bluuebunny/crossref_metadata_2025 huggingface dataset:
The Mediating Effect of Motivation on Human Capital and Performance: A Study of Women Entrepreneurs in Meghalaya
Authors: Chyne Ridameka , Syngkon R. A. J.
Published: November 2021

The study empirically examines the impact of human capital on firm performance in the presence of motivation as a mediating variable. The study is conducted in Meghalaya, in the context of women-owned enterprises, in one of the largest surviving matrilineal cultures in the world found in the north-eastern part of India. Path model has been employed in this study to show the impact of human capital (measured by work experience) on firm performance (measured by growth rate of last five years’ sales) using motivation (measured as total motivation), combining pull and push factors, as the mediating variable. Using self-administered questionnaires, data was captured from 150 first-generation women entrepreneurs in the manufacturing and service sectors. The results show that the direct and indirect impact of human capital on firm performance are positive and significant. The results also indicate that motivation plays a significant role in mediating the relationship between human capital and firm performance. This study was undertaken using a small sample in the three districts of Meghalaya. However, the findings will sensitise and inform business support agents, banks, advisors, academicians and policymakers who rely on data on entrepreneur’s human capital and motivations for decision making.
Entrepreneurial Learning and Microcredit as Triggers of Micro-entrepreneurship in India
Authors: Prathap Sangeetha K. , Sreelakshmi C. C.
Published: November 2021

This article evaluates whether contextual triggers lead to entrepreneurial behaviour among microfinance clients in India. The study identifies entrepreneurial training and microcredit as the contextual triggers that can be effective in creating entrepreneurial intentions and behaviour, respectively. Acquired learning helps to develop capability in an individual to identify the business opportunities around him, which help in creating entrepreneurial intention that can promote action. Microenterprises among low-income clients are usually formed by the support mechanism of triggering events. Shapero’s entrepreneurial event (SEE) model is used to capture the effects of microenterprise trainings that create entrepreneurial learning, leading to entrepreneurial intention and behaviour. The study also extends to capture the effect of microcredit as a moderator in effecting entrepreneurial behaviour among microfinance clients. The study finds that learning outcomes are capable of generating entrepreneurial intentions in a microenterprise context through the construct of desirability. Further, access to microcredit results in entrepreneurial behaviour. The findings provide direction to the effectiveness of entrepreneurial learning derived from entrepreneurial training in creating entrepreneurial intention. It also reveals the significance of moderating role of microcredit that leads to entrepreneurship behaviour. Therefore, findings are useful for policymakers in promoting microenterprises among the microfinance clients to address the problem of poverty.
On sovereign bonds and marijuana: Comparing supremacy limits in the US and the EU
Authors: Moussa Mohamed
Published: November 2021

Against the background of the PSPP judgement, the article conducts an under-researched comparison of the German Court's recent judgement with incidents of defiance from American states’ legislatures. Particularly, it highlights the example of marijuana laws in the US where a handful of states managed to legislate de facto governing norms contrary to the federal ones. The article then examines the German Court's last decision on sovereign bonds to compare the underlying factors that facilitates European judicial defiance with those contributing to occasional state legislator resistance in the US. Comparison to the highly centralized US shows that defiance of supremacy cannot be eliminated, but its conducive factors can be controlled to ensure a functioning constitutional system. To do so, attention must be paid to popular, fiscal and political factors, rather than to exclusively legalistic ones.
Reproduction and Genetic Responsibility: An Interpretive Description of Reproductive Decision-Making for Young People With Li-Fraumeni Syndrome
Authors: Forbes Shepherd Rowan , Werner-Lin Allison , Keogh Louise A. , Delatycki Martin B. , Forrest Laura E.
Published: November 2021

The reproductive decision-making of young people (aged 15–39 years) with Li-Fraumeni syndrome (LFS), an early onset inherited cancer syndrome, has not been studied in depth. Using interpretive description methodology, we conducted semi-structured interviews with 30 young Australians (mean age 25.5 years) diagnosed with LFS or at 50% genetic risk. With reflexive thematic analysis, we show how young people’s reproductive decision-making and ideals for family formation were shaped by a sense of genetic responsibility to ensure the health of future biological kin. Reproductive technology provided choices for family formation in the context of LFS and also complicated reproductive decisions, as these choices were difficult to understand, make, or carry out. We uphold that reproductive decision-making when living with LFS is a profoundly moral practice that may pose significant challenges for young people navigating their formative years. We offer genetic counseling practice recommendations to support individuals with LFS when making reproductive decisions.
Response with pembrolizumab in a patient with EGFR mutated non-small cell lung cancer harbouring insertion mutations in V834L and L858R
Authors: Hadfield Matthew J. , Turshudzhyan Alla , Shalaby Khalid , Reddy Aswanth
Published: November 2021

Introduction

Lung cancer is the leading cause of cancer-related deaths with non-small cell lung cancer (NSCLC) being the most common of them. About a third of NSCLC cases have an epidermal growth factor (EGFR) mutation, which is usually susceptible to tyrosine kinase inhibitors (TKIs). In rare cases where patients progress through TKI therapy, the use of immune checkpoint inhibitors (ICIs) remains controversial.

Case report

We describe a case of a patient with significant history of smoking and EGFR mutated programmed death ligand-1 (PD-L1) positive NSCLC who was initially treated with TKI therapy.

Management/Outcome

While patient progressed on TKI therapy, he was able to achieve a durable response with a single PD-L1 agent, pembrolizumab. Contrary to the available evidence, the presented EGFR mutant NSCLC responded to PD-L1 pathway inhibition.

Discussion

From our observation Pembrolizumab could be promising in patients with rare EGFR mutations who do not respond to EGFR directed therapy. Our report provides supporting data for the use of immunotherapies in patients with EGFR mutated NSCLC.
Molecular detection of Hepatozoon species infections in domestic cats living in Germany
Authors: Schäfer Ingo , Kohn Barbara , Nijhof Ard M , Müller Elisabeth
Published: November 2021

Objectives

Three species of protozoal Hepatozoon species ( H felis, H canis and H silvestris) are known to infect cats in Europe. The objective of this study was to determine the prevalence of Hepatozoon species in samples from cats living in Germany that were submitted to a veterinary laboratory.

Methods

The study included cats tested for Hepatozoon species by PCR between 2007 and 2020 by the Laboklin laboratory. Travel history and haematological results were documented for cats with positive test results. From 2018 onwards, a partial 18S rRNA Hepatozoon gene fragment was sequenced from cats with positive PCR results.

Results

Sixty-four of 931 cats (7%) tested positive for Hepatozoon species. Sex and age did not have a statistically significant impact. Sequencing was carried out for 16 samples and revealed H felis in all cases. All cats with positive test results and a relevant travel history had been imported from the Mediterranean or south-eastern Europe. There were no autochthonous infections with Hepatozoon species. Leukocytosis, haemoconcentration and anaemia were the most common haematological abnormalities.

Conclusions and relevance

Although infections with Hepatozoon species in cats are usually subclinical, it may be useful to screen cats imported from the Mediterranean and south-eastern Europe for these pathogens to prevent local transmission cycles. There was no evidence of autochthonous infections in Germany; however, further investigations regarding a possible transmission of Hepatozoon species from infected cats to blood-feeding arthropods in Germany may be of interest. To avoid potential spread of the pathogens, ectoparasite prophylaxis is advisable.
Ethnic desegregation and ‘resegregation’ in northern English schools
Authors: Hussain Serena
Published: November 2021

This article discusses findings on inter- and intra-ethnic friendship choices among Pakistani, Bangladeshi and white students within three schools characterised by varying ethnic composition and levels of diversity. Although many participants perceived ethnically diverse schools positively, students commonly described the majority of their friends and, in particular, close friends, as belonging to the same ethnic group. Pakistani and Bangladeshi students, although often homogenised as South Asian within academic studies on school segregation, were far more conscious of their own and the others’ cultural distinction than discussed by literature on ethnic minority – and in particular – Muslim youth. The findings demonstrate how presenting ethnic minority concentrations as self-segregated or resegregated can mask the everyday realities of students, who navigate racism, whether subtle or explicit, and find safe and accepting spaces to express their ethnic identities. Through using students’ own accounts of negotiating such challenges, this article adds to our understanding of young peoples’ experiences of multi-ethnic school settings.
Impact of Baseline and Postprocedural Intravascular Ultrasound Findings on 1-Year Primary Patency After Drug-Coated Balloon Treatment of Femoropopliteal Lesions
Authors: Horie Kazunori , Tanaka Akiko , Taguri Masataka , Inoue Naoto
Published: November 2021

Purpose:

Drug-coated balloons (DCBs) are commonly used for endovascular treatment of femoropopliteal lesions. Here, we employed intravascular ultrasound (IVUS) to investigate the predictors of restenosis after DCB treatment.

Methods:

This retrospective and single-center study was performed to examine 1-year primary patency after DCB treatment and to identify the risk factors for restenosis by analyzing clinical characteristics, angiographic findings, and IVUS measurements. We included 111 consecutive patients undergoing DCB treatment for de novo femoropopliteal lesions at our hospital from July 2018 to March 2020.

Results:

The primary patency rate was found to be 80.0% at 1 year. The Cox proportional hazard multivariate analysis revealed that restenosis was independently associated with chronic total occlusion (CTO; p < 0.001), circumferential calcification (p = 0.023), and smaller postprocedural minimum lumen area (MLA; p = 0.036). Furthermore, receiver operating characteristic curve analysis showed that the cutoff value of postprocedural MLA to prevent restenosis was 12.7 mm2, with an area under the curve of 0.774 (p< 0.001). The multivariate analysis indicated that patients with a postprocedural MLA below 12.7 mm2 (n = 44) had a significantly smaller distal reference vessel size (p < 0.001) compared to those with a postprocedural MLA over 12.7 mm2 (n = 67).

Conclusions:

Restenosis after DCB treatment was shown to correlate with CTO, circumferential calcification, and postprocedural MLA as evaluated by IVUS. Moreover, smaller vessel sizes might represent a particular challenge to the DCB strategy due to the difficulty of restoring a sufficient postprocedural lumen area by balloon dilatation.
Comparison of Early and Mid-Term Outcomes After Fenestrated-Branched Endovascular Aortic Repair in Patients With or Without Prior Infrarenal Repair
Authors: D’Oria Mario , Budtz-Lilly Jacob , Lindstrom David , Lundberg Goran , Jonsson Magnus , Wanhainen Anders , Mani Kevin , Unosson Jon
Published: November 2021

Objective:

The purpose of this study was to compare short- and mid-term outcomes of fenestrated-branched endovascular repair (F-BEVAR) of pararenal (PRAA)/thoracoabdominal (TAAA) aortic aneurysms in patients with or without prior endovascular/open (EVAR/OAR) infrarenal aortic repair.

Methods:

Data from consecutive F-BEVAR (2010–2019) at two high-volume aortic centers were retrospectively reviewed. Primary endpoints were technical success, 30-day mortality, and overall survival. Secondary endpoints included 30-day major adverse events (MAE), freedom from type I/III endoleaks, reinterventions, sac expansion, and target vessel (TV) primary patency.

Results:

A total of 222 consecutive patients were included for analysis; of these 58 (26.1%) had prior infrarenal repair (EVAR=33, OAR=25) and 164 (73.9%) had native PRAA/TAAA. At baseline, patients with prior infrarenal repair were older (mean age=75.1 vs 71.6 years, p=.005) and the proportion of females was lower (8.6% vs 29.3%, p=.002). Technical success was 97.8% (n=217) in the entire cohort, without any significant differences between study groups (94.8% vs 98.8%, p=.08). At 30 days, there were no significant differences between patients with prior infrarenal repair as compared with those without in rate of MAE (44.8% vs 54.9%, p=.59). The 5-year estimate of survival for those who underwent native aortic repair was 61.6%, versus 61.3% for those who had a previous repair (p=.67). The 5-year freedom from endoleaks I/III estimates were significantly lower in patients who had prior infrarenal repair as compared with patients undergoing treatment of native aneurysms (57.1% vs 66.1%, p=.03), mainly owing to TV-related endoleaks (ie, type IC and/or IIIC endoleaks). No significant differences were found between study groups in rates of reinterventions and TV primary patency. Five-year estimates of freedom from sac increase >5mm were significantly lower in patients who received F-BEVAR after previous infrarenal repair as compared with those who underwent treatment of native aneurysms (48.6% vs 77.5%, p=.002).

Conclusions:

F-BEVAR is equally safe and feasible for treatment of patients with prior infrarenal repair as compared with those undergoing treatment for native aneurysms. Increased rates of TV-related endoleaks were observed which could lead to lower freedom from aneurysm sac shrinkage during follow-up. Nevertheless, the 5-year rates of reinterventions and TV patency were similar, thereby indicating that overall effectiveness of treatment remained satisfactory at mid-term.
Pediatric Orthopedic Trauma Care During the COVID-19 Pandemic: A Survey of the Pediatric Orthopedic Society of North America
Authors: Johnson Mitchell A. , Ganley Theodore J. , Crawford Lindsay , Swarup Ishaan
Published: November 2021

Background: The COVID-19 pandemic has dramatically altered the practice of pediatric orthopedic trauma surgery in both outpatient and inpatient settings. While significant declines in patient volume have been noted, the impact on surgeon decision-making is unclear. Purpose: We sought to investigate changes in pediatric orthopedic trauma care delivery as a result of COVID-19 and determine their implications for future orthopedic practice. Methods: An electronic survey was distributed to all members (N = 1515) of the Pediatric Orthopedic Society of North America (POSNA) in March to April 2021; only members who provided care for pediatric orthopedic trauma patients were asked to complete it. The survey included questions on hospital trauma call, inpatient care, outpatient clinic practice, and 3 unique fracture case scenarios. Results: A total of 147 pediatric orthopedic surgeons completed the survey, for a 9.7% response rate, with 134 (91%) taking trauma call at a hospital as part of their practice. Respondents reported significant differences across institutions regarding COVID-19 testing, hospital rounding, and employee COVID-19 screening. Changes in outpatient fracture management were observed, including a decreased number of follow-up visits for nondisplaced clavicle fractures, distal radius buckle fractures, and toddler’s fractures. Of respondents who changed their fracture follow-up schedules due to COVID-19, over 75% indicated that they would continue these outpatient treatment schedules after the pandemic. Conclusions: This survey found changes in pediatric orthopedic trauma care as a result of the COVID-19 pandemic. The use of telemedicine and abbreviated follow-up practices for common fracture types are likely to persist following the resolution of the COVID-19 pandemic.
Hematological Changes Following Low Dose Radiation Therapy and Comparison to Current Standard of Care Cancer Treatments
Authors: Jameus Alexandra , Kennedy Allison E. , Thome Christopher
Published: November 2021

Cancer is the second leading cause of mortality worldwide accounting for almost 10 million deaths in 2020. Current standard of care treatment varies depending on the type and stage of disease, but commonly includes surgery, chemotherapy, and/or radiation therapy. There is evidence that whole- and half-body exposure to low dose ionizing radiation can also be an effective therapeutic due to its stimulation of anti-cancer immunity. One of the limiting factors for past clinical trials using low dose radiation therapy has been adverse hematological events. However, similar hematological changes are also frequently reported following standard of care treatments in oncology. This review summarizes the effects of various cancer therapies on hematologic toxicity through the evaluation of complete blood count reports. The reviewed literature elucidates hematological trends in patients undergoing chemotherapy, and both high and low dose radiation therapy. In general, high dose radiation and chemotherapy can result in widespread changes in blood counts, with the most severe effects related to leukopenia. Overall, compared to standard of care treatments, low dose radiation results in similar, yet more mild hematological changes. Taken together, hematological toxicities should not be a limiting factor in the applicability of low dose radiation as a cancer therapeutic.
Entrapment of the index finger radial collateral ligament in the metacarpophalangeal joint: A case report
Authors: Jiang Eric X , Korn Michael A , King Elizabeth A , Holsbeeck Marnix van
Published: November 2021

Introduction

Digital collateral ligament injuries are common hand injuries that can cause significant pain and functional impairment. Ultrasonography can be useful in the evaluation of these ligamentous injuries, as it is both cost-effective and allows for easy, dynamic evaluation during imaging.

Case report

We report a rare sonographic finding of an index finger radial collateral ligament injury that was found to have a flap of the ligament entrapped within the metacarpophalangeal joint, which to our knowledge has not been described previously. We correlate this finding with an intraoperative image of the entrapment of the collateral ligament. We also report on the novel application of superb microvascular imaging to aid in the diagnosis of digital collateral ligament injury.

Discussion

This particular injury pattern has not been reported in the literature previously and likely explains the patient’s lack of improvement with nonoperative management. Our finding is similar to a Stener lesion seen in a thumb ulnar collateral ligament injury in which the ligament is unable to heal due to entrapment. In addition, using superb microvascular imaging (SMI), we were able to visualize hyperemia to surrounding structures and the ligament itself which suggested an acute injury.

Conclusion

We anticipate that this case report will provide sonographers with knowledge and images of this specific injury pattern to the digital collateral ligaments.
The rugby tug-of-war: Exploring concussion-related behavioural intentions and behaviours in youth community rugby union in New Zealand
Authors: Salmon Danielle M , Badenhorst Marelise , Walters Simon , Clacy Amanda , Chua Jason , Register-Mihalik Johna , Romanchuk Janelle , Kerr Zachary Y , Keung Sierra , Sullivan S. John , Whatman Chris
Published: November 2021

Rugby union is a popular team sport, with a high rate of concussions. In adolescents, concussions are further complicated by issues of under-reporting. To encourage more responsible concussion behaviours, it is imperative to understand the factors that influence youth players’ behaviours, including the attitudes and behaviours of their coaches and parents. The aim of this study was to explore concussion-related behavioural intentions and behaviours that may influence effective concussion management across a youth rugby system. The study adopted a pragmatic, descriptive qualitative design and included high schools from four youth rugby catchment areas in New Zealand. Nineteen focus groups and 2 individual interviews were conducted with n = 75 players, n = 22 parents, and n = 8 coaches (N = 105) during the 2018 rugby season. A thematic analysis was conducted, guided by a system’s approach and the Theory of Planned Behaviour. The themes generated reflected a ‘tug-of war’ between various behavioural intentions and reported behaviours present in a youth rugby system. Additionally, the behavioural intentions and reported behaviours of coaches, parents, players and their teammates are intricately linked and collectively influence effective concussion management. Being aware of concussions and caring about their management and consequences was a strong theme present across the system. However, these favourable attitudes and behaviours were countered by players, parents and coaches disregarding the system, downplaying the seriousness of concussion, being competitive and driven to win, regardless of the risks. In players the warrior mentality theme, which included bravado, being tough, and playing through the pain further complicated effective concussion management. The findings suggest that there is not always a strong, favourable network in place that would facilitate similarly favourable concussion-related behaviours. To effect change, a system-wide approach, that takes the unique needs of each stakeholder into account and ultimately aims to reconcile performance and brotherhood with positive concussion related behaviours, is needed.
Weightlifting for Children and Adolescents: A Narrative Review
Authors: Pierce Kyle C. , Hornsby W. Guy , Stone Michael H.
Published: November 2021

The involvement of youth in the sport of weightlifting and the use of weightlifting methods as part of training for youth sport performance appears to be increasing. Weightlifting for children and adolescents has been criticized in some circles and is a controversial aspect of resistance training for young people. Although injuries can occur during weightlifting and related activities, the incidence and rate of injury appear to be relatively low and severe injury is uncommon. A number of performance, physical, and physiological variables, such as body composition, strength, and power, are improved by weightlifting training in children, adolescents, and young athletes. Manipulating program variables, when appropriate, can have a substantial and profound influence on the psychological, physiological, physical, and performance aspects of weightlifters. An understanding of the sport, scientific training principles, and musculoskeletal growth development is necessary to properly construct a reasonable and appropriate training program. A scientific background aids in providing an evidenced basis and sound rationale in selecting appropriate methods and directing adaptations toward more specific goals and enables the coach to make choices about training and competition that might not otherwise be possible. If weightlifting training and competition are age group appropriate and are properly supervised, the sport can be substantially safe and efficacious.
Minimal Change Disease After First Dose of Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Review of Minimal Change Disease Related to COVID-19 Vaccine
Authors: Hanna Jessica , Ingram Alistair , Shao Tiffany
Published: November 2021

Rationale:

While severe complications are generally uncommon with novel coronavirus disease 2019 (COVID-19) vaccine, there has been a steady increase in the number of patients presenting with nephrotic syndrome and acute kidney injury after the administration of COVID-19 vaccine. Physicians should be made aware of minimal change disease as a potential complication associated with COVID-19 vaccine.

Presenting concerns:

A 60-year-old male without significant past medical history presented with new onset of nephrotic syndrome approximately 10 days after his first dose of Pfizer-BioNTech COVID-19 vaccine. Laboratory findings showed hypoalbuminemia (20 g/L), elevated urine albumin/creatinine ratio (668 mg/mmol), and elevated creatinine of 116 µmol/L from a baseline of 79 µmol/L.

Diagnosis:

A diagnostic kidney biopsy was performed 6 weeks after the onset of the edema and approximately 8 weeks after his first dose of Pfizer-BioNTech COVID-19 vaccine. The kidney biopsy findings were consistent with minimal change disease with focal acute tubular injury.

Interventions:

The patient was treated conservatively with ramipril 10 mg and furosemide 80 mg daily 5 weeks after the onset of swelling. Prednisone 1 mg/kg was initiated immediately when the kidney biopsy result became available (approximately 6 weeks after the onset of edema).

Outcomes:

The patient remitted with rapid weight loss starting 2 weeks post prednisone initiation.

Novel findings:

De novo minimal change disease with acute tubular injury is a kidney manifestation following the administration of Pfizer-BioNTech COVID-19 vaccine. Minimal change disease is potentially a rare complication of Pfizer-BioNTech COVID-19 vaccine.
Medical educators’ reflection on how technology sustained medical education in the most critical times and the lessons learnt: Insights from an African medical school
Authors: Owolabi Joshua , Bekele Abebe
Published: November 2021

Stakeholders in the field of medical education globally would generally agree that sustaining medical education through the dark times of the covid-19 pandemic is worth celebrating. In the midst of the difficulties that were created generally by the covid-19 pandemic, sustaining medical education required persistence, strategy, courageous leadership, and innovative adaptations both on the part of the educators, administrators and the students. The implications of continuing medical education during the covid-9 pandemic goes beyond just keeping medical schools open. It has an affective advantage, by impressing on the mind of trainees the importance of strategic adaptation, courage, and resilience. Should anything shut down, it must not be healthcare, and as such medical education should demonstrate such a level of commitment and character. Thankfully, this was what happened in many instances, including ours. One significant factor that made this possible was the integration of technology and innovation. It might not be out of place to say that technology and innovations literally saved medical education amidst the covid-19 pandemic. We also know that the level and quality of integration of technology and innovations varied from place to place. These might be described as heterogeneity of integration, which was further a reflection of inequity in development and advancements in medical education in different parts of the world. This piece includes our reflections on how technology sustained medical education in the most critical times and the lessons learned.
Indonesian Humanitarianism: Foundations, Characteristics and Contributions
Authors: Marzuki Keoni , Tiola
Published: November 2021

In the past two decades, Indonesia has become more active in humanitarian affairs, despite a preoccupation with natural hazards and political hurdles at home. In so doing, the Indonesian government employs “humanitarianism as diplomacy” — humanitarian action to promote its national interests — instead of deploying its efforts under a narrow understanding of humanitarianism. This is demonstrated in the country's humanitarian foci, which form part of its leadership ambitions in resolving crises in ASEAN and in supporting Muslim communities globally. As such, the Indonesian government's contributions are more pronounced in cases which promote Indonesia's regional and global leadership, such as in the Rohingya crisis and the Palestine issue. Indonesia also actively participates in disaster mitigation efforts in disaster-prone countries, which expands its international presence beyond ASEAN and the Middle East. This article identifies the foundation of Indonesia's humanitarianism and its key drivers, humanitarian contributions, and captures the involvement of state and non-state actors in such engagements.
Benchmarking in Congenital Heart Surgery Using Machine Learning-Derived Optimal Classification Trees
Authors: Bertsimas Dimitris , Zhuo Daisy , Levine Jordan , Dunn Jack , Tobota Zdzislaw , Maruszewski Bohdan , Fragata Jose , Sarris George E
Published: November 2021

Background: We have previously shown that the machine learning methodology of optimal classification trees (OCTs) can accurately predict risk after congenital heart surgery (CHS). We have now applied this methodology to define benchmarking standards after CHS, permitting case-adjusted hospital-specific performance evaluation. Methods: The European Congenital Heart Surgeons Association Congenital Database data subset (31 792 patients) who had undergone any of the 10 “benchmark procedure group” primary procedures were analyzed. OCT models were built predicting hospital mortality (HM), and prolonged postoperative mechanical ventilatory support time (MVST) or length of hospital stay (LOS), thereby establishing case-adjusted benchmarking standards reflecting the overall performance of all participating hospitals, designated as the “virtual hospital.” These models were then used to predict individual hospitals’ expected outcomes (both aggregate and, importantly, for risk-matched patient cohorts) for their own specific cases and case-mix, based on OCT analysis of aggregate data from the “virtual hospital.” Results: The raw average rates were HM = 4.4%, MVST = 15.3%, and LOS = 15.5%. Of 64 participating centers, in comparison with each hospital's specific case-adjusted benchmark, 17.0% statistically (under 90% confidence intervals) overperformed and 26.4% underperformed with respect to the predicted outcomes for their own specific cases and case-mix. For MVST and LOS, overperformers were 34.0% and 26.4%, and underperformers were 28.3% and 43.4%, respectively. OCT analyses reveal hospital-specific patient cohorts of either overperformance or underperformance. Conclusions: OCT benchmarking analysis can assess hospital-specific case-adjusted performance after CHS, both overall and patient cohort-specific, serving as a tool for hospital self-assessment and quality improvement.
Are We Able to Determine Differences in Outcomes Between Male and Female Servicemembers Undergoing Hip Arthroscopy? A Systematic Review
Authors: Rhon Daniel I. , Greenlee Tina A. , Dickens Jonathan F. , Wright Alexis A.
Published: November 2021

Background:

Female servicemembers sustain higher rates of lower extremity injuries as compared with their male counterparts. This can include intra-articular pathology in the hip. Female patients are considered to have worse outcomes after hip arthroscopy for femoroacetabular impingement and for hip labral repair.

Purpose:

To (1) compare published rates of hip arthroscopy between male and female military servicemembers and (2) determine if there are any sex-based differences in outcomes after hip arthroscopy in the military.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

We reviewed the literature published from January 1, 2000, through December 31, 2020, to identify studies in which hip arthroscopy was performed in military personnel. Clinical trials and cohort studies were included. The proportion of women within each cohort was identified, and results of any between-sex analyses were reported.

Results:

Identified were 11 studies that met established criteria. Studies included 2481 patients, 970 (39.1%) of whom were women. Surgery occurred between January 1998 and March 2018. Despite women accounting for approximately 15% of the active-duty military force, they represented 39.1% (range, 25.7%-57.6%) of patients undergoing hip arthroscopy. In most cases, there were no differences in self-reported outcomes (pain, disability, and physical function), return to duty, or medical disability status based on sex.

Conclusion:

Women account for approximately 15% of the military, but they made up 40% of patients undergoing hip arthroscopy. Outcomes were not different between the sexes; however, definitive conclusions were limited by the heterogeneity of outcomes, missing data, lack of sex-specific subgroup analyses, and zero studies with sex differences as the primary outcome. A proper understanding of sex-specific outcomes after hip arthroscopy will require a paradigm shift in the design and reporting of trials in the military health system.
Factors used in Applicant Ranking of Orthopedic Foot and Ankle Fellowships and the Availability of Online Information
Authors: Kraus Jonathan C. , Perlewitz Madeline A. , Shi Glenn G. , Law Brian C.
Published: November 2021

Background:

The Internet is often the first resource used by applicants to evaluate fellowship programs. However, information on these websites can be often incomplete, inaccessible, and/or inaccurate. The primary objective of this study was to examine key factors that orthopedic foot and ankle fellowship applicants use to rank programs. The secondary objective was to assess both the accessibility and availability of the information on orthopedic foot and ankle fellowship program websites.

Methods:

A Qualtrics survey was distributed via e-mail to those who matched into an orthopedic foot and ankle fellowship position from years 2008-2020. A comprehensive list of orthopedic foot and ankle fellowship programs was created. Program websites were evaluated for accessibility as well as the quality of recruitment and educational content.

Results:

There were a total of 114 survey responses out of 644 invites (17.7%). The most important factors for establishing a rank list were operative experience, current faculty, and program reputation. Eighty-five percent (41/48) of orthopedic foot and ankle fellowship websites were directly accessible using Google. On average, accessible orthopedic foot and ankle fellowship websites contained only 57% (11.5/20) of the content deemed desirable.

Conclusion:

Orthopedic foot and ankle websites are widely accessible and have higher recruitment and educational quality content scores compared with previously published data. The most important factors for establishing a rank list are consistent with previous literature. Those who ranked operative experience as one of the most important factors when establishing a rank list did not complete more operative cases than those who did not.

Level of Evidence:

Level IV.
Development of molecular markers based on the promoter difference of LcFT1 to discriminate easy- and difficult-flowering litchi germplasm resources and its application in crossbreeding
Authors: Ding Feng , Li Haoran , Wang Jinying , Peng Hongxiang , Chen Houbin , Hu Fuchu , Lai Biao , Wei Yongzan , Ma Wuqiang , Li Hongli , He Xinhua , Zhang Shuwei
Published: November 2021

Background

Litchi is a well-known subtropical fruit crop. However, irregular bearing attributed to unstable flowering is a major ongoing problem for the development of the litchi industry. In a previous study, our laboratory proved that litchi flowering was induced by low temperature and that a FLOWERING LOCUS T (FT) homologue gene named LcFT1 played a pivotal role in this process. The present study aimed to understand the natural variation in FT among litchi germplasm resources and designed markers to verify easy- and difficult-flowering litchi germplasms. A grafting experiment was also carried out to explore whether it could shorten the seedling stage of litchi seedlings.

Results

Two types of LcFT1 promoter existed in different litchi germplasm resources, and we named them the ‘easy-flowering type of LcFT1 promoter’ and ‘difficult-flowering type of LcFT1 promoter’, which resulted in three different LcFT1 genotypes of litchi germplasm resources, including the homozygous easy-flowering type of the LcFT1 genotype, homozygous difficult-flowering type of the LcFT1 genotype and heterozygous LcFT1 genotype of litchi germplasm resources. The homozygous easy-flowering type of the LcFT1 genotype and heterozygous LcFT1 genotype of the litchi germplasm resources completed their floral induction more easily than the homozygous difficult-flowering type of the LcFT1 genotype of litchi germplasm resources. Herein, we designed two kinds of efficient molecular markers based on the difference in LcFT1 promoter sequences and applied them to identify of the easy- and difficult-flowering litchi germplasm resources. These two kinds of molecular markers were capable of clearly distinguishing the easy- from difficult-flowering litchi germplasm resources at the seedling stage and provided the same results. Meanwhile, grafting the scion of seedlings to the annual branches of adult litchi trees could significantly shorten the seedling stage.

Conclusions

Understanding the flowering characteristics of litchi germplasm resources is essential for easy-flowering litchi breeding. In the present study, molecular markers provide a rapid and accurate approach for identifying the flowering characteristics. The application of these molecular markers not only significantly shortened the artificial crossbreeding cycle of easy-flowering litchi cultivars but also greatly saved manpower, material resources and land.
Obesity is a risk factor for central precocious puberty: a case-control study
Authors: Liu Gaiyan , Guo Jinxin , Zhang Xuejing , Lu Yu , Miao Junjie , Xue Hongmei
Published: November 2021

Background

Obesity is an important underlying cause of central precocious puberty (CPP), but previous large studies are flawed by using just age and breast examination to diagnose CPP. We aimed to determine whether overweight and obesity in childhood increases hormonally diagnosed CPP.

Methods

Our retrospective, case-control study recruited 846 children diagnosed as having CPP and randomly sampled 1650 healthy control subjects in Xingtai Third Hospital in China between November 2018 and March 2021. Information was obtained from an electronic medical record and questionnaire investigated in the outpatient visit. Observations were made before the a priori hypothesis. Unconditional logistic regression for analysis was used to determine whether overweight and obesity status and duration of overweight/obesity were associated with CPP.

Results

Overweight and obesity were significantly associated with increased odds of CPP among girls, even after adjusting for birth weight, exclusive breastfeeding for 6 month, household income, maternal overweight, paternal overweight, and maternal menarche age (overweight: the adjusted odds ratio (aOR) (95%CI): 1.92 (1.16, 3.24), p = 0.02; obesity: aOR (95%CI): 1.78 (1.13, 3.48), p = 0.03). Furthermore, the effects of overweight and obesity were significant when ongoing for 1 to 2 years, 2 to 3 years, and greater than 3 years, but not at less than 1 year. For boys, association between obesity and increased odds of CPP was observed (aOR (95%CI): 1.68 (1.09, 3.75), p = 0.03). The effects of overweight and/or obesity were only significant when ongoing for greater than 2 years.

Conclusions

Prolonged overweight and obesity in early childhood may be risk factors for CPP, especially in girls. Weight loss might be an important approach for the prevention of precocious puberty in children.
Retinal vein occlusion with cerebral infarction in a preterm neonate: a case report
Authors: Zhu Xiuyu , Cai Xiaojing , Zhou Xiaohong , Li Yian , Yang Chenhao
Published: November 2021

Background

Retinal vein occlusion (RVO) is a common disease that causes blindness in elderly patients, and cerebral infarction is also a severe disorder impairing the health of individuals. Both diseases are not common in neonates and are related to thrombosis. To date, only one case of simultaneous occurrence of RVO with intracranial haemorrhage in a full-term neonate has been reported.

Case presentation

A preterm neonate was diagnosed with cerebral infarction and RVO. Retinal haemorrhage and macular oedema were detected in the left eye after the onset of ipsilateral stroke. Although the retinal conditions in this case resolved spontaneously without ocular treatment, the long-term effect on visual function is still unknown.

Conclusions

Given that ocular fundus examinations are rarely performed in paediatric stroke patients, a screening fundus examination in these newborns with stroke might be worth considering.
Circulating miRNA repertoire as a biomarker of metabolic and reproductive states in rainbow trout
Authors: Cardona Emilie , Guyomar Cervin , Desvignes Thomas , Montfort Jérôme , Guendouz Samia , Postlethwait John H. , Skiba-Cassy Sandrine , Bobe Julien
Published: November 2021

Background

Circulating miRNAs (c-miRNAs) are found in most, if not all, biological fluids and are becoming well-established non-invasive biomarkers of many human pathologies. However, their features in non-pathological contexts and whether their expression profiles reflect normal life history events have received little attention, especially in non-mammalian species. The aim of the present study was to investigate the potential of c-miRNAs to serve as biomarkers of reproductive and metabolic states in fish.

Results

The blood plasma was sampled throughout the reproductive cycle of female rainbow trout subjected to two different feeding regimes that triggered contrasting metabolic states. In addition, ovarian fluid was sampled at ovulation, and all samples were subjected to small RNA-seq analysis, leading to the establishment of a comprehensive miRNA repertoire (i.e., miRNAome) and enabling subsequent comparative analyses to a panel of RNA-seq libraries from a wide variety of tissues and organs. We showed that biological fluid miRNAomes are complex and encompass a high proportion of the overall rainbow trout miRNAome. While sharing a high proportion of common miRNAs, the blood plasma and ovarian fluid miRNAomes exhibited strong fluid-specific signatures. We further revealed that the blood plasma miRNAome significantly changed depending on metabolic and reproductive states. We subsequently identified three evolutionarily conserved muscle-specific miRNAs or myomiRs (miR-1-1/2-3p, miR-133a-1/2-3p, and miR-206-3p) that accumulated in the blood plasma in response to high feeding rates, making these myomiRs strong candidate biomarkers of active myogenesis. We also identified miR-202-5p as a candidate biomarker for reproductive success that could be used to predict ovulation and/or egg quality.

Conclusions

Together, these promising results reveal the high potential of c-miRNAs, including evolutionarily conserved myomiRs, as physiologically relevant biomarker candidates and pave the way for the use of c-miRNAs for non-invasive phenotyping in various fish species.
Hearing loss genes reveal patterns of adaptive evolution at the coding and non-coding levels in mammals
Authors: Trigila Anabella P. , Pisciottano Francisco , Franchini Lucía F.
Published: November 2021

Background

Mammals possess unique hearing capacities that differ significantly from those of the rest of the amniotes. In order to gain insights into the evolution of the mammalian inner ear, we aim to identify the set of genetic changes and the evolutionary forces that underlie this process. We hypothesize that genes that impair hearing when mutated in humans or in mice (hearing loss (HL) genes) must play important roles in the development and physiology of the inner ear and may have been targets of selective forces across the evolution of mammals. Additionally, we investigated if these HL genes underwent a human-specific evolutionary process that could underlie the evolution of phenotypic traits that characterize human hearing.

Results

We compiled a dataset of HL genes including non-syndromic deafness genes identified by genetic screenings in humans and mice. We found that many genes including those required for the normal function of the inner ear such asLOXHD1,TMC1,OTOF,CDH23, andPCDH15show strong signatures of positive selection. We also found numerous noncoding accelerated regions in HL genes, and among them, we identified active transcriptional enhancers through functional enhancer assays in transgenic zebrafish.

Conclusions

Our results indicate that the key inner ear genes and regulatory regions underwent adaptive evolution in the basal branch of mammals and along the human-specific branch, suggesting that they could have played an important role in the functional remodeling of the cochlea. Altogether, our data suggest that morphological and functional evolution could be attained through molecular changes affecting both coding and noncoding regulatory regions.
Assessment of gentamicin and cisplatin-induced kidney damage mediated via necrotic and apoptosis genes in albino rats
Authors: Abouzed Tarek Kamal , Sherif Eman Abd Elrahman , Barakat Mohamed El Sayed , Sadek Kadry Mohamed , Aldhahrani Adil , Nasr Nasr Elsayed , Eldomany Ehab , Khailo Khaled , Dorghamm Doaa Abdallha
Published: November 2021

Background

Gentamicin (GM) is a low-cost, low-resistance antibiotic commonly used to treat gram-negative bacterial diseases. Cisplatin (Csp) is a platinum-derived anti-neoplastic agent. This experiment aimed to identify the early signs of gentamicin and cisplatin-induced nephrotoxicity in rats. Thirty Wistar rats were divided into three groups of 10: a control group, which received no treatment; a gentamicin group administered by a dose of (100 mg/kg, IP) for 7 consecutive days, and a cisplatin group was administered intraperitoneal in a dose of (1.5 mg/kg body weight) repeated twice a week for 3 weeks.

Results

Both experimental groups exhibited increased levels of creatinine, urea, and uric acid, with the cisplatin-treated group showing higher levels than the gentamicin group. Experimental groups also exhibited significantly increased Malondialdehyde (MDA), reduced glutathione (GSH), and glutathione peroxidase (GSH-Px) with more pronounced effects in the cisplatin-treated group. Further, both experimental groups exhibited significant up-regulation of Tumor Necrosis Factor α (TNF-α), caspase-3, and Bax and down regulation of Bcl-2.

Conclusion

These findings confirm the use of necrotic, apoptotic genes as early biomarkers in the detection of tubular kidney damage. Further, cisplatin was shown to have a greater nephrotoxic effect than gentamicin; therefore, its use should be constrained accordingly when co-administered with gentamicin.