bluuebunny/crossref_metadata_2025 huggingface dataset:
Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis
Authors: Xie Min , Xu Xiaogai , Cao Zhenjie , Xiao Huijie
Published: September 2021

Purpose: Vesicoureteral reflux (VUR) is a risk factor for various renal problems like recurrent urinary tract infections (UTIs), pyelonephritis, renal scarring, hypertension, and other renal parenchymal defects. The interventions followed by pediatricians include low-dose antibiotic treatment, surgical correction, and endoscopy. This meta-analysis aimed to assess the advantages and drawbacks of various primary VUR treatment options. Search Strategy: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of journals, and abstracts from conference proceedings were all used to find randomized controlled trials. The articles were retrieved from 1985 till 2020. Twenty articles were used for the data analysis. Criteria for Selection: Surgery, long-term antibiotic prophylaxis, noninvasive techniques, and any mix of therapies are also options for treating VUR. Collection and Interpretation of Data: Two authors searched the literature separately, determining research qualifications, assessing accuracy, and extracting and entering results. The odds ratio (OR) of these studies was used to construct the forest plot. The random-effects model was used to pool the data. Also, the random-effects model was used with statistical significance at a p value < 0.05 to assess the difference in side effects after treatment of VUR using different modalities. Results: We found no statistically significant differences between surgery plus antibiotics and antibiotic alone-treated patients in terms of recurrent UTIs (OR = 0.581; 95% confidence interval [CI] 0.259–1.30), renal parenchymal defects (OR = 1.149; 95% CI 0.75–1.754), and renal scarring (OR = 1.042; 95% CI 0.72–1.50). However, the risk of developing pyelonephritis after surgical treatment of VUR was lesser than that in the conservative approach, that is, antibiotics (OR = 0.345; 95% CI 0.126–0.946.), positive urine culture (OR = 0.617; 95% CI 0.428–0.890), and recurrent UTIs were more common in the placebo group than in the antibiotic group (p < 0.05; OR = 0.639; 95% CI 0.436–0.936) which is statistically significant. Conclusion: Based on current research, we recommend that a child with a UTI and significant VUR be treated conservatively at first, with surgical care reserved for children who have issues with antimicrobials or have clinically significant VUR that persists after several years of follow-up.
Harmful Interference of Detoxifying Diets and Nutraceuticals with Adherence to Abemaciclib in Advanced Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor-2-Negative Breast Cancer: A Case Report
Authors: Gebbia Vittorio , Piazza Dario , Valerio Maria Rosaria
Published: September 2021

Many cancer patients use integrative therapies with a combination of natural products and diets. In the Western world, integrative medicine is often not shared with oncologists even during antineoplastic treatments. This behavior stems from the unmet needs of cancer patients who may feel oncologists’ underestimation of their symptoms and spiritual aspects. This case report demonstrates the potential harm of inadequate diet and nutraceutical intake in a 68-year-old woman with metastatic estrogen receptor-positive, human epidermal growth factor receptor-2-negative breast cancer. Her care team recommended hormone therapy with abemaciclib plus fulvestrant. Her diarrhea started after 10 days of therapy and did not disappear, despite the use of loperamide, causing a significant reduction in adherence and dose intensity of abemaciclib. The patient finally disclosed to her oncologist she was following a detoxifying diet and taking several nutraceuticals. Her diarrhea was correlated with abemaciclib but most probably exacerbated and prolonged by the diet. Evaluation of disease after 3 months showed progressive disease. Integrative medicine should be in the multidisciplinary management of cancer patients to avoid potentially harmful events and ameliorate patients’ quality of life in a holistic approach.
Clinicopathological and Prognostic Features of 67 Cases with Pulmonary Sarcomatoid Carcinoma: An 18-Year Single-Centre Experience
Authors: Ferhatoglu Ferhat , Amirov Fahmin , Ozkan Berker , Kara Murat , Toker Alper , Ak Naziye , Aydın Esra , Paksoy Nail , Yilmazbayhan Dilek , Aydiner Adnan
Published: September 2021

Introduction: Pulmonary sarcomatoid carcinoma (PSC) is a very rare subtype of non-small-cell lung cancer (NSCLC). It is frequently diagnosed in the advanced stage and is resistant to conventional chemotherapeutics. Due to the unique nature and rarity, we evaluated the epidemiological, clinicopathological, and survival data of PSC patients treated at our centre. Patients and Methods: We retrospectively collected demographic and clinical data of 67 PSC patients from a single tertiary referral hospital, between the 2000 and 2018. Univariate and multivariate analyses were performed to determine the risk factors affecting survival. Results: The median age was 61 years, and the percentage of male was 74.6%. Most of the patients had a smoking history (76.9%). The most common PSC subtype was pleomorphic carcinoma (46.3%). The median overall survival (OS) was 55.4 months, and the 5-year OS rate was 47.5%. Advanced stage, T4 tumour, and positive lymph node involvement were associated with poor OS (p < 0.05). The patients with negative epithelial markers had poorer prognosis (p = 0.027) and had more frequently stage IV disease (p = 0.016). Surgical treatment and stage IV disease were determined to be independent prognostic factors. Conclusion: PSC is an extremely rare and aggressive variant of NSCLC. Positive epithelial markers may have favourable prognostic significance in PSC. Resection of the tumour with a negative surgical margin is crucial for better survival. The prognosis of the disease is very poor in the metastatic stage.
Associations Between Inflammation, Cardiovascular Regenerative Capacity, and Cardiovascular Events: A Cohort Study
Authors: Almuwaqqat Zakaria , Hwan Kim Jeong , Garcia Mariana , Ko Yi-An , Moazzami Kasra , Lima Bruno , Sullivan Samaah , Alkhalaf Jamil , Mehta Anurag , Shah Amit J. , Hussain Mohammad S. , Pearce Brad D. , Bremner J. Douglas , Waller Edmund K. , Vaccarino Viola , Quyyumi Arshed A.
Published: September 2021

Objective:

Circulating progenitor cells possess immune modulatory properties and might mitigate inflammation that is characteristic of patients with coronary artery disease. We hypothesized that patients with fewer circulating progenitor cells (CPCs) will have higher inflammatory markers and worse outcomes.

Approach and Results:

Patients with stable coronary artery disease were enrolled in a prospective study enumerating CPCs as CD (cluster of differentiation)-34–expressing mononuclear cells (CD34+) and inflammation as levels of IL (interleukin)-6 and high-sensitivity CRP (C-reactive protein) levels. Patients were followed for 5 years for the end points of death and myocardial infarction with repeat inflammatory biomarkers measured after a median of 2 years. In the entire cohort of 392 patients, IL-6 and high-sensitivity CRP levels remained unchanged (0.3±2.4 pg/mL and 0.1±1.0 mg/L;
P
=0.45) after 2 years. CPC counts (log-transformed) were inversely correlated with the change in IL-6 levels (r, −0.17;
P
<0.001). Using linear regression, IL-6 and high-sensitivity CRP levels declined by −0.59 (95% CI, −0.90 to −0.20) pg/mL and −0.13 (−0.28 to 0.01) mg/L per 1 log higher CPC counts after adjustment for the demographic and clinical variables, as well as medications. Using Cox models adjusted for these risk factors, a rise in 1 pg/mL of IL-6 was associated with a 11% (95% CI, 9–13) greater risk of death/myocardial infarction. We found that the change in IL6 level partly (by 40%) mediated the higher risk of adverse events among those with low CPC counts.

Conclusions:

Reduced cardiovascular regenerative capacity is independently associated with progressive inflammation in patients with coronary artery disease that in turn is associated with poor outcomes.

Graphic Abstract:

A graphic abstract is available for this article.
Receptor and Molecular Mechanism of AGGF1 Signaling in Endothelial Cell Functions and Angiogenesis
Authors: Wang Jingjing , Peng Huixin , Timur Ayse Anil , Pasupuleti Vinay , Yao Yufeng , Zhang Teng , You Sun-Ah , Fan Chun , Yu Yubing , Jia Xinzhen , Chen Jing , Xu Chengqi , Chen Qiuyun , Wang Qing
Published: September 2021

Objective:

Angiogenic factor AGGF1 (angiogenic factor and G-patch and FHA [Forkhead-associated] domain 1) promotes angiogenesis as potently as VEGFA (vascular endothelial growth factor A) and regulates endothelial cell (EC) proliferation, migration, specification of multipotent hemangioblasts and venous ECs, hematopoiesis, and vascular development and causes vascular disease Klippel-Trenaunay syndrome when mutated. However, the receptor for AGGF1 and the underlying molecular mechanisms remain to be defined.

Approach and Results:

Using functional blocking studies with neutralizing antibodies, we identified α5β1 as the receptor for AGGF1 on ECs. AGGF1 interacts with α5β1 and activates FAK (focal adhesion kinase), Src, and AKT. Functional analysis of 12 serial N-terminal deletions and 13 C-terminal deletions by every 50 amino acids mapped the angiogenic domain of AGGF1 to a domain between amino acids 604-613 (FQRDDAPAS). The angiogenic domain is required for EC adhesion and migration, capillary tube formation, and AKT activation. The deletion of the angiogenic domain eliminated the effects of AGGF1 on therapeutic angiogenesis and increased blood flow in a mouse model for peripheral artery disease. A 40-mer or 15-mer peptide containing the angiogenic domain blocks AGGF1 function, however, a 15-mer peptide containing a single amino acid mutation from −RDD- to −RGD- (a classical RGD integrin-binding motif) failed to block AGGF1 function.

Conclusions:

We have identified integrin α5β1 as an EC receptor for AGGF1 and a novel AGGF1-mediated signaling pathway of α5β1-FAK-Src-AKT for angiogenesis. Our results identify an FQRDDAPAS angiogenic domain of AGGF1 crucial for its interaction with α5β1 and signaling.
Revision and description of three new species of the Palaearctic subgenus Gulanthidium of the wool carder bee genus Anthidium (Apoidea: Megachilidae: Anthidiini)
Authors: KASPAREK MAX
Published: September 2021

The subgenus Anthidium (Gulanthidium) is a species-poor group of similar species, which is distributed across the West Palaearctic, from Morocco in the west to central Asia in the east. Due to some incorrect species determinations in the literature, the taxonomic situation remains to be fully understood. The situation is reviewed with reference to a rich, still unpublished resource of material from throughout the range. Anthidium flavissimum sp. nov. is described from Afghanistan, A. preoccipitale sp. nov. from Iran, and A. occidentale sp. nov. from Morocco, based on a combination of colour, structural traits, genital morphology, and morphometry. The subgenus as treated here now comprises six species for which a key is presented. Some of the species are sympatric. Species of the subgenus Gulanthidium are very close to A. (Proanthidium) and it should be further examined as to whether these two subgenera should be better combined in a single subgenus.
Middle Ordovician (Darriwilian) cheirurid trilobites from the Table Cove Formation, western Newfoundland, Canada
Authors: ADRAIN JONATHAN M. , PÉREZ-PERIS FRANCESC
Published: September 2021

A diverse mid-Darriwilian trilobite fauna from the Table Cove Formation, western Newfoundland, has long been known on the basis of calcareous specimens from the west coast of the Great Northern Peninsula. Discovery of silicified faunas in localities on the east coast provides additional morphological information for previously known species, and also reveals the presence of multiple new genera and species. Many of these species are important, as they represent some of the earliest Laurentian members of the diversifying Whiterock Fauna, and seem phylogenetically near to the base of their respective clades. The concept of Sphaerexochinae is restricted to the genus Sphaerexochus itself, with the possible inclusion of Newfoundlandops n. gen. (type species N. karimae n. sp.), which shares with Sphaerexochus potential synapomorphies including the structure of the hypostome and the presence of fine granular sculpture on the librigenal border and field. Most of the Early and Middle Ordovician taxa with three pygidial segments previously classified as Sphaerexochinae by many authors are reassigned to Acanthoparyphinae on the basis of multiple putative synapomorphies. Other new cheirurid genera from the Table Cove Formation are the pilekiine Harebayaspis n. gen. (type species H. plurima n. sp.), and the deiphonine Mainbrookia n. gen. (type species M. becki n. sp.). Other species revised or described include the cheirurine Laneites polydorus (Billings, 1865), and the acanthoparyphines Cydonocephalus tiffanyae n. sp., Kawina stougei n. sp., and Kawina? sp.
Slit-band gastropods (Pleurotomariida) from the Upper Triassic St. Cassian Formation and their diversity dynamics in the Triassic
Authors: KARAPUNAR BARAN , NÜTZEL ALEXANDER
Published: September 2021

The St. Cassian Formation, Italy, has yielded the most diverse marine invertebrate fauna known from the Triassic. A quarter of all described Triassic gastropod species has been reported from this formation. Most of the gastropod species from the St. Cassian Formation were erected in the 19th century and many of them are known only from their original figures and descriptions. The failure to study type specimens resulted in many erroneous identifications by subsequent authors. Here, we revise the slit band gastropods (Pleurotomariida) from the St. Cassian Formation—one of the major groups present in this formation. A total of 77 nominate Pleurotomariida species belonging to 29 genera and 11 families are present in the St. Cassian Formation which comprises approximately 14 % of the total nominate gastropod species of that formation. In addition, we revise several taxa that had been wrongly assigned to Pleurotomariida. As other gastropod clades, Pleurotomariida experienced a major extinction at the end-Permian mass extinction event. As in the Late Palaeozoic, their relative abundance in gastropod faunas continued to be 30 % in some Anisian faunas but decreased to 5–10 % afterwards. Their diversification at generic level became interrupted by an extinction event within the Carnian, probably by the Carnian Pluvial Event. As a result of their sluggish recovery compared to the other gastropod groups, their species diversity decreased from 26 % during the Permian to 18 % during the Triassic.

                Type specimens of the following genera are studied: Proteomphalus, Rhaphistomella, Temnotropis, Kittlidiscus, Stuorella, Schizogonium, Wortheniella, Bandelium, Lancedellia, Rinaldoella, Pseudowortheniella, Paleunema, Ampezzalina, Bandelastraea, Cheilotomona, Pseudoscalites, Delphinulopsis, and Cochlearia.

                Nine new pleurotomariidan genera are erected: Amplitomaria, Pseudoananias, Lineacingulum, Pressulasphaera, Cancellotomaria, Acutitomaria, Lineaetomaria, Nodocingulum, and Striacingulum.

                Eight new species are described: Schizogonium undae, Acutitomaria kustatscherae, Wortheniella klipsteini, Wortheniella paolofedelei, Rinaldoella tornata, Nodocingulum ernstkittli, Nodocingulum? turris, and Laubella subsulcata.

                Eoworthenia frydai is a new replacement name for Worthenia rarissima Barrande.
Interannual and decadal variability of Arctic summer sea ice associated with atmospheric teleconnection patterns during 1850-2017
Authors: Cai Qiongqiong , Beletsky Dmitry , Wang Jia , Lei Ruibo
Published: September 2021

The interannual and decadal variability of summer Arctic sea ice is analyzed, using the longest reconstruction (1850-2017) of Arctic sea ice extent available, and its relationship with the dominant internal variabilities of the climate system is further investigated quantitatively. The leading empirical orthogonal function (EOF) mode of summer Arctic sea ice variability captures an in-phase fluctuation over the Arctic Basin. The second mode characterizes a sea ice dipolar pattern with out-of-phase variability between the Pacific Arctic and the Atlantic Arctic. Summer sea ice variability is impacted by the major internal climate patterns: the Atlantic Multidecadal Oscillation (AMO), North Atlantic Oscillation (NAO), Arctic Oscillation (AO), Pacific Decadal Oscillation (PDO) and Dipole Anomaly (DA), with descending order of importance based on the multiple regression analyses. The internal climate variability of the five teleconnection patterns accounts for up to 46% of the total variance in sea ice mode 1 (thermodynamical effect), and up to 30% of the total variance in mode 2 (dynamical effect). Furthermore, the variability of sea ice mode 1 decreased from 46% during 1953-2017 to 28% during 1979-2017, while the variability of mode 2 increased from 11% during 1953-2017 to 30% during 1979-2017. The increasingly greater reduction of Arctic summer sea ice during the recent four decades was enhanced with the positive ice/ocean albedo feedback loop being accelerated by the Arctic amplification, contributed in part by the atmospheric thermodynamical forcing from -AO, +NAO, +DA, +AMO, and –PDO and by the dynamical transpolar sea ice advection and outflow driven by +DA- and +AMO-derived strong anomalous meridional winds. Further analysis, using multiple large ensembles of climate simulations and single-forcing ensembles, indicates that the mode 1 of summer sea ice, dominated by the multidecadal oscillation, is partially a forced response to anthropogenic warming.
Effect of Operating Room Personnel Generation on Perceptions and Responses to Surgeon Behavior
Authors: Luc Jessica G. Y. , Corsini Erin M. , Mitchell Kyle G. , Correa Arlene M. , Turner Nadine S. , Vaporciyan Ara A. , Antonoff Mara B.
Published: September 2021

Background

Little is known regarding the impact of operating room (OR) personnel generation on their perceptions to various surgeon behaviors. We aimed to characterize these relationships by evaluating their responses to 5 realistic intraoperative scenarios.

Methods

Operating room personnel were asked to assess surgeon OR behavior across a standardized set of 5 scenarios via an online survey. For each scenario, respondents were asked to identify the behavior as either acceptable, unacceptable but would ignore, unacceptable and would confront the surgeon, or unacceptable and would report to management. Chi-squared analyses were used to compare responses to surgeon behavior with respondent generation.

Results

There were 3101 respondents, of which 41% of respondents were baby boomers (n = 1280), 31% were generation (Gen) X (n = 955), and 28% were Gen Y (n = 866). Overall, when compared to Gen X or Gen Y, baby boomers were significantly more likely to find surgeon behaviors of impatience ( P < .001), being late for a case ( P < .001), swearing in the OR ( P < .001), and shouting with a bleeding patient ( P = .001) to be inappropriate and would talk to the surgeon. Alternatively, Gen Y respondents were more likely to find fault with surgeon behaviors that deviate from rules and regulations, such as forgetting a time-out ( P = .001), when compared to baby boomers and Gen X respondents.

Discussion

Results of our study demonstrate that OR personnel generation affects their perceptions and response to surgeon behavior. Understanding these tendencies can guide efforts to improve OR interactions among team members.
An Overview of Amish Mortalities at a Level I Trauma Center
Authors: Morgan Madison E. , Brown Catherine Ting , Whitney Larissa , Bonneville Kelly , Perea Lindsey L.
Published: September 2021

Background

The Amish population is a unique subset of patients that may require a specialized approach due to their lifestyle differences compared to the general population. With this reasoning, Amish mortalities may differ from typical trauma mortality patterns. We sought to provide an overview of Amish mortalities and hypothesized that there would be differences in injury patterns between mortalities and survivors.

Methods

All Amish trauma patients who presented and were captured by the trauma registry at our Level I trauma center over 20 years (1/2000-2004/2020) were analyzed. A retrospective chart review was subsequently performed. Patients who died were of interest to this study. Demographic and clinical variables were analyzed for the mortalities. Mortalities were then compared to Amish patients who survived.

Results

There were 1827 Amish trauma patients during the study period and, of these, 32 (1.75%) were mortalities. The top 3 mechanisms of injury leading to mortality were falls (34.4%), pedestrian struck (21.9%), and farming accidents (15.6%). Pediatric (age ≤ 14y) (25%) and geriatric (age ≥ 65y) (28.1%) had the highest percentage of mortalities. Mortalities in the Amish population were significantly older (mean age: 39 years vs 27 years, P = .003) and had significantly higher ISS (mean ISS: 29 vs 10, P < .001) compared to Amish patients who survived.

Discussion

The majority of mortalities occurred in the pediatric and geriatric age groups and were falls. Further intervention and outreach in the Amish population should be done to highlight this particular cause of mortality.

Level of Evidence

Level III, epidemiological.
Impact of a Body Mass Index Threshold on Abdominal Wall Hernia Repair at a Safety-Net Hospital
Authors: James Tayler J , Hawley Lauren , Ding Li , Alicuben Evan T , Samakar Kamran
Published: September 2021

Background

Body mass index (BMI) thresholds are utilized as a preoperative optimization strategy for obese patients prior to elective abdominal wall hernia repair. The objectives of this study were to determine the proportion of patients at our institution who ultimately underwent hernia repair after initial deferral due to BMI and to evaluate outcomes of those who required emergent repair during the deferral period.

Methods

A retrospective review was performed from 2016 to 2018 to identify all patients with abdominal wall hernias who were deferred surgery due to BMI. Patient characteristics, hernia type, change in BMI, progression to surgery, acuity of surgery (elective or emergent), and postoperative outcomes were examined.

Results

200 patients were deferred hernia repair due to BMI. Of these, 150 (75%) did not undergo repair over a mean period of 27 months. The remaining 50 patients ultimately underwent repair, 36 of which (72%) were elective and 14 (28%) emergent. The mean initial BMI of the elective group was 35.3 ± 1.8, compared to 39.1 ± 5.3 in the no surgery group and 40.6 ± 8.2 in the emergent group ( P < .01). While the elective group lost weight before surgery, the other groups did not. Patients who required emergent surgery had worse outcomes than those repaired electively.

Conclusions

Preoperative weight loss is unsuccessful in most obese patients presenting for abdominal wall hernia repair at our institution. Patients who required emergent hernia repair had worse outcomes than those who underwent elective repair. Our institution’s BMI threshold is a failed optimization strategy that needs to be reconsidered.
Role of Fracture Liaison Service Program in Reducing Refracture Rate in the Elderly Osteoporotic Trauma Patients Presenting With Vertebral Compression Fracture: A Six-Year Study
Authors: Kelm Noah , Wasfie Tarik , Volk Max , Walker Zach , Galovska Stephanija , Brock Cara , Jackson Avery
Published: September 2021

Introduction

As the elderly population of the United States and the world increases, so does the incidence of osteoporotic fragility fractures from a fall or minor injury. This results in a large cost to the health care system. This cost is further increased as more than 50% of individuals will have refractures within the first year. In order to reduce the refracture rate in such patients, we enrolled our elderly trauma patients with vertebral compression fractures and vertebral augmentation in a Fracture Liaison Service (FLS) clinic for two years and reevaluated their refracture rate.

Method

This is a retrospective analysis of 720 patients. 142 patients (Group A) were seen between 2012 and 2014 before establishing the FLS program and 578 patients (Group B) were seen between 2015 and 2020 after implementation of the FLS program. The patients enrolled in the FLS program were followed for two years after sustaining a vertebral compression fracture. The data collected included age, sex, serum calcium and vitamin D levels, dual energy X-ray absorptiometry (DXA) scan, 10-year fracture risk (FRAX) score, pressure measurements in PSI taken during vertebral augmentation, as well as the refracture rate. The data collected were analyzed and compared between the two groups using the Student’s t-test and chi-square test.

Results

There was significant reduction in the refracture rate of pre-FLS vs post-FLS vertebral, as well as other fractures in the FLS group (pre-FLS: 48.9% vs post-FLS: 37.0%; P = .01). There was no significant difference between groups A and B in regard to the mean serum level of calcium (9.44 mg/dL vs 9.53 mg/dL), vitamin D level (35.04 ng/mL vs 41.39 ng/mL), DXA scan for spine (−.52 vs −.76) and for femur (−1.77 vs −1.52), and 10-year refracture risk for osteoporotic major fracture (FRAX score-mean: 22.6% vs 19.2%) and for hip fracture (9.18% vs 7.53%). There was a significant difference in the mean age between the groups (79.5 vs 73.5 years; P = .01). Of those who underwent vertebral augmentation, 235 had Pressure Scale Index (PSI) measurements taken. There was a trend in increasing refracture rate when PSI ≤199 compared with those who had PSI ≥200, although statistical significance was not met (33.9% vs 27.0%, P = .21).

Conclusion

A Fracture Liaison Service program will improve the bone health of geriatric osteoporotic patients presenting to the trauma service with vertebral compression fractures and thus reduces the subsequent refracture rate. Further study is needed to evaluate the best PSI used to impact reduction in refracture rate.
Orocutaneous Fistula After Oral Cavity Resection and Reconstruction: Systematic Review and Meta-Analysis
Authors: Tassone Patrick , Galloway Tabitha , Dooley Laura , Zitsch Robert
Published: September 2021

Objective:

Orocutaneous fistula (OCF) after reconstruction for oral cavity resection can lead to prolonged hospitalization and adjuvant treatment delay. Few studies have examined factors leading to OCF after oral cavity resection. Primary objective: evaluate overall incidence and factors associated with OCF after oral cavity reconstruction.

Data Sources:

Scopus 1960—database was searched for terms: “orocutaneous fistula,” “oro cutaneous fistula,” “oral cutaneous fistula,” “orocervical fistula,” “oral cavity salivary fistula.”

Review Methods:

English language studies with >5 patients undergoing reconstruction after oral cavity cancer resection were included. About 1057 records initially screened; 214 full texts assessed; 78 full-texts included. PRISMA guidelines were followed, and MINORS criteria used to assess risk of bias. Data were pooled using random-effects model. Primary outcome was OCF incidence. Meta-analysis to determine the effect of preoperative radiation on OCF conducted on 12 eligible studies. Pre-collection hypothesis was that prior radiation therapy is associated with increased OCF incidence. Post-collection analyses: free versus pedicled flaps; mandible-sparing versus segmental mandibulectomy.

Results:

Seventy-eight studies were included in meta-analysis of overall OCF incidence. Pooled effect size showed overall incidence of OCF to be 7.71% (95% CI, 6.28%-9.13%) among 5400 patients. Meta-analysis of preoperative radiation therapy on OCF showed a pooled odds ratio of 1.68 (95% CI, 0.93-3.06). OCF incidence was similar between patients undergoing free versus pedicled reconstruction, or segmental mandibulectomy versus mandible-sparing resection.

Conclusion:

Orocutaneous fistula after oral cavity resection has significant incidence and clinical impact. Risk of OCF persists despite advances in reconstructive options; there is a trend toward higher risk after prior radiation.
Videofluoroscopic Swallow Studies and Diagnostic Outcomes in Otherwise Healthy Infants With Dysphagia
Authors: Shih Michael C. , Rappazzo Christina , Hudson Caroline , Ongkasuwan Julina
Published: September 2021

Objectives:

To evaluate videofluoroscopic swallow study (VFSS) findings in infants with dysphagia and without prior diagnoses, and to characterize the outcomes and any diagnoses that follow.

Methods:

A chart review of all pediatric patients who received a VFSS at a tertiary children’s hospital from November 2008 to March 2017 was performed.

Results:

There were 106 infants (57 males and 49 females) with 108 VFSS. VFSS was normal in 18 (16.98%) infants. Regarding airway protection, 50 (47.17%) infants had laryngeal penetration, and 8 (7.55%) had tracheal aspiration; 3 (2.83%, 37.5% of all aspirators) exhibited silent aspiration. Of the 75 infants with minimum 2-year follow-up, 35 (46.67%) had no sequelae of disease and received no diagnoses. The most common diagnoses and pathologic sequelae were gastroesophageal reflux (n = 18, 24.00%), asthma (n = 8, 10.67%), laryngomalacia (n = 6, 8.00%), and tracheomalacia (n = 4, 5.33%), all consistent with United States pediatric data on prevalence. All infants (n = 51) with follow-up for dysphagia had resolution of symptoms within 9 months from VFSS order date.

Conclusions:

Otherwise healthy infants may show signs of dysphagia and not develop later illness. Parents can thus be counseled on the implications of dysphagia in a previously healthy infant. Our findings provide comparative statistics for future research in pediatric dysphagia.
Statehood and recognition in world politics: Towards a critical research agenda
Authors: Visoka Gëzim
Published: September 2021

This article offers a critical outlook on existing debates on state recognition and proposes future research directions. It argues that existing knowledge on state recognition and the dominant discourses, norms and practices needs to be problematized and freed from power-driven, conservative, positivist and legal interpretations and reoriented in new directions in order to generate more critical, contextual and emancipatory knowledge. The article proposes two major areas for future research on state recognition, which should: (a) expose the politics of knowledge, and positionality, and seek epistemic justice and decolonization of state recognition studies; and (b) study more thoroughly recognitionality techniques encompassing diplomatic discourses, performances and entangled agencies. Accordingly, this article seeks to promote a long overdue debate on the need for re-visioning state recognition in world politics.
The Restorative Justice Attitudes Scale: Development and Initial Psychometric Evaluation
Authors: Taylor Terrill O. , Bailey Tamba-Kuii M.
Published: September 2021

Restorative justice as an applied and theoretical construct has received growing public attention; yet, little research on restorative justice has been conducted within psychology, including counseling psychology—a subfield devoted to social justice, advocacy, and the promotion of human rights and dignity for all people. This may in part be due to the lack of established empirical measurement concerning restorative justice. We developed the Restorative Justice Attitudes Scale (RJAS) using data collected from 650 US adults. Exploratory analyses yielded a 5-factor structure composed of 20 items within five dimensions: (a) Empathic Understanding, (b) Harm and Needs, (c) Restoration Processes, (d) Accountability, and (e) Community Engagement. However, confirmatory analyses suggested the use of a total scale score. Evidence of construct validity was established as the RJAS score was related to measures of empathy and perspective-taking. We discuss implications for the use of the RJAS in practice, advocacy, education, training, and research.
Mental health and wellbeing among Iranian medical students: a descriptive study
Authors: Ashrafi Agaah , Kadhum Murtaza , Molodynski Andrew , Bhugra Dinesh
Published: September 2021

Background:

The psychological wellbeing and stresses on medical students are currently under a global spotlight. Under a wider initiative supported by the British Medical Association (BMA), international surveys have been conducted to understand and begin to tackle these issues.

Method:

This study aimed at describing the mental wellbeing and levels of burnout of Iranian medical students. A total of 179 medical students from 19 different cities participated voluntarily in the survey by answering an online questionnaire between April and August 2020. We detected a trend toward higher prevalence of psychiatric disorders (namely depressive disorders) and substance misuse when compared to previous national studies.

Results:

About 6% of students screened positive for alcohol problems with the CAGE questionnaire. About 77% of medical students screened positive for mental health problems with the GHQ12 questionnaire. Very high rates of burnout were also reported. These findings emphasize the urgent need to define methods to screen at risk medical students and implement local and national initiatives to curtain their potential detrimental effects.
Why Does the Common Law Conform to the Constitution?
Authors: Sheppard Joshua
Published: September 2021

The High Court has often said that the common law must conform to the Constitution. The High Court has not completely explained why this is so. This requirement is not explicitly mentioned anywhere in the Constitution itself. A number of scholars have suggested possible answers. One is that the Constitution is the supreme law and binding on everyone. Another suggestion has been that the common law must conform because the Constitution constrains ‘state action’: something more than just an exercise of constitutionally conferred power. This latter explanation appears to deviate from the High Court's exposition of the common law's relationship with the Constitution in Lange v Australian Broadcasting Commission. This article suggests that the Constitution has a broader application to the common law, in that it constrains all uses of judicial power, not just those that are considered to be ‘state action’. It contends that it is implicit in s 71 of the Constitution that the power to develop the common law yields to constitutional imperatives. This theory is more descriptively consistent with the High Court's practice and observations about the relationship between the common law and the Constitution.
Using cultural hybridity as an analytic lens for missiological research
Authors: Lee Peter T.
Published: September 2021

This article considers cultural hybridity as a concept that helps interpret complex social phenomena found in various intercultural contexts in missions. The concept of cultural hybridity is better used as an analytic tool rather than an object of analysis in order for it to have an interpretive power. Adopting cultural hybridity in missiological research requires focusing on its active, dynamic, and processual nature found in the verb form, “hybridization,” rather than a stationary concept depicted by the noun form, “hybridity.” When using cultural hybridity in empirical studies, the mission researcher needs to develop a framework using the concept by immersing in the prior and current scholarly discussions, analyze social processes at multiple levels, utilize the hybridity theory in conjunction with other relevant social theories, and close the gap between the theory and data by focusing on how things work rather than forcing meanings out of the data. These practices may aid missiologists in their empirical research and increase their understanding of challenging intercultural issues.
Applicability of a sheep model for training in plastic surgery of eyelids and orbit
Authors: Isaacson Glenn , Wulc Allan E.
Published: September 2021

Objective

To test the applicability of a fresh tissue model for teaching facial plastic techniques and approaches to the eyelids and orbit.

Design

Observational animal experiments.

Subjects

Ten prepubescent sheep heads harvested following humane euthanasia at the completion of unrelated live animal research.

Methods

Young sheep were saline perfused at the end of an in vivo protocol. Head and neck tissues were harvested and refrigerated for 3–7 days. An experienced oculoplastic surgeon and an otolaryngologist explored the feasibility of common oculoplastic procedures in the ovine model.

Results

The model has potential for teaching basic principles in eyelid surgery including upper lid blepharoplasty, aponeurotic ptosis repair, upper lid gold weight lid loading for facial paralysis, lateral canthotomy and inferior limb cantholysis, lower lid tightening, and transconjunctival approach to the orbital floor. Eye muscle advancement, optic nerve sheath fenestration, and enucleation also accurately simulated human surgery. Anatomic variations limit the sheep model for orbital floor reconstruction and lacrimal drainage procedures.

Conclusions

The sheep head and neck provide an inexpensive, safe model for developing skills in several oculoplastic procedures. Formal simulation testing is needed to confirm these expert opinions.
Patterns and Processes of Intergenerational Estrangement: A Qualitative Study of Mother–Adult Child Relationships Across Time
Authors: Gilligan Megan , Suitor J. Jill , Pillemer Karl
Published: September 2021

Drawing from the life course perspective, we explored patterns of estrangement between mothers and their adult children across time, and the processes through which these ties remained estranged, or moved in or out of estrangement. We used a prospective design in which data were collected in face-to-face semi-structured interviews with 61 older mothers about their relationships with their 274 adult children at two time points 7 years apart. We began by examining the patterns of stability and change in intergenerational estrangement and identified movement in and out of estrangement across time. Qualitative analyses of the processes underlying estrangement revealed that movement in and out of estrangement reflected nuanced changes in contact and closeness over time rather than abrupt changes resulting from recent transitions in either mothers’ or children’s lives. Taken together, these findings illustrate the complexity of patterns and processes of intergenerational estrangement in later-life families.
A Mixed-Methods Feasibility Study of Breastfeeding Attitudes among Southern African Americans
Authors: Felder Tisha M. , Cayir Ebru , Nkwonta Chigozie A. , Tucker Curisa M. , Harris Eboni H. , Jackson Joynelle Rivers
Published: September 2021

We assessed the feasibility and acceptability of examining breast/chest feeding attitudes among African Americans in South Carolina using an explanatory sequential, mixed methods approach. We surveyed 50 pregnant African American women during their ob-gyn appointment (Phase I), followed by qualitative interviews with four African American couples ( N = 8) (Phase II), and integrating quantitative–qualitative data through joint display (Phase III). Phase I supported the feasibility of recruiting pregnant African American women for our study. However, for Phase II, more research is needed to support the feasibility of recruiting couples from the quantitative phase. The Iowa Infant Feeding Attitude Scale demonstrated moderate reliability (α = 0.68). Participants intending to exclusively breastfeed ( M = 65, SD = 5.79) had higher scores than those intending to exclusively use formula ( M = 50, SD = 4.37, p < .001). The six qualitative themes (Phase II) and data integration (Phase III) identified cultural considerations for future research.
Degrading Bodies in Pandemic Times: Politicizing Cruelty During the COVID-19 and Obesity Crises
Authors: Monaghan Lee F.
Published: September 2021

Mass communications frame fatness and COVID-19 as a dual threat. This discourse furthers well-established tendencies to degrade bodies labelled overweight or obese, positioning them as deficient and requiring correction. Empirically, this article draws from an online US right-wing news media platform, Campus Reform, including readers’ comments (n = 135) on an article denouncing professors working in fat studies during the COVID-19 lockdown. This status degradation ceremony—backed by ‘big money’ that funds campus culture wars—not only targeted fat people but also academic disciplines, expertise, universities and social justice agenda. Analytically, this study draws from ethnomethodology and literature on media and bodyweight, meddling or health fascism, weaponized stigma and the politics of cruelty. Going beyond the flesh and a particular case study, it also challenges the ways in which cruelty enacted towards those deemed fat (especially women) can spiral into corrosive nationalist discourse in pandemic times.
Validation of the Tactual Span in individuals with congenital and acquired blindness
Authors: Heled Eyal , Oshri Or
Published: September 2021

Neuropsychological assessment tools for individuals with blindness are relatively scarce. In the current study, we assessed the validity of the Tactual Span, a task aimed at evaluating tactile working memory. During the task, the fingers of both hands are touched in specific sequences of ascending difficulty, which participants are asked to repeat in exact and reverse order. Twelve participants with congenital blindness and 13 with acquired blindness were examined alongside 18 sighted controls, matched to the experimental group with respect to age and education. Participants performed the Tactual Span and three additional tasks assessing working memory in the auditory modality, as well as a Semantic Fluency test. Results showed that the Tactual Span was significantly correlated with most of the other working memory measures, in all groups, but not with the Semantic Fluency test. In addition, the congenital and acquired blindness groups performed similarly to one another and better than sighted controls on most working memory tasks, but not on the Semantic Fluency test. Findings suggest that the Tactual Span is a feasible task for measuring tactile working memory in individuals with congenital and acquired blindness. Therefore, it can expand the cognitive assessment toolbox of professionals working with blind individuals and increase the strength of conclusions drawn from cognitive assessments in educational and vocational settings.
A review of bioeffects induced by focused ultrasound combined with microbubbles on the neurovascular unit
Authors: Chen Si , Nazeri Arash , Baek Hongchae , Ye Dezhuang , Yang Yaoheng , Yuan Jinyun , Rubin Joshua B , Chen Hong
Published: September 2021

Focused ultrasound combined with circulating microbubbles (FUS+MB) can transiently enhance blood-brain barrier (BBB) permeability at targeted brain locations. Its great promise in improving drug delivery to the brain is reflected by a rapidly growing number of clinical trials using FUS+MB to treat various brain diseases. As the clinical applications of FUS+MB continue to expand, it is critical to have a better understanding of the molecular and cellular effects induced by FUS+MB to enhance the efficacy of current treatment and enable the discovery of new therapeutic strategies. Existing studies primarily focus on FUS+MB-induced effects on brain endothelial cells, the major cellular component of BBB. However, bioeffects induced by FUS+MB expand beyond the BBB to cells surrounding blood vessels, including astrocytes, microglia, and neurons. Together these cell types comprise the neurovascular unit (NVU). In this review, we examine cell-type-specific bioeffects of FUS+MB on different NVU components, including enhanced permeability in endothelial cells, activation of astrocytes and microglia, as well as increased intraneuron protein metabolism and neuronal activity. Finally, we discuss knowledge gaps that must be addressed to further advance clinical applications of FUS+MB.
Real-time recognition of team behaviors by multisensory graph-embedded robot learning
Authors: Reily Brian , Gao Peng , Han Fei , Wang Hua , Zhang Hao
Published: September 2021

Awareness of team behaviors (e.g., individual activities and team intents) plays a critical role in human–robot teaming. Autonomous robots need to be aware of the overall intent of the team they are collaborating with in order to effectively aid their human peers or augment the team’s capabilities. Team intents encode the goal of the team, which cannot be simply identified from a collection of individual activities. Instead, teammate relationships must also be encoded for team intent recognition. In this article, we introduce a novel representation learning approach to recognizing team intent awareness in real-time, based upon both individual human activities and the relationship between human peers in the team. Our approach formulates the task of robot learning for team intent recognition as a joint regularized optimization problem, which encodes individual activities as latent variables and represents teammate relationships through graph embedding. In addition, we design a new algorithm to efficiently solve the formulated regularized optimization problem, which possesses a theoretical guarantee to converge to the optimal solution. To evaluate our approach’s performance on team intent recognition, we test our approach on a public benchmark group activity dataset and a multisensory underground search and rescue team behavior dataset newly collected from robots in an underground environment, as well as perform a proof-of-concept case study on a physical robot. The experimental results have demonstrated both the superior accuracy of our proposed approach and its suitability for real-time applications on mobile robots.
The NLRP3 inflammasome mediates liver failure by activating procaspase-1 and pro-IL-1 β and regulating downstream CD40-CD40L signaling
Authors: Li Zenghui , Jiang Jianning
Published: September 2021

Objectives

In this prospective case–control study, we explored the regulatory roles of the NLRP3 inflammasome in hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF).

Methods

Thirty patients with HBV-ACLF, 30 patients with chronic hepatitis B, and 30 healthy individuals were enrolled. Real-time reverse transcription polymerase chain reaction was used to assess mRNA levels in peripheral blood mononuclear cells and serum protein levels were assessed by enzyme-linked immunosorbent assay.

Results

Serum levels of alanine aminotransferase, asparagine aminotransferase, total bilirubin, and direct bilirubin in patients with HBV-ACLF were increased. Transcript levels of NLRP3 and ASC and protein levels of interleukin (IL)-1β, IL-18, and sCD40L were elevated in patients with HBV-ACLF. Expression of the NLRP3 inflammasome signaling pathway components procaspase-1 and pro-IL-1β was elevated in patients with HBV-ACLF.

Conclusions

This prospective case-control study demonstrated that significant activation of the NLRP3 inflammasome occurs in patients with HBV-ACLF. The activated NLRP3 inflammasome mediated liver failure by stimulating procaspase-1 and pro-IL-1 β and regulating downstream CD40-CD40L signaling.