bluuebunny/crossref_metadata_2025 huggingface dataset:
Enzymatic esterification of lauric acid to give monolaurin in a microreactor
Authors: Miao Shanshan , Li Xin
Published: February 2021

Monolaurin is a naturally occurring compound widely utilized in food and cosmetics. In this paper, we present a new method for the synthesis of monolaurin by esterification between lauric acid and glycerol catalyzed by Novozym® 435 using a microreactor. The conversion of lauric acid is 87.04% in 20 min, compared with 70.54% via the batch approach in 5 h. Using an optimized solvent system consisting of t-BuOH/ tert-amyl alcohol (1:1, v/v), the selectivity using the microreactor method is enhanced to 90.63% and the space–time yield of the process is 380.91 g/h/L. This newly devised method has the potential for application to other multiphase and enzymatic reactions.
Safeguarding children
Authors: Shaikh Sabana , Ali Malik Rubena
Published: February 2021

It is the duty of every healthcare professional to ensure they prioritise the welfare of a child by protecting them from physical or psychological harm. Forms of child abuse include physical abuse, emotional abuse, sexual abuse and neglect. A child subjected to emotional abuse or neglect can present with ambiguous symptoms, making the abuse difficult to detect. Safeguarding concerns must be acted upon according to local procedures, guided by the child safeguarding lead and the practice safeguarding policy. Safeguarding multidisciplinary meetings can be an effective way of communicating with various professionals involved with the family.
Association between tumor molecular subtype, clinical stage and axillary pathological response in breast cancer patients undergoing complete pathological remission after neoadjuvant chemotherapy: potential implications for de-escalation of axillary surgery
Authors: Hong Jin , Tong Yiwei , He Jianrong , Chen Xiaosong , Shen Kunwei
Published: February 2021

Background:

Axillary node status is used in clinical practice to guide the selection of axillary surgery in breast cancer patients. However, to date, the optimal axillary management following neoadjuvant therapy (NAT) for breast cancer remains controversial. Our study aimed to investigate the association of molecular subtype, clinical stage, and ypN status after NAT in breast cancer patients, especially those achieving breast pathological complete remission (pCR).

Patients and methods:

Patients receiving ⩾4 cycles of NAT were retrospectively included between January 2009 and January 2020. ypN status was compared among patients with different breast pCR statuses, clinical stages, and molecular subtypes in univariate and multivariate analyses.

Results:

A total of 1999 patients were included: 457 (22.86%), 884 (44.22%), and 658 (32.92%) patients with cT1-2N0, cT1-2N1, and locally advanced breast cancer (LABC), respectively. Altogether, 435 (21.8%) patients achieved breast pCR: 331 with ypN– and 104 with ypN+ status. Patients achieving breast pCR had a significantly lower ypN+ rate than those without pCR [23.9% versus 62.5%, odds ratio (OR) = 0.14, 95% confidence interval (CI) = 0.09–0.21]. For patients with breast pCR, the ypN+ rate was 6.4%, 25.7%, and 33.9% in cT1-2N0, cT1-2N1, and LABC patients, respectively ( p < 0.001). Furthermore, the ypN+ rate was 30.8%, 16.8%, 17.5%, 29.6%, and 27.6% in breast pCR patients with the Luminal A, Luminal B (HER2+), HER2-amplified, Luminal B (HER2–), and triple-negative subtype, respectively. Luminal B (HER2+) (OR = 0.20, 95% CI = 0.05–0.82) and HER2-amplified (OR = 0.19, 95% CI = 0.05–0.83) tumors were associated with lower ypN+ rates. Moreover, 100% of breast pCR patients with cT1-2N0 and HER2-positive disease achieved pathological pN0.

Conclusion:

In breast pCR patients after NAT, clinical stage and molecular subtype were significantly associated with ypN status. Patients with cT1-2N0 and HER2-positive disease who achieved breast pCR had a very low ypN+ rate, possibly indicating the possibility for de-escalation of axillary surgery in this patient subgroup.
Measurement of Tryptase and CC16/Albumin in Nasal Lavage Fluid as a Screening Tool of Allergic Rhinitis
Authors: Kwon Oh Eun , Lee Young Chan , Park Jung Min , Kim Sung Wan , Eun Young-Gyu , Ko Seong-Gyu
Published: February 2021

Background

There is no trial to make a diagnostic tool of allergic rhinitis (AR) utilizing biomarkers from nasal fluid. Base on previous studies, we selected following five biomarkers in nasal fluids that represent the characteristics of allergic reactions: tryptase, eosinophil cationic protein (ECP), interleukin 5 (IL-5), Clara cell protein 16 (CC16) and CC16-to-albumin ratio.

Objective

This study aimed to identify biomarkers in nasal discharge that may be used in biosensors to diagnose AR as an additional diagnostic tool.

Methods

Patients showed rhinorrhea and tested positive on allergic skin and specific immunoglobulin E (IgE) tests were included in the AR group. The non-AR group included individuals no dominant nasal symptoms and tested negative on allergy tests. Nasal lavage fluid samples were collected from all participants. Biomarkers in the samples were quantified using enzyme-linked immunosorbent assay.

Results

Forty-five patients with AR and 28 non-AR subjects were enrolled in this study. Comparing the concentrations of biomarkers, the concentrations of tryptase and IL-5 were significantly higher in the AR group than in the NAR group. And CC16 level and CC16-to-albumin ratio were significantly lower in the AR group. In the combination of tryptase or CC16-to-albumin ratio, the sensitivity was 90.7% and the specificity was 64.3% ( p = 0.013).

Conclusion

The combination of “tryptase or CC16-to-albumin” could be used as a screening tool for AR. Although this diagnostic method could not replace conventional diagnostic tools, we could consider the method we proposed as an additional screening tool for patients who could not undergo allergy tests.
Myogenic dedifferentiation is associated with poor outcomes in retroperitoneal dedifferentiated liposarcomas
Authors: Dorian Yarih Garcia-Ortega , Claudia HS Caro-Sánchez , Alethia Alvarez-Cano , Mario Alvarez-Bojorquez , Emmanuel Melgarejo-Estefan , Ernesto Rodríguez-Ayala
Published: February 2021

Sarcomas are a heterogenous group of malignant tumors with origin or mesenchymal differentiation, they comprise 1–2% of all solid tumors. Retroperitoneum is the second most frequent site affected. Prognosis is worse compared to the limbs, with a 5y OS of 36–58%, and 50–60% patients will relapse. Dedifferentiated liposarcomas (ddLPS) are more aggressive, it is known that presence of a de-differentiated component increases the probability of distant recurrence and lowers OS. There is little information about the specific impact of each type of de-differentiation. To determine if the presence of myogenic differentiation markers in DDLPS is an adverse prognostic factor. A retrospective, observational, analytic cohort study was performed. Cases identified from the electronic clinical files from the National Cancer Institute in Mexico City, we included cases from January 1st 2005 to December 31st 2016. We correlated the presence of expression of myogenic markers (Smooth muscle actin, Calponin, H-caldesmon, Desmin and Myogenin) in the dedifferentiated component of DDLPS with overall survival and surgical outcomes. One hundred and forty-three cases were analyzed. Eighty-two were liposarcomas, and 38 had a dedifferentiated component. Of these 38 cases, 21(55.3%) were males and, 17(44.7%) were females. Median age was 54.1(27–79) years, median tumor size was 28 cm (13–56). Most patients had locally advanced disease: 32(84.2%) were in stage IIIB. 2.6% had metastatic disease and 5(13.2%) had stage Ib at diagnosis. Myogenic marker expression was found in 18.4% of cases; these patients had a worse median survival than cases with no myogenic expression: 18 months (95% CI 15.4–20.5) vs 32 months (95% CI 21.8–42.1) p = 0.01, we also found a relation with higher postoperative morbidity in these cases ( p = 0.045). The presence of myogenic differentiation markers might be associated with a worse prognosis, in our series it corelated with worse OS, however it is not a common event. Relation with surgical morbidity is to be analyzed in further studies.
Asymmetric Brightness Effects With Dark Versus Light Glare-Like Stimuli
Authors: Kobayashi Yuki , Zavagno Daniele , Morikawa Kazunori
Published: February 2021

The glare effect is a brightness illusion that has captured the attention of the vision community since its discovery. However, its photometrical reversal, which we refer to here as photometrical reversed glare (PRG) stimuli, remained relatively unexplored. We presented three experiments that sought to examine the perceived brightness of a target area surrounded by luminance gradients in PRG stimuli and compare them with conventional glare effect configurations. Experiment 1 measured the brightness of the central target area of PRG stimuli through an adjustment task; the results showed that the target appeared brighter than similar, comparative areas not surrounded by luminance gradients. This finding was unexpected given the recent report that PRG stimuli cause pupil dilation. Meanwhile, Experiments 2 and 3 implemented a rating task to further test the findings in Experiment 1. Again, the study found a robust brightening illusion in the target area of PRG stimuli in a wide range of target and background luminance. The results are discussed in comparison with the brightness enhancement of the glare effect.
Post-decellularization techniques ameliorate cartilage decellularization process for tissue engineering applications
Authors: Nouri Barkestani Mahsa , Naserian Sina , Uzan Georges , Shamdani Sara
Published: February 2021

Due to the current lack of innovative and effective therapeutic approaches, tissue engineering (TE) has attracted much attention during the last decades providing new hopes for the treatment of several degenerative disorders. Tissue engineering is a complex procedure, which includes processes of decellularization and recellularization of biological tissues or functionalization of artificial scaffolds by active cells. In this review, we have first discussed those conventional steps, which have led to great advancements during the last several years. Moreover, we have paid special attention to the new methods of post-decellularization that can significantly ameliorate the efficiency of decellularized cartilage extracellular matrix (ECM) for the treatment of osteoarthritis (OA). We propose a series of post-decellularization procedures to overcome the current shortcomings such as low mechanical strength and poor bioactivity to improve decellularized ECM scaffold towards much more efficient and higher integration.
Change agents’ experiences of implementing a new organizational culture in residential care for older people: A qualitative study
Authors: Ericson-Lidman Eva , Strandberg Gunilla
Published: February 2021

Culture change in organizations may affect employees and change agents are often a forgotten resource; their perspective is often overlooked in research. The aim of the study was to illuminate experiences of being a change agent in order to improve residential care of older people. Interviews were performed with 15 change agents who participated in a large culture transformation in residential care for older people. The study followed COREQ guidelines and content analysis was used to interpret the text. The analysis revealed that the change agents felt chosen when they accepted the challenge to become a change agent, but they also felt that transferring the message to co-workers was demanding. Conflicting demands about measuring care and aggravating circumstances to implement change were described. The results indicate that change agents benefit from preparation for the role itself as they have a great responsibility on their shoulders. In making the process more successful, all co-workers should be involved in the change process from the beginning.
Biomechanical Evaluation of Extramedullary Versus Intramedullary Reduction in Unstable Femoral Trochanteric Fractures
Authors: Kawamura Tadashi , Minehara Hiroaki , Tazawa Ryo , Matsuura Terumasa , Sakai Rina , Takaso Masashi
Published: February 2021

Introduction:

The failure rate of operations involving the cephalomedullary nail technique for unstable femoral trochanteric fractures is 3-12%. Changing the reduction strategy may improve the stability. This study aimed to confirm whether reducing the proximal fragment with the medial calcar contact, as opposed to utilizing an intramedullary reduction, would improve the stability of such fractures.

Materials and Methods:

The unstable femoral trochanteric fracture model was created with fixation by cephalomedullary nails in 22 imitation bones. The 2 reduction patterns were as follows: one was with the proximal head-neck fragment external to the distal bone in the frontal plane and anterior in the sagittal plane as “Extramedullary,” while the other was the opposite reduction position, that is, bone in the frontal plane and sagittal plane as “Intramedullary.” We evaluated the tip-apex distance, compression stiffness, change in femoral neck-shaft angle, amount of blade telescoping, and diameter of the distal screw hole after the compression test. Statistical analysis was conducted using the Mann-Whitney U test.

Results:

No significant differences were seen in compression stiffness ( p = 0.804) and femoral neck-shaft angle change ( p = 0.644). Although the “Extramedullary” tip-apex distance was larger than the “Intramedullary” distance ( p = 0.001), it indicated clinically acceptable lengths. The amount of blade telescoping and the distal screw hole diameter were significantly larger in “Intramedullary” than in “Extramedullary” ( p < 0.001, p = 0.019, respectively). Our results showed that “Intramedullary” had significantly larger blade telescoping and distal screw hole diameters than “Extramedullary,” and contrary to our hypothesis, no significant differences were seen in compression stiffness and femoral neck-shaft angle change.

Conclusions:

As opposed to the “Intramedullary” reduction pattern, the biomechanical properties of the “Extramedullary” reduction pattern improved stability during testing and decreased sliding.
Home Run Derby Participation in Major League Baseball Players: Is There Associated Injury Risk and Impact on Second-Half Performance?
Authors: DeFroda Steven F. , Staffa Steven J. , Keeley Tim , Kriz Peter K.
Published: February 2021

Background:

The Major League Baseball (MLB) All-Star Game (ASG) Home Run Derby (HRD) remains a highly anticipated event, during which contestants can take hundreds of maximum-effort swings en route to hitting a multitude of home runs. Critics have openly questioned the risk-benefit of HRD participation as it pertains to injury, alterations in swing mechanics, and timing.

Purpose:

To determine whether participation in the MLB ASG HRD was associated with both increased injury risk and decline in second-half performance in MLB players.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

MLB players who participated in the HRD between 2006 and 2019 were identified through publicly available internet databases. A control group of ASG participants who had the highest home run totals in the first half of the corresponding MLB season were selected as a control group. Multivariable linear regression was used to determine independent associations between HRD participation and batting metrics in the second half of the season. Multivariable logistic regression also assessed the impact of HRD participation on injured list placement during the second half of the concurrent MLB season.

Results:

A total of 114 HRD participants and 114 ASG participant controls competed during the study period. No statistically significant differences were seen in batting metrics in the second half of the MLB season between HRD participants and ASG controls, although HRD participants had a significantly lower wins-above-replacement statistic for the season compared with controls (4.69 ± 2.06 vs 5.33 ± 2.08; P = .021). HRD participation was not significantly associated with injury during the second half. The number of HRD rounds in which a player participated did not result in a statistically significant increased odds of injury during the second half of the MLB season.

Conclusion:

HRD participants did not have increased odds of being placed on the injured list during the second half of the MLB season compared with controls, nor did they experience second-half performance declines in offensive production versus controls when multivariable linear regression analysis was performed.
Prevalence and Severity of Juvenile Osteochondritis Dissecans in Patients With Juvenile Idiopathic Arthritis
Authors: Hinkle Andrew , Dickason Celeste Quitiquit , Jinguji Thomas , Shenoi Susan , Thapa Mahesh , Saper Michael G. , Bompadre Viviana , Schmale Gregory A.
Published: February 2021

Background:

Juvenile idiopathic arthritis (JIA) is a heterogeneous group of chronic arthritides presenting in patients aged ≤16 years, with a prevalence of 16 to 150 per 100,000. Juvenile osteochondritis dissecans (OCD) is an idiopathic disease of articular cartilage and subchondral bone, has an onset age of 10 to 16 years, and often affects the knee, with a prevalence of 2 to 18 per 100,000. Currently, there are few studies that have evaluated the relationship between JIA and OCD.

Hypothesis:

OCD is more prevalent in children with JIA, and when diagnosed in such patients, OCD often presents at an advanced state.

Study Design:

Case series; Level of evidence, 4.

Methods:

The medical records of patients with diagnoses of both JIA and OCD treated between January 2008 and March 2019 at a single children’s hospital were retrospectively reviewed. Associations between timing of diagnoses, number and types of corticosteroid treatments, category of arthritis, timing of diagnoses, and lesion stability were examined with Spearman correlation coefficients.

Results:

A total of 2021 patients with JIA were identified, 20 of whom (19 female, 1 male) had OCD of the knee and/or talus for a prevalence of 1 in 100 or 1000 in 100,000, or approximately 50 to 500 times that of the general population. These 20 patients had a total of 28 OCD lesions: 43% (9 femur, 3 talus) were radiographically stable over time, 50% (10 femur, 2 patella, 2 talus) were unstable at initial diagnosis, and 7% (2 femur) were initially stable but progressed to unstable lesions despite drilling. Twelve patients (60%) underwent surgery: 4 (20%) with stable femoral lesions for persistent symptoms despite prolonged nonoperative treatment and 8 (40%) for treatment of their unstable lesions (femoral and patellar). Within our study design, we could identify no significant associations between lesion stability and timing of diagnoses, number of joint injections, or limb deformities, nor were there associations between timing of JIA and OCD diagnoses and category of arthritis.

Conclusion:

In our population of patients with JIA, OCD lesions were found to be 50 to 500 times more prevalent when compared with published rates in the general population and often presented at an advanced state, with instability or delayed healing requiring surgery for stabilization or resolution of symptoms.
Comparison of Superior Capsular Reconstruction and Partial Infraspinatus Repair: A Matched-Pair Analysis of Irreparable Rotator Cuff Tears
Authors: Greiner Stefan , Kaeaeb Max , Voss Andreas , Lawton Robert , Bhide Pushkar , Achenbach Leonard
Published: February 2021

Background:

Superior capsular reconstruction (SCR) represents a new option for the treatment of irreparable rotator cuff tears.

Purpose/Hypothesis:

This study aimed to evaluate the clinical and radiologic outcomes of SCR and compare them with the outcomes of partial repair (PR) of the infraspinatus tendon. The hypothesis was that there would be no significant differences between the clinical and radiologic outcome parameters of SCR and PR after a minimum follow-up of 2 years.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Of 21 patients who underwent SCR, 20 patients were matched in a 1:1 ratio according to sex, age, and tear configuration with 20 of 60 patients who had undergone PR; all patients were prospectively evaluated for a minimum follow-up of 2 years. The investigated outcome measures included the Constant score; Western Ontario Rotator Cuff (WORC) index; Disabilities of the Arm, Shoulder and Hand (DASH) score; and radiologic analysis of acromiohumeral distance (AHD) and humeral head centralization (HHC).

Results:

There were no differences in the demographic data between the SCR and PR groups. The mean age of both groups was 62.3 years (range, 47-79 years), the mean tear configuration was Bateman 3.0 and Patte 2.8, and the mean follow-up period was 29.4 months (range, 24-53 months). At final follow-up, no significant differences were seen between the SCR and PR groups with regard to Constant score (77.1 vs 82.7), age- and sex-adapted Constant score (85.5% vs 91.4%), DASH score (15.6 vs 7.8), or WORC index (81.1 vs 90.4). No significant differences in the AHD or HHC were seen between the groups. The reoperation rate was 4.8% (1/21) in the SCR cohort and 15% (9/60) in the PR cohort.

Conclusion:

Both SCR and PR resulted in significant improvements in patient-reported outcomes at 2-year follow-up, with no significant differences in clinical outcomes between the 2 techniques. Further follow-up is needed to determine whether there are long-term differences in HHC and development of cuff tear arthropathy. Further investigations should also focus on the cost-effectiveness of the respective procedures.
Characteristics of Orthopaedic Sports Medicine Fellowship Directors
Authors: Belk John W. , Littlefield Connor P. , Mulcahey Mary K. , McCarty Torrance A. , Schlegel Theodore F. , McCarty Eric C.
Published: February 2021

Background:

No study in the orthopaedic literature has analyzed the demographic characteristics or surgical training of sports medicine fellowship directors (FDs). Objective determinations as to what makes a physician qualified for this leadership position remain unclear; thus, it is important to identify these qualities as future physicians look to fill these roles.

Purpose:

To illustrate characteristics common among sports medicine FDs.

Study Design:

Cross-sectional study.

Methods:

The 2020 Accreditation Council for Graduate Medical Education Fellowship Directory was used to identify the FDs for all orthopaedic sports medicine fellowship programs in the United States. The characteristics and educational background data for FDs were gathered by 2 independent reviewers from up-to-date curricula vitarum, Web of Science, and institutional biographies and consolidated into 1 database. Data points gathered included age, sex, residency/fellowship training location and graduation year, name of current institution, length of time at current institution, time since training completion until being appointed FD, length of time in current FD role, and personal research H-index.

Results:

We identified 90 current orthopaedic sports medicine FDs. The mean Scopus H-index was 24.1 (median, 17). The mean age of FDs was 55.4 years; 87 of 90 (96.7%) were male and 3 (3.3%) were female; and 79/90 (87.8%) were White and 3/90 (3.3%) were African-American. The mean time to complete residency was 5.1 years (range, 5.0-6.0 years), and the most attended residency programs were the Hospital for Special Surgery (n = 9), the Harvard Combined Orthopaedic Residency Program (n = 5), and Duke University Medical Center (n = 4). The mean time required to complete a fellowship was 1.1 years (range, 1.0-2.0 years), and the fellowship programs that produced the most future FDs were the American Sports Medicine Institute (n = 11), the Steadman Hawkins Clinic (Vail) (n = 8), the Kerlan-Jobe Orthopaedic Clinic (n = 7), and the Hospital for Special Surgery (n = 7). The mean time from completion of fellowship to appointment as a FD was 12.8 years (range, 1-39 years).

Conclusion:

Women and minority groups are largely underrepresented among leadership positions in the field of orthopaedic sports medicine.
Is the learning curve for arthroscopic Latarjet procedure facilitated by a specific step-by-step guiding system for the surgical technique?
Authors: Belas Maxime , Gaujac Nicolas , Bouche Pierre Alban , Charousset,MD Christophe
Published: February 2021

Objectives:

Treating anterior shoulder instability with the arthroscopic Latarjet procedure is a complex, operator-dependent technique that requires a learning curve. The objective of the study is to compare a guided technique with cortical button fixation and a non-guided technique with screw fixation.

Methods:

This is a retrospective study including 72 consecutive patients who underwent surgery for recurrent anterior shoulder instability by the arthroscopic Latarjet procedure, with a mean age of 26 years and minimum clinical follow-up of 6 months. The same surgeon performed all the surgeries. The procedure was performed either with an instrument set and dedicated instrumentation that guides the different surgical steps and fixed by two cortical buttons connected by loops of a continuous thread (Group A) or with a specific instrument set and fixed by two cortical screws (Group B). We compared the difficulty of the different surgical steps, each rated from 1 to 5 (1 being the simplest and 5 the most difficult), the number of procedures required to attain a level of difficulty, the operating time and the intraoperative or postoperative complications.

Results:

Coracoid preparation had a score of 1.3 in group A versus 2.9 in group B (p<0.001) with a difficulty level of 1 as of 19 procedures. The Subscapularis split had a score of 1.9 in group A versus 3.2 in group B (p<0.001) with a level as of 15 procedures. Horizontal positioning of the bone block scored 1.4 in group A versus 1.8 in group B (p=0.019) with a level as of 15 procedures. The mean operating time was 95 minutes in group A and 123 minutes in group B (p<0.0001). There was one coracoid fracture in group A, one case of sepsis and 2 repeat procedures for screw removal in group B, and 2 reversible neurological complications in each group.

Conclusion:

The Latarjet procedure performed under arthroscopy remains a difficult procedure. An instrument set and dedicated instrumentation with reciprocating rasp and saw, posterior glenoid drill guide and subscapularis retractors allow faster and more reproducible learning.
What did we learn from our first arthroscopic Trillat procedures? Results, complications and failures in a series of 100 anterior shoulder stabilizations
Authors: Labattut Ludovic , Chauvet Thomas , Colombi Romain , Baulot Emmanuel , Martz Pierre
Published: February 2021

Objectives:

Arthroscopic adaptation of the Trillat procedure has become a part of the armamentarium for anterior shoulder instability. As the first team to have described a surgical technique, we present the results of our first 100 patients.

Methods:

This is a cohort study on a prospective database, descriptive of patients who had undergone surgery for chronic anterior shoulder instability between March 2011 the date our technique was developed, and October 2019. Patients were clinically and radiologically evaluated preoperatively (standard radiographs, CT scan) and postoperatively (standard radiographs) at 1, 3, 6 and 12 months and by CT scan 6 months postoperatively to evaluate the consolidation of the coracoid fracture and subscapularis muscle trophicity. Functional results were evaluated by Constant, SSV, Walch/Duplay and Rowe scores and recurrences of accidents due to instability and complications were collated.

Results:

100 patients, mean follow-up of 25 months (6-96), mean age, 29 years (15-73), 71% sportspeople, mean age at first episode, 20 years (7-59), 20% hyperlaxity. 67% notches, 22% bony Bankart, 15% glenoid wear and 2% rotator cuff tear. The surgical technique was identical, there were 3 operators, average operating time was 50 min (26-145), 70% were ambulatory, there were 13 fractures and no conversion to an open technique. At the last follow-up there were 3 recurrences of luxation and 4 recurrences of subluxation and in 4 cases failure to recover muscle tone was noted. 95% of the sportspersons resumed their activity, 81% at the previous level. One year postoperatively, the Walsh-Duplay score was 88 (40-100) and the Rowe score was 92 (40-100). There were 4 cases of pseudoarthrosis, 3 of which were due to a technical defect, 2 coracoid fractures, 1 case of resolving sepsis and no neurological complications. There was no damage to the subscapularis. 97% of the patients were satisfied or very satisfied.

Conclusion:

This is the largest available series on the arthroscopic Trillat procedure. The results are identical to those in the preliminary series and as good as those for the reference techniques. Failures and complications were few and often the result of technical errors. The recovery of muscle tone in the limb on which surgery was performed seemed to influence the effectiveness of stabilization.
Complete and partial repair of massive rotator cuff tears provide sustainable long term improvement in clinical scores
Authors: Besnard Marion , Freychet Benjamin , Clechet Julien , Carrillon Yannick , Godenèche Arnaud
Published: February 2021

Objectives:

The aim was to report results of arthroscopic repair of 86 massive cuff tears and decided to assess whether or not clinical scores were maintained 5 years later.

Methods:

Of the initial series of 86 shoulders, 2 patients died, 16 were lost to follow-up and 4 had a repeat surgery. Therefore, it was possible to reevaluate 64 patients. Repairs were complete in 44 cases and partial in 20 cases. Seventeen shoulders were pseudoparalytic. Tears with fatty degeneration at stage 4 or higher according to the Goutallier classification were not eligible for repair. Preoperatively, the Constant Score (CS), shoulder strength, location of the tear, tendon retraction and degree of fatty infiltration were assessed. Patients were assessed at 8.1±0.6 years [7.1-9.3] using absolute and age- and sex-adjusted CS, the subjective shoulder value (SSV) and the simple shoulder test (SST).

Results:

The absolute CS was 80.0±11.7 at the first follow-up (at 2-5 years) and decreased to 76.7±10.2 at the last follow-up (at 7-10 years) (p<0.001). The adjusted CS was 99.7±15.9 at the first follow-up and remained at 98.8±15.9 at the last follow-up (ns.). In terms of the other criteria, strength decreased over time (p<0.001) but pain, SSV and SST remained the same. Partial repairs had less strength at the first and last follow-up (p<0.05). Pseudoparalytic shoulders had a lower absolute and adjusted CS at the last follow-up (p<0.05) but the improvement in CS was greater (p=0.014).

Conclusion:

Partial and complete arthroscopic repair provide good long-term results in patients with massive rotator cuff tears, regardless of the location of the tear, the degree of fat infiltration (I to III according to the Goutallier classification) and even in case of a pseudoparalytic shoulder.
Exploring Changes in Caregiver Burden and Caregiving Intensity due to COVID-19
Authors: Cohen Steven A. , Kunicki Zachary J. , Drohan Megan M. , Greaney Mary L.
Published: February 2021

This study explored self-reported changes in caregiving intensity (CI) and caregiver burden (CB) among informal caregivers due to the COVID-19 pandemic overall and by gender. Informal caregivers for someone age 50+ completed a survey via Amazon’s MTurk in June 2020. Participants reported changes in CI and CB due to COVID-19 and provided demographic information. Multinomial logistic regression models assessed changes in CI and CB attributed to the COVID-19 pandemic overall and by gender. The sample ( n = 835) was 68.5% male and had an average age of 34 years ( SD 9.8); 55.7% had increased CI, and 53.1% had increased CB attributed to the pandemic. Increased CB due to COVID-19 was associated with increased CI (OR 5.67, 95% CI 3.92–8.00). Male caregivers with decreased CI due to COVID-19 were nearly seven times as likely as those with no change in CI to have reduced CB due to COVID-19 (OR 6.91, 95% CI 3.29–14.52). Women with decreased CI due to COVID-19 were over eight times as likely to have reduced CB due to COVID (OR 8.30, 95% CI 2.66–25.91). Results indicate that many caregivers experienced increases in CI and CB since the start of the COVID-19 pandemic, and that these changes are complex and vary by gender.
Impact of the COVID-19 Pandemic on Self-Perception of Aging Among Older Adults
Authors: Seifert Alexander
Published: February 2021

The COVID-19 pandemic has created a pattern of physical distancing worldwide, particularly for adults aged 65+. Such distancing can evoke subjective feelings of negative self-perception of aging (SPA) among older adults, but how this pandemic has influenced such SPA is not yet known. This study, therefore, explored SPA at different time phases of the COVID-19 pandemic to explain the pandemic’s impact on SPA among older adults. The analysis employed a sample of 1,990 community-dwelling older adults aged 65 to 95 (mean age = 72.74 years; 43% female) in Switzerland. Data collection from different older adults within one study occurred both before and after Switzerland’s first confirmed COVID-19 case. The descriptive analysis revealed that negative SPA increased, and positive SPA decreased, after the Swiss government recommended physical distancing. After the Federal Council decided to ease these measures, negative SPA slightly decreased and positive SPA increased. According to the multivariate analysis, individuals interviewed after the lockdown were more likely to report greater levels of negative SPA and lower levels of positive SPA. Age, income, and living alone also correlated with SPA. The results suggest that the pandemic has affected older adults’ subjective views of their own aging, and these findings help illustrate the pandemic’s outcomes.
The infrastructures of White settler perception: A political phenomenology of colonialism, genocide, ecocide, and emergency
Authors: Guernsey Paul J
Published: February 2021

Emergencies are an element of perception. Far from a private and personal affair, perception is social, structured by a process of “inculcation.” Perception has a material-political infrastructure in the sense that it is underlain by cultural and economic conditions that refract the colonial, White supremacist, and heteropatriarchal inscriptions of “dominant” society into the quotidian understanding of events, crystalizing intentional modes in subjects, bodies, and communities. These infrastructures are dynamic and multifaceted, but their alloyed effect regulates phenomena of emergency always to the advantage of the settler colonial state and capitalist interests. Infrastructures of settler perception obfuscate the ways in which Native communities experience environmental emergencies as cycles of settler colonial violence and ecocide. Emergencies such as global warming are described as “human-caused” rather than directly linked to settler colonialism, capitalism, and White supremacy. Many uncritical deployments of the term “Anthropocene” commit a similar fallacy, implicating people who have had little or nothing to do with the planetary ecological collapse. In a White logic of death, or “necropolitics,” the structures of colonialism, genocide, war, and slavery represent not the beginning of crisis, but rather the end of violence and disorder. This strategy of obfuscation is employed in a variety of contexts and seen explicitly in the context of Indian education systems that form a political project of spiritual and physical domination. In response, a politics of refusal has emerged in Native communities to form incommensurable collective experiences of emergencies, attending to the ways in which emergencies reveal the relationships between us and how these indicate differential and yet interconnected responsibilities and moral duties that implicate some of us more than others and call incommensurable communities forth to action each in their own way.
Exploring the Biochemical Basis of the Meridian Tropism Theory for the Qi-Invigorating Traditional Chinese Medicine Herb Panax ginseng
Authors: Li Mengmei , Chen Yu , Cai Zhongzhen , Teng Jie , Feng Qian , Chen Yuming , Wang Lin , Li Caixia , Tang Bruce Qing , Bai Xuemei
Published: February 2021

We examined the effect of the Qi-invigorating Traditional Chinese Medicines (TCM) herb Panax ginseng ( P.G.) on mitochondrial functions and cellular antioxidant capacity in different organs of mice. We found that the P.G. extracts had a significant effect on tissues of mice, with the generation of total adenylate pool (TAP) enhanced in all visceral tissues, but not for the brain. The mitochondrial membrane potential (MMP) and antioxidant capacity reflected by superoxide dismutase (SOD) and glutathione (GSH) increased only for the meridian tissues that P.G. belongs to including Heart, Spleen and Lung. Reactive oxygen species (ROS), as a combined result of the increased energy metabolism and antioxidant capacity, varied in different organs. We concluded that: 1) the Qi-invigorating TCM herb P.G. had a significant effect on mice by enhancing TAP production in all of the visceral tissues examined, except for the brain; 2) for the meridional tissues of P.G. (Heart, Spleen and Lung), the P.G. extracts not only promoted the TAP production, but also boosted the antioxidant capacity demonstrated by the simultaneous increase in TAP, and SOD and GSH.
Primary non-continuous new daily persistent headache: Seven cases and proposed diagnostic criteria
Authors: Evans Randolph W
Published: February 2021

Primary new daily persistent headache (NDPH) is a rare disorder defined by the third edition of the International Headache Society (ICHD-3) as a continuous and unremitting headache. Non-continuous cases have been reported which do not fit any ICHD-3 criteria. Seven patients are presented who meet all ICHD-3 criteria except for being non-continuous from onset without treatment with a duration of 4 or more hours per day with only one headache per day. The average age of onset was 35.3 years, 57.1% female, and 71.4% had migraine-like features. No cases were unilateral and all cases were persistent without remission. These seven cases constitute a primary NDPH variant. Criteria are proposed for diagnosis similar to ICHD-3 for NDPH with the following change: “pain becoming daily within 24 hours of onset with a duration of 4 to 24 hours without acute or preventive medication or other treatment.”
Promoting Mental Well-Being Through Employee Assistance Programmes
Authors: Baskar Karuna , Shinde Ellen Mrinalini B. , Srinivasan Deepti A.
Published: February 2021

Mental health is increasingly being recognised as a critical component of employee well-being. Employee Assistance Programmes (EAPs) provide a comprehensive range of services to corporations to enhance the mental well-being of employees, leading to greater productivity. Increased uptake of EAP services across industries in India over the past two decades clearly indicates the growing recognition of the value of such services. Is there a real need in India for mental health services or are EAPs more suited to a western context and typically introduced only in response to a global mandate? How do employees and organisations benefit from the introduction of an EAP? This article seeks to address these questions by examining mental health data and EAP utilisation trends in India. It also explores the business case for EAP, outlines the components of a comprehensive EAP and draws attention to the unique attributes that would make an EAP effective in the Indian context thereby providing a significant return on investment for the organisation.
Bringing a Taste of Wellness to Workstations
Authors: Gupta Subroto , Gupta Malabika , Banerjee Arjyo , Vohra Ashwani
Published: February 2021

Companies providing employees with nutritious and wholesome meals strike the right balance in achieving a productive, creative and well-bonded team. Compass India’s study on ‘Eating at Work’ (EAW) suggests that energy and productivity levels peak between 9 am to 12 pm. Post-lunch these levels registered a sharp drop due to food intake with a high glycaemic index. Even as we peg it on natural human behaviour, with the right diet, one can boost those afternoon levels. Human resource teams plan for initiatives like sleeping pods, massage stations and yet the outcome continues to be a challenge. EAW research shows that these perks start great, but soon decline, that is, the usage of gyms was less than 2 per cent or 3 per cent. Also, ‘73% chose café meals as their preferred non-monetary perk, ranking ahead of flexible work hours and employee wellness programs’. Good food goes a long way in contributing to productivity. For many organisations, while wellness is a big part of their agenda, the role of food is still at its nascent stage. There is opportunity to elevate that. Hence, companies are taking constant intelligent decisions about workplace food.
Training and deploying a deep learning model for endoscopic severity grading in ulcerative colitis using multicenter clinical trial data
Authors: Gutierrez Becker Benjamin , Arcadu Filippo , Thalhammer Andreas , Gamez Serna Citlalli , Feehan Owen , Drawnel Faye , Oh Young S. , Prunotto Marco
Published: February 2021

Introduction:

The Mayo Clinic Endoscopic Subscore is a commonly used grading system to assess the severity of ulcerative colitis. Correctly grading colonoscopies using the Mayo Clinic Endoscopic Subscore is a challenging task, with suboptimal rates of interrater and intrarater variability observed even among experienced and sufficiently trained experts. In recent years, several machine learning algorithms have been proposed in an effort to improve the standardization and reproducibility of Mayo Clinic Endoscopic Subscore grading.

Methods:

Here we propose an end-to-end fully automated system based on deep learning to predict a binary version of the Mayo Clinic Endoscopic Subscore directly from raw colonoscopy videos. Differently from previous studies, the proposed method mimics the assessment done in practice by a gastroenterologist, that is, traversing the whole colonoscopy video, identifying visually informative regions and computing an overall Mayo Clinic Endoscopic Subscore. The proposed deep learning–based system has been trained and deployed on raw colonoscopies using Mayo Clinic Endoscopic Subscore ground truth provided only at the colon section level, without manually selecting frames driving the severity scoring of ulcerative colitis.

Results and Conclusion:

Our evaluation on 1672 endoscopic videos obtained from a multisite data set obtained from the etrolizumab Phase II Eucalyptus and Phase III Hickory and Laurel clinical trials, show that our proposed methodology can grade endoscopic videos with a high degree of accuracy and robustness (Area Under the Receiver Operating Characteristic Curve = 0.84 for Mayo Clinic Endoscopic Subscore ⩾ 1, 0.85 for Mayo Clinic Endoscopic Subscore ⩾ 2 and 0.85 for Mayo Clinic Endoscopic Subscore ⩾ 3) and reduced amounts of manual annotation.

Plain language summary

Patient, caregiver and provider thoughts on educational materials about prescribing and medication safety Artificial intelligence can be used to automatically assess full endoscopic videos and estimate the severity of ulcerative colitis. In this work, we present an artificial intelligence algorithm for the automatic grading of ulcerative colitis in full endoscopic videos. Our artificial intelligence models were trained and evaluated on a large and diverse set of colonoscopy videos obtained from concluded clinical trials. We demonstrate not only that artificial intelligence is able to accurately grade full endoscopic videos, but also that using diverse data sets obtained from multiple sites is critical to train robust AI models that could potentially be deployed on real-world data.
A neutrophil activation signature predicts critical illness and mortality in COVID-19
Authors: Meizlish Matthew L. , Pine Alexander B. , Bishai Jason D. , Goshua George , Nadelmann Emily R. , Simonov Michael , Chang C-Hong , Zhang Hanming , Shallow Marcus , Bahel Parveen , Owusu Kent , Yamamoto Yu , Arora Tanima , Atri Deepak S. , Patel Amisha , Gbyli Rana , Kwan Jennifer , Won Christine H. , Dela Cruz Charles , Price Christina , Koff Jonathan , King Brett A. , Rinder Henry M. , Wilson F. Perry , Hwa John , Halene Stephanie , Damsky William , van Dijk David , Lee Alfred I. , Chun Hyung J.
Published: February 2021

Pathologic immune hyperactivation is emerging as a key feature of critical illness in COVID-19, but the mechanisms involved remain poorly understood. We carried out proteomic profiling of plasma from cross-sectional and longitudinal cohorts of hospitalized patients with COVID-19 and analyzed clinical data from our health system database of more than 3300 patients. Using a machine learning algorithm, we identified a prominent signature of neutrophil activation, including resistin, lipocalin-2, hepatocyte growth factor, interleukin-8, and granulocyte colony-stimulating factor, which were the strongest predictors of critical illness. Evidence of neutrophil activation was present on the first day of hospitalization in patients who would only later require transfer to the intensive care unit, thus preceding the onset of critical illness and predicting increased mortality. In the health system database, early elevations in developing and mature neutrophil counts also predicted higher mortality rates. Altogether, these data suggest a central role for neutrophil activation in the pathogenesis of severe COVID-19 and identify molecular markers that distinguish patients at risk of future clinical decompensation.