bluuebunny/crossref_metadata_2025 huggingface dataset:
Are the Non-poor Households Nutritionally Secure? An Assessment from NSSO Unit Level Data in India Between 2004–2005 and 2011–2012
Authors: Das Pinaki , Basar Sk Md Abul
Published: September 2020

This article analyses the status of nutrition in relation to the status of poverty among the socio-economic groups in both rural as well as in urban India. It also examines the role of public distribution system (PDS) along with other socio-economic factors in the reduction of nutrition insecurity of poor as well as non-poor households on the basis of National Sample Survey Office (NSSO) unit level data of Consumer Expenditure Survey of the latest rounds. It was found that the incidence of poverty as well as nutrition insecurity has declined significantly in the country during the years 2004–2005 and 2011–2012. However, as much as 24.4 per cent non-poor households in 2011–2012 remained nutritionally insecure. They were higher among the non-poor upper caste households and in the urban areas. The latter spent more on food items, evident in the growth rate of monthly per capita food consumption expenditure (MPFCE). But higher nutrition insecurity because of lower value of calorie accompanied diversification of consumption pattern among these households in favour of protein and fat items. Notwithstanding this trend, level of education, food consumption expenditure, PDS benefits and cultivable land have favourable impact on the nutritional status of non-poor households.
Acceptability and Preliminary Outcomes of a Parenting Intervention for Syrian Refugees
Authors: Sim Amanda L. , Bowes Lucy , Maignant Sandra , Magber Sara , Gardner Frances
Published: September 2020

Purpose:

Forced displacement may increase the risk of child maltreatment and mental health problems among children and caregivers. This study assessed the acceptability and preliminary outcomes of a parenting intervention to prevent child maltreatment and improve parental and child mental health among Syrian refugees in Lebanon.

Method:

292 parents and 88 children participated in a structured assessment before and after a group-based parenting intervention implemented by an international nongovernmental organization serving refugee and vulnerable Lebanese communities.

Results:

Paired sample t tests showed significant reductions in harsh punishment and rejecting parenting behavior and significant improvements in measures of parental and child mental health from pre- to postintervention. On average, parents completed 7.7 of 10 sessions.

Discussion:

Preliminary results suggest that the parenting intervention was acceptable to refugee parents and may show promise in reducing child maltreatment and improving parental and child mental health in a humanitarian setting.
Economic Analysis and Clinical Outcomes of Short-Stay Versus Inpatient Total Ankle Replacement Surgery
Authors: Akoh Craig C. , Fletcher Amanda N. , Chen Jie , Wang Juanto , Adams Samuel A. , DeOrio James K. , Nunley James A. , Easley Mark E.
Published: September 2020

Background:

We aimed to perform an economic analysis and compare the clinical outcomes between inpatient and short-stay designation total ankle replacement (TAR).

Methods:

We performed a retrospective study on 178 consecutive patients undergoing primary inpatient versus short-stay designation TAR during the 2016 and 2017 fiscal years. Patient demographics, concomitant procedures, perioperative complications, patient-reported outcomes, and perioperative costs were collected.

Results:

The mean age of our cohort was 62.5 ± 9.6 years (range, 30-88 years), with a significant difference in age (64.1 vs 58.5 years) ( P = .005) and Charlson Comorbidity Index (3.3 ± 1.9 vs 2.3 ± 1.4; P = .002) for the inpatient and short-stay designation groups, respectively. At a mean follow-up of 29.6 ± 11.8 months (range, 12-52.3 months), there was no difference in complications between groups ( P = .97). The inpatient designation TAR group had a worse baseline Short Musculoskeletal Functional Assessment (SMFA) function score (76.1; 95% CI, 70.5-81.6) than the short-stay designation TAR group (63.9; 95% CI, 52.5-75.3) while achieving similar final postoperative SMFA function scores for the inpatient (55.2; 95% CI, 51.1-59.2) and short-stay (56.2; 95% CI, 48.2-64.2) designation TAR groups ( P > .05). However, the inpatient designation TAR group showed a significantly greater mean improvement in SMFA function score (20.9; 95% CI, 19.4-22.4) compared with the short-stay designation TAR group (7.7; 95% CI, 3.7-11.1) ( P = .0442). The total direct cost was significantly higher for the inpatient designation group ($15 340) than the short-stay designation group ($13 002) ( P < .001).

Conclusion:

While inpatient designation TARs were more comorbid, short-stay designation TARs were associated with a 15.5% reduction in perioperative costs, comparable complication rates, and similar final postoperative patient-reported outcome scores compared with inpatient TARs.

Level of Evidence:

Level III, retrospective comparative study.
Service Ecosystem Design: Propositions, Process Model, and Future Research Agenda
Authors: Vink Josina , Koskela-Huotari Kaisa , Tronvoll Bård , Edvardsson Bo , Wetter-Edman Katarina
Published: September 2020

While service design has been highlighted as a promising approach for driving innovation, there are often struggles in realizing lasting change in practice. The issues with long-term implementation reveal a reductionist view of service design that ignores the institutional arrangements and other interdependencies that influence design efforts within multi-actor service systems. The purpose of this article is to build a systemic understanding of service design to inform actors’ efforts aimed at intentional, long-term change in service systems. To achieve this aim, we inform the conceptual building blocks of service design by applying service-dominant logic’s service ecosystems perspective. Through this process, we develop four core propositions and a multilevel process model of service ecosystem design. The conceptualization of service ecosystem design advances service design theory by illuminating previously taken for granted aspects; explaining how intentional, long-term change emerges; and expanding the scope of service design beyond projects. Furthermore, this research offers a foundation for future research on service design that involves extending the systemic conceptualization of service design, conducting more holistic empirical investigations, and developing practical methods and approaches for the embedded, collective processes of designing.
Changes in vascular access blood flow: Etiological factors and clinical implications
Authors: Lopot František , Malík Jan , Švára František , Polakovič Vladimír
Published: September 2020

Changes in access blood flow (QVA) are of utmost importance in vascular access (VA) management when deciding on VA referral for an intervention. The article elucidates impact of different factors on QVA changes.

Methods:

Records of 10,000 QVA measurement performed in 549 patients over 20 years were used as retrospective and anonymized data source, making ethical commission involvement unnecessary. Two approaches are used to elucidate association of QVA changes with different factors: analyses of smaller cohorts in which both the QVA and the respective factor were measured (e.g. association of QVA with cardiac output (CO)), or—in case of rare phenomena—a form of a well illustrated case reports was used (e.g. association of QVA and Kt/V).

Results:

Significant increase in CO after permanent VA creation (3-4-fold of the QVA value) was found. Impact of intradialytic CO changes on QVA is attenuated by relatively stable VA resistance compared to systemic resistance. Blood pressure impact is much stronger and it should therefore be noted at each QVA measurement. As reproducibility of different QVA measurement methods varies, use of the same method should be preferred. Direction of the arterial needle insertion in VA affects the QVA measured, especially in synthetic grafts, too. Also patient’s own QVA variability may be quite high. All this makes KDOQI/EBPG recommended acceptable QVA drops too strict, they should be revised. In re-stenoses prone patients, measurement intervals should be shortened, too.

Conclusion:

QVA values are significantly affected by many factors. Their knowledge appears essential for safe and effective VA surveillance and management.
Identification of Metastasis-Associated Genes in Triple-Negative Breast Cancer Using Weighted Gene Co-expression Network Analysis
Authors: Xie Wenting , Du Zhongshi , Chen Yijie , Liu Naxiang , Zhong Zhaoming , Shen Youhong , Tang Lina
Published: September 2020

Triple-negative breast cancer (TNBC) is the most aggressive and fatal sub-type of breast cancer. This study aimed to identify metastasis-associated genes that could serve as biomarkers for TNBC diagnosis and prognosis. RNA-seq data and clinical information on TNBC from the Cancer Genome Atlas were used to conduct analyses. Expression data were used to establish co-expression modules using average linkage hierarchical clustering. We used weighted gene co-expression network analysis to explore the associations between gene sets and clinical features and to identify metastasis-associated candidate biomarkers. The K-M plotter website was used to explore the association between the expression of candidate biomarkers and patient survival. In addition, receiver operating characteristic curve analysis was used to illustrate the diagnostic performance of candidate genes. The pale turquoise module was significantly associated with the occurrence of metastasis. In this module, 64 genes were identified, and its functional enrichment analysis revealed that they were mainly associated with transcriptional misregulation in cancer, microRNAs in cancer, and negative regulation of angiogenesis. Further, 4 genes, IGSF10, RUNX1T1, XIST, and TSHZ2, which were negatively associated with relapse-free survival and have seldom been reported before in TNBC, were selected. In addition, the mRNA expression levels of the 4 candidate genes were significantly lower in TNBC tumor tissues compared with healthy tissues. Based on the K-M plotter, these 4 genes were correlated with poor prognosis of TNBC. The area under the curve of IGSF10, RUNX1T1, TSHZ2, and XIST was 0.918, 0.957, 0.977, and 0.749. These findings provide new insight into TNBC metastasis. IGSF10, RUNX1T1, TSHZ2, and XIST could be used as candidate biomarkers for the diagnosis and prognosis of TNBC metastasis.
Journalism, public health, and COVID-19: some preliminary insights from the Philippines
Authors: Bernadas Jan Michael Alexandre C , Ilagan Karol
Published: September 2020

In this essay, we engage with the call for Extraordinary Issue: Coronavirus, Crisis and Communication. Situated in the Philippines, we reflect on how COVID-19 has made visible the often-overlooked relationship between journalism and public health. In covering the pandemic, journalists struggle with the shrinking space for press freedom and limited access to information as they also grapple with threats to their physical and mental well-being. Digital media enable journalists to report even in quarantine, but new challenges such as the wide circulation of health mis-/disinformation and private information emerge. Moreover, journalists have to contend with broader structural contexts of shutdown not just of a mainstream broadcast but also of community newspapers serving as critical sources of pandemic-related information. Overall, we hope this essay broadens the dialogue among journalists, policymakers, and healthcare professionals to improve the delivery of public health services and advance health reporting.
EFL learners’ peer negotiated feedback, revision outcomes, and short-term writing development: The effect of patterns of interaction
Authors: Tajabadi Azar , Ahmadian Moussa , Dowlatabadi Hamidreza , Yazdani Hooshang
Published: September 2020

Inspired by Vygotsky’s sociocultural theory and Storch’s framework of peer interaction, this study investigated the nature and outcome of peer interaction in EFL (English as a foreign language) learners’ peer review and revision activities. During two 16-week semesters, 32 lower-intermediate learners participated in an Advanced Writing university course. Each of the learners wrote and revised six one-paragraph writing assignments and exchanged peer negotiated feedback in pairs. The qualitative analysis of their recorded dialogues revealed that although the learners were nearly at the same proficiency level, they adopted a variety of patterns of interaction including collaborative, expert/novice, dominant/dominant, and dominant/passive. Collaborative and dominant/passive patterns were the most and the least frequent patterns, respectively. The analysis of feedback types indicated that the collaborative pairs exchanged the highest number of feedback in total and could extend their focus to content and organization of the texts more than the other pairs. The lowest number of feedback was observed in pairs adopting a dominant/passive pattern of interaction. Further analysis showed that while collaborative learners succeeded in revising the majority of their errors correctly and had the greatest short-term writing development, the passive learners failed at both to a large extent. These findings are discussed drawing on relevant theoretical and practical literature, and implications for second language (L2) writing instructors and researchers are suggested.
A review on kenaf fiber hybrid composites: Mechanical properties, potentials, and challenges in engineering applications
Authors: Yusuff Ikhwan , Sarifuddin Norshahida , Ali Afifah Mohd
Published: September 2020

The developments of agricultural-based composites for structural applications such as in construction, aerospace, and automotive have gained tremendous interest from researchers due to the uniqueness of its behaviors. Among available agricultural fibers, kenaf fiber widely adopted as a reinforcement in polymer composites to form kenaf reinforced polymer matrix composites. The hybridization technique was introduced to enhance the mechanical performances of composite materials wherein two different types of reinforcements were employed to form a hybrid composite. Therefore, in this review paper, the investigations focus on the mechanical properties of kenaf hybrid composites as well as potentials and barriers of agricultural-based composites were discussed to provide a literature source for future research regarding this topic.
Development of the Healthy Work Collaborative: Findings From an Action Research Study to Inform a Policy, Systems, and Environmental Change Capacity-Building Initiative Addressing Precarious Employment
Authors: Welter Christina , Jarpe-Ratner Elizabeth , Bonney Tessa , C. Pinsker Eve , Fisher Elizabeth , Yankelev Anna , Kapadia Devangna , Love Marsha , Zanoni Joseph
Published: September 2020

Precarious employment (PE) is a complex problem that affects an increasing number of workers across all economic sectors who experience low wages, hazardous conditions, and few benefits, and results in adverse health outcomes. PE is characterized by nontraditional work arrangements, precluding workplace-based interventions. Policy, systems, and environmental initiatives that engage cross-sectoral stakeholders may be an applicable health promotion approach to address PE. The University of of Illinois at Chicago Center for Healthy Work’s Healthy Communities through Healthy Work (HCHW) is an outreach project of the Centers for Disease Control and Prevention/National Institute for Occupational Safety and Health–funded Center of Excellence for Total Worker Health that conducted a multiphased qualitative action research (AR) study. AR designs may be a novel approach to develop initiatives to address problems like PE. This article reports on HCHW’s first AR phase to answer four research questions: (1) What are participants’ perceptions of PE? (2) What are participants’ perceptions of their roles in addressing PE? (3) What initiatives are under way that address PE? and (4) How can the findings be used to facilitate opportunities for healthy work? Key informant interviews with health (public health and health care; N = 23) and labor sector organizations (worker centers, worker advocacy organizations, and unions; N = 21) were conducted. Data were thematically analyzed alongside a chart-based content analysis, and shared in 11 key stakeholder meetings. Findings revealed an opportunity for the labor sector to improve health sector readiness to address PE in the context of health, and were used to develop the Healthy Work Collaborative, a cross-sectoral health promotion capacity building policy, systems, and environmenta change initiative to address PE.
Effects of Nonpharmacological Interventions in Chemotherapy-Induced Peripheral Neuropathy: An Overview of Systematic Reviews and Meta-Analyses
Authors: Hao Jie , Zhu Xiaoshu , Bensoussan Alan
Published: September 2020

Introduction:

Chemotherapy-induced peripheral neuropathy (CIPN) is one of the prevalent and disabling side effects of cancer treatment. However, management strategies for CIPN currently remain elusive, with treatment restricted to neuropathic pain medications, supportive care, and chemotherapy dosing adjustments. This overview explores evidence on the potential benefits and safety of nonpharmacological interventions in preventing and treating CIPN in cancer patients.

Methods:

Seven databases were searched for systematic reviews of randomized controlled trials (RCTs). The methodological quality of the selected reviews was assessed by AMSTAR 2, and the quality of evidence was judged by GRADE. Twenty-eight systematic reviews were considered eligible for this review.

Results:

It was found that nonpharmacological interventions (acupuncture, exercise, herbal medicine, nutritional supplements) provided potential benefits for patients with CIPN. Furthermore, Chinese herbal medicine, administered orally or externally, significantly prevented and/or relieved the incidence and severity of CIPN in comparison to control groups (no additional treatment, placebo, and conventional western medicine). However, the quality of evidence and strength of recommendations were compromised by the inconsistencies and imprecision of included studies. The main concerns regarding the quality of systematic reviews included the lack of sufficiently rigorous a priori protocols, and the lack of protocol registration adopted in the included studies.

Conclusions:

Though looking across reviews, Chinese herbal medicine appear generally effective in CIPN, uncertainty remains about the effects of many other nonpharmacological interventions. The evidence on what works was particularly compromised by reporting and methodological limitations, which requires further investigation to be more certain of their effects.
Endovascular Repair of a Ruptured Thoracoabdominal Aortic Aneurysm With the Sandwich Technique: A Case Report
Authors: Marchal Jérémy , Verhelst Robert , Astarci Parla , Elens Maxime
Published: September 2020

Introduction:

aortic aneurysms involving the renal and visceral arteries are endovascular challenges, especially for emergencies. We report a case of ruptured thoracoabdominal aortic aneurysm (TAAA) in a morbidly obese 71-year-old man. The patient was admitted with a stable hemodynamic state. A computed tomography angiogram (CTA) revealed a contained ruptured TAAA with an occluded celiac trunk and left renal artery due to previous nephrectomy. Due to the emergency and his comorbidities, we performed an endovascular aortic repair with the sandwich technique and 2 chimneys. Two bridging stents (chimneys) were deployed between the aorta and the target vessels (superior mesenteric and right renal arteries) in a space created in-between 2 aortic straight endografts. Ten days postoperative, acute renal failure appeared and right renal stent occlusion was diagnosed on CTA. Unfortunately, no adequate kidney revascularization could be obtained, requiring permanent hemodialysis. At a 3-month follow-up visit, the patient did well with stable aneurysm dimensions.

Conclusions:

encouraging outcomes of chimney-EVAR techniques, comparable to those in published reports of fenestrated-EVAR and branched-EVAR, support this procedure as a valid off-the-shelf available alternative in emergency situations. Nevertheless, only few midterm results achieved are actually available and long-term outcomes are actually unknown.
Surgical Support for Severe COVID-19 Patients: A Retrospective Cohort Study in a French High-Density COVID-19 Cluster
Authors: Noll Eric , Muccioli Christophe , Ludes Pierre-Olivier , Pottecher Julien , Diemunsch Pierre , Diemunsch Sophie , Tchentcheli Anaëlle , Clavert Philippe , Joshi Girish P. , Liverneaux Philippe A.
Published: September 2020

Background. The COVID-19 epidemic has resulted in a massive surge in the need for intensive care unit (ICU) care. To avoid being overwhelmed, hospitals had to adapt and support the ICU teams in structured ICU care including involving surgical teams. This work aims at describing the collaborative efforts between the ICU care team and the Surgical Task Force (STF) during a surge of ICU activity in a University Hospital in a French high-density COVID-19 cluster. Study Design. This retrospective single center study analyzed the STF workflow and the ICU population. The study included 55 patients hospitalized in our ICU, ICU-converted step-down units, and post-anesthesia care units. The primary measure was the global daily STF activity. The secondary measure was the daily activity for each of the 5 tasks accomplished by the STF. Results. The STF attempted 415 phone calls for 55 patients’ families, 237 mobilizations of patients requiring prone positions, follow-up of 20 patients requiring medevac, and contribution to ethical discussion for 2 patients. The mean (SD) daily number of successful phones calls, ethical discussions, mobilizations of patients requiring prone positions and medevac follow-up were 18 (7), .1 (.4), 10 (7), and 2 (3), respectively. No actions for discharge summaries writing were required. The maximum number of daily mobilizations for patients requiring prone positions was 25. The maximum number of daily attempted phone calls and successful phone calls were 37 and 26, respectively. Conclusion. Surgeons’ technical and nontechnical skills represented an effective support for ICU teams during the COVID-19 pandemic.
Delayed mesencephalic venous infarction after endovascular treatment of a giant aneurysm of the posterior cerebral artery: Case report and anatomical review
Authors: Kadooka Keisuke , Anagnostakou Vaia , Bozinov Oliver , Kulcsár Zsolt
Published: September 2020

A 54-year old male patient underwent stent reconstruction of the P1-2 segment of the left posterior cerebral artery (PCA) and concomitant coil embolization of a symptomatic giant partially thrombosed P1 segment aneurysm. After an uneventful postinterventional period, on the 7th day the patient developed severe disturbance of consciousness. The imaging workup demonstrated acute venous infarction in the midbrain, caused by the compressive occlusion of the median anterior pontomesncephalic vein by the aneurysm in the interpeduncular fossa.
Uniformly asymptotic stability of second-order linear time-varying systems
Authors: Gu Da-Ke , Lu Chao
Published: September 2020

This paper is concerned with the stability of second-order linear time-varying systems. By utilizing the Lyapunov approach, a generally uniformly asymptotic stability criterion is obtained by adding the system matrices into the quadratic Lyapunov candidate function. In the case of the derivative of the Lyapunov candidate function is semi-positive definite, the stability criterion is also efficient. Based on the proposed results, the systems with uncertain disturbances such as structured independent and structured dependent perturbations are considered. Using the matrix measure and the singular value theory, the bounds of the uncertainties are obtained that guarantee the system uniformly asymptotically stable, while the bounds of state feedback control input are also derived to stabilize the second-order linear time-varying systems. Finally, several numerical examples are given to prove the validity and correctness of the proposed criteria with existing ones.
“A distant mirror”: Sensemaking in the era of Trump
Authors: Chace Sarah , Lynerd Benjamin T , DeSantis Adrianna
Published: September 2020

Sensemaking is an ongoing act of constructing a reality to be interpreted. While numerous articles have explored the notion of sensemaking in organizations, far fewer have examined it through the empirical prism of an individual case of sensemaking, with the notable exception of Weick’s seminal contribution and formulation, “The Collapse of Sensemaking in Organizations: The Mann Gulch Disaster” (1993). In this article, we seek to build on the literature of sensemaking in organizations by offering an analysis of the actions of former Republican Senator Jeff Flake, whose leadership interventions we interpret as efforts at sensemaking in the era of Trump. In this context, we focus on the US Senate as an organ of sensemaking established by the framers of the Constitution to be relied upon in times of disruption, confusion, and chaos—a check on presidential power established by the framers of the US Constitution to provide prospective sensemaking for uncharted waters. In analyzing the case of Jeff Flake as sense-maker, we rely on certain definitions of leadership embedded in the era of post-truth. We conclude that Flake’s actions may be seen as a distant mirror (to quote Tuchman, 1978 ) of Weick’s treatment of the storied smokejumper Wag Dodge—a sense-maker whose persuasive powers failed him in the moment, only to be viewed in retrospect as the one who paved the way forward toward survival in the midst of a “cosmological episode.”
Radiotracking refines the role of food supplementation on overwinter survival of the Dark-eyed Junco (Junco hyemalis)
Authors: Spellmeyer Andrew J , Rogers Christopher M , Schneegurt Mark A
Published: September 2020

Resource availability, particularly food, can limit the size of bird populations during the nonbreeding season. Resident and short-distance migrant birds, wintering in colder environments, should show strong effects of food limitation on winter survival. Here, we introduce a novel experiment testing for the effect of supplemental feeding on the winter survival of the Dark-eyed Junco ( Junco hyemalis), a short- to medium-distance migrant in North America. Color-ringed juncos were monitored by resighting in the winters of 2011, 2012, and 2013. Winter supplemental feeding significantly increased junco survival within winters. However, it is possible that juncos not resighted underwent within-winter dispersal rather than died. Thus, in the winter of 2014, very high frequency radio transmitters were attached to 29 juncos from unsupplemented sites to ascertain the fate of birds not resighted. We found that movement beyond the study area was minimal and most juncos maintained a discrete home range. Of the radiotagged birds, 27.5% were not resighted during observation periods, but were located and confirmed alive via radiotracking. A correction factor for within-winter dispersal was applied to previous years’ data and the effect of food supplementation remained statistically significant for two of the three winters; the trend was the same, but not statistically significant during the warmest winter. The present results contribute to a developing conceptual model of migration-specific effects of winter food limitation. Dark-eyed Juncos are an iconic backyard birdfeeder species that have shown a steady population decline for decades. Supplemental feeding during the wintering period may regularly elevate population recruitment by increasing winter survival in avian species that winter in thermally challenging environments.
Pharmacological Advances of Chloroquine and Hydroxychloroquine: From Antimalarials to Investigative Therapies in COVID-19
Authors: Song Yang , Fields Elise
Published: September 2020

During the coronavirus disease 2019 (COVID-19) pandemic, numerous existing chemicals have been screened for antiviral potential against the emerging coronavirus severe acute respiratory syndrome coronavirus 2. Chloroquine and hydroxychloroquine, after exhibiting potent in vitro efficacy, have gained tremendous attention. Both therapeutics are derivatives of natural alkaloid quinine and were first synthesized to treat malaria. Thereafter, the pharmaceutical applications of the agents have expanded to many new areas. In this article, the medicinal history and pharmacological activities of chloroquine and hydroxychloroquine are summarized. Antimalarial, anti-inflammatory, antitumor, antiviral properties, and therapeutic potential in the emerging viral infection COVID-19 are discussed. Pharmacokinetics, adverse effects, and toxicities are reviewed.
Ankle Joint Pressure in Supination–External Rotation Injuries: A Biomechanical Study in an Unrestrained Cadaver Model
Authors: Fösel Andreas C. , Seidel Angela , Attinger Marc C. , Zderic Ivan , Gueorguiev Boyko , Krause Fabian G.
Published: September 2020

Background

Previous biomechanical studies simulating supination–external rotation (SER) IV injuries revealed different alterations in contact area and peak pressure. We investigated joint reaction forces and radiographic parameters in an unrestrained, more physiological setup.

Methods

Twelve lower leg specimens were destabilized stepwise by osteotomy of the fibula (SER II) and transection of the superficial (SER IVa) and the deep deltoid ligament (SER IVb) according to the Lauge-Hansen classification. Sensors in the ankle joint recorded tibio-talar pressure changes with axial loading at 700 N in neutral position, 10° of dorsiflexion, and 20° of plantarflexion. Radiographs were taken for each step.

Results

Three of 12 specimen collapsed during SER IVb. In the neutral position, the peak pressure and contact area changed insignificantly from 2.6 ± 0.5 mPa (baseline) to 3.0 ± 1.4 mPa (SER IVb) ( P = .35) and from 810 ± 42 mm2 to 735 ± 27 mm2 ( P = .08), respectively. The corresponding medial clear space (MCS) increased significantly from 2.5 ± 0.4 mm (baseline) to 3.9 ± 1.1 mm (SER IVb) ( P = .028). The position of the ankle joint had a decisive effect on contact area ( P = .00), center of force ( P = .00) and MCS ( P = .01).

Conclusion

Simulated SER IVb injuries demonstrated radiological, but no biomechanical changes. This should be considered for surgical decision making based on MCS width on weightbearing radiographs.

Levels of Evidence:

Not applicable. Biomechanical study
Different cytokine patterns associate with melancholia severity among inpatients with major depressive disorder
Authors: Primo de Carvalho Alves Lucas , Sica da Rocha Neusa
Published: September 2020

Background

Six melancholic features (MFs) of the Hamilton Depression Rating Scale (HAM-D6) represent the construct of melancholia along a continuum of severity (from least to most severe: depressed mood, work and activities, somatic symptoms, psychic anxiety, guilty feelings, psychomotor retardation). We aimed to evaluate the association between these MFs and inflammatory cytokines (IC) in the blood.

Methods

Each IC [interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin 2 (IL-2), IL-4, IL-6, IL-10, and IL-17] was associated with the HAM-D6 MFs of 139 severely depressed inpatients, using multiple linear regressions adjusted for covariates. Levels were compared with those of 100 healthy controls.

Results

Depressed mood was associated with higher levels of IL-4 ( β = 0.167; p = 0.041). Psychic anxiety: lower IL-17 levels ( β = –0.173; p = 0.039). Guilt feelings: lower IL-2 levels ( β = −0.168; p = 0.041) Psychomotor retardation: higher IL-6 levels ( β = 0.195; p = 0.017). Depressed patients’ TNF-α, INF-γ, and IL-4 levels were not significantly different from controls. Depressed patients’ IL-2, IL-6, IL-10, and IL-17 levels were higher than those of controls ( p <0.001).

Conclusion

Less severe MFs (depressed mood, psychic anxiety, and guilt feelings) were associated with an anti-inflammatory pattern (higher IL-4, lower IL-17 and lower IL-2, respectively). The presence of the most severe MF, psychomotor retardation, was associated with a higher pro-inflammatory response (higher IL-6).
The boundaries of pragmatism in Muslim education: Comparing the Islamic pedagogies of Sayyid Qutb and Fethullah Gülen
Authors: Guhin Jeffrey
Published: September 2020

Sayyid Qutb and Fethullah Gülen are two of the most important Muslim leaders and intellectuals of the twentieth century: the two are similar not only for their focus on the relationship between Islam and politics, but also for their lifelong commitments to education. For both Qutb and Gülen, schools were a means through which society itself could be made more just and, ultimately, more Islamic, and for both, their philosophy of education and broader political projects were at once pragmatic and implicitly (for Gülen) and explicitly for Qutb contrasted with American pragmatism. Their differing pedagogies are illustrative of their larger visions: for Qutb, Muslim education must be a “total world” in which Islam is protected from secular contagion, while for Gülen, Muslim education can move more slowly through largely secular means. For Gülen, Islam can work outside of and within a secular system; for Qutb, the system must be changed.
Bisphosphonate-related atypical femoral fractures: A novel strategy to improve patient outcomes
Authors: Sahemey Rajpreet , Nikolaides AP , Bhattacharya S , Simons A , Makrides P
Published: September 2020

Background:

Atypical femoral fracture (AFF) is a serious adverse event associated with bisphosphonate therapy and prone to complications and delayed union. We propose a technique and management strategy to maximise bone healing and outcomes.

Methods:

We report on a cohort of patients with AFF using our novel technique of preparing the intramedullary canal and rigid fixation with cephalomedullary nailing. Patients were admitted under a multidisciplinary team with rehabilitation goals of early mobilisation and teriparatide initiation. Clinical and radiographic data were retrospectively reviewed.

Results:

Twenty-eight AFFs were treated with a mean follow-up of 58.5 weeks and a mean age of 75.2 years old. All cases achieved radiological union by a mean of 6 months and post-operative thigh pain experienced up to 8.7 weeks. No cases underwent revision or experienced intraoperative complication.

Conclusion:

Our surgical technique and multidisciplinary management are reproducible with excellent results in patients with this rare yet challenging injury.
Outcome of triamcinolone acetonide injection for lateral malleolar bursitis
Authors: Goh Tae Sik , Ahn Tae Young , Kim Kyeongbaek , Shin Won Chul , Moon Nam Hoon , Woo Seung Hun
Published: September 2020

Purpose:

This study aimed to evaluate the feasibility and effect of triamcinolone acetonide (TA) injection for lateral malleolar (LM) bursitis.

Methods:

We retrospectively reviewed data of 49 consecutive patients (49 ankles) who received TA injection between March 2016 and March 2019. All cases received 1 ml (40 mg) of TA injection after aspiration of fluid in the LM bursal sac. Subsequently, the ankle was compressed with an elastic cohesive bandage for 2 weeks. Treatment responses were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. We used the Medical Outcomes Study Short Form Health Survey (SF-36) and complications at 2 and 4 weeks and at 3 and 6 months after TA injection.

Results:

Forty-four patients (89.8%) experienced complete resolution, four (8.2%) had partial resolution, and one (2.0%) had no resolution after the first or second TA injection. The physical component scores of SF-36 improved from 72.8 ± 6.0 to 82.3 ± 6.5 at the last follow-up ( p < 0.001). Associated complications included skin atrophy in three patients (6.1%) and transient hyperglycemia in four (8.2%).

Conclusion:

TA injection is an effective and safe procedure for LM bursitis. It should be considered as a primary treatment method.
Biomechanical Comparison of Augmentation of Engineered Tendon-Fibrocartilage-Bone Composite With Acellular Dermal Graft Using Double Rip-Stop Technique for Canine Rotator Cuff Repair
Authors: Wang Zhanwen , Long Zeling , Amadio Peter C. , Gingery Anne , Moran Steven L. , Steinmann Scott P. , Zhao Chunfeng
Published: September 2020

Background:

The retear rate after rotator cuff repair remains unacceptably high. Various biological engineered scaffolds have been proposed to reduce the retear rate. We have developed a double rip-stop repair with medial row knot (DRSK) technique to enhance suture-tendon strength and a novel engineered tendon-fibrocartilage-bone composite (TFBC) for rotator cuff repair.

Hypothesis:

DRSK rotator cuff repair augmented with TFBC will have better biomechanical properties than that of DRSK repair with an acellular dermal graft (DG).

Study Design:

Controlled laboratory study.

Methods:

Fresh-frozen canine shoulders (n = 30) and knees (n = 10) were used. TFBCs were harvested from the patellar tendon–tibia complex and prepared for rotator cuff repair. The infraspinatus tendon was sharply detached from its bony attachment and randomly assigned to the (1) control group: DRSK repair alone, (2) TFBC group: DRSK repair with TFBC, and (3) DG group: DRSK repair with DG. All specimens were tested to failure, and videos were recorded. The footprint area, tendon thickness, load to create 3-mm gap formation, failure load, failure modes, and stiffness were recorded and compared. Data were recorded as mean ± SD.

Results:

The mean load to create a 3-mm gap in both the control group (206.8 ± 55.7 N) and TFBC group (208.9 ± 39.1 N) was significantly higher than that in the DG group (157.7 ± 52.3 N) ( P < .05 for all). The failure load of the control group (275.7 ± 75.0 N) and TFBC group (275.2 ± 52.5 N) was significantly higher compared with the DG group (201.5 ± 49.7 N) ( P < .05 for both comparisons). The stiffness of the control group (26.4 ± 4.7 N/mm) was significantly higher than of the TFBC group (20.4 ± 4.4 N/mm) and the DG group (21.1 ± 4.8 N/mm) ( P < .05 for both comparisons).

Conclusion:

TFBC augmentation showed superior biomechanical performance to DG augmentation in rotator cuff tears repaired using the DRSK technique, while there was no difference between the TFBC and control groups.

Clinical Relevance:

TFBC may help to reduce retear or gap formation after rotator cuff repair using the DRSK technique.
Revisiting the Refugee–Host Relationship in Nakivale Refugee Settlement: A Dialogue with the Oxford Refugee Studies Centre
Authors: Bjørkhaug Ingunn
Published: September 2020

Executive Summary

Uganda has long promoted refugee self-reliance as a sustainable livelihood strategy with progressive land-allocation and free-movement-for-work policies. Framed as a dialogue with related Oxford University Refugee Studies Centre (“the Centre”) research on refugee economies, this article explores sustainable solutions that benefit refugees as well as the host populations that receive them. It explores the self-reliance opportunities that depend on the transnational, national, and local markets in which refugees participate. It acknowledges the Centre’s substantial work and welcomes its focus on economic outcomes. For Nakivale Refugee Settlement in Uganda, however, the discussion of “refugee economies” may not be complete without problematizing the effects on the host populations living alongside the refugees. Based on qualitative data collected at Nakivale in 2013 (concurrent with the Centre’s fieldwork), the article discusses the Centre’s market-based approach to refugee economies by emphasizing four essential considerations: Land distribution in Nakivale is not sustainable. Corruption strongly influences the refugee and host populations living in Nakivale. The impact on the local host population is not homogeneous. Among refugees, the Somali–Congolese relationship is exploitative, not amicable. This article discusses how Uganda’s refugee policies create economic profit for some but poverty for others. As a result, its welcoming open door is on the verge of collapse. The recommendations address alternative refugee-protection approaches that aim to lower the pressure on land allocation, enable a self-sustainable approach that protects the host population, and provide refugees with some degree of self-reliance. This discussion does not discount the Centre’s finding that entrepreneurship is an important part of such solutions. Instead, it addresses the challenges of using entrepreneurship as a durable solution — as long as Uganda’s dominant policy is self-reliance based on distribution of food and land and the refugees’ limited cultivation of that land. To addresses some of the obstacles for durable solutions in a way that protects both the refugees and the host population, this article makes four recommendations for policy and practice. With assistance from the international community, the Ugandan government should: Prioritize the welfare of its citizens who live in Nakivale in the national land-allocation strategy. Enact clear and consistent legislation regarding autochthonous land ownership and use of eviction policies, and design economic reforms to eliminate systemic corruption. Include non-agricultural income-generating activities in the self-reliance policy, and finance entrepreneurs through governmental or international funding. Allow refugees to move away from the settlement without loss of refugee status or access to assistance.
Driving Value Creation Through Proper Design of Goal Realization Frameworks
Authors: van Oijen Pieter
Published: September 2020

Organizations have become increasingly aware that customer value creation is critical to remain relevant and to stay in business. Hence, most organizations have incorporated these elements into their overall mission statement and their organization-wide strategy. Yet many of them struggle to create an organization where employees focus effectively on executing the formulated strategy and on delivering and continuously improving customer value. This article describes how clever and tailored design of goal realization in organizations can foster value creation and embed it in the daily work routines of employees. The key to success is to adopt goal realization in such a way that it creates an environment where employees feel safe, empowered and confident to go after aspirational, value-based goals while creating alignment and connecting employees to the overall goals and objectives of the organization. This is illustrated in a practical manner by presenting the framework as adopted by Google.
Implementation researchers can improve the responses of services to the COVID-19 pandemic
Authors: Øvretveit John
Published: September 2020

This article describes a rapid implementation research project with the Stockholm health care system to assist the system to respond to the COVID-19 pandemic. It uses this example to illustrate some ways in which implementation research and knowledge can contribute to improving service responses to the pandemic and its consequences as these evolve over the coming months. A sub-specialty of rapid implementation science is proposed to provide practical assistance and as one way to develop implementation research.

Plain language abstract

This article describes a rapid implementation research project with the Stockholm health care system to assist the system to respond to the COVID-19 pandemic. It uses this example to illustrate some ways in which implementation research and knowledge can contribute to improving service responses to the pandemic and its consequences as these evolve over the coming months. A sub-specialty of rapid implementation science is proposed to provide practical assistance and as one way to develop implementation research.
Simplified seismic loss assessment for optimal structural retrofit of RC buildings
Authors: Gentile Roberto , Galasso Carmine
Published: September 2020

This study deals with selecting optimal seismic retrofit solutions for reinforced concrete (RC) buildings. To this aim, multi-criteria decision-making (MCDM) is implemented explicitly considering earthquake-induced economic loss as a decision criterion. Fragility (i.e. likelihood of damage levels vs intensity measure ( IM) levels) and vulnerability (i.e. likelihood of loss levels vs IM levels) relationships are derived by using three increasingly refined analysis methods: Simple Lateral Mechanism Analysis; numerical pushover; time-history analysis. A seismically deficient RC school index building, with construction details typical of developing countries, is used for illustrative purposes. Concrete jacketing, addition of concrete walls, and addition of steel braces are the considered retrofit alternatives. Intensity-based expected loss and expected annual loss are adopted in the MCDM, among other criteria, independently derived with the three analysis methods. It is shown that, given the adopted loss-analysis methodology, the ranking of the retrofit alternatives is insensitive to both analysis methods and loss metrics, even when the weight for the seismic loss criterion is high. These findings suggest that simplified methods can be effectively employed in the conceptual/preliminary design of retrofit alternatives.
Optimizing therapy in the modern age: differences in length of maintenance therapy in acute lymphoblastic leukemia
Authors: Teachey David T. , Hunger Stephen P. , Loh Mignon L.
Published: September 2020

A majority of children and young adults with acute lymphoblastic leukemia (ALL) are cured with contemporary multiagent chemotherapy regimens. The high rate of survival is largely the result of 70 years of randomized clinical trials performed by international cooperative groups. Contemporary ALL therapy usually consists of cycles of multiagent chemotherapy administered over 2 to 3 years that includes central nervous system (CNS) prophylaxis, primarily consisting of CNS-penetrating systemic agents and intrathecal therapy. Although the treatment backbones vary among cooperative groups, the same agents are used, and the outcomes are comparable. ALL therapy typically begins with 5 to 9 months of more-intensive chemotherapy followed by a prolonged low-intensity maintenance phase. Historically, a few cooperative groups treated boys with 1 more year of maintenance therapy than girls; however, most groups treated boys and girls with equal therapy lengths. This practice arose because of inferior survival in boys with older less-intensive regimens. The extra year of therapy added significant burden to patients and families and involved short- and long-term risks that were potentially life threatening and debilitating. The Children’s Oncology Group recently changed its approach as part of its current generation of trials in B-cell ALL and now treats boys and girls with the same duration of therapy. We discuss the rationale behind this change, review the data and differences in practice across cooperative groups, and provide our perspective regarding the length of maintenance therapy.
Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA
Authors: Mittal Anurag , Meshram Prashant , Kim Woo Hyun , Kim Tae Kyun
Published: September 2020

Unicompartmental knee arthroplasty (UKA) is a bone- and ligament-sparing alternative to total knee arthroplasty in the patients with end-stage single-compartment degeneration of the knee. Despite being a successful procedure, the multiple advantages of UKA do not correlate with its usage, most likely due to the concerns regarding prosthesis survivability, patient selection, ideal bearing design, and judicious use of advanced technology among many others. Therefore, the purpose of this study is to review and summarize the debated literature and discuss the controversies as “Ten Enigmas of UKA.”