bluuebunny/crossref_metadata_2025 huggingface dataset:
Forum: Thinking Theoretically in Unsettled Times: COVID-19 and Beyond
Authors: Sterling-Folker Jennifer , Freyberg-Inan Annette , Wilcox Lauren , Ozguc Umut , Shinko Rosemary E
Published: May 2021

This collection of essays seeks to theorize the politics of the COVID-19 pandemic in international relations (IR). The contributions are driven by questions such as: How can theorizing help us understand these unsettled times? What kind of crisis is this? What shapes its politics? What remains the same and what has been unsettled or unsettling? In addressing such questions, each of the participants considers what we may already know about the pandemic as well as what might be ignored or missed. Collectively, the forum pushes at the interdisciplinary boundaries of IR theorizing itself and, in so doing, the participants hope to engender meaningful understandings of a world in crisis and encourage expansive ways of thinking about the times that lie beyond.
Whitewashing Evangelical Scripture: The Case of Slavery and Antisemitism in the English Standard Version
Authors: Perry Samuel L
Published: May 2021

Religious communities in pluralistic societies often hold in tension the task of reinforcing core identities and ideals within the community while negotiating public relations among those outside the community. Christian communities have sought to accomplish both projects materially through Bible modification, with most historically working to establish transitivity (congruence between the text and their own interpretive tradition), whereas others more recently have emphasized establishing what I call intransitivity (incongruence between the text and negative social interpretations from outsiders). This study examines the ways evangelical translation teams seek to accomplish both agendas simultaneously, creating a materialized instantiation of engaged orthodoxy. Drawing on the case of the English Standard Version (ESV)—a contemporary evangelical revision of the Revised Standard Version (RSV)—I show how the ESV editors, while modifying certain RSV renderings to establish transitivity for their text among complementarian/biblicist Christians, sought to establish intransitivity between the text and more pejorative social interpretations by progressively re-translating lexically ambiguous terms and introducing footnotes to obviate the Bible’s ostensible promotion of slavery and antisemitism. Findings elucidate how a conservative religious subculture, confronted with increasing pluralism, negotiates gaining legitimacy for their text within their sectarian subculture while also whitewashing “the Text” for public relations outside that subculture.
Challenges in Changing Social Norms: Evidence from Interventions Targeting Child Marriage in Ethiopia
Authors: Chow Vinci , Vivalt Eva
Published: May 2021

We study a set of interventions in Ethiopia geared towards eliminating child marriage. The interventions facilitate community discussion about child marriage and provide economic incentives for girls to stay in school and remain unmarried. Changing social norms is often thought of as very difficult, and if there is a marriage penalty to being among the first to deviate to an older age of marriage, raising the typical age at first marriage could be especially challenging. Regardless, using weighting and a difference-in-differences approach, we find that both interventions reduce the probability a girl from 8 to 17 years old has been married by about 4 to 7 percentage points. We observe some positive spillover effects: the program appears to have increased the intra-household decision-making power of women. However, we also find suggestive evidence of increased polarisation in beliefs about child marriage, including some possible backlash especially among men. No robust effects were seen on education outcomes, suggesting that, in contrast to other studies, this was not the mechanism through which the intervention had an effect.
Teacher Versus Parent Informant Measurement Invariance of the Strengths and Difficulties Questionnaire
Authors: Murray Aja Louise , Speyer Lydia Gabriela , Hall Hildigunnur Anna , Valdebenito Sara , Hughes Claire
Published: May 2021

Background and Objectives

Obtaining a multi-informant perspective is important when assessing mental health issues in childhood and adolescence. Obtaining ratings from both parents and teachers also facilitates the evaluation of similarities and contrasts in the nature and severity of symptoms across home and school contexts. However, these informants may differ in their interpretations of observed behaviors, raising questions about the validity of comparing parents’ and teachers’ ratings.

Methods

We evaluated the cross-informant measurement invariance of one of the most widely used measures of child and adolescent mental health: The Strengths and Difficulties Questionnaire (SDQ). Using data from the UK-population representative Millennium Cohort Study, we evaluated configural, metric, and scalar measurement invariance across parents and teachers when children were aged 7 (N = 10,221) and 11 (N = 10,543).

Results

Scalar measurement invariance held at both ages. Parents reported higher levels of symptoms in all domains measured at both ages as well as higher prosociality.

Conclusions

For a UK sample, valid comparisons of parent and teacher SDQ ratings at ages 7 and 11 appear to be possible, facilitating the evaluation of contextual differences in child mental health problems. Further, parents report more problem and prosocial behavior in their children than teachers attribute to them.
The snapshot distance method: estimating the distance to a Type Ia supernova from minimal observations
Authors: Stahl Benjamin E , de Jaeger Thomas , Zheng WeiKang , Filippenko Alexei V
Published: May 2021

We present the snapshot distance method (SDM), a modern incarnation of a proposed technique for estimating the distance to a Type Ia supernova (SN Ia) from minimal observations. Our method, which has become possible owing to recent work in the application of deep learning to SN Ia spectra (we use the deepSIP package), allows us to estimate the distance to an SN Ia from a single optical spectrum and epoch of 2 + passband photometry – one night’s worth of observations (though contemporaneity is not a requirement). Using a compilation of well-observed SNe Ia, we generate snapshot distances across a wide range of spectral and photometric phases, light-curve shapes, photometric passband combinations, and spectrum signal-to-noise ratios. By comparing these estimates to the corresponding distances derived from fitting all available photometry for each object, we demonstrate that our method is robust to the relative temporal sampling of the provided spectroscopic and photometric information, and to a broad range of light-curve shapes that lie within the domain of standard width–luminosity relations. Indeed, the median residual (and asymmetric scatter) between SDM distances derived from two-passband photometry and conventional light-curve-derived distances that utilize all available photometry is $0.013_{-0.143}^{+0.154}$ mag. Moreover, we find that the time of maximum brightness and light-curve shape (both of which are spectroscopically derived in our method) are only minimally responsible for the observed scatter. In a companion paper, we apply the SDM to a large number of sparsely observed SNe Ia as part of a cosmological study.
Circulating endotoxin and inflammation: associations with fitness, physical activity and the effect of a 6-month programme of cycling exercise during haemodialysis
Authors: March Daniel S , Lai Ka-Bik , Neal Tracy , Graham-Brown Matthew P M , Highton Patrick J , Churchward Darren R , Young Hannah M L , Dungey Maurice , Stensel David J , Smith Alice C , Bishop Nicolette C , Szeto Cheuk Chun , Burton James O
Published: May 2021

Background

Intradialytic cycling (IDC) may provide cardiovascular benefits to individuals receiving haemodialysis, but the exact mechanism behind these improvements remains unclear. The primary aim of this study was to investigate the effect of a 6-month programme of IDC on circulating endotoxin (secondary analysis from the CYCLE-HD trial). Secondary aims were to investigate changes in circulating cytokines [interleukin-6 (IL-6), IL-10, tumour necrosis factor-α, C-reactive protein (CRP) and the IL-6:IL-10 ratio] and their associations with physical activity, fitness and cardiovascular outcomes.

Methods

Participants were randomized to either a 6-month programme of IDC (thrice weekly, moderate intensity cycling at a rating of perceived exertion of 12–14) in addition to usual care (n = 46) or usual care only (control group; n = 46). Outcome measures were obtained at baseline and then again at 6 months.

Results

There was no significant (P = 0.137) difference in circulating endotoxin between groups at 6 months (IDC group: 0.34 ± 0.08 EU/mL; control group: 0.37 ± 0.07 EU/mL). There were no significant between-group differences in any circulating cytokine following the 6-month programme of IDC. Higher levels of physical activity and fitness were associated with lower levels of endotoxin, IL-6, CRP and IL-6:IL-10 ratio.

Conclusions

Our data show no change in circulating endotoxin or cytokines following a 6-month programme of IDC. However, higher levels of physical activity outside of haemodialysis were associated with lower levels of inflammation.
GridFree: a python package of imageanalysis for interactive grain counting and measuring
Authors: Hu Yang , Zhang Zhiwu
Published: May 2021

Grain characteristics, including kernel length, kernel width, and thousand kernel weight, are critical component traits for grain yield. Manual measurements and counting are expensive, forming the bottleneck for dissecting these traits’ genetic architectures toward ultimate yield improvement. High-throughput phenotyping methods have been developed by analyzing images of kernels. However, segmenting kernels from the image background and noise artifacts or from other kernels positioned in close proximity remain as challenges. In this study, we developed a software package, named GridFree, to overcome these challenges. GridFree uses an unsupervised machine learning approach, K-Means, to segment kernels from the background by using principal component analysis on both raw image channels and their color indices. GridFree incorporates users’ experiences as a dynamic criterion to set thresholds for a divide-and-combine strategy that effectively segments adjacent kernels. When adjacent multiple kernels are incorrectly segmented as a single object, they form an outlier on the distribution plot of kernel area, length, and width. GridFree uses the dynamic threshold settings for splitting and merging. In addition to counting, GridFree measures kernel length, width, and area with the option of scaling with a reference object. Evaluations against existing software programs demonstrated that GridFree had the smallest error on counting seeds for multiple crop species. GridFree was implemented in Python with a friendly graphical user interface to allow users to easily visualize the outcomes and make decisions, which ultimately eliminates time-consuming and repetitive manual labor. GridFree is freely available at the GridFree website (https://zzlab.net/GridFree).
Third-Party Credit Guarantees and the Cost of Debt: Evidence from Corporate Loans
Authors: Beyhaghi Mehdi
Published: May 2021

Using a comprehensive dataset collected by the Federal Reserve, I find that over one-third of corporate loans issued by US banks are fully guaranteed by legal entities separate from borrowing firms. Using an empirical strategy that accounts for time-varying firm and lender effects, I find that the existence of a third-party credit guarantee is negatively related to loan risk, loan rate, and loan delinquency. Third-party credit guarantees alleviate the effect of collateral constraints in credit market. Firms (particularly smaller firms) that experience a negative shock to their asset values are less likely to use collateral and more likely to use credit guarantees in new borrowings.
Phylogenomic Insights into the Origin of Primary Plastids
Authors: Irisarri Iker , Strassert Jürgen F H , Burki Fabien
Published: May 2021

The origin of plastids was a major evolutionary event that paved the way for an astonishing diversification of photosynthetic eukaryotes. Plastids originated by endosymbiosis between a heterotrophic eukaryotic host and cyanobacteria, presumably in a common ancestor of the primary photosynthetic eukaryotes (Archaeplastida). A single origin of primary plastids is well supported by plastid evidence but not by nuclear phylogenomic analyses, which have consistently failed to recover the monophyly of Archaeplastida hosts. Importantly, plastid monophyly and nonmonophyletic hosts could be explained under scenarios of independent or serial eukaryote-to-eukaryote endosymbioses. Here, we assessed the strength of the signal for the monophyly of Archaeplastida hosts in four available phylogenomic data sets. The effect of phylogenetic methodology, data quality, alignment trimming strategy, gene and taxon sampling, and the presence of outlier genes were investigated. Our analyses revealed a lack of support for host monophyly in the shorter individual data sets. However, when analyzed together under rigorous data curation and complex mixture models, the combined nuclear data sets supported the monophyly of primary photosynthetic eukaryotes (Archaeplastida) and recovered a putative association with plastid-lacking Picozoa. This study represents an important step toward better understanding deep eukaryotic evolution and the origin of plastids. [Archaeplastida; Bayesian; chloroplast; maximum likelihood; mixture model; ortholog; outlier loci; paralog; protist.]
The Strange Survival of ‘Embedded Liberalism’: National Economic Management and Globalization in Britain from 1944
Authors: Tomlinson Jim
Published: May 2021

This article examines the fate of national economic management in Britain in the face of the growing economic international interdependence, which initially grew in the context of the ‘Bretton Woods institutions’, and continued apace up until the crisis of 2007–8. It frames the argument with the concept of ‘Embedded Liberalism’, which allows to examine in detail the evolution of key elements of the Bretton Woods settlement, their subsequent development, and how far these shifts led to a ‘race to the bottom’ in national policies. On the basis of arguments about the continuing viability of national economic management, it questions how far we should accept a story of ‘the short life of social democracy’ as a wholly accurate account of Britain since the 1970s.
Calcific Tendinosis: What the General Radiologist Needs to Know
Authors: Hussain Jawad , Jawhar Omar , Judge Stephen , Joshi Vivek , Stavrakis Costas , Brooks Michael
Published: May 2021

Hydroxyapatite deposition disease (HADD), or calcific tendinosis, is a common cause of atraumatic pain. Radiologists can be of great diagnostic assistance using imaging and clinical data to decipher HADD from other similar presenting pathologies such as infection, gout, trauma, and tumor. The radiologist should be aware of the various diagnostic imaging pitfalls and mimics of calcific tendinosis so that they may prevent further unnecessary workup and invasive procedures. In addition, radiologists should understand the role of percutaneous image-guided interventions as treatment options for HADD. The radiologist's understanding of the clinical presentation, imaging features, and treatment options of HADD will improve diagnostic accuracy and patient outcomes.
Patient With Very High Opioid Tolerance Enrolled in Opioid Agonist Treatment: A Case Report
Authors: Wilson Patty , Lim Ron
Published: May 2021

Background:

Fentanyl and fentanyl analogs have invaded the street-sourced opioid market in North America which has resulted in an unprecedented number of unintentional opioid overdoses. Existing guidelines to treat opioid use disorder are based on evidence that was developed when heroin was the primary street-sourced opioid and proposed dosages of opioid agonist treatments are increasingly inadequate to address patients with high opioid tolerances.

Case Summary:

The authors examine one case study of a patient with an extremely high opioid tolerance and review how responsive dose adjustments outside of the recognized maximum doses allowed for meaningful functional outcomes.

Discussion:

This case demonstrates how patient-centered dose responses with a focus on functional outcomes supersede existing opioids agonist treatment dosing ranges, especially in the context of a patient with a higher than typical opioid tolerance.
Sociodemographic Correlates of Substance Use in a Sample of Egyptian Female University Students
Authors: El-Ghonemy Soheir H. , El-Din Mohamed H. , Mowafy Ahmed , Hasan Haytham , El Ghamry Reem H.
Published: May 2021

Objectives:

The aim was to find out the prevalence of psychoactive substance use among female students in Ain Shams University, Cairo, and to investigate associations between substance use and some selected sociodemographic factors.

Materials and Methods:

A total of 600 female students in their final year of college was recruited from six faculties of Ain Shams University; 3 practical faculties (medicine, dentistry, pharmacy) and 3 theoretical faculties (commerce, arts, law), 100 students from each. They completed the Structured Questionnaire for the Detection of Drug Intake and the Assessment of Sociodemographic Data which is a self-administered questionnaire used for the detection of substance use among university students.

Results:

The most commonly used substance was illicit drugs (9.8%), followed by tobacco (9%). Tobacco smoking was more prevalent between faculty of arts students and tobacco and cannabis use were more prevalent among theoretical faculties students. Being from Cairo, high family income, high daily pocket money, interneting as the main leisure time activity, and having friends or close relatives with substance use were positively associated with substance use among female university students.

Conclusion:

Illicit drugs were the most common substance used among female university students in Egypt. Substance use was influenced by sociodemographic factors; faculty, form of study, residence and living arrangement, parental education, income, leisure time activities, and having friends or relatives with substance use.
Patient outcomes after direct capsular closure following hip arthroscopy: a systematic review
Authors: Morris Jesse H. , Kirven James C. , DiBartola Alex C. , Vasileff William K.
Published: May 2021

Background:

Management of the hip capsule after arthroscopy remains controversial, with proponents of capsule repair arguing that this minimizes instability and restores native hip biomechanics.

Methods:

A systematic review was conducted. PubMed and EmBase were queried for outcomes related to hip arthroscopy. Exclusion criteria included: technique guides, editorials, reviews, biomechanical studies, case reports, studies without full text available, those without patient reported outcomes, and those that focused on high-risk-patient populations. Outcomes and measures of efficacy were collected and analyzed.

Results:

Six studies met all inclusion criteria, with 1428 patients overall. The majority of patients were female (63%) with mean age of 34.7 yr. Patients who were included underwent capsule repair as a standard of care. At average follow-up of 34 mo, weighted hip outcome scores activities of daily living scores improved from 66.2 preoperatively to 87.4 postoperatively, hip outcome scores sport improved from 43.4 to 75.3, and modified Harris Hip Score improved from 58.7 to 81.4. There was 80% patient satisfaction postoperatively. At last follow-up, there was a 5.0% revision arthroscopy rate, with pain as the most commonly cited indication. Lysis of adhesions was the most commonly performed procedure at revision.

Conclusions:

Available evidence was promising in regard to the function and durability of capsule closure when utilized on a routine basis. In this situation, revisions and conversion rates to total hip arthroplasty were very low with significant improvements in patient-reported outcomes. However, our data could not definitively support the claim that routine capsule closure leads to improved outcomes compared with leaving the capsulotomy unrepaired.

Level of Evidence:

Level IV.
Minimally Invasive Corrective Osteotomy for Metacarpal Malrotation
Authors: Duerinckx Joris , Caekebeke Pieter
Published: May 2021

Metacarpal fractures can be complicated by malrotation. This can cause functional problems with overriding or underriding of the fingers with flexion. Surgical treatment consists of corrective osteotomy and derotation. This is typically performed open and different techniques for osteotomy and fixation have been described. Postoperative complications include finger stiffness and hardware irritation. We propose a technique for minimally invasive corrective osteotomy of malunited metacarpal fractures with rotational malalignement. Advantages are quick rehabilitation and no prominent hardware.
Evaluation of systemic estrogen for preventing urinary tract infections in postmenopausal women
Authors: Fox Kate A. , Lokken Erica M. , Reed Susan D. , Rahn David D.
Published: May 2021

Importance:

Current guidelines for postmenopausal recurrent urinary tract infection (rUTI) prevention recommend the use of vaginal topical estrogen products but not systemic estrogens. Studies show that vaginal estrogen decreases the risk of rUTI, but evidence against use of systemic estrogen is less convincing.

Objective:

We performed a comprehensive literature review to evaluate the effect of systemic estrogen on UTI occurrence among postmenopausal women.

Evidence Review:

MEDLINE (PubMed), EMBASE, and CINAHL were searched for manuscripts published in English between January 1990 and July 2020. The search terms were “urinary tract infection” and “estrogen.” Inclusion criteria were studies of postmenopausal women who received systemic estrogen therapy (any regimen) that reported UTI frequency during any follow-up period. Case studies, commentaries, and reviews were excluded. A priori specifications of seven study criteria were set representing the ideal study for assessing efficacy of systemic estrogen for rUTI prevention and were used to evaluate each included study.

Findings:

Searches identified 281 results, and after deduplication and review, 8 studies met inclusion criteria: 4 randomized controlled trials, 1 secondary analysis of a randomized controlled trial, 1 prospective cohort study, 1 case-control study, and 1 cross-sectional study. Of the eight included studies, only two enrolled postmenopausal women with a rUTI diagnosis, four had sufficient sample size to detect a clinically meaningful difference between systemic estrogen versus placebo, two used dosage regimens anticipated to achieve a therapeutic effect, and three assessed UTI rates for an adequate duration of 6 months or more (the standard minimum duration of time needed to make a diagnosis of rUTI). Overall, none of the studies met all predefined criteria for the ideal study to assess the efficacy of systemic estrogen for rUTI prevention.

Conclusions and Relevance:

UTIs will continue to be a significant cause of morbidity and hospitalizations in postmenopausal women unless more research is done to better understand the role of estrogen on UTI rates. The evidence arguing use (or abandonment) of systemic estrogen for the prevention of rUTI is based on few studies with substantial methodologic limitations; there is significant room for improvement.
Coronary artery disease in patients with cancer: challenges and opportunities for improvement
Authors: Carrillo-Estrada Montserrat , Bobrowski David , Carrasco Rodrigo , Nadler Michelle B. , Kalra Sanjog , Thavendiranathan Paaladinesh , Abdel-Qadir Husam
Published: May 2021

Purpose of review

Coronary artery disease (CAD) is a common comorbidity in patients with cancer. We review shared risk factors between the two diseases and cancer treatments that increase the risk of CAD. We also discuss outcomes and management considerations of patients with cancer who develop CAD.

Recent findings

Several traditional and novel risk factors promote the development of both CAD and cancer. Several cancer treatments further increase the risk of CAD. The presence of cancer is associated with a higher burden of comorbidities and thrombocytopenia, which predisposes patients to higher bleeding risks. Patients with cancer who develop acute coronary syndromes are less likely to receive timely revascularization or appropriate medical therapy, despite evidence showing that receipt of these interventions is associated with substantial benefit. Accordingly, a cancer diagnosis is associated with worse outcomes in patients with CAD. The risk-benefit balance of revascularization is becoming more favorable due to the improving prognosis of many cancers and safer revascularization strategies, including shorter requirements for dual antiplatelet therapy after revascularization.

Several factors increase the complexity of managing CAD in patients with cancer. A multidisciplinary approach is recommended to guide treatment decisions in this high-risk and growing patient group.
What's trending: a review of social media in ophthalmology
Authors: Men Mauranda , Fung Simon S.M. , Tsui Edmund
Published: May 2021

Purpose of review

With social media use continuing to increase in popularity, ophthalmologists use social media daily for interactions with patients, colleagues, and the academic community.

Recent findings

The potential reach of social media is overwhelmingly encouraging, but academic organizations have much work to do in order to compete for viewership on social media platforms, and users need to remain vigilant of easily spread misinformation. Individual ophthalmology practices can tailor their social media presence to attract and educate patients. Using hashtags to supplement the experience of academic conferences has boosted engagement both of attendees and other interested parties. As an effective indicator of the popularity of different subjects in medicine, new studies are leveraging social media for epidemiological models. Finally, social media is emerging as a powerful tool for patient advocacy in ophthalmology.

The accessibility of social media uniquely positions it to educate patients, disseminate public eye health initiatives, and increase the reach of individual physicians. It is also able to enhance the academic experience of conferences, connecting new research colleagues, and is becoming the subject of epidemiologic studies itself. Whether using social media for patient education, research, clinical practice, or patient advocacy, ophthalmologists will find social media an increasingly important workplace contributor.
Postoperative Rehabilitation of Rotator Cuff Repair: A Systematic Review
Authors: Matlak Steven , Andrews Albert , Looney Austin , Tepper Kenneth B.
Published: May 2021

Rotator cuff tears are the most common cause of shoulder disability and can cause significant pain and dysfunction. This systematic review summarizes the latest research on rehabilitation following arthroscopic rotator cuff repair. Studies were eligible for inclusion if they pertained to postoperative rehabilitation following arthroscopic rotator cuff repair and were published between 2003 and 2019 with a level of evidence of 1 or 2. Two blinded reviewers screened, graded, and extracted data from articles and recommendations on various aspects of rehabilitation were summarized. A total of 4067 articles were retrieved from the database search and 22 studies were included for data extraction. We noted similar outcomes between early and delayed mobilization following surgery. Reviewed articles support the use of supervised physical therapy, bracing in 15 degrees external rotation, and adjunctive transcutaneous electrical nerve stimulation for pain management. Early isometric loading improved outcomes in 1 study. Evidence is lacking for exercise prescription parameters and postoperative rehabilitation of the subscapularis.
Postoperative Rehabilitation of Ulnar Collateral Ligament Reconstruction: A Systematic Review
Authors: Douoguih Wiemi A. , Day Jonathan , Bahrun Ehab A. , Bodendorfer Blake M. , Brandt Christopher , Looney Austin
Published: May 2021

The incidence of ulnar collateral ligament injuries has increased over the past few decades with greater participation in overhead throwing sports; however, optimal postoperative management following surgery remains unclear. This systematic review summarizes the latest evidence, on postoperative rehabilitation protocols for patients undergoing ulnar collateral ligament reconstruction (UCLR). Studies published in the English language from the year 2000 to 2019 with a level 1 to 4 grade of evidence and examined rehabilitation protocols following UCLR were eligible for inclusion. A multidatabase search was conducted. Two blinded reviewers screened and graded articles for inclusion and a third independent reviewer resolved any conflicts. Ten of the original 139 studies identified were used for analysis. Surgical techniques as well as rehabilitation protocols varied across studies. Analysis gave strong evidence that a 4-phase postoperative rehabilitation protocol utilizing milestone-based goals is effective in returning athletes back to preinjury levels of activity and sport within 1 year following UCLR.
A Protocol for Imaging of Cochlear Implantation
Authors: Wong Stephanie J. , Strohl-Bryan Alexis M. , Crane Benjamin T.
Published: May 2021

Objectives:

Correct electrode placement is a challenge of cochlear implant surgery, which occurs because electrode position cannot be directly visualized. This work aims to 1) develop a protocol for a practical, consistent, single view plain radiograph able to be used to confirm cochlear implantation, 2) confirm its usefulness on patients, and 3) confirm its usefulness for identifying misplaced electrodes in cadaveric ears.

Study Design:

Imaging procedure and quality improvement initiative.

Setting:

Tertiary academic hospital.

Patients:

Cadaveric ears, and patients undergoing cochlear implantation.

Intervention(s):

An intraoperative imaging protocol was developed specifying patient head position, machine position, and exposure setting. This was tested to confirm proper cochlear implantation in patients, including one revision case. This technique allowed the electrode placement to be reliably identified in patients of all ages. Its usefulness for identifying maligned electrodes (partial insertion, and insertion into the vestibule or hypotympanum) was confirmed using four cadaveric hemi-heads.

Main Outcome Measure(s):

Ability to accurately identify correct or incorrect electrode insertion based on radiographic images.

Results:

After adjusting radiographic exposure to account for the embalming process of the cadaveric heads, this new protocol was confirmed to be able to identify incorrect placement. This was also successfully used to confirm proper placement of cochlear implants in patients.

Conclusions:

Following a standardized radiographic protocol for cochlear implantation is a quick and easy method for checking electrode position.

Supplemental Digital Content, http://links.lww.com/MAO/B253.
Radiologic Findings in Pediatric Sudden Sensorineural Hearing Loss
Authors: Tey Ching Siong , Kadom Nadja , Dedhia Kavita
Published: May 2021

Objective:

Pediatric sudden sensorineural hearing loss (pSSNHL) is a rare phenomenon. There is currently no consensus on the role of imaging in the work-up for this patient population. We aim to evaluate the efficacy of magnetic resonance imaging (MRI) and high-resolution computed tomography (CT) studies in determining the etiology of pSSNHL.

Study Design:

Retrospective case review.

Setting:

Tertiary Hospital and Ambulatory Otolaryngology Clinic.

Patients:

Patients ≤18 years of age with sudden sensorineural hearing loss (SSNHL) and who had either MRI or CT imaging between January 2010 and May 2019 were included.

Intervention:

Diagnostic imaging.

Main Outcome Measures:

Clinical characteristics and radiology impressions.

Results:

A total of 11 patients were identified, and 10 had unilateral SSNHL. MRI was performed on all patients, five patients had additional CT imaging. Abnormal imaging findings relevant to SSNHL were observed in five patients (45.5%), which included enlarged endolymphatic duct and sac, labyrinthine ossification, apical petrositis, hypoplastic cochlear nerve, and arachnoid cyst in the internal auditory canal; one patient had unrelated findings (enlarged pituitary gland), all remaining imaging studies were normal.

Conclusion:

In our cohort, we found a higher imaging yield on pSSNHL than what has been reported for adult populations, indicating that the use of imaging in the diagnostic work-up is especially important in children.
Risk of venous thromboembolism and endocrine therapy in older women with breast cancer in the United States
Authors: Faiz Ambarina S. , Guo Shuang , Kaveney Amanda , Philipp Claire S.
Published: May 2021

Our aim was to evaluate the risk of venous thromboembolism (VTE) with tamoxifen and aromatase inhibitor in older women with breast cancer in the United States. The SEER-Medicare-linked database (2007--2013) was used for women of at least 65 years of age diagnosed with breast cancer in the United States. Logistic regression was used to examine unadjusted and adjusted odds ratios (OR) with 95% confidence intervals (CIs) for the risk of VTE. There were 178 059 women aged at least 65 years with breast cancer in the United States. Twenty-two thousand and forty-two (12.4%) women received tamoxifen, 64 384 (36.2%) women received aromatase inhibitors and 17 419 (9.8%) women received chemotherapy. Adjusted OR = 1.18 (95% CI 1.05--1.32) for VTE with tamoxifen for 3 years or less compared with tamoxifen use more than 3 years and OR = 1.07 (95% CI 1.05--1.16) for VTE with aromatase inhibitors 4 years or less compared with aromatase inhibitors use for more than 4 years. White women had OR = 1.19 (95% CI 1.05--1.35) and black women had OR = 1.07 (95% CI 0.76--1.51) for VTE with 3 years or less tamoxifen use compared with longer use. White women had OR = 1.09 (95% CI 1.00--1.18) and black women had OR = 1.07 (95% CI 0.86--1.34) for VTE with 4 years or less aromatase inhibitors use compared with longer use. Chemotherapy was associated with an increased risk of VTE (OR = 1.77, 95% CI 1.69--1.86). Chemotherapy combined with tamoxifen had OR = 1.64 (95% CI 1.45--1.86) and chemotherapy combined with aromatase inhibitors had OR = 1.71 95% CI 1.59–1.84). The study may help to identify a treatment profile for VTE risk that may facilitate VTE prevention.
Genetic analysis of a pedigree with hereditary coagulation factor XII deficiency
Authors: Zhang Haiyue , Pan Dongli , Shen Weifeng
Published: May 2021

The aim of this study was to elucidate the molecular defects of a Chinese family with hereditary coagulation factor XII (FXII) deficiency. The FXII activity (FXII:C) and FXII antigen (FXII:Ag) levels were measured by clotting assay and ELISA, respectively. To identify mutations, the F12 gene sequencing was carried out. ClustalX-2.1-win and four online bioinformatics tools were applied to study the conservatism and harm of the mutation. The proband's FXII:C and FXII:Ag were 3 and 4%, respectively. Sequencing analysis revealed compound heterozygous mutations, including the deletion mutation (c.130delG) resulting in p.E26Sfs∗50 and the missense mutation (c.1561G>A) resulting in p.E502K. Bioinformatics indicated that mutations probably disrupt the function of the FXII protein. The c.130delG heterozygous deletion variation and the c.1561G>A heterozygous missense variation were responsible for the reduction of FXII:C in this family, of which c.130delG was first reported in the world.
Association Between Gastroesophageal Flap Valve and Endoscopically Diagnosed Gastroesophageal Reflux Disease According to Lyon Consensus
Authors: Bao Yun , Chen Xiaosu , Xu Ying , Wang Yan , Lin Lin , Tang Yurong
Published: May 2021

Background:

Lyon Consensus altered the previous understanding of endoscopic gastroesophageal reflux disease (GERD) and pointed out that only high-grade reflux esophagitis (RE) [Los Angeles (LA) grades C or D], Barrett’s esophagus or peptic stricturing were considered confirmatory evidence for GERD but low-grade RE (LA grades A or B) was regarded as suspected GERD. We aimed to summarize the possible relationship between gastroesophageal flap valve (GEFV) and endoscopic GERD according to Lyon Consensus using meta-analysis of studies done in Asia.

Materials and Methods:

Comprehensive searches of PubMed, WOS, Embase, SinoMed, and CNKI databases were completed to identify eligible studies published before September 22, 2019. A total of 237 articles have been reviewed and 2 reviewers independently evaluated the eligibility for inclusion, extracted, and analyzed the statistical data. The pooled risk ratios (RRs) with 95% confidence intervals (CI) were measured for the association. Random-effects models were used when observing significant heterogeneity.

Results:

A total of 15 studies were included and we found that abnormal GEFV (III and IV) could be associated with RE and the correlation become stronger as the grade increases (RE-A vs. controls—RR: 2.186, 95% CI: 1.560-3.064, P<0.001; RE-B vs. RE-A—RR: 1.268, 95% CI: 1.128-1.425, P<0.001; RE-C vs. RE-B—RR: 1.181, 95% CI: 1.000-1.395, P=0.049; RE-D vs. RE-C—RR: 1.471, 95% CI: 1.151-1.879, P=0.002). Both suspected GERD (RR: 2.400, 95% CI: 1.761-3.271, P<0.001) and endoscopic GERD (RR: 1.388, 95% CI: 1.127-1.711, P=0.002) were related to abnormal GEFV.

Conclusion:

Abnormal GEFV could provide useful information for reflux conditions, but it could not distinguish confirmatory GERD from low-grade RE under the upper endoscopy.
Treatment of Monteggia-like-lesion in a young patient
Authors: Santoso Agung R. B. , Huwae Thomas E. C. J. , Wijaya Anindita E. P. , Pribadi Alva , Cendikiawan Felix , Abduh Muhammad
Published: May 2021

Introduction:

A Monteggia fracture was described initially as a fracture of the proximal third ulna and anterior dislocation of the proximal epiphysis radius.
[1]
In 1967, Bado discovered “true Monteggia lesions” and classified them into 4 groups.
[2]
He also used the term “equivalents” or “Monteggia-like-lesions” to describe specific injuries with similar radiographic patterns.
[3]
This type of fracture is rare and frequently associated with complications, poor functional results, and further operations.
[4]

Patient concerns:

A 16-year-old girl was admitted to our emergency department after a single motorcycle accident. Her main complaint was the pain and swollen of her left elbow. She was reluctant to move her arm due to pain.

Diagnosis:

Radiograph examination showed a displaced fracture of the left proximal third ulna accompanied by displacement of the left proximal radius. This fracture was similar to the Monteggia type III fracture except for proximal radial disruption that occurred laterally through a Salter-Harris type II fracture.

Interventions:

The patient underwent surgical debridement, and the forearm was immobilized using a backslap in a supine position and elbow flexion 90o. Open reduction and internal fixation were performed 5 days later. The ulna was reduced and stabilized first using a 3.5 mm one-third tubular plate (ORMED), and internal fixation of the radial epiphysis was done using a 1.6 mm miniplate (Prohealth).

Outcomes:

After 3 months, the patient showed improvement with the Mayo Elbow Performance Score (MEPS) of 85. She did not complain of any pain and decreased strength. The patient regained 0 to 125o of elbow flexion and 0 to 165o of supination and pronation.

Conclusion:

Monteggia-like-lesion has many variations in physical and radiograph appearance. Careful evaluation of fracture pattern, identification of injury mechanism, and appropriate treatment planning based on Monteggia fracture treatment principles are mandatory to achieve the patient's best outcome.
Effect of ultrasound-guided pulsed radiofrequency on intercostal neuralgia after lung cancer surgery
Authors: Wei Tong , Hou Hui , Zhou Li-li , Mu Qiu-xia
Published: May 2021

This retrospective study investigated the effect of ultrasound-guided pulsed radiofrequency (UGPRF) on intercostal neuralgia (ICN) after lung cancer surgery (LCS).

This retrospective observational study analyzed the outcome data of UGPRF on ICN in 80 patients with LCS. All those patients were allocated into a treatment group (n = 40) and a control group (n = 40). All patient data were collected between January 2018 and November 2019. The primary outcome was pain intensity (measured by numerical rating scale, NRS). The secondary outcomes were sleep quality (measured by Pittsburgh Sleep Quality Index, PSQI), anesthetic consumption, and treatment-related adverse events.

After treatment, patients in the treatment group showed better outcomes in NRS (P < .01), PSQI (P < .01), and anesthetic consumption (P < .01), than patients in the control group. No treatment-related adverse events were documented in both groups in this study.

The results of this study found that UGPRF may benefit patients for pain relief of ICN after LCS.
Comparison of liver biochemical abnormality between COVID-19 patients with liver cirrhosis versus COVID-19 alone and liver cirrhosis alone
Authors: An Yang , Ma Zhuang , Guo Xiaozhong , Tang Yufu , Meng Hao , Yu Hao , Peng Chengfei , Chu Guiyang , Wang Xinwei , Teng Yue , Zhang Quanyu , Zhu Tianyi , Wang Bing , Tong Zhenhua , Zhao Haitao , Lu Hui , Qi Xingshun
Published: May 2021

Coronavirus disease (COVID-19) patients frequently develop liver biochemical abnormality. However, liver biochemical abnormality in COVID-19 patients with liver cirrhosis is under-recognized.

Patients hospitalized during COVID-19 pandemic in China (ie, from February to April 2020) were screened. All of 17 COVID-19 patients with liver cirrhosis consecutively admitted to the Wuhan Huoshenshan Hospital were identified. Meanwhile, 17 age-, sex-, and severity-matched COVID-19 patients without liver cirrhosis admitted to this hospital were selected as a control group; all of 14 cirrhotic patients without COVID-19 consecutively admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command were selected as another control group. Incidence of liver biochemical abnormality and decompensated events were primarily compared.

Among the COVID-19 patients with liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 76.50% and 84.60%, respectively; 7 (41.20%) had decompensated events at admission; 1 was transferred to intensive care unit due to gastrointestinal bleeding. Among the COVID-19 patients without liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 58.80% (P = .271) and 60.00% (P = .150), respectively. Among the cirrhotic patients without COVID-19, the incidence of liver biochemical abnormality at admission and during hospitalization were 69.20% (P = .657) and 81.80% (P = .855), respectively; 11 (78.60%) had decompensated events at admission (P = .036). None died during hospitalization among the three groups.

Liver biochemical abnormality is common in COVID-19 patients with liver cirrhosis. Management of decompensated events in cirrhotic patients without COVID-19 should not be neglected during COVID-19 pandemic.
The relationships between thyroid-stimulating hormone level and insulin resistance, glucose effectiveness, first- and second-phase insulin secretion in Chinese populations
Authors: Chuang Tsung-Ju , Lin Jiunn-Diann , Wu Chung-Ze , Ku Hui-Chun , Liao Chun-Cheng , Yeh Chih-Jung , Pei Dee , Chen Yen-Lin
Published: May 2021

Increased insulin resistance (IR); decreased glucose effectiveness (GE); and both first-and second phase of insulin secretion (FPIS, SPIS) have always been important factors for the development of type 2 diabetes. Therefore, in this study, we evaluated the relationships between thyroid-stimulating hormone (TSH) and these 4 factors in adult Chinese.

We randomly enrolled 24,407 men and 24,889 women between 30 and 59 years old. IR, FPIS, SPIS and GE were measured with the equations built by our group.

The t test was performed to evaluate the differences between normal and diabetic groups. To evaluate the differences of the mean values of the 4 groups, from the highest to the lowest levels of TSH, we used a one-way analysis of variance.

Age, high density lipoprotein-cholesterol and GE were higher in women. On the other hand, body mass index, blood pressure, low density lipoprotein-cholesterol, triglyceride, FPIS, SPIS and IR were higher in men. TSH was positively related to IR, FPIS, and SPIS and negatively related to GE. According to the r values, the tightest relationship was between TSH and IR, followed by GE, FPIS and SPIS.

In conclusion, our data showed that IR, FPIS, and SPIS were positively related to the TSH level in middle-aged Chinese, whereas GE was negatively related. In both genders, IR had the tightest association followed by GE, FPIS, and SPIS.
An initial learning experience of tracheal intubation with video laryngoscope
Authors: Shih Chai-Bae , Wu Yu-Hwa , Lin Chung-Ren , Tseng Chia-Chih Alex
Published: May 2021

Tracheal intubation is an essential technique for many healthcare professionals and one of the mega code simulations in advanced cardiac life support. In recent years, video laryngoscopy (VL) has provided a rescue for difficult airways during intubation and has proven to have higher success rates. Moreover, VL facilitates a more rapid learning curve for inexperienced doctors.

In this article, we report 16 cases intubated with VL by a novice doctor of postgraduate year 1, who shared the learning experience and the difficulties encountered in this case series. We also conducted a statistical analysis to evaluate the learning outcomes of the trainee after 1 month.

Our results showed that the overall first-shot success rate was 81.3% for the 16 objectives. Over time, improvements in intubation performance measures, including shortened duration and lower Intubation Difficulty Scale score, have been observed. In this learning project, we found that limitation of mouth opening (<2.5 fingers wide) is an important risk factor for predicting the initial difficulty of tracheal intubation on the novice trainee.

For inexperienced doctors, VL produces high first-shot success rates for tracheal intubation and may be useful for training their performance in a short period of time. In addition, mouth opening <3 fingers wide may result in difficult intubation by novice doctors.