bluuebunny/crossref_metadata_2025 huggingface dataset:
Nomenclatural types of the Umbelliferae in P.E.Boissier’s oriental herbarium (G-BOIS)
Authors: PIMENOV MICHAEL G. , JACQUEMOUD FERNAND
Published: October 2020

G-BOIS (“Flora Orientalis Herbarium”), the result of many years (1844–1888) of titanic work by an outstanding botanist from Geneva Pierre-Edmond Boissier, is the most important taxonomic and nomenclature source of data on the rich flora of the territory from Greece to Middle Asia and the borders of India. It was isolated from an extensive Boissier’s private herbarium after the latter was included in the collection of Conservatoire et Jardin Botaniques and kept in a special underground bunker. A material for 366 species and 47 infraspecific taxa of the Umbelliferae is stored in G-BOIS. Among lectotypes, the vast majority relate to the Boissier taxa; a small minority belong to taxa of other authors (their types and lectotypes are in other herbaria). The materials of other herbaria, Geneva and non-Geneva (Geneva General Herbarium, De Candolle Prodromus Herbarium, K, LE, P, JE, W, B and others) were also checked. Among the Umbelliferae material kept in G-BOIS, lectotypes of 255 names were designated here and those of 107 names have been designated before, including lectotypes selected prior 2011 as types and holotypes which were corrected to lectotypes (89 names). Besides the designated lectotypes and isolectotypes, G-BOIS also contains holotypes of 44 Boissierian Umbelliferae names and syntypes of 81 names. Additionally, holotypes, lectotypes and isolectotypes (in total for 168 names) were revealed in Geneva General herbarium (G). One new species name (Prangos iranica nom. nov.) has been proposed here in the genus Prangos.
Relative Importance of Internal Climate Variability versus Anthropogenic Climate Change in Global Climate Change
Authors: Chen Jie , Li Xiangquan , Martel Jean-Luc , Brissette François P. , Zhang Xunchang J. , Frei Allan
Published: October 2020

To better understand the role of internal climate variability (ICV) in climate change impact studies, this study quantifies the importance of ICV [defined as the intermember variability of a single model initial-condition large ensemble (SMILE)] in relation to the anthropogenic climate change (ACC; defined as multimodel ensemble mean) in global and regional climate change using a criterion of time of emergence (ToE). The uncertainty of the estimated ToE is specifically investigated by using three SMILEs to estimate the ICV. The results show that using 1921–40 as a baseline period, the annual mean precipitation ACC is expected to emerge within this century over extratropical regions as well as along the equatorial band. However, ToEs are unlikely to occur, even by the end of this century, over intratropical regions outside of the equatorial band. In contrast, annual mean temperature ACC has already emerged from the temperature ICV for most of the globe. Similar spatial patterns are observed at the seasonal scale, while a weaker ACC for boreal summer (June–August) precipitation and additional ICV for boreal winter (December–February) temperature translate to later ToEs for some regions. In addition, the uncertainty of ToE related to the choice of a SMILE is mostly less than 20 years for annual mean precipitation and temperature. However, it can be as large as 90 years for annual mean precipitation over some regions. Overall, results indicate that the choice of a SMILE is a significant source of uncertainty in the estimation of ToE and results based on only one SMILE should be interpreted with caution.
Muscle Tension Dysphagia: Contributing Factors and Treatment Efficacy
Authors: Kang Christina H. , Zhang Nan , Lott David G.
Published: October 2020

Objective:

To determine factors contributing to disease etiology and treatment efficacy.

Study Design:

Original Report.

Setting:

Tertiary academic center.

Methods:

IRB approved prospective study of 20 patients with reported dysphagia who exhibited normal oropharyngeal and esophageal swallowing function as evidenced by videofluoroscopic swallow study, esophagogastroduodenoscopy, high-resolution esophageal manometry with stationary impedance, and Bravo pH probe off proton pump inhibitor. Patients underwent speech-language pathology intervention.

Results:

Atypical laryngeal muscle tension was present in 100% of patients. Forty percent of patients had diagnosed positive gastroesophageal reflux disease. Sixty-five percent of patients showed signs of non-specific laryngeal inflammation and laryngeal hyperresponsiveness during strobolaryngoscopy. All patients reported a mean of 90% recovery by the completion of voice therapy directed toward unloading muscle tension.

Conclusion:

The study results suggest an association between laryngeal muscle tension and these patients’ dysphagia symptoms regardless of associated conditions. Speech-language pathology intervention showed high treatment efficacy.

Level of Evidence:

2c- Outcomes research.
Promoting Access and Equity for Underrepresented Racial Minorities? An Examination of Policies and Practices in Community College Baccalaureate Programs
Authors: Cuellar Marcela G. , Gándara Patricia
Published: October 2020

Objective/Research Question: The purpose of this study was to examine the extent to which programs offering community college baccalaureates (CCBs) address access and equity for underrepresented racial minorities (URMs). The study first aimed to understand how administrators described the purpose of CCBs with regard to advancing equity for URMs. Next, the study explored how CCB programs incorporate policies and practices advancing access and success of URM students. Method: The study employed a multiple-case study design by focusing on three states offering bachelor’s degrees at several community colleges. Interviews with administrators were conducted at two colleges offering CCB programs in each state. Colleges differed in demographic composition and in the number and type of CCB programs offered. Results: Administrators described how CCBs advanced socioeconomic mobility, which promoted equity, particularly for low-income students. Findings suggested that only some attention was placed on providing access to URMs, which was largely contingent on the representation of URMs in the surrounding community and feeder programs. Few outreach efforts and support services specifically targeted URMs. Conclusion/Contributions: Given that URMs are largely concentrated at community colleges and significant gaps exist between URMs and non-URMs in college completion, CCBs might serve as an educational policy to reduce those gaps. As CCBs are primarily framed as essential to meeting workforce needs, increased opportunities for URMs may be limited without intentional efforts to outreach and support URMs.
Investigation of Safety-in-Numbers for Pedestrians and Bicyclists at a Macroscopic Level with Various Exposure Variables
Authors: Lee Jaeyoung , Abdel-Aty Mohamed , Cai Qing
Published: October 2020

Safety-in-numbers is a phenomenon whereby the crash risks of road users decrease when their numbers increase. Although several previous studies have confirmed safety-in-numbers at a microscopic level (e.g., intersection), few studies have investigated safety-in-numbers at a macroscopic level (or zonal level). In this study, safety-in-numbers is investigated at a larger scale unit, the metropolitan statistical area (MSA), which is usually composed of multiple counties in the U.S.A. Various pedestrian and bicyclist exposure data were obtained from the U.S. National Household Travel Survey (i.e., trips, miles, and hours). A series of Bayesian Poisson lognormal models confirm safety-in-numbers with the different exposure variables at a large-scale geographic level (i.e., MSA). The findings imply that regional travel behavior and cultures of respect for vulnerable road users play a key role in determining the level of pedestrian and bicyclist safety. In addition, the results reveal other factors important to vulnerable road user involved crashes, including but not limited to the climate, demographic, socioeconomic, and travel characteristics of the study regions.
Intersectionality and Gendered Racism in the United States: A New Theoretical Framework
Authors: Kim Marlene
Published: October 2020

I introduce a new theoretical framework to explain intersectionality and economic disparities by gender and race in the United States. I examine patterns of economic outcomes by race and gender, review explanations for them, and assess the extent to which theories explain the intersection of race and gender in these outcomes. I explore gendered racism as the only concept that can explain these patterns by gender, race, and intersectionality. When employers, coworkers, customers, and communities behave and act on gender and racial prejudices and when institutions, ideologies, and belief systems legitimize, reproduce, and perpetuate these prejudices, gendered racism can explain the resulting economic disparities by race, gender, and intersectionality.
Family Firms: A Breed of Extremes?
Authors: Miller Danny , Le Breton-Miller Isabelle
Published: October 2020

Conflicts in the family business literature abound due to the breed’s heterogeneity. However, a key aspect of heterogeneity has been ignored—a tendency for many family firms to gravitate toward unusual and opposite extremes in their behavior toward stakeholders and their strategic initiatives. We attribute these to family emotional bonds, secrecy from scrutiny, and exceptional managerial discretion. These bivalent qualities may combine to cause both salutary and abusive treatment of stakeholders as well as extraordinary success and abysmal failure at strategic initiatives—depending on the temporal and social priorities of family owners. We present moderating conditions and propositions before developing theoretical and methodological implications.
Something ‘Old’, Something ‘New’? The UK Space of Political Attitudes After the Brexit Referendum
Authors: Lindell Johan , Ibrahim Joseph
Published: October 2020

This study focuses on the political attitudes of UK citizens in the aftermath of the ‘Brexit’ vote. It has been argued that differences within electorates across Europe are found in disputes over taxes, redistribution of wealth and social welfare, as much as in divergent ideas on how to deal with globalisation, migration, and climate change. This article uses the 2016–2017 round of the European Social Survey (N = 1959) to shed light on two important issues in regard to the relationship between ‘old’ and ‘new’ politics. By using multiple correspondence analysis, we first consider the structure, or dimensionality, of the space of political attitudes in contemporary UK society. Contrary to a prevailing discourse that forwards the argument that postmaterial values constitute an altogether separate political dimension in late modernity, we observe that such values collapse into traditional left/right standpoints. Second, we discuss the connection between class (economic capital, cultural capital, and occupational class) and position-takings in the space of political attitudes. We show that class retains a limited effect on political position-takings, where educational capital plays the most important role. The divisions between the politically interested–uninterested, old–young, men–women, and rural–urban are more clearly demarcated than differences between people of different social class positions. Furthermore, polarisation is most prevalent between a highly opinionated, relatively resourceful, small minority of the population.
Globalisation, postnationalism and Australia
Authors: Moran Anthony
Published: October 2020

Postnational institutions and identities are products of globalisation. How far along the ‘postnational’ road the world has travelled is debatable. In the early 2000s Habermas referred to an emerging ‘post national constellation’. While the nation-state is still an important institutional form, postnational identities and experiences challenge the boundaries of nation-states, and also national identities. Cosmopolitanism as an outlook, set of predispositions and practices is often seen as postnational, and celebrated as such, since it implies the embrace of humanity beyond nation. To what extent have national identities (as opposed to other kinds of identities) been threatened, undermined or superseded by postnational identities? To what extent is the postnational a utopian hope for a cosmopolitan future, and to what extent is the postnational already upon us – whether we recognise it or not? What are the most convincing examples of postnationalism? This article addresses such questions, with a focus on Australia.
Targeting the Epithelial-to-Mesenchymal Transition in Cancer Stem Cells for a Better Clinical Outcome of Glioma
Authors: Lu Yu-bao , Sun Tian-Jiao , Chen Yu-tong , Cai Zong-Yan , Zhao Jia-Yu , Miao Feng , Yang Yong-na , Wang Shi-Xin
Published: October 2020

Glioma is one of the most common malignant tumors of the central nervous system with a poor prognosis at present due to lack of effective treatment options. Its initiation, migration, and multipotency are affected by cancer stem cell’s transition. Previous studies imply that changes in the cancer stem cells can affect the malignant differentiation of the tumor. We found that the epithelial-to-mesenchymal transition (EMT)-related regulatory pathway is an important target for tumor therapy. In this review, we discuss the transition factor of EMT and 3 specific pathways that affect the EMT of cancer stem cells during tumor development. We conclude that targeting the EMT process of cancer stem cells can be a feasible approach in the treatment of glioma.
Efficacy and Safety of Transarterial Chemoembolization Combined With Anlotinib for Unresectable Hepatocellular Carcinoma: A Retrospective Study
Authors: Guo Wenbo , Chen Song , Wu Zhiqiang , Zhuang Wenquan , Yang Jianyong
Published: October 2020

Objective:

This study aimed to explore the efficacy and safety of using transarterial chemoembolization (TACE) combined with anlotinib in patients with unresectable hepatocellular carcinoma, compared with TACE alone.

Methods:

This was a single-center study, retrospectively recruited 82 unresectable HCC patients who received either TACE alone (TA group; n = 46) or TACE combined with anlotinib (TC group; n = 36) between Jan 2018 and Jan 2019. The primary outcomes were progression-free survival (PFS) and overall survival (OS). While the secondary outcomes were the objective response rate (ORR), the disease control rate (DCR), and main complications. Log-rank test and Kaplan–Meier method was used to calculate the survival difference. All statistical tests were 2-sided and P value <0.05 were taken as statistically significant.

Results:

Patients in TC group had a significant higher PFS than those in TA group (7.35 months vs. 5.54 months, p = 0.035). Although 3-month survival rate in the 2 groups was not statistically different (97.2% vs. 93.5%, p = 0.627), the survival rate at 6 months and 1 year were strongly higher in TC group (83.3% vs. 56.5%, p = 0.016; 66.7% vs. 19.6%, respectively, p < 0.05). Furthermore, there was a significantly higher ORR in TC group, while no statistical difference existed in DCR. Neither treatment-related mortality nor grade 4 adverse events (AEs) occurred. However, 2 patients in TC group had grade 3 AEs (one suffered with erythra, and the other with hand-foot-skin reaction), which disappeared after prompt treatment.

Conclusion:

TACE combined with anlotinib is safe and may improve outcomes for unresectable HCC patients comparing with TACE alone. Randomized controlled trials are warranted to further evaluate treatment effects of anlotinib in HCC.
Delayed Gastric Emptying Post-Esophagectomy: A Single-Institution Experience
Authors: Frederick Allison B. , Lorenz William R. , Self Stella , Schammel Christine , Bolton William D. , Stephenson James E. , Ben-Or Sharon
Published: October 2020

Objective

Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy in patients with esophageal carcinoma. Management of DGE varies widely and it is unclear how comorbidities influence the postoperative course. This study sought to determine factors that influence postoperative DGE.

Methods

This retrospective study evaluates patients who underwent esophagectomy with gastric pull-up between 2007 and 2019. The cohort was stratified in various ways to determine if postoperative care and outcomes differed, including patient demographics, comorbidities, intraoperative and postoperative procedures.

Results

During the study period, 149 patients underwent esophagectomy and 37 had diabetes. Overall incidence of DGE, as defined in this study, was 76.5%. Surgery type was significantly different between DGE and normal emptying cohorts ( P = 0.005). Comparing diabetic and nondiabetic patients, there was no significant difference noted in DGE ( P = 0.25). Additionally, there was no difference in presence of DGE for patients who underwent any intraoperative pyloric procedure compared to those who did not ( P = 0.36). Of significance, all 16 patients with chronic obstructive pulmonary disease had a delay in gastric emptying ( P = 0.01).

Conclusions

A higher proportion of patients with DGE post-esophagectomy were identified compared to the literature. There is little consensus on a true definition of DGE, but we believe this definition identifies patients suffering in the immediate postoperative period and in follow-up. There is no evidence to support a different postoperative course for patients with diabetes, but the link between chronic obstructive pulmonary disease and DGE warrants further investigation.
European strategic autonomy: Energy at the heart of European security?
Authors: Ryon Eloïse
Published: October 2020

Since Brexit and the COVID-19 pandemic, there has been a radical transformation of the meaning, use and role of the concept of strategic autonomy within the European project. Whereas its application was originally restricted to defence matters, it is now explicitly mentioned in other sectors, including pharmaceuticals. The COVID-19 pandemic and its political, social and economic consequences have considerably boosted the trend to broaden the concept’s sphere of application. Strategic autonomy has found new life as a key political concept that will help shape the future of the EU. But does the concept really apply to all sectors? To what extent is European strategic autonomy behind the development of the Energy Union? The article attempts to provide an answer to these questions through an analysis of the theoretical and practical development of the concept, focusing particularly on the debate around Nord Stream 2.
Conserving what? Conservation easements and environmental justice in the coastal US South
Authors: Van Sant Levi , Hardy Dean , Nuse Bryan
Published: October 2020

Conservation easements, voluntary legal agreements whereby a landowner forfeits some of his or her land development rights in exchange for tax benefits, are an increasingly common strategy for protecting land from development in the United States today. For instance, from 2005 to 2015, private land under conservation easement in the United States increased by 175%, growing to more than 16 million acres held by land trusts, which are collectively endowed with more than $2.2 billion in funding. Recent critical analyses of this trend conceptualize conservation easements as a tool of neoliberal environmental governance, whereby nature is increasingly individuated and conservation is (at least partially) privatized. Conservation easements grew rapidly in the 1980s as the result of a compromise between mainstream environmental organizations and the Reagan administration’s anti-public lands agenda; thus, one interpretation is that they are the pragmatic “roll-out” of conservation efforts from a handcuffed liberal environmental movement. Yet, our historical and qualitative analysis of the politics of conservation easements in the coastal US South suggests that they were actually an elite white class project from the start, rather than a reaction to constraints on public lands protection. Thus, we argue that the environmental justice implications of conservation easements deserve more attention. Our efforts to develop a spatial-statistical assessment of the ways that their ecological benefits are distributed beyond parcel boundaries were limited by the privatization of data on conservation easements. Instead, we assess the distribution of easements themselves across the region, finding limited differences, but ones that we interpret as meaningful, between public and private conservation lands regarding racial composition and incomes of nearby populations. Importantly, this kind of mixed-methods analysis indicates how the exclusive control of data undergirds the exclusive control of land. Most broadly, we argue that Cheryl Harris’s theorization of “whiteness as property” remains an important resource for political ecologists because it helps specify the relationship between race, class, and nature under capitalism.
Repeat cesarean section in a COVID-19 positive mother in the United States
Authors: Daniel Krupa , Goli Kiran , Sargent Anita
Published: October 2020

In our report, we present a case of repeat cesarean section in a 29-year-old Ecuadorian mother who contracted COVID-19 and traveled to the United States during her last trimester of pregnancy. We assembled a multidisciplinary team to safely deliver the mother by cesarean section. She received supportive care for her COVID-19 infection. Infection prevention procedures were based on early available data, and the baby was delivered without complications.
Young Women’s Mental Illness and (In-)visible Social Media Practices of Control and Emotional Recognition
Authors: Hendry Natalie Ann
Published: October 2020

What “counts” as a mental illness–related image matters. Most research attention has focused on distressing or recognizable mental illness–related visual practices, yet this offers partial insight into youth mental health. Using visibility and practice theories, I share an in-depth case study exploring the social media practices of four young women, aged 14–17 years, engaged with an Australian adolescent psychiatric service. They describe how being visible to others on social media potentially produces anxiety and burdens them to respond to others’ questions or unhelpful support. In response, they engage in practices of control to manage the vulnerability of mental illness and burdensome sociality. Their mental illness–related media practices are often invisible; they rework mental illness through ambiguous, supportive or humorous practices or, through imagined intimacy, engage with images that feel relatable to them even if the images do not depict recognizable mental illness content or employ recognizable hashtags or titles. These insights complicate “what counts” as mental illness–related content or practices on social media and challenge researchers and practitioners to consider the sociotechnical contexts that shape young people’s mental health.
Evaluating the Impact of Outpatient Multi-Dose Medication Packaging Service (MDMPS) on Medication Adherence and Clinical Outcomes
Authors: Nair Pratibha , Kee Kok Wai , Mah Choon Siong , Lee Eng Sing
Published: October 2020

Background:

There is limited understanding on the impact of the multidose medication packaging service (MDMPS).

Objectives:

The main objective of this study was to evaluate changes in medication adherence in patients using MDMPS compared to patients receiving standard medication packaging (control group). The other objectives were to determine the association between medication adherence and clinical outcomes, and to assess patients’/caregivers’ perceptions toward MDMPS.

Methods:

A retrospective cohort study was conducted among primary care patients in Singapore enrolled into MDMPS between 2012 and 2017. Eligible patients were taking at least five chronic medications, diagnosed with Hypertension, Hyperlipidemia and/or Type 2 Diabetes, with prescription records for at least six months before and after the index period. They were matched to control patients based on the type of comorbidities and medication adherence status. Medication Possession Ratio (MPR), glycated hemoglobin (HbA1c), blood pressure and low-density lipoprotein-cholesterol (LDL-C) of both groups were compared between baseline and at least six months post-index period. Interviewer-administered questionnaires were also conducted for MDMPS patients.

Results:

The MPR of MDMPS patients (n = 100) increased by 0.37% ( P < .001) compared to the control group (n = 100). MDMPS patients with diabetes had reduced HbA1c by 0.1% after six months ( P = .022) but was not significant after 12 months. No significant changes were seen in blood pressure and LDL-C between both groups. At least 50% of patients were highly satisfied with MDMPS.

Conclusion:

MDMPS can improve medication adherence. Further studies are needed to understand its clinical impact.
Oral Health-Related Quality of Life (OHRQoL) in Patients with Definitive Maxillary Obturator Prostheses: A Prospective Study
Authors: Kalaignan S. Parithimar , Ahmed Syed Ershad
Published: October 2020

Aim:

To assess the impact of definitive maxillary obturator prostheses on oral health-related quality of life (OHRQol).

Materials and Methods:

A presented prospective study comprising 50 patients with maxillectomy defects was selected for the study. Patients with any active or persistent lesion in relation to the defect site, restrictive mouth opening along with poor general health were excluded from the study. All the patients were rehabilitated with definitive maxillary obturator prostheses, respectively. These patients were subjected for assessment of OHRQol and obturator prostheses functioning. These assessments were done using three scales OHIP-Edent-19, obturator functioning scale (OFS-15) and a novel scale—maxillofacial prosthesis performance scale (MFPPS). The assessment was done on all the patients after 2 weeks and 3 months of prosthesis function. The data were tabulated and analysed using paired sample t-test and the Wilcoxon signed rank test for paired groups and unpaired sample t-test for independent groups.

Results:

The scores of OHIP-Edent, OFS and MFPPS for definitive maxillary obturator prostheses after 2 weeks were 37.56, 30.48 and 20.50. The scores of OHIP-Edent, OFS and MFPPS for definitive maxillary obturator prostheses after 3 months were 30.30, 24.26 and 16.10, respectively.

Conclusion:

Mean differences of OHIP-Edent (7.260), OFS (6.220) and MFPPS (4.400) were observed after 2 weeks and 3 months of obturator prosthesis function. These findings show significant improvements of prosthesis in terms of functional, physical, psychological and social parameters after long-term follow-up (3 months).
Esthetic Rehabilitation With Nanohybrid Composite: Case Report Series
Authors: Qaiser Shazeena , Devadiga Darshana , Hegde Mithra N
Published: October 2020

Composite resins represent the current state of the art in the field of restorative materials, for they present a standard aesthetic potential with satisfactory durability and are less cost-effective than a comparable ceramic restoration. The most recent addition to this is a nanohybrid direct composite that demonstrates exceptional handling properties and superior aesthetics.

These series of case reports illustrate the three different scenarios where nanohybrid composite was used as a direct restorative material owing to its high smoothness and favorable mechanical properties; the first case being the fracture of an upper lateral incisor, second of Class IV caries in upper central incisors, and lastly the discolored restoration and Class III caries in upper central incisors. The nanohybrids used provided an acceptable color match in all the three cases with a conservative technique and were relatively easy to maintain.
Return to Play Following Isolated and Combined Anterior Cruciate Ligament Reconstruction: 25+ Years of Experience Treating National Football League Athletes
Authors: Khair Michael , Riboh Jonathan , Solis Jaicus , Maurer Jim , Brown J. Britt , Vandermeer Robert D. , Cooper Daniel E.
Published: October 2020

Background:

The first case series to report on return to play (RTP) in National Football League (NFL) players after primary anterior cruciate ligament (ACL) reconstruction (ACLR) published an RTP rate of 63%. Other studies that have attempted to estimate RTP after ACLR in these elite athletes have been largely based on secondary sources. This study is the second to report the authors’ own results in treating ACL injuries in NFL players spanning a study period of 25+ years.

Purpose:

To report the senior authors’ experience treating ACL injuries in NFL players as well as revisit the concept of RTP as it is currently used to measure successful surgical outcomes in professional athletes.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 47 NFL players were treated at our institution for knee injuries that included a complete tear of the ACL; of these, 41 were primary ACLR and 6 were revision ACLR. Of the primary ACLRs, 6 were classified as ACL plus additional ligament and 3 were classified as multiligament. Return to game play (RTGP) was defined as returning to play in a regular-season game. Successful return to previous participation (RTPP) was defined as return to a level of participation equal to the level the player had reached before injury. Multivariate analysis was used to assess predictors of successful RTPP.

Results:

Using the RTGP criteria proposed by prior authors, the RTGP after primary ACLR was 73%. Using our proposed RTPP criteria, 87.8% of players successfully returned to the same level of participation after primary ACLR. RTGP percentage for all NFL players after ACLR (including multiligament injuries) was 67.6%, and the overall RTPP for those patients was 87.8%. In multivariate analysis, age ≤25 years was predictive of successful RTPP. High draft picks and offensive players played more seasons after primary ACLR. ACL graft rupture occurred in 4.3% of this cohort. Contralateral ACL tear occurred in 8.5%.

Conclusion:

Regardless of which definition is used to measure a successful outcome after ACLR surgery, the findings of this study suggest that successful return after primary ACLR in NFL athletes is higher than previously reported. While concomitant reconstruction of a single collateral ligament did not affect RTPP, revision ACLR or bicruciate plus collateral ligament reconstruction was associated with a lower RTPP rate. Age ≤25 years predicted successful RTPP. The risk of a future ACL tear of either knee after index reconstruction was approximately 13%.
Neuromuscular Training Improves Self-Reported Function and Single-Leg Landing Hip Biomechanics in Athletes After Anterior Cruciate Ligament Reconstruction
Authors: Nagelli Christopher , Di Stasi Stephanie , Tatarski Rachel , Chen Albert , Wordeman Samuel , Hoffman Joshua , Hewett Timothy E.
Published: October 2020

Background:

Neuromuscular training (NMT) has been shown to attenuate high-risk biomechanics in uninjured athletes. At the time that athletes return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR), they demonstrate hip biomechanical deficits associated with injury to the reconstructed knee versus the uninjured contralateral knee.

Purpose:

The primary purpose of the study was to examine whether an NMT program can improve single-leg drop (SLD) landing hip biomechanics for athletes after ACLR. Secondarily, we compared the posttraining SLD hip biomechanics of athletes after ACLR with a control group of athletes who also completed the NMT program.

Study Design:

Controlled laboratory study.

Methods:

A total of 18 ACLR and 10 uninjured athletes were recruited and completed a 12-session NMT program. A knee-specific questionnaire and biomechanics of an SLD task was evaluated for each athlete before and after NMT. Paired t tests were used to compare pre- and posttraining International Knee Documentation Committee (IKDC) scores. Repeated-measures analysis of variance (ANOVA) was performed to assess the main effects and interactions of testing session × limb for the ACLR athletes. A 2-way ANOVA was conducted to quantify the interactions and main effects of group × limb.

Results:

There was a significant increase ( P = .03) in IKDC scores from pre- to posttraining. For the ACLR athletes, there was a significant session × limb interaction for hip external rotation moment ( P = .02) and hip abduction angle ( P = .013). Despite increases in hip external rotation moment, no significant changes from pre- to posttraining were observed for the involved limbs. No significant changes were observed for hip abduction angle of the involved limbs between training sessions. Significant main effects of session ( P < .05) revealed that athletes landed with greater hip excursion, lower hip flexion moment, and lower ground-reaction force after training. The posttraining comparison between the ACLR and control groups found no significant group × limb interactions for any of the hip kinematic or kinetic variables. A significant main effect of group ( P < .05) revealed that the ACLR athletes landed with greater hip flexion angle and hip external rotation moment.

Conclusion:

ACLR athletes demonstrated an improvement in SLD hip biomechanics and neuromuscular control after participating in an NMT program.

Clinical Relevance:

This evidence indicates a potential role for NMT to improve hip biomechanics during an SLD task so as to reduce ACL injury risk.
Territories of state-led aquaculture risk management: Thailand’s Plang Yai program
Authors: Bottema Mariska JM , Bush Simon R , Oosterveer Peter
Published: October 2020

The Thai aquaculture sector faces a range of production, market and financial risks that extend beyond the private space of farms to include public spaces and shared resources. The Thai state has attempted to manage these shared risks through its Plang Yai (or ‘Big Area’) agricultural extension program. Using the lens of territorialization, this paper investigates how, through the Plang Yai program, risk management is institutionalized through spatially explicit forms of collaboration amongst farmers and between farmers and (non-)state actors. We focus on how four key policy instruments brought together under Plang Yai delimited multiple territories of risk management over shrimp and tilapia production in Chantaburi and Chonburi provinces. Our findings demonstrate how these policy instruments address risks through dissimilar but overlapping territories that are selectively biased toward facilitating the individual management of production risks, whilst enabling both the individual and collective management of market and financial risks. This raises questions about the suitability of addressing aquaculture risks by controlling farmer behavior through state-led designation of singular, spatially explicit areas. The findings also indicate the multiple roles of the state in territorializing risk management, providing a high degree of flexibility, which is especially valuable in landscapes shared by many users, connected to (global) value chains and facing diverse risks. In doing so we demonstrate that understanding the territorialization of production landscapes in a globalizing world requires a dynamic approach recognizing the multiplicity of territories that emerge in risk management processes.
Recessive myotonia congenita caused by a homozygous splice site variant in CLCN1 gene: a case report
Authors: Sparber Peter , Sharova Margarita , Filatova Alexandra , Shchagina Olga , Ivanova Evgeniya , Dadali Elena , Skoblov Mikhail
Published: October 2020

Background

Myotonia congenita is a rare neuromuscular disease, which is characterized by a delay in muscle relaxation after evoked or voluntary contraction. Myotonia congenita can be inherited in a dominant (Thomsen disease) and recessive form (Becker disease) and both are caused by pathogenic variants in the CLCN1 gene. Noncanonical splice site variants are often classified as variants of uncertain significance, due to insufficient accuracy of splice-predicting tools. Functional analysis using minigene plasmids is widely used in such cases. Moreover, functional analysis is very useful in investigation of the disease pathogenesis, which is necessary for development of future therapeutic approaches. To our knowledge only one noncanonical splice site variant in the CLCN1 gene was functionally characterized to date. We further contribute to this field by evaluation the molecular mechanism of splicing alteration caused by the c.1582 + 5G > A in a homozygous state.

Case presentation

We report a clinical case of an affected 6-y.o boy with athletic appearance due to muscle hypertrophy, calf muscle stiffness, cramping and various myotonic signs in a consanguineous family with no history of neuromuscular disorders. The neurological examination showed percussion-activated myotonia in the hands and legs. Plasma creatine kinase enzyme and transaminases levels were normal. Electromyography at the time of examination shows myotonic runs in the upper and lower extremities.

Conclusions

Functional analysis of the variant in a minigene system showed alteration of splicing leading to loss of function, thereby confirming that the variant is pathogenic.
The art of balancing: the facilitator’s role in briefing in simulation-based learning from the perspective of nursing students – a qualitative study
Authors: Solli Hilde , Haukedal Thor Arne , Husebø Sissel Eikeland , Reierson Inger Åse
Published: October 2020

Background

Facilitators plays a key role in nursing student’s learning when briefing them for simulation scenarios. However, few studies have explored the importance of the facilitator’s role in preparing students from the students’ perspective. The aim of this study was to explore undergraduate nursing students’ perspectives of the facilitator’s role in briefing.

Methods

An explorative, qualitative approach was used. Four focus group interviews with a total of 30 nursing students constituted the data source. Data collection took place in December 2017 and in May 2018. The data was analysed using systematic text condensation.

Results

Two main categories were identified: “The importance of framing the subsequent scenario” and “The importance of instructing students how to execute nursing actions in the subsequent scenario”. The first category consisted of three subcategories: providing predictability, providing emotional support and providing challenges. The second main category also consisted of three subcategories: providing information about medical and technical equipment, providing a demonstration of the monitor and providing a demonstration of the manikin.

Conclusion

A briefing is more than a general introduction to a simulation scenario, learning objectives, roles, simulation environment and medical equipment. The information provided in a briefing is important for nursing students’ understanding of what they will encounter in the simulation scenario and what is being simulated, as well as possibly being a prerequisite for mastery. The facilitator’s role in the briefing is complex and requires a high level of educational expertise to balance the diversity of students’ learning approaches. Students have to learn how to simulate before the briefing. Therefore, we suggest separating the concepts of prebriefing and presimulation from the concept of briefing, introducing prebriefing and presimulation preparation before briefing, and possibly dividing students into groups based on their learning approach. Such interventions will make it possible for facilitators to balance between students’ needs and the time available for briefing.
PHOSPHO1 is a skeletal regulator of insulin resistance and obesity
Authors: Suchacki Karla J. , Morton Nicholas M. , Vary Calvin , Huesa Carmen , Yadav Manisha C. , Thomas Benjamin J. , Turban Sophie , Bunger Lutz , Ball Derek , Barrios-Llerena Martin E. , Guntur Anyonya R. , Khavandgar Zohreh , Cawthorn William P. , Ferron Mathieu , Karsenty Gérard , Murshed Monzur , Rosen Clifford J. , MacRae Vicky E. , Millán Jose Luis , Farquharson Colin
Published: October 2020

Background

The classical functions of the skeleton encompass locomotion, protection and mineral homeostasis. However, cell-specific gene deletions in the mouse and human genetic studies have identified the skeleton as a key endocrine regulator of metabolism. The bone-specific phosphatase, Phosphatase, Orphan 1 (PHOSPHO1), which is indispensable for bone mineralisation, has been recently implicated in the regulation of energy metabolism in humans, but its role in systemic metabolism remains unclear. Here, we probe the mechanism underlying metabolic regulation by analysing Phospho1 mutant mice.

Results

Phospho1−/−mice exhibited improved basal glucose homeostasis and resisted high-fat-diet-induced weight gain and diabetes. The metabolic protection inPhospho1−/−mice was manifested in the absence of altered levels of osteocalcin. Osteoblasts isolated fromPhospho1−/−mice were enriched for genes associated with energy metabolism and diabetes;Phospho1both directly and indirectly interacted with genes associated with glucose transport and insulin receptor signalling. Canonical thermogenesis via brown adipose tissue did not underlie the metabolic protection observed in adultPhospho1−/−mice. However, the decreased serum choline levels inPhospho1−/−mice were normalised by feeding a 2% choline rich diet resulting in a normalisation in insulin sensitivity and fat mass.

Conclusion

We show that mice lacking the bone mineralisation enzyme PHOSPHO1 exhibit improved basal glucose homeostasis and resist high-fat-diet-induced weight gain and diabetes. This study identifies PHOSPHO1 as a potential bone-derived therapeutic target for the treatment of obesity and diabetes.
Correction to: NetConfer: a web application for comparative analysis of multiple biological networks
Authors: Nagpal Sunil , Baksi Krishanu Das , Kuntal Bhusan K. , Mande Sharmila S.
Published: October 2020

An amendment to this paper has been published and can be accessed via the original article.
Molecular detection of hemotropic mycoplasmas (hemoplasmas) in domestic cats (Felis catus) in Romania
Authors: Imre Mirela , Văduva Cristina , Dărăbuș Gheorghe , Morariu Sorin , Herman Viorel , Plutzer Judit , Suici Tijana , Lait Philippa J P , Imre Kálmán
Published: October 2020

Background

The hemotropic mycoplasmas (hemoplasmas) of the genus Mycoplasma are recognized as important bacteria that parasitize red blood cells, causing hemolytic anemia in many mammalian species, including cats. No information is available concerning the presence of feline hemoplasma infections in cats in Romania. Thus, the objective of the present study was to provide data on the occurrence and molecular characterization of hemotropic mycoplasmas in client-owned cats in Romania.

Methods

Blood samples from 51 unhealthy cats, originating from Timişoara Municipality, Romania, were screened for the presence of hemoplasmas using conventional polymerase chain reaction (PCR) targeting the 16S rRNA gene and sequencing assays. PCR-positive samples were subsequently analyzed by phylogenetic and population genetic analysis.

Results

Molecular analysis revealed 11 (21.6%) positive samples, consisting of 8 (72.7%) Candidatus Mycoplasma haemominutum and 3 (27.3%) Mycoplasma haemofelis confirmed positives. Candidatus Mycoplasma turicensis was not detected, and no co-infections were registered. No significant associations (p > 0.05) were found between the hemoplasma infection status and age, gender, breed, presence of ectoparasites, feline leukemia virus/feline immunodeficiency virus positivity of cats, or the sampling season. However, outdoor access was positively associated (p = 0.049) with infection and could be considered a risk factor (OR = 4.1) in acquiring feline hemotropic mycoplasmas. Phylogenetic analysis revealed that our sequences clustered with those selected from the GenBank database in two distinct clades. The registered population genetic indices were strongly supportive of the great variance in sequences between the recorded Mycoplasma species.

Conclusions

The findings support the occurrence of feline hemoplasma infections in previously uninvestigated territories of Europe, providing useful information for small animal practitioners. To our knowledge, the present survey is the first reported molecular evidence of feline hemoplasma infections in Romania.
Distinct non-ischemic myocardial late gadolinium enhancement lesions in patients with type 2 diabetes
Authors: Bojer Annemie Stege , Sørensen Martin Heyn , Vejlstrup Niels , Goetze Jens P. , Gæde Peter , Madsen Per Lav
Published: October 2020

Background

Cardiovascular magnetic resonance imaging (CMR) have described localised non-ischemic late gadolinium enhancement (LGE) lesions of prognostic importance in various non-ischemic cardiomyopathies. Ischemic LGE lesions are prevalent in diabetes (DM), but non-ischemic LGE lesions have not previously been described or systematically studied in DM.

Methods

296 patients with type 2 DM (T2DM) and 25 sex-matched control subjects underwent echocardiography and CMR including adenosine-stress perfusion, T1-mapping and LGE.

Results

264 patients and all control subjects completed the CMR protocol. 78.4% of patients with T2DM had no LGE lesions; 11.0% had ischemic LGE lesions only; 9.5% had non-ischemic LGE lesions only; and 1.1% had both one ischemic and one non-ischemic lesion. The non-ischemic LGE lesions were situated mid-myocardial in the basal lateral or the basal inferolateral part of the left ventricle and the affected segments showed normal to high wall thickness and normal contraction. Patients with non-ischemic LGE lesions in comparison with patients without LGE lesions had increased myocardial mass (150 ± 34 vs. 133 ± 33 g, P = 0.02), average E/e’(9.9 IQR8.7–12.6 vs. 8.8 IQR7.4–10.7, P = 0.04), left atrial maximal volume (102 IQR84.6–115.2 vs. 91 IQR75.2–100.0 mL, P = 0.049), NT-proBNP (8.9 IQR5.9–19.7 vs. 5.9 IQR5.9–10.1 µmol/L, P = 0.02) and high-sensitive troponin (15.6 IQR13.0–26.1 vs. 13.0 IQR13.0–14.6 ng/L, P = 0.007) and a higher prevalence of retinopathy (48 vs. 25%, P = 0.009) and autonomic neuropathy (52 vs. 30.5%, P = 0.005).

Conclusion

A specific LGE pattern with lesions in the basal lateral or the basal inferolateral part of the left ventricle was found in patients with type 2 diabetes.

Trial registrationhttps://www.clinicaltrials.gov. Unique identifier: NCT02684331.
China’s mental health support in response to COVID-19: progression, challenges and reflection
Authors: Ju Yumeng , Zhang Yan , Wang Xiaoping , Li Weihui , Ng Roger M. K. , Li Lingjiang
Published: October 2020

The continued spread of the coronavirus disease 2019 (COVID-19) has a serious impact on everyone across the globe, both physically and psychologically. In addition to proactive measures addressing physical survival needs and health protection, China has launched a mental health support system to cope with the widespread psychological stress during the pandemic and its aftermath. In this debate, the authors attempted to depict and reflect upon the overall framework of China’s mental health support, with particular reference to the psychological intervention in response to COVID-19 over the last few months. Although a lot of effort has been made to meet the mental health needs, the accessibility, acceptability and effectiveness of the support system still have much room for improvement. Therefore, it is very important to re-think the predicament and challenge on ways of enhancing public mental health emergency responses in China. The concepts of universality, timeliness and scientific rigour were proposed as a possible reform in preparation for large-scale natural or man-made disasters in the coming future.