bluuebunny/crossref_metadata_2025 huggingface dataset:
Employment Quality as a Health Determinant: Empirical Evidence for the Waged and Self-Employed
Authors: Gevaert Jessie , Van Aerden Karen , De Moortel Deborah , Vanroelen Christophe
Published: August 2020

In this study, the authors investigate the health associations of different employment arrangements in the contemporary European labor market. In doing so, a new approach based on the concept of “employment quality” is introduced. Employment quality refers to the multiple dimensions characterizing the employment situation of wage- and self-employed (European Working Conditions Survey 2015 – N = 31,929). Latent class cluster analyses were applied to construct an overarching typology of employment quality for the waged and self-employed. Using logistic regression analyses, strong associations were found with mental well-being and self-reported general health, pointing at a disadvantaged situation for the most precarious employment arrangements. The study shows that employment quality should be taken seriously as a health determinant both among waged workers and the self-employed. Our (novel) holistic approach offers an alternative to current analyses of the health associates of labor market segmentation that were criticized for being overly simplistic and amounting to inconclusive findings.
New Business Models for Biodiversity and Ecosystem Management Services: Action Research With a Large Environmental Sector Company
Authors: Feger Clément , Mermet Laurent
Published: August 2020

Businesses are increasingly called upon to contribute to efforts to protect biodiversity and natural capital. Our article presents the results of an action research conducted with a major company in the environmental sector that has been experimenting with innovative services dedicated to ecosystem management. We show the specific organizational and social challenges the company faced in upscaling this strategy due to its path dependency to its historical value creation model, and to the collective action issues that characterize biodiversity management. We introduce a new interdisciplinary theoretical framework for the development of what we refer to as “business models for ecosystem management services,” defined by the very central place they give to the achievement of measurable biodiversity performances. We then propose four such new business models designed through participatory methods that combine in a unique way a corporate value creation model with an ecological value cocreation model at the ecosystem level.
Prejudice toward Christians and atheists among members of nonreligious groups: Attitudes, behaviors, and mechanisms
Authors: Van Cappellen Patty , LaBouff Jordan P.
Published: August 2020

Much research demonstrates that people high in religiosity tend to be prejudiced against value-threatening groups. Therefore, some researchers have suggested that people who are not religious may be less prejudiced. Are nonreligious people characterized by general tolerance? If not, what are the bases of their prejudices? This research investigated prejudice toward Christians and atheists among people who identify as nonreligious (atheist, agnostic, and spiritual-but-not-religious), documented this prejudice in the form of exclusion behaviors (Study 1) and self-report of affect and social distance (Studies 2–3), and explored potential mechanisms of nonreligious prejudice toward Christians: individual differences in belief style and biases against Christians (Studies 2–3). Results showed the nonreligious are not generally tolerant and that differences among these groups in belief superiority, feelings of distrust, and fear of contamination by unpalatable ideas all explained differences in prejudice toward Christians. These findings help provide a more comprehensive picture of religious intergroup prejudice.
Standing on the shoulders of tech giants: Media delivery, streaming television and the rise of global suppliers
Authors: Chalaby Jean K , Plunkett Steve
Published: August 2020

This article uses the case study of Internet Protocol (IP) delivery for streaming television to demonstrate how technology and globalization combine to change what media firms do, how they create value and with whom. Media delivery – the sum of the value-adding tasks necessary to transfer content from source to audience – has become a mosaic of technologies that sustain a complex and fast-evolving video ecosystem. Broadcasters had been in charge of the full transmission process once, of tasks deemed core to their business. Today, media delivery is externalized to the market and devolved to a network of suppliers. These suppliers are no ordinary firms, but tech giants that have developed deep global capabilities. They gain further leverage by being cross-sectoral, serving clients across multiple industries. Who are these suppliers? What makes them unique? And what are the implications for the television industry?
Meta-analysis: How to quantify and explain heterogeneity?
Authors: Ruppar Todd
Published: August 2020

The number of systematic reviews and meta-analyses submitted to nursing and allied health journals continues to grow. Well-conducted and reported syntheses of research are valuable to advancing science. One of the common critiques identified in these manuscripts involves how the authors addressed heterogeneity among the studies in their meta-analyses. Methodologically inappropriate approaches regarding heterogeneity introduce error and bias into analyses and may lead to incorrect findings and conclusions. This article will discuss some of the approaches to take as well as avoid when addressing heterogeneity in meta-analyses, including suggestions for how to choose a fixed-effect or random-effects meta-analysis model and steps to follow to address heterogeneity in meta-analysis results.
The Rising Cost of Insulin for Pump Users: How Policy Drives Prices
Authors: Brown-Georgi Julia , Chhabra Harmeet , Vigersky Robert A.
Published: August 2020

The price of insulin has increased dramatically over the past two decades. Medicare reimbursement for insulin is based on the route of administration via syringe (Part D) or via pump (Part B). Recently, the Centers for Medicare & Medicaid Services (CMS) announced a voluntary model for Part D enhanced plans that lower out-of-pocket costs to a co-pay of ≤$35/month. Meanwhile, the 21st Century Cures Act and manufacturer price increases raised the cost of insulin for pump users by 304% in less than 2 years. Because insulin is a life-saving necessity and unlike other Part B infused drugs, we call on CMS to determine drug reimbursement on a drug-by-drug basis and to develop a payment model that lowers out-of-pocket costs for patients using insulin delivered via pumps.
Education Quality Assessment in China: What We Learned From Official Reports Released in 2018 and 2019
Authors: Yin (殷丹青) Danqing
Published: August 2020

Purpose:

This article intended to introduce the recent Chinese compulsory education quality assessment.

Design/Approach/Methods:

The article summarized education policy documents relevant to the recent Chinese compulsory education quality assessment, especially from the three reports: The Chinese Compulsory Education Quality Monitoring Report, The Chinese Compulsory Education Quality Monitoring Report on Mathematical Learning, and The Chinese Compulsory Education Quality Monitoring Report on Physical Education and Health.

Findings:

The article examined the development of Chinese education quality assessment in the context of the nation’s pursuit of holistic education. It first reviewed a brief history of the education quality monitoring work in China that bore the fruits of a few recent reports. Second, findings and the framework of the assessment are demonstrated. Finally, I discuss the significance, limitations, and special issues of the assessment.

Originality/Value:

The article is among the earliest to present findings of the recent quality assessment in Chinese compulsory education in English critically.
Can We Accurately Predict Which Geriatric and Middle-Aged Hip Fracture Patients Will Experience a Delay to Surgery?
Authors: Konda Sanjit R. , Johnson Joseph R. , Kelly Erin A. , Chan Jeffrey , Lyon Thomas , Egol Kenneth A.
Published: August 2020

Introduction:

This study sought to investigate whether a validated trauma triage risk assessment tool can predict time to surgery and delay to surgery.

Materials and Methods:

Patients aged 55 and older who were admitted for operative repair or arthroplasty of a hip fracture over a 3-year period at a single academic institution were included. Risk quartiles were constructed using Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) calculations. Negative binomial and multivariable logistic regression were used to evaluate time to surgery and delay to surgery, respectively. Pairwise comparisons were performed to evaluate 30-day mortality rates and demonstrate the effectiveness of the STTGMA tool in triaging mortality risk.

Results:

Six hundred eleven patients met inclusion criteria with mean age 81.1 ± 10.5 years. Injuries occurred mainly secondary to low-energy mechanisms (97.9%). Median time to surgery (31.9 hours overall) was significantly associated with STTGMA stratification ( P = .002). Moderate-risk patients had 33% longer ( P = .019) and high-risk patients had 28% longer time to surgery ( P = .041) compared to minimal risk patients. Delay to surgery (26.4% overall) was significantly associated with STTGMA stratification ( P = .015). Low-risk patients had 2.14× higher odds ( P = .009), moderate-risk patients had 2.70× higher odds ( P = .001), and high-risk patients had 2.18× higher odds of delay to surgery ( P = .009) compared to minimal risk patients. High-risk patients experienced higher 30-day mortality compared to minimal ( P < .001), low ( P = .046), and moderate-risk patients ( P = .046).

Discussion:

Patients in higher STTGMA quartiles encountered longer time to surgery, greater operative delays, and higher 30-day mortality.

Conclusion:

Score for Trauma Triage in the Geriatric and Middle-Aged can quickly identify hip fracture patients at risk for a delay to surgery and may allow treatment teams to optimize surgical timing by proactively targeting these patients.

Level of Evidence:

Prognostic Level III.
The Influence of Participative Leadership on Agricultural Extension Officers’ Engagement
Authors: Usadolo Sam Erevbenagie
Published: August 2020

Employee engagement has garnered a great deal of interest because of its positive effect on employee performance, but the interest has not resulted in in-depth studies on how variables such as participative leadership determine employee engagement. In this study, the role of participative leadership on the three dimensions of engagement experienced by agricultural extension officers is examined. Data from a cross-sectional survey of 189 agricultural extension officers from four provinces in South Africa are analyzed using regression analysis. As hypothesized, results show that participative leadership influences the three dimensions of engagement. The implications of the results are discussed, emphasizing possible ways participative leadership practices could be used to facilitate the engagement of agricultural extension officers.
Who Doesn’t Trust Fauci? The Public’s Belief in the Expertise and Shared Values of Scientists in the COVID-19 Pandemic
Authors: Evans John H. , Hargittai Eszter
Published: August 2020

The primary tension in public discourse about the U.S. government’s response to the coronavirus pandemic has been President Trump’s disagreement with scientists. The authors analyze a national survey of 1,593 Americans to examine which social groups agree with scientists’ ability to understand the novel coronavirus (COVID-19) and which agree that COVID-19 scientists share their values. Republicans and independents are less trusting than Democrats on both measures, as are African Americans. The authors find conservative Protestants and Catholics to be skeptical of scientists’ knowledge but not their values. Working-class men and those who live outside cities believe in scientists’ knowledge but do not think they share scientists’ values. There is little evidence for a direct effect of President Trump’s criticism of scientists. The authors discuss the pragmatic implications for scientists trying to remain influential in COVID-19 policy.
Mutiny in the Band of Brothers: A Juxtaposition of Two Leaders
Authors: Stratton Micheal T. , Clayton Russell , Schaffer Bryan , Julien Mark
Published: August 2020

The first episode of the critically acclaimed television series, Band of Brothers, juxtaposes two leaders navigating an environment of uncertainty and high-risk stakes. We review this first episode, titled Currahee, with the intention of adding to the library of teaching resources that instructors may use to illustrate leader–follower relations, power dynamics, contingency models, and follower voice and mutiny. This dramatic depiction of a team of paratroopers preparing for military engagement in World War II challenges students to examine the human and organizational antecedents and consequences associated with mundane, incompetent, tyrannical, or inspirational leaders. We provide a detailed set of discussion prompts and points of analysis for selected clips that will guide instructors as they implement this resource as part of an in-class exercise, a video case exam, and/or a written assignment for face-to-face and synchronous or asynchronous online classroom formats.
Mycophenolic acid drug monitoring in patients with systemic sclerosis associated with diffuse skin and/or pulmonary involvement: A monocentric and retrospective French study
Authors: Legendre Paul , Blanchet Benoit , Porcher Raphael , Bérezné Alice , Allard Marie , London Jonathan , Terrier Benjamin , Cohen Pascal , Le Jeunne Claire , Mouthon Luc
Published: August 2020

Objective:

To explore pharmacokinetic/pharmacodynamic relationship between mycophenolic acid area under the curve and clinical response at 1 year on skin involvement or interstitial lung disease in patients with systemic sclerosis.

Method:

Retrospective, monocentric study based on French Scleroderma Database in patients receiving mycophenolate mofetil who experienced a limited sampling strategy to estimate individual mycophenolic acid area under the curve plus two pulmonary function tests and skin evaluation after 1 month and 1 year. Efficacy criterions were variations of modified Rodnan skin score, forced vital capacity, and diffusing lung capacity for carbon monoxide at 1 year.

Results:

We included 52 patients; mean age was 49 years (range 17–79), and 36 (69%) were females. Fifty patients (96%) had skin sclerosis, 39 (75%) had diffuse skin involvement with a median modified Rodnan skin score of 14 (0–38). Thirty-eight (76%) had interstitial lung disease, with median forced vital capacity and diffusing lung capacity for carbon monoxide of 81% (37–127) and 56% (28–103) from predicted values, respectively. Twenty-five (51%) patients had pulmonary fibrosis. Mycophenolate mofetil was given for 10 months (0–173) at a median dose of 2000 mg/day (500–3000). In the entire population, no relationship was found between area under the curve and modified Rodnan skin score (p = 0.085), forced vital capacity (p = 0.80), or diffusing lung capacity for carbon monoxide (p = 0.72) variations at 1 year.

Conclusion:

In this retrospective study, we failed to document any relationship between mycophenolic acid area under the curve and skin involvement or interstitial lung disease evolution. Routine monitoring of mycophenolic acid in systemic sclerosis patients treated with mycophenolate mofetil cannot be recommended based on our results.
Privatizing the production of settler colonial landscapes: ‘Authenticity’ and imaginative geography in Wadi Al-Salib, Haifa
Authors: Sa’di-Ibraheem Yara
Published: August 2020

This article explores how urban settler-colonial landscapes are produced in the neoliberal era. Adopting an anti-colonial approach, the article addresses practices of landscape production through the history of Wadi Al-Salib in Haifa after the driving out of its inhabitants in 1948. A micro geographical study of three Palestinian refugees’ houses, sold by the state to private real estate companies during the last two decades, constitutes the empirical mainstay of the article. Located in Wadi Al-Salib where rapid neoliberal urban renewal schemes hope to raise property values and enact demographic change, these houses are often marketed to upper-class Israeli Jews as “authentic”. Such branding indicates that the privatization of the Palestinian refugees' houses may also signify privatization of the colonial imagination, and a broader shift of the landscape into a collage of marketable images, echoing an ‘aesthetic violence’ that evokes past colonial landscapes. Such references create several hyper-realities in the same place, thus canonizing colonial landscapes’ imaginaries.
Pattern and Determinants of Maternal and Child Healthcare Services Among Tribals: With a Special Reference to Tribal Regions of Odisha
Authors: Panda Prasant Kumar , Subudhi Chittaranjan
Published: August 2020

Maternal and child healthcare (MCHC) is an important aspect of healthcare that poses major challenges in the healthcare system. Despite the implementation of various MCHC programmes and policies, MCHC development in India is still grossly lagging. The tribal populations and tribal-dominated areas are more vulnerable, and they are more or less deprived of their basic right to MCHC services. In this context, this article is a modest attempt to analyse the pattern of MCHC services among tribals in India with a special reference to the tribal-dominated districts of Odisha. Besides, the article also aims to explore the factors determining low MCHC achievements in these regions. Secondary data have been used from National Family Health Surveys and other published documents by the Ministry of Tribal Affairs for the study. Simple percentage ratio method and multiple regression techniques have been employed to substantiate the objectives. It is observed that MCHC indicators among tribals and tribal-dominated areas are lagging behind the national indicators and a multipronged approach with an emphasis on effective implementation of schemes in tribal areas is highly required. Districts with dense tribal populations in Odisha are placed among the low-performing districts in MCHC. Women’s education and marriage below legal age emerged significant in determining institutional delivery rate in districts of Odisha. While the coefficient for women’s literacy is positive, it is found to be negative for marriage below legal age. Mother’s education significantly contributes to children’s immunisation as well. The findings suggest the importance of a long-term strategy like improvement of women’s education for MCHC developments. In addition to development of education and awareness, maternal and child health schemes also need to be made available in tribal areas by provision of services in hilly and inaccessible regions and by breaking cultural barriers.
Adsorption of phosphate by halloysite (7 Å) nanotubes (HNTs)
Authors: Gray-Wannell Nia , Holliman Peter J. , Greenwell H. Christopher , Delbos Evelyne , Hillier Stephen
Published: August 2020

The adsorption and retention of phosphates in soil systems is of wide environmental importance, and understanding the surface chemistry of halloysite (a common soil clay mineral) is also of prime importance in many emerging technological applications of halloysite nanotubes (HNTs). The adsorption of phosphate anions on tubular halloysite (7 Å) has been studied to gain a greater understanding of the mechanism and kinetics of adsorption on the surface of HNTs. Two well-characterized tubular halloysites with differing morphologies have been studied: one polygonal prismatic and one cylindrical, where the cylindrical form has a greater surface area and shorter tube length. Greater phosphate adsorption of up to 42 μmol g–1 is observed on the cylindrical halloysite when compared to the polygonal prismatic sample, where adsorption reached a maximum of just 15 μmol g–1 compared to a value for platy kaolinite (KGa-2) of 8 μmol g–1. Phosphate adsorption shows strong pH dependence, and the differences in phosphate sorption between the prismatic and cylindrical morphologies suggest that phosphate absorption does not occur at the same pH-dependent alumina edge sites and that the lumen may have a greater influence on uptake for the cylindrical form.
Simultaneous manipulation of lignin structure and secondary cell wall formation in transgenic poplar
Authors: Nabuqi  , Nuoendagula  , Wu Sejirihu , Takata Naoki , Sakamoto Shingo , Yamamoto Masanobu , Uesugi Mikiko , Déjardin Annabelle , Pilate Gilles , Taniguchi Toru , Mitsuda Nobutaka , Kajita Shinya
Published: August 2020

Increasing the wood density to a preferred range contributes to upgrading the value of wood as raw material. Lignin manipulation can also improve wood quality. This study attempted to accelerate secondary cell wall formation in transgenic poplar with an altered lignin structure. To achieve this, OsSWN1, a rice master switch for secondary cell wall formation in fiber cells, was overexpressed in poplar plants in which monolignol biosynthesis was suppressed by the expression of an RNA-interference construct targeted to the gene for cinnamyl alcohol dehydrogenase 1. The generated transgenic poplars successfully overexpressed the chimeric OsSWN1 construct and monolignol biosynthesis remained altered in these plants. Secondary cell wall thickness was increased in the transgenic plants and their wood density was higher compared to the background line. No difference in lignin content was observed, except in one transgenic line. High saccharification characteristics observed in the background line were preserved in the transgenic line with lower OsSWN1 overexpression, but higher OsSWN1 overexpression had a slight negative impact on enzyme saccharification. Our data suggested that fine-tuning of accelerated deposition of the secondary cell wall combined with alteration of monolignol biosynthesis should improve the lignocellulose quality for conventional and future biorefinery uses.
Chloroplast SRP54s are Essential for Chloroplast Development in Rice
Authors: Shi Yongfeng , He Yan , Lv Xiangguang , Wei Yanlin , Zhang Xiaobo , Xu Xia , Li Liangjian , Wu Jian-li
Published: August 2020

Background

The chloroplast signal recognition particle 54 (cpSRP54) is known for targeting the light-harvesting complex proteins to thylakoids and plays a critical role for chloroplast development in Arabidopsis, but little is known in rice. Here, we reported two homologous cpSRP54s that affect chloroplast development and plant survival in rice.

Results

Two rice cpSRP54 homologues, OscpSRP54a and OscpSRP54b, were identified in present study. The defective OscpSRP54a (LOC_Os11g05552) was responsible for the pale green leaf phenotype of the viable pale green leaf 14 (pgl14) mutant. A single nucleotide substitution from G to A at the position 278, the first intron splicing site, was detected in LOC_Os11g05552 in pgl14. The wild type allele could rescue the mutant phenotype. Knockout lines of OscpSRP54b (LOC_Os11g05556) exhibited similar pale green phenotype to pgl14 with reduced chlorophyll contents and impaired chloroplast development, but showed apparently arrested-growth and died within 3 weeks. Both OscpSRP54a and OscpSRP54b were constitutively expressed mainly in shoots and leaves at the vegetative growth stage. Subcellular location indicated that both OscpSRP54a and OscpSRP54b were chloroplast-localized. Both OscpSRP54a and OscpSRP54b were able to interact with OscpSRP43, respectively. The transcript level of OscpSRP43 was significantly reduced while the transcript level of OscpSRP54b was apparently increased in pgl14. In contrast, the transcript levels of OscpSRP54a, OscpSRP43 and OscpSRP54b were all significantly decreased in OscpSRP54b knockout lines.

Conclusion

Our study demonstrated that both OscpSRP54a and OscpSRP54b were essential for normal chloroplast development by interacting with OscpSRP43 in rice. OscpSRP54a and OscpSRP54b might play distinct roles in transporting different chloroplast proteins into thylakoids through cpSRP-mediated pathway.
Sarcopenia is associated with hypertension in older adults: a systematic review and meta-analysis
Authors: Bai Tingting , Fang Fang , Li Feika , Ren Yan , Hu Jiaan , Cao Jiumei
Published: August 2020

Background

Sarcopenia, particularly low handgrip strength has been observed and correlated in association with hypertension among the older people. However, the results reported in different studies were inconsistent. In the current study, we conducted a systematic review and meta-analysis to reveal the significant association between sarcopenia, handgrip strength, and hypertension in older adults.

Methods

PubMed, MEDLINE, Cochrane Library, and EMBASE databases were searched from inception to 15 November 2019 to retrieve the original research studies that addressed the association between sarcopenia, handgrip strength, and hypertension. All the relevant data were retrieved, analyzed, and summarized.

Results

Twelve articles met the inclusion criteria and a total of 21,301 participants were included in the meta-analysis. Eight eligible studies have reported the odd ratios (ORs) of hypertension and sarcopenia, and the ORs ranged from 0.41 to 4.38. When pooled the ORs together, the summarized OR was 1.29 [95% confidence interval (CI) =1.00–1.67]. The summarized OR for the Asian group 1.50 (95% CI = 1.35–1.67) was significantly higher than that of Caucasian group 1.08 (95% CI = 0.39–2.97). Eleven studies have provided the data on association between handgrip strength and hypertension. The overall OR and 95% CI was 0.99 (95% CI = 0.80–1.23), showing no significant association.

Conclusion

Sarcopenia was associated with hypertension, but no correlation was found between handgrip strength and hypertension in older adults.
Conscientious objection to abortion: why it should be a specified legal right for doctors in South Korea
Authors: Kim Claire Junga
Published: August 2020

Background

In 2019, the Constitutional Court of South Korea ruled that the anti-abortion provisions in the Criminal Act, which criminalize abortion, do not conform to the Constitution. This decision will lead to a total reversal of doctors’ legal duty from the obligation to refuse abortion services to their requirement to provide them, given the Medical Service Act that states that a doctor may not refuse a request for treatment or assistance in childbirth. I argue, confined to abortion services in Korea that will take place in the near future, that doctors should be granted the legal right to exercise conscientious objection to abortion.

Main text

Considering that doctors in Korea have been ethically and legally obligated to refrain from abortions for many years, imposing a universal legal duty to provide abortions that does not allow exception may endanger the moral integrity of individual doctors who chose a career when abortion was illegal. The universal imposition of such a duty may result in repudiation of doctors as moral agents and damage trust in doctors that forms the basis of medical professionalism. Even if conscientious objection to abortion is granted as a legal right, most patients would experience no impediment to receiving abortion services because the healthcare environment of Korea provides options in which patients can choose their doctors based on prior information, there are many doctors who would be willing to provide an abortion, and Korea is a relatively small country. Finally, the responsibility to effectively balance and guarantee the respective rights of the two agents involved in abortion, the doctor and the patient, should be imposed on the government rather than individual doctors. This assertion is based on the government’s past behaviours, the nature of its relationship with doctors, and the capacity it has to satisfy both doctors’ right to conscientious objection and patients’ right to legal medical services.

Conclusion

With regard to abortion services that will be sought in the near future, doctors should be granted the legal right to exercise conscientious objection based on the importance of doctor’s moral integrity, lack of impediment to patients, and government responsibility.
The effect of surgical approach in total hip replacement on outcomes: an analysis of 723,904 elective operations from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man
Authors: Blom Ashley W. , Hunt Linda P. , Matharu Gulraj S. , Reed Michael R. , Whitehouse Michael R.
Published: August 2020

Background

Total hip replacement (THR) is clinically and cost-effective. The surgical approach employed influences the outcome; however, there is little generalisable and robust evidence to guide practice.

Methods

A total of 723,904 primary THRs captured in the National Joint Registry, linked to hospital inpatient, mortality and patient-reported outcome measures (PROMs) data with up to 13.75 years follow-up, were analysed. There were seven surgical approach groups: conventional posterior, lateral, anterior and trans-trochanteric groups and minimally invasive posterior, lateral and anterior. Survival methods were used to compare revision rates and 90-day mortality. Groups were compared using Cox proportional hazards and Flexible Parametric Survival Modelling (FPM). Confounders included age at surgery, sex, risk group (indications additional to osteoarthritis), American Society of Anesthesiologists grade, THR fixation, thromboprophylaxis, anaesthetic, body mass index (BMI) and deprivation. PROMs were analysed with regression modelling or non-parametric methods.

Results

Unadjusted analysis showed a higher revision risk than the referent conventional posterior for the conventional lateral, minimally invasive lateral, minimally invasive anterior and trans-trochanteric groups. This persisted with all adjusted FPM and adjusted Cox models, except in the Cox model including BMI where the higher revision rate only persisted for the conventional lateral approach (hazard rate ratio (HRR) 1.12 [95% CI 1.06,1.17] P < 0·001) and trans-trochanteric approaches (HRR 1.48 [95% CI 1.14,1.91] P = 0.003). PROMs demonstrated statistically, but not clinically, significant differences. Self-reported complications were more frequent with the conventional lateral approach, and the risk of 90-day mortality was higher (HRR 1.15 [95%CI 1.01–1.30] P = 0.029).

Conclusions

Lateral approaches for THR are associated with worse outcomes, including more deaths and revisions, than the posterior approach. We recommend the posterior approach should be considered the current standard approach for THR. Large well-designed studies are needed to assess any potential benefits from using minimally invasive posterior approaches and the conventional anterior approach.
Natural killer cells in cancer biology and therapy
Authors: Wu Song-Yang , Fu Tong , Jiang Yi-Zhou , Shao Zhi-Ming
Published: August 2020

The tumor microenvironment is highly complex, and immune escape is currently considered an important hallmark of cancer, largely contributing to tumor progression and metastasis. Named for their capability of killing target cells autonomously, natural killer (NK) cells serve as the main effector cells toward cancer in innate immunity and are highly heterogeneous in the microenvironment. Most current treatment options harnessing the tumor microenvironment focus on T cell-immunity, either by promoting activating signals or suppressing inhibitory ones. The limited success achieved by T cell immunotherapy highlights the importance of developing new-generation immunotherapeutics, for example utilizing previously ignored NK cells. Although tumors also evolve to resist NK cell-induced cytotoxicity, cytokine supplement, blockade of suppressive molecules and genetic engineering of NK cells may overcome such resistance with great promise in both solid and hematological malignancies. In this review, we summarized the fundamental characteristics and recent advances of NK cells within tumor immunometabolic microenvironment, and discussed potential application and limitations of emerging NK cell-based therapeutic strategies in the era of presicion medicine.
Clinical characterization, genetic profiling, and immune infiltration of TOX in diffuse gliomas
Authors: Zhang Hao , Fan Fan , Yu Yuanqiang , Wang Zeyu , Liu Fangkun , Dai Ziyu , Zhang Liyang , Liu Zhixiong , Cheng Quan
Published: August 2020

Background

Immunotherapies targeting glioblastoma (GBM) have led to significant improvements in patient outcomes. TOX is closely associated with the immune environment surrounding tumors, but its role in gliomas is not fully understood.

Methods

Using data from The Cancer Genome Atlas (TCGA) and the Chinese Glioma Genome Atlas (CGGA), we analyzed the transcriptomes of 1691 WHO grade I-IV human glioma samples. The R language was used to perform most of the statistical analyses. Somatic mutations and somatic copy number variation (CNV) were analyzed using GISTIC 2.0.

Results

TOX was down-regulated in malignant gliomas compared to low grade gliomas, and upregulated in the proneural and IDH mutant subtypes of GBM. TOXlowtumours are associated with the loss of PTEN and amplification of EGFR, while TOXhightumours harbor frequent mutations in IDH1 (91%). TOX was highly expressed in leading edge regions of tumours. Gene ontology and pathway analyses demonstrated that TOX was enriched in multiple immune related processes including lymphocyte migration in GBM. Finally, TOX had a negative association with the infiltration of several immune cell types in the tumour microenvironment.

Conclusion

TOX has the potential to be a new prognostic marker for GBM.
Wheat ear counting using K-means clustering segmentation and convolutional neural network
Authors: Xu Xin , Li Haiyang , Yin Fei , Xi Lei , Qiao Hongbo , Ma Zhaowu , Shen Shuaijie , Jiang Binchao , Ma Xinming
Published: August 2020

Background

Wheat yield is influenced by the number of ears per unit area, and manual counting has traditionally been used to estimate wheat yield. To realize rapid and accurate wheat ear counting, K-means clustering was used for the automatic segmentation of wheat ear images captured by hand-held devices. The segmented data set was constructed by creating four categories of image labels: non-wheat ear, one wheat ear, two wheat ears, and three wheat ears, which was then was sent into the convolution neural network (CNN) model for training and testing to reduce the complexity of the model.

Results

The recognition accuracy of non-wheat, one wheat, two wheat ears, and three wheat ears were 99.8, 97.5, 98.07, and 98.5%, respectively. The model R2 reached 0.96, the root mean square error (RMSE) was 10.84 ears, the macro F1-score and micro F1-score both achieved 98.47%, and the best performance was observed during late grain-filling stage (R2 = 0.99, RMSE = 3.24 ears). The model could also be applied to the UAV platform (R2 = 0.97, RMSE = 9.47 ears).

Conclusions

The classification of segmented images as opposed to target recognition not only reduces the workload of manual annotation but also improves significantly the efficiency and accuracy of wheat ear counting, thus meeting the requirements of wheat yield estimation in the field environment.
A succinct technique for the extraction of the proximal femoral nail anti-rotation (PFNA) after unlocking failure: a case report
Authors: Cao Ming-de , Yang Zhong-Meng , Lu Hua-Ding
Published: August 2020

Introduction

Proximal femoral nail anti-rotation (PFNA) is a routine method to deal with intertrochanteric fractures in the elder population. It is challenging to remove PFNA in some cases as a result of stripping of blade heads. In this case presentation, we describe a novel technique using commonly available instruments that can be used to remove stripped, even broken anti-rotation blade where conventional methods have failed.

Methods

The subject underwent a PFNA removal surgery 15 months after the previous fixation. We encountered difficulties using the regular instrument to remove the anti-rotation blade. A 5-mm tungsten carbide bur was used to drill a single cortical hole at the end of the blade. Then double-strand steel wire was threaded through the hole, and the distal part was shaped into a circle which could tie to the extraction screw. Slide Hammer was applied to gently knock out the blade along the anatomical direction of the femoral neck.

Results

The technique helped us successfully remove the anti-rotation blade and provided the patient with a satisfactory result.

Conclusion

The use of a tungsten reamer and steel wire loop to remove the proximal femoral anti-rotation blade may provide a cost-effective and straightforward method of dealing with extraction failure.
Atorvastatin promotes bone formation in aged apoE–/– mice through the Sirt1–Runx2 axis
Authors: Hong Wei , Wei Zhanying , Qiu Zhaohui , Li Zheng , Fu Chensheng , Ye Zhibin , Xu Xiaoya
Published: August 2020

Background

Statins are the most widely used drugs in elderly patients; the most common clinical application of statins is in aged hyperlipemia patients. There are few studies on the effects and mechanisms of statins on bone in elderly mice with hyperlipemia. The study is to examine the effects of atorvastatin on bone phenotypes and metabolism in aged apolipoprotein E-deficient (apoE–/–) mice, and the possible mechanisms involved in these changes.

Methods

Twenty-four 60-week-old apoE–/–mice were randomly allocated to two groups. Twelve mice were orally gavaged with atorvastatin (10 mg/kg body weight/day) for 12 weeks; the others served as the control group. Bone mass and skeletal microarchitecture were determined using micro-CT. Bone metabolism was assessed by serum analyses, qRT-PCR, and Western blot. Bone marrow-derived mesenchymal stem cells (BMSCs) from apoE–/–mice were differentiated into osteoblasts and treated with atorvastatin and silent information regulator 1 (Sirt1) inhibitor EX-527.

Results

The results showed that long-term administration of atorvastatin increases bone mass and improves bone microarchitecture in trabecular bone but not in cortical bone. Furthermore, the serum bone formation marker osteocalcin (OCN) was ameliorated by atorvastatin, whereas the bone resorption marker tartrate-resistant acid phosphatase 5b (Trap5b) did not appear obviously changes after the treatment of atorvastatin. The mRNA expression of Sirt1, runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP), and OCN in bone tissue were increased after atorvastatin administration. Western blot showed same trend in Sirt1 and Runx2. The in vitro study showed that when BMSCs from apoE–/–mice were pretreated with EX527, the higher expression of Runx2, ALP, and OCN activated by atorvastatin decreased significantly or showed no difference compared with the control. The protein expression of Runx2 showed same trend.

Conclusions

Accordingly, the current study validates the hypothesis that atorvastatin can increase bone mass and promote osteogenesis in aged apoE−/−mice by regulating the Sirt1–Runx2 axis.
Functional deficits in chronic mechanical ankle instability
Authors: Wenning Markus , Gehring Dominic , Mauch Marlene , Schmal Hagen , Ritzmann Ramona , Paul Jochen
Published: August 2020

Background

The interaction of functional and mechanical deficits in chronic ankle instability remains a major issue in current research. After an index sprain, some patients develop sufficient coping strategies, while others require mechanical support. This study aimed to analyze persisting functional deficits in mechanically unstable ankles requiring operative stabilization.

Methods

We retrospectively analyzed the functional testing of 43 patients suffering from chronic, unilateral mechanical ankle instability (MAI) and in which long-term conservative treatment had failed. Manual testing and arthroscopy confirmed mechanical instability. The functional testing included balance test, gait analysis, and concentric-concentric, isokinetic strength measurements and was compared between the non-affected and the MAI ankles.

Results

Plantarflexion, supination, and pronation strength was significantly reduced in MAI ankles. A sub-analysis of the strength measurement revealed that in non-MAI ankles, the peak pronation torque was reached earlier during pronation (maximum peak torque angle at 20° vs. 14° of supination, p < 0.001). Furthermore, active range of motion was reduced in dorsiflexion and supination. In balance testing, patients exhibited a significant increased perimeter for the injured ankle (p < 0.02). During gait analysis, we observed an increased external rotation in MAI (8.7 vs. 6.8°, p<0.02).

Conclusions

This study assesses functional deficits existent in a well-defined population of patients suffering from chronic MAI. Impairments of postural sway, gait asymmetries, and asymmetric isokinetic strength can be observed despite long-term functional treatment. The finding that pronation strength is particularly reduced with the foot in a close-to-accident position indicates potential muscular dysfunction in MAI. Possibly, these deficits alongside the underlying mechanical instability characterize patients requiring mechanical stabilization.
Timing of norepinephrine initiation in patients with septic shock: a systematic review and meta-analysis
Authors: Li Yuting , Li Hongxiang , Zhang Dong
Published: August 2020

Background

The effect of the timing of norepinephrine initiation on clinical outcomes in patients with septic shock is uncertain. A systematic review and meta-analysis was performed to evaluate the impact of early and late start of norepinephrine support on clinical outcomes in patients with septic shock.

Methods

We searched the PubMed, Cochrane, and Embase databases for randomized controlled trials (RCTs) and cohort studies from inception to the 1st of March 2020. We included studies involving adult patients (> 18 years) with septic shock. All authors reported our primary outcome of short-term mortality and clearly comparing early versus late norepinephrine initiation with clinically relevant secondary outcomes (ICU length of stay, time to achieved target mean arterial pressure (≥ 65 mmHg), and volume of intravenous fluids within 6 h). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).

Results

Five studies including 929 patients were included. The primary outcome of this meta-analysis showed that the short-term mortality of the early group was lower than that of the late group (odds ratio [OR] = 0.45; 95% CI, 0.34 to 0.61; P < 0.00001; χ2 = 3.74; I2 = 0%). Secondary outcomes demonstrated that the time to achieved target MAP of the early group was shorter than that of the late group (mean difference = − 1.39; 95% CI, − 1.81 to − 0.96; P < 0.00001; χ2 = 1.03; I2 = 0%). The volume of intravenous fluids within 6 h of the early group was less than that of the late group (mean difference = − 0.50; 95% CI, − 0.68 to − 0.32; P < 0.00001; χ2 = 33.76; I2 = 94%). There was no statistically significant difference in the ICU length of stay between the two groups (mean difference = − 0.11; 95% CI, − 1.27 to 1.05; P = 0.86; χ2 = 0.85; I2 = 0%).

Conclusions

Early initiation of norepinephrine in patients with septic shock was associated with decreased short-term mortality, shorter time to achieved target MAP, and less volume of intravenous fluids within 6 h. There was no significant difference in ICU length of stay between early and late groups. Further large-scale RCTs are still required to confirm these results.
Epigenetic age and pregnancy outcomes: GrimAge acceleration is associated with shorter gestational length and lower birthweight
Authors: Ross Kharah M. , Carroll Judith E. , Horvath Steve , Hobel Calvin J. , Coussons-Read Mary E. , Dunkel Schetter Christine
Published: August 2020

Background

Advanced biological aging, as measured by epigenetic aging indices, is associated with early mortality and morbidity. Associations between maternal epigenetic aging indices in pregnancy and pregnancy outcomes, namely gestational length and birthweight, have not been assessed. The purpose of this study was to examine whether epigenetic age during pregnancy was associated with gestational length and birthweight.

Results

The sample consisted of 77 women from the Los Angeles, CA, area enrolled in the Healthy Babies Before Birth study. Whole blood samples for DNA methylation assay were obtained during the second trimester (15.6 ± 2.15 weeks gestation). Epigenetic age indices GrimAge acceleration (GrimAgeAccel), DNAm PAI-1, DNAm ADM, and DNAm cystatin C were calculated. Gestational length and birthweight were obtained from medical chart review. Covariates were maternal sociodemographic variables, gestational age at blood sample collection, and pre-pregnancy body mass index. In separate covariate-adjusted linear regression models, higher early second trimester GrimAgeAccel, b(SE) = − .171 (.056), p = .004; DNAm PAI-1, b(SE) = − 1.95 × 10−4 (8.5 × 10−5), p = .004; DNAm ADM, b(SE) = − .033 (.011), p = .003; and DNAm cystatin C, b(SE) = 2.10 × 10−5 (8.0 × 10−5), p = .012, were each associated with shorter gestational length. Higher GrimAgeAccel, b(SE) = − 75.2 (19.7), p < .001; DNAm PAI-1, b(SE) = − .079(.031), p = .013; DNAm ADM, b(SE) = − 13.8 (3.87), p = .001; and DNAm cystatin C, b(SE) = − .010 (.003), p = .001, were also associated with lower birthweight, independent of gestational length.

Discussion

Higher maternal prenatal GrimAgeAccel, DNAm PAI-1, DNAm ADM, and DNAm cystatin C were associated with shorter gestational length and lower birthweight. These findings suggest that biological age, as measured by these epigenetic indices, could indicate risk for adverse pregnancy outcomes.