bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Factors Linked to Intimate Partner Violence and Childhood Maltreatment: On Dissociation as a Possible Bridge Symptom
Authors: Krause-Utz Annegret , Černáková Romana , Hoogenboom William , Schulze Anna , Büttner Sarah , Demirelli Zeynep , Mouthaan Joanne , van Schie Charlotte C. , Garnefski Nadia , Kraaij Vivian
Published: July 2023

Intimate partner violence (IPV) is a serious health concern, occurring worldwide in various forms and settings. Over the past years, multiple sources reported an increase of IPV globally, partly related to COVID-19 restrictions. Childhood maltreatment enhances the risk of IPV, possibly via alterations in emotion regulation, attachment, maladaptive core beliefs, dissociation, and psychopathological symptoms. However, studies investigating these associations simultaneously are still needed. This study aimed to investigate association between IPV, childhood maltreatment severity, maladaptive schemata (mistrust, alienation, enmeshment), attachment anxiety, social support, emotion regulation, dissociation, posttraumatic stress disorder (PTSD), and borderline personality disorder (BPD) symptoms. We further explored the complex interplay of all factors, accounting for their shared associations. An anonymous online survey was posted on international online platforms for people experiencing domestic violence and on research platforms. Regression analyses and graph-theoretical network analysis were used to explore associations between all variables. N = 434 participants (40% in treatment) completed the survey. IPV perpetration and victimization were highly correlated. Both were significantly associated with childhood maltreatment severity, early maladaptive schemata, dissociation, BPD features, and PTSD symptoms. When including all variables in one model, IPV was associated with dissociation, which indirectly linked it to childhood maltreatment experiences, PTSD symptoms, withdrawal, and self-blame. Our findings suggest that IPV perpetration and victimization often co-occur. Dissociation may be an important bridge symptom, linking IPV to childhood maltreatment experiences, PTSD symptoms, and maladaptive coping. Prospective studies are needed to corroborate these findings and to establish psychological mechanisms underlying IPV.
“I Wouldn’t Believe Her at First”—A Qualitative Study of Young People’s Sexual Consent Perceptions and Negotiation in Nairobi Informal Settlements
Authors: Oware Phoene Mesa , De Angeles Katrine J. C. , Ntinyari Wendy , Langat Nickson , Mboya Benjamin , Ekström Anna Mia , Kågesten Anna E.
Published: July 2023

Forced or coerced sexual experiences have serious consequences for young people’s health and well-being. Healthy sexual consent communication can foster positive intimate relationships and help prevent unwanted sexual experiences. We aimed to explore how young people in Nairobi’s informal settlements construct, communicate, and negotiate sexual consent within heterosexual partnerships, given the limited insight into such experiences from resource-poor, global-south contexts. A qualitative study with young men and women aged 15 to 21 years was conducted among former participants of a school-based sexual violence prevention intervention in four informal settlements (slums) of Nairobi. Twenty-one individual in-depth interviews ( n = 10 females, n = 11 males) and 10 focus group discussions (five with n = 6–11 males vs. females, respectively), that is, n = 89 in total were conducted. Data were analysed using thematic network analysis and interpreted using the Sexual script theory. Participants’ endorsement of incongruent sexual scripts shaped their perceptions and negotiations of sexual consent. Young men were committed to respecting sexual consent, but promoted male (sexual) dominance, and perceived women’s refusals as token resistance. Per traditional scripts of sexual chastity, young women were largely bound by their use of a “soft no” to give consent, so as to not display direct sexual interest. Actual non-assertive refusals thus risked being interpreted as consent. Young women’s “actual” refusals had to be more assertive (saying a “hard no”) and were described as having been influenced by skills learned during the school-based intervention. Findings highlight the need for sexual consent education to address internalized gendered norms about female token resistance, destigmatize female sexuality, reduce male dominance norms, and encourage young people’s respect for both assertive and non-assertive sexual consent communication.
To Be Involved or Not to Be Involved: Testing Prison Staff Job Involvement Using the Job Demands–Job Resources Model
Authors: May David C. , Lambert Eric G. , Solinas-Saunders Monica , Keena Linda D. , Leone Matthew , Haynes Stacy H.
Published: July 2023

In this study, data were used from 322 employees at a large medium- and maximum-security prison in the Southern United States to examine the influence of job demands (dangerousness of the job, role overload, role ambiguity) and job resources (employee input into decision-making, instrumental communication, job variety) on employee job involvement. We also controlled for demographic characteristics (gender, age, position, tenure, and educational attainment). Drawing on the job demands–job resources model, four separate equations were estimated to assess the influence of job demands and job resources both separately and jointly. Overall, job resources (specifically, employee input into decision-making and job variety) have a stronger influence on job involvement than do job demands. The findings indicate that to boost employee job involvement in correctional settings, employers must implement policies and practices that facilitate the sharing of job resources in the work environment. Implications for policy and future research are also discussed.
Participatory Practices During Organizational Change: Rethinking Participation and Resistance
Authors: Sahay Surabhi , Goldthwaite Christine
Published: July 2023

To encourage buy-in and manage resistance, change managers utilize participatory strategies. This study examined the communication practices and perspectives of implementers and employees as they negotiated the change participation process to better understand resistance dynamics. Data were collected through interviews ( n = 37) and observations ( n = 2) with nurses and change implementers in a medical center. Grounded practical theory was used to reconstruct the stakeholders’ normative theories of participation in which multiple and often contradictory perspectives emerged. Asking employees to participate reduced implementers’ perceptions of control and increased their feelings of vulnerability. Implementers often equated participation with resistance and used different communication techniques to shape how nurses shared ideas, influencing their participation. Theoretically, this article adds to the study of participation and resistance by showing how resistance is constituted through communication by both implementers and change recipients as they attempt to navigate the inevitable contradictions that arise during the change process.
Environmental effect of high-, upper, and lower middle-income economies’ energy mix: Is there a trade-off between unemployment and environmental quality?
Authors: Koyuncu Çakmak Tuğba , Beşer Mustafa Kemal , Alola Andrew Adewale
Published: July 2023

The fact that scenarios of high unemployment potentially offer the opportunity for improved environmental sustainability remains a dilemma. In instances when environmental sustainability is triggered by increased unemployment, that poses a challenge in the simultaneous achievement of sustainable development goals (SDGs) 8 (decent work and economic growth) and 13 (climate action). On the basis of this concern, in this study, we examine whether a swap association exists between unemployment and environmental quality vis-à-vis the environmental Phillips curve (EPC) hypothesis for high-, upper, and lower middle-income (HUmLmI) economies (comprising both developed and developing countries) over the period 1990–2020. We used the novel dynamic autoregressive distributed lag simulation approach. From the findings, the EPC hypothesis is not valid in high-income (developed) economies in the short and long term. However, the validity of the EPC hypothesis was upheld in the upper and lower middle-income (developing) economies. This implies that the lack of decent work opportunities/high unemployment rates hampers environmental quality in high-income countries, promotes environmental quality in upper middle-income countries, and does not drive environmental quality in lower middle-income countries. In addition, economic growth and the use of fossil energy exacerbate environmental degradation. On the other hand, the consumption of renewable energy sources reduces environmental woes by −0.22, −0.54, and −1.15 in HUmLmI countries, respectively. This shows that renewable energy sources adapt to the environmental sustainability motive. These results imply that policy instruments to drive SDGs 8 and 13 in these income-categorized economies should be case specific rather than taking a unilateral policy approach.
Implementation of a medication delivery service for ambulatory oncology infusion patients
Authors: Butts Allison R , Ellis C Scott , Travers Elizabeth A , Reynolds Jeffrey W , Rogers Lauren E , Otto Danielle E , Schwieterman Philip A
Published: July 2023

Objective

Patients receiving infusions for the treatment of cancer are commonly prescribed supportive care medications which are filled through retail pharmacies. The initial phase of the COVID-19 pandemic created hurdles for patients to receive supportive care medications due to concerns related to exposure risk. Meds-to-Chemo Chairs (M2CC) was created allowing an onsite retail pharmacy to dispense and hand-deliver supportive care prescriptions to patients in the infusion suite. The purpose of this study was to assess the value of this program.

Data sources

The volume of prescriptions dispensed through the M2CC service, as well as the financial impact, was tracked through the prescription software system used by the onsite retail pharmacy dispensing and delivering the medications.

Data summary

Through the first 2.5 years of the program, M2CC has delivered over 13,000 prescriptions with an estimated gross revenue of $3.5 million.

Conclusions

The M2CC medication delivery program has proved to be highly successful and feasible.
“Been there, done that but also not quite:” Discoveries and limitations in an evaluative, short-term, and multi-sited ethnography of the boy scouts of America
Authors: Tevington Patricia , Davis William J , Urban Jennifer Brown , Linver Miriam R
Published: July 2023

This paper reflects on the possibilities and limits of a team-based, multi-site, evaluative ethnography. In this study, a team of qualitative researchers deployed participant observation methods to assess the level of standardization and local adaptation in the training curriculum for adult leaders in the Boy Scouts of America. While the umbrella organization remained consistent over the course of the 12-months project, researchers completed intense intervals of observation in 13 different settings across the United States over the course of a year. We reflect on the benefits and challenges that fast-paced, evaluative ethnographic approaches offer for applied settings as well as insight into the complexities of team-based field work with regards to positionality, legitimacy, and relationships between researchers.
Testing Causal Inference Between Social Media News Reliance and (Dis)trust of EU Institutions with an Instrumental Variable Approach: Lessons From a Null-Hypothesis Case
Authors: Moland Martin , Michailidou Asimina
Published: July 2023

Given the well-documented negativity bias and attitudinal entrenchment associated with sharing and debating news in social media, a reasonable and already substantially investigated assumption is that those getting news about the European Union (EU) mostly from social media would be more sceptical of its institutions than others. Empirical research on this topic has thus far largely deployed experimental and observational methods to investigate this assumption. We contribute to the existing literature with an instrumental variable approach well-suited to establishing causal relationships in non-experimental data. However, we find no blanket causal relationship between relying on social media for news about the EU polity and becoming less trustful of its institutions. EU policies aiming to tackle negative effects of social media news consumption, therefore, need to be tailored to different demographic groups.
Safety and Efficacy of Combining Saphenous Endovenous Laser Ablation and Varicose Veins Foam Sclerotherapy: An Analysis on 5500 Procedures in Patients With Advance Chronic Venous Disease (C3-C6)
Authors: Baraldi Christian , Bissacco Daniele
Published: July 2023

Background

endovenous laser ablation (EVLA) represents the gold standard in treating both great and small saphenous veins (GSV and SSV) incompetence. To achieve a “no-scalpel” procedure in patients with chronic venous insufficiency (CVI, CEAP C3-C6), concomitant phlebectomies could be replaced by ultrasound-guided foam sclerotherapy (UGFS) into varicose tributaries. The aim of this study is to present a single-centre experience on EVLA + UGFS for patients with CVI secondary to varicose veins and saphenous trunk incompetence, analysing ling-term outcomes.

Methods

all consecutive patients with CVI and treated by EVLA + UGFS from 2010 to 2022 were included in the analysis. EVLA was performed using a 1470-nm diode laser (LASEmaR® 1500, Eufoton, Trieste, Italy), adapting the linear endovenous energy density (LEED) depending on saphenous trunk diameter. Tessari method was used for UGFS. Patients were evaluated clinically and by duplex scanning at 1, 3 and 6 months, and annually up to 4 years, to assess treatment efficacy and adverse reactions.

Results

5500 procedures in 4895 patients (3818 women, 1077 men) with a mean age of 51.4 years were analysed during the study period. A total of 3950 GSVs and 1550 SSVs were treated with EVLA + UGFS (C3 59%, C4 23%, C5 17% and C6 1%). Neither deep vein thrombosis nor pulmonary embolism were detected during follow-up, as well as superficial burns. Ecchymoses (7%), transitory paraesthesia (2%), palpable vein induration/superficial vein thrombosis (15%) and transient dyschromia (1%) were registered. Saphenous and tributaries closure rate at 30 days, 1 and 4 years were 99.1%, 98.3% and 97.9%, respectively.

Conclusions

EVLA + UGFS for an extremely minimally invasive procedure appears to be a safe technique, with only minor effects and acceptable long-term outcomes, in patients with CVI. Further prospective randomized studies are needed to confirm the role of this combined therapy in such patients.
Lignans and some other non-alkaloid compounds from the stem bark of Zanthoxylum rhetsa and their biological activities
Authors: Tuyen Tran Thi , Cao Bach Pham , Huu Nghi Do , Minh Quan Pham , Hong Minh Pham Thi , Hong Van Nguyen Thi
Published: July 2023

Four lignans, asarinin (1), horsfieldin (2), 5-(4-(3,4,5-trimethoxyphenyl)hexahydrofuro[3,4-c]furan-1-yl)benzo[d][1,3]dioxole (3), 5-(4-(3,5-dimethoxyphenyl)hexahydrofuro[3,4-c]furan-1-yl)benzo[d][1,3]dioxole (4), and four non-alkaloid compounds, piperonylic acid (5), hesperidin (6), syringin (7), and β-sitosterol (8) were isolated from the stem bark of Zanthoxylum rhetsa grown in Vietnam. Their chemical structures were elucidated by spectroscopic analysis and compared with the references. Except for compound 6, all the remaining compounds (1–5, 7, and 8) were isolated for the first time from Z. rhetsa. The isolated compounds were tested for their cytotoxic activity against three human cancer cell lines, LU-1, Hep-G2, and KB. Compound 5 showed moderate cytotoxic activity against all three cell lines with IC50 values ranging from 48.13 to 49.06 µg mL−1. Notably, compound 6 demonstrated selective cytotoxicity against LU-1, Hep-G2, and KB cancer cell lines (IC50 66.48–67.41 µg mL−1) while non-toxic toward normal Vero cell. Compound 6 also exhibited its ability to inhibit main protease (Mpro) enzyme in vitro with an IC50 value of 55.49 µg mL−1 and in silico with the binding affinity toward targeted protein of −14.36 kcal mol−1.
Pilot study on a new endoscopic platform for colorectal endoscopic submucosal dissection
Authors: Maselli Roberta , Spadaccini Marco , Galtieri Piera Alessia , Badalamenti Matteo , Ferrara Elisa Chiara , Pellegatta Gaia , Capogreco Antonio , Carrara Silvia , Anderloni Andrea , Fugazza Alessandro , Hassan Cesare , Repici Alessandro
Published: July 2023

Background:

The endoscopic submucosal dissection (ESD) is a technically demanding and time-consuming procedure, with an increased risk of adverse events compared to standard endoscopic resection techniques. The main difficulties are related to the instability of the operating field and to the loss of traction. We aimed to evaluate in a pilot trial a new endoscopic platform [tissue retractor system (TRS); ORISE, Boston scientific Co., Marlborough, MA, USA], designed to stabilize the intraluminal space, and to provide tissue retraction and counter traction.

Method:

We prospectively enrolled all consecutive patients who underwent an ESD for sigmoid/rectal lesions. The primary outcome was the rate of technical feasibility. Further technical aspects such as en-bloc and R0 resection rate, number of graspers used, circumferential incision time, TRS assemblage time, submucosal dissection time, and submucosal dissection speed were provided. Clinical outcomes (recurrence rate and adverse events) were recorded as well.

Results:

In all, 10 patients (M/F 4/6, age: 70.4 ± 11.0 years old) were enrolled. Eight out of 10 lesions were located in the rectum. Average lesion size was 31.2 ± 2.7 mm, and mean lesion area was 1628.88 ± 205.3 mm2. The two sigmoid lesions were removed through standard ESD, because the platform assemblage failed after several attempts. All rectal lesions were removed in an en-bloc fashion. R0 resection was achieved in 7/8 (87.5%) patients in an average procedure time of 60.5 ± 23.3 min. None of the patients developed neither intraprocedural nor postprocedural adverse events.

Conclusion:

TRS-assisted ESD is a feasible option when used in the rectum, with promising result in terms of efficacy and safety outcomes. Nevertheless, our pilot study underlines few technical limitations of the present platform that need to be overcome before the system could be widely and routinely used.
Does the gender of nurses matter to patients? A qualitative analysis of gender preferences of patients
Authors: Asante Akua Owusua , Korsah Kwadwo Ameyaw , Amoako Clifford
Published: July 2023

Background:

This study argues that the gender of a nurse could give patients the emotional and psychological support they need in their healing process. Nonetheless, in many developing countries, these intricate preferences of patients are usually ignored due to poor staffing and logistical capacities of health facilities. As a contribution to this professional and operation gap, this paper explores patients’ preference for nurses’ gender in health care at the Komfo Anokye Teaching Hospital in Ghana. The paper further explores the importance of these preferences to the delivery of patient-centred care in Ghana and across Africa.

Objective:

The paper has two specific objectives: (a) to explore patients’ preferences for the gender of nurses who attend to them while on admission; and (b) to find out the range of factors that inform these preferences.

Methods:

Qualitative exploratory descriptive design was used to select adult patients who were not seriously ill and nursed by male and female nurses at the medical and surgical wards of the Komfo Anokye Teaching Hospital in Ghana for at least 5 days from January to March 2017 and before their discharge. Participants were recruited using purposive sampling technique. A semi-structured interview guide was used to elicit information from 14 participants after seeking their written informed consent. The data were analysed using content analysis.

Results:

Two major themes emerged. These were: the Preferred Gender of a Nurse in Nursing Care and the Reasons for the Preference or no Preference for Nurses’ Gender in Nursing Care. Under each of these themes, the associated aspects were also discussed. Patients had varying preference for a particular nurse during care but gender was not particularly significant in patients’ preference for nurses. Majority of the participants emphasized their preference for nurses with professional expertise and good virtues to determine a preferred nurse and both genders of nurses can possess these qualities. However, nurses of the same gender as the patient were preferred for intimate procedures to ensure privacy and satisfaction.

Conclusion:

The gender of a nurse is not on top of the preferences list of patients in the study context. This may be attributed to the long-term practice that the participants have not had the chance to be choosing a preferred nurse’s gender, so most patients are tolerant and familiar with both male and female nurses. Instead, patients’ preferences are determined by the performance and quality of service provided by nurses. Age, maturity and social connections were also found to influence patients’ preferences.
Bioimpedance-Guided Monitoring of Volume Status in Patients With Kidney Disease: A Systematic Review and Meta-Analysis
Authors: Horowitz Laura , Karadjian Oliver , Braam Branko , Mavrakanas Thomas , Weber Catherine
Published: July 2023

Background and Objective:

Bioimpedance technologies are increasingly used to determine fluid status in patients with chronic kidney disease and those with end-stage kidney disease on dialysis. We aimed to determine whether this technology improves clinical outcomes as compared with usual care.

Methods:

We performed a systematic review and meta-analysis of trials, comparing fluid management guided by bioimpedance technologies to standard of care in patients with chronic kidney disease. Our primary outcome was all-cause mortality. Secondary outcomes included blood pressure control, all-cause hospitalization, major adverse cardiovascular events, and change in left ventricular mass index.

Results:

Our search identified 819 citations of which 12 randomized controlled trials were included (2420 patients). No studies of non-dialysis-dependent chronic kidney disease patients met inclusion criteria. Mean age was 55 years and mean follow-up was 1 year. There was a statistically significant difference in all-cause mortality between both arms studied (risk ratio [RR] 0.64, 95% confidence interval [CI]: 0.44, 0.99). Better blood pressure control was observed in the bioimpedance arm of the included articles, weighted mean differences (WMD) −3.13 mm Hg (95% CI: −5.73, −0.53 mm Hg) for systolic blood pressure and WMD −2.50 mm Hg (95% CI: −4.36, −0.64 mm Hg) for diastolic blood pressure. No difference was observed concerning the other outcomes.

Conclusions:

Among patients on maintenance dialysis, bioimpedance-guided volume management showed decreased all-cause mortality and blood pressure but no significant difference in all-cause hospitalization, major adverse cardiac event, or change in left ventricular mass index. This may be due to a younger population sample than previous articles. Moreover, our study identified a knowledge gap by highlighting the lack of studies evaluating this technology in non-dialysis-dependent chronic kidney disease patients.
‘Papa, I am gay, please, love me’: Politics of censorship and queer representation in Bollywood
Authors: Maity Abhijit
Published: July 2023

The article explores the problematic issues that arise between Bollywood films projecting homosexual relationships and the Central Board of Film Certification (CBFC) filtering their contents. Queer popular cultural representations in India face challenges to get release certification because of their inherently debatable contents including ‘non-normative’ sexual relationships which are largely identified as a potential threat to the existing heteronormative, majoritarian culture. By giving reference to two queer films, Unfreedom and Angry Indian Goddesses, this article explores the politics of censorship in the light of Foucauldian power relations and the discourse of knowledge production. I argue that by proscribing representations of queer sexualities in films, the CBFC has acted on behalf of the state in decelerating the formation and proliferation of a counter cultural movement to balance homophobia discursively and to peddle majoritarian power politics, and thus the notion of heterosexuality as compulsory form of sexual behaviour is popularized and consolidated in Indian society.
Accuracy of Femoral Tunnel Localization With Mixed Reality Technology–Assisted Single-Bundle ACL Reconstruction
Authors: Wang Jingkun , Liu Jun , Wu Liming , Tao Lun , Liu Xiangdong , Wang Ziming , Xiong Yan
Published: July 2023

Background:

It is clinically challenging to accurately drill femoral and tibial tunnels to reconstruct the anterior cruciate ligament (ACL). Mixed reality (MR) technology, a further development of virtual reality technology, presents virtual scene information in real time and establishes an interactive feedback information loop among the real world, the virtual world, and the user.

Purpose/Hypothesis:

The purpose of this study was to investigate the structural and early clinical outcomes of ACL reconstruction assisted by MR technology. It was hypothesized that MR technology would improve the accuracy of tunnel localization.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 44 patients at a single institution who underwent arthroscopic single-bundle ACL reconstruction between June 2020 and March 2022. Reconstruction with the aid of MR technology was performed in 21 patients (MR group), and conventional arthroscopic reconstruction was performed in 23 patients. Postoperatively, the parameters related to the bone tunnel positioning were compared by computed tomography imaging with 3-dimensional (3D) reconstruction, and 12-month postoperative clinical outcomes were assessed with the Lysholm and International Knee Documentation Committee scores.

Results:

There was no statistically significant difference in projection angles in the coronal, axial, or sagittal plane between the preoperative virtually created tunnel guide pin and the actual tunnel ( P > .05 for all). In the MR group, the center of the femoral tunnel exit was closer to the apex of the lateral femoral condyle along the proximal-distal axis (14.07 ± 4.12 vs 17.49 ± 6.24 mm for the conventional group; P < .05) and the graft bending angle was lower (117.71° ± 8.08° vs 127.81° ± 11.91° for the conventional group; P < .05). The scatterplot of the femoral tunnel location distribution showed that the entrance and exit points in the MR group were more concentrated and closer to the ideal location of the preoperative design than in the conventional group. Patients in both groups had significant preoperative-to-postoperative improvement based on outcome scores ( P < .001 for all), with no significant difference between groups.

Conclusion:

ACL reconstruction with the aid of MR technology allowed for more accurate positioning and orientation of the femoral tunnel during surgery when compared with conventional reconstruction.
The Intersection of Stress, Health, and Health Care Opportunities for Appalachian Transgender and Nonbinary People: An Interpretative Phenomenological Analysis
Authors: Harless Chase , Murphy-Nugen Amy B. , Surles Kristen
Published: July 2023

Transgender or nonbinary (TNB) individuals in the United States South experience higher rates of physical and mental health disparities when compared to their cisgender counterparts. Societal, interpersonal, and individual stigmas contribute to these disparities by increasing the levels of stress in the TNB population, which is a primary factor in higher morbidity and mortality. However, there is a paucity of research examining the impact of these stigmas on health through the lived experiences of TNB people living in Appalachia. An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in Appalachia. Transcribed interviews were analyzed repeatedly by two analysts to identify emergent themes which focused on understanding an individual's lived experiences through interpretation. Ten participants from four Appalachian states within three Appalachian sub-regions participated in this study. Three shared healthcare themes were identified: experiences of stigma related to gender, the impact of stigma on personal wellbeing and perception of health, and the need for affirming TNB healthcare services. Respondents noted that chronic stress factors such as continual and compounding experiences of stigma and discrimination, stemming from religion or lack of affirming providers, negatively impacted their health. TNB individuals living in Appalachia experience chronic societal, interpersonal, and individual stressors that negatively impact their health. By addressing the stigmas, public health leaders, policymakers, and providers can improve access to health care and the health and quality of life of Appalachian TNB people.
Osteochondral Allograft Transplantation for the Unstable Capitellar Osteochondritis Dissecans Lesion: An Anconeus Preserving Approach
Authors: Feroe Aliya G. , Langhans Mark T. , Sanchez-Sotelo Joaquin , Morrey Mark E. , Camp Christopher L.
Published: July 2023

Background:

Osteochondritis dissecans (OCD) of the capitellum can be a disabling condition that typically affects adolescent, overhead athletes. To date, a variety of different surgical treatment options have been described.

Indications:

Surgical indications for osteochondral allograft transplantation (OCA) for capitellar OCD lesions include failure of nonsurgical management or prior surgery and unstable, full-thickness lesions of almost any size affecting both bone and cartilage. The anconeus preserving approach specifically provides wide access to nearly the entire capitellum and can be used for lesions in almost any location.

Technique Description:

The anconeus preserving approach for OCA utilizes the interval between the anconeus and the ulna. With the patient positioned supine and the elbow flexed on an arm table, an incision is made approximately 1 cm lateral to the olecranon and is carried down to the fascia. Electric cautery is used to dissect the interval between the ulna and the anconeus. The anconeus is elevated off the ulna and retracted laterally to expose the underlying joint capsule. An L-shaped capsulotomy is performed over the center of the capitellum, just proximal to the annular ligament of the radial head. A pin is placed into the center of the lesion, perpendicular to the capitellum. A cannulated reamer 0.5 mm smaller than the lesion is used to ream the lesion to a depth of approximately 5 mm. Depth measurements are taken at all 4 poles of the defect. About 3 cc of bone marrow aspirate harvest is then obtained from the ulna using a cannulated needle. The oscillating saw is used to cut the graft to size using the prior measurements. The bone marrow aspirate is placed onto the osseous side of the graft before the osteochondral graft is impacted into the recipient site. The capsulotomy is then closed, and the anconeus is repaired back to the ulna. Postoperatively, patients begin range of motion as soon as tolerated, initiate strengthening at 6 weeks, and initiate return-to-sport programming at 3 months.

Results:

Lesions treated with OCA typically demonstrate improvement in all outcome measures, including functional scores, graft incorporation, articular surface congruity, and return-to-sport. Complications and graft failure is rare.

Discussion/Conclusion:

OCA using an anconeus preserving approach is a reliable option for surgical management of unstable OCD lesions.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
GeCoNet-Tool: a software package for gene co-expression network construction and analysis
Authors: Kuang Junyao , Michel Kristin , Scoglio Caterina
Published: July 2023

Background

Network analysis is a powerful tool for studying gene regulation and identifying biological processes associated with gene function. However, constructing gene co-expression networks can be a challenging task, particularly when dealing with a large number of missing values.

Results

We introduce GeCoNet-Tool, an integrated gene co-expression network construction and analysis tool. The tool comprises two main parts: network construction and network analysis. In the network construction part, GeCoNet-Tool offers users various options for processing gene co-expression data derived from diverse technologies. The output of the tool is an edge list with the option of weights associated with each link. In network analysis part, the user can produce a table that includes several network properties such as communities, cores, and centrality measures. With GeCoNet-Tool, users can explore and gain insights into the complex interactions between genes.
Comparison of continuous pericapsular nerve group (PENG) block versus continuous fascia iliaca compartment block on pain management and quadriceps muscle strength after total hip arthroplasty: a prospective, randomized controlled study
Authors: Duan Lei , Zhang Liang , Shi Chuang-Guo , Huang Li-Gang , Ao Hui , Wang Ze-Peng , Deng Yue , Sun Meng-Liang
Published: July 2023

Background

This investigation aimed to evaluate the impact of continuous pericapsular nerve group (PENG) block and continuous fascia iliac compartment block (FICB) on postoperative pain following total hip arthroplasty (THA).

Methods

This prospective, randomized, and controlled trial recruited a cohort of fifty-seven patients with unilateral femoral neck fractures from Xi’an Aerospace General Hospital in northwest China between July 2020 and November 2021. These patients were randomly assigned to two groups: the continuous PENG block group (PENG group, n = 29) and the continuous FICB group (FICB group, n = 28). Under ultrasound guidance, PENG block and FICB procedures were performed prior to spinal anesthesia, utilizing 20 ml of 0.25% ropivacaine for PENG block and 30 ml of 0.25% ropivacaine for FICB. Subsequently, a catheter was inserted. All study participants received a standardized postoperative multimodal analgesic regimen, including intravenous administration of 30 mg Ketorolac tromethamine every eight hours and patient-controlled neural analgesia (PCNA) after surgery. Numerical rating scale (NRS) scores at rest and during exercise were recorded at various time points: prior to block (T0), 30 min post-blockade (T1), and 6 h (T2), 12 h (T3), 24 h (T4), and 48 h (T5) postoperatively. Additional data collected encompassed postoperative quadriceps muscle strength, the time of initial ambulation after surgery, the number of effective PCNA activations, rescue analgesia requirements, and occurrences of adverse events (such as nausea and vomiting, hematoma, infection, catheter detachment, or displacement) within 48 h following surgery.

Results

In the PENG group, the resting NRS pain scores exhibited lower values at T1, T4, and T5 than those at T0. Furthermore, exercise NRS pain scores at T1-T5 were lower in the PENG group than in the FICB group. Similarly, during the same postoperative period, the PENG group demonstrated enhanced quadriceps strength on the affected side compared to the FICB group. Additionally, the PENG group displayed earlier postoperative ambulation and reduced occurrences of effective PCNA activations and rescue analgesia requirements compared to the FICB group.

Conclusion

Continuous PENG block exhibited superior analgesic efficacy after THA compared to continuous FICB, promoting recovery of quadriceps strength on the affected side and facilitating early postoperative ambulation.

Trial Registration

This clinical trial was registered in the China Clinical Trials Center (http://www.chictr.org.cn) on 20/07/2020, with the registration number ChiCTR2000034821.
Endoscopic injection sclerotherapy for treating recurrent bleeding of small bowel angioectasias
Authors: Yang Jing , Zhou Lei , Xu Dan , Fan Yan , Zhang Heng
Published: July 2023

Background

There is still no consensus on the preferred endoscopic therapy for small bowel angioectasias (SBAs). The aim of this study was to evaluate effectiveness and safety of endoscopic injection sclerotherapy (EIS) for treating recurrent bleeding of SBAs.

Methods

Sixty-six adult patients diagnosed with SBAs by capsule endoscopy (CE) or double-balloon enterscopy (DBE) examinations were enrolled in this retrospective study from September 2013 to September 2021. The patients were divided into an EIS group (35 cases) and a control group (31 cases) according to whether they underwent EIS treatment. Clinical characteristics, medical histories, lesion characteristics, main laboratory indicators, treatments, and outcomes were collected. The rates of re-bleeding, re-admission, and red blood cell (RBC) transfusion were compared between different groups after discharge. The rates of hospitalization and RBC transfusion were compared between before admission and after discharge in both groups. Odds ratios (ORs) and 95% confidence intervals (CIs) were used in the multivariate logistic regression analysis to assess relative factors for re-bleeding.

Results

All the rates of re-bleeding, re-admission and RBC transfusion after discharge in the EIS group were significantly lower than those in the control group (all P < 0.05). The rates of hospitalization and RBC transfusion after discharge were significantly lower than those before admission in the EIS group (both P < 0.05), while those did not reach significant differences in the control group (both P > 0.05). Multivariate logistic regression analysis showed that RBC transfusion before admission (OR, 5.655; 95% CI, 1.007–31.758, P = 0.049) and multiple lesions (≥ 3) (OR, 17.672; 95% CI, 2.246–139.060, P = 0.006) were significant risk factors of re-bleeding, while EIS treatment (OR, 0.037; 95% CI, 0.005–0.260, P < 0.001) was a significant protective factor. No endoscopic adverse events were observed during hospitalization and none of the enrolled patients died within 12 months after discharge.

Conclusion

EIS treatment had good effectiveness and safety for treating recurrent bleeding of SBAs, which could be considered as one of the first-line endoscopic treatment options for SBAs.
Interest in peer support persons among patients experiencing early pregnancy loss
Authors: Conroy Carmen , Jain Tanya , Mody Sheila K.
Published: July 2023

Background

Limited data exist regarding the type of support patients need when experiencing early pregnancy loss (EPL). The objective of this study is to explore how patients emotionally cope with EPL and to assess if there is interest in a peer EPL support program with a self-compassion component.

Methods

We conducted semi-structured interviews with patients who experienced EPL in the past two years. We evaluated the kinds of support that patients felt were most helpful, interest in a possible peer EPL support person, and suggestions for the creation of such a program. Content analysis was utilized to analyze the data and identify themes.

Results

Twenty-one individuals participated in the study. Approximately 52.3% (n = 11) of interviewees reported expectant management of their EPL, 23.8% (n = 5) reported medication management, and 23.8% (n = 5) reported undergoing dilation and curettage. We identified five themes: (1) therapy and in-person support groups are helpful when experiencing EPL, but are sometimes inaccessible; (2) social media support groups are initially advantageous for creating a sense of solidarity, but in the long term can be triggering; (3) support from a peer who has also experienced EPL is uniquely valuable; (4) developing self-compassion is important in emotionally coping with EPL; and (5) there is a demand for emotional and informational support following EPL.

Conclusions

Given the unique support participants identified receiving from a peer with shared lived experience, there is interest in a peer EPL support program with a self-compassion component for emotional and informational support following EPL.
External validation of the AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model for predicting seizures in pregnant women with epilepsy
Authors: Du Yanru , Xu Qi , Lin Jiahe , Gong Jiaoni , Xia Niange , Zhu Zhenguo , Wang Xinshi , Zheng Rongyuan , Xu Huiqin
Published: July 2023

Background

The AntiEpileptic Drug Monitoring in PREgnancy (EMPiRE) model is the only available tool for predicting seizures in pregnant women with epilepsy (WWE) using anti-seizure medications (ASMs); however, its predictive performance requires validation. This study aimed to evaluate the predictive ability of this model in pregnant Chinese WWE and its potential usefulness in clinical practice.

Methods

Data of the EMPiRE model were derived from the EMPiRE study, a prospective multicenter cohort study that recruited women on ASM monotherapy (lamotrigine, carbamazepine, phenytoin or levetiracetam) or polytherapy (lamotrigine with either carbamazepine, phenytoin or levetiracetam). Based on the applicable population of the EMPiRE model, we evaluated 280 patients registered in the Wenzhou Epilepsy Follow-up Registry Database from January 1, 2010, to December 31, 2020. A total of 158 eligible patients were included in the validation cohort. We collected data on the baseline characteristics of patients, eight predictors of the EMPiRE model and outcome events. The outcome was the occurrence of tonic-clonic or non-tonic-clonic seizures at any time in pregnancy up to 6 weeks postpartum. We used the equation of the EMPiRE model to obtain the predicted probabilities of seizures. The predictive ability of the EMPiRE model was quantified by the C-statistic (scale 0–1, values > 0.5 show discrimination), GiViTI calibration test and decision curve analysis (DCA).

Results

Of 158 eligible patients, 96 patients (60.8%, 96/158) experienced one or more seizures at any time between pregnancy and 6 weeks postpartum. The EMPiRE model showed good discrimination with a C-statistic of 0.76 (95% confidence interval [CI] 0.70–0.84). The GiViTI calibration belt showed that the predicted probabilities, which ranged from 16 to 96% (95% CI), were lower than the actual probabilities. DCA indicated that the highest net proportional benefit was obtained for predicted probability thresholds of 15–18% and 54–96%.

Conclusions

The EMPiRE model could discriminate well between WWE with and without seizures during pregnancy and 6 weeks postpartum, but the risk of seizures may be underestimated. The limitations of the model for specific medication regimens may limit its real-world application. If the model is further improved, it will be incredibly valuable.
Identifying important microbial and genomic biomarkers for differentiating right- versus left-sided colorectal cancer using random forest models
Authors: Kolisnik Tyler , Sulit Arielle Kae , Schmeier Sebastian , Frizelle Frank , Purcell Rachel , Smith Adam , Silander Olin
Published: July 2023

Background

Colorectal cancer (CRC) is a heterogeneous disease, with subtypes that have different clinical behaviours and subsequent prognoses. There is a growing body of evidence suggesting that right-sided colorectal cancer (RCC) and left-sided colorectal cancer (LCC) also differ in treatment success and patient outcomes. Biomarkers that differentiate between RCC and LCC are not well-established. Here, we apply random forest (RF) machine learning methods to identify genomic or microbial biomarkers that differentiate RCC and LCC.

Methods

RNA-seq expression data for 58,677 coding and non-coding human genes and count data for 28,557 human unmapped reads were obtained from 308 patient CRC tumour samples. We created three RF models for datasets of human genes-only, microbes-only, and genes-and-microbes combined. We used a permutation test to identify features of significant importance. Finally, we used differential expression (DE) and paired Wilcoxon-rank sum tests to associate features with a particular side.

Results

RF model accuracy scores were 90%, 70%, and 87% with area under curve (AUC) of 0.9, 0.76, and 0.89 for the human genomic, microbial, and combined feature sets, respectively. 15 features were identified as significant in the model of genes-only, 54 microbes in the model of microbes-only, and 28 genes and 18 microbes in the model with genes-and-microbes combined.PRAC1expression was the most important feature for differentiating RCC and LCC in the genes-only model, withHOXB13,SPAG16,HOXC4, andRNLSalso playing a role.Ruminococcus gnavusandClostridium acetireducenswere the most important in the microbial-only model.MYOM3,HOXC4,Coprococcus eutactus,PRAC1, lncRNA AC012531.25,Ruminococcus gnavus,RNLS,HOXC6,SPAG16andFusobacterium nucleatumwere most important in the combined model.

Conclusions

Many of the identified genes and microbes among all models have previously established associations with CRC. However, the ability of RF models to account for inter-feature relationships within the underlying decision trees may yield a more sensitive and biologically interconnected set of genomic and microbial biomarkers.
Ahmed to Baerveldt glaucoma drainage device exchange in pediatric patients
Authors: Jacobson Adam , Bohnsack Brenda L.
Published: July 2023

Background

There is no consensus and few reports as to the surgical management of encapsulated Ahmed glaucoma drainage devices (GDD) which no longer control intraocular pressure (IOP), especially within the pediatric population. The purpose of this study was to report outcomes of exchanging the Ahmed GDD for a Baerveldt GDD in children with refractory glaucoma.

Methods

Retrospective review of children (< 18yrs) who underwent removal of Ahmed FP7 and placement of Baerveldt 350 (2016–2021) with ≥ 3-month follow-up. Surgical success was defined as IOP 5–20 mmHg without additional IOP-lowering surgeries or visually devastating complications. Outcomes included change in best-corrected visual acuity (BCVA), intraocular pressure (IOP), and number of glaucoma medications.

Results

Twelve eyes of 10 patients underwent superotemporal Ahmed FP7 to Baerveldt 350 GDD exchange at 8.8 ± 3.6 years. Time to Ahmed failure was 2.7 ± 1.9 years with 1-, 3-, and 5-year survival rates of 83% with a 95% CI[48,95], 33% with a 95% CI[10, 59], and 8% with a 95% CI[0, 30]. At final follow-up (2.5 ± 1.8 years), success rate for Baerveldt 350 GDDs was 75% (9 of 12 eyes) with 1 and 3-yr survival rates of 100% and 71% with 95% CI[25,92], respectively. IOP (24.1 ± 2.9 vs. 14.9 ± 3.1 mmHg) and number of glaucoma medications (3.7 ± 0.7 vs. 2.7 ± 1.1) were significantly decreased (p < 0.004). BCVA remained stable. Two eyes required cycloablation and 1 eye developed a retinal detachment.

Conclusions

Ahmed removal with Baerveldt placement can improve IOP control with fewer medications in cases of refractory pediatric glaucoma. However, more eyes with greater follow-up are required to determine long-term outcomes.