bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of HCG18 and MCM3AP-AS1 That Associate With Bone Metastasis, Poor Prognosis and Increased Abundance of M2 Macrophage Infiltration in Prostate Cancer
Authors: Chen Yanfang , Chen Zheng , Mo Jian , Pang Mao , Chen Zihao , Feng Feng , Xie Peigen , Yang Bu
Published: February 2021

Background:

Bone metastasis is a leading cause of the high mortality rate of prostate cancer (PCa), but curative strategies remain lacking. Recent studies suggest long non-coding RNAs (lncRNAs) may be potential targets to develop drugs. However, PCa bone metastasis-specifically-related lncRNAs were rarely reported. This study aimed to identify crucial lncRNAs and reveal their function mechanisms.

Methods:

GSE32269 and GSE26964 microarray datasets, downloaded from the Gene Expression Omnibus database, were used to analyze differentially expressed genes (DEGs)/lncRNAs (DELs) and miRNAs (DEMs), respectively. Weighted gene co-expression network analysis was performed to screen PCa bone metastasis-associated modules. The co-expression and competing endogenous RNAs (ceRNAs) networks were constructed to identify hub lncRNAs. Univariate Cox regression analysis was conducted to determine their prognostic values. The correlation of lncRNAs with immune infiltrating cells was analyzed by using Tumor IMmune Estimation Resource. Therapeutic drugs were predicted by querying the Connectivity Map (CMap) and the Comparative Toxicogenomics Database (CTD).

Results:

A total of 18 DELs, 2,614 DEGs and 86 DEMs were screened between bone metastatic and primary PCa samples. Four modules enriched by DEGs were shown to be bone metastasis-associated. LncRNA HCG18 and MCM3AP-AS1 were identified to be important because they existed in both of the co-expression and ceRNA networks (forming the relationship pairs: HCG18/MCM3AP-AS1-KNTC1, MCM3AP-AS1-hsa-miR-508-3p-DTL and HCG18/MCM3AP-AS1-hsa-miR-127-3p-CDKN3). All the genes in these interaction pairs were significantly associated with overall survival of PCa patients. Also, HCG18, MCM3AP-AS1 and their target mRNAs were positively correlated with various tumor-infiltrated immune cells, especially increased M2 macrophages. Valproic acid and trichostatin A may be effective to treat PCa bone metastasis by targeting HCG18 and MCM3AP-AS1.

Conclusion:

HCG18 and MCM3AP-AS1 that regulate M2 macrophage infiltration may be important targets to treat PCa bone metastasis and improve prognosis.
Therapeutic potential of HIV-1 entry inhibitor peptidomimetics
Authors: Korie Nneka PU , Tandoh Kwesi Z , Kwofie Samuel K , Quaye Osbourne
Published: February 2021

Human immunodeficiency virus 1 (HIV-1) infection remains a public health concern globally. Although great strides in the management of HIV-1 have been achieved, current highly active antiretroviral therapy is limited by multidrug resistance, prolonged use-related effects, and inability to purge the HIV-1 latent pool. Even though novel therapeutic options with HIV-1 broadly neutralizing antibodies (bNAbs) are being explored, the scalability of bNAbs is limited by economic cost of production and obligatory requirement for parenteral administration. However, these limitations can be addressed by antibody mimetics/peptidomimetics of HIV-1 bNAbs. In this review we discuss the limitations of HIV-1 bNAbs as HIV-1 entry inhibitors and explore the potential therapeutic use of antibody mimetics/peptidomimetics of HIV-1 entry inhibitors as an alternative for HIV-1 bNAbs. We highlight the reduced cost of production, high specificity, and oral bioavailability of peptidomimetics compared to bNAbs to demonstrate their suitability as candidates for novel HIV-1 therapy and conclude with some perspectives on future research toward HIV-1 novel drug discovery.
Whole-body vibration mediates mechanical hypersensitivity through Aβ-fiber and C-fiber thermal sensation in a chronic pain model
Authors: Sonza Anelise , Sanada Luciana Sayuri , Oliveira Luiza Raulino de , Bernardo-Filho Mario , Sá-Caputo Danúbia da Cunha de , Zaro Milton Antonio , Achaval Matilde
Published: February 2021

Whole-body vibration (WBV), which is widely used as a type of exercise, involves the use of vibratory stimuli and it is used for rehabilitation and sports performance programmes. This study aimed to investigate the effect of WBV treatment in a chronic pain model after 10 WBV sessions. An animal model (chronic pain) was applied in 60 male Wistar rats (±180 g, 12 weeks old) and the animals were treated with low intensity exercise (treadmill), WBV (vibrating platform), and a combined treatment involving both. The controls on the platform were set to a frequency of 42 Hz with 2 mm peak-to-peak displacement, g ≈ 7, in a spiral mode. Before and after the vibration exposure, sensitivity was determined. Aβ-fibers-mediated mechanical sensitivity thresholds (touch-pressure) were measured using a pressure meter. C-fibers-mediated thermal perception thresholds (hot pain) were measured with a hot plate. After each session, WBV influenced the discharge of skin touch-pressure receptors, reducing mechanical sensitivity in the WBV groups ( P < 0.05). Comparing the conditions “before vs. after”, thermal perception thresholds (hot pain) started to decrease significantly after the third WBV session ( P < 0.05). WBV decreases mechanical hyperalgesia after all sessions and thermal sensitivity after the third session with the use of WBV.
Drug class effects on respiratory mechanics in animal models: access and applications
Authors: Oliveira Maria A , Lino-Alvarado Alembert E , Moriya Henrique T , Vitorasso Renato L
Published: February 2021

Assessment of respiratory mechanics extends from basic research and animal modeling to clinical applications in humans. However, to employ the applications in human models, it is desirable and sometimes mandatory to study non-human animals first. To acquire further precise and controlled signals and parameters, the animals studied must be further distant from their spontaneous ventilation. The majority of respiratory mechanics studies use positive pressure ventilation to model the respiratory system. In this scenario, a few drug categories become relevant: anesthetics, muscle blockers, bronchoconstrictors, and bronchodilators. Hence, the main objective of this study is to briefly review and discuss each drug category, and the impact of a drug on the assessment of respiratory mechanics. Before and during the positive pressure ventilation, the experimental animal must be appropriately sedated and anesthetized. The sedation will lower the pain and distress of the studied animal and the plane of anesthesia will prevent the pain. With those drugs, a more controlled procedure is carried out; further, because many anesthetics depress the respiratory system activity, a minimum interference of the animal’s respiration efforts are achieved. The latter phenomenon is related to muscle blockers, which aim to minimize respiratory artifacts that may interfere with forced oscillation techniques. Generally, the respiratory mechanics are studied under appropriate anesthesia and muscle blockage. The application of bronchoconstrictors is prevalent in respiratory mechanics studies. To verify the differences among studied groups, it is often necessary to challenge the respiratory system, for example, by pharmacologically inducing bronchoconstriction. However, the selected bronchoconstrictor, doses, and administration can affect the evaluation of respiratory mechanics. Although not prevalent, studies have applied bronchodilators to return (airway resistance) to the basal state after bronchoconstriction. The drug categories can influence the mathematical modeling of the respiratory system, systemic conditions, and respiratory mechanics outcomes.
Effects of a Collaborative Planning and Consultation Framework to Increase Participation of Students with Severe Disabilities in General Education Classes
Authors: Kuntz Emily M. , Carter Erik W.
Published: February 2021

Although many students with severe disabilities are enrolled in general education classrooms, general educators rarely receive strong training and guidance on supporting the academic and social participation of these students. A multiple probe across participants design was used to evaluate the effectiveness of a collaborative planning and consultation framework on the academic engagement of four middle school students with severe disabilities and the instructional behaviors they receive from their general educators. The intervention package increased each focus student’s academic engagement with classwide instruction and changed the types of instructional behaviors some general educators directed toward these students. Recommendations are offered for research and practice aimed at engaging general educators in the design and delivery of inclusive interventions.
Preoperative nutritional status is independently associated with wound healing in patients undergoing open surgery for ischemic tissue loss
Authors: Tanaka Kiyoshi , Tanaka Shinichi , Okazaki Jin , Mii Shinsuke
Published: February 2021

Objectives

The aim of this study was to determine the relationship between preoperative nutritional status and wound healing in patients undergoing surgical reconstruction for ischemic tissue loss.

Methods

The preoperative nutritional status of patients who underwent surgical reconstruction for ischemic tissue loss for the years 2011–2018 was retrospectively estimated using the Controlling Nutritional Status (CONUT) score. Patients were allocated to two groups: Group I, normal nutrition or mild malnutrition (CONUT score ≤4), and Group II, moderate-to-severe malnutrition (CONUT score ≥5). Wound healing was set as the primary endpoint and major amputation and death as the secondary endpoints. The wound healing, limb salvage, and overall survival rates were calculated after two years using the Kaplan–Meier method, and Cox proportional hazards regression analysis was performed to determine which variables were independently associated with these outcomes.

Results

Forty-eight patients with missing values for the CONUT score were excluded. A total of 174 limbs in 147 patients were studied (Group I: 115 limbs in 100 patients; Group II: 59 limbs in 47 patients). The mean duration of the study was 519 ± 270 days. The Kaplan–Meier curves showed that wound healing in Group I was superior to that in Group II (Group I vs. II: two-year wound healing, 97% vs. 79%; time to 50% wound healing, 83 vs. 150 days, p <  0.001), and multivariate analysis showed that the CONUT score was an independent predictor of wound healing (hazard ratio, 0.63; 95% confidence interval, 0.41–0.98; p =  0.038).

Conclusions

Patients with better preoperative nutritional status are more likely to experience wound healing earlier than those with excessive malnutrition.
Visual servoing of robot manipulator with weak field-of-view constraints
Authors: Xin Jing , Cheng Han , Ran Baojing
Published: February 2021

Aiming at the problem of servoing task failure caused by the manipulated object deviating from the camera field-of-view (FOV) during the robot manipulator visual servoing (VS) process, a new VS method based on an improved tracking learning detection (TLD) algorithm is proposed in this article, which allows the manipulated object to deviate from the camera FOV in several continuous frames and maintains the smoothness of the robot manipulator motion during VS. Firstly, to implement the robot manipulator visual object tracking task with strong robustness under the weak FOV constraints, an improved TLD algorithm is proposed. Then, the algorithm is used to extract the image features (object in the camera FOV) or predict image features (object out of the camera FOV) of the manipulated object in the current frame. And then, the position of the manipulated object in the current image is further estimated. Finally, the visual sliding mode control law is designed according to the image feature errors to control the motion of the robot manipulator so as to complete the visual tracking task of the robot manipulator to the manipulated object in complex natural scenes with high robustness. Several robot manipulator VS experiments were conducted on a six-degrees-of-freedom MOTOMANSV3 industrial manipulator under different natural scenes. The experimental results show that the proposed robot manipulator VS method can relax the FOV constraint requirements on real-time visibility of manipulated object and effectively solve the problem of servoing task failure caused by the object deviating from the camera FOV during the VS.
Improved hybrid A* path planning method for spherical mobile robot based on pendulum
Authors: Zhang Ziang , Wan Yixu , Wang You , Guan Xiaoqing , Ren Wei , Li Guang
Published: February 2021

This article proposes a modification of hybrid A* method used for navigation of spherical mobile robots with the ability of limited partial lateral movement driven by pendulum. For pendulum-driven spherical robots with nonzero minimal turning radius, our modification helps to find a feasible and achievable path, which can be followed in line with the low time cost. Because of spherical shell shape, the robot is point contact with the ground, showing different kinematic model compared with common ground mobile robots such as differential robot and wheeled car-like robot. Therefore, this article analyzes the kinematic model of spherical robot and proposes a novel method to generate feasible and achievable paths conforming to kinematic constraints, which can be the initial value of future trajectory tracking control and further optimization. A concept of optimal robot’s minimum area for rotation is also proposed to improve search efficiency and ensure the ability of turning to any orientation by moving forward and backward in a finite number of times within limited areas.
Leading the curriculum towards social change: Distributed leadership and the inclusive school
Authors: Traver-Martí Joan Andrés , Ballesteros-Velázquez Belén , Beldarrain Nagore Ozerinjauregi , Maiquez María del Carmen Cerezo
Published: February 2021

This study forms part of a participatory action research project, undertaken in four Spanish schools, analysing the planning and development of educational practices that link each school with its territory through community participation processes. The article describes how school leadership can help to develop participatory processes with the educational community in order to foster such practices. Multiple case study methodology was used. Information was gathered and analysed with qualitative research tools, including participant observation, interviews, discussion groups, documentary analysis and the researchers’ field diaries. Results show the importance and influence of the management team’s leadership style in facilitating and developing such practices, and reveal a need to move towards collaborative leadership models. The study also highlighted the importance of ensuring that families and students assume responsibility.
Concurrent validity and intrarater reliability of two ultrasound-based methods for assessing patellar tendon stiffness
Authors: Henriksen P , Brage K , Junge T , Juul-Kristensen B , Bojsen-Møller J , Thorlund JB
Published: February 2021

Introduction

Assessment of tendon stiffness in vivo traditionally involves maximal muscle contractions, which can be challenging in pain populations. Alternative methods are suggested, although the clinimetric properties are sparse. This study investigated the concurrent validity and the intrarater reliability of two ultrasound-based methods for assessing patellar tendon stiffness.

Methods

Patellar tendon stiffness was assessed in 17 healthy adults with (a) the dynamometer and B-mode ultrasonography method (DBUS) and (b) the strain elastography method. Correlations between the two methods were analysed using Kendall’s Tau-b. The relative reliability of both methods was evaluated using intraclass correlation coefficient (ICC). The absolute reliability was presented by Bland–Altman plots, standard error of measurement (SEM) and minimum detectable change (MDC).

Results

No correlation was found between the two methods, irrespective of reference tissue in strain elastography (Kendall’s Tau-b Hoffa = –0.01 (p = 1.00), Kendall’s Tau-b subcutis = 0.04 (p = 0.87)). Tracking of the tendon elongation in the DBUS method had good to excellent relative reliability (ICC = 0.95 (95% confidence interval – CI: 0.85–0.98)) and high absolute reliability (SEM = 0.04 mm (1%), MDC = 0.11 mm (3%)). The strain elastography method had good to excellent relative reliability, regardless of reference tissue (ICC Hoffa = 0.95 (95% CI: 0.86–0.98), ICC subcutis = 0.94 (95% CI: 0.82–0.98)), but low absolute reliability (SEM Hoffa = 0.06 (20%), MDC Hoffa = 0.18 (60%), SEM subcutis = 0.12 (41%), MDC subcutis = 0.32 (110%)).

Conclusions

No concurrent validity existed for DBUS and strain elastography, suggesting that the two methods measure different tendon properties. The overall reliability for the DBUS method was high, but the absolute reliability was low for strain elastography stiffness ratios. Therefore, the strain elastography method may not be recommended for tracking differences in patellar tendon stiffness in healthy adults.
Impossible or just irrelevant? Unravelling the ‘authentic leadership’ paradox through the lens of emotional labour
Authors: Iszatt-White Marian , Stead Valerie , Elliott Carole
Published: February 2021

The clamour for leaders to be authentic in enacting their roles is now widely heard in both the academic literature and popular media. Yet, the authentic leadership (AL) construct remains deeply problematic and arguably impossible to enact. Using the performance of emotional labour (EL) as a lens to view relational transparency, a core component of AL, our research surfaces the paradoxes inherent in this construct and their implications for practicing leaders. Our data reveal something of the mystery surrounding how practicing leaders are able to feel authentic even as they manage their emotions as a routine tool of accomplishing their leadership role. This apparent disconnect between the experiencing of authenticity and the actions/interactions in which this experience is embedded raises profound questions concerning authenticity as a phenomenon, how it is discursively constructed, its relationship to inauthenticity – especially in the practice of leadership – and even its relevance. Drawing on these concerns, we suggest an agenda for future research in relation to authenticity in leadership and highlight the value of EL as a challenging ‘test context’ for honing our understanding of what ‘authenticity’ might mean.
Student Motivation and Associated Outcomes: A Meta-Analysis From Self-Determination Theory
Authors: Howard Joshua L. , Bureau Julien S. , Guay Frédéric , Chong Jane X. Y. , Ryan Richard M.
Published: February 2021

Student outcomes are influenced by different types of motivation that stem from external incentives, ego involvement, personal value, and intrinsic interest. The types of motivation described in self-determination theory each co-occur to different degrees and should lead to different consequences. The associations with outcomes are due in part to unique characteristics and in part to the degree of autonomy each entails. In the current meta-analysis, we examine these different types of motivation in 344 samples (223,209 participants) as they relate to 26 performance, well-being, goal orientation, and persistence-related student outcomes. Findings highlight that intrinsic motivation is related to student success and well-being, whereas personal value (identified regulation) is particularly highly related to persistence. Ego-involved motives (introjected regulation) were positively related to persistence and performance goals but also positively related with indicators of ill-being. Motivation driven by a desire to obtain rewards or avoid punishment (external regulation) was not associated with performance or persistence but was associated with decreased well-being. Finally, amotivation was related to poor outcomes. Relative weights analysis further estimates the degree to which motivation types uniquely predict outcomes, highlighting that identified regulation and intrinsic motivation are likely key factors for school adjustment.
Theory Construction Methodology: A Practical Framework for Building Theories in Psychology
Authors: Borsboom Denny , van der Maas Han L. J. , Dalege Jonas , Kievit Rogier A. , Haig Brian D.
Published: February 2021

This article aims to improve theory formation in psychology by developing a practical methodology for constructing explanatory theories: theory construction methodology (TCM). TCM is a sequence of five steps. First, the theorist identifies a domain of empirical phenomena that becomes the target of explanation. Second, the theorist constructs a prototheory, a set of theoretical principles that putatively explain these phenomena. Third, the prototheory is used to construct a formal model, a set of model equations that encode explanatory principles. Fourth, the theorist investigates the explanatory adequacy of the model by formalizing its empirical phenomena and assessing whether it indeed reproduces these phenomena. Fifth, the theorist studies the overall adequacy of the theory by evaluating whether the identified phenomena are indeed reproduced faithfully and whether the explanatory principles are sufficiently parsimonious and substantively plausible. We explain TCM with an example taken from research on intelligence (the mutualism model of intelligence), in which key elements of the method have been successfully implemented. We discuss the place of TCM in the larger scheme of scientific research and propose an outline for a university curriculum that can systematically educate psychologists in the process of theory formation.
How does the workload applied during the training week and the contextual factors affect the physical responses of professional soccer players in the match?
Authors: Guerrero-Calderón Berni , Klemp Maximilian , Morcillo José Alfonso , Memmert Daniel
Published: February 2021

The aim of this study was to examine whether match physical output can be predicted from the workload applied in training by professional soccer players. Training and match load records from two professional soccer teams belonging to the Spanish First and Second Division were collected through GPS technology over a season ( N = 1678 and N = 2441 records, respectively). The factors playing position, season period, quality of opposition, category and playing formation were considered into the analysis. The level of significance was set at p ≤ .05. The prediction models yielded a conditional R-squared in match of 0.51 in total distance (TD); 0.58 in high-intensity distance (HIRD, from 14 to 24 km · h−1); and 0.60 in sprint distance (SPD, >24 km·h−1). The main finding of this study was that the physical output of players in the match was predicted from the training-load performed during the previous training week. The training-TD negatively affected the match physical output while the training-HIRD showed a positive effect. Moreover, the contextual factors – playing position, season period, division and quality of opposition – affected the players’ physical output in the match. Therefore, these results suggest the appropriateness of programming lower training volume but increasing the intensity of the activity throughout the weekly microcycle, and considering contextual factors within the load programming.
Remaking memory and the agency of the aesthetic
Authors: Rigney Ann
Published: February 2021

This article examines the role of the creative arts in renegotiating the border between memorable and unmemorable lives. It does so with specific reference to the (un)forgetting of the colonial soldiers in European armies during World War One. Focussing on the role of aesthetic form in generating memorability, it shows how the creative use of a medium can help redefine the borders of imagined communities by commanding the attention of individual subjects and hence providing conditions for a cognitive and affective opening to the memory of strangers. It concludes that future studies of transformations in collective memory should take a multiscalar approach which takes into account both the shifting social frameworks of memory and the small changes that occur in the micro-politics of viewing and reading.
Non-subsumptive memory and narrative empathy
Authors: Meretoja Hanna
Published: February 2021

This article shows the relevance of a model of non-subsumptive understanding for theorising memory as a mode of sense-making that can contribute to understanding the other in ethically sustainable ways. It develops a theory of non-subsumptive memory and narrative empathy. While understanding is often seen as a form of appropriation, assimilation, and subsumption of the singular under the general, a hermeneutic approach suggests that there are also non-subsumptive, non-appropriative, dialogical forms of understanding. In dialogue with Jenny Erpenbeck’s novel Gehen, ging, gegangen ( Go, Went, Gone), the article argues that cultural memorial forms, as (narrative) models of sense-making, tend to be productive when they adapt and change as they are applied to new situations and harmful when they subsume new experiences under fixed meaning templates. The article envisages memory as a resource for learning and other-oriented empathy in processes of dialogical understanding.
Ambivalent Déjà-vu: World War II in the poetry of the Northern Irish Troubles
Authors: Armstrong Charles I
Published: February 2021

This article addresses how the poetry of the Northern Irish Troubles enters into a dialogue with the memory of World War II. Poems by Michael Longley, Seamus Heaney, Derek Mahon, and Sinéad Morrissey are analysed, showing how World War II is a controversial source of comparison for these poets. While World War II provides important ways of framing the suffering and claustrophobia of the Northern Irish conflict, evident differences also mean that such comparisons are handled warily and with some irony. The poems are highly self-conscious utterances that seek to unsettle and develop generic strategies in the light of traumatic suffering. This essay draws on Michael Rothberg’s concept of multidirectional memory, and it also makes use of Alison Landsberg’s notion of prosthetic memory in order to highlight how Seamus Heaney in particular makes use of the World War II memories mediated by popular culture to respond to the Troubles.
A qualitative study of seven simulation models for tendon repairs
Authors: Vinnicombe Zak , Asher Christian M. , Super Jonathan , Bystrzonowski Nicola , Katsarma Eufrossyni
Published: February 2021

Seven models for tendon repair simulation (urinary catheter, liquorice, fishing lure, dental rolls, drinking straw, silicone sealant and the authors’ modification of silicone sealant with Micropore™ tape) were assessed for their performance in a number of domains. The silicone sealant and surgical tape model scored highest overall and for each individual domain. This was significantly higher than all other models with the exception of the silicone sealant alone. The lowest scoring model was the drinking straw model.
Health economics of disease-modifying therapy for multiple sclerosis in the United States
Authors: Hartung Daniel M.
Published: February 2021

Multiple sclerosis (MS) is chronic neuroinflammatory condition associated with significant disability. The economic burden of MS is substantial, and high and rising disease-modifying therapy (DMT) prices are the single largest drivers of healthcare expenditures. Over much of the last decade, price increases for most DMTs have surpassed 10% annually. Currently, many MS DMTs exceed US$90,000 a year and their economic value is widely debated. In addition to creating a financial burden for the healthcare system, high DMT costs negatively impact patients through unaffordable out-of-pocket costs and excessive restrictions by insurance companies. The objective of this narrative review is to summarize economic issues related to MS DMTs, including trends in pricing, relative value, and effects on patient care in the United States.
Plate fixation of midshaft clavicle fractures for delayed union and non-union is a cost-effective intervention but functional deficits persist at long-term follow-up
Authors: Fox Ben , Clement Nicholas David , MacDonald Deborah J , Robinson Michael , Nicholson Jamie A
Published: February 2021

Background

The primary aim of this study was to compare the long-term functional outcome of midshaft clavicle fracture fixation for delayed (≥3 month) and non-union (≥6 month) compared to a matched cohort of patients that achieved union with non-operative management. The secondary aim was to assess cost-effectiveness of fixation.

Methods

A consecutive series of patients over 10-years were retrospectively reviewed using the QuickDASH, Oxford Shoulder Score and EuroQol five-dimension summary index (EQ-5D). These patients were compared to a matched cohort that achieved union after non-operative management using propensity score matching.

Results

Sixty patients (follow-up 79%, n = 60/76) at 4.1 years post-operative (1.1–10.0 years) had a QuickDASH of 16.5 (95% CI 11.6–21.5), Oxford Shoulder Score 41.5 (39.0–44.1) and EQ-5D 0.7621 (0.6822–0.8421). One in five patients were dissatisfied with their final outcome ( n = 13/60). Functional outcome was inferior following fixation when compared to patients that united with non-operative management (QuickDASH 16.5 vs. 5.5, p < 0.001 and EQ-5D 0.7621 vs. 0.9073, p = 0.001). However, significant improvements were found when compared to pre-operative scores (QuickDASH p < 0.001 and EQ-5D p < 0.001). The cost per QALY for fixation was £5624.62 for the study cohort.

Conclusions

Clavicle fixation for delayed and non-union is a cost-effective intervention but outcomes are worse compared to patients that unite with non-operative management.
The playing position significantly influences return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players
Authors: Pasqualini Ignacio , Rossi Luciano Andrés , De Cicco Franco Luis , Tanoira Ignacio , Alonso Hidalgo Ignacio , Bongiovanni Santiago , Giunta Diego Hernán , Ranalletta Maximiliano
Published: February 2021

Background

The purpose of our study was to investigate the influence of the different rugby playing positions on return to sports, functional outcomes, and recurrences after an arthroscopic Bankart repair.

Methods

A total of 88 rugby players were treated for anterior shoulder instability in our institution between 2010 and 2018. Functional outcomes, return to sports, recurrences, complications, and revisions rates were evaluated according to the playing position.

Results

Overall, 73.8% of the patients returned to rugby and 60% returned at the same level as before the injury. The tight forwards and outside backs experienced a significant decrease in their competitive level after surgery, and showed the lowest functional outcomes. The tight forwards and outside backs showed a statistically significant increase in recurrence and revision rates, and an OR for recurrence of 12.8 and 9.6, respectively.

Discussion

The playing position significantly influenced return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players. Specifically, the tight forwards and outside backs have returned to a lower level than they had before surgery, showed the lowest functional outcomes, and a significant increase in recurrences and revisions rates than the other groups.
Validity and Utility of the Test of Creative Thinking Drawing Production for Dutch Adolescents
Authors: Desmet Ophélie Allyssa , van Weerdenburg Marjolijn , Poelman Mariska , Hoogeveen Lianne , Yang Yao
Published: February 2021

We examined the divergent validity and utility of the Test for Creative Thinking–Drawing Production (TCT-DP) in an identification protocol for high-ability students that included measures of intelligence, school motivation, inquisitiveness, creativity, and academic achievement. Data were collected from seventh-grade students across 6 years ( n = 710). Small significant correlations between the different measures indicated that the TCT-DP did measure a construct separate from intelligence, school motivation, inquisitiveness, and academic achievement. Furthermore, creativity did not significantly affect academic achievement when controlling for intelligence, school motivation, and inquisitiveness. We did not find support for threshold theory. Finally, we concluded that the TCT-DP provides useful additional information on creativity for high-ability identification in which measures of intelligence, school motivation, and inquisitiveness are already included. Thus, this study’s findings provide evidence for the utility and divergent validity of the TCT-DP when used with a Dutch population.
Infrared Fiber-Optic Spectroscopy Detects Bovine Articular Cartilage Degeneration
Authors: Virtanen Vesa , Nippolainen Ervin , Shaikh Rubina , Afara Isaac O. , Töyräs Juha , Solheim Johanne , Tafintseva Valeria , Zimmermann Boris , Kohler Achim , Saarakkala Simo , Rieppo Lassi
Published: February 2021

Objective

Joint injuries may lead to degeneration of cartilage tissue and initiate development of posttraumatic osteoarthritis. Arthroscopic surgeries can be used to treat joint injuries, but arthroscopic evaluation of articular cartilage quality is subjective. Fourier transform infrared spectroscopy combined with fiber optics and attenuated total reflectance crystal could be used for the assessment of tissue quality during arthroscopy. We hypothesize that fiber-optic mid-infrared spectroscopy can detect enzymatically and mechanically induced damage similar to changes occurring during progression of osteoarthritis.

Design

Bovine patellar cartilage plugs were extracted and degraded enzymatically and mechanically. Adjacent untreated samples were utilized as controls. Enzymatic degradation was done using collagenase and trypsin enzymes. Mechanical damage was induced by (1) dropping a weight impactor on the cartilage plugs and (2) abrading the cartilage surface with a rotating sandpaper. Fiber-optic mid-infrared spectroscopic measurements were conducted before and after treatments, and spectral changes were assessed with random forest, partial least squares discriminant analysis, and support vector machine classifiers.

Results

All models had excellent classification performance for detecting the different enzymatic and mechanical damage on cartilage matrix. Random forest models achieved accuracies between 90.3% and 77.8%, while partial least squares model accuracies ranged from 95.8% to 84.7%, and support vector machine accuracies from 91.7% to 80.6%.

Conclusions

The results suggest that fiber-optic Fourier transform infrared spectroscopy attenuated total reflectance spectroscopy is a viable way to detect minor and major degeneration of articular cartilage. Objective measures provided by fiber-optic spectroscopic methods could improve arthroscopic evaluation of cartilage damage.
Nutritional ketosis to treat pulmonary hypertension associated with obesity and metabolic syndrome: a case report
Authors: Kim Darlene , Roberts Caroline , McKenzie Amy , George M. Patricia
Published: February 2021

Metabolic syndrome is characterized by insulin resistance/hyperinsulinemia, atherogenic dyslipidemia (elevated triglycerides, low HDL), and hyperglycemia. The high prevalence of metabolic syndrome in pulmonary hypertension leads to the hypothesis that metabolic syndrome may play a contributing role in pulmonary hypertension and heart failure with preserved ejection fraction pathogenesis. We present a 62‐year‐old woman with morbid obesity, mild pre‐capillary pulmonary hypertension, and metabolic syndrome. Her metabolic syndrome was treated with a medically‐supervised ketogenic diet delivered by a telehealth healthcare team via a continuous remote care platform. Following one year of treatment, metabolic syndrome was reversed, leading to successful weight loss concurrent with hemodynamic improvement. This case highlights the feasibility of using a nutritional strategy to treat pulmonary hypertension associated with obesity and metabolic syndrome, common contributors to group 2 and 3 pulmonary hypertension. We bring this case and technique to the pulmonary hypertension community to share a tool in our therapeutic toolkit and highlight the importance of nutritional advice extending beyond telling a patient they should lose weight to invoking a rational strategy. We argue that strategic nutritional intervention through reversal of her metabolic syndrome using a medically‐supervised ketogenic diet is a safe and effective treatment strategy in metabolic syndrome‐associated pulmonary hypertension.
Success of endoscopic prostatic surgery in patients with DUA: a prospective observational and analytic study
Authors: Shah Bonny , Chaudhari Rajeev , Gupta Aman , Shah Priyank
Published: February 2021

Introduction:

Detrusor underactivity (DUA) is a highly prevalent and poorly understood disease in urology practice. Conservative treatment in the form of clean intermittent catheterization (CIC) and pharmacotherapy are in use for DUA without good results. Endoscopic prostate surgery was initially considered ineffective in such patients. But a recent series of retrospective studies showed promising results of surgery in DUA. Therefore, we conducted this prospective study to evaluate success of endoscopic prostatic surgery in a patient with DUA.

Materials and methods:

This is prospective observational study of 50 patients, satisfying the inclusion criteria, at Ruby Hall Clinic, Pune, conducted between March 2017 and March 2019. Inclusion criteria are that the patients are male, aged > 50 years; urodynamically diagnosed with DUA; a bladder contractility index < 90 with associated bladder outlet obstruction index (BOOI) between 20–40 (equivocal) or > 40 (obstruction), who presented with lower urinary tract symptoms and poor flow ( Qmax < 10 ml/s in a voided volume of >150 ml. Patients were excluded from the study if they had DUA due to neurological causes or spinal trauma, an acontractile detrusor, and were < 50 years.

Results:

The follow-up period for each patient was 12 months. The mean international prostate specific score reduced from 24.82 ± 2.74 preoperatively to 4.4 ± 1.85 postoperatively. Mean quality of life score reduced from 4.06 ± 0.68 to 0.82 ± 0.62. Mean Qmax increased from 6.26 ±1.46 ml/s to 12.22 ±1.6 ml/s. Mean post-void residual urine volume reduced form 241.9 ±74.9 to 77.3 ±20.75. All of these were statistically significant with a p value < 0.00001.

Conclusion:

Transurethral resection of the prostate (monopolar/laser) to reduce BOO should be considered as an alternative, viable treatment option in men with DUA. Preoperative counselling and postoperative follow-up are crucial in the management of such patients. Level of evidence:
Clinical characteristics and outcome of high-pressure chronic urinary retention: A systematic review
Authors: Madhushankha Madhawa , Jayarajah Umesh , Kuruppu Chandrani , Goonewardena Serozsha AS , Abeygunasekera Anuruddha M
Published: February 2021

Background:

Although not infrequent, publications on high-pressure chronic urinary retention (HPCR) are limited. Lack of awareness of this condition can lead to delayed diagnosis and suboptimal treatment. This systematic review aimed to describe the clinical characteristics and outcome of HPCR.

Methods:

Keywords were searched in PubMed, Scopus, EMBASE, LILACS, Cochrane-CENTRAL, APAMED Central and Google Scholar. Relevant articles were added from the list of references of eligible articles. Studies describing any two of the characteristic features related to HPCR were included. Qualitative analysis was performed using the available data.

Results:

Eight prospective studies with 271 patients ( Mage=66.4 years, range 14–89 years; 263 males) were identified. The commonest presentation was tense painless palpable bladder (99.6%). Late-onset nocturnal enuresis was reported in 68.4%, and resistant hypertension was reported in 41.6%. Elevated levels of serum creatinine were identified in 43–81%. Benign prostatic hyperplasia (64.1%) was the commonest aetiology followed by prostatic malignancy (22.6%). A satisfactory response was seen following the definitive treatment of the underlying aetiology. Initial bladder decompression reversed adverse cardiovascular changes and improved renal function but resulted in post-obstructive diuresis. Heterogeneity of the reported data in available studies was a major limitation.

Conclusions:

Late-onset nocturnal enuresis, a tense painless and non-tender palpable bladder and treatment-resistant hypertension are important clinical findings which would raise the suspicion of HPCR in the clinical setting. Urinary tract ultrasonography showing upper-tract dilatation and raised serum creatinine support the diagnosis. Definitive treatment targeting the underlying aetiology following careful decompression of the bladder showed satisfactory outcomes.

Level of evidence:

Level 2a(-).
Telling Children with Perinatal HIV About Their HIV Serostatus: Healthcare Workers’ Practices and Barriers to Disclosing in a South African Rural Health District
Authors: Madiba Sphiwe , Diko Cynthia
Published: February 2021

In South Africa, caregivers and healthcare workers (HCWs) lack confidence and skills to disclose to children with perinatal HIV (PHIV). Moreover, existing disclosure guidelines do not provide strategies on how to approach disclosure. Although the caregiver has been endorsed as a responsible person to disclose to the child, the involvement of HCWs in the process is critical. Yet research suggests that many HCWs are reluctant to perform disclosure. This study examines the involvement in, practices of, and barriers against HCWs’ disclosing to children with PHIV.

Methods:

We conducted 8 focus group discussions with a total of 51 HCWs comprising nurses, lay counsellors, social workers, and dieticians. The HCWs were selected from 23 health facilities in a rural South African health district by purposive sampling. Data were transcribed verbatim, and data analysis followed qualitative thematic analysis.

Results:

A high proportion of HCWs had no formal training in pediatric disclosure and some had never disclosed to children. Those who routinely disclosed approached disclosure as an ongoing process that unfolded over time. They ensured caregiver readiness as a necessary step in the disclosure process. The main barriers for HCWs to participate fully in the disclosure process were the lack of relevant disclosure guidelines, inadequate disclosure skills, and a shortage of skilled staff. Inadequate skills affected the confidence of the HCWs to disclose, while a lack of standardized disclosure guidelines and HCWs’ reliance on personal experience during disclosure resulted in confusion and uncertainty among them due to the inconsistencies in their approach to disclosure.

Conclusion:

This study confirms the urgent need to train HCWs to attain skills and confidence in disclosure. Training HCWs in standardized disclosure counselling would lead to an increase in the rate of disclosure to children. It is essential that the district adapt the disclosure guidelines to the local context for use in health facilities.
Occupational Risk Perception and the Use of Personal Protective Equipment (PPE): A Study Among Informal Automobile Artisans in Osun State, Nigeria
Authors: Afolabi Funmilayo Juliana , de Beer Paul , Haafkens Joke A.
Published: February 2021

Informal workers in developing countries are exposed to various occupational hazards that may cause accidents, injuries, or diseases. Personal protective equipment (PPE) can be an essential tool for preventing workers from exposure to these hazards. Despite the widely acknowledged benefits of PPE usage, many informal automobile artisans in Nigeria do not use PPE. This study examines factors that predict PPE usage among these artisans, particularly their occupational risk perception. This cross-sectional study adopted a multistage method to select 632 automobile artisans (mechanics, panel beaters, painters, and vulcanizers) in Osun State, Nigeria. A questionnaire was used to obtain information on the dependent variable (the use of PPE) and the independent variables (occupational risk perception and risk tolerance). STATA 14 was used for the multivariate logistic regression analysis. Workers who perceive themselves at high risk of occupational health problems are more likely to use PPE (odds ratio [OR] = 2.1, p = .03), as are those who are very worried about getting accidents/illnesses (OR = 2.6, p = .03) or believe that these health problems are preventable (OR = 2.3, p = .01). Contrary to expectation, workers who experienced accidents/illnesses in the past are less likely to use PPE (OR = 0.3, p = .00) than those who did not. The established positive relationship between occupational risk perception and PPEs’ usage provides information to various stakeholders for designing safety programs that can reduce exposure to the occupational risks for informal automobile artisans in Nigeria.
Economic Crisis and Professions: Chartered Accountants in Zimbabwe
Authors: Maunganidze Farai , Bonnin Debby , Ruggunan Shaun
Published: February 2021

This study examined the effects of a declining economy on the profession of chartered accountants (CAs) in Zimbabwe. The study adopted a qualitative approach using a pragmatic grounded theory design. Primary data were obtained through in-depth interviews with five purposively sampled CAs and two key informants drawn from the professional body and an institution that trains CAs. Furthermore, secondary data were drawn from the professional body’s archives and from newspapers. Data from interviews and documents were analyzed through thematic analysis and content analysis, respectively. The study has revealed that the profession of CAs has been changing in response to the declining economy and the changes include losing its status and autonomy, increased competition from other accounting fields and compromised professional standards. It also emerged that professionals themselves engage in both negative and positive activities that enable them to survive the effects of a declining economy. Recommendations are provided for the professionals and the professional body in dealing with the impact of a precarious economy.
Processes of Change in Trauma-Focused Cognitive Behavioral Therapy for Youths: An Approach Informed by Emotional Processing Theory
Authors: Alpert Elizabeth , Hayes Adele M. , Yasinski Carly , Webb Charles , Deblinger Esther
Published: February 2021

In this study, we examined processes of change in trauma-focused cognitive behavioral therapy (TF-CBT) delivered to a community sample of 81 youths. Emotional processing theory (EPT) is used as an organizational framework. EPT highlights activating and changing pathological trauma-related responses and increasing adaptive responses across cognitive, emotional, behavioral, and physiological domains. We coded sessions during the trauma-narration and -processing phase of TF-CBT to examine the extent to which pathological and adaptive trauma-related responses were activated across domains. Higher scores indicate that more domains (range = 0–4) were activated at a threshold of moderate to high intensity. Curvilinear change (inverted U, increase then decrease) in multimodal negative response scores across sessions predicted improvement in internalizing symptoms and symptoms of posttraumatic stress disorder after treatment. Linear increases in multimodal positive responses predicted improvement in externalizing symptoms. Findings suggest value in activating and changing both pathological and adaptive trauma responses across multiple domains and examining nonlinear patterns of change.