bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of ADHD and Its Comorbidities in a Population-Based Sample
Authors: Mohammadi Mohammad-Reza , Zarafshan Hadi , Khaleghi Ali , Ahmadi Nastaran , Hooshyari Zahra , Mostafavi Seyed-Ali , Ahmadi Ameneh , Alavi Seyyed-Salman , Shakiba Alia , Salmanian Maryam
Published: December 2019

Objective: We aimed to investigate the prevalence of ADHD and its comorbidities and some associated demographic factors in a large sample population-based study. Method: As part of a population-based survey among 30,532 children and adolescents between 6 and 18 years, we used K-SADS-PL to screen and detect ADHD and its comorbidities. Results: The prevalence of ADHD was 4%, with more prevalence among boys (5.2% vs. 2.7%), younger participants, urban residents, and offspring of mothers who had a history of psychiatric hospitalization. Anxiety disorders (37.9%) and behavioral disorders (31%) are the most prevalent group of comorbidities, and oppositional defiant disorder (ODD) is the most prevalent comorbid disorder (26.1%). Mood disorders and anxiety disorders are more common among girls, but conduct disorder has a higher rate among boys. Conclusion: ADHD is a common neurodevelopmental disorder which is accompanied by several comorbid conditions. The high rate of comorbidities makes it complicated and difficult to manage.
Controlled, non-inferiority trial of bupivacaine liposome injectable suspension
Authors: Gordon-Evans Wanda J , Suh Hanah Y , Guedes Alonso G
Published: December 2019

Objectives

Recently, a bupivacaine liposome injectable suspension (BLIS) became commercially available in the veterinary market that may provide local analgesia for 72 h. The purpose of this study was to compare a BLIS incisional block with a control protocol in cats after ovariohysterectomy (OHE). The hypothesis was that a BLIS block would provide equivalent pain relief.

Methods

This study was designed as a randomized, double-blind, non-inferiority trial. Students performed an OHE followed by a two-layer incisional and body wall block with either standard bupivacaine (control) or BLIS. Postoperatively, cats in the control group received robenacoxib, whereas the BLIS cats received saline. All cats were evaluated using the feline Glasgow Composite Measure Pain Scale (GCMPS) at multiple time points postoperatively.

Results

There were 24 control cats and 23 BLIS cats. One cat from each group required rescue medication. The mean GCMPS scores were low and the groups were equivalent at all time points ( P <0.05). This study showed that BLIS was equivalent to the control group up to 42 h and pain scores remained low up to 68 h after surgery.

Conclusions and relevance

BLIS incisional block is equivalent to a control pain protocol and reduces the need for continued postoperative drug administration.
Relevance of Sex and Subtype in Patients With IBS: An Exploratory Study of Gene Expression
Authors: Weaver Kristen R. , Melkus Gail D’Eramo , Fletcher Jason , Henderson Wendy A.
Published: December 2019

Background:

Psychological state, stress level, and gastrointestinal function are intricately related and relevant to symptom exacerbation in patients with irritable bowel syndrome (IBS), but genetic contributors to this brain–gut connection are not fully understood. The purpose of this exploratory study was to compare gene expression in participants with IBS to that of healthy controls (HC) and to examine patterns of expression in participants with IBS by sex and IBS subtype.

Method:

Participants were recruited to an ongoing protocol at the National Institutes of Health. Differences in demographic and clinical characteristics were assessed using descriptive statistics and Mann–Whitney U tests. Expression levels of 84 genes were evaluated in peripheral whole blood using Custom RT2 Profiler polymerase chain reaction (PCR) Arrays, and data analysis was performed through GeneGlobe Data Analysis Center.

Results:

Participants with IBS ( n = 27) reported greater levels of perceived stress ( p = .037) and differed in expression values of ±2 for the genes ADIPOR1, ADIPOR2, CNR2, COMT, OXTR, and PPARA compared to HC ( n = 43). Further analyses by sex and IBS subtype revealed differential patterns of gene expression related to the endocannabinoid system, cytokines, stress, and sex steroid hormones.

Conclusions:

Diverse yet interconnected processes such as metabolism, inflammation, immunity, social behavior, and pain are associated with differences in gene expression between participants with IBS and HC. These findings lend support for genomic associations with the brain–gut connection in patients with IBS and highlight the relevance of sex and IBS subtype in performing such analyses.
Variability of pelvic axial rotation in patients undergoing total hip arthroplasty
Authors: Premkumar Ajay , Almeida Bryan , Ranawat Chitranjan S , Jerabek Seth A , Esposito Christina I , Mayman David J
Published: December 2019

Background:

Pelvic axial rotation affects the functional orientation of an acetabular component. Every 1° of axial rotation changes functional acetabular anteversion by 1°. There is limited information on pelvic rotation in THA patients, since it is difficult to measure on routine radiographs. Therefore, we used spine-to-ankle biplanar radiography to investigate variability in pelvic rotation in patients before and after THA.

Methods:

In 156 patients undergoing primary unilateral THA, we measured preoperative, 6 weeks and 1 year postoperative pelvic rotation in both standing and sitting positions using a biplanar radiography system. Patients with fixed pelvic rotation had a similar magnitude and direction of pelvic rotation in all standing or sitting images. We further identified patients with position-independent or position-dependent fixed pelvic rotation.

Results:

Pelvic rotation was common in THA patients, with 82 patients (53% of 156 patients) having at least 1 image with > 7° of rotational deformity. 12 patients (8% of 156 patients) had fixed rotation, 6 patients (4%) had position-independent fixed axial rotation and 6 patients (4%) had position-dependent fixed axial rotation.

Conclusions:

It may be important to recognise whether a THA patient has a fixed pelvic axial rotational deformity, where 1 hip is consistently forward or backward in functional imaging. Fixed rotation will increase or decrease the functional anteversion of an acetabular component depending on THA side. Further research might better characterise associations and predictors of fixed axial rotation and its impact on patient outcomes after THA.
Safety and efficacy of autologous hematopoietic stem cell transplantation for multiple sclerosis in Norway
Authors: Kvistad Silje Agnethe Stokke , Lehmann Anne Kristine , Trovik Linn Hereide , Kristoffersen Einar Klæbo , Bø Lars , Myhr Kjell-Morten , Torkildsen Øivind
Published: December 2019

Background:

Hematopoietic stem cell treatment (HSCT) is a promising treatment option for multiple sclerosis (MS), but detailed safety and efficacy measures are still scarce.

Objective:

To evaluate the efficacy and safety of HSCT in MS.

Methods:

Retrospective single-center observational study of all MS patients that underwent HSCT in Norway during January 2015 to January 2018. The primary outcome was no evidence of disease activity (NEDA-3) status.

Results:

A total of 30 patients with a median follow-up time of 26 months (range: 11–48) were evaluated. In total, 25 (83%) achieved NEDA-3 status, and none received disease-modifying treatment after HSCT. For 13 (43%) of the patients, there were sustained improvement in Expanded Disability Status Scale (EDSS) score, and 10 (33%) were working full time after the treatment, compared to only 1 (3%) before treatment. There were no serious treatment-related complications and was no mortality. Five patients (17%) were diagnosed with an autoimmune thyroid disease after the procedure, and 10 (43%) of the women had amenorrhea lasting >12 months and symptoms of ovarian failure.

Conclusion:

HSCT in MS is an effective and relatively safe treatment option, with few serious complications and no mortality in Norway, so far. However, long-term adverse event with amenorrhea is a common problem.
The right to minimum subsistence and property protection under the ECHR: Never the twain shall meet?
Authors: Leijten Ingrid
Published: December 2019

This article discusses recent developments concerning the right to minimum subsistence as a matter of property protection under the European Convention on Human Rights. It starts with two recent cases: Bélané Nagy v. Hungary and Baczúr v. Hungary. In its judgments in these cases, the European Court of Human Rights emphasised that, in determining whether an interference with a benefit is proportional, an important consideration is whether the individual still receives a subsistence minimum. It moreover held that a right to a (minimum) benefit can exist even if the conditions for receiving this benefit have not been met. Read together, Bélané Nagy and Baczúr flag an increasingly social interpretation of the property right enshrined in Article 1 of the First Protocol to the ECHR involving positive obligations and a focus on the neediest. On a closer look, however, the Court’s interpretation is not a very straightforward one. Judgments rendered after Bélané Nagy and Baczúr show that, although there is a clear trend to protect claimants’ means of subsistence, the relationship between property and a right to such means remains opaque, and the potential of a property right to guarantee the latter, limited. In this article, I present the recent case law against the background of the increasing significance of Article 1 P1 in the field of social security as well as the obstacles to protecting a subsistence minimum. I will delineate the questions that promise to haunt the Court in the cases to come and explore some of the answers it could formulate in this regard. It is argued that a positive right to a subsistence minimum is, for various reasons, unlikely to be developed as a matter of property protection under the Convention.
Understanding Bismarck’s legacy: The role of work history in Belgian social security law
Authors: Werbrouck Jakob
Published: December 2019

This article examines the role that work history plays in income replacement social security benefits in Belgium. The central premise is that, due to the Bismarckian origins of Belgian social security, work history is a concept that is structurally at the core of this system. However, the fact that this element is, from a legal perspective, considered to be self-evident and a prerequisite for the functioning of social security, should not preclude us from exploring its contingent nature. The article argues that the way in which work history is expressed in the laws governing different social security benefits can sometimes create or perpetuate a certain state of affairs, based on an underlying value judgement. In this sense, work history supersedes the mere technical or neutral character that can be attributed to it, and in fact functions as an implicit or explicit policy tool to help model social security in a particular way
Overview of recent cases before the Court of Justice of the European Union (July 2019-September 2019)
Authors: van der Mei Anne Pieter
Published: December 2019

In the reporting period July-September 2019, the Court of Justice of the European Union delivered various rulings that are significant for social security. The ruling that stands out is the one in Van den Berg and others, which concerned the power of a non-competent Member State to grant residents benefits where they lack insurance cover in the competent State. The other cases included in this overview concern the application of the right to equal treatment to social security conventions concluded between a Member State and a third country ( EU), the retention of the status of self-employed person by women who cease to be active due to pregnancy ( Dakneviciute) and the right to export student financial aid ( Aubriet).
Failure of talc seromadesis for the treatment of subcutaneous chronic seromas after incisional hernia surgery
Authors: Lopez-Monclus J. , Artes M. , Gonzalez J. , Blazquez L. A. , Lucena J. L. , Robin A. , Munoz J. M. , San-Miguel C. , Garcia-Urena M. A.
Published: December 2019

Background and Aim:

Talc poudrage has been used since many years for sclerosing chronic pleural effusion. Several reports have shown good results managing chronic seromas after breast, vascular, and incisional hernia surgeries. The purpose of this study is to determine the utility of talc seromadesis for the management of chronic seromas after incisional hernia surgery

Materials and Methods:

Multicentric prospective observational study including patients diagnosed of chronic seromas after incisional hernia surgery. Under local anesthesia and ultrasonographic control, two percutaneous trocars were placed in the seroma, washing the seroma cavity with 0.9% saline solution and aspirating the remaining liquid. A sample of 4 g of talcum powder was introduced in the seroma cavity, and a 15-F drain was left in place. Patients were followed each week during at least 4 weeks after drainage removal.

Results:

Between January 2013 and December 2016, a total of six patients were enrolled in the study. Talc poudrage was performed without any complications. Drains were pulled out in a mean time of 3 (range: 2–4) weeks. One case of the chronic seromas was efficiently sclerosed with talc without recurrence in time. In three cases, the seroma recurred, and the final solution was surgical decortication of the seroma. In the other two cases, seroma also recurred and were managed with instillation of ethanol and iodine povidone.

Conclusion:

In our experience, the management of chronic seromas after incisional hernia repair with talc seromadesis is ineffective and is associated with a high rate of seroma recurrence.
Dark Triad Traits and Mate Retention Behaviors in Romantic Couples: The Actor–Partner Interdependence Model
Authors: Kardum Igor , Hudek-Knezevic Jasna , Mehic Nermina
Published: December 2019

By using actor–partner interdependence modeling (APIM), we examined the effects of the Dark Triad traits, psychopathy, narcissism, and Machiavellianism on two mate retention (MR) domains, cost-inflicting (C-I B) and benefit-provisioning behaviors (B-P B) as well as overall mate retention (OMR) on the sample of 100 heterosexual romantic couples. These effects were examined first without and then with the control of the overlap between the traits. The results show that actor effects of the Dark Triad traits on MR were stronger in men, and regarding partner effects, the Dark Triad traits in men exerted more frequent MR in women than women’s Dark Triad traits in men. In line with our prediction, psychopathy had the strongest actor and partner effects on MR behaviors, both in men and women. Considering MR domains, we found actor effects on C-I B only in men, whereas actor effects on B-P B in both men and women. The Dark Triad traits, especially in men, exerted stronger partner effects on C-I B than on B-P B domain. Almost all actor and partner effects of psychopathy and narcissism remained significant after the control for the overlap between the traits, whereas all actor effects of Machiavellianism became nonsignificant. In both sets of analyses, without and with the control for the overlap between these traits, the most frequent plausible dyadic patterns were actor-only and couple pattern.
Cervical Microbiome and Response to a Human Papillomavirus Therapeutic Vaccine for Treating High-Grade Cervical Squamous Intraepithelial Lesion
Authors: Ravilla Rahul , Coleman Hannah N. , Chow Cheryl-Emiliane , Chan Luisa , Fuhrman Barbara J. , Greenfield William W. , Robeson Michael Scott , Iverson Kathryn , Spencer Horace , Nakagawa Mayumi
Published: December 2019

Human papillomavirus (HPV) infection is associated with the vast majority of cervical cancer cases as well as with other anogenital cancers. PepCan is an investigational HPV therapeutic vaccine for treating cervical high-grade squamous intraepithelial lesions. The present study was performed to test whether the cervical microbiome influences vaccine responses and to explore host factors as determinants of the cervical microbiome composition in women with biopsy-proven high-grade squamous intraepithelial lesions. In a recently completed Phase I clinical trial of PepCan, histological response rate of 45% (14 of 31 patients), a significant increase in circulating T-helper type 1 cells, and a significant decrease in HPV 16 viral load were reported. DNA, extracted from liquid cytology specimens collected before and after vaccinations, were amplified and then hybridized to a G4 PhyloChip assay to characterize the microbiome. We describe trends that certain bacterial taxa in the cervix may be enriched in non-responders in comparison to responders ( Padj = .052 for phylum Caldithrix and Padj = .059 for phylum Nitrospirae). There was no difference in bacterial diversity between the 2 groups. A permutational analysis of variance performed for various demographic and immune parameters showed significant clustering with microbiome beta diversity for race, HPV 16 status, peripheral T-helper type 1 cells, and HLA-B40 ( P = .001, .014, .037, and .024, respectively). Further analyses showed significant differences at the empirical Operational Taxonomic Unit level for race and HPV 16 status. As these results are from a small Phase I study, further studies are needed to examine the role of cervical microbiome in response to HPV therapeutic vaccines.
Analysis for time-dependent flow of Carreau nanofluid over an accelerating surface with gyrotactic microorganisms: Model for extrusion systems
Authors: Khan Sami Ullah , Shehzad Sabir Ali
Published: December 2019

Recent progress in nanotechnology and nanoscience has attended the researchers’ interest due to its inspiring industrial and technological applications. This contribution investigates the bioconvection flow of Carreau fluid over a periodically moving stretched surface with important feature of magnetic field and thermal radiation. Bioconvection in non-Newtonian nanofluid is utilized with sustaining the joint features of buoyancy and magnetic forces. In addition, thermal radiation consequences are summarized in the energy equation while further computations have been operated under “one parametric approach.” The attended problem is contested with a famous convergent technique having excellent accuracy. A comprehensive graphical approach is constituted to describe the thermo-physical features of interesting physical parameters. The reported results may use in enhancement of extrusion system, bio-fuels, and biotechnology.
An ‘existential threat’ or a ‘past pariah’: Securitisation of Iran and disagreements among American press
Authors: Amin Forough
Published: December 2019

The goal I pursue in this study is to explain the constitutive function of the newspapers’ opinion discourses from the perspective of securitisation theory. I discuss how the opinion articles and editorial collected from The New York Times, The Wall Street Journal, USA Today and New York Post constructed the social reality (the Iran nuclear programme and deal) differently, as a result of their differing political ideologies, and sought to influence American foreign policy in line with their interests. Integrating securitisation theory with CDS, I investigated three types of discursive strategies ( representational, dialogical and argumentative strategies) employed by these articles and discussed their contribution to the construction of elements of securitisation. The findings showed that American newspapers’ commentary articles systematically securitised Iran (but sometimes desecuritised its nuclear programme).1
Case report: Physiological changes due to a rapid ascent from 55 metres underwater
Authors: Homsy Michele , Bounds Catherine , Glover Mark , Castledine Benjamin , Martindale Timothy
Published: December 2019

We present the case of a diver who experienced an uncontrolled ascent from 55 m and presented with a severe decompression illness. She was clinically shocked and in multi organ failure due to massive fluid shifts. She demonstrated bilateral lower limb loss of power and sensation and required multiple hyperbaric therapy sessions. With joint critical care, hyperbaric and physical therapy involvement, she was discharged some five weeks after her presentation with an independent level of function.
Promoting the health of children and young people who migrate: reflections from four regional reviews
Authors: Thompson Jill , Fairbrother Hannah , Spencer Grace , Curtis Penny , Fouche Christa , Hoare Karen , Hogan Deirdre , O’Riordan Jacqui , Salami Bukola , Smith Melody , Taylor Bethany , Whitakker Victoria
Published: December 2019

Calls to enhance the health of migrant population sub-groups are strengthening, with increasing evidence documenting the relationship between migration and health outcomes. Despite the importance of migration to global health promotion, little research has focused on the health experiences of young migrants. As part of a Worldwide University Network project, we completed four systematic reviews examining the existing evidence base on the health experiences of children and young people who migrate. In this commentary, we share commonalities with the international evidence but also reflect on some of the challenges, omissions and limitations. These insights expose significant gaps and methodological shortcomings in the evidence – providing space for new research that seeks to identify the influences on migrant children’s health.
Zinc oxide nanoparticles from microwave-assisted solvothermal process: Photocatalytic performance and use for wood protection against xylophagous fungus
Authors: de Peres Matheus Lemos , Delucis Rafael de Avila , Amico Sandro Campos , Gatto Darci Alberto
Published: December 2019

Nano- and micro-oxides are promising materials due to several interesting characteristics such as photocatalytic and antimicrobial role. In this work, zinc oxide nanorods were obtained by microwave-assisted solvothermal process and their photocatalytic performance and action for wood protection against wood-decay fungus was studied. The morphological (scanning electron microscopy and transmission electron microscopy analyses), microstructural (X-ray powder diffraction analysis) and chemical (infrared spectroscopy) characteristics of the oxide-based nanostructures were investigated. Moreover, photocatalytic performance was evaluated using methylene blue and methyl orange. The nanostructured zinc oxide was impregnated to pinewood samples at 1–5% content and tested for decay resistance using a white-rot fungus. Zinc oxide nanorods agglomerated as urchin-like structures presented high crystallinity, high purity, and high photocatalytic activity. Zinc oxide impregnation was effective in improving pinewood decay resistance, yielding similar protection compared to traditional wood preservative.
Are Repeated Cycles of Intravenous Immunoglobulin Justified in Patients With Poorly Responsive Guillain-Barré Syndrome?
Authors: Algahtani Hussein , Shirah Bader , Alrefaei Khalid , Albassam Mohammed , Abdelghaffar Nawal
Published: December 2019

Guillain-Barré syndrome (GBS) is a life-threatening form of inflammatory polyneuropathy. Immunotherapy with intravenous immunoglobulin (IVIG) has been used successfully in the treatment of GBS. In this case report, we present a severe axonal form of GBS that showed improvement after 3 cycles of IVIG. Repeated cycles of IVIG may be an option for treating severe forms of GBS not responding to the first course of such treatment. The recent work suggests that patients who are severely affected and have severe gadolinium enhancement on the magnetic resonance imaging of the spine should be considered for retreatment with IVIG. Although the cost of management was high, the outcome was excellent, which is definitely considered a reasonable approach. This case report is an urgent call for performing large multicenter trials on the use of repeated cycles of IVIG in the management of severe cases of GBS.
CREB depletion in smooth muscle cells promotes medial thickening, adventitial fibrosis and elicits pulmonary hypertension
Authors: Garat Chrystelle V. , Majka Susan M. , Sullivan Timothy M. , Crossno Joseph T. , Reusch Jane E.B. , Klemm Dwight J.
Published: December 2019

Levels of the cAMP‐responsive transcription factor, CREB, are reduced in medial smooth muscle cells in remodeled pulmonary arteries from hypertensive calves and rats with chronic hypoxia‐induced pulmonary hypertension. Here, we show that chronic hypoxia fails to promote CREB depletion in pulmonary artery smooth muscle cells or elicit significant remodeling of the pulmonary arteries in mice, suggesting that sustained CREB expression prevents hypoxia‐induced pulmonary artery remodeling. This hypothesis was tested by generating mice, in which CREB was ablated in smooth muscle cells. Loss of CREB in smooth muscle cells stimulated pulmonary artery thickening, right ventricular hypertrophy, profound adventitial collagen deposition, recruitment of myeloid cells to the adventitia, and elevated right ventricular systolic pressure without exposure to chronic hypoxia. Isolated murine CREB‐null smooth muscle cells exhibited serum‐independent proliferation and hypertrophy in vitro and medium conditioned by CREB‐null smooth muscle cells stimulated proliferation and expression of extracellular matrix proteins by adventitial fibroblasts. We conclude that CREB governs the pathologic switch from homeostatic, quiescent smooth muscle cells to proliferative, synthetic cells that drive arterial remodeling contributing to the development or pulmonary hypertension.
Natural disaster and political trust: A natural experiment study of the impact of the Wenchuan earthquake
Authors: You Yu , Huang Yifan , Zhuang Yuyi
Published: December 2019

How do natural disasters impact political trust in contemporary China and what is the causal mechanism? Existing literature indicates that the severity of disaster, government relief effort and information dissemination are three key factors influencing people’s political trust in the context of acute natural disasters. This study uses the Wenchuan earthquake as a natural experiment and focuses specifically on the survey data collected right before and after the earthquake. It finds that primarily due to the ‘rally round the flag’ effect and extensive media coverage, public trust in government officials at all levels rose significantly after the earthquake. During the crisis, state-run media played a vital intermediate role. The more a citizen was exposed to the official media coverage, the more likely his/her political trust was to increase. However, the division of work in disaster relief among different levels of government resulted in differences in the level of increase in trust. As local-level governments are often directly responsible for the rescue and post-earthquake relief, they gained the highest increase in political trust, while state-level officials gained the least. The short-run upsurge in political trust receded as time went by. Government mobilization and media coverage are core contributing factors to the increase in political trust during the post-disaster period. Nevertheless, the key to consolidating political legitimacy lies in long-term efforts to build good and effective governance.
Does Immigration Affect Space Identity? Kastamonu Cumhuriyet Square Sample
Authors: Belkayali Nur , Ayan Çeven Elif
Published: December 2019

Humans change places voluntarily or involuntarily because of many factors, such as life struggle, wars, and diseases. The most intense city environments in which these translocations are observed are cities where many native and foreign individuals1 settle with the purposes of job, education, sheltering, and protection. Today, as in many cities of Turkey, it can be observed that the population of neighboring countries’ citizens in Kastamonu is increasing, mostly for educational purposes. The purpose of this study is to determine the effect of cultural differences that especially take place due to migration on the use of public open space. Since squares are the vital points of cities, can be accessed easily by everyone, appeal to everyone, provide opportunity to socializing and they are the democratic environments that symbolize the culture of the city, they were considered to be the public open space which can define the effect of cultural differences in the use of public space the best and in this context Cumhuriyet Square was chosen as the study area which has an important place in the history of the city. In accordance with the aim of the study, the intended use of the square by foreign individuals from different cultures was determined, and therefore, it was aimed to reveal in what way the square was affected by this movement of migration. In the scope of the study, observations were made with area studies, and also 170 questionnaire studies were conducted with the users of the area. As a result of the study, a statistically significant difference was determined between the intended use of the Cumhuriyet Square, which has an important value for the identity of the city, by the local people and foreign individuals. It is required for foreign individuals to socialize with the local people in relation to adopting the space by improving their sense of belonging to prevent the identity of the space to be affected negatively and to create a common value on the emergence of a common culture, and it is considered that the most appropriate place for these values to emerge is squares which are one of the public open spaces.
Performance After Operative Versus Nonoperative Management of Shoulder Instability in the National Basketball Association
Authors: Li Neill Y. , Lemme Nicholas J. , Defroda Steven F. , Nunez Elvis , Hartnett Davis A. , Owens Brett D.
Published: December 2019

Background:

Although nonoperative management after shoulder instability injury allows an athlete to return to play sooner than operative intervention, higher rates of recurrence have been observed after nonoperative management. However, no study has investigated the differences in performance of National Basketball Association (NBA) players after index shoulder instability events managed nonoperatively versus operatively.

Purpose/Hypothesis:

The purpose of this study was to identify shoulder instability events in NBA athletes and assess differences in performance after injury with nonoperative versus operative management. We hypothesized that players who undergo operative intervention have reduced risk of recurrence and are able to continue their elite level of play as opposed to those who undergo nonoperative management.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Publicly available injury data from the 1986-1987 through 2017-2018 seasons were reviewed to identify NBA athletes sustaining a shoulder instability event. In addition to characteristics, player performance information, including games played, player efficiency rating (PER), and win shares, was analyzed before and for 3 seasons after injury. Statistical learning models were applied to identify performance variables that have the greatest predictive value to determine players who would benefit from surgery.

Results:

A total of 60 players with shoulder instability events were identified between 1986 and 2018. After injury, 37 players (61.7%) eventually underwent surgery and 23 players (38.3%) did not. Players who were treated nonoperatively had significantly decreased PER, games played, and offensive win shares in the season after injury ( P < .05). Players who underwent surgery did not see a decline in PER, games played, or win shares. Random forest modeling found that true shooting percentage and win shares per 48 minutes were the performance variables most predictive in determining which players would benefit from surgery after shoulder instability.

Conclusion:

Players who underwent surgical intervention for shoulder instability maintained their PER, games played, and win share performance characteristics, whereas players who did not undergo surgery had declines in these parameters. Given the demands of shoulder function in basketball and the risk of recurrence after an instability event, surgery enhances a player’s opportunity to maintain a high level of performance after injury.
Reliability of Magnetic Resonance Imaging Prediction of Anterior Cruciate Ligament Autograft Size and Comparison of Radiologist and Orthopaedic Surgeon Predictions
Authors: Hanna Andrew , Hollnagel Katharine , Whitmer Kelley , John Christopher , Johnson Brent , Godin Jonathan , Miller Thomas
Published: December 2019

Background:

In anterior cruciate ligament (ACL) reconstruction, hamstring tendon autografts <8 mm have been associated with increased failure rates. There has been no established modality by which orthopaedic surgeons can preoperatively predict graft sizes.

Purpose/Hypothesis:

The purposes of this study were to (1) determine whether routine magnetic resonance imaging (MRI) measurement of hamstring tendon cross-sectional area (CSA) can reliably be used by sports medicine fellowship–trained orthopaedic surgeons to predict graft size and (2) determine whether radiologists and sports medicine surgeons are able to discriminate grafts below a predetermined cutoff value. We hypothesized that radiologists will find a correlation between MRI measurement and intraoperative graft size. Similarly, orthopaedic surgeons will be able to correctly estimate the graft size based on MRI measurement.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Included in this study were 30 consecutive patients (15 women and 15 men) (mean age, 23 years [range, 13-43 years]) for whom MRI-determined hamstring tendon CSA and graft size measurements could be compared. Patients were included if they had a preoperative MRI demonstrating acute ACL rupture and were scheduled with 1 of 3 surgeons for a reconstruction performed using the ST and GR tendons. Operative data were collected over 1 year. Sectra imaging software was used to measure the CSA of the semitendinosus (ST) and gracilis (GR) tendons on the preoperative MRIs. Control measurements were performed intraoperatively using a graft sizing block with 0.5-mm increments. Simple linear regression analysis was used to evaluate the ability of MRI measurements to predict autograft size. Logistic regression was used to determine the minimum CSA for a graft of 8 mm. The intraclass correlation coefficient (ICC) was used to evaluate interrater reliability.

Results:

MRI CSA measurement of the average STGR (ST CSA added to the GR CSA) was a significant predictor of graft size (adjusted R 2 = 0.186; P < .001). The 3 measurements with the strongest correlations with graft size were the ST at the medial femoral condyle (MFC), the STGR at the MFC, and the average STGR. The minimum CSA for the average STGR on MRI to achieve a graft size of 8 mm was 17.168 mm2 ( P < .001). The area under the receiver operating characteristic curve was 0.765. The overall ICC was 0.977.

Conclusion:

Routine preoperative MRI can be used by both radiologists and orthopaedic surgeons to predict the expected ACL autograft size and identify those below a cutoff of 8 mm. This will help in preoperative planning and graft selection.
Anatomy, Classification, and Management of Ankle Fractures Involving the Posterior Malleolar Fragment: A Literature Review
Authors: Bergman Christian , Morin Matthew , Lawson Kevin
Published: December 2019

The posterior malleolar fragment is frequently involved in rotational ankle fractures, but diagnosis and definitive management remains controversial. Ankle fractures with a posterior malleolar component that are not identified and treated in a timely manner may contribute significantly to future comorbidities, including continued pain, instability, and the development of arthritis. This article highlights the anatomic features of posterior malleolar ankle fractures, the classification schemes used, and discusses the various nonsurgical and surgical methods currently used.

Level of Evidence:

Level V, expert opinion.
Spirit hospitals and “concern with herbs”: A political ecology of healing and being-in-common in Ghana
Authors: Hausermann Heidi
Published: December 2019

Despite attention to the transformative capacities of “nonhumans” in both political ecology and commons scholarship, analyses remain limited to material realms, ignoring spiritual understandings. This article draws attention to the neglected domain of spirituality and being-in-common in the geographic study of health and disease. In Ghanaian healing contexts, spiritualists move between human and nonhuman domains to gain information and counter witchcraft, enlisting other material and spiritual entities in the process. Herbalists, by contrast, privilege botanical knowledge/practice over disease ontologies. All healers draw from therapeutic plants in assemblage with others (spirits, witches, ancestors, patients) and enact alternative economies. This research contributes to geographic scholarship in several ways. First, I integrate recent commons research into a political ecology of health framework with an eye on affective healing relations in material and spiritual realms. I draw from long-term ethnographic research and indigenous standpoints to understand spirituality in health contexts. Such integration leads to more robust and decolonial political ecologies of health and clearer understandings of how and why healing occurs.
Structural performance of frames with concrete-filled steel tubular columns and steel beams: Finite element approach
Authors: Ahmed Ahmed Dalaf , Güneyisi Esra Mete
Published: December 2019

Composite columns such as concrete-filled steel tube (CFST) were adopted in many building constructions in recent years because of carrying high loading with the ability to resist buckling and small cross-sectional area. The high behavior of the CFST columns is due to the interaction between steel and concrete which called the composite action. This type of composite column without main and tie reinforcements embedded in concrete gives high axial compression strength to resist the external loadings with the economic sectional area. The work presented in this article includes simulation models that tested by other researchers and a parametric study on the performance of frames that connected steel beam by composed columns of circular CFST that subjected to lateral loading. A finite element (FE) approach is adopted to simulate the models by ANSYS software. All models consider the linear and nonlinear material analysis of the concrete and steel. The validity of the developed model was examined by comparing with the experimental data founded in the literature. Different parameters such as the ratio of the axial load, the slenderness ratio of CFST column, the linear stiffness ratio of the beam–column, the steel yield strength of the beam, the steel yield strength of the tube, and concrete strength on the performance of the composite frames were also studied and the load-deformation performance was obtained over the different cases of the study. Analysis results by FE modeling were in good agreement with the experimental results.
Yarzhemskiite, K[B5O7(OH)2]⋅H2O, a new mineral from the Chelkar salt dome, Western Kazakhstan
Authors: Pekov Igor V. , Zubkova Natalia V. , Korotchenkova Oksana V. , Chaikovskiy Ilya I. , Yapaskurt Vasiliy O. , Chukanov Nikita V. , Belakovskiy Dmitry I. , Lykova Inna S. , Britvin Sergey N. , Pushcharovsky Dmitry Yu.
Published: December 2019

The new mineral yarzhemskiite, K[B5O7(OH)2]⋅H2O, was found in a halite–sylvite evaporite rock at the Chelkar salt dome, Western Kazakhstan Region, Kazakhstan. It is also associated with carnallite, polyhalite, gypsum, strontioginorite, satimolite and quartz. Yarzhemskiite occurs as separate thick tabular, short prismatic or equant crystals up to 0.5 mm × 0.7 mm × 1 mm and grains having irregular outlines up to 1 mm × 1.5 mm × 2 mm. The mineral is transparent, colourless, with vitreous lustre. It is brittle, the Mohs’ hardness is ca 2½. Cleavage is perfect on {100}. Dmeas is 2.13(1) and Dcalc is 2.112 g cm–3. Yarzhemskiite is optically biaxial (+), α = 1.484(2), β = 1.508(2), γ = 1.546(2), 2Vmeas = 75(10)° and 2Vcalc = 80°. Chemical composition (wt.%, electron microprobe, H2O was calculated by stoichiometry) is: Na2O 0.01, K2O 17.84, CaO 0.07, B2O3 67.21, H2Ocalc 13.91, total 99.04. The empirical formula based on 10 O atoms per formula unit is K0.98B5.005O7(OH)2⋅H2O. Yarzhemskiite is monoclinic, P21/c, a = 9.47340(18), b = 7.52030(16), c = 11.4205(2) Å, β = 97.3002(17)°, V = 807.03(3) Å3 and Z = 4. The strongest reflections of the powder XRD pattern [d,Å(I,%)(hkl)] are: 9.39(86)(100), 4.696(41)(200), 3.296(18)($\bar{1}$13), 3.130(19)(022, 300), 2.935(42)(220), 2.898(100)($\bar{3}$02, $\bar{2}$21, 310), 2.832(56)(004) and 1.867(18)($\bar{2}$25). The crystal structure was solved based on single-crystal X-ray diffraction data, R1 = 3.36%. The structure contains infinite chains built by boron-centred polyhedra. The basic structural unit of the chain is a double ring B5O7(OH)2 consisting of one BO4 tetrahedron and four BO3 triangles. K+ cations centre ten-fold polyhedra which form, together with the borate chains [B5O7(OH)2]–∝, layers linked with each other only via H bonds. The mineral is named in honour of the Russian geologist, petrologist and mineralogist Yakov Yakovlevich Yarzhemskii (1901–?), a specialist in petrology of evaporite rocks and mineralogy and genesis of boron deposits related to evaporites.
Cardiac self-efficacy and quality of life in patients with coronary heart disease: a cross-sectional study from Palestine
Authors: Barham Aya , Ibraheem Reem , Zyoud Sa’ed H.
Published: December 2019

Background

Psychological factors, such as self-efficacy, are important in understanding the progress and management of coronary heart disease (CHD), and how patients make lifestyle modifications to compensate for the disease. The main objectives of this research are to assess patterns of cardiac self-efficacy (CSE) and quality of life (QoL) among CHD patients, and to determine the factors that affect their QoL.

Methods

A cross-sectional descriptive correlational study was carried out between August 2016 and December 2016. We used a structured questionnaire completed by interviewers during face-to-face interviews with patients. Cardiac self-efficacy was evaluated using three scales: 1) the 5-item perceived efficacy in patient- physician interaction scale (PEPPI-5); 2) the self-efficacy for managing chronic diseases 6-item scale (SEMCD-6) and 3) Sullivan’s cardiac self-efficacy scale 13-items (SCSES). The 5-level version of the EuroQoL 5-dimensions questionnaire (EQ-5D-5 L), and Euroqol Visual Analogue Scale (EQ VAS) were used to evaluate health-related QoL (HRQoL) among CHD patients. Multiple binary logistic regression was carried out to evaluate the influence on the QoL score of demographic and medical characteristics, and self-efficacy factors.

Results

A total of 275 patients participated in our study. The patients’ mean age was 59.51 ± 1.005 years. The HRQoL was measured by the EQ-5D-5 L index score and EQ-VAS score; their means were 0.62 ± 0.16 and 57.44 ± 1.61, respectively. The QoL showed moderate positive correlations with the PEPPI-5 (r = 0.419; p-value < 0.001), SEMCD-6 (r = 0.419; p-value < 0.001), and SCSES score (r = 0.273; p-value < 0.001). Multiple binary logistic regression showed that only patients with higher PEPPI-5 score (odds ratio (OR) = 1.11; 95% confidence interval (CI) =1.01–1.22; p = 0.036), and higher SCSES score (OR = 1.10; 95% CI = 1.03–1.17; p = 0.004) were significantly associated with a high QoL score. Moreover, multiple binary logistic regression model showed that patients with higher numbers of medications (OR = 0.23; 95% CI = 0.07–0.78); p = 0.018) remained significantly associated with impaired QoL.

Conclusions

Lower levels of self-efficacy and poorer patient-physician interactions predicted poor HRQoL. Thus, health providers should be aware of these factors in CHD patients when trying to improve their QoL.
XEN® stent complications: a case series
Authors: Gupta Chandni , Mathews Divya
Published: December 2019

Background

XEN® gel stent (Allergan, Dublin/Republic of Ireland) is a relatively new microinvasive glaucoma device providing an ab-interno approach to the subconjunctival space for aqueous drainage and reduction of intraocular pressure. It is thought to be less invasive, reduce surgical time and post-operative infection rates compared with traditional glaucoma procedures. Little information however, has been published regarding complications and subsequent management.

Case presentation

The authors highlight five complicated cases of XEN® stent insertion, how they were managed and key learning points. Cases include: entire stent found at the bottom of the anterior chamber several months after uncomplicated insertion, stent broke into multiple pieces during manipulation within subconjunctiva, XEN45 stent migrated into the anterior chamber 7 months post-operatively and a case of limbal-based conjunctival dissection during open revision which lead to additional scarring around the stent and subsequent raised intraocular pressure.

Conclusions

We present some new and interesting complications of XEN implant as well as potential management options. This can assist clinical decision-making and enable better pre-operative discussions with patients regarding risks of surgery.
Case report: maple syrup urine disease with a novel DBT gene mutation
Authors: Feng Wei , Jia Jinfu , Guan Heyang , Tian Qing
Published: December 2019

Background

Maple syrup urine disease (MSUD) is a potentially life-threatening metabolic disorder caused by decreased activity of the branched-chain α-ketoacid dehydrogenase (BCKD) complex. Mutations in four genes (BCKDHA, BCKDHB, DLD and DBT) are associated with MSUD. Here, the presenting symptoms and clinical course of a case of MSUD with a novel DBT gene mutation are described.

Case presentation

We describe an infant with MSUD with the DBT gene mutation who had drowsiness and poor appetite as well as abnormal findings upon head magnetic resonance imaging (MRI), plasma amino acid analysis and urine organic acid analysis. Genetic testing revealed that both parents had the heterozygous mutation c.1132C > T (p.378X) in chr1:100672078, and the patient had the homozygous mutations c.1132C > T (p.378X) in chr1:100672078. Once diagnosed with MSUD, the patient’s disease was controlled with a diet of BCAA-free enteral formula and thiamine.

Conclusion

The mutation c.1132C > T (p.378X) is a novel DBT gene mutation that is associated with MSUD and always has mild clinical manifestations. After timely BCAA-free nutrition and supplementation with thiamine for the patient, the plasma levels of BCAAs reached a safe level, the abnormal range of the multiple intracranial abnormalities was significantly smaller than before, and the symptoms of drowsiness and poor appetite disappeared.