bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on fault prediction of marine diesel engine based on attention-LSTM
Authors: Liu Yi , Gan Huibing , Cong Yujin , Hu Guotong
Published: May 2022

The marine diesel engine is an important guarantee for the safe operation of the ship. It is of great significance to predict the running trend of the diesel engine and infer whether the diesel engine is in an abnormal working state in advance to ensure the safe operation of the ship. In this paper, combining the feature extraction ability of the attention mechanism (Attention) and the time-series memory ability of the long short-term neural network (LSTM), a prediction model of the exhaust gas temperature of the marine diesel engine is constructed. Meanwhile, in order to improve the prediction accuracy of the model, the improved particle swarm algorithm is used to optimize the structural parameters of the model, and a model with higher prediction performance is obtained. Then, according to the residual value distribution between the predicted value and the actual value of the model, the process control method is used to set the fault threshold, and the experimental data of normal and abnormal conditions are used for verification. The results show that the proposed model can accurately predict developing failures and provide a new method for ship condition maintenance.
Investigation on aerodynamic noise generated from the simplified high-speed train leading cars
Authors: Li Chaowei , Zhu Jianyue , Hu Zhiwei , Lei Zhenyu , Zhu Yingmou
Published: May 2022

The aerodynamic noise behavior of flow passing the simplified leading car and nose car scale models of a high-speed train is investigated through the vortex sound theory and acoustic analogy approach. The unsteady flow developed around the geometries is solved numerically and the data are applied to study the near-field quadrupole sound source and calculate the far-field noise radiated. It is found that the turbulent flow developed around the leading car is characterized by multi-scale vortices separated from the geometries. The intensity of volume dipole source is much larger than that of volume quadrupole source and the volume dipole source becomes the predominate source of the near-field quadrupole noise. The flow is separated noticeably in the regions of the nose, bogies, bogie cavities, and train tail of the leading car where the pressure fluctuations are generated largely upon the solid surfaces and correspondingly a dipole noise of high level is produced. By comparison, the noise contribution from the leading bogie and bogie cavity is larger than that from the other components. Moreover, the numerical and experimental results of train nose car model demonstrate that the flow around the bogie region is the dominant aerodynamic sound source. Therefore, the flow-induced noise generated from the leading cars may be reduced efficiently within a certain frequency range and specific direction by mitigating the flow interactions around the areas of leading bogie and bogie cavity.
Out of prison, out of crime? The complex interplay between the process of desistance and severe resource disadvantages in women‘s post-release lives
Authors: Rodermond Elanie , Van De Weijer Steve , Rosenkrantz Lindegaard Marie , Bijleveld Catrien C. J. H. , Slotboom Anne-Marie , Kruttschnitt Candace
Published: May 2022

We examine the influence of social capital, subjective changes and post-release resource disadvantages on women‘s desistance and reentry pathways. Using a sample of 1478 formerly incarcerated women, we estimate logistic hybrid random-effects models to assess the influence of several factors on offending during a 7-year follow-up period. We use interviews with a subsample of women to explore the mechanisms underlying the quantitative findings. Results show that the effect of often-studied forms of social control are to a large degree dependent on (unmeasured) individual differences and circumstances, such as pre- and post-incarceration adversities, and the quality of forms of social control. A desire to desist from crime is often blocked by severe resource advantages.
Risk Markers for Male Perpetration of Sexual Assault on College Campuses: A Meta-Analysis
Authors: Spencer Chelsea M. , Rivas-Koehl Matthew , Astle Shelby , Toews Michelle L. , Anders Kristin M. , McAllister Paige
Published: May 2022

Sexual assault (SA) on college campuses remains a prominent public health issue. This meta-analysis focuses on identifying all potential risk markers for college male SA perpetration. Using standard search procedures, a total of 25 studies yielding 89 unique effect sizes were included in the study. Significant risk markers were related to hegemonic masculinity (e.g., peer approval of SA, rape myth acceptance, sexist beliefs, hostility towards women), other forms of dating violence perpetration (e.g., physical and psychological dating violence perpetration), and the college party culture (e.g., binge drinking, alcohol and substance use, frequency of hook-ups). Psychological dating violence victimization, athletic team membership, race/ethnicity, relationship status, and religiosity were not significant risk markers for SA perpetration. Findings support potential benefits of SA prevention efforts prioritizing peer education/student leaders modeling SA disapproval, challenging hegemonic masculinity, healthy relationship and sexual education, as well as alcohol and substance use awareness.
Stuck in a cul de sac of care: Therapy Assistance Online and the platformization of mental health services for college students
Authors: Gilmore James N. , Troutman Bailey , DePuy Madeline , Kenney Katherine , Engel Jessica , Freed Katherine , Campbell Sidney , Garrigan Savannah
Published: May 2022

Many reports indicate higher education counseling centers are finding it difficult to keep pace with the growing rates of stress, anxiety, depression, and sleeping difficulties in undergraduate populations. Some universities are turning to telepsychology, or means of providing mental health care through videoconferencing, software, and other digital tools. This article analyzes one such platform, therapy assistance online (TAO), through a critical walkthrough of the platform’s self-help modules to consider how they communicate and construct care as individual labor which generates data for the platform. We argue that by removing traces of the therapist’s body and, in turn, dialogic communication, the platform produces modes of neoliberal self-care operationalized through data extraction, where the individual user works through modules while providing personal information to the platform. While TAO is offered as a solution to overcrowded and understaffed care facilities, it demonstrates some limitations of relying on third-party platforms to care for students.
U.S. Gun Culture as a Martial Culture Within a Weberian Framework: Disrupting the State’s Monopoly on Force
Authors: Harmon Josephine
Published: May 2022

This article proposes a new analytical framework to understand U.S. gun culture and its attendant cultural identifiers. It uses the Weberian concept of the state, in which the state’s monopoly on force is the basis of its legitimacy. Using this theory of the state, my key theoretical contribution is that gun culture is a contestation of the state’s monopoly on force. Relatedly, I argue that the system of cultural identifiers attached to gun culture competes with state power. In this way, gun culture asserts a devolved, local and patrimonial system of social power. I use this synthetic context of U.S. gun culture to understand theoretical issues of citizen–state relations and the role of identification in envisaging local power while offering narcissistic compensations to disenfranchised people. This descriptive theory argues that the state monopoly on force constitutes a central clause of the social contract between state and citizen, and the breach of this monopoly within gun culture challenges the contract itself. Identity and its conceptual markers, then, have a political end as a surrogate for social authority and personal-local power. This political function is hinted at but not adequately theorized in gun culture literature, certainly not using a Weberian, ‘monopoly on force’ framework. I propose that gun culture signals an antagonism within the social contract, in which citizens cede use of force to the state. This antagonism is activated in this case but theoretically latent in citizen–state relations. This article builds on the Hobbesian–Weberian premise to propose a model of Martial Culture Theory (MCT) to describe U.S. gun culture and those political movements that seek to reduce through force the state monopoly on power by diminishing its legitimacy and claiming theirs as a legitimate exercise of force.Through this process occurs a renegotiation of socio-political power distribution with the state. I submit this insight has valuable implications for state theory and citizen–state relations. In addition, it offers the most complete theory of how small government conservatism aligns with identity politics in U.S. gun culture, and how the prevailing mode of identitarian politics can manifest and be harnessed toward contestations of state power in Hobbesian-Weberian thought.
F*CK CORONA: Digital Pedagogy, Pandemic Parenting, and Dramatic Acts of Performative Decolonization in the Year 2020
Authors: Hastings Rachel N.
Published: May 2022

In 2020, the CoronaVirus Global Pandemic pressed pause on basic, everyday human activities all around the world. Except online. Hastings draws upon the power of performative writing and autonarratives to stitch together her memories of living and teaching online during a pandemic. By using digital communication tools and social media platforms, Hastings shows how she engaged in a new-age form of performative decolonization that is carried out through dramatic acts of digital advocacy. She presents both a snapshot of the past and a glimpse of how we might use digital resources to move forward—virtually and culturally.
Online Cognitive Therapy for Social Anxiety Disorder in Adolescence: A Clinical Case Study Using the CT@TeenSAD
Authors: Ganho-Ávila Ana , Vieira Figueiredo Diana , Vagos Paula
Published: May 2022

SAD is an intense fear or anxiety associated with past, current, or future social situations. The Clark and Wells (1995) cognitive model for SAD has been proved to be clinically effective in adults, and its developmentally sensitive adaptations for adolescents have recently shown promising results. Given this evidence and considering that adolescence is typically the age of onset for the first SAD symptoms and a critical developmental period for the delivery of evidence-based interventions, we adapted CT for adolescents for online intervention (CT@TeenSAD) encompassing 10 weekly, 90 min sessions, extended by two booster sessions. This work presents the first case study of that intervention as applied to Merida (M.; pseudonym; 17-year-old, girl). The estimated Reliable Change Index shows M.’s progress for most of her symptoms, from pre-to post-treatment (RCI-1 range: −.53 to −8.03), and the maintenance of benefits at 3 months follow-up (RCI-2 range: .00 to −2.25). A relapse in the adoption of safety behaviors was seen between post-treatment and follow-up, which might be explained by the life-changing challenges experienced by M. between session 10 and follow-up, concerning her transition from high school to college. M.’s case study offers a first glance on the promising results of CT@TeenSAD related to its efficacy and feasibility. Likewise, it offers the opportunity to critically appraise the limitations of the intervention as well as practical challenges and suggestions thought to be useful for therapists willing to implement CT@TeenSAD in the future.
A Case Report of Home-Based Cognitive-Behavioural Treatment for Late-Onset Post-Traumatic Stress Disorder, Triggered by Mask-Wearing in the Context of the COVID-19 Pandemic
Authors: Hanafi Adham
Published: May 2022

A small but clinically significant number of people experience delayed-onset Post-traumatic stress disorder (PTSD); symptoms of trauma years after the events which are now being re-experienced. The following case report describes the use of the cognitive-behavioural treatment for PTSD with a woman experiencing flashbacks to domestic abuse endured more than 20 years ago. Mask-wearing mandated as a result of the COVID-19 pandemic triggered non-contextualised memories of life-threatening physical violence by an abuser who covered his face. She had been managing her flashbacks and intrusive thoughts with both behavioural and experiential forms of avoidance. An 18-session intervention was provided in her own home due to physical health difficulties. Treatment focused on managing hyper-arousal, reducing thought suppression, in-vivo exposure, stimulus-discrimination and re-contextualising traumatic memories. Regular outcome measurements were kept and results are presented as a single-case experimental design in ‘AB’ format (i.e. baseline period pre intervention). Symptoms of trauma fell to levels non-indicative of PTSD and speak to the evidence base for this modality, even when applied to delayed-onset difficulties in a non-traditional therapy setting. This conclusion is lent extra credence by an experimental design with good internal validity.
Characterization of the Skin Bacteriome and Histology Changes in Diabetic Pigs
Authors: Li Meirong , Yuan Jifang , Hou Qian , Zhao Yali , Zhong Lingzhi , Dai Xin , Chen Hua , Fu Xiaobing
Published: May 2022

Chronic wound is one of the most common complications that are associated with diabetes. The cutaneous microbiome is known to play essential roles in the regulation of barrier function and protecting against potential assault. Thus, it is necessary to gain a better understanding of the relationship between microbial community and skin structures in unwounded diabetic skin to explore possible preventive strategies. To achieve the same, a pig diabetic model was built in the present study. Further,16S rDNA sequencing was used to characterize the skin bacteriome. It was observed that the pigs showed skin bacteriome similar to humans in the non-diabetes group, while it varied in the case of diabetes. Further, the β-diversity analysis showed that the bacterial community was significantly different under the diabetes group. More species differences were identified between the two groups at genus level. The predictive function analysis also showed the involvement of significantly different pathways of microbial gene function in diabetes. In agreement with this, skin histology analysis also showed signs of reduced epidermal thickness and rete ridges in diabetic skin. Less proliferation of keratinocytes and impaired TJ barrier was also detected. This evidence suggested that pigs might serve as the best surrogate for cutaneous microbiome studies. Altogether, the present study reported that the skin bacteriome and histology changed significantly in unwounded diabetic skin, which provided a theoretical basis for the regulation of disordered skin bacteriome. The findings of the study would assist in the improvement of the skin environment and prevention of skin infection and chronic wounds.
Resistant Chronic Venous Leg Ulcers: Effect of Adjuvant Systemic Hyperbaric Oxygen Therapy Versus Venous Intervention Alone
Authors: Elsharnoby Amr M , El-Barbary Ahmed H , Eldeeb Ali E , Hassan Hassan A
Published: May 2022

The aim of this study was to assess the adjuvant efficacy of adding systemic hyperbaric oxygen therapy (HBOT) to definitive venous intervention for healing of resistant chronic venous leg ulcers (VLUs). From 97 chronic VLUs, 63 were subjected to a pre-study standard wound care. Thirty three ulcers failed to achieve 50% size reduction, after the 4-weeks standard care, and were allocated to be treated with: HBOT plus venous intervention (n = 17), or venous intervention alone (n = 16). Primary outcomes were the change in ulcer area, complete healing frequency and time, as well as ulcer recurrence. There was a history of recurrent ulcer (82.3% vs. 69%) in HBOT versus venous intervention groups, respectively. The comparison between both groups with regard to area change showed non-significant difference after 3 months of therapy, while there was a significant difference at 6 and 12 months. A significant positive correlation was found between the HBO sessions numbers (20-40) and the rate of ulcer size reduction. Ulcer complete closure after 3 months was observed in (41.7%) of HBOT group, versus (23%) in venous intervention group; (p = 0.33). After 12 months, complete closure was observed in (83.3%) of HBOT group, versus (53.8%) in venous intervention group; (p = 0.02). The mean time of complete closure was significantly shorter in HBOT group, (p = 0.001). HBOT may be effective as adjuvant to venous intervention in treatment of chronic resistant VLUs, it should be reserved for persistent ulcer. Randomized controlled trials with larger numbers is still needed to elucidate its exact role and specific indications.
Epilepsy and COVID 2021
Authors: Valencia Ignacio , Berg Anne T. , Hirsch Lawrence J. , Lopez Maria Raquel , Melmed Kara , Rosengard Jillian L. , Tatum William O. , Jobst Barbara C.
Published: May 2022

Coronavirus 19 (COVID-19) has infected over 400 million people worldwide. Although COVID-19 causes predominantly respiratory symptoms, it can affect other organs including the brain, producing neurological symptoms. People with epilepsy (PWE) have been particularly impacted during the pandemic with decreased access to care, increased stress, and worsening seizures in up to 22% of them probably due to multiple factors. COVID-19 vaccines were produced in a record short time and have yielded outstanding protection with very rare serious side effects. Studies have found that COVID-19 vaccination does not increase seizures in the majority of PWE. COVID-19 does not produce a pathognomonic EEG or seizure phenotype, but rather 1 that can be seen in other types of encephalopathy. COVID-19 infection and its complications can lead to seizures, status epilepticus and post-COVID inflammatory syndrome with potential multi-organ damage in people without pre-existing epilepsy. The lack of access to care during the pandemic has forced patients and doctors to rapidly implement telemedicine. The use of phone videos and smart telemedicine are helping to treat patients during this pandemic and are becoming standard of care. Investment in infrastructure is important to make sure patients can have access to care even during a pandemic.
Cascading Effects of Cumulative Trauma: Callous Traits among Justice Involved Youth
Authors: Yoder Jamie , Tunstall Ashley
Published: May 2022

Youth involved in the juvenile justice system (JJS) have high rates of trauma relative to youth in the general population. Criminological research has posited that callous traits are some of the most prominent risk factors associated with onset and recidivistic criminal behavior. It stands to reason that research should test intermediary variables explaining the connection between cumulative trauma and risks for criminal behavior to better isolate trauma-driven determinants of callous traits. This study employs a structural equation model to test the connections between cumulative trauma, trauma symptoms, behavioral regulation, and callous traits among a sample of JJS involved youth ( N = 336). Results revealed there was not a direct relationship between cumulative trauma and callous traits, but there were mediated effects of the variables in portions of the model; the developmental risks resulting from cumulative trauma, specifically trauma symptoms and behavioral regulation increase the likelihood for callous traits. Implications are discussed.
Rehabilitation Definition for Research Purposes. A Global Stakeholders’ Initiative by Cochrane Rehabilitation
Authors: Negrini Stefano , Selb Melissa , Kiekens Carlotte , Todhunter-Brown Alex , Arienti Chiara , Stucki Gerold , Meyer Thorsten ,   3rd Cochrane Rehabilitation Methodology Meeting participants
Published: May 2022

Since its foundation, Cochrane Rehabilitation has faced challenges with rehabilitation definitions because existing definitions did not indicate what rehabilitation includes and what it excludes. We aimed to develop a comprehensive and shared rehabilitation definition for research purposes to: (1) support the conduct of primary studies and systematic reviews, and (2) identify relevant systematic reviews for knowledge translation purposes. We performed a multimodal study including seven preliminary research and discussion papers, four Consensus Meetings, and three Delphi rounds with 80 rehabilitation stakeholders. The Delphi Study aimed to obtain agreement, refine and complete the items composing the definition and meanings of rehabilitation. These stakeholders covered 5 continents, representing 11 global and continental rehabilitation organizations, 11 scientific journals, 4 Cochrane Networks, and 3 Cochrane Groups, and included invited experts, and representatives of low middle-income countries and consumers. We had a 70% to 82.5% response rate to the three Delphi rounds, during which participants responded to all items (100%) and provided relevant comments (range 5.5–50% per item). This participation led to several refinements to the rehabilitation definition through three preliminary versions, and the final items reached an agreement between 88.9% and 100%. We structured the definition using the PICO (Population, Intervention, Comparison, Outcome) framework. We concluded that “In a health care context,” rehabilitation is defined as a “multimodal, person-centered, collaborative process” (Intervention-general), including interventions targeting a person’s “capacity (by addressing body structures, functions, and activities/participation) and/or contextual factors related to performance” (Intervention-specific) with the goal of “optimizing” the “functioning” (Outcome) of “persons with health conditions currently experiencing disability or likely to experience disability, or persons with disability” (Population). Rehabilitation requires that all the items of the definition are satisfied. We defined a “rehabilitation intervention” as “any intervention provided within the rehabilitation process.” We developed a rehabilitation definition for research purposes achieving a broad agreement with global stakeholders. This definition provides explicit criteria to define rehabilitation. Using the proposed definition will improve rehabilitation research by standardizing the description of interventions. Our definition may require revision in the future, as further research enhances understanding and communication of the essence and complexity of rehabilitation.
Reorganization of Ventral Premotor Cortex After Ischemic Brain Injury: Effects of Forced Use
Authors: Frost Shawn B. , Chen Daofen , Barbay Scott , Friel Kathleen M. , Plautz Erik J. , Nudo Randolph J.
Published: May 2022

Background

Physical use of the affected upper extremity can have a beneficial effect on motor recovery in people after stroke. Few studies have examined neurological mechanisms underlying the effects of forced use in non-human primates. In particular, the ventral premotor cortex (PMV) has been previously implicated in recovery after injury.

Objective

To examine changes in motor maps in PMV after a period of forced use following ischemic infarct in primary motor cortex (M1).

Methods

Intracortical microstimulation (ICMS) techniques were used to derive motor maps in PMV of four adult squirrel monkeys before and after an experimentally induced ischemic infarct in the M1 distal forelimb area (DFL) in the dominant hemisphere. Monkeys wore a sleeved jacket (generally 24 hrs/day) that forced limb use contralateral to the infarct in tasks requiring skilled digit use. No specific rehabilitative training was provided.

Results

At 3 mos post-infarct, ICMS maps revealed a significant expansion of the DFL representation in PMV relative to pre-infarct baseline (mean = +77.3%; n = 3). Regression analysis revealed that the magnitude of PMV changes was largely driven by M1 lesion size, with a modest effect of forced use. One additional monkey examined after ∼18 months of forced use demonstrated a 201.7% increase, unprecedented in non-human primate studies.

Conclusions

Functional reorganization in PMV following an ischemic infarct in the M1 DFL is primarily driven by M1 lesion size. Additional expansion occurs in PMV with extremely long periods of forced use but such extended constraint is not considered clinically feasible.
Anastomotic Leak Rate and Prolonged Postoperative Paralytic Ileus in Patients Undergoing Laparoscopic Surgery for Colo-Rectal Cancer After Placement of No-Coil Endoanal Tube
Authors: Ammendola Michele , Ammerata Giorgio , Filice Francesco , Filippo Rosalinda , Ruggiero Michele , Romano Roberto , Memeo Riccardo , Pessaux Patrick , Navarra Giuseppe , Montemurro Severino , Currò Giuseppe
Published: May 2022

Background

Colorectal cancer (CRC) is the second most common gastrointestinal tumor in men and the third in women. Left-hemicolectomy (LC) and low anterior resection (LAR) are considered the gold standard curative treatment. In this retrospective study, we evaluated the presence or absence of post-operative complications, in all patients who underwent Video-laparoscopic (VLS) LAR/LC with No Coil trans-anal tube positioning, and compared the data with the current literature on the topic.

Methods

Thirty-nine patients diagnosed with CRC of the descending colon, splenic flexure, sigma, and rectum were recruited. LC was performed for sigmoid and descending colon cancers, while LAR was applied for tumors of the upper two-thirds of the rectum. The No Coil trans-anal tube (SapiMed Spa, Alessandria, Italy) was placed in all patients of the study at the end of surgical treatment.

Results

Eighteen patients received a LAR-VLS (46%) and 21 patients received a LC-VLS (54%). The average length of hospital stay after surgery was 7 days. PPOI occurred in only one in 39 patients (2.6%) who had undergone LAR-VLS. As for complications, in no patient of the study did AL (0%) occur.

Conclusion

In patients undergoing LAR-VLS and LC-VLS, we performed colorectal anastomosis and in the same surgical operation we introduced the No-Coil device. Although this is a preliminary study and subject to further investigation, we believe that the No Coil tube positioning may reduce the time of presence of first flatus and feces and the risk of AL.
Gameplay Bricks Model, a Theoretical Framework to Match Game Mechanics and Cognitive Functions
Authors: Ben-Sadoun Grégory , Alvarez Julian
Published: May 2022

This article investigated whether it is possible to establish correspondences between game mechanics and particular cognitive stimulations. There are many challenges to prevent and treat cognitive decline with aging or neurocognitive disease. Observing difficulties to establish such correspondences in the scientific literature, we proposed to move away from “classification by genre” or any other type of taxonomy that deviates from the framework of the “Rules/Formal schemas” and the “set of rules” component of the gameplay. Thus, we proposed the Gameplay Bricks model as a theoretical framework for Video Game (VG) and Serious Games (SG). We jointly relied on a framework on fractionated executive functions, memory, and attention. The Gameplay Bricks model currently identifies 14 major Metabricks (game mechanics) through seven Metabricks of obligations and seven of prohibitions. We have proposed first correspondences accompanied by examples from the VG-SGs. The limits and perspectives of these first matches were then discussed.
Seeking a Sense of Control or Escapism? The Role of Video Games in Coping with Unemployment
Authors: Lee Yu-Hao , Chen Mo
Published: May 2022

Unemployment can have devastating effects on people’s psychological and social wellbeing. The effects of unemployment can be exacerbated during the COVID-19 pandemic due to the lack of control over one’s life and the loss of social connectedness. Through a survey of 480 unemployed workers, this study examined how emotion-focused coping using video game can affect the workers’ wellbeing and reemployment. The findings showed that escapism was associated with decreased wellbeing, which reduced job-search efficacy and behaviors. However, when video game playing was viewed as a source of self-determination, it can support the unemployed workers’ intrinsic needs of autonomy and relatedness, which improved their wellbeing, their job-search efficacy, and job-search behaviors. Further comparison of effects between gender, age, race, and income found that unemployed workers who made lower to medium income were more likely to seek escapism through games compared to female unemployed workers.
The Doors of Perception: Horror Video Games and the Ideological Implications of Ludic Virtual Reality
Authors: Christopher David , Leuszler Aidan
Published: May 2022

With the ‘perfect marriage’ between horror and video games has come a concomitant cultural studies discourse surrounding these games. Previously, while Carol Clover insisted that identification through the perspectival screen is poorly understood, she seminally argued that slasher horror in particular allows for more progressive gender identifications. More broadly, and somewhat conversely, Carly Kocurek observes the most reactionary effects of the horror genre’s reduction of cultural ‘others’ to monsters and the problem with their prurient dispatch in video games. Lastly, Tammy Lin argues that the experience of virtual reality (VR) significantly heightens the experience of horror. In concert, these imply that VR should heighten the ideological effects and gender identifications identified by both Kocurek and Clover, for better or for worse. This paper examines the ways in which both ostensibly reactionary and progressive ideological elements have migrated into horror video games and the implications of VR on this phenomenon.
Orthopedic Surgery Fellowship Directors: Trends in Demographics, Education, Employment, and Institutional Familiarity
Authors: Kamalapathy Pramod N. , Raso Jon , Rahman Rana , Harihar Sanjana , Lozano-Calderon Santiago , Hassanzadeh Hamid
Published: May 2022

Background: Fellowship directors are assumed to be distinguished in orthopedics, but the traits and training that have enabled them to achieve their leadership positions have not been assessed. Purpose: We sought to identify common demographics, research output, and educational trends of fellowship directors in orthopedics, with an emphasis on racial, ethnic, and gender diversity. Methods: We conducted a literature review to identify published studies on fellowship directors in orthopedic surgery and found 4 cross-sectional studies of fellowship directors in spine, arthroplasty, pediatrics, and sports medicine subspecialties. Another 4 accredited orthopedic subspecialties and their fellowship directors were identified using the American College of Graduate Medical Education Public Accreditation Data System for 2020-2021 and national fellowship directories. Data endpoints included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at current institution, year of fellowship directors appointment, and h-index. The demographics and educational backgrounds for listed fellowship directors were collected from curricula vitae (CVs). Results: Of the 537 fellowship directors identified among 8 orthopedic subspecialties, the average age was 52.9 ± 2.2 years, 5.6% (N = 30) were women, 79.1% (N = 406) were white, 12.5% (N = 64) were Asian American, 3.7% (N = 19) were African American, 2.9% (N = 15) were Middle Eastern, and 1.7% (N = 9) were Hispanic/Latino. Oncology 20% (N = 4) had the highest percentage of female fellowship directors; 37.6% (N = 202) of fellowship directors were at the same institution they trained at for residency or fellowship. Their average h-index was 18.6 ± 3.7. Conclusion: This study of fellowship directors in orthopedics found that they have a high research output and a high level of institutional familiarity. We identified a need for greater diversity in these leadership positions in both gender and race/ethnicity.
Efficacy of Intraventricular Sponge Placement to Capture Debris in Aortic Valve Replacement
Authors: Purrman Kyle C. , Ndikumana Eric , Amirjamshidi Hossein , Syposs Chauncey , Vidovich Courtney , Boyce Brendan , Knight Peter
Published: May 2022

Objective: Surgical aortic valve replacement (SAVR) carries the known risk of shedding debris into the left ventricle during valve leaflet excision and annulus debridement. Embolization of this debris may have devastating effects for the patient. Although surgeons have developed methods to mitigate this risk, no data exist as to their efficacy. Herein, we present the first study that evaluates the efficacy of a technique for capturing debris during SAVR. Methods: Our group conducted a prospective case series of 20 patients who underwent SAVR using the insertion of an intraventricular surgical sponge prior to valve leaflet excision and annulus debridement to capture debris. Surgical sponges were grossly, radiographically, and histologically examined for the presence of cellular and acellular debris to determine the efficacy of this technique. Results: Of the 20 surgical sponges analyzed, 15 specimens (75%) registered positivity for cellular and/or acellular debris. Seven sponges (35%) were grossly positive, 15 sponges (75%) were radiographically positive, and 4 sponges (20%) were histologically positive for calcified debris on examination. Conclusions: This is one of the few studies to objectively evaluate a method used to capture debris in SAVR procedures. Our results demonstrate a high frequency of debris captured within intraventricular surgical sponges and confirms the efficacy of this technique. While these data are promising, numerous additional approaches exist to capture debris, and a best practice standard should exist across the specialty.  In addition, this study does not address the clinical outcomes associated with this technique. To these ends, additional data and multicenter collaboration are required.
Minimally Invasive Diaphragm Plication for Acquired Unilateral Diaphragm Paralysis: A Systematic Review
Authors: Gritsiuta Andrei I. , Gordon Matthew , Bakhos Charles T. , Abbas Abbas E. , Petrov Roman V.
Published: May 2022

Objective: Diaphragm paralysis is a relatively uncommon entity that can be both congenital and acquired in nature. While commonly asymptomatic, it can also cause a significant decrease in pulmonary function and reserve, particularly in patients with underlying pulmonary diseases. Our aim was to summarize the current literature regarding the minimally invasive techniques used in the surgical correction of acquired diaphragm paralysis via traditional and robotic minimally invasive approaches. Methods: We conducted a systematic review of available literature using the Cochrane methodology and reported findings according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Results: A total of 6,561 citations were identified through initial database and reference searches, of which 90 articles met the inclusion criteria for review. After further assessment, 33 appropriate full-text studies were selected for the review. Of the selected publications, the majority represented case reports and single-center retrospective studies with level of evidence 4. Only 1 level 2b study (individual cohort study) was identified, comparing minimally invasive and open approaches. Conclusions: Each of the minimally invasive approaches has its unique benefits and disadvantages, which are summarized and delineated in this article. Ultimately, no preferred method of diaphragm plication for diaphragm paralysis can be recommended at this time based on clinical data. The choice of procedure and surgical approach continues to be selected based on the surgeon's experience and preference.
Using Theoretical Models in Mixed Methods Research: An Example from an Explanatory Sequential Mixed Methods Study Exploring Teachers' Beliefs and Use of Technology
Authors: Haynes-Brown Tashane K.
Published: May 2022

The purpose of this article is to illustrate the dynamic process involved in developing and utilizing a theoretical model in a mixed methods study. Specifically, I illustrate how the theoretical model can serve as the starting point in framing the study, as a lens for guiding the data collection and analysis, and as the end point in explaining the integrated findings. The article is based on an explanatory sequential mixed methods study conducted with 248 teachers in Jamaican secondary schools that sought to understand how beliefs shaped their use of technology. This article contributes to mixed methods research by providing illustrations and analytical insights into the role of a theoretical model in enhancing rigor in designing and conducting mixed methods research.
Policies and Practices for Equity: Perspectives of Campus Recreation Staff in North America
Authors: Wilson Oliver W. A. , Powers Samantha L. , Bopp Melissa
Published: May 2022

Given continued physical activity disparities among college students based on gender identity, race, and sexual orientation, it is important to identify policies and practices to support more equitable physical activity participation opportunities. This mixed-methods study examined perceptions of equity policies and practices among North American campus recreation staff (n = 254). Institution and staff characteristics along with department values, existence of written policies, and perceptions of current and potential equity policies/practices were collected via an online survey in November 2020. Quantitative data were analyzed with descriptive statistics and importance-performance analysis; qualitative data were analyzed using thematic analyses. Findings indicate an apparent disconnect between campus recreation departments’ stated values and written policies, and reveal gaps between perceived importance and performance of equity priorities. However, qualitative responses included many promising equity practices which could help facilitate physical activity participation for all students through creation of an inclusive, safe, and welcoming environment for diverse student populations.
Patient-Reported Outcomes After Surgical Treatment of Early Osteoarthritis of the First Carpometacarpal Joint
Authors: Hazewinkel Merel H. J. , DiGiovanni Peter , Miyamura Satoshi , Lans Jonathan , Chen Neal C. , Lunn Kiera , Jupiter Jesse B.
Published: May 2022

Background:

The goals of this study are to describe the reoperation rates in patients who underwent Wilson osteotomy compared with patients who underwent carpometacarpal (CMC) arthroplasty for early-stage arthritis and to evaluate the factors influencing the patient-reported outcomes.

Methods:

Retrospectively, 52 patients who underwent surgery for stage I/II osteoarthritis of the thumb carpometacarpal were identified, consisting of 17 (33%) patients who underwent Wilson osteotomy and 35 (67%) who underwent carpometacarpal arthroplasty. A total of 28 (55%) patients completed the outcome questionnaires, consisting of 11 (39%) patients who underwent Wilson osteotomy and 17 (61%) patients who underwent carpometacarpal arthroplasty. We performed a multivariable linear regression model to identify factors associated with the Numeric Rating Scale (NRS) pain intensity at final follow-up.

Results:

Among the patients who underwent CMC arthroplasty, 2 had a reoperation. Among the patients who underwent Wilson osteotomy, 3 had a reoperation. Among the patients who completed the outcome questionnaires, the median quick Disabilities of the Arm, Shoulder and Hand score was 10 and the median NRS Pain Intensity score was 0. In multivariable analysis, the postoperative Patient-Reported Outcomes Measurement Information System Pain Interference (PROMIS PI) was independently associated with higher postoperative NRS pain scores.

Conclusion:

In younger patients with stage I/II CMC osteoarthritis, Wilson osteotomy may be a reasonable alternative to CMC arthroplasty. Outcomes were similar between both groups at mid-term follow-up, with only a slightly higher pain score in the osteotomy group. In patients with stage I/II carpometacarpal osteoarthritis, the PROMIS PI is the main factor indicating successful outcomes.
Postoperative Immobilization of Scaphoid Fractures: A Comprehensive Review of the Literature
Authors: Simon Michael , Gencarelli Pasquale , Yang Jason , Elkhechen Justin N. , Avendano John P. , Kirschenbaum David , Katt Brian M.
Published: May 2022

The optimal protocol for postoperative immobilization following operative treatment of scaphoid fractures remains controversial. Reports of successful management with brief postoperative immobilization suggest that earlier restoration of function may be achieved by limiting the duration of immobilization. However, the risk of nonunion and its associated complications suggest that a more conservative approach with extended immobilization could optimize fracture healing. This paper presents a thorough review of the relevant literature and summarizes the myriad postoperative immobilization protocols and their reported outcomes. Postoperative immobilization protocols and reported outcomes for displaced, comminuted, and proximal pole fractures are discussed separately. The literature is reviewed following different operative techniques, including open reduction internal fixation and percutaneous screw fixation. Vigilant postoperative care of scaphoid fractures managed surgically is warranted to monitor for signs of nonunion while attempting to regain motion and strength to the injured wrist.
Lifestyle Medicine Interventions for Personal and Planetary Health: The Urgent Need for Action
Authors: Pathak Neha , Pollard Kathryn J. , McKinney Amanda
Published: May 2022

The deterioration of planetary health—from threats such as climate change, environmental pollution, biodiversity loss, and ocean acidification—are a growing hazard to the foundation of health and the “healthspan.” For those with chronic conditions—a large and growing subset of the global population—the health dangers are even greater. Climate change is a threat to the very pillars of lifestyle medicine that we rely on to prevent and manage chronic disease. Already, the planetary crisis is limiting our ability to prescribe healthy nutrition, safe outdoor physical activity, stress management strategies, social connection, restorative sleep, and toxic substance avoidance. In this article, we discuss the proceedings of our workshop at the American College of Lifestyle Medicine (ACLM) annual conference LM2021, “Lifestyle Medicine for Personal and Planetary Health.” We examine how lifestyle medicine (LM) interventions are a prescription for individual, community, and planetary health. Our prescriptions work to not only restore the health of individuals and families, but also to bolster health equity while allowing us to mitigate and adapt to the health impacts of the planetary crises.
Volumetric surveillance of brain aneurysms: Pitfalls of MRA
Authors: Raghuram Ashrita , Patel Rishi , Varon Alberto , Sabotin Ryan , Sanchez Sebastian , Derdeyn Colin P , Jabbour Pascal , Hasan David M. , Samaniego Edgar A.
Published: May 2022

Introduction

Untreated brain aneurysms are usually surveilled with serial MR imaging and evaluated with 2D multiplanar measurements. The assessment of aneurysm growth may be more accurate with volumetric analysis. We evaluated the accuracy of a magnetic resonance angiography (MRA) segmentation pipeline for aneurysm volume measurement and surveillance.

Methods

A pipeline to determine aneurysm volume was developed and tested on two aneurysm phantoms imaged with time-of flight (TOF) MRA and 3D rotational angiography (3DRA). The accuracy of the pipeline was then evaluated by reconstructing 10 aneurysms imaged with contrast enhanced-MRA (CE-MRA) and 3DRA. This calibrated and refined post-processing pipeline was subsequently used to analyse aneurysms from our prospectively acquired database. Volume changes above the threshold of error were considered true volume changes. The accuracy of these measurements was analysed.

Results

TOF-MRA reconstructions were not as accurate as CE-MRA reconstructions. When compared to 3DRA, CE-MRA underestimated aneurysm volume by 7.8% and did not accurately register the presence of blebs. Eighteen aneurysms (13 saccular and 5 fusiform) were analysed with the optimized 3D volume reconstruction pipeline, with a mean follow-up time of 11 months. Artifact accounted for 10.2% error in volume measurements using serial CE-MRA. When this margin of error was used to assess aneurysms volume in serial imaging with CE-MRA, only two fusiform aneurysms changed in volume. The variations in volume of these two fusiform aneurysms were caused by intra-mural and intrasaccular thrombosis.

Conclusions

CE-MRA and TOF-MRA 3D volume reconstructions may not register minor morphological changes such as the appearance of blebs. CE-MRA underestimates volume by 7.8% compared to 3DRA. Serial CE-MRA volume measurements had a larger margin of error of approximately 10.2%. MRA-based volumetric measurements may not be appropriate for aneurysm surveillance.
Developing Typologies in Qualitative Research: The Use of Ideal-type Analysis
Authors: Stapley Emily , O’Keeffe Sally , Midgley Nick
Published: May 2022

The tradition of developing typologies has been prominent in research, particularly within the fields of psychology and sociology, for decades. A typology is formed by grouping cases or participants into types on the basis of their common features. Despite the prominence of typologies in research, methodological guidance on the process of developing a typology, particularly as a qualitative method for analysing data, is scarce. Ideal-type analysis is a relatively new addition to the family of qualitative research methods, which offers a systematic, rigorous method for constructing typologies from qualitative data. In our approach to ideal-type analysis, the methodology consists of seven steps: becoming familiarised with the dataset; writing the case reconstructions; constructing the ideal types; identifying the optimal cases; forming the ideal-type descriptions; checking credibility; and making comparisons. This article is a summary of our approach to conducting ideal-type analysis. We hope that this article will help researchers to consider whether using ideal-type analysis may be a suitable approach for their own studies.
Transient-state analysis of hydropower plants with cross-flow turbines
Authors: Svrkota Dragan , Tašin Slobodan , Stamenković Živojin
Published: May 2022

Transients in hydropower plants can result in serious disturbances in a plant operation and damage of mechanical and civil components. The best way to prevent such adverse outcomes is to conduct a transient-state analysis using a mathematical model of the hydropower plant system. Based on the collected data on 270 hydropower plants with cross-flow turbines, regression equations were derived that relate a cross-flow turbine specific speed, rated speed, runner diameter and runner width to the rated turbine head and discharge. The obtained equations were used to estimate the turbine performance characteristics using available unit hill charts of three different cross-flow turbines. Finally, the estimated performance characteristics were used to form the boundary condition ‘cross-flow turbine’ within the unsteady 1D mathematical model. The model was validated through case studies by comparing calculated and measured changes in the turbine speed and inlet pressure, induced by sudden load rejection. The difference between the calculated and measured peak pressures was up to 5% during the most critical period, that is, from the moment of load rejection up to the guide vanes closure. In the case of turbine speed, the difference between the peak values was less than 10% in the same period.