bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal Overresection During Femoral Osteochondroplasty Negatively Affects the Distractive Stability of the Hip Joint: A Cadaver Study
Authors: Lazaro Lionel E. , Lim Daniel P. , Nelson Trevor J. , Eberlein Sam A. , Banffy Michael B. , Metzger Melodie F.
Published: July 2021

Background:

Contact between the acetabular labrum and articular cartilage of the femoral head creates a suction seal that helps maintain stability of the femoral head in the acetabulum. A femoral osteochodroplasty may occasionally extend proximally into the femoral head, diminishing the articular surface area available for sealing contact.

Purpose:

To determine whether proximal overresection decreases the rotational and distractive stability of the hip joint.

Study Design:

Controlled laboratory study.

Methods:

Six hemipelvises in the following conditions were tested: intact, T-capsulotomy, osteochondroplasty to the physeal scar, and 5- and 10-mm proximal extension. The pelvis was secured to a metal plate, and the femur was potted and attached to a multiaxial hip jig. Specimens were axially distracted using a load from 0 to 150 N. For rotational stability testing, 5 N·m of internal and external torque was applied. Both tests were performed at different angles of flexion (0°, 15°, 30°, 60°, 90°). Displacement and rotation were recorded using a 3-dimensional motion tracking system.

Results:

The T-capsulotomy decreased the distractive stability of the hip joint. A femoral osteochondroplasty up to the physeal scar did not seem to affect the distractive stability. However, a proximal extension of the resection by 5 and 10 mm increased axial instability at every angle of flexion tested, with the greatest increase observed at larger angles of flexion ( P < .01). External rotation increased significantly after T-capsulotomy in smaller angles of flexion (0°, P = .01; 15°, P = .01; 30°, P = .03). Femoral osteochondroplasty did not create further external rotational instability, except when the resection was extended 10 mm proximally and the hip was in 90° of flexion ( P = .04).

Conclusion:

This cadaveric study demonstrated that proximal extension of osteochondroplasty into the femoral head compromises the distractive stability of the hip joint but does not affect hip rotational stability.

Clinical Relevance:

Clinically, this study highlights the importance of accuracy when performing femoral osteochondroplasty to minimize proximal extension that may increase iatrogenic instability of the hip joint.
Feminism and Firearms: Gun Ownership, Gun Carrying, and Women’s Empowerment
Authors: Kelley Margaret S.
Published: July 2021

In this article, I use the 2018 Guns in American Life Survey (GALS) to investigate the relationship between feminist identity, gun ownership, gun carrying, and women’s empowerment. Notably, while identifying as a feminist lessens the likelihood that a woman will own a gun, of women who own handguns, feminists are more likely to carry their guns all or most of the time. Past victimization is associated with ownership and carrying, confirming genuine concern by women about their safety. Finally, findings reveal that women are more empowered by guns than are men and the relationship is moderated by age. Results are discussed in light of the current American gun culture focused on self-defense and a carry mindset that some women develop as feminist culture in action.
Older Adults’ Goals and Expectations When Using Long-Term Services and Supports
Authors: Travers Jasmine L. , Hirschman Karen B. , Naylor Mary D.
Published: July 2021

Objective

Despite recent research focused on aging well, little is known regarding the goals and expectations from long-term services and supports (LTSS) use among older adults.

Methods

To address this knowledge gap, interviewer-guided surveys with older adults newly receiving LTSS in home and community-based, assisted living, and nursing home settings in Philadelphia, New Jersey, and New York were conducted.

Results

Twelve subthemes regarding the goals and expectations of 464 older adults receiving LTSS and in the context of Aging Well emerged from our analysis: maintaining function, optimizing health and circumstances, maintaining the status quo, transitioning back to the previous state, achieving independence, preserving cognitive function and capacity for psychosocial and emotional health, achieving purpose, increasing quality of life, receiving social support, increasing engagement, relieving burden, and feeling a sense of security/safety.

Discussion

This in-depth analysis of qualitative data provides context for LTSS use among older adults.
Neural Changes Induced by a Speech Motor Treatment in Childhood Apraxia of Speech: A Case Series
Authors: Fiori Simona , Pannek Kerstin , Podda Irina , Cipriani Paola , Lorenzoni V. , Franchi Beatrice , Pasquariello Rosa , Guzzetta Andrea , Cioni Giovanni , Chilosi Anna
Published: July 2021

We report a case series of children with childhood apraxia of speech, by describing behavioral and white matter microstructural changes following 2 different treatment approaches.

Five children with childhood apraxia of speech were assigned to a motor speech treatment (PROMPT) and 5 to a language, nonspeech oral motor treatment. Speech assessment and brain MRI were performed pre- and post-treatment. The ventral (tongue/larynx) and dorsal (lips) corticobulbar tracts were reconstructed in each subject. Mean fractional anisotropy and mean diffusivity were extracted. The hand corticospinal tract was assessed as a control pathway. In both groups speech improvements paralleled changes in the left ventral corticobulbar tract fractional anisotropy. The PROMPT treated group also showed fractional anisotropy increase and mean diffusivity decrease in the left dorsal corticobulbar tract. No changes were detected in the hand tract. Our results may provide preliminary support to the possible neurobiologic effect of a multimodal speech motor treatment in childhood apraxia of speech.
Comprehensive preview decision-making method for direction and speed of intelligent vehicle based on rules and mechanisms
Authors: Hsin Guan , Fei He , Li-zeng Zhang , Xin Jia
Published: July 2021

According to the existing driver model, the objective function is coupled with continuity factors and discontinuity factors, which makes it difficult to determine the weighting coefficients in multi-objective optimization, which will cause dangerous situations such as the vehicle rushing out of the road boundary; in response to this problem, this paper proposes a driver model adapted to the complex traffic environment, based on the mechanism modeling of continuity factors and rule modeling of discontinuity factors. In view of the difficulty of traditional optimization algorithms to find a balance between efficiency and accuracy, this paper proposes a grid optimization algorithm that takes into account both efficiency and accuracy. In order to reduce the amount of calculation in the preview decision-making process, this paper proposes a curve integral method based on the laws of vehicle kinematics to predict the position of the vehicle to judge whether a collision will occur. The driver model is established in the Simulink simulation environment, and the C-level prototype model in the vehicle dynamics simulation software CarSim is selected as the control object, the results show that the proposed the preview decision model effectively solves the problem of divergence in the optimization solution, and can also ensure safety and traffic rules in a complex traffic environment, improving the quality of the model.
Stamina-Enhancing Effects of Human Adipose-Derived Stem Cells
Authors: Yoon Eun-Jung , Seong Hye Rim , Kyung Jangbeen , Kim Dajeong , Park Sangryong , Choi Ehn-Kyoung , Kim Yun-Bae , Park Dongsun
Published: July 2021

Stamina-enhancing effects of human adipose derived stem cells (hADSCs) were investigated in young Sprague-Dawley rats. Ten-day-old male rats were transplanted intravenously (IV) or intracerebroventricularly (ICV) with hADSCs (1 × 106 cells/rat), and physical activity was measured by locomotor activity and rota-rod performance at post-natal day (PND) 14, 20, 30, and 40, as well as a forced swimming test at PND 41. hADSCs injection increased the moving time in locomotor activity, the latency in rota-rod performance, and the maximum swimming time. For the improvement of physical activity, ICV transplantation was superior to IV injection. In biochemical analyses, ICV transplantation of hADSCs markedly reduced serum creatine phosphokinase, lactate dehydrogenase, alanine transaminase, and muscular lipid peroxidation, the markers for muscular and hepatic injuries, despite the reduction in muscular glycogen and serum triglycerides as energy sources. Notably, hADSCs secreted brain-derived neurotrophic factor (BDNF) and nerve growth factor in vitro, and increased the level of BDNF in the brain and muscles in vivo. The results indicate that hADSCs enhance physical activity including stamina not only by attenuating tissue injury, but also by strengthening the muscles via production of BDNF.
Impoliteness and power dynamics in intimate interactions: An analysis of Joe Blann’s ‘Things We Had’
Authors: Mourad Lina
Published: July 2021

Joe Blann’s (2011) comic ‘Things We had’ is a complex and nuanced multimodal realisation of a tense interaction between a couple, rendered through the subtle interplay of narration, panel composition and dialogue. The tug of war and blame game the couple engage in are rife with instances of impoliteness. Drawing on Culpeper’s (2011a, 2015b) impoliteness framework and an integrative pragmatics approach, this article examines the sophisticated multimodal realisation of impoliteness and power dynamics, with a particular focus on the subtle forms of implicational impoliteness and intricate impoliteness patterning used in the fictional interaction. In doing so, it analyses the interplay between impoliteness and power dynamics in the exchange, highlighting the importance of impoliteness analysis in revealing the fluid relational power dynamics underlying the couple’s interaction. This is accompanied by an analysis of the key affective and interactional role of impoliteness in driving the exchange between the couple. Impoliteness, along with the evaluative negative affect it involves, is shown to be instrumental in the couple’s struggle for interactional power in the course of the interaction, and also more broadly, in their negotiation of relational power within the relationship.
Juxtaposing The Great Indian Kitchen and the Kudumbashree: Women, Work and Agency in Kerala
Authors: Varghese Daigy , Ranganathan Shubha
Published: July 2021

The recent Malayalam film ‘The great Indian kitchen’ invoked debate in Kerala on women’s unpaid work in the house. Taking off from this film, this commentary draws on ethnographic research with women participating in the Kudumbashree, a women’s empowerment programme in Kerala, to engage with questions of paid work, household labour and care arrangements within the household. While the film depicts the struggles of a newly wedded young woman in her in-laws’ house and how she leaves the marriage to follow her dreams, this article shifts the focus to the tactics and strategies used by women in their 40s and 50s who remain within the family fold. We look at the experiences of these women who negotiate work and care arrangements to meet their needs. In doing so, we seek to understand what these strategies say about the conceptualisation of women’s agency and independence, particularly in South Asian contexts.
Factors Influencing China’s Outward Foreign Direct Investment
Authors: Wu Hsiu-Ling , Chen Chien-Hsun , Chen Yi-Rou
Published: July 2021

The main purpose of this study is to explore factors determining China’s outward FDI (OFDI), with particular emphasis on the unique characteristics of China’s economy during the period of institutional transformation. The empirical results obtained in the present study show that Chinese enterprises tend to invest in countries that have a mature economy. Exports have a significantly positive effect on China’s OFDI, with the relationship between OFDI and exports in China being a complementary one. The relationship between imports and OFDI for China is one of substitution, as Chinese enterprises have often relied upon the importation of key components as a means of acquiring the technology they need. Exchange rates, monopolistic advantage, foreign exchange reserves and the level of technology intensity, all have a significant impact on China’s OFDI, while the GDP growth rate and geographical distance have not had a significant impact.

JEL Classification: F200, O160, P450
Relationship Between International Factoring and Cross-border Trade: A Granger Causality Approach
Authors: Marak Zericho R. , Pillai Deepa
Published: July 2021

Trade finance is integral for international trade as it offers fluidity and safety to the movement of merchandise and services globally. After the financial crisis of 2008–2009, there has been an increase in the use of open accounts, which enhances the possibilities for availing factoring for international trade. International factoring has witnessed considerable growth in the last decade. This article examines the relationship between international factoring and cross-border trade using Granger causality. It also examines the causal relations of international factoring with disaggregated data of cross-border trade of imports and exports. We find a unidirectional causal flow from international trade to international factoring, and a unidirectional casual flow from exports to international factoring.

JEL Classification: F10, F30
Tax Effort of the Indian States from 2001–2002 to 2016–2017: A Stochastic Frontier Approach
Authors: Kawadia Ganesh , Suryawanshi Ankit Kumar
Published: July 2021

This article estimates the tax capacity and tax effort of 17 major states of India from 2001–2002 to 2016–2017 using the stochastic frontier panel data model. It is found that per capita income, agriculture activity, infrastructure, labour force and bank credit are the significant determinants of tax capacity, while social sector spending and central transfer to states are significant in determining tax effort. The Goods and Services Tax has reduced the states’ tax powers. Therefore, the states are highly dependent on their limited legislative taxes for revenue mobilization. However, there is little scope for the subnational governments to increase tax revenue as all states have achieved at least 90% of their tax potential.
Evaluating and Managing the Painful Total Ankle Replacement
Authors: Henry Jensen K. , Rider Carson , Cody Elizabeth , Ellis Scott J. , Demetracopoulos Constantine
Published: July 2021

The number of total ankle replacements (TARs) performed in the United States has dramatically increased in the past 2 decades due to improvements in implant design and surgical technique. Yet as the prevalence of TAR increases, so does the likelihood of encountering complications and the need for further surgery. Patients with new-onset or persistent pain after TAR should be approached systematically to identify the cause: infection, fracture, loosening/subsidence, cysts/osteolysis, impingement, and nerve injury. The alignment of the foot and ankle must also be reassessed, as malalignment or adjacent joint pathology can contribute to pain and failure of the implant. Novel advanced imaging techniques, including single-photon emission computed tomography and metal-subtraction magnetic resonance imaging, are useful and accurate in identifying pathology. After the foot and ankle have been evaluated, surgeons can also consider contributing factors such as pathology outside the foot/ankle (eg, in the knee or the spine). Treatment of the painful TAR is dependent on etiology and may include debridement, bone grafting, open reduction and internal fixation, realignment of the foot, revision of the implants, arthrodesis, nerve repair/reconstruction/transplantation surgery, or, in rare cases, below-knee amputation.

Level of Evidence: Level V, expert opinion or review.
Joint Preservation Surgery for Varus Ankle Arthritis with Large Talar Tilt
Authors: Park Chul Hyun , Kim Ji Beom , Kim Jaeyoung , Yi Young , Lee Woo-Chun
Published: July 2021

Background:

Varus ankle arthritis with large talar tilt (TT) is a challenging condition when considering joint preservation surgery. Three-dimensional deformity of the talus has been demonstrated with weightbearing computed tomography in varus ankle arthritis with large TT. The aim of this study was to investigate the clinical and radiographic results of posterior tibial tendon (PTT) transfer generally combined with bony realignment for varus ankle arthritis with large TT in nonparalytic ankle arthritis and to determine the indications for PTT transfer.

Methods:

This study includes 23 ankles with varus arthritis and TT larger than 7.5 degrees. Patients were categorized into improved (19 ankles) and unimproved (4 ankles) groups according to the postoperative clinical results at the last follow-up. Clinical and radiographic results were compared between the groups. A cut-off point for preoperative TT that indicated a borderline between improved and unimproved groups was determined to suggest the appropriate indication for joint preservation surgery.

Results:

In the improved group, TT, radiographic stage, Meary angle, and hindfoot alignment significantly improved at 6 months after surgery and were maintained at the last follow-up. In the unimproved group, the radiographic parameters mentioned above did not improve at 6 months after surgery, and TT decreased to 0.8 degrees as radiographic stage had progressed to end-stage arthritis at the last follow-up. In this small series, the cut-off point for predicting failure of surgery was 14.3 degrees of preoperative TT.

Conclusion:

PTT transfer often combined with bony realignment procedures may be a reasonable option for treating painful varus ankle arthritis with TT less than 14 degrees and hindfoot varus.

Level of Evidence:

Level IV, case series.
Analysis of periodic laminated fiber-reinforced composite beams in free vibration
Authors: Bishay Peter L , Rodriguez Julian
Published: July 2021

The dynamic behavior of solid structures is an important aspect that must be considered in the design phase to ensure that the designed structure will have desired response under external excitation. Periodic structures offer various design possibilities that can tailor the dynamic behavior of the structure to match the desired response under a given applied excitation. The use of laminated fiber-reinforced composite materials in periodic structures further increases the design degrees of freedom by introducing new design parameters, such as the number of plies in each periodic patch and their fiber-orientation angles. In this article, the classical lamination theory is integrated with the forward approach of the wave finite element method to analyze periodic fiber-reinforced composite beams in flexural vibration. Since Euler–Bernoulli’s beam theory is used, the proposed approach is much simpler and computationally efficient than using laminated shell finite elements. The article shows the effects of the number of periodic cells, the segment length ratio, the number of plies in each periodic patch, and their fiber-orientation on the first stop band of the beam. The results reported can guide the design of such structures to attenuate vibration amplitudes at specific target frequency bands and avoid undesired dynamic responses. Results have been validated in the 0–2000 Hz frequency range by comparison with finite element laminated shell models.
A study on an incompressible polymeric pressurized vessel subjected to bulk degradation
Authors: Kazemian M , Moazemi Goudarzi A , Hassani A
Published: July 2021

To study the mechanical behavior of an incompressible polymeric degradable vessel subjected to the neo-Hookean constitutive model, two solution frameworks are introduced. One is combining a recently developed semi-analytical method and the [Formula: see text]-family time approximation (hybrid method). The other is the Standard Galerkin Finite Element Method (SGFEM), which is implemented by providing a script in the FlexPDE commercial software. A deformation-induced evolution law is used to study the dependence of material properties upon time and position in the polymeric vessel during bulk degradation. The convergence of the two proposed methods on degradable vessel responses under the axisymmetric plane-strain conditions is seen. Although the hybrid method, unlike the SGFEM, is implemented as an iteration-based algorithm, it uses highly acceptable central processing unit time because it can directly solve differential equations without converting variables. The FlexPDE method is much easier to extend to more complex case studies because the hybrid method is based on an analytical approach. It is found that less pressure is required to maintain the incompressibility of the material during the degradation. The material response to incompressibility decreases more sharply in the inner radius of the vessel. Initially, the hoop stress decreases in the inner radius but eventually reaches more than its virgin value.
The Influence of the Lotus Flower Theme on the Perception of Contemporary Urban Architecture
Authors: Latała-Matysiak Dżoana , Marciniak Marcin
Published: July 2021

We live in the visual culture times, when images continuously and daily are transferring some information. A visual message is also an indispensable element of architecture, in the semantic layer as an aesthetic value, sometimes fulfilling a narrative function by means of a symbol, which is an international visual code. Most of the symbols, hidden in painting, sculpture, or architecture, are elements of nature. The article discusses examples of architecture whose form is based on a lotus flower. Unification of urban landscapes leads to a decrease in the value of aesthetic impressions; therefore, the unique architecture builds the unique identity of the place.
Alliances, signals of support, and military effort
Authors: DiGiuseppe Matthew , Shea Patrick E.
Published: July 2021

Do alliances allow states to share defense burdens and reduce military spending? Despite expectations that alliances should lead to decreased military spending, the empirical record offers mixed findings. We argue that not all alliances are reliable; thus, only allies that receive signals of reassurance will rely on the external security of allies and subsequently reduce their military spending. Compared to states that do not receive additional signals, these reassured allies will have greater confidence that an ally will come to their aid. As a result, third-party aggressors are deterred and the demand for military spending will decrease. We test this argument with an analysis of US signals of support, alliance commitments, and military spending. We find that American alliances without additional signals of support have a negligible effect on military spending. Yet, we observe that alliances are negatively associated with military spending when signals of support are present. Additional tests indicate that alliance commitments, coupled with strong US signals, are also associated with lower military spending in the rivals of US allies. Our results potentially help explain the mixed evidence in the arms-versus-allies and burden-sharing literatures and further demonstrate that extra-alliance signals play an important role in the practice of International Relations.
Narrative transparency and credibility: First–person process statements in video news
Authors: Bock Mary Angela , Lazard Allison
Published: July 2021

Journalism critics have argued that transparency about the reporting process is an ethical imperative. Convergence offers news organizations opportunities for changed writing styles that may foster more transparency, especially as they embrace video storytelling. This project used two experiments to investigate the impact of transparent language on the way online news consumers perceive the credibility of video news reports. The study operationalized transparency in narrative as the use of first-person statements and references to the newsgathering process. Subjects noticed transparency statements but this had no significant effect on their assessment of the credibility of a story or reporter. The results suggest that transparency is a distinct variable with a complicated relationship to other audience effects.
Highly accurate analytical solution for free vibrations of strongly nonlinear Duffing oscillator
Authors: Ismail Gamal Mohamed , Abul-Ez Mahmoud , Zayed Mohra , Ahmad Hijaz , El-Moshneb Maha
Published: July 2021

Based on the suggested parameter, a new analytical perturbation technique is presented to obtain highly ordered accurate analytical solutions for nonlinear Duffing oscillator with nonlinearity of high order. Comparing the obtained results with the numerical and other previously published results reveals the usefulness and correctness of the present technique. It is shown that the results are valid for small and large amplitudes. Indeed, it is found that our proposed technique produces more accurate and computationally results than the rival known methods. The obtained results show the efficiency and capability of the present perturbation technique to be applied to various strongly nonlinear differential equations.
Digital inequality in Finland: Access, skills and attitudes as social impact mediators
Authors: Heponiemi Tarja , Gluschkoff Kia , Leemann Lars , Manderbacka Kristiina , Aalto Anna-Mari , Hyppönen Hannele
Published: July 2021

In recent years, digital health care and social welfare services have been spreading rapidly and partly replacing face-to-face services, particularly in developed countries. This may lead to a pronounced digital inequality. This population-based study of Finnish adults ( N = 4495) examined the associations of offline resources with perceived benefits from online services and the mediating effects of access, skills and attitudes in these associations. The results indicated that those with lower personal, economic and social offline resources perceived online services as less beneficial. This was largely explained by poor access to the services, poor digital skills and negative attitudes towards online services. To increase equality, it would be important to improve Internet access and digital skills and implement means to address negative attitudes, especially among vulnerable groups. Moreover, online health and social welfare services should be designed to be more inclusive.
‘We went from the anonymity of the internet into my private WhatsApp’: Rituals of transition among dating app users in Berlin
Authors: Broeker Fabian
Published: July 2021

This article focusses on the courtship rituals and practices of intimacy among young dating app users, aged between 20 and 33, in Berlin. Dating app users participate in ‘rituals of transition’ as they signal mutual interest and heightened intimacy by moving conversations from dating apps to social media messaging platforms such as WhatsApp. These rituals of transition play a far more prominent role in signalling romantic interest than the matching-mechanisms inherent in the design of dating apps. Drawing on ethnographic data incorporating 36 semistructured interviews and 45 chat interviews across three popular dating apps, Tinder, Bumble and OkCupid, the study finds that users code the apps installed on their smartphones as hosting spheres of varying intimacy. These spheres are substantiated through the infrastructure of notifications on users’ devices. Rather than drastically altering how users communicate across different apps, rituals of transition are a key moment of communication in themselves.
Regional variation of corneal stromal deformation measured by high-frequency ultrasound elastography
Authors: Kwok Sunny , Hazen Nicholas , Clayson Keyton , Pan Xueliang , Liu Jun
Published: July 2021

The cornea’s mechanical response to intraocular pressure elevations may alter in ectatic diseases such as keratoconus. Regional variations of mechanical deformation in normal and keratoconus eyes during intraocular pressure elevation have not been well-characterized. We applied a high-frequency ultrasound elastography technique to characterize the regional deformation of normal and keratoconus human corneas through the full thickness of corneal stroma. A cross-section centered at the corneal apex in 11 normal and 2 keratoconus human donor eyes was imaged with high-frequency ultrasound during whole globe inflation from 5 to 30 mmHg. An ultrasound speckle tracking algorithm was used to compute local tissue displacements. Radial, tangential, and shear strains were mapped across the imaged cross-section. Strains in the central (1 mm surrounding apex) and paracentral (1 to 4 mm from apex) regions were analyzed in both normal and keratoconus eyes. Additional regional analysis was performed in the eye with severe keratoconus presenting significant thinning and scarring. Our results showed that in normal corneas, the central region had significantly smaller tangential stretch than the paracentral region, and that within the central region, the magnitudes of radial and shear strains were significantly larger than that of tangential strain. The eye with mild keratoconus had similar shear strain but substantially larger radial strains than normal corneas, while the eye with severe keratoconus had similar overall strains as in normal eyes but marked regional heterogeneity and large strains in the cone region. These findings suggested regional variation of mechanical responses to intraocular pressure elevation in both normal and keratoconus corneas, and keratoconus appeared to be associated with mechanical weakening in the cone region, especially in resisting radial compression. Comprehensive characterization of radial, tangential, and shear strains through corneal stroma may provide new insights to understand the biomechanical alterations in keratoconus.
Minimally Invasive and Robotic Mitral Valve Surgery: Methods and Outcomes in a 20-Year Review
Authors: Bonatti Johannes , Crailsheim Ingo , Grabenwöger Martin , Winkler Bernhard
Published: July 2021

In the mid- to late-1990s the cardiac surgery community began to apply limited incisions in mitral valve surgery. Ministernotomies and right-sided minithoracotomies were placed instead of the classic midline sternotomy. Adjunct technology such as videoscopy, advanced peripheral cannulation techniques, procedure specific long shafted surgical instruments, as well as surgical robots became available, and the procedures were refined in a stepwise fashion. In 2021, minimally invasive mitral valve repair is routine at many centers around the globe. We reviewed a total of 50 consecutive patient series published on the topic between 1999 and 2019. Three main versions of minimally invasive mitral valve surgery were applied in 20,539 patients. The surgical methods, their specific results, and the cumulative outcome of less invasive mitral valve surgery published over more than 20 years are reported and an integrated view on what less invasive mitral valve surgery can offer is presented.
Five-Year Outcomes After Hybrid Coronary Revascularization: A Single Center Experience
Authors: de Jong Roos , Jacob Kirolos , Jalali Alireza , Moharrem Yehia , Buijsrogge Marc , Gianoli Monica , Teefy Patrick , Kiaii Bob
Published: July 2021

Objective

Hybrid coronary revascularization (HCR) combines both surgical and percutaneous coronary revascularization procedures. It offers a minimally invasive strategy for multivessel coronary artery disease and combines the advantages of both. However, quantitative long-term patency and clinical outcomes remain understudied. The objective of this study was to assess clinical outcomes and graft and stent patency at 5-year follow-up.

Methods

From January 2004 to January 2015, 120 patients were enrolled in this study. They underwent robotically assisted minimally invasive coronary artery bypass grafting of left internal thoracic artery (LITA) to the left descending artery (LAD) and percutaneous coronary intervention of non-LAD vessels. Primary outcome was graft (LITA-LAD) patency determined at 5 years of follow-up, assessed by computed tomography angiography and rest and stress myocardial perfusion scintigraphy (MPS-MIBI). Secondary outcomes were stent patency and major adverse major cardiac and cerebrovascular events (MACCE). Also, freedom from recurrence of angina was assessed.

Results

At follow-up, 18 of 120 patients (15%) had died (in 5 patients the cause of death was cardiovascular). Among survivors, follow-up was achieved in 83 of 102 (81%). In 76 of 83 patients (92%) there was a patent LITA-LAD graft and in 75 of 83 (90%) a patent stent was demonstrated. MACCE occurred in 36 of 120 patients (30%). Freedom from recurrence of angina occurred in 92 of 120 patients (77%).

Conclusions

HCR is a safe and a promising procedure. It provides a minimally invasive approach and results in complete revascularization with good 5-year patency and clinical outcomes.
‘This is not a case of gender inequality. This is a case of injustice’: Perceptions of online resistance to camera sexual voyeurism
Authors: Vitis Laura , Naegler Laura , Salehin Ahmad
Published: July 2021

In November 2018, Monica Baey, a student at the National University of Singapore (NUS) was recorded by a fellow student while showering in university accommodation. After the perpetrator was issued a formal warning and a one-semester suspension, Baey posted about the case on social media and named the perpetrator. This generated public support, news coverage and institutional reform. In this article, we explore a range of responses to the Monica Baey case through a thematic analysis of publicly available comments about the case on a popular message board forum, Hardwarezone. By contextualising our analysis within the political setting of Singapore, this research demonstrates that public responses to testimony-based resistance require close analysis, as extant tools for citizens to engage in ‘naming and shaming’, were relevant to understanding these responses to this mode of resistance and reflected what Ibrahim (2018) calls ‘everyday authoritarianism’.
Audience Agency in Social Performance
Authors: Taylor Anne
Published: July 2021

Cultural pragmatics is a fruitful analytic tradition in sociology. However, theoretical use of this six-element model has largely focused on actors. Despite fusion’s definition as a product made between actor, audience, and text, the audience has been treated as a passive abstraction. Further, there is no methodical way to parse out the performative actions of the actor from those of the audience in a way that reveals the substantive similarities and differences that comprise fusion or de-fusion. This article seeks a solution via a rigorous theorization of the audience in cultural pragmatics, and argues that they are the sole arbiters of performative outcome. In their arbitration, audiences become performers themselves; they perform fusion or de-fusion in dialogic relation back to the actor, and to other audience members around them. With illustrations from US Senator Bernie Sanders’ political rise over the last decade, this process is visualized with a new analytic tool – arcs of fusion – so as to better trace varying trajectories of performative outcome.
Thromboembolic and atherosclerotic cardiovascular events in inflammatory bowel disease: epidemiology, pathogenesis and clinical management
Authors: Sleutjes Jasmijn A. M. , van Lennep Jeanine E. Roeters , van der Woude C. Janneke , de Vries Annemarie C.
Published: July 2021

Inflammatory bowel disease (IBD) is associated with an increased risk of cardiovascular disease (CVD). The increased risk of CVD concerns an increased risk of venous thromboembolism (VTE), atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF), at corresponding relative risks of 2.5, 1.2 and 2.0, respectively, as compared with the general population. Especially young patients under the age of 40 years run a relatively high risk of these complications when compared with the general population. Chronic systemic inflammation causes a hypercoagulable state leading to the prothrombotic tendency characteristic of VTE, and accelerates all stages involved during atherogenesis in ASCVD. Increased awareness of VTE risk is warranted in patients with extensive colonic disease in both ulcerative colitis and Crohn’s disease, as well as during hospitalization, especially when patients are scheduled for surgery. Similarly, critical periods for ASCVD events are the 3 months prior to and 3 months after an IBD-related hospital admission. The increased ASCVD risk is not fully explained by an increased prevalence of traditional risk factors and includes pro-atherogenc lipid profiles with high levels of small dense low-density lipoprotein cholesterol particles and dysfunctional high-density lipoprotein cholesterol. Risk factors associated with HF are location and extent of inflammation, female sex, and age exceeding 40 years. A dose-dependent increase of overall CVD risk has been reported for corticosteroids. Immunomodulating maintenance therapy might reduce CVD risk in IBD, not only by a direct reduction of chronic systemic inflammation but possibly also by a direct effect of IBD medication on platelet aggregation, endothelial function and lipid and glucose metabolism. More data are needed to define these effects accurately. Despite accumulating evidence on the increased CVD risk in IBD, congruent recommendations to develop preventive strategies are lacking. This literature review provides an overview of current knowledge and identifies gaps in evidence regarding CVD risk in IBD, by discussing epidemiology, pathogenesis, and clinical management.
Potential relation of cardiovascular risk factors to disease activity in patients with axial spondyloarthritis
Authors: Ferraz-Amaro Iván , Rueda-Gotor Javier , Genre Fernanda , Corrales Alfonso , Blanco Ricardo , Portilla Virginia , González Mazón Iñigo , Llorca Javier , Expósito Rosa , Vicente Esther F. , Quevedo-Abeledo Juan Carlos , Rodríguez-Lozano Carlos , Ortega-Castro Rafaela , Ladehesa-Pineda María Lourdes , Fernández-Carballido Cristina , Martínez-Vidal M Paz , Castro-Corredor David , Anino-Fernández Joaquín , García Vivar María Luz , Galíndez-Agirregoikoa Eva , Peiteado Diana , Plasencia-Rodríguez Chamaida , Montes Perez Esther , Fernández Díaz Carlos , Castañeda Santos , González-Gay Miguel Ángel
Published: July 2021

Background:

Axial spondyloarthritis (axSpA) patients are known to have a higher prevalence of several comorbidities, including, among others, an increased risk of atherosclerosis, hypertension, dyslipidemia, and diabetes. The purpose of the present study was to determine whether the sum of traditional cardiovascular (CV) risk factors is related to disease characteristics, such as disease activity, in patients with axSpA.

Methods:

A cross-sectional study that encompassed 804 patients with axSpA was conducted. Patients were assessed for the presence of five traditional CV risk factors (diabetes mellitus, dyslipidemia, hypertension, obesity, and smoking status), and disease activity measurements. A multivariable regression analysis was performed to evaluate whether the number of classic CV risk factors was independently associated with specific features of the disease, to include disease activity.

Results:

A multivariable analysis showed that Ankylosing Spondylitis Disease Activity Score–C reactive protein (ASDAS-CRP) activity score was significantly higher in patients with 1 [beta coefficient 0.3 (95% confidence interval (CI) 0.1–0.5), p = 0.001] and ⩾2 [beta coefficient 0.5 (95% CI 0.3–0.7), p = 0.000] CV risk factors compared with those without CV risk factors. Similarly, patients with 1 [OR 2.00 (95%CI 0.99–4.02), p = 0.053] and ⩾2 [OR 3.39 (95%CI 1.82–6.31), p = 0.000] CV risk factors had a higher odds ratio for the presence of high disease activity compared with the zero CV category. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) activity score was significantly associated with the number of CV risk factors, being higher in patients with more CV risk factors. These relationships showed a CV risk factor-dependent effect being beta coefficients and ORs higher for the effect of ⩾2 over 1 CV risk factor.

Conclusion:

Among patients with axSpA, as the number of traditional CV risk factors increased, disease activity similarly increases in an independent manner.
Diversity and Conservation of Cave-Roosting Bats in Central Ghana
Authors: Nkrumah Evans Ewald , Baldwin Heather Joan , Badu Ebenezer Kofi , Anti Priscilla , Vallo Peter , Klose Stefan , Kalko Elisabeth Klara Viktoria , Oppong Samuel Kingsley , Tschapka Marco
Published: July 2021

Background

Ghana is one of the six bat diversity hotspots on the African continent, yet its caves have not been fully explored for the bats they host.

Research Aims

We aimed to assess the species composition and diversity of five caves in central Ghana and identified those needing immediate conservation attention.

Methods

Using mist-nets, we captured bats over 102 full nights between October 2010 and July 2012 from the Upper Guinean forest and Savannah regions in central Ghana.

Results

A total of 10,226 bats belonging to nine species were recorded. PERMANOVA suggested significant variation in species composition among the caves. A SIMPER analysis revealed Coleura afra and Hipposideros jonesi to be the main discriminating species between caves, with a dominance of Hipposideros cf. ruber in all caves. The Bat Cave Vulnerability Index (BCVI) revealed Mframabuom cave from the Upper Guinean forest region as a high priority cave hosting threatened species, yet highly disturbed. The remaining caves were identified as medium priority caves.

Conclusion

The results of the study suggest the need for further research and an immediate conservation strategy as essential for approaching national conservation goals.
miR-146a-5p Promotes Chondrocyte Apoptosis and Inhibits Autophagy of Osteoarthritis by Targeting NUMB
Authors: Zhang Hongjun , Zheng Wendi , Li Du , Zheng Jia
Published: July 2021

Objective

miR-146a-5p was found to be significantly upregulated in cartilage tissue of patients with osteoarthritis (OA). NUMB was shown to be involved in the autophagy regulation process of cells. We aimed to learn whether NUMB was involved in the apoptosis or autophagy process of chondrocytes in OA and related with miR-146a-5p.

Methods

QRT-PCR was used to detect miR-146a-5p level in 22 OA cartilage tissues and 22 controls. The targets of miR-146a-5p were analyzed using software and the luciferase reporter experiment. The apoptosis and autophagy, and related proteins were detected in chondrocytes treated with miR-146a-5p mimic/inhibitor or pcDNA3.1-NUMB/si-NUMB and IL-1β, respectively. In vivo experiment, intra-articular injection of miR-146a-5p antagomir/NC was administered at the knee of OA male mice before and after model construction. Chondrocyte apoptosis and the expression of apoptosis and autophagy-related proteins were also detected.

Results

miR-146a-5p was highly expressed in knee cartilage tissue of patients with OA, while NUMB was lowly expressed and negatively regulated by miR-146a-5p. Upregulation of miR-146a-5p can promote cell apoptosis and reduce autophagy of human and mouse chondrocytes by modulating the levels of cleaved caspase-3, cleaved PARP, Bax, Beclin 1, ATG5, p62, LC3-I, and LC3-II. Increasing the low level of NUMB reversed the effects of miR-146a-5p on chondrocyte apoptosis and autophagy. Intra-articular injection of miR-146a-5p antagomir can also reverse the effects of miR-146a-5p on the apoptosis and autophagy of knee joint chondrocytes in OA mice.

Conclusion

Downregulation of miR-146a-5p suppresses the apoptosis and promotes autophagy of chondrocytes by targeting NUMB in vivo and in vitro.
The Relationship Between Valence and Chills in Music: A Corpus Analysis
Authors: de Fleurian Rémi , Pearce Marcus T.
Published: July 2021

Chills experienced in response to music listening have been linked to both happiness and sadness expressed by music. To investigate these conflicting effects of valence on chills, we conducted a computational analysis on a corpus of 988 tracks previously reported to elicit chills, by comparing them with a control set of tracks matched by artist, duration, and popularity. We analysed track-level audio features obtained with the Spotify Web API across the two sets of tracks, resulting in confirmatory findings that tracks which cause chills were sadder than matched tracks and exploratory findings that they were also slower, less intense, and more instrumental than matched tracks on average. We also found that the audio characteristics of chills tracks were related to the direction and magnitude of the difference in valence between the two sets of tracks. We discuss these results in light of the current literature on valence and chills in music, provide a new interpretation in terms of personality correlates of musical preference, and review the advantages and limitations of our computational approach.
Utility of St. George’s respiratory questionnaire in predicting clinical recurrence in chronic pulmonary aspergillosis
Authors: Bongomin Felix , Otu Akaninyene
Published: July 2021

Background and Aims:

Patients with chronic pulmonary aspergillosis (CPA) who discontinue antifungal therapy commonly exhibit disease recurrence. We aimed to evaluate the utility of the St. George’s respiratory questionnaire (SGRQ) in predicting the likelihood of clinical recurrence of CPA in patients who come off antifungal therapy.

Methods:

This audit included CPA patients for whom antifungal therapy was discontinued for at least 1 month. Comparisons were made between the quality of life scores at the time of discontinuation of treatment and at the time of diagnosis of clinical recurrence. The change in patients’ self-assessment scores was also compared.

Results:

There were 33 cases and 44 controls. Of the 33 cases, 22 (67%) were males with a mean age of 62 ± 13 years. The median for the symptom component of quality of life (QoL) changed from 78.4 at the time of discontinuation of therapy to 83.1 units at the time of diagnosis of clinical failure ( p = 0.043), whereas that of the impact and activity components changed from 62.7 to 59.1 units ( p = 0.387) and 85.0 to 85.9 units ( p = 0.153), respectively. At 12 months, the symptoms domain of SGRQ was able to discriminate between cases of clinical recurrence and controls [area under the curve (AUC) 0.7, 95% confidence interval (CI): 0.6–0.8, p = 0.009]. The proportion of patients in very poor health status increased from 3/11 (9.1%) to 11/33 (33.3%) ( p = 0.046).

Conclusion:

A deteriorating symptoms component of the SGRQ and a worsening of patients’ self-assessment are associated with clinical recurrence. Failure to improve by >8 units in the symptoms domain appear to be a marker of disease recurrence. We propose that the clinical approach to diagnose recurrent CPA would be a combination of clinical history, SGRQ scoring, chest imaging and a workup to exclude other causes of the patients’ symptoms.
Penile cancer after a tick bite: A possible association
Authors: Ivanovski Ognen , Saidi Skender , Shabani Bashkim , Gurmeshevski Slobodan , Pejkov Risto , Komina Selim , Gavrilovska-Brazanov Aleksandra
Published: July 2021

Penile cancer is a rare cancer in Western countries, but is more common in parts of the developing world. Usually, it is associated with older uncircumcised men who have a long-term phymotic preputium. Here, we report a case of penile cancer in a circumcised patient, occurring 3 months after a tick bite on the head of the penis. To the best of our knowledge, this is the first report that suggests a possible association between Lyme disease and occurrence of “de novo” penile cancer. Further studies are needed to confirm this hypothesis.