bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-calcitonin gene-related peptide monoclonal antibodies for the treatment of vestibular migraine: A prospective observational cohort study
Authors: Russo Cinzia Valeria , Saccà Francesco , Braca Simone , Sansone Mattia , Miele Angelo , Stornaiuolo Antonio , De Simone Roberto
Published: March 2023

Background

Vestibular migraine is considered the most common cause of recurrent vertigo for which specific treatments are missing. Monoclonal antibodies against calcitonin gene-related peptide,, are effective in preventing migraine. Since CGRP is also detected in human cochlear and vestibular organs it may also play a role in vestibular physiology.

Methods

This is a prospective observational cohort study, aiming at evaluating the efficacy of erenumab, fremanezumab or galcanezumab for the treatment of fifty vestibular migraine patients. We assessed mean monthly days with headache and dizziness/vestibular symptoms, pain intensity and migraine-related clinical burden occurring for 18 months.

Results

Response to treatment was excellent as 45 (90%) patients had at least a 50% reduction in vertigo frequency, 43 (86%) had at least a 50% reduction in headache frequency, and 40 (80%) a MIDAS reduction of at least 50%. Overall, 39 (78%) patients had a concomitant reduction of all three parameters. Mean monthly days with dizziness/vestibular symptoms showed an overall significant decrease from a mean of 10.3 ± 1.9 at baseline to 0.8 ± 0.3 days, difference 9.5 (CI 95% 3.6, 15.4; p < 0.001) after twelve months.

Conclusion

We show that anti-CGRP mAbs may be effective in the treatment of Vestibular Migraine. Their use should be encouraged early in the disease course to allow for a better symptom control and quality of life improvement.
Inhibiting PAC1 receptor internalization and endosomal ERK pathway activation may ameliorate hyperalgesia in a chronic migraine rat model
Authors: Zhang Lily , Zhou Yanjie , Wang Yajuan , Yang Liu , Wang Yue , Shan Zhengming , Liang Jingjing , Xiao Zheman
Published: March 2023

Background

Pituitary adenylate cyclase-activating polypeptide (PACAP) is a multipotent neuropeptide widely distributed in the trigeminovascular system (TVS) and higher brain regions. At present, the underlying mechanism of PACAP/PACAP type1 (PAC1) receptor in migraine generation remains unclear.

Methods

The rat model of chronic migraine (CM) was established by repeated intraperitoneal injection of nitroglycerin (NTG). Von Frey filaments and hot plate tests were used to measure the mechanical and thermal thresholds. The expression levels of c-Fos, calcitonin gene-related peptide (CGRP), PACAP, PAC1, protein kinase A (PKA) and phosphorylated extracellular signal-regulated kinase (ERK) were assessed by western blotting or immunofluorescence staining. The internalization of PAC1 receptor was visualized by fluorescence microscope and laser scanning confocal microscope.

Results

The results showed that c-Fos and CGRP expression significantly increased after repeated administrations of NTG or PACAP. Pitstop2 notably improved hyperalgesia in CM rats, while PACAP6–38 offered no benefit. In addition, PACAP-induced PAC1 receptor internalization, PKA and ERK pathways activation were blocked by Pitstop2 instead of PACAP6–38.

Conclusions

Our results demonstrate that inhibition of PAC1 receptor internalization could effectively improve allodynia in CM rats by restraining ERK signaling pathway activation in a chronic migraine rat model. Modulation of receptor internalization may be a novel perspective to explore specific mechanisms of PACAP signaling activation in the trigeminal vascular system.
L'Indien and the Gilded Plaice: Building American Frigates in Amsterdam, 1777–1782
Authors: Odegard Erik
Published: March 2023

In 1777, the American commissioners in Paris, Benjamin Franklin and Silas Deane, contracted with French naval captain Jacques Boux to design two frigates for the Revolutionary cause. The design was the first of a new concept of very large frigates, able to outgun anything they could not outrun. The ships were to be built at a private yard in Amsterdam. One of these vessels, laid down as L’Indien, would ultimately serve the American cause in the South Carolina State Navy under the name South Carolina. This article examines the Dutch period of the two ships built at the yard of Arie Staats in Amsterdam in 1777–1781. Despite the attention given to South Carolina in the historiography, the Dutch sources have not yet been studied. The case of L’Indien and Tijger, her sister ship, illustrates the continuing importance of private contractors to navies in the late eighteenth century.
Coping With Limited Prosecutorial Resources: An Assessment of the Case Processing and Community Impact From the Perspective of Prosecutors and Staff in a Southeastern County
Authors: Metcalfe Christi , Kuhns Joseph B.
Published: March 2023

Counties across the country are experiencing population growth with associated crime increases while prosecutor offices remain under-resourced. Resource constraints have implications for case processing and community relations. This study offers a descriptive assessment of prosecutor and staff perceptions on resource challenges, using the Mecklenburg County District Attorney’s Office in North Carolina as a case study—a county where staffing and funding has stagnated over the past decade. Employing official data, interviews, and surveys, we considered how prosecutorial resources in Mecklenburg County compared with similar counties within the state, region, and country, as well as explored perceptions of resource constraints and the impact on office effectiveness and the community. Results suggested that Mecklenburg County did not compare favorably with similar counties in the region and nation, suffered more broadly from criminal justice funding challenges, and faced staffing shortages and turnover that were perceived as affecting case dispositions, office morale, and community trust.
It’s Understandable If It Destroys You, Right?—Grades, Students’ Self-Images, and Quantification
Authors: Rohde Noëlle
Published: March 2023

Human life is increasingly quantified. From blood pressure to body mass index, from likes and retweets to performance metrics at work, from IQ results to facial attractiveness scores issued by smartphone apps. Many of these numbers have the potential to substantially shape how individuals view themselves, and yet the link between quantification and self-image is to date not well understood. My window into this phenomenon is one of the most ubiquitous and influential metrics worldwide: the school grade. Based on ethnographic fieldwork in a German comprehensive school, I explore how students’ self-images are shaped by their numbers. Comparing students’ official and unofficial remarks reveals a striking contrast between a seemingly detached stance toward marks and a powerful feeling of being defined by them—notably with regards to “intelligence.” Nevertheless, rather than passively identifying with their grades, especially low-performing students draw on a wide range of strategies in an effort to negotiate their self-image in light of their numbers.
Music for Mental Health: An Autoethnography of the Rory Gallagher Instagram Fan Community
Authors: O’Hagan Lauren Alex
Published: March 2023

Since the outbreak of COVID-19, there has been a major increase in anxiety and depression. For many, online music fandoms have offered an important platform to combat loneliness and aid well-being. In this study, I use autoethnography, supported by psychosocial theory on recovery and sociological theory on music fandoms, to track my personal journey of recovery (2020–2022) from a mental health crisis through the support of the Rory Gallagher Instagram fan community. Specifically, I investigate how the community acts as a positive support mechanism for well-being, how my relationship with Rory and his music has changed since joining the community, and how knowledge of Rory’s own personal struggles, coupled with my own experiences, have empowered me to become a mental health advocate. Overall, the study brings attention to the importance of online music communities as informal, holistic regulating agents for mental health conditions and offers alternative ways for health services to approach mental health care.
Functional properties and characterization of maize starch films blended with chitosan
Authors: Hao Yanling , Cheng Long , Song Xiaoshuang , Gao Qiqi
Published: March 2023

The preparation of biodegradable composite films from blending chitosan in maize starch via solution casting was explored and the effect of the ratio of chitosan/starch on the physicochemical, mechanical properties and antimicrobial activity of the films was investigated. The interaction through hydrogen bonding between starch molecules and chitosan and the reduction of crystallinity in blend films were revealed in FTIR and XRD results. The blend films with incorporation of proper amounts of chitosan to a maize starch matrix displayed an enhancement in tensile properties and water vapor barrier performance, an improvement in rigidity and antimicrobial activity accompanied by higher transparency. The film with 1/3 of chitosan/starch ratio appeared homogeneous structure, 21.54 ± 0.78 MPa of tensile strength and (2.81 ± 0.26)×10−10 g·m−1·s−1·Pa−1 of water vapor permeability which were 1.52 times higher and 60.9% lower than those of starch film, respectively. The deteriorated comprehensive performance of the films could be caused by excessively high chitosan content because of an incomplete miscibility between starch and chitosan. The chitosan/starch blend film possessed reasonable thermal stability and it could potentially be useful for food packaging applications.
Describing Remembrance & Renewal: A Holistic Self-Care Program
Authors: Rettig Amy E. , Lambrecht-Stock Emily , Lindsey Amy , Sinnott Loraine T.
Published: March 2023

Background: Holistic care interventions include support for healthcare worker grief in a relationship-based care paradigm. Few programs support oncology healthcare worker grief and renewal prior to and during the COVID-19 pandemic. Objective: Describe “knowledge of” and “engagement with” a program about grief and resilience, Remembrance & Renewal (R&R). Method: An anonymous, electronic survey was available to healthcare workers at an academic, comprehensive cancer center. Demographic questions were analyzed against “knowledge of” and “engagement with.” Results: Of 105 responding to “awareness of,” 81 knew about R&R and 48 had “engaged with” the program. Statistically significant relationships between a characteristic and awareness were found for education ( p  =  .03), setting (p < .01), and the frequency of learning about a death ( p  =  .04). Statistically significant relationships between a characteristic and level of participation were found for profession ( p  =  .02) and length of time in job ( p  =  .03). Open-ended questions asked about impact of patient death ( n  =  93), barriers to participation ( n  =  54), and feelings after “engagement with” ( n  =  45). Responses to impact, barriers, and feelings were respectively: sadness (75.3%); time (77.8%); and calm (75.6%). Conclusion: This study describes “knowledge of” and “engagement with” a holistic grief and renewal program. Further study will add to healthcare worker holistic self-care.
Identification, reproduction, and control of vehicle roll vibration
Authors: Wang Hongnan , Zhang Bao
Published: March 2023

The human body is extremely sensitive to roll vibration, which is also an important indicator for evaluating vehicle comfort. In order to improve the ability of anti-roll vibration of vehicles, the methods of mathematical modeling, dynamic simulation, and vibration test are used in this paper. The generation mechanism, dynamic change law, and key influencing factors of the roll vibration are analyzed. The analysis results include: the dynamic simulation results are in good agreement with the test results, and the use of the simulation model is beneficial to the analysis and control of the roll vibration; the roll vibration is caused by the relative dynamic deformation of the left and right suspensions, and the larger the relative deformation, the more obvious the roll vibration; the optimization of the position and damping of the shock absorber is conducive to the control of roll vibration, which greatly improves the comfort of the vehicle. The research results provide theoretical basis and reference for grasping the characteristics of the roll vibration and vibration reduction design.
Thermal and electroosmotic transport of blood-copper/platinum nanofluid in a microfluidic vessel with entropy analysis
Authors: Sridhar Vemulawada , Khashi'ie Najiyah S , Ramesh Katta
Published: March 2023

Electroosmotic flow through the biomechanical devices is efficient in targeting drug delivery of the human body parts related to the digestive and renal systems. In view of this, the present work is focused on the mathematical modeling of electroosmotic nanofluid transport driven by peristalsis. The impacts of magnetohydrodynamics, viscous dissipation, and thermal radiation on the intended stream have been considered. The resulting system of equations has been simplified with the lubrication approach and obtained the exact solutions for temperature, shear stress, velocity, trapping, and entropy generation. The impact of distinct physical parameters on nanofluid flow is graphically computed. It can be seen from the present study that the stronger electric field accelerates the entropy generation near the channel walls. A higher temperature is observed for blade nanoparticles presented in the base fluid. The stronger magnetic field reduces the size of the bolus. The higher velocities are noticed for the blood-platinum-based nanofluid as compared with blood-copper-based nanofluid.
Understanding the slurry erosion behaviour of iron-based chromium carbide coating material during deposition via arc spray coating method
Authors: Demirsöz Recep , Singla Anil Kumar , Uğur Abdullah , Erdoğdu Ahmet Emrah , Korkmaz Mehmet Erdi , Gupta Munish Kumar , Królczyk Jolanta Beata , Ross Nimel Sworna
Published: March 2023

The material S235JR was spray-coated with iron-based chromium carbide in the present study. The effects of the initial surface roughness on slurry erosion were investigated. Samples with a rough surface and polished surface were used. The impact of particle concentration, impact velocity and impact angle was studied on the slurry erosion characteristics in terms of mass loss, surface roughness and surface temperature. In addition, the surfaces were analysed using a scanning electron microscope (SEM). Further, the estimation equation has been derived using response surface method (RSM) based on the data obtained in the study. The results show that velocity and concentration are the key factors in determining the mass loss and surface temperature while the impact angle has a relatively minor role. Mass losses in rough samples ranged from 8.8 mg to 40 mg; in polished samples, the range ranged from 5.6 mg to 10.9 mg.
Psychosocial determinants of pre-exposure prophylaxis use among pregnant adolescent girls and young women in Cape Town, South Africa: A qualitative study
Authors: Haribhai Sonia , Khadka Nehaa , Mvududu Rufaro , Mashele Nyiko , Bekker Linda-Gail , Gorbach Pamina , Coates Thomas J , Myer Landon , Joseph Davey Dvora Leah
Published: March 2023

Background

In South Africa, at least 7.5 million people (age ≥15 years) are living with Human Immunodeficiency Virus (HIV). In 2020, 220,000 new infections occurred, approximately one-third of which were among cisgender adolescent girls and women (age ≥15 years). The perspectives of pregnant adolescent girls and young women (AGYW) as key, targeted end-users of pre-exposure prophylaxis (PrEP) in this setting are not well known.

Methods

We purposively recruited participants enrolled in an ongoing cohort study at an urban antenatal clinic in Cape Town, South Africa for in-depth interviews between July–September 2020. We restricted our analysis to pregnant AGYW (age: 16–25 years) who initiated daily oral PrEP (Tenofovir/Emtricitabine) antenatally and self-reported either high PrEP persistence (≥25 days in the past 30 days and no missed PrEP collection), or low PrEP persistence and/or discontinuation (missing >5 days in the last 30 days or missed PrEP collection). The findings were organized thematically, per the adapted Health Behavior Model (2000), using Nvivo-v.1.5.

Results

We interviewed 18 AGYW (mean age = 22 years), at a mean of 14 weeks postpartum. Higher self-esteem and high-quality study provider-client relationships, including empathic psychosocial support, facilitated PrEP continuation. Reported barriers included unstable social structure characteristics (i.e., financial hardship) and individual factors (i.e., unintended pregnancy, parental rejection, and inadequate peer- and [non-cohabiting] partner support). Participants self-perceived a need for PrEP, feeling susceptible to non-consensual, forced sex, or considering partners’ (presumed) sexual risk-taking. Limited community awareness regarding PrEP availability and/or perceived complexity in navigating health system access to PrEP, impede continuation.

Conclusions

PrEP-focused healthcare access pathways for pregnant and postpartum AGYW need to be simplified. Further research is needed on health system determinants (i.e., structural barriers, provider-client interactions, and related outcomes) of oral PrEP utilization. In 2022, South Africa announced regulatory approval of long-acting PrEP options (i.e., the dapivirine ring for non-pregnant women and injectable cabotegravir, respectively); these may mitigate implementation barriers reported in this study. However, the safety and efficacy of long-acting PrEP (e.g., injectables, implants) among pregnant or breastfeeding women, specifically, remains to be confirmed in this setting.
Next generation sequencing to examine associations between vaginal washing and vaginal microbiota: A cohort study
Authors: Sabo Michelle C , Balkus Jennifer E , Richardson Barbra A , Srinivasan Sujatha , Kimani Joshua , Anzala Omu , Schwebke Jane , Fiedler Tina L , Fredricks David N , McClelland R Scott
Published: March 2023

Background

The association between vaginal washing and HIV risk may be mediated by vaginal washing-associated changes in vaginal microbiota.

Methods

Data from a cohort of HIV-negative US and Kenyan women enrolled in the Preventing Vaginal Infections trial were analyzed. Vaginal fluid samples and vaginal washing data were collected every 2 months for 12 months. Bacterial relative abundances were measured by broad-range 16S rRNA gene polymerase chain reaction with next generation sequencing. Generalized estimating equations were used to evaluate the association between vaginal washing and i) the Shannon Diversity Index (SDI); and ii) mean change in percent bacterial relative abundances, with application of a 10% false discovery rate (FDR).

Results

Participants ( N = 111) contributed 93/630 (14.8%) vaginal washing visits. Mean SDI was 0.74 points higher (95% CI 0.35, 1.14; p < 0.001) at washing visits among US participants ( N = 26). Vaginal washing was not associated with SDI in Kenyan participants ( N = 85). There were no associations between vaginal washing and vaginal bacterial relative abundances after applying the FDR.

Conclusions

The discordant results in Kenyan versus US women suggests the link between vaginal washing and sub-optimal vaginal microbiota may be context specific. Vaginal microbial shifts may not fully explain the association between vaginal washing and HIV acquisition.
Effect of flash-boiling spray on ignition and flame-holding characteristics under sub-atmospheric pressure
Authors: Miao Junjie , Jiang Kailin , Li Xiankai , Yin Chao , Fan Yuxin
Published: March 2023

To prevent the performance degradation and flameout of an afterburner/ramjet combustor under sub-atmospheric pressure, the flash-boiling spray by twin-orifice nozzle is attempted to incorporate with the pilot flameholder for reliable ignition and flame stability. Herein, the effects of flash boiling spray by twin-orifice nozzle on the ignition and flame-holding characteristics of evaporating V-gutter flameholder under sub-atmospheric pressure are investigated. According to the analysis of flow patterns and fuel concentrate distribution, the flame stabilization mechanisms of evaporating V-gutter flameholder under lean-state and rich-state are concluded. Compared with subcooled spray, the significant improvement of flash boiling spray on fuel atomization and evaporation under sub-atmospheric pressure can effectively broaden the maximum ignitable velocity of the evaporating V-gutter flameholder, and the lean ignition and blowout fuel-to-air ratios can be reduced by 68.2% and 71.3%, respectively. Furthermore, the flash-boiling spray can promote the establishment of initial flame kernel and accelerate the flame-front propagation, and make the flame stabilization mechanism transform from the rich-flame stabilization mechanism under subcooled spray to the lean-flame stabilization mechanism, resulting in a better performance of flame stability. The results provide a theoretical and technical basis for the practical application of flash-boiling spray in engineering afterburner/ramjet combustors under extreme conditions.
Foreign direct investment, development strategy, and green innovation
Authors: Shao Hanhua , Huang Xinpeng , Wen Huwei
Published: March 2023

In developing countries, foreign direct investment (FDI) plays a significant role in industrial catch-up concerning knowledge acquisition and technological innovation. The Chinese government's development strategy is vital in attracting FDI and green innovation (GI). This article investigates the moderating role of development strategy in the causal relationship between FDI and GI from the perspective of new structural economics. We find a U-shaped association between FDI and GI. Specifically, FDI inhibits GI at its low level, and FDI promotes GI with the accumulation of FDI capital. Therefore, cities with moderate catch-up strategies can maximize the impact of FDI on GI. Development strategies can also hinder the effects of FDI-driven GI in cities with a perfect market system while promoting them in cities with relatively backward, cleaner production technology. The development strategy not only has an impact on the FDI-driven GI effects in the region but also on the FDI-driven GI effects in the surrounding regions through the spatial spillover effect. These findings provide references on what type of FDI the government should introduce and how to guide the market to bring the GI effect of FDI into play.
How consumers value improving energy efficiency policy in the electricity market: A contingent valuation experiment in South Korea
Authors: Nam Solji , Shin Jungwoo , Hong Bum Il
Published: March 2023

Global warming concerns have emphasized the need for carbon neutrality. Improving the efficiency of the electricity industry is one method of reducing CO2 emissions. There is a demand response policy that trades the saved electricity through voluntary adjustment of consumption patterns. The introduction of real-time pricing (RTP) based on advanced power supply systems is a method of transitioning to a demand-oriented power system. However, as Korea's power supply system is a relatively less efficient single-rate system, it is necessary to improve the efficiency of demand management. To transition to a demand-oriented power system in Korea, consumer preference is first investigated. This study evaluates the willingness to pay (WTP) for the introduction of RTP in Korea. Based on a survey of 500 households using the contingent valuation method, the monthly average WTP was found to be 2465 Korean won per household ($2.18 per household), which is approximately 7.8% of the electricity rate. Several additional factors influencing WTP were analyzed. Further analysis indicated that it is more effective to establish infrastructure for introducing RTP in local areas with low average electricity rates. These findings are beneficial for the development of future demand response policies.
Modern bridal femininity: Navigating niceness as a Princess Bride and a Bridezilla in the United States
Authors: Sharp Elizabeth A.
Published: March 2023

Despite the widespread popularity of United States (US) weddings and the cultural significance assigned to modern brides, scant research has examined US bridal femininity—an important site of analysis for understanding contemporary norms and expectations of femininity, more generally. In response to this gap, drawing on constructivist grounded theory and poststructural feminism, the present study examined 18 heterosexual, predominantly White, middle-class, cisgender US brides’ experiences of their weddings. Analyses revealed that brides navigated expectations of niceness, engaging in both Princess Bride-like and “Bridezilla”-like behaviors and emotions. Implications for idealized femininity within a neoliberal context are considered.
Let Me Choose: The Role of Choice in the Development of Executive Function Skills
Authors: Carlson Stephanie M.
Published: March 2023

Executive function (EF) skills, including working memory, inhibition, and cognitive flexibility, form the neurocognitive basis for conscious, goal-directed behavior and self-control. Young children are notoriously deficient in such skills, but EF improves most rapidly in the preschool period. Individual differences in EF are predictive of a host of important life outcomes, and recent advances in measurement and intervention are promising. Caregivers play a key role in the development of EF, particularly with respect to supporting the child’s autonomy. I take a closer look at agency and discuss theoretical and empirical support for the notion that giving children a sense of choice in how to act, think, and feel is essential for healthy EF skill development in early childhood.
Everybody Hurts: Intersecting and Colliding Epidemics and the Need for Integrated Behavioral Treatment of Chronic Pain and Substance Use
Authors: Witkiewitz Katie , Vowles Kevin E.
Published: March 2023

Chronic pain and substance use disorders (SUDs) are common, debilitating, and often persist over the longer term. On their own, each represents a significant health problem, with estimates indicating a substantial proportion of the adult population has chronic pain or an SUD, and their co-occurrence is increasing. Chronic pain and SUD are often invisible, stigmatized disorders, and persons with both regularly have difficulty accessing evidence-based treatments, particularly those that offer coordinated and integrated treatment for both conditions. But there is hope. Research is unraveling the mechanisms of chronic pain and substance use, as well as their co-occurrence; integrated behavioral treatment options based on acceptance- and mindfulness-based approaches are increasingly being developed and tested; government agencies are devoting more funds and resources to research on chronic pain and SUD; and there have been growing efforts in training, dissemination, and implementation of evidence-based treatments. At the heart of the matter, though, is the need to recognize that everybody hurts sometimes and treatments must empower people to life effectively with these experiences of being human.
T-cell–rich, large B-cell lymphoma in the brain of a horse
Authors: Rissi Daniel R. , Avery Anne C. , Burnett Robert C.
Published: March 2023

T-cell–rich, large B-cell lymphoma (TCRLBCL) is the most commonly diagnosed type of lymphoma in horses. Here we describe the clinical signs, neuropathology, immunohistochemistry (IHC), and PCR for antigen receptor rearrangement (PARR) analysis results of a TCRLBCL in the brain of an 8-y-old male Quarter Horse that was euthanized after acute anorexia, tremors, head pressing, falling, blindness, incoordination, and seizures. Autopsy revealed a firm, smooth, pale-yellow mass that expanded both lateral ventricles and the adjacent subcortical white matter. Histologically, the mass consisted of a densely cellular neoplasm composed of large, CD79+ neoplastic B-lymphocytes admixed with sheets of small, CD3+ reactive T-lymphocytes, Iba1+ histiocytes, MUM1+ plasma cells, and rare eosinophils supported by a fine fibrovascular stroma. Formalin-fixed, paraffin-embedded tissue scrolls were retrieved and subjected to PARR analysis, which revealed a clonal reaction in the immunoglobulin gene and a polyclonal reaction for the T-lymphocyte receptor gene, consistent with a neoplastic B-lymphocyte and reactive T-lymphocyte proliferation. The diagnosis of TCRLBCL was suspected histologically and confirmed based on IHC and PARR analysis.
The Cognitive Skills in Interpretation of Spatial Situations in the League of Legends game
Authors: Horbiński Tymoteusz , Zagata Krzysztof
Published: March 2023

Background

League of Legends is one of the most popular video games in the world. With the help of the new initiatives of the developers and publishers (Riot Games), professional international and local tournaments were established. Riot Games also took care of establishing regional leagues, such as LCK (League of Legends Champions Korea) or LEC (League of Legends European Championship). The best teams from each region have an annual chance to compete in October / November to become the esports world champions in LoL. Watching the tournaments such as world champions, as well as amateur streams on popular platforms (Twitch, YouTube) is now trending more and more. The fact that the game (especially spatial situations) can be observed by both experts (players of this game) and non-experts (players of other games or non-players at all) creates a field for scientific research.

Intervention

The authors of this article wanted to establish whether or not the League of Legends game offers gamers with different levels of knowledge of the entire game and different range of cognitive skills the same interpretation of spatial situations.

Methods

The research was carried out in the form of a questionnaire (offline), in which respondents were supposed to watch five short videos presenting different situations during the game. Eighty-two respondents, divided into three groups, participated in the research. The Pearson chi-square test was used for the analysis of the differences between groups.

Results and Discussion

As a consequence of the results of this study it may be concluded that gamers on different advancement level do not present the same level of interpretation of spatial situations in the game. The authors, using the scheme of knowledge of the point, lane, and area in the construction of video questionnaire did not focus on the game as a whole, but wanted to highlight crucial elements of the entire game.
Evaluation of a Palliative Care Longitudinal Curriculum for Medical Students Using the Context-Input-Process-Product Model
Authors: Sagin Alana , Balmer Dorene , Rose Suzanne , Musheno Rosie , Olenik Jennifer M. , Dingfield Laura , Dine C. Jessica , Bennett Nadia L.
Published: March 2023

Palliative care (PC) longitudinal curricula are increasingly being recognized as important in Undergraduate Medical Education (UME). They are however, not yet commonplace, and where they do exist may be implemented without a systematic, prospective approach to curriculum evaluation. This paper describes an implementation of a new longitudinal curriculum at the Perelman School of Medicine (PSOM) at the University of Pennsylvania. We used the Context Input Process Product (CIPP) model, a holistic evaluation model, to assess the local environment, design the curriculum, guide the improvement process, and evaluate outcomes. Comprehensive models such as CIPP provide a more robust approach to curriculum evaluation than outcomes-only models and may be of use to other programs who are implementing new curricula or improving upon existing programs.
Critical Care Pharmacist Attitudes and Perceptions of Neuromuscular Blocker Infusions in ARDS
Authors: Devlin John W. , Train Sarah E. , Burns Karen E. A. , Massaro Anthony , Wu Ting Ting , Castor Timothy , Vassaur John , Selvan Kavitha , Kress John P. , Erstad Brian L.
Published: March 2023

Background:

Current critical care pharmacist (CCP) practices and perceptions related to neuromuscular infusion (NMBI) use for acute respiratory distress syndrome (ARDS) maybe different with the COVID-19 pandemic and the publication of 2020 NMBI practice guidelines.

Objective:

To evaluate CCP practices and perceptions regarding NMBI use for patients with moderate-severe ARDS.

Methods:

We developed, tested, and electronically administered a questionnaire (7 parent-, 42 sub-questions) to 409 American College of Clinical Pharmacy (ACCP) Critical Care Practice and Research Network members in 12 geographically diverse states. The questionnaire focused on adults with moderate-severe ARDS (PaO2:FiO2<150) whose causes of dyssynchrony were addressed. Two reminders were sent at 10-day intervals.

Results:

Respondents [131/409 (32%)] primarily worked in a medical intensive care unit (ICU) 102 (78%). Compared to COVID-negative(-) ARDS patients, COVID positive(+) ARDS patients were twice as likely to receive a NMBI (34 ± 18 vs.16 ± 17%; P < 0.01). Respondents somewhat/strongly agreed a NMBI should be reserved until after trials of deep sedation (112, 86%) or proning (92, 81%) and that NMBI reduced barotrauma (88, 67%), dyssynchrony (87, 66%), and plateau pressure (79, 60%). Few respondents somewhat/strongly agreed that a NMBI should be initiated at ARDS onset (23, 18%) or that NMBI reduced 90-day mortality (12, 10%). Only 2/14 potential NMBI risks [paralysis awareness (101, 82%) and prolonged muscle weakness (84, 68%)] were frequently reported to be of high/very high concern. Multiple NMBI titration targets were assessed as very/extremely important including arterial pH (109, 88%), dyssynchrony (107, 86%), and PaO2: FiO2 ratio (82, 66%). Train-of-four (55, 44%) and BIS monitoring (36, 29%) were deemed less important. Preferred NMBI discontinuation criteria included absence of dysschrony (84, 69%) and use ≥48 hour (72, 59%).

Conclusions and Relevance:

Current critical care pharmacists believe NMBI for ARDS patients are best reserved until after trials of deep sedation or proning; unique considerations exist in COVID+ patients. Our results should be considered when ICU NMBI protocols are being developed and bedside decisions regarding NMBI use in ARDS are being formulated.
Myoid Gonadal Stromal Tumor: A New Case Report with a Review of the Literature
Authors: Elousrouti Layla Tahiri , Gouzi Imane , Hammas Naoual , Chbani Laila , Tazi Fadl , Fareh Moulay Hassan , Elfatemi Hinde
Published: March 2023

The myoid gonadal stromal tumor is a very rare testicular spindle cell tumor. Few cases have been reported in the literature from 1977 to 2022. It was an emerging entity in the fourth edition of the WHO Classification of Tumors of the Urinary System and Male Genital Organs and has been instated as a full benign entity in the new edition of 2022. We report herein an additional case of a myoid gonadal stromal tumor. It was a 27-year-old man who presented with an asymptomatic mass in his left testicle for 2 months. The mass was confirmed by ultrasound as a 3 cm solid well-circumscribed lesion for which orchiectomy has been performed. The histological analysis of the specimen and the immunohistochemistry staining was consistent with a myoid gonadal stromal tumor. The characteristics of this tumor are summarized in well-circumscribed, nonencapsulated masses of uniform spindle cells, and immunohistochemically, tumor cells coexpress SMA and S-100 protein. The benign behavior of this tumor is demonstrated by our results and those presented in the previous cases reported in the literature.
30 Years of International Climate Negotiations: Are They Still our Best Hope?
Authors: Clémençon Raymond
Published: March 2023

30 years of international climate talks have not prevented the globe from heating up more than 1 degree Celsius over post-industrial times, nor have they kept the year 2022 from breaking new temperature and extreme weather records around the world. Although the international process has been indispensable for building the foundation to move out of the carbon age, it is now time to shift attention away from the acrimonious climate talks and treat them as a sideshow, rather than the solution to the problem. An analysis of 30 years of international climate negotiations shows that multilateral climate diplomacy years ago stopped driving countries’ action. National political opportunity structures, normative shifts, economic factors, and external events are what shape countries’ climate policies largely independent of international climate negotiations.
The 2-Window Posterolateral vs Single-Window Approach for Ankle Fracture Fixation
Authors: Herbosa Christopher G. , Leucht Philipp , Egol Kenneth A. , Tejwani Nirmal C.
Published: March 2023

Background:

The posterolateral approach to the ankle allows for reduction and fixation of the posterior and lateral malleoli through the same surgical incision. This can be accomplished via 1 or 2 surgical “windows.” The purpose of this study is to compare outcomes including wound complications following direct fixation of unstable rotational ankle fracture through the posterolateral approach using either 1 or 2 surgical windows.

Methods:

One hundred sixty-four patients with bi- or trimalleolar ankle fractures treated using the single-window posterolateral approach (between the peroneal tendons and the flexor hallucis longus [FHL]) or the 2-window technique (between the peroneal tendons and the FHL for posterior malleolus fixation; lateral to the peroneal tendons for fibula fixation) were reviewed for demographics, radiographic details, and clinical outcomes. We were able to review these 164 at the 3-month follow-up and a subset of 104 at a minimum of 12-month follow-up.

Results:

One hundred eight ankles had the single-window approach; 56 had the 2-window approach. These 2 cohorts did not differ in demographic or injury characteristics. Ankles in the 2-window group experienced a greater number of early (3 months postsurgery) wound complications (32% vs 12%, P < .01). Two-window patients had more wound complications among ankles treated later than 1 week after injury (44% vs 16%, P < .01). There was no difference in surgical site infection, with low rates in both cohorts. Single-window patients had greater plantarflexion (35 ± 10 vs 30 ± 11 degrees, P = .025) and dorsiflexion after 12 months (21 ± 10 vs 16 ± 11 degrees, P = .021). We did not find a significant difference in nerve complications for these 2 cohorts.

Conclusion:

In our study, we found the single-window posterolateral approach to be associated with fewer wound complications and better postoperative range of ankle motion when compared to the 2-window approach.

Level of Evidence:

Level III, retrospective cohort study.
Combination of D-dimer and Albumin in the Prediction of Deep Vein Thrombosis in Patients with Spontaneous Intracerebral Hemorrhage
Authors: Chen Lingli , Zhang Wanli , Liu Chunfeng
Published: March 2023

Background and Purpose

Deep venous thrombosis (DVT) makes spontaneous intracerebral hemorrhage (ICH) treatment more challenging. We aimed to determine the predictive ability of D-dimer combination with albumin for DVT in spontaneous ICH.

Methods

Spontaneous ICH patients were retrospectively included. Univariate and multivariate logistic regression analyses were performed. The restricted cubic spline (RCS) curve was adopted. Multivariate logistic regression analysis was further conducted to assess the predictive powers of D-dimer and albumin in different models. Besides, the incremental predictive ability of D-dimer combination with albumin was evaluated with areas under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination index (IDI).

Results

D-dimer was significantly higher, while albumin was considerably lower in the DVT group than in the non-DVT group [D-dimer, 0.47 (0.29, 1.08) versus 0.98 (0.48, 2.49), P < .001; albumin, 39.45 ± 7.05 versus 36.93 ± 4.77, P < .001). The multivariate logistic regression analysis showed that higher D-dimer and lower albumin were independently related to DVT after controlling confounders (D-dimer, OR = 1.061, 95% CI = 1.012–1.112, P = .013; albumin, OR = 0.934, 95% CI = 0.895–0.973, P = .001). The best cut-off value of the D-dimer was 0.40, and the albumin was 37.15. Besides, D-dimer and albumin had good predictive abilities in different models. The AUC, NRI, and IDI revealed that models that included the D-dimer combination with albumin had better predictability than those without.

Conclusions

D-dimer combination with albumin has a good predictability of DVT in spontaneous ICH.
“You can Run, but You Cannot Hide!” Mapping Journalists’ Experiences With Hostility in Personal, Organizational, and Professional Domains
Authors: Ivask Signe , Lon Angelina
Published: March 2023

Our study describes how hostility reaches journalists and their reactions to the experiences. Semi-structured interviews with 18 Estonian journalists were conducted in 2021 from June to December. We divided journalists’ experiences into personal, professional, and organizational domains. One key observation is that journalists cannot avoid work-related hostility, even when off-duty. In addition, as one journalist receives hostility in a myriad of ways, there is a necessity for a multilevel approach when teaching about coping with or preventing unnecessary hostility from reaching journalists. Our mapping can be used when preparing students for occupational hazards or developing journalism curricula.
“I Definitely Would Appreciate a Little More Validation”: Toward an Ethics of Care in College Newsrooms and Journalism Education
Authors: Arrey Taylor , Reynolds Chelsea
Published: March 2023

Drawing on interviews with 10 U.S. student journalists, we introduce an ethics-of-care approach for trauma-informed journalism pedagogy. We express grave concern for mental health in journalism programs, offering an empirical snapshot of students’ traumas and coping strategies. We confirm that student journalists, like working reporters, are traumatized by professional norms, high demands, poor boundaries, safety concerns, and ethical-professional responsibilities. Participants coped through emotional distancing, saving face, and relying on peers. We offer interventions based on student support needs and changing news values, including faculty affirmation, financial support, counselor support, diversity training, newsroom debriefings, emotional leadership, and reporting protocols.
Country Roads and Cityscapes: Examining the Relationship Between Place-Based Identity and Feelings Toward Journalists
Authors: Hmielowski Jay D. , DuBosar Eliana
Published: March 2023

In this article, using two data sets, we examine whether place-based identity correlates with feelings toward journalists. Next, we examine whether the importance of a place-based identity moderates the relationship between place-based identity and feelings toward journalists. Finally, we examine the conditional indirect correlation between place-based identity and media use via feelings toward journalists, which may vary based on identity importance.
Indelible: Violence Against Women and Their Resistance to It in the Visual and Performing Arts in Italy and Beyond
Authors: Hill Sarah P. , d’Arcangeli Luciana
Published: March 2023

The visual and performing arts can be instrumental in exposing the complexity of the numerous forms violence against women and girls takes, and in exploring old and new forms of resistance. The articles in this special issue emerged from a three-year project of the Visual and Performance Studies Research Group funded by the Australasian Centre for Italian Studies (ACIS) to examine the representation of violence against women and their resistance to such violence in Italy and beyond and contribute to analysis and understanding of how gendered violence and resistance to it are represented in the arts. A key strand concerned the arts in contemporary Italy, but its scope was broad and encouraged comparison with other societies in order to share significant aspects of the Italian situation with a wider audience, highlight the global scale of the problem, and help identify opportunities for collective resistance. This scope is reflected in the four pieces here, which examine the possibilities that different forms of representation can offer either to reinforce or contest violence against women.
CDK4/6 inhibitors in metastatic breast cancer, a comparison of toxicity and efficacy across agents in a real-world dataset
Authors: Buller William , Pallan Lalit , Chu Teresa , Khoja Leila
Published: March 2023

Introduction

CDK4/6 inhibitors (ribociclib, palbociclib and abemaciclib) are 1st line therapy in metastatic breast cancer (MBC). No comparative data exists between agents regarding toxicity or efficacy.

Methods

A retrospective study was performed at our tertiary referral centre evaluating patients on a CDK4/6 inhibitor for MBC between July 2017 and December 2021. Toxicity was evaluated along with variability in full blood counts and liver function over the first 12 weeks of therapy.

Results

Two hundred and seventeen patients were treated (palbociclib 59%, abemaciclib 25% and ribociclib 16%). 86% received the agent as 1st line therapy. Most patients were white women with a median age of 61 years (32–95) and ECOG 0/1. Twelve patients were switched to an alternative CDK4/6 inhibitor due to toxicity and two did not tolerate this. Toxicity profiles of agents were consistent with published trials. However, there was greater overlap in hepatitis, diarrhoea and bone marrow suppression. Blood results indicated a minimum of four weeks treatment before development of neutropenia. Forty percent of patients went onto have subsequent lines of therapy. The progression-free survival per agent was palbociclib 27.9 months (95% CI 23–32.5), ribociclib 29 months (95% CI 21.5–37.0) and abemaciclib 20.6 months (95% CI 15.0–26.0). The overall survival was palbociclib 38.0 months (95% CI 33.5–42.5), ribociclib 33.9 months (95% CI 26.7–41.1) and abemaciclib 27.3 months (95% CI 22.5–32.1).

Conclusions

Toxicity across CDK4/6 inhibitors overlaps. The optimal sequence of therapies post CDK4/6 inhibitors remains unknown but rechallenge with an alternative agent is possible.
The safety and efficacy of methylnaltrexone in pediatric oncology patients: A single center experience
Authors: Koranteng Lauren , Mauguen Audrey , Butler Miriam , Yan Shirley Qiong , Taylor Damani
Published: March 2023

Introduction

Peripherally acting μ-opioid receptor antagonists (PAMORAs) are used in the treatment of opioid induced constipation without impacting the actions of opioid analgesics. Subcutaneous methylnaltrexone was one of the first PAMORAs approved in April 2008 for the treatment of opioid induced constipation in adult patients. The safety and effectiveness of methylnaltrexone has not been established in pediatric patients. In this study, the use of subcutaneous methylnaltrexone in pediatric patients is analyzed and reviewed. The primary outcome is occurrence of a bowel movement within 24 h after methylnaltrexone (MNTX) administration and the number of bowel movements following treatment with methylnaltrexone. Secondary outcomes include safety in this patient cohort.

Methods

This is a retrospective study of 79 pediatric patients with opioid induced constipation. Patients were administered methylnaltrexone during their inpatient stay. Data on bowel activity after methylnaltrexone was obtained from the hospital information system.

Results

Out of the 79 patients who received methylnaltrexone, there were seven patients from whom data could not be analyzed. Of the 72 patients whose data was available, 38% ( N = 27) were documented as having a bowel movement, 62% ( N = 45) did not have a bowel movement. Reported adverse events were minimal with nausea ( N = 3), vomiting ( N = 1), and flatulence ( N = 6).

Conclusion

Methylnaltrexone appears safe in the pediatric population and produces bowel movements in more than a third of pediatric patients. It is a feasible and safe option for opioid induced constipation in pediatric patients.