to a 45.9 point improvement in the non-meniscectomy group (p=0.7075). Subjects reported similarly high levels of improvement in the post-meniscectomy arm compared to the non-meniscectomy group (38.2 vs. 51.4, p=0.1108) on the Sports/Rec Activities scale of KOOS. Through two years, none (0%) of the meniscectomy group underwent a conversion to arthroplasty, and study safety events were comparable between the two arms (p=0.2109).

Conclusions:

At two years, the implantable shock absorber provided dramatic improvement on KOOS subscales for subjects with prior meniscectomy and knee OA that is comparable to the improvement for subjects without history of meniscectomy. While this study population was more of a general OA population and not a sports-oriented population, the improvement in KOOS Sports/Rec was notable for the post-meniscectomy cohort. Given the attractive safety profile, the ISA is a potential treatment for patients with post-meniscectomy pain, and the treatment should be evaluated further in this population.
Poster 351: Influence of Injury to the Kaplan Fibers and Anterolateral Ligament on Anterolateral Rotatory Knee Laxity in Adult and Pediatric Patients with Anterior Cruciate Ligament Injury: A Retrospective Cohort Study
Authors: Cui Jiaming
Published: August 2024

Objectives:

To detect concomitant Kaplan fibers (KF) and anterolateral ligament (ALL) injury in knees with anterior cruciate ligament (ACL) injury using magnetic resonance imaging (MRI) in both adult and pediatric patients and compare the effect of KF injury and multiple risk factors (concomitant injury to the ALL, medial collateral ligament [MCL], or anterior, central, or posterior part of the medial or lateral meniscus) on anterolateral rotatory laxity as measured by the pivot-shift test in a clinical setting.

Methods:

The study included 540 patients with primary ACL tears (71 pediatric patients and 469 adults) whose MRI examination and pivot-shift test were conducted within 14 days after injury. KF and ALL injury were assessed by MRI according to previously reported criteria. At the time of ACL reconstruction, the pivot-shift test was performed manually with the patient under anesthesia. Manual grading of the pivot shift was performed according to guidelines of the International Knee Documentation Committee (IKDC). Data were statistically compared between the adult and pediatric groups using the chi-square test and Fisher’s exact test (p < 0.05).

Results:

 Logistic regression analysis with backward elimination was used to identify risk factors associated with a high-grade pivot shift. Of the 12 initially included predictive variables, only four significantly increased the risk of a high-grade pivot shift: sex (odds ratio: 2.268 in total and 2.248 in adults), ALL disruption (odds ratio: 0.488 in total and 0.445 in adults), KF injury (odds ratio: 0.193 in pediatric patients), and injury to the posterior horn of the lateral meniscus (odds ratio: 0.545 in total and 0.559 in adults). Logistic regression analysis with backward elimination was also used to identify risk factors associated with KF injury. Of the 3 initially included predictive variables, 2 significantly increased the risk of KF injury: ALL injury (odds ratio: 0.271 in total and 0.206 in adults) and ALL disruption (odds ratio 0.267 in pediatric patients, odds ratio 0.580 in adults and 0.552 in total).

Conclusions:

Concomitant KF injury significantly affects the pivot-shift phenomenon in pediatric patients with acute ACL injury. These findings suggest that KFs may play an important role in controlling anterolateral rotatory knee laxity in pediatric patients.
Poster 395: Long Term Outcomes of Fasciotomy for Chronic Exertional Compartment Syndrome
Authors: Moore Michael , Lezak Bradley , Buldo-Licciardi Michael , Hughes Andrew , Wolfe Isabel , Seidenberg Julian , Jazrawi Laith
Published: August 2024

Objectives:

Operative treatment of Chronic Exertional Compartment Syndrome (CECS) with fasciotomy has been shown to be effective in symptomatic resolution of CECS, but outcomes at long term follow-up are not well understood. The purpose of this study is to present the long-term outcomes for CECS patients treated with fasciotomy.

Methods:

We conducted a retrospective review of patients who underwent fasciotomy of one or more compartments for treatment of CECS at our institution from 2010 to 2021. Outcomes were assessed using the Tegner Activity Scale, symptom resolution, patient satisfaction, return to sports (RTS) and the EuroQol (EQ-5D-5L) survey. Statistical analysis was completed using SPSS, Version 24 (IBM Corp., Armonk, NY). Normally distributed continuous variables between cohorts were compared using the two-sample Student t-test.

Results:

Thirty-four patients, 16 males and 18 females, who underwent open fasciotomy for CECS were included. Mean age at the time of surgery was 29.6 ±12.7 years and mean follow-up was 6.1 ±2.2 years (range 2.5-10.3). Tegner activity level scores at final follow up were significantly higher compared to scores at symptom onset (mean: 4.8 vs. 3.3, p<0.001). Regression analyses showed EQ-5D-5L scores were significantly associated with a post-operative diagnosis of popliteal artery entrapment syndrome (β=-0.135, p=0.023) and increased pre-operative symptom duration (β=-0.0003, p=0.043). 28/34 (82.3%) reported improved symptoms following fasciotomy, 5 (14.7%) reported no change, and 1 (2.9%) had worsened symptoms. Of those with improved symptoms, 19/28 (67.9%) reported complete symptom resolution. Twenty-six (76.5%) patients returned to sport and of these patients, 18/26 (69.2%) returned to their preinjury level. The average time to return to sport was 23.4±27.4 months. Of the 20 patients who worked prior to surgery, 18 (90.0%) returned to their pre-injury level and average time to return to work was 6.5±12.5 months. Twenty-four (70.6%) patients would be willing to have their fasciotomy again and average VAS satisfaction rate was 78.1.

Conclusions:

Pre-operative symptom duration and post-operative diagnosis of popliteal artery entrapment syndrome were poor prognostic indicators for patients diagnosed with CECS following fasciotomy at long term follow up. Tegner scores significantly improved at final follow up and the majority of patients returned to sport and work.
Gender Bias and Perceptions of the Nursing Profession in Croatia: A Cross-Sectional Study Comparing Patients and the General Population
Authors: Neuberg Marijana , Sopić Danijela , Košanski Tina , Grabant Mateja Križaj , Ribić Rosana , Meštrović Tomislav
Published: August 2024

Background

The way the nursing profession is perceived plays a pivotal role in shaping the public's attitude toward its members, primarily influenced by interactions with nurses and media representation. However, it can be significantly impacted by historical and traditional stereotypes, coupled with enduring gender bias and other preconceived notions.

Objectives

The study aimed to examined how the title “nurse” reflects the profession's identity, perception as a female occupation, and status as a healthcare activity. It also assessed awareness of nurses’ roles, education and public presence, comparing general population and patients’ opinions in the Republic of Croatia.

Methods

Conducted as a cross-sectional study, this research employed a structured questionnaire and a convenience sampling approach. It encompassed both the general population and patients from Croatia, with data collection spanning from February 15, 2023, to March 16, 2023, and resulting in a total sample size of 624 participants. Statistical analysis included both descriptive and inferential techniques, and significance was set at p < .01 (two-tailed).

Results

A substantial proportion of respondents, amounting to 38.1%, correlate the term “nurse” with the role of the physician's assistant, whereas only 49.5% associate it with a true professional functioning within their field of work. Furthermore, 73.7% study participants perceive the nursing profession as being desirable for men. Upon examining the perspectives of the general population and patients, statistically significant differences emerged in terms of their perceptions regarding the perceived work scope ( p < .001) and the level of sufficient educational attainment ( p < .001) of nursing professionals.

Conclusion

The analysis uncovers varying perceptions of the nursing profession in the Republic of Croatia, as well as evolving perceptions of gender diversity within nursing roles. Differing viewpoints between the general population and patients in this study emphasize the need for tailored education and communication initiatives to improve the image of nursing.
Supervisory Alliance in Medical Training: Associations with Educational Engagement and Satisfaction
Authors: Terry Danielle L. , Sehrish Laraib
Published: August 2024

Objectives

While medical education requires frequent interactions with attending physicians and supervisors, little research has explored the role of supervisory alliance in the learning process. In other learning environments, supervisory alliance, or the bond between a supervisor and trainee, is considered a key ingredient of effective supervision. Medical educators or attending physicians who aim to enhance learning and engagement in medical education may benefit from understanding specific factors that increase or decrease engagement and how those might intersect within a context that requires learning through supervision. This cross-sectional study examined associations between supervisory alliance and (a) program satisfaction, (b) educational engagement, (c) and career purpose.

Methods

Participants were medical trainees from the rural Northeast (n = 108, response rate = 81%) who completed an electronic and anonymous survey.

Results

Multiple linear regression was used to examine whether total supervisory alliance independently predicted behavioral and emotional engagement in learning while controlling for hours slept, hours worked, and burnout. Supervisory alliance predicted trainees’ career purpose, program satisfaction, and emotional engagement in learning.

Conclusions

Findings from this study lay groundwork for consideration of the role of supervisory alliance in medical learning processes. Future research might explore whether targeted mentorship programs or faculty enhancement training that focuses on the supervisory relationship might positively impact learning outcomes.
Co-localization of NCCT hypodensity and CTA spot sign predicts substantial intracerebral hematoma expansion: The Black-&-White sign
Authors: Pensato Umberto , Tanaka Koji , Horn MacKenzie , Teleg Ericka , Al Sultan Abdulaziz Sulaiman , Kasickova Linda , Ohara Tomoyuki , Ojha Piyush , Marzoughi Sina , Banerjee Ankur , Kulkarni Girish , Dowlatshahi Dar , Goyal Mayank , Menon Bijoy K. , Demchuk Andrew M.
Published: August 2024

Background:

Existing radiological markers of hematoma expansion (HE) show modest predictive accuracy. We aim to investigate a novel radiological marker that co-localizes findings from non-contrast CT (NCCT) and CT angiography (CTA) to predict HE.

Methods:

Consecutive acute intracerebral hemorrhage patients admitted at Foothills Medical Centre in Calgary, Canada, were included. The Black-&-White sign was defined as any visually identified spot sign on CTA co-localized with a hypodensity sign on the corresponding NCCT. The primary outcome was hematoma expansion (⩾6 mL or ⩾33%). Secondary outcomes included absolute (<3, 3–6, 6–12, ⩾12 mL) and relative (0%, <25%, 25%–50%, 50%–75%, or >75%) hematoma growth scales.

Results:

Two-hundred patients were included, with 50 (25%) experiencing HE. Forty-four (22%) showed the spot sign, 69 (34.5%) the hypodensity sign, and 14 (7%) co-localized both as the Black-&-White sign. Those with the Black-&-White sign had higher proportions of HE (100% vs 19.4%, p < 0.001), greater absolute hematoma growth (23.37 mL (IQR = 15.41–30.27) vs 0 mL (IQR = 0–2.39), p < 0.001) and relative hematoma growth (120% (IQR = 49–192) vs 0% (0–15%), p < 0.001). The Black-&-White sign had a specificity of 100% (95%CI = 97.6%–100%), a positive predictive value of 100% (95%CI = 76.8%–100%), and an overall accuracy of 82% (95%CI = 76%–87.1%). Among the 14 patients with the Black-&-White sign, 13 showed an absolute hematoma growth ⩾12 mL, and 10 experienced a HE exceeding 75% of the initial volume. The inter-rater agreement was excellent (kappa coefficient = 0.84).

Conclusion:

The Black-&-White sign is a robust predictor of hematoma expansion occurrence and severity, yet further validation is needed to confirm these compelling findings.
Megaprojects: Beyond the managerial and activist traps
Authors: Audikana Ander , Beria Paolo , Arellano-Yanguas Javier
Published: August 2024

The megaprojects paradox is still there: while large investments, infrastructures, facilities, and variegated ventures are more in demand than ever, scientific criticism and public opposition are increasingly strong, and difficulties to formulate alternative policies and development patterns are notorious. The impossibility of getting out of the paradox is due to the managerial and activist traps in which the scholarship on megaprojects is caught. This paper advocates for a more direct and conscious cross-fertilization between managerial and activist approaches on megaprojects in order to overcome their respective traps. It identifies 10 axes for further future collaboration which will serve as a basis for a shared research agenda. In this research agenda, the study of megaprojects appears as an autonomous research field in which the relationship between megaprojects and development patterns is systematically assessed and the analysis of policy alternatives to megaprojects becomes pivotal.
Ophthalmic Outcomes After Silicone Oil Removal
Authors: Jiao George , Shah Paras P. , Shakin Eric P. , Lee Jessica G. , Ferrone Philip J. , Rhee David Y. , Romero Juan M. , Rosenblatt Brett J. , Graham Kenneth B. , Lin James
Published: August 2024

Purpose: To describe the ophthalmic outcomes and complications after silicone oil (SO) removal. Methods: This nonrandomized retrospective review comprised patients who had SO removal from January 2020 to December 2022. Data collected included patient demographics, visual acuity (VA), intraocular pressure (IOP), initial tamponade, indication for SO placement, duration of SO in the eye, indication for SO removal, cataract progression, rates of retinal redetachment, cornea-related complications, additional surgical interventions, and other complications. Results: The study comprised 107 eyes (mean age, 56.6 years; 67% men). The most common indications for SO tamponade were rhegmatogenous retinal detachment (RRD), RRD with proliferative vitreoretinopathy (PVR), and tractional RD. The mean SO tamponade duration was 9.3 months and was longer for patients who did not have redetachment than for those who had detachment (10 months vs 6.8 months; P = .024). The mean preoperative logMAR VA had significantly improved by the final follow-up (1.44 vs 1.19; P < .001). The mean IOP was 16.43 mm Hg preoperatively and 16.81 mm Hg at the final visit ( P = .672). Retinal redetachment occurred in 20.6% of patients, and the anatomic success rate at the final follow-up was 86.0%. A history of recurrent detachment and PVR was not associated with increased rates of postoperative redetachment. The overall rate of hypotony was 3.7% and of ocular hypertension, 7.5%. Significant cataract progression occurred in 69% of eyes. Conclusions: After SO removal, there was an overall improvement in VA and a stable IOP. Cataract progression was the most common complication. Although there is a risk for redetachment after SO removal, it may not have a detrimental effect on redetachment rates with a longer duration of SO tamponade.
Living in Marooned Island: Growing Old as Gay Men
Authors: Roy Himadri
Published: August 2024

Growing old is related with all human beings, but for those whose sexualities do not follow the social normative structure of family, growing old is more related to loneliness. This article will refer to such people with a different sexual orientation, in this case, mainly gay men. It will deal with the qualitative queer methodologies used for this particular topic.

Queer gerontology has hardly been dealt with anywhere in research in this country; talking about old gay men seems to many that it does not need any methodology to deal with. But when academics try to investigate, interpret and interject many subjects and various areas, it is seen that the ‘queering communications’, ‘queer conversations’ and ’queer(y)ing ethics’ in qualitative methodology are always considered as similar as any social sciences qualitative methodology, or specifically gender qualitative methodology. This article will try to critically analyse how normative gerontology is very different from queer gerontology.

This article includes a sample of 50 gay men in five different categories based on age: 30–35, 35–40, 40–45, 45–50 and 50–55 years. The sample includes gay men from different social and cultural backgrounds, various professional fields and several regions and languages, focusing mainly on people, power and place. Beside these, it will also have two broad categories: one who stays single and one who stays with a partner.

Being a gay man brings lots of packages along with life—discrimination, violence, rights and privileges as a citizen of India are some of them that this article will also deal with. This article will try to bring the queer methodological structure into focus with the area of growing old gay men in a society where the socio-legal conditions consider them as criminals. The socio-psychological aloofness begins at an early age, and as one grows older, it corrugates the lives of such gay men as lonely, abhorrent human beings in society.
Addressing financial hardship in malignant hematology and hematopoietic cell transplant: a team approach
Authors: Jones Salene M. W. , Ohlsen Timothy J. D. , Karvonen Kristine A. , Sorror Mohamed
Published: August 2024

Financial hardship is a common experience for patients and their families after the diagnosis of a hematologic malignancy and is associated with worse outcomes. Health care costs, increased costs of living, income poverty, and inadequate wealth contribute to financial hardship after the diagnosis and treatment of a hematologic malignancy and/or hematopoietic cell transplant. Given the multidimensional nature of financial hardship, a multidisciplinary team-based approach is needed to address this public health hazard. Hematologists and oncologists may mitigate the impact of financial hardship by matching treatment options with patient goals of care and reducing symptom burden disruptive to employment. Social workers and financial navigators can assist with screening and resource deployment. Policymakers and researchers can identify structural and policy changes to prevent financial hardship. By alleviating this major health care burden from patients, care teams may improve survival and quality of life for patients with hematologic malignancies.
Association between a recalled positive airway pressure device and incident cancer: a population-based study
Authors: Kendzerska Tetyana , Pendharkar Sachin R. , Talarico Robert , Blades Kenneth , Mackenzie Constance , Gershon Andrea S. , Ayas Najib , Kaminska Marta , Fenton Mark , McBrien Kerry A. , Hawken Steven , Ratycz Diana , Lishchenko Vadym , Owens Robert L. , Povitz Marcus
Published: August 2024

Background

The real-world consequences of a Philips Respironics recall for positive airway pressure (PAP) devices distributed between 2009 and 2021 are unknown.

Methods

We conducted a retrospective population-based study using health administrative databases (Ontario, Canada) on all new adult PAP users identified through the provincial funding system, free of cancer at baseline, who initiated (claimed) PAP treatment between 2012 and 2018. Everyone was followed from the PAP claim date to the earliest of incident cancer diagnosis, death or end of follow-up (March 2022). We used inverse probability of treatment weighting to balance baseline characteristics between individuals on recalled devices and those on devices from other manufacturers. Weighted hazard ratios of incident cancer were compared between groups.

Results

Of 231 692 individuals identified, 58 204 (25.1%) claimed recalled devices and 173 488 (74.9%) claimed devices from other manufacturers. A meaningful baseline difference between groups (standardised difference ≥0.10) was noted only by location-relevant covariates; other variables were mostly equally distributed (standardised differences ≤0.06). Over a median (interquartile range) follow-up of 6.3 (4.9–8.0) years, 11 166 (4.8%) developed cancer: unadjusted rates per 10 000 person-years of 78.8 (95% CI 76.0–81.7) in the recall groupversus74.0 (95% CI 72.4–75.6) in others (p=0.0034). Propensity score weighting achieved excellent balance in baseline characteristics between groups (standardised differences ≤0.07). On a weighted sample, there was no statistical difference in the hazard of incident cancer between groups: cause-specific hazard ratio (recalledversusothers) 0.97 (95% CI 0.89–1.06).

Conclusion

In our real-world population study, compared to other manufacturers and adjusting for confounders, recalled Philips Respironics PAP devices do not appear to be independently associated with developing cancer.