bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Significance of Lobular Carcinoma In-Situ (LCIS) Diagnosed Alongside Invasive Breast Cancer
Authors: Braasch Maxwell C , Amin Amanda L , Balanoff Christa R , Wagner Jamie L , Larson Kelsey E
Published: March 2022

Purpose:

Women with lobular carcinoma in-situ (LCIS) have an increased risk for developing breast cancer (BC) compared with the general population. However, little is known about the clinical implication of diagnosing LCIS concurrently with an invasive breast cancer. We aimed to define the rate of LCIS diagnosed concurrently with an invasive breast cancer and investigate the risk of contralateral breast cancer (CBC) during survivorship care.

Materials and methods:

A single center retrospective review over 6 years identified women with stage I-III BC who underwent lumpectomy or unilateral mastectomy. Patients with or without concurrent LCIS were compared using Chi-squared analyses to assess for differences in clinicopathologic factors and risk of future CBC (including invasive and in-situ disease).

Results:

Of 1808 patients, 16.6% (n = 301) had LCIS concurrent with their index breast cancer. Patients with LCIS had a higher rate of subsequent CBC development than those without LCIS (3.3% versus 1.0%, P = .004). The risk ratio for patients with LCIS developing subsequent CBC compared with those without LCIS was 3.3 (95% confidence interval [CI]: 1.5-7.3).

Conclusions:

Patients with LCIS diagnosed concurrently with their index breast cancer at surgery are at higher risk for subsequent CBC than those without LCIS. The evidence from this study suggest that it may be appropriate for women with LCIS diagnosed alongside an index breast cancer to consider on-going high-risk screening during survivorship care.
Clinical outcomes following reperfusion therapy in acute ischemic stroke patients with infective endocarditis: a systematic review
Authors: Maheshwari Rohan , Cordato Dennis J. , Wardman Daniel , Thomas Peter , Bhaskar Sonu M. M.
Published: March 2022

Background

Acute ischemic stroke (AIS) is a common and fatal complication of infective endocarditis (IE); however, there is a lack of understanding regarding treatment efficacy. This systematic review aimed to evaluate the safety and efficacy of intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT) in IE patients experiencing AIS.

Objectives

The aim of this study was to perform a systematic review investigating the outcomes of AIS in IE patients receiving IVT and/or EVT as a treatment method and to evaluate the safety and efficacy of these methods of reperfusion therapy.

Design

A systematic review in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was conducted.

Data Sources and Methods

The EMBASE, Cochrane, and PubMed databases were searched for literature published between 2005 and 2021 investigating outcomes of reperfusion therapy post-AIS in IE and non-IE patients. Descriptive statistics were used to describe the overall frequency of clinical outcomes, and groupwise comparisons were performed using Fisher’s exact test to assess the significance of groupwise differences.

Results

Three studies were finally included in the systematic review. A total of 13.5% of IE patients compared to 37% of non-IE patients achieved a good functional outcome (modified Rankin Scale score≤ 2) ( P < .001). Furthermore, a larger percentage of the IE cohort achieved good functional outcomes after EVT (22.0%) compared to IVT (10.4%) ( P = .013). The IE cohort also had a higher 3-month postreperfusion mortality rate (48.8%) compared to the non-IE cohort (24.9%) ( P < .001). The rate of intracranial hemorrhage (ICH) postreperfusion was also significantly higher in the IE cohort (23.5%) than in the non-IE cohort (6.5%) ( P < .001).

Conclusion

AIS patients with IE, treated with IVT, EVT, or a combination of the two, experience worse clinical and safety outcomes than non-IE patients. EVT yielded better functional outcomes, albeit with higher postreperfusion ICH rates, than IVT.
Space, Place, and Countervisuality in Montgomery: A Rhetorical Analysis of the National Memorial for Peace and Justice
Authors: Davis Patricia
Published: March 2022

The National Memorial for Peace and Justice (NMPJ) is a site of conscience that simultaneously mobilizes and interrogates the neoliberal cityscape of its location in downtown Montgomery, Alabama, USA. The memorial is comprised of a monument commemorating the more than 4,000 documented lynching victims in the United States and a museum that provides the historical and contemporary contexts for lynching and other forms of racial violence. Located in an iconic city of the African American civil rights movement that is attempting to rebrand itself as a scene of racial reconciliation, the memorial mobilizes discourses of space and place to situate contemporary mass incarceration as the “unfinished business” of the era. This essay addresses the commemorative duality implicated in the NMPJ’s ability to marshal and contest the neoliberal assumptions activated through rhetorics of reconciliation, redemption, post-racialism—and, ultimately, American exceptionalism—to offer a countervisual reading of Montgomery’s cityscape.
Virus amongst the vegetables: Peruvian marketplaces, hygiene, and post-colonial indigeneity under gender-segregated quarantine
Authors: Irons Rebecca
Published: March 2022

Gender and public markets have long been intertwined in Peru. The vast majority of market-sellers are women, and significantly this kind of work has been intimately related to women’s empowerment and agency within a deeply patriarchal society. However, with the arrival of COVID-19 the woman-centred space of the marketplace became compromised. While once a place of female empowerment, during the pandemic the market became seen as a dangerous ‘viral vector’, with 79% of Lima market sellers testing positive for Coronavirus during the first lockdown of 2020. Further still, a gender-segregated quarantine policy drove women to the markets en-masse; a policy that was withdrawn early due to its spectacular, although unsurprising, failure, causing a total inability to social distance on ‘women’s days’. As such, this paper investigates the extent to which the pandemic increased the ‘feminised burden of care’ to include deadly viral infection during the gender segregated quarantine. Applying an intersectional, post-colonial framework, the ‘feminised burden of care’ is approached as stratified along racial and class lines since markets are not spaces for all women. Furthermore, this paper will show how these intersecting structures of power that have persisted through time may become more visible and observable in times of crisis, such as through Peru’s short-lived gender segregated quarantine. With this in mind, it will be possible to suggest that the events of 2020 were more than just policymaker missteps, but a persistence and exacerbation of long-existing entangled structures of colonial and patriarchal powers. As such, it can be inferred that in an emergency, it is these power structures that were automatically adopted as the first port of call, and thereby perpetuate and strengthen them into the future.
Tenofovir alafenamide fumarate
Authors: Lee William A , Cheng Andrew K
Published: March 2022

Tenofovir alafenamide fumarate is a lipophilic prodrug of tenofovir which is preferentially metabolized in lymphatic tissue resulting in high concentrations of tenofovir (TFV) and its active diphosphate metabolite inside the cells that replicate HIV. Due to its selectivity for these tissues, lower total doses of TAF can be administered relative to tenofovir disoproxil fumarate (TDF) which results in improved bone and renal biomarkers. Tenofovir alafenamide fumarate has become the “backbone” of multiple combination products for the treatment of HIV, combined with emtricitabine for PreP and as a monotherapy for the treatment or HBV.
A comparative study of the flexural performance of hybrid-reinforced (glass fiber reinforced polymer and steel bars) concrete beams before and after exposure to chloride environment
Authors: Lu Chunhua , Yang Yuting , Ruan Xiangjie , Wu Xiaolong
Published: March 2022

To investigate the flexural performance of hybrid-reinforced concrete (HRC) beams before and after exposure to chloride environment comparatively, 12 HRC beams with two types of reinforcements of glass fiber reinforced polymer (GFRP) bars and steel bars, and four steel-reinforced concrete (SRC) beams were fabricated. Based on definitions of the balanced reinforcement ratio and the appropriate HRC beam, the calculation model of the flexural capacity of HRC beams after exposure to chloride environment was proposed in this study. The experimental results verified the validity of the plane section assumption on all test HRC beams. It is found that the deflection of unconditioned HRC beams increases faster than that of unconditioned SRC beams but slower than that of conditioned HRC beams exposed to chloride environment. Besides, the flexural capacity of conditioned HRC beams decreases due to the exposure and the retention ratio of flexural capacity correlates positively with the ratio of nominal reinforcement ratio converted by the elastic modulus to balanced reinforcement ratio converted by the elastic modulus ( ρnom,E/ ρb,E). The good agreement between the predicted values of flexural capacity and measured ones shows the applicability of the calculation model proposed for HRC beams.
#CancelCulture: Examining definitions and motivations
Authors: Tandoc Edson C , Tan Hui Ru Beverly , Lee Huei Gabrielle , Min Qi Charlyn Ng , Chua Rachel Angeline , Goh Zhang Hao
Published: March 2022

While cancel culture has become a social media buzzword, scholarly understanding of this phenomenon is still at its nascent stage. To contribute to a more nuanced understanding of cancel culture, this study uses a sequential exploratory mixed-methods approach by starting with in-depth interviews with social media users ( n = 20) followed by a national online survey ( n = 786) in Singapore. Through the interviews, we found that our participants understand cancel culture as more than just a mob engaged in public shaming on social media; it also involves perceptions of power imbalance and social justice. Building on these perspectives from our interviews, we tested the framework of theory of planned behavior in predicting intention to engage in cancel culture and expanded it by examining the effects of people’s belief in a just world using an online national survey in Singapore. The analysis showed that attitude, subjective norms and perceived behavioral control were positively related to intention to engage in cancel culture, while general belief in a just world was a negative predictor.
The steam platform economy: From retail to player-driven economies
Authors: Thorhauge Anne Mette
Published: March 2022

In this article, I analyse the Steam platform as a configuration of several market contexts. I argue that Valve, the owner of Steam, maintains a classical retail market catering to large game publishers, while the emphasis of Valve’s own game titles is in alternative market contexts based on player-driven economies. I first discuss Steam as a distinct type of platform economy due to its roots in player-driven game economies. I then introduce the notion of ‘markets as fields’ as my analytical framework. Based on this framework, I describe three different contexts of economic transaction: the Steam Game Store, the Steam Community Workshop and the Steam Community Market. I analyse how the approximately 46,500 game titles published on the platform are distributed across these contexts and how these games can be ranked with regard to current player numbers, and discuss Valve’s position as combined platform owner, game developer and game publisher.
Microstructural evolution of Al0.25CoCrFeNiCu and Al0.45CoCrFeNiSi0.45 high-entropy alloys during laser cladding
Authors: Samoilova Olga , Shaburova Nataliya , Samodurova Marina , Pashkeev Kirill , Ostovari Moghaddam Ahmad , Doubenskaia Maria , Sova Alexey , Trofimov Evgeny
Published: March 2022

Additive manufacturing of high-entropy alloys has recently attracted considerable scientific interest owing to their exceptional mechanical properties and corrosion resistance. In this work, Al0.25CoCrFeNiCu and Al0.45CoCrFeNiSi0.45 high-entropy alloys coatings are deposited on stainless steel using laser cladding. The prealloyed high-entropy alloys fabricated by arc melting followed by crushing were used as a precursor for laser cladding, which significantly decreased the optimum laser power to 1400–1600 W and hence minimized the thermal effect on the substrate. Laser cladding preserved the dendritic structure of arc melted alloys, while highly refined the dendritic microstructure. Some extent of substrate dilution effect was also observed in the cladding layers.
The puzzle of competitive fairness
Authors: Suttle Oisin
Published: March 2022

There is a sense of fairness that is distinctive of markets. This is fairness among economic competitors, competitive fairness. We regularly make judgments of competitive fairness about market participants, public policies and institutions. However, it is not clear to what these judgments refer, or what moral significance they have. This paper offers a rational reconstruction of competitive fairness in terms of non-domination. It first identifies competitive fairness as a distinctive claim, advanced within markets in turn characterized as antagonistic, instrumental and procedural. It distinguishes competitive fairness from a number of familiar ideals with which it might be confused: legitimate expectation, equality of opportunity, sporting fairness and economic efficiency. While many exponents likely assume competitive fairness can be explained in terms of one of these ideals, in each case there are significant objections to doing so. Instead, the paper argues that the most promising justification of competitive fairness is under the republican ideal of non-domination, which can reconstruct many of the intuitive judgments of competitive fairness that we make in particular cases. However, it concludes, this explanation makes it difficult for exponents to continue to emphasize competitive fairness, given diverse other risks of domination, and to other values, in markets.
Integrating annotations into multidimensional visual dashboards
Authors: Badam Sriram Karthik , Chandrasegaran Senthil , Elmqvist Niklas
Published: March 2022

Multidimensional data is often visualized using coordinated multiple views in an interactive dashboard. However, unlike in infographics where text is often a central part of the presentation, there is currently little knowledge of how to best integrate text and annotations in a visualization dashboard. In this paper, we explore a technique called FacetNotes for presenting these textual annotations on top of any visualization within a dashboard irrespective of the scale of data shown or the design of visual representation itself. FacetNotes does so by grouping and ordering the textual annotations based on properties of (1) the individual data points associated with the annotations, and (2) the target visual representation on which they should be shown. We present this technique along with a set of user interface features and guidelines to apply it to visualization interfaces. We also demonstrate FacetNotes in a custom visual dashboard interface. Finally, results from a user study of FacetNotes show that the technique improves the scope and complexity of insights developed during visual exploration.
Identifying Critical Factors When Predicting Remedial Mathematics Completion Rates
Authors: Mgonja Thomas , Robles Francisco
Published: March 2022

Completion of remedial mathematics has been identified as one of the keys to college success. However, completion rates in remedial mathematics have been low and are of much debate across America. This study leverages machine learning techniques in trying to predict and understand completion rates in remedial mathematics. The purpose of this study is to build machine learning models that can predict students that are least likely to complete remedial mathematics and identify which factors are most influential when computing those predictions. The study discovers random forest as the highest performing model. Furthermore, the study reveals that the remedial course a student begins with, credit completion rate, math placement score, and high school G.P.A as the most influential predictors of completion rates. The study also offers future research directions, especially in how to improve the performance of the machine learning models.
Clinical Impact of the Size of Drug-Coated Balloon Therapy on Restenosis Rate in Femoropopliteal Lesions
Authors: Kurata Naoya , Iida Osamu , Takahara Mitusyoshi , Asai Mitsutoshi , Masuda Masaharu , Okamoto Shin , Ishihara Takayuki , Nanto Kiyonori , Kanda Takashi , Tsujimura Takuya , Matsuda Yasuhiro , Hata Yousuke , Mano Toshiaki
Published: March 2022

Purpose:

Although the size of drug-coated balloons (DCBs) is determined according to the vessel diameter during femoropopliteal (FP)-endovascular therapy (EVT), the measurements of the vessel diameter vary among modalities and its definitions. The aim of this study was to reveal whether the DCB size fitting (1) angiographically-measured lumen diameter (Angio-lumen size), (2) intravascular ultrasound (IVUS)-measured lumen diameter (IVUS-lumen size), or (3) IVUS-measured external elastic membrane (EEM) diameter (IVUS-EEM size) would be beneficial in restenosis occurrence.

Materials and Methods:

This retrospective, single-center study included 231 de novo FP lesions in 165 patients with peripheral artery disease treated with IN.PACT Admiral DCB under IVUS evaluation. The reference vessel diameter was evaluated as the lumen or EEM diameter at the healthy site distal to the lesion. We retrospectively determined whether the DCB size was close to (ie, equal to or different by <0.5 mm from) Angio-lumen size, IVUS-lumen size, and IVUS-EEM size. The association of the size of DCB with restenosis risk was investigated.

Results:

The mean lesion length was 13 ± 9 cm and the prevalence of chronic total occlusion was 18%. During a mean follow-up period of 17 ± 9 months, restenosis occurred in 26% of lesions. Lesions treated with a DCB of IVUS-EEM size had a lower 2 year restenosis rate than those treated with a DCB over/under IVUS-EEM size (19.7 ± 5.7% vs 34.5 ± 4.7%, p=0.02 by the log-rank test), while the restenosis rate was not significantly different between DCBs of Angio-lumen size or IVUS-lumen size and those over/under the size (both p>0.05). The multivariate Cox regression analysis revealed that DCBs of IVUS-EEM size were independently associated with a reduced risk of restenosis (adjusted hazard ratio 0.50; 95% confidence interval 0.27–0.95; p=0.03).

Conclusion:

The DCBs of IVUS-EEM size, but not of Angio-lumen size or IVUS-lumen size, were associated with a reduced risk of restenosis after FP-EVT. Determining the DCB size according to IVUS-evaluated EEM diameter would be potentially beneficial in restenosis occurrence.
Does the Hospital Day of Surgery for Endovascular Repair of Symptomatic Abdominal Aortic Aneurysms Affect Outcomes?
Authors: Dauer Marc J. , Friedmann Patricia , Parides Michael , Lipsitz Evan , Indes Jeffrey , Teo Richard , Koleilat Issam
Published: March 2022

Objective:

Symptomatic abdominal aortic aneurysms (sAAA) are considered surgically urgent. Recent data suggest delaying surgery allows for medical optimization without affecting outcomes. We investigated the association of the hospital day of surgery with 30 day outcomes.

Methods:

Patients with infrarenal sAAA undergoing endovascular aortic repair (EVAR) between 2011 and 2018 in the American College of Surgeons National Surgery Quality Improvement Project database were included. The primary outcome was 30 day mortality. Additional outcomes included myocardial infarction, pulmonary complications, length of stay, and discharge disposition. Days-to-surgery were classified as the day of presentation (D0), day 1, day 2, days 3 and 4, days 5 to 7 (D5), and day 8 or more (D8).

Results:

A total of 804 patients were identified. D8 patients had higher proportions of dyspnea on exertion, chronic obstructive pulmonary disease, congestive heart failure, and history of dialysis. D0 surgery appeared protective of mortality (odds ratio [OR] 0.34, p=0.0132). Each additional day increased the mortality risk (OR 1.23, p<0.001) although not within the first 4 days. There was increased mortality for patients having surgery at D5 (7.7%) and D8 (23.8%) compared with repair earlier (1%–4%, p=0.03). Bivariable analysis revealed no significant differences in secondary outcomes. Multivariable modeling revealed increased mortality for D8 versus D0 (adjusted OR of 6.8, 95% confidence interval 1.7–26.5).

Conclusions:

While D0 appears to have the lowest risk of mortality, EVAR for sAAA up to 4 days may not be associated with increased mortality. Further research should determine delay etiologies and whether they improve operative planning and optimization without impacting morbidity and mortality.
Clinical Analysis of 50 Cases of Primary Pulmonary Lymphoma: A Retrospective Study and Literature Review
Authors: Hu Mingbin , Gu Weiguo , Chen Shaoqing , Mei Jinhong , Wang Weijia
Published: March 2022

Objective: This study aimed at to raise the awareness understanding of primary pulmonary lymphoma (PPL) by analyzing the clinical manifestation, imaging, pathology, diagnosis, treatment, and prognostic features of 50 cases of PPL. Methods: The study of 50 individuals with PPL diagnosed at the First affiliated hospital of Nanchang university between January 2009 and December 2019 was performed. Results: Overall, 27 males and 23 females were enrolled, with an average age of 57.6 ± 15.6 years. The primary symptoms included, cough (n = 37), expectoration (n = 25), sputum with blood (n = 12), and chest pain (n = 12). Two individuals had Hodgkin's lymphoma and 48 patients had non-Hodgkin's lymphoma (NHL). We divided the NHL cases into mucosa-associated lymphoid tissue lymphoma (MALT) (n = 21), diffuse large B-cell lymphoma (n = 12), small lymphocytic lymphoma ( n = 2), mantle B-cell lymphoma (n = 2), follicular lymphoma (n = 1), B-cell lymphoma without further classification (n = 8), and T-cell lymphoma (n = 2). The imaging findings revealed that unilateral lung involvement was more common among the patients. The longest follow-up duration up to December 2019 was 123 months with 40 surviving patients. The 5-year overall survival and progression-free survival were 46.7% and 44.4%, respectively. Age was an independent predictive factor for the 5-year survival (hazard ratio, 8.900; P = .038), ( P < .05). Conclusion: PPL is a uncommon disease with atypical clinical manifestations and is often misdiagnosed. Immunohistochemistry is currently the standard used in pathologic evaluation of PPL. MALT prognosis is better in contrast with other kinds of PPL. Surgery or radiotherapy can be considered in patients with limited lesions, and chemotherapy is the first treatment option for diffuse lesions. Age of ≥ 60 years was reported as an independent adverse predictive factor.
Dysregulation of multiple signaling pathways: A possible cause of cerebral palsy
Authors: Upadhyay Jyoti , Ansari Mohd Nazam , Samad Abdul , Sayana Ashutosh
Published: March 2022

Cerebral palsy (CP) is a lifelong disability characterized by the impairment of brain functions that result in improper posture and abnormal motor patterns. Understanding this brain abnormality and the role of genetic, epigenetic, and non-genetic factors such as signaling pathway dysregulation and cytokine dysregulation in the pathogenesis of CP is a complex process. Hypoxic–ischemic injury and prematurity are two well-known contributors of CP. Like in the case of other neurodevelopmental disorders such as intellectual disability and autism, the genomic constituents in CP are highly complex. The neuroinflammation that is triggered by maternal cytokine response plays a critical role in the pathogenesis of fetal inflammation response, which is one of the contributing factors of CP, and it continues even after the birth of children suffering from CP. Canonical Wnt signaling pathway is important for the development of mammalian fetal brain and it regulates distinct processes including neurogenesis. The glycogen synthase kinase-3 (GSK-3) antagonistic activity in the Wnt signaling pathway plays a crucial role in neurogenesis and neural development. In this review, we investigated several genetic and non-genetic pathways that are involved in the pathogenesis of CP and their regulation, impairment, and implications for causing CP during embryonic growth and developmental period. Investigating the role of these pathways help to develop novel therapeutic interventions and biomarkers for early diagnosis and treatment. This review also helps us to comprehend the mechanical approach of various signaling pathways, as well as their consequences and relevance in the understanding of CP.
Surgical Trigger Finger Release Is Associated With New-Onset Dupuytren Contracture in the Short-Term Postoperative Period: A Matched Analysis
Authors: Maasarani Samantha , Wee Corinne E. , Lee Christina D. , Khalid Syed I. , Layon Sarah , Noland Shelley S.
Published: March 2022

Background:

This article compares the rates and time-to-development of new-onset Dupuytren disease in patients with trigger finger treated by steroid injection, surgical release, or both.

Methods:

PearlDiver’s Mariner 30 database was queried to identify patients with trigger finger between January 2010 and June 2019. One-to-one exact matching based on baseline patient demographics allowed us to create 4 identical groups defined by the type of trigger finger intervention received.

Results:

The matched population analyzed in this study consisted of 85 944 patients who were equally represented in the steroid injection cohort (n = 21 486, 25.00%), surgical release cohort (n = 21 486, 25.00%), steroids prior to surgery cohort (n = 21 486, 25.00%), and no intervention (control) cohort (n = 21 486, 25.00%). A new Dupuytren diagnosis after trigger finger treatment occurred in 1 in 128 patients overall, 1 in 156 patients treated with steroid injection, and 1 in 126 patients treated with surgical release. Trigger fingers treated by steroid injection only had the lowest rates of Dupuytren disease overall (n = 137, 0.64%, P = .0424) and treatment with fasciectomy (n = 14, 0.07%, P < .0005). In all, 171 patients in the surgery cohort developed Dupuytren disease 1 year after undergoing surgical trigger finger release. Furthermore, this cohort had the highest rates of fasciectomy (n = 55, 0.26%, P < .0005) and the lowest rates of no intervention (n = 103, 0.48%, P = .0471). Trigger fingers managed by surgical release developed Dupuytren disease (mean, 56.11 days; SD, 80.93 days, log-rank P = .02) and underwent fasciectomy (mean, 49.74 days; SD, 62.27 days; log-rank P < .0005) more quickly than all other cohorts.

Conclusions:

Patients solely undergoing surgical release of their trigger finger had significantly higher odds and expedited rate of developing new-onset Dupuytren disease overall and undergoing subsequent treatment by fasciectomy compared with trigger fingers managed by other interventions.
Conservative versus aggressive antiplatelet strategy for emergent carotid stenting during stroke thrombectomy
Authors: Pop Raoul , Severac François , Hasiu Anca , Mihoc Dan , Mangin Pierre H , Chibbaro Salvatore , Simu Mihaela , Tudor Raluca , Gheoca Roxana , Quenardelle Véronique , Wolff Valérie , Beaujeux Rémy
Published: March 2022

Background

There is no consensus regarding optimal antiplatelet regimen for emergent carotid stenting during stroke thrombectomy. We aimed to assess the safety and efficacy of an aggressive periprocedural antiplatelet strategy focused on preserving stent patency, in comparison with conservative antiplatelet strategy consisting of aspirin monotherapy.

Materials and Methods

Retrospective review of a prospectively collected database in a comprehensive stroke center, including all cases of emergent carotid stenting for tandem lesions stroke between 01.03.2012–01.06.2021. Aggressive antiplatelet strategy consisted of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel loading doses, with added intravenous (IV) tirofiban if in-stent thrombosis was observed during thrombectomy. Clinical and radiological outcomes were compared between conservative and aggressive antiplatelet treatment groups using inverse probability of treatment weighting (IPTW) analysis based on propensity scores.

Results

We included 132 cases (76.5% atheroma, 22.7% dissection, 0.7% carotid web). Forty-five patients (34%) cases received conservative antiplatelet therapy. The remaining 87 (65.9%) received aggressive antiplatelet therapy: 66 (75.8%) treated with DAPT, 21 (24.1%) with DAPT and tirofiban. Periprocedural heparin was avoided in all cases. In adjusted analysis of the weighted samples, aggressive antiplatelet strategy was associated with improved carotid stent patency (aOR 0.23, 95% CI 0.07–0.80, p = 0.021), higher proportion of moderate clinical outcome (mRS ≤ 3, aOR 2.72, 95% CI 1.01–7.30, p = 0.04), with no significant differences in mortality and hemorrhagic transformation (HT) rates.

Conclusions

In this retrospective study, aggressive periprocedural antiplatelet strategy led to improved stent patency and clinical outcomes, without increased HT. Further prospective randomized research is warranted to identify the optimal combination of antiplatelet agents for emergent carotid stenting in the setting of acute stroke.
Principal-designed structures that enhance middle leaders’ professional learning
Authors: Bryant Darren A , Walker Allan
Published: March 2022

Middle leaders in schools are increasingly recognised as playing pivotal roles in school improvement. Although some school systems provide formal professional development for middle leaders, many middle leaders express a preference for job-embedded learning. Yet, international research has documented difficulties in providing intensive support from principals which instead is often ad hoc. This study examines how middle leaders’ professional learning can be supported through the development of appropriate organisational structures. It presents three principal-designed models distilled from qualitative data collected in 12 case study schools, inclusive of public, semi-private, and international schools in four East Asian societies. Each model contributed to the development of middle leadership capacity in areas relevant to the schools’ improvement agendas. The models vary in degrees of formality, resource intensiveness, and processes for engaging and developing leadership. The findings contribute to the growing literature on middle leader development, and the role of school infrastructure in professional learning by suggesting how school-based leader development strategies can be framed in coherent and intentional models that take into account of the available infrastructure and potential professional interactions to provide systematic in situ support for middle leaders.
Combining capacity for instructional leadership with individual core practices in the Norwegian policy context
Authors: Jenssen Mette Marit Forsmo , Paulsen Jan Merok
Published: March 2022

This study explores how Norwegian school leaders develop their capacity for instructional leadership, a leadership style that is strongly related to school effectiveness and school improvement across a range of national school systems. The concept captures important aspects of Norwegian school leaders’ task preferences. To gain further insight into the process of developing the capacity for instructional leadership, this study links instructional leadership to school leaders’ core practices. The multidimensional concept of core practices views school leaders as goal oriented and actively involved in teachers’ collaboration and professional development, observation, and supervision. Moreover, the concept covers school leaders’ efforts to redesign and improve their schools’ instructional programs. In this study, school leaders assessed instructional leadership related to three distinctive core practices: observation and supervision, collaborative learning engagement, and time allocation for data use. Multiple regression analyses were conducted, and overall, the regression model, with all the predictors included as a set, was significant. 28.5% of the variance in school leader's capacity for instructional leadership is explained by the three distinct factors. The results indicate that when school leaders adapt core practices of leadership to their work context, their capacity as instructional leaders increases. The findings and implications will be discussed.
The relationship between physical qualities and contact technique in academy rugby union players
Authors: den Hollander Steve , Lambert Michael , Jones Ben , Hendricks Sharief
Published: March 2022

This study investigated the relationship between physical qualities and contact technique proficiency in rugby union players. Thirty-eight (n = 38) male academy rugby union players participated in the study. Physical measures of anthropometry, functional mobility, strength endurance, strength, power, speed, agility, and anaerobic and aerobic endurance were assessed. Tackler, ball-carrier, and ruck technique were assessed using video analysis of a standardised two-on-two contact drill. Seven physical qualities were moderately associated with tackler technique; Push-ups (r2 = 0.2; β = 0.04; p = 0.005; ES = 0.26), Sit-ups (r2 = 0.2; β = 0.08; p = 0.004; ES = 0.27), Relative 1RM Bench Press (r2 = 0.2; β = 2.32; p = 0.003; ES = 0.29), Broad Jump (r2 = 0.2; β = 0.03; p = 0.009; ES = 0.22), Agility (r2 = 0.2; β = −0.47; p = 0.019; ES = 0.19), 40m-Speed with Ball (r2 = 0.1; β = 0.93; p = 0.027; ES = 0.16) and Functional Mobility (r2 = 0.2; β = 0.16; p = 0.007; ES = 0.25). There was a large association between ball-carrier technique and Medicine Ball Throw (r2 = 0.3; β = 1.13; p = 0.001; ES = 0.37), and a moderate association between ruck technique and agility without (r2 = 0.2; β = −0.75; p = 0.005; ES = 0.21) and with (r2 = 0.2; β = −0.55; p = 0.015; ES = 0.29) the ball. The findings demonstrate the important contribution of physical strength and conditioning to contact technique in rugby union players. Contact technique training should be accompanied with physical strength and conditioning, as improvements in physical qualities may serve as foundational components to underpin improvements in technique.
Ultrasound-guided aponeurotomy and interphalangeal joint capsular release for treatment of Dupuytren’s disease
Authors: Villanueva Manuel , Iborra Álvaro , Fahandezh-Saddi Homid , Sanz-Ruiz Pablo , Noriega Concepción
Published: March 2022

This study describes a new ultrasound-guided surgical technique for aponeurotomy and interphalangeal joint capsular release in patients with Dupuytren’s disease and analyses the clinical outcomes. We carried out a retrospective review of 70 digits in 35 patients who underwent ultrasound-guided aponeurotomy and interphalangeal joint capsular release, with a minimum follow-up of 2 years. The primary outcome was the correction of the deformity and the QuickDASH questionnaire score after surgery and at 1 and 2 years. The secondary outcome was the presence of residual contracture immediately after surgery. The mean QuickDASH score fell from 28 before surgery to 14 after surgery. A significant decrease of −63° was observed for the global contracture, −35° the metacarpophalangeal joint contracture and −28° for the proximal interphalangeal joint contracture. Ultrasound-guided aponeurotomy and interphalangeal joint capsular and palmar plate releases are highly accurate and safe.

Level of evidence: IV
Camellia oil Enhances Plasma Antioxidant Metabolism and Improves Plasma Lipid Metabolism in High-fat Diet-fed Rats
Authors: Shi Hao , Zhou Xiangyu , He Xiaoe , Wang Rencai , Zhou Wenhua
Published: March 2022

Living on a high-fat, high-calorie, and high-protein diet for a long period may compromise human immunity due to the long-term accumulation of free radicals and plasma lipids. The antioxidant and lipid-lowering compounds (ie polyphenols and vitamin E) in Camellia oil help to decrease the risk of numerous ailments, including cardiovascular disease (CVD), and obesity.

The aims of this study were to study the hypolipidemic and antioxidant effects of Camellia oil in high-fat-fed rats and to promote the high-value use of camellia resources. The high-fat-fed rats were administrated with 2.5, 7.5, and 15 mL/kg BW Camellia oil (Camellia oil group), and 10 mg/kg BW atorvastatin (atorvastatin group), respectively, and compared with a model group (only fed with high fat) and a control group (fed with basal diet). Several parameters were measured, including (1) body weight (BW), liver-to-BW ratio; (2) plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C); and (3) alanine aminotransferase (ALT), alanine aminotransferase (AST), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activity, model driven architecture (MDA) content, lipid metabolism-related genes, and antioxidant-related genes in liver tissue.

Compared with the model group, the high-fat-fed rats in the Camellia oil and atorvastatin group had significantly lower BW and liver-to-BW ratio ( P < .01), plasma TC, TG, and LDL-C levels and ALT and AST activities, but higher HDL-C levels. The relative expressions of ACAT1, DGAT2, FAS, and SREBP genes were significantly reduced in the Camellia oil and atorvastatin groups, while the relative expressions of LCAT, UCP2, MCD, and CPT-1 genes were significantly increased. The rats in the Camellia oil group showed significantly higher SOD and GSH-Px activities, significantly lower MDA content, and significantly higher relative expression of antioxidant genes (eg SOD1, GPx1, CAT, and Gclm). Thus, atorvastatin and Camellia oil exhibited significant hypolipidemic and antioxidant effects, which were better at a dose of 7.5 mL/kg (BW) of Camellia oil. Therefore, Camellia oil becomes a potential new natural resource for future research and development of antioxidant and hypolipidemic drugs, nutraceuticals, and additives.
Outcomes Following Repeat Ankle Arthroscopy and Microfracture for Osteochondral Lesions of the Talus
Authors: Schafer Kevin A. , Cusworth Brian M. , Kazarian Gregory S. , Backus Jonathon D. , Klein Sandra E. , Johnson Jeffrey E. , McCormick Jeremy J.
Published: March 2022

Background

The management of symptomatic osteochondral lesions of the talus (OLTs) previously treated with arthroscopy is controversial. Minimal data exist on the role for repeat arthroscopy. Here, we describe our experience with repeat arthroscopy and microfracture for symptomatic OLTs.

Methods

Our database was queried over an 8-year period to identify patients undergoing repeat arthroscopy and microfracture as treatment for symptomatic OLTs. Phone surveys were conducted to assess residual pain, patient satisfaction, and need for subsequent surgery. We compared patient outcomes based on the size of their OLT (small lesions ≤150 mm2, large >150 mm2) and the presence or absence of subchondral cysts.

Results

We identified 14 patients who underwent repeat arthroscopy and microfracture for symptomatic OLTs. Patients reported reasonable satisfaction (7.6 ± 3.5 out of 10) but moderate residual pain (4.7 ± 3.4 out of 10) at midterm follow-up (5.1 ± 2.9 years). In total, 21% (3/14) of patients had undergone subsequent surgery. Patients with small (n = 5) and large OLTs (n = 9) had similar postoperative pain scores (4.2 ± 4.1 vs 4.9 ± 3.2) and postoperative satisfaction levels (6.4 ± 4.9 vs 8.3 ± 2.5).

Conclusion

At midterm follow-up, repeat arthroscopy for symptomatic OLTs demonstrated reasonable satisfaction but moderate residual pain. Lesion size or presence of subchondral cysts did not affect outcome, but our sample size was likely too small to detect statistically significant differences. These data show that repeat ankle arthroscopy can be performed safely with modest outcomes, and we hope that this report aids in managing patient expectations. Level of Evidence: Level IV Case Series
Collecting and sharing self-generated health and lifestyle data: Understanding barriers for people living with long-term health conditions – a survey study
Authors: Brown Richard , Coventry Lynne , Sillence Elizabeth , Blythe John , Stumpf Simone , Bird Jon , Durrant Abigail C.
Published: March 2022

Background

The growing popularity of collecting self-generated health and lifestyle data presents a valuable opportunity to develop our understanding of long-term health conditions and improve care. Barriers remain to the effective sharing of health and lifestyle data by those living with long-term health conditions which include beliefs around concepts of Trust, Identity, Privacy and Security, experiences of stigma, perceptions of risk and information sensitivity.

Method

We surveyed 250 UK adults who reported living with a range of long-term health conditions. We recorded data to assess self-reported behaviours, experiences, attitudes and motivations relevant to sharing self-generated health and lifestyle data. We also asked participants about their beliefs about Trust, Identity, Privacy and Security, stigma, and perceptions of risk and information sensitivity regarding their health and lifestyle data.

Results

Three-quarters of our sample reported recording information about their health and lifestyle on a daily basis. However, two-thirds reported never or rarely sharing this information with others. Trust, Identity, Privacy and Security concerns were considered to be ‘very important’ by those with long-term health conditions when deciding whether or not to share self-generated health and lifestyle data with others, with security concerns considered most important. Of those living with a long-term health condition, 58% reported experiencing stigma associated with their condition. The greatest perceived risk from sharing with others was the potential for future harm to their social relationships.

Conclusions

Our findings suggest that, in order for health professionals and researchers to benefit from the increased prevalence of self-generated health and lifestyle data, more can be done to address security concerns and to understand perceived risks associated with data sharing. Digital platforms aimed at facilitating the sharing of self-generated health and lifestyle data may look to highlight security features, enable users to control the sharing of certain information types, and emphasise the practical benefits to users of sharing health and lifestyle data with others.
Pregnancy outcome following exposure to ocrelizumab in multiple sclerosis
Authors: Chey Shin Yee , Kermode Allan G.
Published: March 2022

Background

Ocrelizumab is a monoclonal antibody targeting CD20-expressing B cells used in the treatment of multiple sclerosis (MS). Currently, there is limited safety data in pregnancy.

Objectives

To report the pregnancy outcome following exposure to ocrelizumab in MS.

Methods

We retrospectively identified 14 pregnancies of 12 MS patients who had been exposed to ocrelizumab within 6 months prior to conception or during pregnancy from a specialty clinic in Western Australia.

Results

13 of 14 pregnancies resulted in live births. One pregnancy was electively terminated following detection of a chromosomal defect. One pregnancy was complicated with placental insufficiency and the infant developed hyaline membrane disease which was complicated by sepsis. There were no observed major congenital anomalies, preterm births, stillbirths or low birthweight. We did not observe any serious maternal infections. All patients were relapse-free despite a mean ocrelizumab-free interval of 65.1 weeks.

Conclusions

We did not identify any major safety signals among the patients who received ocrelizumab prior to conception or during the first trimester of pregnancy. Our patients appeared to have a stable disease course despite a prolonged period of treatment interruption during pregnancy.
Implementation of a Virtual Reality recreation program in long-term care
Authors: Hayden Leigh , Chaze Ferzana , Kamath Ashwin , Azevedo Andrea , Bucko Destanee , Jackson Alexandra , Reyna Christianne , Kashlan Yara , Dube Mireille , De Paula Jacqueline , Warren-Norton Kathryn , Dupuis Kate , Tsotsos Lia
Published: March 2022

Introduction

This manuscript describes the implementation of a Virtual Reality (VR) recreation program at long-term care sites across Ontario, Canada, using the RE-AIM Framework to guide the implementation and its evaluation.

Methods

We developed a VR recreation program to enhance the lives of long-term care residents, through 3 sequential phases. In Phase 1, we learned about resident and staff needs through focus groups, staff surveys and observations. In Phase 2, we developed 10 VR experiences, based on the data from Phase 1. In Phase 3, we implemented the VR experiences and supporting manual and measured their implementation, using the RE-AIM Framework.

Results

We found the VR program to be highly (but not consistently) implementable across all sites. Factors that supported implementation were the following: resident interest in the content and technology, relative ease of use for staff to implement and formally integrating VR into the recreation calendar. Factors that impeded implementation were the following: the size of the headset, inability for the headset to cast given the sites' Information Technology infrastructure and some content that was not engaging.

Conclusions

VR programs are highly implementable and this implementation is enhanced by integration of the program into existing recreational systems, ease of use and resident engagement.
Synovial tuberculosis in wrist diagnosed based on metagenomic next-generation sequencing: A case report
Authors: Wu Meimei , Lan Xianfeng , Lin Shibei , Lai Tian , Lin Weiguo , Wu Hao
Published: March 2022

Synovial tuberculosis in the wrist is a rare disease that is usually misdiagnosed at the early stage. In this case, we presented a 67-year-old male with wrist joint tuberculosis who presented repeated left wrist joint edema for more than 2 years. The patient received surgery twice. During the second surgery, the combination of metagenomic next-generation sequencing (mNGS) and pathological analysis contributed to the detection of Mycobacterium tuberculosis in lesion tissues. Conventional anti-tubercular therapy confirmed the diagnosis of synovial tuberculosis in the wrist joint. In conclusion, mNGS contributed to the rapid and accurate detection of tubercle bacillus.
Teleworking in the Public Administration: An Analysis Based on Spanish Civil Servants’ Perspectives During the Pandemic
Authors: Ortiz-Lozano José M. , Martínez-Morán Pedro C. , de Nicolás Víctor L.
Published: March 2022

COVID-19 has inflicted unprecedented damage on the entire concept of work and has prompted a paradigm shift in workplace relations. Many work environments have faced a context in which on-site work has been restricted and telework has been the only viable option. In countries like Spain, the pandemic has forced the Public Administration to opt for this way of working in order to continue operating. Therefore, this study aims to determine the catalysts and blockers for Spanish civil servants wanting to telework. To achieve the study’s objectives, descriptive statistics were obtained using the multiple linear regression technique, with a model building system known as backward stepwise. The identification of these catalysts and blockers will help to facilitate human resource management based on teleworking in the public sector. This study’s findings could help to recommend possible actions to improve the employees’ teleworking experience at the Spanish Administración General del Estado. These actions include investing in equipment, providing training in information and communication technologies, and defining human resources policy to promote the work-life balance.