bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrodeposition of hydroxyapatite coating on Mg alloy modified with organic acid self-assembled monolayers
Authors: Škugor Rončević Ivana , Vladislavić Nives , Buzuk Marijo , Buljac Maša
Published: December 2019

Calcium phosphate coatings are used in orthopedics due to their excellent bioactivity, which improves the bonding between the metal implant and the bone. The use of self-assembling monolayers of long-chain organic acids can induce calcium phosphate growth. In this article, the self-assembling monolayers of stearic acid and octadecylphosphonic acid formed on the Mg alloy surface were additionally modified with electrodeposited hydroxyapatite coating to increase the bioactivity and biocompatibility of the Mg alloy in a physiological solution. Hydroxyapatite coating was prepared by a two-step reaction: hydrogen phosphate formed by electrodeposition at constant potential was converted into hydroxyapatite coating through an acid–base reaction. The results obtained by voltammetry and electrochemical impedance spectroscopy have shown a beneficial effect of organic acid self-assembling monolayer and especially of organic acid self-assembling monolayer modification by hydroxyapatite electrodeposition on the corrosion properties of Mg alloy in physiological solution. Fourier transform infrared spectroscopy and scanning electron microscopy were used to verify the existence of the organic acid SAM|HAp film on the Mg alloy surface and their morphology.
Ciceronian international society
Authors: Sims Stephen Patrick
Published: December 2019

This article explores what Cicero as a political thinker can offer to the study of international relations. Although previous readings of Cicero have emphasized his Stoic influences and his natural law teaching as the basis of a cosmopolitan world society, I emphasize the way in which Cicero can deepen the concept of international society. International society relies on certain norms and institutions to function properly, such as international law, sovereignty, and the use of war to restrain violence and redress injustice. We find all these concepts articulated clearly in Cicero’s moral and political thought. Cicero also shows the limits of these institutions and norms, explaining why none of them is absolute. Finally, Cicero adds to our theorizing about international society by drawing attention to the role of honor, ruling, and inequality in international society. As such, classical political thought, and Cicero’s in particular, provide a valuable resource for future thinking about international theory.
Structures at Risk During Percutaneous Extra-Articular Chevron Osteotomy of the Distal First Metatarsal
Authors: McGann Maria , Langan Travis M. , Brandão Roberto A. , Berlet Gregory , Prissel Mark
Published: December 2019

Background. Minimally invasive surgery of the forefoot has regained popularity as an alternative to traditional open procedures. Minimally invasive hallux valgus surgery has been shown to be effective and reproducible for the treatment of mild to moderate hallux valgus. The aim of this study is to identify vital structures that are at risk for iatrogenic damage while performing a minimally invasive distal chevron osteotomy due to limited direct visualization. Methods. Ten fresh-frozen below knee cadavers were used for this study. A minimally invasive distal chevron osteotomy and medial eminence resection with a 2.2 mm × 22 mm Shannon burr was performed on each cadaver. Each specimen was dissected to expose the potential structures at risk for injury during the procedure. Structures evaluated included the medial neurovascular bundle, first metatarsophalangeal joint capsule, extensor hallucis longus tendon, flexor hallucis longus tendon, abductor hallucis tendon, and the sesamoid apparatus. Results. Ten specimens were evaluated. The dorsal medial cutaneous nerve was directly injured in 5 of the 10 cadaver specimens and intact/uninjured in the remaining 5 specimens. The flexor hallucis longus, extensor hallucis longus, adductor tendon, sesamoid apparatus, and first metatarsophalangeal joint capsule were uninjured in all specimens. Conclusion. Minimally invasive chevron distal osteotomy and medial eminence resection has a high learning curve. The resection of the medial eminence may iatrogenically injure the dorsal medial cutaneous nerve. The incidence is higher in this study than prior reported cadaveric studies and may warrant extra care to protect vital structures.

Level of Evidence: Level IV: Cadaver study
Risk of Complications With the Total Contact Cast in Diabetic Foot Disorders
Authors: Riopelle Alexandria , LeDuc Ryan , Wesolowski Michael , Schiff Adam P. , Pinzur Michael S.
Published: December 2019

The custom-fabricated total contact cast is commonly used in the treatment of diabetic foot disorders. This resource-consuming treatment option has been associated with iatrogenic morbidity as well as the need for urgent cast removal and inspection of the underlying limb when potential problems arise. Over a 10-year period, 381 diabetic patients had 2265 total contact cast applications by certified orthopaedic technologists, in a university orthopaedic practice, under the supervision of university faculty. Patients were stratified by glycemic control based on hemoglobin A1c levels, and obesity based on body mass index (BMI). Complications were grouped as (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change or removal. At least 1 complication was observed in 159 of 381 patients. The odds of experiencing a cast-related event for patients with a BMI greater than 30 kg/m2 was 1.55 times greater than patients with a BMI less than 25 kg/m2. As compared to patients with good glycemic control, the odds of experiencing a cast-associated complication was 1.27 times greater in patients with moderate glycemic control and 1.48 times greater in patients with poor glycemic control. The total contact cast is commonly used in the treatment of diabetic foot morbidity. Treatment-associated morbidity may well be greater than previously appreciated. Complications are more likely in patients who have poor glycemic control and are morbidly obese. This information will hopefully stimulate interest in developing commercially available nonrigid alternatives that retain the attributes of the resource-consuming rigid device, with the potential advantage of avoiding the associated morbidity.

Levels of Evidence: Level IV, retrospective chart review
A Similarity Mindset Matters on Social Media: Using Algorithm-Generated Similarity Metrics to Foster Assimilation in Upward Social Comparison
Authors: Kang Jin , Liu Bingjie
Published: December 2019

Upward social comparison on social networking sites (SNSs) makes SNS users feel bad about themselves. Would emphasizing overall similarity between SNS users and the upward comparison targets make them feel good about themselves (i.e., assimilation)? We examined this question using a 3 (overall similarity: zero vs. moderate vs. high) × 2 (comparison dimension: physical appearance vs. financial status) between-subjects online experiment with 143 college students. Participants were recommended with a Facebook user who was physically attractive or financially successful (i.e., an upward comparison target). Right before seeing more details about the target, participants saw a visual cue indicating they shared zero (0%), moderate (50%), or high (90%) overall similarity with the target purported to be algorithm-generated. Results revealed that after seeing images showing the target’s physical attractiveness or financial success, those who shared moderate and high overall similarity with the target rated themselves more positively on physical appearance and financial status and also reported higher liking for the target, the effect of which was mediated by perceived similarity with the target. Moderate, but not high overall similarity improved participants’ life satisfaction. Theoretical and design implications are discussed in light of our findings.
Negotiating Collaborations: BookTubers, The Publishing Industry, and YouTube’s Ecosystem
Authors: Tomasena José M.
Published: December 2019

BookTubers (from the acronym book + YouTuber) have become key players for the publishing industry, given their influence on children and teens to promote reading and book consumption. Based on an 18-month digital ethnography that combines direct observation, digital interactions on YouTube channels, and other social media and semistructured interviews with 17 Spanish-speaking BookTubers, this study uses Pierre Bourdieu’s concepts of field and capital to analyze how BookTubers negotiate their practices with other agents of the publishing world. This article characterizes the challenges the Spanish-language publishing industry is facing in the context of digitalization to attract readers; describes the position that BookTubers have within the YouTube ecosystem, and how they relate with the platform’s actors, politics, and affordances; and analyzes the exchanges that BookTubers establish with publishers—often referred as collaborations—and their implications for their autonomy. This case study helps to understand how platformization allows new agents to transfer capital gained in social media to other cultural industries.
Tumor and nodal staging of colon cancer: accuracy of preoperative computed tomography at a Swedish high-volume center
Authors: Korsbakke Kevin , Dahlbäck Cecilia , Karlsson Niklas , Zackrisson Sophia , Buchwald Pamela
Published: December 2019

Background

When deciding treatment options for patients with colon cancer, accurate staging is required. In Sweden, the main preoperative evaluation modality to determine tumor and nodal stage is computed tomography (CT).

Purpose

The aim of this study was to investigate how well the preoperative (CT-determined) clinical tumor and nodal stage (cTN) correlated with the postoperative histopathological stage (pTN). Another aim was to validate the tumor and nodal stage data in the Swedish Colorectal Cancer Registry (SCRCR).

Material and Methods

The SCRCR was used to identify patients with colon cancer, treated at a Swedish high-volume center during 2013–2016 (n = 974). Data were gathered from medical records regarding cTN and pTN stage, and predefined patient and tumor variables. The agreement between cTN and pTN was analyzed using kappa statistics.

Results

After excluding patients with either pre- or postoperative TN stage missing, 383 patients remained for further analyses. The analyses showed an agreement between cT and pT of κ: 0.27 and between cN and pN of κ: 0.21 (fair agreement). When comparing tumors with low (T1–3; N0) versus high risk (T4; N1–2), the kappa value was 0.19 (slight agreement). When comparing the SCRCR to medical records, 78% of completely staged tumors had been correctly reported.

Conclusion

The agreement between cTN and pTN was low in this study population, indicating a need for enhanced precision of the preoperative staging process. A high frequency of erroneous preoperative staging data in the SCRCR shows the need for further efforts of ensuring correct data transfers into the registry.
Giving and getting parole: The changing characteristics of parole in England and Wales
Authors: Padfield Nicola
Published: December 2019

This article is written as part of a special issue of the European Journal of Probation, which seeks not simply to describe and to critique ‘parole’ as it has evolved over time, but to focus on the justifications and the actors involved in parole decision-making and supervision. This article explores the changing face of ‘parole’ in England and Wales. The Parole Board today has little in common with the Parole Board of 1967. The characteristics of the prisoners who appear before panels of the Board have also changed. ‘Parole’ is now a very different process, no longer ‘early conditional release’, but what might better be described as ‘delayed conditional release’. This requires a fundamental re-analysis of its purpose and the justifications for its use.
Deconstructing “Single” Mothers by Choice: Transcending Blood, Genes, and the Biological Nuclear Family?
Authors: Bravo-Moreno Ana
Published: December 2019

The concept of biological kinship is a sociocultural construction of facts taken for granted as “natural.” The concept of blood, of “bond,” of “connection,” symbolizes the fact that relatives are perceived as having claims on one another by virtue of DNA. It is taken for granted that the biological relation attains a meaning in human relations. Yet, this taken-for-grantedness is rarely deconstructed. Thus, the purpose of this article is threefold: (a) to examine the conceptualization of the links between the social and the biological in societies of the Global North, and to analyze the assumptions that implicitly underpin the literature on new forms of family, in particular, “single” mothers by choice with donor-conceived children. Two of the most prolific scholars on the subject, from the field of psychology in the United Kingdom and from the field of social anthropology in Spain, will be discussed, taking into account a preliminary analysis of 35 ethnographic interviews with “single” mothers by choice that I have conducted during my fieldwork in Spain and in the United Kingdom; (b) to interrogate the discourses that categorize this group of women who have chosen to be mothers; and (c) to suggest a new research agenda building on the critical insights produced from addressing the first and second aims.
Lower Limb Biomechanics During Level Walking After an Isolated Posterior Cruciate Ligament Rupture
Authors: Yu Yuanyuan , Huang Hongshi , Ren Shuang , Shi Huijuan , Zhang Si , Liang Zixuan , Ao Yingfang
Published: December 2019

Background:

The posterior cruciate ligament (PCL) is an important structure in knee stabilization. Knee cartilage degeneration after a PCL injury has been reported in several studies. Understanding the changes in movement patterns of patients with PCL ruptures could help clinicians make specific treatment protocols to restore patients’ sporting ability and prevent joint degeneration. However, the kinematics and kinetics of the lower limb in patients with PCL injuries are still not clear.

Purpose:

To investigate the biomechanical characteristics during level walking in patients with isolated PCL deficiency.

Study Design:

Controlled laboratory study.

Methods:

Three-dimensional videographic and force plate data were collected for 27 healthy male participants (control group) and 25 male patients with isolated PCL-deficiency (PCL-d group) walking at a constant self-selected speed. Paired and independent t tests were performed to determine the differences between the involved and uninvolved legs in the PCL-d group and between the PCL-d and control groups, respectively.

Results:

Compared with the control leg, both legs in the PCL-d group had smaller knee moments of flexion and internal rotation; greater hip angles of flexion and adduction; greater hip moments of internal rotation; greater ankle angles of extension and adduction; and smaller ankle moments of flexion, adduction, and internal rotation. Moreover, compared with the uninvolved leg in the PCL-d group, the involved leg in the PCL-d group had significantly smaller knee extension angles and moments during the terminal stance phase, greater hip external rotation angles and extension moments, and smaller ankle adduction angles and flexion moments.

Conclusion:

PCL ruptures altered walking patterns in both the involved and uninvolved legs, which could affect alignment of the lower limb and loading on the knee, hip, and ankle joints. Patients with PCL injuries adapted their hip and ankle to maintain knee stability.

Clinical Relevance:

The kinematic and kinetic adaptations in the knee, hip, and ankle after a PCL rupture during level walking are likely to be a compensatory strategy for knee instability. The results of this study suggest that these adaptations should be considered in the treatment of patients with PCL ruptures.
Ethnic Conflict in the Indian Subcontinent: Assessing the Impact of Multiple Cleavages
Authors: Das Soham
Published: December 2019

As majoritarian electoral politics and religious conservatism are rising in the major multi-ethnic South Asian countries, such as India and Pakistan, the events of mob lynching, ethnic clashes and targeting non-plural and minority communities are becoming more frequent. This article analyses which cleavages of marginalisation make some ethnic groups prone to violent social movements vis-a-vis others. Theoretically, through social constructivism and horizontal inequality, the study argues that socioeconomic condition, religion and language are the three broad cleavages that influence political behaviour of ethnic groups. Explicating the theory about underlying versus facilitating conditions of ethnic–civil conflicts, this article examines the prerequisites of ethnic conflicts. Thereafter, it evaluates which single cleavages and combinations of the aforementioned cleavages increase the probability of conflict occurrence in the Indian subcontinent. The argument is empirically evaluated on a sample of 60 ethnic groups of the Indian subcontinents over the period of 1947–2013. We find that groups affected by reinforcing cleavages of religious and economic marginalisation, and religious, economic and lingual marginalisation have engaged in active violence over the period of our study. Additionally, the reinforcing cleavages of language and economy, and language and religion are associated with sporadic violence. Apart from the combined effects, we find that the ethnic groups facing economic disadvantage alone can also engage in violence.
US-led Alliances and Contemporary International Security Disorder: Comparative Responses of the Transatlantic and Asia-Pacific Alliance Systems
Authors: Richey Mason
Published: December 2019

US-led security architectures in the Asia-Pacific and Europe are experiencing pressure due to ongoing geostrategic transformation in these regions, most notably the rapid expansion of China’s power, North Korea’s nuclear brinkmanship and Russia’s renewed aggressive adventurism. These readjustments have often been examined through the prism of changing balance of power between the US-led liberal international forces and revisionist powers aiming to alter the international order. Going beyond this analysis in the literature, this article sheds lights on the ways in which the USA has attempted and is attempting to reshape US-led alliances in the Asia-Pacific and Europe. The article finds that the US-led alliance systems and security partnerships will continue to evolve divergently due both to their different path-dependent identities and the different types of challenges they face regionally.
Towards a Model for the Development of the Mesolonghi-Aitoliko Sea Lagoon in Greece
Authors: Siampani Mari
Published: December 2019

The Sea Lagoon of Mesolonghi is located in central-west Greece and is considered to be one of the most significant sea lagoons in Europe in terms of ecological and environmental interests. It is an area of exceptional natural beauty, with a wide variety of rare plants and animals. Characterized as a biotope, it is a habitat protected by the Natura treaty and the Ramsar Convention that occupies 150,000 acres. Traces of continuous human life, as suggested by prehistoric findings, Greek mythology, archaeological sites, Early Christian temples and Byzantine monuments, till the modern period, are present in the area. Most significant examples of traditional architecture are the ‘Ivaries and Pelades’ used by the local fishermen for lodging purposes.

The Mesolonghi Sea Lagoon offers an exemplary multidisciplinary laboratory of natural fishing techniques, local crafts and traditional architecture. As such, it is important to study this further for its potential for growth both as a rural landscape and as a form of traditional local tangible and intangible heritage. In this article, we discuss and present the relationships between the benefits of organized/natural sea cultivation processes, architectures’ contribution to the whole attempt of prosperity and economic growth of the community and the re-imagined rural landscape as well as the local development potential in a direction aligned with the environment, the local history and local traditions.
Reverse Shoulder Arthroplasty for B2 Glenoid Deformity
Authors: Holt Andrew M. , Throckmorton Thomas W.
Published: December 2019

In shoulder osteoarthritis, the B2 glenoid presents challenges in treatment because of the excessive retroversion and posterior deficiency of the glenoid. Correction of retroversion and maintenance of a stable joint line with well-fixed implants are essential for the successful treatment of this deformity with arthroplasty. Reverse shoulder arthroplasty offers several key advantages in achieving this goal, including favorable biomechanics, a well-fixed baseplate, and proven success in other applications. Techniques such as eccentric reaming, bone grafting, and baseplate augmentation allow surgeons to tailor treatment to the patient’s altered anatomy. Eccentric reaming is favored for correction of small defects or mild version anomalies. Current trends favor bone grafting for larger corrections, though augmented components have shown early promise with the potential for expanded use. With overall promising results reported in the literature, reverse shoulder arthroplasty is a useful tool for treating older patients with B2 glenoid deformities.
Prompt Improvement of an Enlarging Pigment Epithelial Detachment Following Intravitreal Dexamethasone in Neovascular Age-Related Macular Degeneration
Authors: Powers James H. , Wisely C. Ellis , Sastry Ananth , Fekrat Sharon
Published: December 2019

Purpose:

This report discusses a case of neovascular age-related macular degeneration with mixed serous pigment epithelial detachment (PED) that was unresponsive to antivascular endothelial growth injections but responded to the addition of intravitreal steroid injection.

Methods:

We report a case.

Results:

A 75-year-old woman with neovascular age-related macular degeneration developed a mixed serous PED in her right eye. Three monthly aflibercept (Eylea, Regeneron) treatments led to resolution of associated intraretinal fluid; however, the mixed serous and fibrovascular PED significantly increased in size. The addition of intravitreal dexamethasone (Ozurdex, Allergan) to monthly aflibercept led to prompt flattening of the PED. Three months later, the PED recurred despite continued administration of monthly aflibercept.

Conclusions:

This case supports a growing body of research that PEDs unresponsive to antivascular endothelial growth injections may respond to intravitreal steroid injections.
Sex, Sexuality and Gender-Related Issues in Child Psychiatric Practice: A Review
Authors: Sravanti Lakshmi , Girimaji Satish Chandra
Published: December 2019

In child and adolescent psychiatric practice, it is important for a clinician to be aware of contexts in which children are brought with concerns related to sexual behaviors. Johnson described a continuum of natural and healthy behaviors to sexually aggressive behaviors. Sexual development begins in fetal life and continues through infancy, childhood, and adolescence along characteristic pathways. Typically, developing children exhibit a wide range of sexual behaviors. Children and adolescents may display increased or deviant sexual behavior as a result of certain stressors, traumatic experiences, or psychiatric illnesses. This has been emerging as an important clinical issue over the past few years. It is important to distinguish between normal behaviors and disordered behaviors before planning any intervention. This article summarizes the sexuality- and gender-related issues that are encountered in child and adolescent psychiatric practice.
Has the Kama Sutra Not Made a Difference? Making Psychologists in India Explore Sexual Functioning and Master Sex Therapy
Authors: Manickam L. S. S.
Published: December 2019

There is no dearth of web-based scientific information on sexuality and related matters, and it is shared in private social groups. Yet there appears to be a resistance on the part of psychologists in India in exploring the sexual functioning of clients. This article explores the possible reasons for the neglect that prevails and the consequences. Since, psychologists who are qualified in helping avoid addressing the sexual concerns of the people, it leads to widespread “malpractice” by the quacks. Neglect in identifying the underlying sexual problems that are manifested as various somatoform disorders and other medically unexplainable symptoms leads to emotional distress of the clients and increases the health costs. Hesitation and the “taboo” of the psychologists hinder the therapeutic contact between the therapists and the clients and, hence, people do not disclose their sexual concerns and problems. Personal discomfort of psychology trainees due to “unfinished business,” inadequate input on the role of sexual functioning and the inadequate exposure to people with sexual concerns may have contributed to this impasse. Supervised training of upcoming psychologists would help improve the quality of sexual life of people of all ages and prevent children and adolescents from sexual abuse. The need for using the ancient Indian masterpiece of sexual science, Kama Sutra, in getting over the taboo is also recommended.
Childhood Masturbation: A Case Report from Bangladesh
Authors: Arafat S. M. Yasir , Khan Sanjida Tanjin
Published: December 2019

Masturbation is a normal sexual behavior; however, masturbation in childhood is less commonly addressed in research. Here we report a case of childhood masturbation in Bangladesh. A six-year-old girl was presented at a private chamber of a psychiatrist with the complaints of episodic frictions of pubic area with edges of bed, furniture, and other approachable particles for last one and half years. The average duration of episodes was about 5 minutes. After taking detailed history, and performing physical and mental state examination, the girl was labeled as a case of childhood masturbation. Adequate psychoeducation was provided to the mother regarding the disorder as well as its management such as behavior therapy. She was also ensured repeatedly regarding the diagnosis as well as the management so that she can believe and maintain the behavior therapy. However, the mother was found challenging to accept the diagnosis as well as treatment without any medication. This article is expected to raise the issue among clinical practitioners other than psychiatrists who in turn would reduce the sufferings of the patients and anxiety of the caregivers.
Dhat Syndrome: A Review and Update
Authors: Prakash Om , Kar Sujita Kumar
Published: December 2019

Dhat syndrome is known as a culture-bound syndrome of South East Asia. Its manifestations mimic the phenomenology of neurotic spectrum disorders. Myths related to semen loss are the core belief around which anxiety, depressive as well as somatic symptoms develop. Often the patients respond to psychoeducation focusing on resolving the sexual myths and misconceptions. There is an ongoing controversy regarding the nosological status of Dhat syndrome. Extensive research on Dhat syndrome may provide an answer to this controversy through understanding about the entity. This review is a synthesis of literature on Dhat syndrome from its inception till date.
An Experiential Account of Sexual Dysfunction Among Women with Schizophrenia: A Qualitative Study from India
Authors: Simiyon Manjula , Chandra Prabha , Desai Geetha
Published: December 2019

Aims: The study aimed to gather the perspectives of women with schizophrenia who had sexual dysfunction (SD) and to assess their perceptions related to discussions about sexual concerns with mental health professionals (MHP).

Settings: Female patients attending the outpatient department of a tertiary care university psychiatric hospital, who were diagnosed to have schizophrenia and in remission, were recruited and assessed for SD. Those who had SD and were willing to participate were interviewed for the qualitative study.

Methods and Materials: A guided interview format was used to gather their narratives. Interviews were transcribed and translated from audio recordings on the same day. The analysis of transcript from 9 patients reached theoretical saturation.

Analysis: The data were retrieved, coded, and systematically organized according to patterns and themes. The manual inductive coding method was used to arrive at the themes.

Results: 4 themes were found for the question assessing their perspective regarding SD and 3 themes on their perspectives regarding the discussion with MHP. Many of them had misconceptions regarding their sexual lives and the relationship between sexuality and their illness. It was evident that hardly any MHP had ever inquired about their sexual functioning.

Conclusion: This qualitative research on women with schizophrenia having SD gives us in-depth knowledge regarding their snags. Results of such studies will help the clinicians pay justifiable attention to these least spoken problems.
A modern reassessment of glycoprotein-specific direct platelet autoantibody testing in immune thrombocytopenia
Authors: Al-Samkari Hanny , Rosovsky Rachel P. , Karp Leaf Rebecca S. , Smith David B. , Goodarzi Katayoon , Fogerty Annemarie E. , Sykes David B. , Kuter David J.
Published: December 2019

Key Points

When performed in accordance with modern ASH and ISTH guidelines, PA testing is sensitive and specific for ITP diagnosis. More glycoproteins targeted by autoantibodies predicts for more severe disease, and autoantibodies resolve with clinical remission.
Inhibition of microRNA-29a alleviates hyperoxia-induced bronchopulmonary dysplasia in neonatal mice via upregulation of GAB1
Authors: Hu Yu , Xie Liang , Yu Jing , Fu Hongling , Zhou Dan , Liu Hanmin
Published: December 2019

Background

The main features of bronchopulmonary dysplasia (BPD) are alveolar simplification, pulmonary growth arrest, and abnormal lung function. Multiple studies have highlighted microRNA-29 (miR-29) as a potential biomarker for lung diseases and cancers. Upregulation of miR-29a has been known to downregulate GRB2-associated-binding protein 1 (GAB1), which is often highly expressed in the lung. The current study was designed to investigate the potential role of miR-29a in hyperoxia-induced BPD by targeting GAB1 in a neonatal mouse model.

Methods

The expression of miR-29a and GAB1 in lung tissues of neonatal mice with hyperoxia-induced BPD and mouse alveolar epithelial cells (MLE-12) was determined using RT-qPCR and western blot analysis. Subsequently, the relationship between miR-29a and GAB1 was verified using in silico analysis. In order to assess the effects of miR-29a or GAB1 on BPD, the pathological characteristics of alveoli, as well as proliferation and apoptosis of cells were measured through gain- and loss-of-function studies.

Results

Upregulation of miR-29a and downregulation of GAB1 were evident in both lung tissues and MLE-12 cells following BPD modeling. GAB1 was a direct target gene of miR-29a. Inhibition of miR-29a and overexpression of GAB1 were shown to alleviate lung injury, promote cell proliferation and inhibit apoptosis but reduce chord length in lung tissues of neonatal mice following hyperoxia-induced BPD modeling.

Conclusion

Altogether, down-regulation of miR-29a can potentially elevate GAB1 expression, reducing cell apoptosis and stimulating proliferation, ultimately retarding the development of BPD in mice. This study highlights the potential of a promising new target for preventing BPD.
Disorders of FZ-CRD; insights towards FZ-CRD folding and therapeutic landscape
Authors: Milhem Reham M. , Ali Bassam R.
Published: December 2019

The ER is hub for protein folding. Proteins that harbor a Frizzled cysteine-rich domain (FZ-CRD) possess 10 conserved cysteine motifs held by a unique disulfide bridge pattern which attains a correct fold in the ER. Little is known about implications of disease-causing missense mutations within FZ-CRD families. Mutations in FZ-CRD of Frizzled class receptor 4 (FZD4) and Muscle, skeletal, receptor tyrosine kinase (MuSK) and Receptor tyrosine kinase-like orphan receptor 2 (ROR2) cause Familial Exudative Vitreoretinopathy (FEVR), Congenital Myasthenic Syndrome (CMS), and Robinow Syndrome (RS) respectively. We highlight reported pathogenic inherited missense mutations in FZ-CRD of FZD4, MuSK and ROR2 which misfold, and traffic abnormally in the ER, with ER-associated degradation (ERAD) as a common pathogenic mechanism for disease. Our review shows that all studied FZ-CRD mutants of RS, FEVR and CMS result in misfolded proteins and/or partially misfolded proteins with an ERAD fate, thus we coin them as “disorders of FZ-CRD”. Abnormal trafficking was demonstrated in 17 of 29 mutants studied; 16 mutants were within and/or surrounding the FZ-CRD with two mutants distant from FZ-CRD. These ER-retained mutants were improperly N-glycosylated confirming ER-localization. FZD4 and MuSK mutants were tagged with polyubiquitin chains confirming targeting for proteasomal degradation. Investigating the cellular and molecular mechanisms of these mutations is important since misfolded protein and ER-targeted therapies are in development. The P344R-MuSK kinase mutant showed around 50% of its in-vitro autophosphorylation activity and P344R-MuSK increased two-fold on proteasome inhibition. M105T-FZD4, C204Y-FZD4, and P344R-MuSK mutants are thermosensitive and therefore, might benefit from extending the investigation to a larger number of chemical chaperones and/or proteasome inhibitors. Nonetheless, FZ-CRD ER-lipidation it less characterized in the literature and recent structural data sheds light on the importance of lipidation in protein glycosylation, proper folding, and ER trafficking. Current treatment strategies in-place for the conformational disease landscape is highlighted. From this review, we envision that disorders of FZ-CRD might be receptive to therapies that target FZ-CRD misfolding, regulation of fatty acids, and/or ER therapies; thus paving the way for a newly explored paradigm to treat different diseases with common defects.
What proportion of care home outbreaks are caused by norovirus? An analysis of viral causes of gastroenteritis outbreaks in care homes, North East England, 2016–2018
Authors: Inns Thomas , Wilson Deb , Manley Petra , Harris John P. , O’Brien Sarah J. , Vivancos Roberto
Published: December 2019

Background

Outbreaks of infectious gastroenteritis are common in care homes for the elderly. Norovirus can cause these outbreaks, but diagnosis is frequently based solely on clinical characteristics. Our objective in this study was to describe the epidemiology of norovirus and other gastrointestinal pathogens in these settings.

Methods

We analysed surveillance data from gastroenteritis outbreaks reported in North East England between 04 July 2016 to 01 July 2018. Stool samples taken during these outbreaks were tested for a range of viral and bacterial pathogens. We described the epidemiology of these outbreaks and explored the characteristics of norovirus outbreaks versus from other viral causes using multivariable logistic regression.

Results

From the 566 care home gastroenteritis outbreaks in this study, we found that norovirus was the pathogen most frequently isolated. Norovirus was detected in 64% of outbreaks with a pathogen identified. Sapovirus was found in 13%; rotavirus in 11%. We found that norovirus outbreaks were associated with higher attack rates (aOR 1.03, 95% CI 1.01–1.05) and fewer cases sampled (aOR 0.74, 95% CI 0.60–0.91), compared to outbreaks caused by other viral pathogens.

Conclusions

These results are important as they quantify the contribution of norovirus to gastroenteritis outbreaks in care homes. Given this evidence, we emphasize the importance of non-specific outbreak interventions that can affect the impact of all such outbreaks. We further recommend that these findings are used to inform the implementation strategies of any norovirus-specific interventions such as a norovirus vaccine.
Pre-contrast T1 and cartilage thickness as confounding factors in dGEMRIC when evaluating human cartilage adaptation to physical activity
Authors: Tiderius Carl Johan , Hawezi Zana K. , Olsson Lars E. , Dahlberg Leif E.
Published: December 2019

Background

The dGEMRIC (delayed Gadolinium-Enhanced MRI of Cartilage) technique has been used in numerous studies for quantitative in vivo evaluation of the relative glycosaminoglycan (GAG) content in cartilage. The purpose of this study was to determine the influence of pre-contrast T1 and cartilage thickness when assessing knee joint cartilage quality with dGEMRIC.

Methods

Cartilage thickness and T1 relaxation time were measured in the central part of the femoral condyles before and two hours after intravenous Gd-DTPA2−administration in 17 healthy volunteers from a previous study divided into two groups: 9 sedentary volunteers and 8 exercising elite runners. Results were analyzed in superficial and a deep weight-bearing, as well as in non-weight-bearing regions of interest.

Results

In the medial compartment, the cartilage was thicker in the exercising group, in weight-bearing and non-weight-bearing segments. In most of the segments, the T1 pre-contrast value was longer in the exercising group compared to the sedentary group. Both groups had a longer pre-contrast T1 in the superficial cartilage than in the deep cartilage. In the superficial cartilage, the gadolinium concentration was independent of cartilage thickness. In contrast, there was a linear correlation between the gadolinium concentration and cartilage thickness in the deep cartilage region.

Conclusion

Cartilage pre-contrast T1 and thickness are sources of error in dGEMRIC that should be considered when analysing bulk values. Our results indicate that differences in cartilage structure due to exercise and weight-bearing may be less pronounced than previously demonstrated.
A novel Bcl-2 inhibitor, BM-1197, induces apoptosis in malignant lymphoma cells through the endogenous apoptotic pathway
Authors: Sun Yue-Li , Jiang Wen-Qi , Luo Qiu-Yun , Yang Da-Jun , Cai Yu-Chen , Huang Hui-Qiang , Sun Jian
Published: December 2019

Background

Bcl-2 family members play an important role in the development of malignant lymphoma and can induce drug resistance in anticancer treatment. The development of small molecules targeting Bcl-2 family proteins may be a new strategy for the treatment of malignant lymphoma. In this study, we investigate the antitumor effect and cellular mechanism of a novel Bcl-2/Bcl-xL dual inhibitor, BM-1197, in DCBCL and Burkitt lymphoma cells.

Methods

The CCK-8 assay was used to detect cell viability. Apoptosis was determined by Hoechst 33258 staining and flow cytometry. The activity of caspase-3/caspase-9 was determined using a caspase-3/caspase-9 activity kit. Western blotting analysis was performed to evaluate the changes in protein expression. Functional analysis was performed via immunoprecipitation and siRNA interference. Human malignant lymphoma xenograft models in nude mice were established for in vivo efficacy detection.

Results

We find that BM-1197 exerts potent growth-inhibitory activity against lymphoma cells that harbor high expression of Bcl-2 and Bcl-xL in vitro and has a synergistic effect with chemotherapeutic drugs. Mechanistically, we see that the intrinsic apoptosis pathway is activated upon BM-1197 treatment. BM-1197 affects the protein interactions of Bak/Bcl-xl, Bim/Bcl-2, Bim/Bcl-xl, and PUMA/Bcl-2 and induces conformational changes in the Bax protein, which result in the activation of Bax and release of cytochrome c, activate caspase − 9, − 3, and − 7 and finally induce cell apoptosis. Furthermore, our data demonstrate that BM-1197 exhibits strong anti-tumor effects against established human malignant lymphoma xenograft models.

Conclusions

Our study demonstrated BM-1197 exerts potent antitumor effects both in vitro and in vivo and provides promising preclinical data for the further development of BM-1197 in malignant lymphoma.
Students with specific learning disabilities experiences of pre-registration physiotherapy education: a qualitative study
Authors: Norris M. , Hammond J. , Williams A. , Walker S.
Published: December 2019

Background

Attainment gaps for students with disabilities have been noted in pre-registration physiotherapy courses in the UK. Previous research suggests disclosure, lack of staff knowledge and poor communication between University and placement sites may be relevant, but these are limited to small case studies with students with visual or physical disabilities. The purpose of this study was to explore disabled physiotherapy students’ experiences of their education in order to elucidate factors that may influence success.

Methods

Qualitative study drawing on phenomenological traditions. Four focus groups including 15 students with disabilities were conducted. Transcripts were analysed thematically. Procedures for transparency and rigour such as member checking and peer debriefing were implemented.

Results

Three major themes were derived from data. “It was quite a relief” explores the personal and social implications of diagnosis. “They’re not natural” focuses on academic assessment and the specifics of adjustments made and not made within that context. “My dyslexia doesn’t switch off” explores the inaccessibility of the learning environment and dissects the contrast between the 24-h nature of having a specific learning condition and the somewhat piecemeal nature of adjustments during their education.

Conclusions

This study indicates that having a specific learning disability or anxiety creates a number of hurdles to success in physiotherapy education. Most were within the University setting and were perceived to result from staff ignorance or piecemeal approaches to inclusion. A lack of consistency alongside facilitated dialogue and acknowledgement of enhancements results in frustration, ambiguity towards disclosure and reinforcement of a deficit model. Such an approach belies the intention of the profession and the NHS and does not maximise the potential of widening participation.
Effective clinical supervision of allied health professionals: a mixed methods study
Authors: Snowdon David A. , Sargent Michelle , Williams Cylie M. , Maloney Stephen , Caspers Kirsten , Taylor Nicholas F.
Published: December 2019

Background

Clinical supervision is recommended for allied health professionals for the purpose of supporting them in their professional role, continued professional development and ensuring patient safety and high quality care. The aim of this mixed methods study was to explore allied health professionals’ perceptions about the aspects of clinical supervision that can facilitate effective clinical supervision.

Methods

Individual semi-structured interviews were conducted on a purposive sample of 38 allied health professionals working in a metropolitan public hospital. Qualitative analysis was completed using an interpretive description approach. To enable triangulation of qualitative data, a quantitative descriptive survey of clinical supervision effectiveness was also conducted using the Manchester Clinical Supervision Scale (MCSS-26).

Results

Three main themes emerged from qualitative analysis: Allied health professionals reported that clinical supervision was most effective when their professional development was the focus of clinical supervision; the supervisor possessed the skills and attributes required to facilitate a constructive supervisory relationship; and the organisation provided an environment that facilitated this relationship together with their own professional development. Three subthemes also emerged within each of the main themes: the importance of the supervisory relationship; prioritisation of clinical supervision relative to other professional duties; and flexibility of supervision models, processes and approaches to clinical supervision. The mean MCSS-26 score was 79.2 (95%CI 73.7 to 84.3) with scores ranging from 44 to 100. MCSS-26 results converged with the qualitative findings with participants reporting an overall positive experience with clinical supervision.

Conclusions

The factors identified by allied health professionals that influenced the effectiveness of their clinical supervision were mostly consistent among the professions. However, allied health professionals reported using models of clinical supervision that best suited their profession’s role and learning style. This highlighted the need for flexible approaches to allied health clinical supervision that should be reflected in clinical supervision policies and guidelines. Many of the identified factors that influence the effectiveness of clinical supervision of allied health professionals can be influenced by health organisations.
Ethnicity recording in health and social care data collections in Ireland: where and how is it measured and what is it used for?
Authors: Hannigan Ailish , Villarroel Nazmy , Roura Maria , LeMaster Joseph , Basogomba Alphonse , Bradley Colette , MacFarlane Anne
Published: December 2019

Background

In the European Union (EU), discrimination based on racial and ethnic origin is prohibited under the Racial Equality Directive. Ireland is one of only three EU countries where a legal duty of equality data collection is placed on public bodies. It provides an important context in which to study ethnic equality monitoring; however no systematic mapping of where it occurs in health information systems has been carried out. The aim of this study is to identify all existing national health and social care data collections with information on ethnicity and to explore how this data has been collected and used.

Methods

An electronic search of a national catalogue of health and social care data collections (N = 97) was carried out to identify any collections which contained information on ethnicity. Data dictionaries were searched and key informants contacted. For each of the data collections that collected information on ethnicity, data was extracted on the ethnic categories used and how this data is collected; the completeness of ethnicity recording; and other measures related to ethnicity in the data collection. Relevant outputs for these data collections, related to ethnicity, were identified through key informants and electronic searches.

Results

Of the 97 data collections, 14 (14%) collected information on ethnic or cultural background. Country of birth was collected by 10 of these 14 data collections. Most used the ethnic categories in the Census and recommended that ethnicity should be self-identified and not assigned. Reported rates of identification were generally high (≥90%). Data collections which recorded ethnicity tended to be focused on potentially high-risk populations with no routine recording in primary care. There were some examples of where ethnic equality monitoring had informed targeted interventions e.g. vaccination awareness initiatives or cultural training for healthcare staff.

Conclusions

Despite strong policy and legal imperatives, there is limited data collection of ethnicity in health and social care data collections in Ireland. While there are some examples of where differences by ethnicity have been identified and acted upon, a more coordinated and comprehensive approach to the collection, quality and utilization of ethnicity data is needed to promote health equity.