bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Characteristics of Anaphylaxis in Children Aged 0–16 Years in Xi’an, China
Authors: Su Yufei , Wen Jun , Zhang Huifang , Zou Zongyi , Cai Yuxiang , Zhang Cui
Published: December 2022

Introduction: Anaphylaxis is a serious systemic hypersensitivity reaction that usually has a rapid onset and may cause death. The aim of this study was to clarify the clinical characteristics of anaphylaxis in children of all ages in Xi’an, China. Methods: A retrospective study was conducted on anaphylaxis cases in the emergency department of the Affiliated Children’s Hospital of Xi’an Jiaotong University between January 1, 2016, and July 1, 2021. The statistical methods used were the χ2 test, Fisher’s exact test, and Z-test. Results: A total of 110 cases of anaphylaxis were collected: 70% were male, 13 were <1 year old, 17 were 1–2 years old, 42 were 3–6 years old, 38 were 7–16 years old, 10 (9.1%) had ≥2 anaphylaxis, and 75 (68.1%) had a previous history of allergy. The triggers of anaphylaxis were analyzed: 50 cases (45.5%) were induced by food, 37 cases (33.6%) by drugs, 6 cases (5.5%) by insect bites, 4 cases (3.6%) by exercise, and 12 cases (11.8%) by unknown causes. Common food allergens were milk (20%, 10/50), buckwheat (16%, 8/50), eggs (14%, 7/50), and fruits (14%, 7/50). The most common drug triggers were antibiotics (59.4%, 22/37), non-steroidal anti-inflammatory drugs (NSAIDs) (10.8%, 4/37), vaccines (10.8%, 4/37), and herbal medicines (10.8%, 4/37). Common food allergens vary by age: milk and eggs for infants, fruit for children aged 1–2 years, and buckwheat for children older than 3 years. Ninety-eight cases (89.1%) had skin mucosal involvement, 78 (70.9%) had respiratory compromise, 45 (40.9%) had cardiovascular compromise, and 31 (28.2%) had gastrointestinal symptoms. Cardiovascular compromise and reduced level of consciousness were statistically different between the age groups (p < 0.05). Twenty cases (18.2%) had resolved spontaneously when they reached the hospital, 53 cases (48.1%) received epinephrine, 18 (16.4%) were hospitalized, and 2 (1.8%) experienced a biphasic reaction. Conclusions: Males are overrepresented in children with anaphylaxis, and food and drugs are common triggers in children. However, the types of common food triggers differ across age groups, and infants are more likely to have cardiovascular compromise and a reduced level of consciousness. However, the use of epinephrine remains inadequate. The training of clinical staff in recognizing anaphylaxis needs to be strengthened.
Early Initiation of Exoskeletal Robotic Gait Training Improves Functional Outcomes in the Patients with Stroke: A Retrospective Observational Study
Authors: Degami Akira , Taki Shingo , Imura Takeshi , Iwamoto Yuji , Imada Naoki , Tanaka Ryo , Urakawa Susumu , Inagawa Tetsuji , Araki Hayato , Araki Osamu
Published: December 2022

Introduction: The effect of early initiation of gait training using hybrid assistive limb (HAL) remains unclear. This observational study aimed to investigate whether early initiation of gait training using HAL improves functional outcomes in patients with stroke. Methods: We retrospectively analyzed patients with acute stroke admitted to our facility. HAL was used for exoskeletal robotic gait training. Study participants were median split into an early group and a late group based on the days from stroke onset to initiation of gait training using HAL. The functional outcomes, defined by the Brunnstrom recovery stage (BRS), modified Rankin Scale (mRS), and Functional Independence Measure (FIM) at discharge, were compared using propensity score-matched analysis. Results: We performed a propensity score-matched analysis in 63 patients with stroke (31 from the early group and 32 from the late group), and 17 pairs were matched. There were no significant differences in discharge in the BRS of the upper limb and finger in the post-matched cohort. On the other hand, the BRS of the lower limb in the early group was significantly higher than that in the late group. In addition, the mRS, but not FIM scores, was significantly better in the early group than that in the late group. Conclusions: In conclusion, early initiation of gait training using HAL might improve the motor function of the paralyzed lower limb and disability in patients with stroke.
Prediction of Therapeutic Response Using Contrast-Enhanced Ultrasound in Japanese Patients Treated with Atezolizumab and Bevacizumab for Unresectable Hepatocellular Carcinoma
Authors: Takada Hitomi , Yamashita Koji , Osawa Leona , Komiyama Yasuyuki , Nakakuki Natsuko , Muraoka Masaru , Suzuki Yuichiro , Sato Mitsuaki , Takano Shinichi , Fukasawa Mitsuharu , Yamaguchi Tatsuya , Maekawa Shinya , Enomoto Nobuyuki
Published: December 2022

Introduction: Atezolizumab and bevacizumab (AB) therapy was the first-line treatment for unresectable hepatocellular carcinoma (u-HCC). However, the predictive marker of therapeutic response that can be easily used in clinical practice is still unknown. We prospectively investigated the utility of time-intensity curve (TIC) analysis using contrast-enhanced ultrasound (CEUS) as a predictive indicator of therapeutic response after the start of AB therapy. Methods: Thirty-five patients who received AB therapy for u-HCC were included in this study. TIC analysis was performed in 28 patients who were able to undergo CEUS before and 3–7 days after administration. We analyzed prognostic factors related to the initial therapeutic response and long progression-free survival (PFS). Results: The initial therapeutic response using dynamic computed tomography or Gd-EOB magnetic resonance imaging at 8–12 weeks after administration was partial response/stable disease/progressive disease (PD) in 14/12/9 cases (40/34/26%). Cases with PD (n = 9) had more cases without decreased blood flow in TIC analysis compared with cases with non-PD (100 vs. 18%, p = 0.001). Cases without decreased blood flow in TIC analysis (n = 10) had more cases with PD compared with cases with decreased blood flow (60 vs. 0%, p = 0.001). PFS in patients without decreased blood flow early after the administration was shorter than that in those with decreased blood flow (9.1 vs. 28 weeks, p = 0.0051). Conclusion: Early evaluation by TIC analysis using CEUS may be useful in predicting the therapeutic response in patients treated with AB therapy for u-HCC.
Preparação para o mergulho, desejo de convívio
Authors: Melo Luciana Cezário Milagres de
Published: December 2022

Este artigo tem o intuito de compartilhar o work in process (trabalho em processo) da pesquisa que estou desenvolvendo como mestranda em Artes da Cena. Irei realizar uma residência artística em quatro presídios femininos a partir de reflexões e práticas contemporâneas em teatro: a escrita e compartilhamento de cartas pessoais autobiográficas e ficcionais será mote para o encontro. Os princípios metodológicos são a atitude fenomenológica, a perspectiva etnográfica, a bricolagem, a desmontagem e a abordagem (auto)biográfica. Os principais instrumentos são a escrita de diários de bordo e a criação de mapas da pesquisa. A reflexão teórica será um estudo da etnografia do trabalho realizado e poderá suscitar contribuições para o campo da pesquisa em arte e para as mulheres participantes.
Teatro menor: crises e potências na intersecção dos processos de gestão, produção e criação artística de um teatro latino-americano
Authors: Silva Heloisa Marina da
Published: December 2022

Este artigo deriva da minha pesquisa de doutorado na qual investigo características de produção e gestão teatral, num contexto latino-americano, de obras, grupos, núcleos e artistas circunscritos no âmbito do que defini como teatro menor, metáfora inspirada nas reflexões de Deleuze e Guattari a respeito da literatura menor. São tomados como referências práticas trabalhos teatrais em que o artista, em especial atores e atrizes, possui também atribuições administrativas, visando questionar as práticas de produção e gestão como processos exclusivamente instrumentais, atentando para suas implicações como meio. Essa mudança de ponto de vista tem como fim a reorganização do ato da produção, sugerindo que a relação existente entre processo criativo e de produção define as práticas ideológicas desse tipo de fazer teatral.
Protokoli bodovanja težine ozljede kao prediktori ishoda za politraumatizirane pacijente
Authors: Spahić Ademir , Konjo Hadžan
Published: December 2022

Uvod: Težina ozljede kod politrauma procjenjuje se na temelju ljestvica koje se koriste zbrojem bodova (numerički sustavi), činjenica ozljede kao i na temelju iskustva u procjeni težine ozljeda. Skraćena ljestvica ozljeda (eng. Abbreviated Injury Scale - AIS) rangira ozljede od 1 do 6, s tim da 1 označava lakše ozljede, a 6 maksimalno teške ozljede. Ljestvica nije dizajnirana za predviđanje preživljavanja i koristi se rezultatima koji se temelje na konsenzusu. Ocjena ozbiljnosti ozljede (eng. Injury Severity Score - ISS) dodjeljuje bodove ozljedama traumatiziranog pacijenta s višestrukim ozljedama cijelog tijela. Cilj je ovog rada odrediti prediktivne vrijednosti postojeće ljestvice ozljeda na ISS ljestvici.Metode: Uzorak je obuhvatio 84 pacijenta oba spola i svih dobnih skupina koji su praćeni tijekom jedne godine. Ispitanici su imali višestruke, prodorne i nepenetrantne ozljede, a uključivali su i one čiji su vitalni parametri stabilizirani te je dijagnostika provedena prema protokolu u Klinici za intenzivnu njegu bez obzira na konačni ishod. Primijenjena je formula koja se koristi za pretvaranje AIS-a u ISS rezultat protokola gradacije.Rezultati: Ispitanici su bili prosječno u dobi od 40 ± 17,6 godina, od kojih je većina bila muškaraca, a prometne su nesreće bile prevladavajući mehanizam ozljeđivanja. ISS se povećava s težinom ozljeda. Udio pacijenata s CCC bodom ≤ 14 imao je pozitivnu prediktivnu vrijednost različitu od ISS-a. Udio ispitanika s politraumom koji su imali CCC rezultat = 15 i ISS < 15 imao je negativnu prediktivnu vrijednost.Zaključak: Utvrđeno je da postoji razlika u pouzdanosti između CCC-a i ISS sustava u određivanju stupnja ozbiljnosti stanja u bolesnika liječenih u Klinici za intenzivnu njegu.
Poučavanje sestrinskog umijeća pomoću književnosti, glazbe i slikarstva
Authors: Abou Aldan Damjan , Čargo Marin
Published: December 2022

Od sredine 20. stoljeća kroz izvorne sestrinske teorije pokušava se odrediti autentičnost sestrinstva kao discipline. Ono se uglavnom utvrđuje u odmaku od klasične biomedicinske paradigme koja je vezana za medicinu i liječničku profesiju. Već je Florence Nightingale taj odmak smatrala nužnim, a utvrdila ga je u holističkom pristupu čovjeku koji je odredila pomoću koncepta umijeća. Mnoge su druge teoretičarke, počevši od Peplau 1952. godine, ono autentično u sestrinstvu odredile u spoznajama koje su između empirijskog i neempirijskog, odnosno ono što će Cooper nazvati posebnim znanjima u sestrinstvu. Budući da se radi o teorijskim modelima i konceptima koji se razvijaju uglavnom na američkom tlu tijekom proteklih desetljeća, njihov je utjecaj još na razini razvijanja jedinstvenih hipoteza i sporadičnih istraživanja.Ipak, fenomeni koji obuhvaćaju te vrste spoznaja proizlaze iz neposrednog iskustva i doživljaja čovjeka u bolesti ili pri povratku zdravlja, stoga su u domeni subjektivnih spoznaja. S jedne su strane ta iskustva teška za konceptualiziranje, a time i istraživanje, a s druge su iznimno izazovna za poučavanje.Prijedlog autora je da se, utemeljeno na dostupnoj literaturi i pozitivnim primjerima iz prakse, kao metoda poučavanja za osjećaj suosjećanja i razumijevanja iskustva uvedu sadržaji umjetnosti kako to predlaže Watson, odnosno da se izlaganjem učenika i studenata umjetničkim sadržajima potakne njihova senzibilizacija za emotivna reagiranja sa svim pozitivnim posljedicama istih.
Global Characteristics and Dynamics of Single Immune Cells After Myocardial Infarction
Authors: Zhuang Lingfang , Wang Yaqiong , Chen Zhaoyang , Li Zhigang , Wang Ziyang , Jia Kangni , Zhao Jiaxin , Zhang Hang , Xie Hongyang , Lu Lin , Chen Kang , Chen Lei , Fukuda Keiichi , Sano Motoaki , Zhang Ruiyan , Liu Jun , Yan Xiaoxiang
Published: December 2022

Background

Myocardial infarction (MI) is characterized by the emergence of dead or dying cardiomyocytes and excessive immune cell infiltration after coronary vessel occlusion. However, the complex transcriptional profile, pathways, cellular interactome, and transcriptional regulators of immune subpopulations after MI remain elusive.

Methods and Results

Here, male C57BL/6 mice were subjected to MI surgery and monitored for 1 day and 7 days, or sham surgery for 7 days, then cardiac CD45‐positive immune cells were collected for single‐cell RNA sequencing to determine immune heterogeneity. A total of 30 135 CD45
+
immune cells were partitioned into macrophages, monocytes, neutrophils, dendritic cells, and T or B cells for further analysis. We showed that macrophages enriched for Olr1 and differentially expressed Gpnmb represented 2 crucial ischemia‐associated macrophages with distinct proinflammatory and prophagocytic capabilities. In contrast to the proinflammatory subset of macrophages enriched for Olr1, Gpnmb‐positive macrophages exhibited higher phagocytosis and fatty acid oxidation preference, which could be abolished by etomoxir treatment. In addition to macrophages, MI triggered prompt recruitment of neutrophils into murine hearts, which constituted the sequential cell‐fate from naïve S100a4‐positive, to activated Sell‐high, to aging Icam1‐high neutrophils. In silico tools predicted that the excessively expanded neutrophils at 1 day were attributed to chemokine C‐C motif ligand/chemokine C‐X‐C motif ligand pathways, whereas CD80/inducible T‐cell costimulator (ICOS) signaling was responsible for the immunosuppressive response at day 7 after MI. Finally, the Fos/AP‐1 (activator protein 1) regulon was identified as the critical regulator of proinflammatory responses, which was significantly activated in patients with dilated cardiomyopathy and ischemic cardiomyopathy. We showed the enriched Fos/AP‐1 target gene loci in genome‐wide association study signals for coronary artery diseases and MI. Targeting Fos/AP‐1 with the selective inhibitor T5224 blunted leukocyte infiltration and alleviated cardiac dysfunction in the preclinical murine MI model.

Conclusions

Taken together, this single‐cell RNA sequencing data lay the groundwork for the understanding of immune cell heterogeneity and dynamics in murine ischemic hearts. Moreover, Fos/AP‐1 inhibition mitigates inflammatory responses and cardiac dysfunction, which might provide potential therapeutic benefits for heart failure intervention after MI.
Community Gardens in Michigan: Demographic Attributes of Managers, Neighborhood Characteristics, and the Impacts of a Pandemic
Authors: Taylor Dorceta E. , Thompson Ki’Amber , Abednour-Brown Dominique , McCoy Ember , Daupan Socorro M. , Hollenquest Clarice
Published: December 2022

Community gardens are more popular than ever, yet we know little about how leadership structure and neighborhood characteristics relate to programming. Hence, this paper analyzes how the racial/ethnic backgrounds of the community garden leaders are related to the activities the garden undertakes. What types of initiatives do gardens undertake to reduce food insecurity? The paper analyzes how the location of the garden impacts what it does. The article presents novel findings on the impact of leadership and neighborhood characteristics on community garden operations and outcomes. Hence, the essay examines how the race/ethnicity of garden managers and their sex and neighborhood characteristics, such as poverty rate, household income, and racial composition, are related to garden initiatives. Finally, the paper examines how community gardens responded to increased demands for food and services during the Coronavirus Disease 2019 pandemic. We studied 53 community gardens in Michigan from the summer 2020 through the winter 2021. Whites manage 66% (35) of the gardens, while People of Color manage 34% (18). Roughly half of the gardens are managed by males and the remainder by females. The gardens, which lack paid staff, rely heavily on volunteers. Almost 53% of the gardens are in low-income census tracts (with median income of $40,000 or less). During the pandemic, 31% of the gardens reduced their staff, 51.4% had fewer volunteers than in pre-pandemic times, and 51.9% had increased amounts of people seeking food.
Formulary Drug Reviews: Betibeglogene Autotemcel
Authors: Levien Terri L. , Baker Danial E.
Published: December 2022

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
Decolonising social work with Nepali women
Authors: Ghimire Pratiksha , Yadav Raj , Davis Cindy
Published: December 2022

A plethora of discussion informs decolonising social work. However, how social work can be decolonised from women’s perspective is still unexplored. Using the context of Nepal as a case study, this article theoretically explores ‘the what’, ‘the why’ and ‘the how’ of decolonising social work from women’s standpoint. It is hoped this analysis will initiate and contribute to the critical debate on women, social work and decolonisation in Nepal and elsewhere.
COVID-19 and Street Vending in Tribal Areas: A Qualitative Analysis From Ground Zero—Aizawl, Mizoram, Northeast India
Authors: Lyngwa Aayushi , Sahoo Bimal Kishore
Published: December 2022

This study explores the impact of the COVID-19-induced economic crisis on tribal street vendors in Aizawl, India, using the framework of resilience theory. The paper uses a case-study approach to examine how street vendors recouped their economic losses after the relaxed lockdown phase during the region’s most celebrated Christmas and New Year festivals. A total of 74 street vendors were interviewed for this study using a semi-structured questionnaire. The study discusses that despite the relaxation of lockdowns, vendors faced extreme challenges in earning their daily wages, causing an inability to satisfy basic requirements like food, paying rent, and experiencing harsher workplace conditions. We observe that street vendors had heterogeneous motives toward street vending and were not driven by a single theoretical perspective. We present that most street vendors during the lockdowns reflect resilience in their businesses, socioeconomic, and workplace conditions through their indigenous coping mechanisms and social networking. We find that street vendors displayed entrepreneurial qualities during the lockdowns by either changing the goods they sold or how they were sold before the pandemic. The study recommends different economic and financial policies for street vendors at the ground level such as improving basic workplace amenities, safety, and awareness among street vendors and consumers.
Imago Dei in Early Christian Anaphoras
Authors: Zakhary Beniamin
Published: December 2022

Genesis expresses human creation in God's image and likeness. This Divine image— imago Dei—given to humanity, was an important notion in the liturgical prayers of early Christians. This paper shows that early Christian anaphoras of the first five centuries utilize image language to introduce the economy of salvation, emphasizing a need for Christ's salvific incarnation, while highlighting traditional descriptions of the imago Dei. Two descriptions of the imago Dei emerge in early anaphoras. One focuses on the immortality and rationality of the human soul as the depiction of the Divine image, seen in the anaphora of St Mark, the Armenian Anaphoras of St Basil, the Byzantine Anaphora of St Basil, and the Apostolic Constitutions. The second description of the imago Dei—best seen in the anaphora of St Gregory the Theologian and the Apostolic Constitutions—ties image to authority and complements Genesis 1:26, which references humanity's dominion after creation in the Divine image. These descriptions seem to take a secondary role, since introducing the salvation narrative remains the most dominant use of the imago Dei language, which highlights the link between creation and incarnation.
Healthcare use and healthcare costs for patients with advanced cancer; the international ACTION cluster-randomised trial on advance care planning
Authors: Korfage Ida J , Polinder Suzanne , Preston Nancy , van Delden Johannes JM , Geraerds Sandra (A)JLM , Dunleavy Lesley , Faes Kristof , Miccinesi Guido , Carreras Giulia , Moeller Arnfeldt Caroline , Kars Marijke C , Lippi Giuseppe , Lunder Urska , Mateus Ceu , Pollock Kristian , Deliens Luc , Groenvold Mogens , van der Heide Agnes , Rietjens Judith AC
Published: December 2022

Background:

Advance care planning supports patients to reflect on and discuss preferences for future treatment and care. Studies of the impact of advance care planning on healthcare use and healthcare costs are scarce.

Aim:

To determine the impact on healthcare use and costs of an advance care planning intervention across six European countries.

Design:

Cluster-randomised trial, registered as ISRCTN63110516, of advance care planning conversations supported by certified facilitators.

Setting/participants:

Patients with advanced lung or colorectal cancer from 23 hospitals in Belgium, Denmark, Italy, the Netherlands, Slovenia and the UK. Data on healthcare use were collected from hospital medical files during 12 months after inclusion.

Results:

Patients with a good performance status were underrepresented in the intervention group ( p< 0.001). Intervention and control patients spent on average 9 versus 8 days in hospital ( p = 0.07) and the average number of X-rays was 1.9 in both groups. Fewer intervention than control patients received systemic cancer treatment; 79% versus 89%, respectively ( p< 0.001). Total average costs of hospital care during 12 months follow-up were €32,700 for intervention versus €40,700 for control patients ( p = 0.04 with bootstrap analyses). Multivariable multilevel models showed that lower average costs of care in the intervention group related to differences between study groups in country, religion and WHO-status. No effect of the intervention on differences in costs between study groups was observed ( p = 0.3).

Conclusions:

Lower care costs as observed in the intervention group were mainly related to patients’ characteristics. A definite impact of the intervention itself could not be established.
Therapeutic uses of psychedelics for eating disorders and body dysmorphic disorder
Authors: Ledwos Nicole , Rodas Justyne D. , Husain M. Ishrat , Feusner Jamie D. , Castle David J.
Published: December 2022

Background:

Clinical use of psychedelics has gained considerable attention, with promising benefits across a range of mental disorders. Current pharmacological and psychotherapeutic treatments for body dysmorphic disorder (BDD) and eating disorders (EDs) have limited efficacy. As such, other treatment options such as psychedelic-assisted therapies are being explored in these clinical groups.

Aims:

This systematic review evaluates evidence related to the therapeutic potential of psychedelics in individuals diagnosed with BDD and EDs.

Methods:

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of all study designs published to the end of February 2022 that identified changes in ED/BDD symptom severity from psychedelics using validated measures to assess symptom changes.

Results:

Our search detected a total of 372 studies, of which five met inclusion criteria (two exploratory studies, two case reports, and one prospective study). These were included in the data evaluation. Effects of psychedelics on BDD and various ED symptoms were identified mostly through thematic analyses and self-reports.

Conclusions:

Our findings highlight that more research is needed to determine the safety and efficacy of psychedelics in BDD and EDs and we suggest avenues for future exploration.
Unboxing International Public Administrations: The Politics of Structural Change in the UN System (1998–2019)
Authors: Fleischer Julia , Buzogány Aron
Published: December 2022

Recent debates in international relations increasingly focus on bureaucratic apparatuses of international organizations and highlight their role, influence, and autonomy in global public policy. In this contribution we follow the recent call made by Moloney and Rosenbloom in this journal to make use of “public administrative theory and empirically based knowledge in analyzing the behavior of international and regional organizations” and offer a systematic analysis of the inner structures of these administrative bodies. Changes in these structures can reflect both the (re-)assignment of responsibilities, competencies, and expertise, but also the (re)allocation of resources, staff, and corresponding signalling of priorities. Based on organizational charts, we study structural changes within 46 international bureaucracies in the UN system. Tracing formal changes to all internal units over two decades, this contribution provides the first longitudinal assessment of structural change at the international level. We demonstrate that the inner structures of international bureaucracies in the UN system became more fragmented over time but also experienced considerable volatility with periods of structural growth and retrenchment. The analysis also suggests that IO's political features yield stronger explanatory power for explaining these structural changes than bureaucratic determinants. We conclude that the politics of structural change in international bureaucracies is a missing piece in the current debate on international public administrations that complements existing research perspectives by reiterating the importance of the political context of international bureaucracies as actors in global governance.
Urethral rupture concomitant with penile fracture does not adversely affect functional outcomes
Authors: Yilmaz Hasan , Avci Ibrahim Erkut , Cinar Naci Burak , Akdas Enes Malik , Unal Muhlis , Baynal Enes Abdullah , Kara Onder , Teke Kerem
Published: December 2022

Introduction:

The aim of this study was to identify possible risk factors for urethral rupture and to evaluate the effect of urethral rupture repair on long-term functional outcomes and complications.

Materials and methods:

The medical records of consecutive penile fracture patients were retrospectively reviewed. Penile fracture patients with and without urethral rupture were compared according to demographics, clinical and intraoperative findings. Comparisons of postoperative functional results of the groups were performed using the 5-item version of the International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS). Finally, among them, long-term penile complications including penile curvature, painful erection, palpable nodule, and paresthesia were assessed.

Results:

Fifty-three patients participated. Patients with urethral rupture ( n = 8) were older (44.50 ± 10.69, 36.58 ± 10.33 years, p = 0.052). There was no significant difference in fracture etiology ( p = 0.64). Urethral bleeding was present only in patients with urethral rupture ( p < 0.001). Although no bilateral corpus cavernosum rupture was encountered in penile fracture patients without urethral rupture, this rate was significantly higher in those with urethral rupture at a rate of 62.5% ( p < 0.001). The time from surgical repair to sexual activity was similar in both groups ( p = 0.66). There was no significant difference in IPSS and IIEF-5 scores, the presence of erectile dysfunction and complication rates ( p > 0.05).

Conclusions:

Older age is a possible risk factor for a concomitant urethral rupture with penile fracture and it seems to be associated with urethral bleeding and bilateral corpus cavernosum involvement. Additionally, urethral rupture repair neither adversely affected functional outcomes nor increased penile complication rates.
MAiD as a case study in evidence for policy making: An account of the CCA assessment on medical assistance in dying
Authors: Meslin Eric M. , Creutzberg Tijs
Published: December 2022

In December 2016, the Council of Canadian Academies (CCA) was asked by the Government of Canada to undertake an assessment on Medical Assistance in Dying (MAiD), following from Parliament’s passage of Bill C-14: An Act to amend the Criminal Code and to make related amendments to other Acts. The CCA was asked to undertake an assessment of the state of knowledge on three topics that Parliament excluded from C-14: requests for MAiD by mature minors, advance requests for MAiD, and requests for MAiD where a mental disorder is the sole underlying medical condition. Here, we describe the way that the CCA responded to the request from the Government of Canada using a multidisciplinary expert panel approach, how different forms of evidence were identified and used, the impact of the CCA assessment as part of the broader conversation occurring in Canada, and its implications for health leaders.
A Case of Refractory Angioedema
Authors: Irwin Thomas M. , Irwin Thomas M. , Longanecker Andrew , Bodenhamer William Spence , Keirns Carla C.
Published: December 2022

Angioedema is an acute disorder that affects mucous membranes and the deepest layers of the skin along with underlying tissue, marked by rapid swelling, large welts, and pain. There are 3 major subtypes of angioedema: mast-cell mediated, bradykinin-mediated, and multifactorial or unclear mechanism subtype. The most common subtype of bradykinin-mediated angioedema is ACE-inhibitor induced, which disproportionately affects African-Americans. It is most often self-limiting and usually responds to the withdrawal of the offending agent. The prolonged duration of angioedema is uncommon in the absence of a persistent stimulus, though it is more likely when there is an abnormality of the metabolic pathways, such as in hereditary angioedema or other gene polymorphisms affecting the complement system. We present a case of severe angioedema that persisted for over a month and required a tracheostomy to manage the airway.
Compilation of cutting load spectrum for CNC lathe based on DBN-BP prediction model
Authors: Li Guofa , Meng Fanning , Wang Jili , He Jialong , Zhao Xinyue , Feng Cong
Published: December 2022

Load spectrum can effectively represent variations in statistical load, and it is the foundation data for the overall product’s reliability test, reliability design and fatigue life analysis. However, compiling a load spectrum of small sample conditions is difficult because of the complicated and variable load conditions of machine tools and kaleidoscopic cutting process. Additionally, extreme load extrapolating is susceptible to subjective influences, thereby resulting in some uncertainties. Therefore, this study proposes a cutting load spectrum compilation method for computerised numerical control (CNC) lathe based on deep belief network-back propagation (DBN-BP) load prediction model, combining multi-source load condition information with deep learning. Firstly, single-layer BP and multi-layer restricted Boltzmann machine (RBM) were used to create a cutting load prediction model. Mixed distribution of mean and range of dynamic cutting load and parameters in copula function are predicted by using cutting process parameters. The number of hidden layers and single-layer nodes in the prediction model were determined using mean average (MA) precision and training time. Secondly, dynamic cutting load conditions were divided into the prediction model’s training, test and prediction sets; and the model’s accuracy was verified using comparative tests. Lastly, the two-dimensional mean-range matrix of load in each typical working condition was compiled using the prediction model, and the cutting load spectrum and two-dimensional CNC lathe programme loading spectrum were constructed. The proposed method saves time and personnel for numerous cutting tests when working with small samples and also assures load prediction accuracy.
Proprioceptive Focal Stimulation (Equistasi®) for gait and postural balance rehabilitation in patients with Parkinson’s disease: A systematic review
Authors: Alashram Anas R , Annino Giuseppe , Romagnoli Cristian , Raju Manikandan , Padua Elvira
Published: December 2022

Gait and postural deficits are the most common impairments in patients with Parkinson’s Disease (PD). These impairments often reduce patients’ quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.
Recent advances in wearable actuated ankle-foot orthoses: Medical effects, design, and control
Authors: Zhou Yuan
Published: December 2022

This paper presents a survey on recent advances of wearable actuated ankle-foot orthoses (AAFOs). First of all, their medical functions are investigated. From the short-term aspect, they lead to rectification of pathological gaits, reduction of metabolic cost, and improvement of gait performance. After AAFO-based walking training with sufficient time, free walking performance can be enhanced. Then, key design factors are studied. First, primary design parameters are investigated. Second, common actuators are analysed. Third, human-robot interaction (HRI), ergonomics, safety, and application places, are considered. In the following section, control technologies are reviewed from the aspects of rehabilitation stages, gait feature quantities, and controller characteristics. Finally, existing problems are discussed; development trends are prospected.
In plain sight: School librarian practices within infrastructures for learning
Authors: Centerwall Ulrika
Published: December 2022

This study explored how school librarian practices are resources that can support teaching and learning at schools in Sweden. The empirical material was produced through 22 semi-structured interviews with ‘best practice’ awarded librarians at 14 Swedish secondary and upper-secondary schools. The theoretical framework consisted of a practice theory approach coupled with analytical concepts from information infrastructure studies. The findings highlighted how teachers and librarians collaborate closely in schools with designated best practice libraries. Members of both professions collaborated in teaching and interdisciplinary projects and were supported by management teams at the schools under study. However, the librarians expressed a disconnect between themselves and the teachers and leaders of the school. This disconnect was evidenced by a lack of planning practices and classroom teaching, impelling the librarians to advocate continuously for better awareness and visibility of their practices. The article offers insights into school librarian practices at sites that function simultaneously as both workplaces for professionals with multiple competencies and educational settings for students.
Community laboratories in the United States: BioMakerspaces for life science learning
Authors: Walker Justice T. , Stamato Lydia , Asgarali-Hoffman S. Nisa , Hamidi Foad , Scheifele Lisa Z.
Published: December 2022

Informal learning environments play a critical role in science, technology, engineering, and mathematics learning across the lifespan and are consequential in informing public understanding and engagement. This can be difficult to accomplish in life science where expertise thresholds and logistics involved with handling biological materials can restrict access. Community laboratories are informal learning environments that provide access to the resources necessary to carry out pursuits using enabling biotechnologies. We investigate a group of these spaces in order to ascertain how this occurs—with specific attention to how material and intellectual resources are structured and shape learning. Using surveys and focus group interviews, we explore a group of these spaces located in the United States. We found that the spaces examined offer learning activities that are sufficiently scaffolded and flexible as to promote personalized and community-driven practice. We discuss these findings in relation to informal learning environment design and learning.
Confronting Populism
Authors: Weinstock Daniel M
Published: December 2022

The core populist claim is that ‘the people’ have been unjustly neglected by government. This core claim, while unexceptionable on its face, tends to be associated with claims that would corrode liberal democratic institutions. It is important that political and legal theorists identify the claims made by citizens who may be attracted by populist political forms, lest they manifest themselves in political forms toxic to (broadly understood) liberal democratic norms and institutions. They must address these claims, even as they also consider ways in which to confront these political forms. An example of how this work might proceed can be gleaned from some recent democratic theory and practice, which has ‘democratized’ membership in political parties as well as the process of selection of the party leader. This apparent democratization both disserves the cause of democratic deliberation, and opens the door to the risk of populist takeover of traditional parties.
Peripherally Inserted Central Catheter Fracture in a Preterm Neonate—Case Report
Authors: Mukherjee Devdeep , Das Saurabhi , Bhattacharjya Sudipto , Nayak Hemant Kumar
Published: December 2022

Peripherally inserted central catheters (PICC) are commonly used in the neonatal intensive care unit. They help in administering fluids, nutrition, and antibiotics. They have a lower risk for injury, infection, and thrombosis compared to central venous catheters. PICC fracture in a neonate has been rarely documented. We present a pre term neonate who had a PICC fracture remnant in the right atrium which was diagnosed following a contrast x ray and echocardiography. The PICC was removed percutaneously by our intervention pediatric cardiologist. All central venous access lines should be carefully monitored in the neonatal intensive care unit for risk of complications.
Abraham Lincoln: “A Man of Sorrows and Acquainted with Grief ”
Authors: Smith Harold Ivan
Published: December 2022

Many terms could answer the question, “Who was Abraham Lincoln?” Husband, father, president, emancipator and martyr are appellations attached to the sixteen president. Rarely, however, is griever mentioned and rarely have Lincoln's accumulated losses been examined through a thanatological lens. After early losses of mother, sister, and fiancée, Lincoln came to be described as “a man of sorrows.” The author explores an historical perspective of the impact of Lincoln's multiple losses, and offers a counseling tool—a grief grid--to inventory Lincoln's grief experiences. At a glance, the grid provides a clinician or grief educator insight to the potential impacts of Lincoln's multiple losses. Clinicians can adapt the grief grid for use with clients who have experienced multiple losses to prompt therapeutic reflection as well as for teaching and presentations. Indeed, Lincoln was well “acquainted with grief.
Application of WeChat-Utilized Mobile Health in Transitional Care Among Patients Undergoing Hepatectomy: A Pilot Study
Authors: Wang Meng , Long Fei , Liu Defang , Zhuo Yue , Tian Lijuan , Liang Hongyin
Published: December 2022

This study aimed to investigate whether mobile health (mHealth)-based transitional care, which utilized WeChat, could benefit patients undergoing hepatectomy. From January 2019 to December 2020, 807 patients who underwent hepatectomy in a tertiary care hospital were included in the study. Patients were divided into a transitional care group (TC group) ( n = 238) and a control group ( n = 569) based on whether they participated in mHealth-based transitional care, which utilized the WeChat application. Depending on the type of variables, t-tests, χ2 tests, and other statistical methods were used to compare differences between groups. Propensity score matching analysis was conducted for factors that differed in basic characteristics. After 1:1 matching, 238 patients were included in each group. Less readmission within 90 days of discharge, better quality of life, and higher satisfaction were found in the TC group both before and after matching ( p < .05). This study showed the potential of applying mHealth-based transitional care among post-hepatectomy patients.
A Multi-Centre, Single-Arm Clinical Study to Confirm Safety and Performance of PuraStat®, for the Management of Bleeding in Elective Carotid Artery Surgery
Authors: Stenson Katherine M. , Loftus Ian M. , Chetter Ian , Fourneau Inge , Cavanagh Stephen , Bicknell Colin , Loftus Paros
Published: December 2022

Anastomotic bleeding in vascular surgery can be difficult to control. Patients, in particular those undergoing carotid surgery, have often been started on treatment with dual antiplatelet agents and receive systemic heparinization intraoperatively. The use of local hemostatic agents as an adjunct to conventional methods is widely reported. 3-D Matrix’s absorbable hemostatic material RADA16 (PuraStat®), is a fully synthetic resorbable hemostatic agent. The aim of this study is to confirm the safety and performance of this agent when used to control intraoperative anastomotic bleeding during carotid endarterectomy (CEA). A prospective, single-arm, multicenter study involving 65 patients, undergoing CEA, in whom the hemostatic agent was applied to the suture line after removal of arterial clamps. Patients were followed up at 24 h, discharge, and one month after surgery. Time to hemostasis was measured as the primary endpoint. Secondary endpoints included hemostasis efficacy and safety outcomes, blood loss, intraoperative and postoperative administration of blood products, and incidence of reoperation for bleeding. A total of 65 cases (51 male and 14 female) undergoing CEA, utilizing patch reconstruction (90. 8%), eversion technique (6.1%), and direct closure (3.1%) were analyzed. All patients received dual antiplatelet therapy preoperatively and were administered systemic intravenous heparin intraoperatively, as per local protocol. The mean time to hemostasis was 83 s ± 105 s (95% CI: 55-110 s). Primary hemostatic efficacy was 90.8%. The mean volume of product used was 1.7 mL ± 1.1 mL. Hemostasis was achieved with a single application of the product in 49 patients (75.3%). Two patients required a transfusion of blood products intraoperatively. There were no blood product transfusions during the postoperative period. The intraoperative mean blood loss was 127 mL ± 111.4 mL and postoperatively, the total mean drainage volume was 49.0 mL ± 51.2 mL. The mean duration of surgery was 119 ± 35 min, and the mean clamp time was 35 min 12 s ± 19 min 59 s. In 90.8% of patients, there was no presence of hematoma at 24 h postoperatively. Three returned to theatre due to bleeding (2 in the first 24 h), however, none of these cases were considered product related. Overall, there were no device-related serious adverse events (SAE) or unanticipated device-related SAEs reported. Use of the hemostatic agent PuraStat® is associated with a high rate of hemostatic efficacy (90.8%) and a short time to hemostasis. The safety of the product for use on vascular anastomoses has been demonstrated.
Racial and Ethnic Disparities in U.S Children Undergoing Surgery for Congenital Heart Disease: A Narrative Literature Review
Authors: Ross Faith J. , Latham Gregory , Tjoeng Lie , Everhart Kelly , Jimenez Nathalia
Published: December 2022

Congenital Heart Disease (CHD) is a significant source of pediatric morbidity and mortality. As in other fields of medicine, studies have demonstrated racial and ethnic disparities in congenital heart disease outcomes. The cause of these outcome disparities is multifactorial, involving biological, behavioral, environmental, sociocultural, and systemic medical factors. Potential contributors include differences in preoperative illness severity secondary to coexisting medical conditions, differences in the rate of prenatal and early postnatal detection of CHD, and delayed access to care, as well as discrepancies in socioeconomic and insurance status, and systemic disparities in hospital care. Understanding the factors that contribute to these disparities is an essential step towards developing strategies to address them. As stewards of the perioperative surgical home, anesthesiologists have an important role in developing institutional policies that mitigate racial disparities. Here, we provide a thorough narrative review of recent research concerning perioperative factors contributing to surgical outcomes disparities for children of all ages with CHD, examine potentially modifiable contributing factors, discuss avenues for future research, and suggest strategies to address disparities both locally and nationally.
Neuropathological Findings in Short-Chain enoyl-CoA Hydratase 1 Deficiency (ECHS1D): Case Report and Differential Diagnosis
Authors: Pena-Burgos Eva Manuela , Regojo Rita María , Sáenz de Pipaón Miguel , Santos-Simarro Fernando , Ruiz-Sala Pedro , Pérez Belén , Esteban-Rodríguez María Isabel
Published: December 2022

Short-chain enoyl-CoA hydratase 1 (ECHS1) is an enzyme that participates in the metabolism of valine, transforming methacrylyl-CoA in β–hydroxy–isobutyryl-CoA. There is an accumulation of intermediate acids and ammonium as a consequence of its deficit. This background generates a harmful environment for the brain causing neuronal death and severe brain lesions. We present a case of a 39 weeks newborn that died at 31 hours old. We found vacuolization in basal areas, brain stem, cerebellum and spinal cord white matter (spongiform myelinopathy). These vacuoles were periodic acid–Schiff stain negative, there were neither acompanion gliosis nor macrophagic reaction. These findings were suggestive of metabolism acid disorders. The final diagnosis was confirmed by genetic study by massive parallel sequencing, showing 2 previously described pathogenic variants (c.160C > T and c.394G > A) of short-chain enoyl-CoA hydratase 1 gene. To our knowledge, this is the first case reporting the histological changes in short-chain enoyl-CoA hydratase 1 deficiency. Histological study provides useful information to orientate the diagnostic and clarify the clinical manifestations, especially in hospitals where urine or blood samples are not taking routinely or where genetic studies may not be performed.

Synopsis: The main neuropathological findings in Short-chain enoyl-CoA hydratase 1 deficiency are the presence of whitte matter vacuoles in basal areas, brain stem and spinal cord.