bluuebunny/crossref_metadata_2025 huggingface dataset:
Mainland Chinese students in Hong Kong: Coping with the Socio-Political Challenges of 2017 to 2020
Authors: Ma Anna , Holford John
Published: July 2023

Over the past two decades Hong Kong's higher education institutions have become favored destinations for students from Mainland China. They find Hong Kong society both familiar and strange. Though Chinese, its political history differs markedly from their homeland's. Since 2010, moreover, conflicts have arisen in Hong Kong between local and Mainland Chinese people, culminating between 2017 and 2020 with clashes over issues of autonomy and governance. This study investigates Mainland Chinese students’ experiences in Hong Kong during the 2017–2020 period, and the strategies they developed to cope with the pressures they faced. We found that coping strategies included: active approaches such as learning Cantonese and joining local student societies or campus activities; limiting their friendships to students from similar backgrounds; endurance and acceptance; and ‘letting nature take its course’. The study also shows weaknesses in university assistance for Mainland students, and has broader implications for student support and identity formation.
Australia, ‘the most voter-friendly country in the world’? Examining voting rights for people with physical disabilities
Authors: Katz Ethan
Published: July 2023

Despite Australia’s reputation as a jurisdiction with enviable voter enfranchisement and participation procedures, people with physical disabilities are inadequately catered for by federal and state/territory electoral processes. While alternative voting schemes seek to address this issue, they are either too narrowly constructed, carry election integrity risks, or otherwise provide a voting experience lacking independence. This article examines adequate enfranchisement for people with physical disabilities in the context of Australia’s international human rights law obligations, including the case study of Given v Australia. Barriers to full enfranchisement of people with physical disabilities are considered, including cost, logistics and political will.
Family Experiences with Diagnosis of Craniosynostosis: Thematic Analysis of Online Discussion Boards
Authors: Varagur Kaamya , Murphy John , Skolnick Gary B. , Naidoo Sybill D. , McEvoy Sean D. , Strahle Jennifer M. , Patel Kamlesh B
Published: July 2023

Objective

Apply thematic analysis of online discussion boards to characterize families’ experiences and concerns regarding craniosynostosis diagnoses to aid physicians in tailoring care to families.

Design

Grounded theory-based qualitative analysis.

Setting

Discussion boards related to craniosynostosis identified via Google and Yahoo.

Patients/Participants

Posts about craniosynostosis between 2017–2022.

Interventions

Thematic analysis was performed using three rounds of coding. Post features including author type and use of technical language were examined.

Main Outcome Measure

Overarching themes emerging from analysis of posts, with forums analyzed until sufficient thematic repetition was observed.

Results

366 posts from 4 websites by 290 unique users were included. Parents of patients with craniosynostosis wrote 59% of posts while patients wrote 4%. Five selective codes were identified: 1) Building Community, 2) Diagnosis/Evaluation, 3) Treatment, 4) Outcomes, and 5) Emotional Concerns. Building Community was the most assigned code (85% of posts). 71% of parents’ posts expressing emotional concerns expressed negative emotions, commonly regarding anxiety about diagnosis (71%), frustration about doctors’ responses (21%), or negative reactions to online search results (17%). 88% of patients’ posts expressed positive emotions, discussing positive long-term outcomes. Concerns that may guide physicians included anxiety about delayed diagnosis, difficulty distinguishing postpartum head shape changes from craniosynostosis, and difficulty finding a care team.

Conclusions

Online discussion boards allow families of patients with craniosynostosis to share experiences and find community. Improving communication between surgeons, pediatricians, and families about timing of evaluation and revising online information about this condition may ameliorate some anxiety associated with this diagnosis.
Endobronchial Glandular Papilloma With Atypical Histologic Characteristics: A Case Report and Literature Review
Authors: Yang Linlin , Tomashefski Joseph F. , Keskin Taha , Santoscoy Thomas G. , Abramovich Caroline
Published: July 2023

Papilloma of the lung is a rare benign entity and can be solitary or multiple. Solitary papilloma is subclassified into three categories: squamous papilloma, glandular papilloma, and mixed squamous and glandular papilloma. Glandular papilloma is the rarest subtype among them and occurs mostly in the sixth decade without any relation to smoking, syndrome, or infection. Histology is characterized by mixture of pseudostratified, columnar, nonciliated, mucinous epithelium-lined papillary fronds without any mitoses, necrosis, or atypia. The differential diagnosis can be broad depending upon the histologic features present in a particular case and may include both benign and malignant entities. We present here a patient with glandular endobronchial papilloma showing unusual clinical history and atypical histologic features, which required extensive immunohistochemical evaluation to establish a final diagnosis.
Multifaceted Spindle Cell/Sclerosing Rhabdomyosarcoma With Role of Immunohistochemistry in Avoiding Misdiagnosis: A Multi-Institutional Study of 45 Distinct Tumors
Authors: Jain Ekta , Munjal Gauri , Sharma Shivani , Brar Zoya , Bhardwaj Nitin , Dewan Aditi , Jain Deepika , Jha Shilpy , Lobo Anandi , Malik Vipra , Arora Samriti , Varshney Juhi , Beg Arshi , Sampat Nakul Y. , Parwani Anil V. , Balzer Bonnie , Varma Monica , Yadav Brijpal S. , Sharma Shailendra K. , Singh Hena Paul , Gogoi Kamakhya , Kumar Devendra , Bhandari Vijinder , Fulara Lalit M. , Kumar Arvind , Singh Harish , Bhattacharya Munmun , Dixit Mallika , Mohanty Sambit K.
Published: July 2023

Background. Spindle cell/sclerosing rhabdomyosarcoma is a rare neoplasm and has an aggressive clinical course. Because of its rarity, we performed a multi-institutional collaboration to comprehend the overarching clinical, histopathological, and immunohistochemical characteristics of a cohort of spindle cell/sclerosing rhabdomyosarcoma. Materials and Methods. Forty-five patients with spindle cell/sclerosing rhabdomyosarcoma were identified. Demographics, clinical, histopathological, and immunohistochemistry data were reviewed and recorded. Results. The patients’ age ranged from 1 to 85 years with a male to female ratio of 1.2:1. There were 15 children/adolescents and 30 adults. Eighteen (40%) tumors were located in the head and neck region. Twenty-four (53%) tumors displayed a bimorphic cellular arrangement with hypercellular areas having short, long, and sweeping fascicular and herringbone pattern, and hypocellular areas with stromal sclerosis and associated hyalinized and/or chondromyxoid matrix. Histomorphological differentials considered were leiomyosarcoma, malignant peripheral nerve sheath tumor, fibrosarcoma, nodular fasciitis, liposarcoma, synovial sarcoma, sarcomatoid carcinoma, solitary fibrous tumor, dermatofibrosarcoma protuberans, and schwannoma. Six tumors exhibited marked stromal sclerosis. The myogenic nature was confirmed by immunohistochemistry. Positivity for at least one skeletal muscle-associated marker (MyoD1 and/or myogenin) was observed. Conclusion. Spindle cell/sclerosing rhabdomyosarcoma diagnosis can be challenging as a number of malignant spindle cell neoplasm mimic this entity. Thus a correct diagnosis requires immunohistochemical work up with a broad panel of antibodies. In view of rarity of this neoplasm, further studies on a large cohort of patients with clinical follow-up data are needed for a better understanding of this tumor.
Ectopic Liver Tissue Associated With the Gallbladder: Two Unique Patients and a Literature Review
Authors: Xu Zhengfan , Stanton Cletus N. , Ahsan Beena U.
Published: July 2023

Ectopic/accessory liver tissue is a rare developmental anomaly thought to be due to abnormal development of the liver during embryogenesis. Most patients with ectopic liver tissue are asymptomatic, and the condition is usually discovered incidentally during intraabdominal surgery or autopsy. In rare symptomatic cases, patients’ presentations can range from mild liver function test abnormalities to severe abdominal pain or discomfort secondary to torsion and ischemia. Here, we report 2 patients with ectopic liver tissue identified incidentally during cholecystectomy: one with histologic manifestations of sickle cell congestion and the other with steatohepatitis. A possible relationship between ectopic liver tissue and gallbladder and biliary diseases, such as cholecystitis, has been proposed. To the best of our knowledge, ectopic liver tissue with sickle cell congestion has not been reported previously.
Acute Deltoid Injury in Ankle Fractures: A Biomechanical Analysis of Different Repair Constructs
Authors: Wagner Emilio , Wagner Pablo , Escudero Mario I. , Pacheco Florencia , Salinas David , Godoy-Santos Alexandre Leme , Palma Felipe , Guzmán-Venegas Rodrigo , Berral–De la Rosa Francisco Jose
Published: July 2023

Background:

The importance of the deltoid ligament in the congruency and coupling of the tibiotalar joint is well known. The current trend is to repair it in cases of acute injuries in the context of ankle fractures; however, there is limited information on how it should be reconstructed. The objective of this study was to compare different deltoid ligament repair types in an ankle fracture cadaveric model.

Methods:

Sixteen cadaveric foot-ankle-distal tibia specimens were used. All samples were prepared as a supination external rotation ankle fracture model. Axial load and cyclic axial rotations were applied on every specimen using a specifically designed frame. This test was performed without deltoid injury, with deltoid injury, and after repair. The reconstruction was performed in 4 different ways (anterior, posterior, middle, and combined). Medial clear space (MCS) was measured for each condition on simulated weightbearing (WB) and gravity stress (GS) radiographs. Reflective markers were used in tibia and talus, registering the kinematics through a motion analysis system to record the tibiotalar uncoupling.

Results:

After deltoid damage, in all cases the MCS increased significantly on GS radiographs, but there was no increase in the MCS on WB radiographs. After repair, in all cases, the MCS was normalized. Kinematically, after deltoid damage, the tibiotalar uncoupling increased significantly. All isolated repairs achieved a similar tibiotalar uncoupling value as its baseline condition. The combined repair resulted in a significant decrease in tibiotalar uncoupling.

Conclusion:

Our results show that deltoid repair recovers the tibiotalar coupling mechanism in an ankle fracture model. Isolated deltoid repairs recovered baseline MCS and tibiotalar uncoupling values. Combined repairs may lead to overconstraint, which could lead to postoperative stiffness. Clinical studies are needed to prove these results and show clinically improved outcomes.

Clinical Relevance:

This study helps in finding the optimum deltoid repair to use in an acute trauma setting.
Plasticity of Dendritic Spines Underlies Fear Memory
Authors: Choi Ja Eun , Kaang Bong-Kiun
Published: July 2023

The brain has the powerful ability to transform experiences into anatomic maps and continuously integrate massive amounts of information to form new memories. The manner in which the brain performs these processes has been investigated extensively for decades. Emerging reports suggest that dendritic spines are the structural basis of information storage. The complex orchestration of functional and structural dynamics of dendritic spines is associated with learning and memory. Owing to advancements in techniques, more precise observations and manipulation enable the investigation of dendritic spines and provide clues to the challenging question of how memories reside in dendritic spines. In this review, we summarize the remarkable progress made in revealing the role of dendritic spines in fear memory and the techniques used in this field.
Polarization or Mainstreaming? How COVID-19 News Exposure Affects Perceived Seriousness of the Pandemic and the Susceptibility to COVID-19 Misinformation?
Authors: Han Jiyoung , Lee Eun-Ju
Published: July 2023

Two surveys investigated whether the exposure to COVID-19 news widens (polarization) or narrows (mainstreaming) the partisan gap in perceived seriousness of the pandemic, and how the perception affects individuals’ susceptibility to COVID-19 misinformation that either exaggerates or downplays its health risks. Overall exposure to COVID-19 news homogenized the partisans’ otherwise divergent risk perceptions, but the partisan divide was wider among those selectively approaching like-minded news outlets. Perceived seriousness of COVID-19 subsequently altered participants’ susceptibility to either fear-arousing or fear-suppressing COVID-19 misinformation in a belief-confirming manner. It is discussed how news media shape the public’s reality perception amid the global crisis.
A new dynamic model for gear systems incorporating the sliding friction and time-varying pressure angle
Authors: Liu Hao , Zhang Dayi , Wang Jianjun
Published: July 2023

The dynamic characteristics of gear systems are affected by the sliding friction and time-varying pressure angle. In the previous studies, the sliding friction is usually neglected for simplification, while the pressure angle is always considered as a constant. Therefore, the coupling effect between the sliding friction and pressure angle is not considered. In view of this, a new six degrees-of-freedom model for spur gear systems is proposed. The sliding friction and time-varying pressure angle are emphasized in this model. The differential equations of motion are derived using Lagrange’s equation. The Runge–Kutta numerical integration algorithm is applied to gain dynamic response. The proposed model is somewhat more realistic compared to previous models. Furthermore, parametric studies are carried out to reveal the effects of friction coefficient and equivalent shaft-bearing stiffness (directly related to translational motion and time-varying pressure angle). The coupling effect between the sliding friction and pressure angle is verified not only by the mathematical model but also by the dynamic response. The results reveal that both friction coefficient and equivalent shaft-bearing stiffness affect the contact ratio and pressure angle and lead to distinctive dynamic responses. This research can provide a foundation for further study and be used as a reference for gear system design and vibration prediction.
Evaluation Paradoxes: Responding to Tensions Between Stability and Change in Social Investment Evaluation
Authors: Nordesjö Kettil
Published: July 2023

The relationship between stability and change is a central paradox of administration that pervades all forms of organizing. Evaluation is not unfamiliar with paradoxical objectives and roles, which can result in tensions for evaluators and stakeholders. In this article, paradoxes between stability and change in the implementation of evaluation, and responses to them, are investigated through the case of social investment funds in Swedish local government. From interviews with staff, managers, and evaluators, findings show how responses to four main paradoxes give priority to top-down summative evaluation that produces instrumental knowledge on outcomes and costs for decision makers. The responses show that the concept of social investment fund evaluation is elastic to contain paradoxes and address different audiences. Also, paradoxes within the structure of the organization develop into paradoxes concerning the roles and goals of evaluation, raising the question of whether individual actors can deal with paradoxes.
Surveillance After a Previous Cutaneous Melanoma Diagnosis: A Scoping Review of Melanoma Follow-Up Guidelines
Authors: Johnston Leah , Starkey Samantha , Mukovozov Ilya , Robertson Lynne , Petrella Teresa , Alhusayen Raed
Published: July 2023

Introduction

Cutaneous melanoma accounts for more than 70% of all skin cancer deaths. Follow-up surveillance is an integral part of melanoma patient care, to facilitate early detection of recurrences and subsequent primary melanomas. The purpose of this scoping review is to provide an overview of recently published melanoma surveillance guidelines from regional and national melanoma working groups.

Methods

A systematic search for relevant studies in MEDLINE and Embase was conducted in September 2022 and was limited to publications from 2010 or later.

Results

A total of 1047 articles were retrieved, and after abstract and full text review, 26 articles from 19 different organizations met inclusion criteria. Life-long annual skin surveillance with a physician was recommended by 53% (9/17) of guidelines. Routine laboratory investigations were recommended by 7/19 guidelines. Regional lymph node ultrasound was recommended by 9/16 guidelines, most often in stage IB or higher, and was optional in 7/16 for patients who met specific criteria. Surveillance with PET-CT or CT and MRI was recommended by 15 and 11 guidelines, respectively, most commonly in stage IIC or higher, with a variable frequency and total duration. Five out of 9 guidelines indicated a preference for skin surveillance to be completed with a dermatologist.

Conclusion

Guidelines were highly variable for many aspects of melanoma surveillance, which may be partly attributed to regional differences in healthcare workforce distribution and availability of imaging technologies. Further high-level studies are recommended to provide more evidence on the most effective clinical and imaging follow-up surveillance protocols.
Blended versus face-to-face cognitive behavioural therapy for severe fatigue in patients with multiple sclerosis: A non-inferiority RCT
Authors: de Gier Marieke , Beckerman Heleen , Twisk Jos , Knoop Hans , de Groot Vincent
Published: July 2023

Background:

Cognitive behavioural therapy (CBT) reduces multiple sclerosis (MS)-related fatigue. Implementation of face-to-face CBT is hindered by limited treatment capacity and traveling distances to treatment locations.

Objective:

Evaluate whether blended CBT (online treatment modules supported with guidance by a therapist) is non-inferior to face-to-face CBT in reducing fatigue severity in severely fatigued patients with MS.

Method:

A non-inferiority multicentre randomized clinical trial, in which 166 patients with MS were allocated to either face-to-face or blended CBT. Primary outcome was fatigue severity assessed with the Checklist Individual Strength fatigue subscale directly post-treatment (week 20). Mixed model analysis was used by a statistician blinded for allocation to determine between-group differences post-treatment. The upper limit of the 95% confidence interval (CI) was compared to a pre-specified non-inferiority margin of 5.32.

Results:

Blended CBT ( N = 82) was non-inferior to face-to-face CBT ( N = 84) (B = 1.70, 95% CI: −1.51 to 4.90). Blended CBT significantly reduced therapist time ( B = −187.1 minutes, 95% CI: 141.0–233.3). Post hoc analysis showed more improvement ( B = −5.35, 95% CI: −9.22 to −1.48) when patients received their preferred treatment. No harm related to treatment was reported.

Discussion:

Blended CBT is an efficient alternative to face-to-face CBT. Offering the preferred CBT format may optimize treatment outcome.
Who knows? On the epistemic status of experience in sugar-dating research
Authors: Johansson Wilén Evelina , Gunnarsson Lena
Published: July 2023

Sugar dating has gained extensive media coverage over the last couple of years, often being depicted as a veiled form of prostitution / sex work. While similar dating arrangements encompassing some sort of economic compensation are well researched in an African and Asian context, sugar dating has only garnered attention from researchers in the Global North during the last decade, in the wake of a proliferation of websites facilitating the practice. In light of the contested nature of the phenomenon, in this article we critically assess how knowledge about sugar dating is constructed in the emerging literature on the topic in the Global North, with a particular focus on the role attributed to sugar daters’ own experiential accounts. Alongside furthering the discourse on sugar dating by unravelling the epistemological underpinnings of existing research, we utilise the case of sugar-dating research to elaborate on the continued relevance of feminist debates on the epistemological status of experience. We call for a more comprehensive theoretical examination of experience in sugar-dating research and posit that some versions of feminist standpoint theory, as well as strands in feminist phenomenology, provide valuable theoretical tools for navigating between understanding experience as an ideological construct and/or as a privileged foundation of knowledge.
Super-giant fusiform basilar artery aneurysm
Authors: Haroon Khawaja Hassan , Ali Liaquat , Muhammad Ahmad
Published: July 2023

Intracranial aneurysms are focal pathological dilatation of the arteries with a prevalence of 3.2%. Fusiform aneurysms are rare and mainly due to dissection or atherosclerosis. They may manifestas as stroke, cranial nerve palsies, brainstem compression and Sub-arachnoid hemorrhage. A diameter greater than 10 mm is a risk factor for rupture and warrants early intervention.
Mode II interlaminar shear behavior of needled/tufted interlocking composites
Authors: Li Jiao , Chen Li , Zheng Hongwei , Wei Yuying , Chen Xiaoming
Published: July 2023

The needled/tufted interlocking fabric is a new fabric structure. At present, the mode II interlaminar shear behavior of needled/tufted interlocking composite has not been clarified. In this work, the needled/tufted interlocking fabrics and reinforced composites were fabricated, and the interlaminar shear behavior of mode II was studied experimentally and numerically, the mechanism of tufting effect on interlaminar shear properties of needled composites was revealed. The study found that the interlaminar shear properties of needled/tufted interlocking composites were greatly improved by tufted fiber bundles. The maximum failure load of the needled/tufted interlocking specimen increased 108.93%, and the interlaminar shear stress of the needled/tufted interlocking specimen improved by 89.39%. The interlaminar shear strength increased linearly with the increase of tufted fiber bundle implantation volume. The implantation pattern of tufted fibers had effected on interlaminar shear property. Under the same implantation volume, the thinner tufted fiber bundles and more implantation points were more beneficial to improve the interlaminar shear performance. The typical shear failure modes included matrix cracking, fibers pullout, and brittle fracture of tufted fiber bundles and needled fiber bundles. Moreover, a numerical simulation model of interlaminar shear behavior based on three cohesive zones (TCZMs) was proposed. The predicted displacement-load curves were highly in accord with the experiments. The error range was controlled within 1.08% - 3.76%. The simulation model could predict the mode II shear behavior of needled and tufted interlocking composites effectively, which was helpful to the early manufacturing process design of needled and tufted interlocking fabrics.
Robotic Microsurgery in Plastic and Reconstructive Surgery: A Literature Review
Authors: Ghandourah Hussain S. H. , Schols Rutger M. , Wolfs Joost A. G. N. , Altaweel Fahed , van Mulken Tom J. M.
Published: July 2023

Background

Surgical robots have innovated the microsurgical field by providing advantages that improve surgical performance. These robots have been adopted by certain specialties more than others. This study discusses the potential advantages of robotics in plastic and reconstructive surgery.

Method

This study is a literature review of articles investigating “robotic microsurgery in plastic and reconstructive surgery” using the PubMed database and the Cochrane Library.

Result

A total of nineteen relevant articles were found and 5 articles performed a direct comparison between the robotic and manual approaches. Longer operating times were reported in the robotic groups featuring higher learning curves. Reported advantages to robotic use included higher accuracy, precision and flexibility, elimination of tremor and improvement of ergonomic factors.

Conclusion

While the results provide an outlook into the outcome of robotic platforms in this field, current research is limited and further studies are required to provide a fundamental analysis.
Understanding the Nature of and Identifying and Formulating “Research Problems” in Mixed Methods Research
Authors: Younas Ahtisham , Durante Angela , Fàbregues Sergi
Published: July 2023

Mixed methods research (MMR) is suitable for studying research problems that cannot be adequately investigated through qualitative and quantitative methods alone. Nevertheless, the MMR literature offers a very limited discussion about “research problems.” To address this gap, this paper uses Elliott’s conceptual framework to offer guidance on how to identify and formulate research problems in MMR and understand their nature. This article contributes to the field of MMR by reframing the concept of research problems in this type of research and offering a conceptual and methodological approach to describing and characterizing research problems for investigation in social and cultural contexts.
From Uncomfortable Squirm to Self-Discovery: A Phenomenological Analysis of the Bracketing Experience
Authors: Thomas Sandra P. , Sohn Brian K.
Published: July 2023

Bracketing (also called epoche) is fundamental in phenomenological philosophy and is a widely recognized practice in phenomenological and other qualitative research methodologies. Bracketing definitions, types, and procedures still generate debate among contemporary phenomenological methodologists and other qualitative researchers. The purpose of this paper is to contribute to the dialogue about the topic of bracketing with empirical research on one of its forms. In this study, we analyzed self-reflection reports of doctoral students who had engaged in a bracketing interview and subsequent group analysis. Our results show that the bracketing process can be an educational and revelatory experience for the novice researcher including heightening awareness of their presuppositions and other commonly discussed benefits in the literature. An unanticipated finding includes the powerful effect of bracketing as a springboard to developing a researcher identity. Being understood and validated by the research group was a unique experience for participants that helped to dispel student feelings of being an impostor and/or inadequately prepared to conduct doctoral research. Implications for improving the bracketing process for novice researchers include clear communication prior to bracketing and explicit instruction on research journaling.
The effect of COVID-19 on utilization of chronic diseases services
Authors: Moradi Ghobad , Piroozi Bakhtiar , Khayyati Fariba , Moradpour Farhad , Safari Hossein , Mohamadi Bolbanabad Amjad , Fattahi Hamed , Younesi Fatemeh , Ebrazeh Ali , Shokri Azad
Published: July 2023

Objectives

The aim of the present study is to evaluate the impact of Covid-19 on utilization of chronic diseases services.

Methods

Interrupted time-series design was used to examine the utilization of chronic diseases services before and during the Covid-19 pandemic among hospitals in Iran. Chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes, heart failure, and chemotherapy were selected as a proxy to indicate the impact of Covid-19 on utilization of chronic diseases services. Data were collected in 24 sites from 12 months before the onset of Covid-19 (from March 2019 to February 2020) to 12 months during the Covid-19 pandemic (February 2020 to March 2021).

Results

A total of 7,039,378 services were provided, of which 51.92% were provided for women and 62.73% for >65 age group. A sudden decrease was observed in monthly utilization of services during the Covid-19 pandemic; ranging from 13.91 (95% CI = −21.73, 6.10, P = 0.001) for chemotherapy to 606.39 (95% CI = −1040.72, 172.06, P = 0.009) for heart failure services per 100 thousand population. A decrease was observed in COPD services; 15.28 services compared with the period before Covid-19. Subsequently, the monthly utilization trends of asthma, type 2 diabetes, and chemotherapy services increased significantly ( P < 0.05).

Discussion

Although chronic diseases are a factor in more severe form of Covid-19, their failure to seek diagnostic, prevention and treatment services has somewhat complicated the issue.
The rs216009 single-nucleotide polymorphism of the CACNA1C gene is associated with phantom tooth pain
Authors: Morii Masako , Ohka Seii , Nishizawa Daisuke , Hasegawa Junko , Nakayama Kyoko , Ebata Yuko , Soeda Moe , Fukuda Ken-ichi , Yoshida Kaori , Koshika Kyotaro , Ichinohe Tatsuya , Ikeda Kazutaka
Published: July 2023

Phantom tooth pain (PTP) is a rare and specific neuropathic pain that occurs after pulpectomy and tooth extraction, but its cause is not understood. We hypothesized that there is a genetic contribution to PTP. The present study focused on the CACNA1C gene, which encodes the α1C subunit of the Cav1.2 L-type Ca2+ channel (LTCC) that has been reported to be associated with neuropathic pain in previous studies. We investigated genetic polymorphisms that contribute to PTP. We statistically examined the association between genetic polymorphisms and PTP vulnerability in 33 patients with PTP and 118 patients without PTP but with pain or dysesthesia in the orofacial region. From within and around the CACNA1C gene, 155 polymorphisms were selected and analyzed for associations with clinical data. We found that the rs216009 single-nucleotide polymorphism (SNP) of the CACNA1C gene in the recessive model was significantly associated with the vulnerability to PTP. Homozygote carriers of the minor C allele of rs216009 had a higher rate of PTP. Nociceptive transmission in neuropathic pain has been reported to involve Ca2+ influx from LTCCs, and the rs216009 polymorphism may be involved in CACNA1C expression, which regulates intracellular Ca2+ levels, leading to the vulnerability to PTP. Furthermore, psychological factors may lead to the development of PTP by modulating the descending pain inhibitory system. Altogether, homozygous C-allele carriers of the rs216009 SNP were more likely to be vulnerable to PTP, possibly through the regulation of intracellular Ca2+ levels and affective pain systems, such as those that mediate fear memory recall.
Between Art and Propaganda: The Rise of Polish Animation 1946–1956
Authors: Oczko Patryk
Published: July 2023

Whilst the origins of Polish animation go back to the inter-war years, its rapid and consistent development did not occur until after World War II, and was therefore influenced by and directly dependent on the socialist system. The aim of this article is to identify the nature of the links between the then prevailing ideology and the content and form of animated films that created it, and to further discuss the main trends in this respect. The late 1940s were a time of a kind of creative freedom, which came to an end with the imposition of socialist realism. Transferred from the USSR to Poland, the doctrine began to lose its momentum as early as 1953, gradually embracing modern visual solutions. The complete rejection of socialist realism came in the wake of the political thaw of 1956. These contexts meant that the role of animation evolved and so, too, did its character. Examples used in this article include selected cartoons, puppet and cut-out films made in all the production centres active at that time. They are presented according to content and form, which has made it possible to further discuss the various aspects of the subject under discussion, and to indicate its development milestones. It seems a safe assumption that animation in its modern form was born twice in Poland. Initially, as a part of intuitive pioneering experiments and, later, having gained a wealth of practical and ideological experience following the political thaw of 1956.
Implausible Possibility: Freedom and Realism in Live-Action/Animated Gag Comedies
Authors: Holmaas Luke
Published: July 2023

While often unacknowledged, gags and gag comedy remain a vital part of Hollywood cinema. Following the runaway success of Who Framed Roger Rabbit (1988), an increase in the production of films combining live-action and animation has helped them become a central venue for gag comedy. However, while live-action/animation hybrids can be enormously successful, they are also extremely difficult and risky ventures, both in terms of their technical challenges and production costs. Given this, what is the rationale behind combining live-action and animation for comedy at all? As the author argues, both theoretical considerations of animation and hybrids as well as the discourse from creators of such films frame live-action/animation as particularly well suited for gag comedy due to its ability to balance the freedom of animation with the grounding realism of live-action. Films such as The Adventures of Rocky and Bullwinkle (2000), Looney Tunes: Back in Action (2003), and The SpongeBob Movie: Sponge Out of Water (2015) serve to highlight the interaction between cartoonish animation and realistic live-action as well as key tensions that arise in combining the two forms. Examining the opportunities and challenges provided by these combinations helps explain why hybrid films remain a common vehicle for gag comedy today and an important subset of Hollywood comedy as a whole.
Preparation of ZrO2/Na-β and ZrO2/H-β catalysts and their catalytic performance for the Meerwein–Ponndorf–Verley reaction of cyclohexanone and isopropanol
Authors: Dong Lin-hui , Meng Fan-fei , Liu Li-ye , Qiu Jun
Published: July 2023

ZrO2/Na-β and ZrO2/H-β catalysts are prepared by the reflux impregnation method and are applied to the Meerwein–Ponndorf–Verley reduction of cyclohexanone and isopropanol. The catalysts are characterized by X-ray diffraction, scanning electron microscopy-energy dispersive spectrum, temperature-programmed desorption of ammonia, N2 isothermal adsorption and desorption, and inductively coupled plasma mass spectrometry. The products are identified by gas chromatography‒mass spectrometry and analyzed by gas chromatography. The experimental results showed that ZrO2/H-β exhibits higher catalytic activity for the above Meerwein–Ponndorf–Verley reduction because ZrO2/H-β has both Zr4+ and Al3+ ion acid centers, which provide the moderately strong acid needed for the reaction. Under optimized conditions, ZrO2/H-β(6) is used as the catalyst, and the conversion rate of cyclohexanone was 92.0% as determined by the area-normalized calculation based on cyclohexanone. The catalyst can be regenerated by programmed heating calcination. The conversion rate of cyclohexanone decreased to 79.4% after five recycling cycles, and its service life needs further study to be improved.
Strategies for Supporting Learners With Disabilities in Postsecondary Education
Authors: Rogers-Shaw Carol , Park Tulare Williams , Mohney Kayla D.
Published: July 2023

Through thoughtful course design and the use of targeted strategies, postsecondary instructors can assist students with disabilities in attaining academic goals. When success within the classroom increases, more positive evaluations of instructors who support student achievement can result, and both graduation and retention rates can rise. This article provides guidance for postsecondary instructors about how to proactively address the needs of all students, including those with disabilities. It focuses on timesaving tactics for creating inclusive classrooms through applying Universal Design for Learning, supporting student self-advocacy, boosting student communication skills, encouraging student independence, and recognizing intersectionality.
Perplexing Initial Presentations of MOGAD in Two Children: Intracranial Hypertension and New-Onset Seizure
Authors: Zhou Daniel J. , Powers Andria M. , Cave Caleb A. , Dickas Emily K. , Rickard Mary C. , Rathore Geetanjali , Wright Rhonda R. , Zabad Rana K. , Koh Sookyong
Published: July 2023

We report two distinct challenging initial presentations of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Case 1 describes a 12-year-old boy who developed headaches refractory to pain medication followed by cranial neuropathies and intracranial hypertension, confirmed by lumbar puncture with an opening pressure >36 cm H2O. Case 2 describes a 3-year-old boy who developed new-onset seizures refractory to antiseizure medications, a presentation of FLAIR-hyperintense lesions in MOG-antibody associated encephalitis with seizures (FLAMES). On repeat magnetic resonance imaging, both patients were found to have cortical T2 hyperintensities, leptomeningeal contrast enhancement, and bilateral optic nerve enhancement. In the cerebrospinal fluid, both patients had CSF pleocytosis with neutrophilic predominance. The patients were treated with intravenous immunoglobulins, plasma exchange, and high-dose corticosteroids. The first patient achieved disease remission, whereas the second patient required the addition of rituximab for management of seizures. The two cases highlight the pleomorphic clinical phenotypes of MOGAD.
Immune cell infiltration in the pancreas of type 1, type 2 and type 3c diabetes
Authors: Kattner Nicole
Published: July 2023

The different types of diabetes differ in disease pathogenesis but share the impairment or loss of β-cell function leading to chronic hyperglycaemia. While immune cells are present throughout the whole pancreas in normality, their number and activation is increased in diabetes. Different patterns and composition of inflammation could be observed in type 1, type 2 and type 3c diabetes. Immune cells, pancreatic stellate cells and fibrosis were present in the islet microenvironment and could add to β-cell dysfunction and therefore development and progression of diabetes. First studies investigating the use of anti-inflammatory drugs demonstrate their ability to rescue remaining β-cell function and their potential benefit in diabetes treatment. This article provides an overview of immune cell infiltrates in different types of diabetes, highlights the knowledge of their impact on β-cell function and introduces the potential of immunomodulatory strategies.
The socioeconomic impact of disability progression in multiple sclerosis: A retrospective cohort study of the German NeuroTransData (NTD) registry
Authors: Dillon Paul , Heer Yanic , Karamasioti Eleni , Muros-Le Rouzic Erwan , Marcelli Giuseppe , Di Maio Danilo , Braune Stefan , Kobelt Gisela , Wasem Jürgen
Published: July 2023

Background

Multiple sclerosis (MS) is a progressively debilitating neurologic disease that poses significant costs to the healthcare system and workforce.

Objective

To evaluate the impact of MS disease progression on societal costs and quality of life (QoL) using data from the German NeuroTransData (NTD) MS registry.

Methods

Cross-sectional cohort study. The cost cohort included patients with MS disability assessed using Expanded Disability Status Scale (EDSS) in 2019 while the QoL cohort included patients assessed using EDSS and EuroQol-5 Dimension 5-Levels between 2009 and 2019. Direct and indirect medical, and non-medical resource use was quantified and costs derived from public sources.

Results

Within the QoL cohort ( n = 9821), QoL worsened with increasing EDSS. Within the cost cohort ( n = 7286), increasing resource use with increasing EDSS was observed. Societal costs per patient, excluding or including disease-modifying therapies, increased from €5694 or €19,315 at EDSS 0 to 3.5 to €25,419 or €36,499 at EDSS 4 to 6.5, and €52,883 or €58,576 at EDSS 7 to 9.5. In multivariate modeling, each 0.5-step increase in EDSS was significantly associated with increasing costs, and worsening QoL.

Conclusion

This study confirms the major socioeconomic burden associated with MS disability progression. From a socioeconomic perspective, delaying disability progression may benefit patients and society.
Health-economic benefits of anti-CD20 treatments in relapsing multiple sclerosis estimated using a treatment-sequence model
Authors: Smets Ide , Versteegh Matthijs , Huygens Simone , Corsten Cato , Wokke Beatrijs , Smolders Joost
Published: July 2023

Background

In high-income countries, four anti-CD20 monoclonal antibodies (mAbs) are used or in the pipeline for relapsing MS: ocrelizumab, ofatumumab (both registered), ublituximab (awaiting registration) and rituximab (off-label). List prices differ significantly between registered and off-label drugs.

Objective

Comparing differences in benefits between anti-CD20 mAbs from a health-economic and societal perspective.

Methods

To reflect lifetime use of DMTs, we used a treatment-sequence model to compare ocrelizumab/ofatumumab and eight other drug classes in terms of health (lifetime relapses, time to Expanded Disability Status Scale [EDSS] 6, lifetime quality-adjusted life years) and cost-effectiveness (net health benefit). To become cost-effective compared to ocrelizumab, we modelled the list price of ublituximab and desired effect on EDSS progression of rituximab.

Results

Although drug sequences with ocrelizumab in first- and second-line were more cost-effective than ofatumumab, our probabilistic analysis suggests this outcome was very uncertain. To be more cost-effective than ocrelizumab, ublituximab needs to be about 25% cheaper whilst rituximab needs to equal the effect on disability progression seen with first-line treatments.

Conclusions

Our model showed no clear difference in cost-effectiveness between ocrelizumab and ofatumumab. Hence, prescribing the least costly anti-CD20 mAb can democratise MS care without a loss in health benefits.
Determinants of enrollment in community based health insurance program among households in East Wollega Zone, west Ethiopia: Unmatched case-control study
Authors: Desalegn Mengistu , Lemu Teferi , Tadesse Bekuma , Olana Tariku , Kaba Zalalem , Tolossa Tadesse
Published: July 2023

Background:

Ethiopia has launched a community-based health insurance (CBHI) since 2011, which is an innovative financing mechanism to enhance domestic resource mobilization and sustainable health financing. This study assessed determinants of CBHI enrollment among HHs (households) of East Wollega, Ethiopia, 2022.

Method and materials:

Community based unmatched 1:2 case-control study design was conducted between Jan 7and Feb 5/2022 among 428 HHs (144 cases and 284 controls). Cases were selected from HHs who registered for CBHI and currently using CBHI. Controls were from those who do not registered for CBHI membership. Data collected using a semi-structured, interview administered questionnaire. Multivariable logistic regression with SPSS version 25 was employed for analysis and variables were declared statistical significant association at p-value < 0.05, 95% CI.

Result:

Data from 428 (144 cases and 284 controls to CBHI) were collected; a response rate of 98.8%. Statistically lower odds of CBHI enrollment was observed among HHs who have poor knowledge [AOR = 0.48 (95% CI:0.27, 0.85)], perceived not respectful care [AOR = 0.44 (95% CI :0.24, 0.81)], unavailability of laboratory services [AOR = 0.37(95% CI:0.21, 0.66)], inappropriate time of premium payment [AOR = 0.31(95% CI:0.18, 0.52)]. In addition, medium wealth status category [AOR = 0.11(95% CI: 0.03, 0.45)]. Higher odd of CBHI enrollment observed among who have formal education [AOR = 2.39(95% CI: 1.28, 4.48)].

Conclusion and recommendation:

Educational level, knowledge, time of membership payment, laboratory test availability, perception of respectful care and wealth status were significant determinants of CBHI enrollment status. Hence, the responsible bodies should discuss and decide with community on the appropriate time of premium payment collection, and enhance community education on CBHI benefit package.
Posterior Hip Impingement at Maximal Hip Extension in Female Patients With Increased Femoral Version or Increased McKibbin Index and Its Effect on Sports Performance
Authors: Boschung Adam , Antioco Tiziano , Steppacher Simon D. , Tannast Moritz , Novais Eduardo N. , Kim Young-jo , Lerch Till D.
Published: July 2023

Background:

The location of posterior hip impingement at maximal extension in patients with posterior femoroacetabular impingement (FAI) is unclear.

Purpose:

To investigate the frequency and area of impingement at maximal hip extension and at 10° and 20° of extension in female patients with increased femoral version (FV) and posterior hip pain.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Osseous patient-specific 3-dimensional (3D) models were generated of 50 hips (37 female patients, 3D computed tomography) with a positive posterior impingement test and increased FV (defined as >35°). The McKibbin index (combined version) was calculated as the sum of FV and acetabular version (AV). Subgroups of patients with an increased McKibbin index >70° (24 hips) and FV >50° (20 hips) were analyzed. A control group of female participants (10 hips) had normal FV, normal AV, and no valgus deformity (neck-shaft angle, <139°). Validated 3D collision detection software was used for simulation of osseous impingement-free hip extension (no rotation).

Results:

The mean impingement-free maximal hip extension was significantly lower in patients with FV >35° compared with the control group (15° ± 15° vs 55° ± 19°; P < .001). At maximal hip extension, 78% of patients with FV >35° had osseous posterior extra-articular ischiofemoral hip impingement. At 20° of extension, the frequency of posterior extra-articular ischiofemoral impingement was significantly higher for patients with a McKibbin index >70° (83%) and for patients with FV >35° (76%) than for controls (0%) ( P < .001 for both). There was a significant correlation between maximal extension (no rotation) and FV ( r = 0.46; P < .001) as well as between impingement area at 20° of extension (external rotation [ER], 0°) and McKibbin index (0.61; P < .001). Impingement area at 20° of extension (ER, 0°) was significantly larger for patients with McKibbin index >70° versus <70° (251 vs 44 mm2; P = .001).

Conclusion:

The limited hip extension found in our study could theoretically affect the performance of sports activities such as running, ballet dancing, or lunges. Therefore, although not examined directly in this study, these activities are not advisable for these patients. Preoperative evaluation of FV and the McKibbin index is important in female patients with posterior hip pain before hip preservation surgery (eg, hip arthroscopy).