bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-sectional and Prospective Associations of Rest-Activity Rhythms With Body Mass Index in Older Men: A Novel Analysis Using Harmonic Hidden Markov Models
Authors: Heckler Brian , Lee Miryoung , Stone Katie , Bauer Cici , Xiao Qian
Published: November 2022

Growing evidence supports a role for rest-activity rhythms (RARs) in metabolic health. Epidemiological studies in adolescents and young adults showed that RAR characteristics consistent with weakened rhythmicity were associated with obesity. However, studies in older adults are lacking. The objective of this study was to examine the cross-sectional and prospective associations between RAR and obesity in older men using the Harmonic Hidden Markov Model (HHMM), a novel analytical approach with several advantages over conventional methods for characterizing RAR. The analysis included nearly 3,000 participants in the Osteoporotic Fractures in Men study with 5-day 24-h actigraphy data. The strength of RAR was measured by rhythmic index (RI), a scaled value between 0 and 1 with higher values indicating better RAR. Multiple linear and logistic regression adjusting for multiple confounders were performed to examine the RI in relation to body mass index (BMI) and obesity status at baseline and after ~3.5 years of follow-up. We showed that the HHMM can derive both meaningful visual profile and quantifier of RAR. A lower RI was associated with higher BMI and obesity at baseline, and an elevated likelihood for developing obesity over follow-up. Specifically, when compared with men in the highest quartile of RI, those in the lowest quartile on average had a higher BMI (β [95% confidence interval (CI)], 1.76 [1.39, 2.13]) and were more likely to be obese at baseline (odds ratio (OR) [95% CI], 2.63 [2.03, 3.43]). Moreover, among nonobese men at baseline, those in the lowest quartile of RI were 2.06 times (OR [95% CI], 2.06 [1.02, 4.27]) more likely to develop obesity over follow-up when compared with those in the highest quartile. In conclusion, our study demonstrated the utility of HHMM in characterizing RAR and showed that rhythmicity strength was associated with BMI and risk of obesity in older men.
Fabrication of a photoacoustic cell and thermal diffusivity measurement of graphene oxide using photoacoustic spectroscopy
Authors: Sarkar Minarul I , Upadhyay Madan M , Kumar Kaushal
Published: November 2022

Photoacoustic spectroscopy (PAS) is an important technique for the characterization of materials by measuring the heat produced due to the non-radiative transitions. Here, the authors have fabricated a photoacoustic cell and made parametric studies to get maximum signal sensitivity. For the optimum signal, the cavity volume of the sample chamber is found to be 1.763 × 10–6 m3. After optimization of the cell, the thermal diffusivity of hummers method synthesized graphene oxide (GO) powder was measured using laser excitation at 980 nm and it is found to ∼(1.84 ± 0.10) × 10–4 m2/s. Also, the thermal diffusivity of the same sample was measured using 560 and 680 nm excitation wavelengths. No measurable change in thermal diffusivity with excitation wavelength is seen and it confirms that thermal diffusivity is independent of the excitation wavelength. Lastly, photoacoustic spectrum of the GO sample was measured in the 400–1200 nm range and compared with the spectrum of lamp black.
Unsteady aerodynamics of flapping bionic eagle wings in forward flight: An experimental and numerical study
Authors: Azargoon Yegane , Djavareshkian MH
Published: November 2022

The aerodynamic performance of fabricated eagle wing with the corrugated trailing edge was investigated experimentally and numerically in this study. In this respect, wings were designed by imitating the bionic eagle wing and fabricated using a 3D printer. Tests on the wings were performed in a wind tunnel for different bending deflection angles, flapping frequencies, angles of attack, and forward flight velocities. As the key parameters, lift and thrust forces, lift-to-drag and input power were compared between eagle wing and simplified wing. The results revealed that the eagle wing with the corrugated trailing edge led the lift force to be improved by 14% on average compared to the simplified wing, with the largest improvement of 45%. Further, the thrust force of a eagle wing was greater than that of the simplified wing (up to 21%). Also, the input power of the simplified wing mechanism was greater than that of the eagle wing. Numerical simulations were performed to study flow physics. After validating the numerical results against the experimental results, the lift and thrust force, lift-to-drag, pressure contours and vortex were compared between the eagle and simplified wings. The results of the numerical simulation revealed that lift-to-drag increased with for eagle wing with the corrugated trailing edge of eagle wing. the pressure difference between the upper and lower surfaces of the eagle wing was larger than that of the simplified wing; therefore, the lift force produced by the eagle wing was larger than that of the simplified wing.
Dynamic size optimization approach to support railway carbody lightweight design process
Authors: Cascino Alessio , Meli Enrico , Rindi Andrea
Published: November 2022

The transition to a globalised electrical power supply pushes rolling stock manufacturers to find structural solutions for reducing the power required by the vehicles. Within a market where details can make the difference in economic terms, the concept of design optimization is becoming established. However, current industrial procedure for the evaluation of carbody structural strength, in static field and according to EN 12663-1:2015 standard, does not include any optimization process. More in general, optimization processes, and especially dynamic optimization, are not widely used for designing of railway vehicles. In this framework, the present paper proposes a new dynamic optimization approach to support the design of railway vehicle carbodies subjected to static loads. Proposed methodology aims to minimize the mass of the metallic structure, working on the thicknesses of the optimized components, maintaining the baseline geometry. The constraint function was imposed on the first natural vibration frequency of the system. The optimization strategy is based on a dynamic size optimization process in conjunction with modal analysis techniques, applied on the single carbody shell. The procedure has involved the roof assembly of a single tram vehicle body. The proposed approach is resulted numerically efficient in terms of calculation times. Encouraging results have been achieved in terms of mass saving and mechanical behaviour of the carbody shell. Optimized components were 21% lighter than the original, that corresponds to 3% if evaluated on the total mass of the single carbody metallic structure. The methodology turns out to be a useful tool for supporting designers to reduce the mass of the carbody structures, reducing overdimensioning condition that could affect the carbody structure.
Cardiac involvement in a Spanish unicentric prospective cohort of patients with systemic lupus erythematosus
Authors: Álvarez Troncoso Jorge , Soto Abanades Clara , Robles Marhuenda Ángel , Martínez Robles Elena , Noblejas Mozo Ana , Florez Gómez Roberto , Pérez David Esther , Ríos Blanco Juan José
Published: November 2022

Background

Cardiac involvement is one of the most frequent manifestations of Systemic Lupus Erythematosus (SLE). Transthoracic echocardiogram (TTE) may be valuable for the early detection of cardiac abnormalities in SLE. Few studies analyze both TTE findings in SLE and the risk factors that predispose to different cardiac manifestations in a long follow-up cohort. We aimed to investigate cardiac involvement’s prevalence, risk factors, and outcomes in a Spanish Lupus Clinic.

Methods

Spanish single-center prospective study of cardiac involvement in SLE. Two hundred and one patients met the 2019 EULAR/ACR classification criteria, performed TTE, and were eligible for the study.

Results

Cardiac involvement was present in 43.8%. Patients with older age, hypertension, hyperlipidemia, higher body mass index, peripheral arterial disease, thrombosis, and major cardiovascular events had significantly more cardiac involvement. Neurological, hematological, and serosal involvement (pleuritis and/or pericarditis) were clinical risk factors for abnormal TTE. The combination of the four clinical variables (dyspnea, chest pain, cough, and/or syncope) was present in 40.9% of the patients with abnormal TTE in the follow-up and was superior to each of the manifestations separately. Troponin I (TnI) ≥ 0.2 ng/mL and NTproBNP ≥ 300 pg/mL were excellent biomarkers with a good correlation with cardiac abnormalities. Anti-B2GP1 was the only autoantibody associated with cardiac involvement in our cohort. Presenting cardiac involvement was correlated with higher SLICC Damage Index and increased mortality risk in the 2-year follow-up period.

Conclusions

Cardiac involvement in SLE is diverse, heterogeneous, and highly prevalent. Presenting a pathological TTE was associated with greater damage accrual and greater mortality. Based on our results, we consider that echocardiographic screening of patients with SLE is essential, especially those symptomatic and/or with risk factors, to diagnose and treat cardiac involvement earlier.
Towards More Sustainable, Equitable and Just Internationalisation Practices: The Case of Internationalisation Conferences
Authors: Chasi Samia , Heleta Savo
Published: November 2022

In this article, we offer a critical perspective on the interrelationship between internationalisation and sustainability, particularly regarding the contribution higher education internationalisation practices reliant on mobility have made to climate degradation. Specifically, we focus on carbon emissions linked to air travel in the context of in-person internationalisation conferences. Drawing on decolonial approaches and lived realities in the global South, we argue that a return to pre-pandemic practices in the midst of the ongoing COVID-19 pandemic and, more importantly, an existential climate crisis, is highly irresponsible, unjust and exclusionary. We raise issues and propose questions for internationalisation professionals and organisations to consider, unpack and action, both individually and collectively, aiming to move away from exclusionary and harmful internationalisation practices and to bring about change for a new and better ‘normal’ for all.
Addressing the dauntingness of formulation: The value of considering empathy as “grasping”
Authors: Smith Graeme C
Published: November 2022

Aims and objectives

To explore the value of using Karl Jaspers’ lived experience concept of ‘grasping’ in remediating the reported dauntingness of formulation.

Conclusions

Formulation can be construed as both the process and explication of understanding why a patient is presenting in a particular way. In an automatic process of abduction, ‘feeling into’ the mind of the other, hypotheses are posted to consciousness with little mental effort as meaningful connections are grasped. Subsequent more deliberative reasoning is synthesised continuously and with surprisingly little mental effort into the best explanation(s). Karl Jaspers’ introduction to Psychiatry of the concepts involved, empathy and understanding, and his aim of making their use more scientific established the ongoing, often fierce debate about the ontology of Psychiatry; empirical versus interpretive. Trainees must resolve this for themselves in explicating a formulation, risking exposure of their prejudices. Jaspers’ emphasis on the lived experience of empathic understanding that psychiatrists bring to their work found him often using the term ‘grasp’ rather than ‘empathise’. ‘Grasping’ seems to convey more vividly and meaningfully the role that empathy plays in the initial ascertainment of mood and the subsequent hypothesis discovery, testing and synthesis.
Body–Product Relationship for Aging Women Examined Through the Lens of Functional Anthropometry
Authors: Griffin Linsey , Juhnke Bethany , Pokorny Colleen , Seifert Emily , Savvateev Elisheva , Yu Minji
Published: November 2022

The purpose of this research was to understand how measurements of the aging body change in the seated and standing positions. An integrated approach was taken to select the appropriate 3D scanning technology, develop a landmarking method, and position the body to analyze the waist–hip–thigh region. Each part of the method was developed to enable an in-depth analysis of circumference measurements and shape change, including the expansion and contraction of body shape across different postures. New 3D scanning methods to quantify diverse bodies can improve product fit and create inclusive, quality design for all.
Serum amyloid A and other clinicopathological variables in cats with intermediate- and large-cell lymphoma
Authors: Schiavo Luca , Odatzoglou Petros , Hare Cassia , Williams Tim L , Dobson Jane M
Published: November 2022

Objectives

Serum amyloid A (SAA) concentrations are increased in cats with lymphoma vs healthy cats; however, the association between SAA concentrations and prognosis in cats with lymphoma is unclear. The aim of this study was to evaluate if SAA concentrations were different in cats with nasal vs non-nasal lymphoma, if SAA concentrations are prognostic in patients treated with high-dose chemotherapy and if SAA concentrations are correlated with other clinicopathological variables.

Methods

Cats diagnosed with intermediate- or large-cell lymphoma between 2012 and 2022 with SAA concentration data available were included. Associations between tumour site (nasal vs non-nasal), stage, response to treatment and SAA concentration were evaluated using non-parametric statistics. Associations between SAA concentrations and stage with survival time were evaluated using Cox regression analysis. Patients with nasal tumours and those not receiving high-dose chemotherapy were excluded from the survival analyses.

Results

Thirty-nine cats were included. Median SAA concentrations were significantly higher in non-nasal compared with nasal lymphoma (42 µg/ml [range <0.3–797] vs <0.3 µg/ml [range <0.3–0.9]; P = 0.026). SAA concentrations did not correlate with tumour stage. Median survival time for patients with non-nasal tumour and undergoing chemotherapy was 49 days (range 2–1726). Responders had a better median survival time than non-responders (273 days [range 43–1728] vs 39 days [range 2–169]; P <0.001), whereas SAA concentrations were not associated with survival time. Lower haematocrit at presentation was associated with a reduced median survival time (P = 0.007).

Conclusions and relevance

In the population examined, no correlation between serum concentration of SAA and prognosis in patients with lymphoma was identified, while low haematocrit and lack of response to treatment were both found to be associated with survival time. SAA concentrations were elevated in patients with non-nasal lymphoma vs patients with tumours confined to the nasal cavity.
The compressive mechanical properties of honeycomb plates and beetle elytron plates with different foam densities and height-to-thickness ratios
Authors: He Chaochao , Liu Yalan , Chen Jinxiang , Hao Ning , Guo Zhensheng
Published: November 2022

To investigate a new type of bionic energy-saving sandwich plate—the beetle elytron plate (BEP), the compressive mechanical properties of short basalt fiber reinforced epoxy resin composite BEPs and honeycomb plates with different polyvinyl chloride foam densities and height-to-thickness ratios were investigated. The mechanism of the coupling effect of the core structure, foam density and height-to-thickness ratio was revealed by observing the failure mode of the outer and inner ring honeycomb walls. This study can provide useful instruction for designing lightweight sandwich structures and accelerate the application of BEPs in engineering.
More insights into the interaction between age, exposure, and attitudes in language attrition and retention from the perspective of bilingual returnees
Authors: Matos Joana , Flores Cristina
Published: November 2022

Aims and Objectives:

The study investigates the effects of age, language use, and attitudes on Portuguese returnee bilinguals’ knowledge of German nominal morphology. We focused on language attrition. In addition, we compared whether the results of returnee bilinguals differ in relevant ways from the performance of L1 speakers of German and, if so, in which domains.

Methodology:

A background questionnaire and offline tasks that elicit lexical knowledge, case, gender, and plural marking in German were applied to a group of Portuguese–German bilingual returnees ( N = 20) and a group of German L1 speakers ( N = 20).

Data and Analysis:

The elicited data were analyzed through non-parametric tests (Mann–Whitney tests, Wilcoxon tests, and Spearman correlation tests), since not all the requirements for running mixed models could be fulfilled.

Findings:

The results show that bilingual returnees have very stable knowledge of the analyzed properties: parts of morphosyntactic knowledge are acquired and stabilized in childhood and remain highly invulnerable to loss of contact throughout the speakers’ lifetime. However, returnees’ knowledge of the German case system is constrained by age of input loss, language use, and attitudes. Ungrammatical plural marking is correlated with the speakers’ bonds to the German language and culture. No cross-linguistic influence from Portuguese was found in the domain of plural marking.

Originality:

This study resumes the question of differential attrition effects in returnee bilinguals by using a more controlled methodology. It extends the investigation to returnees’ performance in the lexical domain and with regard to case, gender, and number morphology in German, also quantifying other variables, such as the age of onset of bilingualism, the amount of contact with German after return, and the length of residence in Portugal. In addition, it focuses the less researched question regarding the role of the returnees’ attitudes toward both their languages.

Significance/Implications:

The study highlights the multi-dimensional factors that constrain language proficiency over a bilingual speaker’s lifetime.
Defining affordances in social media research: A literature review
Authors: Ronzhyn Alexander , Cardenal Ana Sofia , Batlle Rubio Albert
Published: November 2022

An increasingly influential strand of research on social media relies on the concept of affordances to account for effects. However, hindering the possibility of a unified theory of affordances in social media is the conceptual blurring surrounding the concept. This article engages in a comprehensive review of the affordances literature in social media, aiming to provide an overview of the current state of the art and clarify the use of the concept. Through a systematic literature review, the characteristics of affordances research in social media are uncovered: the most prominent areas of application, research approaches, and dominant typologies and conceptualisations. Significant blurriness of the term ‘affordance’ is identified as well as an inconsistent use in research. To tackle these problems, a unified definition of affordances in social media is proposed based on the synthesis of knowledge on affordances in technology and social media. The suggested definition captures the core aspects of the concept to reduce ambiguity in the use of the concept and further the research on affordances of social media. The article provides the groundwork for future use of affordances theory in social media research.
Preferences as a Determinant of the Measurement-Unit Effect for Unit Prices
Authors: Ohlwein Martin
Published: November 2022

The extent to which alternative measurement units affect consumer behaviour is the subject of a handful of studies, which, however, measure this effect at an aggregate level. This presents a gap in that it is of great importance for marketing practice to understand whether the observed effect applies to all consumers to a similar extent. Investigating the product category bottled beer and applying an importance-focused post hoc segmentation, it is discovered that no measurement-unit effect occurs for brand-oriented customers. The unit of measurement in which a unit price is indicated substantially influences the preference structure for only one in five respondents. Both strategic and operational decisions with regard to unit prices should therefore not be based on an averaged market view, but on a segment-specific perspective.
Long-Term Effects of Acute Kidney Injury Following Endovascular Femoropopliteal Intervention: Insights From a Multicenter Trial
Authors: Katsogridakis Emmanuel , Saha Prakash , Diamantopoulos Athanasios , Saratzis Nikolaos , Davies Robert , Zayed Hany , Bown Matthew J. , Saratzis Athanasios
Published: November 2022

Purpose:

To examine the association between acute kidney injury (AKI) severity and duration with cardiovascular mortality, following endovascular treatment of femoropopliteal disease, and whether it is AKI in itself that confers an increased risk of cardiovascular mortality.

Methods:

A retrospective analysis of prospectively collected data obtained between 2014 and 2019 from 3 vascular centers. Renal function was followed up for a minimum of 90 days. Electronic records were queried to establish a cause of death, where applicable. Patients were excluded if unable to provide written informed consent or if presenting with acute limb ischemia. Primary outcomes were the hazard ratios for cardiovascular death (AKI patients vs no AKI; no AKI vs stage 1 AKI vs stage 3 AKI; and no AKI vs transient AKI vs established AKI). Propensity score–matched analysis was used to establish whether developing AKI, in patients with similar demographics and procedural characteristics, is associated with a higher risk of cardiovascular death.

Results:

Overall 239 patients developed AKI, and this was associated with an increased risk of cardiovascular mortality (hazard risk [HR]: 4.3, 95% confidence intervals [CIs]: 2.1–6.8, pairwise comparison p value=0.006]. This was dependent on the severity of the AKI stage (HR 5.4, 95% CI: 2.4–7.3, pairwise comparison p value=0.01) and duration (HR 4.2, 95% CI: 2.3–6.2, pairwise comparison p value=0.04). The propensity score–matched analysis showed that even when patients are matched for comorbidity and procedural characteristics, AKI confers an increased risk of mortality (p=0.04).

Conclusions:

Acute kidney injury is common after femoropopliteal endovascular therapy. It confers an increased risk of long-term cardiovascular mortality, which is still present when renal decline is transient, and highest for patients with established decline in renal function.

Clinical Impact

This is the first study in the setting of peripheral arterial disease to show that acute kidney injury has an adverse effect on cardiovascular mortality, in the long-term, that is dependent on its severity, and present even when the AKI is transient. We have also shown that this difference in cardiovascular mortality becomes more pronounced from the medium-term, and thus closer follow-up of these patients is required.
Retrograde Balloon-Assisted Approach to Prevent Distal Embolization During Complex Recanalization Procedures
Authors: Ysa August , Lobato Marta , Arroniz Amaia , Arruabarrena Amaia , Gómez Roberto , Quintana Ana , Metcalfe Matthew , Fonseca Juan L.
Published: November 2022

Purpose:

The purpose of the study is to describe a bailout technical strategy to prevent below-the-knee (BTK) distal embolization during procedures with increased inherent risk using universally-available “off-the-shelf” devices.

Technique:

A conventional retrograde access is obtained of the BTK target vessel where embolization protection is sought. Before starting any potential proximal maneuver with an associated significant risk of distal embolization (eg, atherectomy and mechanical thrombectomy), a low-profile balloon is inserted and inflated through the distal retrograde access, so that any debris resulting from the recanalization procedure is blocked by the stagnant column of blood generated by the inflated balloon. Once the revascularization procedure has been completed, a 4F curved catheter is antegradely advanced down to the distally-inflated balloon, and in case of distal embolization the debris is aspirated in a standard fashion way.

Conclusion:

A retrograde balloon-assisted “off-the-shelf” embolic protection approach may be considered for BTK revascularization procedures where there is an inherent increased risk of distal trash, especially in the presence of distal single-vessel runoff.

Clinical Impact

Distal embolization following endovascular procedures can have devastating consequences and there is a general recommendation for selective use of EPDs in high-risk-scenarios. The increased cost and low availability of the current EPD devices for BTK/BTA arteries have prohibited their widespread use. The retrograde balloon-assisted “off-the-shelf” EPD prevents distal embolization during procedures with increased risk of distal trash using inexpensive, nonspecific equipment available in any basic endovascular suite.
Multicultural Music Education in Chinese Middle School General Music Classes, 1978–1988
Authors: Le Xinyue
Published: November 2022

This historical study is an extension of an earlier study “The Origins of Multicultural Music Education in Chinese Secondary Schools’ General Music Classes.” In the earlier study, I examined multicultural music education in middle school music classes in the People’s Republic of China from 1989 to 2010. The present study examines the same topic during an earlier time period, 1978–1988. Primary sources are national syllabi issued by the Chinese Ministry of Education and State Education Commission. The study concludes that during the time period Chinese multicultural music education highlighted the diversity of Chinese music culture, involving music from 56 nationalities in the People’s Republic of China. The findings, along with the findings of the earlier study, reveal trends in multicultural music education in Chinese schools.
The Caged Knickerbocker: A Novel Modification to Targeted False Lumen Management in Complex Aortic Dissection
Authors: Blitzer David N. , Pereira Gabriel A. , Drucker Charles , Rolle Nicholas , Nagarsheth Khanjan , Karwowski John , Hall Michael , Taylor Bradley , Ghoreishi Mehrdad , Toursavadkohi Shahab
Published: November 2022

Introduction

Targeted false lumen management has been described for complex presentations of aortic dissection. The “Knickerbocker” technique is often referenced and includes dilating a focal portion of an oversized endograft in the true lumen to purposefully rupture the false lumen septum, but at the expense of increased risk for visceral propagation and malperfusion. This case series describes a novel modification of the Knickerbocker technique by caging the distal end of the endograft prior to focal dilation.

Methods

A retrospective chart review was conducted at a tertiary academic center from 2018-2020. Patients were included if they had a history or current presentation of aortic dissection and underwent a Caged Knickerbocker (CKB) repair. Data were collected to include demographics, indications for repair, technical success, perioperative outcomes, hospital course, mortality, and further aortic interventions.

Results

Five patients were included in our evaluation. Four patients (80%) presented with chronic Type B aortic dissection (cTBAD) and concomitant aneurysmal degeneration of the thoracic aorta; 1 patient (20%) presented with an acute rupture secondary to cTBAD. Three patients (60%) had previous aortic repairs, 2 of which were for Type A Aortic Dissection that additionally required redo sternotomy and total arch replacement prior to CKB. CKB was technically successful in all cases with no peri-operative complications. Two (40%) patients required further aortic intervention due to aneurysmal degeneration.

Conclusion

Achieving complete false lumen thrombosis is a considerable challenge when managing complex aortic dissections. Our data demonstrate the technical feasibly and early successful outcomes with the CKB approach. Importantly, CKB facilitates future distal extension into the para-visceral aorta in cases of complex thoracoabdominal aortic aneurysms. Further research should focus on discerning individual patients who will benefit from targeted false lumen management and compare outcomes between different approaches.
The use of fetal bovine acellular dermal matrix in severe diabetic foot ulceration and threatened limbs with tissue loss the use of FBADM as an adjunct for complex wounds
Authors: Gormley Sinead , Hart Odette , French Stephen , O’Shea Claire , Khashram Manar
Published: November 2022

Objectives

Foot ulceration associated with diabetic foot disease (DFD) and chronic limb-threatening ischaemia (CLTI) presents a complex clinical challenge and failure to heal the wound imposes a significant risk of major limb amputation (MLA). In attempt to accelerate wound healing rates and decrease MLA, tissue engineering research into bio-engineered scaffolds and skin substitutes has become a growing area of interest. Advanced wound therapies such as fetal bovine acellular dermal matrix (FBADM) may have success in the treatment of difficult to heal chronic foot ulcers. The FBADM traps and binds the patients’ own epithelial cells to rebuild the dermis layer of the skin. Previous studies have suggested that wounds treated with FBADM had a faster healing rate than wounds managed with conventional dressings. However, these studies excluded foot wounds with chronic exposed bone or tendon, active infection, gangrene, or osteomyelitis and patients with uncontrolled blood glucose levels were excluded. The aim of this study was to assess the efficacy of FBADM for patients admitted to hospital acutely with severe foot ulceration secondary to DFD and CLTI.

Methods

Between February 2020 and December 2021, inpatients admitted acutely at a single tertiary centre with a severe non-healing foot ulcer and had a wound suitable for application of a FBADM after primary debridement were included in the study. A severe non-healing foot wound was defined as a Society for Vascular Surgery Wound, Ischaemia, and foot Infection (WIfI) stage of 3 or 4. Participants were prospectively followed up at regular intervals at a multidisciplinary high-risk diabetic foot clinic until June 2022. The primary endpoint was time to wound closure. The secondary endpoints were number of applications of FBADM, readmission rate and amputation-free survival.

Results

There were 22 patients included in the study with a median age of 71 (50–87) years and 15 were male. Five patients had a WIfI stage of 3 and 17 had a WIfI score of 4. Overall, 14 patients required revascularisation procedures (6 open surgery,8 endovascular intervention). A total of 18 patients achieved complete wound healing with a median time to wound healing of 178 (28–397) days. Two patients underwent a MLA and two patients died prior to complete wound healing. The median length of stay was 16.5 (5–115) days, and 4 patients were readmitted to hospital within 12 months.

Conclusion

FBADM may be a useful adjunct in the acute setting of complex DFD and CLTI ulceration to assist with wound healing. Future comparative prospective studies are required to further validate these preliminary findings.
Changes in the thymus gland with age: A sonographic evaluation
Authors: Alamdaran Seyed Ali , Mahdavi Rashed Masoud , Yekta Mohammad , Teimouri Sani Fatemeh
Published: November 2022

Background:

Ultrasound evaluation of normal, ectopic, asymmetric, and hyperplastic thymus and also its differentiation from abnormalities are challenging in children, and few studies have addressed this issue. This study aimed to investigate the thymus sonographic changes with age.

Methods:

In this cross-sectional study, 118 healthy children were categorised into six age groups. Sonographic features of the thymus, including volume, anatomical position, symmetry, and echo-texture, were recorded.

Results:

The thymus was visible at all ages from the suprasternal view. In 77.5% of participants, the thymus gland volume in lobes was symmetrical; however, left (21.2%) and right (1.3%) predominance were also found. The most common position of the thymus was in front of the great vessels (100%) with suprasternal extension (97.5%). The mean volume of thymus was 21.3 ± 10.5 (mm). There was no significant difference in the volumes of the thymus between different age groups. The predominant echo-texture of the thymus in different age groups was hypoechoic with thin echogenic septa (liver-like) in below 2–3 years of age, the appearance of echogenic foci and hyperechoic echo-texture (liver-like with starry sky) in 2–14 years, and uniform hyperechoic echo-texture (fatty liver-like) or geographic echo-texture with coarse reticular pattern in above 14 years.

Conclusion:

In children, the thymus gland is visible in ultrasound examination in all age groups from the suprasternal view; however, the echo-texture of the normal thymus changes with age. There was no significant correlation between age and sex with total thymic volume. The specificity of these appearances has made ultrasound a problem-solving modality in children.
A review exploring coach knowledge, attitudes/beliefs and behaviours towards low energy availability in athletes
Authors: Hamer Jennifer , Desbrow Ben , Irwin Chris
Published: November 2022

Coaches are important figures of influence with potential to create environments that influence athlete health and performance outcomes. Ideally, coaches provide supportive environments that lead to performance optimisation and long-term health. Coaches who employ language and behaviours that overemphasise body composition and/or provide misinformed nutrition advice may predispose athletes to low energy availability (LEA) and the associated health consequences. Having a clear understanding of current knowledge, attitudes and beliefs of coaches with regard to LEA is required to guide future coach education/support initiatives to optimise athlete health and performance. Thus, the aim of this investigation was to systematically review published literature regarding coach knowledge, attitudes/beliefs and behaviours of LEA.

Data from 20 eligible studies was extracted into predetermined categories according to coach ‘knowledge‘; ‘attitudes/ beliefs’; and ‘behaviours’ regarding LEA/Relative Energy Deficiency in Sport/Female Athlete Triad and/or eating disorders and/or disordered eating. Any single study could provide outcomes to inform one or multiple of these categories. The majority of results were drawn from studies conducted prior to LEA being defined as a concern for athlete health, which limited our understanding of the contemporary knowledge, attitudes/eliefs and behaviours of coaches on this important issue. That said, indications of gaps in coach knowledge and the employment of inappropriate attitudes/beliefs and behaviours regarding issues associated with LEA were evident. An opportunity exists for key stakeholders to develop comprehensive coach education frameworks, which equip coaches with the adequate capability, opportunity and motivation to support athlete health and avoid the consequences of LEA.
Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis
Authors: de Queiros Victor Sabino , Rolnick Nicholas , dos Santos Ísis Kelly , de França Ingrid Martins , Lima Rony Jerônimo , Vieira João Guilherme , Aniceto Rodrigo Ramalho , Neto Gabriel Rodrigues , de Medeiros Jason Azevedo , Vianna Jeferson Macedo , de Araújo Tinôco Cabral Breno Guilherme , Silva Dantas Paulo Moreira
Published: November 2022

Context:

Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory.

Objectives:

To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses.

Data Sources:

CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022.

Study Selection:

Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model.

Study Design:

Systematic review and meta-analysis.

Level of Evidence:

Level 2.

Data Extraction:

All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer.

Results:

Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar.

Conclusion:

In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.
Are staging bone scans necessary in patients with T3a prostate cancer? A multicentre study
Authors: Whiting Danielle , Giona Simone , Yao Mark , Hassan Roa , Doan Hong , Karanjia Rustam , Hicks James , Eddy Ben , Madaan Sanjeev , Bott Simon
Published: November 2022

Objective:

Studies reporting increased risk of metastases in T3a disease are based on clinical staging (Digital rectal examination) in the pre-multiparametric–magnetic resonance imaging (MRI) (mp-MRI) era. The aim of our study was to assess the rate of positive bone scans in patients ascribed with T3a prostate cancer on a pre-biopsy mp-MRI.

Methods:

We performed a multicentre, retrospective analysis of all patients with T3a prostate cancer staged by mp-MRI who had a bone scan between January 2017 and April 2020.

Results:

A total of 586 patients were diagnosed with T3a prostate cancer on mp-MRI, with a median age of 71 years (range: 47–87). The median presenting PSA was 11 ng/mL (range: 1–537); 125 patients (21.3%) had a PSA ⩽ 20 and either grade group (GG) 1 or 2 in their prostate biopsy; none of these patients had bone metastases. Eighteen patients (3.1%) were found to have bone metastases: 11 patients had GG ⩾ 3 disease on biopsy and nodal disease, 6 had GG ⩾ 3 without evidence of nodal disease and 1 had a PSA of 103.

Conclusion:

The use of bone scans in patients with T3a prostate cancer staged on mp-MRI but without other evidence of high-risk disease (GG ⩾ 3 and PSA > 20 ng/mL) appears to be unnecessary and could be safely avoided.

Level of evidence:

2b
Determinants of escape from echo chambers: The predictive power of political orientation, social media use, and demographics
Authors: Chan Chi Kit , Zhao M M , Lee Paul SN
Published: November 2022

This study aims to understand the determinants of escape from echo chambers. Social media users can control the content to which they are exposed by confining their contacts to like-minded individuals. The resulting echo chamber effect can reinforce existing views and discourage rational discussion. We conducted a survey with a representative sample of 1969 respondents in 2020. Contrary to common expectation, a liberal political orientation was insignificant in predicting reference to differing views, but political partisanship, media trust, time spent on social media, education levels, and gender were significant. Those who spent more time on social media and had lower trust in media were found to refer to other views more frequently and were less susceptible to the echo chamber effect. The results of this study suggest that open-mindedness, independence, critical scepticism, and social activeness are significant resources for one to escape from the echo chamber.
“Communist Controlled Black Barbarism”: The Citizen’s Councils of America’s Anti-Communist Master Frame Cluster and the Renovation of White Supremacist Ideology
Authors: Wright Devon A.
Published: November 2022

Using insights from a content coding analysis of discourse from the most influential White supremacist segregationist organization of the early Cold War decades, Citizen’s Councils of America (CCA or Council), I argue that social movement organizations use a master frame cluster, a package of closely related, overlapping frames with a core master frame to adapt and update pre-existing, older ideology to contemporaneous sociopolitical currents and thereby mainstream, modernize, and streamline propaganda messaging. From its media outlets and White supremacist ideology, the Council deployed what I call its Anti-Communist Master Frame Cluster, proclaiming that unrestrained Black savagery and misguided White sympathy, including liberals, leftists, and socialists, all followed a downward slope toward communist tyranny or what the Council called, “Communist controlled Black barbarism.” Twenty-first century conservative rightwing media has inherited the CCA’s master frame cluster to discredit Black Lives Matter protests, still using anti-communist messaging, but with a “Black-on-Black” crime narrative as the main propaganda weapon against Black protest.
Turnover intentions and safety compliance in the military: A psychological contract perspective
Authors: Kraak Johannes M , Griep Yannick , Barbaroux Pierre , Lakshman C
Published: November 2022

NATO members have been coping with low motivation and morale. Such environments typically have high turnover intentions and neglect behavior. However, safety behavior is paramount for military organizations and neglect behavior can have serious consequences. Social exchanges are often cited as the main reason for these phenomena. We therefore examine turnover intentions and safety compliance behavior of 1,593 airmen from a European NATO Air Force by focusing on different psychological contract (PC) dimensions. We use polynomial regression and response surface analysis. Results show that higher levels of PC fulfillment are related to lower levels of turnover intentions and higher levels of safety compliance behavior. Furthermore, perceptions of PC overfulfillment are negatively associated with turnover intentions, whereas safety compliance is unaffected by positive (overfulfillment) and negative (underfulfillment) PC discrepancies along all PC dimensions. We discuss implications for the PC literature, make suggestions for future research, and provide practical implications.

JEL CLASSIFICATIONS: M0 - general; M1 - business administration; C3 - Multiple or Simultaneous Equation Models; Multiple VariablesKeyword
Identifying and Building Strengths: An Experiential Exercise in Developing Classroom Contributions
Authors: Dunn Mary B.
Published: November 2022

This experiential exercise uses feedback from peers to develop students’ classroom contributions and build a classroom climate that encourages active engaging and learning. It is best suited for courses that require active classroom participation, but works well in any format, traditional and online, and with any level of students. The activity takes a strengths-based approach, anchored in positive psychology, appreciative inquiry, and positive organizational scholarship, to guide peer feedback about classroom contributions. It asks students to provide appreciative and evaluative feedback to their teammates and discuss ways they can be more effective contributors in the classroom. This activity has several important learning objectives for students: (1) describe specific behaviors associated with effective contributions in the classroom, (2) gain awareness of how others view their classroom contributions, and (3) use appreciative and evaluative feedback to improve their contributions in the future.
Bone Marrow Stimulation and Biologics for Osteochondral Lesion of the Talus: A Systematic Review and Meta-Analysis of Clinical Comparative Studies
Authors: Ubillus Hugo A. , Seow Dexter , Azam Mohammad T. , Yasui Youichi , Mercer Nathaniel P. , Weiss Matthew B. , Pearce Christopher J. , Kennedy John G.
Published: November 2022

Category:

Ankle; Ankle Arthritis; Basic Sciences/Biologics; Sports; Trauma

Introduction/Purpose:

Osteochondral lesion of the talus (OLT) is a commonly occurring injury, typically treated with bone marrow stimulation (BMS) in the small to medium-sized lesions after a failed course of conservative treatment. The current evidence suggests that biologics can improve chondrocyte growth and differentiation. However, the lack of consensus to date on the efficacy of biologics + BMS for OLT has warranted further investigation. The purpose of this study is to clarify the effectiveness and safety of biologics as an augmentation in BMS by assessing complication rates, continuous functional outcome scores and return to play data compared to BMS alone for OLT.

Methods:

A systematic review and meta-analysis were performed. The PubMed and Embase databases were searched using specific search terms and eligibility criteria according to the PRISMA guidelines. The level of evidence was assessed using published criteria by The Journal of Bone & Joint Surgery and the quality of evidence using the Modified Coleman Methodology Score. Fixed- effects models were employed if heterogeneity was graded low (I2 <25%), and random-effects models if heterogeneity was graded moderate to high (I2>=25%).

Results:

For BMS versus BMS + hyaluronic acid (HA), the fixed-effects model for American Orthopaedic Foot and Ankle Society score revealed a mean difference increase that is an improvement of 4.88 (95% CI, 2.33 to 7.44; I2 = 0%; p = 0.0002) points, in favor of BMS + HA. The fixed-effects model for 10mm Visual Analog Scale pain revealed a mean difference decrease that is an improvement of 1.21 (95% CI, 0.70 to 1.73; I2 = 0%; p < 0.00001) points, also in favor of BMS + HA. For BMS versus BMS + concentrated bone marrow aspirate (CBMA), the pooled complication rate was 17/64 (26.6%) versus 11/71 (15.5%), respectively, with a chi-squared test of p = 0.11. The pool revision rate was 15/64 (23.4%) versus 6/71 (8.5%), respectively, with a chi-squared test of p = 0.016.

Conclusion:

Adjuvant biologic use with BMS may provide superior outcomes, notably that of HA and CBMA, based on the current evidence. Future studies must aim to establish the clinical superiority of the various other biologics + BMS versus BMS alone. These studies must compare the various biologics against one another to determine, if any, the optimal biologic for OLT.