bluuebunny/crossref_metadata_2025 huggingface dataset:
Kitten Scanner reduces the use of sedation in pediatric MRI
Authors: Cavarocchi Eleonora , Pieroni Ilde , Serio Antonio , Velluto Lucio , Guarnieri Biancamaria , Sorbi Sandro
Published: July 2018

The use of sedation before a magnetic resonance imaging (MRI) scan is a common practice to overcome motion artifacts and anxiety in children. However, this technique has its drawbacks. We retrospectively compared the number of children undergoing a brain MRI scan with or without sedation before and after the introduction of an educational training protocol using a toy scanner (the Philips Kitten Scanner) and we investigated the effectiveness of this training in relation to children’s age and gender. We considered 1461 children between 4 years and 14 years. Of them, 158 had a diagnosis of autism spectrum disorder or attention-deficit hyperactivity disorder and were excluded from further analysis. After the introduction of the Kitten Scanner training protocol, the sedation need decreased by 30% in the total sample group and in children younger than 10 years in particular. Before the training, females were more likely to undergo the MRI examination without sedation as compared to males, while after its introduction this gender difference was no more visible.
Rethinking the assumptions of intervention research concerned with care at home for people with dementia
Authors: Ceci Christine , Symonds Brown Holly , Judge Harkeert
Published: July 2018

Aging populations have been positioned as a challenge to health and social service planning around the world, a situation even more pronounced in the case of persons with a diagnosis of dementia. While policy responses emphasize that care be provided for persons with dementia in home settings for as long as possible and that family carers be supported in the provision of this care, finding good ways to support families as they do the work of ‘delaying institutionalization’ has been challenging despite decades of intervention research intended to develop and evaluate interventions to support families. In this context of limited effectiveness it is useful to examine the assumptions informing research practices. Problematization is a method of literature analysis useful for clarifying and challenging assumptions informing a field of research in order to generate new approaches to research or new research questions. Our analysis suggests that although community-based intervention research has contributed significant knowledge about the kinds of things that might help families, there are limitations related to the dominant assumptions underlying the field. We highlight three areas for re-consideration: the overriding focus on caregiver–care recipient dyads, the under-determination of the object(s) of inquiry and the algorithmic nature of interventions themselves. Issues in these areas, we argue, arise from a commitment to homogeneity characteristic of biomedical models of disease that may need to be rethought in the face of consequential heterogeneity among research populations. That is, there is a mismatch between ‘dementia’ in the intervention research literature and ‘dementia’ in the life that is consequential for families living with these concerns.
Shifting paradigms in environmental research methods through the visual arts
Authors: Kaplan Abram W
Published: July 2018

Arts-based research offers a potentially valuable approach for students trained in the positivist tradition of environmental issues to expand their repertoire. This article traces the experience of students in an undergraduate course that examines the US food system through immersive photography, using arts-based research as the core methodological theme of exploration and inquiry. The research approach to assessing student growth and integration of this model builds on both quantitative and qualitative designs, offering a triangulated look at interdisciplinarity. The article contemplates the ways in which situated learning through visual immersion helps students construct new ways of understanding the world around them. Further, this research promotes opportunities for research-grounded paradigm shifts with the help of supportive environments, scaffolding embodied knowledge through creative experience.
Critically engaging discourses on quality improvement: Political and pedagogical futures in early childhood education
Authors: Reinke Stephanie , Peters Lacey , Castner Daniel
Published: July 2018

This article is a commentary developed by three early childhood teacher educators who are concerned about the negative consequences of contemporary policy trends in the United States. The commentary critically examines the influence of quality improvement in early childhood as it relates to environmental rating systems and the use of teacher performance assessments, more specifically, the Early Childhood Environmental Rating Scale and the Teacher Performance Assessment. The article concludes with a potential vision for early childhood scholars and practitioners—building solidarity to function as an emerging, powerful, ethical community of early childhood curriculum workers that thrives without consensus.
Exploratory Neural Reactions to Framed Advertisement Messages of Smoking Cessation
Authors: Yang Dong-Jenn
Published: July 2018

This study used Mind Wave, a brain wave–reading device from NeuroSky, to replace self-reporting measures in the examination of the effects of advertisement messages and understand audiences’ underlying attention on the delivered ideas and its relation to the physiological process behind message framing for smoking cessation. A total of 130 undergraduate male students consisting of 65 smokers and 65 non-smokers participated in the between-subject experimental study. The results revealed that participants who are smokers and received positively framed messages showed higher attention on smoking cessation than the negatively framed group. In contrast, participants who are non-smokers and received negatively framed messages had better attention. This showed that the framed message strategy is a better option for public health-care advertising.
Electromagnetic shielding performance of three-dimensional woven fabrics with copper-based hybrid yarn in X-band frequency range
Authors: Pandey Dharmendra Nath , Basu Arindam , Kumar Pramod , Baskey Himangshu B
Published: July 2018

This study involves a comprehensive evaluation of electromagnetic shielding characteristics of multilayer three-dimensional conductive fabrics by using cotton/copper wrapped hybrid yarn in X band frequency range. Five, three-dimensional fabrics with different structural configuration, such as orthogonal, angle interlock, cellular spacer, multi-tubular spacer, and contour were produced. Three different series of all five structures was also developed using pure cotton fabric, conductive hybrid yarn in weft and one-third hybrid yarn and two-third cotton yarn in warp Also, the effect of vertical and horizontal polarization of electromagnetic waves on electromagnetic shielding effectiveness was studied. The comparative analysis of reflectance transmittance and absorption behavior was also undertaken. The results indicate that pure cotton fabric (A series) does not have electromagnetic shielding capabilities. The difference between the electromagnetic shielding effectiveness values in vertical and horizontal planes of fabrics, having conductive hybrid yarn in weft direction (B series), showed significantly better results on the vertical plane in comparison to that on the horizontal plane. Fabric containing conductive hybrid yarn in both warp and weft (C series) exhibits consistent electromagnetic shielding effectiveness in both the planes. It is worth mentioning that the structural configuration in all five three-dimensional fabrics in B and C series has shown differential trends of electromagnetic shielding effectiveness in terms of reflectance, transmittance and absorption behavior. They are also found to be statistically significant. Finally, it is concluded that the conductive 3-D multilayer system develops special protective capabilities, mostly due to its larger surface area.
Primary medial femoral condyle vascularized bone graft for scaphoid nonunions with carpal collapse and proximal pole avascular necrosis
Authors: Kollitz Kathleen M. , Pulos Nicholas , Bishop Allen T. , Shin Alexander Y.
Published: July 2018

This study aimed to determine the outcome of free vascularized medial femoral condyle bone grafts in the primary treatment of scaphoid nonunions with scaphoid foreshortening or carpal collapse and intraoperatively documented avascular necrosis. Thirty-two patients (28 male, four female) met the inclusion criteria. Median time from injury to surgery was 70 weeks. Thirty of 32 patients healed at a median of 12 weeks. There was significant improvement from preoperative to postoperative lateral intrascaphoid angle, scapholunate angle, and radiolunate angle. Two scaphoids failed to unite; one patient underwent scaphoidectomy and four-corner fusion 15 months postoperatively after suffering a subsequent injury. Another patient underwent 1,2-intercompartmental supraretinacular artery-based vascularized bone grafting at 4 months postoperatively and then scaphoid excision with four-corner fusion 4 years later. The free vascularized medial femoral condyle bone graft restores scaphoid vascularity and architecture while promoting union in a subset of scaphoid nonunions that has historically been a clinical challenge.

Level of evidence: IV
Utilizing Neutral Affective States in Research: Theory, Assessment, and Recommendations
Authors: Gasper Karen
Published: July 2018

Even though researchers regularly use neutral affect induction procedures (AIPs) as a control condition in their work, there is little consensus on what is neutral affect. This article reviews five approaches that researchers have used to operationalize neutral AIPs: to produce a(n) (a) minimal affective state, (b) in-the-middle state, (c) deactivated state, (d) typical state, or (e) indifferent state. For each view, the article delineates the theoretical basis for the neutral AIP, how to assess it, and provides recommendations for when and how to use it. The goal of the article is to encourage researchers to state their theoretical assumptions about neutral affect, to validate those assumptions, and to make appropriate conclusions based on them.
When do literacy skills begin to decline among Chinese adults?
Authors: Wu Qiong
Published: July 2018

Literacy skills have been used in some studies as a proxy for premorbid intelligence because they are considered relatively resistant to normal aging. This study aims to explore whether there are signs of decline with aging in literacy skills among Chinese adults with average lower levels of education than their Western peers. Drawing on data from a nationally representative survey, the study uses two repeated literacy tests administered at four-year intervals to investigate at what age literacy skills begin to decline and the effects of possible risk factors. On average, literacy skills have been shown to decline at age 45 and above among Chinese adults. While gender, education, marital status, income, urban status, and subjective cognitive impairment were all associated with the level of literacy skills at baseline, only gender and education were predictive of change over time. Females declined at a slower rate, and the decline appeared to be statistically significant only for those with low education levels. The use of literacy skills as an indicator of premorbid intelligence may need to be reconsidered for the poorly educated. These findings highlight the greater burden of cognitive aging in China due to average low education levels.
Characteristic patterns of HLA presentation and T cell differentiation in adult-onset Still’s disease
Authors: Jung Ju-Yang , Choi Bunsoon , Sayeed Hasan MD , Suh Chang-Hee , Kim Ye Won , Kim Hyoun-Ah , Sohn Seonghyang
Published: July 2018

We examined the expression of human leukocyte antigen (HLA) and composition of differentiated T cells in the peripheral blood to understand the characteristics of the immune changes in patients with adult-onset Still’s disease (AOSD). This study enrolled patients with AOSD (n = 14), patients with rheumatoid arthritis (RA, n = 20), and healthy controls (HC, n = 20). The percentage of surface-stained cells with HLA-DP, DQ, and DR alleles and the composition of differentiated T cells in peripheral blood leukocytes (PBLs) were evaluated by flow cytometry. AOSD patients exhibited significantly higher percentages of lymphocytes presenting HLA-DP and HLA-DR, and lower percentages of cells presenting HLA-DQ, than RA patients or HC. The proportions of CD4+, CD4+CCR7+, CD4+CD62L–, and CD8+CD62L– cells from PBLs were decreased in AOSD patients relative to RA patients or HCs. By contrast, AOSD patients had higher proportions of CD8+naïve T cells in whole blood relative to RA patients or HC. The proportions of CD4+ effector memory T cells, CD8+ naïve T cells, and CD8+ effector memory T cells in whole blood cells and CD4+ effector memory T cell in lymphocytes were significantly associated with the systemic score. While the proportions of CD4+, CD8+, CCR7+, CD4+CCR7+, CD4+CD62L–, and CD8+CD62L– cells were significantly decreased in AOSD patients, and the proportion of CD8+naïve T cells was elevated in AOSD and correlated with the systemic score. Further studies of a large cohort of AOSD patients will be necessary to evaluate these markers in the pathogenesis of AOSD.
The effect of exposure of SO2 in high concentrations on CD19+ cells in reactive airway dysfunction syndrome in rat
Authors: Zhang Zhiyuan , Ma Zhuang , Sun Wenwu , Ma Debin , Cao Jianping
Published: July 2018

Reactive airway dysfunction syndrome (RADS) has a clinical manifestation similar to asthma, but some features are different between both the diseases. To probe the effect of CD19+ cells in RADS pathogenesis by inhalation of sulfur dioxide (SO2), rats were exposed to SO2 at 600 ppm for 2 h per day for 7 days and the CD19 expression in lung tissue was detected both at mRNA and protein levels by RT-PCR and western blot. The percentages of CD19+ and CD19+ CD23+ cells were measured by flow cytometry. IgG, IgA, and IgE in serum and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA). Histological analysis was performed. The results showed that expression of CD19 in SO2 exposure group was lower than that in the control both at mRNA and protein levels ( P < 0.05). Flow cytometry analysis showed that the percentages of CD19+ and CD19+ CD23+ were significantly lower in the SO2 exposed group than that in the control ( P < 0.05). There was no difference between the control and SO2 exposed groups in both serum and BALF levels of IgG, IgA, and IgE. Pathological changes, such as chronic bronchitis, local alveolar hemorrhage, and lymphocytes infiltration were observed in SO2 exposed. RADS is a non-immunogenicity, chronic airway inflammatory disease caused by irritation of harmful factor and manifests as airway hyperresposiveness.
Quantitizing and qualitizing (im-)possibilities in mixed methods research
Authors: Nzabonimpa Jean Providence
Published: July 2018

Mixed methods research has gained momentum over the past decade, but critics rightly charge that the integration of qualitative and quantitative data remains an unresolved methodological issue. While each of the dualistic and canonized methodological paradigms has its own way of handling analysis, researchers in mixed methods as a new paradigm have invested considerable efforts in more complex mixed analysis. They use the quantitizing of qualitative data and qualitizing of quantitative data as the strategies to effect data integration in mixed methods research. While attempts have been made to achieve quantitizing and qualitizing of data, few empirical studies have been conducted in a two-phase convergent parallel mixed methods design to investigate such data conversion approaches, especially dichotomization, within a single inquiry. To contribute to this ongoing methodological quest, this article explores the possibilities and impossibilities offered by either strategy to convert narratives into numerical data and numerical data into narratives.
The Impact of E-Banking Service Quality on Customer Satisfaction: Evidence From the Lebanese Banking Sector
Authors: Hammoud Jamil , Bizri Rima M. , El Baba Ibrahim
Published: July 2018

The purpose of this study was to examine the relationship between the dimensions of E-Banking service quality and customer satisfaction to determine which dimension can potentially have the strongest influence on customer satisfaction. Data were gathered using a survey instrument, which was distributed among bank clients in the Lebanese banking sector. The data were statistically analyzed using structural equation modeling with SPSS and Amos (20). The findings show that reliability, efficiency, and ease of use; responsiveness and communication; and security and privacy all have a significant impact on customer satisfaction, with reliability being the dimension with the strongest impact. E-Banking has become one of the essential banking services that can, if properly implemented, increase customer satisfaction, and give banks a competitive advantage. Knowing the relative importance of service quality dimensions can help the banking industry focus on what satisfies customers the most.
Biomarkers of Ossification of the Spinal Ligament
Authors: Kawaguchi Yoshiharu
Published: July 2018

Study Design:

Literature review.

Objectives:

To review biomarkers in patients with ossification of the spinal ligament (OSL), including ossification of the posterior longitudinal ligament and ossification of the ligamentum flavum and to raise the present issues.

Methods:

A literature search was performed using PubMed and MEDLINE databases. The biomarkers were classified according to category. The number of the subjects and reproducibility were assessed.

Results:

Eleven articles were included in this review. There were 9 articles from Japan, 1 article from Taiwan, and 1 article from China. The biomarkers were classified into calcium-phosphate metabolism markers, bone turnover markers, sclerostin, dickkopf-1, secreted frizzled-related protein-1, fibroblast growth factor-23, fibronectin, menatetrenone, leptin, pentosidine, and hypersensitive C-reactive protein. However, there were several limitations in the research studies, such as small research field, small number of subjects, and a lack of reproducibility.

Conclusions:

Although there have been several studies that have analyzed biomarkers for OSL, there are no definitive conclusions to date. Numerous issues will need to be resolved in the future. It is imperative to continue this research because the results might prove beneficial to elucidate the pathology of OSL and the measures to prevent the initiation and progression of the disease.
Analysis of Postoperative Complications in Spinal Surgery, Hospital Length of Stay, and Unplanned Readmission: Application of Dindo-Clavien Classification to Spine Surgery
Authors: Camino Willhuber Gaston , Elizondo Cristina , Slullitel Pablo
Published: July 2018

Study Design:

Retrospective study. Level of evidence III.

Objective:

Postoperative complications in spine surgery are associated with increased morbidity, hospital length of stay, and health care costs. Registry of complications in orthopedics and the spine surgery is heterogeneous.

Methods:

Between July 2016 and June 2017, 274 spinal surgeries were performed, the presence of postoperative complications was analyzed at 90 days (according to the classification of Dindo-Clavien, grades I-V), hospital length of stay, surgical complexity (low, medium, and high), unplanned readmission, and risk factors were evaluated.

Results:

A total of 79 patients suffered a complication (28.8%), of them 21 (26.7%) were grade I, 24 (30.3%) were grade II, 4 (5.7%) were grade IIIA, and 29 (37.3%) were grade IIIB. There were no IV and V grade cases. The most frequent complication was excessive pain followed by deep wound infection and anemia. Surgical complexity and surgical time were significantly associated with the risk of developing a complication. The average number of hospital length of stay in patients without and with complications were 2.7 and 10.6, respectively, and the unplanned readmission rate was 11%.

Conclusions:

Registry of postoperative complications allows the correct standardization and risk factors required to establish measures to decrease them, the application of Dindo-Clavien classification was useful for the purpose of our study.
Management of Failed Proximal Biceps Surgery: Clinical Outcomes after Revision to Subpectoral Biceps Tenodesis
Authors: Savin David , Waterman Brian Robert , Richardson Catherine , Sumner Shelby , Romeo Anthony A.
Published: July 2018

Objectives:

The preferred technique for management of biceps-superior labral pathology is often debated, and rates of revision and persistence pain vary widely accordingly to surgical technique and patient demographics. The purpose of this study was to evaluate the clinical and functional outcomes of patients undergoing revision subpectoral biceps tenodesis after failed primary tenodesis or tenotomy.

Methods:

A retrospective review was completed to identify of all patients undergoing revision biceps tenodesis by the senior surgeon with minimum 24-month follow-up. Demographic variables including age, sex, insurance status, and tobacco use were recorded, Patient reported outcomes including the functional score, Single Assessment Mumeric Evaluation (SANE) rating, Visual Analog Scale (VAS) pain scale, Simple Shoulder Test (SST), and American Shoulder and Elbow Score (ASES) were obtained, and range of motion (ROM), strength, and complications were quantified.

Results:

In total, 36 patients with revision biceps tenodesis were identified, with a mean age of 46 ± 12 years and mean follow up of 60 ± 29 months. The indication for revision surgery was failure of index suprapectoral biceps tenodesis (56%), subpectoral biceps tenodesis (36%), and failure of tenotomy (8%). Concomitant procedures including rotator cuff repair and capsular release were performed in 25% and 8% of index surgeries respectively. There was a significant improvement in VAS score (P <0.001), SST (P<0.009), functional score (P<0.001) and forward elevation (P<0.001). Postoperative shoulder strength (P = 0.082), SANE (P = 0.074), abduction (P = 0.096) and external rotation (P =0.8) improved, but failed to achieve statistical significance. were not significantly improved following revision surgery. There was no difference in post-operative outcome measures between surgical indication, concomitant procedures and sex. 86% of patients reported high satisfaction and stated they would have this revision surgery again. Overall complication rate was 33% with the majority of these being either acute or chronic pain, with 8% of patients requiring additional surgeries to manage stiffness, chronic pain or rotator cuff deficiency.

Conclusion:

The current study demonstrates high patient satisfaction (86%) and significant improvement in functional outcomes with revision biceps tenodesis after previous failed tenodesis or tenotomy. Revision biceps tenodesis using a mini-open, subpectoral technique may be an effective strategy to address failed prior surgery, although the potential for persistent pain must be emphasized.
Operative And Non-operative Management Of Osteochondritis Dissecans In The Knee Of Skeletally Immature Patients: Rates Of Persistent Knee Pain, Osteoarthritis, And Arthroplasty At Mean 14- Years Follow-up
Authors: Hevesi Mario , Sanders Thomas L. , Pareek Ayoosh , Milbrandt Todd , Levy Bruce A. , Saris Daniël B. , Krych Aaron John
Published: July 2018

Objectives:

The purpose of this study was to report long-term follow-up of skeletally immature OCD lesions treated operatively and non-operatively and determine risk factors for persistent knee pain at final follow-up.

Methods:

A large, geographic database of over 500,000 patients was reviewed in this case series to identify and confirm patients with OCD of the knee. Presenting radiographs and MRI were reviewed. Clinical course including operative management, persistent knee pain, and conversion to TKA were obtained and analyzed through review of clinical and operative notes.

Results:

95 skeletally immature patients (70 males, 25 females) with OCD lesions diagnosed at a mean age of 13 years (range: 7-16) were followed for a mean of 14 years (range: 2-40). 53 patients (56%) were treated operatively and 42 patients (44%) were treated non-operatively. At final follow up, 13 patients with a mean age of 30 years noted persistent knee pain, 8 (15%) treated operatively versus 5 (12%) treated non-operatively. Risk factors for knee pain were female gender, patellar lesion location, and unstable lesions (Table 1). Four patients (8%) treated operatively and two (5%) treated non-operatively developed symptomatic osteoarthritis at a mean of 28.6 years following diagnosis. One patient treated operatively and two treated non-operatively converted to TKA at a mean of 37 years following diagnosis. Mean age at TKA was 52 years, significantly younger than that observed for primary TKA at our institution (p = 0.004).

Conclusion:

Patients with skeletally immature OCD lesions have an estimated 14% rate of persistent knee pain, 6% risk of symptomatic osteoarthritis, and 3% risk of conversion to TKA at a mean of 14 years following time of diagnosis. Female patients, patellar lesions, and unstable lesions demonstrated increased risk of persistent knee pain at final follow-up. Patients with OCD of the knee convert to TKA at a significantly younger age than that of the general primary TKA population. [Table: see text]
Trans-osseous versus Anchor Repair of Acute Patellar Tendon Ruptures
Authors: O’Dowd James A. , Lehoang David , Butler Rebecca K. , De Witt David , Mirzayan Raffy
Published: July 2018

Objectives:

Patellar tendon ruptures are relatively uncommon injuries. They require prompt diagnosis and surgical repair to restore the extensor mechanism of the knee. The gold standard procedure is a suture repair of the tendon, passed through trans-osseous tunnels, and tying of the sutures on the superior pole of the patella. Suture anchors have gained popularity with a recent cadaveric study demonstrating significantly less gap formation during cyclic loading and significantly higher ultimate failure loads. We present the largest series of patellar tendon repairs and compare the clinical outcomes and complications of trans-osseous (TO) and anchor (A) repair types.

Methods:

All patients who underwent a primary repair of a traumatic patellar tendon rupture within 45 days of injury, between 2007 and 2016, were retrospectively reviewed. Surgeries were performed at a multi-surgeon (114 surgeons), multi-center (13 centers) community-based integrated health care system. Patients with prior knee surgery, use of graft, patellar debridement for tendonitis, inferior pole avulsion fracture, concurrent knee surgery with other procedures were excluded. Patient demographic information, repair type, complications, and time from surgery to release from medical care were recorded.

Results:

361 patients (374 knees) met our inclusion criteria. 13 had bilateral repairs during our study period and an additional 8 had a contralateral repair prior to our study period, for a bilateral incidence at 5.8%. The average age was 39.8 years (9 to 86 years). There were 341 males (94.5%). The most common mechanism of injury was basketball (47%), fall (19.5%), football (5.0%), and soccer (4.8%). Average time from injury to surgery was 6.3 days (range: 1- 45 days). There were 321 TO and 53 A repairs. There was no significant difference in the mean age (P=0.27), gender (P=0.79), tourniquet time (P=0.93), or BMI (P=0.78) between the two groups. There was a significant difference in re-rupture between (24 of 321) TO (7.5%) and (0 of 53) A (0%) (P=0.034). Using logistic regression, we found that TO had 3.244 times the odds of re-operation as those with A (95% CI: 0.757, 13.895. p-value: 0.1129) but did not reach signficance. The infection rate was 7.5% for A and 1.6% for TO (P= 0.160). There was no difference in time to release from medical care, 18.4 weeks for and 17.1 weeks (P=0.92).

Conclusion:

Compared to Anchors, primary repair of patellar tendon ruptures with trans-osseous repair had a significantly higher re-rupture rate, but there was no difference in re-operation rate, infection, or release from medical care.
Patellar Tendon Thickness and Failure After Anterior Cruciate Ligament Reconstructions with Bone-Patella Tendon-Bone Autograft
Authors: Roach Ryan , Kramarchuk Mark , Pham Hien , Mastio Michele , Dai Amos , Alaia Michael Joseph , Gonzalez-Lomas Guillem
Published: July 2018

Objectives:

The purpose of this study was to determine if patellar tendon (PT) thickness measured on pre-operative magnetic resonance imaging (MRI) is a risk factor for failure after anterior cruciate ligament reconstruction (ACLR) using bone-patella tendon-bone (BTB) autograft.

Methods:

18 patients [age (mean 96 Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:”Table Normal”; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow: yes; mso-style-priority:99; mso-style-parent:”“; mso-padding-alt:0in 5.4 pt 0in 5.4 pt; mso-para-margin:0in; mso-para-margin-bottom:.0001 pt; mso-pagination: widow-orphan; font-size:11.0 pt; mso-bidi-font-size:12.0 pt; font-family: Helvetica;} ± standard deviation) 21.5 ± 4.99years] that underwent an ACLR with BTB autograft and returned for revision ACLR between July 2005-January 2017 at our institution were included in the study. Failures were age-, sex-, height-, and weight-matched to 36 control (age 21.5 ± 4.99years) BTB-ACLR patients that have not required revision at a minimum of 2-years follow-up. Demographic data and mechanism of injury were recorded from patients’ medical records. PT thickness was measured at 3 points (5 mm lateral to the center, center, and 5 mm medial to the center) each at the level of the inferior pole of the patella (IPP), midpoint (MP), and insertion to tibial tubercle (ITT) on pre-operative axial-cut MRI.

Results:

All ACLR failures occurred after a non-contact pivot-shift type injury. Mean time between primary ACLR and revision was 2.4 ± 2.4 years and mean follow-up time was 3.1 ± 0.9 years in the control group. Patients with a failed ACLR had significantly thicker PTs at the IPP (lateral: 4.66 ± 1.47 vs 3.96 ± 0.66 mm; central: 5.39 ± 1.49 vs 4.51 ± 1.04 mm; medial: 5.51 ± 1.52 vs 4.59 ± 1.05 mm) and MP (lateral: 4.50 ± 0.83 vs 4.12 ± 0.54 mm; central: 4.83 ± 0.80 vs 4.43 ± 0.59 mm; medial: 4.57 ± 0.88 vs 4.13 ± 0.59 mm). There were no significant differences in PT thickness at the ITT. PT width tended to be larger in the failure cohort but this was not statistically significant (IPP: 32.2 ± 4.6 vs 29.8 ± 4.3 mm; MP: 31.3 ± 4.9 vs 29.5 ± 3.8 mm; ITT: 27.7 ± 3.7 vs 26.2 ± 2.9 mm).

Conclusion:

Contrary to conventional wisdom, we found that BTB autograft ACLR failures had significantly thicker patellar tendons at the inferior pole of the patella and midpoint. Further studies are need to investigate possible causes for this inverse correlation, such as poor histological tendon quality or mechanical impingement due to increased tendon size.
Accuracy of MRI and Varus Stress Radiographs in Diagnosing Fibular Collateral Ligament Injuries
Authors: Provencher Matthew T. , Kane Patrick W. , DePhillipo Nicholas N. , Cinque Mark , Moatshe Gilbert , Murphy Colin , Sanchez Anthony , LaPrade Robert F.
Published: July 2018

Objectives:

To evaluate the diagnostic accuracy of magnetic resonance imaging and varus stress radiographs for FCL tears, and compare these modalities to intraoperative findings.

Methods:

All patients who underwent an isolated FCL or combined ACL/FCL reconstruction by a single surgeon between 2010 and 2017 with preoperative varus stress radiographs and MRI were included in this study. A control group was comprised of patients with an MRI and intact ACL and FCL. Sensitivity and specificity of diagnosing FCL injuries on MRI were determined based on review by a fellowship-trained musculoskeletal radiologist. The sensitivity of diagnosing an FCL injury based on varus stress radiographs was also determined. Furthermore, the ability of both imaging modalities to identify an FCL injury was stratified based on acute versus chronic etiology.

Results:

A total of 232 patients were included: 98 patients in the FCL tear group and 134 patients in the control group. Varus stress radiographs were determined to be more sensitive in diagnosing FCL injuries compared to MRI, with an overall sensitivity of 70% compared to 66%. Based on chronicity of the injuries, MRI was more accurate for detecting acute FCL injuries than chronic injuries (p=0.002), and varus stress radiographs were more accurate for detecting chronic FCL injuries than acute injuries (p=0.041).

Conclusion:

To our knowledge, this is the first clinical study to directly compare the diagnostic accuracy of FCL tear detection utilizing MRI and varus stress radiographs in the same patient cohort. While varus stress radiographs appear to have a higher accuracy overall, the results from our study support the use of both varus stress radiographs and MRI in diagnosing FCL injuries, as MRI is more sensitive in diagnosing an acute FCL tear, and varus stress radiographs are more sensitive in diagnosing a chronic FCL tear.
Shoulder Injection Prior to Rotator Cuff Repair is Associated with Increased Risk of Subsequent Surgery
Authors: Traven Sophia , Brinton Daniel , Simpson Kit , Adkins Zachary , Althoff Alyssa , Palsis John Andrew , Slone Harris
Published: July 2018

Objectives:

Corticosteroid injections (CSI) are frequently utilized in the nonoperative management of rotator cuff tears. However, recent literature suggests that injections may reduce biomechanical strength of tendons and ligaments in animal models and increase the risk of postoperative infections following surgery. The goal of this study was to determine if the timing of CSI is associated with an increased risk of reoperation following primary rotator cuff repair (RCR).

Methods:

A retrospective analysis of claims data of privately-insured subjects from the MarketScan® database for the years 2010-2014 was conducted. A cohort of subjects aged 18-64 who were diagnosed with a rotator cuff tear and underwent repair in 2011 was identified. Multivariable logistic regression models were used to compare the odds of reoperation between groups.

Results:

A total of 4,959 subjects with an arthroscopic RCR were identified. Of this, 550 subjects required reoperation within the following 3 years. Patients who had a CSI within 6 months preceding the RCR were at a much higher risk of undergoing reoperation: 0-3 months prior, AOR 1.536 (95% CI: 1.201 -1.965); 3-6 months, AOR 1.843 (95% CI: 1.362-2.494); and 6-12 months AOR 1.339 (95% CI: 0.914 -1.962). Of those patients that underwent a reoperation, the most common surgery performed was revision rotator cuff repair followed by arthroscopic debridement (48.5% versus 38.9%, respectively).

Conclusion:

Patients who had received a CSI within 6 months prior to RCR were much more likely to undergo a subsequent reoperation within the following 3 years. These odds diminished as more time passed between CSI and primary repair. Consideration should therefore be given to delaying primary rotator cuff repair for 6 months following injection. [Table: see text][Figure: see text]
Working time regimes: A panel discussion on continuing problems
Authors: Costas Jana , Ekman Susanne , Empson Laura , Kärreman Dan , Muhr Sara Louise
Published: July 2018

This article records a panel discussion at the Organizational Working Time Regimes conference on 31 March 2017 at the University of Graz, Austria. The discussion was moderated by Sara Louise Muhr and the panelists were Jana Costas, Susanne Ekman, Laura Empson and Dan Kärreman. The discussion both departed from yet centred on the concept of time itself: how we understand time as academics, employees and managers, and how the notion of time guides and controls all of us in various ways. Through the different perspectives that the panelists have on time and work regimes, it became evident that time – and discussions of time – is complex and context-dependent and needs to be researched as such. The discussion passionately weaved in and out of key questions on work intensification, inequality regimes and resistance to working time regimes that are deeply entwined with dynamic dialectics such as personal/professional, past/future, individual/organizational, worker/leader, good/bad. The panel in this way takes the reader through difficult discussions about what is ‘extreme’, for whom is it extreme and what interventions (if any) can be made by academics. Doing so, the panelists sensitively drew attention to our own line of work, academia, and the work regimes controlling academics.
Evaluation of Unit Equivalency of Insulin Glargine to Insulin Detemir in an Acute Care Setting
Authors: Cook Elizabeth A. , Gill Taylor , Taylor Scott
Published: July 2018

Background: Insulin glargine and insulin detemir are the most commonly prescribed basal insulins in the United States. While these analogs chemically differ, clinical trials have established no significant difference in efficacy. However, controversy remains as to whether the 2 agents are comparable with regard to unit equivalency. Objectives: To determine the ratio of glucose lowering between insulin detemir and insulin glargine. Methods: This institutional review board-approved, single-center, retrospective, case-crossover study was conducted in patients with diabetes mellitus with inpatient admissions between June 30, 2014, to July 1, 2015. Patients must have received both insulin detemir and insulin glargine on either the same or separate hospital visits. A blood glucose–lowering ratio for both insulin glargine and insulin detemir was calculated for each patient based off of up to 5 days of fasting blood glucose values and the total number of units of insulin administered. Results: Fifty-two patients were included in this study. No significant difference was found in the blood glucose–lowering ratio between insulin glargine (0.23 mg/dL/unit) as compared with insulin detemir (0.16 mg/dL/unit; P = .08). Conclusion: No difference was found in the blood glucose–lowering ratio between insulin glargine and insulin detemir. The results of this study suggest that conversion between insulin glargine and insulin detemir using a 1:1 ratio in an acute care setting may be appropriate.
Full width at half maximum of low-angle basal phyllosilicate X-ray diffraction reflections: fitted peaks vs. diffraction traces
Authors: Kisch Hanan J.
Published: July 2018

Bernard Kübler measured illite ‘crystallinity’, the half-height width or full width at half maximum (FWHM) of the X-ray diffraction line of illite/mica at 10 Å, directly on the diffraction traces; this procedure has since been followed by the vast majority of workers. However, some workers have recently measured the FWHM of the fitted Pearson VII function rather than on the diffraction traces. The FWHM of this function for low-angle phyllosilicate diffraction peaks (FWHM*PVII) is almost consistently ‘broader’ than those measured directly on the diffraction trace profiles (FWHMtrace) by up to 0.08°Δ2θ for the broader peaks. The Pearson VII function shows gentle curvature (‘smoothing’) at its tops and fast fading of the tails relative to virtually all 10 Å diffraction traces. The broad FWHM*PVII results from the consequent lowering/’under-fitting’ of the peak tops and the upper tails and compensatory broadening/’over-fitting’ of the intermediate peak flanks. FWHM*PVII ‘contraction’ with respect to FWHMtrace and enhancement of the peak maximum is found on traces of muscovite strips. The fitting reliabilities of the Cauchy function are almost invariably better than those of the Pearson VII function. Their FWHM*Cauchy values are narrower for both the illite/mica 10 Å and the chlorite 7 Å reflections; although they still differ somewhat from the FWHMtrace, they are much closer, usually within 0.02°Δ2θ. This markedly lesser broadening of FWHM* of the Cauchy of the Pearson VII function is the result of its stronger top curvature and notably faster tail fading (less ‘smoothening’). For higher-angle mica peaks, the FWHM* values of the Pearson VII and Cauchy functions converge, usually differing only by 0.01–0.03°Δ2θ for the 5 Å peak, and even less for the 3.3 Å peak. It is therefore strongly recommended that FWHM values of the illite/mica 10 Å reflections be measured on the diffraction traces rather than on fitted functions. Where peak fitting is unavoidable (e.g. in order to separate the contributions of adjoining, partly resolved or unresolved reflections on broadened 10 Å reflections), Cauchy rather than Pearson VII functions should be used.
Oncogenic activation of the STAT3 pathway drives PD-L1 expression in natural killer/T-cell lymphoma
Authors: Song Tammy Linlin , Nairismägi Maarja-Liisa , Laurensia Yurike , Lim Jing-Quan , Tan Jing , Li Zhi-Mei , Pang Wan-Lu , Kizhakeyil Atish , Wijaya Giovani-Claresta , Huang Da-Chuan , Nagarajan Sanjanaa , Chia Burton Kuan-Hui , Cheah Daryl , Liu Yan-Hui , Zhang Fen , Rao Hui-Lan , Tang Tiffany , Wong Esther Kam-Yin , Bei Jin-Xin , Iqbal Jabed , Grigoropoulos Nicholas-Francis , Ng Siok-Bian , Chng Wee-Joo , Teh Bin-Tean , Tan Soo-Yong , Verma Navin Kumar , Fan Hao , Lim Soon-Thye , Ong Choon-Kiat
Published: July 2018

Key Points

Alterations in JAK/STAT signaling pathway are highly prevalent in PTCL and NKTL, where STAT3 and TP53 are the most frequently mutated genes. STAT3 activation drives PD-L1 expression in NKTL, providing a rationale to combine STAT3 inhibitors with immune checkpoint inhibitors.
Validation of the 2017 revision of the WHO chronic myelomonocytic leukemia categories
Authors: Loghavi Sanam , Sui Dawen , Wei Peng , Garcia-Manero Guillermo , Pierce Sherry , Routbort Mark J. , Jabbour Elias J. , Pemmaraju Naveen , Kanagal-Shamanna Rashmi , Gur H. Deniz , Hu Shimin , Zuo Zhuang , Medeiros L. Jeffrey , Kantarjian Hagop M. , Khoury Joseph D.
Published: July 2018

Key Points

Validation of the WHO 2017 CMML categories supports distinguishing MP-CMML from MDS–CMML. The prognostic value of the new 3-tiered blast-based CMML stratification scheme is limited.
Prevalence of dengue fever virus antibodies and associated risk factors among residents of El-Gadarif state, Sudan
Authors: Eldigail Mawahib H. , Adam Gamal K. , Babiker Rabie A. , Khalid Fatima , Adam Ibrahim A. , Omer Osama H. , Ahmed Mohamed E. , Brair Sara L. , Haroun Eltahir M. , AbuAisha Hassan , Karrar Abdelrahim E. , Abdalla Hamid S. , Aradaib Imadeldin E.
Published: July 2018

Background

Dengue fever, caused by dengue virus (DENV), has become one of the most important mosquito-borne viral diseases with a steady rise in global incidence, including the Sudan. Sporadic cases and frequent acute febrile illness outbreaks, compatible with Dengue fever, have been reported in El-Gadarif State, Sudan. However, diagnosis was based almost exclusively on clinical signs without confirmatory laboratory investigations. Despite the magnitude of the problem in El-Gadarif State, no information is currently available with regard to the epidemiology of the disease in this State. El-Gadarif State is one of the largest commercial centers in the Sudan. The objective of the present investigation is to estimate the prevalence of DENV antibodies, and determine the potential risk factors associated with seropositivity among residents of El-Gadarif State.

Methods

A cross sectional study was conducted in a total of 701residents randomly selected from all 10 localities in El-Gadarif State. The sera from the 701 residents were tested for the presence of DENV-specific immunoglobulin G (IgG) antibodies using a commercially available Anti-dengue IgG enzyme-linked immunosorbent assay (ELISA).

Results

Among the 701 residents, 334 residents (47.6%) were seropositive for DENV. Mosquito control (OR = 2.73, CI = 1.37–5.87, p-value = 0.001); low income (OR = 2.31, CI: 1.71–6.36, p value = 0.032); sleeping out-doors (OR = 3.73, CI = 2.63–6.23, p-value = 0.013), and localities were determined as potential risk factors for contracting DENV infection.

Conclusions

The prevalence rate of DENV antibodies among residents of El-Gadarif State is significantly high (47.6%). Further epidemiologic studies including, distribution of mosquito vectors and implementation of improved surveillance are urgently warranted for better prediction and prevention of a possible DENV outbreak in El-Gadarif State, Sudan.
The book on how to make all the colour paints for illuminating books: unravelling a Portuguese Hebrew illuminators’ manual
Authors: Melo Maria J. , Castro Rita , Nabais Paula , Vitorino Tatiana
Published: July 2018

The book on how to make all the colour paints for illuminating books invites readers to step inside the workshop of a fifteenth century illuminator in Portugal. This illuminator was the carrier of a tradition on how to make colours with ‘which you can illuminate or paint or capitalize or write’ that dates back, at least, to the thirteenth century. This unique knowledge and know-how was carefully preserved in Portuguese language, in Hebrew characters, in a collection of texts now known as Ms. Parma 1959 (Parma, Italy, Biblioteca Palatina, MS 1959, folios 1r–20r). Its ultimate purpose was possibly to assist on the production of Hebrew Bibles, where the precision of the text would have been illuminated by the colours described in this ‘book of all colour paints’. This medieval treatise describes the main steps and ingredients for producing painting materials, such as mosaic gold, red lead, verdigris, brazilwood lake pigments, lac dye red, vermilion, parchment glue, among others. It also instructs on the binding media that should be used to produce the colour paints. In this paper, we will discuss the technical aspects relevant for the success of the making of the painting materials and of the experimentation of this remarkable text, copied in the fifteenth century.
Theranostics and contrast agents for magnetic resonance imaging
Authors: Jeong Yohan , Hwang Hee Sook , Na Kun
Published: July 2018

Background

Magnetic resonance imaging is one of the diagnostic tools that uses magnetic particles as contrast agents. It is noninvasive methodology which provides excellent spatial resolution. Although magnetic resonance imaging offers great temporal and spatial resolution and rapid in vivo images acquisition, it is less sensitive than other methodologies for small tissue lesions, molecular activity or cellular activities. Thus, there is a desire to develop contrast agents with higher efficiency. Contrast agents are known to shorten both T1 and T2. Gadolinium based contrast agents are examples of T1 agents and iron oxide contrast agents are examples of T2 agents. In order to develop high relaxivity agents, gadolinium or iron oxide-based contrast agents can be synthesized via conjugation with targeting ligands or functional moiety for specific interaction and achieve accumulation of contrast agents at disease sites.

Main body

This review discusses the principles of magnetic resonance imaging and recent efforts focused on specificity of contrast agents on specific organs such as liver, blood, lymph nodes, atherosclerotic plaque, and tumor. Furthermore, we will discuss the combination of theranostic such as contrast agent and drug, contrast agent and thermal therapy, contrast agent and photodynamic therapy, and neutron capture therapy, which can provide for cancer diagnosis and therapeutics.

Conclusion

These applications of magnetic resonance contrast agents demonstrate the usefulness of theranostic agents for diagnosis and treatment.