bluuebunny/crossref_metadata_2025 huggingface dataset:
Police Resilience as a Multilevel Balance: Needs and Resources for Victim Support Officers
Authors: Domínguez Ruiz Ignacio Elpidio , Rué Alèxia , Jubany Olga
Published: June 2022

Providing face-to-face support to victims entails one the most intense stress- and trauma-laden exchanges of law enforcement tasks, which frequently triggers long lasting negative effects on police officer’s psychological wellbeing. When exploring this phenomenon, police resilience is often interpreted as police officers’ and organization’s capacity to react and recover from negative experiences and impediments, and as such it may be perceived as both a trait and a trainable and promotable skill. Yet, in very recent times, police resilience has faced new or transformed challenges due to the COVID-19 pandemic, as victims, citizens, and public institutions have encountered new needs and situations. Drawing from a unique qualitative, in-depth research with police officers that provide support to victims of gender-based and domestic violence, this paper analyzes officers’ needs and challenges regarding their interactions with victims, colleagues, superiors, and other occupational demands, as they interplay into stress and trauma that may lead to burnout and compassion fatigue. Illustrated with the empirical findings of the case study of the Catalonia’s Mossos d’Esquadra police corps, the paper explores how officers negotiate individuals’ expectations, needs, and procedures signals towards potential challenges and threats to their psychological wellbeing with implications for police forces and other public and private institutions. The specific needs and demands of the participants’ policing, related to support to gender-based and domestic violence, presents an in-depth analysis of how stress and trauma are understood and experienced from the police officers’ perspectives.
Is There an Association Between Salivary Cortisol and Dropping Out of Inpatient Substance Addiction Treatments? A Prospective Repeated Measures Study
Authors: Bøhle Kari , Otterholt Eli , Bjørkly Stål
Published: June 2022

Several studies have found an association between salivary cortisol levels and dropping out of inpatient substance addiction treatment programs. The results are mixed due to variations in the study design and the lack of standardized routines for cortisol assessment. The aim of this study was to investigate whether there was (1) an association between salivary cortisol levels and dropping out from inpatient substance addiction treatments; (2) higher predictive validity for dropout in one of the cortisol indexes: Area Under the Curve with respect to ground (AUCG) or Daily Cortisol Slope (DCS); (3) an interaction effect with time for each cortisol index; and (4) different dropout rates for sex and patients in short-term versus long-term treatment programs. This was a prospective, repeated-measures observational study. Patients (n = 173) were recruited from 2 inpatient facilities in the central region of Norway between 2018 and 2021. Salivary cortisol was measured 4 times during the treatment period, with 8 samples collected over 2 consecutive days at each time point. Cortisol levels were calculated using the cortisol indices AUCG and DCS. Dropout was used as the outcome measure at each time point. Associations were calculated using a logistic linear regression. The results suggest a main effect of AUCG, whereby higher levels reduce dropout risk (OR = 0.92, P = .047). An interaction with time in treatment also revealed a higher dropout risk (OR = 1.09, P = .044) during week 4 of the treatment, depending on the AUCG. These results support using AUCG as the recommended index when assessing cortisol, and that the relationship between cortisol levels and length of treatment should be further investigated.
Determining Prognostic Factors of Disease-Free Survival in Breast Cancer Using Censored Quantile Regression
Authors: Yazdani Akram , Haghighat Shahpar
Published: June 2022

Background:

The analysis of disease-free survival and related factors leads to a better understanding of the patient’s condition and recurrence-related characteristics and provides a basis for more appropriate treatment guidance. In this study, we aimed to investigate the role of prognostic factors on disease-free survival in breast cancer with a quantile regression model.

Methods:

This retrospective study was conducted by reviewing data obtained from 2056 breast cancer patients. Age at diagnosis and education status, tumor size, lymph node ratio, tumor grade, estrogen receptor and progesterone receptor, type of surgery, use of radiotherapy, chemotherapy, and hormone therapy were the prognosis factors considered in this study. A quantile regression model was used to investigate prognostic factors of disease-free survival in breast cancer.

Results:

Disease recurrence was verified in 251 (13.9%) women, and 39 (0.02%) women died before experience recurrence. The 10th percentile of disease-free survival for patients with the hormone therapy was 23.85 months greater than patients who did not receive this treatment ( P value < .001). In the examination of the tumor size, the 10th and 20th percentiles of disease-free survival for patients with tumor size > 5 cm were 31.06 and 27 months less than patients with the tumor size < 2 cm, respectively ( P value = .006 and .021, respectively). Compared with grade 1 tumors, the 10th and 20th percentiles of disease-free survival for patients with grade 3 tumors decreased 30.11 and 38.32 months, respectively ( P value < .001 and .038, respectively). The 10th and 20th percentiles of disease-free survival decreased 28.16 and 45.32 months with a 1 unit increase in lymph node ratio, respectively ( P value = .032 and .032, respectively).

Conclusions:

Among the prognostic factors, tumor size, grade, and lymph node ratio showed a close relationship with disease-free survival in breast cancer. The findings indicated that developing public screening and educational programs through the health care system with more emphasis on low-educated women is needed among Iranian women.
Pride and promotion: Exploring relationships between national identification, destination advocacy, tourism ethnocentrism and destination image
Authors: Lever Michael W , Elliot Statia , Joppe Marion
Published: June 2022

Social media sites are an increasingly popular forum for loyal and engaged destination advocates to promote a place and encourage visitation. Motivation to advocate is related to one's identity, belonging and involvement with a place, factors of particular relevance to residents. Borrowing from the field of social psychology, this study examines the role of national identification as a determinant of residents’ destination advocacy behaviour. Adapted to a tourism context, it measures relationships between identity and advocacy for the first time. Canadian residents (n = 465) were surveyed online through Destination Canada's Facebook page, revealing that the stronger one's national identification, the more likely one is to advocate for their nation. The relationship positively impacts destination image and tourism ethnocentrism, newly identified relationships that contribute to destination marketing theory and practice. Further, it is not destination image that influences an ethnocentric sense of duty to travel within one's boundary; it is national identification.
Association of interactions between tele-critical care and bedside with length of stay and mortality
Authors: O’Shea Amy MJ , Reisinger Heather S , Panos Ralph , Goede Matt , Fortis Spyridon
Published: June 2022

Introduction

Substantial variation exists in telemedicine critical care (Tele-CC) effectiveness, which may be explained by heterogeneity in Tele-CC implementation and utilization.

Methods

We studied inpatient intensive care unit (ICU) admissions within the Veterans Health Administration from January 2005 to September 2018. Tele-CC affiliation was based on a facility's Tele-CC go-live date. Tele-CC interaction was quantified as the monthly number of video activations, recorded in the eCaremanager® (Phillips) system, per patient days. Tele-CC affiliated facilities were propensity-score matched to facilities without Tele-CC by hospital volume and average modified APACHE scores. We examined the effect of Tele-CC affiliation and the quantity of video interactions between Tele-CC and bedside on hospital outcomes.

Results

Comparing Tele-CC affiliated and control facilities, affiliated patients were, on average, younger (66.8 years vs 67.8 years; p < 0.001) and more likely to be rural residents (11.3% vs 6.5%; p < 0.001). Stratifying the Tele-CC affiliated facilities, facilities with frequent interactions care for more rural and sicker patients relative to facilities with infrequent interactions. Adjusting for patient demographics, facilities in the top tertile of interactions and propensity score matched control facilities were assessed; patients in ICU's with Tele-CC access experienced shorter ICU-specific lengths of stay (RR = 0.39; 95% CI = [0.23, 0.65]). However, when facilities in the bottom tertile and propensity score matched control facilities were assessed, no significant differences were noted in ICU length of stay.

Discussion

Tele-CC interactions may occur more frequently for higher acuity patients. Increased Tele-CC interactions may improve health outcomes for the most acute and complex ICU cases.
Adherence versus striving to adhere to vegan, vegetarian, or pescatarian diets: Applying a goal-centered, self-regulatory framework
Authors: Ruehlman Linda S , Karoly Paul
Published: June 2022

Adherence to plant-rich diets remains low despite numerous health benefits accruing to such practices. We sought to distinguish college students who report high adherence to a plant-rich diet (“Sustainers”) from those who are less successful (“Strivers”). Sustainers more strongly endorsed multiple ethical dietary motives and indicated stronger allegiance to their values compared to Strivers, who rated health reasons more highly. Sustainers scored better on seven factors relating to effective dietary goal pursuit. Results underscore the importance of motivational factors in the maintenance of plant-based eating.
Special Issue: Composite Materials
Authors: Tita Volnei , da Silva Lucas F.M.
Published: June 2022

First, the Guest Editors are grateful to all authors for their effort in writing the papers in time and acknowledge the outstanding work of all reviewers, allowing this Special Issue to be published as planned. The Guest Editors would like to thank Proceedings of the Institution of Mechanical Engineers, Part L: Journal of Materials: Design and Applications (JMDA) for the opportunity to produce this Special Issue related to the BCCM 5 – 5th Brazilian Conference on Composite Materials, which took place in virtual format from January18th to 22nd 2021, in Sao Carlos, Sao Paulo, Brazil.
Numerical study on the influence of process parameters in direct ink writing of high viscosity bio-inks
Authors: Loghman Fatemeh , Kami Abdolvahed , Azami Mahmoud , Abedini Vahid
Published: June 2022

This study uses a computational fluid dynamics model to investigate the effect of direct ink writing process parameters on the quality of 3D-printed sedimentary materials. The numerical simulation employs the level-set method of the two-phase flow module of COMSOL Multiphysics software. The selected bio-ink consists of the powder portion (45s5 bio-glass and β-TCP nanoparticles) and the polymer portion (polyvinyl alcohol), which has applications in constructing biological bone scaffolds. First, the empirical results validate the extrudate shape obtained from numerical simulation. According to the observations, increasing the inlet velocity from 15 mm/s increased the extruded ink distortion, and finally, at 50 mm/s, the distortion reached its maximum. Secondly, after calibration and validation results, the role of the most common nozzles with different diameters and input speeds on the maximum ink output velocity of the nozzle is predicted. Finally, the influence of the two dimensionless parameters (the ratio of the distance between nozzle and bed to nozzle diameter and the ratio of inlet ink velocity to print speed) on the adhesion and shape of the printed layers is examined. At distances greater than 1.5 times the diameter of the nozzle, when the extrusion speed is greater (more than 1.5 times) relative to the linear speed of the nozzle, the printed filament becomes uneven. Reducing the speed ratio between 1× and 1.5× prevents the printed filament from sticking to the substrate or causing distortion.
2 Txt or Not 2 Txt?: Examining Student Interaction via Text and Its Influence on Students’ Intent to Persist
Authors: Otto Andrew
Published: June 2022

Texting is a universal form of communication used by traditional undergraduate students. Its influence on higher education cannot be understated, particularly as it pertains to institutional retention efforts. Communication with an academic advisor has been shown to impact student persistence and retention. Tinto’s theory of student departure posits student persistence is the result of a longitudinal process emphasizing student integration within an institution’s social and academic settings. Student interactions with academic advisors warrant further research given the advisor’s contribution to student integration. Traditional undergraduate students, age 18–24, were surveyed to examine the impact texting with an academic advisor had on a student’s intent to persist. Results indicate a significant, positive correlation exists between a student’s interaction with an academic advisor via text and their intent to persist. Texting, because of its prevalence, warrants consideration in strategic outreach efforts within the academic advising function to positively impact an institution’s retention efforts.
G-protein Coupled Receptor 34 Promotes Gliomagenesis by Inducing Proliferation and Malignant Phenotype via TGF-Beta/Smad Signaling Pathway
Authors: Cheng Yanhao , Heng Xueyuan , Feng Fan
Published: June 2022

Background: G-protein coupled receptor 34 (GPR34) is involved in cell motility, differentiation, and mitosis. GPR34 was reported to be highly expressed and play an oncogenic role in several solid tumors. Here, we investigated the mechanisms underlying how GPR34 promotes glioma progression. Methods: Bioinformatic analysis was performed on RNA-seq and clinical data from the gene expression omnibus (GEO), cancer genome atlas (TCGA), and Genotype-Tissue Expression (GTEx) databases. TIMER database and single-sample GSEA (ssGAEA) method were used to investigate the association between the GPR34 expression and immune infiltration level in glioma. Cox regression analysis was employed to ascertain whether the risk signature was an independent prognostic indicator for glioma. The viability and migratory/invasive potential of glioma cells were assessed using Cell Counting Kit-8, colony formation, wound healing, and Transwell assays. Results: We found that GPR34 expression was positively correlated with immune infiltration level and that high GPR34 level may be associated with poor prognosis in glioma. We further found that GPR34 may serve as an independent prognostic marker and prediction factor for the clinicopathological features of glioma. We showed that knocking down GPR34 attenuated the viability and migratory/invasive capacity of glioma cells (U251 and LN229), while GPR34 overexpression exerted the opposite effects. Additionally, core enrichment in the GSEA analysis indicated that GPR34-mediated gliomagenesis was associated with the cell cycle arrest, epithelial–mesenchymal transition (EMT), and activation of the TGF-β/Smad pathway; furthermore, inhibiting TGF-β/Smad signaling using LY2157299, a TGF-β inhibitor, reversed the oncogenic effects and malignant phenotype associated with GPR34 overexpression. Conclusion: GPR34 enhances the malignancy and carcinogenesis of glioma by promoting an EMT-like process, G1/S phase cell cycle transition, and TGF-β/Smad signaling. Accordingly, GPR34 likely functions as an oncogene in glioma and may represent a potential therapeutic target for this cancer.
The Acute Toxicities and Efficacy of Concurrent Chemotherapy With Docetaxel Plus Cisplatin, or Docetaxel, or Cisplatin and Helical Tomotherapy in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma: A Randomized Single-Center Phase II Trial
Authors: Luo Yanrong , Cai Boning , Li Bo , Liu Fang , Du Lei , Zhao Dawei , Fan Wenjun , Meng Linlin , Zhang Xinxin , Ma Lin
Published: June 2022

Objective: The objective of this trial is to evaluate and compare the acute toxicity in patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with docetaxel plus cisplatin, or docetaxel, or cisplatin concurrently with helical tomotherapy during concurrent chemoradiotherapy (CCRT). Methods: In a prospective, single-center, open-label, randomized phase II study, after 2 cycles of induction chemotherapy with docetaxel plus cisplatin regimen, 125 patients with LA-NPC (stage III and IVA, UICC eighth) diagnosed pathologically from June 2017 to November 2019 were randomized into CCRT with docetaxel plus cisplatin group (25 patients), CCRT with docetaxel group (50 patients), and CCRT with cisplatin group (50 patients). The incidence of grade 3 or 4 acute toxicities and clinical efficacy were analyzed among the 3 groups. Results: Safety evaluation was completed in all the 125 patients, during the CCRT period, 66.4% of patients completed 3 cycles of chemotherapy, 24.0% completed 2 cycles of chemotherapy, and 9.6% completed 1 cycle of chemotherapy according to the research plan. The incidence of grade 3 or 4 acute toxicity in CCRT with docetaxel plus cisplatin (DP), docetaxel (D), and cisplatin (P) groups was 88.0%, 72.0%, and 56.0%, respectively. The incidence of grade 3 or 4 acute toxicities in the DP group was significantly higher than that in the D and P groups ( P = .015), no significant difference was detected between the D and P groups ( P = .096). The most common toxicities were mucositis (40.0%), leukopenia (29.6%), neutropenia (26.4%), and pharyngo-esophagitis (12.0%); compared to D and P groups, DP group did not significantly improved the 3-year overall survival (96.0% vs 87.0% and 87.6%), progression-free survival (92.0% vs 79.7% and,76.9%), locoregional failure-free survival (96.0% vs 91.8% and 92.7%), and distant failure-free survival (100% vs 90.0% and 89.0%), there were no significant difference in survival data among the 3 groups (all P > .05). Conclusions: Higher survival benefits did not achieve from intensified CCRT with DP, CCRT with P or D obtained similar short-term survival outcomes with similar acceptable toxicities in LA-NPC patients.
Robotic Transgastric Reconstruction of the Double Lumen Esophagus
Authors: Gritsiuta Andrei I. , Bakhos Charles T. , Petrov Roman V. , Abbas Abbas E.
Published: June 2022

Double lumen esophagus is an extremely rare condition, developing in most cases as a complication of antireflux procedures or gastroesophageal reflux itself secondary to the severe inflammatory process in and around the lower esophagus. We describe a case of iatrogenic double lumen esophagus after multiple previous Nissen fundoplications for chronic gastroesophageal reflux disease. There is no standard surgical intervention for the management of this complication. We present a first report of successful robot-assisted surgical reconstruction of a double lumen esophagus.
Endoscopic Robotic Mitral Valve Surgery in Patients With Previous Sternotomy Cardiac Surgery
Authors: Murphy Douglas A. , Jonsson Amalia A. , Halkos Michael E.
Published: June 2022

Objective: Mitral surgery is higher risk in patients with a previous median sternotomy. We describe an endoscopic robotic approach in this higher-risk cohort by an experienced robotic team. Methods: From January 2006 through June 2021, 152 consecutive patients with previous sternotomy cardiac surgery underwent mitral surgery using endoscopic robotics. Peripheral perfusion with endoaortic balloon occlusion was used in 148 patients (97.4%) and ventricular fibrillation in 4 patients (2.6%). Results: Mitral repair was performed in 73 patients (48%) including primary repair in 57 patients and re-repair in 16 patients, mitral replacement in 78 patients (51.3%) including primary replacement in 26 patients, conversion of a previous repair to replacement in 28 patients, and re-replacement in 24 patients. A paravalvular leak was primarily repaired in 1 patient (0.7%). Concomitant procedures included tricuspid repair in 28 patients (18.4%) and cryoablation in 8 patients (5.3%). Postoperative echocardiography in the mitral repair patients demonstrated none to mild regurgitation in 72 patients (98.6%). One repair patient (1.4%) had severe regurgitation and required robotic mitral replacement 5 days postoperatively. There were no paravalvular leaks in the mitral replacement patients. Operative mortality occurred in 3 patients (1.97%). Stroke occurred in 1 patient (0.7%), prolonged ventilation in 18 patients (11.8%), renal failure in 2 patients (1.4%), and re-exploration for bleeding in 10 patients (6.6%). Mean length of stay for the entire cohort was 5 ± 5.4 days. Conclusions: Robotic mitral valve surgery can be extended to patients with previous sternotomy with satisfactory efficacy and low operative mortality and morbidity.
Minimally Invasive Approach for Cardiac Hemangioma Resection in a Teenager
Authors: Thornton Steven W. , Hoover Anna C. , Nellis Joseph R. , Overbey Douglas M. , Andersen Nicholas D. , Haney John C. , Turek Joseph W.
Published: June 2022

Cardiac hemangiomas are a rare tumor traditionally resected by median sternotomy. We performed a minimally invasive right ventricular cardiac hemangioma resection via a left anterior mini-incision (LAMI). The procedure was without complication, and the patient was discharged on postoperative day 2. The LAMI has been used broadly by our team for operations involving the right ventricular outflow tract, as an alternative to median sternotomy. Here we show that it can also be used for the resection of a cardiac tumor.
Transfemoral Flow-Reversal for Carotid Artery Stenting with Balloon Guide Catheter: Proof of Concept with Robotic Transcranial Doppler
Authors: Cappuzzo Justin M , Monteiro Andre , Waqas Muhammad , Baig Ammad A , Snyder Kenneth V , Levy Elad I , Siddiqui Adnan H
Published: June 2022

In this video, we demonstrate our technique for transfemoral carotid artery stenting (CAS) with flow-reversal through a Walrus balloon guide catheter (BGC) using robotic transcranial Doppler (rTCD) monitoring. Before crossing the plaque for distal filter placement and/or angioplasty, the BGC is inflated and the three-way stopcock opened, allowing back-bleeding. Immediately, the rTCD shows a change in blood-flow direction, indicating flow-reversal, which likely occurs due to a passive pressure gradient between the intracranial compartment and the atmospheric pressure. Then, the filter is placed with reduced risk of displacing plaque fragments, and angioplasty and stenting are performed with dual protection afforded by the BGC and filter. This technique may confer greater safety for CAS. Although in this case rTCD was used for proof of concept, it could also be used as a tool to monitor embolic load during CAS procedures.
The lubrication characteristics of magnetized journal bearings affected by magnetic fluids considering the elasticity of its liner
Authors: Hu Rui , Xu Chunxia , Maiti Raman , Mcquade Catherine , Yang Yue
Published: June 2022

In order to investigate the lubrication characteristics of journal bearings with the elasticity of liner affected by magnetic fluids, a theoretic computation model was developed based on magnetic fluids supporting force parameter ([Formula: see text]) and couple-stress factor ([Formula: see text]). The results indicate that maximum dimensionless pressure peak ([Formula: see text]) of oil-film increases with increase in magnetic fluids supporting force parameter ([Formula: see text]), couple-stress factor ([Formula: see text]) and with decrease in elastic deformation coefficient ( Ce) of the liner. The loading capacity ([Formula: see text]) increases with increase in [Formula: see text], [Formula: see text] and with decrease in Ce particularly in the high eccentricity ratio ( ε); The attitude angle ([Formula: see text]) of S with different [Formula: see text] and [Formula: see text] decreases in a small range of ε at first, and then increases, it increases with the decrease of [Formula: see text] and [Formula: see text], and with the increase of [Formula: see text], theses phenomena are more obvious for [Formula: see text] at low ε and for [Formula: see text] and [Formula: see text] at moderate and high ε; the modified coefficient of friction ([Formula: see text]) decreases with increase in [Formula: see text], [Formula: see text] and with decrease in Ce; the side leakage ( Q) decreases with increase in [Formula: see text], with decrease in [Formula: see text] and with increase in Ce particularly in the low ( ε). Moreover, the increase of elastic deformation coefficient ( Ce) weaken the impacts of [Formula: see text], [Formula: see text] on the increase of [Formula: see text], [Formula: see text],[Formula: see text], and the decrease of [Formula: see text], Q.
Platelet-rich plasma improves lipopolysaccharide-induced inflammatory response by upgrading autophagy
Authors: Li Yanhui , Shao Chunyan , Zhou Mou , Shi Linying
Published: June 2022

Objectives

Platelet-rich plasma (PRP) plays an important role at all stages of wound healing, including the inflammatory stage. Macrophage autophagy has been found to influence the inflammatory response process. However, it is unclear whether PRP can affect inflammatory responses via macrophage autophagy. In the present study, we explored the effect of PRP on inflammatory responses and researched the underlying mechanism.

Methods

RAW 264.7 macrophages were treated with PRP and/or lipopolysaccharide (LPS). The effects of PRP on the expression of inflammatory factors were determined by ELISA and qRT-PCR. Macrophage autophagosomes were also assessed by TEM and immunofluorescence. Autophagy and NLRP3-related proteins were investigated using Western blot analysis.

Results

PRP reduced the levels of inflammatory factors and increased autophagy in RAW 264.7 cells. Pretreatment with 3-MA, which is an autophagy inhibitor, abolished the impact of PRP on the inflammatory response. Moreover, PRP induced macrophage autophagy by activating the NLRP3 inflammasome.

Conclusions

These results show that PRP can attenuate LPS-induced inflammatory responses by enhancing autophagy via NLRP3. These study also provides a new perspective on the molecular mechanism of PRP therapy in wound healing.
Toward stable astronaut following of extravehicular activity assistant robots using deep reinforcement learning
Authors: Hu Ruijun , Zhang Yulin , Li Chuanxiang
Published: June 2022

The use of mobile robots for assisting astronauts in extravehicular activities could be an effective option for improving mission productivity and crew safety. It is thus critical that these robots follow the astronaut and maintain a stable distance to provide personalized and timely assistance. However, most extraterrestrial bodies exhibit rugged terrain that can impede a robot’s movements. As such, a novel predictive-guide following strategy is proposed to improve the stability of astronaut–robot distance in obstructive environments. This strategy combines a deep reinforcement learning navigator and a Kalman filter-based predictor to generate optimized motion sequences for safely following the astronaut and acquire predictive guidance concerning future astronaut movements. The proposed model achieved a success rate of 95.0% in simulated navigation tasks and adapted well to untrained complex environments and varied robot movement settings. Comparative tests indicated our strategy managed to stabilize the following distance to within ±1.0 m of the reference value in obstructed environments, significantly outperforming other following strategies. The feasibility and advantage of the proposed approach was validated with a physical robotic follower in a Mars-like environment.

[Formula: see text]
Encoding arm and leg movements in the same or opposite direction
Authors: Xie Tingting , Wang Lijuan
Published: June 2022

This study examined whether working memory performance for arm and leg movements differed when encoding in the same or opposite direction (relative to the observed direction) and which direction was better for encoding these two kinds of movements. The results showed that encoding direction regulated the comparison between arm and leg movements in working memory performance. In the same-direction encoding condition, arm movements performed better than leg movements, whereas in the opposite-direction encoding condition, arm movements performed worse. In addition, arm movements performed better when they were encoded in the same direction, while encoding leg movements in the same direction did not differ from encoding them in the opposite direction. Therefore, we should move appropriate body parts for the same and opposite learning directions. The same direction is suitable for learning arm movements but not leg movements; the opposite direction is suitable for learning leg movements but not arm movements. We should also consider the appropriate learning direction for arm movements rather than leg movements. Arm movements are encoded more effectively in the same direction than in the opposite direction.
Avatrombopag ethnic sensitivity analysis in chronic liver disease and thrombocytopenia patients: individual-level pooled analysis
Authors: Lu Jun , Jamieson Brian D. , Hui Ai-Min
Published: June 2022

Introduction:

Few data have been published on the ethnic sensitivity of effectiveness, pharmacokinetics (PK), and pharmacodynamics (PD) of avatrombopag for the management of thrombocytopenia in patients with chronic liver disease (CLD).

Methods:

An ethnic sensitivity analysis was performed based on the results from two phase III studies (ADAPT-1 and ADAPT-2), with a primary endpoint of the proportion of patients without the requirement of platelet transfusion or rescue treatment for bleeding after randomization to 7 days following a scheduled procedure, and three phase I studies in healthy subjects. Cochran–Mantel–Haenszel and Fisher’s exact tests were used to compare the differences in effectiveness in different ethnicities and overall population.

Results:

In total, 435 patients (placebo, n = 158; avatrombopag, n = 277) were stratified into various ethnic groups: 121 East Asians, including the subgroup of 27 Chinese, and 259 Caucasians. The proportion of patients who did not receive a platelet transfusion and those with a platelet count ⩾50 × 109/L in the avatrombopag 40 and 60 mg groups were higher than that of placebo for all ethnicities and in the overall population. Statistical significance was obtained in the overall population and for all ethnicities other than Chinese patients, a group with a very small sample size. No significant difference was observed in the proportion of responders in each ethnic group compared to overall population ( p > 0.05). The incidence of adverse events in East Asians was similar to that in both Caucasians and the overall population.

Conclusion:

Avatrombopag was effective and safe in the management of thrombocytopenia in Chinese patients with CLD. Ethnicity does not appear to influence the efficacy, safety, PK, or PD of avatrombopag.
Novel method for the treatment of congenital pseudarthrosis of the tibia using the gastrocnemius flap: A preliminary study
Authors: Cai Wenquan , Su Yuxi , Nan Guoxin
Published: June 2022

Purpose:

Congenital pseudarthrosis of the tibia is a rare disease that is particularly difficult to treat; the most difficult complications include nonunion of the tibia, refracture, and failed surgery. This study aimed to evaluate the efficiency of transposing gastrocnemius flaps for the treatment of congenital pseudarthrosis of the tibia.

Methods:

Nine patients (aged 6.2 ± 3.6 years) diagnosed with congenital pseudarthrosis of the tibia in our hospital between March 2013 and March 2018 were enrolled. The tibial pseudarthrosis and thickened periosteum were completely removed, and intramedullary nails were used to fix the tibia. Bone harvest from the iliac, mixed with allogenic bone, was filled in the gap created by excision of the pseudarthrosis site and the surrounding periosteum; the gastrocnemius flap was then used to wrap the pseudoarthrosis site. The plaster cast was fixed postoperatively. The tibial union was evaluated via radiograph, and the plaster cast was removed after 12–24 weeks. Patients began walking approximately 12–14 weeks postoperatively.

Results:

Anatomical reduction was achieved in all the patients; the mean bone healing time was 10.1 ± 2.1 months. Bone nonunion was observed in one patient, and no neurovascular injury or wound infection occurred. Limb length discrepancy was in the range 3.2 ± 1.8 cm at 1 year and 4.7 ± 2.7 cm at 2 years after surgery. Two patients underwent replacement of the intramedullary nail, and eight patients exhibited good functional and radiographic outcomes.

Conclusion:

This preliminary study proved that using the gastrocnemius muscle flap to cover the pseudarthrosis site was an effective method to promote the tibial union and treat congenital pseudarthrosis of the tibia.
Postoperative growth rate affects time to growth arrest after percutaneous physiodesis: A radiostereometric analysis
Authors: Wingstrand Maria , Elfving Maria , Hägglund Gunnar , Lauge-Pedersen Henrik
Published: June 2022

Purpose:

The aim of this study was to determine the time at which physeal arrest is achieved after percutaneous physiodesis, and whether immediate postoperative growth rate affects the time to reach physeal arrest.

Methods:

Radiostereometric analysis, with implantation of tantalum balls as radiographic markers on each side of the physes, was used to measure residual longitudinal growth in 21 children (10 boys and 11 girls) after percutaneous physiodesis for leg length discrepancy or extreme tall stature. In total, 25 femoral and 20 tibial physes were operated on. Median age at surgery was 13.9 years (range = 11.4–16.1). Radiostereometric analysis was performed postoperatively and after 3, 6, 9, 12, 26, and 52 weeks. Longitudinal growth rate <50 µm per week was defined as physeal arrest. Descriptive statistics were used for evaluation.

Results:

Physeal arrest was obtained in 19 of the 21 children (40 physes) within 12 weeks postoperatively. One child was reoperated on in three out of four physes because of continued growth, and in one child, delayed physeal arrest was present at 26 weeks postoperatively. Time to physeal arrest was longer in physes with a higher immediate postoperative growth rate.

Conclusion:

Postoperative follow-up with radiostereometric analysis at 12 and 15 weeks can determine whether physeal arrest has been achieved. The immediate postoperative growth rate after physiodesis seems to affect the time to physeal arrest. This implies that the risk for complications is greater for children during an accelerated growth period, for example, in boys, younger children and in distal femoral physes.

Level of evidence:

level III.
Association between femoroacetabular impingement syndrome and limited lateral hip rotation in young athletes: A case–control study
Authors: Šarčević Zoran , Tepavčević Andreja
Published: June 2022

Purpose:

Hip pain is very common in athletes. One of the main disorders causing hip pain is femoroacetabular impingement syndrome. This study aimed to identify a new etiological risk factor for femoroacetabular impingement in the hip.

Methods:

This case–control study included 88 young athletes, 34 with pains in the hip (supposedly with femoroacetabular impingement) and 54 controls. Femoroacetabular impingement was diagnosed with a flexion, adduction, internal, and rotation test and a particular type of hip pain during sports activities. The medial (internal) and lateral (external) hip ranges of rotation have been measured with an inclinometer. The data were analyzed using a t-test, the Wilcoxon test, the Mann–Whitney U test, and logistic regression.

Results:

There is a statistically significant difference in the external hip rotation range between the athletes with hip pain and controls. Logistic regression analysis showed that external hip range of motion is significantly associated with femoroacetabular impingement.

Conclusion:

Limited external hip range of motion was found to be significantly associated with the diagnosis of femoroacetabular impingement in young athletes. A biomechanical explanation of the hypothesis that limited external hip rotation can predict femoroacetabular impingement is given. Based on our results, the hip’s lateral range of motion screening can be advised within the regular screening of young athletes. Kinesiotherapeutic procedures for stretching the muscles of the medial hip rotors can be advised to prevent the lateral hip rotation restriction and lower the risk of femoroacetabular impingement in case the limited rotation is due to muscular restriction.

Level of evidence:

level III—case–control study.
Patterns of Timing and Intensity of Physical Activity and HbA1c Levels in Hispanic/Latino Adults With or at Risk of Type 2 Diabetes
Authors: Kerr David , Abbasi Mahsan , Bevier Wendy , Glantz Namino , Larez Arianna , Sabharwal Ashutosh
Published: June 2022

Background:

Despite the clear benefits of increased physical activity (PA) on glycemic control, little is known about the importance of the timing of exercise among people with diabetes. Our objective was to compare the time of day of PA with concurrent HbA1c levels and body mass index (BMI) among Hispanic/Latino adults with or at risk of type 2 diabetes (T2D).

Methods:

Monitored activity data obtained from Hispanic/Latino adults were summarized as number of steps per day, moderate-to vigorous-intensity physical activity (MVPA), and energy expenditure (kcals/day). We next examined the association between PA measures and participants’ HbA1c. K-means clustering analysis was applied to identify daily PA patterns by time of day and intensity.

Results:

Three dominant clusters were identified: low-intensity PA, and early and late PA by time of day. The step counts were correlated with HbA1c in the late-active group ( P = .01). Furthermore, independently in younger adults (age ≤ 50 years) and in overweight adults 25 ≤ BMI < 30 kg/m2), there was an association between HbA1c and step counts ( P < .01 and P < .005, respectively) as well as HbA1c and MVPA ( P < .05 and P < .035, respectively).

Conclusions:

For Hispanic/Latino adults with or at risk of T2D, there appears to be clustering of PA by intensity and time of day which, in turn, may influence achieved HbA1c and BMI. Our findings demonstrate that the amount of activity is more efficacious on HbA1c in participants who are more active later during the day and separately in overweight and younger individuals. This finding may help design more personalized PA recommendations in this population.

ClinicalTrials.gov Identifiers:

NCT03830840 and NCT03736468.
Safety and Functional Integrity of Continuous Glucose Monitoring Sensors When Used During Radiologic Procedures Under High Exposure Conditions
Authors: Matievich William , Kiaie Namvar , Dunn Timothy C.
Published: June 2022

Background:

We investigated wearable components of the Abbott Diabetes Care FreeStyle Libre® (continuous glucose monitoring [CGM 1), FreeStyle Libre® 2 (CGM 2), and FreeStyle Libre® 3 (CGM 3) systems in simulated diagnostic radiologic procedures.

Methods:

Sensors were loaded with simulated glucose data and exposed to X-ray scanning, computed tomography (CT), and magnetic resonance imaging (MRI) to simulate radiotherapeutic procedures. The exposure settings were representative of maximum in clinical settings. After the simulations, bench tests were used to assess data integrity and responsiveness of sensors to various concentrations of aqueous glucose.

Results:

All sensors passed all acceptance criteria following each session of X-ray, CT, and MRI exposures. During the 3 T MRI simulation, the displacement forces for the CGM 1, CGM 2, and CGM 3 sensors were 0.132, 0.109, and 0.063 N, respectively, which are more than 100× smaller than the force of 15.97 N required to dislodge the sensor from the body. Data stored in the sensors prior to the exposures remained intact.

Conclusion:

The sensors maintained functionality following a series of high exposure conditions in both X-ray and CT scanning systems, and the sensors were easily visible and identifiable when scanned using clinically relevant scanning parameters. Therefore, patients can continue to wear and use their sensors during and after imaging. The nonclinical MRI testing demonstrated that the sensors can be worn under the specified MRI conditions.
Anemia Severity and the Risks of Postoperative Complications Following Total Ankle Arthroplasty
Authors: Gordon Adam M. , Malik Azeem Tariq
Published: June 2022

Background:

Although studies have demonstrated the effect of anemia severity on postoperative complications after arthroplasties of the shoulder, hip, and knee, no studies have investigated the effect on total ankle arthroplasty (TAA). The objective was to determine the influence of preoperative anemia severity on complications following TAA.

Methods:

The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was queried from 2006 to 2019 for patients undergoing TAA. Utilizing the World Health Organization (WHO) definitions of anemia, patients were stratified into 3 cohorts: nonanemia (hematocrit >36% for women, >39% for men), mild anemia (hematocrit 33%-36% for women, 33%-39% for men), and moderate to severe anemia (hematocrit <33% for both women and men). Demographics, comorbidities, length of stay, and short-term (30-day) postoperative complications were compared between groups. Bivariate analyses, including χ2 and analysis of variance, and multivariable logistical regression were performed.

Results:

After exclusion, 1490 patients (1313 nonanemia [88.1%], 154 mild anemia [10.3%], and 23 moderate/severe anemia [1.6%]) were included. Increasing severity of anemia was associated with an increased average hospital length of stay (1.84 vs 2.19 vs 2.78 days, P < .001) and rate of reoperation (0.38% vs 3.90% vs 4.35%, P < .001). There was a statistically significant increase in wound disruptions (0.15% vs 1.95% vs 4.35%, P = .001), minor complications (1.52% vs 4.55% vs 8.70%, P = .008), major complications (1.98% vs 5.84% vs 4.35%, P < .033), and any complications (3.50% vs 10.39% vs 13.04%, P = .001) between groups. Multivariate analysis identified mild and moderate/severe anemia as a predictor of reoperation and extended length of stay (P ≤ .033).

Discussion:

Preoperative anemia is a modifiable risk factor for medical and surgical complications within 30 days of TAA. Medical optimization prior to surgical intervention is necessary in patients undergoing TAA.

Level of Evidence:

Level III: Retrospective comparative study
Presence and absence: Crisis pregnancy centers and abortion facilities in the contemporary reproductive justice landscape
Authors: Thomsen Carly , Levitt Zach , Gernon Christopher , Spencer Penelope
Published: June 2022

This article uses driving time to examine the geographic relationship of abortion facilities to crisis pregnancy centers (CPCs) in terms of race/ethnicity and population density. We analyze both the current reproductive justice landscape and predict how this landscape will change following the projected reversal of Roe v. Wade. Our results demonstrate that disparities in the presence of abortion facilities and CPCs manifest in terms of rural/urban classification and race/ethnicity. These disparities will become more pronounced in the post- Roe landscape. Four major findings include: 1.) Following the projected reversal of Roe, the ratio of abortion facilities to CPCs will change from 1:3 to 1:5; 2.) the number of people who live closer to a CPC than an abortion facility will nearly double post- Roe; 3.) people in rural areas live in disproportionate proximity to CPCs, although the number of people in large metropolitan areas living closer to a CPC than an abortion facility will increase nearly four-fold post- Roe; 4.) compared to other racial and ethnic groups, a greater percentage of Native Americans live closer to a CPC than an abortion facility and the share of Black and Hispanic/Latino people who live closer to a CPC than an abortion facility will more than double post- Roe. Ultimately, our results push scholars, advocates, and policy makers to discuss access to reproductive healthcare and reproductive justice in terms of presence of CPCs as much as absence of abortion facilities.
The iridocorneal angle and related anterior segment structures in pediatric anisohyperopic amblyopic eyes
Authors: Karabulut Müjdat , Karabulut Sinem , Simsek Hüseyin Cem , Karalezli Aylin
Published: June 2022

Objectives:

We aimed at investigating the iridocorneal angle, anterior segment structural differences, and their relationship in pediatric anisohyperopic amblyopic eyes.

Methods:

This study was designed as an observational case-control study. We prospectively evaluated the pediatric patients who were newly diagnosed with hyperopic anisometropic amblyopia. Iridocorrneal angle in four sectors, axial length, and anterior segment structures were compared to emmetropic fellow and control eyes using Pentacam and IOLMaster 700 devices. The anisohyperopia and iridocorneal angle related factors were determined in hyperopic anisometropic amblyopic eyes.

Results:

Forty-three hyperopic anisometropic amblyopic eyes, 43 fellow eyes, and 44 control eyes were included. The mean axial length, anterior chamber volume, and anterior chamber depth were significantly reduced in the study eyes compared to the fellow (p < 0.001, p = 0.021, and p = 0.045, respectively) and control eyes (p < 0.001, p = 0.001, and p = 0.009, respectively). The average iridocorneal angle was significantly lower in the study eyes than in the fellow and control eyes (p < 0.001 and p = 0.018, respectively). The iridocorneal angle correlated with anterior chamber depth (r = 0.49, p = 0.013), anterior chamber volume (r = 0.42, p = 0.038), the anterior radius of curvature (r =−0.54, p = 0.005), the posterior radius of curvature (r =−0.58, p = 0.002), and lens thickness (Rho =−0.41, p = 0.033) in the study eyes. Anisohyperopia was related to the interocular difference in axial length (Rho = 0.53, p = 0.005), anterior chamber depth (Rho = 0.53, p = 0.005), and anterior chamber volume (Rho = 0.42, p = 0.031).

Conclusion:

Pentacam and IOLMaster 700 are suitable for non-contact imaging of iridocorneal angle and anterior segment structures in the pediatric age. These biometric differences and their relationship should be kept in mind whenever anterior or posterior segment surgery is planned for pediatric anisohyperopic amblyopic eyes.
Diagnosis and management of a laryngeal cyst in a domestic shorthair cat
Authors: Manson Katrina C , Graham Julia L , Rozanski Elizabeth A
Published: June 2022

Case summary

A 7-year-old male neutered domestic shorthair cat was presented with a 3-month history of dyspnea when exercising and increased respiratory noise when purring. Initial radiographs identified a suspected laryngeal mass. Point-of-care ultrasound found a fluid-filled structure on the larynx, which was drained percutaneously. The cat initially recovered well but, due to recurrence of clinical signs, a CT scan was performed, which confirmed the presence of a laryngeal cyst that was subsequently surgically resected. Histopathological analysis was consistent with a suspected thyroglossal cyst.

Relevance and novel information

This is only the second report of a laryngeal cyst in the cat. While malignant laryngeal disease may be more prevalent in the cat, benign differentials should be considered as treatment could be curative, as was observed in this case.