bluuebunny/crossref_metadata_2025 huggingface dataset:
I Think I’ll Stay for a Year or Two: A Conversation With Dr. Mitchell Yell
Authors: Teagarden Jim , Zabel Robert , Kaff Marilyn
Published: August 2020

Dr. Mitchell Yell’s career has focused on children and youth with significant behavior and emotional challenges. His career has focused on special education law, progress monitoring, and behavior management. Mitch has focused providing opportunities and experiences for others in the service of those students who pose the greatest challenges within the educational environment. In this conversation, he provides his reflections and advice for those working with challenging youth.
Tisagenlecleucel in Acute Lymphoblastic Leukemia: A Review of the Literature and Practical Considerations
Authors: Halford Zachery , Anderson Mary Kate , Bennett Lunawati L. , Moody Jonathan
Published: August 2020

Objective

To evaluate the current literature for tisagenlecleucel in the treatment of relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (ALL).

Data Sources

A literature search of PubMed (inception to June 18, 2020) and ClinicalTrials.gov was conducted using the following search terms: CTL019, chimeric antigen receptor, CAR-T, and tisagenlecleucel.

Study Selection and Data Extraction

All trials evaluating the use of tisagenlecleucel in B-cell ALL were reviewed and considered for inclusion.

Data Synthesis

Tisagenlecleucel displayed overall remission rates ranging from 69% to 93% in patients who historically respond extremely poorly to salvage therapy. Remissions were durable, with 12-month relapse-free survival (RFS) rates of 55% to 59%. These promising results are tempered by the unique adverse effect profile of chimeric antigen receptor (CAR) T-cell therapy. Potentially life-threatening cytokine release syndrome (CRS) occurred in 77% to 100% of patients, and immune effector cell–associated neurotoxicity syndrome (ICANS) developed in 31% to 45% of patients receiving tisagenlecleucel.

Relevance to Patient Care and Clinical Practice

The successful utilization of tisagenlecleucel therapy requires meticulous planning, prudent patient selection, multidisciplinary collaboration, and expert training to ensure optimal patient care. The complex interplay of patient- and treatment-related factors creates problematic barriers that must be expertly navigated by the health care team and authorized treatment center.

Conclusions

As the first US Food and Drug Administration–approved gene therapy, tisagenlecleucel heralds an immunotherapeutic breakthrough for treating pediatric and young adult patients with r/r B-cell ALL. Many questions surrounding patient-specific gene and cellular therapies remain, but their transformative potential in cancer care remains promising.
Ankle Arthrodesis Through a Fibular-Sparing Anterior Approach
Authors: Rogero Ryan G. , Fuchs Daniel J. , Corr Daniel , Shakked Rachel J. , Raikin Steven M.
Published: August 2020

Background:

The open anterior approach to ankle arthrodesis offers a technique that provides several advantages for surgeons, such as easier visualization of the joint for deformity correction and preservation of the malleoli for potential future conversion to total ankle arthroplasty. The purpose of this study was to evaluate clinical, radiographic, and functional outcomes in a large series of patients undergoing open ankle arthrodesis via a fibular-sparing anterior approach.

Methods:

A retrospective review was performed of patients undergoing primary ankle arthrodesis with a single fellowship-trained foot and ankle orthopedic surgeon between 2009 and 2017. Patients were excluded if an approach other than anterior was performed. Patient-reported outcome measures (Foot and Ankle Ability Measure–Activities of Daily Living [FAAM-ADL], Short-Form 12 [SF-12], and visual analog scale [VAS] pain) were subsequently collected at a minimum of 24 months (2 years) following index surgery, along with outcome satisfaction and likelihood to repeat surgery. Fusion of the tibiotalar joint at the time of last radiographic follow-up was also assessed. Paired t tests were performed to assess change in pre- to postoperative outcomes, while linear regression analysis was performed to identify any patient factors associated with outcomes. Eighty-one patients, including 31 women and 50 men, with a mean age of 51.5 years and a mean follow-up of 58.9 (range, 24-104) months, were included.

Results:

Sixty-two patients reported significant improvement in mean FAAM-ADL ( P < .0001), SF-12 Physical Composite Scale ( P < .0001), and VAS pain ( P < .0001), while the SF-12 Mental Composite Scale also improved, though not significantly ( P = .2854). Twelve patients (14.8%) experienced complications following their arthrodesis procedure. Seventy-nine patients (97.5%) achieved fusion at their last radiographic follow-up. Multiple linear regression analysis revealed age ( B = 0.071 [0.004, 0.128]; P = .0373) to have a positive association with postoperative VAS pain.

Conclusion:

Ankle arthrodesis utilizing a fibular-sparing anterior approach combined with the transarticular screw fixation technique offers surgeons several advantages, along with a low postoperative complication rate, high rate of radiographic evidence of joint fusion, and substantially large improvement in pain and functional levels.

Level of Evidence:

Level IV, retrospective case series.
Effect of Postoperative Oral Antibiotics on Infections and Wound Healing Following Foot and Ankle Surgery
Authors: Carl Jacob , Shelton Trevor J. , Nguyen Kevin , Leon Isabella , Park Jeannie , Giza Eric , Kreulen Christopher
Published: August 2020

Background:

There is controversy regarding the effectiveness of postoperative antibiotics to prevent wound infection. Some surgeons still use a routine postoperative oral antibiotic regimen. The purpose of this study was to review a series of cases and document statistically any difference in infection rates and whether routine postoperative antibiotics in foot and ankle surgery are justified.

Methods:

A retrospective chart review of 649 patients was performed who underwent elective foot and ankle surgery. Six hundred thirty-one patient charts were included in the final analysis. Evaluated were patients who did and did not receive postoperative oral antibiotics in order to identify whether a difference in infection rate or wound healing occurred. The study also evaluated risk factors for developing infection following foot and ankle surgery.

Results:

The number of infections in patients receiving postoperative oral antibiotics was 6 (3%), while the number of infections in those who did not receive postoperative oral antibiotics was 10 (2%) ( P = .597). The difference of deep versus superficial infections and delays in wound healing between the 2 groups was not statistically significant. Patients who developed infections were older and had a higher prevalence of hypertension, a history of neoplasm, and a greater American Society of Anesthesiologists Classification of Physical Health.

Conclusion:

This study suggests that routine use of postoperative antibiotics in foot and ankle surgery does not affect wound complications or infection rates. Additionally, patients who are older and those with multiple medical problems may be at higher risk for developing postoperative infection following foot and ankle surgeries.

Level of Evidence:

Level III, retrospective comparative series.
Enhanced deep residual network with multilevel correlation information for fault diagnosis of rotating machinery
Authors: Xiong Shoucong , He Shuai , Xuan Jianping , Xia Qi , Shi Tielin
Published: August 2020

Modern machinery becomes more precious with the advance of science, and fault diagnosis is vital for avoiding economical losses or casualties. Among massive diagnosis methods, deep learning algorithms stand out to open an era of intelligent fault diagnosis. Deep residual networks are the state-of-the-art deep learning models which can continuously improve performance by deepening the network structures. However, in vibration-based fault diagnosis, the transient property instability of vibration signal usually calls for time–frequency analysis methods, and the characters of time–frequency matrices are distinct from standard images, which brings some natural limitations for the diagnosis performance of deep learning algorithms. To handle this issue, an enhanced deep residual network named the multilevel correlation stack-deep residual network is proposed in this article. Wavelet packet transform is used to preprocess the sensor signal, and then the proposed multilevel correlation stack-deep residual network uses kernels with different shapes to fully dig various kinds of useful information from any local regions of the processed input. Experiments on two rolling bearing datasets are carried out. Test results show that the multilevel correlation stack-deep residual network exhibits a more satisfactory classification performance than original deep residual networks and other similar methods, revealing significant potentials for realistic fault diagnosis applications.
Imagining the I-You Through Embodied Writing
Authors: Yoo Joanne
Published: August 2020

Deep understanding resides in our bodies. To understand is to draw on the sensations on your skin, in your bones, and in the pit of your stomach. It is to feel the pain and suffering of others, as if it is experienced by your own body. In times of social unrest and division, embodied understanding, rather than logical rationalization, becomes paramount. Embodied understanding minimizes divisiveness and demolishes the borders that create a sense of otherness. As academic writers, we are responsible for cultivating embodied ways of knowing by writing reflexively about our practices and depicting them in rich sensorial ways.
Family and Community Approaches to Intimate Partner Violence: Restorative Programs in the United States
Authors: Pennell Joan , Burford Gale , Sasson Erika , Packer Hillary , Smith Emily L.
Published: August 2020

Now is the time to rethink reliance on legal intervention to end intimate partner violence (IPV). Arrest, incarceration, and family separation have fallen disproportionately on people who are Black or Brown, impoverished, or immigrant, lesbian, gay, bisexual, transgender and queer (LGBTQ). Restorative approaches bring together the persons harmed, persons causing harm, their family or community networks, or combinations of these stakeholders. Based on a U.S. national study, this article examines: What influences programs to adopt a restorative approach to ending IPV? How do programs safeguard their original vision for social change? What principles guide the programs in carrying out their work in safe and productive ways?
Retrospective study evaluating the safety of administering pegfilgrastim on the final day of 5-fluorouracil continuous intravenous infusion
Authors: Draper Amber S , Lafollette Jennifer , Kim Chaejin , Wu Christina S
Published: August 2020

Background

Pegfilgrastim, a long-acting granulocyte-colony-stimulating factor used to prevent neutropenia, is not indicated for administration within 24 h of completion of chemotherapy. The safety of administering pegfilgrastim in gastrointestinal cancer chemotherapy regimens containing continuous intravenous infusion of 5-fluorouracil (5-FUCI) on the day of completion of 5-fluorouracil has not been adequately studied.

Methods

An institutional review board-approved retrospective analysis of patients with a gastrointestinal malignancy receiving pegfilgrastim on the final day of 5-FUCI was conducted. The primary end point was to determine the incidence of grade 3 and grade 4 neutropenia and febrile neutropenia when pegfilgrastim was administered on the final day of 5-FUCI. The secondary endpoint was to determine rate of dose reductions and treatment delays.

Results

A total of 300 patients were reviewed from January 2010 to May 2017. The most common cancers were colorectal (25%) and pancreatic (60%), with 77% of patients having late stage disease. The risk of a patient developing grade 3 neutropenia was 0.010 (95% CI 0.002–0.029) and grade 4 neutropenia was 0.007 (95% CI 0.001–0.024). The risk of febrile neutropenia was 0.007 (95% CI 0.001–0.024). The risks of treatment delay and treatment reduction were 0.013 (95% CI 0.004–0.034) and 0.010 (95% CI 0.002–0.029), respectively.

Conclusion

The low risk of grade 3 and grade 4 neutropenia, febrile neutropenia, as well as dose delays and/or reduction suggests that pegfilgrastim can be administered on the final day of 5-FUCI. Limitations of this study were that it was retrospective in nature and was conducted at a single institution.
Untargeted Metabolomic Approach Shows No Differences in Subcutaneous Adipose Tissue of Diabetic and Non-Diabetic Subjects Undergoing Bariatric Surgery: An Exploratory Study
Authors: Vizioli Carlotta , Jaime-Lara Rosario B. , Franks Alexis T. , Ortiz Rodrigo , Joseph Paule V.
Published: August 2020

Background:

Obesity plays a major role in the development of insulin resistance (IR) and diabetes (T2DM). Increased adipose tissue (AT) is particularly of interest because it activates a chronic inflammatory response in adipocytes and other tissues. AT plays key endocrine and metabolic functions, acting in the regulation of insulin sensitivity and energy homeostasis. Additionally, it can be easily collected during bariatric surgery. The purpose of this pilot study was to explore the potential differences in AT metabolism, through comparing the untargeted metabolomic profiles of diabetic and non-diabetic obese patients undergoing bariatric surgery.

Methods:

For this exploratory study, samples were collected from 17 subjects. Subcutaneous AT (SAT) samples from obese-diabetic (n = 8) and Obese-non-Diabetic (n = 9) subjects were obtained from the Human Metabolic Tissue Bank. Untargeted metabolomic profiling was performed by Metabolon® Inc. Statistical analysis was performed using the MetaboAnalyst 4.0 platform.

Results:

Among the 421 metabolites identified and analyzed there were no significant differences between the Obese-Diabetics and the Obese-non-Diabetics. Small changes were observed by fold change analysis mainly in lipid (n = 12; e.g. NEFAs) and amino acid (n = 8; e.g. BCAAs) metabolic pathways. Dysregulation of these metabolites has been associated with IR and other T2DM-related pathophysiological processes.

Conclusion:

Obesity may influence SAT metabolism masking T2DM-dependent dysregulation. Better understanding the metabolic differences within SAT in diabetic populations may help identify potential biomarkers for diagnosis and monitoring of T2DM in patients undergoing bariatric surgery.
Development of a new comprehensive preoperative risk score for predicting 1-year mortality in patients with hip fracture: the HULP-HF score. Comparison with 3 other risk prediction models
Authors: Menéndez-Colino Rocío , Gutiérrez Misis Alicia , Alarcon Teresa , Díez-Sebastián Jesús , Díaz de Bustamante Macarena , Queipo Rocío , Otero Angel , González-Montalvo Juan I
Published: August 2020

Purpose:

The aim of this study was to develop a new comprehensive preoperative risk score for predicting mortality during the first year after hip fracture (HF) and its comparison with 3 other risk prediction models.

Methods:

All patients admitted consecutively with a fragility HF during 1 year in a co-managed orthogeriatric unit at a university hospital were assessed and followed for 1 year. Factors independently associated with 1-year mortality were used to create the HULP-HF (Hospital Universitario La Paz – Hip Fracture) score. The predictive validity, discrimination and calibration of the HULP-HF score, the American Society of Anesthesiologists (ASA) scale, the abbreviated Charlson comorbidity index (a-CCI) and the Nottingham Hip Fracture score (NHFS) were compared. Discriminative performance was assessed using the area under the curve (AUC) and calibration by the Hosmer-Lemeshow goodness-of-fit-test.

Results:

509 patients were included. 1-year mortality was 23.2%. The 8 independent mortality risk factors included in the HULP-HF score were age >85 years, baseline functional and cognitive impairment, low body mass index, heart disease, low hand-grip strength, anaemia on admission, and secondary hyperparathyroidism associated with vitamin D deficiency. The AUC was 0.79 in the HULP-HF score, 0.66 in the NHFS, 0.61 in the abbreviated CCI and 0.59 in the ASA scale. The HULP-HF score, the NHFS and the abbreviated CCI all presented good levels of calibration ( p > 0.05).

Conclusions:

The HULP-HF score has a predictive capacity for 1-year mortality in HF patients slightly superior to that of other previously existing scores.
COVID-19 pneumonia in a multiple sclerosis patient with severe lymphopenia due to recent cladribine treatment
Authors: Dersch Rick , Wehrum Thomas , Fähndrich Sebastian , Engelhardt Monika , Rauer Sebastian , Berger Benjamin
Published: August 2020

Background:

Most cases of COVID-19 are considered mild, but patients with immunosuppressant treatment might be prone to severe courses of disease. Expert panels advise to delay treatment with cell-depleting MS therapies during the COVID-19 pandemic.

Methods:

We report a case of a patient with relapsing-remitting multiple sclerosis who developed COVID-19 pneumonia 2 weeks after the first week of cladribine therapy.

Results:

Despite a severe lymphopenia (absolute lymphocyte count 240/µL), the patient had a moderate course of COVID-19.

Conclusion:

Apart from maximal supportive treatment, this could be due to cladribine reducing inflammatory response, which probably contributes considerably to severe courses of COVID-19 pneumonia.
Recovery from COVID-19 in a B-cell-depleted multiple sclerosis patient
Authors: Wurm Hannah , Attfield Kate , Iversen Astrid KN , Gold Ralf , Fugger Lars , Haghikia Aiden
Published: August 2020

Approximately 200,000 multiple sclerosis (MS) patients worldwide receive B-cell-depleting immunotherapy with rituximab (anti-CD20), which eliminates the ability to generate an antibody response to new infections. As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific antibodies might help viral clearance, these patients could be at risk of severe complications if infected. Here, we report on an MS patient who had received rituximab for ~3 years. The patient was examined 5 days before the onset of coronavirus disease 2019 (COVID-19) symptoms and was admitted to the hospital 2 days after. She recovered 14 days after symptom onset despite having a 0% B lymphocyte count and not developing SARS-CoV-2 immunoglobulin G (IgG) antibodies.
Future tense: Scandalous thinking during the conjunctural crisis
Authors: Hearn Alison , Banet-Weiser Sarah
Published: August 2020

This brief essay considers the impact of the current conjunctural crisis on ideas about, and access to the ‘future’. It explores ways in which cultural critics and scholars might learn to think ‘scandalously’ in order to imagine and build a more equitable and humane world.
Producing the category of ‘Islamist’ women: a Deleuzian perspective
Authors: Aksel Hesna Serra
Published: August 2020

When addressing the Muslim women question, one of the problematic issues is the centrality of a religious tradition or a political ideology as a primary subject of inquiry. Muslim women are seen as the embodiment of a singular tradition or ideology, as in the case of Turkey, where the contemporary headscarf-wearing women are represented as ‘Islamist’. In this project, I aim to problematise this stereotyping categorisation through ontological conceptualisations, inspired by the French thinker Gilles Deleuze. To implement the relational ontology of Deleuze, I examine headscarf contestations in Turkey through interviews conducted in two women’s organisations in Turkey: Capital City Women’s Platform (Baskent Kadin Platformu) and Hazar. I argue that the world constantly ‘becomes’ through flows of relations between multiple elements; therefore, it is a multiplicity, an intensity and fractured. With this Deleuzian ontology in mind, I consider the quotidian physical, material and social resources of my interviews with the aim of elucidating relations between a female body and the commodities produced by multiple socio-economic and political factors in Turkey. Then I address a Deleuzian understanding of categorisations such as class, gender, race and ideology. These categorisations, for Deleuze, are aggregations of multiplicities and fluidities forming specific fixations according to a range of ascribed characteristics, such as income, education, employment or dress codes. In this regard, I conclude that the label ‘Islamist’ restrains the relational and multiple characters of headscarf practices within a unifying category by attributing certain features to particular embodiments and materials.
Online Patriarchal Bargains and Social Support: Struggles and Strategies of Unwed Single Mothers in China
Authors: Zhao Xiaoman , Lim Sun Sun
Published: August 2020

Patriarchal bargains have been studied in many settings as a strategy that helps women circumvent constraints and forge spaces for individual empowerment. Despite the growing use of mediated communication, little is known about how patriarchal bargains are enacted and realized within online interactions such as in discussion forums. By analyzing how Chinese unwed single mothers renegotiate the state’s oppressive population control and gender policies through their online activity, this study proposes the concept of “online patriarchal bargain” to extend patriarchal bargain theory to women’s Internet use. It further explores linkages between social support and patriarchal bargain to elucidate how support is integral to enacting agency in the face of forbidding systemic constraints. The findings also delve into the role of therapeutic culture in the day-to-day experiences of women, especially those in marginalized communities.
“It’s [Not] Like a Racist Thing”: Producing Controversial Racial Representations in Postapartheid South Africa
Authors: Bradfield Shelley-Jean
Published: August 2020

The production and airing of Color TV (2011–2012), a variety comedy show, on the South African Broadcasting Corporation was seemingly driven by creator, producer, and industry desire for increased representation of “coloreds,” or people of mixed race, seventeen years after the end of apartheid. Although constitutional mandates and nation-building discourses support proportionate racial representations, the series was not renewed. Using critical race theory and a production studies approach, this analysis explores the apparently supportive context that engenders controversial racial representations by minority television personnel. Drawing on in-depth interviews with the creator of Color TV, and the show’s commissioning editor, the study explores how the political economic context of television production constrains racial representations to favor integrative nation-building programming and construct palatable racial representations of minorities.
A Descriptive Analysis of Location of Older Adult Falls That Resulted in Emergency Department Visits in the United States, 2015
Authors: Moreland Briana L. , Kakara Ramakrishna , Haddad Yara K. , Shakya Iju , Bergen Gwen
Published: August 2020

Introduction. Falls among older adults (age ≥65) are a common and costly health issue. Knowing where falls occur and whether this location differs by sex and age can inform prevention strategies. Objective. To determine where injurious falls that result in emergency department (ED) visits commonly occur among older adults in the United States, and whether these locations differ by sex and age. Methods. Using 2015 National Electronic Injury Surveillance System-All Injury Program data we reviewed narratives for ED patients aged ≥65 who had an unintentional fall as the primary cause of injury. Results. More fall-related ED visits (71.6%) resulted from falls that occurred indoors. A higher percentage of men’s falls occurred outside (38.3%) compared to women’s (28.4%). More fall-related ED visits were due to falls at home (79.2%) compared to falls not at home (20.8%). The most common locations for a fall at home were the bedroom, bathroom, and stairs. Conclusion. The majority of falls resulting in ED visits among older adults occurred indoors and varied by sex and age. Knowing common locations of injurious falls can help older adults and caregivers prioritize home modifications. Understanding sex and age differences related to fall location can be used to develop targeted prevention messages.
Quantifying hole quality through geometry accuracy and surface qualities in rotary ultrasonic machining of carbon fiber–reinforced plastic composites
Authors: Zhang Dongzhe , Wang Hui , Cong Weilong
Published: August 2020

Rotary ultrasonic machining has been approved as an effective and efficient hole making process for carbon fiber–reinforced plastic composites. Hole quality plays an important role in assembling carbon fiber–reinforced plastic components and can be affected by the carbon fiber reinforcement structures. In this study, experiments are conducted to assess hole quality in carbon fiber–reinforced plastic composites with three carbon fiber reinforcement structures under different combinations of machining variables. Hole quality is quantified through geometrical accuracy (perpendicularity, cylindricity, and hole diameter) and surface qualities (delamination and surface roughness). Results show that the highest level of interlacement among yarn of plain woven structure induce the highest level of compression to the workpiece and the largest amount of additional material removal, leading to the largest perpendicularity and hole diameter. The worst fabric integrity of unidirectional structure generates the largest amount of non-uniform material removal on the machined surface, resulting in the largest cylindricity. It is also found that compared with woven structures, unidirectional structure is more likely to induce push-out delamination due to its smaller critical energy release rate. The lowest constancy of the fabric in twill woven structure leads to the largest surface roughness.
Unmanned aerial vehicle control costs mirror bird behaviour when soaring close to buildings
Authors: Guerra-Langan Ana , Araujo-Estrada Sergio , Windsor Shane
Published: August 2020

Small unmanned aerial vehicles (SUAVs) are suitable for many low-altitude operations in urban environments due to their manoeuvrability; however, their flight performance is limited by their on-board energy storage and their ability to cope with high levels of turbulence. Birds exploit the atmospheric boundary layer in urban environments, reducing their energetic flight costs by using orographic lift generated by buildings. This behaviour could be mimicked by fixed-wing SUAVs to overcome their energy limitations if flight control can be maintained in the increased turbulence present in these conditions. Here, the control effort required and energetic benefits for a SUAV flying parallel to buildings whilst using orographic lift was investigated. A flight dynamics and control model was developed for a powered SUAV and used to simulate flight control performance in different turbulent wind conditions. It was found that the control effort required decreased with increasing altitude and that the mean throttle required increased with greater radial distance to the buildings. However, the simulations showed that flying close to the buildings in strong wind speeds increased the risk of collision. Overall, the results suggested that a strategy of flying directly over the front corner of the buildings appears to minimise the control effort required for a given level of orographic lift, a strategy that mirrors the behaviour of gulls in high wind speeds.
Rapid Implementation of a Diabetes Telemedicine Clinic During the Coronavirus Disease 2019 Outbreak: Our Protocol, Experience, and Satisfaction Reports in Saudi Arabia
Authors: Al-Sofiani Mohammed E. , Alyusuf Ebtihal Y. , Alharthi Sahar , Alguwaihes Abdullah M. , Al-Khalifah Reem , Alfadda Assim
Published: August 2020

Background:

The importance of telemedicine in diabetes care became more evident during the coronavirus disease 2019 (COVID-19) pandemic as many people with diabetes, especially those in areas without well-established telemedicine, lost access to their health care providers (HCPs) during this pandemic.

Subjects and Methods:

We describe a simplified protocol of a Diabetes Telemedicine Clinic that utilizes technological tools readily available to most people with diabetes and clinics around the world. We report the satisfaction of 145 patients and 14 HCPs who participated in the virtual clinic and 210 patients who attended the virtual educational sessions about “Diabetes and Ramadan.”

Results:

The majority of patients agreed or strongly agreed that the use of telemedicine was essential in maintaining a good glucose control during the pandemic (97%) and they would use the clinic again in the future (86%). A similar high satisfaction was reported by patients who attended the “Diabetes and Ramadan” virtual educational session and 88% of them recommended continuing this activity as a virtual session every year. Majority of the HCPs (93%) thought the clinic protocol was simple and did not require a dedicated orientation session prior to implementing.

Conclusions:

The simplicity of our Diabetes Telemedicine Clinic protocol and the high satisfaction reported by patients and HCPs make it a suitable model to be adopted by clinics, especially during pandemics or disasters in resource-limited settings. This clinic model can be quickly implemented and does not require technological tools other than those widely available to most people with diabetes, nowadays. We were able to successfully reduce the number of patients, HCPs, and staff physically present in the clinics during the COVID-19 pandemic without negatively impacting the patients’ nor the HCPs’ satisfaction with the visits.
Viral Infections of the Upper Airway in the Setting of COVID-19: A Primer for Rhinologists
Authors: Yuen Erick , Gudis David A. , Rowan Nicholas R. , Nguyen Shaun A. , Schlosser Rodney J.
Published: August 2020

Background

Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current Coronavirus Disease 2019 (COVID-19) pandemic highlights the devastating toll that respiratory viruses have on humanity and the desperate need to understand the biological characteristics that define them in order to develop efficacious treatments and vaccines. To date, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected nearly 600 times more people and resulted in 200 times more deaths relative to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) combined.

Objective

Through this review, we aim to summarize the key characteristics of respiratory viruses that hold global significance, with a focus on SARS-CoV-2. Our goal is to disseminate our current knowledge of these infectious agents to otolaryngologists, in particular rhinologists, practicing in the COVID-19 era.

Methods

The general and clinical characteristics of selected respiratory viruses along with available viral treatments and vaccines are reviewed.

Results

There has been significant progress in our understanding of the epidemiology and pathogenesis of various respiratory viruses. However, despite the advancement in knowledge, efficacious vaccines and antiviral treatments remain elusive for most respiratory viruses. The dire need for these scientific discoveries is highlighted by the recent COVID-19 pandemic, which has prompted investigators worldwide to conduct clinical trials at an accelerated timeline in an effort to reduce the morbidity and mortality associated with SARS-CoV-2 infection. Rhinologists will continue to remain on the front-lines of pandemics associated with respiratory viruses.

Conclusion

In light of these unprecedented times, the need to understand the nuances of these viral respiratory pathogens, especially SARS-CoV-2, cannot be overemphasized. This knowledge base is of particular importance to otolaryngologists, whose expertise in the upper airway coincides with the anatomic tropism of these infectious agents.
A Second-Order Disaster? Digital Technologies During the COVID-19 Pandemic
Authors: Madianou Mirca
Published: August 2020

One of the most striking features of the COVID-19 pandemic in the United Kingdom has been the disproportionate way in which it has affected Black, Asian, ethnic minority, and working class people. In this article, I argue that digital technologies and data practices in the response to COVID-19 amplify social inequalities, which are already accentuated by the pandemic, thus leading to a “second-order disaster”—a human-made disaster which further traps disadvantaged people into precarity. Inequalities are reproduced both in the everyday uses of technology for distance learning and remote work as well as in the public health response. Applications such as contact tracing apps raise concerns about “function creep”—the reuse of data for different purposes than the one for which they were originally collected—while they normalize surveillance which has been traditionally used on marginalized communities. The outsourcing of the digital public health response consolidates the arrival of the privatized digital welfare state, which increases risks of potential discrimination.
Analysis of Temporal Changes in Dural Sac Morphology After XLIF Indirect Decompression
Authors: Kono Yutaka , Gen Hogaku , Sakuma Yoshio
Published: August 2020

Study Design:

Retrospective study.

Objective:

To investigate temporal changes in dural sac morphology after extreme lateral interbody fusion (XLIF) indirect decompression for central lumbar spinal stenosis and to study the factors influencing the changes.

Methods:

The morphology of the dural sac was categorized into 4 grades (A, minor; B, moderate; C, severe; and D, extreme) by partially modifying Schizas classification (m-Schizas). The study involved 38 patients and 47 intervertebral spaces treated with indirect decompression (grade C or D). We evaluated m-Schizas before surgery, immediately after surgery, and at final follow-up. We performed a statistical analysis on the risk factors of grade C or D stenosis (poor morphological improvement) at final follow-up. The factors evaluated were preoperative dural sac cross-section area (CSA), diagnosis, cage size, location of cage insertion, locked facets, bony lateral recess stenosis, end plate injury, and changes in the posterior disc height (PDH) and disc angle (DA).

Results:

On morphological evaluation, improvement to grade A or B was seen in 10 intervertebral spaces (21.2%) immediately after the surgery, and improvement was achieved in 38 intervertebral spaces (80.8%) at final follow-up. The risk factor of poor morphological improvement was found to be small preoperative dural sac CSA (odds ratio 1.32, P < .002).

Conclusions:

After XLIF indirect decompression, the morphological improvement of the dural sac was remodeled with time and further expansion was seen in many patients. However, the study suggested that sufficient morphological improvement may not be achieved in spinal stenosis whose preoperative state is severe.
Three-Dimensional Printing for Preoperative Planning and Pedicle Screw Placement in Adult Spinal Deformity: A Systematic Review
Authors: Lopez Cesar D. , Boddapati Venkat , Lee Nathan J. , Dyrszka Marc D. , Sardar Zeeshan M. , Lehman Ronald A. , Lenke Lawrence G.
Published: August 2020

Study Design:

Systematic review.

Objectives:

This current systematic review seeks to identify current applications and surgical outcomes for 3-dimensional printing (3DP) in the treatment of adult spinal deformity.

Methods:

A comprehensive search of publications was conducted through literature databases using relevant keywords. Inclusion criteria consisted of original studies, studies with patients with adult spinal deformities, and studies focusing on the feasibility and/or utility of 3DP technologies in the planning or treatment of scoliosis and other spinal deformities. Exclusion criteria included studies with patients without adult spinal deformity, animal subjects, pediatric patients, reviews, and editorials.

Results:

Studies evaluating the effect of 3DP drill guide templates found higher screw placement accuracy in the 3DP cohort (96.9%), compared with non-3DP cohorts (81.5%, P < .001). Operative duration was significant decreased in 3DP cases (378 patients, 258 minutes) relative to non-3DP cases (301 patients,272 minutes, P < .05). The average deformity correction rate was 72.5% in 3DP cases (245 patients). There was no significant difference in perioperative blood loss between 3DP (924.6 mL, 252 patients) and non-3DP cases (935.6 mL, 177 patients, P = .058).

Conclusions:

Three-dimensional printing is currently used for presurgical planning, patient and trainee communication and education, pre- and intraoperative guides, and screw drill guides in the treatment of scoliosis and other adult spinal deformities. In adult spinal deformity, the usage of 3DP guides is associated with increased screw accuracy and favorable deformity correction outcomes; however, average costs and production lead time are highly variable between studies.
Spine Surgery and COVID-19: The Influence of Practice Type on Preparedness, Response, and Economic Impact
Authors: Weiner Joseph A. , Swiatek Peter R. , Johnson Daniel J. , Louie Philip K. , Harada Garrett K. , McCarthy Michael H. , Germscheid Niccole , Cheung Jason P. Y. , Neva Marko H. , El-Sharkawi Mohammad , Valacco Marcelo , Sciubba Daniel M. , Chutkan Norman B. , An Howard S. , Samartzis Dino
Published: August 2020

Study Design:

Cross-sectional observational cohort study.

Objective:

To investigate preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons.

Methods:

AO Spine COVID-19 and Spine Surgeon Global Impact Survey includes domains on surgeon demographics, location of practice, type of practice, COVID-19 perceptions, institutional preparedness and response, personal and practice impact, and future perceptions. The survey was distributed by AO Spine via email to members (n = 3805). Univariate and multivariate analyses were performed to identify differences between practice settings.

Results:

A total of 902 surgeons completed the survey. In all, 45.4% of respondents worked in an academic setting, 22.9% in privademics, 16.1% in private practice, and 15.6% in public hospitals. Academic practice setting was independently associated with performing elective and emergent spine surgeries at the time of survey distribution. A majority of surgeons reported a >75% decrease in case volume. Private practice and privademic surgeons reported losing income at a higher rate compared with academic or public surgeons. Practice setting was associated with personal protective equipment availability and economic issues as a source of stress.

Conclusions:

The current study indicates that practice setting affected both preparedness and response to COVID-19. Surgeons in private and privademic practices reported increased worry about the economic implications of the current crisis compared with surgeons in academic and public hospitals. COVID-19 decreased overall clinical productivity, revenue, and income. Government response to the current pandemic and preparation for future pandemics needs to be adaptable to surgeons in all practice settings.
Serum prolactin and CA 125 levels in uterine adenomyosis
Authors: Yorganci Ayçağ , Kadioğlu Nezaket , Gümgümcü Harika , Özyer Şebnem , Engin-Ustun Yaprak
Published: August 2020

Objective:

It is suggested that prolactin has a role in the pathogenesis of uterine adenomyosis. Besides, it is also reported that elevated cancer antigen 125 levels are related with this benign disorder. The aim of the study was to investigate serum prolactin and cancer antigen 125 levels in patients with adenomyosis.

Methods:

In this retrospective chart review study, data of patients with clinically diagnosed and histopathologically proven adenomyosis in hysterectomy specimens were analyzed. Patients were divided into two groups according to the ultrasonographically calculated preoperative uterine volume: Group 1 (n = 62): uterine volume ⩽240 cm3 (⩽12 gestational weeks) and Group 2 (n = 42): uterine volume >240 cm3 (>12 gestational weeks). Age, obstetric history, body mass index, preoperative hemoglobin, thyroid stimulating hormone, prolactin and cancer antigen 125 levels, and ultrasonographic findings were recorded. Preoperative prolactin and cancer antigen 125 values were compared between the two groups.

Results:

A total of 104 patients were included in the study. No differences in the baseline characteristics were observed between the groups, except the number of pregnancies and miscarriages. Furthermore, no significant differences were observed in terms of serum prolactin and cancer antigen 125 levels between the groups.

Conclusion:

Serum prolactin and cancer antigen 125 levels were not associated with uterine volume in patients with uterine adenomyosis.
Transient Cardiomyopathy in a Patient With Coronavirus Disease-2019
Authors: Anupama B. K. , Thapa Simant S. , Amzuta Ioana
Published: August 2020

A 66-year-old male patient with coronavirus disease-19 (COVID-19) developed cardiogenic shock with echocardiographic evidence of decreased left ventricular ejection fraction and global hypokinesia concomitant with a robust systemic inflammatory response. Following the administration of convalescent plasma therapy and inotropic support, left ventricular function recovered fully in accordance with the decrease in the concentration of the inflammatory markers. Thus, we demonstrate the presence of transient reversible cardiomyopathy in a patient with severe COVID-19 and illustrate the association of acute cardiac dysfunction with profound systemic inflammation among COVID-19 patients.
Social, Clinical, and Behavioral Determinants of HIV Infection and HIV Testing among Black Men in Toronto, Ontario: A Classification and Regression Tree Analysis
Authors: Djiadeu Pascal , Smith Martez D. R. , Kushwaha Sameer , Odhiambo Apondi J. , Absalom David , Husbands Winston , Tharao Wangari , Regan Rotrease , Sa Ting , Zhang Nanhua , Kaul Rupert , Nelson LaRon E.
Published: August 2020

Black men bear a disproportionate burden of HIV infection. These HIV inequities are influenced by intersecting social, clinical, and behavioral factors. The purpose of this analysis was to determine the combinations of factors that were most predictive of HIV infection and HIV testing among black men in Toronto. Classification and regression tree analysis was applied to secondary data collected from black men (N = 460) in Toronto, 82% of whom only had sex with women and 18% whom had sex with men at least once. For HIV infection, 10 subgroups were identified and characterized by number of lifetime male partners, age, syphilis history, and perceived stigma. Number of lifetime male partners was the best single predictor of HIV infection. For HIV testing, the analysis identified 8 subgroups characterized by age, condom use, number of sex partners and Chlamydia history. Age (>24 years old) was the best single predictor of HIV testing.
Mental Health and COVID-19: Implications for the Future of Telehealth
Authors: Pfender Emily
Published: August 2020

This article uses mental health trends during the COVID-19 pandemic to question how we can leverage current technologies such as telehealth to provide better mental health care. Based on this compilation of literature, an increase in suicide rates, suicidal ideation, and mental health disorders is possible as a result of the impact of COVID-19. By increasing the use of telehealth and investigating best practices for its use, the outcome is 3-fold. We can provide preventative measures after the COVID-19 pandemic subsides, more effective care to patients during future pandemics and global crises, and reduce mental health care disparities by reaching rural Americans.
Interprofessional Team-based Learning: Building Social Capital
Authors: Burgess Annette , van Diggele Christie , Matar Elie
Published: August 2020

Often the first-time health professionals work together is as new graduates, with a paucity of shared learning among the various health disciplines within university curricula. This is largely due to the complexities of delivering interprofessional education (IPE) and the preference of individuals to work within their established silos. With its ability to nurture collaboration among students, there is a developing trend to use team-based learning (TBL) as a teaching method to engage health care students in IPE. Using the conceptual lens of social capital theory, the purpose of this article is to provide readers with an overview and evidence for the use of TBL within the interprofessional health care education setting, highlighting the benefits and challenges.
Pseudohyperkalemia with concurrent tumor lysis syndrome in extreme leukocytosis: Diagnostic and management pitfalls
Authors: Tan Hui Zhuan , Choo Jason Chon Jun
Published: August 2020

Introduction:

Pseudohyperkalemia is a well-described phenomenon in extreme leukocytosis and thrombocytosis. Clinical recognition can be challenging, especially in the setting of coexisting disorders known to cause true hyperkalemia. We present a case of pseudohyperkalemia occurring in tandem with tumor lysis syndrome and progressive kidney injury.

Case description:

A 74-year-old gentleman was diagnosed with chronic myeloid leukemia complicated by blast crisis. Investigations demonstrated an elevated potassium result which was initially attributed to tumor lysis syndrome and acute kidney injury. Further investigations revealed underlying pseudohyperkalemia, supported by the absence of classical electrocardiographic changes of hyperkalemia. Patient was subsequently initiated on kidney replacement therapy due to progressive kidney injury with anuria. Diagnosis and management of this phenomenon is discussed.

Conclusion:

Due to the potential for harm with erroneous treatment, physicians should develop an increased appreciation for the diagnostic and management pitfalls associated with pseudohyperkalemia in hematological conditions.
Experimental study on cutting parameters and machining paths of SiCp/Al composite thin-walled workpieces
Authors: Liu Yunan , Huang Shutao , Jiao Keru , Xu Lifu
Published: August 2020

Thin-walled workpieces of silicon carbide particle-reinforced aluminum matrix (SiCp/Al) composites with outstanding properties have been widely applied in many fields, such as automobile, weapons, and aerospace. However, the thin-walled workpieces exhibit poor rigidity, large yield ratio, and easily deform under the cutting force and cutting heat during the machining process. Herein, in order to improve the processing efficiency and precision of higher volume fraction SiCp/Al composite thin-walled workpieces, the influence of different high-speed milling parameters and machining paths on the edge defects is analyzed. The results reveal that the cutting force initially increased and then decreased with the cutting speed. Besides, the cutting force steadily increased with radial cutting depth and feed per tooth, but the influence of feed per tooth is less than radial cutting depth. After up-milling cut-in and cut-out processing and down-milling cut-out processing, the cut-in end of the workpiece exhibited higher breakage and obvious edge defects. However, the workpiece edges remained intact after down-milling cut-in processing. In conclusion, a higher cutting speed, a smaller radial cutting depth, and moderate feed per tooth are required to decrease the cutting force during the milling of SiCp/Al composite thin-walled workpiece. Furthermore, down-milling cut-in processing mode can reduce the edge defects and improve the processing efficiency and precision of the workpiece.