bluuebunny/crossref_metadata_2025 huggingface dataset:
Right Atrial Isolation Associated with Atrial Septal Closure in Patients with Atrial Septal Defect and Chronic Atrial Fibrillation
Authors: Minzioni G. , Graffigna A. , Pagani F. , Vigano M.
Published: September 2022

To restore sinus rhythm in the remaining heart chambers of six adult patients with atrial septal defect and chronic or paroxysmal atrial fibrillation, electrical, right atrial isolation associated with surgical correction of the defect was performed. All but one patient was free from atrial fibrillation without medication 2–25 months after operation. The isolated right atrial appendages showed intrinsic rhythmical activity in five patients and no electrical activity in one. Right atrial isolation is a safe and effective procedure that abolishes atrial fibrillation in patients with arrhythmia after surgical correction of atrial septal defect.
In Situ Saphenous Vein Grafts for Femorodistal Bypass: Evaluation of Endoscopically Monitored Valvulotomy on Graft Patency
Authors: Woelfle K.D. , Bruijnen H. , Zuegel N. , Mayer H. , Hudde M. , Loeprecht H.
Published: September 2022

An overview of a total of 135 in situ femorocrural bypass operations is given. In the operations all grafts were anastomosed distally to the infrapopliteal arteries: to the proximal half of the crural vessels 52 times and to the distal half 83 times. The indication for surgery was critical limb ischaemia. In addition to routine intraoperative angiography, orthograde angioscopy of the graft was carried out to assess the completeness of valvulotomy in 96 patients (group A). In 39 patients (group B) for whom an endoscope was not available, completion angiography was conducted to ensure graft integrity. The two groups were comparable with respect to their composition. On the basis of the endoscopic findings, revisions were performed in 17 patients with incomplete valve ablation in group A, whereas in group B there were no interventions ( P <0.01. χ2 test). Using life-table analysis, cumulative primary patency rates for groups A and B were 76% and 76% at 30 days, 62% and 44% at 1 year and 43% and 27% at 4 years, respectively. By comparison with the log rank test, a significant difference in patency among both groups could not be established ( P = 0.18).
Effect of Gradual Reperfusion on Ventricular Function after 6-h Preservation
Authors: Ueno T. , Yamada T. , Yoshikai M. , Natsuaki M. , Itoh T.
Published: September 2022

This experiment was designed to determine the effect of a gradual increase in reperfusion pressure on ventricular function after 6-h preservation of the heart. Twenty-four rabbit hearts were allocated to four groups, each reperfused at different pressures: group I (80mmHg); group II (40mmHg for 10min, then increased to 80mmHg); group III (20mmHg for 5min, then increased by 20mmHg at 5-min intervals); and group IV (as group III + perfusion with recombinant human superoxide dismutase). The developed pressures at balloon volumes of 1.2, 1.5 and 1.8 ml were significantly higher in groups III and IV than in group I. The values of left ventricular peak d P/d t were significantly greater in groups II, III, and IV than in group I. Light microscopical examination revealed severe interstital oedema in group I, moderate oedema in group II, and minimal oedema in groups III and IV. Gradual reperfusion resulted in significantly better systolic function and less interstitial oedema. Use of recombinant human superoxide dismutase provided little additional benefit when combined with gradual reperfusion.
Multi-Branch Renal Artery Lesions: Surgical Options and Results
Authors: Tapper S. S. , Meacham P. W.
Published: September 2022

Renovascular lesions affecting more than one primary or secondary renal artery branch represent a challenging therapeutic problem. Over the last 5 years, the authors have treated 20 patients with complex multi-branch renal lesions. The number of renal artery branches per kidney ranged from two to seven. The pathological etiology of the multi-branch lesion was atherosclerotic occlusive disease in ten patients, fibromuscular occlusive disease in four (two with spontaneous dissection), renal artery aneurysm in three and abdominal aortic coarctation in three. Ex vivo techniques were used in nine patients, whereas in situ reconstruction was used in 11. Ten patients had a complex procedure involving aortic or other visceral reconstruction; two patients had solitary kidneys. There was one death in the series from an intraoperative anesthetic complication. One primary nephrectomy was performed after ex vivo exploration revealed unreconstructable disease in a significant number of branches. Severe hypertension present in all the patients before surgery was cured in five patients and improved in 14 after the operation. Renal insufficiency, present in nine patients before surgery, was improved in all cases.
Intraoperative Transvascular Balloon Catheter Management for Arterioureteral Fistula
Authors: Shutze W. P. , Schoenvogel R. C. , Jacobson R. M. , Talkington C. M.
Published: September 2022

An arterioureteral fistula is a rare but intriguing anomaly. Fewer than two dozen cases have been recorded, and all have relayed the extreme diagnostic and therapeutic challenges that this entity presents to the clinician. Factors contributing to the development of such a fistula include prolonged ureteral catheterization, prior pelvic vascular or urologic surgery, cancer or radiation. These patients are severely debilitated, and repair has a mortality rate in excess of 15%. Experience with such a patient is reported, as well as use of a minimally invasive approach to repair the abnormality. By using transvascular balloon occlusion of the involved iliac vessel and extra-anatomic vascular reconstruction, the significant morbidity and mortality associated with this disorder were avoided. Suspicion of an arterioureteral fistula should be increased in those at risk, and treatment can be effected with this minimally invasive method.
Drawing the boundaries of ‘good citizenship’ through state-led urban redevelopment in Dikmen Valley
Authors: Yardımcı Öznur
Published: September 2022

This article explores the role of contemporary urban redevelopment in invoking a renegotiation of citizenship. There has been a wide acknowledgement that neoliberalism is a political project involving transformations in the state–market–citizen relations. However, the scholarly emphasis on market-led principles in remaking places and people falls short of acknowledging political aspirations and struggles that intrude in processes of inclusion and exclusion at the city scale. Focussing on the case of Turkey, where neoliberal urban policies and practices have been linked to the central government’s political ambitions, the article illustrates that urban redevelopment projects help the state actors realign citizenship with the authoritarian regime. A focus on the state-led urban interventions from the perspective of bordering the ‘good citizen’ suggests that neoliberal urban redevelopment projects are mobilised by the state to promote official citizenship agendas. Drawing on in-depth interviews, photos and observations from 9-month fieldwork in Dikmen Valley (Ankara), this article ethnographically documents how the ideals of the ‘good citizen’ in an authoritarian context differ from the market-led promotion of consumerist, aspirational and active citizens.
Auditory imagery in congenital amusia
Authors: Loutrari Ariadne , Ansell Kathryn , Philip Beaman C , Jiang Cunmei , Liu Fang
Published: September 2022

Congenital amusia is a neurogenetic disorder affecting various aspects of music and speech processing. Although perception and auditory imagery in the general population may share mechanisms, it is not known whether previously documented perceptual impairments in amusia are coupled with difficulties in imaging auditory objects. We employed the Bucknell Auditory Imagery Scale (BAIS) to assess participants’ self-perceived voluntary imagery and a short earworm questionnaire to gauge their subjective experience of involuntary musical imagery. A total of 32 participants with amusia and 34 matched controls, recruited based on their performance on the Montreal Battery of Evaluation of Amusia (MBEA), filled out the questionnaires in their own time. The earworm scores of amusic participants were not statistically significantly different from those of controls. By contrast, their scores on vividness and control of auditory imagery were significantly lower relative to controls. Overall, results suggest that the presence of amusia may not have an adverse effect on generating involuntary musical imagery—at the level of self-report—but still significantly reduces the individual’s self-rated voluntary imagery of musical, vocal, and environmental sounds. We discuss the findings in the light of previous research on explicit musical judgments and implicit engagement with music, while also touching on some statistical power considerations.
Aducanumab for Alzheimer’s disease: Observations and opportunities
Authors: Pridmore William
Published: September 2022

Objective

To analyse the overseas approval of aducanumab for Alzheimer’s disease, in order to derive lessons of potential interest to individuals and groups involved in dementia drug development and regulation in Australia.

Conclusions

Opportunities were identified regarding optimising clinical trial design and solidifying regulatory responsibilities. Increased awareness of the attitudes and needs of patients and patient advocacy organisations would likely improve the patient-clinician alliance. Incorporation of these factors into research design has the potential to improve patient satisfaction with outcomes.
Review on single-phase driven ultrasonic motors
Authors: DongMei Xu , BingJie Zhang , SiMiao Yu , XuHui Zhang
Published: September 2022

In recent decades, various single-phase drive ultrasonic motors have emerged, and only a single excitation signal is used in their working states. Single-phase driven ultrasonic motors have the benefits of most ultrasonic motors, as well as the advantages of a simple driving circuit construction, low cost, high design flexibility, and high reliability, among others. According to the working principles, they are divided into three types: the vibration mode alternating type, the vibration mode coupling type, the vibration mode converting type. This paper summarizes various types of single-phase ultrasonic motors. The three types of the working principles and its representative structures are explained; output performances of the single-phase ultrasonic motors are described; then, practical and potential applications of the single-phase ultrasonic motors are introduced; finally, the research of single-phase ultrasonic motors are reviewed, and its development prospect is prospected. This review is helpful for a comprehensive understanding of single-phase drive ultrasonic motors. This paper offers the groundwork for the development of a novel single-phase driven ultrasonic motor with improved mechanical output.
Too Much of a Good Thing? Associations among Parenting Profiles and Helicopter Parenting
Authors: Turner Karina A. , Elkins Sara R. , Walther Christine A. P. , Short Mary B. , Schanding G. Thomas
Published: September 2022

Helicopter parenting is defined by popular culture as a set of parenting practices characterized by overinvolvement. However, empirical research has not adequately defined the construct, and it is unclear how helicopter parenting may relate to existing parenting behaviors and parenting styles. Participants included 341 caregivers from across the United States who completed a survey about their parenting beliefs and behaviors. Latent class analysis was used to determine combinations of parenting behaviors, and the identified classes of parents were then used to conduct one-way ANOVAs to examine differences in helicopter parenting between the different classes. Results suggest that parents who fit the authoritative parenting profile endorse greater helicopter parenting. Further research needs to be conducted to determine the “tipping point” for when positive parenting practices, which are often associated with positive outcomes, begin to produce negative outcomes.
Consumers’ Environmental Sustainability Beliefs and Activism: A Cross-Cultural Examination
Authors: Leonidou Constantinos N. , Gruber Verena , Schlegelmilch Bodo B.
Published: September 2022

Environmental sustainability research suffers from a paucity of comprehensive, cross-cultural investigations and lacks insight into the interplay of human values and environmental beliefs and behaviors. In addition, despite the importance of understanding why consumers engage in active attempts to protect the environment, studies examining the role of environmental sustainability activism remain scarce, poorly integrated, and ill-defined. Against this backdrop, this research captures the links of specific human values with environmental sustainability beliefs and their subsequent relationships with individuals’ environmental sustainability activism and quality of life. Using data from the United States and China, the authors show that religiosity and interdependence are consistently related to environmental sustainability beliefs, whereas, contrary to previous findings, materialism has no significant relationship. In addition, generativity is positively linked with environmental sustainability beliefs only in the U.S. sample, whereas family values are significant only in the China sample. The results show that environmental sustainability beliefs influence environmental sustainability activism, which in turn is linked with individual perceptions of superior quality of life. The study discusses several implications for practice and identifies fruitful future research directions.
How Can Companies Recover from Liability-Invoking Failures? Exploring the Role of Uncertainty Avoidance in Facilitating Consumer Compliance Across National Cultures
Authors: Astvansh Vivek , Duffek Barbara , Eisingerich Andreas B.
Published: September 2022

A company often faces incidents in which its offerings cause bodily (e.g., product safety defects) or psychological (e.g., data breach) harm to its consumers. Such incidents may invoke product liability lawsuits against the company. The company may try to recover from the liability-invoking failure by notifying the affected consumers, offering a remedy, and persuading them to comply with the company message. The authors theorize and experimentally demonstrate that, on average, a prevention-focused message receives greater compliance than a promotion-focused message. Further, a prevention-focused message is more effective with consumers from high-uncertainty-avoidance cultures, whereas a promotion-focused message is more effective in low-uncertainty-avoidance cultures. Perceived compatibility of prevention or promotion goals with low or high values of uncertainty avoidance mediates the interaction effect on compliance. The findings can help companies overcome consumer apathy to product recall or data breach notices and offer managers ways to promote consumer safety and protection.
Additional effects and vibration characteristics of the excited plate buried in particles
Authors: Pan Jingwu , Li Jian
Published: September 2022

A coupled dynamical system of a vibrating plate buried in particles is established using the discrete element method, and the effect of particle material parameters on the vibration behavior of the plate is investigated. Meanwhile, a parameter identification method based on the time-domain signal is proposed and applied to obtain the additional effect of the particles on the plate. The results show that the particle parameters can significantly affect the plate behaviors, and the nonlinear jumping phenomenon observed in our previous experiment appears when the particle elastic modulus is sufficient. The negative mass effect is found in the certain frequency band, and a reasonable mechanism is presented for the emergence of the negative mass effect, and the jump phenomenon is generated by the disappearance of the stiffness effect due to the phase transition of the particles.
Contact stress induced by the rotation of a rigid bolt bonded to an elastic body
Authors: Malits Pinchas
Published: September 2022

Torsional deformation of an elastic half-space containing a vertical cylindrical cavity caused by a rotation of a bonded rigid bolt with a long shank is studied in this article by employing Weber integral transforms and integral equations. In the limiting case of the infinite shank, we suggest two different techniques reducing the problem to the regular integral equations of the second kind, which permit efficient solutions in distinct ranges of geometric parameters and allow us to derive a highly accurate approximate analytic solution of the problem for any values of the parameters. Almost exact approximations are suggested for the stress concentration at the edge of the bolt head. In the case of a bolt with a long finite shank, relationships between the torque and the angle of twist of the bolt are derived by utilizing solutions obtained for the bolt with the infinite shank as asymptotic approximations. The effect of the geometric parameters is investigated providing insight into the behavior of the bolt and contact stress in dependence on the bolt head radius and the length of the shank.
On the Sevostianov–Kachanov approximation for the incremental compliances of non-elliptical contacts
Authors: Argatov Ivan
Published: September 2022

The incremental normal contact compliance of an elastic body beneath a frictionless indenter of arbitrary smooth shape is considered under the assumption of a simply connected domain of contact. An approximate expression for the contact stress-intensity factor in conjunction with the Griffith–Irwin formula for the variation of the elastic energy under a small perturbation of the contact contour is used to estimate the contact compliance. It is shown that the Sevostianov–Kachanov variational approach allows to derive upper and lower bounds, whose arithmetic mean is found to possess high accuracy for contacts of regular polygonal form. A number of possible generalizations are briefly discussed.
A review of localised Māori community responses to Covid-19 lockdowns in Aotearoa New Zealand
Authors: Cassim Shemana , Keelan Teorongonui Josie
Published: September 2022

Aotearoa New Zealand has been commended for the overarching effectiveness of its Covid-19 response. Yet, the lockdowns challenged the health of whānau Māori (Māori families) alongside their social, cultural and financial well-being. However, Māori have repeatedly demonstrated innovative means of resilience throughout the pandemic. This review aimed to document the local grassroots, community-level responses to Covid-19 lockdowns by Māori. Three sources for searching for evidence were used: academic, websites and media, and Māori community networks. A total of 18 records were reviewed. Four of these records comprised published academic literature, 13 comprised news, online and media articles, and one was a situation report. Findings were grouped into three categories: distributive networks, well-being and resource support. The findings of this review provide an exemplar for the strength of Māori leadership and agency, alongside value-driven holistic approaches to health and well-being that could positively impact the health of all.
Rikch’arisun, sayarisun, k’ancharisun: Indigenous knowledge systems and research for planetary beauty
Authors: Sumida Huaman Elizabeth
Published: September 2022

What are beautiful Indigenous communities? How are we as original communities good for each other and our planet? This article asserts that these kinds of questions undergird Indigenous research methodologies as more than research paradigms and as life-sustaining worldviews that produce research designs that engage processes of healing and helpfulness and that reflect Indigenous pluriversal realities. Anchored by Indigenous knowledge systems, Indigenous pluriversalities counter the ubiquity and pervasiveness of coloniality by presenting, on one hand, distinct experiences under coloniality and, on the other hand, creative anti-colonial and decolonial strategies to care for the many Indigenous worlds that constitute planetary life. Within the current global schematic designed to produce consumers, this article considers how Indigenous research as a field continues to make space for ideas of individual and collective responsibilities to emerge.
Measuring Some Oxidative Stress Biomarkers in Autistic Syrian Children and Their Siblings: A Case-Control Study
Authors: Nasrallah Oula , Alzeer Samar
Published: September 2022

Objective:

Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder whose cause remains unknown. Oxidative stress is one of the possible causes of many disorders, including neurological ones. This study aims to measure some oxidative stress biomarkers (Malondialdehyde “MDA,” Advanced Oxidation Protein Product “AOPP,” Glutathione “GSH”) within Syrian children with ASD.

Methods:

MDA, AOPP & GSH were measured in the plasma of a total of 60 children. The ages of the children ranged from 1 to 13 years old. Thirty children had ASD and were compared with 30 controls that don’t have ASD. Fifteen of the controls were siblings of an ASD child, while the remaining 15 had no relations with ASD.

Results:

MDA and AOPP plasma levels were higher in ASD children compared with non-related controls ( P = .0001). However, there were no significant differences between MDA and AOPP plasma levels in ASD children in comparison with related controls ( P > .05). Alternatively, GSH plasma levels were lower in ASD children compared with both related and non-related controls ( P = .0001).

Conclusion:

Further studies are needed to investigate more regarding the diagnostic use of oxidative stress biomarkers, and the therapeutic use of antioxidants in children affected with the autism spectrum disorder.
Contributors to Diagnostic Error or Delay in the Acute Care Setting: A Survey of Clinical Stakeholders
Authors: Redmond Sarah , Barwise Amelia , Zornes Sarah , Dong Yue , Herasevich Svetlana , Pinevich Yuliya , Soleimani Jalal , LeMahieu Allison , Leppin Aaron , Pickering Brian
Published: September 2022

Diagnostic error or delay (DEOD) is common in the acute care setting and results in poor patient outcomes. Many factors contribute to DEOD, but little is known about how contributors may differ across acute care areas and professional roles. As part of a sequential exploratory mixed methods research study, we surveyed acute care clinical stakeholders about the frequency with which different factors contribute to DEOD. Survey respondents could also propose solutions in open text fields. N = 220 clinical stakeholders completed the survey. Care Team Interactions, Systems and Process, Patient, Provider, and Cognitive factors were perceived to contribute to DEOD with similar frequency. Organization and Infrastructure factors were perceived to contribute to DEOD significantly less often. Responses did not vary across acute care setting. Physicians perceived Cognitive factors to contribute to DEOD more frequently compared to those in other roles. Commonly proposed solutions included: technological solutions, organization level fixes, ensuring staff know and are encouraged to work to the full scope of their role, and cultivating a culture of collaboration and respect. Multiple factors contribute to DEOD with similar frequency across acute care areas, suggesting the need for a multi-pronged approach that can be applied across acute care areas.
Tribological properties and lubrication state transitions of textured CSS-42L bushing filled with Sn-Ag-Cu-Ti3C2 of oil-film bearing
Authors: Xue Yawen , Shi Xiaoliang , Huang Qipeng , Zhang Kaipeng , Wu Chaohua
Published: September 2022

To improve the antifriction and vibration reduction performances of oil-film bearings in hydroelectric generating set, textured CSS-42L surfaces filled with Sn-Ag-Cu-Ti3C2 (TSs-SACT) were prepared, and the friction and vibration experiments under oil lubrication were carried out. The results showed that TSs-SACT with texture pitch of 600 μm and MXene of 5 wt.% (TSs-SACT(5%)-600) had the best antifriction, which reduced the fluctuation amplitudes of frictional forces and suppressed the friction-induced vibrations. The wear morphologies were improved by the synergistic effects of oil, grooves and Sn-Ag-Cu-Ti3C2, and TSs-SACT(5%)-600 with uniform profiles had the excellent wear resistance. The complexity of surface profiles could be characterized by fractal dimension, which can be enhanced by Sn-Ag-Cu-Ti3C2. TSs-SACT(5%)-600 with complex profiles keeps good antifriction during lubrication state transitions, which effectively improves the operation reliability of oil-film bearing in hydroelectric generating set.
Learning from the secondary: Rethinking architectural conservation through ‘barn architecture’
Authors: Kalakoski Iida , Thorgrimsdottir Sigrun
Published: September 2022

This article explores material culture and peoples’ engagement with built environments from the perspective of vernacular architecture, adaptive reuse and more specifically barn-inspired architecture. Departing from actual cases of conversions that involve material reuse and initiate a correspondence between various more-than-human actors and temporal dimensions, we join the debate around sustainable architecture. We understand sustainability rather as transmission than as arresting change, and we have taken into consideration a broad scope of heritage, including masses of unlisted and abandoned buildings. Adaptive reuse and other comparable forms of using and caring for the outworn existing building stock are practices intended to prolong the lifespan of material resources through reinterpretation. Through barn architecture, we suggest alternative approaches and concepts, such as mending and care, to both fields of architecture and architectural conservation.
Combined use of F22 aligners and intermaxillary elastics in mild skeletal Class II: Two case reports
Authors: Palone Mario , Cremonini Francesca , Guiducci Daniela , Lombardo Luca
Published: September 2022

Introduction:

The aim of these two case-reports is to illustrate and compare the therapeutic effects of Class II elastics in combination with F22 aligners in an adult and an adolescent patient, respectively.

Case presentation:

Two patients with a mild skeletal Class II malocclusion, associated with mild-to-moderate crowding, presented for orthodontic treatment. The first patient was 12 years old, while the second was 40 years old. In both cases, the goal was to obtain bilateral molar and canine Class I with ideal overjet and overbite, and Class II skeletal relationship improvement in the young patient as well. Both treatments were approached without extractions and using clear aligners (CAs) in combination with Class II elastics, giving the patient the opportunity to take advantage of a therapy that is both comfortable and aesthetic.

Discussion:

Final records of both cases demonstrate how appropriate analysis and diagnosis enable CAs in conjunction with Class II elastics to be used with considerable efficiency and efficacy for Class II treatment. In the first case, the key to success was exploiting residual jaw growth, while in the second case it was careful orthodontic digital planning.

Conclusion:

In the presence of good patient compliance, CAs associated with Class II elastics provide satisfactory occlusal outcomes if biomechanics and digital set-up are carefully evaluated and executed and if diagnosis is appropriate.
Imaging cancer: image-based diagnostic communication in radiologists’ embodied cognition
Authors: Briedis Mindaugas
Published: September 2022

This article thematizes the specific process of cancer detection in radiology, which presupposes a delicate synthesis of the specifics of oncoradiology images and the skilful actions performed by the radiologist. The enactment of cancer via meaningful action rather than recognizing static depiction puts the structures of image consciousness into the wider context along with memory, free imagination and amodal completion, among others. Hence, by way of reinterpreting phenomenological projects via enactivism and incorporating them into the radiologist’s work (cases, radiograms), medical diagnostics in general and oncoradiology in particular presuppose a multimodal categorial structuring (of meaning) that goes far beyond direct sensory givens. In most branches of radiology, we cannot tell what the cancer is without attending to the multitude of its appearance and the perceptual and imaginative strategies of those who make it appear. As such, this article also considers the wider problem of how knowledge is related to the (embodied) subjectivity in a particular social setting.
Predicting Altruistic Behaviour by the Benefactor-Beneficiary Relationship
Authors: Palmer Jack A. , Palmer Linda K.
Published: September 2022

The evolution of altruism—costly behaviour by an individual (the benefactor) that benefits another individual (the beneficiary)—has been theorized as a function of kinship, reciprocity potential, shared group membership, and costly signalling. These benefactor-beneficiary relationships have predictive value for real-life altruistic acts. J. A. Palmer designed the Costly Signals Questionnaire (CSQ) to measure participants’ level of support for altruistic acts performed under the varying conditions of (1) close kin, (2) person who can reciprocate, (3) group co-members, and (4) anonymous strangers (representing costly signalling theory). After signing consent forms, participants (n = 465) were given an opportunity to perform an altruistic act anonymously (donate valuable raffle tickets) and then completed the CSQ and measures of altruism, empathy, and religiosity. Statistical analyses support CSQ reliability and revealed that the CSQ significantly predicted altruistic action; the other measures did not (although they significantly correlated with the CSQ). Participants’ support for altruistic acts ranked significantly from strongest to weakest: kin-based > reciprocity > shared group > anonymous stranger. The CSQ appears to be a reliable, valid instrument for predicting altruistic action and measuring support of altruism based on benefactor-beneficiary relationships per evolutionary theory.
Rehabilitation to Improve Gaze and Postural Stability in People With Multiple Sclerosis: A Randomized Clinical Trial
Authors: Loyd Brian J. , Fangman Annie , Peterson Daniel S. , Gappmaier Eduard , Thackeray Anne , Schubert Michael C. , Dibble Leland E.
Published: September 2022

Background

People with multiple sclerosis (PwMS) frequently experience dizziness and imbalance that may be caused by central vestibular system dysfunction. Vestibular rehabilitation may offer an approach for improving dysfunction in these people.

Objective

To test the efficacy of a gaze and postural stability (GPS) retraining intervention compared to a strength and endurance (SAE) intervention in PwMS.

Methods

About 41 PwMS, with complaints of dizziness or history of falls, were randomized to either the GPS or SAE groups. Following randomization participants completed 6-weeks of 3×/week progressive training, delivered one-on-one by a provider. Following intervention, testing was performed at the primary (6-weeks) and secondary time point (10-weeks). A restricted maximum likelihood estimation mixed effects model was used to examine changes in the primary outcome of the Dizziness Handicap Inventory (DHI) between the 2 groups at the primary and secondary time point. Similar models were used to explore secondary outcomes between groups at both timepoints.

Results

Thirty-five people completed the study (17 GPS; 18 SAE). The change in the DHI at the primary time point was not statistically different between the GPS and SAE groups (mean difference = 2.33 [95% CI −9.18, 12.85]). However, both groups demonstrated significant improvement from baseline to 6-weeks (GPS −8.73; SAE −7.31). Similar results were observed for secondary outcomes and at the secondary timepoint.

Conclusions

In this sample of PwMS with complaints of dizziness or imbalance, 6-weeks of GPS training did not result in significantly greater improvements in dizziness handicap or balance compared to 6-weeks of SAE training.
Hypersensitivity reactions following vein closure therapy with venasealTM (n-butyl- 2-cyanoacrylate)
Authors: lanakiev Abby , Codispodi Christopher D. , Patel Payal D.
Published: September 2022

VenaSealTM is composed of a cyanoacrylate adhesive compound often utilized for chronic venous stasis treatment. Rare case reports of hypersensitivity reactions to this compound exist. We present the first case of dermatographism and angioedema after utilization of VenaSealTM successfully treated via high dose antihistamines. We also present a case of type IV hypersensitivity to VenaSealTM, a cyanoacrylate, occurring in a patient with known meth(acrylate) allergy indicating a possible cross reactivity between these acrylate groups.
Contextual diversity during word learning through reading benefits generalisation of learned meanings to new contexts
Authors: Norman Rebecca , Hulme Rachael C , Sarantopoulos Christina , Chandran Varsha , Shen Hantong , Rodd Jennifer M , Joseph Holly , Taylor J. S. H
Published: September 2022

From mid-childhood onwards, most new words are learned through reading. The precise meaning of many words depends upon the linguistic context in which they are encountered, which readers use to infer the appropriate interpretation. However, it is unclear what features of these linguistic contexts best support learning of new word meanings. We investigated whether learning words in contextually diverse sentences benefits word form and meaning learning in adults ( n = 239). Participants learned meanings for 8 pseudowords through reading 10 sentences about each. Four pseudowords were learned in a diverse condition (10 sentences on different topics) and four were learned in a non-diverse condition (10 sentences on the same topic). An old-new decision post-test indicated that diversity did not influence word form learning. In a second post-test, participants chose which trained pseudoword completed a sentence from either an unfamiliar, untrained context, or a familiar, trained context. For familiar contexts, accuracy was higher for pseudowords learned in the non-diverse condition, but for unfamiliar contexts, accuracy was higher for pseudowords learned in the diverse condition. These results suggest that diverse contexts may promote development of flexible, decontextualised meaning representations that are easier to generalise to new contexts. Conversely, non-diverse contexts may favour extraction of context-bound representations that are more easily used in the same context.
Working hard to avoid: Fixed-ratio response effort and maladaptive avoidance in humans
Authors: Dymond Simon , Xia Weike , Lloyd Keith , Schlund Michael W , Zuj Daniel V
Published: September 2022

Maladaptive avoidance of safe stimuli is a defining feature of anxiety and related disorders. Avoidance may involve physical effort or the completion of a fixed series of responses to prevent occurrence of, or cues associated with, the aversive event. Understanding the role of response effort in the acquisition and extinction of avoidance may facilitate the development of new clinical treatments for maladaptive avoidance. Despite this, little is known about the impact of response effort on extinction-resistant avoidance in humans. Here, we describe findings from two laboratory-based treatment studies designed to investigate the impact of high and low response effort on the extinction (Experiment 1) and return (Experiment 2) of avoidance. Response effort was operationalised as completion of fixed-ratio (FR) reinforcement schedules for both danger and safety cues in a multi-cue avoidance paradigm with behavioural, self-report, and physiology measures. Completion of the FR response requirements cancelled upcoming shock presentations following danger cues and had no impact on the consequences that followed safety cues. Both experiments found persistence of high response-effort avoidance across danger and safety cues and sustained (Experiment 1) and reinstated (Experiment 2) levels of fear and threat expectancy. Skin conductance responses evoked by all cues were similar across experiments. The present findings and paradigm have implications for translational research on maladaptive anxious coping and treatment development.
The role of vonoprazan in patients with erosive esophagitis
Authors: Zhang Mengyu , Xiao Yinglian , Chen Minhu
Published: September 2022

Acid suppression is the primary therapy for erosive esophagitis (EE). Although proton pump inhibitors (PPIs) are considered as the first-line medication for EE, 10–20% of patients with Los Angeles C and D grade EE do not gain complete mucosal healing and symptom control despite 8-week double-dose PPI treatment. Vonoprazan is a novel potassium-competitive acid blocker (P-CAB), which blocks the H+, K+-adenosine triphosphatase enzymes in a K+-competitive and reversible manner. Vonoprazan exhibits different pharmacological and pharmacokinetic profiles from conventional PPIs, and has a rapid, potent and sustained acid inhibitory effect. In this review, we summarized and discussed current evidence regarding the role of vonoprazan in terms of mucosal healing, maintaining remission and symptom relief for the management of EE, including the initial and maintenance treatment of EE, as well as for PPI-resistant EE patients. Safety concerns and cost-effectiveness analysis of vonoprazan were also mentioned in the article. As a potent and well-tolerated acid blocker, vonoprazan has the potential to become a novel option for the management of EE.
Real-world global data on targeting epidermal growth factor receptor mutations in stage III non-small-cell lung cancer: the results of the KINDLE study
Authors: Jazieh Abdul Rahman , Onal Huseyin Cem , Tan Daniel Shao-Weng , Soo Ross A. , Prabhash Kumar , Kumar Amit , Huggenberger Reto , Cho Byoung Chul
Published: September 2022

Background:

Tyrosine kinase inhibitors (TKIs) are the standard of care for resectable and metastatic non-small-cell lung cancer (NSCLC) harbouring epidermal growth factor receptor (EGFR) mutations (EGFRm). We describe the real-world practice of EGFRm testing, prevalence, treatment and outcomes in EGFRm stage III NSCLC from a multi-country, observational study.

Methods:

The KINDLE study retrospectively captured diagnostic information, treatments and survival outcomes in patients with stage III NSCLC from January 2013 to December 2017. Baseline characteristics and treatments were described and real-world outcomes from initial therapy were analysed using Kaplan–Meier methods.

Results:

A total of 3151 patients were enrolled across three regions: Asia ( n = 1874), Middle East and North Africa (MENA) ( n = 1046) and Latin America (LA) ( n = 231). Of these, 1114 patients (35%) were tested for EGFRm (46% in Asia, 17% in MENA and 32% in LA) and EGFRm was detected in 32% of tested patients (34.3% in Asia, 20.0% in MENA and 28.4% in LA). In a multi-variate analysis, overall EGFRm patients treated with EGFR-TKI monotherapy as initial treatment, without any irradiation, had twice the risk of dying (hazard ratio: 1.983, 95% confidence interval: 1.079–3.643; p = 0.027) versus any other treatment. Finally, unresectable patients with EGFRm NSCLC who received concurrent chemoradiotherapy (cCRT) as initial therapy had longer overall survival (OS) compared with their counterparts who only received TKI monotherapy without any irradiation (48 months versus 24 months; p < 0.001).

Conclusion:

The KINDLE study showed that a minority of stage III NSCLC patients were tested for EGFRm. Patients with EGFRm with unresectable NSCLC had similar outcomes from cCRT as initial therapy compared with EGFR wild type with a trend in OS favouring the EGFRm group. Outcomes with EGFR-TKI monotherapy as initial therapy, without any irradiation, were worse. The ongoing LAURA study (NCT03521154) will help define the role of EGFR-TKIs in EGFRm stage III NSCLC treated with cCRT.

Trial Registration:

NCT03725475.
The Glycemic Ratio Is Strongly and Independently Associated With Mortality in the Critically Ill
Authors: Roberts Greg , Krinsley James S. , Preiser Jean-Charles , Quinn Stephen , Rule Peter R. , Brownlee Michael , Schwartz Michael , Umpierrez Guillermo E. , Hirsch Irl B.
Published: September 2022

Background:

Interventional studies investigating blood glucose (BG) management in intensive care units (ICU) have been inconclusive. New insights are needed. We assessed the ability of a new metric, the Glycemic Ratio (GR), to determine the relationship of ICU glucose control relative to preadmission glycemia and mortality.

Methods:

Retrospective cohort investigation (n = 4790) in an adult medical-surgical ICU included patients with minimum four BGs, hemoglobin (Hgb), and hemoglobin A1c (HbA1c). The GR is the quotient of mean ICU BGs (mBG) and estimated preadmission BG, derived from HbA1c.

Results:

Mortality displayed a J-shaped curve with GR (nadir GR 0.9), independent of background glycemia, consistent for HbA1c <6.5% vs >6.5%, and Hgb >10 g/dL vs <10 g/dL and medical versus surgical. An optimal range of GR 0.80 to 0.99 was associated with decreased mortality compared with GR above and below this range. The mBG displayed a linear relationship with mortality at lower HbA1c but diminished for HbA1c >6.5%, and dependent on preadmission glycemia. In adjusted analysis, GR remained associated with mortality (odds ratio = 2.61, 95% confidence interval = 1.48-4.62, P = .0012), but mBG did not (1.004, 1.000-1.009, .059). A single value on admission was not independently associated with mortality.

Conclusions:

The GR provided new insight into malglycemia that was not apparent using mBG, or an admission value. Mortality was associated with acute change from preadmission glycemia (GR). Further assessment of the impact of GR deviations from the nadir in mortality at GR 0.80 to 0.99, as both relative hypo- and hyperglycemia, and as duration of exposure and intensity, may further define the multifaceted nature of malglycemia.
Arthroscopic Fixation Using Bioabsorbable Pins With Bone Grafting via a Medial Malleolus Approach to Treat Osteochondral Lesion of the Talus
Authors: Nakasa Tomoyuki , Ikuta Yasunari , Sumii Junichi , Nekomoto Akinori , Kawabata Shingo , Adachi Nobuo
Published: September 2022

Fixation of the osteochondral fragment has the advantage to restore the naturally congruent morphology of the talar dome with native hyaline cartilage in the treatment of the osteochondral lesion of the talus (OLT). Surgical treatment of medial talar osteochondral lesions is commonly done through a medial malleolar osteotomy. However, a medial malleolar osteotomy is an invasive procedure and gives negative impacts on clinical outcomes. Fixation for the posteromedial lesion of the OLT without the medial malleolar osteotomy may provide good clinical outcomes. We showed arthroscopic fixation for medial OLT without the medial malleolar osteotomy. Curettage and bone grafting between the fragment and its bed were performed, and then 2-mm bone tunnel in the medial malleolus was created. Bioabsorbable pins were inserted through the tunnel to fix the osteochondral fragment. Three cases (mean age 18.6 years) were treated using this technique for medial OLT and followed at 16 months (range, 12-24 months). The Japanese Society for Surgery of the Foot scale improved from 73.3 ± 1.2 points before surgery to 95.7 ± 7.5 points at the final follow-up. Bone union of the osteochondral fragment was confirmed on magnetic resonance imaging (MRI). Arthroscopic fixation for medial OLT is less invasive and yields good clinical outcomes.

Levels of Evidence: Level V
Increased Prevalence of Eosinophilic Esophagitis in Patients With Chronic Rhinosinusitis
Authors: Simmons Jordan K. , Leiman David A. , Patil Sarita U. , McCoul Edward , Chen Philip G. , Tang Dennis M. , Kuan Edward C. , Chang Elena E. , Wu Arthur W.
Published: September 2022

Background

Chronic rhinosinusitis (CRS) and eosinophilic esophagitis (EoE) are immune-mediated inflammatory conditions that share common histopathologic features. Once considered two separate pathologies, preliminary data has suggested that a higher prevalence of EoE may exist in patients with CRS.

Objectives

We aimed to expand the base of evidence across geographic regions and investigate the association between EoE and CRS, including CRS with nasal polyposis (CRSwNP).

Methods

Quantitative data detailing the prevalence of CRS, CRSwNP, and EoE were pooled from 6 large academic institutions spread across the United States using Epic electronic medical record system. One-way analysis of variance was then used to analyze the data.

Results

The mean prevalence of EoE in our general population sample of over 26 million individual records was 0.058% (range, 0.013%-0.103%). The mean prevalence of EoE in our sub-populations of individual with diagnoses of CRS and CRSwNP was 0.43% (F(1,12)  =  [8.194], P  =  .01) and 0.84% (F(1,12)  =  [23.61], P < .01) respectively.

Conclusion

This study reveals an 8-fold greater prevalence of concurrent EoE in patients with CRS. Importantly, this is the first study to describe the association of EoE and the CRSwNP subtype, and we demonstrate a 14-fold greater prevalence of EoE in patients with CRSwNP.
The prevalence and associated predictors for Bethesda III–VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia
Authors: Alyousif Hussain , Adam Ishag , Alamin Naser A. , Sid Ahmed Mona A. , Al Saeed Ayat , Hassoni Abdulmuhsen Hussein , Musa Imad R.
Published: September 2022

Background:

Thyroid cancer is increasing globally and is currently the most prevalent endocrine malignancy. Recent data show an increase in the incidence of thyroid cancer in the Kingdom of Saudi Arabia (KSA). Thyroid ultrasound and fine-needle aspiration cytology (FNAC) are the cornerstones in managing thyroid nodules. We conducted this study to evaluate the prevalence and the associated predictors for thyroid nodule Bethesda III–VI in eastern KSA.

Methods:

A retrospective study was conducted between January 2015 and 31 August 2021. The participants were recruited patients who received a thyroid ultrasound and ultrasound-guided thyroid FNAC, using the thyroid imaging reporting and data system (TI-RADS) and the Bethesda Classification, respectively.

Result:

Three hundred and ten patients who underwent thyroid FNAC were enrolled in the study. The median (interquartile, IQR) age was 47.0 (20.0) years, and 266 (85.8%) of them were females. The median (IQR) body mass index was 30.2 (7.6) kg/m2. Out of these participants, 64.8% were euthyroid, 27.4% had hypothyroidism and 7.7% had hyperthyroidism. The ACR TI-RADS-3, 4 and 5 were 51.3%, 46.1% and 2.6%, respectively. The Bethesda outcome of thyroid FNAC I–VI was 5.2%, 63.9%, 15.5%, 5.8%, 3.5% and 6.1%, respectively. The risk for malignancy (Bethesda III–VI) was documented in 31.0% and atypia of undetermined significance was most prevalent (15.5%). A higher ACR TI-RADS score was associated with a higher risk of malignancy: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%). In a multivariate analysis, only the ACR TI-RADS score was significantly associated with the outcome of thyroid FNAC: ACR TI-RADS-4 [OR = 2.59 (95% CI = 1.54–4.36)] and ACR TI-RADS-5 [OR = 29.03 (95% CI = 3.44–245.07)].

Conclusion:

There was a high prevalence of Bethesda III–VI and atypia of undetermined significance was most prevalent. A thyroid ultrasound report for TI-RADS was significantly associated with the outcome of thyroid FNAC and is a reliable tool in the absence of molecular testing for thyroid cancer.