bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant Fibrovascular Polyp of Hypopharynx: A Case Report and Literature Review
Authors: Yang Liyun , Zhao Runyu , Lu Dan , Zhang Yi , Hu An , Huang Shuixian
Published: January 2023

Fibrovascular polyps (FVPs) are rare benign submucosal tumor-like lesions originating in the cervical esophagus and sporadically in the hypopharynx. In this article, we report a rare case of FVPs of the hypopharynx (hFVPs) with a mass measuring 16.0 × 4.0 × 1.8 cm in size, discussed its surgical strategy, and additionally reviewed relevant literature on important factors, such as age, sex, symptoms, size, treatments, and recurrence, associated with hFVPs.
Voting on Auditor Ratification by Shareholder Type: Impact of Institutional Shareholder Dissent on NAS Fees and Audit Quality
Authors: Purohit Siddharth , Desai Naman
Published: January 2023

Institutional investors have a better understanding of corporate performance than non-institutional investors, and their presence tends to improve the overall governance mechanism of a company and discipline top management against taking self-serving or myopic decisions. In this study, we examine shareholder voting patterns on auditor reappointments in Indian companies and examine whether institutional shareholder dissent on auditor reappointment acts as a disciplining mechanism on subsequent auditor actions and leads to improvement in audit quality. Our results indicate that institutional shareholder dissent on auditor reappointment is positively related to relative magnitude of non-audit services (NAS) fees in the previous year. More importantly, we observe that auditors are sensitive to institutional dissent and respond by charging a lower amount of NAS fees and providing superior audit quality in the subsequent year to signal increased independence and objectivity. Similar results are not observed in the case of retail shareholders. Our findings reinforce the role of institutional shareholders as important monitors in the corporate governance process and call for regulation to mandate the participation of shareholders in the auditor appointment process.
Cooperation in Networked Collective-Action Groups: Information Access and Norm Enforcement in Groups of Different Sizes
Authors: Harrell Ashley , Wolff Tom
Published: January 2023

Norms, typically enforced via sanctions, are key to resolving collective-action problems. But it is often impossible to know what each individual member is contributing to group efforts and enforce cooperation accordingly. Especially as group size increases, people commonly have access to the behaviors of—and can sanction—only those to whom they are tied in a broader network. Here we integrate two streams of research: one conceptualizing ties in networked collective-action groups as access to information about what others are doing and a second where ties represent information plus opportunities to enforce cooperation via punishment. While both have pointed to the cooperation benefits of more ties in the network, we argue that these benefits will depend on group size and whether ties provide access to information about what others are doing or whether they also entail opportunities for norm enforcement. Our experiment demonstrates that densely tied information networks facilitate cooperation but only when the group size is small. When people can also enforce their ties’ cooperation, however, densely tied networks particularly benefit larger groups. The results demonstrate how network-level properties and individual-level tie patterns intersect to promote contributions in small and large collective-action groups.
Interpersonal Discrimination and Relationship Quality among Married Mid-Life and Older Black Adults
Authors: Henderson Andrea K. , Wong Jaclyn S. , Dues Adrianne , Walsemann Katrina M.
Published: January 2023

Theories of minority stress contagion suggest that the consequences of racial discrimination may extend beyond the individual to impact close others. We empirically test direct and spillover associations between racialized stress and marital support and strain among mid-life and older Black spouses. We use actor-partner interdependence models to analyze dyadic data from 280 different-sex, married Black couples from the 2014 and 2016 Health and Retirement Study who completed the psychosocial leave-behind module. We find significant actor effects for husbands’ racial discrimination on their own marital support and strain, while wives’ racial discrimination is positively associated with their own marital strain. We find no evidence of partner effects nor significant gender differences in the association between racial discrimination and marital quality. The findings highlight pathways by which racial discrimination affects the marriage quality of Black men and women in mid- to late-life.
Trajectories of Paternal Contact After Parental Separation: A Latent Class Growth Analysis
Authors: Baude Amandine , Drapeau Sylvie , Lachance Véronique , Ivers Hans
Published: January 2023

A latent class growth curve analysis was conducted to model post-separation, paternal involvement trajectories over an 8-year period from the time of separation. Our sample was composed of 245 separated mothers whose data was drawn from a representative survey of Québec children. Four classes of distinct trajectories were identified: shared-time, near-shared-time, moderate-stable, and low-decreasing. The majority of fathers maintained a consistently high level of contact with their children, and the frequency of visits at the time of separation seemed to determine future father–child contact. Several factors predicted contact trajectories, including socioeconomic status, a new partner in the mother’s life, and the quality of the inter-parental relationship.
Health Experiences of Nurses during the COVID-19 Pandemic: A Mixed Methods Study
Authors: Harris Melissa L. , McLeod Anne , Titler Marita G.
Published: January 2023

This study characterizes the impact of the COVID-19 pandemic on the mental and physical health of nurses. Qualitative data (collected using semi-structured interviews) were integrated with quantitative data (collected concurrently using the SF-12 Health Survey). Nurses ( N = 30) compared their health prior to and during the first pandemic wave (March–May 2020). Interviews were analyzed thematically; descriptive statistics and t-tests compared pre-pandemic to current SF-12 scores. Qualitative findings demonstrated an impact on nurses’ mental health expressed as isolation, loss, intense emotions, and feelings of being expendable. Impact on nurses’ physical health included exhaustion, personal protective equipment skin breakdown, limited breaks from work, and virus exposure. Quantitative results show nurses’ experienced declines in overall mental health ( p < .001), and multiple physical health domains: role limitations due to physical problems ( p < .0001), bodily pain ( p < .0001), and general health ( p < .0001). Promotion of nurses’ well-being and safety, as well as education in emergency preparedness, must be given precedence to protect nurses’ health.
Flexural behavior of RC continuous beams having hybrid reinforcement of steel and GFRP bars
Authors: Fouad Randa , Aboubeah Ayman S , Hussein Ayman , Zaher Amr , Said Hadad
Published: January 2023

Fiber reinforced polymers (FRP) have been considered to be the alternative material to steel in reinforced concrete structures (RC) with the advantages of corrosion resistance, non-conductivity, and high strength-to-weight ratio. FRP-RC beam is featured with higher deformability and larger crack width. However, there is no recognizable ductility in FRP-RC members. Due to the lack of the ductility of FRP-RC beam, it was suggested using hybrid reinforcement of steel and FRP to achieve a preferable strength and ductility. The flexural behavior of the concrete beams reinforced with hybrid reinforcement was investigated through series of six continuous beams. The positive moment GFRP reinforcement ratios of 0.75% and 1.25% were used and the steel reinforcement ratios were ranged to determine the optimum percentage to work efficiently with GFRP. The experimental results showed that increasing GFRP positive moment reinforcement ratio to be more than 1.4 [Formula: see text] increased the flexural capacity of the section but with less ductile behavior. However, increasing the steel positive moment reinforcement ratio leaded to the increase of both the flexural capacity and the ductile behavior in a condition that the steel positive moment reinforcement ratio was [Formula: see text]. It was shown that the flexural capacity predication of the hybrid section using the semi brittle elastic material method to present the de-bonding of moment that occurred at the failure stage had a good accuracy with the experimental results.
A PROACTIVE Coping Scale for U.S. College Students: Initial Evidence and Implications
Authors: Tian Lu , Tsai Chia-lin , Khalsa Gurusewak , Condie Morgan , Kopystynsky Nicholas , Ohde Kaitlin , Zhao Adam
Published: January 2023

The present studies report the development of a PROACTIVE coping scale to evaluate actions used by U.S. college students to prevent or prepare for potential future stressors. Results of EFA and CFA using two samples of U.S. college students (total N = 1123) indicated the viability and stability of a 19-item four-factor model of proactive coping: Active Preparation, Ineffective Preparation, Self-Management, and Utilization of Social Resources. The scale demonstrated good psychometric properties, and each factor represents a meaningful and distinctive facet of proactive coping behavior. Concurrent and incremental validity estimates indicated that the subscales of the scale were (a) associated with problem-solving appraisal, future-oriented thoughts, life satisfaction, and optimism in expected ways, and (b) accounted for more variance on life satisfaction beyond the effect of the problem-solving appraisal. The results from this study indicate the importance of broadening coping to include proactive coping and how proactive coping is associated with various psychological outcomes.
Performance evaluation of CNN-based crack detection for electrical discharge machined steel surfaces
Authors: Lakshmi M , Das Raja
Published: January 2023

Electrical discharge machining (EDM) is a non-traditional machining technique that is frequently employed on hard materials. In today's industrial practice, it has been the most prevalent non-traditional material removal procedure. It allows you to process challenging materials and construct complicated forms with excellent accuracy. In the context of image pre-processing approaches to discover defective or non-defective machining pieces through EDM, the Centre of attention of this article is utilizing convolutional neural networks (CNN) to create a machinery piece defective detection approach. A total of 180 datasets of varying sizes produced from public datasets, the proposed CNN model is assessed and compared to pre-trained networks, namely the VGG-16, VGG-19, ResNet-50, and ResNet-101 models. The assessment took into crack detection outcomes, and classification parameters such as accuracy, precision, recall, and F1-score. Also, we have given the receiver operating characteristic (ROC) curve, precision–recall curve, and confusion matrices for each model for the required classification to predict the defective cracks, and also, we included the histograms to find the probabilities of defective and non-defective cracks. The suggested model can discriminate between pictures that are cracked and those that are not. According to the findings, VGG-16 has the best accuracy out of all of these models. In comparison to prior conventional procedures, the proposed EDM crack defective detecting methodology gives great accuracy.VGG-16 attains 93% accuracy, 93% of F1-score, 94% of precision, 93% of recall, 93% of specificity, as well as 97% of AUC, testing findings suggest that our strategy is capable of incredible performances.
Experimental and simulation study on the effect of different wheel profiles on the dynamics and wheel wear of high-speed trains
Authors: Wang Chengtao , Dai Huanyun , Wang Jianbin , Qi Yayun
Published: January 2023

The wheel profile has a significant impact on the dynamics and operation economy of high-speed trains (HST). To study the effect of different wheel profiles on the operating performance of the HST. This paper proposed a combination method of experimental and simulation to study the performance of different profiles. A certain type of X-type HST with different wheel profiles S1002CN, LMB10 and XP55 to study the operating performance of the HST were investigated. A dynamic model of HST and a Jendel wear model were also developed to study the dynamics and wear characteristics of the HST. The experimental results found that the wheel re-profiling mileage of the three types of wheel profiles were 112,000 km, 140,000 km and 211,000 km, respectively. Therefore, the XP55 wheel profile was the optimum profile and the S1002CN wheel profile was the worst profile when matched with the X-type HST. The bogie hunting frequency of three wheel profiles before wheel re-profiling was 8.3 Hz, 8.5 Hz and 6.8 Hz, respectively. The vehicle dynamics performance of the XP55 profile is the best and the S1002CN profile is the worst, and wheel wear prediction results showed that XP55 had the smallest wear depth. The article provides a basis for the selection of wheel profiles for HST.
Saddlepoint approximation p-values of weighted log-rank tests based on censored clustered data under block Efron’s biased-coin design
Authors: Newer Haidy A.
Published: January 2023

Clustered survival data frequently occurs in biomedical research fields and clinical trials. The log-rank tests are used for two independent samples of clustered data tests. We use the block Efron’s biased-coin randomization (design) to assign patients to treatment groups in a clinical trial by forcing a sequential experiment to be balanced. In this article, the [Formula: see text]-values of the null permutation distribution of log-rank tests for clustered data are approximated via the double saddlepoint approximation method. Comprehensive numerical studies are carried out to assess the accuracy of the saddlepoint approximation. This approximation demonstrates great accuracy over the asymptotic normal approximation.
Mitochondrial Transfer Induced by Adipose-Derived Mesenchymal Stem Cell Transplantation Improves Cardiac Function in Rat Models of Ischemic Cardiomyopathy
Authors: Mori Daisuke , Miyagawa Shigeru , Kawamura Takuji , Yoshioka Daisuke , Hata Hiroki , Ueno Takayoshi , Toda Koichi , Kuratani Toru , Oota Miwa , Kawai Kotoe , Kurata Hayato , Nishida Hiroyuki , Harada Akima , Toyofuku Toshihiko , Sawa Yoshiki
Published: January 2023

Although mesenchymal stem cell transplantation has been successful in the treatment of ischemic cardiomyopathy, the underlying mechanisms remain unclear. Herein, we investigated whether mitochondrial transfer could explain the success of cell therapy in ischemic cardiomyopathy. Mitochondrial transfer in co-cultures of human adipose-derived mesenchymal stem cells and rat cardiomyocytes maintained under hypoxic conditions was examined. Functional recovery was monitored in a rat model of myocardial infarction following human adipose-derived mesenchymal stem cell transplantation. We observed mitochondrial transfer in vitro, which required the formation of cell-to-cell contacts and synergistically enhanced energy metabolism. Rat cardiomyocytes exhibited mitochondrial transfer 3 days following human adipose-derived mesenchymal stem cell transplantation to the ischemic heart surface post-myocardial infarction. We detected donor mitochondrial DNA in the recipient myocardium concomitant with a significant improvement in cardiac function. Mitochondrial transfer is vital for successful cell transplantation therapies and improves treatment outcomes in ischemic cardiomyopathy.
The Multidimensionality of Low Health Literacy in Older Adults: A Scoping Review of International Studies
Authors: Cardoso Rachel S. S. , Tosin Michelle H. S. , de Oliveira Beatriz G. R. B. , Moraes Katarinne Lima , Santana Rosimere Ferreira
Published: January 2023

This scoping review aims to map the dimensions encompassing the low health literacy (HL) of older adults, describing their respective causes and consequences. A three-step search strategy was conducted using 16 databases from nine portals and reference lists. Of the 4,259 identified studies, 2,845 were screened and 29 (1%) were included. Studies were published between 1999 and 2021, most of them in English (86.2%), from the American continent (48.3%) and with observational design (86.2%). Four dimensions encompassing the low HL of older adults were mapped: (1) patient dimension, (2) healthcare system dimension, (3) social/economic dimension, and (4) health condition dimension. This review highlights specific dimensions encompassing the low literacy in older adults with evidence about its causes and consequences. These results can guide future research and evidence-based practice involving HL of older adults.
Surgical Management of Submucous Cleft Palate by Radical Muscle Dissection Veloplasty: Speech Outcomes in Patients with 22q11.2 Deletion Syndrome
Authors: Ghanem Ali M , Borg Tiffanie-Marie , Youssef Gehad , Ridout Deborah , Gilleard Onur , Birch Malcolm , Sell Debbie , Sommerlad Brian C
Published: January 2023

Objective

To evaluate the benefit of anatomical muscle dissection repair for velopharyngeal insufficiency (VPI) in patients with submucous cleft palate (SMCP) with 22q11.2 deletion syndrome.

Design

Retrospective blinded randomised analysis of a surgeon's management over 10 years.

Setting

The study was performed at a specialised Paediatric hospital in the United Kingdom.

Patients

Children with SMCP and 22q11.2 deletion syndrome.

Interventions

All participants underwent radical muscle dissection veloplasty.

Outcomes measured

Pre- and post- operative measurements included severity of anatomical defect, speech samples and lateral images which were digitised, randomised then externally and blindly analysed using validated techniques. Stata software was used to perform statistical analysis.

Results

57 children with 22q11.2 deletion syndrome were included in this analysis. Intra-operatively, the majority of cases were identified as SMCP Grade I anomalies. Post-operatively, a statistically significant improvement in hypernasality, resting palate length, palate length at maximum closure, palate excursion and gap size at maximum closure was observed. Secondary surgery was performed for 59% of patients by ten years.

Conclusion

Muscle dissection repair improves hypernasality, palate closure function and the closure gap in patients with 22q11.2 deletion syndrome. Although over 50% of patients may require further surgery, muscle dissection repair should be a first step due to its utility at a younger age, when invasive investigations are impossible, its lower morbidity, speech and language benefits or altering the plans for less obstructive secondary surgery when it lead to reduced velo-pharyngeal gap and improved palate mobility even when adequate velo-pharyngeal closure was not achieved.
Opium may affect coronary artery disease by inducing inflammation but not through the expression of CD9, CD36, and CD68
Authors: Momeni-Moghaddam Mohammad Amin , Asadikaram Gholamreza , Masoumi Mohammad , Sadeghi Erfan , Akbari Hamed , Abolhassani Moslem , Farsinejad Alireza , Khaleghi Morteza , Nematollahi Mohammad Hadi , Dabiri Shahriar , Arababadi Mohammad Kazemi
Published: January 2023

The molecular mechanisms of opium action with regard to coronary artery disease (CAD) have not yet been determined. The aim of this study was to evaluate the effect of opium on the expression of scavenger receptors including CD36, CD68, and CD9 tetraspanin in monocytes and the plasma levels of tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), malondialdehyde (MDA), and nitric oxide metabolites (NOx) in CAD patients with and without opium addiction. This case–control study was conducted on three groups: (1) opium-addicted CAD patients (CAD + OA, n = 30); (2) CAD patients with no opium addiction (CAD, n = 30); and (3) individuals without CAD and opium addiction as the control group (Ctrl, n = 17). The protein and mRNA levels of CD9, CD36, and CD68 were evaluated by the flow cytometry and quantitative polymerase chain reaction (RT-qPCR) methods, respectively. The consumption of atorvastatin, aspirin, and glyceryl trinitrate was found be higher in the CAD groups compared with the control group. The plasma level of TNF-α was significantly higher in the CAD + OA group than in the CAD and Ctrl groups (p = 0.001 and p = 0.005, respectively). MDA levels significantly increased in CAD and CAD + OA patients in comparison with the Ctrl group (p = 0.010 and p = 0.002, respectively). No significant differences were found in CD9, CD36, CD68, IFN-γ, and NOx between the three groups. The findings demonstrated that opium did not have a significant effect on the expression of CD36, CD68, and CD9 at gene and protein levels, but it might be involved in the development of CAD by inducing inflammation through other mechanisms.
Prognostic model for predicting overall survival in patients with glioblastoma: an analysis based on the SEER database
Authors: Luo Yuanbo , Hao Lingyu , Liu Chenchao , Xiang Yijia , Han Xu , Bo Yin , Han Zhenfeng , Wang Zengguang , Wang Yi
Published: January 2023

Predicting the prognosis of glioblastoma (GBM) has always been important for improving survival. An understanding of the prognostic factors for patients with GBM can help guide treatment. Herein, we aimed to construct a prognostic model for predicting overall survival (OS) for patients with GBM. We identified 11,375 patients with pathologically confirmed GBM from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. The 1-, 2-, and 3-year survival probabilities were 48.8%, 22.5%, and 13.1%, respectively. The patients were randomly divided into the training cohort (n = 8531) and the validation cohort (n = 2844). A Cox proportional risk regression model was used to analyze the prognostic factors of patients in the training cohort, and a nomogram was constructed. Then concordance indexes (C-indexes), calibration curves, and receiver operating characteristic (ROC) curves were used to assess the performance of the nomograms by internal (training cohort) and external validation (validation cohort). Log-rank test and univariate analysis showed that age, race, marital status, extent of surgical resection, chemotherapy, and radiation were the prognostic factors for patients with GBM (p < 0.05), which were used to construct nomogram. The C-index of the nomogram was 0.717 (95% confidence interval (CI), 0.710–0.724) in the training cohort, and 0.724 (95% CI, 0.713–0.735) in the validation cohort. The nomogram had a higher areas under the ROC curve value. The nomogram was well validated, which can effectively predict the OS of patients with GBM. Thus, this nomogram could be applied in clinical practice.
Calculation on flexural capacity of recycled aggregate concrete beams
Authors: Li Tan , Wang Changqing , Wang Chunhui
Published: January 2023

Based on the constitutive relation of recycled aggregate concrete (RAC, referred to as recycled concrete), from the calculation formulas of the equivalent rectangular block parameters in the compression zone of recycled concrete beams under different recycled coarse aggregate replacement ratios, the calculation formulas of the key parameters 𝛼1 and 𝛽1 of recycled concrete are deduced. Based on 𝛼1 and 𝛽1, the flexural bearing capacity of recycled concrete beams is given. In addition, the nonlinear finite element method is applied, and the simulation results are compared with the calculation results to verify the accuracy of the calculation results. Then, the limit compression zone height and maximum reinforcement ratio of recycled concrete beams, as well as the variation characters of compression zone height and reinforcement ratio under certain size and load are analyzed and obtained.
Validity of the coding for appendicitis, appendectomy, and diagnostic laparoscopy in the Danish National Patient Registry
Authors: Fonnes Siv , Erichsen Rune , Rosenberg Jacob
Published: January 2023

Background and objective:

We aimed to validate the diagnostic accuracy of appendicitis, its severity, its description, and the surgical approach, including open or laparoscopic appendectomy and diagnostic laparoscopy, in the Danish National Patient Registry (DNPR) against information from the electronic medical records.

Methods:

A random sample of 1046 patients of all ages and sexes recorded in the DNPR from the Capital Region of Denmark during 2010–2015 was investigated. Patients’ admission had to include a discharge code for appendicitis (K35−K379) according to the International Classification of Disease version 10 (ICD-10) alone or in combination with a surgical code for appendectomy or the surgical code for a diagnostic laparoscopy. We calculated the positive predictive values (PPVs) with 95% confidence intervals.

Results:

Data from a total of 1018 patients were available for data analysis. The ICD-10 codes for appendicitis resulted in a good PPV of >95% when combined with a surgical code. ICD-10 codes combined with the surgical codes could discriminate between uncomplicated and complicated appendicitis with some caution as the PPVs ranged from 68% to 93%. Only the surgical code for laparoscopic appendectomy yielded a good PPV (99%) for the actual surgical approach. The surgical code for a diagnostic laparoscopy alone did not cover a normal diagnostic laparoscopy.

Conclusions:

The diagnostic accuracy of appendicitis and appendectomy in routinely collected administrative health data is good for ICD-10 codes for appendicitis in combination with a surgical code and especially for laparoscopic appendectomy. Uncomplicated and complicated appendicitis can be distinguished with some caution.
Angle-of-attack and Mach number effects on the aeroacoustics of an SD7003 airfoil at Reynolds number 60,000
Authors: Vittal-Shenoy Dhanush , Gojon Romain , Jardin Thierry , Jacob Marc C.
Published: January 2023

The aeroacoustics of an SD7003 airfoil at Reynolds number 60,000 is investigated using Large Eddy Simulation. Five simulations are performed to study the effects of angle-of-attack and Mach number at fixed Reynolds number. For the three cases with angle-of-attack equal to 0° (M = 0.1, 0.3 and 0.6), a pure tonal noise associated with a 2D organisation of the flow is obtained. This flow topology is due to the establishment of a well known aeroacoustic feedback loop between the separation point on the suction side of the airfoil and the trailing edge. The occurrence of this loop is corroborated by the presence of a standing wave pattern with characteristic mode number in accordance with Panda’s model. The main effect of the Mach number is to promote flow separation and hence increase separation length and mode number. In addition, the first harmonic and the sub-harmonic of the tone, observed in the far field acoustic spectrum, are found to be generated in the wake, presumably due to non-linear vortex interactions. For the two other angles-of-attack 4° and 8° at M = 0.1, the feedback loop does not establish and a Laminar Separation Bubble (LSB) is observed. When increasing the angle-of-attack, the LSB shrinks with earlier reattachment. For those two cases, far-field spectra are characterized by a low frequency associated with the breathing motion of the LSB and the reattachment point fluctuating in space. The frequency of this fluctuation depends on the curvature of the bubble. Far-field spectra are also characterized by a broadband trailing edge noise whose frequency range decreases with the angle-of-attack. Again, this evolution is found to depend on the curvature of the bubble which may promote a centrifugal instability in the separated shear layer.
COVID-19 Disparities Among Arab, Middle Eastern, and West Asian Populations in Toronto: Implications for Improving Health Equity Among Middle Eastern and North African Communities in the United States
Authors: Sharif Mienah Z. , Maghbouleh Neda , Baback Boozary Andrew S.
Published: January 2023

Introduction:

Equity-oriented efforts to mitigate and prevent COVID-related disparities are hindered due to methodological limitations of the categorization of racial and ethnic groups, including Arabs and Middle Eastern and North African (MENA) communities, which remain invisible in national data collection efforts. This study highlights the disparities in COVID-related outcomes in Toronto, Canada and supports ongoing calls to collect public health data among MENA communities in the United States.

Methods:

Data on racial/ethnic identity and hospitalizations were collected by the Toronto Public Health (TPH) of the Ontario Ministry of Public Health Case between May 20, 2020, and September 30, 2021 from people with a confirmed or probable case of COVID-19.

Results:

The reported COVID-19 infection rate for Arab, Middle Eastern, West Asians (i.e., categories used to self-identify as MENA in Canada) relative to Whites in Toronto was 3.51. The age-standardized hospitalization rate ratio between Arab, Middle Eastern, West Asians and Whites was 4.59.

Discussion:

Data from Toronto highlight that Arab, Middle Eastern, and West Asians have higher rates of COVID-19 infections and hospitalizations than their White counterparts. Comparable studies are currently not possible in the United States due to lack of data that can disaggregate MENA individuals. This study underscores the critical need to collect data among MENA communities in the United States to advance our field’s goal of promoting and advancing equity.
Vascular Closure Devices For Axillary Artery Access: A Systematic Review and Meta-Analysis
Authors: Koziarz Alex , Kennedy Sean A. , Awad El-Karim Ghassan , Tan Kong T. , Oreopoulos George D. , Kalra Sanjog , Etz Christian D. , Rajan Dheeraj K. , Mafeld Sebastian
Published: January 2023

Purpose:

To evaluate the technical success and complication rates of vascular closure devices (VCDs) in the axillary artery.

Materials and Methods:

MEDLINE and Embase were searched independently by two reviewers to identify observational studies from inception through October 2021. The following outcomes were meta-analyzed: technical success, hematoma, dissection, pseudoaneurysm, infection, and local neurological complications. Complications were also graded as mild, moderate, and severe. A logistic regression evaluating the influence of sheath size for the outcome of technical success rate was performed using individual patient–level data.

Results:

Of 1496 unique records, 20 observational studies were included, totaling 915 unique arterial access sites. Pooled estimates were as follows: technical success 84.8% (95% confidence interval [CI]: 78%–89.7%, I2=60.4%), hematoma 7.9% (95% CI: 5.8%–10.6%, I2=0%), dissection 3.1% (95% CI: 1.3%–7.3%, I2=0%), pseudoaneurysm 2.7% (95% CI: 1.3%–5.7%, I2=0%), infection <1% (95% CI: 0%–5.7%, I2=20.5%), and local neurological complications 2.7% (95% CI: 1.7%–4.4%, I2=0%). There was a significant negative association between sheath size and technical success rate (odds ratio [OR]: 0.87 per 1 French (Fr) increase in sheath size, 95% CI: 0.80–0.94, p=0.0005). Larger sheath sizes were associated with a greater number of access-site complications (adjusted odds ratio [aOR]: 1.21 per 1 Fr increase sheath size, 95% CI: 1.04–1.40, p=0.013).

Conclusions:

Off-label use of VCDs in the axillary artery provides an 85% successful closure rate and variable complication rate, depending on the primary procedure and sheath size. Larger sheaths were associated with a lower technical success and greater rate of access-related complications.

Clinical Impact

Safe arterial access is the foundation for arterial intervention. While the common femoral artery is a well established access site, alternative arterial access sites capable of larger sheath sizes are needed in the modern endovascular era. This article provides the largest synthesis to date on the use of vascular closure devices for percutaneous axillary artery access in endovascular intervention. It should serve clinicians with added confidence around this approach in terms of providing a reference for technical success and complications. Clinically, this data is relevant for patient consent purposes as well as for practice quality improvement in setting safety standards for this access site.
A novel model-based unbalance monitoring and prognostics for rotor-bearing systems
Authors: Lin Chun-Ling , Liang Jin-Wei , Huang Yi-Mei , Huang Shyh-Chin
Published: January 2023

A novel model-based unbalance monitoring and prognostics for rotor-bearing systems is introduced in the paper. An analytical method is first applied for rotor modeling and the calculated first natural frequency is validated by an FEM model. The rotor-bearing model with the identified bearing parameters is next validated with an operational 3-stage turbine-bearing’s machine on the first critical speed. The novelty of the approach is that the unbalance proceeding with optimization schemes is evaluated in two phases. In phase I, the bearing parameters and the initial unbalances are simultaneously evaluated based on the operational data soon after an overhaul. In phase II, the unbalance deterioration with time is identified through every day’s measured vibration at two bearings. A set of operational data over 16 months, provided by a local company, are used to test the approach. The evaluated unbalance deterioration trend is verified by the collaborated company from two consecutive overhauls. Five optimization algorithms are also tested and the results prove the robustness of the derived approach. Finally, the unbalance forecasting capability extrapolating from historical unbalance curve is demonstrated and that can work as prognostics in a condition-based maintenance strategy.
Clarifying Eudaimonia and Psychological Functioning to Complement Evaluative and Experiential Well-Being: Why Basic Psychological Needs Should Be Measured in National Accounts of Well-Being
Authors: Martela Frank , Ryan Richard M.
Published: January 2023

Measuring subjective well-being as a key indicator of national wellness has increasingly become part of the international agenda. Current recommendations for measuring well-being at a national level propose three separate dimensions: evaluative well-being, experiential well-being, and eudaimonia. Whereas the measurement of the first two dimensions is relatively standardized, the third category has remained undertheorized, lacking consensus on how to define and operationalize it. To remedy the situation, we propose that the third dimension should focus on psychological functioning and the identification of key psychological factors humans generally need to live well. A key part of psychological functioning is the satisfaction of basic psychological needs—specific types of satisfying experiences that are essential for psychological health and well-being. Psychological needs as a category provides a parsimonious set of elements with clear inclusion criteria that are strongly anchored in theory and our current understanding of human nature—and could thus form a core part of the third, “eudaimonic” dimension of well-being. The needs for autonomy, competence, and relatedness have especially received broad empirical support. Accordingly, national accounts of well-being should include measures for key psychological needs to gain an enriched and practically useful understanding of the well-being of the citizens.
Marginal secondary displacement in fractures of the distal radius at follow-up – an important predictor for late displacement and malunion
Authors: Schmidt Viktor , Mellstrand-Navarro Cecilia , Mukka Sebastian , Wadsten Mats
Published: January 2023

Treatment recommendations in fractures of the distal radius are often based on the degree of displacement and functional demands. The fracture may be within an acceptable radiological range, but a marginal deterioration in alignment then occurs between the initial visit and follow-up. This may pose a risk for late displacement that may require further treatment. We secondarily analysed prospectively collected data and included 165 patients. We found that marginal secondary displacement (odds ratio (OR) 9.7), anterior comminution (OR 8.8), loss of anterior apposition (OR 6.8) and dorsal comminution (OR 2.6) were predictors of late displacement. Marginal secondary displacement is an important predictor of late displacement and malunion in fractures of the distal radius. Clinicians should not unequivocally accept general guidelines on alignment but also assess a deterioration in fracture alignment on radiographic follow-up and be aware of the potential need for surgery to avoid malunion in cases that show early secondary displacement, even when radiographic measures are within acceptable limits.

Level of evidence: III
Comparison of proximal and distal involvement of upper extremity metastatic lesions: an analysis of 55 cases
Authors: Yunyu Justine Lee , Man Janet Hung Ngai , Zhixue Lim , Sebastin Sandeep Jacob , Puhaindran Mark Edward
Published: January 2023

We analysed the differences in clinical presentation between proximal (above elbow) and distal (below elbow) upper limb metastases in a retrospective review of patients presenting to our centre from 2011 to 2019. There were 55 cases, 64% involving the humerus and 62% occurring in men. The median age at the time of diagnosis was 64 years. Thirty-one per cent of the cases were proximal lesions. Distal upper limb metastases were more likely to be soft tissue lesions (71%) compared with proximal lesions (8%). The median age of patients with distal lesions was significantly lower at 58 years compared with 65 years for proximal lesions. Overall, non-small cell lung carcinoma was the most common primary malignancy (25%), however haematological cancers were most common in the distal group (29%). Distal upper limb metastases have distinct features that distinguish them from proximal lesions.

Level of evidence: IV
Worsening of Articular Tissue Damage as Defined by Semi-Quantitative MRI Is Associated With Concurrent Quantitative Cartilage Loss Over 24 Months
Authors: Roemer Frank , Maschek Susanne , Wisser Anna , Guermazi Ali , Hunter David , Eckstein Felix , Wirth Wolfgang
Published: January 2023

Objective

To assess the association of worsening of magnetic resonance imaging (MRI) semi-quantitative (SQ) tissue features with concurrent change in quantitative (Q) cartilage thickness measurements over 24 months within the Foundation for the National Institutes of Health (FNIH) Biomarker Consortium study.

Methods

In all, 599 participants were included. SQ assessment included cartilage damage, meniscal extrusion and damage, osteophytes, bone marrow lesions (BMLs), and effusion- and Hoffa-synovitis. Change in medial compartment Q cartilage thickness was stratified by concurrent ipsicompartmental SQ changes. Between-group comparisons were performed using analysis of covariance (ANCOVA) with adjustment for age, sex, and body mass index (BMI). Results were presented as adjusted mean difference.

Results

Knees with any increase in SQ cartilage scores in the medial compartment ( n = 268) showed more Q cartilage loss compared to knees that remained stable (mean adjusted difference [MAD] = -0.16 mm, 95% confidence interval [CI]: [-0.19, -0.13] mm). Knees with any increase in meniscal extrusion in the medial compartment (n = 98) showed more Q cartilage loss than knees without (MAD = -0.18 mm, 95% CI: [-0.22, -0.14] mm. Comparable findings were seen for meniscal damage worsening. Regarding BMLs, an increase by one subregion resulted in a MAD of Q cartilage loss of -0.10 mm, 95% CI: [-0.14, -0.06] mm, while this effect almost tripled for change in two or more subregions. Increase in either effusion- and/or Hoffa-synovitis by one grade resulted in a MAD of -0.07 mm, 95% CI: [-0.10, -0.03] mm.

Conclusion

Worsening of SQ cartilage damage, meniscal extrusion and damage, number of subregions affected by BML, maximum size of BMLs and worsening of effusion- and/or Hoffa synovitis is associated with increased Q cartilage loss.
Prognostic Factors for the Clinical Outcome after Microfracture Treatment of Chondral and Osteochondral Defects in the Knee Joint: A Systematic Review
Authors: van Tuijn Iris M. , Emanuel Kaj S. , van Hugten Pieter P.W. , Jeuken Ralph , Emans Pieter J.
Published: January 2023

Objective

The objective of this study is to establish which patient and lesion characteristics are related to the clinical outcome after microfracture of cartilage defects in the knee.

Study design

Systematic review.

Methods

After preregistration, PubMed, Embase, and Cochrane were searched for studies that analyzed prognostic factors for the outcome of microfracture treatment in the knee. The criteria for inclusion were outcome measured using Patient-Reported Outcome Measures (PROMs), a clinical study with ≥10 participants receiving microfracture, and a minimal follow-up period of 1 year.

Results

For none of the investigated prognostic factors, effect size reporting was sufficiently homogeneous to conduct a meta-analysis. However, a majority of the included studies identified higher age, larger lesion size, longer preoperative symptom duration, and previous surgery on the ipsilateral knee, especially meniscectomy and anterior cruciate ligament reconstruction, as factors that are reported to be correlated to a less favorable outcome. A lesion location that does not include the trochlea or the patellofemoral joint and is not weightbearing, a nondegenerative mechanism of injury, and a single lesion were reported as factors that predict a favorable outcome. As to gender, body mass index, preoperative activity level, smoking, and concomitant knee surgery, the included articles were inconclusive or no effect was reported.

Conclusions

Several factors correlated with the clinical result after microfracture treatment. However, the information on the effect sizes of the influence on clinical outcome is incomplete due to poor reporting. Large-scale registries or pooling of homogeneous, well-reported data is needed to work toward prognostic models. That would be an important step toward personalized treatment.
Role of serum lactate as prognostic marker of mortality among emergency department patients with multiple conditions: A systematic review
Authors: Alshiakh Safinaz M
Published: January 2023

Objective:

In the Emergency Department, the physician’s purpose is to rapidly and accurately diagnose the severity of a patient’s condition so that proper treatment can be administered. Therefore, this study pays close attention to the association and prognostic value of blood lactate on different disease outcomes by systematically reviewing recently published studies.

Methods:

The search strategy was developed based on searches in the year 2022 for potential publications including original articles, case reports, and reviews using the following web databases google scholar, PubMed, and Science Direct. A total of 25 studies were identified and reviewed extensively to evaluate the link between mortality and serum lactate levels.

Results:

This literature review presents the strong association of elevated serum lactate levels with the in-hospital mortality rate among emergency department patients.

Conclusion:

These findings suggest that even a moderately raised lactate level in serum can predict the severe outcome in emergency department patients suffering from different conditions. Therefore, early (at the time of administration of hospital) and periodic serum lactate value determination through different techniques and scores is of need and should become part of routine analyses in emergency department to predict and choose therapies that could benefit critically ill patients.
Perspective: Telehealth – beyond legislation and regulation
Authors: Al-Alawy Khamis , Moonesar Immanuel Azaad
Published: January 2023

The World Health Organization describes health innovation as developing new or improved systems, policies, products, technologies, services or delivery approaches that improve health and well-being, specifically of vulnerable people. The study’s objectives were to (a) explore the legislative and regulatory journey of telehealth across the Organisation for Economic Co-operation and Development and non-Organisation for Economic Co-operation and Development countries and (b) provide recommendations to strengthen health system performance. We reviewed information sources for Organisation for Economic Co-operation and Development and non-Organisation for Economic Co-operation and Development countries opportunistically, including government and medical board publications, media coverage and peer-reviewed papers, to provide a perspective on the legislative and regulatory telehealth journey. Our review of countries suggests that legislation and regulation remain essential for governance, accountability and assuring that healthcare professionals and technologies are safe and secure. However, there was no uniform approach to telehealth legislation and regulation, and the precautionary approach was observed in some countries. Different strategies appear to have been adopted for telehealth implementation. There is a need to go beyond legislation and regulation to strengthen health system performance and assure the future success of telehealth services. Health system decision makers should work with health system stakeholders to strategise and plan for telehealth services as it will have implications on the future delivery of healthcare services and the health system. Further research is needed to explore how policy frameworks may support innovations in healthcare, such as telehealth.
Magnitude of extra-analytical errors and associated factors in medical laboratories in thirteen Public Hospitals in Addis Ababa, Ethiopia
Authors: Degfe Cheru , Mohammed Ousman
Published: January 2023

Background:

Currently, more than two-thirds of medical decisions are made based on laboratory test results. However, due to the compromised pre-analytical and post-analytical phases (or extra-analytical phase), the reporting of incorrect or inappropriate test results was still prevalent. Studies focusing on the prevalence of and factors associated with laboratory error remain very limited in Ethiopia.

Objective:

This study aimed to assess the magnitude of extra-analytical errors and associated factors in medical laboratory services in 13 public hospitals in Addis Ababa, Ethiopia, from January to April 2020.

Materials and Methods:

A hospital-based cross-sectional study was conducted in the medical laboratories of public hospitals in Addis Ababa from January to April 2020 to assess extra-analytical errors and associated factors. Data were collected from 2401 laboratory request forms ordered within the study period and 169 laboratory professionals working in public hospitals. The collected data were entered and analyzed using SPSS version 23 software. Data were analyzed using simple descriptive statistics, percentages, and frequencies and summarized using tables and text. Bivariate logistic regression analysis was conducted, and variables (with a p value below 0.25) were included in the multivariate logistic regression model. A p value <0.05 was considered a cutoff point in the final model.

Results:

In this study, of the errors detected, 60.3% occurred in the pre-analytical phase and 39.7% in the post-analytical phase. Extra-analytical errors in laboratory services were significantly associated with lack of written procedures for laboratory activities (adjusted odds ratio = 2.79, 95% confidence interval = 1.34–5.86), 1–2 years of work experience (adjusted odds ratio = 5.5, 95% confidence interval = 2.54–9.31), work experience (3–5 years) (adjusted odds ratio = 2.67, 95% confidence interval = 0.94–4.56), and education (diploma) (adjusted odds ratio = 6.30, 95% confidence interval = 2.17–12.26).

Conclusion:

This study discovered errors in the pre-analytical (60.3%) and post-analytical (39.7%) phases, and none of the requisition papers had complete data. This frequency may be affected by workload, a lack of written procedures, the number of years of work experience, and the level of education of the staff.