bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental and statistical analysis of carbon fiber/epoxy composites interleaved with nylon 6,6 nonwoven fabric interlayers
Authors: Beylergil Bertan , Tanoğlu Metin , Aktaş Engin
Published: May 2020

Thermoplastic interleaving is a promising technique to improve delamination resistance of laminated composites. In this study, plain-weave carbon fiber/epoxy composites were interleaved with nylon 6,6 nonwoven fabrics with an areal weight density of 17 gsm. The carbon fiber/epoxy composite laminates with/without nylon 6,6 nonwoven fabric interlayers were manufactured by VARTM technique. Double cantilever beam fracture toughness tests were carried out on the prepared composite test specimens in accordance with ASTM 5528 standard. The experimental test data were statistically analyzed by two-parameter Weibull distribution. The results showed that the initiation and propagation fracture toughness Mode-I fracture toughness of carbon fiber/epoxy composites could be improved by about 34 and 156% (corresponding to a reliability level of 0.50) with the incorporation of nylon 6,6 interlayers in the interlaminar region, respectively. The results also revealed that the percent increase in the propagation fracture toughness value was 67 and 41% at reliability levels of 0.90 and 0.95, respectively.
Physical Activity Among Adults With Autism: Participation, Attitudes, and Barriers
Authors: Hillier Ashleigh , Buckingham Abigail , Schena David
Published: May 2020

Children and adolescents with autism spectrum disorder (ASD) have shown have low levels of physical fitness, increasing risks for health-related problems associated with inactivity, such as being overweight, when compared with typically developing children. Few studies have examined physical activity (PA) among adults with ASD. This U.S.-based study examined participation in and attitudes and barriers toward PA among adults with ASD and their peers without ASD. We used standardized existing scales to survey participants for data regarding their frequency of engagement in weekly PA (strenuous, moderate, light), attitudes toward PA, expectations of others, perceived behavioral control, intention toward PA, and perceived PA barriers. Findings indicated that, on average, the ASD group compared with the comparison group reported (a) less frequent strenuous or moderate PA, (b) less positive attitudes toward PA, (c) less perceived behavioral control or ease of performing PA, and (d) more PA barriers. There was also evidence that the ASD group reported less PA intent, but there was no difference between groups regarding beliefs about others’ PA expectations for them. These findings suggest a need for more PA for adults with ASD, particularly because PA has potential to attenuate such ASD challenges as anxiety, stress, and sleeping difficulties.
Should Anyone Care about Scientific Progress?
Authors: Sassower Raphael
Published: May 2020

Scientific progress has been understood as synonymous with the growth of knowledge and the advancement of humanity. In this brief survey, this concept is problematized both in rhetorical terms and within the neoliberal framework. Despite the sustained marketing of the scientific community and its funding agencies, the dangers associated with progress are explained and highlighted.
Instrumentalizing and Naturalizing Social Ontology: Replies to Lohse and Little
Authors: Lauer Richard
Published: May 2020

This article addresses Simon Lohse’s and Daniel Little’s responses to my article “Is Social Ontology Prior to Social Scientific Methodology?.” In that article, I present a pragmatic and deflationary view of the priority of social ontology to social science methodology where social ontology is valued for its ability to promote empirical success and not because it yields knowledge of what furnishes the social world. First, in response to Lohse, I argue that my view is compatible with a role for ontological theorizing in the social sciences. However, the view that results instrumentalizes social ontology. Second, in my response to Little, I argue that the same considerations I made in my article apply to naturalistic attempts to motivate a non-deflationary view, repeating some of the central issues of that article.
Can outpatient total hip arthroplasty be safely performed in the Caribbean? A case report
Authors: Mencia Marlon M
Published: May 2020

Over the past decade, outpatient total hip arthroplasty has been performed successfully with increasing frequency in the United States. The principles for success have been the focus of many recent publications. Despite this, there remains scepticism among surgeons as to the generalisability of outpatient arthroplasty. In the Caribbean basin, our challenges are different from those faced in the high-resource world, but increased patient demand, the shift towards value-based healthcare and the natural evolution of the procedure is likely to result in hip arthroplasty transitioning into the outpatient setting. The present case report describes a patient’s surgical journey through outpatient hip arthroplasty in a developing country. To the best of my knowledge, this case is the first report of a successful outpatient total hip arthroplasty in the Caribbean.
Effect of boiler oversizing on efficiency: a dynamic simulation study
Authors: Bennett George , Elwell Cliff
Published: May 2020

Gas boilers dominate domestic heating in the UK, and significant efficiency improvements have been associated with condensing boilers. However, the potential remains for further efficiency improvement by refining the control, system specification and installation in real dwellings. Dynamic building simulation modelling, including detailed heating system componentry, enables a deeper analysis of boiler underperformance. This paper explores the link between the space heat oversizing of boilers and on/off cycling using dynamic simulation, and their subsequent effect on boiler efficiency and internal temperatures. At plant size ratio (PSR) 8.5 daily cycles numbered over 50, similar to median levels seen in real homes. Simulations show that typical oversizing (PSR >3) significantly increases cycling behaviour and brings an efficiency penalty of 6–9%. There is a clear link between raising PSR, increased cycling and an associated decreased efficiency; however, in the UK, boilers are regularly oversized with respect to space heating, especially combination boilers to cover peak hot water demand. Current legislation and labelling (ErP and SAP) overlook PSR as a determinant of system efficiency, failing to incentivise appropriate sizing. Reducing boiler oversizing through addressing installation practices and certification has the potential to significantly improve efficiency at low cost, decreasing associated carbon emissions.

Practical application: This research provides the basis for a practical and cost effective means of assessing the potential for underperformance of boiler heating systems at the point of installation or refurbishment. By assessing the oversizing of the boiler with respect to space heating, unnecessary cycling and the associated efficiency penalty can be avoided. Plant size ratio, as an indicator of cycling potential, can be implemented in energy performance certificates (EPCs), through the standard assessment procedure (SAP), using existing data. The potential for real carbon savings in the existing boiler stock is considerable, and the findings have wider implications for next generation heating systems.
Cerebellar syndrome after occipital nerve block: A case report
Authors: Pincherle Alessandro , Bolyn Serge
Published: May 2020

Background

Occipital nerve blocks are commonly used in the treatment of different types of refractory headaches. The procedure is considered safe, and serious complications have rarely been described.

Case presentation

We report a serious complication of occipital nerve blockade secondary to the penetration of local anesthetic and non-steroidal anti-inflammatory drugs into the posterior fossa in a patient affected by type I Arnold Chiari malformation.

Conclusions

This case reminds that a proper injection technique is mandatory to avoid potentially severe complications when performing occipital nerve blocks.
The Influence of Religious Involvement on Intimate Partner Violence Victimization via Routine Activities Theory
Authors: Zavala Egbert , Muniz Caitlyn N.
Published: May 2020

Routine activities theory attempts to explain victimization by examining how one’s behavior, or routine activities, increases or decreases their likelihood of victimization. It has been postulated that religious individuals are less likely to associate with motivated offenders, less likely to reduce their target suitability, and more likely to enhance their guardianship, in turn reducing victimization. How, if at all, this theoretical framework can predict protection from a specific form of victimization, such as intimate partner violence (IPV), remains unexplored. Using the American subsample of the International Dating Violence Study ( n = 4,162), this article attempts to determine whether religious involvement can serve as a factor that reduces IPV victimization indirectly through the three elements of routine activities theory: motivated offenders, target suitability, and capable guardianship. To test this research question, a series of logistic regression models are conducted. Results of these models indicate that religiosity does have a negative and significant impact on victims of IPV, net of variables derived from routine activities theory. This study is among the first to suggest that perhaps this theoretical framework may not be applicable to all forms of victimization. The major practical implication of this finding is that IPV victimization could be reduced using faith-based strategies. For example, religious counseling or preventive and intervention programs that increase prosocial bonds between partners are viable options in helping to reduce IPV victimization among couples. Nevertheless, it is imperative to determine other non-religious programs or methods to protect from IPV for individuals who are not religious.
Nationalist Imaginaries and Political Mobilization Against Global Extractive Capital
Authors: Faruque M. Omar
Published: May 2020

Contemporary scholarship on neoliberal globalization and countermovement tends to focus on the global dimension of political struggles. The role of nationalist imaginaries in mobilizing grievances against neoliberal globalization receives little attention in this literature. This article probes these ideas using the case of NCBD, known for its political struggles against global extractive capital in Bangladesh. Drawing on critical globalization scholarship vis-à-vis the power of the state and the ability of countermovements to contest neoliberal globalization, the article analyzes how NCBD’s political imaginaries center on nature, nation, and the state to achieve its movement agenda. Based on qualitative data derived from a set of interviews and relevant organizational documents, it demonstrates the relevance of national scale as a movement site in mediating local and global questions for emancipatory political struggles. It explains how NCBD articulates nationalist imaginaries to mobilize a political vision of the “national” in an era of neoliberal globalism.
Optimization of the interference parameters of an Orbit motor using genetic algorithm
Authors: Nag Abhijit , Ramachandran Harish , Shriwastava Aditya
Published: May 2020

In the present study, the leakage of fluid due to gap generation at the contact points is eliminated by introducing interference between the rotor and the stator of an Orbit motor. Interference is incorporated in the system by modifying the roller radius, the chordal thickness, and the pitch circle radius. In an Orbit motor of interference-fit type, the contact points and the rotor center deviate from their original positions as found in an Orbit motor of perfect-fit type. A corrective technique based on minimization of the potential energy of the system is used to obtain the rotor center of an interference-fit motor. The rotor profile is initially generated around the geometrically obtained center of a perfect-fit motor. It is then shifted in the direction of decreasing potential energy, until the rotor center corresponding to minimum energy is attained. The main drawback of introducing interference is the generation of an unbalanced torque which affects the output torque of the motor. Thus, optimization of interference parameters using genetic algorithm is carried out to determine a system for which no gap is generated at the contacts and simultaneously it is ensured that the unbalanced torque ripple amplitude is minimum.
Freud and Albert Moll: how kindred spirits became bitter foes
Authors: Oosterhuis Harry
Published: May 2020

This article explores the antagonism between Sigmund Freud and the German neurologist and sexologist Albert Moll. When Moll, in 1908, published a book about the sexuality of children, Freud, without any grounds, accused him of plagiarism. In fact, Moll had reason to suspect Freud of plagiarism since there are many parallels between Freud’s Drei Abhandlungen zur Sexualtheorie and Moll’s Untersuchungen über die Libido sexualis. Freud had read this book carefully, but hardly paid tribute to Moll’s innovative thinking about sexuality. A comparison between the two works casts doubt on Freud’s claim that his work was a revolutionary breakthrough. Freud’s course of action raises questions about his integrity. The article also critically addresses earlier evaluations of the clash.
Trafficking and Activity of Glutamate and GABA Receptors: Regulation by Cell Adhesion Molecules
Authors: Keable Ryan , Leshchyns’ka Iryna , Sytnyk Vladimir
Published: May 2020

The efficient targeting of ionotropic receptors to postsynaptic sites is essential for the function of chemical excitatory and inhibitory synapses, constituting the majority of synapses in the brain. A growing body of evidence indicates that cell adhesion molecules (CAMs), which accumulate at synapses at the earliest stages of synaptogenesis, are critical for this process. A diverse variety of CAMs assemble into complexes with glutamate and GABA receptors and regulate the targeting of these receptors to the cell surface and synapses. Presynaptically localized CAMs provide an additional level of regulation, sending a trans-synaptic signal that can regulate synaptic strength at the level of receptor trafficking. Apart from controlling the numbers of receptors present at postsynaptic sites, CAMs can also influence synaptic strength by modulating the conductivity of single receptor channels. CAMs thus act to maintain basal synaptic transmission and are essential for many forms of activity dependent synaptic plasticity. These activities of CAMs may underlie the association between CAM gene mutations and synaptic pathology and represent fundamental mechanisms by which synaptic strength is dynamically tuned at both excitatory and inhibitory synapses.
Low-velocity impact analysis of viscoelastic composite laminated nanoplate based on nonlocal strain gradient theory for different boundary conditions
Authors: Rashidpour Peyman , Ghadiri Majid , Zajkani Asghar
Published: May 2020

In this paper, the dynamic behavior of the nanoparticle low-velocity impact on viscoelastic laminated composite nanoplate has been investigated. To determine the impact force between nanoparticle and laminated composite nanoplate, the van der Waals interaction force is considered based on the description of Lennard-Jones. The material properties of each layer of laminated composite nanoplate are supposed to be viscoelastic based on the Kelvin–Voigt model. The governing equations of the system are derived based on the first-order shear deformation plate theory and the nonlocal strain gradient theory by employing Hamilton’s principle. Galerkin’s method is employed to solve differential equations of nanoplate with different boundary conditions. Afterward, the system of time-dependent equations is solved by applying the Newmark’s method. The parametric study is presented to examine the effect of particle initial velocity, particle radius, viscoelastic modulus, fiber orientation, nonlocal parameter, length scale parameter, and different boundary conditions on the impact response of nanoplate.
Store-and-forward teledermatology impact on diagnosis, treatment and dermatology referrals: Comparison between practice settings
Authors: Pasadyn Selena R , McAfee John L , Vij Alok , Warren Christine B
Published: May 2020

Introduction

Store-and-forward (SAF) teledermatology involves non-dermatologists sending clinical images to dermatologists. This improves patient care while reducing unwarranted face-to-face (FTF) specialist office visits. Comparisons between dermatologist diagnostic concordance with referring provider, treatment change recommendations, and FTF referrals have yet to be compared by type of provider and practice setting.

Methods

This retrospective chart review examined SAF teledermatology eConsults from four practice settings: Doctor of Medicine (MD)/Doctor of Osteopathic Medicine (DO) office visits, MD/DO walk-in clinics, nurse practitioner (NP)/physician assistant (PA) office visits and NP/PA walk-in clinics. The most recent 100 MD/DO office- and 100 NP/PA walk-in-referred patient charts were reviewed. There were only 71 NP/PA office and 47 MD/DO walk-in eConsults to review.

Results

Teledermatologists agreed with referring provider diagnoses 50% of the time for MD/DO office visits, 29.8% for MD/DO walk-in clinics, 33.8% for NP/PA office visits and 34% for NP/PA walk-in clinics. Diagnostic concordance was significantly higher for eConsults from MD/DO office visits than MD/DO walk-in clinics ( p = 0.021), NP/PA office visits ( p = 0.035) or NP/PA walk-in clinics ( p = 0.022). There were significantly more treatment changes recommended after walk-in eConsults than office visits (67 versus 44%, p < 0.0001). FTF visits were recommended more after office visits than walk-in clinics (46 versus 27%, p = 0.001). Overall, 21% (68/318) of patients ultimately attended FTF appointments.

Discussion

SAF teledermatology improves diagnosis, reducing barriers to specialty care. Overall, potential FTF visit reduction was 79%. Expanding eConsult programmes, particularly in walk-in settings, and for use by NP/PAs or early career internists, may render dermatological care more expeditiously and avoid unnecessary FTF visits.
Constraints on speech rate: A heritage-language perspective
Authors: Nagy Naomi , Brook Marisa
Published: May 2020

Research questions:

Polinsky argues that speech rate in heritage languages is highly correlated with proficiency level. In sociolinguistics studies, speech rate in monolingual speakers is found to be conditioned by social factors. What occurs when both proficiency and social factors vary? Is speech rate a valid measure of proficiency?

Methodology:

We use two automated methods of measuring articulation rate (syllables per second), cross-referenced to improve accuracy: an orthographic vowel count and an acoustic measure of amplitude changes from syllable nucleus to periphery.

Data and analysis:

Across 51 speakers, each recorded in an hour-long conversation in Heritage Italian, Russian, Ukrainian, or Homeland Italian, we calculate speech rate in more than 10,000 clauses.

Findings:

Linear regression analyses reveal that articulation rate correlates with generation (since immigration) and age, but, surprisingly, not with ethnic orientation, sex or language. Age and generation are partly collinear in our sample, and models with generation fit better than those with age. We also find that articulation rate does not predict performance on sociolinguistic variables (voice onset time for stops, subject pronoun presence) in heritage varieties.

Originality:

This study compares two ways of calculating articulation rate automatically, examining whether speech rate is a viable stand-in for proficiency when social factors and proficiency vary independently. We resolve several obstacles to using articulation rate as a stand-in for more labor-intensive proficiency measures in spontaneous speech data.

Implications:

These findings suggest that speech rate is a valid proxy for heritage language proficiency. The factor with the strongest effect is generation since immigration (indicating the dominant language in the speaker’s childhood community). The effects of the social factors are complex but must be considered in order to interpret the proficiency measure accurately.
The challenge of recruiting and engaging reluctant non-expert representatives
Authors: Giorgi Alberta
Published: May 2020

Methodological literature dealing with the challenges in sampling, recruiting and engaging research participants for qualitative interviews usually assumes that potential informants are informed. But what happens when the potential informants make it clear that they have little to say because under-informed on the topic? This article explores the challenges in recruiting and engaging under-informed research participants by revisiting my fieldwork experience as a researcher for the ERC-funded project GRASSROOTSMOBILISE – Directions in Religious Pluralism in Europe. The article describes potential interviewees’ claims of under-information as a specific type of reluctance, displaying in both the recruitment and the interview processes, and discusses the potential strategies to overcome this reluctance by paying attention to the role of researchers.
Encountering authority and avoiding trouble: Young migrant men’s narratives of negotiation in Europe
Authors: Fox Claire , Deakin Jo , Spencer Jon , Acik Necla
Published: May 2020

Drawing on data from seven European countries (Czech Republic, Finland, France, Germany, Ireland, Italy and the United Kingdom), this article seeks to identify how young migrant men engage with authority and avoid conflict against a backdrop of increasing hostility towards migrants in many European countries. As this article contends, even those with permanent residency status in the host country often find themselves having to justify their legitimacy to carry out daily tasks, resulting in many young male migrants living with feelings of perpetual insecurity. As such, a number of coping strategies are employed by young migrant men in order to assuage such feelings and mitigate potential risks. Focusing on the lived experiences of this group, as described in narrative interviews, our study found that many young migrant men are required to enter into negotiations with authority figures, where there is a considerable power differential. Acting as risk assessors, they find themselves forced to navigate complex and challenging social relations and support networks. We show how self-limiting behaviour intended to avoid or control interactions with authority and the negotiations conducted to minimize the risk of ‘trouble’ by young migrant men not only are problematic in the context of day-to-day activities but can very often have a detrimental impact on their lives.
Early Birds: An Exploration of Early College Initiative High Schools in New York City and College Persistence
Authors: Britton Tolani A. , Symns Millie O. , Paul Vanessa
Published: May 2020

The Early College Initiative (ECI) high schools in New York City provide opportunities to take college-credit courses up to the equivalent of an associate’s degree while in high school. In this study, we measure the association between attending an ECI high school and college persistence. Our sample is the 3,271 students who graduated from New York City public high schools in the ECI network between Fall 2006 and Fall 2013 and enrolled in college. We use survival analysis to measure the relationship between demographic, academic, and behavioral risk factors and persistence of ECI graduates. We find that Black and Latinx students are as likely as White students to persist, when both high school achievement and behavioral factors, such as attendance, are taken into account. Differences in persistence do exist by gender with young women more likely to persist when compared with young men. This study provides empirical evidence that attending early college high schools has the potential to narrow racial and ethnic gaps in postsecondary outcomes.
Knowledge and Practice of Harm Reduction Strategies Among People Who Report Frequent Cannabis Use
Authors: Kruger Jessica S. , Kruger Daniel , Collins R. Lorraine
Published: May 2020

We examined knowledge and practice of harm reduction strategies among people who use cannabis attending an annual public cannabis advocacy event. We also assessed the sources from which they glean information about cannabis. Participants ( n = 472) completed a brief survey assessing cannabis use, sources for information on cannabis, and harm reduction strategies. Participants’ knowledge of cannabis was based mostly on their own experiments and experiences rather than on information from health professionals. Participants generally had low accuracy in identifying effective harm reduction techniques and low rates of utilizing effective harm reduction techniques, using them at the same rate overall as techniques without empirical support. Results from this survey will be useful to public health professionals developing and implementing harm reduction educational strategies related to cannabis use.
Does Baking Soda Function as a Magic Bullet for Patients With Cancer? A Mini Review
Authors: Yang Mengyuan , Zhong Xian , Yuan Ying
Published: May 2020

Sodium bicarbonate, commonly known as baking soda, is widely used in the clinic as an antacid for treating gastric hyperacidity, among other conditions. Chao et al have reported a clinical trial about targeting intratumor lactic acidosis–transarterial chemoembolization. Based on conventional transarterial chemoembolization, the authors added a 5% sodium bicarbonate solution to cytotoxic drugs, resulting in a high local control rate. The explanation for the antitumor effects of sodium bicarbonate is related to acidosis in the tumor microenvironment. In this review, we summarize the findings from studies administering sodium bicarbonate alone or in combination with other anticancer therapies as cancer treatments, and discuss methods for safe and effective use of sodium bicarbonate in the clinic.
Langenskiöld Procedure for Treatment of Partial Growth Arrest of Distal Ulna After Septic Osteomyelitis: A Case Report
Authors: Yoshida Takashi , Oka Yoshinobu , Nishida Atsushi , Wada Hiroaki , Kim Wook-Cheol
Published: May 2020

Background: Although cases of impaired long bone growth due to bone and joint infections in childhood are sometimes reported, few cases of growth impairment of the ulna due to septic osteomyelitis have been described. We report herein a case of ulnar partial physeal arrest treated using the Langenskiöld procedure. Materials and Methods: A boy developed septic osteomyelitis of the right distal ulna at age 2 years 6 months. Osteomyelitis subsided after antibiotic treatment and external immobilization. As a result of impaired growth of the ulna along the long axis, shortening and trumpet-shaped deformity of the metaphysis gradually appeared. Computed tomography revealed a bony bridge, and premature epiphyseal closure due to osteomyelitis was diagnosed. The Langenskiöld procedure was performed at 4 years 4 months old. Results: As of 2 years 9 months later, no further ulnar shortening has occurred and morphological remodeling has been confirmed. Conclusions: The treatments employed for ulnar shortening include ulnar lengthening by callotasis as well as stapling of the distal radial epiphyseal line or radial shortening osteotomy. In this case, the Langenskiöld procedure proved effective because the patient was still young with growth potential and the area of the bony bridge after osteomyelitis-induced epiphyseal line damage was <30%.
From Policy Interest to Media Appearance: Interest Group Activity and Media Bias
Authors: Binderkrantz Anne Skorkjær , Halpin Darren R. , Pedersen Helene Helboe
Published: May 2020

Media attention is a scarce, yet attractive, resource for interest groups. Existing studies show that media attention is concentrated on a relatively small number of well-resourced groups, often representing economic interests. However, the literature still struggles to disentangle the reasons behind this bias in media attention. Is it explained by media selection practices or uneven interest group activity? We cannot separate these two possible mechanisms by simply studying aggregate levels of media attention. In this study, we therefore compare the set of groups that lobby in specific policy areas with the groups that appear in the news on issues related to those same policy areas. The investigation is based on data from Denmark and the United Kingdom. First, we use survey data to identify the policy areas in which groups actively lobby. Second, we identify groups’ media appearances in news stories related to those same policy areas. Third, we compare diversity among the groups actively lobbying with the groups actually appearing in the news and investigate possible biases. We find that even when the analysis of media appearances is narrowed down to only those groups active in a policy area, the news media allow more access to well-resourced groups. However, in contrast to previous findings, differences in media appearances across interest group types are not reproduced. These results imply that media selection biases are mainly produced by varying lobbying resources rather than discrimination based on the type of interests that groups represent.
Association of uncoupling protein (Ucp) gene polymorphisms with cardiometabolic diseases
Authors: Pravednikova Anna E. , Shevchenko Sergey Y. , Kerchev Victor V. , Skhirtladze Manana R. , Larina Svetlana N. , Kachaev Zaur M. , Egorov Alexander D. , Shidlovskii Yulii V.
Published: May 2020

The hereditary aspect of obesity is a major focus of modern medical genetics. The genetic background is known to determine a higher-than-average prevalence of obesity in certain regions, like Oceania. There is evidence that dysfunction of brown adipose tissue (BAT) may be a risk factor for obesity and type 2 diabetes (T2D). A significant number of studies in the field focus on the UCP family. TheUcpgenes code for electron transport carriers. UCP1 (thermogenin) is the most abundant protein of the UCP superfamily and is expressed in BAT, contributing to its capability of generating heat. Single nucleotide polymorphisms (SNPs) ofUcp1–Ucp3were recently associated with risk of cardiometabolic diseases. This review covers the mainUcpSNPs A–3826G, A–1766G, A–112C, Met229Leu, Ala64Thr (Ucp1), Ala55Val, G–866A (Ucp2), and C–55 T (Ucp3), which may be associated with the development of obesity, disturbance in lipid metabolism, T2D, and cardiovascular diseases.
Understanding the role of total knee arthroplasty for primary treatment of tibial plateau fracture: a systematic review of the literature
Authors: Wong Murray T. , Bourget-Murray Jonathan , Johnston Kelly , Desy Nicholas M.
Published: May 2020

Background

Surgical fixation of tibial plateau fracture in elderly patients with open reduction and internal fixation (ORIF) provides inferior outcomes compared with younger patients. Primary total knee arthroplasty (TKA) may be of benefit in elderly patients with a combination of osteoporotic bone and metaphyseal comminution. However, there continues to be conflicting evidence on the use of TKA for primary treatment of tibial plateau fracture. This systematic review was performed to quantify the outcomes and perioperative complication rates of TKA for primary treatment of tibial plateau fracture.

Materials and methods

A comprehensive search of MEDLINE, Embase, and PubMed databases from inception through March 2018 was performed in accordance with PRISMA guidelines. Two reviewers independently screened papers for inclusion and identified studies featuring perioperative complications and outcomes of primary TKA for tibial plateau fracture. Weighted means and standard deviations are presented for each outcome.

Results

Seven articles (105 patients) were eligible for inclusion. All-cause mortality was 4.75 ± 4.85%. The total complication rate was 15.2 ± 17.3%. Regarding outcomes, Knee Society scores were most commonly reported. The average Knee Society Knee Score was 85.6 ± 5.5, while the average Knee Society Function Score was 64.6 ± 13.7. Average range of motion at final follow-up was 107.5 ± 10.0°.

Conclusions

Primary TKA for select tibial plateau fractures has acceptable clinical outcomes but does not appear to be superior to ORIF. It may be appropriate to treat certain geriatric patients with TKA to allow for early mobilization and reduce the need for reoperation. Other factors may need to be considered in deciding the optimal treatment.

Level of evidence

Level III.
Role of angiotensin-converting enzyme in myeloid cell immune responses
Authors: Cao Duo-Yao , Saito Suguru , Veiras Luciana C. , Okwan-Duodu Derick , Bernstein Ellen A. , Giani Jorge F. , Bernstein Kenneth E. , Khan Zakir
Published: May 2020

Angiotensin-converting enzyme (ACE), a dicarboxypeptidase, plays a major role in the regulation of blood pressure by cleaving angiotensin I into angiotensin II (Ang II), a potent vasoconstrictor. Because of its wide substrate specificity and tissue distribution, ACE affects many diverse biological processes. In inflammatory diseases, including granuloma, atherosclerosis, chronic kidney disease and bacterial infection, ACE expression gets upregulated in immune cells, especially in myeloid cells. With increasing evidences connecting ACE functions to the pathogenesis of these acquired diseases, it is suggested that ACE plays a vital role in immune functions. Recent studies with mouse models of bacterial infection and tumor suggest that ACE plays an important role in the immune responses of myeloid cells. Inhibition of ACE suppresses neutrophil immune response to bacterial infection. In contrast, ACE overexpression in myeloid cells strongly induced bacterial and tumor resistance in mice. A detailed biochemical understanding of how ACE activates myeloid cells and which ACE peptide(s) (substrate or product) mediate these effects could lead to the development of novel therapies for boosting immunity against a variety of stimuli, including bacterial infection and tumor.
Design of high-oleic tobacco (Nicotiana tabacum L.) seed oil by CRISPR-Cas9-mediated knockout of NtFAD2–2
Authors: Tian Yinshuai , Chen Kai , Li Xiao , Zheng Yunpu , Chen Fang
Published: May 2020

Background

Tobacco seed oil could be used as an appropriate feedstock for biodiesel production. However, the high linoleic acid content of tobacco seed oil makes it susceptible to oxidation. Altering the fatty acid profile by increasing the content of oleic acid could improve the properties of biodiesel produced from tobacco seed oil.

Results

Four FAD2 genes, NtFAD2–1a, NtFAD2–1b, NtFAD2–2a, and NtFAD2–2b, were identified in allotetraploid tobacco genome. Phylogenetic analysis of protein sequences showed that NtFAD2–1a and NtFAD2–2a originated from N. tomentosiformis, while NtFAD2–1b and NtFAD2–2b from N. sylvestris. Expression analysis revealed that NtFAD2–2a and NtFAD2–2b transcripts were more abundant in developing seeds than in other tissues, while NtFAD2–1a and NtFAD2–1b showed low transcript levels in developing seed. Phylogenic analysis showed that NtFAD2–2a and NtFAD2–2b were seed-type FAD2 genes. Heterologous expression in yeast cells demonstrated that both NtFAD2–2a and NtFAD2–2b protein could introduce a double bond at the Δ12 position of fatty acid chain. The fatty acid profile analysis of tobacco fad2–2 mutant seeds derived from CRISPR-Cas9 edited plants showed dramatic increase of oleic acid content from 11% to over 79%, whereas linoleic acid decreased from 72 to 7%. In addition, the fatty acid composition of leaf was not affected in fad2–2 mutant plants.

Conclusion

Our data showed that knockout of seed-type FAD2 genes in tobacco could significantly increase the oleic acid content in seed oil. This research suggests that CRISPR-Cas9 system offers a rapid and highly efficient method in the tobacco seed lipid engineering programs.
Interleukin-6 is associated with acute concussion in military combat personnel
Authors: Edwards Katie A. , Gill Jessica M. , Pattinson Cassandra L. , Lai Chen , Brière Misha , Rogers Nicholas J. , Milhorn Denise , Elliot Jonathan , Carr Walter
Published: May 2020

Background

Concussion is the most common type of TBI, yet reliable objective measures related to these injuries and associated recovery processes remain elusive, especially in military personnel. The purpose of this study was to characterize the relationship between cytokines and recovery from acute brain injury in active duty service members. Inflammatory cytokines (IL-6, IL-10, and TNFα) were measured acutely in blood samples within 8 h following a medically diagnosed concussion and then 24 h later.

Methods

Participants (n = 94) were categorized into two groups: 1) military personnel who sustained provider-diagnosed concussion, without other major medical diagnosis (n = 45) and 2) healthy control participants in the same deployment environment who did not sustain concussion or other illness or injuries (n = 49). IL-6, IL-10, and TNFα concentrations were measured using an ultrasensitive single-molecule enzyme-linked immunosorbent assay. Differences in cytokine levels between concussed and healthy groups were evaluated at two time points (time point 1 ≤ 8 h after injury; time point 2 = 24 h following time point 1).

Results

At time point 1, IL-6 median (IQR) concentrations were 2.62 (3.62) in the concussed group, which was greater compared to IL-6 in the healthy control group (1.03 (0.90); U = 420.00, z = − 5.12, p < 0.001). Compared to healthy controls, the concussed group did not differ at time point 1 in IL-10 or TNFα concentrations (p’s > 0.05). At time point 2, no differences were detected between concussed and healthy controls for IL-6, IL-10, or TNFα (p’s > 0.05). The median difference between time points 1 and 2 were compared between the concussed and healthy control groups for IL-6, IL-10, and TNFα. Change in IL-6 across time was greater for the concussed group than healthy control (− 1.54 (3.12); U = 315.00, z = − 5.96, p < 0.001), with no differences between groups in the change of IL-10 or TNFα (p’s > 0.05).

Conclusion

Reported here is a significant elevation of IL-6 levels in concussed military personnel less than 8 h following injury. Future studies may examine acute and chronic neurological symptomology associated with inflammatory cytokine levels, distinguish individuals at high risk for developing neurological complications, and identify underlying biological pathways to mitigate inflammation and improve outcomes.
Efficacy of interventions for amblyopia: a systematic review and network meta-analysis
Authors: Li Yonghong , Sun Huan , Zhu Xiaojuan , Su Yana , Yu Tianqi , Wu Xinyu , Zhou Xiaoqin , Jing Li
Published: May 2020

Background

Many treatments are currently available for amblyopic patients; although, the comparative efficacy of these therapies is unclear. We conducted a systematic review and network meta-analysis (NMA) to establish the relative efficacy of these treatments for amblyopia.

Methods

Electronic databases (MEDLINE, EMBASE, Cochrane Library) were systematically searched from inception to Sep. 2019. Only Randomized clinical trials comparing any two or three of the following treatments were included: refractive correction (spectacles alone), patching of 2 h per day (patch 2H), patch 6H, patch 12H, patch 2H + near activities (N), patch 2H + distant activities (D), atropine (Atr) daily, Atr weekly, Atr weekly + plano lens over the sound eye (Plano), optical penalization and binocular therapy. The reviewers independently extracted the data according to the PRISMA guidelines; assessed study quality by Cochrane risk-of-bias tool for randomized trials. The primary outcome measure was the change in best-corrected visual acuity (BCVA) expressed as log MAR lines. Direct comparisons and a Bayesian meta-analysis were performed to synthesize data.

Results

Twenty-three studies with 3279 patients were included. In the network meta-analysis, optical penalization was the least effective of all the treatments for the change of visual acuity, spectacles (mean difference [MD], 2.9 Log MAR lines; 95% credibility interval [CrI], 1.8–4.0), patch 2H (MD, 3.3; 95% CrI, 2.3–4.3), patch 6H (MD, 3.6; 95% CrI, 2.6–4.6), patch 12H (MD, 3.4; 95% CrI, 2.3–4.5), patch 2H + N (MD, 3.7; 95% CrI, 2.5–5.0), patch 2H + D (MD, 3.5; 95% CrI, 2.1–5.0), Atr daily (MD, 3.2; 95% CrI, 2.2–4.3), Atr weekly (MD, 3.2; 95% CrI, 2.2–4.3), Atr weekly + Plano (MD, 3.7; 95% CrI, 2.7–4.7), binocular therapy (MD, 3.1; 95% CrI, 2.0–4.2). The patch 6H and patch 2H + N were better than spectacles ([MD, 0.73; 95% Crl, 0.10–1.40]; [MD, 0.84; 95% CrI, 0.19–1.50]).

Conclusions

The NMA indicated that the efficacy of the most of the examined treatment modalities for amblyopia were comparable, with no significant difference. Further high quality randomized controlled trials are required to determine their efficacy and acceptability.

Systematic review registration

CRD42019119843.
Impact of intravitreal aflibercept dosing regimens in treatment-naïve patients with neovascular age-related macular degeneration: 2-year results of RAINBOW
Authors: Weber Michel , Dominguez Marcel , Coscas Florence , Faure Céline , Baillif Stéphanie , Kodjikian Laurent , Cohen Salomon-Yves
Published: May 2020

Background

To review treatment outcomes from real-world data of patients with neovascular age-related macular degeneration (nAMD) treated with intravitreal aflibercept (IVT-AFL) injection.

Methods

RAINBOW (ClinicalTrials.gov, NCT02279537) is an ongoing, observational, 4-year study to monitor the effectiveness and safety of IVT-AFL in patients with nAMD in clinical practice in France. Treatment-naïve patients diagnosed with nAMD who had been prescribed IVT-AFL by their treating physician were eligible. The regimens of interest were regular treatment interval cohort (patients who received three initial monthly IVT-AFL injections followed by regular injections every 2 months) and two irregular treatment interval cohorts (with and without three initial monthly injections). Here we describe results at 24 months in patients according to IVT-AFL treatment regimen.

Results

The mean change in best-corrected visual acuity (BCVA) with IVT-AFL from baseline to 24 months was + 3.0 letters in the overall population (P < 0.05 vs baseline). The mean change was positive for the regular and irregular treatment interval cohorts with initial doses (+ 4.9 and + 4.0 letters, respectively; P < 0.05 vs baseline) and negative for the irregular treatment interval cohort without initial doses (− 2.5 letters; P = 0.365 vs baseline) at 24 months. The mean overall number of IVT-AFL injections over 12 and 24 months was 6.0 and 8.8, respectively. The most common ocular adverse events were lack of efficacy (6.3%), vitreous floaters (2.7%), and increased lacrimation (1.7%).

Conclusions

In the real-world RAINBOW study, visual outcomes observed at 24 months were consistent with results from the primary endpoint at 12 months. In this study, treatment-naïve patients who received three initial IVT-AFL doses and regular IVT-AFL treatment over the first 24 months experienced better visual outcomes than patients who received no initial doses and an irregular treatment regimen.

Trial registration

www.ClinicalTrials.gov (NCT02279537). Registered 29 October 2014.
Exploring assessor cognition as a source of score variability in a performance assessment of practice-based competencies
Authors: Roduta Roberts Mary , Cook Megan , Chao Iris C. I.
Published: May 2020

Background

A common feature of performance assessments is the use of human assessors to render judgements on student performance. From a measurement perspective, variability among assessors when assessing students may be viewed as a concern because it negatively impacts score reliability and validity. However, from a contextual perspective, variability among assessors is considered both meaningful and expected. A qualitative examination of assessor cognition when assessing student performance can assist in exploring what components are amenable to improvement through enhanced rater training, and the extent of variability when viewing assessors as contributing their individual expertise. Therefore, the purpose of this study was to explore assessor cognition as a source of score variability in a performance assessment of practice-based competencies.

Method

A mixed-method sequential explanatory study design was used where findings from the qualitative strand assisted in the interpretation of results from the quantitative strand. Scores from one objective structured clinical examination (OSCE) were obtained for 95 occupational therapy students. Two Generalizability studies were conducted to examine the relative contribution of assessors as a source of score variability and to estimate the reliability of domain and holistic scores. Think-aloud interviews were conducted with eight participants assessing a subset of student performances from the OSCE in which they participated. Findings from the analysis of think-aloud data and consideration of assessors’ background characteristics were used to assist in the interpretation of variance component estimates involving assessors, and score reliability.

Results

Results from two generalizability analyses indicated the highest-order interaction-error term involving assessors accounted for the second-highest proportion of variance, after student variation. Score reliability was higher in the holistic vs. analytic scoring framework. Verbal analysis of assessors' think-aloud interviews provided evidential support for the quantitative results.

Conclusions

This study provides insight into the nature and extent of assessor variability during a performance assessment of practice-based competencies. Study findings are interpretable from the measurement and contextual perspectives on assessor cognition. An integrated understanding is important to elucidate the meaning underlying the numerical score because the defensibility of inferences made about students’ proficiencies rely on score quality, which in turn relies on expert judgements.