bluuebunny/crossref_metadata_2025 huggingface dataset:
Intersexual Twins due to Tetragametic Chimerism
Authors: Wimmer Rainer , Neumann Uta , Weber André , Isau Melanie , Renner-Luetzkendorf Heike , Zschieschang Petra , Wachter Oliver , Hirv Kaimo , Stumm Markus
Published: December 2022

Disorders of or differences in sexual development (DSD) are defined by congenital conditions in which development of chromosomal, gonadal, or anatomic sex are atypical. Here, we report on monochorionic diamniotic twins delivered by caesarean section in the 36th week of pregnancy. Monochorionic twins are usually monozygous and thus should have the same sexual differentiation. In this case, one twin had female external genitalia, while the other showed ambiguous genitalia. At first, a diagnosis of mixed gonadal dysgenesis was proposed because of the obvious sexual discrepancy between the supposedly monozygous twins. Cytogenetic analyses were performed to assure the sex chromosome status for both children. Male and female cells were found subsequently in both children. While hematopoietic chimerism of monochorionic dizygous twins as a result of twin-to-twin blood transfusion is a rare but already well-documented phenomenon, to our knowledge this is the first case description of tetragametic chimerism that led to intersexuality.
Repurposing a Drug Targeting Inflammatory Bowel Disease for Lowering Hypertension
Authors: Mei Xue , Mell Blair , Manandhar Ishan , Aryal Sachin , Tummala Ramakumar , Kyoung Jun , Yang Tao , Joe Bina
Published: December 2022

Background

The gut and gut microbiota, which were previously neglected in blood pressure regulation, are becoming increasingly recognized as factors contributing to hypertension. Diseases affecting the gut such as inflammatory bowel disease (IBD) present with aberrant energy metabolism of colonic epithelium and gut dysbiosis, both of which are also mechanisms contributing to hypertension. We reasoned that current measures to remedy deficits in colonic energy metabolism and dysbiosis in IBD could also ameliorate hypertension. Among them, 5‐aminosalicylic acid (5‐ASA; mesalamine) is a PPARγ (peroxisome proliferator‐activated receptor gamma) agonist. It attenuates IBD by a dual mechanism of selectively enhancing colonic epithelial cell energy metabolism and ameliorating gut dysbiosis.

Methods and Results

A total of 2 groups of 11‐ to 12‐week‐old male, hypertensive, Dahl salt‐sensitive (S) rats were gavaged with (n=10) or without (n=10) 5‐aminosalicylic acid (150 mg/kg) for 4 weeks. Rats receiving 5‐aminosalicylic acid treatment had a lower mean blood pressure than controls (145±3 mm Hg versus 153±4 mm Hg;
P
<0.0001). This reduction in blood pressure was accompanied by increased activity of PPARγ, increased expression of energy metabolism–related genes, and lowering of the Firmicutes/Bacteroidetes ratio in the colon, the reduction of which is a marker for the correction of gut dysbiosis. Furthermore, these data were consistent with the American Gut Project wherein the Firmicutes/Bacteroidetes ratio of non‐IBD (n=611) patients was significantly lower than patients with IBD (n=631).

Conclusions

5‐Aminosalicylic acid could be repurposed for hypertension by specifically enhancing the gut energy metabolism and correction of microbiota dysbiosis.
Reference intervals for thyroid disorders calculated by indirect method and comparison with reference change values
Authors: Yildiz Zeynep , Dağdelen Lale Köroğlu
Published: December 2022

IntroductionThe aim of the study was to calculate reference intervals (RIs) for thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) and evaluate the clinical significance of these intervals by use of reference change values (RCV) of the analytes.
Materials and methodsLaboratory patient data between August and December 2021 were evaluated for the study. A total of 188,912 patients with TSH, fT4, fT3, anti-thyroid peroxidase antibodies (Anti-TPO) and anti-thyroglobulin antibodies (Anti-Tg) results were evaluated. All measurements were performed on Cobas c801 (Roche Diagnostics, Penzberg, Germany) using electrochemiluminescence immunoassay technology. Estimated RIs were compared with manufacturer’s by means of RCVs of analytes.
ResultsThyroid stimulating hormone values didn’t differ significantly by gender and age. The combined RIs for whole group (N = 28,437) was found as 0.41-4.37 mIU/mL. Free T4 values (11.6-20.1 pmol/L, N = 13,479 in male; 10.5-19.5 pmol/L, N = 17,634 female) and fT3 values (3.38-6.35 pmol/L, N = 2,516 in male; 3.39-5.99 pmol/L, N = 3,348 pmol/L in female) significantly differed by gender (P < 0.050). Both fT4 and fT3 values also showed significant differences in age subgroups comparisons. So, male and female RIs were represented separately for age subgroups. When compared with manufacturer’s RIs, TSH whole group and fT4 subgroups RIs didn’t exceed the analytes’ RCVs, but this difference was greater for fT3.
ConclusionsReference interval estimation by use of indirect method out of laboratory data may be more accurate than manufacturer provided RIs. This population based RIs evaluated using RCV of analytes may provide useful information in clinical interpretation of laboratory results.
The Art of Thinking and the Reception of the Parva naturalia in a Fifteenth-Century Hebrew Source
Authors: Gentili Hanna
Published: December 2022

This article offers an insight into Yoḥanan Alemanno’s study of the ‘art of thinking’ through his notes from Averroes’s commentaries on Posterior Analytics, De anima and Parva naturalia. This case study represents an important example of the 15th-century Jewish learning based on the Arabic-Hebrew philosophical tradition and shows the continuity between the Provençal world and the Italian Renaissance. The textual appendix included at the end of the article aims at showing how Alemanno selected portions of Averroes’s commentaries on logic and psychology that define the role of the faculty of imagination and the processes through which we acquire true knowledge.
James Crawford and the Australian Government
Authors: Campbell Bill , Ierino Stephanie
Published: December 2022

This article by two international lawyers advising the Australian Government focuses on the cases before international courts and tribunals in which Professor Crawford appeared as counsel on behalf of the Australian Government including the Southern Bluefin Tuna Cases, the East Timor Case, the Whaling in the Antarctic Case and the Certain Documents and Data Case. The article also covers advice Professor Crawford provided to the Australian Government both in the course of those cases and on other matters such as compulsory pilotage in the Torres Strait. To paint the full picture, mention also is made of a limited number of matters earlier in his career in which he acted against Australia. The article illuminates Professor Crawford’s role as adviser, counsel and advocate for Australia across the full breadth of international law, from law of the sea and international environmental law, to the law on diplomatic protection and the law of treaties.
Clinical Impact of Prolonged Helicopter Emergency Travel Times in a Rural Trauma System
Authors: Rhodes Heather , Poulin Stephen R. , Pepe Antonio
Published: December 2022

Background

In the United States, healthcare organizations utilize helicopter emergency medical services (HEMS), which are well-established and integral to trauma and emergency medical transport. HEMS expedites critical resources to trauma patients at the initial scene of the accident, which typically falls outside of the effective service area of ground transportation.

Methods

This is a single-center study of trauma registry data, inclusive years July 1, 2016, to September 26, 2021. The inclusion criteria were all adult ICU patients (≥18 years) traveling by air. An initial bivariate analysis was used to describe differences in HEMS vs rendezvous (ground + HEMS) mode of arrival. A multivariate linear regression was calculated to predict elapsed transport times on predictor variables to determine the clinical impact of prolonged transport times.

Results

There were 242 patients identified in the analysis, with 87 (36%) traveling by HEMS and 155 (64%) traveling by rendezvous. A significant regression equation was found (F(29,198) = 2.39, P < .01), with an R2 of .26. As the transport time increased by 10.67 minutes, the shock index ratio (SIR) increased by one unit ( P = .04). Conversely, for each unit increase in Glasgow Coma Scores (GCS), flight time decreased by 1.03 minutes ( P < .01). Rendezvous transport times were on average eight minutes longer than HEMS alone ( P < .01).

Conclusions

Those with prolonged travel times were likely to travel by rendezvous with presentation of lower GCS and higher SIR upon arrival, despite equivocal injury patterns and severity. This research highlights the need for a helicopter auto-launch program to expedite helicopter travel times in distant locations to the only Level I trauma center in the region.
Indications for Operative Management of Complicated Duodenal Diverticula: A Review
Authors: Chait Joshua S. , Galli Lucas D. , Clark Clancy J.
Published: December 2022

The duodenum is the second most common location for a diverticulum to form after the colon. These duodenal diverticula (DD) are often found incidentally and rarely require intervention. In recent years, surgical management has been restricted to patients with significant complicated sequelae, such as perforation, abscess, or fistula formation. We present the rare case of a perforated broad-based diverticulum in the third portion of the duodenum necessitating surgical correction. The patient presented with persistent symptoms following failure of conservative management and underwent surgical resection. Due to difficulty visualizing the extent of the diverticulum, a novel intraoperative technique of bowel insufflation via nasogastric tube was used allowing for elucidation of the diverticular borders and complete resection. Although DD are common, there exists no consensus on when operative intervention is indicated. Given that significant morbidity and mortality can be associated with symptomatic DD, a systematic way to guide management decisions is needed. After conducting a review of the literature, we propose that the modified Hinchey classification can be used not only to categorize duodenal diverticulitis but to guide treatment choice in cases with unclear risk benefit profiles.
Effects of COVID-19 Pandemic on Investor Attention in Global Stock Markets: An Empirical Assessment
Authors: Goel Garima , Dash Saumya Ranjan , Debata Byomakesh
Published: December 2022

Using the data from 50 global stock markets, this article examines the impact of the COVID-19 pandemic on investor attention. Using Google search volume as a proxy for country-specific and worldwide investor attention, this article provides initial evidence on the relationship between the spread of the pandemic and investor attention. Our results suggest that the increasing number of daily deaths and confirmed cases significantly negatively impact investor attention. Results are robust to the country characteristics like the nature of the financial system, financial stability and investor attention risk pricing nature. Our results indicate a positive and significant impact of government responses for restoring investor attention in the market.

JEL Codes: G10, G14, G15, C23
Help-Seeking Buffers the Impact of Grief on Quality of Life: A Study of Loss During the COVID-19 Pandemic
Authors: Salisbury Marlee R. , Harmsen Cassandra R. W. , Muller Robert T.
Published: December 2022

The COVID-19 pandemic has presented a global challenge for anticipating the support and treatment needs of bereaved individuals. However, no studies have examined how mourners have been coping with grief and which strategies may buffer negative mental health consequences. We examined the various coping strategies being used and which strategies best support quality of life. Participants completed self-report measures of demographic and loss-related characteristics, grief symptoms, quality of life (QOL), and coping strategies used. Despite help-seeking being one of the least endorsed coping strategies used, help-seeking was the only coping strategy that buffered the impact of grief on QOL for individuals with high grief severity. Results support predictions that grief may become a global mental health concern requiring increased accessibility and availability of grief therapies and professional supports for bereaved individuals during and in the aftermath of the pandemic.
Sacred Stories for Human Beings with Bodies and Brains
Authors: Bruehler Bart B.
Published: December 2022

Recent studies on the dynamics and purposes of storytelling have highlighted the ways that stories employ embodied, affective, and conceptual elements in order to reinforce cultural values and prompt further ethical reflection. These aspects of storytelling are supported and enriched by insights from ancient rhetoricians and contemporary cognitive scientists who have shown how vivid description, mental simulation of embodied activity, and conceptual blending work through our bodies and brains to move us affectively and mentally. The sacred stories of the Bible, strengthened by their divine dimensions and existential issues, work with the same elements to move their audiences. Luke 5:27–39 (Jesus’s encounter with Levi) and Luke 7:11–17 (Jesus raising a widow’s son) are explored as test cases to illuminate the power that embodiment, emotion, simulation, and conceptualization can have in stories that touch upon the sacred, prompting their audiences to ethical reflection and action.
New Public Transportation Infrastructure and Tax Delinquency in Shrinking Cities: The Case of Detroit
Authors: Alfaro Fernanda , Paredes Dusan , Skidmore Mark
Published: December 2022

Fiscal stress is a common condition in shrinking cities such as Detroit. Among the contributing factors, property tax delinquency is a significant consideration due to the unwillingness or inability to pay property taxes. The literature shows that improvement in the quality of public goods and services can increase tax compliance and strengthen the social contract between taxpayers and the local government. Nonetheless, this relationship is unclear in the context of low-income shrinking cities. This article estimates the effects of new publicly provided transportation infrastructure on property tax compliance in Detroit, Michigan. Specifically, we use the announcement of the Qline in Detroit. We compute the effects of the Qline announcement on tax delinquency behavior using a Spatial Difference-in-Difference approach. The results indicate that the announcement of the Qline had an economically and statistically significant impact on tax delinquency for properties within one mile of the nearest Qline station.
From Fit to Fitting: A routine dynamics perspective on M&A synergy realization
Authors: Mirc Nicola , Sele Kathrin , Rouzies Audrey , Angwin Duncan N.
Published: December 2022

Many mergers and acquisitions (M&A) fail to achieve anticipated synergistic benefits. The combination of resources and processes is particularly difficult. This paper uses a routine dynamics perspective to study an acquisition in the consultancy sector where the strategy of combining two routines, designed to commercialize a new offer, failed. Zooming in on the micro dynamics of synergy realization, we show how the envisioned design was challenged only once the combined routine was enacted. The joint performance of the routine revealed incompatibilities at three levels: within the combined routine; with adjacent routines; and across the merging organizations. We identify two mechanisms that drive these incompatibilities: conflicting actors’ intentions and conflicting organizational norms. We discuss how synergy realization requires both the converging of intentions and norms and the interweaving of actions, routines, and organizations. Our paper contributes to M&A research by challenging the notion of “fit” as a prerequisite for success and by developing the notion of “fitting” as an unfolding process, i.e., through a design–action loop in which sources of incompatibilities are revealed and adjusted. We elucidate the dynamic and iterative nature of synergy realization and argue for a rethinking of pre- and post-acquisition periods as fundamentally interlinked. We also contribute to research on routine dynamics by enhancing the understanding of routine interdependencies and the intentionality of routines in cross-organizational settings.
Laboratory Performance Evaluation of Asphalt-Treated Cold Recycled Mixtures Using Existing Practical Tests
Authors: Habbouche Jhony , Boz Ilker , Diefenderfer Brian K. , Jones David , Hand Adam J. T.
Published: December 2022

Agencies currently utilize several proxy tests, related to level of compaction (density) and moisture content, to assess the quality of a recycled pavement during construction. These proxy tests are not completely able to indicate sufficient quality or stability of recycled pavements under trafficking or surfacing, especially at early ages. The lack of sound and rapid tests for use in process control and acceptance during construction limits the use of the recycling techniques by agencies, therefore they do not fully benefit from the advantages that pavement recycling offers. This study evaluates the viability of currently available simple and practical stiffness tests (i.e., soil stiffness gauge and light weight deflectometer tests), deformation resistance tests (i.e., Marshall hammer test), and penetration resistance tests (i.e., dynamic cone penetration test) to characterize the properties of asphalt-treated cold recycled mixtures. The scope of the work included laboratory testing of 18 different cold recycled mixtures, prepared through different processes combining different binding agents and filler types, at different curing times via the selected tests. The collected data were analyzed to evaluate these tests in relation to their repeatability characteristics and versatility to capture the performance of recycled materials with respect to changes in curing time, type of stabilizing/recycling agent, and presence of active filler. The data obtained showed the ability of these tests to capture the effect of curing. Moreover, these tests were found to be sensitive to changes in the recycling agent type, recycling agent content, and presence of active filler.
Structurational Divergence, Implicit Orientations to Active Followership, and Employees’ Selection of Upward Dissent Strategies and Silence
Authors: Zanin Alaina C. , Bisel Ryan S.
Published: December 2022

This study investigated dissent strategy selection as a product of structurational divergence (SD) and individuals’ lay theories of leader and follower roles. A survey of working adults ( N = 338) revealed that employees who reported experiencing structurational divergence in their workplace were more likely to engage in circumvention, threatening resignation, and defensive silence. Analysis also indicated that employees with an active followership mindset were more likely to report engaging in prosocial and repetition dissent strategies. Meanwhile, they were less likely to report engaging in circumvention, threatening resignation, and defensive silence. Importantly, perceptions of SD were negatively associated with members’ implicit belief that a good follower is an active follower. Implications for structurational divergence theory, implicit theories of followership, and organizational dissent conclude the paper.
Teaching Unilateral Cleft lip Repair: Lessons from Simulation-Based Mining of Trainee Strengths and Performance Gaps
Authors: Stanek Krystof , Yao Caroline A. , Livingston Katie A. , Weinstock Peter H. , Rogers-Vizena Carolyn R.
Published: December 2022

Objective

To identify specific areas for improvement in cleft lip repair teaching.

Design

Secondary analysis of prospectively-collected, blinded data.

Setting

Three residency programs rotating at a single academic children's hospital.

Participants

Plastic surgery residents, and craniofacial/pediatric plastic surgery fellows.

Main Outcome Measures

Mean scores for each skill in an 18-item Unilateral Cleft Lip Repair competency assessment tool (UCLR) (1–3 scale for each item) were rank ordered. Correlation between level of training (PGY) and performance on steps of the procedure was examined using Pearson R.

Results

Simulation participants (n = 26) scored highest on skills in the “Marking“ subscale (2.38–2.63 mean score). Procedural steps that scored lowest were: closing the nasal floor (2.00), repairing oral mucosa (2.15) and avoiding over/under-dissection (2.19). Interestingly, none of these skills correlated with PGY, suggesting they do not improve with training.

Conclusions

These results suggest that marking cleft lip repair is taught well in our current teaching environment, while steps like closing the nasal floor and repairing the oral mucosa are taught less well. Improved teaching of these steps could be achieved with deliberate instruction, video, digital simulation, and high fidelity simulation.
Visual performance and impact of residual refractive errors with trifocal intraocular lenses of different aspheric design
Authors: Rementería-Capelo Laureano A , Contreras Inés , García-Pérez Jorge L , Blázquez Vanesa , Ruiz-Alcocer Javier
Published: December 2022

Background

To assess the visual quality and the tolerance to low refractive errors of two trifocal intraocular lenses (IOL) with different amounts of spherical aberration (SA).

Methods

The study included patients having bilateral implantation of the AcrySof® IQ PanOptixTM (aberration-correcting) or the RayOneTM (aberration-free) Trifocal IOL. Three months after the surgery patients underwent: monocular/binocular and uncorrected/corrected distance visual acuity (VA) and binocular defocus curves. Binocular contrast sensitivity (CSF) and subjective halo perception were assessed with the best distance correction (CDVA), with a positive defocus of + 0.50D and with a negative defocus of −0.50D. Patient's satisfaction was evaluated with the Catquest9-SF questionnaire.

Results

This study included 54 eyes (28 with PanOptix and 26 with RayOne) of 27 patients. Both groups achieved corrected/uncorrected and monocular/binocular distance VA values better than 0.0 logMAR (1.0 decimal) with no statistically significant differences between them (p > 0.05 for all cases). Defocus curves showed a VA of 0.1 logMAR or better between −2.5 and + 1.0D with no differences between groups (p > 0.05 at all distances). Overall CSF values remained stable under the induced residual refractions for both groups. The halo effect remained stable for the PanOptix group but increased with myopization in the RayOne group (p = 0.02). The questionnaire showed high rates of patient's satisfaction with no differences between groups.

Conclusion

Both lenses showed overall good visual outcomes and offered high rates of patient's satisfaction. Moreover, in normal patients with trifocal IOLs, the combination of residual refractive errors and certain amounts of SA may increase some visual disturbances.
Swept-source optical coherence tomography angiography automatic analysis of microvascular changes secondary to systemic hypertension
Authors: Remolí Sargues Lidia , Monferrer Adsuara Clara , Castro Navarro Verónica , Navarro Palop Catalina , Montero Hernández Javier , Cervera Taulet Enrique
Published: December 2022

Introduction

The aim of our study is to report swept-source optical coherence tomography angiography (SS-OCTA) quantitative parameters of retinal and choroidal microvasculature in patients with systemic hypertension (HTN) using a built-in software of SS-OCTA.

Methods

We performed a retrospective study. This study enrolled 93 eyes of 51 subjects with HTN and 71 eyes of 38 healthy subjects. OCTA quantitative parameters (vessel density (VD) and foveal avascular zone (FAZ) area of superficial capillary plexus (SCP), middle capillary plexus (MCP), deep capillary plexus (DCP), total capillary plexus (TCP) and choriocapillaris (CC)) of the OCTA cube of 4,5 mm × 4,5 mm were recorded.

Results

A decrease of parafoveal VD in CC, DCP and TCP were demonstrated between HTN group and control group ( p < 0,05). Conversely, no differences were demonstrated in parafoveal VD of SCP and MCP ( p > 0,05). Subgroup analysis revealed a diminution of central VD at SCP, DCP and TCP in patients taking one antihypertensive drug compared to patients treated with two medications ( p < 0,05). Correlation analysis showed a significant, albeit weak, negative correlation between HTN duration, and parafoveal VD in the SCP and FAZ area at SCP, DCP and TCP ( p < 0,05 and r < 0,300).

Conclusion

When normative data are available, OCTA might be used as a potential tool in the prevention and follow-up of end-organ damage secondary to HTN. Nonetheless, further studies are needed to confirm this hypothesis.
Diverse research teams: A framework for research review
Authors: Akbar Skye , Greenacre Luke , Defina Rebecca , Garay Lorraine
Published: December 2022

Indigenous groups voices have often been missing from the marketing research collegiate. The Aboriginal and Torres Strait Islander Peoples of the land now known as Australia, for example, are among the most researched peoples in the world (Martin & Mirraboopa, 2003), yet are underrepresented among research practitioners. The present underrepresentation among practitioners is only slowly, and occasionally haphazardly, being addressed by the growing number of more junior Indigenous researchers entering the field. Until greater representation among senior researchers is achieved, research teams are likely to include a mixture of Indigenous and non-Indigenous researchers. Such teams must therefore address a unique combination of power imbalance and minority inclusion in how they work.

This need for inclusion can become more challenging for research teams when the research topic addresses issues impacting Indigenous peoples. And while numerous ethical and research guidelines exist for how researchers work with participants who are members of a minority group and are likely to have less power, there are few frameworks addressing how such challenges should be managed for the researchers within a research team.

In this paper, we use an action research method to critically reflect on how to manage research teams that include more junior Indigenous researchers whose voices are vital to the research project. Reflexive and proactive processes were developed to ensure a culture of reflection both regarding interactions within the research team and in the project. To structure and share these reflections, the team developed and enunciated a fit-for-purpose framework. This framework was informed by the work of Narungga Professor Rigney (1999) that lists foundational Indigenist research methods. The framework also draws on the layers of reflexivity proposed by Nicholls (2009) and insider/outsider group theory previously advocated for (Ameka, 2018).
An Innovative Method: Predicting the Visibility of Radial Endobronchial Ultrasound for Peripheral Pulmonary Nodules by Virtual Bronchoscopic Navigation
Authors: Chen Hui , Yu Yiming , Yu Xuechan , Li Sha , Zheng Lin , Zhang Shuya , Zhuang Qidong , Deng Zaichun , Chen Zhongbo
Published: December 2022

Background: The diagnosis of peripheral pulmonary nodules (PPNs) still is the key and difficult point. Previous studies have demonstrated that the diagnostic yield of radial endobronchial ultrasound (rEBUS) visible nodules is significantly higher than that of invisible nodules. The traditional method of predicting the rEBUS-visibility of nodules is based on the CT-bronchus signs, but its effectiveness may be unsatisfactory. Objective: We innovate a valuable predictive model based on virtual bronchoscopic navigation to identify beforehand which PPNs are likely to be successfully visualized by rEBUS. The innovative predictor is the ratio of the size of lesions (S) to the shortest straight-line distance (D) from the terminal point of the virtual navigation path to the localization point of the nodule. Methods: This is a retrospective study. On the training dataset of 214 patients, a receiver operating characteristic curve was drawn to understand the utility of the predictive model and get the optimal cut-off points. Ninety-two cases were enrolled in the validation dataset to validate the external predictive accuracy of the predictor. Results: The optimal cut-off point of the curve was 1.84 with the Youden index of 0.65, at which point the area under the curve was 0.85 (95% CI: 0.76-0.95). The predictor has a good performance in the validation dataset with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 81%, 100%, 100%, 71%, and 87%, respectively. Conclusion: The S/D ratio is a valuable and innovative method to identify beforehand which PPNs are likely to be successfully visualized by rEBUS. If the S/D ratio of the nodule is greater than 1.84, it will be visualized by rEBUS.
Three-dimensional rotational angiography improves mechanical thrombectomy recanalization rate for acute ischaemic stroke due to middle cerebral artery M2 segment occlusions
Authors: Rosi Andrea , Bernava Gianmarco , Hofmeister Jeremy , Nicolò Madruzzato , Boto José , Yilmaz Hasan , Reymond Philippe , Brina Olivier , Muster Michel , Carrera Emmanuel , Lövblad Karl-Olof , Machi Paolo
Published: December 2022

Background

Occlusions of the middle cerebral artery (MCA) M2 segments can be difficult to address with mechanical thrombectomy (MTB) using standard projections and this can affect the final recanalization. Three-dimensional rotational angiography (3D-RA) allows to obtain a 3D model of cerebral vessels in a few seconds and to determine the best two-dimensional (2D) projections to be selected to evaluate and treat cerebrovascular diseases, such as aneurysms or vascular malformations. We aimed to determine if 3D-RA could be applied also in MTB.

Methods

A retrospective review of two patient cohorts treated during two time periods of 12 months before and after the introduction of 3D-RA use at our institution for MTB in M2 occlusions. Analyses were conducted to compare the two groups for procedural characteristics, such as timing, recanalization rate and complications and clinical outcome.

Results

One hundred acute ischaemic stroke (AIS) patients (3D-RA group = 57; controls = 43) underwent MTB for an M2 occlusion during the two study periods. Recanalization rates were significantly higher in cases treated with 3D-RA. The mean 3D technique thrombectomy time was compared to that of non-3D cases (47 vs. 49 min, respectively).

Conclusions

Our findings showed that 3D-RA is a useful tool to select specific working projections to AIS patients presenting an M2 occlusion by improving final recanalization compared to standard projections, without increasing the overall procedural time.
Distributed leadership in Chinese higher education: Conceptual understanding and barriers to its implementation
Authors: Lu Xintong
Published: December 2022

There is a prevailing trend of distributed leadership in the West as it balances the weaknesses and combines the capabilities of different individuals in knowledge-based societies. Conversely, there is still a lack of understanding and literature on distributed leadership in Chinese universities. We know little about how faculty members in Chinese universities understand this term and the possible challenges of leadership distribution in Chinese higher education contexts. This article explores the conceptual understanding of distributed leadership and what barriers exist to its implementation in Chinese higher education through the perception of Chinese leaders and staff members. Drawing on questionnaires and semi-structured interviews, the findings suggest that respondents have gained a good understanding of the principles of this leadership model. However, distributed leadership is seen as delegation and erosion of power by the respondents; this creates certain sociocultural barriers to its use in Chinese higher education.
Employers’ perceptions of young higher education graduates’ employability in Belarus
Authors: García-Aracil Adela , Isusi-Fagoaga Rosa , Navarro-Milla Isidora
Published: December 2022

This paper explores the employability of young Higher Education (HE) graduates in Belarus, from the point of view of employers. Graduate employability can be defined by six items: starting a job; learning at work; performing work tasks; improving professional prospects; improving personal development; and developing entrepreneurial capacity. The FOSTERC database contains representative information on 261 employers in 2018 derived from an employer questionnaire. The questionnaire includes a specific section, which asked about 24 competencies associated with obtaining a job after graduation, and the competency levels required by employers. The responses to these questions allow analysis of employability based on HE achievements and subsequent workplace learning. The 24 competencies are grouped into five categories: entrepreneurial, leadership, interdisciplinary, cognitive and adaptability. The findings provide strong support for the assumption that the match between individual human capital competencies and the characteristics of the firms and organisations matters.
Coping or Thriving? Reviewing Intrapersonal, Interpersonal, and Societal Factors Associated With Well-Being in Singlehood From a Within-Group Perspective
Authors: Girme Yuthika U. , Park Yoobin , MacDonald Geoff
Published: December 2022

Singlehood, defined as not being in a romantic relationship, is becoming increasingly common worldwide. Despite this, research on singlehood has not received remotely equivalent research attention as romantic relationships. Well-being research that has explicitly included singles has focused on whether coupled versus single people are more satisfied with their lives. However, these between-group comparisons have not attended to within-group variability among singles that can point to when and for whom singlehood is associated with thriving. In this review, we document findings from the emerging field of singlehood studies to highlight what is and is not known about factors that are associated with the well-being of single individuals from a within-group perspective. Our review examines (a) intrapersonal factors (characteristics of the individual), (b) interpersonal experiences (qualities of one’s social relationships and experiences), and (c) societal influences (features related to one’s broader social or cultural context) related to well-being in singlehood. We conclude by offering future directions for the conceptualization of and research on singlehood with the goal of promoting a thorough and inclusive perspective.
Do sex and violence sell internationally? A moderating role of cultural differences in the mediation effect of age ratings on the relationship between films’ content elements and worldwide box office performance
Authors: Feng Guangchao Charles , Luo Nan
Published: December 2022

Although the determinants of films’ box office performance have been extensively examined in the past, there is a gap in the literature with regard to how the mediation effect of age ratings for movies on the relationship between content elements and box office performance differs across cultures. Through a moderated mediation analysis of films released in 111 countries in the past 100 years (between 1921 and 2020), this paper finds that when there are wider cultural distances between the home and host countries, content with higher levels of violence and morally loaded behaviors reap greater box office revenues in host countries. However, in total, movies with higher elements of violent content rather than content related to morally loaded behaviors contribute to high box office revenues in the international film market.
Long-term efficacy and safety of neridronate treatment in patients with complex regional pain syndrome type 1: a pre-specified, open-label, extension study
Authors: Varenna Massimo , Gatti Davide , Zucchi Francesca , Crotti Chiara , Braga Vania , Iolascon Giovanni , Frediani Bruno , Nannipieri Fabrizio , Rossini Maurizio
Published: December 2022

Background:

No data on the permanent and curative effect of bisphosphonate treatment in patients with complex regional pain syndrome type-1 (CRPS-1) are currently available. The aim of this pre-specified, open-label, observational study was to evaluate the long-term efficacy and safety of neridronate treatment.

Design:

A pre-specified, open-label, extension study.

Methods:

Patients treated with intramuscular (IM) placebo in the double-blind phase of the study were assigned to 100 mg intravenous (IV) neridronate treatment administered 4 times over 10 days. These patients, together with those previously treated with 400 mg IM neridronate, were followed for 1 year. Efficacy was assessed using a visual analogue scale (VAS) pain score. Changes in clinical signs and symptoms, quality of life (QoL) using the Short Form Health Survey (SF-36), and the McGill Pain Questionnaire were also assessed.

Results:

Benefits on pain, clinical and functional measures were maintained and further improved over 12 months in most patients treated with neridronate administered either IM or IV. In IM-treated patients, the percentage of those defined as responders (VAS score reduction ≥ 50%) progressively increased up to day 360 to 32 of 35 patients (91.4%). Among the 27 patients referred to as responders at the end of the double-blind phase, 26 reported the same result at day 360 (96.3%). In IV-treated patients, a responder rate of 88% (22 out 25) was found at day 360 (p = 0.66 between groups). Consistent improvements were also observed for all clinical signs and functional questionnaire. No drug-related adverse events were reported during the study.

Conclusion:

In patients with acute CRPS-1, the benefit in pain, clinical, and functional measures observed a few weeks after neridronate treatment administered either IM or IV is maintained and further improved over 12 months. Parenteral neridronate induces permanent disease remission preventing chronic pain and motor dysfunction.

Trial registration:

EU Clinical Trials Register (EudraCT Number): 2014-001156-28
In-Hospital Cost Comparison for Open Versus Endoscopic Endonasal Approach for Meningioma Resection
Authors: Parasher Arjun K. , Lerner David K. , Miranda Stephen P. , Douglas Jennifer E. , Glicksman Jordan T. , Alexander Tyler , Lin Theodore , Ebesutani Darren , Kohanski Michael , Lee John Y.K. , Storm Phillip B. , O’Malley Bert W. , Yoshor Daniel , Palmer James N. , Grady M. Sean , Adappa Nithin D.
Published: December 2022

Objective

To determine the in-hospital cost implications of an endoscopic expanded endonasal approach (EEEA) for meningioma resection relative to the open transcranial approach.

Methods

All anterior skull base meningioma surgeries performed over a period from January 1st, 2015 to October 31th, 2017 were evaluated. The electronic medical record was reviewed for patient factors, tumor characteristics, and cost variables associated with each hospital stay and univariate analysis was performed using R software. All cost data were converted into August 2021-equivalent dollar amounts using the United States Bureau of Labor Statistics consumer price index.

Results

Thirty-five patients met study criteria, including 27 patients undergoing an open transcranial approach and 8 undergoing an EEEA. Average length of stay for patients undergoing an open approach was 9.3 days compared to 5.6 within the EEEA group ( P = .126). The average total in-hospital cost of patient undergoing an EEEA was $35417.1 compared to $46406.9 among patients undergoing an open transcranial approach ( P = .168). On univariate analysis, the cost of an open transcranial approach relative to the EEEA was $10989.8 ( P = .411).

Conclusions

The open transcranial approach remained the dominant surgical approach to anterior skull base meningiomas over our study time period. However, despite limited patient numbers the EEEA was associated with decreased total in-hospital costs.
A comprehensive technique using digital workflow to improve an unpleasant smile: A clinical report
Authors: Zhivago Paul , Yun Sarah , Turkyilmaz Ilser
Published: December 2022

By utilising open-source digital software, clinicians can create an integrative digital workflow composed of various technological systems. This report presents a clinical case that follows a comprehensive digital workflow to improve the smile of a 42-year-old female patient. The patient presented with minor attrition of maxillary anterior teeth and discoloured, asymmetrical composite restorations on central maxillary incisors. Her smile was rehabilitated by restoring her maxillary anterior teeth with lithium disilicate ceramic veneers. A smile design system was used to create a virtual simulation of the patient’s desired treatment outcome. Utilising a 3D tooth library generated by the smile design system, extra-oral photographs, and intra-oral scans of the patient’s maxillary and mandibular arches, a 3D model of the proposed smile design was created in an advanced 3D sculpting software. The resin casts that were fabricated with a 3D printer were used to fabricate a mockup and sent to the laboratory as reference for the final restoration. The specific shade recipe for the ceramic veneers was obtained using a special polar eye filter and digital shade matching software. There is no doubt that advancements in digital technology are providing clinicians with limitless treatment modalities. From intra-oral scanners and smile design systems to 3D sculpting software and even digital shade matching systems, continuous technological developments are paving the way for the complete digitalisation of dentistry. This case report presents an example of this digital revolution.
Clinical performance of lithium disilicate and zirconia CAD/CAM crowns using digital impressions: A systematic review
Authors: Benli Merve , Turkyilmaz Ilser , Martinez Jacqueline L. , Schwartz Shelby
Published: December 2022

Purpose:

The purpose of this systematic review was to compare the clinical performance of lithium disilicate (LDS) and zirconia (Z) single crowns manufactured by computer-aided design/computer-aided manufacturing (CAD/CAM) systems using intraoral optical scanners (IOS).

Materials and methods:

An electronic search for articles published between January 2012 and January 2022 in the English language was performed with the Medline/Pubmed database under the guidelines of Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA). The specific search terms used were “zirconia”, “lithium disilicate”, “CAD/CAM”, “intraoral optical scanner”, and “survival”.

Results:

The initial electronic search resulted in 278 articles. Most of the resulting articles were excluded, six clinical studies addressing the clinical outcomes of Z and LDS crowns fitted the inclusion criteria and were selected for review. Of these six studies, three were randomised controlled trials, two were retrospective studies, and one was a prospective study. To quantify the clinical performance of the crowns several parameters were recorded, including fractures, endodontic complications, periodontal complications, technical complications, aesthetic complications, and biological complications. It was noted that the most common technical complication of Z and LDS crowns was chipping at a rate of 1.4% and 5% respectively. Regarding Z crowns, aesthetic concerns were the most frequently observed complication.

Conclusion:

The outcomes of this systematic review indicate that Z and LDS crowns display a similar incidence of periodontal and endodontic complications when compared to metal-ceramic crowns, suggesting that these all-ceramic materials are viable alternatives. The incidence of chipping was higher in LDS crowns compared to other materials, while Z crowns were inferior in terms of aesthetics.
CAD/CAM technology for fabrication of reduction guide for RPD parallel guiding planes preparation: A dental technique
Authors: Carvalho Porto de Freitas Rodrigo Falcão , Carneiro Pereira Ana Larisse , da Fonte Porto Carreiro Adriana
Published: December 2022

Introduction:

The preparation of parallel axial wall guide planes in abutment teeth is essential for providing a correct path of insertion and removal axis for removable partial dentures (RPDs). With the introduction of digital resources, new alternatives to the conventional method can be used to manufacture guide preparation for guide planes.

Aims:

To describe the use of computer-aided design/computer-aided manufacturing (CAD/CAM) technology for the manufacture of guide planes to guide the reduction of the axial walls of abutment teeth according to the insertion and removal axis of the RPD.

Methods:

This technique used the “bite splint” module of the Dental Wings software for the virtual planning of guide planes, to promote the construction of axial walls parallel to the abutment teeth. This was performed from the virtual design on a standard tessellation language (STL) file obtained by intraoral scanning, which determined the best trajectory for insertion and removal of the metallic structure.

Conclusion:

Digital technology allows the design and production of guide planes for the preparation of abutment teeth, simplifying the conventionally used technique, with precision and speed.
Influence of surface treatment and ageing on the bond strength of resin cement to hybrid and glass-ceramic CAD/CAM materials
Authors: Pucci Juliana , Dal Picolo Mayara Zaghi , Brasil Laila , Giannini Marcelo , Cavalli Vanessa
Published: December 2022

The influence of different surface treatments and ageing on the shear bond strength (SBS) of computer-aided design/computer-aided manufacturing (CAD/CAM) materials is still contentious. Therefore, this study evaluated the effect of surface treatments and ageing on the SBS of resin cement to polymer-infiltrated ceramic network (PICN) and zirconia-reinforced lithium silicate (ZLS) CAD/CAM materials. Specimens of PICN (n=10) and ZLS (n=10) were submitted to four surface treatment groups: 1) 5% hydrofluoric acid etching (HF) + silanisation (SI); 2) Air abrasion (AB)+HF+SI; 3) HF + universal adhesive (UA); 4) AB+HF+SI+UA. The treated specimens were bonded with resin cement cylinders and tested in SBS after 24 h and one year of water storage. Data were assessed by “analysis of variance” (ANOVA) and Tukey test (α=0.05) and failure modes were classified. No significant differences were observed among treatments at each evaluation time (p>0.05). SBS decreased after one year of storage, except for PICN treated with HF+UA (p=0.068). Air-abraded groups displayed a lower SBS reduction for ZLS. PICN and ZLS exhibited predominantly adhesive and mixed failures, but at one year, PICN cohesive failures increased. In conclusion, HF+UA is an effective surface treatment for PICN, while the combination AB+HF+SI+UA was more appropriate for ZLS. The water storage for one year reduced the SBS for most groups.
Virtual reality enhancing medical education and practice: Brief communication
Authors: Syed Abdul Shabbir , Upadhyay Umashankar , Salcedo Daniel , Lin Che-Wei
Published: December 2022

The COVID-19 pandemic has become a major cause of rapid globalization and digitization of educational institutions, including medical education. The adaptation to digital technologies is the purpose of best education and training practices in the development of the academic medical curriculum. Virtual reality (VR) is embraced by the 3D environment and network resources which allow the expansion of VR from the entertainment industry to the education industry. This brief communication explains our understanding and the challenges in adopting VR technologies for medical training at an academic medical center. Advancement in VR technology assists medical institutes to strategize for the further development of medical training and education. There is a timely need for persistence to make the VR content accessible widely and open source. There is an urgent need for collaboration of medical institutes and technology industries on the development of education-related VR content and simulations.