bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract SY29-02: Novel mechanisms of PARP inhibitor resistance
Authors: D'Andrea Alan D.
Published: July 2017

Large-scale genomic studies have demonstrated that approximately 50% of high-grade serous ovarian cancers (HGSOCs) harbor genetic and epigenetic alterations in homologous recombination repair (HRR) pathway genes. The most commonly altered HRR genes are BRCA1 and BRCA2, followed by other Fanconi anemia genes including FANCN/PALB2, FANCO/RAD51, FANCJ/BRIP, and FANCA. Loss of HRR causes genomic instability, hyperdependence on alternative DNA repair mechanisms, and enhanced sensitivity to platinum analogues, topoisomerase inhibitors, and PARP-inhibitors (PARPi). The synthetic lethal interaction with PARPi is being exploited therapeutically in diverse clinical contexts and most notably in ovarian cancer, where the PARPi olaparib is FDA approved for use in patients with germline BRCA1/2 mutations. PARP inhibitor resistance has already emerged as a vexing clinical problem for the treatment of BRCA1/2-deficient tumors. The most prevalent mechanism of PARPi resistance is secondary events that cancel the original HRR alteration and restore HRR proficiency. However, PARPi resistance may still develop without restoration of HRR proficiency via disruption of multiple proteins, such as PTIP or CHD4, that leads to replication fork (RF) stabilization. Importantly, this latter mechanism—namely, the restoration of RF stability—appears to be a highly prevalent mechanism of PARP inhibitor resistance in vitro and in vivo, particularly in tumor cells with an underlying BRCA2 deficiency. Due to their underlying deficiency in BRCA2 and inability to generate RAD51 nucleofilaments, these tumor cells are unable to restore HRR mechanisms. Instead, these cells acquire PARP inhibitor resistance by limiting the nucleolytic degradation of their stalled replication forks. We have recently made the surprising observation that BRCA2-deficient tumors can become resistant to PARPi by downregulating the expression of the polycomb repressive complex PRC2, a methyltransferase complex containing EZH2, SUZ12, EED, and RbAp48. Importantly, downregulation of PRC2 results in the reduced recruitment of the nuclease MUS81 to the RF, thereby providing a novel mechanism of RF protection and PARPi resistance. A molecular understanding of PARP inhibitor resistance mechanisms may allow the generation of a new class of drugs or a repurposing of existing drugs, which may reverse this resistance and extend the use of PARP inhibitors to more tumor types.

Citation Format: Alan D. D'Andrea. Novel mechanisms of PARP inhibitor resistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr SY29-02. doi:10.1158/1538-7445.AM2017-SY29-02
Abstract SY32-01: The new genetics and treatment of CLL
Authors: Croce Carlo M.
Published: July 2017

Loss of miR-15/16 on chromosome 13q14 is the most common genetic alteration in CLL. Recently, we discovered that miR-15/16 target BCL2, an antiaptoptic gene we discovered and named in 1984. Thus, loss of miR-15/16 leads to overexpression of BCL2 (the driver) and causes sensitivity of CLL cells to the antiBcl2 drug venetoclax that is capable of inducing complete remission of CLL in patients and was approved by the FDA in April 2016. The discovery of the involvement of miR-15/16 in CLL also indicated that alterations in genes not encoding proteins can cause cancer. Before our publication of 2002, the dogma was that alterations in protein coding genes, oncogenes, and suppressor genes, cause cancer. We speculate that by looking at other targets of miR-15/16 we might discover other biomarkers that are overexpressed because of miR-15/16 loss, providing novel opportunities to discover targetable targets. Since it seems likely that among the billions of leukemic cells in patients, there are a few that do not respond to the drug—for example, because of mutations in the Bcl2 pocket binding the drug—it is important to develop other drugs capable of killing CLL cells because they have lost miR-15/16. We propose to define whether loss of miR-15/16 may lead to overexpression of specific surface markers that can be targeted by specific monoclonal antibodies. The availability of these antibodies will allow the killing of the same leukemic cells by using a combination of the antibodies and venetoclax minimizing the possibility of drug resistance. Finally, we will assess the role of a new family of short noncoding RNAs we have discovered, ts-RNAs, in the pathogenesis of CLL.

Citation Format: Carlo M. Croce. The new genetics and treatment of CLL [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr SY32-01. doi:10.1158/1538-7445.AM2017-SY32-01
Abstract SY33-02: Fueling T cells and antitumor immunity
Authors: Rathmell Jeffrey C.
Published: July 2017

Lymphocyte activation leads to rapid proliferation and differentiation, and we have shown that T-cell subsets require distinct metabolic programs. The effector CD4 T-cell fates (Th1, Th2, Th17) activate a highly glycolytic program. Regulatory CD4 T cells (Treg), in contrast, utilize a more oxidative metabolism and utilize lipids as a major fuel. These metabolic distinctions may allow new understanding of T-cell function in tumors and approaches to manipulate immunity. We have now examined the metabolism of Treg in detail and found that FoxP3 itself can promote oxidative metabolism characteristic of Treg and that this is critical to maximize Treg suppressive capacity. Treg can be glycolytic and proliferative in vivo. We found, however, that glucose uptake and glycolysis impaired Treg stability. Thus, Treg regulate glycolytic and oxidative metabolism to balance proliferation and suppressive function. Conversely, the requirement of effector T cells for glucose uptake and glycolysis poses a barrier to inflammatory function in tumors. Understanding mechanisms that regulate T-cell metabolism may provide new tools to modulate immunity through the balance of T-cell effector and regulatory populations.

Citation Format: Jeffrey C. Rathmell. Fueling T cells and antitumor immunity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr SY33-02. doi:10.1158/1538-7445.AM2017-SY33-02
Tropical Atmospheric Madden–Julian Oscillation: A Strongly Nonlinear Free Solitary Rossby Wave?
Authors: Yano Jun-Ichi , Tribbia Joseph J.
Published: July 2017

The Madden–Julian oscillation (MJO), a planetary-scale eastward-propagating coherent structure with periods of 30–60 days, is a prominent manifestation of intraseasonal variability in the tropical atmosphere. It is widely presumed that small-scale moist cumulus convection is a critical part of its dynamics. However, the recent results from high-resolution modeling as well as data analysis suggest that the MJO may be understood by dry dynamics to a leading-order approximation. Simple, further theoretical considerations presented herein suggest that if it is to be understood by dry dynamics, the MJO is most likely a strongly nonlinear solitary Rossby wave. Under a global quasigeostrophic equivalent-barotropic formulation, modon theory provides such analytic solutions. Stability and the longevity of the modon solutions are investigated with a global shallow-water model. The preferred modon solutions with the greatest longevities compare well overall with the observed MJO in scale and phase velocity within the factors.
Collective Leadership: Principals’ Decision Influence and the Supportive or Inhibiting Decision Influence of Other Stakeholders
Authors: Ni Yongmei , Yan Rui , Pounder Diana
Published: July 2017

Purpose: Using the collective leadership framework, this study examines (a) how principals perceive their own influence and that of other key stakeholders in various school decisions and (b) how principals’ perceived influences of other stakeholders are associated with their own influence. Research Method/Approach: This study uses the nationally representative database of public school principals from the 2007 to 2008 School and Staffing Survey. A series of ordinary least squares regression models were estimated to examine how principals’ perceptions of decision influence were associated with principal characteristics, school contextual factors, and influences of other stakeholders. Findings: Among all the stakeholders, principals perceived themselves to have the greatest influence in school decisions in almost all key decision areas, while other stakeholders also exerted significant influences to different extents. Depending on the decision area, principals viewed other stakeholders’ influence as either supporting or inhibiting their own influence. For example, principals perceived influences from teachers and school districts as high and supportive. On the other hand, the influence of state agencies were perceived as generally inhibiting. In addition, collective leadership was more prevalent in some decision areas (e.g., setting standards and establishing curriculum) than others (e.g., hiring and evaluating teachers). Conclusions and Implications: School leadership does not have to be a zero-sum game. Principals’ decision influence does not necessarily diminish when other stakeholders gain more influence. Improving collective leadership and maintaining the right balance of decision influence among stakeholders and across decision zones have the potential to create a harmonious and high-functioning school environment.
Concession Bargaining
Authors: Alberti Federica , Fischer Sven , Güth Werner , Tsutsui Kei
Published: July 2017

We test experimentally whether dynamic interaction is crucial for concession bargaining. In our complete information bargaining experiments, two parties with asymmetric conflict payoffs try to agree how to share a commonly known pie by bargaining over a finite number of successive trials (agreement attempts). We compare the fully dynamic interaction to one less dynamic and one static protocol. In the quasi-dynamic protocol, later trials merely reveal that so far no agreement has been reached, and in the static protocol, no feedback information is given about earlier trials. We find that neither conflict rate nor efficiency or inequality of agreements differs across protocols. Comparing different numbers of maximal trials shows that more trials render conflict more likely due to less concessions.
Biglycan and Decorin Expression and Distribution in Palatal Adhesion
Authors: Ibrahim I. , Serrano M.J. , Ruest L.B. , Svoboda K.K.H.
Published: July 2017

Previous studies demonstrated that chondroitin sulfate proteoglycans (CSPGs) on apical surfaces of palatal medial edge epithelial (MEE) cells were necessary for palatal adhesion. In this study, we identified 2 proteoglycans, biglycan and decorin, that were expressed in the palatal shelves prior to adhesion. In addition, we established that these proteoglycans were dependent on transforming growth factor β (TGFβ) signaling. Laser capture microdissection was used to collect selected palatal epithelial cells from embryonic mouse embryos at various palate development stages. The expression of specific messenger RNA (mRNA) for biglycan and decorin was determined with quantitative real-time polymerase chain reaction. The TGFβrI kinase inhibitor (SB431542) was used in palatal organ cultures to determine if blocking TFGβ signaling changed biglycan and decorin distribution. Immunohistochemistry of both biglycan and decorin revealed expression on the apical and lateral surfaces of MEE cells. Biglycan protein and mRNA levels peaked as the palatal shelves adhered. Decorin was less abundant on the apical epithelial surface and also had reduced mRNA levels compared to biglycan. Their proteins were not expressed on MEE cells of palates treated with SB431542, an inhibitor of TGFβ signaling. The temporal expression of biglycan and decorin on the apical surface of MEE, combined with the evidence that these proteins were regulated through the TGFβ pathway, indicated that they may be important for adhesion.
The Financial Foundations of the Productivity Puzzle
Authors: Chadha Jagjit S. , Kara Amit , Labonne Paul
Published: July 2017

The financial crisis has led to a change in the mix of capital and labour employed in the UK and a sharp decline in total factor productivity. This has meant that labour productivity has not recovered to any great degree since the financial crisis. We explore the role of overall and sectoral productivity in explaining the fall in labour productivity, but also question the extent to which productivity in the service sector may be measured with error. We outline the links between a constrained financial sector and a fall in overall productivity – in which intangible capital seems to play an important role – and illustrate how a financial sector providing intermediate services may act to amplify the business cycle impetus from a total factor productivity shock within the context of a calibrated model.
Medium-Run Implications of Changing Demographic Structures for the Macro-Economy
Authors: Aksoy Yunus , Basso Henrique S. , Smith Ron P.
Published: July 2017

While there may be an important, but transitory, cyclical component in the poor performance of the past decade, we will emphasise the secular forces: the impact of demographic structure and innovation. We draw on the empirical and theoretical work reported in Aksoy, Basso, Smith and Grasl (2015), ABSG, about the impact of changes in demographic structure on macroeconomic outcomes. This suggests that changes in age profile not only have significant implications for savings, investment, real interest rates and growth but also for innovation. The size of the effects seems plausible. For instance, if in 2015 the UK had the 1970 age structure, it would have added 0.68 percentage points to the long-run annual growth rate. The model suggests that the population ageing predicted for the next decades will tend to reduce output growth and real interest rates across OECD countries.
Self-cleaning effect of electrospun poly (1,4-cyclohexanedimethylene isosorbide terephthalate) nanofibers embedded with zinc oxide nanoparticles
Authors: Khan Muhammad Qamar , Lee Hoik , Koo Jun Mo , Khatri Zeeshan , Sui Jianhua , Im Seung Soon , Zhu Chunhong , Kim Ick Soo
Published: July 2017

This study examined the photocatalytic self-cleaning of novel nanofibers of co-polyester poly(1,4-cyclohexanedimethylene isosorbide terephthalate) (PICT). To obtain the self-cleaning property, zinc oxide (ZnO) nanoparticles were blended into the solution of PICT at five different concentrations. The morphology of the nanofibers was analyzed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM), and the degradation spectrum of the target dyes was confirmed by Fourier Transform Infrared (FT-IR) spectroscopy. Especially in the TEM images, there was clear evidence of a uniform dispersion of the ZnO nanoparticles embedded in the nanofibers. As the concentration of ZnO increased to 9 wt%, there was a greater dispersion of the ZnO nanoparticles on the nanofibers. The photocatalytic activity indicated that more efficient self-cleaning occurred at an irradiation time of 3 hours and a 9% concentration of ZnO nanoparticles in the nanofibers. We achieved around 99% self-cleaning efficiency from these nanofibers.
Writing the world into counter-hegemony: identity, power, and ‘foreign policy’ in ethnic movements
Authors: Balci Ali
Published: July 2017

This article is an attempt to develop a theoretical framework about how to study dissident ethnic movements’ foreign policies. Is it possible to speak about foreign policies of ethnic dissident movements, especially when it is considered that they have no characteristics of modern sovereignty such as territory and recognition? For example, do the Berbers in Morocco, the Catalans in Spain, the Balochs in Iran, and the Kurds in Turkey have a foreign policy? If they do, how do we study their policies toward the outside world? Specifically, focusing on the case of the Kurds in Turkey, this article attempts to provide a theoretical framework for how to study dissident ethnic movements’ foreign policy performances. By looking at the effect of the end of the Cold War on the Kurdish nationalists’ imagination of the United States, this article interrogates how the change in their imagination played a role in the construction and reconstruction of the post-1980 Kurdish identity in Turkey. It also draws on the work of poststructural and postcolonial Ernesto Laclau, David Campell, and Edward W. Said in order to develop the theoretical framework.
Therapeutic Effects of Doxycycline on the Quality of Repaired and Unrepaired Achilles Tendons
Authors: Nguyen Quynhhoa T. , Norelli Jolanta B. , Graver Adam , Ekstein Charles , Schwartz Johnathan , Chowdhury Farzana , Drakos Mark C. , Grande Daniel A. , Chahine Nadeen O.
Published: July 2017

Background:

Achilles tendon tears are devastating injuries, especially to athletes. Elevated matrix metalloproteinase (MMP) activity after a tendon injury has been associated with deterioration of the collagen network and can be inhibited with doxycycline (Doxy).

Hypothesis:

Daily oral administration of Doxy will enhance the histological, molecular, and biomechanical quality of transected Achilles tendons. Additionally, suture repair will further enhance the quality of repaired tendons.

Study Design:

Controlled laboratory study.

Methods:

Randomized unilateral Achilles tendon transection was performed in 288 adult male Sprague-Dawley rats. The injured tendons were either unrepaired (groups 1 and 2) or surgically repaired (groups 3 and 4). Animals from groups 2 and 4 received Doxy daily through oral gavage, and animals from groups 1 and 3 served as controls (no Doxy). Tendons were harvested at 1.5, 3, 6, and 9 weeks after the injury (n = 18 per group and time point). The quality of tendon repair was evaluated based on the histological grading score, collagen fiber orientation, gene expression, and biomechanical properties.

Results:

In surgically repaired samples, Doxy enhanced the quality of tendon repair compared with no Doxy ( P = .0014). Doxy had a significant effect on collagen fiber dispersion, but not principal fiber angle. There was a significant effect of time on the gene expression of MMP-3, MMP-9 and TIMP1, and Doxy significantly decreased MMP-3 expression at 9 weeks. Doxy treatment with surgical repair increased the dynamic modulus at 6 weeks but not at 9 weeks after the injury ( P < .001). Doxy also increased the equilibrium modulus and decreased creep strain irrespective of the repair group. Doxy did not have a significant effect on the histology or biomechanics of unrepaired tendons.

Conclusion:

The findings indicate that daily oral administration of Doxy accelerated matrix remodeling and the dynamic and equilibrium biomechanics of surgically repaired Achilles tendons, although such enhancements were most evident at the 3- to 6-week time points.

Clinical Relevance:

The inhibition of MMPs at the optimal stage of the repair process may accelerate Achilles tendon repair and improve biomechanical properties, especially when paired with surgical management.
(Co)meta-reflection as a method for the professional development of academic middle leaders in higher education
Authors: Thorpe Anthony , Garside Diane
Published: July 2017

The professional development of middle leaders in higher education is little considered in existing research, though there are general concerns being raised about the suitability of the professional development opportunities currently available. This article develops and explores the use of meta-reflection as a method for professional development, particularly of academics with direct responsibilities for courses and programmes such as course leaders, directors and co-ordinators. As an extension of reflective practice, (co)meta-reflection is proposed as a joint activity involving two or more people, seeking to develop their thought and practice by moving from descriptive to analytical levels of reflection. We provide an example of a (co)meta-reflective exercise and identify it as an approach with considerable potential to address the problems that middle leaders face, and call for further exploration of it as a method for professional development.
What Facilitates “Patient Empowerment” in Cancer Patients During Follow-Up: A Qualitative Systematic Review of the Literature
Authors: Jørgensen Clara R. , Thomsen Thora G. , Ross Lone , Dietz Susanne M. , Therkildsen Signe , Groenvold Mogens , Rasmussen Charlotte L. , Johnsen Anna T.
Published: July 2017

Empowerment is a concept of growing importance in cancer care, but little is known about cancer patients’ experiences of empowerment during follow-up. To explore this area, a qualitative systematic literature review was conducted in PubMed, CINAHL, and PsycINFO. A total of 2,292 papers were identified and 38 articles selected and included in the review. The thematic synthesis of the papers resulted in seven analytical themes being identified: empowerment as an ongoing process, knowledge is power, having an active role, communication and interaction between patients and health care professionals, support from being in a group, religion and spirituality, and gender. Very few articles explicitly explored the empowerment of cancer patients during follow-up, and the review identified a lack of attention to patients’ own understandings of empowerment, a lack of specific focus on empowerment during follow-up, and insufficient attention to collective empowerment, as well as ethnic, social, and gender differences.
Effect of First Tarsometatarsal Joint Derotational Arthrodesis on First Ray Dynamic Stability Compared to Distal Chevron Osteotomy
Authors: Klemola Tero , Leppilahti Juhana , Laine Vesa , Pentikäinen Ilkka , Ojala Risto , Ohtonen Pasi , Savola Olli
Published: July 2017

Background:

Hallux valgus alters gait, compromising first ray stability and function of the windlass mechanism at the late stance. Hallux valgus correction should restore the stability of the first metatarsal. Comparative studies reporting the impact of different hallux valgus correction methods on gait are rare. We report the results of a case-control study between distal chevron osteotomy and first tarsometatarsal joint derotational arthrodesis (FTJDA).

Methods:

Two previously studied hallux valgus cohorts were matched: distal chevron osteotomy and FTJDA. Seventy-seven feet that underwent distal chevron osteotomy (chevron group) and 76 feet that underwent FTJDA (FTJDA group) were available for follow-up, with a mean of 7.9 years (range, 5.8-9.4 years) and 5.1 years (range, 3.0-8.3 years), respectively. Matching criteria were the hallux valgus angle (HVA) and a follow-up time difference of a maximum 24 months. Two matches were made: according to the preoperative HVA and the HVA at late follow-up. Matching provided 30 and 31 pairs, respectively. Relative impulses (%) of the first toe (T1) and metatarsal heads 1 to 5 (MTH1-5), weightbearing radiographs, and American Orthopaedic Foot & Ankle Society (AOFAS) (hallux metatarsophalangeal-interphalangeal [MTP-IP]) scores were studied.

Results:

The relative impulse of MTH1 was higher in the FTJDA group, whereas a central dynamic loading pattern was seen in the chevron group. This result remained when relative impulses were analyzed according to the postoperative HVA. The mean difference in the HVA at follow-up was 6.2 degrees (95% confidence interval, 3.0-9.5; P = .001) in favor of the FTJDA group.

Conclusion:

The dynamic loading capacity of MTH1 was higher in the FTJDA group in comparison to the chevron group. The follow-up HVA remained better in the FTJDA group.

Level of Evidence:

Level III, case-control study.
Views and strategies of African-American caregivers of persons with schizophrenia on medication treatment and other supports
Authors: Joy Michelle T , Kohler Christian G , Griffith Tracy H
Published: July 2017

African-Americans are more likely to be diagnosed with schizophrenia than persons of other ethnic identities, necessitating an understanding of this group’s perceptions of the mental health system. Interviews with 10 African-American caregivers of persons with schizophrenia underwent qualitative data analysis to elucidate perspectives on medication adherence and their caretaking roles and supports. Medication adherence-related themes (interactive strategies, organizational strategies) and non-medication-related themes (support of patient, support of caregiver) were detected. These results describe the complex role that African-American caregivers of persons with schizophrenia undertake and identify possible interventions to address related mental health disparities.
Pedagogies of indignation and The Lives of Others
Authors: Suissa Judith
Published: July 2017

Neel Mukherjee’s novel, The Lives of Others, which depicts characters dealing with a situation of extreme and violent oppression, is used as the basis for looking more closely at some of the theoretical assumptions about hope, agency and critical consciousness that underpin Critical Pedagogy. It is suggested that it may be educationally and philosophically valuable to reflect on the ethically troubling choices that individuals in extreme situations make in their fight against oppression, and to ask questions about the risks and the costs involved when people, through a process of critical consciousness, become fully free to claim their moral and political agency.
Policy transfer as the growth of dynamics and challenges: The case of school textbooks in Greece
Authors: Stamelos Georgios , Karachontziti Elena , Paivandi Saeed
Published: July 2017

The Greek school textbook is at the core of this article and is treated as a matter of policy. In 2003, the Greek Government decided to include the publishing of school textbooks in the current Community support framework and as a result school textbook publishing goes beyond Greek priorities and gains European interest, which means that the whole process, being mainly supported by Community funding, has to respect certain of its rules and procedures. Our aim here is to show how European policies were transferred to the Greek context and how they inter-reacted with the corresponding Greek rules and procedures. The theoretical framework is based on Dolowich and Marsh’s (2008) proposal concerning the transformation of the concept of policy transfer into an analytical schema in the study of the policy transfer process. The methodology includes the content analysis of 29 school textbooks and comparison of the old ones with the new, and 32 interviews with actors involved in writing and publishing them.
Clinical Impact of Intravascular Ultrasound Guidance During Endovascular Treatment of Subclavian Artery Disease
Authors: Chung Wen-Jung , Soga Yoshimitsu , Tomoi Yusuke , Fujihara Masahiko , Okazaki Shinya , Yamauchi Yasutaka , Shintani Yoshiaki , Suzuki Kenji
Published: July 2017

Purpose: To evaluate the short- and long-term efficacy of intravascular ultrasound (IVUS) guidance during endovascular treatment (EVT) of subclavian artery disease. Methods: The multicenter SCALLOP registry (SubClavian Artery disease treated with endovascuLar therapy; muLticenter retrOsPective registry) was interrogated to identify 542 patients who underwent successful EVT for SCAD between January 2003 and December 2012. Lesions were classified according to the use of IVUS guidance: 177 patients (mean age 68.9±8.6 years; 149 men) with and 373 patients (mean age 69.9±8.7 years; 275 men) without. The main outcome was the difference in primary patency; secondary outcomes were differences in assisted primary patency, secondary patency, overall survival, freedom from major adverse cardiovascular events [MACE; all-cause mortality, myocardial infarction (MI), and stroke], and freedom from major adverse events (MAE). Multivariate analysis of the IVUS+ group was performed to identify predictors of failure; results are presented as the hazard ratio (HR) and 95% confidence interval (CI). Results: In total, 538 (97.8%) lesions were treated with stents and 12 lesions by balloon angioplasty alone. Periprocedural and in-hospital overall complication rates did not differ significantly between IVUS+ (10.2%) and IVUS– (8.8%, p=0.617). Long-term follow-up demonstrated no significant difference between IVUS+ and IVUS– groups in 5-year all-cause mortality (p=0.37), MI (p=0.07), stroke (p=0.31), or MACE (p=0.07). However, 5-year primary patency was significantly higher in the IVUS+ group (88.5% vs 77.7%, p=0.03). There were no group differences in 5-year assisted primary patency (90.4% vs 89.9%, p=0.81) or secondary patency (99.4% vs 97.1%, p=0.25). Multivariate analysis of the IVUS+ group identified in-hospital stroke (HR 16.92, 95% CI 3.60 to 79.42, p<0.01) and combined use of balloon-expandable and self-expanding stents (HR 5.59, 95% CI 1.22 to 25.65, p=0.02) as independent negative predictors of primary patency. Conclusion: These results suggest that IVUS guidance can significantly improve long-term primary patency following endovascular treatment of subclavian artery disease.
The global impact of IBS: time to think about IBS-specific models of care?
Authors: Corsetti Maura , Whorwell Peter
Published: July 2017

Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal (GI) disorder that can significantly erode the quality of life (QoL) of sufferers and places a major cost burden on healthcare services. This paper reviews the literature on the impact of IBS on healthcare services and society, including a recent report on the subject, in order to formulate a plan for the future. A completely different model of care for these patients is recommended based on this review and the experience of the two authors who have been treating patients with functional GI disorders for 20 and 35 years, respectively.
Guns Automatically Prime Aggressive Thoughts, Regardless of Whether a “Good Guy” or “Bad Guy” Holds the Gun
Authors: Bushman Brad J.
Published: July 2017

The mere presence of weapons can increase aggression—called the “weapons effect.” Weapons are theorized to increase aggression by priming aggressive thoughts. This research tested the robustness of the weapons effect using two large representative samples of American adults (total N = 1,097). Participants saw photos of criminals, soldiers, police in military gear, or police in regular gear with guns. Experiment 2 also included a condition with photos of Olympians with guns used to shoot inanimate targets. The control group was police in plainclothes without guns. The accessibility of aggressive thoughts was measured using a word fragment task (e.g., KI_ _ can be completed as KILL or KISS). Photos of individuals with guns used to shoot human targets primed aggressive thoughts, regardless of whether a “good guy” (soldier, police) or “bad guy” (criminal) held the gun. Photos of Olympians with guns used to shoot inanimate targets did not prime aggressive thoughts.
Assessment and management of sexual dysfunction in the context of depression
Authors: Chokka Pratap R. , Hankey Jeffrey R.
Published: July 2017

Sexual dysfunction (SD) is pervasive and underreported, and its effects on quality of life are underestimated. Due in part to its bidirectional relationship with depression, SD can be difficult to diagnose; it is also a common side effect of many antidepressants, leading to treatment noncompliance. While physicians often count on patients to spontaneously report SD, treatment is optimized when the clinician instead performs a thorough assessment of sexual functioning before and during drug therapy using a standardized questionnaire such as the Arizona Sexual Experiences Scale (ASEX). Separating the effects of the disorder from those of medications is challenging; we present a concise, evidence-based schematic to assist physicians in minimizing treatment-emergent sexual dysfunction (TESD) while treating depression. Vascular, hormonal, neurogenic, and pharmacological factors should be considered when a patient presents with SD. We also recommend that physicians obtain patient information about baseline and historical sexual functioning before prescribing a drug that may lead to SD and follow up accordingly. When the goal is to treat depression while attenuating the risk of sexual symptoms, physicians may wish to consider agomelatine, bupropion, desvenlafaxine, moclobemide, trazodone, vilazodone, and vortioxetine.
Explanatory factors in the renewal of contracts for the privatisation of public services
Authors: Campos-Alba Cristina M , Higuera-Molina Emilio J de la , Pérez-López Gemma , Zafra-Gómez José L
Published: July 2017

After analysing the explanatory factors underlying the renewal of privatisation contracts, this paper examines the likelihood of local authorities renewing their contracts with private entities for the provision of public services, by studying a sample of 623 Spanish municipalities for the period 2002–2013, using a logit model. The type of service, the duration of the contract and certain political and economic factors were all found to influence the renewal or otherwise of this type of contract. Moreover, this effect differed between initial privatisation and subsequent contract renewal.
Attribution of oral cancer in the Sudan to Toombak dipping
Authors: Hassanin Ahmed Abbas , Idris Ali Mohamed
Published: July 2017

Background:

Toombak dipping-a form of smokeless tobacco-is highly prevalent in the Sudan.

Materials and methods:

For a case–control study, we selected oral cancer cases ( n = 98) and controls ( n = 98) at the Khartoum Teaching Dental Hospital. They were directly interviewed using a validated and a reliable instrument. For descriptive statistics, χ2 test was used for determining the odds ratio (OR) measuring the association between exposed and non-exposed. The effects of the confounding factors were tested by multivariate logistic regression analyses. The attributable risk of this agent in oral carcinogenesis was evaluated.

Results:

Significant risks for Toombak dipping (OR 3.8, 95% CI 1.7–8.6) and cigarette smoking (OR 2.7, 95% CI: 1.2–6.2) were found. The site of Toombak dipping and the tumor location showed positive correlation. The attribute risk for exclusive dippers was found to be 93% and 67% in females and males, respectively, whereas the adjusted attributable risk was 70.1%. The remaining 20–30% risks were attributed to other risk factors.

Conclusion:

In the Sudan, Toombak dipping is a major risk factor for oral squamous cell carcinoma. We were able to demonstrate a high attributable risk to this agent in oral carcinogenesis.
Hip Arthroscopy Failure in the Setting of Acetabular Dysplasia: A Concerning Trend?
Authors: Clohisy John C. , An Tonya , Haynes Jacob , Nepple Jeffrey J. , Schoenecker Perry , Baca Geneva ,   ANCHOR Group
Published: July 2017

Objectives:

Despite the success of hip arthroscopy, evidence suggests that arthroscopy alone is inadequate for treatment of conditions such as acetabular dysplasia (AD) due to its failure to correct structural deformity. Our objective was to define the incidence of failed hip arthroscopy in patients with symptomatic AD requiring periacetabular osteotomy (PAO). We secondarily analyzed the patient and structural characteristics of the failed arthroscopy cases.

Methods:

Utilizing a prospective, multicenter joint preservation database, we identified a cohort of primary AD patients from 2009-2014 who underwent PAO after a single prior ipsilateral hip arthroscopy. A comparison cohort of PAO patients without prior arthroscopy was isolated. Patients with hip disease attributable to cerebral palsy, Perthes, etc. were excluded. Demographic and radiographic data were summarized for each category. We compared the proportion of PAO after failed hip arthroscopy between the beginning and end of the study period by 2-tailed z-test with P<0.05 regarded as statistically significant.

Results:

Ninety-nine patients (99 hips) had received arthroscopic surgery prior to PAO, while 1053 patients (1103 hips) underwent PAO without prior hip arthroscopy. The proportion of PAO procedures after previous ipsilateral hip surgery stayed constant (13-19%); however, the incidence of PAO after previous hip arthroscopy increased from 2.5% in 2009 to 9.8% in 2014 (P=0.004). Over the 6 year period, the rate of all PAO procedures increased 12% per year, whereas rates of PAO after hip arthroscopy grew an average 54% per year. Female sex, increased average LCEA and ACEA, and decreased acetabular inclination were associated with failed hip arthroscopy (P<0.01).

Conclusion:

Over the last six years, we have seen clear increases in the rate of PAO after previous hip arthroscopy. Though the rate of PAO following previous ipsilateral surgery remains constant, hip arthroscopies now constitute almost 60% of those previous surgery attempts. Additionally, we have identified mild dysplastic features and female sex as characteristics that are associated with failure of hip arthroscopy. These results are consistent with prior literature suggesting that inadequately corrected structural deformity is the most common indication for revision surgery. These findings raise concern that isolated hip arthroscopy is being increasingly utilized in patients with acetabular dysplasia and highlight the need for refined surgical indications for hip arthroscopy and further investigation into its impact on subsequent surgeries. [Figure: see text]
O’Donoghue Sports Injury Award 10 Year Outcomes and Risk Factors after ACL Reconstruction: A Multicenter Cohort Study
Authors: Spindler Kurt P. , Huston Laura J. ,   MOON Knee Group
Published: July 2017

Objectives:

Identify the patient-reported outcomes (IKDC, KOOS, Marx activity scale) and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction.

Methods:

Unilateral ACL reconstructions were identified and prospectively enrolled between 2002 and 2004 from 7 sites in the Multicenter Orthopaedics Outcome Network (MOON). Patients pre-operatively d a series of validated outcome instruments, including the IKDC, KOOS, and Marx activity scale. At the time of surgery, physicians documented all intraarticular pathology, treatment, and surgical techniques utilized. Patients were followed at a minimum of 2, 6, and 10 years post-op, and asked to the same outcome instruments that they d at surgery (T0). Incidence and details of any subsequent knee surgeries were also obtained. Multivariable regression analysis was used to control for patient demographic variables, surgical technique and pathology variables, and incidence of subsequent surgery, in order to identify factors associated with patient-reported outcomes 10 years after ACL reconstruction.

Results:

A total of 1597 patients were eligible (57% male; median age 23 years). Ten-year follow-up was obtained on 83% (1320) [86% (1379) at 2 years, 86% (1375) at 6 years], while subsequent surgery data was obtained on over 90% of the cohort. Both IKDC and KOOS scores significantly improved after 2 years and were maintained at 6 and 10 years (Figure 1). Interestingly, Marx activity level scores dropped markedly over time, from a median score of 12 pts at baseline, 9 pts at 2 years, 7 pts at 6 years, to 6 pts at 10 years. The patient-specific risk factors for worse 10-year outcomes are shown in Table 1. The significant drivers of poorer outcomes were lower baseline outcome scores, higher BMI, smoker at baseline, history of medial meniscus surgery prior to ACL reconstruction, having a revision ACL reconstruction, grades 3-4 articular cartilage pathology in the medial, lateral and patellofemoral compartments, and having any subsequent ipsilateral surgery. Graft type (autograft BTB, autograft soft tissue, allograft), MCL or LCL pathology, and medial or lateral meniscus surgery at the time of ACL reconstruction were not found to be significant risk factors.

Conclusion:

Patients are able to perform sports-related functions and maintain a high knee-related quality of life 10 years after ACL reconstruction, although activity level declines over time. Multivariable analysis identified several key modifiable risk factors that significantly influence outcome. This prognostic information will undoubtedly aid physician counseling of patients’ expectations after ACL reconstruction at surgery and at 2 and 6 years to predict 10 year outcome. [Table: see text]
The Frequency of Glenohumeral Cartilage Lesions at the time of Shoulder Instability Surgery: A Multicenter Comparison of Primary and Revision Surgery Patients
Authors: Duchman Kyle R. , Hettrich Carolyn M. , Westermann Robert W. , Glass Natalie , Kuhn John E. , Wolf Brian R.
Published: July 2017

Objectives:

Revision shoulder stabilization procedures present a unique set of challenges that should be recognized by the treating surgeon in order to improve the likelihood of success. The current study aims to compare patient factors, intraoperative findings, and patient reported outcome measures between patients undergoing primary versus revision shoulder stabilization surgery.

Methods:

The Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort was utilized to identify all patients undergoing primary and revision open or arthroscopic shoulder instability surgery. Patients with concomitant rotator cuff pathology requiring operative repair were excluded. Patient demographic characteristics, intraoperative findings, and patient reported outcome measures at the time of shoulder stabilization were compared between primary and revision shoulder instability surgery patients using univariate methods using chi-square or Fisher exact tests for categorical variables and Wilcoxon rank sum test for continuous variables.

Results:

Primary shoulder stabilization procedures were performed in 625 (87.0%) patients and revision stabilization procedures in 93 patients (13.0%). Patients undergoing revision surgery were older (25.9 vs. 23.5 years, p<0.001), more frequently smoked (11.8 vs. 6.1%, p = 0.04), had a higher number of reported dislocation events (p = 0.004), and were more likely to undergo an open procedure as opposed to an all arthroscopic shoulder instability procedure (67.7 vs. 5.8%, p<0.001). Patients undergoing revision procedures were more likely to have glenoid or humeral head cartilage lesions at the time of surgery (77.4 vs. 57.8%, p<0.001), with bone loss involving greater than 20% of the glenoid or humeral head more frequently reported in revision procedures (19.4 vs. 2.6%, p <0.001) (Figure 1). However, the presence of glenohumeral bone loss did not negatively impact patient reported outcomes at the time of shoulder instability surgery.

Conclusion:

Glenohumeral articular cartilage lesions are a common finding at the time of shoulder stabilization procedures and are particularly frequent in patients undergoing revision stabilization procedures. Surgeons routinely performing these procedures should be prepared to deal with the technical challenges associated with glenoid or humeral head bone loss. However, at the time of surgery, the presence of articular cartilage lesions did not appear to negatively influence patient reported outcomes. Future studies should investigate the influence of articular cartilage lesions at mid- and long-term follow-up in this cohort of patients.
Remplissage Versus Modified Latarjet For Off-Track Hill-Sachs Lesions With Subcritical Glenoid Bone Loss
Authors: Yang Justin Shu , Mazzocca Augustus D. , Arciero Robert A.
Published: July 2017

Objectives:

Off track Hill-Sachs lesions have been associated with high rate of recurrent shoulder instability. Both arthroscopic Bankart with Remplissage and modified Latarjet have been described to treat off-track Hill-Sachs lesions. However, few comparative studies exist between the two techniques in heterogeneous populations. The purpose of this study was to examine the outcome of the two procedures in patients with off-track Hill-Sachs lesions with subcritical (<25%) glenoid bone loss, both in the primary and revision setting.

Methods:

Arthroscopic Bankart with Remplissage was performed in thirty-one patients and modified Latarjet was performed in forty patients with recurrent anterior shoulder instability, off-track Hill-Sachs lesion, and less than 25% glenoid bone loss. Surgeries were performed at two centers. Patients were divided based on if they have had no previous surgical stabilization (Group A) or if they have had one or more previous surgical stabilization (Group B). The mean follow up time was four years. Patients were assessed for their risk of recurrence using the Instability Severity Index score and had preoperative 3-dimensional imaging to assess humeral and glenoid bone loss. Single Assessment Numeric Evaluation (SANE), Western Ontario Shoulder Instability Index (WOSI), radiographs, range of motion, recurrence rate, subsequent procedures and complications were analyzed.

Results:

In the thirty-two patients of group A, seventeen had remplissage and fifteen had Latarjet performed. Within group A, there were no difference found between the two techniques in regards to SANE, WOSI, range of motion (p>0.35). There were no complications, recurrence or revision with both techniques in group A. In the thirty-nine patients of group B, fourteen had remplissage and twenty-five had Latarjet performed. In group B, the reoperation surgery rate was significantly higher in the remplissage group (36% vs 8%, p=0.044). The reoperation was performed predominately for pain in patients with remplissage and for recurrent instability with Latarjet. Recurrence instability rate were similar between the remplissage and Latarjet group (14% vs 8%, p=0.45). The WOSI score was similar between the remplissage and Latarjet group (405 vs 461, p=0.66). The complication rate was also similar (36% vs 40%, p=1).

Conclusion:

For off-track Hill-Sachs lesions with subcritical glenoid bone loss, both the remplissage and modified Latarjet can achieve excellent clinical results in the primary setting (no previous instability surgery). However, in the revision setting (one or more previous instability surgery), patients with remplissage may have a higher reoperation rate.