bluuebunny/crossref_metadata_2025 huggingface dataset:
Corporate Debt Vulnerability and Non-performing Assets in India
Authors: Dhananjaya K.
Published: July 2020

This article examines the increasing corporate debt vulnerability and its impact on the asset quality of the Indian public sector banks (PSBs) in the post-global financial crisis (post-GFC) of 2008. The study shows that the stress in both corporate and bank balance sheets has increased in the post-GFC. As a result, there has been a steep increase the proportion of firms with negative profitability. The article finds that the declining profitability has severely affected the debt serviceability of the firms. Consequently, the debt at risk has risen significantly, which in turn has contributed to increase in non-performing assets (NPAs) of the banking sector, particularly, the PSBs. Using the panel regression technique, the study finds that the corporate debt vulnerability is an important determinant of the growth of NPAs along with other factors such as debt concentration, corporate sales growth, lending to sensitive sectors, bank profitability, bank size and the efficiency of banks.
Mental Well-Being and Its Associated Factors Among Myanmar Migrant Workers in Penang, Malaysia
Authors: Htay Mila Nu Nu , Latt Swe Swe , Maung Khine Sandar , Myint Wai Wai , Moe Soe
Published: July 2020

International migration has become a global phenomenon bringing with it complex and interrelated issues related to the physical and mental well-being of the people involved. This study investigated the mental well-being and factors associated with mental health among Myanmar migrant workers (MMW) in Malaysia. The cross-sectional study was conducted in Penang, Malaysia by using the WHO-5 Well-Being Index Scale (WHO-5) and the Mental Health subscale of 36 items in the Short Form Health Survey (SF-36). Among 192 migrant workers who were understudied, 79.2% had poor mental well-being according to the WHO-5 scale. The duration of stay in Malaysia and without receiving financial aid from their employers despite having a physical illness were significantly associated with poor mental well-being. Mental health support groups should target migrant workers for mental health education and find ways to provide assistance for them. Furthermore, premigration training should be delivered at the country of origin that also provides information on the availability of mental health support in the host country.
Revisiting the Causal Links between Economic Sanctions and Human Rights Violations
Authors: Liou Ryan Yu-Lin , Murdie Amanda , Peksen Dursun
Published: July 2020

There is some consensus in the literature that economic sanctions might prompt more human rights abuses in target countries. Yet, the causal mechanisms underlining the sanctions–repression nexus remain little understood. Using causal mediation analysis, we examine the processes through which sanctions might deteriorate human rights conditions. We specifically propose two indirect mechanisms driving human rights violations: increased domestic dissent and reduced government capacity. Sanctions are likely to trigger domestic dissent, and this instability would further induce the government to employ repression. Reduced government capacity caused by sanctions will harm the government’s ability to screen and oversee its security agents, which would subsequently lead to increased human rights abuses. Results from a time-series, cross-national data analysis indicate that sanctions-induced dissent, particularly violent dissent, plays a significant mediating role in the sanctions–repression link. Likewise, we find strong evidence that diminished fiscal capacity triggered by sanctions is likely to result in more repression. There is also some modest evidence that corruption as a proxy for poor governance mediates the sanctions–repression relationship.
Carcinoma Showing Thymus-Like Differentiation (CASTLE) Arising in the Sublingual Gland
Authors: Ardighieri Laura , Tomasoni Michele , Battocchio Simonetta , Facchetti Fabio , Maroldi Roberto , Nicolai Piero , Lombardi Davide
Published: July 2020

Carcinoma showing thymic-like differentiation (CASTLE) is a rare tumor most commonly occurring in the thyroid and soft tissues of the neck. We report the first case of CASTLE occurring in the sublingual gland. The patient, a 35-year-old healthy man, presented with a submucosal lesion located in the anterior right floor of the oral cavity and an ipsilateral neck mass. The lesion had been previously investigated by neck computed tomography and ultrasound-guided fine needle aspiration cytology and diagnosed as metastatic squamous cell carcinoma. After oral cavity magnetic resonance imaging, positron emission tomography, and a non-diriment, fine needle aspiration cytology of the sublingual mass, the patient was treated as affected by a sublingual gland malignancy with removal of primary tumor and neck dissection. Morphological and immunohistochemical findings were diagnostic for primary sublingual gland CASTLE. The patient received adjuvant radiotherapy and is free of disease 2 years after treatment. We describe the pathological features of the lesion and discuss the possible differential diagnoses.
Pes Planus Deformity and Its Association With Hallux Valgus Recurrence Following Scarf Osteotomy
Authors: Heyes Gavin John , Vosoughi Amir R. , Weigelt Lizzy , Mason Lyndon , Molloy Andrew
Published: July 2020

Background:

Hallux valgus recurrence is an unsatisfactory complication, with many causes postulated. This study investigated the effect of pes planus on recurrence after scarf osteotomy.

Methods:

A total of 183 feet were retrospectively reviewed. All patients were treated with a scarf osteotomy and if required Akin osteotomy. We measured preoperative lateral talus first metatarsal angle (T1MA) to study pes planus; an angle of under −4 degrees was considered pes planus. We measured pre and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and sesamoid location. In total 164 feet were suitable for inclusion, with follow-up of at least 6 months (10 males and 154 females, mean age: 52 years).

Results:

Recurrence frequency (HVA greater than 15 degrees) was 27 feet (16%). Hallux valgus recurrence was not influenced by gender ( P value = .66) or preoperative IMA ( P value = .48). Preoperative HVA greater than 35 degrees was associated with increased frequency of recurrence ( P value = .004). Those with T1MA less than −10 degrees demonstrated progression in HVA and deterioration in sesamoid location up to 6 months postoperatively ( P value = .038). HVA did not progress beyond 6 months. The prevalence of recurrent hallux valgus with normal T1MA was 1%, in T1MA −4 to −10 degrees it was 29% and in T1MA less than −10 degrees it was 47% ( P value <.001). Breaks in T1MA less than −4 degrees were found at the naviculocuneiform joint in 68% of feet in this series.

Conclusion:

The prevalence of hallux valgus recurrence correlated with the severity of pes planus.

Level of Evidence:

Level III, retrospective cohort study.
How Do Local Policy Makers Learn about Climate Change Adaptation Policies? Examining Study Visits as an Instrument of Policy Learning in the European Union
Authors: Haupt Wolfgang
Published: July 2020

Study visits are an underresearched phenomenon, particularly in the field of climate change adaptation. Drawing on interviews with key local stakeholders, this article investigates study visits organized by European municipal climate networks. The results of this exploratory research show that study visits about adaptation policies can (1) particularly stimulate conceptual learning, (2) increase the credibility of policies within municipal administrations, (3) be used as strategic instruments by mentor cities, (4) be more successful if the peer-cities are not too different (in terms of size, institutional context), and (5) under certain conditions, lead to policy adoption in a learning city. Future research needs to critically discuss the mass suitability of learning from frontrunner cities. Furthermore, a call is raised for more research and practical action on how to initiate and improve learning exchanges beyond the strict division between mentors and learners. Instead, the focus needs to be on mutual learning exchanges.
Interference: A Much-Neglected Aspect in High-Throughput Screening of Nanoparticles
Authors: Andraos Charlene , Yu Il Je , Gulumian Mary
Published: July 2020

Despite several studies addressing nanoparticle (NP) interference with conventional toxicity assay systems, it appears that researchers still rely heavily on these assays, particularly for high-throughput screening (HTS) applications in order to generate “big” data for predictive toxicity approaches. Moreover, researchers often overlook investigating the different types of interference mechanisms as the type is evidently dependent on the type of assay system implemented. The approaches implemented in the literature appear to be not adequate as it often addresses only one type of interference mechanism with the exclusion of others. For example, interference of NPs that have entered cells would require intracellular assessment of their interference with fluorescent dyes, which has so far been neglected. The present study investigated the mechanisms of interference of gold NPs and silver NPs in assay systems implemented in HTS including optical interference as well as adsorption or catalysis. The conventional assays selected cover all optical read-out systems, that is, absorbance (XTT toxicity assay), fluorescence (CytoTox-ONE Homogeneous membrane integrity assay), and luminescence (CellTiter Glo luminescent assay). Furthermore, this study demonstrated NP quenching of fluorescent dyes also used in HTS (2′,7′-dichlorofluorescein, propidium iodide, and 5,5′,6,6′-tetrachloro-1,1′,3,3′-tetraethyl-benzamidazolocarbocyanin iodide). To conclude, NP interference is, as such, not a novel concept, however, ignoring this aspect in HTS may jeopardize attempts in predictive toxicology. It should be mandatory to report the assessment of all mechanisms of interference within HTS, as well as to confirm results with label-free methodologies to ensure reliable big data generation for predictive toxicology.
Thromboelastography in cats with cholestatic liver disease
Authors: Kakar Neketa , Daniel Gideon , Fellman Claire , de Laforcade Armelle , Webster Cynthia RL
Published: July 2020

Objectives

While thromboelastography (TEG) has helped define a complex state of hemostasis in dogs and humans with hepatobiliary disease, it has not been explored in cats with cholestatic liver disease (CLD). The objective of this study was to describe TEG parameters in cats with CLD and to compare these parameters with conventional plasma-based coagulation tests, white blood cell (WBC) count and biochemical indicators of liver disease grade and severity.

Methods

Eighteen cats with CLD, defined by a serum bilirubin ⩾3 mg/dl and a greater than two-fold increase in serum alanine aminotransferase (ALT) and/or alkaline phosphatase (ALP) activity, were prospectively enrolled. All cats received vitamin K1 subcutaneously for 24–36 h prior to acquisition of blood for kaolin-activated TEG analysis, prothrombin time (PT) and activated partial thromboplastin time (aPTT). Patient total solids, packed cell volume, platelet count, WBC count, and serum liver enzymes and bilirubin were extracted from the medical record and correlated with coagulation test results.

Results

TEG global clot strength (TEG G) values defined 9/18 (50%), 5/18 (28%) and 4/18 (22%) cats as hypercoagulable, normocoagulable or hypocoagulable, respectively. TEG G was significantly negatively correlated with PT, aPTT and serum ALP activity and positively correlated with total solids. Five cats (5/18, 28%) were hyperfibrinolytic with clot lysis at 60 mins (LY 60) >15.3%. LY 60 was significantly positively correlated with PT.

Conclusions and relevance

By TEG analysis, cholestatic cats replete with vitamin K1 display a variety of coagulation profiles. Indications of synthetic failure (prolonged PT and aPTT) were associated with hypocoagulable and hyperfibrinolytic TEG parameters. High disease activity (serum ALP) was associated with a hypocoagulable state.
Academic Southernness as Affective Boldness: A Quarantined Testimonial
Authors: Barbosa Eliana Rosa de Queiroz
Published: July 2020

This position statement elaborates on academic southernness, arguing its endemic quarantined position in Western and Northern academia. Drawing from the author’s personal experiences, this piece creates a critical dialogue with bell hook’s “choosing the margin as a space of radical openness” (2000), building the notion of academic southernness. Academic southernness is conceived summing Bhan’s notion of southern urban practice (2019) and Hutta’s affective boldness (2019), and is based on prioritizing action (against reflection), embeddedness (contrary to distance), and solidarity (in opposition to critique). Academic southernness is a permanent engaged and grounded perspective and attitude when facing (endemic) urban crisis, summarized by an extreme pragmatism, commonly unfamiliar for those from the “north” and explained by the anthem “act first, theorize later.” Academic southernness is foregrounded in contexts of crisis, such as the current pandemic, by affectively engaging in practices and with practitioners throughout territories of precarity, demonstrating engagement, embeddedness, and bold solidarities.
Restricted Spatiality and the Inflation of Digital Space, an Urban Perspective
Authors: Iranmanesh Aminreza , Alpar Atun Resmiye
Published: July 2020

This article aims to explore whether or not digital space assumes the role of the spatial urban grid when movement of people is restricted under quarantine. The era of Web 2.0 and the increasingly easy access to mobile devices and the internet has created alternative virtual space for urban socio-spatial interactions. The article addresses these concepts in three parts. First, it adapts a theoretical framework that can address the emerging digital public and spatial restrictions. Second, it explores the possible inflation of digital space. Third, it questions the possibility of transfer of spatiality into virtual space. The finding shows significant inflation of digital space after quarantine, but no significant spatial characteristic can be identified among those interactions. The study emphasizes the importance of adapting existing theories for evolving urban challenges.
Quarantine(d) Space: Urla-Izmir (Smyrna) Island
Authors: Tuncbilek Gonca Z.
Published: July 2020

Even in the twenty-first century, pandemics lead to a particular kind of spatial organization, such as quarantine. The outbreak of the contamination era re-justifies the medicalization of spaces. Throughout history, there have been several attempts to design spaces for contagious diseases and pandemic situations all over the world—quarantine islands, lazarettos, and healthcare architecture. In the nineteenth century, the first quarantine procedures started in the Ottoman Empire, and Urla-Izmir (Smyrna) island was established as one of the examples of the quarantine system. This study investigates the architecture organization of the quarantine island as an example of a “panoptic” space.
What’s in a name? That which we call Multiple Sclerosis Fatigue
Authors: Hubbard Amy Lynn , Golla Heidrun , Lausberg Hedda
Published: July 2020

Very limited progress has been made to date in the treatment of debilitating Multiple Sclerosis (MS) daily onset symptoms. These daily symptoms include motor, sensory, and cognitive impairments as well as an overwhelming feeling of tiredness, often referred to as “MS fatigue.” Although widely cited as a main cause of inability to work and poor quality of life in patients with MS, daily onset MS-related tiredness continues to defy definition, and, consequently, measurement and treatment. Beginning with a historical overview of observations of daily onset MS-related tiredness, this Topical Review demonstrates how the misnomer “MS fatigue” has introduced ongoing misunderstanding for patients, investigators, clinicians, and therapists. Finally, combining current findings in clinical neuroscience with the striking set of long-standing commonalities present throughout the past 200 years of clinical observations, we underscore the immediate necessity for conceptual and applied change, to be initiated by the renaming of this distinct syndrome.
Assessment of Sex Differences in Recovery of Motor and Sensory Impairments Poststroke
Authors: Hawe Rachel L. , Cluff Tyler , Dowlatshahi Dar , Hill Michael D. , Dukelow Sean P.
Published: July 2020

Background. Understanding potential sex differences in stroke recovery is important for prognosis, ensuring appropriate allocation of health care resources, and for stratification in research studies. Previously, functional measures have shown poorer outcomes for females, however, little is known about sex differences that may exist in specific motor and sensory impairments. Objective. The aim of this study was to utilize robotic assessments of motor and sensory impairments to determine if there are sex differences at the impairment level in stroke recovery over the first 6 months poststroke. Methods. We used robotic and clinical assessments of motor and sensory impairments at 1, 6, 12, and 26 weeks poststroke in 108 males and 52 females. Linear mixed models were used to examine the effect of sex on recovery poststroke, controlling for age and lesion volume. Results. In general, we did not find significant sex differences across a range of assessments. The exception to this was a sex × age interaction for the Purdue Pegboard Assessment, where we found that females had better performance than males at younger ages (<62 years), but males had better performance at older ages. Conclusions. While recruitment biases need to be acknowledged when generalizing our results to stroke recovery at-large, our results suggest that sex differences do not exist at the impairment level poststroke.
Quantifying Postural Control in Premanifest and Manifest Huntington Disease Using Wearable Sensors
Authors: Porciuncula Franchino , Wasserman Paula , Marder Karen S. , Rao Ashwini K.
Published: July 2020

Background. Impairments in postural control in Huntington disease (HD) have important consequences for daily functioning. This observational study systematically examined baseline postural control and the effect of sensory attenuation and sensory enhancement on postural control across the spectrum of HD. Methods. Participants (n = 39) included healthy controls and individuals in premanifest (pHD) and manifest stages (mHD) of HD. Using wearable sensors, postural control was assessed according to (1) postural set (sit vs stand), (2) sensory attenuation using clinical test of sensory integration, and (3) sensory enhancement with gaze fixation. Outcomes included sway smoothness, amplitude, and frequency. Results. Based on postural set, pHD reduced postural sway in sitting relative to standing, whereas mHD had pronounced sway in standing and sitting, highlighting a baseline postural deficit. During sensory attenuation, postural control in pHD deteriorated relative to controls when proprioceptive demands were high (eyes closed on foam), whereas mHD had significant deterioration of postural control when proprioception was attenuated (eyes open and closed on foam). Finally, gaze fixation improved sway smoothness, amplitude, and frequency in pHD; however, no benefit was observed in mHD. Conclusions. Systematic examination of postural control revealed a fundamental postural deficit in mHD, which further deteriorates when proprioception is challenged. Meanwhile, postural deficits in pHD are detectable when proprioceptive challenge is high. Sensory enhancing strategies using gaze fixation to benefit posture may be useful when introduced well before motor diagnosis. These findings encourage further examination of wearable sensors as part of routine clinical assessments in HD.
Preparation of an N-doped mesoporous carbon sphere and sheet composite as a high-performance supercapacitor
Authors: Hu Xiaolin , Liu Lei , Zhang Yue , Chen Aibing
Published: July 2020

Carbon-based materials with multidimensional structures generally exhibit improved properties compared with single-morphology carbon materials for various applications including catalysis, adsorption, and energy storage. Here, an N-doped mesoporous carbon sphere and sheet composite is prepared by a co-assembly strategy using an ionic liquid ([C18Mim]Br) as the structure-directing agent, ethylenediamine as the catalyst, tetraethyl orthosilicate as the pore-forming agent, and resorcinol formaldehyde resin as the carbon precursor. [C18Mim]Br and ethylenediamine not only induce formation of the unique structure but also lead to in situ nitrogen doping on the N-doped mesoporous carbon skeleton. The obtained N-doped mesoporous carbon shows a unique composite structure of thin sheets embedded with carbon spheres, having high a specific surface area and uniform mesopore distribution. When used as an electrode material, the N-doped mesoporous carbon shows a good specific capacity of 273 F g−1 at a current density of 0.5 A g−1 and a good rate capability (82.1% of the capacitance is retained at a high current density of 10 A g−1). Moreover, the N-doped mesoporous carbon exhibited ideal stability behavior (91.6% capacitive retention after 10,000 cycles), indicating a promising role as an electrode material for excellent performance supercapacitors.
Application of improved intelligent ant colony algorithm in protein folding prediction
Authors: Wang Fengjuan , Xu Cheng , Jiang Shufeng , Xu Fengxia
Published: July 2020

While the single ant colony algorithm and the fish swarm algorithm have many advantages, they also have various shortcomings. After analyzing the advantages and disadvantages of the ant colony algorithm and the fish swarm algorithm, this paper uses the complementary principle of the two algorithms to effectively fuse the two population intelligent algorithms. The improved swarm intelligence algorithm is applied to the well-considered protein folding prediction problem, and the simplified protein structure Toy model is verified, and the ideal results are obtained. The improved algorithm enhances the search ability, and the computational efficiency is greatly improved, ensuring the accuracy of the operation.
Efficacy and safety of adalimumab in Chinese patients with moderately to severely active Crohn’s disease: results from a randomized trial
Authors: Chen Baili , Gao Xiang , Zhong Jie , Ren Jianlin , Zhu Xuan , Liu Zhanju , Wu Kaichun , Kalabic Jasmina , Yu Zhuqing , Huang Bidan , Kwatra Nisha , Doan Thao , Robinson Anne M. , Chen Min-Hu
Published: July 2020

Background and Aims:

Efficacy of adalimumab in Crohn’s disease (CD) has not been shown in China. The aim of this study was to evaluate the efficacy and safety of adalimumab in Chinese patients with CD.

Methods:

This 26-week, multicenter, phase III study evaluated patients with moderately to severely active CD and elevated high-sensitivity C-reactive protein (⩾3 mg/l) who were naïve to anti–tumor necrosis factor therapy. Patients were randomized to double-blind adalimumab 160/80 mg at weeks 0/2 and 40 mg at weeks 4/6 or placebo at weeks 0/2 followed by blinded adalimumab 160/80 mg at weeks 4/6. At week 8, all patients received open-label 40 mg adalimumab every other week through week 26. The primary endpoint was clinical remission [CD activity index (CDAI) <150] at week 4. Clinical remission at week 26 was assessed in week-8 responders (decrease in CDAI ⩾70 points at week 8 from baseline) and compared with a clinically meaningful threshold of 30%. Adverse events (AEs) were recorded throughout the study.

Results:

At baseline, 205 patients were enrolled, with mean [standard deviation (SD)] age of 32.9 (9.9) years and CD duration of 2.7 (3.0) years. At week 4, 38/102 patients (37%) receiving adalimumab and 7/103 (7%) receiving placebo ( p < 0.001) achieved clinical remission. Among week-8 responders, 93/144 (65%) achieved clinical remission at week 26 ( p < 0.001). No unexpected AEs and no malignancies, active tuberculosis, or deaths were reported.

Conclusions:

Adalimumab induced and maintained remission in Chinese patients with CD. Safety results were consistent with the known safety profile of adalimumab.

identifier:

NCT02499783
Social Media Use and Participation in Dueling Protests: The Case of the 2016–2017 Presidential Corruption Scandal in South Korea
Authors: Chang Kiyoung , Park Jeeyoung
Published: July 2020

This study examines how citizens’ social media use may have influenced their participation in highly polarizing protests during the 2016–2017 corruption scandal in South Korea. As social media users mobilize politically by acquiring varied political information from other users, social media use created more incentives for citizens to participate in both pro- and anti-impeachment protests during the scandal. Given that social media is an important arena for political activism, participation in rival protests also influences many motivated protesters to strengthen their side’s voices online. Thus, protests may increase citizens’ political use of social media. Our empirical analysis suggests that social network service use does not influence citizens’ political activities in a unidirectional manner. We have found that social media use and participation in rival protests reciprocally influence each other.
Flowing With the River’s Go: Seeking Ethical, Pragmatic, and Strategic Participation in the Design of a Regional Funding Strategy
Authors: Ortiz Aragón Alfredo , Hoetmer Raphael
Published: July 2020

In this article, we share methodological lessons learned from a participatory regional planning process which was intended to produce a regional strategy for a multiactor program on human rights and rural development in the Southern Highlands of Peru, funded by the Belgian solidarity organization Broederlijk Delen (BD). The underlying goal of the planning process, which was also funded by BD, was to shift the practices of planning, decision making, and evaluation in the program, by strengthening participation of local communities and social change-focused organizations. As such, a broad group of these actors were invited and participated in the nearly year-long planning process. Throughout, we as facilitators used many creative, reflective methods—for example, drawings, co-construction of timelines and mind maps, reflective plenaries, and so forth—that we hoped would “speak” to the different participants’ learning styles and ways of knowing and therefore increase their levels of participation and ownership in the process and program. In this article, we ask the question “to what extent was the process really participatory?” in order to help explain ways in which “participatory methods” enable and constrain participant knowledge and identity, and highlight ways to improve participation through the use of methodology.
Defending the Sex/Gender Binary: The Role of Gender Identification and Need for Closure
Authors: Morgenroth Thekla , Sendén M. Gustafsson , Lindqvist A. , Renström E. A. , Ryan M. K. , Morton T. A.
Published: July 2020

In the Western world, gender/sex is traditionally viewed as binary, with people falling into one of two categories: male or female. This view of gender/sex has started to change, triggering some resistance. This research investigates psychological mechanisms underlying that resistance. Study 1 ( N = 489, UK) explored the role of individual gender identification in defense of, and attempts to reinforce, the gender/sex binary. Study 2 ( N = 415, Sweden) further considered the role of individual differences in need for closure. Both gender identification and need for closure were associated with binary views of gender/sex, prejudice against nonbinary people, and opposition to the use of gender-neutral pronouns. Policies that aim to abolish gender/sex categories, but not policies that advocate for a third gender/sex category, were seen as particularly unfair among people high in gender identification. These findings are an important step in understanding the psychology of resistance to change around binary systems of gender/sex.
Assaults on capitalism and democratic backsliding: Evidence from Asia
Authors: Gilley Bruce
Published: July 2020

It is generally assumed that stable democracies depend on sufficient economic freedoms that support ideas of individual independence and that shift resources from state to society. The growth and consolidation of economic freedoms under capitalism has been empirically linked to the growth and consolidation of democracy. Asia as a region has generally conformed to this theory, albeit with delayed democratic transitions due to the state-directed nature of development. This article revisits the capitalism/democracy relationship in East and Southeast Asia with a particular focus on contemporary concerns with global democratic backsliding. It shows the enduring analytic and empirical utility of capitalism to explain structural pressures on democratic development. It also shows how assaults on capitalism have predictive and descriptive value as indicators of authoritarian repression and democratic backsliding. The article highlights the continued relevance of capitalism for understanding democratic development, and underscores the significance of Asia to broader debates on democratic backsliding.
Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society
Authors: Reyes Bernardo J. , Mendelson Daniel A. , Mujahid Nadia , Mears Simon C. , Gleason Lauren , Mangione Kathleen K. , Nana Arvind , Mijares Maria , Ouslander Joseph G.
Published: July 2020

Background:

The majority of patients require postacute care (PAC) after a hip fracture. Despite its importance, there is no established consensus regarding the standards of care provided to hip fracture patients in PAC facilities.

Methodology:

A writing group was created by professionals from the International Geriatric Fracture Society (IGFS) with representation from other organizations. The focus of the statements included in this article is toward PAC providers located in nursing facilities. Contributions were integrated in a single document that underwent several reviews by each author and then underwent a final review by the lead and senior authors. After this process was completed, the document was appraised by reviewers from IGFS.

Results/Conclusion:

A total of 15 statements were crafted. These statements summarize the best available evidence and is intended to help PAC facilities managing older adults with hip fractures more efficiently, aiming toward overall better outcomes in the areas of function, quality of life, and with less complications that could interfere with their optimal recovery.
Toward an Understanding of University Students’ Continued Intention to Use MOOCs: When UTAUT Model Meets TTF Model
Authors: Wan Liyong , Xie Shoumei , Shu Ai
Published: July 2020

This study tries to propose a unified model integrating the unified theory of acceptance and use of technology (UTAUT) model, task–technology fit (TTF) model, and user satisfaction to investigate the determinants that affect university students’ continued intention of using massive open online courses (MOOCs). Based on the data of a survey on 464 respondents, structural equation modeling is adopted to assess the model. The results reveal that performance expectancy, effort expectancy, social influence, and user satisfaction are the crucial predictors of university students’ continued intention. TTF has an indirect influence on continued intention through user satisfaction. Performance expectancy is affected both by effort expectancy and TTF. Facilitating conditions do not directly influence continued intention; however, they present indirect influences in that they play a mediating role for user satisfaction. The findings help researchers and practitioners to attain a better understanding of university students’ continued usage intention of MOOCs. The implications and limitations of this study are also described.
Comparative Efficacy and Tolerability of Nonsurgical Therapies for the Treatment of Midportion Achilles Tendinopathy: A Systematic Review With Network Meta-analysis
Authors: Rhim Hye Chang , Kim Min Seo , Choi Seungil , Tenforde Adam S.
Published: July 2020

Background:

Achilles tendinopathy (AT) is a common cause of overuse injury in both athletes and nonactive individuals, especially at older ages. Due to the limited number of direct comparisons among interventions, determining the best treatment option can be difficult.

Purpose:

To evaluate the comparative efficacy and tolerability of nonsurgical therapies for midportion AT.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

PubMed, MEDLINE, EMBASE, and Google Scholar were searched from database inception through June 20, 2019. Randomized controlled trials investigating the effect of nonsurgical therapies for midportion AT using the Victorian Institute of Sports Assessment–Achilles (VISA-A) assessment were eligible for inclusion. Primary outcome was mean change in VISA-A score from baseline. Comparisons between interventions were made through use of random-effects network meta-analysis over the short term (≤3 months) and longer term (>3 to <12 months). A safety profile was defined for each intervention by rate of all-cause discontinuation (dropout) during follow-up. Relative ranking of therapies was assessed by the surface-under-the–cumulative ranking possibilities.

Results:

A total of 22 studies with 978 patients met the inclusion criteria. In short-term studies, high-volume injection with corticosteroid (HVI+C) along with eccentric exercise (ECC) significantly improved the change of VISA-A score compared with that of ECC alone (standardized mean difference [SMD], 1.08; 95% CI, 0.58-1.58). Compared with ECC, acupuncture showed benefits over both the short term (SMD, 1.57; 95% CI, 1.00-2.13) and longer term (SMD, 1.23; 95% CI, 0.69-1.76). In longer-term studies, the wait-and-see approach resulted in unfavorable outcomes compared with ECC (SMD, −1.51; 95% CI, −2.02 to −1.01). Improvement was higher when ECC was combined with HVI+C (SMD, 0.53; 95% CI, 0.05-1.02) and extracorporeal shockwave therapy (ESWT) (SMD, 0.99; 95% CI, 0.48-1.49). All interventions had a similar safety profile.

Conclusion:

From available high-level studies, HVI+C and ESWT may be possible interventions to add along with ECC to improve longer-term outcomes.
Sport-Related Concussion in Female Athletes: A Systematic Review
Authors: McGroarty Neil K. , Brown Symone M. , Mulcahey Mary K.
Published: July 2020

Background:

Female athletes are more susceptible to sport-related concussions (SRCs) and experience worse outcomes compared with male athletes. Although numerous studies on SRC have compared the outcomes of concussions in male and female athletes after injury, research pertaining to why female athletes have worse outcomes is limited.

Purpose:

To determine the factors that predispose female athletes to more severe concussions than their male counterparts.

Study Design:

Systematic review; Level or evidence, 3.

Methods:

A systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines. The MEDLINE, EMBASE, CINAHL, PsychINFO, and Cochrane Library databases were systematically searched on July 5 to July 20, 2018. Included were cohort, case-control, and cross-sectional studies that examined the effects of concussive and subconcussive head impacts in only female athletes of all ages, regardless of competition level. These studies were further supplemented with epidemiologic studies. Exclusion criteria included narrative reviews, single case reports, abstracts and letters to the editor, and studies related to chronic traumatic brain injury.

Results:

A total of 25 studies met the inclusion criteria. Female athletes appear to sustain more severe concussions than male athletes, due in part to a lower biomechanical threshold tolerance for head impacts. Additionally, concussions may alter the hypothalamic-pituitary-ovarian axis, resulting in worse symptoms and amenorrhea. Although females are more likely to report concussions than males, underreporting still exists and may result in concussions going untreated.

Conclusion:

This systematic review demonstrates that female athletes may be more susceptible to concussion, have prolonged symptoms after a concussion, and are more likely to report a concussion than their male counterparts. However, underreporting still exists among female athletes. Possible factors that put female athletes at a higher risk for concussions include biomechanical differences and hormonal differences. To effectively prevent, diagnose, and treat concussions in female athletes, more research is required to determine when and how such injuries are sustained. Despite sex-based differences in the clinical incidence, reporting behavior, and outcomes of SRCs, female athletes remain an understudied population, resulting in lack of sex-specific treatment guidelines for female athletes postinjury.
Risk Factors for Post–Open-Globe Injury Endophthalmitis
Authors: Uppuluri Aditya , Zarbin Marco A. , Bhagat Neelakshi
Published: July 2020

Purpose:

The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI).

Methods:

This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results.

Results:

Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis.

Conclusions:

Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.
Cereblon harnesses Myc-dependent bioenergetics and activity of CD8+ T lymphocytes
Authors: Hesterberg Rebecca S. , Beatty Matthew S. , Han Ying , Fernandez Mario R. , Akuffo Afua A. , Goodheart William E. , Yang Chunying , Chang Shiun , Colin Christelle M. , Alontaga Aileen Y. , McDaniel Jessica M. , Mailloux Adam W. , Billington Julia M. R. , Yue Lanzhu , Russell Shonagh , Gillies Robert J. , Yun Sang Y. , Ayaz Muhammad , Lawrence Nicholas J. , Lawrence Harshani R. , Yu Xue-Zhong , Fu Jianing , Darville Lancia N. , Koomen John M. , Ren Xiubao , Messina Jane , Jiang Kun , Garrett Timothy J. , Rajadhyaksha Anjali M. , Cleveland John L. , Epling-Burnette Pearlie K.
Published: July 2020

Immunomodulatory drugs, such as thalidomide and related compounds, potentiate T-cell effector functions. Cereblon (CRBN), a substrate receptor of the DDB1-cullin-RING E3 ubiquitin ligase complex, is the only molecular target for this drug class, where drug-induced, ubiquitin-dependent degradation of known “neosubstrates,” such as IKAROS, AIOLOS, and CK1α, accounts for their biological activity. Far less clear is whether these CRBN E3 ligase-modulating compounds disrupt the endogenous functions of CRBN. We report that CRBN functions in a feedback loop that harnesses antigen-specific CD8+ T-cell effector responses. Specifically, Crbn deficiency in murine CD8+ T cells augments their central metabolism manifested as elevated bioenergetics, with supraphysiological levels of polyamines, secondary to enhanced glucose and amino acid transport, and with increased expression of metabolic enzymes, including the polyamine biosynthetic enzyme ornithine decarboxylase. Treatment with CRBN-modulating compounds similarly augments central metabolism of human CD8+ T cells. Notably, the metabolic control of CD8+ T cells by modulating compounds or Crbn deficiency is linked to increased and sustained expression of the master metabolic regulator MYC. Finally, Crbn-deficient T cells have augmented antigen-specific cytolytic activity vs melanoma tumor cells, ex vivo and in vivo, and drive accelerated and highly aggressive graft-versus-host disease. Therefore, CRBN functions to harness the activation of CD8+ T cells, and this phenotype can be exploited by treatment with drugs.
Myositis-specific antibodies identify a distinct interstitial pneumonia with autoimmune features phenotype
Authors: Graham Julia , Bauer Ventura Iazsmin , Newton Chad A. , Lee Cathryn , Boctor Noelle , Vu Pugashetti Janelle , Cutting Claire , Joerns Elena , Sandhu Habrinder , Chung Jonathan H. , Garcia Christine Kim , Kadoch Michael , Noth Imre , Adegunsoye Ayodeji , Strek Mary E. , Oldham Justin M.
Published: July 2020

Interstitial pneumonia with autoimmune features (IPAF) characterises individuals with interstitial lung disease (ILD) and features of connective tissue disease (CTD) who fail to satisfy CTD criteria. Inclusion of myositis-specific antibodies (MSAs) in the IPAF criteria has generated controversy, as these patients also meet proposed criteria for an antisynthetase syndrome. Whether MSAs and myositis-associated antibodies (MAA) identify phenotypically distinct IPAF subgroups remains unclear.

A multicentre, retrospective investigation was conducted to assess clinical features and outcomes in patients meeting IPAF criteria stratified by the presence of MSAs and MAAs. IPAF subgroups were compared to cohorts of patients with idiopathic inflammatory myopathy-ILD (IIM-ILD), idiopathic pulmonary fibrosis and non-IIM CTD-ILDs. The primary end-point assessed was 3-year transplant-free survival.

269 patients met IPAF criteria, including 35 (13%) with MSAs and 65 (24.2%) with MAAs. Survival was highest among patients with IPAF-MSA and closely approximated those with IIM-ILD. Survival did not differ between IPAF-MAA and IPAF without MSA/MAA cohorts. Usual interstitial pneumonia (UIP) morphology was associated with differential outcome risk, with IPAF patients with non-UIP morphology approximating survival observed in non-IIM CTD-ILDs. MSAs, but not MAAs identified a unique IPAF phenotype characterised by clinical features and outcomes similar to IIM-ILD. UIP morphology was a strong predictor of outcome in others meeting IPAF criteria.

Because IPAF is a research classification without clear treatment approach, these findings suggest that MSAs should be removed from the IPAF criteria and such patients should be managed as an IIM-ILD.
PyIR: a scalable wrapper for processing billions of immunoglobulin and T cell receptor sequences using IgBLAST
Authors: Soto Cinque , Finn Jessica A. , Willis Jordan R. , Day Samuel B. , Sinkovits Robert S. , Jones Taylor , Schmitz Samuel , Meiler Jens , Branchizio Andre , Crowe James E.
Published: July 2020

Background

Recent advances in DNA sequencing technologies have enabled significant leaps in capacity to generate large volumes of DNA sequence data, which has spurred a rapid growth in the use of bioinformatics as a means of interrogating antibody variable gene repertoires. Common tools used for annotation of antibody sequences are often limited in functionality, modularity and usability.

Results

We have developed PyIR, a Python wrapper and library for IgBLAST, which offers a minimal setup CLI and API, FASTQ support, file chunking for large sequence files, JSON and Python dictionary output, and built-in sequence filtering.

Conclusions

PyIR offers improved processing speed over multithreaded IgBLAST (version 1.14) when spawning more than 16 processes on a single computer system. Its customizable filtering and data encapsulation allow it to be adapted to a wide range of computing environments. The API allows for IgBLAST to be used in customized bioinformatics workflows.
Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections
Authors: Pieniawska-Śmiech Karolina , Bar Kamil , Babicki Mateusz , Śmiech Karol , Lewandowicz-Uszyńska Aleksandra
Published: July 2020

Background

Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 350 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn’t present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 195 patients’ medical histories from their hospitalization at Clinical Immunology and Paediatrics Ward of J. Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with PID and children with RRTI by assessment of their height and weight. All of parameters were evaluated using centile charts, suitable best for the Polish population.

Results

The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 18% of them had their height situated below 3rd percentile. The statistically relevant differences have been found between them and RRTI group in terms of weight, height and nutritional status. The statistically significant difference was detected between the nutritional status of PID and control group.

Conclusions

There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.