bluuebunny/crossref_metadata_2025 huggingface dataset:
Significant Factors of High Performance Outcomes for Tibial Plafond Fractures
Authors: Wheelwright John C. , Christensen Garrett V. , Cizik Amy M. , Zhang Chong , Marchand Lucas S. , Haller Justin M.
Published: July 2022

Background:

Limited research exists about high performance postsurgical tibial plafond fractures. This study aimed to identify aspects of the plafond fracture injury and care associated with “high performance” based on Patient Reported Outcome Measurement Information System (PROMIS) Physical Function (PF) scores.

Methods:

Tibial plafond fracture patients with minimum 12-month follow-up treated at a level 1 trauma center from 2006 to 2019 were categorized into high (top 25%) vs average-low (AL) (bottom 75%) performers based on PROMIS PF scores. Demographics and fracture characteristics of high and AL performers were compared. Variables with a P value less than .1 were used in stepwise logistic regressions.

Results:

The final cohort of 198 patients was divided into high (n=51) and AL (n=147) performers based on PF scores. The mean PF scores for the high and AL groups were 58 (SD=5.3) and 41.9 (SD=6.5), respectively. The mean PROMIS Pain Interference scores for the high performers and AL were 43.3 (SD=4.9) and 56.8 (SD=8.6) ( P < .001), respectively. FAAM activities of daily living (high 95.4 [SD=5.5] vs AL 70.4 [SD=19.8], P < .001) and FAAM sports (high 76.8 [SD=21.3] vs AL 27.3 [SD=28.9], P < .001) subscale scores were significantly greater in the high-performing group. Sex, age, marital status, and diabetes were nonsignificant factors in univariate analysis. Significant demographic factors associated with high performance from univariate analysis were Caucasian race, private insurance, no tobacco use, lower body mass index (BMI), and mechanism of injury. Patients with fracture characteristics of OTA 43C (complete articular) fractures, bone loss, open fractures, or nonexcellent reduction were significantly less likely to be high performers. Additionally, less than excellent reductions were more common in more complex fracture patterns. Multivariable regression modeling showed that higher BMI, OTA/AO 43-C (complete articular) fracture classification, and open fracture were significant independent risk factors for reducing likelihood of high performance.

Conclusion:

Significant independent factors associated with high performance after tibial plafond fracture are lower BMI, closed fracture, and OTA/AO 43-B (partial articular) fracture.
Perineuronal Nets: Subtle Structures with Large Implications
Authors: Carceller Héctor , Gramuntell Yaiza , Klimczak Patrycja , Nacher Juan
Published: July 2022

Perineuronal nets (PNNs) are specialized structures of the extracellular matrix that surround the soma and proximal dendrites of certain neurons in the central nervous system, particularly parvalbumin-expressing interneurons. Their appearance overlaps the maturation of neuronal circuits and the closure of critical periods in different regions of the brain, setting their connectivity and abruptly reducing their plasticity. As a consequence, the digestion of PNNs, as well as the removal or manipulation of their components, leads to a boost in this plasticity and can play a key role in the functional recovery from different insults and in the etiopathology of certain neurologic and psychiatric disorders. Here we review the structure, composition, and distribution of PNNs and their variation throughout the evolutive scale. We also discuss methodological approaches to study these structures. The function of PNNs during neurodevelopment and adulthood is discussed, as well as the influence of intrinsic and extrinsic factors on these specialized regions of the extracellular matrix. Finally, we review current data on alterations in PNNs described in diseases of the central nervous system (CNS), focusing on psychiatric disorders. Together, all the data available point to the PNNs as a promising target to understand the physiology and pathologic conditions of the CNS.
Remote Learning Strategies for Students With Emotional and Behavioral Disorders
Authors: Heinz Sarah N. , Andzik Natalie R.
Published: July 2022

There is a growing concern among teachers and parents regarding how best to teach children with emotional and behavioral disorders (EBD) in a remote learning format. Students with EBD may have specific needs that present as unique and challenging for teachers to address and when engaging in remote learning. We will discuss research-informed, adapted virtual methods, including strategies to make students feel comfortable socially and academically.
Axially symmetric continuum mechanical model for the oscillon
Authors: Hill James M , Spencer Anthony JM , McCue Scott W
Published: July 2022

The oscillon is a highly localized dynamical phenomenon occurring in a thin horizontal layer of granular material, which rests on a rigid plate oscillating in the vertical direction. The geometry is axially symmetric and physically resembles a splash of liquid due to a falling drop, except that it continually perpetuates itself and does not generate a spreading wave, as is the case for a liquid splash. The oscillon moves from “peak” to “crater” and “crater” to “peak” such that the time from “peak” to “peak” or “crater” to “crater” is twice the period of the oscillating plate. The physics of granular phenomena is not properly understood, and there is no continuum mechanical theory of granular materials which is widely accepted as accurately describing their behaviour. Here for a free-flowing (cohesion-less) granular material, under axially symmetric conditions, we present a partial continuum mechanical analysis assuming the Coulomb–Mohr yield function and non-dilatant double-shearing theory. We examine small perturbations superimposed upon a purely vertical vibration, and make the assumption that throughout the motion, the lower surface of the layer remains in contact with the rigid metal plate. We show how the temporal dependence, which decouples from the spatial structure, is governed by Mathieu’s equation for the physically relevant case of the rigid plate oscillating sinusoidally, and therefore stability is determined by certain key parameters. We explore a variety of possible forms for spatial dependence. The present axially symmetric analysis complements that presented by the authors for plane strain conditions, and we find, quite remarkably, that apart from constants, both flows are governed by similar fourth-order systems of ordinary differential equations. This means that for both plane strain and axially symmetry, analogous pattern forming conditions can operate.
Effects of Evaporative Cooling Air Conditioning on Classroom Pollutants and Thermal Environment
Authors: Xiao Lu , Du Zhenyu
Published: July 2022

Indoor particles and carbon dioxide concentration are major indices to evaluate indoor air quality. Based on the two-dimensional filler sieving model of the direct evaporative cooling segment, the porous media model was used for the simulation of the water filler section, the filtering efficiency of particle was simulated by adjusting the water drenching density and airflow velocity in different operating conditions. The three-dimensional classroom model used to change the exhaust outlet position and control the use of air conditioners simulated the indoor thermal environment and the changes in pollutant concentration. The Euler method and Lagrangian method were used to analyze the indoor flow field and particle sieving in the direct evaporation section, respectively. Conclusions show that in the application of evaporative cooling and stratum ventilation air conditioning system in classroom, the position of the exhaust port affects the concentration of carbon dioxide in the student’s breathing area. The water filler section can effectively reduce the concentration of particle and carbon dioxide supplied indoors. The filtration efficiency of particle in outdoor air passing through the direct evaporative cooling section based on diffusion, inertial collision, and interception is affected by the combined effect of particle size, onward wind speed, and water spray density. The filtration efficiency of particle increases as the density of the spray water increases. With the increase of head-on wind speed, the filtration efficiency of coarse particulate matter is higher than that of fine particulate matter. The research results help policy makers decide whether to install evaporative cooling air conditioning in schools and determine which exhaust outlet positions are most effective in improving indoor air quality.
Latrine Utilization and Associated Factors Among Community-Led Total Sanitation and Hygiene (CLTSH) Implemented Kebeles in Gurage Zone, Southern Ethiopia: A Cross-Sectional Study
Authors: Woyessa Eshetu Teshome , Ashenafi Tesfaye , Ashuro Zemachu , Ejeso Amanuel
Published: July 2022

Background:

In developing countries, open defecation is still a major health issue. While there has been a great deal of empirical research on latrine coverage. But little is known about household latrine utilization behavior. The objective of this study was to assess latrine utilization and associated factors among Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles in Gurage Zone, Southern Ethiopia.

Methods:

A community-based cross-sectional study was conducted on 585 randomly selected households in Gurage Zone’s rural Community-Led Total Sanitation and Hygiene (CLTSH) implemented kebeles. The data were entered into Epi-data version 3.1 and analyzed in SPSS version 20. A binary logistic regression analysis was used to identify factors associated with latrine utilization, and a P-value < .05 was used to declare significance.

Results:

In this study, 65.8% of households used latrines [95% CI: 61.8%-69.8%]. The odds of using a latrine were higher in households with less than 5 family members [AOR = 2.53, 95% CI: 1.33-4.84], in households with no vegetation around their latrines [AOR = 4.56, 95% CI: 2.27-9.18], households with clean latrines [AOR = 2.19, 95% CI: 1.17-4.12], households with latrines located <6 m from the dwellers [AOR = 5.94, 95% CI: 3.13-1.27], households with latrines located 6 to 10 m from the dwellers [AOR = 3.94, 95% CI: 1.93-8.03], households head not attending formal education [AOR = 0.24, 95% CI: 0.13-0.44], households without school children [AOR = 0.15, 95% CI: 0.08-0.28], households owned latrine for less than 1 year’s [AOR = 0.24, 95% CI: 0.12-0.49], Households owned latrine for 1 to 3 year’s [AOR = 0.39, 95% CI: 0.25-0.64], and latrine that does not require maintenance 1.94 [AOR = 1.92, 95% CI: 1.04-3.61], were significantly associated with latrine utilization.

Conclusion:

The findings of this study revealed that open field defecation is still practiced by households in CLTSH implemented kebeles. Therefore, to improve latrine utilization, community awareness must be raised through regular training on proper latrine construction, latrine usage, and sanitation and hygiene practices.
Gamifying English Language Learning through Interactive Storytelling and MALL Technologies
Authors: Raffone Annalisa
Published: July 2022

In today’s society, marked by the spread of Covid-19 that forced the shift from a traditional face-to-face to a fully online setting, digital tools are becoming more and more essential to engage 21st Century students in their classroom activities. In the context of ELT (English Language Teaching), Digital Game-Based Language Learning (DGBLL) has increasingly been shown to foster language development since its interactivity allows for the creation of a constructivist learning environment in which students do not experience feelings of stress and anxiety. This article aims to present the design, development, and testing of an original class-interactive storytelling game addressing EFL (English as a Foreign Language) Italian Secondary School students. Quantitative and qualitative data were collected and submitted to statistical and Computer-assisted content analyses to triangulate and enhance findings. The results showed that DGBLL had positive effects on students’ language development and the enhancement of 21st Century Skills, including critical thinking, engagement, collaboration, and the reduction of the fear of failure.
The critical (micro)political economy of health: A more-than-human approach
Authors: Fox Nick J
Published: July 2022

The critical political economy of health offers different explanations for the social causes of health and the social factors determining the distribution of these causes. However, the relational, post-anthropocentric and monist ontology of the new materialisms overcomes this complexity, while retaining a critical focus. In this perspective, the social, economic and political relations of capitalism act upon bodies and other matter in everyday events, rather than as ‘social structures’. Using a conceptual toolkit of ‘affect’, ‘assemblage’, ‘capacity’ and ‘micropolitics’, the paper asks the question: ‘what does capitalism do?’ The re-analysis of the social and economic relations of capitalism in terms of a production-assemblage and a market-assemblage reveals not only the workings of capitalist accumulation, but also how previously-unremarked more-than-human affects in these assemblages simultaneously produce uncertainty, waste and inequalities. This micropolitical economy of health is illustrated with examples from recent research, including a critical assessment of health inequalities during the Covid-19 pandemic.
Tell the story of a virus
Authors: Pearl Monica B.
Published: July 2022

This article is part of the special Cultural Commons edition on It’s a Sin. It argues that if It’s a Sin is the queer Friends of the UK AIDS era, it loses its nerve: while it gets right the ways that queer kinship reinvented the conventional family during the AIDS crisis, it still makes the domestic sphere its ultimate thematic focus - and mothers the villains.
Conceptualising change in equality, diversity and inclusion: A case study of the Irish film and television sector
Authors: O’Brien Anne , Kerrigan Paraic , Liddy Susan
Published: July 2022

Research is key to supporting diversity and inclusion practices in media and creative industries because it articulates the structural and cultural barriers to participation by workers with a broad range of underrepresented social identities. However, currently there is a lack of research that problematises how change happens with regard to equality, diversity and inclusion in creative industries. Very little research looks beyond specific initiatives, particular employers or individual organisations to explore how change is adopted more broadly within the sector. This article seeks to address that gap by applying a number of literatures on policy and organisational or cultural change to generate a schema that allows the complexity of change to be understood through a unified model of a policy regime. This article adopts a qualitative case study methodology to examine equality, diversity and inclusion regime change in the film and television industries in Ireland from 2015 to 2021. Key findings map how policy goal changes, paradigm shifts in thinking on equality, organisational coalitions and a change in power arrangements all combined resulting in significant change in the gender and equality regime in Irish film and television work. This framework is valuable because it provokes questions about how equality, diversity and inclusion initiatives can be more effective, how various cases of change compare with each other and how some efforts at change ultimately fail.
Aeration desulfurization of offshore oilfield produced water used for preparation of polymer solutions
Authors: Shi Weiye , Fan Zhenhua , Liu Tongzhe , Zhang Lei
Published: July 2022

It is an inevitable trend to reuse treated oilfield produced water to prepare polymer solutions due to the shortage of freshwater resources in offshore platforms. The presence of S2− in produced water reduces the viscosity of the prepared polymer solution, which proves unfavorable for oil displacement. In this study, the aeration and sedimentation techniques were employed to desulphurize the produced water of an offshore oilfield in the Shengli Oil Field. The oxygen mass transfer coefficient was directly proportional to the aeration rate and the concentration of micromolecular organics, but inversely proportional to the concentration of petroleum hydrocarbons. Raising the air-water ratio from 0.1 to 2 increased the removal rate of S2− from 16% to 100%. The high temperature of produced water could enhance the oxidation of S2−, the products of which principally comprised elemental sulfur and thiosulfate at a low air-water ratio, but sulfate and sulfite at a higher ratio. An 8 h static sedimentation of the aerated produced water led to a significant decrease in the concentration of dissolved oxygen (DO), which was consumed by the low-valence sulfur-containing substances and reactive organic matters. When the hydraulic retention time was 20 min and the air-water ratio was 1, both S2− and DO were not detected in the produced water after sedimentation, which was qualified for confection of polymer solutions. Findings in this research is expected to provide a theoretical basis for optimization of parameters in the processes of aeration and sedimentation.
A generic, visual system-based model for discomfort from glare
Authors: Vissenberg MCJM , Perz M , Donners MAH , Sekulovski D
Published: July 2022

Conventional measures of discomfort from glare are based on glare source properties like luminous intensity or luminance and typically are valid only to specific situations and to specific types of light sources. For instance, the unified glare rating (UGR) is intended for indoor lighting conditions with medium-sized glare sources, whereas another class of glare measures is specifically devoted to car headlamps. Recently, CIE TC 3-57 started with the aim to develop a more generic glare sensation model based on the human visual system. We present an example of such a model, including a detailed description of aspects like pupil constriction, retinal image formation, photoreceptor response and adaptation, receptive field-type filtering in the retina and neural spatial summation. The linear correlation of the model to UGR in an indoor setting and to subjective glare responses in an outdoor-like setting indicate that the human-visual-system-based model may indeed be considered generic.
Mobile Health (mHealth) Interventions to Increase Cancer Screening Rates in Hispanic/Latinx Populations: A Scoping Review
Authors: Watanabe-Galloway Shinobu , Ratnapradipa Kendra , Subramanian Roma , Ramos Athena , Famojuro Oluwaseun , Schmidt Cynthia , Farazi Paraskevi
Published: July 2022

Hispanic/Latinx persons have disproportionately lower breast, cervical, and colorectal cancer screening rates than non-Hispanic White (NHW) persons. This low participation in cancer screening results in late-stage cancer diagnosis among Hispanic persons compared to NHW persons. Mobile health (mHealth) interventions effectively improve cancer screening rates in the general population; however, few reviews about mHealth interventions are tailored to Hispanic populations. This is important to investigate given that Hispanic persons differ from NHW persons with regard to culture, language, and health care utilization. Therefore, in this study, we investigated: (a) What types of mHealth interventions have been undertaken to increase cancer screening rates among Hispanic persons in the United States? (b) How effective have these interventions been? and (c) What features of these interventions help increase cancer screening rates? Searches conducted during December 2020 identified 10 articles published between January 2017 and December 2020 that met our inclusion criteria. The review revealed that mHealth interventions mainly provided education about cancer and cancer screening using videos, PowerPoint slides, and interactive multimedia. mHealth interventions that effectively improved screening behavior were mainly for easy-to-screen cancers like skin and cervical cancer. Finally, reviewed studies did not provide details on how cultural adaptations were made, and it is unclear what specific features of mHealth interventions increase cancer screening rates among Hispanic persons. Future research should identify and evaluate the effects of different components of culturally tailored interventions on cancer screening. Public health practitioners and health care providers should tailor mHealth approaches to their clients or patients and practice environment.
An intelligent fuzzy parameterized multi-criteria decision-support system based on intuitionistic fuzzy hypersoft expert set for automobile evaluation
Authors: Ihsan Muhammad , Saeed Muhammad , Rahman Atiqe Ur , Khalifa Hamiden Abd El-Wahed , El-Morsy Salwa
Published: July 2022

In every decision-making scenario, the role of parameters is pertinent but it becomes critical for the situations when parameters are ambiguous to be assessed by the experts so this sort of uncertainty is judged by assigning a fuzzy membership-grade to each parameter. The existing literature on fuzzy parameterization is unable to provide an appropriate model which may cope with hypersoft setting, multi-decisive opinions of experts and intuitionistic setting collectively. This shortcoming leads to the motivation of this study. In this paper, fuzzy parameterized intuitionistic fuzzy hypersoft expert set (FPIFHsES) is characterized which is capable to address the insufficiencies of existing models like fuzzy parameterized intuitionistic fuzzy soft expert set (FPIFSES) for the consideration of multi-argument approximate function. With the entitlement of this function, FPIFHsES tackles the real-life scenario where each attribute is meant to be further classified into its respective sub-attribute valued disjoint set. The FPIFHsES is more flexible and the reliable with the deep analysis of attributes in the decision-support system. The characterization of FPIFHsES is accomplished by employing theoretic, axiomatic, and algorithmic approaches. In order to validate the proposed model, an algorithm is proposed to study its role in decision-making while dealing with a real-world scenario.
Air-breathing hypersonic vehicle trajectory optimization with uncertain no-fly zones
Authors: Tian Muyin , Shen Zuojun
Published: July 2022

The air-breathing hypersonic planes are considered to be the future of commercial airlines, which can fly from NYC to London in under an hour. For air-breathing vehicles, 3D trajectory planning will become extremely important due to its significant impact on flight performance. Past research on this issue was not comprehensive enough. Thus, we proposed a hybrid method for generating the optimal trajectories efficiently. No-fly zones are specified for geopolitical restrictions in air-breathing hypersonic vehicle missions. However, previous studies focused on no-fly zone constraints with fixed locations and boundaries. For robust execution, we must take into account no-fly zones’ uncertainties, which arise due to uncertain localization, measurement errors, and no-fly zones’ movement. A chance-constrained approach is presented here to deal with such uncertainties. The key idea of this method is controlling risk when the flight path is close to the uncertain no-fly zones. First, the trajectory planning of air-breathing hypersonic vehicles is modeled as a chance-constrained optimization (CCOPT) problem. With the help of the convexification and linearization techniques, we can approximate the non 3.2.2 CCOPT problem as a convex second-order cone programing under the Gaussian distribution assumption. It can be solved to global optimality by the interior point method. Finally, we give numerical simulation results to prove the effectiveness of this method.
Supramolecular chemistry of organoplatinum(IV) complexes: A syndiotactic polymer with uracil substituents
Authors: Nieradko Michael J , Puddephatt Richard J
Published: July 2022

The reaction of RCH2X with [PtMe2(DPA)], 1, (DPA = di-2-pyridylamine) has given [PtXMe2(CH2R)(DPA)] by cis oxidative addition to give 2a, when R = 6-uracil, X = Cl, or 3a, when R = CO2H, X = Br, but by a mixture of cis and trans oxidative addition to give 4a/4b when R = 4-C6H4CO2H, X = Br. The unusual cis stereochemistry of oxidative addition is rationalized thermodynamically by the formation of an intramolecular hydrogen bond in 2a and 3a but not 4a, and kinetically by the role of the ligand DPA NH group in hydrogen bonding to halide. Complex 2a in the solid state forms an unusual supramolecular syndiotactic polymer by forming two different intermolecular NH..O=C hydrogen bonds to neighbouring molecules.
An integrated lifetime prediction method for double-nut ball screws subject to preload loss failure mode
Authors: Zhou Hua-Xi , Zhou Chang-Guang , Feng Hu-Tian
Published: July 2022

Existing lifetime prediction methods for ball screws are mainly based on the failure mechanism modeling, while the accuracy is quite limited due to the need for a large number of failure samples and the ignorance of the uncertainty during the failure evolution. Therefore, we proposed an integrated lifetime prediction method for the double-nut ball screws utilizing both the degradation mechanism model and the uncertainty evaluation method. The Bayesian inference is used to update the posterior distribution of the wear coefficient on the basis of the condition monitoring data. The posterior distribution of wear coefficient gets narrower with more degraded preload data acquired, which indicates the uncertainty of the wear coefficient due to different material properties and working conditions is decreased. The experimental results showed that, without the need for a large number of failure samples, the proposed integrated lifetime prediction method for double-nut ball screws achieved much higher accuracy than existing methods.
Conflicting institutional logics in the control of crime and disorder: The double strategy of administrative and criminal law
Authors: Salet Renze , Terpstra Jan
Published: July 2022

The management of crime and disorder is increasingly based not only on criminal law, but also on administrative law. This paper deals with the question of how this double strategy can be understood from the perspective of institutional logics. This analysis is based upon a study in the Netherlands about the use of administrative powers in relation to criminal law. Special attention is paid to the relations between local government and the police. The study concentrates on three different administrative powers: the area ban, the closure of premises, and the power to refuse or revoke subsidies and permits if there is a risk that these may facilitate criminal activities. The study shows that the two logics may conflict, but also that new combinations of logics are created. These may create new tensions that result, in particular, from the dominance of criminal law over the administrative logic.
Polypharmacy among older individuals with heart failure: trends between 2000 and 2017 in the province of Quebec, Canada
Authors: Campeau Calfat Alexandre , Simard Marc , Ouali Amina , Blais Claudia , Sirois Caroline
Published: July 2022

Objective:

Pharmacological management of heart failure and comorbidities may result in polypharmacy, but there are few population-based studies that portray the use of medications over time. We aimed to describe the trends in polypharmacy and medication use in older adults with heart failure.

Methods:

We performed a study including all adults >65 years with heart failure between 2000 and 2017 using health administrative databases in Quebec, Canada. Medication use was ascertained by the presence of at least one claim in each year. We defined three levels of polypharmacy: ⩾10, ⩾15 and ⩾20 different medications/year, and evaluated the use of guideline-recommended and potentially inappropriate medications. We calculated age- and sex-standardized proportions of users each year.

Results:

The use of ⩾10, ⩾15 and ⩾20 medications increased from 62.2%, 30.6% and 12.2% in 2000 to 71.9%, 43.9% and 22.7%, respectively, in 2017. The combination of β-blocker and angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) was used by 30.4% of individuals in 2000 and 45.5% in 2017. ACEI/ARB users decreased from 65.8% in 2000 to 62.1% in 2017. Potentially inappropriate medication use decreased over time.

Conclusion:

Polypharmacy is significant among older adults with heart failure. Implications of such medication burden should be investigated.
Mid-term MRI evaluation reveals microstructural white matter alterations in COVID-19 fully recovered subjects with anosmia presentation
Authors: Pelizzari Laura , Cazzoli Marta , Lipari Susanna , Laganà Maria Marcella , Cabinio Monia , Isernia Sara , Pirastru Alice , Clerici Mario , Baglio Francesca
Published: July 2022

Background:

Little is still known about the mid/long-term effects of coronavirus disease 2019 (COVID-19) on the brain, especially in subjects who have never been hospitalized due to the infection. In this neuroimaging exploratory study, we analyzed the medium-term effect of COVID-19 on the brain of people who recovered from COVID-19, experienced anosmia during the acute phase of the disease, and have never been hospitalized due to SARS-Co-V-2 infection.

Methods:

Forty-three individuals who had (COV+, n = 22) or had not (COV−, n = 21) been infected with SARS-Co-V-2 were included in the study; the two groups were age- and sex-matched and were investigated using 3T magnetic resonance imaging (MRI). Gray matter (GM) volume, white matter (WM) hyperintensity volume, WM microstrutural integrity (i.e. fractional anisotropy [FA], mean diffusivity [MD], axial diffusivity [AD], radial diffusivity [RD]) and cerebral blood flow (CBF) differences between the two groups were tested with either analysis of covariance or voxel-wise analyses. Results were family wise error (FWE) corrected.

Results:

No significant differences between COV+ and COV− groups were observed in terms of GM volume, WM hyperintensity volume, and CBF. Conversely, local WM microstructural alterations were detected in COV+ when compared with COV− with tract-based spatial statistics. Specifically, COV+ showed lower FA (pFWE-peak = 0.035) and higher RD (pFWE-peak = 0.038) than COV− in several WM regions.

Conclusion:

COVID-19 may produce mid/long-term microstructural effect on the brain, even in case of mild-to-moderate disease not requiring hospitalization. Further investigation and additional follow-ups are warranted to assess if the alterations reported in this study totally recover over time. As brain alterations could increase the risk of cognitive decline, greater knowledge of their trajectories is crucial to aid neurorehabilitation treatments.
The role of chemotherapy in the treatment of advanced appendiceal cancers: summary of the literature and future directions
Authors: Strach Madeleine C. , Sutherland Sarah , Horvath Lisa G. , Mahon Kate
Published: July 2022

Appendiceal cancer is rare and encompasses a diverse group of tumours ranging from low-grade appendiceal mucinous neoplasms to high-grade adenocarcinomas. Appendiceal cancers often spread to the peritoneal cavity causing extensive mucinous dissemination and peritoneal metastases. Prognosis varies with histological subtype. Cytoreductive surgery and heated intraperitoneal chemotherapy is well-established as the most effective treatment achieving long-term survival in some patients. Chemotherapy regimens used to treat appendiceal cancer are extrapolated from the colorectal cancer setting, but disease biology differs and outcomes are inferior. The role of chemotherapy in the treatment of appendiceal cancer remains poorly defined. There is an urgent need to develop novel tailored treatment strategies in the perioperative and unresectable setting. This review aims to evaluate the literature for patients who received intraperitoneal and systemic chemotherapy for appendiceal cancers.
Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study
Authors: Lee Suey-Haur , Lin Yu-Ching , Chiu Li-Chung , Ju Jia-Shiuan , Tung Pi-Hung , Huang Allen Chung-Cheng , Li Shih-Hong , Fang Yueh-Fu , Chen Chih-Hung , Kuo Scott Chih-Hsi , Wang Chin-Chou , Yang Cheng-Ta , Hsu Ping-Chih
Published: July 2022

Background:

Although bevacizumab in combination with afatinib or erlotinib is an effective and safe first-line therapy for advanced epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC), there are very few clinical data comparing afatinib and erlotinib combined with bevacizumab. We performed a retrospective multicenter analysis for the comparison of two combination therapies.

Methods:

Between May 2015 and October 2020, data of 135 stage IIIB/IV EGFR-mutated NSCLC patients receiving first-line afatinib or erlotinib combined with bevacizumab combination therapy in Linkou, Keelung, Chiayi, and Kaohsiung Chang Gung Memorial Hospitals were retrieved and retrospectively analyzed.

Results:

In all, 67 patients received afatinib plus bevacizumab, and 68 patients received erlotinib plus bevacizumab. Afatinib combined with bevacizumab had an objective response rate (ORR) of 82.1% and a disease control rate (DCR) of 97.0%, and the ORR and DCR were 83.8 and 95.6%, respectively, in the erlotinib combined with bevacizumab group ( p = 0.798 and p = 1.000). The median progression-free survival was 20.7 and 20.3 months for the afatinib plus bevacizumab group and the erlotinib plus bevacizumab group, respectively [hazard ratio (HR) = 1.02; 95% confidence interval (CI), 0.891–1.953; p = 0.167). The overall survival was 41.9 and 51.0 months for the afatinib plus bevacizumab group and erlotinib plus bevacizumab group, respectively (HR = 1.42; 95% CI, 0.829–2.436; p = 0.201). The secondary EGFR-T790M mutation rates after disease progression were 44% in the afatinib plus bevacizumab group and 58.8% in the erlotinib plus bevacizumab group ( p = 0.165). Skin toxicity was the most frequent treatment-related adverse event (AE) in both treatment groups. Diarrhea, an AE, occurred significantly more frequently in the afatinib plus bevacizumab group than in the erlotinib plus bevacizumab group ( p < 0.05).

Conclusion:

Afatinib combined with bevacizumab was equally as effective as erlotinib combined with bevacizumab for untreated advanced EGFR-mutated NSCLC. Prospective clinical studies that explore bevacizumab combined with afatinib or erlotinib for advanced EGFR-mutated NSCLC are warranted.
Gene therapy in haemophilia: literature review and regional perspectives for Turkey
Authors: Kavaklı Kaan , Antmen Bülent , Okan Vahap , Şahin Fahri , Aytaç Selin , Balkan Can , Berber Ergül , Kaya Zühre , Küpesiz Alphan , Zülfikar Bülent
Published: July 2022

Haemophilia is an X-linked lifelong congenital bleeding disorder that is caused by insufficient levels of factor VIII (FVIII; haemophilia A) or factor IX (FIX; haemophilia B) and characterized by spontaneous and trauma-related bleeding episodes. The cornerstone of the treatment, factor replacement, constitutes several difficulties, including frequent injections due to the short half-life of recombinant factors, intravenous administration and the risk of inhibitor development. While extended half-life factors and subcutaneous novel molecules enhanced the quality of life, initial successes with gene therapy offer a significant hope for cure. Although adeno-associated viral (AAV)-based gene therapy is one of the most emerging approaches for treatment of haemophilia, there are still challenges in vector immunogenicity, potency and efficacy, genotoxicity and persistence. As the approval for the first gene therapy product is coming closer, eligibility criteria for patient selection, multidisciplinary approach for optimal delivery and follow-up and development of new pricing policies and reimbursement models should be concerned. Therefore, this review addresses the unmet needs of current haemophilia treatment and explains the rationale and principles of gene therapy. Limitations and challenges are discussed from a global and national perspective and recommendations are provided to adopt the gene therapies faster and more sufficient for the haemophilia patients in developing countries like Turkey.
Outcomes of patients with diffuse large B-cell and high-grade B-cell lymphomas with synchronous CNS and systemic involvement at diagnosis treated with high-dose methotrexate and R-CHOP: a single-center retrospective study
Authors: Fleming Megan , Huang Ying , Dotson Emily , Bond David A. , Reneau John , Epperla Narendranath , Alinari Lapo , Brammer Jonathan , Christian Beth , Baiocchi Robert A. , Maddocks Kami , Sawalha Yazeed
Published: July 2022

Background:

The optimal treatment of patients with systemic diffuse large B-cell (DLBCL) or high-grade B-cell (HGBL) lymphomas with synchronous central nervous system (CNS) involvement at diagnosis is not well defined. High-dose methotrexate administered concurrently with R-CHOP (RM-CHOP) is a commonly used regimen, but data on outcomes achieved with this regimen are limited.

Objective:

To report our experience with RM-CHOP in patients with systemic DLBCL or HGBL with synchronous CNS involvement at diagnosis.

Design:

A single-center retrospective analysis.

Methods:

We identified consecutive patients with systemic DLBCL or HGBL with synchronous CNS involvement at diagnosis who were treated with RM-CHOP from January 2012 to January 2021.

Results:

Fifty patients were included with a median age of 62 years; 82% had DLBCL ( n = 41) and 18% had HGBL ( n = 9). Treatment with RM-CHOP was followed by consolidative autologous hematopoietic cell transplantation in 14 patients (28%). The complete response (CR) rate following RM-CHOP was 62%. With a median follow-up of 40 months, the median progression-free (PFS) and overall (OS) survivals were 16 and 58 months, and the 2-year PFS and OS were 41% and 57%, respectively. The 2-year cumulative incidence of CNS progression/relapse was 29%. Outcomes were particularly poor in HGBL, with median PFS and OS of 6 and 7 months, compared with median PFS and OS of 22 months and not reached in DLBCL, respectively. The outcomes of patients with relapsed/progressive disease were poor, with only 63% of patients receiving subsequent treatments and only 21% achieving CR to next subsequent treatment. Most patients (58%) with disease relapse/progression had CNS involvement which was associated with very poor outcomes (median OS of 2 months).

Conclusion:

CNS involvement in aggressive B-cell non-Hodgkin lymphoma at diagnosis dictates clinical outcomes and requires more effective treatment options.
Cryptococcosis in a patient with multiple myeloma receiving pomalidomide: a case report and literature review
Authors: Chastain Daniel B. , Golpayegany Sahand , Henao-Martínez Andrés F. , Jackson Brittany T. , Stoudenmire Laura Leigh , Bell Kaye , Stover Kayla R. , Franco-Paredes Carlos
Published: July 2022

While overall survival with multiple myeloma (MM) has improved, patients suffer from overwhelming tumor burden, MM-associated comorbidities, and frequent relapses requiring administration of salvage therapies. As a result, this vicious cycle is often characterized by cumulative immunodeficiency stemming from a combination of disease- and treatment-related factors leading to neutropenia, T-cell deficiency, and hypogammaglobulinemia. Infectious etiologies differ based on the duration of MM and treatment-related factors, such as number of previous treatments and cumulative dose of corticosteroids. Herein, we present the case of a patient who was receiving pomalidomide without concomitant corticosteroids for MM and was later found to have cryptococcosis, as well as findings from a literature review. Most cases of cryptococcosis are reported in patients with late-stage MM, as well as those receiving novel anti-myeloma agents, such as pomalidomide, in combination with corticosteroids or following transplantation. However, it is likely cryptococcosis may be underdiagnosed in this population. Due to the cumulative immunodeficiency present in patients with MM, clinicians must be suspicious of cryptococcosis at any stage of MM.
Comparison of 1-year healthcare resource utilization and related costs for patients with heart failure in the Chagas and non-Chagas matched cohorts
Authors: Olivera Mario J. , Arévalo Adriana , Muñoz Lyda , Duque Sofía , Bedoya Juan , Parra-Henao Gabriel
Published: July 2022

Background:

Chagas disease is one of the leading causes of heart failure (HF) in Latin Americans, and there are limited data available that examine related costs of care for patients with HF. This study aimed to compare healthcare resource utilization and related costs for patients with HF, with and without Chagas disease.

Methods:

A prospective matched-cohort study comparing the healthcare costs for patients with HF with Chagas disease and care costs for patients with HF without Chagas disease was conducted between January 2019 and December 2019. Only direct costs have been estimated, including hospitalization costs, medications and other cardiovascular interventions, and clinical and laboratory follow-up for up to 1 year.

Results:

A total of 80 patients with chronic HF were included in the study. Of the 80 patients, 40 patients in the Chagas cohort and 40 patients in the non-Chagas cohort were matched for age, insurer and sex. From a social security system perspective, the total costs for the two cohorts during the study period were U$970,136. Specifically, the healthcare costs for the Chagas cohort were greater than the total healthcare costs for the non-Chagas group (U$511,931 versus U$458,205; p = 0.6183) Most costs were associated with hospitalizations (65.5% versus 59.6%), with averages of U$12,798.5 and U$11,455.1 per person in the Chagas and non-Chagas groups, respectively. In both the Chagas (51.6%) and non-Chagas cohorts (54.5%), causes of readmission unrelated to HF outweighed causes of readmission related to HF. High incidences of hospital admissions were observed during the rainy (cold) season for both cohorts

Conclusions:

Over a 12-month follow-up period, patients with chronic HF and Chagas consume as many healthcare resources as those with chronic HF and without Chagas. These data highlight the considerable and growing economic burden of HF on the Colombian health system.
‘I wanna kill my rapist’: Margaret Cho’s #12DaysofRage campaign as promotional digital activism
Authors: Trusolino Madison
Published: July 2022

On November 1, 2015, comedian Margaret Cho announced a two-part campaign inspired by her history as a sexual-abuse survivor, to promote her new music video ‘I Wanna Kill My Rapist’. This included the creation of the hashtag #12DaysofRage. In this article, I explore how Cho used her status as a celebrity to circulate #12DaysofRage which acted as a discursive intervention in rape culture. I used content analysis and thematic analysis to identify themes in the archive of 2401 tweets I collected. I also performed a feminist discourse analysis on both the tweets and news coverage of the campaign to situate the hashtag within its historical, social, and political context. I argue that Cho performed what I call ‘promotional activism’, a subsection of celebrity activism where a celebrity promotes a cause as part of the promotion of a particular project or product. Cho’s choice to centre herself in the campaign made it impossible to separate Cho from the hashtag, preventing #12DaysofRage from greater viral potential, but still acting as a resonant, but ephemeral, gathering point for survivor-focused advocacy.
Accuracy of the Traditional COVID-19 Phone Triaging System and Phone Triage-Driven Deep Learning Model
Authors: Ahmed Marwa M. , Sayed Amal M. , Khafagy Ghada M. , El Sayed Inas T. , Elkholy Yasmine S. , Fares Ahmed H. , Hasan Marwa D. , El Nahas Heba G. , Sarhan Mai D. , Raslan Eman I. , Elsayed Radwa M. , Sayed Asmaa A. , Elmeshmeshy Eman I. , Yassen Rehab M. , Tawfik Nadia M. , Hussein Hala A. , Gaber Dalia M. , Shehata Mervat M. , Fares Samar
Published: July 2022

Objectives:

During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients.

Setting:

This is a retrospective study conducted at the family medicine department, Cairo University.

Methods:

The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted.

Results:

Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%.

Conclusion:

Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources.
Quality Management Practices and Inter-Organizational Project Performance: Moderating Effects of Inter-Organizational Communication, Relationship, and Process Conflicts in Healthcare
Authors: Shah Syed Asim , Asif Muhammad Ali , Shoukat Muhammad Haroon , Polatci Sema , Rehman Shafique Ur
Published: July 2022

The purpose of this study is to empirically examine the relationship between quality management practices (QMP) and inter-organizational project performance (IPP), as well as the moderating effects of inter-organizational communication (ICOM), relationship, and process conflicts in Pakistan’s-government healthcare organizations (NGOs) and public healthcare organizations. We developed a hypothetical model based on contingency theory. Using a self-administered questionnaire, the empirical data was collected from 296 respondents from NGOs and public healthcare in Pakistan between March and November 2019. SmartPLS 3.3.9 was used to apply structural equation modeling (SEM). The findings show that QMP significantly impacts IPP in healthcare inter-organizational collaborative projects. ICOM and process conflict significantly moderate the impact of QMP on IPP. In contrast, relationship conflict does not affect IPP. This study has practical implications for healthcare NGOs and public healthcare organizations that want to improve the performance of their projects by implementing QMP in their projects. This study added to the total quality management literature by clearly understanding QMP and its relationship to IPP.