bluuebunny/crossref_metadata_2025_split huggingface dataset:
Studying the influence of friction stir welding parameters on the mechanical properties of PP/EPDM/Clay nanocomposites by response surface methodology combined with desirability function approach
Authors: Rezaei Gholamreza , Mostafa Arab Nasrollah Bani , Ayaz Mohsen 
Published: November 2022

The main objective of the present study is to investigate the influence of friction stir welding (FSW) parameters using a novel tool on the mechanical properties of polypropylene-ethylene-propylene diene monomer/clay (PP/EPDM/Clay) nanocomposite. The response surface method of design of experiments in combination with the desirability function approach is applied to quantify the effects of clay content, tool rotational speed, welding speed, and tool shoulder temperature on tensile strength and elongation of welded joints. It was observed that the tool rotational speed had the maximum effect on the tensile strength, while the greatest influence on the elongation was due to the tool shoulder temperature. The addition of clay nanoparticles up to 6 wt% into the PP matrix reduced the tensile strength and elongation of the weld by about 38% and 20%, respectively. Moreover, an improvement of about 45% was observed in the tensile strength when the rotational speed increased from 800 to 1600 r/min, while the tensile strength deteriorated by about 29% when the linear speed increased from 10 to 20 mm/s. A rise in shoulder temperature from 50 to 100°C was also accompanied by an enhancement in the tensile strength and elongation by 20 and 50%, respectively. Nevertheless, the desired operating conditions were found to be 0.85 wt% for clay, 1390 r/min for the tool rotational speed, 10 mm/min for the welding speed, and 100°C for the tool shoulder temperature. The fracture morphologies obtained by scanning electron microscopy (SEM) were in good agreement with corresponding tensile strength and elongation results.
Policy, professionalism and psychotherapy; the clinical practice guidelines’ dilemma
Authors: Anaf Gil , Prager Shirley 
Published: November 2022

Objective To review a rebuttal to widely published concerns that the Clinical Practice Guidelines (CPG) devalues the role of long-term psychodynamic psychotherapy as a treatment in mood disorders. Conclusion There is a wider context to this debate. The CPG presents the RANZCP with a dilemma about treatments, professionalism and policy; it requires amendment.
Reciprocal Effects of Career Adaptability and Occupational Self-Efficacy: A Three-Wave Longitudinal Study With Varying Time Lags
Authors: Volmer Judith , Spurk Daniel , Orth Maximilian , Göritz Anja 
Published: November 2022

Researchers widely agree upon the pivotal role of career self-management in vocational development. Yet, little is known about how core self-management constructs denoting agentic capacity affect each other reciprocally over time. We address the shortage of existing longitudinal change investigations by proposing and testing a reciprocal model in which career adaptability and occupational self-efficacy as core career self-management constructs are reciprocally interrelated. Cross-lagged panel analyses of three-wave data from a large and heterogeneous sample of employees indicate support for the presence of substantial reciprocal effects of career adaptability and occupational self-efficacy across time lags of three, six, and nine months. From a series of exploratory multigroup analyses, this pattern of results emerges as robust across a range of sociodemographic variables, including gender, age, education, leadership position, and organizational tenure. Moreover, the results remained stable after considering further controls (e.g., future temporal focus, grade point average). Our findings broaden the scope of dynamic vocational research by demonstrating the utility of a change-oriented approach in elucidating the emergence of individuals’ career self-management. We discuss practical implications concerning career intervention strategies, study limitations, and prospects for future research.
Leaf Extract and Active Fractions of Dillenia pentagyna Roxb. Reduce In Vitro Human Cancer Cell Migration Via NF-κB Pathway
Authors: De Debapriya , Chowdhury Priyanka , Panda Sujogya Kumar , Ghosh Utpal 
Published: November 2022

Background: Different parts of Dillenia pentagyna have long been used in traditional medicines to cure several diseases including cancer. However, the mechanism(s) of anti-cancer effects are still unknown. We aimed to elucidate the anti-metastatic potential of ethanolic extracts of leaves of D. pentagyna (EELDP) and active fractions of it in highly metastatic human cancer cells. Methods: We screened different HPLC fractions of EELDP based on their anti-metastatic effect. We used TLC and ESI-MS for determining the presence of various phytochemicals in EELDP and fractions. We monitored in vitro anti-metastasis effect of EELDP (0-0.6 mg/ml) and active fractions (0-0.050 mg/ml) on various human cancer cells like A549, HeLa, and U2OS. Results: EELDP significantly reduced cell viability and cell migration in A549, HeLa, and U2OS cells. However, higher sensitivity was observed in A549 cells. We screened 2 active HPLC fractions F6 and F8 having anti-MMPs activity. EELDP and active fractions reduced metastasis via the NF-κB pathway, decreased the expression of Vimentin, N-cadherin, and increased the expression of Claudin-1. Conclusion: Significant reduction of metastasis by EELDP at a dose of 0.1 mg/ml or by active fractions at 0.050 mg/ml implicates that the active compound(s) present in crude or fractions are extremely potent to control highly metastatic cancer.
Impact of the COVID-19 pandemic on cardiovascular heart disease medication use: time-series analysis of England’s prescription data during the COVID-19 pandemic (January 2019 to October 2020)
Authors: Barrett Ravina , Hodgkinson James 
Published: November 2022

Background: Management of high blood pressure (BP) typically requires adherence to medication regimes. However, it is known that the COVID-19 pandemic both interrupted access to some routine prescriptions and changed some patient health behaviours. Aim: This study, therefore, retrospectively investigated prescription reimbursement of cardiovascular (CVD) medicines as a proxy measure for patient adherence and access to medicines during the pandemic. Methods: A cohort study of all primary care patients in England prescribed CVD medicines. The exposure was to the global pandemic. Prescriptions were compared before and after the pandemic’s onset. Statistical variation was the outcome of interest. Results: Descriptive statistics show changes to monthly prescriptions, with wide confidence intervals indicating varying underlying practice. Analysis of variance reveals statistically significant differences for bendroflumethiazide, potassium-sparing diuretics, nicorandil, ezetimibe, ivabradine, ranolazine, colesevelam and midodrine. After the pandemic began (March–October 2020), negative parameters are observed for ACE inhibitors, beta-blockers, calcium channel blockers, statins, antiplatelet, antithrombotics, ARBs, loop diuretics, doxazosin, bendroflumethiazide, nitrates and indapamide, indicating decelerating monthly prescription items (statistically significant declines of calcium channel blockers, antithrombotic, adrenoreceptor blockers and diuretics) of CVD medicines within the general population. Many data points are not statistically significant, but fluctuations remain clinically important for the large population of patients taking these medications. Conclusion: A concerning decline in uptake of CVD therapies for chronic heart disease was observed. Accessible screening and treatment alongside financial relief on prescription levies are needed. A video abstract is (4 min 51 s) available: https://bit.ly/39gvEHi
Hip morphology on initial ultrasound predicts hip morphology at one year in developmental dysplasia of the hip
Authors: Kanakamedala Ajay C , Jejurikar Neha S , Castañeda Pablo 
Published: November 2022

Purpose: This study aimed to determine whether point-of-care ultrasound performed during the Pavlik method treatment of developmental dysplasia of the hip predicts acetabular morphology at 12 months of age. Methods: We reviewed the medical records, ultrasounds, and radiographs of patients treated successfully with the Pavlik method between 2017 and 2019. We performed sonographic measurements on point-of-care ultrasound at the initial presentation, the Pavlik discontinuation, and an additional sonographic follow-up. We measured the acetabular index on a plain anteroposterior radiograph of the pelvis obtained at a minimum of 12 months of age. Spearman’s rank correlation coefficient was used to analyze for correlation between sonographic measurements and the acetabular index. Results: A total of 72 patients were included in the final analysis. There were no residual or late dysplasia cases at the last radiographic follow-up (mean age = 14.8 ± 2.7 months). Sonographic parameters at the initial presentation significantly correlated with the acetabular index at the final radiographic follow-up (p < 0.001). Patients with worsening degrees of developmental dysplasia of the hip based on stability on sonographic testing (stable, unstable, or dislocated) had higher acetabular indices at the final radiographic follow-up (p < 0.05). Conclusion: Point-of-care ultrasound at initial presentation and the Pavlik discontinuation significantly correlate with acetabular morphology at 1–1.5 years of age. At initial presentation, hips that were unstable or dislocated on point-of-care ultrasound had significantly greater acetabular indices than stable hips at the final follow-up. Level of evidence: level IV case series.
The hard truth about soft skills: Exploring the association between leadership competency and career advancement of allied health professionals
Authors: Koh Jeremy Meng-Yeow , Ang Hui-Gek , Lee Jeffrey , Pua Yong-Hao 
Published: November 2022

Backgroud: Globally, employee engagement in healthcare organisations is low, with career advancement one of its main determinants. It may be useful for healthcare organisations to determine the factors of career advancement, to guide them to more effectively engage their workforce. Leadership competency is factor that may be crucial in influencing career advancement for healthcare employees. To our knowledge, a comprehensive analysis on its impact on the perception of career advancement within the healthcare setting has not been conducted. Research Design: An ecological, cross-sectional study was conducted, aimed at examining the association between leadership competency of healthcare professionals and perceptions of career advancement. Poisson generalized-estimating-equation models were fitted to estimate the adjusted rate ratios with bootstrap 95% confidence intervals for the associations of the AHEAD items with the number of favourable responses on the career advancement items. In each model, we accounted for clustering by departments and controlled for length of service as a confounder. Results: Statistically significant predictors of perception of career advancement were found, and included skills - Interpersonal Skills (aRR 1.53 CI 1.12–2.96), Motivating (aRR 1.31 CI 1.10–2.16), and Mentoring (aRR 1.30 CI 1.08–1.13); and values - Compassion (aRR 1.37 CI 1.17–3.40), and Collegiality (aRR 1.31 CI 1.00–1.99). Conclusion: Our findings show an association between some components of leadership competency and the perception of career advancement. These results provide initial evidence that apart from hard skills, soft skills may play an equally (or more important) role in influencing the perception of career advancement.
Pedicled dorsal penile skin tube as neourethra in total penectomy for primary male urethral carcinoma
Authors: Yepes Christian , Bandini Marco , Joshi Pankaj M , Alrefaey Ahmed A , Bhadranavar Shreyas , Bafna Sandeep , Kulkarni Sanjay B 
Published: November 2022

Background: The aim of this article is to present our experience of pedicled dorsal penile skin tube as neourethra after radical penectomy due to invasive primary male carcinoma of anterior urethra. Methods: This is an observational descriptive study including seven men with primary urethral carcinoma who underwent radical penectomy between 2018 and 2021. Instead of urinary derivation with suprapubic catheter, perineal urethrostomy, or bladder orthotopic/heterotopic reconstruction, patients underwent reconstruction of the anterior urethra with a pedicled dorsal penile skin tube. In brief, before corpora amputation and radical urethrectomy, the dorsal penile skin is preserved to reconstruct the neourethra. The distal end of the skin is anastomosed with the proximal urethral stump (usually membranous urethra) to assure continuity of the urinary tract, without jeopardising urinary continence. Finally, the flap is tubularized with two layers of watertight running sutures. Results: Median age was 50 (35–70) years. Histology revealed squamous cell carcinoma in all patients. Almost 100% of patients presented locally advanced (pT3–4, G3) disease and received perioperative chemotherapy (MVAC). The median follow-up was 10 (5–24) months. Median operative time was 230 min (190–315). There were not severe (Clavien–Dindo III–IV) perioperative complications. All patients were able to void in standing position through the reconstructed neourethra. No patients reported post-operative incontinence. Two patients died after 8 and 11 months from surgery. Conclusion: This new technique of using the dartos-based dorsal penile skin tube urethroplasty offers the possibility to void in standing position after radical penectomy with no need of urinary derivations. Level of evidence: Not applicable.
Juvenile hyperinsulinism in a Maine Coon kitten
Authors: Kornya Matthew , Abrams-Ogg Anthony , Comeau Dominique , Caswell Jeff 
Published: November 2022

Case summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabolism (ie, storage diseases and urea cycle disorders), infection or iatrogenic hypoglycemia were negative. An inappropriately high serum insulin level was noted in the face of marked hypoglycemia. The insulin:glucose ratio was 0.44 (<0.3) and the amended insulin:glucose ratio was 1268 (<30). Thoracic radiography and abdominal ultrasonography did not identify a cause for this elevated insulin level. Stabilization with a low, but adequate, blood glucose occurred with corticosteroid therapy, with further significant improvement with the addition of diazoxide. Peripheral neuropathy developed several months later, and concerns for quality of life led to humane euthanasia approximately 1 year after the initial diagnosis. Insulin levels remained high at the time of euthanasia. Necropsy found no gross lesions, though microscopic degeneration of the sciatic nerve and subjectively mildly increased size and number of pancreatic islets was noted. These findings were consistent with a diagnosis of congenital hyperinsulinism. Relevance and novel information This is the first reported case of congenital hyperinsulinism in a cat and may parallel the diffuse form of hypoglycemic hyperinsulinism reported in humans and a single dog. It should be considered a differential diagnosis in kittens presenting for refractory hypoglycemia.
Profiles of resilience in multiple sclerosis family care-partners: A Canadian cross-sectional study
Authors: Cardwell Katherine , McKenna Odessa , Steffener Jason , Pilutti Lara , Fakolade Afolasade 
Published: November 2022

Background Psychological resilience may play an important role in protecting multiple sclerosis care-partners from the negative effects of their support role. However, predictors of resilience in this population have yet to be identified. Objectives To identify characteristics predictive of psychological resilience in multiple sclerosis care-partners as informed by the Ecological Model of Resilience. Methods Informal multiple sclerosis care-partners ( n = 540) completed an online survey. Psychological resilience was measured using the 25-item Connor-Davidson Resilience Scale. Sociodemographic and care-context predictors of resilience were analyzed using hierarchical regression. Results The mean resilience score was 59.0 ( SD = 7.6) out of a possible 100. Sociodemographic variables accounted for 31% of the variance in resilience scores in multiple sclerosis care-partners. When care-context variables were incorporated into the model, 55% of variance was explained ( F[7,320] = 26.824, p < 0.001). Each group of variables remained significant in both low disability and high disability models. Social support was the only individual variable that remained significant across all models ( p < 0.05). Conclusions Multiple sclerosis care-partners differ strikingly from other caregiving populations. Both sociodemographic and care-context variables were found to promote or hinder resilience in multiple sclerosis care-partners. Social support, in particular, may be an important target for promoting resilience in multiple sclerosis care-partners and could be leveraged in future initiatives.
High-Demand Spinal Deformity With Multi-Rod Constructs and Porous Fusion/Fixation Implants: A Finite Element Study
Authors: Panico Matteo , Chande Ruchi D. , Lindsey Derek P. , Maria Tobia Villa Tomaso , Yerby Scott A. , Brayda-Bruno Marco , Bassani Tito , Polly David W. , Galbusera Fabio 
Published: November 2022

Study Design Basic science (finite element analysis). Objectives Pedicle subtraction osteotomy (PSO) at L5 is an effective treatment for sagittal imbalance, especially in select cases of patients showing kyphosis with the apex at L4-L5 but has been scarcely investigated. The aim of this study was to simulate various “high-demand” instrumentation approaches, including varying numbers of rods and sacropelvic implants, for the stabilization of a PSO at L5. Methods A finite element model of T10-pelvis was modified to simulate posterior fixation with pedicle screws and rods from T10 to S1, alone or in combination with an L5 PSO. Five additional configurations were then created by employing rods and novel porous fusion/fixation implants across the sacroiliac joints, in varying numbers. All models were loaded using pure moments of 7.5 Nm in flexion-extension, lateral bending, and axial rotation. Results The osteotomy resulted in a general increase in motion and stresses in posterior rods and S1 pedicle screws. When the number of rods was varied, three- and four-rod configurations were effective in limiting the maximal rod stresses; values approached those of posterior fixation with no osteotomy. Maximum stresses in the accessory rods were similar to or less than those observed in the primary rods. Multiple sacropelvic implants were effective in reducing range of motion, particularly of the SIJ. Conclusions Multi-rod constructs and sacropelvic fixation generally reduced maximal implant stresses and motion in comparison with standard posterior fixation, suggesting a reduced risk of rod breakage and increased joint stability, respectively, when a high-demand construct is utilized for the correction of sagittal imbalance.
Intra-articular Injection of Mesenchymal Stem Cells After High Tibial Osteotomy: A Systematic Review and Meta-analysis
Authors: Jin Lingpeng , Yang Guang , Men Xiaoqian , Zhang Jian , Chen Zhen , Li Zhongwei , Li Yusheng , Ma Jun , Dong Jiangtao 
Published: November 2022

Background: Multiple studies have investigated the use of mesenchymal stem cells (MSCs) for patients undergoing high tibial osteotomy (HTO), and the effectiveness thereof remains controversial. Purpose: To analyze the effectiveness of intra-articular MSC injection in patients who underwent HTO in terms of clinical outcomes, radiological outcomes, and cartilage repair by a meta-analysis of the available literature. Study Design: Systematic review; Level of evidence, 3. Methods: The electronic databases of PubMed, Embase, Web of Science, and the Cochrane Library were searched from their inception to October 30, 2021, for comparative studies between patients who underwent HTO with and without intra-articular injection of MSCs, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study quality was assessed by the Coleman Methodology Score (CMS). Data with comparable results were pooled for meta-analysis. The primary outcomes of interest were the Hospital for Special Surgery (HSS), International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), and Lysholm scores, as well as the International Cartilage Regeneration & Joint Preservation Society (ICRS) grade of cartilage repair. Radiological outcomes including femorotibial angle, posterior tibial slope, and hip-knee-ankle (HKA) angle were included as secondary outcomes. A fixed-model effect was used for meta-analyses with low heterogeneity between studies ( I 2 < 25%), while the random-model effect was used for medium- to high-heterogeneity analyses ( I 2 ≥ 25%). Results: A total of 843 studies were screened, of which 6 studies with 452 patients met the inclusion criteria and were included. The mean CMS was 81.17. Patients with MSC injection had significantly higher Lysholm scores ( P = .007) and HSS scores ( P = .01) and higher proportions of ICRS grade 1 ( P = .03) and grade 2 ( P = .02) cartilage repair in the medial femoral condyle and grade 2 cartilage repair in the tibial plateau ( P = .04). There were no significant differences between groups in the IKDC score, KOOS Pain and Symptoms subscales, femorotibial angle, posterior tibial slope, or HKA angle. Conclusion: Intra-articular MSC injection may enhance the cartilage repair for patients who undergo HTO. However, evidence of improvement in knee functions remains limited. Registration: CRD42021291345 (PROSPERO).
Health economic perspective on a community-based intervention for older people at risk of care dependency – results of a prospective quasi-experimental study
Authors: Lampe David , Hasemann Lena , Nebling Thomas , Thiem Ulrich , Greiner Wolfgang 
Published: November 2022

This prospective, quasi-experimental study aims to compare healthcare resource utilization (HCRU) and costs of a multi-component care approach for older people in a community setting (intervention group (IG)) with usual care in a matched control group (CG) during a 21-month observation period. The reablement-oriented intervention included a geriatric assessment, a case and network management and digital supporting tools. Regression models were applied to determine intervention effects regarding hospitalization, total hospital length of stay (LOS), number of physician consultations, and healthcare costs using claims data. 872 subjects were included in the IG and 1,768 in the CG. The analyses showed that the intervention did not affect hospitalization ( OR = 1.153; 95% CI: 0.971–1.369, p = .105). However, participating in the IG lead to a small but significant increase of physician contacts by a factor of 1.078 (Exp( ß) = 1.078; 95% CI: 1.011–1.149; p = .022). A non-significant mean difference in costs of €1,183 (95% CI: €−261.6 to €2,627.6, p = .108) per participant was identified. Further research is needed to generate robust evidence on the optimal design of care approaches for older people and the health economic implications of such interventions to improve care and resource allocation decision-making. Trial registration: The study was registered at the German Clinical Trials Register (DRKS00027866).