bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Risk Factors for Ramp Lesions Associated With Anterior Cruciate Ligament Injury
Authors: Kim Seong Hwan , Seo Hyun Je , Seo Dong Won , Kim Kang-Il , Lee Sang Hak
Published: May 2020

Background:

The incidence of meniscocapsular junction tears of the medial meniscus posterior horn, known as ramp lesions, is reported to be 9.3% to 23.9%. However, these lesions are not consistently diagnosed with routine arthroscopic exploration and magnetic resonance imaging (MRI).

Purpose:

To determine risk factors associated with ramp lesions in anterior cruciate ligament–injured knees.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 275 patients undergoing anterior cruciate ligament reconstruction between June 2011 and March 2019 were included in this study. Exclusion criteria were revisions, fracture histories, and multiple-ligament injuries other than medial collateral ligament injury. Patients were divided into 2 groups, those with and without ramp lesions according to arthroscopic diagnosis. Binary logistic regression was used to analyze risk factors: age, sex, body mass index, time from injury to surgery (<3 or ≥3 months), mechanism of injury (contact/noncontact), Segond fracture, side-to-side laxity, location of bone contusion, medial and lateral tibial/meniscal slope, and mechanical axis angle. Receiver operating characteristic curves and area under the curve were evaluated. A prediction model was developed by multivariable regression with generalized estimating equations.

Results:

Overall, 95 patients (34.5%) were confirmed as having a ramp lesion. The sensitivity of MRI for ramp lesions was 85.3%, and specificity was 78.3%. Significant risk factors for ramp lesion were as follows: posterior medial tibial plateau bone contusion on MRI (odds ratio [OR], 4.201; 95% CI, 2.081-8.482; P < .001), ≥3 months from injury (OR, 4.818; 95% CI, 2.158-10.757; P < .001), varus knee >3° (OR, 2.339; 95% CI, 1.048-5.217; P = .038), steeper medial tibial slope (OR, 1.289; 95% CI, 1.002-1.66; P = .049) and meniscal slope (OR, 1.464; 95% CI, 1.137-1.884; P = .003), and gradual lateral tibial slope (OR, 0.775; 95% CI, 0.657-0.914; P = .002). The area under the curve for the prediction model developed by logistic regression was 0.779 (sensitivity, 75.8%; specificity, 71.7%; P < .001) for ramp lesions.

Conclusion:

Care should be taken with patients who have significant risk factors for ramp lesions, including bone contusion at the posterior medial tibial plateau, chronic injury, steeper medial tibial and meniscal slope, gradual lateral tibial slope, and varus knee >3°.
Inflammatory Response of Articular Cartilage to Femoroacetabular Impingement in the Hip
Authors: Haneda Masahiko , Rai Muhammad Farooq , O’Keefe Regis J. , Brophy Robert H. , Clohisy John C. , Pascual-Garrido Cecilia
Published: May 2020

Background:

Femoroacetabular impingement (FAI) has been proposed as an etiologic factor in up to 50% of hips with osteoarthritis (OA). Inflammation is thought to be one of the main initiators of OA, yet little is known about the origin of intra-articular inflammation in FAI hips.

Hypothesis:

Articular cartilage from the impingement zone of patients with FAI has high levels of inflammation, reflecting initial inflammatory process in the hip.

Study Design:

Controlled laboratory study.

Methods:

Head-neck cartilage samples were obtained from patients with cam FAI (cam FAI, early FAI; n = 15), advanced OA secondary to cam FAI (FAI OA, late FAI; n = 15), and advanced OA secondary to developmental dysplasia of the hip (DDH OA, no impingement; n = 15). Cartilage procured from young adult donors (n = 7) served as control. Safranin O–stained sections were assessed for cartilage abnormality. Tissue viability was detected by TUNEL assay. Immunostaining of interleukin 1β (IL-1β), catabolic markers (matrix metalloproteinase 13 [MMP-13], a disintegrin and metalloproteinase with thrombospondin motif 4 [ADAMTS-4], aggrecan antibody to C-terminal neoepitope [NITEGE]), and an anabolic marker (type II collagen [COL2]) was performed to evaluate molecular inflammation and metabolic activity. The average percentage of immunopositive cells from the total cell count was calculated. Kruskal-Wallis test followed by Steel-Dwass post hoc test was used for multiple comparisons.

Results:

Microscopic osteoarthritic changes were more prevalent in cartilage of cam FAI and FAI OA groups compared with DDH OA and control groups. Cartilage in cam FAI and FAI OA groups, versus the DDH group, had higher expression of inflammatory molecules IL-1β (69.7% ± 18.1% and 72.5% ± 13.2% vs 32.7% ± 14.4%, respectively), MMP-13 (79.6% ± 12.6% and 71.4% ± 18.8% vs 38. 5% ± 13.3%), ADAMTS-4 (83.9% ± 12.2% and 82.6% ± 12.5% vs 45.7% ± 15.5%), and COL2 (93.6% ± 3.9% and 92.5% ± 5.8% vs 53.3% ± 21.0%) ( P < .001). Expression of NITEGE was similar among groups (cam FAI, 89.7% ± 7.7%; FAI OA, 95.7% ± 4.7%; DDH OA, 93.9% ± 5.2%; P = .0742). The control group had minimal expression of inflammatory markers. Inflammatory markers were expressed in all cartilage zones of early and late FAI but only in the superficial zone of the no impingement group.

Conclusion:

Cartilage from the impingement zone in FAI is associated with a high expression of inflammatory markers, extending throughout all cartilage zones.

Clinical Relevance:

Inflammation associated with FAI likely has a deleterious effect on joint homeostasis. Further clinical and translational studies are warranted to assess whether and how surgical treatment of FAI reduces molecular inflammation.
Static analysis of co-cured composite structures with double-layer damping membranes embedded
Authors: Wang Shaoqing , Liang Sen , Zheng Changsheng , Zhai Yanchun , Yan Yangyang
Published: May 2020

The purpose of this study is to determine the effects of various parameters on the deflection value and strain energy for the individual stress of a co-cured composite structure with double-layer damping membranes embedded (CCSDDME) simply supported on four edges. To achieve this goal, an analytical solution (double Fourier sine series) was developed for the deflection of an embedded co-cured damping composite plate with double-layer damping membranes embedded. The deflection value and strain energy of each stress component are deduced. The present formulation is validated based on the results obtained using the finite element method and parametric studies are then carried out to illustrate the effects of various parameters on the deflection value and strain energy for an individual stress of CCSDDME.
Framework for estimation of nacelle drag on isolated aero-engines with separate jets
Authors: Ramirez-Rubio Santiago , MacManus David G
Published: May 2020

Typically, the evaluation of nacelle drag in preliminary design is required to find an overall optimum engine cycle and flight trajectory. This work focuses on the drag characteristics of aero-engine nacelles with separate jet exhausts. The main body of analysis comes from 3D numerical simulations. A new near-field method to compute the post-exit force of a nacelle is presented and evaluated. The effects of the engine size, Mach number, mass flow capture ratio and angle of attack are assessed. The results obtained from the numerical assessments were used to evaluate conventional reduced-order models for the estimation of nacelle drag. Within this context, the effect of the engine size is typically estimated by the scaling ratio between the maximum areas and Reynolds numbers. The effect of the angle of attack on nacelle drag is mostly a function of the nacelle geometry and angle of attack. In general, typical low-order models based on skin friction and form factor can underestimate the friction drag by up to 15% at cruise operating point. Similarly, reduced-order models based solely on Reynolds number, and Mach number can underestimate the overall nacelle drag by up to 74% for free stream Mach number larger than the drag rise Mach number.
Book review: Supriya Singh, Commercialization of Hinterland and Dynamics of Class, Caste and Gender in Rural India
Authors: Bhattacharyya Urmi
Published: May 2020

Supriya Singh, Commercialization of Hinterland and Dynamics of Class, Caste and Gender in Rural India. Newcastle upon Tyne: Cambridge Scholars Publishing, 2017, 148 pp., £58.99 (Hardbound). ISBN: 978-1-4438-8647-5.
The Role of Religious Rituals in Fishing Community: A Study of Irakkam Fishermen in Pulicat Lake
Authors: Reddy C. Subba
Published: May 2020

This article focuses on the religious rituals associated with fishing and the processes that are in vogue in the fishermen community of Pulicat Lake. The role of the rituals in the contemporary socioeconomic context of the fishermen community is analyzed by applying functionalistic approach. The data were collected from the fishermen of Irakkam Island in Tada mandal of Nellore district of Andhra Pradesh state, by employing the qualitative techniques such as in-depth interview, observation, and focus group discussions. It is found that fishermen perform varieties of rituals such as annual worshipping of ancestral spirits, ritual of launching of new boat, worshipping of clan deities at clan level, and communal worship at village level. All these rituals are considerably functional in fulfilling the psychological needs of individuals and social needs of the community at the household, clan, and community levels. The psychological prop and social cohesion are found to be the most essential features of fishermen community to cope up with the social, economic, and environmental challenges, and these rituals function as instruments to instill psychological strength and social solidarity.
Indo-Nepal Trade and Investment: An Analysis
Authors: Taneja Nisha , Prakash Shravani , Bimal Samridhi , Garg Sakshi , Roy Riya
Published: May 2020

India and Nepal have traditionally shared a unique relationship of friendship and economic cooperation. The relationship is characterised by an open and people-friendly border and is built on shared historical, cultural, linguistic and ethnic links between people residing in India and Nepal.

With Nepal being a priority under India ‘Neighborhood First’ policy, strengthening the economic relationship holds immense significance and potential for both the countries. While the political relations between India and Nepal have been extensively studied, there is not much literature that explores the economic relationship between the two nations. This is an important issue to study, as India is Nepal’s largest export market, the biggest source of its imports, the top investor of foreign capital stock and among the largest donors of foreign aid. India also provides Nepal transit facility through its territory to access seaports for trading with the rest of the world.

Given this, the main objective of this article is to suggest policy measures, which can increase bilateral trade and investment between India and Nepal. The article analyses the bilateral trade patterns and estimates the maximum additional trade potential. A wide range of issues of importance pertaining to bilateral trade, including tariffs, levy of an agricultural reform fee, under utilisation of the tariff rate quota, non-tariff measures, issues related to Rules of Origin (ROO) and physical barriers to cross-border movement of goods are discussed. The trends and changing sectoral composition of India’s investment in Nepal and barriers and opportunities for Indian investment in Nepal are also analysed. The article concludes by charting a way forward for bolstering economic cooperation between the two countries by listing down recommendations for enhancing trade, addressing non-tariff barriers, upgrading infrastructure to improve connectivity and enhancing Indian FDI in Nepal.

JEL Classification: F10, F13, F15, F50, F53, P45
Bees Out of the Pandora’s Box: Economic Consequences of National Register in Assam
Authors: Sengupta Atanu , De Sanjoy
Published: May 2020

In India, at present, there is a lot of hue and cry for and against the National Register of Citizens (NRC) in Assam. All the arguments are however based on false perception of migration and its ill or well effects on the economy. The latest 2011 Census does not provide the migration tables in detail. Hence, we had no other option but to use the Census 2001 data to understand the nature and trend of migration in Assam. Our analysis suggests that the recent uproar over illegal migrants from neighboring country in Assam is more of a myth than reality and does not hold much economic justification. Firstly, official data suggests that the flow of internal migration in various districts of Assam is miniscule. Moreover, it is showing a declining trend over the last few decades. The historical international migration that took place in Assam was due to mainly ‘push’ factor and no such ‘push’ factors have been in sight in the last few decades. Secondly and more importantly, migration of any form (though waning in Assam) adds to the prosperity and well-being of the state.

JEL: J61, J6, Q56
Criminal Justice–Involved Women Navigate COVID-19: Notes From the Field
Authors: Ramaswamy Megha , Hemberg Jordana , Faust Alexandra , Wickliffe Joi , Comfort Megan , Lorvick Jennifer , Cropsey Karen
Published: May 2020

In March–April, 2020, we communicated with a cohort of criminal justice–involved (CJI) women to see how they were navigating COVID-19, chronic illness, homelessness, and shelter-in-place orders in Oakland, Birmingham, and Kansas City. We report on conversations with N = 35 women (out of the cohort of 474 women) and our own observations from ongoing criminal justice involvement studies. Women reported barriers to protecting themselves given widespread unstable housing and complex health needs, though many tried to follow COVID-19 prevention recommendations. Women expressed dissatisfaction with the suspension of research activities, as the pandemic contributed to a heightened need for study incentives, such as cash, emotional support, and other resources. COVID-19 is illuminating disparities between those who can follow recommended actions to prevent infection and those who lack resources to do so. Concerted efforts are required to reduce inequities that put the 1.3 million U.S. women under criminal justice supervision at risk for infection and mortality.
Building From the Bottom Up: The Importance of Tier 1 Supports in the Context of Tier 2 Interventions
Authors: Van Camp Alyssa M. , Wehby Joseph H. , Copeland Bailey A. , Bruhn Allison L.
Published: May 2020

School-Wide Positive Behavior Interventions and Supports (SWPBIS) relies on effective implementation of Tier 1 practices to ensure accurate identification of students in need of more intensive supports at Tier 2 or Tier 3. While measures of school-level fidelity are widely used, measures of classroom-level implementation of Tier 1 supports are less common. If classroom levels of Tier 1 supports are variable, schools may identify students for Tier 2 supports when, instead, teachers need support implementing Tier 1 in classrooms. The purpose of this case study was to assess the impact of a self-monitoring intervention, Monitoring Behavior on the Go (MoBeGo), on the academic engagement and disruptive behavior of a middle school student. Initially, the impact of the self-monitoring intervention was inadequate. In the context of evaluating the impact of a Tier 2 intervention, we identified an opportunity to assess whether a class-wide Tier 1 program, Class-Wide Function-Related Intervention Teams (CW-FIT), enhanced the effectiveness of the Tier 2 intervention. Using an A-B-BC-B-BC design, we compared the effectiveness of a Tier 2 intervention alone with a combined Tier 1 + Tier 2 intervention. When the class-wide Tier 1 program was layered on top of the Tier 2 intervention, the student’s academic engagement showed an increase in level and stability.
Detection, localization, and characterization of vision-threatening features of microaneurysms using optical coherence tomography angiography in diabetic maculopathy
Authors: Khatri Anadi , Pradhan Eli , KC Bal Kumar , Kharel Muna , Rijal Roshija Khanal , Timalsena Satish , Gurung Jeena , Gautam Sudhir , KC Ashma
Published: May 2020

Introduction

Diabetic maculopathy is a leading retinal cause of blindness. This study was conducted using optical coherence tomography angiography and noninvasive imaging modalities. Microaneurysms were evaluated for location, flow, and adjacent retinal tissue changes to establish knowledge of possible vision-threatening features. Methodology: This is a hospital-based, cross-sectional observational study. Eighteen patients with diabetic maculopathy were included in the study. Fundus photo, red-free filter image, infrared images with shadowgrams, optical coherence tomography cross sections, and optical coherence tomography angiography were analyzed. Mean, standard deviation, odds ratio, and 95% confidence interval were used for statistical analysis, and p-value of <0.05 was considered statistically significant where applicable.

Results

A total of 64 microaneurysms were evaluated. Forty-six (71.8%) microaneurysms were identifiable in all imaging modalities. In total, 53 (82.8%) were high-flow microaneurysms and 11 (17.2%) were low-flow microaneurysms. Thirty-eight of the high-flow microaneurysms (71.6% of the high-flow microaneurysms) were found in the deep capillary plexus, while only 15 (28.4% of the high-flow microaneurysms) were found in the superficial capillary plexus. Twenty-seven (71%) of the high-flow microaneurysms in deep capillary plexus were present in the areas of retinal thickening (odds ratio: 4.5, 95% confidence interval: 1.26–16.0, p = 0.02). A total of 11 microaneurysms were classified as low-flow microaneurysms and identified using fundus photo, red-free filter image, infrared images with shadowgrams, and optical coherence tomography—cross sections. They had a tendency to be present in the areas of decreased capillary plexus density (odds ratio: 25.6, 95% confidence interval: 5.09–128.7, p = 0.001).

Conclusion

Noninvasive imaging modalities combined with optical coherence tomography angiography can provide valuable information regarding microaneurysms. Certain features such as location and flow may help in predicting impending macular edema or ischemia.
Female warriors: a reproduction of patriarchal narrative of Hua Mulan in The Red Detachment of Women (1972)
Authors: Li Zhuying
Published: May 2020

During the Chinese Cultural Revolution, the CCP officially claimed that Chinese women achieved an equal position as men, and the Confucian patriarchal family was deconstructed. This article is an ongoing exploration of Maoist gender discourse by analysing the image of female warriors in the revolutionary opera film, The Red Detachment of Women (1972) which was made and popularised during the Cultural Revolution. This article finds that Maoist gender discourse failed to deconstruct the Confucian patriarchy. The image of female warriors in the revolutionary opera films was a reproduction of the patriarchal narrative of Hua Mulan, which served an ethical symbol of loyalty and filial daughter in the discourse of Confucian patriarchy. Similar to Mulan, the masculinised image of female warriors in the revolutionary opera films cannot be identified as a feminist representation yet a cultural and ethical symbol of filial daughter that leads to women’s subordination to men’s needs.
Childhood maltreatment on young adult depression: A moderated mediation model of negative automatic thoughts and self-compassion
Authors: Hou Xiang-Ling , Bian Xiao-Hua , Zuo Zhi-Hong , Xi Ju-Zhe , Ma Wei-Jun , Owens Laurence D
Published: May 2020

This study examines the mediating role of negative automatic thoughts on the link between childhood maltreatment and young adult depression, and the moderating role of self-compassion in this indirect link. College students ( N = 578) completed self-report questionnaires assessing the mentioned study variables. The results showed that childhood maltreatment was positively associated with young adult depression via negative automatic thoughts. Moreover, self-compassion moderated this indirect link such that participants with low self-compassion demonstrated a stronger indirect link than those with high self-compassion. These findings highlight the important role of self-compassion in countering the adverse outcomes of childhood maltreatment.
Risk Factors for Cardiovascular Events in Patients on Antidementia Medications
Authors: He Meiqi , Stevenson James M. , Zhang Yuting , Hernandez Inmaculada
Published: May 2020

Objective:

To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications.

Methods:

Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events.

Results:

Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27).

Conclusions:

Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.
Valuing relationships: The impact of a sensory program on the interactions of adolescents with severe-to-profound intellectual disabilities
Authors: Yuile Lauren Emily , Smidt Andy , Quinlan Sinead
Published: May 2020

Background:

People with severe-to-profound intellectual disabilities often lack meaningful interactions with others. Communication partners need to be skilled in identifying and responding to often-subtle behaviours. One method of facilitating interaction is the use of sensory-based stimuli.

Method:

This study measured the impact of sensory-based stimuli paired with behaviour chain interruptions for three participants in an alternating treatment design using a novel intervention, SensEngage. Measurements included behaviours previously identified as indicating person engagement, self-engagement, happiness as well as participants’ use of potential communicative acts (PCAs).

Results:

The results showed increased person engagement and happiness in the SensEngage condition compared to the non-sensory condition for all three participants. An increased use of PCAs and decrease in self-engagement were observed for two participants.

Conclusions:

SensEngage appears to positively impact person engagement, happiness, PCAs and self-engagement for people with severe-to-profound intellectual disabilities.
Big Five and HEXACO Personality Traits, Proenvironmental Attitudes, and Behaviors: A Meta-Analysis
Authors: Soutter Alistair Raymond Bryce , Bates Timothy C. , Mõttus René
Published: May 2020

With climate change and its consequences believed to be among the most vital challenges for humanity and the Earth’s ecosystem, it is important to understand why individuals do or do not adopt proenvironmental attitudes and behaviors. Personality traits are well suited for this purpose. Because no recent work has systematically combined the accumulating evidence on this topic, we aimed to meta-analyze the associations of the Big Five and HEXACO personality domains with proenvironmental attitudes and behaviors. A meta-analysis of 38 sources ( N = 44,993) implicated openness and honesty-humility as the strongest correlates of proenvironmental attitudes ( r = .22 and .20) and behaviors ( r = .21 and .25). Agreeableness, conscientiousness, and, to a lesser extent, extraversion were also associated with proenvironmental attitudes ( r = .15, .12, and .09) and behaviors ( r = .10, .11, and .10). Heterogeneity among effect sizes was partly explained by samples’ gender ratio, age, and country of origin and by the personality model. P-curve analyses, funnel plots, and Egger’s tests indicated significant but sporadic and small publication bias. As a validity test, the meta-analytic associations collectively provided substantial predictive accuracy for proenvironmental attitudes ( r = .44–.45) and behaviors ( r = .28–.43) in independent holdout samples.
Elbow flexion strength and contractile activity after partial ulnar nerve or intercostal nerve transfers for brachial plexus injuries
Authors: Chia Dawn Sinn Yii , Doi Kazuteru , Hattori Yasunori , Sakamoto Sotetsu
Published: May 2020

We compared the outcomes of 23 partial ulnar nerve and 15 intercostal nerve transfers for elbow flexion reconstruction in patients with C56 or C567 brachial plexus injuries using manual muscle power, dynamometric measurements of elbow flexion strength and electromyography. The range of elbow flexion and muscle strength recovery to Grade 3 or 4 were comparable between the two groups. The patients with C567 injuries had significantly stronger eccentric contraction after the partial ulnar nerve transfer than after the intercostal nerve transfer ( p < 0.05). Electromyography of individual muscles demonstrated that the patients with partial ulnar nerve transfers were unable to voluntarily isolate biceps contraction and recruited forearm flexors and extensors. The patients after partial ulnar nerve transfer had significantly more activity of the forearm muscles during concentric elbow flexion than after intercostal nerve transfers ( p < 0.05). We conclude that partial ulnar nerve transfers were superior to intercostal nerve transfers when assessed quantitatively with the dynamometer to evaluate elbow flexion, although simultaneous recruitment of forearm muscles may have contributed to the increased elbow flexion strength in the patients with the partial ulnar nerve transfer.

Level of evidence: III
The incidence of medial end clavicle fractures is higher than had previously been considered
Authors: Al-Hadithy Nawfal , Khokher Zakir H , Kang Niel , Rensburg Lee Van , Tytherleigh-Strong Graham
Published: May 2020

Background

Previous X-ray epidemiological studies have estimated the incidence of medial end clavicle fractures to account for 2–3% of all clavicle fractures.

Materials and methods

At our institution X-rays of every patient attending the Emergency Department are reviewed at a Virtual Fracture Clinic by a Consultant Orthopaedic Surgeon. Patients with a fracture are referred to the Shoulder and Elbow Fracture Clinic. Patients without a fracture are contacted and, if there are on-going concerns, are referred to the Shoulder and Elbow Fracture Clinic. Over an 18-month period we identified every patient that attended our Emergency Department that had sustained a clavicle fracture.

Results

In total 558 clavicle fractures were identified (139 (24.9%) – lateral, 360 (64.5%) – middle, 59 (10.6%) – medial). Of the 59 medial end fractures, 31 (52.5%) were identified on presentation at the Emergency Department, 13 (22%) at the Virtual Fracture Clinic, 6 (10.2%) on computed tomography scan at the Shoulder and Elbow Fracture Clinic and 9 (15.3%) were admitted directly to the trauma unit.

Conclusion

The results of this study suggest that the incidence of medial end clavicle fractures in the general population is higher than had previously been considered.

Level of evidence

IV
Predicting STAT1 as a prognostic marker in patients with solid cancer
Authors: Zhang Jinguo , Wang Fanchen , Liu Fangran , Xu Guoxiong
Published: May 2020

Background:

Aberrant activities of signal transducer and activator of transcription 1 (STAT1) have been implicated in cancer development. However, the prognostic value of STAT1 remains unclear. This report identified the role of STAT1 in prognosis in patients with solid cancer through open literature and The Cancer Genome Atlas (TCGA) database.

Methods:

Published articles were obtained from PubMed, Web of Science, and Embase databases according to a search strategy up to October 2019. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted to assess the prognostic factors of patients. TCGA datasets were used to explore the prognostic value of STAT1 in various cancers.

Results:

A total of 15 studies incorporating 2839 patients with solid cancers were included. Pooled data showed that overexpressed STAT1 favored long overall survival (OS) (HR = 0.604, 95% CI = 0.431–0.846, p = 0.003) and disease-specific survival (DSS) (HR = 0.650, 95% CI = 0.512–0.825, p = 0.000). In subgroup analyses, highly expressed STAT1 was correlated with long OS of patients with high-grade serous ovarian cancer and oral squamous cell carcinoma. Data extracted from TCGA datasets unveiled that STAT1 expression was significantly higher in 12 cancers (e.g. bladder and breast) than their adjacent normal tissues. Again, highly expressed STAT1 favored long OS of patients with ovarian cancer as well as rectum adenocarcinoma, sarcoma, and skin cutaneous melanoma. However, in renal carcinoma, brain lower grade glioma, lung adenocarcinoma, and pancreatic cancer, highly expressed STAT1 was correlated with poor OS of patients. Particularly in renal carcinoma, increased STAT1 expression was associated with high grade, later stage, large tumor size, and lymph node and distant metastasis.

Conclusion:

STAT1 has been identified to have prognostic value in patients with solid cancer. Highly expressed STAT1 may predict prognosis in cancer patients based on their tumor types.
Analysis of 408 Total Ankle Arthroplasty Adverse Events Reported to the US Food and Drug Administration From 2015 to 2018
Authors: Chen Jie , Akoh Craig C. , Kadakia Rishin , Somerson Jeremy S. , Easley Mark E. , Adams Samuel B. , DeOrio James K. , Nunley James A.
Published: May 2020

Background. Total ankle arthroplasty (TAA) use has increased with newer generation implants. Current reports in the literature regarding complications use data extracted from high-volume centers. The types of complications experienced by lower-volume centers may not be reflected in these reports. The purpose of this study was to determine a comprehensive TAA adverse event profile from a mandatory-reporting regulatory database. Methods. The US Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) database was reviewed from 2015 to 2018 to determine reported adverse events for approved implants. Results. Among 408 unique TAA device failures, the most common modes of failure were component loosening (17.9%), intraoperative guide or jig error (15.4%), infection (13.7%), and cyst formation (12.7%). In addition, the percentage distribution of adverse event failure types differed among implants. Conclusion. The MAUDE database is a publicly available method that requires mandatory reporting of approved device adverse events. Using this report, we found general agreement in types of complications reported in the literature, although there were some differences, as well as differences between implants. These data may more accurately reflect a comprehensive profile of TAA complications as data were taken from a database of all device users rather than only high-volume centers.

Levels of Evidence: NA
Review of Orbital Fractures in an Urban Level I Trauma Center
Authors: Amin Dina , Al-Mulki Kareem , Henriquez Oswaldo A. , Cheng Angela , Roser Steven , Abramowicz Shelly
Published: May 2020

Objective:

To perform a comprehensive review and analysis of surgically treated orbital fractures.

Study Design:

Retrospective cohort chart review study for surgically treated orbital fractures during 5 years.

Results:

A total of 173 patients (average age 41.6 years) were diagnosed with orbital fractures. Most were male with a ratio of 3.3:1. Most fractures were caused by assault (39.3%); 22.5% of the cases were bilateral. The left orbit (40.5%) was fractured more than the right. The orbital floor (97.1%) was the most common anatomic location and the maxilla (65.3%) was the most commonly involved bone. The average time from trauma to surgical intervention was 8.7 ± 14.6 days and the average time from surgical intervention to discharge was 5.1 ± 9.0 days. The transconjunctival incision (63%) was the most commonly used incision, and nonresorbable implant (92.7%) was the most commonly used implant. Finally, the length of stay for the repair of a simple orbital fracture was less than for complex orbital fracture (1.5 days and 5.9 days, respectively).

Conclusion:

Understanding the patterns and mechanisms of injury associated with orbital fractures can assist in developing standardized treatment protocols across all surgical specialties. This would ultimately allow for a uniform high quality of surgical care for patients with maxillofacial fractures.
Hyperinsulinemia contributes to impaired-glucose-tolerance-induced renal injury via mir-7977/SIRT3 signaling
Authors: Gao Zhongai , Wang Ziyan , Zhu Hong , Yuan Xinxin , Sun Mengdi , Wang Jingyu , Zuo Minxia , Cui Xiao , Han Ying , Zhang Yi , Yang Shaohua , Qin Yongzhang , Xu Jie , Yang Juhong , Chang Baocheng
Published: May 2020

Background:

Increasing evidence indicates that impaired glucose tolerance (IGT) is independently associated with chronic kidney disease, but the characteristics and underlying mechanisms remain largely unknown.

Methods:

Here, the cross-sectional study was performed to study the characteristics of IGT-induced renal injury (IGT-RI). Furthermore, urine microRNA profile was evaluated and microRNAs involved in tubular injury were determined by in-vitro experiments.

Results:

It was found that 12.1% of IGT patients had microalbuminuria, which we termed “IGT-RI.” Overall, 100% of patients with IGT-RI exhibited reabsorption dysfunction and 58.3% had structural damage in the renal tubules. Two-hour postprandial insulin, retinol-binding protein, and N-acetyl-β-glucosaminidase were significantly associated with microalbuminuria and they were independent risk factors for IGT-RI. The expression of mir-7977 was altered in IGT-RI patients and may be involved in cellular response to oxidative stress. In proximal tubule epithelial cells in vitro, a high level of insulin increased the expression of mir-7977 and decreased that of sirtuin 3 (SIRT3), leading to oxidative stress. Overexpression of mir-7977 further decreased SIRT3 expression, whereas inhibition of mir-7977 had the opposite effect. Furthermore, mir-7977 can bind to the 3′-untranslated region of SIRT3 mRNA and inhibit its expression. Moreover, inhibition of SIRT3 reduced the expression of cubilin and the endocytosis of albumin.

Conclusions:

In conclusion, IGT-RI mainly manifests as tubular injury, especially reabsorption dysfunction. Compensatory hyperinsulinemia may be involved. A high level of insulin can activate mir-7977/SIRT3 signaling, resulting in tubular injury by inducing oxidative stress as well as reabsorption dysfunction by inhibiting the expression of cubilin, ultimately contributing to IGT-RI.
Evaluating the risks of arrhythmia following electrical injury: Two cases of electrical injuries in the upper limbs
Authors: Jingo Koichi , Kondo Yutaka , Hirano Yohei , Inoue Juri , Kawasaki Takaaki , Miyoshi Yukari , Ishihara Tadashi , Okamoto Ken , Tanaka Hiroshi
Published: May 2020

Electrical injuries induce ventricular arrhythmias, which are lethal. Therefore, it is important to evaluate the risk of arrhythmias at initial presentation to the emergency department in cases of electrical injuries. Here, we report two cases with electrical injuries, where current flowed between the upper limbs, requiring 24-h hospitalization for arrhythmia monitoring. The patients were 57- and 30-year-old men, who sustained separate electrical injuries (6600 V, line voltage), with current flow from one hand to the other. They did not develop any ventricular arrhythmias during hospitalization and were discharged. The risk for ventricular arrhythmias is lower for electrical injuries occurring between the upper limbs than for those occurring between the upper and lower limbs. We conclude that 24-h hospitalization for monitoring of patients with electrical injuries of the upper limbs may be sufficient.
Chronic kidney disease impact on total joint arthroplasty outcomes: A National Inpatient Sample-based study
Authors: DiMagno Allyson N , Hajj-Hussein Inaya , Othmani Amjad El , Stasch Jordan , Sayeed Zain , El-Othmani Mouhanad M
Published: May 2020

Introduction:

In the United States, chronic kidney disease (CKD) affects roughly 11% of the population or 19.2 million people. As the prevalence of CKD and demand for total joint arthroplasty (TJA) continue to rise, it is critical to assess the impact of CKD on postoperative clinical and economic outcomes.

Methods:

Discharge data from 2006 to 2011 National Inpatient Sample were used for this study. A total of 851,150 TJA patients were divided into three cohorts: group 1 included no CKD, CKD stage I, and CKD stage II; group 2 included CKD stage III and stage IV; group 3 included CKD stage V. Inverse probability of treatment weighting/propensity score weighting was used to predict outcome variables as a function of age, sex, and Elixhauser comorbidities. Patients were compared against group I for in-hospital postoperative outcomes.

Results:

Stage III/IV CKD patients undergoing primary TJA had higher odds of any complication (odds ratio (OR), 2.63; p < 0.0001), longer length of stay (LOS), and higher total charge (LOS, 4.34 vs. 3.48 days; total charge, US$56,003 vs. US$46,115; p < 0.0001) when compared to patients with no CKD/stage I or II. Similarly, stage V CKD patients undergoing primary TJA had higher odds of any complication (OR, 1.64; p < 0.0001), longer LOS, and higher total charges (LOS, 5.81 vs. 3.48 days; total charge, US$59,869 vs. US$46,115) than their counterparts with no CKD/stage I or II CKD.

Discussion:

Our results indicate that stage III, IV, or V CKD, compared with those with no CKD, stage I or II patients are at a greater risk for postoperative complications and consume more resources following TJA.
Crossword: At the Crossroad
Authors: Jha Suchita
Published: May 2020

This case critically analyses the changing scenario of business dynamics in book reading. “Crossword,” a brand from India which started as a platform for bookselling, is finding difficult in recent times to survive in the market with people accessing books online or purchasing books online. The company has always tried to work on the innovation model to survive in the market .To be there in such a competitive market, it is important to streamline how the company should go ahead. The marketing team is not clear on what that should be, which should be the focus of their marketing plan. Should they start giving more emphasis to other divisions or book should be the basic source of their revenue model? They are also not clear that investing on communication will give them good returns.
Does Land Tenure Insecurity Affect Forest Cover Change? Evidence from Gerejeda State Forest in Ethiopia
Authors: Alemie Berhanu Kefale , Amsalu Tadesse
Published: May 2020

Literature shows that most evidences on the link between land tenure and land cover change come either from theoretical models or isolated tenure regimes. Specific to Ethiopia, the existing literature is limited to the investigation of these pertinent issues in isolation. This research aimed to investigate the effect of different tenure regimes on forest cover changes in Ethiopia. Three tenure regimes are experienced in Ethiopia from 1973 to 2015. Both social and spatio-temporal data analyses are carried out. The spatial results demonstrated that the forest cover has declined across time. This study reveals that tenure security is necessary to prevent mismanagement of forest cover, and its effect becomes more visible when it is integrated with measures that halt the direct and underlying drivers of forest cover change. Thus, tenure security should be considered as one important attribute in realizing sustainable forest management in particular and rural development in general.
Power, Hegemony, and World Society Theory: A Critical Evaluation
Authors: Downey Liam , Lawrence Elizabeth , Pyles Micah , Lee Derek
Published: May 2020

World society theory has been one of the better published theoretical paradigms of the past 30 to 40 years. But despite its publishing successes, world society theory and research are beset by a number of theoretical and empirical problems that call into question the theory’s ability to accurately describe and explain the global diffusion of government practices, policies, and structures. The authors summarize world society theory’s key claims, demonstrate that the theory has trouble explaining a set of diffusion outcomes that it needs to be able to explain, and show that a key reason for this is that the actors highlighted by the theory are embedded in hierarchical and power-laden organizations, networks, and fields that strongly limit the kinds of actions these actors can take and the kinds of cultural scripts they can follow.
The Speed and the Degree of SME Internationalisation in Bangalore: An Analysis of its Determining Factors
Authors: Santhosh Channappa , Bala Subrahmanya Mungila Halemane
Published: May 2020

This article presents an empirical inquiry on the drivers that have influenced the speed and the degree of SME internationalisation in Bangalore. The article is based on primary data gathered from 70 internationalised small and medium enterprises (SMEs) belonging to the machinery industry in Bangalore urban district. Our analysis ascertained that the size of the firm and CEOs’ foreign language proficiency are the significant determinants of the speed of SME internationalisation. CEOs’ international experience, motivation, international network and speed of entry positively influenced the degree of SME internationalisation. Thus, the present study lays emphasis on ‘entrepreneurial competence’ and ‘strategic entry’ that determine the speed and degree of internationalisation of SMEs, for appropriate policy attention for promoting SME internationalisation.
Individualized environments, individual cures: An examination of Lyme disease activism in Virginia
Authors: Kaup Brent Z , Abel Matthew , Sikirica Amanda
Published: May 2020

Doctors, patients, and public health professionals widely recognize that certain physical environments are more conducive to the emergence and spread of Lyme disease. However, ecological solutions to the spread of the disease are rarely pursued. Drawing on interviews with Lyme activists, politicians, and state and local administrators dealing with Lyme disease related issues as well as an analysis of Lyme disease legislation in the state of Virginia, we examine why solutions to Lyme disease most often focus on expanding individual choices for diagnosis and treatment over changing the environments that enhance the risk of Lyme disease. We argue that the emergence of Lyme disease in a neoliberal society pushed debates on how to best deal with the disease away from its underpinning environmental causes and into individual human bodies.
Inducible MyD88/CD40 synergizes with IL-15 to enhance antitumor efficacy of CAR-NK cells
Authors: Wang Xiaomei , Jasinski Daniel L. , Medina Jan L. , Spencer David M. , Foster Aaron E. , Bayle J. Henri
Published: May 2020

Natural killer (NK) cells expressing chimeric antigen receptors (CARs) are a promising anticancer immunotherapy, leveraging both innate NK cell antitumor activity and target-specific cytotoxicity. Inducible MyD88/CD40 (iMC) is a potent, rimiducid-regulated protein switch that has been deployed previously as a T-cell activator to enhance proliferation and persistence of CAR-modified T cells. In this study, iMC was extended to CAR-NK cells to enhance their growth and augment cytotoxicity against tumor cells. iMC-activated NK cells substantially increased cytokine and chemokine secretion and displayed higher levels of perforin and granzyme B degranulation. In addition, iMC activation could be coupled with ectopic interleukin-15 (IL-15) to further enhance NK cell proliferation. When coexpressed with a target-specific CAR (CD123 or BCMA), this IL-15/iMC system showed further augmented antitumor activity through enhanced CAR-NK cell expansion and cytolytic activity. To protect against potential toxicity from engineered NK cells, an orthogonal rapamycin-regulated Caspase-9 (iRC9) was included in a 4-gene, dual-switch platform. After infusion of dual-switch NK cells, pharmacologic iRC9 dimerization led to rapid elimination of a majority of expanded transduced NK cells. Thus, CAR-NK cells utilizing dual molecular switches provide an innovative and effective approach to cancer immunotherapy with controlled specificity, efficacy, and safety.
Targeted busulfan-based reduced-intensity conditioning and HLA-matched HSCT cure hemophagocytic lymphohistiocytosis
Authors: Felber Matthias , Steward Colin G. , Kentouche Karim , Fasth Anders , Wynn Robert F. , Zeilhofer Ulrike , Haunerdinger Veronika , Volkmer Benjamin , Prader Seraina , Gruhn Bernd , Ehl Stephan , Lehmberg Kai , Müller Daniel , Gennery Andrew R. , Albert Michael H. , Hauck Fabian , Rao Kanchan , Veys Paul , Hassan Moustapha , Lankester Arjan C. , Schmid Jana Pachlopnik , Hauri-Hohl Mathias M. , Güngör Tayfun
Published: May 2020

Reduced-intensity/reduced-toxicity conditioning and allogeneic T-cell replete hematopoietic stem cell transplantation are curative in patients with hemophagocytic lymphohistiocytosis (HLH). Unstable donor chimerism (DC) and relapses are clinical challenges . We examined the effect of a reduced-intensity conditioning regimen based on targeted busulfan to enhance myeloid DC in HLH. The European Society for Bone and Marrow Transplantation–approved reduced-intensity conditioning protocol comprised targeted submyeloablative IV busulfan, IV fludarabine, and serotherapy comprising IV alemtuzumab (0.5-0.8 mg/kg) for unrelated-donor and IV rabbit anti–T-cell globulin for related-donor transplants. We assessed toxicity, engraftment, graft-versus-host disease (GHVD), DC in blood cell subtypes, and overall survival/event-free survival. Twenty-five patients from 7 centers were treated (median age, 0.68 year). The median total dose and cumulative area under the curve of busulfan was 13.1 mg/kg (6.4-26.4) and 63.1 mg/L × h (48-77), respectively. Bone marrow, peripheral blood stem cell, or cord blood transplants from HLA-matched related (n = 7) or unrelated (n = 18) donors were administered. Donor cells engrafted in all patients (median: neutrophils d+20/platelets d+28). At last follow-up (median, 36 months; range, 8-111 months), the median DC of CD15+ neutrophils, CD3+ T cells, and CD16+56+ natural killer cells was 99.5% (10-100), 97% (30-100), and 97.5% (30-100), respectively. Eight patients (32%) developed sinusoidal obstruction syndrome, resolving after defibrotide treatment. The 3-year overall survival and event-free survival rates were both 100%. None of the patients developed acute grade III to IV GHVD. Limited chronic GVHD was encountered in 4%. This regimen achieves excellent results with stable DC in patients with HLH.