bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of anaesthetic use on healing in sub cutaneous abscess management: a retrospective before and after cohort study
Authors: Elkadi HH , Dodd E , Poulton T , Bolton W , Burke JR , Tiernan J , Jayne D 
Published: May 2022

Introduction There is wide variation in the management of simple subcutaneous abscesses in the UK and no national guidelines describing best practice. During the SARS-CoV-2 pandemic, regional or local anaesthesia (LA) use was recommended instead of general anaesthesia. This study aimed to assess the effect of anaesthetic use on outcomes following incision and drainage (I&D) of simple subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital in Leeds were identified retrospectively over a 14-week period before (P1) and after (P2) the introduction of the COVID-19 anaesthetic guidelines. The number of follow-up appointments for repacking and representation to healthcare services 30 days after I&D were used as surrogate endpoints for wound healing. Results A total of 133 patients were included (n=70, P1 and n=63, P2). Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p<0.0001) with a significant reduction in wound packing (68.3% vs 87.1%; p=0.00473). Follow-up analysis found no significant difference in the median number of follow-up appointments (7.46 vs 5.11; p=0.0731) and the number of patients who required ongoing treatment after 30 days (n=14, P1 vs n=14, P2; p=0.921). Conclusions Drainage of simple subcutaneous abscess under 5cm in diameter is safe under LA, with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient-reported outcomes, including pain management, cosmesis and the cost and sustainability implications of a change in this common procedure.
Predictors of mortality and nephrectomy in emphysematous pyelonephritis: a tertiary care centre study
Authors: Aggarwal D , Mandal S , Parmar K , Manoharan V , Singh S , Yadav AK , Kumar S , Sharma AP , Singh SK 
Published: May 2022

Introduction Emphysematous pyelonephritis (EPN) is a deadly disease due to its associated morbidity and mortality. Attempts have been made to identify predictors of severity, mortality and need for nephrectomy in EPN with little success. Methods We conducted an ambispective study of EPN patients between March 2014 and September 2019. Retrospective data were collected which included age, sex, comorbidities, symptoms, signs, laboratory investigations including imaging, need for dialysis, management and any complications. All patients were then followed prospectively for renal dynamic scan, stone surgery or nephrectomy. Univariate analysis was performed to identify factors affecting mortality and need for elective nephrectomy. Results In total, 112 patients were included. Mean patient age was 50.01 years, 55% were female and 5% had bilateral involvement. Fever and flank pain were the most common symptoms. Diabetes was seen in 75% of cases and 30% of cases required haemodialysis at initial presentation. About 60% of patients improved with pigtail drainage. Need for nephrectomy was greater in Huang–Tseng stage 3a (14.8%). Huang–Tseng stages 3b and 4 had higher mortality rates (25%) than the other stages (2.2%). Twelve of 99 patients had non functional kidney on follow-up and underwent elective nephrectomy. Low platelet counts, high body mass index, septic shock, dialysis and higher Huang–Tseng stage were found to be predictive of mortality and renal parenchymal thickness on computed tomography scan was predictive of follow-up nephrectomy. Conclusions Thrombocytopaenia, high body mass index, septic shock, haemodialysis and higher Huang–Tseng stage are predictors of mortality and renal parenchymal thickness <5mm is a predictor of poor salvage of affected kidney on follow-up.
Optimising the use of physiotherapy resources after manipulation under anaesthetic for frozen shoulder
Authors: Castelhano R , Woods J , Akehurst H , Mitra A , James M , Berntzen B , Dacombe P , Tasker A , Woods D 
Published: May 2022

Introduction Manipulation under anaesthetic (MUA) is a successful treatment for frozen shoulder (FS), and the recovery period and recurrence rates may be reduced by postoperative physiotherapy. This study evaluates two physiotherapy pathways for patients undergoing MUA for FS. Methods Between 2016 and 2018, 248 age- and sex-matched patients presented to either a NHS secondary care upper limb service or the lead author’s independent practice with a diagnosis of FS. The patients had differential access to postprocedure physiotherapy based on which service they presented to. In Group 1, physiotherapy advice only was given to the patient. In Group 2, supervised hydrotherapy and physiotherapy occurred postoperatively. Pre- and postprocedure Oxford Shoulder Scores (OSS) were collected for each group. Analysis of covariance (ANCOVA) was used to measure the effect of physiotherapy on postoperative OSS. Results Group 2 showed a significantly greater improvement in postprocedure OSS when compared with Group 1 (18.2 vs 16.7) p<0.001). The estimated maximum effect of physiotherapy on postoperative OSS was an increase of 3.2. Conclusion Following MUA for FS, a statistically significant increase in OSS was detected in patients receiving postprocedure physiotherapy compared with advice alone. There was no difference in recurrence rates. The increase in OSS (3.2) is below the minimal clinically important difference, raising questions regarding the relative importance of postprocedure physiotherapy in a resource-limited environment.
‘I see a wall… then I cannot reach my son.’ Coercive control tactics by one parent alienate the child from the other
Authors: Dijkstra Sietske 
Published: May 2022

This article, drawing from practice-based research, explores the impact of coercive control tactics used by one parent against the other to alienate the affections of the child from the other parent. Such tactics tend to corrupt the child and disempower the victimised parent. In the first of three sections is a research-based consideration of relevant terms and meanings. In the second part, the results of the qualitative research based on interviews with ten victimised mothers are presented. Analysis of these interviews illuminates some gendered ways in which the dominant partner can sabotage the relationship between the other parent and the child(ren), employing a pattern of coercive tactics. The interviews also reveal how social professionals can be manipulated to misperceive the situation, assuming without sufficient evidence that the two divorced partners have equivalent power, when in fact the power relationship is asymmetrical, with emotional violence happening under the surface. In such situations, the poisoning of parent–child relationships can lead to the alienated parent’s losing direct and even indirect contact with the child(ren). In the third and last section, recommendations pay particular attention to gendered manifestations of child–parent alienation such as diminishing space for action, distorted views and fraying bonds of affection.
The article concludes with a plea for more awareness of asymmetrical and gendered parental relationships after divorce and the relationship between coercive control, gender and alienation of affection.
The ESCAPE trial for older people with chronic low back pain: Protocol of a randomized controlled trial
Authors: Silva Hytalo de Jesus , Fonseca Leticia Soares , Mascarenhas Rodrigo Oliveira , Miranda Júlio Pascoal de , Almeida Paulo André , Souza Mateus Bastos , Pereira Leani Souza Maximo , Oliveira Murilo Xavier , Oliveira Vinicius Cunha 
Published: May 2022

Background
Low-back pain is one of the most common health conditions worldwide. It is defined as pain below the costal margin and above the inferior gluteal folds. Current guidelines recommend management of chronic health (e.g., low back pain) conditions in older people at primary health care settings using active strategies (e.g., exercise). In non-specific low back pain, high quality evidence supports active strategies for general population. However, the management of non-specific low back pain in the older people has been overlooked and evidence is limited to a small number of low powered randomized controlled trials with high risk of bias.

Methods
This is a prospectively registered, open, two-arm randomised controlled trial comparing the group-based exercise and waiting list in pain intensity (11-item Pain Numerical Rating Scale) and disability (Roland Morris questionnaire) of older people (i.e., 60 years old or over) with chronic non-specific low back pain. One hundred and twenty patients will be recruited from Diamantina, Brazil. Follow-ups will be conducted in post-treatment (8 week) and 6- and 12-months post-randomisation.

Discussion
Our hypothesis is that group-based exercise will be better than waiting list in reducing pain intensity and disability in older people with chronic non-specific low back pain.

Impact
The practice of individualized exercise has been studied for the management of chronic non-specific low back pain in older people. However, the group exercise, even showing high quality evidence for the improvement of several important outcomes in this population, has been ignored until now. Thus, the results of this study have the potential to indicate a viable and accessible strategy for managing chronic non-specific low back pain in the older people.

Trial registration
The study was prospectively registered at www.ensaiosclinicos.gov.br (RBR-9j5pqs). Date-11/18/2020.
Analysis of cathepsin S expression in gastric adenocarcinoma and in Helicobacter pylori infection
Authors: Costa Adriano C. , Santa-Cruz Fernando , Araújo Raphael L. C. , Leitão Glauber , Figueiredo José-Luiz , Ferraz Álvaro A. B. 
Published: May 2022

Background
Recent experimental studies have suggested a potential link between cathepsin S (CTTS) and gastric adenocarcinoma progression. Herein, we aimed to evaluate the expression of CTTS in gastric adenocarcinoma in patients who underwent curative-intent surgical resection.

Methods
This was a cross-sectional study that included two groups: gastric adenocarcinoma (n = 42) and gastritis (n = 50). The gastritis group was then subdivided into H. pylori-positive (n = 25) and H. pylori-negative (n = 25) groups. Gastric tissue samples were analysed to determine CTTS expression through immunohistochemistry. Samples were obtained by oesophagogastroduodenoscopy or surgical specimens.

Results
In patients with gastritis, the age ranged from 18 to 78 years. Among them, 34% were male, and 66% were female. In patients with gastric adenocarcinoma, the age ranged from 37 to 85 years. Among them, 50% were male. When comparing the expression of CTTS between the two groups, only 16% of the gastritis samples had an expression higher than 25%. Alternatively, among patients with gastric adenocarcinoma, 19% had expression between 25–50%, 14.3% between 51–75%, and 26.2% had expression higher than 75% (p < 0.001). In the gastritis group, CTTS expression was significantly higher in patients with a positive test for H. pylori than negative test for H. pylori: 87.5% and 38.5%, respectively (p<0.001). There was no statistically significant association between CTTS positivity and clinicopathological variables, including tumour staging, histological type, angiolymphatic invasion, recurrence, current status and death.

Conclusion
CTTS expression is higher in gastric adenocarcinoma samples. Patients with gastritis due to H. pylori also show a higher expression of CTTS than patients with negative results for this bacterium.
Development and delivery of an allied health team intervention for older adults in the emergency department: A process evaluation
Authors: Cassarino Marica , Cronin Úna , Robinson Katie , Quinn Rosie , Boland Fiona , Ward Marie E. , McNamara Rosa , O’Connor Margaret , McCarthy Gerard , Ryan Damien , Galvin Rose 
Published: May 2022

Background
There is encouraging evidence that interdisciplinary teams of Health and Social Care Professionals (HSCPs) can enhance patient care in the Emergency Department (ED), especially for older adults with complex needs. However, no formal process evaluations of implementations of ED-based HSCP interventions are available. The study aimed to evaluate the development and delivery of a HSCP team intervention for older adults in the ED of a large Irish teaching hospital.

Methods
Using the Medical Research Council (MRC) Framework for process evaluations, we investigated implementation and delivery, mechanisms of impact, and contextual influences on implementation by analysing the HSCP team’s activity notes and participant recruitment logs, and by carrying out six interviews and four focus groups with 26 participants (HSCP team members, ED doctors and nurses, hospital staff). Qualitative insights were analysed thematically.

Results
The implementation process had three phases (pre-implementation, piloting, and delivery), with the first two described as pivotal to optimise care procedures and build positive stakeholders’ involvement. The team’s motivation and proactive communication were key to promote acceptability and integration in the ED (Theme 1); also, their specialised skills and interdisciplinary approach enhanced patient and staff’s ED experience (Theme 2). The investment and collaboration of multiple stakeholders were described as essential contextual enablers of implementation (Theme 4). Delivering the intervention within a randomised controlled trial fostered credibility but caused frustration among patients and staff (Theme 3).

Discussion
This process evaluation is the first to provide in-depth and practical insights on the complexities of developing and delivering an ED-based HSCP team intervention for older adults. Our findings highlight the importance of establishing a team of HSCPs with a strong interdisciplinary ethos to ensure buy-in and integration in the ED processes. Also, actively involving relevant stakeholders is key to facilitate implementation.

Trial registration
ClinicalTrials.gov, NCT03739515; registered on 12th November 2018.
Comercio internacional y especialización portuaria: las relaciones entre Bristol y la bahía guipuzcoana de Pasaia a fines de la Edad Media
Authors: Irixoa Cortés Iago 
Published: May 2022

El papel de los vascos en el comercio marítimo medieval ha sido subrayado en numerosas ocasiones. Tanto los investigadores nacionales como internacionales han remarcado su desarrollo e importancia como transportistas. Se les ha colocado en numerosos lugares a la vez, tanto en el Mediterráneo como en el Atlántico, con una intensidad destacada. No obstante, esta visión global debe ser matizada. No todas las poblaciones costeras vascas tuvieron el mismo grado de desarrollo marítimo, ni se dedicaron a todas y a cada una de las actividades con la misma fuerza. Aunque integradas en un marco general condicionado en gran medida por las relaciones internacionales y sin olvidar la colaboración y relaciones con las poblaciones vecinas, cabe reflexionar si las comunidades repartidas a lo largo de la costa guipuzcoana y vizcaína no trazaron recorridos singulares entre los que también figuraba la preferencia por determinadas rutas; dicho de otra manera, si no experimentaron cierta especialización geográfica en cuanto a los destinos. Las fuentes locales nos pueden ayudar a perfilar unas líneas al respecto, pero son incompletas y, sobre todo, tardías. En esta tesitura, la documentación extranjera constituye un interesante soporte, especialmente en aquellos lugares donde los registros portuarios son relativamente tempranos y son cuantitativamente remarcables. Uno de esos casos lo constituye la ciudad inglesa de Bristol, que, en líneas generales, cuenta con registros portuarios a partir de la década de 1460; la localidad, además, fue un importante destino para el hierro vasco. Sin embargo, una aproximación geográfica a los datos arrojados por sus documentos constata que el transporte de mercancías protagonizado por los barcos vascos estuvo concentrado en determinada zona guipuzcoana, la comprendida por la bahía de Pasaia y las diversas comunidades asentadas en ella; unos nexos que se atisban en la documentación local, pero que aparecen mucho más nítidos en las fuentes inglesas. A través de las siguientes líneas abordaremos ese caso, realizando una primera aproximación mediante un análisis geográfico de las embarcaciones vascas que aparecen en los registros de Bristol.
De Ayala, C., García Fitz, F. y Palacios, J. S. (Coords.) (2021). Memoria y fuentes de la guerra santa peninsular (siglos X-XV). Gijón: Ediciones Trea. 483 pp. ISBN: 978-84-18105-48-7
Authors: Vital Fernández Sonia 
Published: May 2022

Reseña: De Ayala, C., García Fitz, F. y Palacios, J. S. (Coords.) (2021). Memoria y fuentes de la guerra santa peninsular (siglos X-XV). Gijón: Ediciones Trea. 483 pp. ISBN: 978-84-18105-48-7
Quantification of high and low sEMG spectral components during sustained isometric contraction
Authors: Costa‐García Álvaro , Iáñez Eduardo , Yokoyama Moeka , Ueda Sayako , Okajima Shotaro , Shimoda Shingo 
Published: May 2022

AbstractSuperficial Electromyography (sEMG) spectrum contains aggregated information from several underlying physiological processes. Due to technological limitations, the isolation of these processes is challenging, and therefore, the interpretation of changes in muscle activity frequency is still controversial. Recent studies showed that the spectrum of sEMG signals recorded from isotonic and short‐term isometric contractions can be decomposed into independent components whose spectral features recall those of motor unit action potentials. In this paper sEMG spectral decomposition is tested during muscle fatigue induced by long‐term isometric contraction where sEMG spectral changes have been widely studied. The main goals of this work are to validate spectral component extraction during long‐term isometric muscle activation and the quantification of energy exchange between the low‐ and high‐frequency bands of sEMG signals during muscle fatigue.
Teacher resilience and triple crises: Confucius Institute teachers’ lived experiences during the Covid-19 pandemic
Authors: Lu Xiuchuan , Hua Zhu 
Published: May 2022

Abstract
This article aims to investigate Confucius Institute teachers’ lived intercultural experiences during the triple crises, i.e., the pandemic, hostility towards Confucius Institutes (CIs) and rampant racism. Through the analytical lens of teacher resilience, the article looks beyond what has gone wrong and foregrounds resourcefulness, strength, and agency of CI teachers. It draws the data from interviews with nine CI teachers based in US, Europe and Australia where CI closure has been reported, over a period of three months in 2020 and 2021. In addition to technological and pedagogical challenges and well-being issues, CI teachers found themselves in the vulnerable position of ‘being caught in the middle’ exacerbated by the changing political dynamics, rising anti-Chinese racism, cross-cultural differences in health behaviours and broken partnership with the host universities. Our analysis shows that despite these challenges, CI teachers built resilience and remain committed to their professional values. They adopted a pragmatic approach to depoliticise language teaching through ‘safe’ cultural activities and engaged in perspective-taking and reflexivity. The findings further demonstrate the importance of mutual support and co-learning for developing resilience, thus offering new insights on factors contributing to teacher resilience. Our research raises questions about the CI operational/partnership model and urges policy makers and senior management teams to put teachers and students’ needs first in their decisions.
Impact of a live bacterial-based direct-fed microbial (DFM) postpartum and weaning system on performance, mortality, and health of Najdi lambs
Authors: Amran Ramzi A. , Alhimaidi Ahmad R. , Al-Ghadi Muath Q. , Ammari Aiman A. , Matar Abdulkareem M. 
Published: May 2022

Abstract
Among the non-nutritive additives available for lamb nutrition, direct-fed microbial (DFM) stands out for altering rumen fermentation and increasing animal productivity. This study was conducted to evaluate the effects of DFM and weaning systems on performance, mortality, and health of newborn lambs. A total of 60 newborn lambs were divided into 4 equal groups and assigned to one of 4 treatments: Control (C) without DFM and late weaning; T1, DFM and early weaning; T2, DFM and mid weaning; and T3, DFM and late weaning. Each lamb in the treated group received 3 doses of DFM (5 mL/lamb). The mortality was reduced by 80% compared to the control group. Lambs in the T2 and T3 with DFM groups had significantly (P < 0.05) higher body weight (BW) and body weight gain (BWG) than lambs in the C group. Glucose, creatinine, and urea nitrogen levels of T3 lambs were significantly (P < 0.05) higher in late weaning compared with the remining treatments. DFM supplementation and weaning system significantly (P < 0.01) reduced serum Zn concentration. These results suggest that the addition of DFM to the diet of newborn lambs and weaning at 60 days improves the overall performance and immunity of the lambs and consequently reduces the mortality rate.
A Staggered Discontinuous Galerkin Method for Quasi-Linear Second Order Elliptic Problems of Nonmonotone Type
Authors: Zhao Lina , Park Eun-Jae 
Published: May 2022

Abstract
In this paper, we present a priori and a
posteriori analysis of a staggered discontinuous Galerkin (DG)
method for quasi-linear second order elliptic
problems of nonmonotone type.
First, existence is proved by using Brouwer’s fixed point argument and
uniqueness is verified utilizing Lipschitz continuity
of the discrete solution map. Next, optimal a priori error estimates for both potential and flux variables
are derived.
Then the residual based a posteriori error estimates
on the potential energy error and the flux

L
2

{L^{2}}

error,
respectively, are proposed. The flux error estimator makes use of a Helmholtz-type
decomposition for the nonlinear system, which relies on
appropriate choice of an auxiliary problem. While a priori error
analysis is based on the observation that the staggered DG method
can be viewed as a nonconforming approximation of the primal mixed
formulation of the problem, a posteriori error estimation takes
advantage of the primal formulation which can be obtained from the
primal mixed formulation by eliminating the flux variable in the
continuous setting.
Finally, the theoretical findings are illustrated by numerical
experiments.
Two-stage adsorber optimization of NaOH-prewashed oil palm empty fruit bunch activated carbon for methylene blue removal
Authors: Sarawanan Tivya , Mahat Noor Sabariah , Mohamed Rusli Nurfarhain , Ahmad Zaini Muhammad Abbas 
Published: May 2022

Abstract
The objective of the present work was to evaluate the performance of two-stage adsorber of activated carbon from oil palm empty fruit bunch for methylene blue removal. The model was developed to predict optimum adsorbent mass and time at a specified volumes and concentrations of dye solution. Results show that the adsorbent mass can be reduced by 6.67%. Operating time taken to attain the equilibrium in a two-stage adsorber has dramatically decreased from 22 h to 0.52 h. In the performance evaluation, the adsorbent mass in stage-1 is higher than in stage-2, which lessen the workload to achieve equilibrium. A two-stage adsorber aids to optimize the mass and contact time for different percentage of dye removal that economically feasible for industrial applications.