bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Digital-Based Psychotherapy in Overcoming Psychological Problems in College Students During the COVID-19 Pandemic: A Scoping Review
Authors: Sriati Aat , Kurniawan Kurniawan , Senjaya Sukma , Khoirunnisa Khoirunnisa , Muslim Revita Nur Istiqomah , Putri Azalia Melati , Aghnia Nuraulia , Fitriani Nurlaila
Published: April 2023

Purpose: This review aims to determine the effectiveness of the application of digital-based psychotherapy in overcoming the psychological problems of college students during the COVID-19 pandemic. Methods: Several databases consisting of EBSCO-Host CINAHL, PubMed, Scopus, Sage Journal, and Taylor and Francis were used in the search process and resulted in experimental studies focusing on the effectiveness of the application of digital-based psychotherapy during the COVID-19 pandemic timeline (2019–2022). Descriptive and exploratory analyses were performed based on the data set from the study. Results: A total of 12 articles were included in the review. The digital psychotherapy interventions found are diverse including websites, smartphone applications, and video conferencing with the types of therapies provided in the form of, Cognitive Therapy, Cognitive-Behavioral Therapy, Psychodynamic Therapy, and Mindfulness Therapy. Each intervention has a diverse duration and frequency adjusting to the type of therapy given. Digital psychotherapeutic interventions are effective in reducing mental health problems among college students during the COVID-19 pandemic. Conclusions: The use of digital psychotherapy can be used as a prevention and support service for students who experience psychological problems during the COVID-19 pandemic. The combination of the use of digital media with video conferencing can be considered to increase the effectiveness of this service. Nurses need to understand how the procedure for implementing digital-based psychotherapy is to improve the quality of mental care services as an effort to prevent and support students. More research is needed to find out the effectiveness of the use of digital psychotherapy services and how they impact the psychological well-being of students holistically.
Biocompatible 3D printed yttria-stabilized zirconia parts using direct ink writing
Authors: Buj-Corral Irene , Sanz-Fraile Hector , Tejo-Otero Aitor , Vidal Daniel , Padilla José Antonio , Xuriguera Elena , Otero Jorge
Published: April 2023

Metals such as titanium or Cr-Co alloys have been the most widely used materials in biomedical applications that require high mechanical properties, like implants. However, these materials present the disadvantage of releasing ion metals into the body. As an alternative, prostheses made of ceramic materials have been developed, as they produce less debris and have better durability. The aim of the present work is to test the biocompatibility of 3D-printed yttria-stabilized zirconia parts by culturing human bone-marrow-derived mesenchymal stem cells. Two different scaffols were 3D printed having a liner infill pattern, with 80 % and 95 % infill rate respectively. Results on surface roughness and biocompatibility tests confirmed that 3 mol % yttria-stabilized zirconia is a highly promising material as it presented high biocompatibility. In adition, similar results were obtained with or without the use of a type I collagen coating., which suggest that coating could be avoided when on zirconia substraes.
Reliability based design of propeller and Rushton impellers for maximizing the overall heat transfer coefficient in coal gasification
Authors: Purushottam Karthik J , Raguraman CM , Tara Sasanka C
Published: April 2023

The present study aims to identify the optimal process parameters to maximize the Overall Heat Transfer Coefficient for preparation of coal-water slurry used for gasifier in power plants. For this purpose, a jacketed vessel is designed with radial flow (rushton) and axial flow (propeller) impellers to prepare the coal-water slurry. Experiments have been conducted using L9 orthogonal array for Impeller speed (N), ratio of clearance height with diameter of tank (C/T) and ratio of slurry height with tank diameter (Z/T) parameters at three different levels for designed jacketed vessel. The best ranking is arranged in ascending order for propeller Z/T ratio, impeller speed and C/T ratio, for rushton impeller speed, Z/T ratio and C/T ratio. Statistical analysis reveals the percentage contribution of parameters for maximize of heat transfer coefficient in descending order in propeller Z/T ratio (64%), impeller speed (34.92%) and C/T ratio (1.07%), for rushton impeller speed (60.08%), Z/T ratio (36.86%) and C/T ratio (2.48%).
Who engages with science, and how? An empirical typology of Europeans’ science engagement
Authors: Losi Lucilla
Published: April 2023

This article seeks to expand the literature on science attitudes by developing an empirical typology of people’s engagement choices and investigating their sociodemographic characteristics. Public engagement with science is gaining a central role in current studies of science communication, as it implies a bidirectional flow of information, which makes science inclusion and knowledge co-production realizable goals. However, research has produced few empirical explorations of the public’s participation in science, especially considering its sociodemographic characteristics. By means of segmentation analysis using Eurobarometer 2021 data, I observe that Europeans’ science participation can be distinguished into four types, disengaged, the largest group, aware, invested, and proactive. As expected, descriptive analysis of the sociocultural characteristics of each group suggests that disengagement is most common among people with lower social status. In addition, in contrast to the expectations from existing literature, no behavioral distinction emerges between citizen science and other engagement initiatives.
William Attree (died 1846): Royal and army surgeon who underwent amputation of the leg at Brighton, England (1807)
Authors: Cooper Maxwell John , Whiston Benjamin , Cooper Sarah
Published: April 2023

William Attree (1780–1846) came from a prominent family in Brighton, England. He studied medicine at St Thomas’ Hospital, London, and there was unwell for nearly 6 months with severe ‘spasms’ of the hand/arm/chest (1801–1802). Attree qualified Member of the Royal College of Surgeons in 1803 and served as dresser to Sir Astley Paston Cooper (1768–1841). In 1806 Attree is recorded as ‘Surgeon and Apothecary’ of Prince's street, Westminster. In 1806 Attree's wife died in childbirth and the following year he underwent emergency amputation of the foot in Brighton following a road traffic accident. Attree served as surgeon in the Royal Horse Artillery at Hastings, presumably in a regimental or garrison hospital. He went onto become surgeon to the Sussex County Hospital, Brighton, and Surgeon Extraordinary to two Kings: George IV and William IV. In 1843 Attree was appointed as one of the original 300 Fellows of the Royal College of Surgeons. He died in Sudbury, near Harrow. His son William Hooper Attree (1817–1875) was surgeon to Don Miguel de Braganza, the former King of Portugal. The medical literature appears to lack a history of nineteenth century doctors (especially military surgeons) with physical disability. Attree's biography goes a small way towards developing this field of enquiry.
Energy poverty in the Energy Community region: Interrogating policy formulation and coverage
Authors: Bouzarovski Stefan , Brajković Jurica , Robić Slavica , Brown Charlotte , Vuchkova Ivana
Published: April 2023

The capacity of the state to develop and implement policy at the complex nexus of energy infrastructure, social inequality and housing is indicative of the political priorities of governing structures and, by extension, the nature of statecraft more generally. We compare and contrast the energy poverty amelioration policies of two former Yugoslav and two post-Soviet states located outside the European Union, but seeking to join its regulatory sphere – Serbia, Montenegro, Ukraine and Georgia – against the background of deep and persistent patterns of domestic energy hardship. We are particularly interested in uncovering the time horizons, socio-technical systems and target constituencies of different policy measures, as well as energy sector–specific responses to the COVID-19 pandemic. We find that most states in the region have done little to address some of the more substantive challenges around improving housing quality, energy efficiency and gender inequality. However, energy poverty is present in the policy lexicon of all case study countries, and Ukraine, in particular, has advanced a number of more sophisticated approaches and programmes.
Purpurin, a Natural Anthroquinone Ameliorates Streptozotocin-induced Diabetic Nephropathy via Attenuating Hyperglycemia, Dyslipidemia, and Inflammation in Rats
Authors: Shang Yan , Mohideen Abubucker Peer
Published: April 2023

Background

Throughout the world, diabetic nephropathy has been treated by managing hyperglycemia and hypertension with antidiabetic and antihypertensive drugs, but the potency of reversing the diabetic nephropathy-induced complications is still questionable.

Materials and Methods

This study was focused on elucidating the nephroprotective effect of purpurin, a natural anthraquinone, against diabetic nephropathy induced in an in vivo model. Diabetic nephropathy was induced in rats by injecting streptozotocin (STZ) and then treating them with purpurin. The rats were analyzed for food intake, body weight gain, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), serum insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) to analyze the anti-glycemic effect of purpurin on diabetic nephropathy-induced rats. The lipid profile, blood urea nitrogen (BUN), serum creatinine, and lactate dehydrogenase (LDH), and kidney injury molecule-1 (KIM-1) levels were assessed. Proinflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6), were quantified to determine the anti-inflammatory effect of purpurin on diabetic nephropathy-induced rats. Finally, histopathological analysis of kidney tissue was performed.

Results

Purpurin effectively decreased the body weight, FBG, HbA1c, HOMA-IR values, and increased insulin levels. It significantly decreased lipid profiles while increasing high-density lipoprotein (HDL) in diabetic nephropathy-induced rats. It also decreased the BUN, creatinine, LDH, and KIM-1 levels. The reduction in proinflammatory cytokine levels was observed in the purpurin-treated diabetic nephropathy rats. Finally, the histopathological analysis confirms the nephroprotective effect of purpurin.

Conclusion

Taken together, our results conclude that purpurin possesses therapeutic potency to ameliorate diabetic-induced nephropathy, and it can be a promising drug for diabetic nephropathy in the future.
Early versus standard management of chimeric antigen receptor therapy toxicities and management's impact on safety and efficacy
Authors: Gaffney Kelly J , Davis James A , McGann Mary , Edwards Kathy , Ahmed Zaheer , Butcher Colleen , Greenwell Brian , Hess Brian T , Hashmi Hamza
Published: April 2023

Background

Cytokine release syndrome (CRS) and immune effector cell-associated neurologic syndrome (ICANS) are well-documented toxicities of CAR T-cell therapy. To mitigate excessive toxicity, our center has formulated treatment protocols (early vs. standard) for timely management of CRS and ICANS with tocilizumab and/or corticosteroids.

Methods

This retrospective, single-center analysis included patients treated with CAR T-cell therapy. The goal was to describe the association of two management protocols with toxicity and efficacy outcomes.

Results

Fifty-five percent of the 40 patients assigned to early management, out of which 5% and 9% developed grade 3+ CRS and ICANS, respectively. Seventy-seven percent and 41% of these patients received tocilizumab and corticosteroids, respectively. Forty-five percent of patients were stratified as standard management, out of which 0% and 11% developed grade 3+ CRS and ICANS, respectively. Seventeen percent and 28% of these patients received tocilizumab and corticosteroids, respectively. The day +90 overall response rate (ORR) for all patients was 63%, with an ORR of 89% for those managed per early management versus 50% for those managed per standard protocol.

Conclusion

Early use of tocilizumab and corticosteroids is effective in preventing excessive CAR-T-related toxicities with no negative impact on efficacy.
Updates in the use of targeted therapies for the treatment of cholangiocarcinoma
Authors: Lodl Emma , Ramnaraign Brian , Sahin Ilyas , Wheeler Sarah
Published: April 2023

Objective

Many patients with cholangiocarcinoma (CCA) are not surgical candidates, and the survival benefit of chemotherapy is less than 12 months. Several mutations and mutational clusters have recently been identified in CCA, some of which are pharmacologically targetable. The emergence of targeted therapies has significantly altered the treatment landscape of CCA and improved the prognosis for advanced or metastatic CCA. The purpose of this review is to describe past and current treatment strategies of CCA with a focus on FDA-approved targeted therapies.

Data sources

A systematic evaluation of all FDA-approved targeted treatments for CCA through October 2022 was conducted. Information related to pharmacology, clinical efficacy, and safety was gathered from the package insert, and clinical trial data.

Data summary

As of the writing of this review, four targeted agents are FDA approved for the treatment of locally advanced or metastatic CCA. These agents include the IDH1 inhibitor ivosidenib and the FGFR2 inhibitors pemigatinib, infigratinib, and futibatinib. Collectively, these agents have provided additional treatment options for select patients with previously treated locally advanced or unresectable CCA. These agents have also contributed to the development of other targeted therapies for the treatment of CCA and have opened the door for the exploration of novel treatment combinations such as chemotherapy and immunotherapy, which have recently become a front-line treatment option.

Conclusions

Four targeted small molecule agents have emerged as effective therapies in the second-line setting for CCA, which has immensely changed the treatment landscape and directly led to further investigation of targeted agents and immunotherapy as treatment for CCA.
Systemic lupus erythematosus purtscher like retinopathy: Optical coherence tomography angiography assessment implications
Authors: Garcia-Soler Enrique , Martinez-Rubio Clara , De Smet Marc D. , Udaondo Patricia , Salom-Alonso David
Published: April 2023

Purpose

to underline the importance of optical coherence tomography angiography (OCT-A) in the diagnosis, assessment of final visual outcome and better understanding of the Purtscher like retinopathy, as well as to emphasize on performing an ophthalmologic evaluation in all patients with systemic lupus erythematosus, as eye involvement is closely related with disease activity.

Methods

case report. Ophthalmologic multimodal imaging assessment of a patient short after experiencing a systemic lupus erythematosus severe outset.

Results

fundus examination revealed multiple cotton-wool exudates and sharp defined intraretinal white flecken lesions, concentrated in the posterior pole, which along macular edema and the context of lupus disease led to the diagnosis of Purtscher like retinopathy, raising concern about underlying disease activity. OCT-A evidenced ischemic affront in the superficial and deep vascular plexuses but also at choroidal level, preconizing a poor visual outcome. Precapillary retinal vascular stops and choroid lobular ischemic images, with a honey comb configuration in the latter, were of note. Six months after initial consultation, previously displayed ischemic images gave rise to retinal and choroidal atrophy translated into counting fingers best corrected visual acuity with the posterior ensue of retina neovascularization.

Conclusions

This case proves ophthalmologic evaluation mandatory for all patients suffering from lupus and reveals OCT-A as an imaging tool of great value in the assessment of Purtscher retinopathy. To our knowledge, this would be the first report of a SLE Purtscher-like retinopathy characterized by OCT-A, matching graphically and unprecedently vascular micro-embolism stops and ischemic areas, seen as void signals, with the pathognomonic Purtscher flecken, and Paracentral Acute Middle Maculopathy (PAMM) lesions.
Documenting language barriers in a general hospital psychiatry setting
Authors: Arpin-Gemme Krystel , Noah Gelgoot Eden , Miklavcic Alessandra , Jarvis G. Eric
Published: April 2023

Previous research has demonstrated that without the use of professional interpreters, language barriers interfere with patient care. The literature recommends documenting the presence of language barriers in medical charts. To our knowledge, this mixed methods study is the first to examine language documentation practices in a Canadian inpatient psychiatry setting. The research team interviewed 122 patients admitted to a tertiary care psychiatry ward in Montreal, Canada between 2016−2017 to assess their ability to communicate in the healthcare establishment's languages (English/French). Nineteen participants identified as having a language barrier were selected for a qualitative analysis of the retrospective audit of their medical charts. The presence of a language barrier was reflected in 68% of these charts. When a language barrier was documented, professional interpreters were never used. Our qualitative analysis, informed by literature on medical discourse, aimed to provide clinical, administrative, and organizational recommendations to optimize the utilization of interpreting services in psychiatric wards. Documentation of language data was inconsistently collected, often vague, and shed light on the clinical challenges involved in differentiating language barriers from psychopathology. Normalization of limited care for language diverse patients was reflected in the clinical notes. Findings show that a change of organizational culture is imperative to provide optimal care to language diverse patients. We recommend clinician education and standardization of documentation practices, along with institutional policies supporting the systematic use of professional interpreters in mental healthcare settings, to maximize human rights and patient safety, and to bring medical practices to an acceptable standard of care.
Coping strategies of unaccompanied refugee minors shortly after arrival in Belgium
Authors: Behrendt Malte , Lietaert Ine , Bal Sarah , Derluyn Ilse
Published: April 2023

Unaccompanied refugee minors (URMs) are a group in an especially vulnerable situation with heightened psychological suffering due to both stressful life events and current daily stressors. Research has shown that certain coping strategies such as avoidance can be adaptive in the face of ongoing stress. We conceptualize social support as an essential coping resource that these strategies tap into. Since the interrelations between these factors are often not clear in the literature, this study strives to identify and link URMs’ coping strategies, the respective coping resources and the various stressors they target, shortly after arrival in a high-income country. Seventy-nine URMs from various backgrounds were recruited in two first-phase reception centers in Belgium. In addition to self-report questionnaires to assess stressful life events and current daily stressors, we conducted semi-structured interviews, with cultural mediators if required. Thematic analysis was applied to the participants’ accounts and resulted in the identification of four coping strategies: avoidance and distraction, continuity and coherence, selective reliance, and positive appraisal and acceptance. The relation between these coping strategies, the various coping resources used, and the specific stressors at which they aim are discussed. We conclude that avoidant coping and contact with the ethnic community, particularly the peer group, are fundamental strategies for successful coping. Practitioners need to support URMs in their coping efforts by providing and facilitating appropriate coping resources.
SURE: EU support to national short-term working schemes and its openness to non-standard workers
Authors: Elia Panayiotis , Bekker Sonja
Published: April 2023

In response to the labour market effects of the COVID-19 pandemic, the European Union (EU) implemented ‘Temporary Support to mitigate Unemployment Risks in an Emergency’ (SURE). This instrument enables loans to be made under favourable conditions from the EU to affected Member States, covering part of their costs for national short-time work (STW) schemes or similar policies. In essence, STW prevents unemployment by helping employers to temporarily reduce the working hours of their personnel, while providing these employees with income support from the state for the hours not worked. During the COVID-19 crisis, non-standard workers in particular experienced job loss or a reduction of working hours, while often having inadequate access to social security. This article assesses the inclusiveness of SURE in terms of providing, via national STW, support to all workers. Firstly, it explores the options provided by the SURE Regulation to finance STW schemes which also cover non-standard workers. Secondly, it gives an EU-wide overview of which schemes and which types of workers have been supported. Thirdly, the paper analyses in detail how three Member States – Belgium, Cyprus and Poland – have used SURE to support non-standard and self-employed workers. The article adds to the currently scarce analyses on how SURE is used by countries with various STW systems. Moreover, it shows whether SURE may fit the growing EU focus on providing access to social security for all types of workers irrespective of their employment relationship, as for instance codified in the EU Pillar of Social Rights.
Anatomical Feasibility of an Off-the-shelf Single-Renal Scalloped Stent-Graft for Hostile Neck Abdominal Aortic Aneurysm: A Preclinical Study
Authors: Gennai Stefano , Leone Nicola , Andreoli Francesco , Migliari Mattia , Silingardi Roberto
Published: April 2023

Objectives:

To evaluate the feasibility of a standardized single-renal scallop stent-graft.

Design:

Preclinical, single-center, real-world, all-comers, retrospective cohort study.

Methods:

A total of 1347 abdominal aortic aneurysm (AAA) repairs (endovascular and open) performed between 2010 and 2020 were screened for elective treatment and retrievable preoperative high-quality computed tomography angiography (CTA) performed <6 months of the surgical procedure. Six hundred of the included CTAs involved prespecified measurements and a morphological assessment protocol (NCT05150873). The proximal sealing zones suitable for standard stent-graft implantations were further analyzed (N=547). The primary outcome assessed the feasibility of 2 single-renal scallop designs (10×10 mm and 15×10 mm, height × width). The feasibility was the inter-renal length ≥10 mm and ≥15 mm for prototypes #10 and #15, respectively. The secondary outcome quantified hypothetical length and surface improvements comparing those suitable for investigational devices implantation (study group) versus those not (control group).

Results:

Of the total, 24.7% (n=135) was feasible with prototype #10. The study versus control group sealing zones were shorter (p=0.008), with a smaller surface (p=0.009) and a higher alpha angle (p=0.039). The length and surface area increased by about 25% and 23%, respectively, (both p<0.001) within the study group and became significantly better versus the control group (standard stent-graft; both p<0.001). Of the total, 7.1% (n=39) was suitable for prototype #15. The study versus control group sealing zones were shorter (p=0.148), with a smaller surface (p=0.077) and a higher alpha angle (p=0.027). The length and surface area increased by about 34% and 31%, respectively, (both p<0.001) within the study group and became significantly higher versus the control group (standard stent-graft; both p<0.001).

Conclusions:

The use of single-renal scalloped stent-graft might be feasible in a considerable number of AAA patients. The breakthrough stands in treating hostile AAAs presenting in mismatched renal arteries, keeping the complexity of the repair as similar as possible to standard endovascular repair with a remarkable improvement in sealing.

Clinical Impact

The anatomic feasibility of a single renal stent graft for the treatment of “hostile” abdominal aortic aneurysm (AAA) with mismatched renal arteries was evaluated. The experimental device could be feasible in a considerable number of patients with AAA, approaching 25%, and demonstrate significant improvements in sealing. As far as we know, this is the first paper to report the prevalence of mismatched renal arteries in a large cohort of AAA patients in the real world, while proposing a dedicated device. The breakthrough is to keep the complexity of the repair as close as possible to standard endovascular repair
Assessing Endovascular Aneurysm Repair Suitability According to Graft-Specific Instructions for Use in Patients With a Ruptured Abdominal Aortic Aneurysm
Authors: Gjosha Bergin , Jan Boer Gert , Fioole Bram , Buimer M.G. , de Bruin Jorg L. , Suman Arnela , van der Laan Lijckle
Published: April 2023

Purpose:

The purpose of the study is to ascertain endovascular aneurysm repair (EVAR) suitability in relation to stent-graft-specific instructions for use (IFU) in patients with a ruptured abdominal aortic aneurysm (RAAA).

Materials and Methods:

Using the preoperative computed tomography angiography (CTA), the aortic morphology of patients undergoing surgical repair of a RAAA in 2 Dutch hospitals between January 2014 and December 2019 was retrospectively assessed. Three-dimensional and central luminal line reconstructions were used. Anatomical suitability was defined according to the IFU of the stent graft system used.

Results:

Of 128 included patients, 112 (88%) were men and the mean age was 74.1 (SD=7.6) years. Anatomy within IFU for EVAR was present in 31 patients (24%). Overall, 94 patients (73%) were treated with open surgical repair (OSR) and 34 patients (27%) were treated with EVAR. Anatomy within IFU was present in 15 OSR patients (16%) and 16 EVAR patients (47%). In patients with anatomy outside of IFU, 90% (87/97) had unsuitable neck anatomy and 64% (62/97) had insufficient neck length. An unsuitable distal iliac landing zone was observed in 35 patients. Perioperative mortality was 27% (34/128), with no difference between OSR and EVAR (25/94 vs 9/34; p=0.989).

Conclusion:

Most RAAA patients in this series did not have aortic anatomy within IFU for EVAR, mainly due to insufficient neck length. However, whether anatomy outside of IFU equates to unsuitability for EVAR in an emergency setting remains a matter of debate and warrants further research.

Clinical Impact

The treatment of a ruptured abdominal aortic aneurysm can consist of endovascular repair or open repair. Retrospective anatomical assessment shows that most patients do not have anatomy inside the instructions for use for endovascular aneurysm repair, mainly due to insufficient neck length. Whether anatomy outside the instructions for use equates unsuitability for endovascular aneurysm repair remains a matter of debate.
The Association Between the D-dimer Level at 1 Year After EVAR and Sac Diameter Change in Patients With Persistent Type 2 Endoleak
Authors: Sugimoto Masayuki , Sato Tomohiro , Ikeda Shuta , Kawai Yohei , Niimi Kiyoaki , Banno Hiroshi
Published: April 2023

Purpose:

Recent studies suggested that continuous clotting renewal in thrombi plays a central role in sac enlargement after endovascular aneurysm repair (EVAR). We reviewed patients with persistent type 2 endoleak (T2EL) to estimate the impact of D-dimer level on sac enlargement.

Methods:

A retrospective review of elective EVAR for infrarenal abdominal aortic aneurysm performed between June 2007 and February 2020. Persistent T2EL was defined as T2EL confirmed at both the 6 and 12 month contrast-enhanced computed tomography (CECT) follow-ups. “Isolated” T2EL was defined as T2EL without other types of endoleak within 12 months. Patients with >2 year follow-up, persistent isolated T2ELs, and D-dimer level data at 1 year (DD1Y) were included. Patients with any reintervention within 12 months were excluded. The association between DD1Y and aneurysm enlargement (AnE), defined as a ≥5 mm diameter increase, within 5 years was analyzed. Among 761 conventional EVAR, 515 patients had >2 years of follow-up. Thirty-three patients with any reintervention within 12 months and 127 patients without CECT at either 6 or 12 months were excluded. Among 131 patients with persistent isolated T2ELs, 74 patients with DD1Y data were enrolled. During a 37 month median follow-up [25–60, IQR], 24 AnEs were observed. In the AnE patients, the median DD1Y was significantly higher than that in the other patients (12.30 [6.88–21.90] vs 7.62 [4.41–13.00], P=0.024). ROC curve analysis indicated that the optimal cutoff point of DD1Y for AnE was 5.5 µg/mL (AUC=0.681). In univariate analysis, angulated neck, occlusion of the inferior mesenteric artery, and DD1Y≥5.5 µg/mL were significantly associated with AnE (P= 0.037, 0.038, and 0.010). Cox regression analysis revealed that DD1Y≥5.5 µg/mL was correlated with AnE (P=0.042, HR [95% CI] 4.520 [1.056–19.349]).

Conclusion:

A 1 year higher D-dimer level can potentially predict AnE within 5 years in persistent T2EL patients. AnE was considered improbable when the D-dimer level was low enough.

Clinical Impact

The present study suggests that a 1-year higher D-dimer level could potentially predict aneurysm expansion within 5 years in patients with persistent type 2 endoleak (T2EL). On the other hand, aneurysm expansion was considered unlikely if the D-dimer level was low enough. As there are many patients with T2EL who require regular follow-up, any predictor of future aneurysm expansion could be of great help in conserving medical resources. In patients with a low likelihood of future expansion, we might consider delaying follow-up, similar to patients with sac shrinkage.
Four cases of localized plaque psoriasis successfully treated by intense pulsed light: A case series
Authors: Hu Cai-Xia , Cui Yu , Cheng Yi , Gao Shun-Qiang , Wang Wen-Qing , Jiang Shao-Qian , Zhang Yan
Published: April 2023

Four patients with localized plaque psoriasis had used various systemic drugs along with topical cream. However, their skin lesions recurred, and the disease was refractory. After 2 weeks of discontinuation of oral and external medication, they were given three consecutive irradiation treatments with intense pulsed light once every 2 weeks for a 6-week period. After treating for 6 weeks, the erythema colors of the patients were evidently darkened, the scales were evidently reduced, and the skin lesions were significantly thinner or even flattened. The treatment was satisfactory, without occurrence of severe adverse reactions.
Dynamic data-enabled stratified sampling for trial invitations with application in NHS-Galleri
Authors: Brentnall Adam R , Mathews Chris , Beare Sandy , Ching Jennifer , Sleeth Michelle , Sasieni Peter
Published: April 2023

Background:

Participants of health research studies such as cancer screening trials usually have better health than the target population. Data-enabled recruitment strategies might be used to help minimise healthy volunteer effects on study power and improve equity.

Methods:

A computer algorithm was developed to help target trial invitations. It assumes participants are recruited from distinct sites (such as different physical locations or periods in time) that are served by clusters (such as general practitioners in England, or geographical areas), and the population may be split into defined groups (such as age and sex bands). The problem is to decide the number of people to invite from each group, such that all recruitment slots are filled, healthy volunteer effects are accounted for, and equity is achieved through representation in sufficient numbers of all major societal and ethnic groups. A linear programme was formulated for this problem.

Results:

The optimisation problem was solved dynamically for invitations to the NHS-Galleri trial (ISRCTN91431511). This multi-cancer screening trial aimed to recruit 140,000 participants from areas in England over 10 months. Public data sources were used for objective function weights, and constraints. Invitations were sent by sampling according to lists generated by the algorithm. To help achieve equity the algorithm tilts the invitation sampling distribution towards groups that are less likely to join. To mitigate healthy volunteer effects, it requires a minimum expected event rate of the primary outcome in the trial.

Conclusion:

Our invitation algorithm is a novel data-enabled approach to recruitment that is designed to address healthy volunteer effects and inequity in health research studies. It could be adapted for use in other trials or research studies.
IBD barriers across the continents: a continent-specific analysis: Latin America
Authors: Queiroz Natália Sousa Freitas , Martins Camilla de Almeida , Quaresma Abel Botelho , Olivera Sendra Pablo A. , Ernest-Suarez Kenneth , Kotze Paulo Gustavo
Published: April 2023

Latin America (LATAM) is a large region comprising 47 countries and territories. Each one carries a different cultural and historical background, diverse political systems, and a particular approach to healthcare management. There is a lack of high-quality data on the epidemiology of inflammatory bowel diseases (IBD) in this region, including broad and detailed information about the penetration of biological and advanced therapies as treatment strategies. From an IBD perspective, patients experience, in general, fragmentations and inequities in the healthcare systems, with different and usually delayed access to qualified health services. This review explores the barriers to accessing IBD care throughout LATAM. The authors compiled data from multiple sources, such as studies focusing on epidemiology, biological penetration, and surgical rates. In addition, overall access to IBD treatments was assessed through a questionnaire distributed to physicians in LATAM via email and direct messaging to capture local perspectives.
TV News and the Military: Exploring Media Frames of an American Institution
Authors: Luchsinger Alex , O'Boyle Jane
Published: April 2023

This exploratory study analyzes television news transcripts ( N = 300) to examine how broadcast news networks (ABC, CBS, and NBC) and cable news networks (CNN, Fox, and MSNBC) cover military veterans and service members in news programming. Findings show that the stories and sources of broadcast news networks focused on veterans and service members or their families, while cable news networks relied on legislative issues, politicians and other elite sources. Other findings and recommendations are discussed.
Ultrasound-Guided Glenohumeral Corticosteroid Injection for the Treatment of Adhesive Capsulitis of the Shoulder: The Role of Clinical Stage in Response to Treatment
Authors: Ammerman Brittany M. , Dennis Elizabeth R. , Ling Daphne , Hannafin Jo A.
Published: April 2023

Background:

Treatment for idiopathic adhesive capsulitis of the shoulder remains controversial. Stages 1 to 2 reflect an inflammatory process supporting a rationale for intra-articular glenohumeral joint corticosteroid injection to treat synovial inflammation and prevent progression to capsular fibrosis.

Hypothesis:

We hypothesize that an intra-articular ultrasound-guided glenohumeral injection (USGI) of corticosteroid in patients diagnosed with Stage 1 or 2 idiopathic adhesive capsulitis will result in timely functional recovery and resolution of pain and stiffness.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

Patients with Stage 1 or 2 idiopathic adhesive capsulitis treated with an intra-articular corticosteroid injection were included. Patients were seen by a single physician and diagnosed using history and physical examination with careful attention to measurement of glenohumeral range of motion (ROM). A total of 61 patients met inclusion criteria. ROM measurements documented in the patient charts were recorded in forward flexion, abduction, internal rotation, and external rotation in neutral abduction. All ROM measurements were performed pre- and postinjection. All patients were treated with an USGI of local anesthetic and depomedrol. Recovery criteria were defined as forward flexion, abduction, and external rotation within 15° of the contralateral side and internal rotation within 3 spinous process levels of the contralateral side.

Results:

A total of 11 patients with Stage 1 and 50 patients with Stage 2 adhesive capsulitis comprised the final study cohort. Within the Stage 1 cohort, all 11 patients met recovery criteria for forward flexion and internal rotation (100%), 10 met recovery criteria for abduction (91%), and 8 met recovery criteria for external rotation (73%). Within the Stage 2 cohort, 31 patients met recovery criteria for forward flexion (62%), 30 met recovery criteria for abduction (60%), 36 met recovery criteria for internal rotation (72%), and 25 met recovery criteria for external rotation (50%). The difference in time to recovery in days was statistically significant in all ROM planes and was within 2 to 6 weeks for patients in Stage 1 and 7 to 10 weeks for Stage 2.

Conclusion:

USGI for early adhesive capsulitis allows patients to recover ROM more rapidly if performed early after onset of pain and stiffness.

Clinical Relevance:

These results stress the importance of recognition of idiopathic adhesive capsulitis in its early stages and subsequent intervention with an intra-articular glenohumeral corticosteroid injection.
Bupropion-Induced Myoclonus: Case Report and Review of the Literature
Authors: Riaz Asad , Ali Hossam Tharwat , Allahham Abdulrahman , Fornari Caprara Ana Leticia , Rissardo Jamir Pitton
Published: April 2023

Bupropion is an atypical antidepressant agent approved for treating major depressive disorders and prescribed for smoking cessation, attention deficit hyperactive disorder (ADHD), and sexual dysfunction. In a few cases, bupropion was associated with myoclonus. We present a case of a 58-year-old male, a heavy smoker seeking smoking cessation, was prescribed bupropion 150 mg twice daily. The subject doubled the dosage without medical advice. After 3 days of the increased dosage, he started to experience abnormal movements in his upper limbs associated with diffuse facial twitching. Neuroimaging, electrodiagnostic studies, and laboratory exams were unremarkable. Bupropion was discontinued, and clonazepam was initiated. The subject fully recovered within 24 hours. To the authors’ knowledge, only 8 cases of bupropion-induced myoclonus were reported in the literature. Bupropion discontinuation was the most common management. All individuals except 2 cases fully recovered after bupropion withdrawal. The mechanism of bupropion is probably associated with the serotoninergic pathway.
The effect of the Ebe Evimde application on the self-efficacy and anxiety levels of mothers: Randomized controlled trial
Authors: Bozkurt Merve Ayşe , Cesur Büşra
Published: April 2023

Objective

Family health can be improved by making home visits with mobile applications. This study was carried out to evaluate the effect of a mobile application and web-based software called Ebe Evimde (My Home Midwife), which was designed by the researchers for use in the postpartum period, on mothers’ self-efficacy and anxiety levels.

Methods

Home visits to 60 mothers in the intervention group, who are over 18 years of age, who have given birth at term, who have no complications in mother and baby, and who are in the second to fifth postpartum days, were made with the online home visits mobile support application Midwifery Home software and their self-efficacy and anxiety levels were evaluated. Mothers were divided into two groups as intervention (60) and control group (60) using a random number table.

Results

While there was a significant difference between the pretest and posttest self-efficacy levels of the intervention group, there was no difference between the pretest and posttest self-efficacy levels of the control group. When the groups obtained from the Postpartum Specific Anxiety Scale were examined, it was seen that there was a negative and very strong significant relationship between the pretest and posttest scores of the mothers in the intervention group, while when the relationship between the pretest and posttest scores of the mothers in the control group was examined; no significant relationship was observed.

Conclusion

The practice of Ebe Evimde (My Home Midwife) had a positive effect on mothers’ self-efficacy and postpartum anxiety levels.
Examining the role of social media and mobile social networking applications in socio-political contestations in Nigeria
Authors: Uwalaka Temple , Nwala Bigman
Published: April 2023

Social media platforms continue to flourish as practices encompassing them become deeply embedded in many cultures. As more people embrace social media platforms, their affordances and opportunities are leading to improved communication, and helping hold authorities to account. To further scrutinize the importance of these platforms, this study interrogates the role of digital media in socio-political contestations in Nigeria by examining the media used to mobilize, coordinate, and document the 2020 #EndSARS protests in Nigeria. Analyses of survey data collected in 2020 during the protests in Lagos and Port Harcourt, Nigeria (N = 391) show that demonstrators who were 30 years and older and used WhatsApp and Facebook to learn about the protests as well as coordinate their participation in the protests are more likely to report participating on the first day of the protests than protesters who are younger than 30 and used other media platforms. Findings further illustrate that digital enthusiasm facilitated by hedonic-experiential and epicurean communication on WhatsApp and Facebook eventuated a process of emotional contagion through connective repertoires that created propitious emotional conditions for mass collective protest actions. Finally, the article discusses how the use of WhatsApp and Facebook gave protesters strategic communicative power during the protests.
When domestic interests and norms undermine the rules-based order: Reassessing Japan's attitude toward international law
Authors: Hein Pat
Published: April 2023

It has been widely acknowledged that Japan is a full and equal member of the international legal order as it stands, asserting its postwar identity as a responsible and law-abiding member of the international community. However, this essay argues that Japan's external compliance with a rules-based order and international legal norms is not reflected in corresponding domestic practices. The article provides a social constructivist grounded in-depth analysis of the various interests and constraints that have shaped Japan's domestic response to international legal norms. The selected five comparative case studies—Non-proliferation Treaty obligations, whaling policies, the detention and deportation of asylum seekers, the dumping of radioactive waters into the high seas off Fukushima and sovereignty claims over the Senkaku/Diaoyu islands—suggest that pragmatic nationalism and cultural norms undermine Japan's commitment to the rules-based order.
Radiation Recall Dermatitis Following Treatment With Pembrolizumab: A Case Report and Review of the Literature
Authors: Sandhu Michael , Ashok Kumar Prashanth , Deck Jared , Zerdan Maroun Bou , Lacombe Michael , Sivapiragasam Abirami
Published: April 2023

Radiation recall dermatitis is an inflammatory reaction of the skin that may infrequently occur in areas of the skin that have been previously treated with radiation therapy. This is thought to be due to a triggering agent administered after radiation therapy which leads to an acute inflammatory reaction, manifesting as a skin rash. We present the case of a 58-year-old male with recurrent invasive squamous cell carcinoma of the tongue, previously treated with chemotherapy and radiation therapy, who presented with progression of his disease. He was treated with pembrolizumab and subsequently developed a new-onset facial rash over the previously treated radiation field. The distribution of the rash was suggestive of radiation recall dermatitis. A biopsy showed dermal necrosis without evidence of dermatitis, vasculitis, or infectious process. This case highlights the incidence of a rare complication of immune checkpoint inhibitor therapy and emphasizes the need for careful monitoring for radiation recall dermatitis.
Evaluation of Social Media and Online Utilization Among Members of the American Orthopaedic Society for Sports Medicine: Implications in Practice
Authors: Kerzner Benjamin , Hodakowski Alexander , Fortier Luc M. , Dasari Suhas P. , Swindell Hasani W. , Rea Parker M. , Khan Zeeshan A. , Gursoy Safa , Bush-Joseph Charles A. , Verma Nikhil N. , Chahla Jorge
Published: April 2023

Background:

Social media has the potential to act as an avenue for patient recruitment, patient and surgeon education, and expansion of the physician-patient relationship.

Purpose:

To evaluate the existing social media presence among members of the American Orthopaedic Society for Sports Medicine (AOSSM) to describe trends in different subgroups within the membership.

Study Design:

Cross-sectional study.

Methods:

The AOSSM database was queried for a complete membership list. Members were excluded from analysis if they were not orthopaedic sports medicine surgeons practicing in the United States. Demographic characteristics, online media profiles, and levels of online presence were evaluated, and an online media presence score was calculated. Bivariate analysis was performed to compare demographic variables and levels of online presence.

Results:

A total of 2870 surgeons were included in the analysis. LinkedIn was the most used platform (56%), while YouTube was the least used (10%). Surgeons in academic practice had a significantly greater overall social media presence than their private practice counterparts. Female surgeons had a more significant active online presence on Twitter, Instagram, and Facebook than male surgeons. Surgeons practicing in the Northeast had a greater social media presence than those in any other United States region, and surgeons in the earlier stages of practice (0-14 years) were more likely to utilize social media than their more senior colleagues (≥15 years of practice). On multivariate analysis, surgeons in the earlier stages of practice were more likely to have active Twitter, Instagram, and Facebook accounts, and female surgeons were more likely to have an active Facebook account. Additionally, multivariate analysis revealed that a greater number of ResearchGate publications were associated with male sex and having an academic practice. Comparatively, active Twitter and Instagram use was associated with having an academic practice.

Conclusion:

The most used platform in this surgeon population was LinkedIn. Orthopaedic surgeons in academic practice, female surgeons, those early in their career, and those practicing in the Northeast highlighted a subset of the sports medicine community who were more likely to have an active online presence compared to the rest of the AOSSM.