bluuebunny/crossref_metadata_2025 huggingface dataset:
Ulnar Collateral Ligament Laxity After Repetitive Pitching: Associated Factors in High School Baseball Pitchers
Authors: Hattori Hiroshi , Akasaka Kiyokazu , Otsudo Takahiro , Hall Toby , Sakaguchi Katsunobu , Tachibana Yomei
Published: April 2021

Background:

Medial elbow injury is common in baseball pitchers, with evidence of elbow valgus instability after only 60 consecutive pitches. However, the tissue-specific effects of repetitive pitching on medial elbow stabilizers are largely unknown.

Purpose/Hypothesis:

This study aimed to investigate changes in the ulnar collateral ligament (UCL) and forearm flexor-pronator muscles (FPMs) during repetitive pitching and factors that relate to identified change. We hypothesized that repetitive pitching would increase elasticity of the medial elbow stabilizers and therefore induce laxity.

Study Design:

Descriptive laboratory study.

Methods:

A total of 30 high school baseball pitchers participated (mean ± SD age, 16.6 ± 0.5 years). Each participant pitched 100 times (5 blocks of 20 pitches). The strain ratio, indicating elasticity in the UCL and FPMs, was measured using ultrasound before pitching and after every 20-pitch block. Data for each pitch block were compared using analysis of variance. Multiple regression analysis was used to investigate factors related to the change rate of the strain ratio.

Results:

The strain ratio of the UCL after 100 pitches was significantly less than that before pitching (before pitching, 4.83 ± 1.70; after 100 pitches, 3.59 ± 1.35; P = .013), but this was not the case for the FPMs (before pitching, 0.57 ± 0.24; after 100 pitches, 0.43 ± 0.18; P = .07). The ratio of the strain ratio in the UCL and FPMs (UCL/FPMs) before pitching (β = −0.385; P = .031) and the elbow flexion range of motion before pitching (β = −0.352; P = .046) were significantly and independently correlated with the change rate of the UCL.

Conclusion:

Elasticity significantly increased for the UCL, indicating laxity, but not for the FPMs after 100 pitches. Furthermore, the ratio of elasticity (UCL/FPMs) and the elbow flexion range of motion before pitching were significantly related to the change rate of UCL elasticity.

Clinical Relevance:

To reduce laxity of the UCL, pitchers should be limited to <100 pitches per game. Sustaining a lower level of relative FPMs to UCL elasticity at rest and maintaining a large muscle volume to avoid excessive elbow flexion range of motion may prevent UCL laxity that develops during repetitive pitching.
Climate emotions and emotional climates: The emotional map of ecological crises and the blind spots on our sociological landscapes
Authors: Neckel Sighard , Hasenfratz Martina
Published: April 2021

The public debate on climate change and environmental destruction belongs to those social conflicts that are carried out with an especially great emotional intension. In these disputes, the facet of emotions ranges from negative feelings such as shame, guilt and grief, to positive ones such as hope and compassion. In our paper, we put a focus on these feelings, drawing a conceptual map of emotions triggered by ecological crises. In doing so, our aim is to highlight the ambivalences of the intense emotionality of climate change and its societal effects. The great attention and the reflexivity accorded to ‘climate emotions’, however, should not obscure the view towards those emotional dynamics that are responsible for concealing and denying ecological problems. Based on ethnographic and other empirical studies from social sciences we outline that it is precisely these little-illuminated aspects of emotional re-framing and public emotional silence, which often turn out to be particularly consequential moments in politics. Hence, the emotional motives behind the scene should not go unnoticed in sociological research on emotions within the ecological crises.
Combinatorial Optimization for Urban Planning: Strategic Demolition of Abandoned Houses in Baltimore, MD
Authors: Garboden Philip M. E. , Fan Chi-Wen , Budavári Tamás , Basu Amitabh , Braverman Michael , Evans John David
Published: April 2021

In 2017, Baltimore City was awarded $75 million earmarked for the targeted demolition of a portion of its 16,000 vacant and abandoned buildings. Selecting an optimal set of demolition targets is difficult given that the cost per demolition is not independent of the overall demolition pattern; like many older cities, Baltimore’s abandoned housing includes a large number of attached row houses, which require the construction of retaining walls when a demolished home abuts a non-demolished home. In this paper, we present a method by which planners can use integer linear programming to identify optimal demolition targets for a number of potential objectives. The simplest objective, demolishing the maximum number of houses for a specific budget, is compared with more complex functions that attempt to proxy improved quality of life resulting from the demolitions. The results of different objective functions are then assessed in terms of equity and efficiency using the spatial distribution of proposed targets as a point of comparison.
Improving Evidence-Based Program Repositories: Introducing the Evidence-Based Cancer Control Programs (EBCCP) Web Repository
Authors: Percy-Laurry Antoinette , Adsul Prajakta , Uy Annabelle , Vinson Cynthia
Published: April 2021

To reduce the research to practice gap, promoting the utility of evidence-based repositories is essential among both practitioners and researchers. Organizing these repositories to address the needs of these audiences requires a user-centered design approach as proposed recently in an article by Harden et al, 2020. This commentary builds on the proposed solutions to introduce a recently redesigned Evidence-Based Cancer Control Programs (EBCCP) web repository (formerly Research-Tested Intervention Programs (RTIPs)) from the National Cancer Institute. Specifically, we describe the user-centered redesign process, strategies for broader dissemination of the repository using digital tools and provide future directions for the evidence-based program repository.
Latina Paraeducators’ Stories of Resistance, Resilience, and Adaptation in an Alternative Route to Teaching Program
Authors: Ernst-Slavit Gisela , Newcomer Sarah N. , Morrison Steven J. , Lightner Lindsay K. , Morrison Judith A. , Ardasheva Yuliya , Carbonneau Kira J.
Published: April 2021

Adichie asserts that “stories matter” because they help us to humanize and empower one another. Stories allow us to make sense of our experiences or the “lived stories” of our lives. This qualitative case study draws from a federally funded, multiyear mixed-methods study focusing on an alternative route to teaching program designed to certify English language learning and bilingual teachers. Using Yosso’s Community Cultural Wealth (CCW) model and the Funds of Knowledge (FoK) framework via the analysis of video-recorded classes, observations, interviews, and written artifacts, we explore how six Latina paraeducators draw from their personal FoK and CCW to overcome great challenges before, during, and after they obtained their teaching credentials. This study points to the need for institutions of higher education, particularly teacher education programs, to apply asset-based perspectives in the recruitment, retention, and graduation of culturally and linguistically diverse teachers.
Optimization of ground heat exchanger of the ground source heat pump system based on exergetic analysis using Taguchi technique
Authors: Ahmad Saif Nawaz , Prakash Om
Published: April 2021

The present research work focuses on the optimization of the ground heat exchanger of the Ground source heat pump system for heating application based on exergetic analysis using the Taguchi method. For this work, we select four influencing factors such as the mass flow rate of water (A), the specific heat of water (B), inlet temperature (C) of water to and outlet temperature of water (D) from the ground heat exchanger at three levels. An L9 orthogonal array was selected for experimental trials and in each trial, we calculate the exergy destruction for the ground heat exchanger, thereafter using statistical software Minitab, we get signal to noise ratios based on smaller is better criterion. After analyzing the response table of Taguchi results, we get the optimum level of all the factors. The ANOVA technique was also applied for getting the most significant factors which affect the output results by calculating the percentage contribution of each factor. According to our results, the best combination of all the four factors for exergetic destruction of the ground heat exchanger was A3B1C1D3 and the most influencing factor was inlet water temperature with a contribution factor of 56.03%.
Study of the performance parameters of friction stir welded magnesium AZ31B alloy at optimized process parameters
Authors: K Yadav Pradeep , Khurana Manoj K
Published: April 2021

The present study is aimed to analyze the effect of process parameters on the qualities of the Friction Stir Welded AZ31B Mg Alloy. Response Surface Methodology based Grey Relation Analysis technique was used to multi-optimization of the response parameters such as tensile strength (TS), percentage elongation (El), microhardness (MH), and impact strength (IMP). The mathematical models for response parameters were developed by considering tool rotational speed (RS), tool shoulder diameter (SD), and welding speed (WS) as process parameters. ANOVA (Analysis of Variance) was performed to check the adequacy of the formulated mathematical model and figure out the significant parameters. The results revealed that RS of 950 rpm, WS of 150 mm/min, and SD of 11 mm are the optimal process parameters for optimum response parameters (TS of 157.8700 MPa, IMP of 4.3001 Joule, MH of 84.1335 Hv, and El of 10.0071%). WS is the most significant factor, followed by RS and SD. The grain growth was observed in thermo-mechanically affected zone (TMAZ). The fracture analysis indicated that crack had initiated from the bottom of the centerline in the welded zone and propagated towards the advancing side.
Experimental investigation on friction stir welding of dissimilar aluminium alloys
Authors: Verma Shubham , Misra Joy P
Published: April 2021

In current research work, dissimilar aluminium alloys such as AA5083, AA6081, AA6082, and AA7039 are butt joined by employing friction stir welding (FSW). The present study explores the effect of material positions of aluminium alloys (i.e., advancing side (AS) and retreating side (RS)) on the mechanical and metallurgical properties of FS welded dissimilar aluminium joints. The performance characteristics of the present study are analyzed in terms of mechanical and metallurgical properties. It is concluded that maximum strength is obtained for all the joints in which higher strength aluminium alloy is placed on the AS ((i.e., 386 MPa for AA7039-AA5083, 343 MPa for AA7039-AA6082, 320 MPa for AA5083-AA6082, and 225 MPa for AA6082-Aa6061). Furthermore, two types of macrostructures (i.e., banded and an onion ring) are observed at the nugget zone (NZ) of all the welded joints during metallurgical analysis. Besides this, energy-dispersive X-ray spectroscopy (EDS) analysis at NZ of FSW joints is also carried out to find out the chemical composition at NZ. It is observed that the key element of AS material is high er in weight percent as compared to RS at NZ. Moreover, tensile fractured surface locations are also analyzed to understand the process better. It is witnessed that most joints are fractured at heat affected zone (HAZ) on the lower strength material side.
Parameter study and multi-objective optimization for crashworthiness of a B-type metro train
Authors: Liu Yanwen , Yang Bing , Xiao Shou-ne , Zhu Tao , Yang Guangwu , Xiu Ruixian
Published: April 2021

A train’s crashworthiness responses are directly affected by the vehicle weight M, train collision speed V, and empty stroke D. This study investigated the influences of M, V, and D on train crashworthiness. A one-dimensional multi-body dynamics model for a B-type metro train was created and verified. Approximate models were established for the total compression displacement (TS) and overall average collision deceleration (TMA) based on M, V, and D, and a novel method was proposed for quickly predicting the output response of a train’s crashworthiness. The effects of the various parameters on TS and TMA were investigated, and a multi-objective optimization for minimizing TS and TMA was conducted. The results indicated that V has the greatest influence on TS and TMA, followed by M, and then D; M has a positive effect on TS and negative effect on TMA, whereas D has a negative effect on both TS and TMA; V has a positive effect on TS, but for TMA, the effect changes from positive to negative when V increases to 23 km/h. The optimized metro train has higher integrity in the passenger living space and a lower train collision average deceleration, and the crashworthiness is significantly improved.
Commentary
Authors: Mizio Emelicia
Published: April 2021

Additional thoughts are presented regarding the need for knowledge of, and sensitivity to, cultural factors in relation to Puerto Rican clients
Termination of Psychotherapy: Some Salient Issues
Authors: Levinson Hilliard L.
Published: April 2021

The manner in which a therapeutic relationship is ended has a major influence on the degree to which gains are maintained and further growth promoted
Metaplastic Breast Carcinoma: Experience of a Tertiary Cancer Center in the Middle East
Authors: Erjan Ayah , Almasri Hanan , Abdel-Razeq Hikmat , Al-Masri Mahmoud , Haddad Hussam , Alnsour Anoud , Rahman Fadwa Abdel , Dayyat Abdulmajeed
Published: April 2021

Background:

Metaplastic breast cancer (MetBC) represents a therapeutic challenge. We evaluated the impact of clinicopathological characteristics and treatment modalities on outcomes among MetBC patients treated at our center.

Methods:

Women with stage I-III MetBC were reviewed from our database from 2005-2018. Kaplan-Meier method was used to calculate locoregional-failure-free survival (LRFFS), overall-survival (OS) and distant-metastases-free survival (DMFS). We assessed associations with survival outcomes by log-rank tests. Multivariate Cox proportional-hazards models were used to identify independent predictors of LRFFS, OS and DMFS.

Results:

81 patients were eligible for the study. Median age at diagnosis was 48 years. 90.1% had G-III tumors, 64.2% were pathologically node negative and lympho-vascular invasion (LVI) was absent in 72.8%. 67.8% were triple negative, and 7.4% were HER2-neu positive. Most (66.7%) patients underwent mastectomy. Free margins were achieved in the entire cohort, however, 17.3% had close margin (<2 mm). Almost all patients received chemotherapy. 75.3% received radiotherapy, 23.5% received hormonal therapy and 6.2% received Trastuzumab. With a median follow-up of 54 months, 18.5% developed loco-regional recurrence and 34.6% relapsed distally. Five-year OS was 66.0%. On multivariate analysis: adjuvant radiotherapy correlated with better OS ( P < .0001), and tumor size >5 cm, nodal involvement and LVI correlated with worse OS, ( P = .019, P = .021, P = .028, respectively). There were no survival differences with respect to age, triple negativity, and morphologic subtype.

Conclusion:

We report the largest single institutional series on MetBC in the Middle East region. MetBC confers worse survival outcomes, and more aggressive local and systemic treatment strategies should be investigated.
Constraint-force driven control design for rail vehicle virtual coupling
Authors: Wang Bin , Yang Dengke , Zhang Xinrong , Jia Xingheng
Published: April 2021

This study investigates the constraint-force driven control problem of virtual coupling. To solve the constraint force, the explicit equation of vehicle motion with equality constraints is established using the Udwadia–Kalaba approach. First of all, this study introduces a brief overview of virtual coupling concepts in the European Railway Traffic Management System and some scenes of virtual coupling. The control method is proposed to enable the mechanical system to follow the designed constraint. Moreover, the dynamic model for virtual coupling problem is established. Second, combined with the dynamic model, the equation constraint is designed to make the rail vehicle movenment reach the control objective. By solving the equation based on the Udwadia–Kalaba approach, the control inputs that can render the vehicle to move along the desired trajectory. Third, numerical simulation results demonstrate the effectiveness of the proposed method in virtual coupling problem.
Factors Predicting Family Violence Revictimization Among Army Families With Child Maltreatment
Authors: Kaye Miranda P. , Aronson Keith R. , Perkins Daniel F.
Published: April 2021

The Army Family Advocacy Program (Army FAP) strives to prevent family violence and intervene to reduce the deleterious effects of exposure to family violence. This paper examines the individual, family, community, and treatment factors associated with family violence revictimization. Case files of 134 families with substantiated child maltreatment and associated Army FAP interventions that closed in 2013 were coded across risk and protective factors and intervention characteristics and were matched to Army Central Registry files to identify revictimization rates through 2017. Revictimization, experienced by 23% of families, was predicted by community risk and reduced by intervention dose. With the high rates of relocations, housing or neighborhood issues, and the isolation military families experience and the relationship of these concerns to repeated family violence, identifying the impact of community risk is particularly important. Similarly, research that elucidates the effective treatment components is needed.
Dating Violence and the Impact of Technology: Examining the Lived Experiences of Sorority Members
Authors: Emelianchik-Key Kelly , Byrd Rebekah , Gill Carman S.
Published: April 2021

Dating violence (DV) is pervasive on college campuses with far-reaching health implications. We examined 70 sorority members’ lived experiences with DV and explored the role of technology. Experience, perpetration, exposure, support systems, and conceptualization of DV were assessed, and sorority members engaged in small focus groups to examine their lived experiences. Emerging themes included (a) normalization of unhealthy behaviors, (b) technology and the experience of violence, and (c) sources of support and coping. Findings included significant correlations between the experience and perpetration of DV. Results highlight the need for peer intervention and prevention programming and infusing technology in constructive ways.
Role of Dental Nutrition Knowledge and Socioecological Factors in Dental Caries in Low-Income Women
Authors: Sachdev Prageet K. , Freeland-Graves Jeanne , Ranjit Nalini , Babaei Mahsa
Published: April 2021

Dental caries is a chronic oral condition that disproportionately affects low-income women. The aim of this research was to investigate relationships between dental nutrition knowledge, socioecological factors, and prevalence of dental caries in low-income women. This quantitative cross-sectional study involved 220 women who were recruited from Central Texas. Participants completed demographics, the Dental Nutrition Knowledge Competency Scale, United States Adult Food Security Survey Module, and the Multidimensional Home Environment Scale. Two dentists measured dental caries via the Decayed, Missing, Filled Teeth Index. Regression models were conducted to test the effects of dental nutrition knowledge and Multidimensional Home Environment Scale factors on dental caries. Finally, mediation analysis explored relationships between dental nutrition knowledge and dental caries, adjusting for Multidimensional Home Environment Scale scores. Results showed that dental nutrition knowledge and Multidimensional Home Environment Scale score were significantly associated with dental caries. Subscales of self-efficacy for eating healthy, oral hygiene practices, emotional eating, availability of unhealthy foods at home, and social support were related to dental caries. The relationship between dental nutrition knowledge and caries was mediated by Multidimensional Home Environment Scale scores. This research emphasizes the role of dental nutrition knowledge and socio-ecological factors on prevalence of dental caries. Public health interventions to reduce dental caries should involve strategies that increase dental nutrition knowledge and encourage behavior change in low-income populations.
Association of Vitamin D Receptor Gene Polymorphisms With the Evolution of MODY Diabetes: Study in Tunisian Patients
Authors: Guesmi Amal , Zouaoui Manel , Haouat Emna , Oueslati Sabrine , Dabboussi Malek , Kassmi Chaima , Mahjoub Rahma , Kammoun Ines , Bibi Amina
Published: April 2021

Vitamin D (VD) cannot be considered as a true vitamin, but rather as a hormone, which exerts its action via a vitamin D receptor (VDR). Many genes have been shown to be involved in the evolution of diabetes in various populations, such as the vitamin D receptor gene. The aim of our study was to investigate if BsmI, TaqI, ApaI, FokI, and Tru9I, polymorphisms of VDR gene have an impact on MODY diabetes and its clinical aspects in a Tunisian population. A total of 95 patients and 153 controls were genotyped using PCR-RFLP. The comparison of the allelic and genotypic frequencies of the five polymorphisms between MODY subjects and control groups revealed the association of MODY diabetes with TaqI, Tru9I and BsmI polymorphisms and no significant differences were observed in the distributions for the ApaI and FokI polymorphisms. After stratification with biochemical and clinical parameters and TaqI, Tru9I and BsmI polymorphisms, we found an association between the three SNPs and different parameters such as age of diagnosis, therapy, hsCRP and HDL-C levels. Our results revealed that TaqI, Tru9I and BsmI polymorphisms may be more related to the progression of MODY diabetes. The possible role of vitamin D in the pathogenesis of MODY is far from being completely understood. Further knowledge on this issue may identify new candidate targets in the treatment and prevention of the disease. Our findings suggest that the TaqI, Tru9I and BsmI polymorphisms may be more related to the progression of MODY diabetes.
The impact of the SARS-CoV-2 epidemic outbreak on the vascular access team operations after conversion to COVID-19 dedicated hospital
Authors: Deganello Elisa , Gastaldo Francesco , Masiero Sonia , Fasson Milena , Colopi Riccardo Ivan , Girotto Luciano , Monticelli Jacopo , Marcante Elena , Furlan Patrizia , Baldo Vincenzo , Pilerci Claudio , Realdon Piero , Montemurro Domenico , Rigo Alberto , Benini Patrizia , Baratto Fabio
Published: April 2021

Background:

On February 21 2020, in Schiavonia Hospital occurred the first death by COVID-19 in Italy and since this date SARS-CoV-2 caused more than 100,000 deaths in our country. Our hospital was immediately closed and re-opened after 15 days as a reference Covid Hospital. Among services involved in a process of destruction and rebirth there was also the Vascular Access Team.

Methods:

We analyzed our Vascular Access Team activity comparing data from the first month (March) in which basically it did not work and data from the following month (April) in which we began to re-build the Team adapting it to the new reality.

Results:

In all patients admitted to Intensive Care Unit a Centrally Inserted Central Catheter multilumen was placed, but in March only 5.5% of patients admitted to Medicine-Sub-intensive Unit had a catheter different from the short peripheral cannula while in April it was possible to guarantee a more suitable catheter 31.7% of patients admitted to Medicine-Sub-intensive Unit ( p < 0.000). In April, compared to March, a significant higher number of Midline were implanted in Medicine-Sub-intensive Unit (36/139 vs 12/238 p < 0.000) where also a higher number of Centrally Inserted Central Catheter and Femoral Inserted Central Catheter were implanted (8/139 vs 1/238 p = 0.003). This change allowed us to implant more vascular accesses in Medicine-Sub-intensive Unit favoring Midline with a longer average duration. Only one patient with Midline developed a catheter vein thrombosis, and in only one patient the device was removed for suspected infection.

Conclusions:

The experience we gained will allow us to be more prepared in the future and our experience has highlighted that a structured Vascular Access Team is necessary to respond adequately to COVID-19 patients’ needs, to ensure the effectiveness of the maneuver, to reduce complications and to avoid the waste of resources, always working in safe condition.
Erroneous placement of central venous catheters in subclavian artery: Retrieval and successful hemostasis with a femoral closure device
Authors: Verloh Niklas , Scharf Gregor , Bäumler Wolf , Pfister Karin , Oikonomou Kyriakos , Stroszczynski Christian , Uller Wibke , Dollinger Marco
Published: April 2021

Background:

Retrospective evaluation of the safety and efficacy of the retrieval of misplaced central venous catheters (CVCs) in subclavian arteries using the femoral closure device Angio-Seal™.

Methods:

The clinical data of five patients (female, n = 2; mean age, 55.0 years ± 11.9) in whom a misplaced CVC within a subclavian artery was removed followed by closure of the vessel entry site with 8-French (F) Angio-Seal™ was analyzed.

Results:

In 4/5 patients (80%; CVC diameter, 7-8F) the procedure was technically successful without complications. In 1/5 patients (20%; CVC diameter, 11.5F) the procedure failed and an additional covered stent was placed for successful closure of the vessel entry site. There were no complications associated with the Angio-Seal™ or stent implantation during follow-up.

Conclusion:

Retrieval of a misplaced CVC within a subclavian artery using the percutaneous closure device Angio-Seal™ is quite safe and effective; however, caution is required if there is a mismatch in the diameter of the Angio-Seal™ and CVC. In the case of procedure failure, successful closure of the vessel entry site can be achieved by covered stent placement.
Male Breast Cancer—Immunohistochemical Patterns and Clinical Relevance of FASN, ATF3, and Collagen IV
Authors: André Saudade , Pinto António E , Silva Giovani L , Silva Fernanda , Serpa Jacinta , Félix Ana
Published: April 2021

Background:

Male breast carcinoma (male BC) is an uncommon neoplasia without individualized strategies for diagnosis and therapeutics. Low overall survival (OS) rates have been reported, mostly associated with patients’ advanced stage and older age. Intratumoral heterogeneity versus homogeneity of malignant epithelial cells seems to be an important factor to consider for the development of combination therapies with curative intention.

Objective:

In this preliminary study, we aim to provide valuable insight into the distinct clinicopathologic features of male BC.

Material and methods:

In a series of 40 male BC patients, we evaluated by immunohistochemistry androgen receptor; activating transcription factor 3 (ATF3); p16; cyclin D1; fatty acid synthase (FASN); fatty acid transport protein 1 (FATP1); β1, β3, β4, and β6 integrins; collagen I and collagen IV; and their interactions. Kaplan-Meier survival curves and log-rank tests were assessed for statistical analysis.

Results:

Homogeneous epithelial staining of p16, ATF3, β6 integrin, FASN, and FATP1 was found to be significantly intercorrelated, and associated with high Ki67. These markers also stained tumor stromal fibroblasts. The prognostic analysis showed statistically significant associations of FASN with disease-free survival (DFS) and OS, as well as of ATF3 with OS and collagen IV with DFS.

Conclusions:

This study highlights, as a novel finding, the relevance of FASN, ATF3, and collagen IV immunophenotypes, which may have innovative application in the clinical management of male BC.
Clinical presentation and long-term follow-up of 45 patients with Mondor disease: A single-center longitudinal study
Authors: Kreuzpointner Robert , Johner Fabian , Roth-Zetzsche Stéphanie , Kucher Nils , Barco Stefano
Published: April 2021

Mondor disease is characterized by an acute painful thrombophlebitis occurring at specific anatomical sites. Data on its incidence, characteristics of clinical presentation, and course are unavailable to date. We studied the course of Mondor disease in patients diagnosed and followed at the University Hospital Zurich (Switzerland) between 2004 and 2020. The primary study outcomes were a diagnosis of active cancer either at the time of clinical diagnosis of Mondor disease or within 1 year, as well as 1-year all-cause death and recurrent Mondor disease. We included 45 patients and classified them into one of the three Mondor disease subgroups: thoracic ( n = 26), penile ( n = 12), or axillary ( n = 7). The median age was 39 (Q1–Q3: 30–45) years and 44% of patients were men. Surgery was the likely cause of Mondor disease in 53.8% of patients with a thoracic form, 41.7% of those with a penile location, and all of those with an axillary location. Known active cancer was present in nine (20%) of 45 patients at baseline. One-year follow-up was available for 43 patients (median 94 months), whereas 6-month data were available for the remaining two patients. During the available follow-up, no patient had a new diagnosis of cancer. In conclusion, one in five patients with Mondor disease had known cancer at the time of diagnosis. During follow-up, the rate of new cancer diagnosis and death was negligible, providing reassurance about the good prognosis of this condition. Based on these preliminary data, extended cancer screening besides what is recommended by current guidelines for the general population might not be necessary in patients with Mondor disease.
Sustained physical activity in peripheral artery disease: Associations with disease severity, functional performance, health-related quality of life, and subsequent serious adverse events in the LITE randomized clinical trial
Authors: Slysz Joshua T , Rejeski W. Jack , Treat-Jacobson Diane , Bazzano Lydia A , Forman Daniel E , Manini Todd M , Criqui Michael H , Tian Lu , Zhao Lihui , Zhang Dongxue , Guralnik Jack M , Ferrucci Luigi , Kibbe Melina R , Polonsky Tamar S , Spring Bonnie , Sufit Robert , Leeuwenburgh Christiaan , McDermott Mary M
Published: April 2021

This study investigated cross-sectional associations of peripheral artery disease (PAD) severity (defined by the ankle–brachial index (ABI)) and amounts of daily sustained physical activity (PA) (defined as > 100 activity counts per minute lasting 5 consecutive minutes or more). This study also investigated associations of amounts of daily sustained PA with 6-minute walk (6MW) distance and the Short Form-36 physical functioning domain (SF-36 PF) score in cross-sectional analyses and with serious adverse events (SAEs) in longitudinal analyses of people with PAD. PA was measured continuously for 10 days using a tri-axial accelerometer at baseline in 277 participants with PAD randomized to the LITE clinical trial. In regression analyses, each 0.15 lower ABI value was associated with a 5.67% decrease in the number of daily bouts of sustained PA (95% CI: 3.85–6.54; p < 0.001). Every additional bout of sustained PA per day was associated with a 4.56-meter greater 6MW distance (95% CI: 2.67–6.46; p < 0.0001), and a 0.81-point improvement in SF-36 PF score (95% CI: 0.34–1.28; p < 0.001). Participants with values of daily bouts of sustained PA below the median had higher rates of SAEs during follow-up, compared to participants above the median (41% vs 24%; p = 0.002). In conclusion, among participants with PAD, lower ABI values were associated with fewer bouts of daily sustained PA. A greater number of bouts of daily sustained PA were associated with better 6MW performance and SF-36 PF score, and, in longitudinal analyses, lower rates of SAEs. Clinicaltrials.gov ID: NCT02538900.
Bottle-feeding, a neglected area of learning and support for nurses working in child health: An exploratory qualitative study
Authors: Kotowski Judith , Fowler Cathrine , Orr Fiona
Published: April 2021

Breastfeeding is the ideal infant feeding modality; however, the reality is some parents need or choose to use bottles to feed their infants. Parents who bottle-feed have been identified as not receiving adequate levels of bottle-feeding information and advice from health professionals. This study’s aim was to explore nurses’ knowledge of the components in the bottle-feeding act. Twenty-one nurses working in early parenting residential units participated in three focus groups. Three themes were identified relating to nurses’ bottle-feeding knowledge: experience not evidence-based, it is hard to know what to advise, we will support whatever choice they make. The nurses identified a deficit in their knowledge, education and training related to the components of bottle-feeding. The nurses struggled with their interpretation of infant feeding policies and the provision of bottle-feeding information to parents. Nurses working in child and family health were motivated to inform, educate and enable parents to confidently make decisions concerning infant feeding. The healthcare system and the infant feeding policy drivers appear to have a mixed and at times negative impact on nurses’ practice. Further research is required across a larger population of nurses.
‘Forced empathy’: Manipulation, trauma and affect in virtual reality film
Authors: Schlembach Raphael , Clewer Nicola
Published: April 2021

Exploring two recent examples of virtual reality (VR) short films designed to produce visceral experiences (on solitary confinement and on seeking asylum), we call into question claims that assign normative value and even transformative power to the VR medium – imagined as so-called ‘empathy machines’. Drawing on a growing body of literature that seeks to contest such claims, we point to and problematise both the manipulative intent of such projects and the liberal-humanitarian logic, which underpins them. Based on such a logic, advocacy through immersive technologies supposes that if only individuals can be made to ‘feel’ something they will be changed by it and so will their behaviour. Whatever progressive motivations of the content producers, the emphasis on empathetic identification threatens to by-pass critical engagement and raises wider questions about the potentially de-politicising effects of seeking technological solutions to effect social change.
Warm up intensity influences running performance despite prolonged recovery
Authors: Paris Hunter L , Sinai Erin C , Leist Margaret A , Crain Carrington M , Keller Alexandra M , Malysa William , Renzullo Shelby C
Published: April 2021

When competing in road races, runners enter starting corrals long before the starting gun triggers. Athletes consequently must complete warm up routines well in advance of race commencement. To optimize performance readiness warm up intensity may need altered to account for the prolonged time between warm up and performance. This study tested the effectiveness of various warm up intensities on 1600 m run performance given a 20 min separation between warm up and time trial, and assessed the physiological bases for performance outcomes. In a randomized, crossover design, 14 athletic men and women [(age (mean ± SEM) = 22 ± 1 y; V·O2peak = 50.3 ± 2.5 ml·kg−1·min−1] completed three warm up routines (light-, moderate-, or high-intensity warm up), rested for 20 min, and ran a 1600 m time trial. Warm up procedures were evaluated for their influence on performance, blood lactate, V·O2, and alterations to neuromuscular function. Time trial performance was significantly faster ( P < 0.03) following a moderate-intensity warm up (6:12 ± 18 min:s·1600 m−1) compared to a light-intensity warm up (6:30 ± 18 min:s·1600 m−1). Performance following the high-intensity warm up (6:18 ± 24 min:s·1600 m−1) fell between the light and moderate conditions. When stratified based on starting lactate concentrations, 1600 m performance was optimized when pre-time trial lactate was 2.0–4.9 mmol·l−1. When a prolonged rest separates warm up exercise from time trial performance, warming up remains efficacious. Optimal warm up intensity may be identified using starting lactate as a gauge for performance readiness.
Epistaxis After Orthognathic Surgery: Literature Review and Three Case Studies
Authors: Girard Alisa , Lopez Christopher D. , Chen Jonlin , Perrault David , Desai Nikhil , Bruckman Karl C. , Bartlett Scott P. , Yang Robin
Published: April 2021

Study Design:

This is a literature review with 3 case studies.

Objective:

Intraoperative and postoperative bleeding are the most common complications of orthognathic surgery and have the potential to become life-threatening. The rarity of severe postoperative epistaxis has resulted in limited characterization of these cases in the literature. The purpose of this study is to 1) differentiate various presentations of epistaxis following orthognathic surgery in the literature, 2) identify management approaches, and 3) to synthesize a treatment algorithm to guide future management of postoperative epistaxis.

Methods:

A literature search of PubMed was conducted and 28 cases from 17 studies were assessed.

Results:

Bleeding within the first week may indicate isolated epistaxis, often resolved with local tamponade. Half of cases were attributed to pseudoaneurysm rupture (n = 14), with epistaxis onset ranging from postoperative day 6 to week 9. Angiography was used in most cases (n = 17), often as the primary imaging modality (n = 11). Nasal endoscopy is a less invasive and effective alternative to angiography with embolization. Proximal vessel ligation was used in 3 cases but is not preferred because collaterals may reconstitute flow through the defect and cause rebleeding. Repeat maxillary down-fracture with surgical exploration was described in 4 cases.

Conclusions:

As outlined in our management algorithm, nasal packing and tamponade should be followed by either local electrocautery or vascular imaging. Angiography with embolization is the preferred approach to diagnosis and management, whereas surgical intervention is reserved for cases of embolization failure or unavailability.
High Histamine Control Concentration Leads to False Negative Allergy Skin Testing
Authors: Amirneni Amulya , Tversky Jody
Published: April 2021

Background

Allergy skin test reliability depends on the reagents and controls selected. Histamine is used at 1 mg/ml and 6 mg/ml concentration but few studies address the rationale for selecting one versus the other and how this may impact diagnostic accuracy.

Objective

To determine the rate of false negative allergen skin tests responses between UniTest PC (using the 1 mg/mL histamine) and Quintip devices (using 6 mg/mL) for 4 common aeroallergens.

Methods

Subjects aged 18-65 with symptoms of allergy to cat and/or ragweed received skin testing with 4 aeroallergens (dust mite mix, timothy grass, ragweed, cat), histamine and control diluent. Those individuals who tested positive to cat or ragweed with one skin prick test (SPT) device but not the other then proceeded to nasal allergen challenge (NAC). The primary outcomes were the aeroallergen false negative rates and sensitivities of the skin test devices followed by nasal allergen (NAC).

Results

Twenty-five individuals were recruited and underwent a total of 300 SPTs. SPT to allergens (ragweed, dust mite, cat, and timothy grass) resulted in a statistically significant difference in wheal size among the two skin testing devices ( p value <0.0001, 0.0001, 0.0006, and 0.0053 respectively). Six NAC procedures were performed to cat/ragweed and 5 of 6 (83% were positive). The overall allergen sensitivity rate for UniTest and Quintip were 97% and 78% respectively with most false negatives due to the use of 6 mg/ml histamine control reagent.

Conclusion

Our study shows that 6 mg/ml concentration of histamine control reagent may contribute to a false interpretation of aeroallergen skin prick test results.
Side-effect monitoring of continuing LAI antipsychotic medication in UK adult mental health services
Authors: Paton Carol , Craig Tom K. J. , McConnell Brittany , Barnes Thomas R. E.
Published: April 2021

Background:

Long-acting injectable (LAI) antipsychotic medications are used to optimise treatment outcomes in schizophrenia. Guaranteed medication delivery increases the responsibility of prescribers to monitor and manage adverse effects.

Methods:

In the context of a quality improvement programme conducted by the Prescribing Observatory for Mental Health, a clinical audit addressed documented side-effect monitoring in patients prescribed continuing LAI antipsychotic medication under the care of United Kingdom adult mental health services.

Results:

A total of 62 mental health services submitted data on 5169 patients prescribed LAI antipsychotic medication for more than a year. An assessment of side effects had been documented in the past year in 2304 (45%) cases. Post hoc analysis showed that extrapyramidal side effects were more likely to have been assessed and found to be present in those patients prescribed LAI haloperidol, flupentixol or zuclopenthixol. There was little other targeting of assessments to the known side effects profiles of individual LAI antipsychotic medications, but when dysphoria had been assessed it was most commonly found with LAI haloperidol treatment and when weight gain, sexual and prolactin-related side effects had been assessed, they were more often identified with LAI paliperidone.

Conclusion:

The data suggest a relatively low frequency of side-effect assessments, largely untargeted. This is likely to result in many adverse effects going unrecognised and unmanaged, thus failing to tackle their potential to confound mental state assessment and adversely affect physical health and adherence. Patients receiving LAI antipsychotic medication have regular contact with a healthcare professional who administers the medication, which provides an opportunity to potentially remedy this situation.
Vulvar swelling and the timely diagnosis of Crohn’s disease: A case report
Authors: Gomolin Arieh , Zargham Hanieh , Sant’Anna Ana Maria , Lovett Audrey
Published: April 2021

Children with vulvar swelling often present to multiple physicians and face a prolonged period of ambiguity and extraneous treatments. Here, we report a case of an 8-year-old girl who presented to the dermatology clinic with a 2-month history of vulvar swelling and was ultimately diagnosed with Crohn’s disease. Although extra-intestinal manifestations are common in inflammatory bowel diseases, they rarely present before an existing diagnosis. This report highlights this potential early manifestation and demonstrates how timely diagnosis leads to improved outcomes for patients, their families, and healthcare systems.
The influence of social belonging and creativity on the immoral consumption behaviors of new adolescents: A cross-cultural study of 16–24 year olds
Authors: Maille Virginie , Gentina Elodie , Li Zhen
Published: April 2021

Why do adolescents engage in immoral consumer behavior, like changing a price or lying for a discount? Based on the theory of the need for social belonging, a study of 1,326 Brazilian, Chinese, American, and French adolescents aged 16–24 demonstrates the coexistence of two opposing relationships between belonging to a peer group and judgment of immoral consumption behavior: a direct relationship in which adolescents who feel most integrated are those whose judgment is the most severe, but also an indirect relationship, in which social belonging increases creative self-efficacy, which in turn makes the subject more forgiving of immoral behavior. The respective weights of direct and indirect paths vary with national culture, here the country of residence, and the value of individualism/collectivism. In Brazil and China, which have collectivist cultures, the direct path dominates. In the United States and France, which are more individualistic, the path is indirect.
In what sense should we talk about the perception of other minds?
Authors: Fei Duoyi
Published: April 2021

By means of spontaneous and unconscious imitation, an observer may be able to directly experience the inner states of another person because the observer and the observed share similar neural pathways. This discovery of a common neural basis reveals the correlative mechanisms through which the intentions of others are perceived. While analysing the implications of this discovery, this paper notes that the correlation does not provide a complete explanation of our understanding of other minds. Instead, the correlation comes into play only to a minimal degree. The paper also explores the epistemological characteristic of the knowledge harboured by other minds. That is, as a kind of private knowledge, the experience of other minds can help us arrive at a relatively consistent understanding of others and engage in communication with them through public expression and the description of mental states. However, it is impossible to truly understand other minds because conscious experience in the strict sense resides only in its owner, and the unique qualia emerging inside the subject cannot be directly observed from a third-person perspective. In this sense, the so-called perception of other minds is not suited to seeking a causal explanation of the ways in which others act, but for reading the meanings expressed by them in a given situation.
The Impact of Immunization and Use of Oseltamivir on Influenza-Related Hospitalizations: A Population-Based Study
Authors: Athanassoglou Vassilis , Wilson Lauren A. , Liu Jiabin , Poeran Jashvant , Zhong Haoyan , Memtsoudis Stavros G.
Published: April 2021

Background

As the COVID-19 pandemic continues into flu season, it is critical to minimize hospitalizations to maximize capacity and preserve critical care resources. We sought to identify risk factors for influenza-related hospitalization, specifically the role of immunization and oseltamivir prescriptions.

Methods

Patients with influenza diagnoses were identified from the MarketScan database (2014-2018). Primary risk factors of interest were an influenza vaccination within 6 months prior to infection and oseltamivir prescriptions (filled on the day diagnosis, the following day, or 2-5 days). A multivariable logistic regression model was run to identify risk factors for influenza-related hospitalizations within 30 days of diagnosis.

Results

Among 2 395 498 influenza infections, 0.27% were hospitalized. Of those prescribed oseltamivir the day of diagnosis, 0.13% were later hospitalized, compared to 0.67% among those who filled prescriptions the following day and 11.8% when filled within 2 to 5 days. Upon adjustment, oseltamivir prescriptions filled on the day of diagnosis were associated with significantly decreased odds of hospitalization (OR 0.51 CI 0.48-0.55). Prescriptions filled within 1 to 5 days of diagnosis were associated with significantly increased odds of hospitalization (1 day OR 2.01 CI 1.81-2.24; 2-5 days OR 34.1 CI 31.7-36.6). Flu vaccination was associated with a lower odds for hospitalization (OR 0.84 CI 0.74-0.95).

Conclusions

We recommend oseltamivir be prescribed to patients when they first present with influenza-like symptoms to reduce the burden on the healthcare system. We also identified reduced odds of hospitalization associated with influenza vaccination, which is already well established, but particularly important this coming flu season.