bluuebunny/crossref_metadata_2025 huggingface dataset:
A Smaller Tibiotalar Sector Is a Risk Factor for Recurrent Anterolateral Ankle Instability after a Modified Broström-Gould Procedure
Authors: Zendeli Flamur , Pflüger Patrick , Viehöfer Arnd F. , Hodel Sandro , Wirth Stephan H. , Farshad Mazda , Weigelt Lizzy
Published: February 2024

Background:

Several demographic and clinical risk factors for recurrent ankle instability have been described. The main objective of this study was to investigate the potential influence of morphologic characteristics of the ankle joint on the occurrence of recurrent instability and the functional outcomes following a modified Broström-Gould procedure for chronic lateral ankle instability.

Methods:

Fifty-eight ankles from 58 patients (28 males and 30 females) undergoing a modified Broström-Gould procedure for chronic lateral ankle instability between January 2014 and July 2021 were available for clinical and radiological evaluation. Based on the preoperative radiographs, the following radiographic parameters were measured: talar width (TW), tibial anterior surface (TAS) angle, talar height (TH), talar radius (TR), tibiotalar sector (TTS), and tibial lateral surface (TLS) angle. The history of recurrent ankle instability and the functional outcome using the Karlsson Score were assessed after a minimum follow-up of 2 years.

Results:

Recurrent ankle instability was reported in 14 patients (24%). The TTS was significantly lower in patients with recurrent ankle instability (69.8 degrees vs 79.3 degrees) ( P < .00001). The multivariate logistic regression model confirmed the TTS as an independent risk factor for recurrent ankle instability (OR = 1.64) ( P = .003). The receiver operating characteristic curve analysis revealed that patients with a TTS lower than 72 degrees (=low-TTS group) had an 82-fold increased risk for recurrent ankle instability ( P = .001). The low-TTS group showed a significantly higher rate of recurrent instability (58% vs 8%; P = .0001) and a significantly lower Karlsson score (65 points vs 85 points; P < .00001).

Conclusion:

A smaller TTS was found to be an independent risk factor for recurrent ankle instability and led to poorer functional outcomes after a modified Broström-Gould procedure.

Level of Evidence:

Level IV, retrospective cohort study.
Linear matrix inequality-based vibration control of three-dimensional Euler–Bernoulli beam with external disturbance
Authors: Ji Jiewen , Liu Jinkun , Sun Lin
Published: February 2024

In this paper, we address the LMI-based vibration control problem of a three-dimensional Euler–Bernoulli beam subject to external disturbance. First, the dynamics of the system is characterized by several partial differential equations (PDEs). Second, in order to realize the disturbance rejection, we propose the disturbance observers. Based on these, the boundary control protocols are designed via linear matrix inequality (LMI) method for suppressing elastic vibration. A significant feature of LMI is that the control gains can be efficiently solved by this method. Finally, some simulation examples illustrate the effectiveness of the proposed theoretical results.
Personality Traits of Creative Advertising Professionals
Authors: Devlin Michael B.
Published: February 2024

Within the evolving landscape of advertising, educators and employers continuously strive to recognize students and potential employees for every competitive advantage. Creativity, a pivotal determinant of campaign effectiveness, has been recognized as the foremost soft skill sought by employers according to LinkedIn. Grounded in trait theory, this paper posits that personality serves as a crucial tool for educators and employers in identifying individuals predisposed to a career in creative advertising and delineates personality traits that are predictive of an individual’s propensity to engage in creative advertising. This not only bridges the gap between personality and advertising practices but also offers empirical insights that could inform educational strategies and recruitment processes. Thus, it contributes a novel perspective to the discourse on talent identification and development in the creative advertising domain. Lastly, this study utilizes HEXACO Personality Inventory, an advancement from models such as the Big-5 to advance trait theory research.
Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study
Authors: Ramezanzadeh Hamed , Khosravi Navid , Hosseininejad Seyed Mohammad , Mahmoodi Mahboobe , Zakariaei Zakaria , Sadeghi Mahdieh
Published: February 2024

Opioids are a class of drugs that are commonly used to manage pain due to their analgesic and sedative effects. However, the high consumption of opioids in the community has led to an increase in the incidence of overdoses and poisonings caused by various types of these drugs, whether intentional or unintentional. Therefore, comprehending the epidemiological features of patients experiencing opioid poisoning is crucial. We decided to investigate various epidemiological aspects of patients with opioid poisoning in the Mazandaran province, located in northern Iran, during the period of 2020 to 2021. The present investigation was conducted as a descriptive cross-sectional study, wherein we collected data on patients registered in the Mazandaran Registry Center of Opioid Poisoning (MRCOP) who had a history of using any kind of opioid. We collected information on various parameters, including patient demographics, the type of opioid consumed, the mode of consumption, and clinical outcomes. A total of 240 patients were initially registered at the registry center. However, 17 cases were excluded with personal consent, and eventually, a total of 223 patients were included in the investigation. The majority of the patients 70.9% (n = 158) were male, and the average age was 34.4 ± 16.55 years. The most common cause of poisoning reported in our study was intentional, which was mainly due to a suicide attempt. Furthermore, the most prevalent type of opioid consumed was methadone. The most frequently observed symptoms of poisoning among the patients were drowsiness, a decreased level of consciousness, and reduced arterial oxygen saturation levels. Based on the results of our study, several factors were found to be significant in methadone poisoning, including addiction, age, gender, suicide attempt, and a history of psychiatric disorder. These findings highlight the need for public education and awareness campaigns on the risks associated with opioid use, particularly methadone.
Impact of comorbid opioid use disorder and major depressive disorder on healthcare utilization outcomes in patients with peripheral artery disease: A National Readmission Database analysis
Authors: Amenyedor Kelvin , Lee Megan , Algara Miguel , Siddiqui Waleed Tariq , Hardt Madeleine , Romain Gaëlle , Mena-Hurtado Carlos , Smolderen Kim G
Published: February 2024

Background:

Prior research has demonstrated that individuals with peripheral artery disease (PAD) often have comorbid opioid use disorder (OUD) and major depressive disorder (MDD), with limited data regarding their impact on readmission outcomes, length of stay, and cost. This study aimed to investigate these healthcare utilization outcomes in patients with PAD who have comorbid OUD and MDD.

Methods:

Data were obtained from the National Readmission Database from 2011 through 2018. The study population included all hospitalizations with PAD as the primary or secondary diagnosis, from which hospitalizations with OUD and MDD were extracted using appropriate ICD-9/10 diagnosis codes. Primary outcomes were 30-day and 90-day readmission, total cost, and total length of stay within the calendar year. We created hierarchical multivariable logistic regression models examining OUD with and without MDD, with a random effect for healthcare facility location.

Results:

From 2011 to 2018, 13,265,817 weighted admissions with PAD were identified. These admissions were segmented into four categories: No OUD/No MDD (12,056,466), OUD/No MDD (323,762), No OUD/MDD (867,641), and OUD/MDD (17,948). The group with No OUD/No MDD was used as the reference group for all subsequent comparisons. Regarding 30-day and 90-day readmissions, patients with OUD/MDD had odds of 1.14 (95% CI 1.10, 1.18) and 1.09 (95% CI 1.06, 1.13), respectively. Patients with OUD/No MDD bore the highest median cost of $64,354 (IQR $30,797–137,074), and patients with OUD/MDD marked the lengthiest median stay of 6.01 days (IQR 2.01–13.30).

Conclusion:

This study found a significant association between these comorbidities and outcomes and therefore calls for targeted interventions and pain management strategies.
Social media shaping autism perception and identity
Authors: Skafle Ingjerd , Gabarron Elia , Nordahl-Hansen Anders
Published: February 2024

The aim of this study was to explore how autistic adults experienced using social media to find information about autism, and how they experienced online autistic communities. There is little research on the rationale why autistic people look for information on autism via social media, and on how such information is perceived from an autistic viewpoint. Twelve Norwegian autistic adults (aged 18–49 years) completed semi-structured interviews where they discussed social media and content specifically about autism and online autistic communities. Using reflexive thematic analysis, three main themes were developed. The themes were (1) Representation and Identity: An Online Journey; (2) An Unreliable, but Necessary Tool; and (3) Tensions and Discord. The findings indicated that even though social media was looked upon as an unreliable information source, the participants found information that helped them to learn about their experiences which had not been fully captured by the majority of the current research literature and online health sites. Also, social media groups for autistic people did not necessarily create a sense of community, as participants reported feeling alienated by hostile discussions. This study highlights the importance of having a greater variation and availability of information about autism online through official health channels.

Lay abstract

This study suggested that social media can provide important information about autism to autistic people. We interviewed 12 autistic adults (aged 18–49 years) and talked to them about the use of social media to find both general information and content specifically about autism, autism identity and online autistic communities. There is little research exploring how autistic people find information about autism on social media and how that makes them feel. Therefore, it is important to ask autistic people about their experiences with using social media to obtain content about autism. The 12 participants explained that when they searched for information about autism on the official health pages, they often felt that the information they found was insufficient and could not answer their questions. In addition, they searched on social media platforms for information about autism despite that they perceived social media as an unreliable source. On the social media platforms, many found content that was positive in relation to their autistic identities. The participants also found comfort in some of the forums and social media groups and received helpful advice. Nevertheless, some of the discussions were aggressive and the participants felt alienated, which did not provide a sense of community online. The findings from the study may advice on what is missing in the official pages about autism, and highlight the need to involve the autistic community in writing the content on such platforms.
Work ability trends 2000–2020 and birth-cohort projections until 2040 in Finland
Authors: Lahti Jouni , Reinikainen Jaakko , Kontto Jukka , Zhou Zhi , Koskinen Seppo , Laaksonen Mikko , Partonen Timo , Elonheimo Hanna , Lundqvist Annamari , Tolonen Hanna
Published: February 2024

Aims: To examine age-group and birth-cohort trends in perceived work ability in Finland in 2000–2020 and make projections of perceived work ability up to 2040 based on the observed birth-cohort development. Methods: Ten population-representative cross-sectional surveys conducted in Finland between 2000 and 2020 were used (overall N = 61,087, range 817–18,956). Self-reported estimates of current work ability in relation to the person’s lifetime best on a scale from zero to ten (0–10) were classified into three groups: limited (0–5), intermediate (6–7), and good (8–10). Multiple imputation was used in projecting work ability. Results: Examining past trends by 5-year birth-cohorts born between 1961 and 1995 showed that work ability has declined steadily over time among older birth-cohorts, while in the two younger cohorts a stable development before 2017 and a steep decline between 2017 and 2020 was seen. Trends by 5-year age groups showed a declining trend of good work ability among 20–44-year-olds, a stable trend among 45–54-year-olds, and an improving trend among 55-year-olds and older was observed for the period 2000–2020. Among the under 55-year-olds the prevalence of good work ability ended up around 75% and at 68% among the 55–59-year-olds, 58% among the 60–69-year-olds and 49% among the 70–74-year-olds in 2020. Birth-cohort projections suggested a declining work ability in the future among all age groups included (30–74 years). By 2040, the prevalence of good work ability is projected to decline by 10 to 15 percentage points among 45–74-year-olds. Conclusions: The projections suggest declining work ability in the future. Efforts to counteract the decline in work ability are needed.
Technology is a wish your heart makes: How Disney harnesses practical magic discourse to legitimize MyMagic+
Authors: Cotter Kelley , Kumar Priya , De Ankolika , Tan Ryan
Published: February 2024

This article explores how Disney employs magical discourse to legitimize its MyMagic+ system. Through an analysis of the Disney Parks blog, we introduce the concept practical magic discourse, which entices users to indulge in the fantasy of transcending the constraints of reality, while obscuring the labor involved in the system’s development and maintenance. Practical magic discourse differs from existing conceptualizations of magical discourse, emphasizing experiential aspects of technology rather than capabilities; its mundane, rather than grandiose aesthetic; and individual level, rather than societal effects. Like existing conceptualizations, it is performative in willing a particular kind of relationship with a technology. Consequently, it holds the potential to enhance the allure of data-intensive systems, while diverting attention away from negative consequences. We discuss implications of practical magic discourse and underscore the need for critical examination of the enchanting narratives surrounding technological advancements beyond the realm of Big Tech.
Geek nostalgia: The reflective and restorative defence of white male geek culture
Authors: Ottemo Andreas , Berge Maria , Mendick Heather , Silfver Eva
Published: February 2024

During recent decades, geek culture has become increasingly visible, and the geek has left the cultural margins, becoming more popular than ever. At the same time, nostalgia has emerged as a central component of geek culture. Framed by a post-structural understanding of gender and race and drawing on cultural theorist Svetlana Boym’s distinction between reflective and restorative nostalgia, this article explores how and why geeks nostalgically long for a time when they were largely marginalized. We combine readings of Swedish online geek podcasts and YouTube channels with ethnographic visits to geek conferences and pop-cultural “geek fairs,” such as Comic Con and SciFiWorld. We argue that geek nostalgia represents a clinging on to a “constitutive wound,” allowing the geek figure to mobilize masculine victimhood in ways that simultaneously underpin geek privilege and allow the geek to continue operating as a white male gatekeeper of geek culture.
Setting the misinformation agenda: Modeling COVID-19 narratives in Twitter communities
Authors: Unlu Ali , Truong Sophie , Sawhney Nitin , Tammi Tuukka
Published: February 2024

This research investigates the dynamics of COVID-19 misinformation spread on Twitter within the unique context of Finland. Employing cutting-edge methodologies including text classification, topic modeling, social network analysis, and correspondence analysis (CA), the study analyzes 1.6 million Finnish tweets from December 2019 to October 2022. Misinformation tweets are identified through text classification and grouped into topics using BERTopic modeling. Applying the Leiden algorithm, the analysis uncovers retweet and mention networks, delineating distinct communities within each. CA determines these communities’ topical focuses, revealing how various groups prioritized different misinformation narratives throughout the pandemic. The findings demonstrate that influential, diverse communities introduce new misinformation, which then spreads to niche groups. This agenda-setting effect is amplified by social media algorithms optimized for engagement. The results provide valuable insights into how online communities shape public discourse during crises through the strategic dissemination of misinformation.
Discourse markers in small talk and tasks
Authors: Guydish Andrew J , Nguyen Allison , Fox Tree Jean E
Published: February 2024

Discourse markers help people navigate conversations. We tested how the use of five discourse markers – so, but, oh, I think, and like – was influenced by communication medium (text, phone, videoconferencing) and conversation type (task-related conversation or small talk). Additionally, we tested whether these discourse markers influenced the amount of words contributed throughout the conversation and how interlocutors felt about their conversations. These discourse markers were used more while working on a task compared to casual chat during a phone conversation, but less while working on a task compared to casual chat during instant messaging and videoconferencing conversations. We observed no relationships between discourse marker use and the amount participants contributed to their conversations, nor did we observe relationships between discourse marker use and conversational appraisals in the phone or videoconferencing conversations. We observed a trending relationship in instant messaging conversations where the more discourse markers used, the more communicators enjoyed their conversations. The work presented here expands understanding of discourse markers by documenting variation by setting and task type. The findings support the argument that discourse markers are used to negotiate conversations.
A misfire-integrated Gaussian process (MInt-GP) emulator for energy-assisted compression ignition (EACI) engines with varying cetane number jet fuels
Authors: Narayanan Sai Ranjeet , Ji Yi , Sapra Harsh Darshan , Kweon Chol-Bum Mike , Kim Kenneth S , Sun Zongxuan , Kokjohn Sage , Mak Simon , Yang Suo
Published: February 2024

For energy-assisted compression ignition (EACI) engine propulsion at high-altitude operating conditions using sustainable jet fuels with varying cetane numbers, it is essential to develop an efficient engine control system for robust and optimal operation. Control systems are typically trained using experimental data, which can be costly and time consuming to generate due to setup time of experiments, unforeseen delays/issues with manufacturing, mishaps/engine failures and the consequent repairs (which can take weeks), and errors in measurements. Computational fluid dynamics (CFD) simulations can overcome such burdens by complementing experiments with simulated data for control system training. Such simulations, however, can be computationally expensive. Existing data-driven machine learning (ML) models have shown promise for emulating the expensive CFD simulator, but encounter key limitations here due to the expensive nature of the training data and the range of differing combustion behaviors (e.g. misfires and partial/delayed ignition) observed at such broad operating conditions. We thus develop a novel physics-integrated emulator, called the Misfire-Integrated GP (MInt-GP), which integrates important auxiliary information on engine misfires within a Gaussian process surrogate model. With limited CFD training data, we show the MInt-GP model can yield reliable predictions of in-cylinder pressure evolution profiles and subsequent heat release profiles and engine CA50 predictions at a broad range of input conditions. We further demonstrate much better prediction capabilities of the MInt-GP at different combustion behaviors compared to existing data-driven ML models such as kriging and neural networks, while also observing up to 80 times computational speed-up over CFD, thus establishing its effectiveness as a tool to assist CFD for fast data generation in control system training.
Unsupervised damage assessment under varying ambient temperature based on an adjusted artificial neural network and new multivariate covariance-based distances
Authors: Nikdel Ali , Shariatmadar Hashem
Published: February 2024

Temperature variability is one of the critical environmental conditions that causes confusing changes in structural properties and dynamic responses of bridges similar to damage. In this case, false alarms and mis-detection are among the major errors in health monitoring of such civil structures. High damage detectability is another significant challenge in bridge health monitoring. To deal with these issues, this article proposes an unsupervised damage assessment technique comprising two steps of data normalization and novelty detection. For the first step, an adjusted artificial neural network is considered to remove the effects of temperature variability from dynamic features (modal frequencies). This process is carried out by an auto-associative neural network by adjusting its hidden layer neurons through a new hyperparameter selection algorithm. Using normalized features obtained from the first step, this article proposes three multivariate covariance-based distances called linear dissimilarity analysis, multivariate Kullback–Leibler divergence, and multivariate Bregman distance to compute damage indices or novelty scores for damage assessment. The fundamental principles of these distances lie in three aspects: dividing the normalized features into segments, estimating the covariances of segmented feature sets, and incorporating the estimated covariances into the proposed distance measures. The major contributions of this article include proposing three non-parametric distance measures and developing an unsupervised data normalization framework via a new hyperparameter tuning algorithm for adjusting an artificial neural network. A concrete box-girder bridge is considered to verify the proposed approach, along with several comparative studies. Results show that the method presented here can mitigate severe temperature variability and increase damage detectability with superiority over some traditional and state-of-the-art damage assessment techniques.
Effect of medium and pressure on stress corrosion cracking susceptibility of a nickel-based alloy
Authors: Chen Zhenyu , Zhu Zhongliang , Liu Ju , Li Peihan , Chen Zhangyang , Zhang Tianyi , Zhang Naiqiang
Published: February 2024

Nickel-based alloy Inconel 617 is a candidate material for advanced ultra-supercritical units. Stress corrosion cracking (SCC) susceptibility of Inconel 617 under low-pressure superheated steam (0.1 MPa), high-pressure superheated steam (8 MPa) and supercritical water (25 MPa) at 650 °C was studied through slow strain rate tensile tests at strain rate of 5 × 10−7 s−1. The results indicate that Inconel 617 is susceptible to SCC in both superheated steam and supercritical water, with susceptibility increasing with pressure. In a nitrogen atmosphere, fractures were predominantly transgranular ductile. The fracture surface featured dimples and micropores. In three corrosive environments, both intergranular and transgranular fractures were observed. The rock sugar-like morphology becomes more and more obvious as the pressure increases. A large number of cracks perpendicular to the loading axis were found on gauge surface. The SCC mechanism for Inconel 617 in superheated steam and supercritical water conditions is internal oxidation.
Rescue From Permanent Kidney Injury in Acute Thrombosis of Both Renal Veins, the Inferior Vena Cava, and Both Iliofemoral Veins by Catheter-Based Thrombectomy
Authors: Hofer Felix , Mueller Jan , Copic Dragan , Eichinger-Hasenauer Sabine , Kinstner Christian , Reider Lukas , Merrelaar Marieke , Korn Stephan , Bauer Wolfgang , Koppensteiner Renate , Aschauer Constantin , Sunder-Plassmann Gere , Schmidt Alice , Schlager Oliver
Published: February 2024

Case:

A 33-year-old man with previously diagnosed lupus membranous nephropathy presented with painful swelling in both legs. Laboratory tests revealed acute kidney injury, and imaging studies by duplex ultrasound and computed tomography scan showed acute thrombosis of both renal veins, the infrahepatic inferior vena cava, and both iliofemoral venous segments. Initially, pharmacomechanical thrombolysis led to an insufficient morphological result. The therapeutic breakthrough was achieved by catheter-based mechanical thrombectomy of the infrarenal vena cava and both renal veins, which successfully cleared all affected venous segments from thrombus, paralleled by improvement of the patient’s condition. However, after 1 week, the patient experienced recurrent thrombosis of the right renal vein with hemorrhagic infarction of the right kidney. After further optimization of immunomodulatory and antithrombotic therapy, a repeated catheter-based mechanical thrombectomy resulted in sustained clinical improvement and preservation of renal venous drainage and kidney function.

Conclusion:

Extensive acute thrombosis of both renal veins, the inferior vena cava, and both iliofemoral venous segments is a rare emergency potentially threatening kidney function. Immediate effective thrombus removal is essential to preserve kidney function and can be achieved by catheter-based mechanical thrombectomy embedded in a comprehensive immunomodulatory and antithrombotic therapeutic concept.

Clinical Impact

This case demonstrated the efficacy of a catheter-based therapeutic approach in patients with extensive thrombosis of the venous system. A catheter-based approach must be embedded in a comprehensive medical therapeutic concept, which is essential to achieve a sustainable result.
Associations Between Systolic Pressure, Vascular Waveform, and Volume Flow with Debridement or Amputation Treatment Decisions in Diabetic Foot Ulcer Patients
Authors: Darwis Patrianef , Syaifudin Ahmad , Suhartono Raden , Muradi Akhmadu , Pratama Dedy , Dewi Dian Kusuma , Hamzah Alif
Published: February 2024

Introduction

Diabetic foot ulcer disease, affecting 6.3% of the global population, necessitates crucial decisions regarding debridement and amputation, with substantial cost, morbidity, and mortality implications. This study's primary goal is to determine effective vascular examination modalities, including systolic blood pressure, vascular waveforms, and blood volume flow to guide optimal treatments for diabetic foot patients.

Method

This cross-sectional study at Cipto Mangunkusumo General Hospital aimed to identify effective vascular examination modalities, such as systolic blood pressure, vascular waveforms, and blood volume flow, to guide treatment choices for diabetic foot patients. The study included 38 subjects, equally split between debridement and amputation groups.

Results

Notably, the presence of a biphasic pattern in popliteal artery vascular examinations was associated with the decision for amputation in diabetic foot patients (p < 0.05). The Chi-square test revealed that a biphasic ultrasound pattern served as a predictive factor for amputation among diabetic foot patients, with three times more biphasic patients choosing amputation over debridement. Conversely, assessments of popliteal artery systolic pressure, common femoral artery waveform, popliteal artery volume flow, and common femoral artery volume flow showed no significant correlations with the choice of debridement or amputation treatment for diabetic foot patients.

Conclusion

In summary, ultrasound assessment of vascular waveform in the popliteal artery emerges as a predictive factor for amputation or debridement in diabetic foot patients.
Onyx®, A New Tool for Intraoperative Localization of Liver Lesions
Authors: Rubio-García J. J. , Mantilla Pinilla A. J. , Gil Sánchez S. , Villodre Tudela C. , Alcázar López C. , Melgar Requena P. , Rodríguez Laiz G. , Irurzun López J. , Ramia-Ángel J. M.
Published: February 2024

Background

Precise preoperative localization of liver tumors facilitates successful surgical procedures, Intraoperative ultrasonography is a sensitive imaging modality. However, the presence of small non-palpable isoechoic intraparenchymal lesions may be challenging intraoperatively.

Methodology and Material Description

Onyx® is a non-adhesive liquid agent comprised of ethylene-vinyl alcohol usually used dissolved in dimethyl-sulfoxide and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy and ultrasonography and a macroscopic black shape. This embolization material has been increasingly used for the embolization of intracranial arteriovenous malformations. We present the novel application of Onyx® on liver surgery.

Current Status

We present the case of a female, 55 years-old, whose medical history revealed an elective sigmoidectomy (pT3N1a). After 17 months of follow up, by PET-CT scan, the patient was diagnosed of a small intraparenchymal hypo-attenuated 13 mm tumor located at segment V consistent with metachronous colorectal liver metastasis. Open metastasectomy was performed, ultrasonography-guided Onyx® infusion was delivered the day after, intraoperative ultrasonography showed a palpable hyperechoic material with a posterior acoustic shadowing artifact around the lesion. Onyx® is a promising new tool, without any previous application on liver surgery, feasible with advantages in small not palpable intraparenchymal liver lesions.
Characteristics of successful performance support team members at the Olympic games
Authors: Burns Lauren , Stanimirovic Rosanna , Donaldson Alex
Published: February 2024

Objectives

Athletes and coaches rely on their performance support team to optimise training and competition. The specific characteristics of performance support teams that contribute to success in competition from the perspective of athletes and coaches have not been examined. Olympic gold medal winning athletes and coaches were asked about the characteristics they valued in the performance support team members who were with them at the Olympic Games. The insights shared provide important context to the role of the performance support team member, beyond technical skills, in the high-stress environment of elite sporting competition.

Methods

Concept mapping was completed online to collect, analyse, and visually represent insights from 30 Olympic gold medal winning athletes and coaches. The concept mapping focus prompt used to generate insights from participants was ‘When I reflect on my gold medal winning performance, a characteristic that I really valued within my support team was….’. Athletes then brainstormed, sorted, and rated relevant statements.

Results

Multidimensional scaling and hierarchical cluster analysis produced an 8-cluster map – Way of Working, Communication Style, Emotional Management in Competition, Teamwork, Commitment to Athlete Preparation, Professionalism, Embracing the Experience, and Equality – as the best visual representation of the way participants sorted the 49 unique brainstormed statements.

Conclusions

Olympic gold medal winning athletes and coaches prioritised ways of working, communication style, emotional management, and teamwork as the characteristics they valued most in their performance support team. These constructs, when further examined by item, encourage performance support staff to develop emotional management skills to (a) strengthen interpersonal relationships within the team, (b) enhance the working alliance with athletes and coaches, and (c) contribute to team performance overall. Concept mapping provided a structured way of collecting lived experience insights that may compliment other qualitative approaches such as structured interviews.
Shoulder arthroplasty in the management of native shoulder joint infections has a high complication rate and poor functional outcome – a systematic review
Authors: Jordan Robert W , Ahmed Imran , D’Alessandro Peter , Woodmass Jarret M , MacDonald Peter B , Malik Shahbaz S
Published: February 2024

Background

Shoulder arthroplasty is a treatment option of the sequelae of native shoulder joint infections. However, the functional outcomes and re-infection rates are unknown. The aim of this review was to analyse the outcome of shoulder arthroplasty in patients with native shoulder infections.

Methods

A review of the online databases MEDLINE and Embase was conducted according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Studies reporting either primary or secondary infections of native shoulder joints treated with any form of arthroplasty were included and appraised using the methodological index for non-randomised studies (MINORS) tool.

Results

Fourteen studies were eligible for inclusion. Mean age ranged from 56 to 72 years and the mean follow-up from 20.5 months to 8.2 years. Primary shoulder infections were present in 50 patients and secondary infections in 86. 76 patients underwent a two stage: 46 patients a single-stage procedure whilst 14 refused second-stage surgery. Mean post-operative Constant score ranged from 38 to 56.2. The overall reported re-infection rate was 2.3% and complication rate was 26%.

Conclusion

Shoulder arthroplasty in the management of either primary or secondary native shoulder infections has a high complication rate and low functional outcome but low re-infection rates at short-term follow-up.
Prognosis of patients with residual pathological disease after neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy and surgery for esophageal squamous cell carcinoma: a retrospective cohort study
Authors: Okunaka Mashiro , Kotani Daisuke , Fujiwara Hisashi , Sato Kazuma , Fujiwara Naoto , Mishima Saori , Sakashita Shingo , Yoshino Takayuki , Fujita Takeo , Kojima Takashi
Published: February 2024

Background:

Docetaxel, cisplatin, and 5-fluorouracil (DCF) combination chemotherapy has been established as one of the standard neoadjuvant therapies for locally advanced esophageal squamous cell carcinoma (ESCC). However, little is known about prognostic factors in patients with residual pathological disease after neoadjuvant DCF followed by surgery for locally advanced ESCC who are candidates for adjuvant nivolumab.

Objectives:

This study aimed to investigate prognostic factors in patients with residual pathological disease after neoadjuvant DCF chemotherapy followed by surgery for locally advanced ESCC.

Design:

This was a retrospective cohort study.

Methods:

This retrospective cohort study included patients who received neoadjuvant DCF followed by surgery for locally advanced ESCC between June 2014 and January 2020 at the National Cancer Center Hospital East.

Results:

Among a total of 210 patients, 45 patients (21.4%) achieved a pathological complete response. The 3-year disease-free survival (DFS) rate was significantly lower in patients with residual pathological disease than in those with a pathological complete response [53.5% versus 74.5%; hazard ratio (HR): 2.09, 95% confidence interval (CI): 1.16–3.77, p = 0.01]. In patients with residual pathological disease ( n = 165), multivariate analysis revealed that pathological node positivity (HR: 3.59, 95% CI: 1.92–6.71, p < 0.01), supraclavicular lymph node metastasis (HR: 2.15, 95% CI: 1.19–3.90, p = 0.01), and lymphovascular invasion (HR: 1.90, 95% CI: 1.14–3.17, p = 0.02) were significantly associated with poor DFS.

Conclusion:

In this largest-to-date cohort study, patients with residual pathological disease after neoadjuvant DCF followed by surgery for locally advanced ESCC had a poor prognosis. In these patients, pathological node positivity, including supraclavicular lymph node metastasis, and lymphovascular invasion were considered significant prognostic factors.
Enophthalmos: Historical Perspective on Definitions, Measurement Devices, and Clinical Significance
Authors: Mayo John , Schubert Warren
Published: February 2024

Assessing enophthalmos is critical in facial trauma patients, and there are many ways to do so. We have reviewed the various devices for measuring enophthalmos over the last 155 years. Knowing the benefits and drawbacks of each instrument is important in obtaining accurate results and interpreting them. We have reviewed the evolution of enophthalmos definitions and surgical indications. Although 2 mm of enophthalmos is commonly used as a cutoff for clinical significance, one should take into account individual patient factors, measurement techniques used, symptoms and/or the patient’s aesthetic concerns. The decision to operate must also be balanced with the risks of surgery, which may cause or worsen symptoms, such as diplopia, soft tissue deformities related to the surgical approach, and possibly blindness. We question whether enophthalmos greater than 2 mm should be considered the main criteria for corrective surgery.
Effects of self-avatar cast shadow and foot vibration on telepresence, virtual walking experience, and cybersickness from omnidirectional movie
Authors: Nakamura Junya , Ikei Yasushi , Kitazaki Michiteru
Published: February 2024

Human locomotion is most naturally achieved through walking, which is good for both mental and physical health. To provide a virtual walking experience to seated users, a system utilizing foot vibrations and simulated optical flow was developed. The current study sought to augment this system and examine the effect of an avatar's cast shadow and foot vibrations on the virtual walking experience and cybersickness. The omnidirectional movie and the avatar's walking animation were synchronized, with the cast shadow reflecting the avatar's movement on the ground. Twenty participants were exposed to the virtual walking in six conditions (with/without foot vibrations and no/short/long shadow) and were asked to rate their sense of telepresence, walking experience, and occurrences of cybersickness. Our findings indicate that the synchronized foot vibrations enhanced telepresence as well as self-motion, walking, and leg-action sensations, while also reducing instances of nausea and disorientation sickness. The avatar's cast shadow was found to improve telepresence and leg-action sensation, but had no impact on self-motion and walking sensation. These results suggest that observation of the self-body cast shadow does not directly improve walking sensation, but is effective in enhancing telepresence and leg-action sensation, while foot vibrations are effective in improving telepresence and walking experience and reducing instances of cybersickness.
Evaluation of the diagnostic utility of metagenomic next-generation sequencing testing for pathogen identification in infected hosts: a retrospective cohort study
Authors: Williams Austin , Webster William Zach , Cai Chao , Milgrom Alexander , Al-Hasan Majdi , Bookstaver P. Brandon
Published: February 2024

Background:

Metagenomic next-generation sequencing (mNGS) testing identifies thousands of potential pathogens in a single blood test, though data on its real-world diagnostic utility are lacking.

Objectives:

Determine the diagnostic utility of mNGS testing in practice and factors associated with high clinical utility.

Design:

Retrospective cohort study of mNGS tests ordered from June 2018 through May 2020 at a community teaching hospital.

Methods:

Tests were included if ordered for diagnostic purposes in patients with probable or high clinical suspicion of infection. Exclusions included patient expiration, hospice care, or transfer outside of the institution. Utility criteria were established a priori by the research team. Two investigators independently reviewed each test and categorized it to either high or low diagnostic utility. Reviewer discordance was referred to a third investigator. The stepwise multiple regression method was used to identify clinical factors associated with high diagnostic utility.

Results:

Among 96 individual tests from 82 unique patients, 80 tests met the inclusion criteria for analysis. At least one potential pathogen was identified in 58% of tests. Among 112 pathogens identified, there were 74 bacteria, 25 viruses, 12 fungi, and 1 protozoon. In all, 46 tests (57.5%) were determined to be of high diagnostic utility. Positive mNGS tests were identified in 36 (78.3%) and 11 (32.4%) of high and low diagnostic utility tests, respectively ( p < 0.001). Antimicrobials were changed after receiving test results in 31 (67.4%) of high utility tests and 4 (11.8%) of low utility tests ( p < 0.0001). In the multiple regression model, a positive test [odds ratio (OR) = 10.9; 95% confidence interval (CI), 3.2–44.4] and consultation with the company medical director (OR = 3.6; 95% CI, 1.1–13.7) remained significantly associated with high diagnostic utility.

Conclusion:

mNGS testing resulted in high clinical utility in most cases. Positive mNGS tests were associated with high diagnostic utility. Consultation with the Karius® medical director is recommended to maximize utility.
Metastatic gastric adenocarcinoma to the cutaneous neck and chest wall
Authors: Murphy Christina M , Wang Kevin , Wachuku Christopher , Prasad Aman , Dhawan Ishita , Morgan Eric E , Brown Katherine K , Wang Leo
Published: February 2024

This case describes an atypical cutaneous presentation of metastatic gastric carcinoma in a patient initially presenting with dysphagia and a sclerotic red plaque overlying the anterior neck and chest. Skin biopsy revealed metastatic adenocarcinoma from the upper gastrointestinal tract. Esophagogastroduodenoscopy revealed stage IV metastatic gastric adenocarcinoma. Treatment with chemotherapy was initiated.
Association between adult-onset still’s disease and COVID-19: A report of two cases and brief review
Authors: Fet-He Sarah , Ibarra Lecompte Gabriel , Quiroz Alfaro Alejandro José
Published: February 2024

Adult-onset still’s disease is a rare multisystemic autoinflammatory disorder with an estimated annual incidence of 0.16–0.62 per 100,000 individuals worldwide. It is typically considered a diagnosis of exclusion. SARS-CoV-2 is a positive-strand RNA virus that causes the acute respiratory infection known as COVID-19. Although COVID-19 predominantly affects the respiratory system, it has also been proposed as a trigger for autoimmune diseases, like adult-onset still’s disease, as both share considerable pathophysiological similarities. We report two cases of patients with adult-onset still’s disease, where COVID-19 was the most likely cause for a flare-up in the first case and the most likely trigger for adult-onset still’s disease in the second case. Although the exact mechanism is not entirely understood, the similarities between adult-onset still’s disease and COVID-19 could indicate a shared underlying mechanism explaining why COVID-19 can lead to adult-onset still’s disease or worsen its symptoms. Further research is necessary to fully comprehend the intricate connections between the two conditions and their immunological effects.
Cardiovascular Risk in Patients With Glomerular Disease: A Narrative Review of the Epidemiology, Mechanisms, Management, and Patient Priorities
Authors: Myette Robert L. , Lamarche Caroline , Odutayo Ayodele , Verdin Nancy , Canney Mark
Published: February 2024

Purpose of review:

Cardiovascular (CV) disease is a major cause of morbidity and mortality for patients with glomerular disease. Despite the fact that mechanisms underpinning CV disease risk in this population are likely distinct from other forms of kidney disease, treatment and preventive strategies tend to be extrapolated from studies of patients with undifferentiated chronic kidney disease (CKD). There is an unmet need to delineate the pathophysiology of CV disease in patients with glomerular disease, establish unique risk factors, and identify novel therapeutic targets for disease prevention. The aims of this narrative review are to summarize the existing knowledge regarding the epidemiology, molecular mechanisms, and management of CV disease in patients with common glomerular disease, highlight the patient perspective, and propose specific areas for future study.

Sources of information:

The literature for this narrative review was accessed using common research search engines, including PubMed, PubMed Central, Medline, and Google Scholar. Information for the patient perspective section was collected through iterative discussions with a patient partner.

Methods:

We reviewed the epidemiology, molecular mechanisms of disease, management approaches, and the patient perspective in relation to CV disease in patients with glomerulopathies. Throughout, we have highlighted the current knowledge and have discussed future research approaches, both clinical and translational, while integrating the patient perspective.

Key findings:

Patients with glomerular disease have significant CV disease risk driven by multifactorial, molecular mechanisms originating from their glomerular disease but complicated by existing comorbidities, kidney disease, and medication side effects. The current approach to risk stratification and treatment relies heavily on existing data from CKD patients, but this may not always be appropriate given the unique pathophysiology and mechanisms associated with CV disease risk in patients with glomerular disease. We highlight the need for ongoing glomerular disease-focused studies aimed to better delineate CV disease risk, while integrating the patient perspective.

Limitations:

This is a narrative review and does not represent a comprehensive and systematic review of the literature.