bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a Flexor Digitorum Superficialis Hemitenodesis on Reducing Volar Plate Strains for Swan Neck Deformities
Authors: Haddara Mohammad M. , Kadar Assaf , Ferreira Louis M. , Suh Nina
Published: August 2021

Background

Flexor digitorum superficialis (FDS) hemitenodesis is a common procedure to treat swan neck deformity (SND). We hypothesize that this surgical technique is a biomechanically effective way to reduce strain in the volar plate at the proximal interphalangeal joint (PIPJ).

Methods

Fifteen digits from 5 cadaveric specimens were tested using a novel in vitro active finger motion simulator under 4 finger conditions: intact, SND, FDS hemitenodesis, and FDS hemitenodesis with distal interphalangeal (DIP) joint fusion. Tensile loads in FDS and flexor digitorum profundus (FDP) and joint ranges of motion were measured by electromagnetic tracking. In addition, strain gauges were inserted under the volar plate to measure strain during PIPJ hyperextension. Results were analyzed using 1-way repeated-measures analysis of variance tests.

Results

The SND condition increased volar plate strain by 176% ± 25% ( P < .001) compared with the intact condition. The FDS hemitenodesis repair relieved more than 50% of the SND strain, restoring it to within no statistical difference from intact. The DIP fusion further reduced strain with no further statistical significance. At full flexion, FDS and FDP tendon loads diverged as a function of the test condition ( P < .001). With the FDS hemitenodesis, the FDP load increased by 2.1 ± 1.5 N from the SND condition ( P < .001), whereas the FDS load decreased by 1.3 ± 1.3 N ( P = .012).

Conclusion

The FDS hemitenodesis repair restored strains to within 3.0 milli-strain of the intact condition with no significant difference. Application of DIP fusion did not further protect the PIPJ from increased hyperextension and further exacerbated the imbalance of flexor tendon loads.
NFTs: Digital things and their criminal lives
Authors: Mackenzie Simon , Bērziņa Diāna
Published: August 2021

The extraordinary current craze around NFTs reflects their perceived value as a technological development that can bring greater certainty to questions of ownership and authenticity in fields like art and other collectibles. This is, among other things, the promise of crime prevention through technology, as ownership and authenticity are in the art world closely tied to criminal legal matters like theft, handling stolen goods and fraud. The crime prevention promise looks to fall flat though, as the technology seems to be less capable of delivering these benefits than has been assumed by its promoters. Much of the attraction of NFTs is therefore not actually based on effective crime prevention, but rather on hype. This paper explores the hype, and its relationship to the crime prevention promise of NFTs, through the lens of ‘the social lives of things’. We argue that as well as social lives, things have criminal lives. Analysis sensitive to the criminal lives of things finds an NFT trading scene heated by emotion: excitement, attraction, temptation, speculative euphoria and acquisitive, possessive sentiment. This creates a sense of object agency more active than the cold traditional vision of material structure presented in standard criminological treatments of things-in-the-world as passive opportunity structures. The hyped NFT market trades in affecting objects that create crime in emotional as well as structural ways. We therefore arrive at a conclusion opposite to starting assumptions: far from preventing crime, NFTs are making it.
Do-it-yourself surveillance: The practices and effects of WhatsApp Neighbourhood Crime Prevention groups
Authors: van Steden Ronald , Mehlbaum Shanna
Published: August 2021

WhatsApp Neighbourhood Crime Prevention (WNCP) groups are popular in the Netherlands. As a basic assumption, this kind of digital neighbourhood watch could prevent crime, but what is the evidence? Drawing on a mixture of qualitative research and a review of additional publications, we conclude that WNCP groups stimulate social cohesion rather than prevent crime. We reach our conclusion by applying the evaluation EMMIE framework – an acronym for Effect, Mechanisms, Moderators, Implementation and Economics – to the available data. A point for further discussion is the limited scope of the economic dimension. Moral costs must be calculated, too, as WNCP groups tend to deepen divisions between groups of citizens and fuel exclusionary practices in the name of community safety.
Empowering Aboriginal Families as Their Children’s First Teachers of Cultural Knowledge, Languages and Identity at Galiwin’ku FaFT Playgroup
Authors: Gapany Dorothy , Murukun Marilyn , Goveas Jessica , Dhurrkay Jonica , Burarrwanga Verity , Page Jane
Published: August 2021

Embracing and embedding the rich cultural knowledge, languages, concepts and skills that Aboriginal families and children bring to playgroup is key to empowering families as their children’s first teachers and strengthening young children’s self-esteem, pride, confidence and identities. In this article, we share our story of how we have explored and upheld the strengths of Yolŋu identity, cultural knowledge and language in the Galiwin’ku Families as First Teachers (FaFT) playgroup early educational program. We highlight the ways we have supported mothers to embed gesture, sign language, Yolngu Matha language conventions, Yolŋu kinship, clan concepts and dance into their daily interactions with their children at FaFT. We reflect on what has empowered mothers to feel agentic in their children’s learning in these playgroups and to build strong Yolŋu identities in young children and argue that playgroup is a vital educational platform through which to deliver culturally meaningful early learning experiences for Aboriginal children prior to preschool.
Optimizing Engagement in an mHealth Intervention for Diabetes Support During Pregnancy: the Role of Baseline Patient Health and Behavioral Characteristics
Authors: Steinberg Jecca R. , Yeh Chen , Jackson Jenise , Saber Rana , Niznik Charlotte M. , Leziak Karolina , Yee Lynn M.
Published: August 2021

Background:

Mobile health (mHealth) technology that addresses diabetes mellitus in pregnancy has the potential to improve maternal and child health while diminishing socioeconomic and racial disparities. Little is known about health literacy, electronic health literacy, or patient characteristics that contribute to increased mHealth use. In this pilot study, we aimed to examine patient factors associated with user engagement with a novel app for diabetes support during pregnancy.

Method:

Low-income pregnant individuals with gestational or type 2 diabetes mellitus were recruited for a 2-week usability assessment of a novel mHealth smartphone application, “SweetMama,” designed to improve diabetes care. This analysis of user characteristics was a pilot assessment of data from the usability study phase. Participants completed assessments of patient health literacy, electronic health literacy, diabetes self-efficacy, and activation. User metrics (eg, sessions and total duration of use) were evaluated by participant characteristics. Descriptive analyses were conducted to assess outcomes with respect to patient’s clinical history, health literacy, electronic health literacy, diabetes self-efficacy, and activation.

Results:

Twenty-two diverse, low-income pregnant patients with either gestational or type 2 diabetes engaged with SweetMama for 14 days. Participants with gestational diabetes had greater mean minutes of use per session and mean total duration of use than those with type 2 diabetes. Participants with greater electronic health literacy, lower patient activation, and greater self-efficacy demonstrated greater total duration of use. No user metrics differed significantly by participant general health literacy.

Conclusions:

Findings of this pilot study suggest engagement with a novel mHealth app for diabetes support during pregnancy varied by baseline behavioral and clinical characteristics. Results could indicate that digital health literacy better differentiates engagement patterns than general health literacy.
Shoulder Range of Motion Deficits in Youth Throwers Presenting With Elbow Pain
Authors: Rosen Michael , Meijer Karim , Tucker Scott , Wilcox C. Luke , Plummer Hillary A. , Andrews James R. , Ostrander Roger V.
Published: August 2021

Background:

Glenohumeral internal rotation deficit (GIRD) and total arc of motion difference (TAMD) have been associated with elbow injuries in throwing athletes.

Hypothesis:

Youth pitchers with elbow pain will have greater GIRD and TAMD compared with youth pitchers without elbow pain.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Glenohumeral range of motion of 25 consecutive throwing athletes presenting with elbow pain and that of a matched control group of 18 asymptomatic throwing athletes were compared. Bilateral glenohumeral internal rotation, external rotation, and horizontal adduction at 90° were measured and GIRD and TAMD were then calculated. An analysis of variance was performed to compare range of motion between throwers with and without elbow pain.

Results:

The average GIRD of the elbow pain group was 32.7° compared with 14.5° in the control group ( P < 0.05). The average TAMD in the elbow pain group was 28.3° compared with 6.7° in the control group ( P < 0.05). GIRD and TAMD were present in 88% (22 of 25) and 96% (24 of 25) of the elbow pain group versus 33.3% (6 of 18) and 55.6% (10 of 18) of the control group, respectively.

Conclusion:

Compared with asymptomatic youth pitchers, those presenting with elbow pain have a statistically significant GIRD and TAMD.

Clinical Relevance:

This study suggests that a GIRD and TAMD may predispose youth pitchers to present with symptomatic elbow pain.
Treatment of a middle cerebral artery bifurcation aneurysm with the novel Contour Neurovascular System compatible with 0.021″ catheters
Authors: Thormann Maximilian , Mpotsaris Anastasios , Behme Daniel
Published: August 2021

Background

For wide-necked intracranial aneurysms, endo-saccular flow disruption can be a viable alternative to coiling or flow diverters. The Contour Neurovascular System is an intrasaccular flow diverter device targeting the neck of the aneurysm. Until now, the system had to be delivered through a 0.027″ microcatheter. We report the first implantation and follow-up of the novel Contour 021 system compatible with 0.021″ microcatheters. Case presentation: A 54-year-old male patient presented with an unruptured right middle cerebral artery aneurysm at the right temporopolar branch. Existing medication included apixaban. An arteriogram showed a broad-based aneurysm. Due to its asymmetric geometry, neither the Woven EndoBridge nor stent-assisted coil embolisation were regarded as promising treatment strategies. To uphold the option of different treatment options, prasugrel 10 mg was initiated before treatment. Implantation was performed under general anaesthesia via femoral artery puncture. A 0.021″ Headway™ catheter was used for accessing the aneurysm. The Contour device was oversized to the equatorial plane. Deployment was successful with only one attempt without the need for re-sheathing. Follow-up catheter angiography was performed after three months, showing complete occlusion of the aneurysm. No procedure-related complications occurred.

Conclusion

The 0.021 design of the Contour enlarges the subgroup of patients that can be treated with endo-saccular devices and will enable treatment of smaller and more distal aneurysms.
Assessing attacks and treatment response rates among adult patients with NMOSD and MOGAD: Data from a nationwide registry in Argentina
Authors: Carnero Contentti Edgar , Lopez Pablo A , Pettinicchi Juan Pablo , Criniti Juan , Pappolla Agustín , Miguez Jimena , Patrucco Liliana , Cristiano Edgardo , Liwacki Susana , Tkachuk Verónica , Balbuena María E , Vrech Carlos , Deri Norma , Correale Jorge , Marrodan Mariano , Ysrraelit María C , Leguizamon Felisa , Luetic Geraldine , Menichini María L , Tavolini Darío , Mainella Carolina , Zanga Gisela , Burgos Marcos , Hryb Javier , Barboza Andrés , Lazaro Luciana , Alonso Ricardo , Liguori Nora Fernández , Nadur Débora , Chertcoff Aníbal , Alonso Serena Marina , Caride Alejandro , Paul Friedemann , Rojas Juan I
Published: August 2021

We aimed to examine treatment interventions implemented in patients experiencing neuromyelitis optica spectrum disorders (NMOSD) attacks (frequency, types, and response).

Methods

Retrospective study. Data on patient demographic, clinical and radiological findings, and administered treatments were collected. Remission status (complete [CR], partial [PR], no remission [NR]), based on changes in the EDSS score was evaluated before treatment, during attack, and at 6 months. CR was analyzed with a generalized estimating equations (GEEs) model.

Results

A total of 131 patients (120 NMOSD and 11 myelin oligodendrocyte glycoprotein-antibody-associated diseases [MOGAD]), experiencing 262 NMOSD-related attacks and receiving 270 treatments were included. High-dose steroids (81.4%) was the most frequent treatment followed by plasmapheresis (15.5%). CR from attacks was observed in 47% (105/223) of all treated patients. During the first attack, we observed CR:71.2%, PR:16.3% and NR:12.5% after the first course of treatment. For second, third, fourth, and fifth attacks, CR was observed in 31.1%, 10.7%, 27.3%, and 33.3%, respectively. Remission rates were higher for optic neuritis vs. myelitis (p < 0.001). Predictor of CR in multivariate GEE analysis was age in both NMOSD (OR = 2.27, p = 0.002) and MOGAD (OR = 1.53, p = 0.03).

Conclusions

This study suggests individualization of treatment according to age and attack manifestation. The outcome of attacks was generally poor.
The Effect of Cooling Times on the Bonding Between Porcelain and Metal Alloys Fabricated by Different Techniques: In Vitro Study
Authors: Ünal Emine , Tugut Faik
Published: August 2021

Aim:

The aim of this study was to evaluate the effect of different cooling times on shear bond strength between cobalt–chromium metal frameworks fabricated by different techniques and veneering porcelain.

Materials and Methods:

One hundred twenty cobalt–chromium metal ceramic samples were obtained by three different techniques (casting, milling, and laser sintering). During the porcelain firing, fast and slow cooling protocols were applied. Ten specimens from each group were determined for all groups. The shear bond strength of the metal ceramic samples was measured by a universal testing machine with a constant crosshead speed of 0.5 mm/min. One sample from each group was evaluated by the scanning electron microscopy analysis in terms of surface change and fracture morphology. Variance analysis and Tukey test were used to analyze statistically significant differences between groups.

Results:

It was seen that the difference between the bond strengths of the metal frameworks obtained by different techniques was statistically significant ( P < .05). All groups except for difference between the bond strengths of all the frameworks metal groups with G-Ceram porcelain were statistically significant ( P < .05). The best bond strengths that were statistically significant were fast cooling G-Ceram (19.65 ± 2.65 MPa) with metal frameworks fabricated by laser sintering, fast cooling with metal framework fabricated by milling Noritake (19.17 ± 2.91 MPa), and the metal framework fabricated by casting was found to be slow cooling Noritake (12.99 ± 2.08 MPa) were seen.

Conclusion:

The porcelain cooling times had significant effect on the shear bond strength of porcelain to casting, milling and laser sintering alloys.
Assessing Shared Decision-Making in Cystic Fibrosis Care Using collaboRATE: A Cross-Sectional Study of 159 Programs
Authors: Homa Karen , Stevens Gabrielle , Forcino Rachel , Scalia Peter , Mertz Pamela , Elwyn Glyn
Published: August 2021

There are numerous opportunities for shared decision-making (SDM) in cystic fibrosis (CF) care, yet little is known about patients’ SDM experiences. This study evaluated SDM across 159 CF care programs (4024 participants) in the United States. Shared decision-making was assessed using the patient-reported collaboRATE measure, which was included in the CF Foundation’s Patient and Family Experience of Care Survey over 18 months. Overall, 69% of respondents reported experiencing SDM. Respondents at pediatric programs were more likely to experience SDM than those at adult programs (72% vs 67%, P < .001). Multivariable logistic regression analyses showed a relationship between SDM and patient age, whereby SDM was less likely to occur with patients aged 18 to 24 years, compared to some younger and older age groups ( P = .02-<.001). Shared decision-making was more likely to occur at pediatric programs when patients had better general health ( P = .02-<.01), and at pediatric and adult programs when patients had better mental health ( P = .02-<.001). Disparities in SDM experiences highlight a need to improve decision-making processes in CF care. Interventions tailored for improving SDM among specific patient populations may be particularly advantageous.
Australian and Italian Psychologists’ View of Replication
Authors: Agnoli Franca , Fraser Hannah , Singleton Thorn Felix , Fidler Fiona
Published: August 2021

Solutions to the crisis in confidence in the psychological literature have been proposed in many recent articles, including increased publication of replication studies, a solution that requires engagement by the psychology research community. We surveyed Australian and Italian academic research psychologists about the meaning and role of replication in psychology. When asked what they consider to be a replication study, nearly all participants (98% of Australians and 96% of Italians) selected options that correspond to a direct replication. Only 14% of Australians and 8% of Italians selected any options that included changing the experimental method. Majorities of psychologists from both countries agreed that replications are very important, that more replications should be done, that more resources should be allocated to them, and that they should be published more often. Majorities of psychologists from both countries reported that they or their students sometimes or often replicate studies, yet they also reported having no replication studies published in the prior 5 years. When asked to estimate the percentage of published studies in psychology that are replications, both Australians (with a median estimate of 13%) and Italians (with a median estimate of 20%) substantially overestimated the actual rate. When asked what constitute the main obstacles to replications, difficulty publishing replications was the most frequently cited obstacle, coupled with the high value given to innovative or novel research and the low value given to replication studies.
B-cell acute lymphoblastic leukemia in patients with germline RUNX1 mutations
Authors: Six Kathryn A. , Gerdemann Ulrike , Brown Anna L. , Place Andrew E. , Cantor Alan B. , Kutny Matthew A. , Avagyan Serine
Published: August 2021

Germline RUNX1 mutations underlie a syndrome, RUNX1-familial platelet disorder (RUNX1-FPD), characterized by bleeding symptoms that result from quantitative and/or qualitative defect in platelets and a significantly increased risk for developing hematologic malignancies. Myeloid neoplasms are the most commonly diagnosed hematologic malignancies, followed by lymphoid malignancies of T-cell origin. Here, we describe the first 2 cases of B-cell acute lymphoblastic leukemia (B-ALL) in patients with confirmed germline RUNX1 mutations. While 1 of the patients had a known diagnosis of RUNX1-FPD with a RUNX1 p.P240Hfs mutation, the other was the index patient of a kindred with a novel RUNX1 variant, RUNX1 c.587C>T (p.T196I), noted on a targeted genetic testing of the B-ALL diagnostic sample. We discuss the clinical course, treatment approaches, and the outcome for the 2 patients. Additionally, we describe transient resolution of the mild thrombocytopenia and bleeding symptoms during therapy, as well as the finding of clonal hematopoiesis with a TET2 mutant clone in 1 of the patients. It is critical to consider testing for germline RUNX1 mutations in patients presenting with B-ALL who have a personal or family history of thrombocytopenia, bleeding symptoms, or RUNX1 variants identified on genetic testing at diagnosis.
Genome-wide identification and function analysis of HMAD gene family in cotton (Gossypium spp.)
Authors: Wang Qinqin , Lu Xuke , Chen Xiugui , Zhao Lanjie , Han Mingge , Wang Shuai , Zhang Yuexin , Fan Yapeng , Ye Wuwei
Published: August 2021

Background

The abiotic stress such as soil salinization and heavy metal toxicity has posed a major threat to sustainable crop production worldwide. Previous studies revealed that halophytes were supposed to tolerate other stress including heavy metal toxicity. ThoughHMAD(heavy-metal-associated domain) was reported to play various important functions inArabidopsis, little is known inGossypium.

Results

A total of 169 G. hirsutumgenes were identified belonging to theHMADgene family with the number of amino acids ranged from 56 to 1011. Additionally, 84, 76 and 159HMADgenes were identified in eachG. arboreum, G. raimondiiandG. barbadense, respectively. The phylogenetic tree analysis showed that theHMADgene family were divided into five classes, and 87 orthologs ofHMADgenes were identified in fourGossypiumspecies, such as genesGh_D08G1950andGh_A08G2387ofG. hirsutumare orthologs of theGorai.004G210800.1andCotton_A_25987gene inG. raimondiiandG. arboreum, respectively. In addition, 15 genes were lost during evolution. Furthermore, conserved sequence analysis found the conserved catalytic center containing an anion binding (CXXC) box. TheHMADgene family showed a differential expression levels among different tissues and developmental stages inG. hirsutumwith the different cis-elements for abiotic stress.

Conclusions

Current study provided important information aboutHMADfamily genes under salt-stress inGossypiumgenome, which would be useful to understand its putative functions in different species of cotton.
Genetic mapping high protein content QTL from soybean ‘Nanxiadou 25’ and candidate gene analysis
Authors: Wang Jia , Mao Lin , Zeng Zhaoqiong , Yu Xiaobo , Lian Jianqiu , Feng Jun , Yang Wenying , An Jiangang , Wu Haiying , Zhang Mingrong , Liu Liezhao
Published: August 2021

Background

Soybean is a globally important legume crop that provides a primary source of high-quality vegetable protein and oil. Seed protein content (SPC) is a valuable quality trait controlled by multiple genes in soybean.

Results

In this study, we performed quantitative trait loci (QTL) mapping, QTL-seq, and RNA sequencing (RNA-seq) to reveal the genes controlling protein content in the soybean by using the high protein content variety Nanxiadou 25. A total of 50 QTL for SPC distributed on 14 chromosomes except chromosomes 4, 12, 14, 17, 18, and 19 were identified by QTL mapping using 178 recombinant inbred lines (RILs). Among these QTL, the major QTL qSPC_20–1 and qSPC_20–2 on chromosome 20 were repeatedly detected across six tested environments, corresponding to the location of the major QTL detected using whole-genome sequencing-based QTL-seq. 329 candidate DEGs were obtained within the QTL region of qSPC_20–1 and qSPC_20–2 via gene expression profile analysis. Nine of which were associated with SPC, potentially representing candidate genes. Clone sequencing results showed that different single nucleotide polymorphisms (SNPs) and indels between high and low protein genotypes in Glyma.20G088000 and Glyma.16G066600 may be the cause of changes in this trait.

Conclusions

These results provide the basis for research on candidate genes and marker-assisted selection (MAS) in soybean breeding for seed protein content.
Commentary on the NICE guideline on renal replacement therapy and conservative management
Authors: Kharbanda Kunaal , Iyasere Osasuyi , Caskey Fergus , Marlais Matko , Mitra Sandip
Published: August 2021

Background

NICE Guideline NG107, “Renal replacement therapy and conservative management” (Renal replacement therapy and conservative management (NG107); 2018:1–33) was published in October 2018 and replaced the existing NICE guideline CG125, “Chronic Kidney Disease (Stage 5): peritoneal dialysis” (Chronic kidney disease (stage 5): peritoneal dialysis | Guidance | NICE; 2011) and NICE Technology Appraisal TA48, “Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure”(Guidance on home compared with hospital haemodialysis for patients with end-stage renal failure (Technology appraisal guideline TA48); 2002) The aim of the NICE guideline (NG107) was to provide guidance on renal replacement therapy (RRT), including dialysis, transplant and conservative care, for adults and children with CKD Stages 4 and 5. The guideline is extremely welcomed by the Renal Association and it offers huge value to patients, clinicians, commissioners and key stakeholders. It overlaps and enhances current guidance published by the Renal Association including “Haemodialysis” (Clinical practice guideline: Haemodialysis; 2019) which was updated in 2019 after the publication of the NICE guideline, “Peritoneal Dialysis in Adults and Children” (Clinical practice guideline: peritoneal Dialysis in adults and children; 2017) and “Planning, Initiation & withdrawal of Renal Replacement Therapy” (Clinical practice guideline: planning, initiation and withdrawal of renal replacement therapy; 2014) (at present there are no plans to update this guideline).

There are several strengths to NICE guideline NG107 and we agree with and support the vast majority of recommendation statements in the guideline. This summary from the Renal Association discusses some of the key highlights, controversies, gaps in knowledge and challenges in implementation. Where there is disagreement with a NICE guideline statement, we have highlighted this and a new suggested statement has been written.
Educational inequalities, urbanicity and levels of non-communicable diseases risk factors: evaluating trends in Argentina (2005–2013)
Authors: Rodríguez López Santiago , Bilal Usama , Ortigoza Ana F. , Diez-Roux Ana V.
Published: August 2021

Background

We investigated a) whether urbanicity is associated with individual-level non-communicable diseases (NCD) risk factors and whether urbanicity modifies trends over time in risk factors; and (b) whether educational inequalities in NCD risk factors change over time or are modified by province urbanicity.

Methods

We used data from three large national surveys on NCD risk factors (Encuesta Nacional de Factores de Riesgo; ENFR2005–2009-2013) conducted in urban areas of Argentina (n = 108,489). We used gender-stratified logistic random-intercept models (individuals nested within provinces) to determine adjusted associations of self-reported individual NCD risk factors (hypertension, diabetes, obesity, and current smoking) with education and urbanicity.

Results

In both men and women, the prevalence of obesity and diabetes increased over time but smoking decreased. Hypertension prevalence increased over time in men. Higher urbanicity was associated with higher odds of smoking and lower odds of hypertension in women but was not associated with NCD risk factors in men. Obesity increased more over time in more compared to less urbanized provinces (in men) while smoking decreased more over time in less urbanized provinces. All risk factors had a higher prevalence in persons with lower education (stronger in women than in men), except for diabetes in men and smoking in women. Educational inequalities in obesity (in men) and hypertension (in men and women) became stronger over time, while an initial inverse social gradient in smoking for women reverted and became similar to other risk factors over time. In general, the inverse associations of education with the risk factors became stronger with increasing levels of province urbanicity.

Conclusion

Increasing prevalence of diabetes and obesity over time and growing inequities by education highlight the need for policies aimed at reducing NCD risk factors among lower socioeconomic populations in urban environments in Argentina.
Exploring the beliefs and perceptions of spending time in nature among U.S. youth
Authors: Zamora Astrid N. , Waselewski Marika E. , Frank Abby J. , Nawrocki Jack R. , Hanson Aspen R. , Chang Tammy
Published: August 2021

Purpose

The prevalence of poor mental health continues to rise among youth; however, large-scale interventions to improve mental and physical health remain a public health challenge. Time spent in nature is associated with improved health among youth. This study aimed to assess youth experiences with nature and the self-perceived impact on their mental and physical health among a nationwide sample of US youth.

Methods

In September 2020, five open-ended questions that aimed to assess perceptions regarding nature were posed to 1174 MyVoice youth, aged 14–24 years. Qualitative responses were analyzed using thematic analysis, and data were summarized using descriptive statistics.

Results

The mean (SD) age of the 994 respondents (RR = 84.7%) was 18.9 (2.7) years; 47.4% were female, and 57.4% Non-Hispanic White. Among youth, many felt that spending time in nature positively impacted their mental health, with 51.6% mentioning that it made them “feel calm when I am out in nature”; 22.1% said that it relieved stress or “reduces my anxiety,” and 17.1% felt that being in nature positively impacted their physical health and “makes me feel more active and in shape.” However, 7.0% said it negatively impacted their health, such as “It makes me feel isolated.” Most youth (87.8%) want to spend more time in nature, with 22% mentioning barriers (i.e., busy schedules, built environment, and COVID-19) impeding them from doing so.

Conclusions

Youth in our sample generally report feeling physically and mentally better when spending time in nature and want to spend more time in nature. Public health policies and practices that eliminate barriers and actively support time spent outside may be a feasible and acceptable practice to promote overall well-being among youth.
Norepinephrine modulates IL-1β-induced catabolic response of human chondrocytes
Authors: Hwang Hyun Sook , Lee Mi Hyun , Go Dong Jin , Kim Hyun Ah
Published: August 2021

Background

The influence of the sympathetic nervous system (SNS) on metabolism of bone and cartilage expressing β-adrenergic receptors (AR) was suggested. Here, we investigated whether the SNS functions as a modulator of cartilage metabolism induced by interleukin-1beta (IL-1β).

Methods

Human articular chondrocytes and articular cartilage were collected from patients with osteoarthritis (OA). Chondrocyte monolayer and cartilage explant culture were stimulated with IL-1β. The activity of β-ARs was modulated by an agonist, norepinephrine (NE), and antagonists, including propranolol, atenolol, nebivolol, and nadolol.

Results

The levels of β1-, β2-, and β3-AR in OA cartilage and IL-1β-treated chondrocytes were lower than normal cartilage and untreated cells. Treatment of chondrocytes with IL-1β and β-blockers, including propranolol, atenolol, nebivolol, and nadolol, for 6 h significantly upregulated IL-1β-induced expression of MMP-1, -3, and − 13, compared to chondrocytes treated with IL-1β alone, indicating that antagonism of β-AR confers catabolic signals. On the other hand, NE antagonized IL-1β-induced catabolic response. In addition, NE significantly inhibited IL-1β-induced release of glycosaminoglycan (GAG) from cartilage explant culture. In addition, β-AR activity significantly affected IL-1β-stimulated phosphorylation of JNK and ERK. These results indicate that β-AR signal is associated with cartilage metabolism.

Conclusions

Our findings showed that β-ARs is a regulator of cartilage catabolism induced with IL-1β.
Associations of overweight, obesity and osteoporosis with ankle fractures
Authors: Hjelle Anja M. , Apalset Ellen M. , Gjertsen Jan-Erik , Nilsen Roy M. , Lober Anja , Tell Grethe S. , Mielnik Pawel F.
Published: August 2021

Background

Studies exploring risk factors for ankle fractures in adults are scarce, and with diverging conclusions. This study aims to investigate whether overweight, obesity and osteoporosis may be identified as risk factors for ankle fractures and ankle fracture subgroups according to the Danis-Weber (D-W) classification.

Methods

108 patients ≥40 years with fracture of the lateral malleolus were included. Controls were 199 persons without a previous fracture history. Bone mineral density of the hips and spine was measured by dual-energy x-ray absorptiometry, and history of previous fracture, comorbidities, medication, physical activity, smoking habits, body mass index and nutritional factors were registered.

Results

Higher body mass index with increments of 5 gave an adjusted odds ratio (OR) of 1.30 (95% confidence interval (CI) 1.03–1.64) for ankle fracture, and an adjusted OR of 1.96 (CI 0.99–4.41) for sustaining a D-W type B or C fracture compared to type A. Compared to patients with normal bone mineral density, the odds of ankle fracture in patients with osteoporosis was 1.53, but the 95% CI was wide (0.79–2.98). Patients with osteoporosis had reduced odds of sustaining a D-W fracture type B or C compared to type A (OR 0.18, CI 0.03–0.83).

Conclusions

Overweight increased the odds of ankle fractures and the odds of sustaining an ankle fracture with possible syndesmosis disruption and instability (D-W fracture type B or C) compared to the stable and more distal fibula fracture (D-W type A). Osteoporosis did not significantly increase the odds of ankle fractures, thus suffering an ankle fracture does not automatically warrant further osteoporosis assessment.
Can low-intensity pulsed ultrasound (LIPUS) accelerate bone healing after intramedullary screw fixation for proximal fifth metatarsal stress fractures? A retrospective study
Authors: Murakami Ryo , Sanada Takaki , Inagawa Miyu , Yoshitomi Hiroki , Honda Eisaburo , Fukai Atsushi , Iwaso Hiroshi
Published: August 2021

Background

Intramedullary screw fixation is considered the standard treatment for proximal fifth metatarsal stress fractures. Low-intensity pulsed ultrasound (LIPUS) is a well-known bone-healing enhancement device. However, to the best of our knowledge, no clinical study has focused on the effect of LIPUS for postoperative bone union in proximal fifth metatarsal stress fractures. This study aimed to investigate the effect of LIPUS treatment after intramedullary screw fixation for proximal fifth metatarsal stress fractures.

Methods

Between January 2015 and March 2020, patients who underwent intramedullary screw fixation for proximal fifth metatarsal stress fractures were investigated retrospectively. All patients underwent intramedullary screw fixation using a headless compression screw with autologous bone grafts from the base of the fifth metatarsal. The time to restart running and return to sports, as well as that for radiographic bone union, were compared between groups with or without LIPUS treatment. LIPUS treatment was initiated within 3 weeks of surgery in all cases.

Results

Of the 101 ft analyzed, 57 ft were assigned to the LIPUS treatment group, and 44 ft were assigned to the non-LIPUS treatment group. The mean time to restart running and return to sports was 6.8 and 13.7 weeks in the LIPUS treatment group and was 6.2 and 13.2 weeks in the non-LIPUS treatment group, respectively. There were no significant differences in these parameters between groups. In addition, the mean time to radiographic bone union was not significantly different between the LIPUS treatment group (11.9 weeks) and the non-LIPUS treatment group (12.0 weeks). The rate of postoperative nonunion in the LIPUS treatment group was 0% (0/57), while that in the non-LIPUS treatment group was 4.5% (2/44). However, this difference was not statistically significant.

Conclusions

There were no statistically significant differences regarding the time to start running, return to sports, and radiographic bone union in patients with or without LIPUS treatment after intramedullary screw fixation for proximal fifth metatarsal stress fractures. Therefore, we cannot recommend the routine use of LIPUS to shorten the time to bone union after intramedullary screw fixation for proximal fifth metatarsal stress fractures.
A new roadmap for social medicine curriculum design based on mixed methods student and faculty evaluations of the preclinical curriculum
Authors: Finnie Sheridan M. , Brach Richard J. , Dawson Christina A. , Epstein Samuel B. , Goyal Raghav K. , Lounsbury Karen M. , Eldakar-Hein Shaden T. , Lahey Timothy
Published: August 2021

Background

To support the development of social medicine curricula that empower medical school graduates to redress health inequities, we conducted a mixed methods student and faculty evaluation of an expanded and innovative preclinical social medicine curriculum.

Methods

We implemented a longitudinal, interactive preclinical social medicine curriculum that was closely integrated with foundational science teaching then conducted a survey-based mixed methods student and faculty curriculum evaluation. Based on these results, we propose a novel conceptual roadmap for social medicine curriculum design.

Results

Student and faculty evaluations of an expanded and innovative longitudinal preclinical social medicine curriculum were strongly favorable. Both student and faculty respondents indicated a particular desire for deeper coverage of race and poverty among other social medicine domains. Qualitative student evaluations highlighted the importance of faculty champions to social medicine teaching as well as the educational impact of stories that exemplify the practical impact of the social determinants of health on specific patient experiences. Qualitative faculty evaluations pointed to the challenges of curriculum integration and the need for faculty career development in social medicine teaching.

Conclusions

Based on mixed methods student and faculty curriculum evaluation data, we propose a novel conceptual roadmap for the design of social medicine curricula at other institutions.
The impact of clinical pharmacist services on patient health outcomes in Pakistan: a systematic review
Authors: Ahmed Ali , Saqlain Muhammad , Tanveer Maria , Blebil Ali Qais , Dujaili Juman Abdulelah , Hasan Syed Shahzad
Published: August 2021

Background

The pharmacist’s role shifts from dispensing to bedside care, resulting in better patient health outcomes. Pharmacists in developed countries ensure rational drug use, improve clinical outcomes, and promote health status by working as part of a multidisciplinary team of healthcare professionals. However, clinical pharmacist services on healthcare utilization in low-and middle-income countries (LMICs) like Pakistan are unclear. As a result, we aim to systematically review pharmacists’ clinical roles in improving Pakistani patients’ therapeutic, safety, humanistic, and economic outcomes.

Methods

We searched PubMed, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 28th February 2021. All authors were involved in the screening and selection of studies. Original studies investigating the therapeutic, humanistic, safety, and economic impact of clinical pharmacists in Pakistani patients (hospitalised or outpatients) were selected. Two reviewers independently assessed the risk of bias in studies, and discrepancies were resolved through mutual consensus. All of the included studies were descriptively synthesised, and PRISMA reporting guidelines were followed.

Results

The literature search found 751 articles from which nine studies were included; seven were randomized controlled trials (RCTs), and two were observational studies. Three RCTs included were having a low risk of bias (ROB), two RCTs were having an unclear ROB, while two RCTs were having a high ROB. The nature of clinical pharmacist interventions included one or more components such as disease-related education, lifestyle changes, medication adherence counselling, medication therapy management, and discussions with physicians about prescription modification if necessary. Clinical pharmacist interventions reduce medication-related errors, improve therapeutic outcomes such as blood pressure, glycemic control, lipid control, CD4 T lymphocytes, and renal functions, and improve humanistic outcomes such as patient knowledge, adherence, and health-related quality of life. However, no study reported the economic outcomes of interventions.

Conclusions

The findings of the studies included in this systematic review suggest that clinical pharmacists play important roles in improving patients’ health outcomes in Pakistan; however, it should be noted that the majority of the studies have a high risk of bias, and more research with appropriate study designs is needed.
Upregulation of leukocyte immunoglobulin-like receptor B4 on interstitial macrophages in COPD; their possible protective role against emphysema formation
Authors: Mitsune Ayumi , Yamada Mitsuhiro , Fujino Naoya , Numakura Tadahisa , Ichikawa Tomohiro , Suzuki Ayumi , Matsumoto Shuichiro , Mitsuhashi Yoshiya , Itakura Koji , Makiguchi Tomonori , Koarai Akira , Tamada Tsutomu , Endo Shota , Takai Toshiyuki , Okada Yoshinori , Suzuki Satoshi , Ichinose Masakazu , Sugiura Hisatoshi
Published: August 2021

Background

Leukocyte immunoglobulin-like receptor B4 (LILRB4) is one of the inhibitory receptors in various types of immune cells including macrophages. Previous reports suggested that LILRB4 could be involved in a negative feedback system to prevent excessive inflammatory responses. However, its role has been unclear in chronic obstructive pulmonary disease (COPD), in which macrophages play a crucial role in the pathogenesis. In this study, we aimed to examine the changes of LILRB4 on macrophages both in the lung specimens of COPD patients and the lungs of a mouse emphysema model. We then tried to compare the differences in both inflammation and emphysematous changes of the model between wild-type and LILRB4-deficient mice in order to elucidate the role of LILRB4 in the pathogenesis of COPD.

Methods

We prepared single-cell suspensions of resected lung specimens of never-smokers (n = 21), non-COPD smokers (n = 16), and COPD patients (n = 14). The identification of LILRB4-expressing cells and the level of LILRB4 expression were evaluated by flow cytometry. We analyzed the relationships between the LILRB4 expression and clinical characteristics including respiratory function. In the experiments using an elastase-induced mouse model of emphysema, we also analyzed the LILRB4 expression on lung macrophages. We compared inflammatory cell accumulation and emphysematous changes induced by elastase instillation between wild-type and LILRB4-deficient mice.

Results

The levels of surface expression of LILRB4 are relatively high on monocyte linage cells including macrophages in the human lungs. The percentage of LILRB4+ cells in lung interstitial macrophages was increased in COPD patients compared to non-COPD smokers (p = 0.018) and correlated with the severity of emphysematous lesions detected by CT scan (rs = 0.559, p < 0.001), whereas the amount of smoking showed no correlation with LILRB4 expression. Increased LILRB4 on interstitial macrophages was also observed in elastase-treated mice (p = 0.008). LILRB4-deficient mice showed severer emphysematous lesions with increased MMP-12 expression in the model.

Conclusions

LILRB4 on interstitial macrophages was upregulated both in human COPD lungs and in a mouse model of emphysema. This upregulated LILRB4 may have a protective effect against emphysema formation, possibly through decreasing MMP-12 expression in the lungs.
Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan
Authors: Kumar Ramesh , Farzeen Midhat , Ahmed Jamil , Lal Manohar , Somrongthong Ratana
Published: August 2021

Background

Malaria is endemic to Pakistan with high prevalence among pregnant women and linked with maternal anaemia, intrauterine growth retardation, preterm birth, and low birth weight. The use of long-lasting insecticidal nets (LLINs) is a proven and cost-effective intervention preventing malaria among pregnant women. The present study aimed to explore predictors of knowledge and use of LLINs among pregnant women in Pakistan.

Methods

This was part of a quasi-experimental study of 200 pregnant women conducted in a rural district of Sindh province in Pakistan. Data were collected using Malaria Indicator Survey questionnaires developed by Roll Back Malaria Partnership to end Malaria Monitoring and Evaluation Reference Group. Pregnant women and mothers with newborns of six months of age were interviewed in their homes.

Results

The age of the women was from 18 to 45, two thirds of the respondents (72.5%) were uneducated and married (77%). Majority (92%) of the women had received antenatal care during pregnancy, and 29.5% women had received counseling on malaria during their antenatal care visits. Multiple linear regression showed that the type of latrine was the most significant (β = 0.285, p < 0.001) determinant of knowledge about malaria among pregnant women followed by the death of a newborn (β = 0.271, p < 0.001). The use of mobile phone was the most significant (β = 0.247, p < 0.001) predictor of usage of LLINs among pregnant women followed by the death of a newborn (β = 0.232, p < 0.05).

Conclusions

Maternal education, type of latrine, use of mobile phone, malaria during previous pregnancy and newborn death were strong predictors of knowledge and use of LLINs in pregnant women in Pakistan. There is a need to scale-up programmes that aim to create awareness regarding malaria among pregnant women. Mobile phone technology can be used to implement awareness programmes focusing on malaria prevention among women.
Short-term PM2.5 and cardiovascular admissions in NY State: assessing sensitivity to exposure model choice
Authors: He Mike Z. , Do Vivian , Liu Siliang , Kinney Patrick L. , Fiore Arlene M. , Jin Xiaomeng , DeFelice Nicholas , Bi Jianzhao , Liu Yang , Insaf Tabassum Z. , Kioumourtzoglou Marianthi-Anna
Published: August 2021

Background

Air pollution health studies have been increasingly using prediction models for exposure assessment even in areas without monitoring stations. To date, most studies have assumed that a single exposure model is correct, but estimated effects may be sensitive to the choice of exposure model.

Methods

We obtained county-level daily cardiovascular (CVD) admissions from the New York (NY) Statewide Planning and Resources Cooperative System (SPARCS) and four sets of fine particulate matter (PM2.5) spatio-temporal predictions (2002–2012). We employed overdispersed Poisson models to investigate the relationship between daily PM2.5 and CVD, adjusting for potential confounders, separately for each state-wide PM2.5 dataset.

Results

For all PM2.5 datasets, we observed positive associations between PM2.5 and CVD. Across the modeled exposure estimates, effect estimates ranged from 0.23% (95%CI: -0.06, 0.53%) to 0.88% (95%CI: 0.68, 1.08%) per 10 µg/m3 increase in daily PM2.5. We observed the highest estimates using monitored concentrations 0.96% (95%CI: 0.62, 1.30%) for the subset of counties where these data were available.

Conclusions

Effect estimates varied by a factor of almost four across methods to model exposures, likely due to varying degrees of exposure measurement error. Nonetheless, we observed a consistently harmful association between PM2.5 and CVD admissions, regardless of model choice.