bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Deleterious Rare Alleles for Acute-Onset Diffuse Interstitial Lung Disease in Collagen Diseases
Authors: Furukawa Hiroshi , Oka Shomi , Shimada Kota , Hashimoto Atsushi , Komiya Akiko , Matsui Toshihiro , Tohma Shigeto
Published: July 2019

Objective:

Acute-onset diffuse interstitial lung disease (AoDILD) includes acute exacerbation of interstitial lung disease (ILD), drug-induced ILD, and Pneumocystis pneumonia in collagen diseases patients. As AoDILD causes a poor prognosis in collagen disease patients, the pathogenesis of AoDILD should be investigated. Exome sequencing studies revealed that rare variants were detected to be causative in some diseases. Recently reported upregulated genes in acute exacerbation of idiopathic pulmonary fibrosis could provide candidate genes for restricted exome analysis of AoDILD in collagen disease. Here, we investigated rare variants in the coding and boundary regions of these candidate genes in AoDILD.

Methods:

Deleterious rare variants in the coding and boundary regions of the candidate genes were analyzed by exome sequencing and the deleterious rare allele frequencies in AoDILD were compared with those of controls.

Results:

A significant association was detected for deleterious rare alleles in NPL ( P = .0044, Pc = .0399, odds ratio [OR] = 10.05, 95% confidence interval [CI] = 3.01-33.55). A deleterious rare allele frequency in the 9 candidate genes ( P = .0011, OR = 7.17, 95% CI = 2.80-18.33) was also increased in AoDILD in multigene panel analysis. The Krebs von den Lungen–6 (KL-6) levels in AoDILD patients with deleterious rare alleles were tended to be lower than those without ( P = .0168, Pc = .1509).

Conclusions:

The deleterious rare alleles in NPL were associated with AoDILD. In addition, the deleterious rare allele frequency in the 9 candidate genes was also increased in AoDILD. The deleterious rare alleles might contribute to the pathogenesis of AoDILD.
Whole Brain White Matter Microstructure and Upper Limb Function: Longitudinal Changes in Fractional Anisotropy and Axial Diffusivity in Post-Stroke Patients
Authors: Oey Nicodemus Edrick , Samuel Geoffrey Sithamparapillai , Lim Joseph Kai Wei , VanDongen Antonius MJ , Ng Yee Sien , Zhou Juan
Published: July 2019

Background:

Diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) measuring fractional anisotropy (FA) and axial diffusivity (AD) may be a useful biomarker for monitoring changes in white matter after stroke, but its associations with upper-limb motor recovery have not been well studied. We aim to describe changes in the whole-brain FA and AD in five post-stroke patients in relation to kinematic measures of elbow flexion to better understand the relationship between FA and AD changes and clinico-kinematic measures of upper limb motor recovery.

Methods:

We performed DTI MRI at two timepoints during the acute phase of stroke, measuring FA and AD across 48 different white matter tract regions in the brains of five hemiparetic patients with infarcts in the cortex, pons, basal ganglia, thalamus, and corona radiata. We tracked the progress of these patients using clinical Fugl-Meyer Assessments and kinematic measures of elbow flexion at the acute phase within 14 (mean: 9.4 ± 2.49) days of stroke symptom onset and at a follow-up appointment 2 weeks later (mean: 16 ± 1.54) days.

Results:

Changes in FA and AD in 48 brain regions occurring during stroke rehabilitation are described in relation to motor recovery. In this case series, one patient with a hemipontine infarct showed an increase in FA of the ipsilateral and contralateral corticospinal tract, whereas other patients with lesions involving the corona radiata and middle cerebral artery showed widespread decreases in perilesional FA. On the whole, FA and AD seemed to behave inversely to each other.

Conclusions:

This case series describes longitudinal changes in perilesional and remote FA and AD in relation to kinematic parameters of elbow flexion at the subacute post-stroke period. Although studies with larger sample sizes are needed, our findings indicate that longitudinally measured changes in DTI-based measurements of white matter microstructural integrity may aid in the prognostication of patients affected by motor stroke.
Electoral performance beyond leaders? The organization of populist parties in postcommunist Europe
Authors: Gherghina Sergiu , Soare Sorina
Published: July 2019

In spite of extensive research dedicated to the rise and development of fringe populist political parties in Eastern Europe, little attention has been paid to the organizational determinants of their electoral performance. This article aims to fill this void in the literature and analyzes the extent to which particular types of leadership and party organization could influence the electoral performance of three political parties from Bulgaria, Republic of Moldova, and Romania. The qualitative analysis is conducted for the period 2012–2015 and uses a combination of primary (party statutes) and secondary sources (party histories, electoral databases, and literature). The results indicate how the existence of underdeveloped party organizations has a negative influence on the electoral performance, while strong and charismatic leaders are an insufficient condition for ensuring survival in the political arena.
Intergenerational touch in physical education in relation to heteronormativity: Female students’ perspectives
Authors: Caldeborg Annica , Öhman Marie
Published: July 2019

Research within the field of intergenerational touch has shown that there is a tension between the need to use physical contact as an obvious pedagogical tool, and the no-touch discourse. Within this tension physical contact between physical education teachers and students has also been shown to be a gender/ed issue with heteronormative points of departure. The aim of this study is to investigate how young adult female students’ talk about physical contact between teachers and students in physical education is related to heteronormativity. The study takes its starting point in Foucault’s work on discourses and Butler’s performative perspective. Thirteen female students in upper secondary school were interviewed in four focus groups using photo elicitation. In the findings, three performatives are identified that show how the students’ talk about physical contact between teacher and student in physical education is related to heteronormativity. The three performatives are: (a) gendering with age; (b) being wary of men; and (c) feeling sympathy for men. The paper discusses the effects the heteronormative discourse has on young adult female students and male teachers in relation to physical contact in physical education.
Asynchronous telepsychiatry: A systematic review
Authors: O’Keefe Molly , White Kelsey , Jennings J’Aime C
Published: July 2019

Introduction

Healthcare providers and systems increasingly utilize telehealth modalities to address barriers and challenges for healthcare delivery. Specialties, such as psychiatry, are testing asynchronous methods for telehealth delivery. The National Quality Forum (NQF) developed a framework with which to assess the quality of telemedicine according to measures and measure concepts within four domains. This review assesses existing asynchronous telepsychiatry (ATP) research according to the telehealth domains established by NQF, evaluates the prevalence and quality of ATP, and identifies the areas in which more research must be conducted.

Methods

A systematic review of ATP methods was conducted according to PRISMA guidelines. Studies were categorized according to NQF telehealth domains and subdomains to further examine study outcomes.

Results

The review initially identified 205 studies that were narrowed down to a final sample of 11 articles. Of the final articles, most studies addressed the effectiveness of ATP or users’ experience with ATP.

Discussion

The initial investigation of published ATP literature suggests promising results. ATP studies suggest that these services improve access to care, can be feasibly implemented by the clinical team, maintain patient/family satisfaction, and potentially reduce the cost of services. The limited sample of published literature necessitates further study of the practice in order to assess ATP according to the quality domains identified by NQF, especially access to care for patients and caregivers, the financial costs incurred by both providers and patients, and barriers to uptake.
Performing heterosexual attraction in a bisexual interview: A methodological account of gendered power
Authors: Turai Ráhel Katalin
Published: July 2019

The article describes the specific gender and sexuality relations that emerged in a life story interview I conducted with a gay-identified man who desires both women and men. I provide a detailed description not only of the eroticization he performed in the interview, but also of my reactions: I felt vulnerable, attractive, attracted, and repulsed. My reflexive analysis frames these reactions in the context of the power dynamics between us, as well as in the context of his narrated experiences with women (including solidarity, desire, abuse and economic interests) – some of which my analysis would not have revealed without taking our interaction into account. I thus argue for the importance of processes of embodied learning, and specifically, for the theoretical significance of the bisexual gendered dynamics between researcher and respondent. Further, my account illuminates the ambiguity of bonding between queer women and men. I argue that owing to the theoretical productivity of the researcher’s reflexivity, the transactional erotic aspects of our own subjectivity are telling of the very meanings (of sex, gender, sexuality and other categories) we aim to interrogate.
Probabilistic models of legal corroboration
Authors: Urbaniak Rafal , Janda Pavel
Published: July 2019

The aim is to develop a sensible probabilistic model of legal corroboration in response to an attack on the probabilistic approach to legal reasoning due to Cohen. One of Cohen’s arguments is that there is no probabilistic measure of evidential support which satisfactorily captures the situation in which independent witnesses testify to the truth of the same proposition (or independent pieces of evidence converge on a certain claim)—the phenomenon called corroboration (or convergence). We investigate the properties of several probabilistic measures discussed by Cohen, discuss Cohen’s criticism of those measures, and develop our own. Finally, we offer a probabilistic measure of corroboration that evades the critical points raised against the ones discussed so far.
A qualitative study of nurses’ perspectives of caring for children with intellectual disability and their families in a paediatric acute care setting
Authors: Lewis Peter , Wilson Nathan J , Jaques Hayden , O’Reilly Kate , Wiese Michele
Published: July 2019

Children with intellectual disability (ID) experience chronic and pervasive limitations across intellectual and adaptive functioning. They are also at risk of developing co-morbidities. They are likely to be hospitalised more frequently and for longer periods of time than other children. The purpose of this study was to understand the experiences of nurses when caring for children and teenagers with ID in an acute paediatric hospital setting. The aim of the research was to inform future directions for the delivery of equitable and effective care for this vulnerable population. This study used a qualitative thematic analysis of individual interviews conducted with eight registered and enrolled nurses who provided care to children and adolescents with ID in an Australian paediatric acute hospital setting. Themes which emerged from this analysis were (1) Recognising similarities and managing differences; (2) Nurse–parent relationships; and (3) Caring for children with ID requires additional time. This study highlights that navigating care delivery and relationships when working with young people with ID and their caregivers in an acute care setting is complex. Nursing children with ID in hospital requires sophisticated skills. To ensure quality healthcare for patients with ID, a range of strategies are proposed.
Lost in the Process? The impact of devolution on abortion law in the United Kingdom
Authors: Moon David S , Thompson Jennifer , Whiting Sophie
Published: July 2019

Using the case study of abortion policy across the United Kingdom, this article takes a feminist institutionalist approach to advance our understanding of state architecture and party competition within decentralised political systems. Despite increasing divergences across the United Kingdom in relation to abortion policy, contemporary debates around abortion access have rarely become politicised. Moreover, as this article demonstrates, when they have, the subject has been framed by politicians as a constitutional matter, relating to legislative competencies, rather than considered in terms of women’s rights. This framing, we argue, is linked to the specific constitutional arrangements of the post-devolution UK and the political strategies of the parties operating within them. Drawing upon parliamentary debates and interviews with political representatives to map the circumstances driving changes to abortion policy in the United Kingdom, this article introduces important comparative lessons for other cases of political decentralisation on the discussions and policies concerning women’s rights.
Tests of Income Convergence in ASEAN and SAARC Trading Blocs
Authors: Zia Uzma , Mahmood Zafar
Published: July 2019

The cherished goal of speedy economic growth in the Asian regional blocs cannot be achieved without attaining income convergence among them. Economic integration and assessment of income convergence or disparities among Asian blocs is the aim of this study. This study assesses a number of factors, such as trade openness, foreign direct investment, intellectual property rights protection and governance, to see how open economies are integrating themselves while competing with each other. Findings reveal that the SAARC group has not shown intra-regional income convergence, while the ASEAN group provides sufficient evidence. Although simultaneously considering SAARC and ASEAN groups in the form of a panel, there is evidence of non-convergence between the two regional groups. An important policy implication of the study is that the ASEAN and SAARC blocs are in dire need for combined and collective policy framework at the regional level.

JEL: O19, O31, F15
The use of online social networking sites to nurture and cultivate bonding social capital: A systematic review of the literature from 1997 to 2018
Authors: Williams Joshua R.
Published: July 2019

Any social phenomenon with more than a billion participants daily is ripe for investigation into the implications of social capital. This research conducts a systematic review of the peer-reviewed literature and conference material published between 1 January 1997 and 31 March 2018 regarding the question, can the use of online social networking sites cultivate and nurture an individual’s bonding social capital? The systematic review using EBSCOhost, EndNote, and final manual review process has aggregated 54 articles containing 116 distinct studies resulting in 85 answering in the affirmative to the research question. These studies are coded into a 13-category framework to provide a roadmap to future researchers. The results are wide and varied providing data from large and small groups. Generalization of the results supports the research question in that individual bonding social capital can be cultivated and nurtured via use of online social networking sites.
Optimisation of hybridised cane wood–palm fruit fibre frictional material
Authors: Achebe CH , Obika EN , Chukwuneke JL , Ani OE
Published: July 2019

A brake pad has been developed employing a hybrid of cane wood and palm fruit fibre as filler material. The filler materials were extracted and processed; however, the palm fruit fibre was further treated with NaOH to remove oil remnants. After proper drying, the filler materials were ground and sieved into 150 µm particle size. The experimental design was set up using Central Composite Design in Design Expert software. The design varied the percentage composition of the filler materials and the binder. At constant press time of 8 min, press temperature of 160 ℃ and curing time of 2 h, 20 test samples were produced and tested for mechanical and physical properties. These include hardness, wear rate and water absorption. The Fourier transform infrared analyses showed that both cane wood and palm fruit fibres have active alcohol (O–H) and amine (C–N) functional groups. The experimental results were analysed and optimised using response surface methodology and validated using the analysis of variance tool of the Design Expert software. An optimal 30% resin, 3.48% palm fruit fibre and 6.52% cane wood composition by mass was developed, which gave a product with 98.25 MPa hardness, 4.13 mg/m wear rate and 0.494% water absorption. This result indicated that hybridised cane wood–palm fruit fibre is a good filler material for brake pad production.
Political institutions and collective attachments
Authors: Aksoy Deniz , Hadzic Dino
Published: July 2019

We argue that the geographic distribution of power across different levels of government influences citizens’ attachments to alternative collective groups. In federal states where authority is shared between the center and regions, individuals are more likely to have attachments to multiple groups. We present evidence for the impact of state structure on collective attachments using the case of supranational European identity. We show that in countries where state structure empowers sub-state governments, individuals manifest stronger attachments to a supranational European community than they do in unitary states. This study indicates that when we examine individuals’ attachments to a collective group, the political-institutional context in which these individuals are embedded is an important factor to consider.
Plants and tourism: Not seeing the forest [n]or the trees
Authors: Cohen Erik , Fennell David
Published: July 2019

This article aims to explore an emergent sub-field in the study of tourism: the relationship between plants and tourism, which has been neglected in the literature. We discuss plants as a life form and confront the animal–plant divide, implicitly permeating tourism studies, with recent findings in biology and arguments in contemporary ontological anthropology, which seek to erase that divide and emphasize plant–animal continuity. We discuss the role of plants in the tourist experience and their place in differentially framed tourist settings, ranging from fully-natural to fully-contrived ones. We present the various ethical theories bearing on human conduct toward plants and indicate their applicability to tourism in the various settings. In conclusion we call for greater attention to the significant but overlooked role of plants in various touristic contexts.
A thematic analysis of Chinese people with dementia and family caregivers’ experiences of home care in China
Authors: Zhang Xiubin , Clarke Charlotte L , Rhynas Sarah J
Published: July 2019

Ageing in place is a key principle of older care services in many countries, especially in China where the social convention, cultural expectation and legal obligation emphasise that looking after parents is the children’s responsibility. As a result, the majority of older, frail Chinese have been cared for at home by their families. Previous studies have argued that being cared for at home contributes positively to the well-being and quality of life of older people and to economic cost. However, due to the sociocultural, economic and demographic changes in China, older people and their family caregivers are facing many challenges as they ‘age in place’ at home. This study aims to explore the meaning of family supported home care in China from the perspectives of people with dementia and family caregivers. The study is based on qualitative data collected from 24 people with dementia and family caregivers recruited from one mental health centre in Shandong province, China. Three main themes and nine subthemes were found: home care may create a sense of social isolation; home care is a burden; home care versus institutional care. The study suggests that while home care may bring social and psychological benefits, it also can be a barrier to building social connection, receiving social support, and other related services in China.
A Decade of Empirical Research on Research Integrity: What Have We (Not) Looked At?
Authors: Aubert Bonn Noémie , Pinxten Wim
Published: July 2019

Research on research integrity has become a field of its own; yet, a comprehensive overview the field is still missing. We systematically searched SCOPUS, Web of Science, and PubMed for relevant articles published between 2005 and 2015. We extracted the topic, methodology, focus, and citations from each articles. From the 986 articles included, only 342 report empirical data. Empirical papers predominantly targeted researchers and students. Although empirical articles questioning causes for misconduct mostly blamed research systems (e.g., pressure, competition) for detrimental research practices, articles proposing approaches to foster integrity focused on researchers’ awareness and compliance rather than on system changes. Involving nonresearchers and reconnecting what is known to what is proposed may help research on research integrity move forward.
Characterizing and modeling of low twist yarn mechanics
Authors: Cheung Benjamin K O , Carey Jason P
Published: July 2019

Twist in yarns can be used for handling or testing purposes, but it is not necessary when using continuous multifilament yarns as compared to the spinning required for a short fiber yarn. Small amounts of twist have shown to increase the strength of the yarn while decreasing the longitudinal stiffness. Previous models, including Gegauff’s cos2 θ model and Rao and Farris’ model, are compared and discussed. A para-aramid (Kevlar 49) and a regenerated cellulose (BioMid) yarn are tested at various levels of twist to compare with these models. Twist is manually applied, and the samples are tested under continuous rate of extension to determine chord modulus, breaking tenacity, and elongation and break. The results are then fit to existing prediction models using a minimization of the standard error of the regression. Finally, a linear regression is also applied to the data to contrast the fit compared to traditional models. It was found that while the Gegauff model and the Rao and Farris model may capture the overall trend and decrease in longitudinal stiffness over a large range of twist, the small range over which twist can practically be used is not well represented by these models and is better represented by a simple linear relationship.
The role of the upper and lower limbs in front crawl swimming: The thoughts and practices of expert high-performance swimming coaches
Authors: Morris Kirstin S , Jenkins David G , Osborne Mark A , Rynne Steven B , Shephard Megan E , Skinner Tina L
Published: July 2019

The perceptions of high-performance swimming coaches regarding the relative contribution of the upper and lower limbs are crucial in optimising athletic performance through subsequent prescription of training. Problematically, examination of these perspectives is lacking. To develop knowledge in this area, perceptions regarding the upper and lower limb velocity and metabolic contributions and reasoning surrounding whole body, arms-only and legs-only training prescription (referred to as swim, pull and kick, respectively) were garnered from seven male expert swimming coaches. The semi-structured interviews were transcribed verbatim by the lead researcher. Thematically analysed through open and axial-coding, results revealed that all coaches believed the upper limbs were the primary velocity generators but placed great importance on having well-conditioned muscles of the lower limbs. All coaches identified multiple interrelated parameters contributing to velocity generation and metabolic cost. In a typical training week, coaches allocate, on average, 58% (40–85%), 19% (0–30%) and 22% (10–40%) of the total training volume to swim, pull and kick training, respectively. All training prescription was based on anecdotal evidence and personal experience. Considering the variability in training allocation reported by these high-performance coaches, sport scientists and developmental coaches are encouraged to understand how factors such as the distance specialisation of the swimmers, injury status, stroke technique and physiological conditioning status of the upper and lower limb muscles influence the prescription of swim, pull and kick training within a typical training season.
A new δ-shock model for systems subject to multiple failure types and its optimal order-replacement policy
Authors: Jiang Yi
Published: July 2019

In this article, a generalized δ-shock model with multi-failure thresholds is studied. For the new model, the system fails depending on the interval times between two consecutive shocks which arrive according to a Poisson process. The shorter interval times may cause more serious failures and thus result in longer down times and more costs for repair. Assuming that the repair is imperfect, an order-replacement policy N is adopted. Explicitly, the spare system for replacement is ordered at the end of ( N – 1)th repair and the aging system is replaced at the Nth failure or at an unrepairable failure, whichever occurs first. In addition, the system must meet the requirement of availability, that is, the long-run average operating time per unit time should not be lower than a certain level. The average cost rate C( N) and the stationary availability A( N) are derived analytically. Some convergence properties of A( N) and C( N) are also investigated. The optimal order-replacement policy N* can be obtained numerically with the constraint of availability. Finally, an illustrative example is given and some sensitivity analyses are conducted to demonstrate the proposed shock model.
Non-commemorative memory in news production: Discovering underlying motivations for journalists’ memory work
Authors: Trümper Stefanie , Broer Irene GB
Published: July 2019

Memory in journalism has largely been investigated in relation to the commemoration of historical key events. This article sheds light on everyday, less obvious forms of memory in journalism with a focus on non-commemorative memory. We carried out a large-scale content analysis of contemporary newspaper articles (n = 2799) about two historic storm surge disasters in the Netherlands (1953) and Germany (1962) and a subsequent qualitative study based on 10 interviews with Dutch and German journalists. Combining content-based results with actor views enabled us to look below the surface of memory in news reporting and lay bare potential triggers, justifications, and underlying motivations for memory use. We found that journalists frequently use memory to connect past, present, and future, driven by a range of professional, economic, ideological, and cultural motivations that go beyond commemoration. We propose the term “strategic motivations” to better understand the dynamics of memory in journalism.
Queueing decision model for throughput maximization in green communications networks
Authors: Gbenga-Ilori Abiodun , Ladipo Oluwabusayo , Alamu Olumide
Published: July 2019

The various advancement in cellular technology has drawn huge attention to green communication by the stakeholders. Base station (BS) sleeping technique has been proposed as a way to reduce energy consumption in cellular networks, however, this may result in service delay for cellular users. In this article, we propose a queueing decision model for BS sleeping technique that maximizes energy-efficient utilization of the BSs in a green communication network while reducing the mean service waiting time for cellular users. The proposed model also ensures an optimal and interference-free resource sharing scheme that effectively enables channel borrowing through BS association in the network, thereby reducing call drop rate and further improving quality of service in the network. Numerical simulations are performed to observe the impact of the proposed model on spectrum access and consequently on the throughput of the green communication network. The article also observed the possible improvement in network delay with the proposed model. Results show that the queueing decision model is more energy-efficient. The model also provides a more spectrum-efficient sharing scheme compared to existing models, thereby enabling better network throughput.
Synthesis and Сytotoxicity of A-Azepanobetulinic Acid N-Methyl-Piperazinylamide
Authors: Giniyatullina Gulnara V. , Kazakova Oxana B. , Baikova Irina P. , Yamansarov Emil Yu. , Osterman Ilya A. , Komarova Ekaterina S. , Skvortsov Dmitry A. , Saltikova Irina V. , Majouga Alexander G. , Ivanenkov Yan A.
Published: July 2019

The synthesis of A-azepanobetulinic acid N-methylpiperazinylamide was performed through a series of transformations (oximation, Beckmann rearrangement, reduction) of previously synthesized betulonic acid N-methylpiperazinylamide. In vitro cytotoxic activity was detected for the obtained compound against a number of cancer cell lines, and its potential was revealed as an antibacterial agent.
Anticancer, Antibacterial, and Phytochemicals Derived From Extract of Aerva javanica (Burm.f.) Juss. ex Schult. Grown Naturally in Saudi Arabia
Authors: Al-Shehri Mohammed , Moustafa Mahmoud
Published: July 2019

Aerva javanica (Burm.f.) Juss. ex Schult. (Amaranthaceae family) has many pharmaceutical properties. This study aimed to determine the anticancerous effect of A. javanica methanol extract (AJME) on breast cancer cell lines and prostate cancer cell lines. The antibacterial potency of A. javanica solvent extracts was tested against Micrococcus luteus, Staphylococcus aureus, Pseudomonas aeruginosa, and Shigella flexneri. A screening of five concentrations of A. javanica was done on prostate and breast cancer cell lines using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. The results showed that AJME had various levels of cytotoxicity toward both cancer cell lines. A significant decrease in the rate of cancer cells was associated with a higher concentration of the plant extract. The half maximal inhibitory concentration IC50 value was 4.50 μg/ml for the breast cancer cells and 14.51 μg/ml for the prostate cancer cells. The dried and fresh solvent extracts made with methanol and chloroform demonstrated maximum potency against all the tested pathogenic microbes. The petroleum ether and acetone extracts showed moderate activity, while the diethyl ether and hot water extracts had the lowest antibacterial activity. The gas chromatography-mass spectroscopy analysis showed that AJME had various chemical compounds that have many biological benefits. In conclusion, A. javanica is a promising candidate as a natural herb to treat cancers, more so in breast cancer than in prostate cancer, and it has potential as an antimicrobial agent against multidrug-resistant microbes.
Retrospective Study: Association of Chronic Sphenoid Rhinosinusitis With Community Acquired Pneumonia
Authors: McQuitty Robert , Bui Roger , Chaaban Mohamad R.
Published: July 2019

Objectives

Our objective in this study is to examine the association between chronic sphenoid rhinosinusitis and community acquired pneumonia (CAP).

Study Design

Retrospective chart review.

Methods

A list of chronic rhinosinusitis (CRS) patients who presented to a tertiary rhinology clinic from 2013 to 2015 was conducted. Patients were excluded if they were not seen for at least 2 years. Patients were categorized into CRS with sphenoid sinusitis (group A) and CRS without sphenoid sinusitis (group B). The former group was divided into 2 categories according to their computed tomography scan/endoscopy findings: mucosal thickening and opacification (partial, complete, purulent sphenoid drainage on endoscopy). Posterior ethmoid disease was analyzed in the same fashion. Charts were then reviewed on whether the patients developed CAP within 2 years of their visit to the rhinologist.

Results

Six hundred forty-five of 1061 patients were included in the analysis. There were 178 (27.60%) patients in group A and 467 (72.40%) patients in group B. There were 40 total cases of pneumonia with 27 (67.50%) cases having chronic sphenoid sinusitis. Patients with sphenoid sinusitis were 6.77 (95% confidence interval [CI], 3.36–13.66) times more likely to have pneumonia. Patients with partial/complete opacification of the sphenoid sinus were 19.76 (95% CI, 8.78–44.47) times more likely to have pneumonia. Patients with only mucosal thickening of the sphenoid sinus did not have significantly increased odds of having pneumonia. Posterior ethmoid disease did not have an association with CAP nor did it increase the risk of CAP in sphenoid sinusitis patients.

Conclusions

There is an association between chronic sphenoid rhinosinusitis and CAP. Partial/complete opacification of the sphenoid sinus had the highest association with pneumonia.
State policies in the United States impacting drug-related convictions and their consequences in 2015
Authors: Cramer Ryan , Hexem Sarah , Thompson Kelly , LaPollo Archana Bodas , Chesson Harrell W , Leichliter Jami S
Published: July 2019

Background:

Criminal justice system involvement has been associated with health issues, including sexually transmitted disease. Both incarceration and sexually transmitted disease share associations with various social conditions, including poverty, stigma, and drug use.

Methods:

United States state laws (including Washington, D.C.) regarding drug possession and consequences of drug-related criminal convictions were collected and coded. Drug possession policies focused on mandatory sentences for possession of marijuana, crack cocaine and methamphetamines. Consequences of drug-related convictions included ineligibility for public programmes, ineligibility for occupational licences and whether employers may ask prospective employees about criminal history. We analysed correlations between state sexually transmitted disease rates and percentage of a state's population convicted of a felony.

Results:

First-time possession of marijuana results in mandatory incarceration in one state; first-time possession of crack cocaine or methamphetamines results in mandatory incarceration in 12 (23.5%) states. Many states provide enhanced punishment upon a third possession conviction. A felony drug conviction results in mandatory ineligibility for the Supplemental Nutrition Assistance Program and/or Temporary Assistance for Needy Families in 17 (33.3%) states. Nine (17.6%) states prohibit criminal history questions on job applications. Criminal convictions limit eligibility for various professional licences in all states. State chlamydia, gonorrhoea and syphilis rates were positively associated with the percentage of the state population convicted of a felony ( p < 0.05).

Conclusion:

While associations between crime, poverty, stigma and health have been investigated, our findings could be used to investigate the relationship between the likelihood of criminal justice system interactions, their consequences and public health outcomes including sexually transmitted disease risk.
Have We Surrendered to Gun Violence in Urban America? Federal Neglect Stymies Efforts to Stop the Slaughter Among Young Black Men
Authors: Carswell Shirley M.
Published: July 2019

For the last three decades, young Black men in the United States have been killed in gun violence at rates more than double any other group, which threatens to wipe out an entire generation. The reasons for the carnage have not been adequately investigated due to a federal ban on gun research, fueled by the massive lobbying power of the National Rifle Association. With no leadership from the federal government and lawmakers’ refusal to pass tougher gun policies, a patchwork of violence prevention efforts has emerged at the local level. The programs that appear to have had the greatest success in reducing homicides approach gun violence as a public health issue and address problems such as unemployment, substance abuse, and childhood trauma in young men. However, those programs are underfunded, and the national gun homicide toll has begun to climb again after a decade of relative stability. The public’s attention—and thus policy makers’ focus—seems to have shifted from urban homicides to mass shootings. In this essay, I argue that, because the gun homicide crisis disproportionately impacts young Black men, it will not get the attention nor federal funding it deserves until the Black community rises up to demand it.
Patient-Reported Allergies, a Marker of Preoperative Pain and Disability in Elective Spine Surgery
Authors: Lyons Keith W. , Borsinger Tracy M. , Lucas Adriana P. , McGuire Kevin J. , Pearson Adam M. , Abdu William A.
Published: July 2019

Study Design:

Retrospective review.

Objective:

Previous literature demonstrates mixed results regarding the relationship between patient-reported allergies and pain, function, and satisfaction scores. The objective of this study was to investigate the correlation between patient-reported allergies and preoperative Oswestry Disability Index (ODI), Neck Disability Index (NDI), and Patient-Reported Outcomes Measurement System (PROMIS) scores.

Methods:

All patients undergoing elective cervical, lumbar procedures between May 2017 and October 2018 were included. Baseline demographic information was recorded, as well as all reported allergies or adverse reactions. Preoperative PROMIS, ODI, and NDI scores were recorded. Hierarchical multiple linear regressions were used to assess the relationship between total number of allergies and the preoperative pain and function scores.

Results:

A total of 570 patients were included (476 lumbar, 94 cervical). The mean number of allergies reported was 1.89 ± 2.32. The mean preoperative ODI and NDI scores were 46.39 ± 17.67 and 43.47 ± 16.51, respectively. The mean preoperative PROMIS Physical Health and PROMIS Mental Health scores were 37.21 ± 6.54 and 43.89 ± 9.26, respectively. Hierarchical multiple linear regression showed that total number of reported allergies shared a statistically significant negative relationship with all of the following scores: ODI ( B = 0.83, P = .02), NDI ( B = 1.45, P = .02), PROMIS Physical Health ( B = −0.29, P = .013), and PROMIS Mental Health ( B = −0.38, P = .024).

Conclusions:

Patient-reported allergies share a statistically significant negative relationship with preoperative pain and function scores; as patients have increasing total number of allergies, the ODI/NDI scores become worse (increase) and the PROMIS scores become worse (decrease).
What should we be careful of ankle arthroscopy?
Authors: Ahn Jae Hoon , Park Dojoon , Park Yong Taek , Park Joonyoung , Kim Yoon-Chung
Published: July 2019

Purpose:

Ankle arthroscopy has been used as a standard tool by foot and ankle surgeons. To overcome the narrowness of ankle joint, a noninvasive distraction technique is used for the successful visualization in ankle arthroscopy. The aim of this study was to investigate the incidence and type of complications associated with ankle arthroscopy using a noninvasive distraction technique and to report a troublesome complication.

Methods:

We reviewed 514 patients’ charts from 2003 to 2011. The same noninvasive distraction technique was used. Patients’ demography, duration of follow-up, diagnoses, procedures, and complications related to ankle arthroscopy were analyzed.

Results:

There were 388 male and 126 female; mean age was 37.2 years; mean follow-up duration was 33 months. The diagnoses were osteochondral lesion of talus, chronic ankle instability, anterolateral soft tissue impingement syndrome, and anterior bony impingement. We performed arthroscopic synovectomy, osteochondral procedure, bony spur excision, and loose body removal. The mean time of arthroscopic procedure was 47 min. There were neurologic complications (eight cases), skin necrosis of posterior thigh (three cases), instrument breakage (two cases), and superficial wound infection (one case). All complications were well resolved. The total duration of distraction plus tourniquet inflation exceeded 120 min in the three cases of skin necrosis. Skin necrosis was deemed to be resulted from the long tourniquet time.

Conclusion:

The noninvasive distraction technique is safe and effective for ankle arthroscopy. However, the distraction plus tourniquet requires attention because it can cause high pressure on posterior thigh resulting in soft tissue injury.
Percutaneous endoscopic debridement and drainage for the treatment of instrumented lumbar spine infection
Authors: Yang Shih-Chieh , Chiu Yen-Chun , Chen Hung-Shu , Kao Yu-Hsien , Jou I-Ming , Tu Yuan-Kun
Published: July 2019

Purpose:

The purpose of this study is to evaluate the efficacy of percutaneous endoscopic debridement and drainage (PEDD) in patients with surgical site infection (SSI) following instrumented lumbar fusion.

Methods:

We retrospectively reviewed the medical records of 20 patients (6 women and 14 men; average age, 60.1 years) who underwent PEDD at our institute to treat SSI following instrumented lumbar fusion from January 2010 to December 2015. The terminal event, or failure of PEDD treatment, was defined as a shift in treatment methods to open surgery. Risk factors were analyzed to determine their effect on the therapeutic results of PEDD. Clinical outcomes were assessed by careful physical examination, regular serologic testing, and imaging studies to determine whether continued conservative treatment or open surgery was necessary.

Results:

Causative bacteria was identified in 17 (85%) of the 20 biopsy specimens. Successful infection control through PEDD was identified in 13 patients (65%). Both the visual analog scale and Oswestry disability index significantly improved in these patients. Detection of the causative pathogens was the only risk factor influencing the terminal event in the remaining seven patients (35%).

Conclusion:

In this study, PEDD was an effective treatment approach for obtaining a bacteriological diagnosis, relieving the patient’s symptoms, and assisting in eradication of SSI following instrumented lumbar fusion. The use of species-specific antibiotics for the offending pathogens appears to be the most important factor to determine the success rate. The indications of this procedure could be extended to treat patients with SSI after instrumented lumbar fusion.
Periarticular injection of tranexamic acid promotes early recovery of the range of knee motion after total knee arthroplasty
Authors: Hirose Hitoshi , Ogawa Hiroyasu , Matsumoto Kazu , Akiyama Haruhiko
Published: July 2019

Purpose:

Tranexamic acid (TXA) is a commonly used compound that reduces postoperative blood loss. Periarticular injection of TXA is a recently reported procedure with some advantages such as cost-effectiveness and the ease of performance over an intravenous or topical administration. However, its association with functional recovery remains unclear. This study aimed to examine the effect of periarticular injection of TXA on early postoperative recovery of knee functionality after total knee arthroplasty (TKA).

Methods:

Eighty-four patients who underwent primary unilateral TKA from February 2013 to August 2016 were classified into two groups based on whether they received TXA injection (44 cases each in the TXA and control groups). Patients in the TXA group received periarticular injection of TXA (1000 mg) just prior to incision closure. Ten-meter walk test (s), pain visual analog scale, knee extension muscle force (N), range of motion (ROM) (maximum flexion angle, maximum extension angle, and motion arc), and blood loss (mL) were assessed.

Results:

The maximum flexion angle and maximal extension angle on postoperative day (POD) 4, POD7, POD10, and POD14 in the TXA group were significantly larger than those in the control group. The postoperative drained blood in the TXA group was significantly less than that of the control group (543.9 ± 464.3 mL and 814.9 ± 481.4 mL, respectively, p < 0.05). No significant difference was observed in the other parameters at any time point.

Conclusion:

Periarticular injection of TXA significantly promotes early recovery of knee ROM after TKA. Level of Evidence: Level IV, therapeutic case series.
Hamstring Injury Trends in Major and Minor League Baseball: Epidemiological Findings From the Major League Baseball Health and Injury Tracking System
Authors: Okoroha Kelechi R. , Conte Stan , Makhni Eric C. , Lizzio Vincent A. , Camp Christopher L. , Li Bernard , Ahmad Christopher S.
Published: July 2019

Background:

Hamstring strains are the most common injury for professional baseball players and can result in significant time on the disabled list. To date, no study has reported the current trends in hamstring strains in professional baseball.

Hypothesis:

Professional baseball players would have an increased incidence of hamstring strains from 2011 through 2016.

Study Design:

Descriptive epidemiology study.

Methods:

Injury data were prospectively collected from 2011 through 2016 for every Major League Baseball (MLB) and Minor League Baseball (MiLB) team and was recorded in the MLB Health and Injury Tracking System. Data collected for this study included date of injury, activity during injury, time lost, primary injury or reinjury status, and imaging findings as well as player demographic information related to level of play, age, and position for all hamstring injury events. Injury rates were reported as hamstring injuries per number of games.

Results:

From 2011 to 2016, there were 2633 hamstring strains in professional baseball players. The rate of hamstring strains increased in MLB from a low of 1 injury every 39 games in 2011 to a high of 1 injury every 30 games in 2016. In MiLB, there were 2192 hamstring strains, with 1 injury every 35 games in 2011 compared with 1 injury every 30 games in 2016. The majority of injuries occurred in the infielder positions (37.5%) and resulted from base running (>50%), most commonly from home to first base. The most common hamstring injury was a grade 2 injury to the distal biceps femoris. The mean time missed after a hamstring injury was 14.5 days. Grade 3 and grade 2 hamstring strains resulted in significantly more days missed compared with grade 1 injuries ( P = .005 and P = .002, respectively). The rate of recurrent hamstring injuries was 16.3% for MLB and 14.2% for MiLB. Recurrent hamstring injuries resulted in more time lost than primary injuries (mean, 16.4 vs 14.5 days, respectively; P = .02). A total of 42 injuries were treated with platelet-rich plasma, and 19 were treated with surgery. The number of injuries treated with platelet-rich plasma increased in successive years.

Conclusion:

The rate of hamstring strains in professional baseball players has increased over the past 6 years and has resulted in a significant loss of playing time. Study results indicated that these injuries are affected by injury characteristics, position played, running to first base, seasonal timing, and history of hamstring injuries.