bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Feedback Control for the Proportion of Energy Cost in the Upper-Arm Reaching Movement
Authors: Taniai Yoshiaki
Published: September 2023

The minimum expected energy cost model, which has been proposed as one of the optimization principles for movement planning, can reproduce many characteristics of the human upper-arm reaching movement when signal-dependent noise and the co-contraction of the antagonist’s muscles are considered. Regarding the optimization principles, discussion has been mainly based on feedforward control; however, there is debate as to whether the central nervous system uses a feedforward or feedback control process. Previous studies have shown that feedback control based on the modified linear-quadratic gaussian (LQG) control, including multiplicative noise, can reproduce many characteristics of the reaching movement. Although the cost of the LQG control consists of state and energy costs, the relationship between the energy cost and the characteristics of the reaching movement in the LQG control has not been studied. In this work, I investigated how the optimal movement based on the LQG control varied with the proportion of energy cost, assuming that the central nervous system used feedback control. When the cost contained specific proportions of energy cost, the optimal movement reproduced the characteristics of the reaching movement. This result shows that energy cost is essential in both feedforward and feedback control for reproducing the characteristics of the upper-arm reaching movement.
Was Medusa a Priestess of Athena?
Authors: Henry John
Published: September 2023

In Book 4 of Ovid’s Metamorphoses, the famous backstory of the Gorgon Medusa is related by her slayer Perseus: Neptune raped her in the temple of Minerva, and the goddess turned her hair into snakes out of divine vengeance for the desecration of her sanctuary. With few exceptions, most Ovid scholars are hesitant to posit any explanation for Medusa’s appearance at the temple, which does not appear to be justified in Ovid’s poem as it stands. In this article, the possibilities will be further explored: was Medusa (1) a priestess, (2) a suppliant or (3) simply a young woman of otherwise unspecified status? On further examination of the Book 4 passage, it will be argued that Ovid presents the metamorphosis myth of Medusa as an allusion, and that earlier sources were more likely to be forthcoming in their identification of the character.
“What’s the Purpose of Having a Say If I Cannot Participate?”
Authors: Strømland Monica , Bahus Marianne K. , Andersen Anders J.W.
Published: September 2023

The aim of this study was qualitatively to describe, explore and reflect upon young people’s experiences of being heard and to participate in decision-making processes made in their best interests when in contact with child welfare services (cws) in Norway. Despite children’s right to be heard according to national and international legislation, three out of nine interviewees expressed an overall experience of this when in contact with professionals. Positive experiences of being heard and experienced opportunities of participation formed a basis for personal well-being and trustful relations, whereas negative experiences were associated with mistrust and discontent. We analysed the interviews in light of child participation theory and the Capability Approach, using thematical content analysis. Based on our findings we suggest the Capability Approach in combination with theory of participation to operationalise children’s right to be heard.
Event-triggered state and fault simultaneous estimation for nonlinear systems with time delays
Authors: Huong Dinh Cong
Published: September 2023

This paper addresses the problem of event-triggered robust state and fault simultaneous estimation for nonlinear time-delay systems subject to actuator and sensor unknown disturbances. Based on a fault decomposition technique and some basic mathematical transformations, we obtain an augmented system where the state vector consists of the variable of the original system and the fault. Then a novel event-triggered state observer for the augmented system is proposed to robustly estimate the variable of the original system and the fault. We next established a sufficient condition for the existence of such an observer. We translated it into a linear matrix inequality (LMI), which can be effectively solved using the MATLAB LMI Control Toolbox. Finally, an illustrative example is applied to test the proposed method.
Robust tracking strategy for nonlinear connected vehicle cyber-physical systems
Authors: Yang Yushi , Li Meng , Chen Yong
Published: September 2023

This paper investigates the problem of tracking target control of a nonlinear system in the context of cyber-physical systems for connected autonomous vehicles with external unknown disturbances. A new robust tracking strategy via backstepping sliding-mode control is proposed. First, a connected nonlinear vehicle dynamical model with disturbances is constructed. Then, a disturbance observer is presented to approximate the unknown disturbances when the derivative of the disturbance is bounded. This paper has proved that the error of the observation can converge to zero in finite time. Third, a tracking control method is designed which combines the backstepping method with the sliding-mode method. According to the method, the estimated values of interference are used as a priori knowledge. Furthermore, the stability of the designed control strategy is demonstrated through using the Lyapunov theory. Finally, simulation experiments are presented to demonstrate the feasibility of the proposed approaches.
Gender equality discourse in classical music higher education: Women, individualisation, and change
Authors: Werner Ann , Kuusi Tuire
Published: September 2023

This article takes its’ starting point in the ongoing debate about gender and gender equality in higher music education (HME) institutions where new policies, projects and initiatives have been developed during the first decades of the 21st century. This article’s analysis is framed by feminist scholarship on gender equality, and gender mainstreaming, as well as music education research about gender and gender equality. The aim is to investigate how gender and gender equality is talked about in classical music higher education, analyse how it is experienced and in what terms it is described. The main research question is, how is gender and gender equality constructed among leaders, teachers and students in three HME institutions in Nordic (Finland), Baltic (Estonia) and Central European (Hungary) countries. It is based on qualitative thematic semi-structured interviews with 45 participants, analysed with qualitative data-driven content analysis. In the discussion we argue that gender and gender equality are, in our material, constructed as being about women, that gender is rarely related to other types of discrimination or inequalities and that the cause of gender inequality is individualised. The conclusions suggest steps for further pursuing gender equality in HME.
Is cohabitation a prerequisite for marriage?: Exploring Ghanaian emerging adults’ attitudes and intentions
Authors: Gyasi-Gyamerah Angela Anarfi , Quansah Christabel , Annor Francis , Gyasi-Gyamerah Kwasi
Published: September 2023

With cohabitation increasingly becoming a relationship option for many young adults, understanding the attitudes and intentions that fuel the decision to cohabit is important. Using a generic qualitative research design, we set out to explore this among emerging adults in a Ghanaian university. Our sample included 44 students who participated in a discussion focused on determining what cohabitation means to them, the significance they attach to cohabitation, their evaluations and whether they intend to cohabit. Regarding participants’ attitudes, four themes were generated from analyses of the data including ‘Meaning of Cohabitation’, ‘Cohabitation before Marriage is Crucial to Marital Success’, ‘Cohabitation is a Gateway to Moral and Institutional Transgressions’, and ‘As Long as We Marry’. Findings also showed significant gender differences in intention to cohabit although the consensus among participants was that one’s intention to cohabit is dependent on the individual’s personal and vicarious experiences within their environment. Based on these findings, we recommend that counsellors and guardians be equipped with the knowledge base and skills required to help young adults navigate cohabitation relationships and advocate for strengthening policy and education on cohabitation.
A mathematical characterization of minimally sufficient robot brains
Authors: Sakcak Basak , Timperi Kalle G , Weinstein Vadim , LaValle Steven M
Published: September 2023

This paper addresses the lower limits of encoding and processing the information acquired through interactions between an internal system (robot algorithms or software) and an external system (robot body and its environment) in terms of action and observation histories. Both are modeled as transition systems. We want to know the weakest internal system that is sufficient for achieving passive (filtering) and active (planning) tasks. We introduce the notion of an information transition system (ITS) for the internal system which is a transition system over a space of information states that reflect a robot’s or other observer’s perspective based on limited sensing, memory, computation, and actuation. An ITS is viewed as a filter and a policy or plan is viewed as a function that labels the states of this ITS. Regardless of whether internal systems are obtained by learning algorithms, planning algorithms, or human insight, we want to know the limits of feasibility for given robot hardware and tasks. We establish, in a general setting, that minimal information transition systems (ITSs) exist up to reasonable equivalence assumptions, and are unique under some general conditions. We then apply the theory to generate new insights into several problems, including optimal sensor fusion/filtering, solving basic planning tasks, and finding minimal representations for modeling a system given input-output relations.
Diagnostic performance of two versions of an artificial intelligence system in interval breast cancer detection
Authors: Çelik Levent , Güner Davut Can , Özçağlayan Ömer , Çubuk Rahmi , Arıbal Mustafa Erkin
Published: September 2023

Background

Various versions of artificial intelligence (AI) have been used as a diagnostic tool aid in the diagnosis of breast cancer. One of the most important problems in breast screening progmrams is interval breast cancer (IBC).

Purpose

To compare the diagnostic performance of Transpara v1.6 and v1.7 in the detection of IBC.

Material and Methods

Reports of screening mammograms of a total 2,248,665 of women were evaluated retrospectively. Of 2,129,486 mammograms reported as Breast Imaging Reporting and Data System (BIRADS) 1 and 2, the IBC group consisted of 323 cases who were diagnosed as having cancer on mammography and were correlated with pathology in second mammogram taken >30 days after first mammogram. Four hundred and forty-one were defined as the control group because they did not change over 2 years. Cancer risk scores of both groups were determined from 1 to 10 with Tranpara v1.6 and v1.7. Diagnostic performances of both versions were evaluated by the receiver operating characteristic curve.

Results

Cancer risk scores 1 and 10 in v1.7 increased compared to v1.6 ( P < 0.001). In all cases, sensitivity for v1.6 was 56.6%, specificity was 90%, and, for v1.7, sensitivity was 65.9% and specificity was 90%, respectively. In all cases, area under the curve values were 0.812 for v1.6 and 0.856 for v1.7, which was higher in v1.7 ( P < 0.001). Diagnostic performance of v1.7 was higher than v1.6 at the 7–12-month period ( P < 0.001).

Conclusion

The present study showed that Tranpara v1.7 has a higher specificity, sensitivity and diagnostic performance in IBC determination than v1.6. AI systems can be used in breast screening as a secondary or third reader in screening programs.
Unproductive Labor and the Smile Curve
Authors: Quentin Clair
Published: September 2023

A production boundary consistent with Marx’s theory of value may be drawn around labor that is quantitatively predicated by output at the point of exchange, as opposed to being merely causally predicated. The key difference between that production boundary and received Marxist doctrine on unproductive labor is that all other labor is excluded, rather than only such other labor that also falls to be treated as forming part of the “sphere of circulation.” Alternatively put, both sides of the “smile curve” are unproductive of value, rather than just the right-hand side. This conclusion substantiates the analytical nexus as between material production and global inequality to be found in critical global value chain literature.

JEL Classification: B51, D43, D46, F66, O34
Early outcomes of peritoneal dialysis in a middle-income country: A retrospective cohort study of a large dialysis network in Colombia
Authors: Rivera Angela S , Vesga Jasmin I , Páez Sergio , Astudillo Kindar , Aldana Andrea , Alba Yolima , Niño Luz E , Castillo Juan C , Sanabria Mauricio , Lindholm Bengt , Rutherford Peter
Published: September 2023

Background:

The first year of dialysis is critical given the significant risk for complications following dialysis initiation. We analysed complications during the first year among incident peritoneal dialysis (PD) patients.

Methods:

This retrospective cohort study comprised adult kidney failure patients starting PD in Baxter Renal Care Services in Colombia, receiving their first PD catheter between 1 January 2017 and 31 December 2020 and were followed up for up to 1 year. We analysed incidence, causes and factors associated with complications using logistic regression and transfer to haemodialysis (HD) using the Fine–Gray regression model.

Results:

Among 4743 patients receiving their first PD catheter: 4628 (97.6%) of catheter implantations were successful; 377 (7.9%) patients experienced early complications. The incidence rate of complications during the year was 0.51 events per patient-year (95% CI: 0.48–0.54). Age, obesity and urgent start were associated with higher probability of complications after catheter implantation. The cumulative incidence of transfer to HD within 1 year of PD initiation was 10.1% [95% CI: 9.2–11.1%]. The hazard function for transfer to HD showed an accelerating pattern during the first month followed by progressive decrease during the first year.

Conclusions:

In this large population of incident PD patients, there is a high primary catheter placement success rate. Urgent start, age ≥65 years, obesity, centre size ≥150 PD patients and diabetes were risk factors associated with early complications. The follow-up of the cohort from day 1 of PD treatment showed that the risk for transfer to HD was higher during the first month.
An algorithm for solving the equilibrium points of high-dimensional nonlinear vehicle dynamic system based on a combination of genetic algorithm, sequential quadratic programming method, and continuation method
Authors: Wang Xianbin , Langari Reza , Pei Yulong , Li Zhipeng , Li Weifeng
Published: September 2023

The paper proposes an algorithm that combines Genetic Algorithm, Sequential Quadratic Programming, and Continuation Method to solve the equilibrium points of a multi-degree-of-freedom vehicle nonlinear system. The algorithm’s effectiveness is demonstrated by applying it to search for equilibrium points of a 5-degree-of-freedom (5DOF) nonlinear vehicle model, which considers both longitudinal and lateral motion. The dynamic equilibrium points of front-wheel-drive, rear-wheel-drive, and all-wheel-drive vehicles with different front-wheel steering angle inputs are calculated. Taking the front-wheel-drive system as an example, the system equilibrium points are further analyzed using phase space analysis and eigenvalue analysis for verification. In addition, the impact of the driving effect on the equilibrium points bifurcation is investigated. The results show that compared with the Genetic Algorithm alone and the combination method of Genetic Algorithm and Sequential Quadratic Programming, the proposed algorithm can effectively and accurately solve the equilibrium points of the 5DOF vehicle model. The study also reveals that the driving effect significantly influences the vehicle equilibrium point bifurcation.
Hontologie: A Lacanian theory of shame
Authors: Green Sharon R. , Vanheule Stijn
Published: September 2023

This article develops a Lacanian theory of shame in dialogue with the work generated by shame pioneers in the post-Freudian traditions. The article’s hypothesis is that shame is an index pointing to ontological lack. The neologism hontologie combines the French words for shame and ontology; it is a negative ontology proper to Lacan’s theory that the subject lacks an essential core of identity or unity. Key concepts used to theorize shame in the psychoanalytic literature are examined, including the self, ego, and the gaze. These concepts are revised and incorporated into a Lacanian theory of shame starting with Lacan’s mirror stage through the evolution of his work to include the object a, the partial drives, and the fundamental fantasy. In a cross-theoretical dialogue, shame is described in terms of the Imaginary and Symbolic registers. The article also addresses the misconception that Lacanians ignore the importance of affect.
A globally exponentially stable observer for torque estimation with only position measurement
Authors: Liu Li , Yue Xiaokui , Wen Haowei , Hao Zhiwei , Zhu Yuan
Published: September 2023

A novel estimation scheme for joint torque information is constructed by observer design method in the case that force/torque/velocity/acceleration sensors of manipulator are not available. Based on generalized dynamic scaling function and scalar filtering, the globally exponentially stable observer for torque estimation with only position measurement is presented in this article. The main contribution lies in the development of the classic Nicosia observer with performance improvements and significant order reduction compared to the existing results. Comparative simulations demonstrate the effectiveness and superiority of the proposed scheme.
Experimental study on autonomous docking and hook-locking control for unmanned surface vehicle platforms
Authors: Wu Nailong , Gao Tianming , Wang Meng , Gao Kunpeng , Qi Jie , Chen Xinyuan , Wang Yueying , Feng Zhiguang
Published: September 2023

The challenge in autonomous docking and hook locking of multiple unmanned surface navigation platforms is to design an appropriate autonomous docking controller and ensure that the electric control hook can iteratively dock with the passive vessel. The current docking control solution for unmanned surface platforms needs to design an automatic tracking–generated trajectory and visual guidance docking system, capable of detecting the connection status after the hook-lock action to ensure a successful connection. However, most of the docking control designs for unmanned surface platforms pay more attention to the first-time success rate but pay less attention to the failures caused by complex and intelligent docking devices or environmental interference during docking. This article proposes a control strategy for autonomous docking and hook locking of two unmanned surface platforms. It guides the active vessel to the side of the passive vessel under the task requirements and triggers the visual docking control algorithm to complete the mechanical connection of the two joints. This method employs an iterative detection mechanism to improve the automatic hook and lock capability of both the active and passive vessels. The indoor pool and outdoor lake experiments demonstrate that the proposed method can successfully perform automatic iterative docking and hook locking, even in the presence of wave disturbance, showcasing the effectiveness of the proposed method.
Prescription analgesic medication use among osteoarthritis patients
Authors: Huang Zhenzhen , Chen Xinxin , Gan Xihong , Chen Jiajia
Published: September 2023

Objective

Pharmacotherapy is the most common strategies to reduce pain for osteoarthritis (OA) patients. To analyze the trend and pattern of prescription analgesic medication use in American OA patients. Besides, our study also tried to figure out the demographic characteristics of opioid use among OA population which may helpful for managing the use of opioids.

Methods

We included 2214 OA patients from 2007 to 2018. We extracted data from National Health and Nutrition Examination Survey (NHANES) database. We compared analgesics and anti-depression medications use by category between survey participants with OA and without.

Results

For OA patients, NSAIDs, acetaminophen and gabapentinoid were the mostly highly used analgesics (10.2%, 9.0% and 8.9%, respectively). However, we also found that opioids use was very common in OA patients (7.7%) and the duration of opioids use was significantly long. In addition, the opioids use did not decrease from 2007 to 2018, while gabapentinoid increased rapidly from recent decade (From 5.0% to 12.1%). The common analgesic combination used by OA population was opioids with acetaminophen and gabapentinoid with selective serotonin reuptake inhibitors (SSRIs) (2.9% and 2.7%, respectively).

Conclusion

The use of gabapentinoid increased rapidly from recent decade, while opioids use did not decrease. The long-term excessive use of opioids was also a serious problem for OA pain control. More improvements such as focusing more on healthcare education and paying more attention on non-pharmacotherapy and the psychological situation of patients are needed.
Domestic Violence and Alcohol and Other Drug Use: Australian Pilot Intervention Findings
Authors: Meyer Silke , Helps Nicola , McGowan Jasmine , Williamson Harley
Published: September 2023

Purpose: Problematic alcohol and drug use (AOD) is a contributing factor to escalate domestic violence (DV). Yet, combined DV and AOD interventions remain limited. This article examines a combined pilot intervention for men with comorbid AOD and DV use. Methods: Mixed methods with concurrent triangulation design. Data comprises victim-survivors' reports of abuse at intake and exit, interviews with men and victim-survivors at exit and 6-month followup, and 12-month follow-up court data. Study participants included 30 male program participants and 14 female victim-survivors. Results: Findings suggest reduced AOD and DV use at program exit, that appears maintained for most men at 6-month followup. The victim-survivor data suggests more positive outcomes among men who maintained or resumed their relationship with the victim-survivor than separated men. Conclusions: Findings indicate benefits of combined early interventions addressing comorbid AOD and DV use and highlight the importance of victim-survivor voices in program reviews.
Tools, Potential, and Pitfalls of Social Media Screening: Social Profiling in the Era of AI-Assisted Recruiting
Authors: Kong Yeqing , Ding Huiling
Published: September 2023

Employers are increasingly turning to innovative artificial intelligence recruiting technologies to evaluate candidates’ online presence and make hiring decisions. Such social media screening, or social profiling, is an emerging approach to assessing candidates’ social influence, personalities, and workplace behaviors through their publicly shared data on social networking sites. This article introduces the processes, benefits, and risks of social profiling in employment decision making. The authors provide important guidance for job applicants, technical and professional communication instructors, and hiring professionals on how to strategically respond to the opportunities and challenges of automated social profiling technologies.
Lower Leg Lateral Chronic Exertional Compartment Syndrome: Prospective Surgical Treatment Outcomes for Isolated or Combined Lateral Fasciotomy
Authors: van Zantvoort Aniek P. M. , de Bruijn Johan A. , Hundscheid Henricus P. H. , Teijink Joep A. W. , Scheltinga Marc R.
Published: September 2023

Background:

Chronic exertional compartment syndrome involving the lower leg lateral compartment (lat-CECS) seldom occurs isolated but is usually combined with CECS of the anterior (ant-CECS) or deep posterior compartment (dp-CECS). Patient characteristics in lat-CECS and outcome after surgery are largely unknown. The aim of this prospective case series was to describe patient characteristics and symptoms and to report on outcome following a fasciotomy.

Methods:

All patients diagnosed with lat-CECS based on exertional lateral lower leg symptoms and elevated intracompartmental pressure (ICP) measurements according to the Pedowitz criteria (ICP ≥ 15 mm Hg at rest, and/or ≥30 mm Hg after 1 minute, and/or ≥20 mm Hg 5 minutes after exercise) were eligible for this study. A standard intake questionnaire scoring symptom patterns was completed by all patients. Patients who were operated for lat-CECS were asked to complete a 3-month and 12-month postoperative questionnaire scoring symptoms and surgical outcome. Patients with a history of CECS surgery, recent lower leg trauma, or peripheral neurovascular disease were excluded.

Results:

A total of 881 patients with possible lower leg CECS completed an intake questionnaire and 88 (10%) were diagnosed with lat-CECS according to the Pedowitz criteria (isolated lat-CECS n = 10; lat/ant CECS n = 54, lat/ant/dp CECS n = 19, lat/dp CECS n = 5). Severe pain during exercise and moderate tightness during rest were frequently reported. A group of 28 patients (49 legs; isolated lat-CECS n = 2; lat/ant CECS n = 22, lat/ant/dp CECS n = 3, lat/dp CECS n = 1) was analyzed after fasciotomy. Complications were minor (wound infection requiring antibiotics, n = 3; temporary complex regional pain syndrome with spontaneous recovery, n = 1). Superficial peroneal nerve damage was not observed. One year after surgery, 64% rated outcome as excellent or good, whereas 71% had resumed sports activities.

Conclusion:

One in 10 patients with anterolateral exertional lower leg pain evaluated in a tertiary referral center met diagnostic criteria for lat-CECS. Pain and tightness were present during exertion and were often reported occurring during rest and at night. In this series, we found fasciotomy—either an isolated (lateral) or a multiple (combined with anterior and/or deep posterior) compartment fasciotomy—is safe and beneficial in most patients.

Level of Evidence:

Level IV, case series.
A novel cross-bearing fault diagnosis method based on pseudo-label transitive domain adaptation networks
Authors: Zhang Kai , Ding Kun , Zheng Qing , Zou Yisheng , Ding Guofu
Published: September 2023

Transfer across bearings produces a greater domain shift than transfer across working conditions (WCs). Because different bearings may have differences in structural parameters, measurement environments, and WCs, a direct transfer may significantly lower the diagnostic accuracy of the target bearing. A novel fault diagnosis method based on pseudo-label transitive domain adaptation networks (PLTDANs) is proposed to address this problem. First, empirical selection criteria are offered to ensure that appropriate intermediate domains are selected and can better bridge the source and target domains. The intermediate-domain-added TDAN can split the direct transfer process into source-intermediate and intermediate-target transfer diagnoses. This division allows for the gradual correction of the domain shift. Second, the cross-domain pseudo-label constraint (CDPLC) is proposed to select high-confidence intermediate domain samples and generate corresponding pseudo-labels. Pseudo-labels highlight the health status of intermediate domain samples. The application of CDPLC aims to minimize the cumulative error of the TDAN. A cross-bearing fault diagnosis experiment demonstrated the PLTDAN's effectiveness.
Openings
Authors: Salvo James
Published: September 2023

The work of good editing creates openings for others to express their own ideas. The world is such that—to put it in the language of game theory—we must play cooperatively in the academy. The urgency of things needing our attention and action does not leave time for us to play strategic games wherein we compete with those who would be allies in our striving toward the flourishing of all.
Should All Patients With Pulmonary Hypertension Undergoing Non-Cardiac Surgery Be Managed by Cardiothoracic Fellowship-Trained Anesthesiologists?
Authors: Bhatia Meena , Scheiber Christopher J. , Arora Simrat , Gustafson Chelsea , Funk Ian , Grosshuesch Craig , Simmers Carter , Li Quefeng , Liu Yutong , Smeltz Alan M.
Published: September 2023

Objectives

To identify differences in practice patterns and outcomes related to the induction of general anesthesia for patients with pulmonary hypertension (PH) performed by anesthesiologists who have completed a cardiothoracic fellowship (CTA group) vs those who have not (non-CTA group).

Design

Retrospective study with propensity score matching.

Setting

Operating room.

Participants

All adult patients with PH undergoing general anesthesia requiring intubation at a single academic center over 5 years.

Interventions

Patient baseline characteristics, peri-induction management variables, post-induction mean arterial pressure (MAP), and other outcomes were compared between CTA and non-CTA groups.

Methods and main results:

Following propensity scoring matching, 402 patients were included in the final model, 100 in the CTA group and 302 in the non-CTA group. Also following matching, only cases of mild to moderate PH without right ventricular dysfunction remained in the analysis. Matched groups were overall statistically similar with respect to baseline characteristics; however, there was a greater incidence of higher ASA class ( P = .025) and cardiology and thoracic procedures ( P < .001) being managed by the CTA group. No statistical differences were identified in practice patterns or outcomes related to the induction of anesthesia between groups, except for longer hospital length of stay in the CTA group ( P = .008).

Conclusions

These results provide early evidence to suggest the induction of general anesthesia of patients with non-severe PH disease can be comparably managed by either anesthesiologists with or without a cardiothoracic fellowship. However, these findings should be confirmed in a prospective study.
A case of panuveitis caused by caterpillar setae
Authors: Zhang Ying , Yuan Yuan , Zhao Ruyi , Tan Wei
Published: September 2023

Introduction

Panuveitis is a serious inflammatory disease. Setae are fibers produced by many insects and plants. Many case reports have described caterpillar and spider fibers entering the eye. These hairs are covered with tiny barbs that help them enter and migrate into the eye tissue, leading to severe inflammation. Normally, they are buried mainly in the conjunctiva and cornea. However, in the present case, they entered the posterior segment of the eye, which is very rare.

Case description

A female patient presented with a complaint of repeated foreign body sensation, redness, pain, and photophobia in the left eye for 9 years following initial exposure to caterpillars. She visited the doctor in January after aggravation of symptoms. Slit-lamp examination, ultrasound biomicroscopy, ultrasound B-scan, fluorescein angiography, and indocyanine green angiography revealed the presence of a foreign body in the vitreous, which caused discomfort in the patient's left eye and subsequently, panuveitis of the left eye. The symptoms improved significantly after foreign body removal using vitrectomy. Microscopic examination revealed that the foreign body was caterpillar setae.

Conclusion

Clinicians should be more vigilant about history of contact with caterpillars while examining uveitis that has recurred for many years. Identification of the root cause of the disease can ensure better treatment.
Top-down mass spectrometry for characterizing the low molecular weight proteome of canine osteosarcoma cell phenotypes
Authors: Yang Liping , Stanisheuski Stanislau , Song Zifeng , Bracha Shay , Maier Claudia S.
Published: September 2023

Osteosarcoma (OS) is the most common primary malignant tumor of bone, which occupying about 20% of all bone cancers. To increase understanding of the biology of OS, we developed and evaluated a top-down mass spectrometry approach to detect, identify and quantify low molecular weight (MW) proteins (i.e., 1 kDa < MW < 30 kDa) in osteosarcoma cells. Top-down proteomic (TDP) data was acquired using reversed phase nano-liquid chromatography in conjunction with high-resolution mass spectrometry and resulted in the assignment of 328 proteins and 820 proteoforms or degradation products with high confidence. Eight post-translational modifications (PTMs) were identified in the present study, including N-terminal acetylation, lysine acetylation, succinylation, malonylation, serine/tyrosine phosphorylation, histidine methylation and N-acetylleucine. We confirmed that a truncated N-terminal proteoform lost 73 Da of mass through removal of the N-terminal Met (−131 Da), acetylation of the second amino acid (+42 Da), and Met oxidation (+16 Da). The results showed that the levels of proteoforms/biodegradable peptides correlated with the metastatic phenotypes of osteosarcoma cell lines. This study demonstrates the benefits of TDP for the characterization and relative quantification of proteoforms with relevance to OS biology and the potential of small molecular weight proteoforms to serve as a still underappreciated source of biomarkers.
Clinical, imaging, and management features of symptomatic carotid web: Insight from CAROWEB registry
Authors: Olindo Stephane , Gaillard Nicolas , Chausson Nicolas , Turpinat Cedric , Dargazanli Cyril , Bourgeois-Beauvais Quentin , Signate Aissatou , Joux Julien , Mejdoubi Mehdi , Piotin Michel , Obadia Mickael , Desilles Jean-Philippe , Delvoye François , Holay Quentin , Gory Benjamin , Richard Sébastien , Denier Christian , Robinet-Borgomano Emmanuelle , Carle Xavier , Desal Hubert , Guillon Benoit , Viguier Alain , Lamy Matthias , Pico Fernando , Landais Anne , Boulanger Marion , Renou Pauline , Gariel Florent , Jean Papaxanthos , Yann Lhermitte , Papillon Lisa , Marnat Gaultier , Smadja Didier
Published: September 2023

Background:

Although carotid web (CaW) is increasingly diagnosed as a cause of cryptogenic stroke, data are still limited to monocentric small sample cohort. To broaden knowledge on symptomatic CaW, CAROWEB registry has been recently implemented.

Aims:

In a large cohort of symptomatic CaW patients, we described epidemiologic characteristics, admission clinical and imaging features, and the current management including the secondary preventive strategy choice made in comprehensive French Stroke Units.

Methods:

CAROWEB is an ongoing French observational multicenter registry enrolling consecutive CaW patients diagnosed after an ipsilateral ischemic stroke (IS) or transient ischemic attack (TIA). Submitted cases were validated by two experienced neurologist and neuroradiologist. Clinical, imaging, and management features were collected for this study.

Results:

Between June 2019 and December 2021, 244 cases were submitted by 14 centers, 42 rejected, and 202 included (IS, 91.6%; TIA, 7.9%; retinal infarction, 0.5%; mean age, 50.8 ± 12.2 years; female, 62.9%; Caucasian, 47.5%; Afro-Caribbean, 20.3%). IS patients showed median (interquartile range (IQR)) admission National Institutes of Health Stroke Scale (NIHSS) score, 8 (2–15); intracranial artery occlusion, 71.8%; ipsilateral chronic cerebral infarction (CCI), 16.3%; and reperfusion treatment, 57.3%. CaW was not identified during the mechanical thrombectomy procedure in 30 of 85 (35.3%) patients. Secondary prevention was invasive in 55.6% (stenting, n = 80; surgery, n = 30). In multivariable analysis, the invasive therapeutic option was associated with ipsilateral CCI (odds ratio (OR): 4.24 (1.27–14.2), p = 0.019) and inversely associated with risk factors (OR: 0.47 (0.24–0.91), p = 0.025) and admission NIHSS score (OR: 0.93 (0.89–0.97), p = 0.001).

Conclusion:

CaW must be considered in all ethnic groups including Caucasians. Secondary prevention is heterogeneous in large French Stroke Centers. The absence of risk factors, milder severity strokes, and ipsilateral CCI were predictive variables of secondary invasive treatment. The high rate of invasive treatment suggests that medical treatment alone is deemed ineffective to avoid recurrence and emphasize the need of randomized trials.
Transient left bundle branch block associated with very high coronary artery calcium: a case report
Authors: Razavi Alexander C. , Prabakaran Sindhu , Sawan Mariem , Tummala Lakshmi , Onuorah Ifeoma , Amin Sagar B. , van Assen Marly , De Cecco Carlo N. , Quyyumi Arshed A. , Whelton Seamus P. , Sperling Laurence S. , Rollin Francois G.
Published: September 2023

Coronary artery calcium (CAC) is the measure of subclinical coronary artery atherosclerosis most strongly associated with atherosclerotic cardiovascular disease (ASCVD) risk. However, CAC is rarely reported in the inpatient setting to guide chest pain management. We present a case of very high CAC in a 64-year-old woman with hypertension, type 2 diabetes, and hyperlipidemia presenting with dyspnea. Initial electrocardiogram (ECG) demonstrated normal conduction with a heart rate of 76 beats/min, but new T-wave inversions in V1–V4 and a high-sensitivity troponin-I (hsTnI) value of 6 ng/L (normal < 6 ng/L). Repeat ECG in the emergency department showed normal sinus rhythm (heart rate of 80 beats/min); however, it subsequently demonstrated a left bundle branch block (LBBB) with a repeat hsTnI of 7 ng/L. Stress testing with pharmacologic single-photon emission computerized tomography did not show scintigraphic evidence of ischemia but noted extensive CAC and a concern for balanced ischemia. Subsequent coronary computed tomography angiography (CCTA) showed nonobstructive disease and a total Agatston CAC score of 1262. Invasive evaluation with left heart catheterization was deferred given the patient’s unchanged symptoms and CCTA findings. Statin therapy was intensified and aspirin, metoprolol succinate, and antihypertension therapies were continued. Initiation of glucose-lowering therapy and lipoprotein(a) testing was strongly recommended on follow-up. Our case suggests that CAC ⩾ 1000 may be incidentally associated with transient LBBB during the workup of coronary artery disease. Here, we specifically show that functional testing that incorporates measurement of CAC burden can help to improve ASCVD-preventive pharmacotherapy initiation and intensification beyond the identification of obstructive disease alone.
Obesity and the correlation with full-thickness rotator cuff tears in younger patients
Authors: Romiyo Vineeth , Curry Michael , Wright Branden , Pohl Nicholas , Gentile Pietro M , Hunter Krystal , Fedorka Catherine J
Published: September 2023

Background

The purpose of this study is to assess the relationship between obesity and full-thickness rotator cuff (FT-RTC) tears in patients under 50 years of age.

Methods

A retrospective review of 571 patients aged 18–70 years who underwent FT-RTC repair was conducted. Patients were stratified into less than 50 years old (LT50; n = 84) and greater than or equal to 50 years old (GT50; n = 487) cohorts. Dependent variables included body mass index (BMI ≥ 30, ≥35, and ≥40), comorbidities, sex, race, and social history. Inter-cohort differences were analyzed with Student's t-tests, Pearson Chi-squared tests, and linear regressions.

Results

The LT50 cohort reported greater mean BMI (37.61 ± 5.62 vs 35.16 ± 4.62; p = 0.002). There was no difference in %BMI ≥30 between cohorts. The LT50 showed a significantly higher %BMI than the GT50 cohort when stratifying by BMI ≥ 35 [34.5% (35.10–51.30) vs 17.5% (35.00–55.30), p < 0.001] and BMI ≥40 [15.5% (40.10–51.30) vs 6.4% (40.19–55.30), p = 0.004], a 2.5- and 2.7-times greater odds, respectively. Linear regressions of the GT50 cohort demonstrated increasing age was associated with decreased odds of obesity ( β = -0.041, p = 0.003, OR: 0.96, 95% CI: 0.93–0.99).

Discussion

Although the incidence of FT-RTCs is lower in patients under 50 years of age, the results of this study are the first to suggest that obesity is positively correlated with premature FT-RTCs.

Level of Evidence

III.
Outcomes of revision versus re-revision reverse total shoulder arthroplasty: A case–control-matched cohort study
Authors: S O'Keefe Daniel , Teurlings Tyler L , Hao Kevin A , Saengchote Supreeya A , Schoch Bradley S , Wright Thomas W , Farmer Kevin W , Struk Aimee M , King Joseph J
Published: September 2023

Background

The increasing incidence of reverse total shoulder arthroplasties (RTSA) has led to an increase in revision surgery. We aimed to compare patients undergoing re-revision RTSA to a matched cohort undergoing first-revision RTSA.

Methods

A retrospective review of all revision RTSAs was performed at a single institution. Sixteen shoulders that underwent re-revision RTSA were matched 1:3 to shoulders that underwent revision RTSA with a minimum two-year follow-up. Outcome scores including the American Shoulder and Elbow Surgeons Shoulder Score (ASES), Short-Form 12 (SF-12), Shoulder Pain and Disability Index (SPADI), and Simple Shoulder Test (SST) scores, range of motion (ROM), and improvement from preoperative to postoperative outcomes after re-revision RTSA were assessed. Additionally, postoperative outcomes after re-revision RTSA were compared to patients that underwent first revision RTSA and subsequently compared to the minimal clinically important difference (MCID) values for the outcome scores and ROM measurements assessed.

Results

Sixteen shoulders that underwent re-revision RTSA and 78 revision RTSAs met the final inclusion criteria to be included in this study. Significant improvement from preoperative to postoperative re-revision RTSA was seen in the ASES score (p = 0.046), SPADI score (p = 0.044), SST (p = 0.008), abduction (p = 0.016), and elevation (p = 0.025), but not the SF-12 score (p = 0.396), external rotation (p = 0.449), or internal rotation (p = 0.451). Outcomes after revision RTSA were found to be superior to outcomes after re-revision RTSA for all outcome scores (ASES p = 0.029, SF-12 p = 0.018, SPADI p = 0.003) except the SST score (p = 0.080) and all ROM measures (p > 0.05 for all). Internal rotation was equivalent postoperatively between both groups. From preoperative to postoperative re-revision RTSA, the mean improvement exceeded the MCID for the SST score, abduction, forward elevation, and external rotation. When comparing postoperative revision RTSA to postoperative re-revision RTSA, the mean difference between revision and re-revision RTSA exceeded the MCID for the SPADI score and external rotation. The complication rate was 19% in shoulders undergoing first revision and 41% in shoulders undergoing re-revision RTSA.

Conclusion

Patients undergoing re-revision RTSA receive improvement in clinical outcomes, but do not achieve outcomes comparable to those achieved after first revision RTSA.
Territory, affective intensities, and how alcohol comes to matter
Authors: Waitt Gordon , De Jong Anna
Published: September 2023

In response to Jayne and Valentine's (2024) article, we build on their arguments that, like alcohol studies, many more-than-representational geographical accounts of alcohol consumption rely on a priori assumptions, ‘expressions’, and ‘facts’. To do so, we embrace their critique that our previous work fails to fully interrogate how alcohol consumption ‘transforms’, ‘shapes’, and ‘mediates’ emotions and effects. In revisiting our interpretation, we draw on Deleuze and Guattari's concept of territory to employ the interpretative strategies outlined by Jayne and Valentine of de-determination and how unfolding moments of socio-material relationships shape the affective capacity of bodies to act and sense. We illustrate how the concept of territory presents a productive analytical framework for alcohol, drinking, and drunkenness.
Early Outcomes of Pulmonary Valve Replacement With the Edwards Inspiris Resilia Pericardial Bioprosthesis
Authors: Sengupta Aditya , Pastuszko Peter , Zaidi Ali N. , Murthy Raghav A.
Published: September 2023

Background

Controversy regarding the optimal pulmonary valve substitute remains, with no approved surgical valve for pulmonary valve replacement (PVR). Furthermore, unfavorable anatomy often precludes transcatheter PVR in patients with congenital heart disease. We therefore sought to evaluate the feasibility of the Edwards Inspiris pericardial aortic bioprosthesis in the pulmonary position in pediatric and adult patients requiring PVR.

Methods

Data from consecutive patients who underwent PVR from February 2019 to February 2021 at our institution were retrospectively reviewed. Postoperative adverse events included paravalvular or transvalvular leak, endocarditis, explant, thromboembolism, valve thrombosis, valve-related bleeding, hemolysis, and structural valve degeneration. Progression of valve gradients was assessed from discharge to 30 days and one year.

Results

Of 24 patients with median age of 26 years (interquartile range [IQR]: 17-33; range: 4-60 years), 22 (91.7%) patients had previously undergone tetralogy of Fallot repair and 2 (8.3%) patients had undergone double-outlet right ventricle repair in the neonatal period or infancy. All patients had at least mild right ventricular (RV) dilatation (median RV end-diastolic volume index 161.4, IQR: 152.3-183.5 mL/m2) and at least moderate pulmonary insufficiency (95.8%) or stenosis (8.3%). Median cardiopulmonary bypass and cross-clamp times were 71 (IQR: 63-101) min and 66 (IQR: 60-114) min, respectively. At a median postoperative follow-up of 2.5 years (IQR: 1.4-2.6; range: 1.0-3.0 years), there were no mortalities, valve-related reoperations, or adverse events. Postoperative valve gradients and the severity of pulmonary regurgitation did not change significantly over time.

Conclusions

At short-term follow-up, the bioprosthesis in this study demonstrated excellent safety and effectiveness for PVR. Further studies with longer follow-up are warranted.
Rescue Sternotomy in a 540 g Neonate for Right Atrial Perforation During Percutaneous Ductal Device Occlusion
Authors: Ramakrishnan Karthik , Siddiq Bilal , Fountain Bailey , Sathanandam Shyam , Kiene Ashley , Boston Umar S.
Published: September 2023

Percutaneous ductal device closure in neonates is gaining popularity. Cardiac perforation is a rare but catastrophic complication that can occur during this procedure. Surgical options to salvage this situation are limited in extremely low-weight babies. In this report, we describe one such case managed successfully and offer some suggestions to achieve a successful outcome.
Documenting Black Faculty Experiences in the “Stop Woke” Era
Authors: Topalidis Yiorgo , Austin Sharon
Published: September 2023

The Black Faculty Recruitment and Retention at the University of Florida Oral History Project documented the experiences of prejudice and discrimination by current and former UF faculty and staff members. A total of 46 respondents participated, 23 male and 23 female, between the Summer and Fall semester of 2021. While several salient themes emerged from these interviews, this paper focuses primarily on the respondents’ experiences of silencing, prejudice, discrimination at UF, and anti-racist White allyship. Such experiences ranged from respondents being overburdened with the mentorship of Black and Brown students to overt episodes of prejudice and discrimination that drove faculty members to resign from their positions. For example, some respondents noted the silencing of dissenting Black voices at faculty meetings by White colleagues. Extant scholarship has documented similar themes, and the present study employs them to contextualize its findings. This paper concludes by emphasizing respondents’ advice for administrators to help mitigate the negative impact of prejudice and discrimination on Black faculty at UF and avoid tokenistic diversity initiatives that constitute ineffective diversity regimes.