bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between Dysarthria and Oral-Oropharyngeal Dysphagia: The present evidence
Authors: Wang Brandon J. , Carter Felicia L. , Altman Kenneth W.
Published: October 2020

There is a high prevalence of dysphagia in patients with neuromuscular diseases and stroke, and consequences can be profound. However, the correlation of dysarthria and oral-oropharyngeal dysphagia remains unclear. This review aimed to define the clinical co-presentation of dysarthria and dysphagia in this population. A PubMed search to identify literature on the prevalence of dysarthria and dysphagia was systematically conducted in the English language literature since 1995. Subjective and objective outcomes instruments were identified for both dysarthria and dysphagia. Studies that included prevalence and co-presentation were included. Inclusion and exclusion criteria were applied according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA). Of the 1,056 articles identified in the search, 20 articles met the search criteria. An additional 4 articles were examined for a total of 24 articles for analysis. Dysarthria and dysphagia were found to be highly prevalent among patients with neuromuscular disease (NMD). Overall, there was a higher prevalence of dysarthria than dysphagia. Of those patients with dysphagia, some reports estimate 76-90% of patients with NMD also had dysarthria. Dysarthria is a strong clinical clue to the presence of dysphagia. Existing subjective questionnaires may not reveal the presence of oropharyngeal dysphagia, but objective measures are more revealing. Further study to correlate the degree of dysarthria and severity of oral-oropharyngeal dysphagia are warranted.
Extramedullary Plasmacytoma of Nasal Cavity: A Case Report and Literature Review
Authors: Hu Xianwen , Peng Chaoyan , Wang Pan , Cai Jiong
Published: October 2020

Extramedullary plasmacytoma (EMP) is a tumor characterized by plasma cell proliferation in organs or tissues outside the bone marrow. It originates from B lymphocytes and can occur in all extramedullary tissues and organs of the body. Primary EMPs of the nasal cavity are relatively rare and mostly presented as case reports. Nasal EMP usually manifests as nasal obstruction, epistaxis, and progressive dyspnea. A 64-year-old man was admitted to our hospital because of rhinorrhagia with nasal obstruction. Computed tomography (CT) revealed a mass in the right nasal passage, which we resected under nasal endoscopy. At the 2-year follow-up, positron emission tomography/CT showed osteolytic bone destruction in the third cervical vertebra and its accessories, accompanied by increased metabolism. We considered the possibility of progression to myeloma, but the patient refused another puncture biopsy. We reviewed the literature for the clinical characteristics and CT findings of 14 patients pathologically confirmed with EMPs of the nasal cavity. All patients had nonspecific clinical manifestations, such as nasal obstruction and epistaxis. Computed tomography mostly showed a uniform-density polypoid mass in the nasal cavity. Therefore, nasal EMP should be included in the differential diagnosis of nasal polyps and other nasal tumors.
Montgomery Salivary Bypass Tube in Head and Neck Cancer: The Experience of Our Otolaryngology Clinic
Authors: Minni Antonio , Ralli Massimo , Di Cianni Simone , Cialente Fabrizio , Candelori Francesca , Colizza Andrea , Cambria Francesca , de Vincentiis Marco
Published: October 2020

Introduction:

One of the most common complications in the immediate and late postoperative period following total laryngectomy or pharyngolaryngectomy is pharyngocutaneous fistulae (PCF) formation and pharyngoesophageal stenosis (PES), causing significant mortality and morbidity. Since 1978, Montgomery salivary bypass tube (MSBT) has been used to reduce the incidence of PCF and PES. The aim of this retrospective study was to analyze the outcomes of using MSBT both as a tool to prevent PCF and PES and to treat these complications in the postoperative period.

Methods:

Between January 2013 and December 2019, we inserted 109 MSBT in 87 patients with laryngeal/hypopharyngeal cancer treated in the Unit of Otolaryngology of our University Hospital.

Results:

Sixty (86.9%) patients healed from complications with primary and secondary placement of MSBT. Seven patients presented a persistence of PCF and 2 presented a recurrence of PES. Secondary placement of MSBT allowed treating successfully 15 (83%) of 18 patients. Only 3 of them presented a PCF at the end of the follow-up period.

Conclusion:

According to our experience, the MSBT is an affordable, easy to apply and well-tolerated tool. Although it is generally used for PCF treatment, it can also be used intraoperatively for PCF and PES prevention.
Juridification as politics: An institutional view
Authors: Croce Mariano
Published: October 2020

In the existing literature on depoliticization, the increasing use of law as a medium to tackle social and political issues is deemed to be detrimental to the legitimacy of political processes. Against this view, I argue that this trend – which some scholars call ‘juridification’ – can be key to giving life to new forms of politics. First, I show why juridification is a political more than a legal process. Second, I illustrate recent critiques of the dangers inherent in the particular type of juridification that involves the growing use of rights. Third, while concurring with these critiques, I make the case that other facets of juridification are often underrated that can ignite a novel kind of politics. On this account, I go on by elaborating on the idea of self-organization of social groups vis-à-vis the state that is entailed in this notion of politics. Finally, I discuss the recognition of non-conventional family networks to exemplify how a politics of juridification could work. The conclusion is that, while juridification calls for a thorough revision of the tasks of politics, it does not thwart it. Rather, traditional representative politics could and should take stock of how it involves social actors in the creation of new bodies of regulation.
Evaluation of Rat Acute Phase Proteins as Inflammatory Biomarkers for Vaccine Nonclinical Safety Studies
Authors: Reagan William J. , Shoieb Ahmed M. , Schomaker Shelli J. , Markiewicz Victoria R. , Clarke David W. , Sellers Rani S.
Published: October 2020

The objectives were to characterize the kinetics of acute phase proteins (APPs) α-2 macroglobulin (A2M), α-1 acid glycoprotein (A1AGP), and fibrinogen (FIB), and injection site macroscopic and microscopic findings following intramuscular administration of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (TDaP; Adacel); adjuvants (aluminum phosphate [AlPO4]; aluminum hydroxide, Al[OH]3; CpG/Al[OH]3; or Quillaja saponaria 21 [QS-21]); or saline to female Wistar Han rats. Intravascular lipopolysaccharide (LPS) was a positive control. Injection sites and lymph nodes were evaluated microscopically, using hematoxylin and eosin (H&E) stained sections, 48 hours postdose (HPD) and compared with APP concentrations; A2M and A1AGP were measured using Meso Scale Discovery analyzer. Fibrinogen was measured on STA Compact analyzer. In a time-course study, APP peaked at 24 or 48 HPD. In a subsequent study at 48 HPD, injection site microscopic changes included inflammation and muscle degeneration/necrosis, which was different in severity/nature between groups. The APPs were not increased in rats administered saline, Al(OH)3, or AlPO4. Fibrinogen and A1AGP increased in rats administered CpG/Al(OH)3, QS-21, or TDaP; and A2M increased in rats administered QS-21. Fibrinogen, A2M, and A1AGP increased after LPS administration. Acute phase proteins can be used to monitor inflammatory responses to adjuvants; however, some adjuvants may induce inflammation without higher APPs.
High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis
Authors: Yeh Shu-Wei , Lin Li-Fong , Chen Hung-Chou , Huang Li-Kai , Hu Chaur-Jong , Tam Ka-Wai , Kuan Yi-Chun , Hong Chien-Hsiung
Published: October 2020

Objective:

This study aimed to investigate the efficacy of high-intensity functional exercise among older adults with dementia.

Methods:

In this systematic review and meta-analysis of randomized controlled trials, we collected articles published before August 2020 from PubMed, Embase, and the Cochrane Library to evaluate the effect of high-intensity functional exercise on older adults with dementia. Primary outcomes included improvements in balance function and gait performance (speed, cadence, and stride length). The secondary outcomes included lower limb strength, activities of daily living, psychiatric well-being, depression, and cognition. Furthermore, we performed subgroup analysis with two high-intensity functional exercise programs: the Umeå program and Hauer’s program.

Results:

We identified 15 articles describing six trials including older adults with dementia undergoing high-intensity functional exercise or control activity. The meta-analysis indicated that high-intensity functional exercise, both in Hauer’s program and in the Umeå program, significantly improved balance function (pooled standardized mean difference 0.57, 95% confidence interval 0.31–0.83). Hauer’s program significantly improved gait speed, cadence, stride length, and lower limb strength. Beneficial effects on speed, cadence, and lower limb strength were retained for several months. The Umeå program facilitated activities of daily living and psychiatric well-being, with effects on activities of daily living lasting several months. In the only eligible trial, no effects on cognition were observed. Adverse effects of high-intensity functional exercise were minimal to none.

Conclusions:

High-intensity functional exercise is generally safe and is recommended for older individuals with mild or moderate dementia to provide benefits in motor performance and daily functioning.
A smartphone application to facilitate adherence to home-based exercise after flexor tendon repair: A randomised controlled trial
Authors: Svingen Jonas , Rosengren Jenny , Turesson Christina , Arner Marianne
Published: October 2020

Objective:

Evaluate the effect of a smartphone application on exercise adherence, range of motion and self-efficacy compared to standard rehabilitation after repair of the flexor digitorum profundus tendon.

Design:

Prospective multi-centre randomised controlled trial.

Setting:

Four hand surgery departments in Sweden.

Subjects:

A total of 101 patients (35 women) (mean age 37.5 ± 12.8) were randomised to control ( n = 49) or intervention group ( n = 52).

Intervention:

A smartphone application to facilitate rehabilitation.

Main outcome measures:

Adherence assessed with the Sport Injury Rehabilitation Adherence Scale at two and six weeks (primary outcome). Secondary outcomes were self-reported adherence in three domains assessed at two and six weeks, self-efficacy assessed with Athlete Injury Self-Efficacy Questionnaire at baseline, two and six weeks. Range of motion and perceived satisfaction with rehabilitation and information were assessed at 12 weeks.

Results:

Twenty-five patients were lost to follow-up. There was no significant between group difference in Sport Injury Rehabilitation Adherence Scale at two or six weeks, mean scores (confidence interval, CI 95%) 12.5 (CI 11.8–13.3), 11.8 (CI 11.0–12.8) for the intervention group, and 13.3 (CI 12.6–14.0), 12.8 (CI 12.0–13.7) for the control group. Self-reported adherence for exercise frequency at six weeks was significantly better for the intervention group, 93.2 (CI 86.9–99.5) compared to the controls 82.9 (CI 76.9–88.8) ( P = 0.02). There were no differences in range of motion, self-efficacy or satisfaction.

Conclusion:

The smartphone application used in this study did not improve adherence, self-efficacy or range of motion compared to standard rehabilitation for flexor tendon injuries. Further research regarding smartphone applications is needed.

Level of evidence:

I. Randomised controlled trial
The effect of an integrated multidisciplinary rehabilitation programme for patients with chronic low back pain: Long-term follow up of a randomised controlled trial
Authors: Schmidt Anne Mette , Laurberg Trine Bay , Moll Line Thorndal , Schiøttz-Christensen Berit , Maribo Thomas
Published: October 2020

Objective:

To compare the long-term effectiveness of an integrated rehabilitation programme with an existing rehabilitation programme, in terms of back-specific disability, in patients with chronic low back pain.

Design:

A single-centre, pragmatic, two-arm parallel, randomised controlled trial.

Setting:

A rheumatology rehabilitation centre in Denmark.

Subjects:

A total of 165 adults (aged ⩾ 18 years) with chronic low back pain.

Interventions:

An integrated programme (a pre-admission day, two weeks at home, two weeks inpatient followed by home-based activities, plus two 2-day inpatient booster sessions, and six-month follow-up visit) was compared with an existing programme (four-week inpatient, and six-month follow-up visit).

Main measure:

The primary outcome was disability measured using the Oswestry Disability Index after one year. Secondary outcomes included pain intensity (Numerical Rating Scale), pain self-efficacy (Pain Self-Efficacy Questionnaire), health-related quality of life (EuroQol-5 Domain 5-level (EQ-5D)), and depression (Major Depression Inventory). Analysis was by intention-to-treat, using linear mixed models.

Results:

303 patients were assessed for eligibility of whom 165 patients (mean age 50 years (SD 13) with a mean Oswestry Disability Index score of 42 (SD 11)) were randomly allocated (1:1 ratio) to the integrated programme ( n = 82) or the existing programme ( n = 83). The mean difference (integrated programme minus existing programme) in disability was –0.53 (95% CI –4.08 to 3.02); p = 0.770). No statistically significant differences were found in the secondary outcomes.

Conclusion:

The integrated programme was not more effective in reducing long-term disability in patients with chronic low back pain than the existing programme.
Telomerase reverse transcriptase rs2736098 polymorphism is associated with lung cancer: A meta-analysis
Authors: Wang Meihua , Sun Yaping
Published: October 2020

Background

A meta-analysis was conducted to determine whether telomerase reverse transcriptase (TERT) rs2736098 polymorphism was related to the incidence of lung cancer.

Methods

We systematically searched the following three electronic databases: PubMed, Embase, and China National Knowledge Infrastructure (CNKI), for relevant articles. Statistical analysis was performed using the odds ratio (OR) and the corresponding 95% confidence interval (CI).

Results

Seven articles involving 3836 healthy controls and 3637 patients were included in this meta-analysis. TERT rs2736098 polymorphism was significantly related to lung cancer incidence (AA vs. GG: OR=1.83, 95% CI=1.58–2.12; AG vs. GG: OR=1.21, 95% CI=1.10–1.34; Dominant model: OR=1.33, 95% CI=1.22–1.46; Recessive model: OR=1.66, 95% CI=1.44–1.90). Moreover, this polymorphism was found to be correlated with the susceptibility to lung cancer when studies were stratified based on the sample size and the Hardy–Weinberg equilibrium.

Conclusion

The present findings indicate that the TERT rs2736098 polymorphism may be a risk factor for the development of lung cancer.
Association between umbilical cord vitamin D levels and adverse neonatal outcomes
Authors: Treiber M. , Mujezinović F. , Pečovnik Balon B. , Gorenjak M. , Maver U. , Dovnik A.
Published: October 2020

Objective

We investigated the associations between cord blood concentration of 25-hydroxyvitamin D [25(OH)D], neonatal outcomes, and the risk of hospitalization during the first year of life.

Methods

A total of 402 newborn infants and their mothers were prospectively enrolled and divided in four groups according to season of the year. We determined 25(OH)D serum concentrations from maternal–neonatal pairs at delivery by electrochemiluminescence immunoassay. Cut-offs at 25, 50, and 75 nmol/L defined vitamin D status, corresponding to deficiency, insufficiency, and sufficiency, respectively. Crude odds ratio (cOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results

Vitamin D severe deficiency (i.e., <25 nmol/L) was present in 18% of newborns. Cord blood severe deficiency was associated with an increased risk of preterm birth (cOR 3.6, 95% CI: 1.1–12.2), neonatal respiratory distress syndrome (cOR 5.9, 95% CI: 1.1–33.2), and increased risk of hospitalization during the first year of life because of acute respiratory infection (cOR 3.9, 95% CI: 1.4–10.6) or acute gastroenterocolitis (cOR 5.2, 95% CI: 1.4–19.1).

Conclusion

Cord blood vitamin D deficiency is associated with increased risk of preterm birth, neonatal respiratory distress syndrome, and hospitalization during the first year of life.
Method for evaluating the human bioequivalence of acarbose based on pharmacodynamic parameters
Authors: Xu Su-Mei , Xu Yu-Ying , Yan Juan , Zhang Yi-Fei , Li Dai , Li Dan , Li Xiao-Min , Guo Jie , Xu Ping-Sheng
Published: October 2020

Objective

To explore a method for evaluating the bioequivalence of acarbose based on pharmacodynamic parameters using a single-dose, randomized-sequence, three-way crossover study of acarbose test (T) and reference (R) formulations.

Methods

Baseline-adjusted, pre-dose value deduction, and direct comparison methods were used to evaluate the geometric T/R ratios and 90% confidence intervals (CIs) of the ln-transformed pharmacodynamic parameters to identify the most suitable evaluation system. Twelve participants were randomly divided into three groups to receive treatment in the following sequences: TRR, RTR, and RRT, each including a 7-day washout period between treatment periods. The serum glucose concentration (baseline) was determined. Pharmacodynamic parameters, including the maximum reduction in serum glucose concentrations (ΔCSG,max) and difference of the AUC of glucose between before and after acarbose exposure (ΔAUEC), were tested.

Results

Using the direct comparison method, the geometric mean ratios of CSG,max, AUEC(0-2h), and AUEC(0-4h) were 94.13%, 97.82% and 99.76%, respectively. The 90% CIs of the geometric T/R ratios for CSG,max, AUEC(0-2h), and AUEC(0-4h) all fell between 80% and 125%. Conversely, ΔCSG,max and ΔAUEC(0-4h) were less reliable measures of acarbose bioequivalence.

Conclusions

Pre-dose value deduction and direct comparison methods can be initially considered suitable for assessing acarbose bioequivalence.
Serum oestradiol levels are inversely associated with C-reactive protein levels in premenopausal women, but not postmenopausal women
Authors: Park Jae-Min , Lee Yong-Jae
Published: October 2020

Objective

Epidemiological studies on the association of serum oestradiol levels and inflammatory markers have reported inconsistent and conflicting results. Therefore, we investigated the association between serum oestradiol and high-sensitivity C-reactive protein (CRP) levels in women on the basis of their menopausal status.

Methods

This cross-sectional study examined the association between serum oestradiol and CRP levels on the basis of menopausal status in 151 premenopausal women aged 42.7 ± 6.7 years and 394 postmenopausal women aged 58.1 ± 6.7 years who participated in a health examination program. Multiple linear regression analysis was conducted using CRP levels as the dependent variable.

Results

Multiple linear regression analysis showed that serum oestradiol levels were inversely associated with CRP levels in premenopausal women (β coefficient = −0.298) after adjusting for age, body mass index, smoking, mean arterial pressure, and levels of fasting plasma glucose, triglycerides, high-density lipoprotein cholesterol, aspartate aminotransferase, and alanine aminotransferase. However, this association was not found in postmenopausal women after adjusting for the same confounding factors.

Conclusions

Serum oestradiol levels are inversely associated with CRP levels in premenopausal women, but not in postmenopausal women. Lower oestrogenic activity may at least partly contribute to the pathogenesis of chronic inflammation, particularly in premenopausal women.
Safety and oncological outcomes for large (stage ≥T2b) and locally advanced renal cell carcinoma: comparison between laparoscopic and modified hand-assisted laparoscopic radical nephrectomy
Authors: Guo Xudong , Wang Hanbo , Xiang Yuzhu , Jin Xunbo , Jiang Shaobo
Published: October 2020

Objective

To compare the operative and oncologic outcomes between hand-assisted laparoscopic radical nephrectomy (HALRN) and laparoscopic radical nephrectomy (LRN) for large (stage ≥T2b) and locally advanced renal cell carcinoma.

Methods

We retrospectively collected data from patients who underwent HALRN or LRN for stage ≥T2b renal cell carcinoma from January 2011 to January 2018 in our institution. The patients’ demographics, perioperative parameters, and postoperative follow-up data were compared between the two groups. The survival outcome was estimated using the Kaplan–Meier method.

Results

The HALRN group comprised 78 patients, and the LRN group comprised 63 patients. The median operative duration was significantly shorter in the HALRN than LRN group. The two groups were equivalent in terms of the incision length, blood loss, complication rate, and duration of hospitalization. In the HALRN and LRN groups, the 5-year overall survival rates were 69.4% and 73.1%, the 5-year cancer-specific survival rates were 80.0% and 83.3%, and the 5-year progression-free survival rates were 66.4% and 74.7%, respectively, with no significant differences.

Conclusions

Compared with LRN, HALRN may offer a shorter operative duration and equivalent surgical outcomes without sacrificing oncological efficacy. In addition, HALRN has specific advantages for extremely large and complicated renal tumors.
Antibiotic-induced black hairy tongue: two case reports and a review of the literature
Authors: Ren Jing , Zheng Yao , Du Hui , Wang Shan , Liu Linna , Duan Wanshi , Zhang Zeping , Heng Lijun , Yang Qi
Published: October 2020

Black hairy tongue (BHT) is characterized by a discolored, hairy tongue. We herein report two cases of BHT associated with antibacterial agents and review previous cases. In Case 1, a 17-year-old girl with a central neurocytoma was administered intravenous piperacillin–tazobactam for postoperative infection, and BHT developed 12 days later. Her symptoms resolved 8 days after she discontinued the piperacillin–tazobactam and brushed her tongue three times daily. In Case 2, a 65-year-old man was administered intravenous piperacillin–tazobactam and levofloxacin to treat multidrug-resistant Pseudomonas aeruginosa, and BHT developed 15 days later. The piperacillin–tazobactam was discontinued and the patient brushed his tongue, and the discoloration gradually subsided thereafter. However, the BHT reappeared after linezolid treatment. The patient had adverse drug reactions to both the piperacillin–tazobactam and linezolid treatments. The BHT might have been related to antibiotic use in both cases. We identified 19 cases of antibiotic-related BHT in a literature search, but none were related to piperacillin–tazobactam use. In all cases, symptoms resolved after discontinuation of the drug and brushing of the tongue. BHT may be a rare adverse effect of antibiotics. Treatment strategies include removal of the causative agents, mechanical debridement, and good oral hygiene.
Association Between Mandibular Prognathism and MATRILIN-1 Gene in Central India Population: A Cross-sectional Study
Authors: Kulkarni Shilpa Devdatt , Bhad Wasundhara A , Doshi Umal H
Published: October 2020

Introduction:

Mandibular prognathism (MP) is known to be an inherited trait. Secondary condylar cartilage is the postnatal growth site of the mandible. Chromosome location 1p36 contains MATRILIN-1, which is related to cartilage matrix formation. The aim of this article is to find out relation between mutation in gene encoding MATRILIN-1 at 1p36 and MP.

Material and Methods:

This case control study included 35 skeletal class III patients with MP (18 males and 17 females in the age range from 6 years to 63 years; mean age was 21.74 ± 12.87 years) and 30 control individuals with orthognathic skeletal relation (17 males, 13 females in the age range from 19 years to 25 years, mean age of 21.57 ± 2.59 years) without any family history of MP. DNA was extracted from venous blood and genotyped. Two loci on chromosome 1p36 (rs20566 and rs1065755) encoding MATRILIN-1 were studied for mutation.

Results:

Single-nucleotide polymorphism (SNP) at rs20566 and frameshift mutation at rs1065755 had a significantly greater frequency in MP cases than in control.

Conclusions:

Mutation at both the sites can be attributed to increased risk of developing MP.
Activity participation patterns of community mental health consumers
Authors: Jennings Courtney , Lhuede Kate , Bradley Gail , Pepin Genevieve , Hitch Danielle
Published: October 2020

Introduction

Previous international research indicates that people with severe mental illness often experience lower levels of activity participation and may therefore be marginalized from occupational opportunities that support recovery. This study aimed to describe activity and participation patterns of consumers of mental health services living in the community and identify significant relationships with demographic characteristics.

Method

A cross-sectional observational study design was utilized, via data mining of the Activity and Participation Questionnaires completed while receiving services from an area mental health service. Data for 282 consumers, who submitted 333 questionnaires, were included.

Results

Consumers were mostly engaged in home-based and unpaid work, and their participation in these tasks significantly increased over time. Significant relationships were found between activity participation and age, gender and primary language. Consumers who were older were less likely to participate in employment, education and physical activity, while female and culturally and linguistically diverse consumers were less likely to engage in activities in the community.

Conclusion

Demographic factors may have a significant impact on the ability of consumers to participate in activities. This may require targeted approaches to activity and participation interventions for specific groups of consumers.
Blinded by the slide show: Ignorance and the commodification of expertise
Authors: Stein Felix
Published: October 2020

This article investigates how commodification operates with reference to expertise, rather than material objects. By drawing on the work of German management consultants, it highlights three forms of ignorance that arise as part of commodifying expertise. These are here described as ignorance due to profit, ignorance due to rhetoric and ignorance due to strong assumptions. These forms of ignorance render invisible the wider socio-economic effects of consulting, hide the degree to which corporate representations may not reflect the world they purport to describe, and postulate specific yet highly skewed understandings of freedom regarding human subjects. Taken together, they point out that a distinguishing feature of the commodification of expertise, vis-à-vis that of material objects, is that it provides greater scope for the creation and use of ignorance, as it blurs the boundaries between commodity and context.
Between the devil and the deep blue sea: Objectivity and political responsibility in the litigation of the Exxon Valdez oil spill
Authors: Kirsch Stuart
Published: October 2020

Objectivity is widely recognized as a fundamental value in the sciences. Yet objectivity may be deployed as a filter or screen that discourages scientists from reflecting on the political consequences of their work. This article examines the relationship between scientific commitment to objectivity and recent critiques of the influence of corporations on research. It does so by analysing legal documents and examples of ‘life writing’, including a prominent environmental sociologist’s candid reflections on his decision to consult for Exxon after 1989 Valdez oil spill in Alaska. The article considers how objectivity may facilitate participation in research intended to promote doubt and uncertainty about the harm caused by corporations. It asks whether such decisions are better understood as unavoidable blind spots or examples of wilful blindness.
Dynamics of wilful blindness: An introduction
Authors: Bovensiepen Judith , Pelkmans Mathijs
Published: October 2020

What are the politics of ignorance in an age of misinformation? How can the concept of ‘wilful blindness’ help us to understand the logics involved? We start the introduction to this special issue by arguing that the intrinsic instability of wilful blindness draws valuable attention to the graded nature of intentionality and perception, and the tensions between them. These features are an essential part of the workings of ignorance, as we illustrate with reference to the shifting intentions of drug couriers, the fleeting moments in which the humanity of victims is recognised in the midst of violent acts, and the affects that channel economic behaviour, such as in the subprime mortgage crisis. When approaching perception and intentionality as complexly entangled in institutionalised fields of power, ‘wilful blindness’ emerges as a powerful and critical diagnostic of the epistemic instabilities of our time.
Arthroscopic Anatomic Glenoid Reconstruction Using Distal Tibial Allograft for Recurrent Anterior Shoulder Instability: Clinical and Radiographic Outcomes
Authors: Wong Ivan , John Rakesh , Ma Jie , Coady Catherine M.
Published: October 2020

Background:

The all-arthroscopic anatomic glenoid reconstruction technique using a distal tibial allograft avoids damage to the subscapularis muscle and allows repair of the capsulolabral tissue.

Purpose:

To analyze the clinicoradiologic outcomes of patients who underwent this procedure to treat anterior shoulder instability with glenoid bone loss with a minimum 2-year follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

Over 6 years, 73 patients (52 male and 21 female; mean age, 28.8 years) under the care of the same surgeon underwent arthroscopic stabilization with capsulolabral Bankart repair and bony allograft augmentation of the glenoid for recurrent shoulder instability with significant bone loss. Pre- and postoperative patient-reported functional assessment was performed using 2 questionnaires, the Western Ontario Shoulder Instability Index (WOSI) and the Disabilities of the Arm, Shoulder and Hand, and radiological assessment was performed using radiographs and computed tomography scans obtained preoperatively and approximately 1 year later (mean ± SD, 0.9 ± 1.1 years).

Results:

The mean follow-up was 4.7 ± 1.1 years. The mean pre- and postoperative WOSI scores were 71.1 ± 17.5 and 25.6 ± 21.9, respectively ( P < .001). There were no recurrences of dislocation, although 1 patient had symptoms of subluxation; however, 5 patients had hardware complications that required screw removal. There were no cases of nerve injury. Postoperative computed tomography scans were available for 66 patients. Seven patients were lost to follow-up. The graft union rate was 100%. Overall, graft resorption was <50% in 86% of patients (57/66). Eighteen patients (27%) had no resorption (grade 0), 39 (59%) had <50% (grades 1 and 2), and 9 (14%) had ≥50% (grade 3); however, none had symptoms of instability. The mean alpha angle of the screw between the screw shaft axis and the native glenoid axis was 18.3°± 5.7°. Graft positioning was flush with the glenoid in 61 of 66 patients (92.4%), and vertical positioning was excellent in 64 of 66 patients (97.0%) (3- to 5-o’clock position).

Conclusion:

Arthroscopic stabilization using distal tibial allograft augmentation resulted in excellent clinicoradiologic outcomes at a 2-year follow-up. This procedure has the advantages of being an anatomic reconstruction that addresses bony and soft tissue instability. However, long-term follow-up studies are necessary for better assessment of outcomes.
Foods for Health: An Integrated Social Medical Approach to Food Insecurity Among Patients With Diabetes
Authors: Blitstein Jonathan L. , Lazar Danielle , Gregory Kathleen , McLoughlin Colleen , Rosul Linda , Rains Caroline , Hellman Talya , Leruth Chelsey , Mejia Jairo
Published: October 2020

Purpose:

Examine a clinic-based approach to improve food security and glycemic control among patients with diabetes.

Design:

One-group repeated-measures design.

Setting:

Federally Qualified Health Centers in a large Midwest city.

Sample:

Of the 933 patients with diabetes who consented at baseline, 398 (42.66%) returned during the follow-up period for a visit that included Hemoglobin A1c (HbA1c) results.

Intervention:

Integrated social medicine approach that includes food insecurity screening, nutrition education, and assistance accessing food resources as a standard-of-care practice designed to minimize disruptions in how patients and providers experience medical care.

Measures:

HbA1c collected as part of a standard blood panel.

Analysis:

Repeated-measure, mixed-effect linear regression models.

Results:

There was a decrease in mean HbA1c (Δ = −0.22, P = 0.01) over the study period. The model examining change over time, glycemic control (GC), and food security status (F1, 352 = 5.80, P = 0.02) indicated that among participants with poor GC (33.12%), food secure (FS) participants exhibited significantly greater levels of improvement than food insecure (FI) participants (Δ = −0.55, P = 0.04). Among participants with good GC, changes in HbA1c were not significantly different between FS and FI participants (Δ = 0.23, P = 0.21).

Conclusion:

Providing nutrition education and food assistance improved HbA1c profiles among FS and FI participants, but FI participants may face social and structural challenges that require additional support from health care teams.
Evaluation of the residual stress in stainless steel 304L hydraulically expanded joints
Authors: Hong Ying , Wang Xuesheng , Wang Yan , Zhang Zhao , Han Yong
Published: October 2020

Stainless steel 304 L tubes are commonly used in the fabrication of heat exchangers for nuclear power stations. The stress corrosion cracking (SCC) of 304 L tubes in hydraulically expanded tube-to-tubesheet joints is the main reason for the failure of heat exchangers. In this study, 304 L hydraulically expanded joint specimens were prepared and the residual stresses of a tube were evaluated with both an experimental method and the finite element method (FEM). The residual stresses in the outer and inner surfaces of the tube were measured by strain gauges. The expanding and unloading processes of the tube-to-tubesheet joints were simulated by the FEM. Furthermore, an SCC test was carried out to verify the results of the experimental measurement and the FEM. There was good agreement between the FEM and the experimental results. The distribution of the residual stress of the tube in the expanded joint was revealed by the FEM. The effects of the expansion pressure, initial tube-to-hole clearance, and yield strength of the tube on the residual stress in the transition zone that lay between the expanded and unexpanded region of the tube were investigated. The results showed that the residual stress of the expanded joint reached the maximum value when the initial clearance was eliminated. The residual stress level decreased with the decrease of the initial tube-to-hole clearance and yield strength. Finally, an effective method that would reduce the residual stress without losing tightness was proposed.
Sample size and sample composition for constructing growth reference centiles
Authors: Cole TJ
Published: October 2020

Growth reference centile charts are widely used in child health to assess weight, height and other age-varying measurements. The centiles are easy to construct from reference data, using the LMS method or GAMLSS (Generalised Additive Models for Location Scale and Shape). However, there is as yet no clear guidance on how to design such studies, and in particular how many reference data to collect, and this has led to study sizes varying widely. The paper aims to provide a theoretical framework for optimally designing growth reference studies based on cross-sectional data. Centiles for weight, height, body mass index and head circumference, in 6878 boys aged 0–21 years from the Fourth Dutch Growth Study, were fitted using GAMLSS. The effect on precision of varying the sample size and the distribution of measurement ages (sample composition) was explored by fitting a series of GAMLSS models to simulated data. Sample composition was defined as uniform on the age λ scale, where λ was chosen to give constant precision across the age range. Precision was measured on the z-score scale, and was the same for all four measurements, with a standard error of 0.041 z-score units for the median and 0.066 for the 2nd and 98th centiles. Compared to a naïve calculation, the process of smoothing the centiles increased the notional sample size two- to threefold by ‘borrowing strength’. The sample composition for estimating the median curve was optimal for λ=0.4, reflecting considerable over-sampling of infants compared to children. However, for the 2nd and 98th centiles, λ=0.75 was optimal, with less infant over-sampling. The conclusion is that both sample size and sample composition need to be optimised. The paper provides practical advice on design, and concludes that optimally designed studies need 7000–25,000 subjects per sex.
Isolation and Differentiation of Amniotic Membrane Stem Cells Into Keratinocytes
Authors: Lan Dam Thi Phuong , Binh Pham Thai , Giang Nguyen Thi Quynh , Van Mao Can , Chung Dang Thanh , Van Diep Nong , Trung Do Minh , Van Tran Pham
Published: October 2020

The human amniotic membrane is a highly abundant and readily available tissue that may be useful for regenerative medicine and cell therapy. The amniotic membrane stem cells can differentiate into multiple cell lineages; they have low immunogenicity and anti-inflammatory functions. This research aims to examine the protocols for the isolation of human amniotic membrane stem cells, including their phenotypic characterization and in vitro potential for differentiation toward keratinocytes. Human placentas were obtained from selected cesarean-sectioned births. We isolated amniotic stem cells by trypsin and collagenase B digestion and centrifuged with Percoll. After monolayer expansion of adherent cells, the cells were characterized by immunocytology with octamer-binding transcription factor 4 and differentiated into keratinocytes by treating the cells with insulin, hydrocortisone, BMP-4, and vitamin C. Protocol for isolation of stem cells from amniotic membrane has high efficiency. Differentiation markers of stem cells into keratinocytes, such as vimentin, cytokeratin (CK) 14, and CK19, were determined by reverse transcription-polymerase chain reaction increase over time in culture. Stem cells isolated from the amniotic membrane can differentiate into keratinocytes. It has opened the prospect of using stem cells to regenerate skin and clinical applications.
Stem Cell Transplantation Therapy: A Potential Method for Treating Cytokine Storm Syndromes Induced by COVID-19
Authors: Wang Hayson Chenyu , Wang Xiaojun , Long Xiao
Published: October 2020

Novel therapies are urgently needed to combat the severe cytokine storm syndromes induced by coronavirus disease 2019 (COVID-19). An increasing number of preclinical and clinical investigations of stem cell and derivatives therapy for COVID-19 were being carried out, among which several studies have preliminarily demonstrated the safety and possible efficacy of stem cell transplantation therapy, providing a hint to solve the tricky situation of anti-COVID-19.
Childhood Overweight: Parental Perceptions and Readiness for Change
Authors: Howard Kristen R.
Published: October 2020

Although the national health crisis of childhood obesity is a well-documented problem, few if any clinical interventions have had success in curbing its growth. In fact, childhood obesity, along with its associated morbidities, continues to climb even in the face of increased awareness. Research shows that factors contributing to obesity are almost entirely modifiable on some level. Furthermore, specific behavior changes have been shown to result in positive outcomes, yet these changes have not been widely implemented by practitioners, families, or individuals. The transtheoretical model of health behavior change offers insight into assessing individuals and targeting interventions for behavior change. This article focuses on guiding school nurses to assess parents of school-age children at risk for obesity for readiness for health behavior change, then choosing parent-focused interventions based on their stage of readiness for change.
Clusters as a Mechanism of Sharing Knowledge and Innovation: Case Study from a Network Approach
Authors: Franco Mário , Esteves Lurdes , Rodrigues Margarida
Published: October 2020

Following a network approach, this study aims to understand the potential of inter-organizational relationships in clusters for sharing knowledge and innovation. To this end, qualitative research of an exploratory nature was undertaken, with the information being gathered through interviews with owners and managers of small and medium-sized family enterprises belonging to an agro-industrial cluster in Portugal. Through content analysis, the results obtained showed that clustering 1 promotes the publicizing and internationalization of products and has an impact on small and medium-sized enterprises’ (SME) results. The importance of the cluster’s action regarding innovation was also confirmed, and so was its potential as a catalyst for the sharing of knowledge. Business-people’s attitude and relational competences, particularly trust, mutual help and having an open mind, were found to be essential factors for successful network functioning and the clustering process. Therefore, this study contributes to the developing existing theory by analysing clustering as inter-organizational networks of sharing knowledge and innovation activities in the light of the network theory and its association with resource-based and knowledge-sharing theories.
Developing a Scale to Measure Institutional Effectiveness in the Context of Indian Business Schools: Using Exploratory Factor Analysis
Authors: Dhir Swati
Published: October 2020

This article is about the development of a measurement scale for assessing institutional effectiveness (IE) in the context of business schools (B-schools) in India. In the twenty-first century, IE has become an integral part of quality higher education. It attracts more scholars and academicians around the globe than ever before. The methodology comprises extensive review of literature, focusing on models and scale construction of IE. The content of the items was validated by academic and industry experts for 30 items under 6 factors. The definitions of the expected constructs were explained to the experts. Then, in the second phase, after the collection and filtration of responses, a total number of 205 respondents of the complete questionnaire were supported by literature review. As a result of the study, a standardized scale was developed with 15 items distributed among four major factors that made it possible to measure and, hence, improve the outcomes of an institution’s mission in terms of its planning, performance and effectiveness. The scale has been tested for content, construct and criterion validity with reliability scores of each factor. The article also provides the limitations of the study and the future scope for researchers to further explore and improve the measurement of the construct named IE.
Book review: Jatinder S. Bedi. 2018. Policy Impacts on Qualitative and Quantitative Aspects of Indian Education Special Emphasis on Punjab
Authors: Kumar Rajiv
Published: October 2020

Jatinder S. Bedi. 2018. Policy Impacts on Qualitative and Quantitative Aspects of Indian Education Special Emphasis on Punjab. Springer Nature Singapore Pte Ltd, Price: €103,99 (₹8,300), pp. 5. ISSN 2198-0012. ISSN 2198-0020 (electronic).
Inclusive Instruction for Students With Emotional/Behavioral Disorders: Service in the Absence of Intervention Research
Authors: McKenna John William , Garwood Justin , Parenti Melissa
Published: October 2020

Various stakeholders continue to have concerns regarding the school performance of students with emotional and behavioral disorders (EBD). In an effort to improve student outcomes, schools may rely on improving student access to general education classrooms (e.g., inclusion). This trend occurs at a time when districts across the nation face heightened expectations regarding the provision of a free appropriate public education. Although federal policy emphasizes the use of research-based practices to improve student outcomes, there appears to be little research to inform decision-making when planning inclusive instruction for students with EBD. In the absence of intervention research, practitioners must largely rely on their professional judgment to operationalize inclusive instruction and monitor student response to inclusive instructional practices. This column summarizes relevant intervention research focusing on academic performance, makes recommendations for additional research to better inform school practice, and suggests practices to improve service delivery.
Ten Years Later: Would You Recognize Universal Design for Learning If You Saw It?
Authors: Edyburn Dave L.
Published: October 2020

This is the third and final column of a special series on the topic of universal design for learning. Interested readers are encouraged to review the previous two articles: Enhancing Executive Function While Addressing Learner Variability in Inclusive Classrooms (Volume 56, Issue 3) and Classroom Menus for Supporting the Academic Success of Diverse Learners (Volume 56, Issue 4). In the following column, I examine the relationship between universal usability and universal design for learning (UDL).