bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smallholders and Farmworkers in Agricultural Value Chains: No Upgrading Without Collective Action and State Support
Authors: Karatepe Ismail Doga , Scherrer Christoph 
Published: July 2021

Abstract
This article presents findings from field studies of smallholders and farmworkers producing coffee, mangoes, and rice in several countries in the global South. It is one of the few comparative studies of the constraints and opportunities for social upgrading in global agricultural value chains (gvcs). We argue that the ease with which new suppliers can be found gives highly concentrated global wholesalers and retailers enormous leverage over smallholders. As a result, opportunities for social upgrading tend to be limited. Even in successful cases, it is accompanied by fewer employment opportunities. Cooperatives, which enjoy government support and enforced labor laws, are an exception. The article begins with a discussion of problems in measuring the impact of gvc participation and a theoretical explanation of why economic upgrading is not sufficient to ensure social upgrading. Special attention is given to the role of the state in promoting social upgrading.
Diagnosis of Tilted Weather Radars Using Solar Interference
Authors: Curtis Mark , Dance Sandy , Louf Valentin , Protat Alain 
Published: July 2021

AbstractFor mechanically scanning weather radars, precise pointing of the antenna is a key factor in ensuring accurate observation of the atmosphere at far range. Since operational radars typically scan the atmosphere using a series of 360° sweeps at fixed elevation angles, level scanning during azimuthal rotation is also important, but often not actively monitored after installation.One method of gauging pointing accuracy of a radar is to use solar interference which occurs as the antenna sweeps past the sun. By comparing the observed position of the sun with its known position, an estimate of pointing error in both elevation and azimuth can be obtained. A basic model for this error assumes that the radar sweep is perfectly level and that biases in elevation are therefore independent of azimuth. We extend this model to allow for the possibility that the plane of rotation may not be level. Consequently, the direction and severity of tilt may be diagnosed in addition to any constant error in elevation and azimuth pointing.The extended model was applied to a subset of radars from the Australian weather radar network resulting in the discovery of several out of level radars. One radar, Captains Flat near Canberra, showed a severe tilt of 0.81° prompting inspection by a technician. This revealed that mounting studs on the pedestal of the radar tower were badly worn and loose. Correction of this issue resolved the tilt component of the diagnosed elevation error and prevented further mechanical damage to the instrument.
Compression of the Right Atrium and Inferior Vena Cava from an Extrahepatic Biloma Following Liver Trauma
Authors: Thrash Brandon T. , Smith Alison A. , Fairchild Alexandra H. , Ustunsoz Bahri , Brown Tommy A. , Chapman Brett M. , Hunt John P. , Marr Alan B. , Stuke Lance E. , Schoen Jonathan E. , Greiffenstein Patrick P. 
Published: July 2021

A 26-year-old male presented to a Level 1 trauma center following a motorcycle crash. Workup of his injuries demonstrated a grade 5 liver laceration with active extravasation, grade 5 kidney laceration, right apical pneumothorax, and a sternal fracture. The patient underwent hepatic artery embolization with interventional radiology (IR) followed by an exploratory laparotomy, liver packing, and small bowel resection with primary anastomosis. Four days post-op, the patient developed dyspnea, tachycardia, and decreasing oxygen saturation. Computed tomography pulmonary angiography demonstrated perihepatic fluid compressing the right atrium and inferior vena cava. Percutaneous perihepatic drain placement with aspiration of 700 mL bilious fluid resulted in immediate resolution of the compression. He subsequently underwent endoscopic retrograde cholangiopancreatography (ERCP) with stenting of the ampulla nine days later. The patient was discharged ten days post-ERCP with oral amoxicillin/clavulanic acid for polymicrobial coverage and follow-up with gastroenterology and IR for stent removal and drain maintenance.
Racial Disparities in Adult Cochlear Implantation
Authors: Mahendran Geethanjeli N. , Rosenbluth Tyler , Featherstone Miriam , Vivas Esther X. , Mattox Douglas E. , Hobson Candace E. 
Published: July 2021

ObjectiveTo compare rates of cochlear implant referral and cochlear implantation across different races and to compare audiometric profiles of these patients.Study DesignRetrospective study.SettingAcademic tertiary care institution.MethodsDemographic and audiometric data were collected for patients who underwent cochlear implant evaluation or cochlear implantation from 2010 to 2020.ResultsA total of 504 patients underwent cochlear implant evaluation; 388 met cochlear implant candidacy criteria, and 258 underwent implantation. Of the patients referred for cochlear implant evaluation, 68.5% were White, 18.5% were Black, and 12.3% were Asian, while the institution’s primary service area is 46.9% White, 42.3% Black, and 7.7% Asian (P <. 001). Black patients referred for cochlear implant evaluation had significantly worse hearing (mean pure‐tone average [PTA] 84.5 dB, 26.1% word recognition) than White patients (mean PTA 78.2 dB, P =. 005; 35.7% word recognition, P =. 015) and Asians patients (mean PTA 77.9 dB, P =. 04; 36.5% word recognition, P =. 04). Black patients who underwent cochlear implant evaluation also had significantly worse AzBio scores than White patients: 24.5% versus 36.7% (P =. 003). There was no significant difference in cochlear implantation rates between Black and White candidates (P =. 06).ConclusionBlack patients undergo cochlear implant evaluation and cochlear implantation at rates disproportionately lower than expected based on local demographics. In addition, Black patients have significantly worse hearing at the time of cochlear implant referral than White and Asian patients. Identifying and increasing awareness of these disparities are essential steps to improving cochlear implant access for potentially disadvantaged populations.
Effects of Social Determinants of Health Care on Pediatric Thyroid Cancer Outcomes in the United States
Authors: Gruszczynski Nelson R. , Low Christopher M. , Choby Garret , Meister Kara D. , Smith Byron H. , Balakrishnan Karthik 
Published: July 2021

ObjectiveTo identify social determinants of health care that are associated with poorer pediatric well‐differentiated thyroid cancer (WDTC) outcomes and increased stage at presentation.Study DesignUsing the SEER database (Surveillance, Epidemiology, and End Results), we retrospectively gathered data on pediatric WDTC across the United States between 1973 and 2015.SettingAll patients between 0 and 19 years old with a diagnosis of WDTC were included.MethodsPatient variables were analyzed for relationships to AJCC stage at presentation (American Joint Committee on Cancer), overall survival, and disease‐specific survival.ResultsAmong 3913 patients with pediatric thyroid cancer, 3185 were female (81.4%), 3366 had papillary thyroid cancer (85.3%), and 367 had follicular thyroid cancer (9.4%). Two‐ and 5‐year overall and disease‐specific survival approached 100%. However, when outcomes were analyzed by specific populations, male sex, non‐Caucasian race, poverty, and language isolation were linked to worse overall survival. Male sex and poverty were associated with poorer disease‐specific survival. Regarding overall AJCC stage at presentation, male sex and Black race were related to higher overall presenting AJCC stage. Later AJCC T stage at presentation was seen in male, Hispanic, Asian, and Black patients. There were no variables significantly related to following through with recommended surgery.ConclusionPediatric WDTC continues to carry an excellent prognosis in the United States. However, when we consider specific populations, the social determinants of health care affect survival and disease burden at presentation: male sex, poverty, language isolation, and race affected survival and/or AJCC stage at presentation in pediatric WDTC.
Efficacy of magnesium sulfate as an adjuvant to rocuronium in general anaesthesia: a meta-analysis
Authors: Sun Haiyan , Jin Tao , Wu Xiping , Yang Lei , Zuo Yunxia , Liao Ren 
Published: July 2021

Objective Magnesium sulfate is considered to be an effective adjuvant to rocuronium in general anaesthesia. We conducted a meta-analysis to clarify its efficacy. Methods We searched the PubMed, Embase, Web of Science, Cochrane Library, WanFang, Chinese Biomedical Literature, and China National Knowledge Infrastructure databases for randomized controlled trials (RCTs) of magnesium sulfate as an adjuvant to rocuronium from the start of the database establishment until May 2020. Results Eleven RCTs were analysed. The pooled meta-analysis showed that using magnesium sulfate as an adjuvant significantly shortened the onset time and prolonged the clinical duration of neuromuscular blockade by rocuronium compared with the control group without magnesium sulfate. However, there was no significant difference in recovery index of neuromuscular block between the magnesium and control groups. Furthermore, magnesium sulfate significantly increased the rates of excellent and clinically acceptable intubation conditions. Conclusion Adding magnesium sulfate to rocuronium during general anaesthesia can alter the neuromuscular parameters, including shortening the anaesthesia-onset time and prolonging the clinical duration, without significantly increasing the recovery time. Pretreatment with magnesium sulfate may also improve intubation conditions during general anaesthesia.
Human sperm-associated antigen 4 as a potential prognostic biomarker of lung squamous cell carcinoma
Authors: Wang Yongheng , Tang Yao , Li Jianhui , Wang Danfang , Li Wenhan 
Published: July 2021

Objective Lung cancer (LC) is one of the most prevalent malignant tumors worldwide. As a subtype of LC, lung squamous cell carcinoma (LUSC) has a 5-year survival rate of less than 15%. In this study, we aimed to evaluate the prognostic value of a glycolysis-related gene signature in LUSC patients. Methods We obtained RNA-Seq data from The Cancer Genome Atlas (TCGA) database. Prognosis-related genes were screened out by Gene Set Enrichment Analysis (GSEA) and Cox proportional regression models. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) was used to verify the mRNA expression levels in relevant tissues. Results We found that sperm-associated antigen 4 (SPAG4) overexpression was an independent risk factor for overall survival (OS) in LUSC. Patients with high-risk scores had higher mortality rates than those with low-risk scores. Moreover, by using RT-qPCR, we validated that SPAG4 mRNA was overexpressed in LUSC tissue samples compared with their paired para-cancerous histological normal tissues. Conclusions Analysis of aberrantly overexpressed SPAG4 may provide a further useful approach to complement existing methods and predict prognosis in LUSC patients.
Lateral Extra-articular Tenodesis Alters Lateral Compartment Contact Mechanics under Simulated Pivoting Maneuvers: An In Vitro Study
Authors: Marom Niv , Jahandar Hamidreza , Fraychineaud Thomas J. , Zayyad Zaid A. , Ouanezar Hervé , Hurwit Daniel , Zhu Andrew , Wickiewicz Thomas L. , Pearle Andrew D. , Imhauser Carl W. , Nawabi Danyal H. 
Published: July 2021

Background: There is concern that utilization of lateral extra-articular tenodesis (LET) in conjunction with anterior cruciate ligament (ACL) reconstruction (ACLR) may disturb lateral compartment contact mechanics and contribute to joint degeneration. Hypothesis: ACLR augmented with LET will alter lateral compartment contact mechanics in response to simulated pivoting maneuvers. Study Design: Controlled laboratory study. Methods: Loads simulating a pivot shift were applied to 7 cadaveric knees (4 male; mean age, 39 ± 12 years; range, 28-54 years) using a robotic manipulator. Each knee was tested with the ACL intact, sectioned, reconstructed (via patellar tendon autograft), and, finally, after augmenting ACLR with LET (using a modified Lemaire technique) in the presence of a sectioned anterolateral ligament and Kaplan fibers. Lateral compartment contact mechanics were measured using a contact stress transducer. Outcome measures were anteroposterior location of the center of contact stress (CCS), contact force from anterior to posterior, and peak and mean contact stress. Results: On average, augmenting ACLR with LET shifted the lateral compartment CCS anteriorly compared with the intact knee and compared with ACLR in isolation by a maximum of 5.4 ± 2.3 mm ( P < .001) and 6.0 ± 2.6 mm ( P < .001), respectively. ACLR augmented with LET also increased contact force anteriorly on the lateral tibial plateau compared with the intact knee and compared with isolated ACLR by a maximum of 12 ± 6 N ( P = .001) and 17 ± 10 N ( P = .002), respectively. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress by 0.7 ± 0.5 MPa ( P = .005) and by 0.17 ± 0.12 ( P = .006), respectively, at 15° of flexion. Conclusion: Under simulated pivoting loads, adding LET to ACLR anteriorized the CCS on the lateral tibial plateau, thereby increasing contact force anteriorly. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress at 15° of flexion. Clinical Relevance: The clinical and biological effect of increased anterior loading of the lateral compartment after LET merits further investigation. The ability of LET to anteriorize contact stress on the lateral compartment may be useful in knees with passive anterior subluxation of the lateral tibia.
Thulium laser vapo-enucleation treatment for prostates >100 cc following urinary retention
Authors: Patel Sheena , Khan Masood A 
Published: July 2021

Introduction: Practical advantages of Thulium in the endoscopic treatment of BPH include its technical versatility, precision and safety, offering reduced need for haemostasis and risk of injury. Evidence has shown Holmium laser to be effective in the treatment of chronic retention, however no studies address the use of Thulium laser for larger prostates after urinary retention. Objectives: We have selected this group in our retrospective analysis on the efficacy of Thulium laser vapo-enucleation for men with both urinary retention and large prostate volumes greater than 100 cc. Methods: We analysed a 10-year single centre operation database of 740 Thulium vapo-enucleation of prostates. An inclusion of 47 living patients with prostates over 100 cc who have undergone the procedure following urinary retention secondary to bladder outflow obstruction (BOO) from benign prostatic hyperplasia (BPH). Patients were sub grouped into Group 1: 100–149 cc and Group 2: >150 cc. Results: Number of patients in sub groups 1 ( n = 27) and 2 ( n = 20) had mean prostate volumes of 116 and 173 cc respectively, with the largest measuring 234 cc. Mean resected volumes were 26 g (range 15–50.5 g) and 28 g (range 2–57 g). The overall trial without catheter (TWOC) pass rate for all patients in our series was 96% with comparable results between the two groups. Overall known early and late complication rates for all patients was 17% (UTI 13%, urosepsis 2%, AUR 2%) and 12.5% (failure 5%, OAB symptoms 5%, significant haematuria requiring surgical intervention 2.5%) respectively. Success of surgery was 96%, with an average follow-up of 5 months and no re-referrals for lower urinary tract symptoms following discharge. Conclusion: We show the use of Thulium laser vapo-enucleation to be safe and effective in the treatment of retention for large prostates. Results have demonstrated signs of long-term efficacy with a low failure rate.
Primary and Specialist-Level Palliative Care during the spring 2020 COVID-19 Surge: A Single-Center Experience in the Bronx
Authors: Zhang Kaleena , Shi Marc , Powell Tia , Chuang Elizabeth 
Published: July 2021

Introduction: The COVID-19 pandemic surge necessitated a rapid increase in provision of goals of care communication for patients with respiratory failure and high risk of death. We aimed to describe the outcomes and incidence of code status changes for mechanically ventilated patients in an acute care hospital after deploying strategies to enhance primary palliative care, including provision of goals of care communication scripts to front-line physicians. Methods: This is a retrospective cohort study including all patients admitted with COVID-19 disease and requiring mechanical ventilation during a 2-week period in March and April of 2020. Results: Of the 440 total patients, 327 (74.3%) died. 162 patients received a documented attempt at cardiopulmonary resuscitation (CPR) and only 4 (2.5%) of them survived. No patient above the age of 64 survived a CPR attempt. On admission, 404 patients (92.8%) were Full Code. 165 patients (37.5%) had a code status change. Almost half of the patients (n = 219) had a palliative care consult. Patients with a palliative care consult were more likely to have a code status change (56.6% v. 18.6%, χ2 = 68.0, p < 0.01). Discussion: Mechanically ventilated patients had a high mortality, and CPR did not result in survival to discharge in patients over 65. Palliative care specialists are needed to guide goals of care discussions during the COVID-19 pandemic, as there are numerous barriers to equipping primary care teams to lead such discussions. The COVID-19 pandemic has underscored the vital role of palliative care in disaster response.
OCT retinal angiography features in patients with rheumatoid arthritis: A pilot study
Authors: Iacono Pierluigi , Da Pozzo Stefano , Bedendo Alberto , Arrigo Alessandro , Parravano Mariacristina , Varano Monica , Battaglia Parodi Maurizio 
Published: July 2021

Purpose: To evaluate the superficial (SCP) and deep retinal capillary plexus (DCP) by mean of optical coherence tomography angiography (OCTA) in treatment-naïve patients affected by rheumatoid arthritis (RA). Methods: Between March 2019 and January 2020, patients with recent diagnosis of “definite RA” based on 2010 Rheumatoid Arthritis Classification Criteria were included in a Prospective, observational single center case-control study carried out at G.B. Bietti Foundation. Data were compared with those of 16 healthy age- and sex-matched subjects. Values of the vessel density (VD) of SCP and DCP, central foveal thickness (CFT), foveal avascular zone (FAZ) were collected by mean of OCTA. Main outcome measure was the VD alteration of SCP and DCP in treatment-naïve RA-patients. Results: No difference in age, sex-distribution, best-corrected visual acuity, CFT was registered between the two groups. OCTA data analysis showed in RA-patients a statistically significant reduction in the VD in the mean global area, inner ring, especially in the superior quadrant of the SCP. A trend of VD reduction was also registered in temporal, nasal, and inferior quadrants, respectively, although it did not reach a statistically significant value. Assessment of VD of DCP and FAZ area did not evidence any difference among the groups. Conclusions: OCTA allows to highlight the vascular remodeling of the retinal microcirculation in RA-patients, even in early stages of the disease, demonstrating a reduction of VD. Outcomes of the current investigation can provide new insight in the pathogenetic mechanism of RA and extend the potential applications of this diagnostic tool.
Hip hemiarthroplasty for the treatment of femoral neck fractures in dialysis patients
Authors: Lee Ryan , Lee Danny , Heyer Jessica H , Richards Stephen , Hughes Alice J , Schumer Grace B , Shincovich Christina I , Pandarinath Rajeev 
Published: July 2021

Objectives: This study sought to delineate the postoperative outcomes in dialysis patients undergoing hip hemiarthroplasty (HHA) for the treatment of femoral neck fractures (FNF) in order to better optimise pre- and postoperative management and minimise short-term morbidity and mortality rates. Methods: 16,955 patients who had undergone HHA for femoral neck fractures from 2005 to 2018 were isolated from a multi-institutional surgical registry, of which 343 (2.0%) were on dialysis and 16,612 (98.0%) were not. The cohorts were identified/analysed for differences in their comorbidities, demographic factors, and 30-day postoperative complications using Fischer’s exact tests and Mann-Whitney U-tests. Coarsened exact matching (CEM) was implemented in order to control for baseline difference in demographics and comorbidities. Multivariate logistic regression analyses were used to assess the impact of dialysis as an independent risk factor for various complications, including reoperations, readmissions, and mortality. Results: Upon CEM-matching (L1-statistic <0.001), weighted multivariate logistic regression analyses demonstrated dialysis to be an independent risk factor for minor complications (OR 3.051, p  < 0.001), pneumonia (OR 3.943, p  < 0.001), urinary tract infections (UTIs) (OR 2.684, p  < 0.001), major complications (OR 1.892, p  < 0.001), unplanned intubation (OR 2.555, p  = 0.047), cardiac arrest (OR 11.897, p  < 0.001), deep vein thrombosis (DVT), (OR 2.610, p  = 0.049), and mortality (OR 2.960, p  < 0.001). Conclusions: Dialysis independently increased the risk for unplanned intubation, cardiac arrest, blood transfusions, pneumonia, DVT, and mortality. In communicating postoperative expectations, surgeons should aim to clarify the patients’ preferences and potential resuscitation designations prior to surgical intervention due to the increased risk of serious complications. A lower threshold of suspicion for DVT in this population is reasonable. Identifying high-risk patient populations that may experience increased rates of complications, with the ensuing financial expenditures, due to medical complexity rather than subpar management may help providers avoid penalties in caring for these patients.
Catheterization of PICC through a superficial femoral vein for patients with superior vena cava syndrome using ECG positioning and ultrasound-guided technologies
Authors: Xiao Weizhu , Lin Qiuju , Chen Shuping , Li Shanshan , Lin Cuifen , Su Shaoyan , You Xiaofang 
Published: July 2021

Objective: We herein demonstrate the efficacy of PICC placement through a superficial femoral vein in patients with superior vena cava syndrome using ultrasound guidance and electrocardiographic localization. The treatment of PICC disconnection was also discussed. Methods: The study enrolled 51 patients with superior vena cava syndrome. Ultrasound-guided technology and ECG positioning technology are employed to help these patients in catheterization. The puncture time, the number of punctures, and catheter tip position were recorded. The patient was followed up for at least 2 years. The complications and treatment during follow-up were recorded. Result: The average puncture time was 32.13 ± 3.91 min. A total of 49 patients were successfully punctured once, while 2 patients failed in the first puncture. The main reason for puncture failure is that the inability of a guide wire to pass through. After the nurse removed the needle and pressed the puncture point until no rebleeding occurred, the puncture above the original puncture point was successful. X-ray examination revealed that the catheter tip was located in the inferior vena cava, above the diaphragm, near the right atrium. The success rate of catheterization was 100%. The visual analog scale (VAS) score was (2.44 ± 0.73) at the time of puncture, which was tolerable during the operation, and the patient did not complain of obvious pain following the operation. One patient developed complications of broken tube half a year after the puncture. Interventional physicians utilized angiography to locate the broken catheter. Conclusion: It is safe and feasible to place PICC through a superficial femoral vein under ultrasound combined with ECG positioning technology in patients with superior vena cava syndrome.