bluuebunny/crossref_metadata_2025 huggingface dataset:
Can natives be settlers? Emptiness, settlement and indigeneity on the settler colonial frontier in Chile
Authors: Giminiani Piergiorgio Di , Fonck Martin , Perasso Paolo
Published: August 2019

Under settler colonialism, dispossession is enabled by discursive strategies aimed at curtailing indigenous entitlement to land. One such strategy is the mutual determination of the native-settler categories whereby the native status is bound to a condition of ahistorical emplacement to specific tracts of land, while settlers can claim native status towards the nation state as a whole. The settler-native dichotomy fails to account for the possibility that settlement could be appropriated by indigenous collectivities as a process constitutive of land attachment and a sense of belonging. This analysis of memories and practices of indigenous settlement in the Mapuche frontier region in Chile indicates that, unlike dominant narratives of emptiness and environmental transformation reproduced under settler colonialism, indigenous settlement can unfold as an unstable ontological achievement aimed at both transforming and maintaining the land’s topological diversity and ability to partake in human social life. Indigenous settlement can work as a critical intervention against the reductionist determination of the category of native through which indigenous land entitlement is delegitimized under settler colonialism.
Nitrogen-containing cyclic compounds as iminium ion sources for selected reaction monitoring detection of derivatized analytes
Authors: Žilionis Andrius
Published: August 2019

Liquid chromatography–tandem mass spectrometry is one of the most sensitive tools for determination of trace amounts of analytes in metabolomics and proteomics. The highest sensitivity is achieved in selected reaction monitoring detection, which involves fragmentation of the molecular ion between two levels of mass selection. However, fragmentation of some compounds is complicated. Detection sensitivity of such analytes may be increased by derivatizing them with a specific moiety fragmentation of which results in product ion of high abundance. In this work, we reveal the influence of iminium ions' structures on their stability by comparing six nitrogen-containing cyclic compounds as derivatization reagents for tandem mass spectrometric analysis of amino group-containing analyte. Commercially available starting materials (piperidine, 2,6-dimethylpiperidine, 1-methylpiperazine, morpholine, pyrrolidine and 1-cyanomethyl-3-methylimidazolium ionic liquid) were used for the synthesis of corresponding carboxylic acids which were further used for derivatization of the model analyte tryptamine. Liquid chromatographic–mass spectrometric analysis of differently derivatized tryptamine was performed for the evaluation of release and stability of corresponding iminium ions under collision-induced dissociation conditions. As a result, morpholine moiety was shown being the most promising iminium ion source among tested compounds. Possible sub-fragmentation pathways of investigated iminium ions were discussed, and the structures of secondary product ions were proposed.
A Collimator Setting Optimization Algorithm for Dual-Arc Volumetric Modulated Arc Therapy in Pancreas Stereotactic Body Radiation Therapy
Authors: Li Xinyi , Wu Jackie , Palta Manisha , Zhang You , Sheng Yang , Zhang Jiahan , Wang Chunhao
Published: August 2019

Purpose:

To optimize collimator setting to improve dosimetric quality of pancreas volumetric modulated arc therapy plan for stereotactic body radiation therapy.

Materials and Methods:

Fifty-five volumetric modulated arc therapy cases in stereotactic body radiation therapy of pancreas were retrospectively included in this study with internal review board approval. Different from the routine practice of initializing collimator settings with a template, the proposed algorithm simultaneously optimizes the collimator angles and jaw positions that are customized to the patient geometry. Specifically, this algorithm includes 2 key steps: (1) an iterative optimization algorithm via simulated annealing that generates a set of potential collimator settings from 39 cases with pancreas stereotactic body radiation therapy, and (2) a multi-leaf collimator modulation scoring system that makes the final decision of the optimal collimator settings (collimator angles and jaw positions) based on organs at risk sparing criteria. For validation, the other 16 cases with pancreas stereotactic body radiation therapy were analyzed. Two plans were generated for each validation case, with one plan optimized using the proposed algorithm ( Planopt) and the other plan with the template setting ( Planconv). Each plan was optimized with 2 full arcs and the same set of constraints for the same case. Dosimetric results were analyzed and compared, including target dose coverage, conformity, organs at risk maximum dose, and modulation complexity score. All results were tested by Wilcoxon signed rank tests, and the statistical significance level was set to .05.

Results:

Both plan groups had comparable target dose coverage and mean doses of all organs at risk. However, organs at risk (stomach, duodenum, large/small bowel) maximum dose sparing ( D0.1 cc and D0.03 cc) was improved in Planopt compared to Planconv. Planopt also showed lower modulation complexity score, which suggests better capability of handling complex shape and sparing organs at risk .

Conclusions:

The proposed collimator settings optimization algorithm successfully improved dosimetric performance for dual-arc pancreas volumetric modulated arc therapy plans in stereotactic body radiation therapy of pancreas. This algorithm has the capability of immediate clinical application.
MAGP2, a Component of Extracellular Matrix, Is Upregulated in Colorectal Cancer and Negatively Modulated by miR-200b-3p
Authors: Feifei Wei , Hui Guo , Ruiqiang Zhao , Qunxiang Jiang , Yu’an Xie
Published: August 2019

Background:

Colorectal cancer is one of the leading causes of cancer-related death worldwide, but its mechanism has not been clarified clearly. Microfibrial-associated glycoprotein 2 is mainly located in extracellular matrix, and its role in colorectal cancer is obscure.

Methods:

Immunohistochemical staining and quantitative real-time polymerase chain reaction were used to compare the expression level of microfibrial-associated glycoprotein 2 in colorectal cancer tissues and adjacent tissues. Western blot was used to detect the expression of microfibrial-associated glycoprotein 2 in colorectal cancer cell lines and normal colonic epithelium cell line. Kaplan-Meier analysis and χ2 test were applied to evaluate the potential of microfibrial-associated glycoprotein 2 to function as cancer biomarker. Lentiviral transduction was used to induce microfibrial-associated glycoprotein 2 overexpression in HCT116 cells and NCM460 cells, followed by detecting cell proliferation, migration, and invasion. Quantitative real-time polymerase chain reaction was used to investigate the changes in downstream genes after microfibrial-associated glycoprotein 2 overexpression. Luciferase assay was conducted to validate whether miR-200b-3p can directly target microfibrial-associated glycoprotein 2.

Results:

We validated that microfibrial-associated glycoprotein 2 was upregulated in colorectal cancer samples and cells. We also demonstrated its upregulation was associated with several clinicopathologic features such as Dukes stage ( P = .048), differentiation status ( P = .034), and local lymphatic metastasis ( P = .036) of patients with colorectal cancer, and its high expression indicated shorter overall survival of the patients. Microfibrial-associated glycoprotein 2 overexpression remarkably promoted cell proliferation and metastasis via regulating the downstream genes of Notch, including hes family bHLH transcription factor 1 (HES1), Slug, Snail, matrix metalloproteinase 2, matrix metalloproteinase 9, and Kruppel-like factor 4. We also identified miR-200b-3p as a posttranscriptional regulator of microfibrial-associated glycoprotein 2, which partly explain the high expression mechanism of microfibrial-associated glycoprotein 2 in cancer tissues. Conclusion: Microfibrial-associated glycoprotein 2, negatively modulated by miR-200b-3p, is an oncogene of colorectal cancer associated with patients’ prognosis. It may function as a potential biomarker and therapeutic target for colorectal cancer.
Impact of Gender on Outcomes Following Abdominal Aortic Aneurysm Repair
Authors: Locham Satinderjit , Shaaban Abdelrahman , Wang Linda , Bandyk Dennis , Schermerhorn Marc , Malas Mahmoud B.
Published: August 2019

Objective:

The purpose of this study is to use a large, nationally representative vascular database to assess differences in patient characteristics, aortic neck anatomy, and outcomes between men and women following open (open aneurysm repair [OAR]) and endovascular (endovascular aneurysm repair [EVAR]) abdominal aortic aneurysm (AAA) repair.

Methods:

Patients undergoing AAA repair from 2003 to 2018 in Vascular Quality Initiative were identified and stratified by procedure (EVAR vs OAR). Thirty-day mortality and major in-hospital complications were assessed between genders within each operative cohort. An EVAR subset analysis was performed to assess differences in aortic neck anatomy; hostile neck anatomy was defined as length <15 mm (L < 15), angle >60° (A > 60), and/or diameter >28 mm (D > 28). Standard univariate and multivariable analyses were performed.

Results:

A total of 50 213 patients were identified: 9263 (19%) OAR and 40 950 (82%) EVAR. In both cohorts, majority of patients were men (OAR 73% and EVAR 81%). Women were more likely to have a hostile neck (31.7% vs 24.1%, P < .001), L < 15 (19.8% vs 11.9%, P < .001), and A > 60 (11.5% vs 5.4%, P < .001). Men had larger aneurysm (mean, 57 vs 55 mm, P < .001) and were more likely to have D > 28 (14.0% vs 10.6%, P < .001). Women undergoing EVAR were more likely to undergo aortic extensions (21.9% vs 16.0%) and receive higher contrast volume. After adjusting for potential confounders, female gender was associated with 86% and 50% increased risk of 30-day mortality in OAR and EVAR, respectively. Women were more likely than men to experience renal, cardiac, and pulmonary complications only in the EVAR cohort. Women had a 2-fold increased odds of developing type 1 endoleak.

Conclusion:

Our study demonstrates unfavorable neck anatomy occurs more frequently in women compared to men. Women were also at an increased risk of developing major complications, particularly following EVAR. Careful patient selection is indicated in all patients to reduce complications, with special attention in women with hostile neck.
Analysis of space labeling through binary fingerprinting
Authors: Mizmizi Marouan , Reggiani Luca
Published: August 2019

In the context of fingerprinting applications, this article presents the performance analysis of a type of space labeling based on the binary quantization of the received signal strength indicator. One of the common drawbacks of fingerprinting is the large data size and consequently the large search space and computational load as a result of either vastness of the positioning area or the finer resolution in the fingerprinting grid map. Our approach can be considered, for example, when we use very small, inexpensive beacons, like those based on bluetooth low energy technology, radio frequency identification, or in the future context of the Internet of Things. One of the interesting properties of this deployment is that it can be interpreted as a form of space labeling or encoding since space is divided into cells, and each cell is associated to a binary codeword with the corresponding scalability of the spatial resolution. Here, it developed the performance estimation, exploiting the association of this deployment to an error correcting code. The analysis and numerical and experimental results allow a deeper understanding of the impact of the proposed solution and show that it is robust and computationally efficient with respect to the traditional fingerprinting technique.
Node optimization coverage method under link model in passive monitoring system of three-dimensional wireless sensor network
Authors: Hao Zhanjun , Qu Nanjiang , Dang Xiaochao , Hou Jiaojiao
Published: August 2019

3D coverage is not only closer to the actual application environment, but also a research hotspot of sensor networks in recent years. For this reason, a node optimization coverage method under link model in passive monitoring system of three-dimensional wireless sensor network is proposed in this article. According to wireless link-aware area, the link coverage model in three-dimensional wireless sensor network is constructed, and the cube-based network coverage is used to represent the quality of service of the network. This model takes advantage of the principle that the presence of human beings can change the transmission channel of the link. On this basis, the intruder is detected by the data packets transmitted between the wireless links, and then the coverage area is monitored by monitoring the received signal strength of the wireless signal. Based on this new link awareness model, the problem of optimal coverage deployment of the receiving node is solved, that is, how to deploy the receiving node to achieve the optimal coverage of the monitoring area when the location of the sending node is given. In the process of optimal coverage, the traditional genetic algorithm and particle swarm optimization algorithm are introduced and improved. Based on the genetic algorithm, the particle swarm optimization algorithm which integrates the idea of simulated annealing is regarded as an important operator of the genetic algorithm, which can converge to the optimal solution quickly. The simulation results show that the proposed method can improve the network coverage, converge quickly, and reduce the network energy consumption. In addition, we set up a real experimental environment for coverage verification, and the experimental results verify the feasibility of the proposed method.
Body Mass Index and Risk of Prostate Volume, International Prostate Symptom Score, Maximum Urinary Flow Rate, and Post-Void Residual in Benign Prostatic Hyperplasia Patients
Authors: Li Bing-Hui , Deng Tong , Huang Qiao , Zi Hao , Weng Hong , Zeng Xian-Tao
Published: August 2019

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Qmax), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Qmax, and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Qmax, and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Qmax, or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.
Requirements elicitation for robotic and computer-assisted minimally invasive surgery
Authors: Nakawala Hirenkumar , De Momi Elena , Tzemanaki Antonia , Dogramadzi Sanja , Russo Andrea , Catellani Michele , Bianchi Roberto , De Cobelli Ottavio , Sideridis Aristotelis , Papacostas Emmanuel , Koupparis Anthony , Rowe Edward , Persad Raj , Ascione Raimondo , Ferrigno Giancarlo
Published: August 2019

The robotic surgical systems and computer-assisted technologies market has seen impressive growth over the last decades, but uptake by end-users is still scarce. The purpose of this article is to provide a comprehensive and informed list of the end-user requirements for the development of new generation robot- and computer-assisted surgical systems and the methodology for eliciting them. The requirements were elicited, in the frame of the EU project SMARTsurg, by conducting interviews on use cases of chosen urology, cardiovascular and orthopaedics procedures, tailored to provide clinical foundations for scientific and technical developments. The structured interviews resulted in detailed requirement specifications which are ranked according to their priorities. Paradigmatic surgical scenarios support the use cases.
Self-management support preferences of people with asthma or chronic obstructive pulmonary disease: A systematic review and meta-synthesis of qualitative studies
Authors: O’Connell Selena , McCarthy Vera JC , Savage Eileen
Published: August 2019

Objectives

To synthesise findings from qualitative studies on the preferences of people with asthma or chronic obstructive pulmonary disease (COPD) for self-management support.

Methods

A thematic synthesis of literature was carried out. Six databases (ASSIA, CINAHL, MEDLINE, PsycINFO, Psychology and the Behavioural Sciences and SSCI) were used to search for qualitative studies eliciting perspectives of adults with asthma and/or COPD on self-management support, published between May 2008 and April 2018.

Results

A total of 968 articles were retrieved across databases, with 15 articles included in the synthesis. Three themes were identified: Types of Support described the range of supports valued by participants in the studies, particularly education provided by competent healthcare professionals; The Support Relationship highlighted the importance of a collaborative relationship with one’s healthcare professional which was characterised by communication, trust and continuity over time and Accessibility identified the considerations of participants relating to physically accessible, prompt support which is provided in a format preferred by the individual.

Discussion

Increased understanding of patients’ preferences may provide insight which can be used to enhance engagement with self-management support. Further research needs to examine self-management support preferences outside the context of evaluating interventions for people with asthma/COPD and needs to address the optimal means of enhancing accessibility.
Coach–athlete relationships, basic psychological needs satisfaction and thwarting, and the teaching of life skills in Canadian high school sport
Authors: Camiré Martin , Rathwell Scott , Turgeon³ Stéphanie , Kendellen Kelsey
Published: August 2019

High school sport is one of the most popular school-based extracurricular activities in North America, situated as a developmental activity during which coaches can foster quality relationships with students to promote basic psychological needs satisfaction and teach life skills. The primary purpose of the study was to examine associations between coach–athlete relationships, basic psychological needs satisfaction and thwarting, and the teaching of life skills in Canadian high school sport. The secondary purpose consisted of addressing the psychometric properties of the scales employed in the study, namely the Coach–Athlete Relationship Questionnaire, the self-report version of the Interpersonal Behaviors Questionnaire, and a modified coach version of the Life Skills Scale for Sport. The sample was comprised of 1238 (58.8% male) Canadian high school coaches and the data were analysed using structural equation modelling. The mediated model indicated that coaches' perceptions of their interpersonal behaviours satisfying athletes' basic psychological needs either fully or partially mediated the positive relationships between coach–athlete relationships and the teaching of life skills. Coach–athlete relationships, particularly those within which coaches exhibit interpersonal behaviours that satisfy athletes' basic psychological needs, appear to be associated with the teaching of life skills in the context of high school sport.
In idiopathic cubital tunnel syndrome, ulnar nerve excursion and instability can be reduced by repairing Osborne’s ligament after simple decompression
Authors: Kwak Sang Ho , Lee Seung-Jun , Bae Jung Yun , Jeong Hee Seok , Kang Sang Woo , Suh Kuen Tak
Published: August 2019

Osborne’s modified decompression involves repairing Osborne’s ligament beneath the ulnar nerve after simple decompression for idiopathic cubital tunnel syndrome. In this retrospective interrupted time series, 31 patients underwent modified simple decompression and 20 patients underwent conventional simple decompression. In the modified simple decompression group, the ulnar nerve length was measured at operation in full elbow flexion and extension before and after repair of Osborne’s ligament. Ulnar nerve instability during elbow motion was measured using ultrasonography before operation and at 12 months after operation. In patients treated by modified simple decompression, the ulnar nerve length in full elbow flexion reduced significantly after repair of Osborne’s ligament. At 12 months after surgery, the grade of ulnar nerve instability was lower in the modified simple decompression group than in the conventional simple decompression group. The clinical outcomes did not differ significantly between the groups at 24 months after operation.

Level of evidence: III
A New Era of Extended Time Window Acute Stroke Interventions Guided by Imaging
Authors: Rehani Bhavya , Ammanuel Simon G. , Zhang Yi , Smith Wade , Cooke Daniel L. , Hetts Steven W. , Josephson S. Andrew , Kim Anthony , Hemphill J. Claude , Dillon William
Published: August 2019

Ischemic stroke is one of the most debilitating and deadliest conditions worldwide. Intravenous t-PA is the current standard treatment within 4 hours after onset of symptoms. Recent randomized controlled trials have demonstrated the efficacy of neurointerventional intra-arterial treatment in acute ischemic stroke. About 20% of acute ischemic stroke are classified as wake-up strokes, which falls out of the conventional treatment time window. New evidence suggests that some patients with longer time from symptom onset (up to 24 hours) may benefit from thrombectomy, probably in part due to variations in collateral circulation among individual patients. Advanced imaging can play a crucial role in identifying patients who could benefit from endovascular intervention presenting within extended treatment time windows. In this article, we review the advanced imaging algorithm for ischemic stroke workup in the multiple studies published to date and summarize the results of the clinical trials for late ischemic stroke that can be clinically useful.
Discernment, technology, and digital citizenship in a Christian school system
Authors: Smith David I , Sevensma Kara
Published: August 2019

Using a qualitative analysis of school artifacts, this article analyzes the documentary record of one Christian school system’s experience with technological change. It focuses on documentary evidence for how the concept of Christian discernment was deployed to situate new technologies within a Christian discourse. The idea of discernment shifted in emphasis as new technologies were implemented. The theologically rooted concept of discernment both shaped and was shaped by the ongoing effort to manage technological change. Examining this evolution offers an empirical contribution to discussions of how Christian schools can sustain an integrity of fit between faith and practice.
Attitudes Toward Intimate Partner Violence Against Women in Latin America and the Caribbean
Authors: Bucheli Marisa , Rossi Maximo
Published: August 2019

We analyze individual and country factors that explain attitudes toward intimate partner violence against women (IPVAW) in Latin America and the Caribbean. Most patterns at individual level are similar to the international ones: for example, approval of IPVAW is higher among women and people in rural areas or in disadvantaged socio-economic situations. The most novel contribution of our work is the study of the variables at country level: approval of IPVAW increases with poverty, fertility rate, and equal gender outcomes. It decreases with Internet access and, less robustly, with the time elapsed since the enactment of women’s suffrage.
Emotion Regulation Difficulties Related to Depression and Anxiety: A Network Approach to Model Relations Among Symptoms, Positive Reappraisal, and Repetitive Negative Thinking
Authors: Everaert Jonas , Joormann Jutta
Published: August 2019

Frequent repetitive negative thinking and infrequent positive reappraisal use are theorized to increase risk for depression and anxiety. Yet, research has studied these regulatory strategies at the disorder level, ignoring the clinical heterogeneity and differential relations among their individual symptoms. In this study, we examined the associations among repetitive negative thinking, positive reappraisal, and individual symptoms of depression and anxiety disorders. Models of regularized partial-correlation networks were estimated using cross-sectional data from 468 participants. Results showed that repetitive negative thinking and positive reappraisal were differentially related to affective, cognitive, and somatic symptoms of depression and anxiety. Moreover, repetitive negative thinking was more central than positive reappraisal with stronger connections to individual symptoms. Finally, repetitive negative thinking was more important than positive reappraisal in connecting clusters of depression and anxiety symptoms. These findings cast light on potential pathways through which repetitive negative thinking and positive reappraisal may operate within depression and anxiety.
Assessing Patient Participation Burden Based on Protocol Design Characteristics
Authors: Getz Kenneth , Sethuraman Venkat , Rine Jessica , Peña Yaritza , Ramanathan Sharma , Stergiopoulos Stella
Published: August 2019

Background:

Although a number of studies have quantitatively measured investigative site burden to administer increasingly complex protocol designs, robust scholarly research has not been performed to quantify the burden that patients face as participants in clinical trials.

Methods:

This paper presents the results of a cross-sectional pilot study conducted by the Tufts Center for the Study of Drug Development and ZS Associates among nearly 600 patients via an online survey conducted between February and March 2019. Respondents rated the perceived burden of 60 commonly administered protocol procedures. The association and relationship between overall patient burden—derived from aggregating mean perceived burden ratings for individual procedures—and performance (eg, screen failure and retention rates, clinical trial cycle times) for a cross-sectional sample of 137 individual protocols was assessed. Descriptive statistics, significance tests, and univariate analyses were performed.

Results:

Strong positive, statistically significant associations were observed between a composite measure of patient burden and protocol-specific design and performance measures, most notably study visits above the tolerable mean and the study conduct duration from first patient first visit to last patient last visit.

Conclusions:

The study results suggest a new and viable approach to optimize protocol design and improve patient engagement.
Top 100 Cited Articles on Lumbar Spondylolisthesis: A Bibliographic Analysis
Authors: Aldawsari Khalifah , Alotaibi Mohammad T. , Alsaleh Khalid
Published: August 2019

Study Design:

Bibliographic analysis.

Objective:

The aim of this study is to identify the most cited studies on lumbar spondylolisthesis and report their impact in spine field.

Methods:

Thomson Reuters Web of Science–Science Citation Index Expanded was searched using title-specific search “spondylolisthesis.” All studies published in English language between 1900 and 2019 were included with no restrictions. The top 100 cited articles were identified using “Times cited” arranging articles from high to low according to citation count. Further analysis was made to obtain the following items: article title, author’s name and specialty, country of origin, institution, journal of publication, year of publication, citations number, study design.

Results:

The citation count of the top 100 articles ranged from 68 to 589. All published between 1932 and 2016. Among 20 journals, Spine had the highest number of articles (49), with citation number of 6155 out of 13 618. Second ranked was Journal of Bone and Joint Surgery with 15 articles and total citations of 3023. With regard to the primary author’s specialty, orthopedic surgeons contributed to the majority of top 100 list with 82 articles, and neurosurgery was the second specialty with 11 articles. The United States had produced more than half of the list with 59 articles. England was the second country with 7 articles. Surgical management of degenerative lumbar spondylolisthesis was the most common discussed topic.

Conclusion:

This article identifies the top 100 influential articles on lumbar spondylolisthesis and recognizes an important aspect of knowledge evolution served by leading researchers as they guided today’s clinical decision making in spondylolisthesis.
Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury
Authors: Ung Lars , Ohlmeier Malte , Jettkant Birger , Grasmücke Dennis , Aach Mirko , Meindl Renate , Nicolas Volkmar , Schildhauer Thomas A. , Citak Mustafa
Published: August 2019

Study Design:

Retrospective observational study.

Objectives:

To analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI).

Methods:

Between January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital. A total of 58 patients met the inclusion criteria and were recruited for final analysis. Patients with 2-stage procedure or incomplete clinical records with lost-to-follow-up were excluded from the study. Patients were divided into 2 groups (group 1= internal fixation; group 2 = external fixation). Primary outcome measures were to identify the number of nonunions via Kaplan-Meier analysis and the time to bone consolidation. The diagnosis of a pseudarthrosis was made after more than 180 days of consolidation time. Considering the Kaplan-Meier analysis, pseudarthrosis was interpreted as treatment failure. Secondary outcome measure was to evaluate the complication rate with special focus on heterotopic ossification.

Results:

A total of 58 chronic SCI patients with closed bone fractures were included in this study. Fifty-two fractures (88%) were simple and 7 (12%) were complex (type C) fractures according to AO classification. The majority of patients (34 cases, 59%) developed femur fractures followed by 24 tibial fractures (41%). Seventeen patients received an external (29%) and 41 an internal fixation (71%). Bone consolidation was reported in 31 patients (53%) with a mean time interval of bone consolidation after 97 days (range from 45 to 160 days; SD = 30). The reported nonunion (pseudarthrosis) rate was 47%. Comparing the internal group (n = 15 patients) versus the external group (n = 14), we could not find any significant difference ( P = .939) concerning the bone consolidation time. The Kaplan-Meier analysis showed a 75% cumulative survivorship at 120 days (internal group) versus 111 days (external group). Most common postoperative complications occurred in the internal fixation group with Wound infections being predominantly observed (10%), followed by heterotopic ossifications (8%).

Conclusions:

Our results show that surgical treatment of lower limb fractures in chronic SCI patients is a challenging treatment with a high pseudarthrosis rate in both groups. The complication rate seems to be lower in the patients treated with external fixation. As a clinical recommendation, longer implants should be used for a stable osteosynthesis since SCI patients seem to have a higher load on the osteosynthesis material due to missing sensomotoric feedback.
Rights or Benefits? The Indian Supreme Court and Criminal Procedure
Authors: Sekhri Abhinav
Published: August 2019

This article suggests that the recent decisions by the Indian Supreme Court in Mohan Lal v. State of Punjab, and Varinder Kumar v. State of H.P., are perhaps indicative of a more pervasive trend that stretches back to the dawn of the due process era in Indian law. This trend is one where the Supreme Court is confronted with systemic issues in the criminal process while dealing with petitions brought by singularly oppressed litigants, and it treats the litigation itself as a means to solve the perceived problem. The tool to solve these problem in the criminal process is the creation of new criminal procedure rights through the vehicle of Article 21. In its reformist zeal, scant attention is paid to the several important questions of scope and consequential remedy that are inherent to any notion of rights. Over time though, the Court seems to realise that hard cases make bad law. And when cases involving seemingly undeserving litigants start invoking those procedural rights, the Court signals a retreat and transforms the ‘right’ into a ‘benefit’, that it can dole out in only the most deserving cases. This is not a definitive study, but only offers a different perspective to examine the Supreme Court’s contribution to the field of criminal procedure.
Integrating Mental Health Perspectives into the Legal Discourse on Reproductive Justice in India
Authors: Parthasarathy Malavika
Published: August 2019

The reproductive justice framework envisions a world where all women, including those situated at the intersection of multiple structures of oppression such as class, caste, sexual orientation, disability and mental health, are able to exercise their right to decisional and reproductive autonomy. S. 3(4)(a) of the Medical Termination of Pregnancy Act, 1971, provides that an abortion cannot be performed on a mentally ill woman without the consent of her guardian. I analyse the Indian Supreme Court’s decision in Suchita Srivastava v. Chandigarh Administration [(2009) 9 SCC 1] in light of contemporary legal developments in the field of disability law and mental health law. The first argument that I make in this paper is that the Rights of Persons with Disabilities Act, 2016, covers persons with mental illness, with the rights in the Act applicable to those with mental illness as well. The second argument rests on the Mental Healthcare Act, 2017, which recognizes the right to privacy and dignity of mentally ill persons, including their capacity to make decisions affecting healthcare.

I argue that the judgment, while path-breaking in its recognition of the reproductive rights of disabled women, is inimical to the rights of mentally ill women, perpetuating dangerous stereotypes about their ability to exercise choices, and dehumanizing them. It is imperative for the reproductive justice framework to inform legal discourse and judicial decision-making, to fully acknowledge the right to self-determination and bodily integrity of mentally ill persons.
HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease
Authors: Vidal José Ernesto
Published: August 2019

Cerebral toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characteristics are focal subacute neurological deficits and ring-enhancing brain lesions in the basal ganglia, but the spectrum of clinical and neuroradiological manifestations is broad. Early initiation of antitoxoplasma therapy is an important feature of the diagnostic approach of expansive brain lesions in PLWHA. Pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) seem to present similar efficacy, but TMP-SMX shows potential practical advantages. The immune reconstitution inflammatory syndrome is uncommon in cerebral toxoplasmosis, and we now have more effective, safe, and friendly combined antiretroviral therapy (cART) options. As a consequence of these 2 variables, the initiation of cART can be performed within 2 weeks after initiation of antitoxoplasma therapy. Herein, we will review historical and current concepts of epidemiology, diagnosis, and treatment of HIV-related cerebral toxoplasmosis.
Failed Dermal Allograft Procedures for Irreparable Rotator Cuff Tears Can Still Improve Pain and Function: The “Biologic Tuberoplasty Effect”
Authors: Mirzayan Raffy , Stone Michael A. , Batech Michael , Acevedo Daniel C. , Singh Anshuman
Published: August 2019

Background:

Acellular dermal matrices (ADMs) have been used in the treatment of shoulders with massive rotator cuff tears (MRCTs). Despite clinical improvement, correlation of clinical findings with ADM integrity on imaging has not been investigated.

Hypothesis:

The pain in shoulders with MRCTs is partially due to bone-to-bone contact between the tuberosity and acromion. Coverage of the tuberosity with an intact graft or a graft that is torn in a way that the tuberosity remains covered will act as an interpositional tissue, preventing bone-to-bone contact and leading to clinical improvement.

Study Design:

Case series; Level of evidence, 4.

Methods:

Between 2006 and 2016, a total of 25 shoulders with MRCTs underwent a procedure with an ADM. Pre- and postoperative visual analog scale (VAS) results, American Shoulder and Elbow Surgeons (ASES) score, Hamada grade, and Goutallier classification were reviewed. A postoperative magnetic resonance imaging (MRI) was obtained in 22 (88%) shoulders. The status of the graft was divided into the following categories: type I, intact graft; type II, graft tear with tuberosity covered; and type III, graft tear with tuberosity uncovered (bare).

Results:

The mean patient age was 61 years (range, 49-73 years), and the mean follow-up was 25.6 months (range, 10-80 months). Mean length from surgery to postoperative MRI was 13.9 months (range, 6-80 months). The graft was torn in 59% (13/22 shoulders). Significant improvements were found in VAS and ASES scores (7 vs 0.7 and 32.6 vs 91.2, respectively; P < .01) for type I grafts and in VAS and ASES scores (8.1 vs 1.3 and 26.3 vs 84.6, respectively; P < .01) for type II grafts. No difference was found in postoperative VAS and ASES (0.7 vs 1.3 and 91.2 vs 84.6, respectively; P = .8) between type I and type II grafts. No improvement was seen in VAS (7.3 vs 5.7; P = .2) or ASES (30.6 vs 37.2; P = .5) for type III grafts.

Conclusion:

MRI appearance of the graft has a significant impact on functional outcomes. Patients with an intact graft or a graft tear leaving the tuberosity covered have lower pain and higher functional scores than those in whom the torn graft leaves the tuberosity uncovered.
Addressing Literacy Needs of Struggling Spanish-Speaking First Graders: First-Year Results From a National Randomized Controlled Trial of Descubriendo la Lectura
Authors: Borman Trisha H. , Borman Geoffrey D. , Houghton Scott , Park So Jung , Zhu Bo , Martin Alejandra , Wilkinson-Flicker Sidney
Published: August 2019

Given the growing number of Latino English learners and the lack of evidence-based educational opportunities they are provided, we investigated the impact of one potentially effective literacy intervention that targets struggling first-grade Spanish-speaking students: Descubriendo La Lectura (DLL). DLL provides first-grade Spanish-speaking students one-on-one literacy instruction in their native language and is implemented at an individualized pace for approximately 12 to 20 weeks by trained bilingual teachers. Using a multisite, multicohort, student-level randomized controlled trial, we examined the impact of DLL on both Spanish and English literacy skills. In this article, we report findings from the first of three cohorts of students to participate in the study. Analyses of outcomes indicate that treated students outperformed control students on all 11 Spanish literacy assessments with statistically significant effect sizes ranging from 0.34 to 1.06. Analyses of outcomes on four English literacy assessments yielded positive effect sizes, though none were statistically significant.
Does the Flipped Classroom Improve Student Learning and Satisfaction? A Systematic Review and Meta-Analysis
Authors: Låg Torstein , Sæle Rannveig Grøm
Published: August 2019

We searched and meta-analyzed studies comparing flipped classroom teaching with traditional, lecture-based teaching to evaluate the evidence for the flipped classroom’s influence on continuous-learning measures, pass/fail rates, and student evaluations of teaching. Eight electronic reference databases were searched to retrieve relevant studies. Our results indicate a small effect in favor of the flipped classroom on learning (Hedges’ g = 0.35, 95% confidence interval [CI] [0.31, 0.40], k = 272). However, analyses restricted to studies with sufficient power resulted in an estimate of 0.24 (95% CI [0.18, 0.31], k = 90). Effects on pass rates (odds ratio = 1.55, 95% CI [1.34, 1.78], k = 45) and student satisfaction (Hedges’ g = 0.16, 95% CI [0.06, 0.26], k = 69) were small and also likely influenced by publication bias. There is some support for the notion that the positive impact on learning may increase slightly if testing student preparation is part of the implementation.
Encouraging Activism Through Art: Preservice Teachers Challenge Censorship
Authors: Leland Christine H. , Bangert Sara E.
Published: August 2019

According to the American Library Association, book censorship is on the rise. While many censored books are adolescent novels, some titles for younger children are challenged as well. Books dealing with difficult social issues have been targets for censors historically, but recent attacks have focused on books portraying members of the lesbian, gay, bisexual, transgender, questioning, and other sexual identities (LGBTQ+) community. The goal of this qualitative study was to build prospective teachers’ (PTs’) knowledge of censorship while also providing an opportunity for them to take a sociopolitical stance. Students in a children’s literature course read source materials and reacted by creating a transmediation that used some form of art. Lenses for data analysis included qualitative research, critical discourse analysis, and visual discourse analysis. The first major theme focused on freedom and democracy and the threat censorship poses. Within this category, two subthemes were identified: (1) children having freedom to learn about real-world issues and (2) children having freedom to read books that meet their personal needs. A second major theme focused on how PTs thought people should respond to censorship. Responses expressing fear and/or confusion about censorship were coded as demonstrating a teacher dilemma, while examples showing a challenge to censorship were coded as demonstrating resistance. Findings indicate that PTs were shocked by what they learned about censorship, and many of them engaged in culture jamming, which involves using the arts to challenge oppressive systems. Many used art to critique censorship and advocate for children’s rights. This study challenges the common cultural assumption that teaching is an apolitical or neutral activity.
Intravitreal Injections Among Medicare Part B Beneficiaries, 2012-2016
Authors: Andersen Dallin J. , Ludwig, BM Parker E. , Janot Adam C.
Published: August 2019

Purpose:

Intravitreal injection therapy (IVIT) has transformed the management of many chorioretinal diseases. Although these treatments are effective, they can also be expensive. Using the Medicare Provider and Utilization Data Report (MPUDR), we aim to quantify the costs of these drugs to Medicare and to project future cost trends.

Methods:

Data were harvested from the MPUDR for all ophthalmology providers who delivered intravitreal injections (IVT) (CPT code 67028) during the years 2012-2016. Linear regression utilizing the MPUDR data was used to analyze cost trends and to project Medicare costs out to year 2026.

Results:

From 2012 to 2016, the total number of IVTs increased from 2 286 593 to 2 936 274 ( R2 = 0.98; P = .001). The per-beneficiary Medicare cost rose significantly from $3,148 to $3,945 ( R2 = 0.92; P = .03). The total cost to Medicare for IVIT increased from $1.68 billion to $2.73 billion ( R2 = 0.99; P < .005). IVIT accounts for 37% of all ophthalmology Medicare reimbursements. At the current rate, IVIT costs will exceed $5 billion per year by 2026.

Conclusions:

The total number of injections and costs for IVIT rose significantly from 2012 to 2016. At the current rate, Medicare reimbursement for brand-name drugs will make up a large proportion of future costs.
Endoscopic management of refractory benign oesophageal strictures
Authors: Everett Simon M.
Published: August 2019

Refractory benign oesophageal strictures are an infrequent presentation but a cause of significant morbidity and mortality. The treatment of these strictures has changed little in recent years, yet new evidence is emerging for the optimal timing and application of different therapies. In this article, we have carefully reviewed the current literature on the evaluation and management of refractory strictures and provided practical advice as to their management. A number of areas require attention in future research, including carefully designed randomised trials of endoscopic and medical therapies, and a focus on risk factors at a patient and molecular level to facilitate development of medical therapies that can reduce recurrent fibrosis in these patients.
Training program-induced skeletal muscle adaptations in two men with myotonic dystrophy type 1
Authors: Roussel Marie-Pier , Morin Marika , Girardin Mélina , Fortin Anne-Marie , Leone Mario , Mathieu Jean , Gagnon Cynthia , Duchesne Elise
Published: August 2019

Objective

The purpose of this side product of another unpublished research project, was to address the effects of a training program on skeletal muscle adaptations of people with myotonic dystrophy type 1 (DM1), under a multifaceted perspective. The objective of this study was to look at training induced muscular adaptations by evaluating changes in muscle strength, myofiber cross-sectional area (CSA), proportion of myofiber types and with indirect markers of muscle growth [proportion of centrally nucleated fibers (CNF) and density of neutrophils and macrophages]. Two men with DM1 underwent a 12-week strength/endurance training program (18 sessions). Two muscle biopsies were obtained pre- and post-training program.

Results

Muscular adaptations occurred only in Patient 1, who attended 72% of the training sessions compared to 39% for Patient 2. These adaptations included increase in the CSA of type I and II myofibers and changes in their proportion. No changes were observed in the percentage of CNF, infiltration of neutrophils and macrophages and muscle strength. These results illustrate the capacity of skeletal muscle cells to undergo adaptations linked to muscle growth in DM1 patients. Also, these adaptations seem to be dependent on the attendance.

Trial registration Clinicaltrials.gov NCT04001920 retrospectively registered on June 26th, 2019