bluuebunny/crossref_metadata_2025_split huggingface dataset:
What’s in a Pinch: A Closer Look at Lower Eyelid Pinch Blepharoplasty
Authors: Roelofs Kelsey A. , Soriano Teresa , Smart Chandra , Cohen Liza M. , Diniz Stefania B. , Chen Teresa , Goodyear Kendall , Karlin Justin N. , Goldberg Robert A. , Rootman Daniel B. 
Published: July 2022

Introduction: The skin pinch technique is generally thought to excise a skin-only specimen, with minimal damage to the underlying orbicularis oculi muscle. The purpose of this study was to assess for the presence and quantity of muscle excised during routine lower eyelid pinch blepharoplasty. Methods and Materials: Horizontal tissue sectioning (Mohs technique) with histologic circumferential peripheral and deep margin assessment was employed to allow for evaluation of the entire deep margin of the pinch specimen. Hematoxylin and eosin slides were examined. The presence of and total surface area of skeletal muscle were calculated. Results: Ten pinch blepharoplasty specimens with a mean surface area of 70.6 ± 29.0 mm2 were evaluated. Overall, 90% (9/10) of specimens had at least 1 quadrant with muscle. On average, 3 ± 3% (range 0%-9%) of the total pinch specimen surface area contained muscle. There was a strong positive correlation between the size of skin excision and the percentage of surface area with muscle (Pearson correlation: 0.942; P < .001). Discussion: In the majority of cases, the amount of muscle excised during pinch blepharoplasty is negligible; however, larger skin excisions may be expected to result in disproportionately greater muscle resection. Conclusions: The lower eyelid pinch blepharoplasty technique is an effective method of excising redundant skin with minimal resection of orbicularis muscle.
Personality and limitations in instrumental activities of daily living in old age: Reciprocal associations across 12 years
Authors: Chereches Flavia S. , Brehmer Yvonne , Olaru Gabriel 
Published: July 2022

Personality traits have been reported to predict difficulties in performing instrumental activities of daily living (IADL) in old age, such as preparing meals or shopping. However, little is known about the reciprocal effects on personality. In this study, we examined bidirectional relationships between personality traits and the capacity to perform IADL using four waves of longitudinal data from 3540 older adults (aged 65 years and older) from the Health and Retirement Study. We applied a random-intercept cross-lagged panel model to separate between- and within-person effects across time and compared it to a traditional cross-lagged panel model. At the between-person level, higher neuroticism and lower conscientiousness were associated with more IADL limitations. Within individuals across time, increases in neuroticism and decreases in conscientiousness and extraversion were associated with increases in IADL limitations 4 years later. In contrast, increases in IADL limitations only predicted increases in neuroticism and decreases in extraversion. These results indicate that some personality traits affect and are affected by limitations in functional capacities in old age. Results of the within-person model build a strong foundation for future personality interventions as a pathway to maintain high functioning in old age.
Successful Co-Lactation by a Queer Couple: A Case Study
Authors: Schnell Alyssa 
Published: July 2022

Introduction: With cultural and social evolution and improvements in reproductive technology, an increasing number of babies are born to lesbian, gay, bisexual, transgender, intersex, queer and/or questioning, and asexual and/or ally parents. As parental roles and gender expression become more expansive, the role of breastfeeding a baby must naturally also expand to include the option of sharing of breastfeeding among parents, called co-lactation (Bamberger & Farrow, 2021). In most cases, co-lactation involves a gestational parent and a non-gestational parent. If a non-gestational parent desires to produce milk for the purpose of breastfeeding, they do so by inducing lactation. While interest in and research about induced lactation are developing quickly, little information is currently available about co-lactation. Main Issue: A couple identifying as queer presented with concerns about inducing lactation in the non-gestational parent, as well as seeking assistance in managing a successful sharing of the breastfeeding relationship. Management: Breast massage, milk expression, acupuncture, hormone therapy, and galactagogues, including domperidone, goat’s rue, and malunggay ( moringa oleifera) were used to initiate and establish lactation by the non-gestational parent. Parents shared the breastfeeding relationship equally and carefully managed milk expression when the other parent was breastfeeding to maintain or increase lactation. Conclusion: With professional lactation support, commitment to a lactation plan, responsive parenting, and strong communication and cooperation between parents, two parents were able to successfully co-lactate for more than a year. Breastfeeding was shared equally and supplementation of breastfeeds was rarely needed.
Nano-enhanced sulfonated poly(arylene ether sulfone) composite membranes and their characterization
Authors: Venkatachalam Kaarthick Raaja , Gautham Sachin M.B , Anegondi Nateri Achyuth , Nambi Krishnan Jegatha 
Published: July 2022

Chlorine is a widely used oxidizing agent in desalination to control bacteria that cause biofouling. The lack of chlorine resistance in commercial desalination membranes urged the development of an alternate polymer material. In this study, commercially available copolymer (SES0005, AquafoneTM), resistant to dissolved chlorine in water, has theoretical IEC of 2.08 meq.g-1 is blended with 0.5-15 %(w/w) TiO2 nanoparticles of <25 nm diameter and 45-55 m2.g-1 surface area by using ball milling device. SEM-EDS (Scanning Electron Microscope-Energy Dispersive Spectroscopy) result supports TiO2 content and uniform distribution. The chlorine stability of membranes was evaluated in sodium hypochlorite solution from 100 to 2000 ppm (pH 9). TGA and FT-IR analysis were performed for these membranes. The 1.5 %(w/w) TiO2 nano-enhanced membrane water retention is 23 % which is ∼53 % higher than that of pristine (15 %) membrane. Tensile strength of pristine and 0.5 %(w/w) TiO2 nano-enhanced membrane is 23, and 44 MPa, respectively. TiO2 nanoparticle addition improved dimensional and mechanical properties. This study attempts to correlate the SES polymer-TiO2 interactions with the characterization techniques.
Augmenting Osteochondral Autograft Transplantation and Bone Marrow Aspirate Concentrate with Particulate Cartilage Extracellular Matrix Is Associated With Improved Outcomes
Authors: Drakos Mark C. , Hansen Oliver B. , Eble Stephanie K. , Kukadia Saanchi , Cabe Taylor N. , Kumar Prashanth , Patel Karan A. , Sofka Carolyn M. , Deland Jonathan T. 
Published: July 2022

Background: Osteochondral autograft transplant (OAT) is often used to treat large osteochondral lesions of the talus and is generally associated with good outcomes. The addition of adjuncts such as cartilage extracellular matrix with bone marrow aspirate concentrate (ECM-BMAC) may further improve the OAT procedure but have not been thoroughly studied. We hypothesized that the placement of ECM-BMAC around the OAT graft would improve radiographic and patient-reported outcomes following OAT. Methods: Patients who received OAT, with ECM-BMAC or BMAC alone, were screened and their charts were reviewed. For patients who did receive ECM-BMAC, the mixture was spread around the edges of the OAT plug and into any surrounding areas of cartilage damage. Survey and radiographic data were collected. Average follow-up in both groups was over 2 years. Magnetic resonance imaging scans were scored using the Magnetic Resonance Observation of Cartilage Tissue (MOCART) system. Outcomes were compared statistically between groups. Results: Patients treated with ECM-BMAC (n = 34) demonstrated significantly greater improvement of scores in the FAOS categories Symptoms (17 vs −3; P = .02) and Sports Activities (40 vs 7; P = .02), and the MOCART category Subchondral Lamina ( P = .008) compared to those treated with BMAC alone (n = 30). They also experienced significantly lower rates of postoperative cysts (53% vs 18%, P = .04) and edema (94% vs 59%, P = .02). Conclusion: The addition of ECM-BMAC to OAT was associated with improved imaging and clinical outcomes compared to OAT with BMAC alone.
Qualification of non-pediatric ophthalmologists in examining children
Authors: Mezad-Koursh Dapha , Skaat Alon , Davidov Bar , Manaim Tova , Leshno Ari 
Published: July 2022

Background This study is aimed to evaluate the clinical approach of non-pediatric ophthalmologists, working in community-based clinics towards Pediatric Patients and their management including referral rates to Pediatric Ophthalmologists and Orthoptists. Methods an online survey was sent to all community ophthalmologists through national society and social media platforms. The questionnaire included questions regarding the responders’ professional experience as well as regarding the responders’ approach to children younger than 8 years, and the level of confidence in 4 main aspects of children’s management and referral rates. Results 93 physicians working as general ophthalmologists completed the questionnaire. Most respondents have been in practice for over 10 years (64/93, 68.8%) and over two-thirds were also hospital affiliated (65/93, 69.1%). The responders estimated on average that 35.1 ± 29.6% of patients under 8 years of age are referred for a consult to a pediatric ophthalmologist The level of confidence of three aspects unique to Pediatric Ophthalmology; cycloplegic refraction, strabismus evaluation, and prescribing glasses were significantly lower ( p < 0.01) than confidence in performing a basic eye exam. Conclusions many Ophthalmologists do not feel fully capable or experienced to perform the appropriate tests for the pediatric population, especially during the critical timeframe, before 8 years of age. The very high rate of referrals stands in contradiction to the reported low rate of eye pathologies in the pediatric population. These findings suggest that more pediatric-specific training is needed to improve the physician’s skills to perform a comprehensive evaluation of pediatric patients in order to reduce the referral burden.
Explicit and implicit attachment representations in cognitively able school-age children with autism spectrum disorder: A window to their inner world
Authors: Giannotti Michele , Bentenuto Arianna , Venuti Paola , de Falco Simona 
Published: July 2022

The few studies available on quality of attachment in school-age children with autism spectrum disorder (ASD) exclusively used questionnaires assessing explicit attachment representations. Thus, in the current study we assessed both explicit and implicit attachment representations in 23 children with ASD (without intellectual disability), 22 with learning disabilities and 27 with typical development aged from 7 to 13 years. A self-reported measure on the quality of attachment to parents and a semi-structured interview were administered to the children. In addition, a developmental assessment of the child including measures of intelligence and social-communication impairment was conducted. Despite the lack of group differences on explicit attachment representations, we found that children with ASD showed higher rates of at-risk self-protective strategies and psychological trauma compared to the TD group. Children with SLD also showed a high level of at-risk implicit attachment representations than TD, albeit to a lesser extent compared to children with ASD. These results may be related to several factors associated with ASD impairment and developmental pathways, such as the atypical learning process which occur at interpersonal level, the difficulties in social information processing and reflective functioning. Our findings suggested that children with ASD may experience difficulties in the construction of balanced implicit attachment representations. Thus, a more comprehensive assessment of attachment including both implicit and explicit representations is recommended.
Child protection investigations by private consultants or municipally employed social workers: What are the differences for children?
Authors: Bergman Ann-Sofie , Arnesson Kerstin , Berggren Ulrika Järkestig 
Published: July 2022

Summary In Sweden, a practice has developed where the social services have started to hire private consultants in child protection investigations. This article analyses and compares the handling of child protection investigations carried out by private consultants and municipally employed social workers with regard to the reasons for the reports, the investigations, the assessments, and the decisions taken about interventions. The concepts funnel and filtering and children's participation are used in the analysis. The study has a mixed-methods design, where qualitative and quantitative data and analysis are combined and integrated. Data consists of 120 case files regarding the social service's handling of investigations as well as interviews with managers of social service departments. Findings The results show several differences in the handling of child protection investigations carried out by social workers and private consultants in the municipalities studied. The private consultants worked to a greater extent with investigations that were initiated due to concerns about violence. Investigations conducted by consultants contained less information and specifically concerning children's perspective. These children also received interventions to a lesser extent than children assessed by the municipal social workers. Application The study indicates that from a child’s perspective, it matters whether a municipally employed social worker or a private consultant performs an investigation. Consultants generally work temporarily in a workplace, and it may therefore be more difficult to establish a trusting relationship with the children, which can be a barrier to children's participation and the implementation of a child’s perspective.
Reliability of Assessing Distal Radius Fractures on a Smartphone Versus PACS
Authors: Adams Alexander J. , Miller Andrew , Tan Emily , Shin Eon K. , Tosti Rick 
Published: July 2022

Background: Communication between health care providers is becoming more intertwined with technology. During the pandemic, telehealth strategies grew exponentially. Remote viewing of imaging on a smartphone may offer efficient communication; however, the reliability of injury assessment when compared with traditional methods is not known. The purpose of this study was to evaluate intraobserver and interobserver reliability of distal radius fracture radiograph review for smartphone versus traditional Picture Archiving and Communication System (PACS). Methods: Eight evaluators (3 attending hand surgeons, 3 hand surgery fellows, 2 orthopedic residents) evaluated 26 distal radius fracture radiographs on 2 different viewers: smartphone or PACS. The reviewers were asked to record: (1) operative or nonoperative preference; (2) fracture classification (based on Fernandez and Jupiter); and (3) treatment strategy (volar plate, dorsal plate, pins, cast, bridge plate, or fragment-specific fixation). The percentage of intraobserver agreement was recorded for each observer. Reliability was calculated using Fleiss’ kappa coefficient for intraobserver and interobserver agreement and graded by strength of correlation. Results: Intraobserver agreement averaged 97% when deciding between operative and nonoperative treatment, 76% for classification, and 84% for treatment. Kappa scores were graded as “excellent” for operative decision and “substantial” for classification and treatment. Attendings and fellows generally had higher agreement than that of residents. Interobserver agreement was graded as “substantial” for all categories for both PACS and smartphone. Conclusions: Evaluation of radiographs on a smartphone for the purpose of treating distal radius fractures does not appear to be significantly different from an evaluation on traditional PACS.
Exercise interventions to reduce anxiety in mid-life and late-life anxiety disorders and subthreshold anxiety disorder: a systematic review
Authors: Chong Terence W.H. , Kootar Scherazad , Wilding Helen , Berriman Sarah , Curran Eleanor , Cox Kay L. , Bahar-Fuchs Alex , Peters Ruth , Anstey Kaarin J. , Bryant Christina , Lautenschlager Nicola T. 
Published: July 2022

Background: Anxiety disorders are highly prevalent and cause significant distress, disability, and cost. Medication adverse effects and interactions increase in mid-life and late-life, highlighting the need for effective non-pharmacological interventions. Objectives: We aimed to evaluate the extent of evidence supporting exercise interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. Design: Systematic review. Data Sources and Methods: We searched MEDLINE, PsycINFO, Embase, Emcare, Ovid Nursing, CINAHL Plus, Cochrane Library, Health Collection, Humanities & Social Sciences Collection, and https://clinicaltrials.gov databases for trials published January 1994–May 2019. Randomised controlled trials of exercise interventions involving aerobic exercise or resistance training for adults aged 40 years and above with anxiety or subthreshold anxiety disorders in residential or health settings were identified. The primary outcome was change in anxiety. We excluded trials including participants aged below 40 years, participants with diagnosis of separation anxiety, selective mutism, obsessive-compulsive disorder, acute stress disorder and post-traumatic stress disorder, and head-to-head comparisons of interventions. Trial quality was assessed using the Cochrane Risk of Bias Tool and evidence synthesised in narrative form. Results: Four trials totalling 132 participants met inclusion criteria, although some had methodological limitations. Interventions included a home-based resistance training intervention, supervised group-based aerobic intervention, Tai Chi intervention, and supervised group-based aerobic and strength intervention. Three trials included late-life participants and the fourth mid-life. Three trials demonstrated greater reductions in anxiety in the intervention group compared with control. The fourth trial showed pre–post reductions in anxiety in both groups, with between-group difference not reaching statistical significance. Conclusion: There is limited supportive evidence suggesting that exercise interventions have potential to be effective, feasible and safe non-pharmacological interventions for anxiety and subthreshold anxiety disorders in mid-life and late-life. The heterogeneity, limited number and high risk of bias of some trials meant that we were not able to conduct a meta-analysis. Tailoring of interventions may improve uptake and reduce dropout. The paucity of research in this area with only four included trials demonstrates the urgent need for future and larger trials to provide proof of concept, data about effective types and doses of exercise interventions, and guidance to community, clinical, and public health services.
Learning by Researching: Achievements and Actions of Teacher Learning in a School–University Collaborative Project
Authors: Wei (魏戈) Ge , Chung (钟启旸) Chi-yang 
Published: July 2022

Purpose This study explores the achievements and process of a group of Chinese primary school teachers learning from a research-based school–university collaborative project. Design/Approach/Methods We used qualitative methods to construct our research design, collecting data through participatory observations of weekly meetings, teacher interviews, and participants’ reflective journals. Both thematic analysis and discursive analysis were employed as strategies to scrutinize the data. Findings We categorize teachers’ learning into five achievements: outcome, processual, democratic, catalytic, and dialogic achievement. A further examination highlights seven successive learning actions composing an implicit mechanism to facilitate these achievements: questioning, analyzing, modeling, examining, implementing, reflecting, and consolidating. Originality/Value Through this longitudinal study, we more comprehensively record details about teachers’ learning as they conduct their own research. Although school–university heterogeneous collaboration has potential conflicts, teachers can improve their problem-solving and knowledge creation and sharing abilities, promoting a sense of professional accomplishment. These findings also suggest the need to reconsider the authentic process of teacher research, a task equally significant for international educators.
Acute Vertebral Fractures in Skiing and Snowboarding: A 20-Year Sex-Specific Analysis of National Injury Data
Authors: Huffman William H. , Jia Lori , Pirruccio Kevin , Li Xinning , Hecht Andrew C. , Parisien Robert L. 
Published: July 2022

Background: The epidemiology of acute vertebral fractures (AVFs) sustained while skiing and snowboarding remains poorly defined in the United States. Hypothesis: It was hypothesized that there would be no significant differences across sex and a greater number of AVFs in younger age groups associated with skiing and snowboarding. Study Design: Descriptive epidemiological study. Methods: The authors utilized the National Electronic Injury Surveillance System to identify patients who were reported in emergency departments in the United States from 2000 to 2019. All patients were noted to have sustained AVFs during skiing or snowboarding. National estimates and demographic analysis were performed. Results: A total of 466 AVFs were identified, or roughly 23.3 AVFs per year. Compared with women, men accounted for the majority of AVFs sustained in both skiing and snowboarding: 67.8% (95% CI, 62.6%-73.0%) during skiing and 82.1% (95% CI, 76.3%-87.8%) during snowboarding. This represented a significantly larger percentage of AVFs while snowboarding compared with skiing ( P = .002). Women accounted for 32.2% (95% CI, 27.0%-37.4%) of AVFs while skiing and 17.9% (95% CI, 12.2%-23.7%) while snowboarding, which indicated a significantly larger percentage of AVFs sustained during skiing compared with snowboarding ( P = .002). Snowboarders were more likely than skiers to sustain an AVF in the region of the coccyx (21.5% [95% CI, 14.3%-28.7%] vs 11.5% [95% CI, 3.5%-16.9%], respectively; P = .003) and as a result of a fall at ground level (69.2% [95% CI, 62.1%-76.4%] vs 52.8% [95% CI, 43.2%-62.4%], respectively; P = .009). A significant decrease in the number of snowboarding-related AVFs was identified over the 20-year study period: 899 in 2000-2003 versus 283 in 2016-2019 ( P < .01). The change in skiing-related AVFs over the study period was not statistically significant (694 vs 462; P = .5). Conclusion: This national study of AVFs sustained while skiing and snowboarding identified critical sex- and age-specific differences in the population at risk, anatomic location of injury, and mechanism of injury. The national data generated from this study over a 20-year period may be utilized to better inform public health injury awareness and prevention initiatives in the rapidly growing sports of skiing and snowboarding.