bluuebunny/crossref_metadata_2025 huggingface dataset:
Do cobalt or chromium accumulate in metal-on-metal hip arthroplasty patients who have mild, moderate, or severe renal insufficiency?
Authors: Manninen Eveliina , Lainiala Olli , Karsikas Mari , Reito Aleksi , Jämsä Pyry , Eskelinen Antti
Published: July 2021

Aims

To find out if there is an inverse association between estimated glomerular filtration rate (eGFR) and whole blood cobalt (Co) and chromium (Cr) levels in patients with metal-on-metal (MoM) hip arthroplasties and renal insufficiency, suggesting that renal insufficiency could cause accumulation of Co and Cr in blood.

Methods

Out of 2,520 patients with 3,013 MoM hip arthroplasties, we identified 1,244 patients with whole blood Co, Cr, and creatinine measured within no more than a one-year interval. We analyzed the correlation of blood metal ion levels and eGFR to identify a potential trend of accumulating Co or Cr with decreasing eGFR.

Results

Of the 1,244 patients, 112 had normal renal function (eGFR > 90 ml/min/1.73 m2), 715 had mild renal insufficiency (eGFR 60 to 89), 384 had moderate renal insufficiency (eGFR 30 to 59), 27 had severe renal insufficiency (eGFR 15 to 29), and six had end-stage renal insufficiency (eGFR < 15). Median eGFR was 68 ml/min/1.73 m2 (interquartile range (IQR) 56 to 82), median whole blood Co was 3.3 µg/l (IQR 1.1 to 9.9), and median Cr was 2.0 µg/l (IQR 1.2 to 3.6). We did not observe an association between decreased eGFR and increased whole blood Co and Cr concentrations, but instead both increased Co and Cr were associated with higher eGFR, indicating better kidney function.

Conclusion

As patients with MoM hip arthroplasties get older, the prevalence of renal insufficiency among them will increase, and orthopaedic surgeons will increasingly have to evaluate whether or not this affects patient follow-up. The USA Food and Drug Administration suggests that closer follow-up may be needed for MoM patients with renal insufficiency. We did not observe accumulation of blood Co or Cr in MoM hip arthroplasty patients with mild to severe renal insufficiency. Cite this article: Bone Joint J 2021;103-B(7):1231–1237.
Risk of revision for medial unicompartmental knee arthroplasty according to fixation and bearing type
Authors: Burger Joost A. , Zuiderbaan Hendrik A. , Sierevelt Inger N. , van Steenbergen Liza , Nolte Peter A. , Pearle Andrew D. , Kerkhoffs Gino M. M. J.
Published: July 2021

Aims

Uncemented mobile bearing designs in medial unicompartmental knee arthroplasty (UKA) have seen an increase over the last decade. However, there are a lack of large-scale studies comparing survivorship of these specific designs to commonly used cemented mobile and fixed bearing designs. The aim of this study was to evaluate the survivorship of these designs.

Methods

A total of 21,610 medial UKAs from 2007 to 2018 were selected from the Dutch Arthroplasty Register. Multivariate Cox regression analyses were used to compare uncemented mobile bearings with cemented mobile and fixed bearings. Adjustments were made for patient and surgical factors, with their interactions being considered. Reasons and type of revision in the first two years after surgery were assessed.

Results

In hospitals performing less than 100 cases per year, cemented mobile bearings reported comparable adjusted risks of revision as uncemented mobile bearings. However, in hospitals performing more than 100 cases per year, the adjusted risk of revision was higher for cemented mobile bearings compared to uncemented mobile bearings (hazard ratio 1.78 (95% confidence interval 1.34 to 2.35)). The adjusted risk of revision between cemented fixed bearing and uncemented mobile bearing was comparable, independent of annual hospital volume. In addition, 12.3% of uncemented mobile bearing, 20.3% of cemented mobile bearing, and 41.5% of uncemented fixed bearing revisions were for tibial component loosening. The figures for instability were 23.6%, 14.5% and 11.7%, respectively, and for periprosthetic fractures were 10.0%, 2.8%, and 3.5%. Bearing exchange was the type of revision in 40% of uncemented mobile bearing, 24.3% of cemented mobile bearing, and 5.3% cemented fixed bearing revisions.

Conclusion

The findings of this study demonstrated improved survival with use of uncemented compared to cemented mobile bearings in medial UKA, only in those hospitals performing more than 100 cases per year. Cemented fixed bearings reported comparable survival results as uncemented mobile bearings, regardless of the annual hospital volume. The high rates of instability, periprosthetic fractures, and bearing exchange in uncemented mobile bearings emphasize the need for further research. Cite this article: Bone Joint J 2021;103-B(7):1261–1269.
Biologics in professional and Olympic sport: a scoping review
Authors: Murray Iain R. , Makaram Navnit S. , Rodeo Scott A. , Safran Marc R. , Sherman Seth L. , McAdams Timothy R. , Murray Andrew D. , Haddad Fares S. , Abrams Geoffrey D.
Published: July 2021

Aims

The aim of this study was to prepare a scoping review to investigate the use of biologic therapies in the treatment of musculoskeletal injuries in professional and Olympic athletes.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews and Arksey and O’Malley frameworks were followed. A three-step search strategy identified relevant published primary and secondary studies, as well as grey literature. The identified studies were screened with criteria for inclusion comprising clinical studies evaluating the use of biologic therapies in professional and Olympic athletes, systematic reviews, consensus statements, and conference proceedings. Data were extracted using a standardized tool to form a descriptive analysis and a thematic summary.

Results

A total of 202 studies were initially identified, and 35 met criteria for the scoping review; 33 (94.3%) were published within the last eight years, and 18 (51.4%) originated from the USA. Platelet rich plasma was the most studied biologic therapy, being evaluated in 33 (94.3%) studies. Ulnar collateral ligament and hamstring injuries were the conditions most studied (nine (25.7%) studies and seven (20.0%) studies, respectively). Athletes most frequently participated in baseball, soccer, and American football. Only two (5.7%) studies were level 1 evidence, with interpretation and comparison between studies limited by the variations in the injury profile, biologic preparations, and rehabilitation protocols.

Conclusion

There is diverse use of biologic therapies in the management of musculoskeletal injuries in professional and Olympic athletes. There is currently insufficient high-level evidence to support the widespread use of biologic therapies in athletes. Further research priorities include the development of condition/pathology-specific preparations of biologic therapies, and of outcome measures and imaging modalities sufficiently sensitive to detect differences in outcomes, should they exist. Cite this article: Bone Joint J 2021;103-B(7):1189–1196.
Dislocation rates following total hip arthroplasty via the direct anterior approach in a consecutive, non-selective cohort
Authors: Horberg John V. , Coobs Benjamin R. , Jiwanlal Aneel K. , Betzle Christopher J. , Capps Susan G. , Moskal Joseph T.
Published: July 2021

Aims

Use of the direct anterior approach (DAA) for total hip arthroplasty (THA) has increased in recent years due to proposed benefits, including a lower risk of dislocation and improved early functional recovery. This study investigates the dislocation rate in a non-selective, consecutive cohort undergoing THA via the DAA without any exclusion or bias in patient selection based on habitus, deformity, age, sex, or fixation method.

Methods

We retrospectively reviewed all patients undergoing THA via the DAA between 2011 and 2017 at our institution. Primary outcome was dislocation at minimum two-year follow-up. Patients were stratified by demographic details and risk factors for dislocation, and an in-depth analysis of dislocations was performed.

Results

A total of 2,831 hips in 2,205 patients were included. Mean age was 64.9 years (24 to 96), mean BMI was 29.2 kg/m2 (15.1 to 53.8), and 1,595 patients (56.3%) were female. There were 11 dislocations within one year (0.38%) and 13 total dislocations at terminal follow-up (0.46%). Five dislocations required revision. The dislocation rate for surgeons who had completed their learning curve was 0.15% compared to 1.14% in those who had not. The cumulative periprosthetic infection and fracture rates were 0.53% and 0.67%, respectively.

Conclusion

In a non-selective, consecutive cohort of patients undergoing THA via the DAA, the risk of dislocation is low, even among patients with risk factors for instability. Our data further suggest that the DAA can be safely used in all hip arthroplasty patients without an increased risk of wound complications, fracture, infection, or revision. The inclusion of seven surgeons increases the generalizability of these results. Cite this article: Bone Joint J 2021;103-B(7 Supple B):38–45.
Changes in opioid discharge prescriptions after primary total hip and total knee arthroplasty affect opioid refill rates and morphine milligram equivalents
Authors: Chalmers Brian P. , Lebowitz Juliana , Chiu Yu-Fen , Joseph Amethia D. , Padgett Douglas E. , Bostrom Mathias P. G. , Gonzalez Della Valle Alejandro
Published: July 2021

Aims

Due to the opioid epidemic in the USA, our service progressively decreased the number of opioid tablets prescribed at discharge after primary hip (THA) and knee (TKA) arthroplasty. The goal of this study was to analyze the effect on total morphine milligram equivalents (MMEs) prescribed and post-discharge opioid repeat prescriptions.

Methods

We retrospectively reviewed 19,428 patients undergoing a primary THA or TKA between 1 February 2016 and 31 December 2019. Two reductions in the number of opioid tablets prescribed at discharge were implemented over this time; as such, we analyzed three periods (P1, P2, and P3) with different routine discharge MME (750, 520, and 320 MMEs, respectively). We investigated 90-day refill rates, refill MMEs, and whether discharge MMEs were associated with represcribing in a multivariate model.

Results

A discharge prescription of < 400 MMEs was not a risk factor for opioid represcribing in the entire population (p = 0.772) or in opioid-naïve patients alone (p = 0.272). Procedure type was the most significant risk factor for narcotic represcribing, with unilateral TKA (hazard ratio (HR) = 5.62), bilateral TKA (HR = 6.32), and bilateral unicompartmental knee arthroplasty (UKA) (HR = 5.29) (all p < 0.001) being the highest risk for refills. For these three procedures, there was approximately a 5% to 6% increase in refills from P1 to P3 (p < 0.001); however, there was no significant increase in refill rates after any hip arthroplasty procedures. Total MMEs prescribed were significantly reduced from P1 to P3 (p < 0.001), leading to the equivalent of nearly 500,000 fewer oxycodone 5 mg tablets prescribed.

Conclusion

Decreasing opioids prescribed at discharge led to a statistically significant reduction in total MMEs prescribed. While the represcribing rate did not increase for any hip arthroplasty procedure, the overall refill rates increased by about 5% for most knee arthroplasty procedures. As such, we are now probably prescribing an appropriate amount of opioids at discharge for knee arthroplasty procedure, but further reductions may be possible for hip arthroplasty procedures. Cite this article: Bone Joint J 2021;103-B(7 Supple B):103–110.
The importance of registry for systematic review and clinical trial
Authors: Soetikno Vivian
Published: July 2021

[None]
The Matter of Mapping Multispecies Entanglements of Mourning—A Manifesto’s Shout, An Orca’s Tour of Grief
Authors: Moulton Jacqueline Viola
Published: July 2021

Mapping entanglements is work—work of care, maintenance, and mourning. This project utilises a new materialist methodology inherited from the work of Gilles Deleuze and Félix Guattari, who follow lines of becoming to track compositions which compose worlds. To map (non-linear, temporal, and situated) lines of loss across multispecies landscapes is material work of more-than-human mourning. The New York City-based performance artist Mierle Laderman Ukeles—alongside scholars such as María Puig de la Bellacasa and Donna J. Haraway—reorient configurations of work and care, which enable these lines to be followed into more-than-human worlds. Mapping lines of mourning into multispecies worlds is material work of the aesthetic-ethical response within shared and troubled landscapes. The key storytellers within the narrative of mourning and joy woven into this paper are the Salish Sea, the Lummi Nation, the Chinook Salmon, and the Southern Resident killer whale; the voices and cries to which this project, in work and care, is dedicated.
Barreras comunicacionales en la práctica de la Maternidad Subrogada. Una crisis en tiempos de pandemia
Authors: Muñoz-Gómez Diana Sthefanía
Published: July 2021

La puesta en práctica de la maternidad subrogada ha suscitado alrededor del mundo un intenso debate bioético y jurídico asociado a los conflictos de difícil solución que desencadena y que revelan, sin duda, la complejidad del tema. El propósito de este artículo es responder a la pregunta sobre, cuáles son las barreras comunicacionales que emergen en la práctica biomédica de la maternidad subrogada en tiempos ordinarios y de pandemia, con el objetivo de entender sus implicaciones bioéticas y jurídicas a la luz del principio universal de la dignidad humana y de sostener la necesidad de resolver dichas barreras. Para lo anterior, se realizó una aproximación conceptual del tema junto con la caracterización de las principales problemáticas adyacentes y su respectivo marco legislativo a nivel internacional. Posteriormente se identifican las barreras comunicacionales, externas e internas, que se desencadenan en el ecosistema bio-reproductivo de la maternidad subrogada con un especial análisis de la situación en tiempos de pandemia. Finalmente, se plantea la discusión en el marco del principio bioético y derecho humano de la dignidad humana, para confirmar la tesis que explica cómo las barreras comunicacionales desencadenan una afectación a la dignidad de las personas que intervienen en esta práctica.
Rol del lenguaje en la humanización de la salud
Authors: Rodríguez Suárez Nathalia , Prieto Martínez Paula
Published: July 2021

Objetivo: Los estudios sobre el encuentro médico-paciente han descrito brechas entre estos agentes que afectan de manera negativa el proceso de atención en salud. La intención de este estudio fue analizar las narrativas del encuentro médico-paciente en un escenario particular: la Unidad de Cuidado Intensivo, motivados por la descripción de este contexto como aquel que es más proclive a generar experiencias deshumanizantes. Diseño: Este estudio es cualitativo de tipo narrativo-retrospectivo con una muestra intencional, de caso único. Se analizaron las narrativas derivadas de un encuentro médico-paciente, recolectadas a través de la Red de Asociativa (2, 3), una entrevista semiestructurada y la observación no participante. La información se analizó con ayuda del programa NVivo v12 ®. Resultados: El análisis de las narrativas generó 3 ejes temáticos emergentes: el thelos del acto médico, el rol de la tecnología en la experiencia de la UCI y el proceso de comunicación entre el médico y el paciente. En conclusión, parece tenerse una brecha en el diálogo entre el médico y el paciente que podría surgir de los diferentes horizontes de sentidos entre dichos agentes, brecha que puede acortarse a través de procesos de educación.
Efficient hybrid method for the modal analysis of optical microcavities and nanoresonators
Authors: Wu T. , Arrivault D. , Duruflé M. , Gras A. , Binkowski F. , Burger S. , Yan W. , Lalanne P.
Published: July 2021

We propose a novel hybrid method for accurately and efficiently analyzing microcavities and nanoresonators. The method combines the marked spirit of quasinormal mode expansion approaches, e.g., analyticity and physical insight, with the renowned strengths of real-frequency simulations, e.g., accuracy and flexibility. Real- and complex-frequency simulations offer a complementarity between accuracy and computation speed, opening new perspectives for challenging inverse design of nanoresonators.
D1- and D2-like receptors differentially mediate the effects of dopaminergic transmission on cost–benefit evaluation and motivation in monkeys
Authors: Hori Yukiko , Nagai Yuji , Mimura Koki , Suhara Tetsuya , Higuchi Makoto , Bouret Sebastien , Minamimoto Takafumi
Published: July 2021

It has been widely accepted that dopamine (DA) plays a major role in motivation, yet the specific contribution of DA signaling at D1-like receptor (D1R) and D2-like receptor (D2R) to cost–benefit trade-off remains unclear. Here, by combining pharmacological manipulation of DA receptors (DARs) and positron emission tomography (PET) imaging, we assessed the relationship between the degree of D1R/D2R blockade and changes in benefit- and cost-based motivation for goal-directed behavior of macaque monkeys. We found that the degree of blockade of either D1R or D2R was associated with a reduction of the positive impact of reward amount and increasing delay discounting. Workload discounting was selectively increased by D2R antagonism. In addition, blocking both D1R and D2R had a synergistic effect on delay discounting but an antagonist effect on workload discounting. These results provide fundamental insight into the distinct mechanisms of DA action in the regulation of the benefit- and cost-based motivation, which have important implications for motivational alterations in both neurological and psychiatric disorders.
The CATP-8/P5A-type ATPase functions in multiple pathways during neuronal patterning
Authors: Tang Leo T. H. , Trivedi Meera , Freund Jenna , Salazar Christopher J. , Rahman Maisha , Ramirez-Suarez Nelson J. , Lee Garrett , Wang Yu , Grant Barth D. , Bülow Hannes E.
Published: July 2021

The assembly of neuronal circuits involves the migrations of neurons from their place of birth to their final location in the nervous system, as well as the coordinated growth and patterning of axons and dendrites. In screens for genes required for patterning of the nervous system, we identified the catp-8/P5A-ATPase as an important regulator of neural patterning. P5A-ATPases are part of the P-type ATPases, a family of proteins known to serve a conserved function as transporters of ions, lipids and polyamines in unicellular eukaryotes, plants, and humans. While the function of many P-type ATPases is relatively well understood, the function of P5A-ATPases in metazoans remained elusive. We show here, that the Caenorhabditis elegans ortholog catp-8/P5A-ATPase is required for defined aspects of nervous system development. Specifically, the catp-8/P5A-ATPase serves functions in shaping the elaborately sculpted dendritic trees of somatosensory PVD neurons. Moreover, catp-8/P5A-ATPase is required for axonal guidance and repulsion at the midline, as well as embryonic and postembryonic neuronal migrations. Interestingly, not all axons at the midline require catp-8/P5A-ATPase, although the axons run in the same fascicles and navigate the same space. Similarly, not all neuronal migrations require catp-8/P5A-ATPase. A CATP-8/P5A-ATPase reporter is localized to the ER in most, if not all, tissues and catp-8/P5A-ATPase can function both cell-autonomously and non-autonomously to regulate neuronal development. Genetic analyses establish that catp-8/P5A-ATPase can function in multiple pathways, including the Menorin pathway, previously shown to control dendritic patterning in PVD, and Wnt signaling, which functions to control neuronal migrations. Lastly, we show that catp-8/P5A-ATPase is required for localizing select transmembrane proteins necessary for dendrite morphogenesis. Collectively, our studies suggest that catp-8/P5A-ATPase serves diverse, yet specific, roles in different genetic pathways and may be involved in the regulation or localization of transmembrane and secreted proteins to specific subcellular compartments.
Genetic variation of BnaA3.NIP5;1 expressing in the lateral root cap contributes to boron deficiency tolerance in Brassica napus
Authors: He Mingliang , Wang Sheliang , Zhang Cheng , Liu Liu , Zhang Jinyao , Qiu Shou , Wang Hong , Yang Guangsheng , Xue Shaowu , Shi Lei , Xu Fangsen
Published: July 2021

Boron (B) is essential for vascular plants. Rapeseed (Brassica napus) is the second leading crop source for vegetable oil worldwide, but its production is critically dependent on B supplies. BnaA3.NIP5;1 was identified as a B-efficient candidate gene in B. napus in our previous QTL fine mapping. However, the molecular mechanism through which this gene improves low-B tolerance remains elusive. Here, we report genetic variation in BnaA3.NIP5;1 gene, which encodes a boric acid channel, is a key determinant of low-B tolerance in B. napus. Transgenic lines with increased BnaA3.NIP5;1 expression exhibited improved low-B tolerance in both the seedling and maturity stages. BnaA3.NIP5;1 is preferentially polar-localized in the distal plasma membrane of lateral root cap (LRC) cells and transports B into the root tips to promote root growth under B-deficiency conditions. Further analysis revealed that a CTTTC tandem repeat in the 5’UTR of BnaA3.NIP5;1 altered the expression level of the gene, which is tightly associated with plant growth and seed yield. Field tests with natural populations and near-isogenic lines (NILs) confirmed that the varieties carried BnaA3.NIP5;1Q allele significantly improved seed yield. Taken together, our results provide novel insights into the low-B tolerance of B. napus, and the elite allele of BnaA3.NIP5;1 could serve as a direct target for breeding low-B-tolerant cultivars.
Unhygienic stool-disposal practices among mothers of children under five in Cambodia: Evidence from a demographic and health survey
Authors: Vong Pisey , Banchonhattakit Pannee , Sim Samphors , Pall Chamroen , Dewey Rebecca S.
Published: July 2021

Background

Unhygienic disposal of children’s stools affects children’s health in terms of their susceptibility to many diseases. However, there are no existing studies into the impact of unhygienic stool disposal in Cambodia. Therefore, this study aimed to identify factors associated with the unhygienic disposal of children’s stools among children under the age of five in Cambodia.

Methods

An analytical cross-sectional study was conducted using data from the Cambodia Demographic and Health Survey (CDHS) 2014. A multivariable binary logistic regression was conducted using Stata to analyze factors associated with the unhygienic disposal of children’s stools.

Results

Overall, the prevalence of practicing unhygienic disposal of children’s stools was 29.27% (95%CI: 27.51%- 31.09%). Factors statistically associated with this practice were: living in the Central Plain, Plateau and Mountains, Coastal and Sea regions (AOR = 1.65; 95% CI: 1.33–2.04), (AOR = 2.53; 95% CI: 1.98–3.24) and (AOR = 4.16; 95% CI: 3.15–5.48) respectively, poor household wealth (AOR = 1.58; 95% CI: 1.31–1.91), the mother having no education (AOR = 1.45; 95% CI: 1.14–1.85), a high number of children aged under five (AOR = 1.11; 95% CI: 1.03–1.20), being in the “other” religious category (AOR = 1.77; 95% CI: 1.25–2.51), living in a household with unimproved toilet facilities (AOR = 1.22; 95% CI: 1.11–1.34), living in a household with inadequate hygiene (AOR = 1.33; 95% CI: 1.12–1.59), and the household not being visited by a family planning worker in the last year (AOR = 1.45; 95% CI: 1.19–1.77). However, an increase in the child’s age by even a month had significant negative associations with unhygienic practice (AOR = 0.65; 95% CI: 0.60–0.70), even when controlling for other covariates.

Conclusion

Almost one third of the mothers do not practice hygienic disposal of children’s stools in Cambodia. Unhygienic practices were more prevalent in certain regions, and were also associated with low wealth, lack of education, an increase in the number of children under five in the household, religion, lack of sanitation and access to healthcare professionals. Conversely, the child’s age was found to be positively associated with the hygienic disposal of children’s stools.
Service utilization and HIV outcomes among transgender women receiving Ryan White Part A services in New York City
Authors: Thomas Jacinthe A. , Irvine Mary K. , Xia Qiang , Harriman Graham A.
Published: July 2021

Background

Prior research has found evidence of gender disparities in U.S. HIV healthcare access and outcomes. In order to assess potential disparities in our client population, we compared demographics, service needs, service utilization, and HIV care continuum outcomes between transgender women, cisgender women, and cisgender men receiving New York City (NYC) Ryan White Part A (RWPA) services.

Methods

The analysis included HIV-positive clients with an intake assessment between January 2016 and December 2017 in an NYC RWPA services program. We examined four service need areas: food and nutrition, harm reduction, mental health, and housing. Among clients with the documented need, we ascertained whether they received RWPA services targeting that need. To compare HIV outcomes between groups, we applied five metrics: engagement in care, consistent engagement in care, antiretroviral therapy (ART) use, point-in-time viral suppression, and durable viral suppression.

Results

All four service needs were more prevalent among transgender women (N = 455) than among cisgender clients. Except in the area of food and nutrition services, timely (12-month) receipt of RWPA services to meet a specific assessed need was not significantly more or less common in any one of the three client groups examined. Compared to cisgender women and cisgender men, a lower proportion of transgender women were durably virally suppressed (39% versus 52% or 50%, respectively, p-value < 0.001).

Conclusions

Compared with cisgender women and cisgender men, transgender women more often presented with basic (food/housing) and behavioral-health service needs. In all three groups (with no consistent between-group differences), assessed needs were not typically met with the directly corresponding RWPA service category. Targeting those needs with RWPA outreach and services may support the National HIV/AIDS Strategy 2020 goal of reducing health disparities, and specifically the objective of increasing (to ≥90%) the percentage of transgender women in HIV medical care who are virally suppressed.
Biomechanics of subtrochanteric fracture fixation using short cephalomedullary nails: A finite element analysis
Authors: Kwak Dae-Kyung , Bang Sun-Hee , Kim Won-Hyeon , Lee Sung-Jae , Lee Seunghun , Yoo Je-Hyun
Published: July 2021

A finite element analysis was performed to evaluate the stresses around nails and cortical bones in subtrochanteric (ST) fracture models fixed using short cephalomedullary nails (CMNs). A total 96 finite element models (FEMs) were simulated on a transverse ST fracture at eight levels with three different fracture gaps and two different distal locking screw configurations in both normal and osteoporotic bone. All FEMs were fixed using CMNs 200 mm in length. Two distal locking screws showed a wider safe range than 1 distal screw in both normal and osteoporotic bone at fracture gaps ≤ 3 mm. In normal bone FEMs fixed even with two distal locking screws, peak von Mises stresses (PVMSs) in cortical bone and nail constructs reached or exceeded 90% of the yield strength at fracture levels 50 mm and 0 and 50 mm, respectively, at all fracture gaps. In osteoporotic bone FEMs, PVMSs in cortical bone and nail constructs reached or exceeded 90% of the yield strength at fracture levels 50 mm and 0 and 50 mm, respectively, at a 1-mm fracture gap. However, at fracture gaps ≥ 2 mm, PVMSs in cortical bone reached or exceeded 90% of the yield strength at fracture levels ≥ 35 mm. PVMSs in nail showed the same results as 1-mm fracture gaps. PVMSs increased and safe range reduced, as the fracture gap increased. Short CMNs (200 mm in length) with two distal screws may be considered suitable for the fixation of ST transverse fractures at fracture levels 10 to 40 mm below the lesser trochanter in normal bone and 10 to 30 mm in osteoporotic bone, respectively, under the assumptions of anatomical reduction at fracture gap ≤ 3 mm. However, the fracture gap should be shortened to the minimum to reduce the risk of refracture and fixation failure, especially in osteoporotic fractures.
High rate of HSV-1 reactivation in invasively ventilated COVID-19 patients: Immunological findings
Authors: Seeßle Jessica , Hippchen Theresa , Schnitzler Paul , Gsenger Julia , Giese Thomas , Merle Uta
Published: July 2021

SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome with the need of invasive ventilation. Pulmonary herpes simplex-1 (HSV-1) reactivation in invasively ventilated patients is a known phenomenon. To date very little is known about the frequency and the predisposing factors of HSV-1 reactivation in COVID-19. Therefore, we evaluated our cohort of invasively ventilated COVID-19 patients with severe pneumonia for HSV-1 in respiratory specimens and combined these results with functional immunomonitoring of the peripheral blood. Tracheal secretions and bronchial lavages were screened by PCR for HSV-1 positivity. Comprehensive immunophenotyping and quantitative gene expression analysis of Interferon-stimulated genes (IFI44L, MX1, RSAD2, ISIG15 and IFIT1) and IL-1 beta were performed in whole blood. Time course of infection beginning at symptom onset was grouped into three phases (“early” phase 1: day 1–10, “middle” phase 2: day 11–30 and “late” phase 3: day 31–40). Pulmonary HSV-1 reactivation was exclusively observed in the later phases 2 and 3 in 15 of 18 analyzed patients. By FACS analysis a significant increase in activated CD8 T cells (CD38+HLADR+) in phase 2 was found when compared with phase 1 (p<0.05). Expression of Interferon-stimulated genes (IFI44L, RSAD2 ISIG15, MX1, IFIT1) was significantly lower after HSV-1 detection than before. Taken together, reactivation of HSV-1 in the later phase of SARS-CoV-2- infection occurs in parallel with a drop of antiviral innate responsiveness as shown by decreased expression of Interferon-stimulated genes and a concurrent increase of highly activated CD38+HLADR+ CD8 T cells.
Punção lombar
Authors: Piazzetta Gustavo Ranzolin , Pereira Hugo Cataud Pacheco
Published: July 2021

Punção lombar é um procedimento invasivo cuja finalidade é a retirada de líquido cefalorraquidiano para exames laboratoriais, medida da pressão de abertura, descompressão do sistema liquórico e infusão de medicamentos. É um método simples que revela informações importantes para a decisão clínica. A punção lombar é geralmente um procedimento seguro, mas podem ocorrer complicações que variam de leve (p. ex., dor nas costas) a potencialmente devastadora (p. ex., hérnia cerebral). Os avanços tecnológicos mudaram as indicações e a maneira como a punção lombar é feita. A suspeita de infecção no sistema nervoso central continua sendo a indicação mais comum para punção lombar. O intuito deste capítulo é trazer informações essenciais para que o leitor conheça a técnica e possa realizá-la com segurança.
Distúrbios do Sódio
Authors: Gomes Eduardo Borges , Pereira Hugo Cataud Pacheco
Published: July 2021

O sódio é o principal íon do espaço extracelular e é mantido em constante equilíbrio graças a um constante trabalho celular buscando a homeostase. Diversos distúrbios podem elevar ou diminuir sua concentração, levando a sérias consequências. Este capítulo aborda esses distúrbios, como reconhecê-los na prática clínica e corrigi-los, trazendo resumos, quadros e exercícios para facilitar o entendimento do leitor.
Potential Bias and Misconceptions in Liver Transplantation for Alcohol- and Obesity-Related Liver Disease
Authors: Van Jeremy , Aloman Costica , Reau Nancy
Published: July 2021

INTRODUCTION:

Bias and misconceptions surrounding alcohol-related liver disease (ALD) and obesity-related liver disease (OLD) may lead to transplant listing inequities. The aim of this study was to evaluate patients, medical students, residents, fellows, and attending physicians for bias and misconceptions regarding liver transplantation (LT) for patients with ALD and OLD.

METHODS:

Participants took a survey asking them whether patients with ALD who continue/discontinue drinking alcohol or patients with OLD who do/do not commit to a weight loss program deserve equal LT rights. A Likert scale was used for their responses. Participants also estimated 5-year survival and advanced fibrosis recurrence after LT. The primary outcome of the study was bias measured by expected agreement or disagreement to questions using a Likert scale, significant underestimation of a 5-year survival rate after LT, and significant overestimation of 5-year advanced fibrosis recurrence after LT.

RESULTS:

A total of 381 participants were included in the analysis: 153 residents/fellows, 31 attending physicians, 98 medical students, and 99 patients. A higher percentage from all 4 participating groups either were neutral or disagreed with equal LT rights for patients with ALD who discontinue drinking compared with patients with OLD who commit to weight loss program. The attending physician group was the only group with a majority estimating >60% 5-year survival after LT in patients with ALD and OLD (P < 0.05). All 4 groups had a majority estimate >20% 5-year advanced fibrosis recurrence in patients with ALD and OLD (P > 0.05).

DISCUSSION:

There seems to be current bias and misconceptions regarding LT for patients with ALD and OLD.
The Spatiotemporal Evolution of Urban Impervious Surface for Chengdu, China
Authors: Li Mujie , Zheng Zezhong , Zhu Mingcang , He Yue , Xia Jun , Chen Xueye , Peng Qingjun , He Yong , Zhang Xiang , Li Pengshan
Published: July 2021

The spatiotemporal evolution of an impervious surface (IS) is significant for urban planning. In this paper, the IS was extracted and its spatiotemporal evolution for the Chengdu urban area was analyzed based on Landsat imagery. Our experimental results indicated that convolutional
neural networks achieved the better performance with an overall accuracy of 98.32%, Kappa coefficient of 0.98, and Macro F1 of 98.28%, and the farmland was replaced by IS from 2001 to 2017, and the IS area (ISA) increased by 51.24 km2; that is, the growth rate was up to 13.8% in
sixteen years. According to the landscape metrics, the IS expanded and agglomerated into large patches from small fragmented ones. In addition, the gross domestic product change of the secondary industry was similar to the change of ISA between 2001 and 2017. Thus, the spatiotemporal evolution
of IS was associated with the economic development of the Chengdu urban area in the past sixteen years.
O olhar das professoras na escrita da História da Educação
Authors: Follador Kellen Jacobsen
Published: July 2021

O livro é fruto de um projeto internacional “Mulheres e inovação docente. São Paulo e França nas décadas de 1860-1960", firmado entre a Universidade de São Paulo e a universidade francesa Sorbonne Paris Cité. Foi organizado por Diana Gonçalves Vidal e Paula Perin Vicentini, igualmente autoras e pesquisadoras do projeto. As demais autoras são igualmente pesquisadoras integrantes do projeto, sejam alunas de doutorado, pós-doutorandas ou professoras universitárias. O livro foi escrito por mulheres professoras que investigaram e escreveram parte da história de outras mulheres professoras.
O relato testemunhal na cobertura do Jornal Hoje à tragédia de Brumadinho: reflexões a partir dos modos de endereçamento
Authors: Negrini Michele , Redü Natália Sheikha
Published: July 2021

O rompimento da barragem de Brumadinho foi uma das maiores tragédias ambientais do Brasil, causando a morte de mais de 200 pessoas e gerando grandes devastações ao meio ambiente. O evento foi amplamente apresentado nos meios de comunicação e teve grande cobertura dos telejornais. O Jornal Hoje, no dia 26 de janeiro de 2019, apresentou uma edição especial de cobertura ao acontecimento trágico. Desta forma, este artigo tem como foco a observação do papel dos mediadores, no programa Jornal Hoje, na captação do relato testemunhal na tragédia de Brumadinho. Vamos desenvolver o estudo a partir da ótica dos modos de endereçamento, com foco em um dos quatro operadores de análise propostos por Gomes (2007): os mediadores.
Expediente
Authors: Luís Geraldo Vitor Hugo
Published: July 2021

Conselho Editorial Téssera
O imaginário no cordel Antonio Conselheiro: o profeta do sertão
Authors: Karlo-Gomes Geam
Published: July 2021

Esta abordagem, numa perspectiva da psicologia analítica e do imaginário coletivo, perfaz uma leitura mítico-arquetípica do imaginário no cordel. O corpus de análise é um cordel brasileiro, intitulado Antonio Conselheiro: o profeta do sertão (RINARÉ, 2015). No intuito de interpretar os mitos e arquétipos que organizam a imagem messiânica de Antonio Conselheiro nessa poética de Rinaré, notam-se: o mitologema da Criança Divina como marco originário de sua trajetória mística; o arquétipo do Velho Sábio em suas virtudes como um conselheiro espiritual; e o mito do Salvador, acentuando sua figura de esperança para um destino com bem-aventuranças em Canudos.
El valor formativo de la Historia como disciplina escolar desde los programas de estudio de la educación secundaria chilena. Un análisis a través del código disciplinar
Authors: Guzmán Contreras Patricio
Published: July 2021

A partir de constatar los cambios que ha tenido la asignatura dentro del curriculum nacional, también la reducción de horarios y eliminación en los dos últimos años de secundaria, este artículo tiene por objetivo identificar, desde los programas de estudio de la materia, las orientaciones curriculares sobre el aporte formativo de la enseñanza de la historia escolar. Se enmarca en el análisis del código disciplinar propuesto por Cuesta Fernández. En la actualidad, la asignatura se ha puesto en entredicho respecto a su utilidad y aporte en el aprendizaje estudiantil, para esto, la labor docente requiere acciones concretas para poder perfeccionar la calidad del aprendizaje disciplinar, por esta razón es que, el análisis de contenido de los documentos oficiales del Estado necesariamente debe ser interpretado bajo la lupa de las competencias contemporáneas, así se revaloriza la disciplina y la labor del profesor como experto en educación.
Prácticas de lectura para enseñar Didáctica de las Ciencias Sociales en la formación inicial de maestrxs. Pensar el trabajo docente desde la Didáctica Profesional
Authors: Ladowski Mariana
Published: July 2021

La lectura de textos suele ser la práctica predominante para enseñar ciencias sociales en el Nivel Superior, práctica que en general se supone ya adquirida por lxs estudiantes y por ello no se enseña.  Desde la perspectiva que adoptamos, la lectura es central para construir conocimientos y, por lo tanto, debería constituirse en objeto de enseñanza en la formación docente. Este artículo recorre una investigación que explora y analiza diversas prácticas de lectura –y los supuestos sobre las mismas- implementadas por una docente para enseñar Didáctica de las Ciencias Sociales en la formación inicial de maestrxs. Asimismo, desde el enfoque de la Didáctica Profesional y la clínica de la actividad buscamos promover un proceso reflexivo sobre la actividad docente y una mayor comprensión de las situaciones profesionales. Mediante el diálogo entre docente e investigadora, procuramos el encuentro de la profesora con las huellas de su actividad, con el propósito de generar una reflexividad que ayude a recrearla y elaborar formas alternativas de enseñanza.
Am´ézola, G. de (coord.) (2020). Enseñar Historia. Temas y problemas
Authors: Gonzalez Ana Ruth , Dragowski Andrés
Published: July 2021

.
ASSISTÊNCIA FARMACÊUTICA NA ATENÇÃO PRIMÁRIA SOB A ÓTICA DE PRESCRITORES DE MEDICAMENTOS DE UM MUNICÍPIO DO SERIDÓ ORIENTAL POTIGUAR
Authors: Soares da Rocha Jéssica , Mariz Batista Almária
Published: July 2021

O objetivo do presente estudo foi avaliar a percepção de prescritores de medicamentos da Atenção Primária de Currais Novos, RN, sobre Assistência Farmacêutica. Trata-se de estudo transversal, com abordagem quantitativa. A coleta de dados deu-se via aplicação de instrumento adaptado a partir de metodologia proposta para Pesquisa Nacional sobre Acesso, Utilização e Uso Racional de Medicamentos. Dos 34 profissionais, 41,18% eram médicos e 58,82% dentistas, com prevalência do sexo feminino (55,88%). O vínculo empregatício prevalente foi o contrato (32,35%) sob regime de 40h semanais (55,88%). A maioria dos prescritores conhecia a Lista Padronizada de Medicamentos (73,52%); porém, 61,77% nunca participaram de sua elaboração e 61,76% não sabiam como proceder para solicitar inclusão e/ou exclusão de medicamentos nesta. Utilização de protocolos de uso de medicamentos não era uma realidade para 73,54% dos entrevistados, como também o acesso ao Centro de Informações sobre Medicamentos (2,94%). A adoção da Denominação Comum Brasileira foi citada como conduta por 52,94% dos respondentes. Informações sobre disponibilidade de medicamentos na farmácia municipal era comum para 70,59% dos entrevistados e quando os prescritores identificavam falta deles, substituíam na prescrição (76,47%). A adesão dos usuários à prescrição era prevalente para os respondentes (55,89%), contudo, a notificação de queixas técnicas e eventos adversos a medicamentos era baixa (14,71%). A avaliação dos prescritores sobre atividades da assistência farmacêutica apresentou pontos positivos e outros passíveis de melhoria, portanto, é necessária maior aproximação dos prescritores em relação a esta prática, via um trabalho interprofissional.
Diseño de un atenuador de impacto utilizando un material alternativo
Authors: Rojas Reinoso Edgar Vicente , Pancha Ramos Johnny Marcelo , Néjer Guerreo Jorge Mauricio , Romero Hidalgo Vicente
Published: July 2021

RESUMEN
Objetivo: El presente trabajo muestra el diseño y simulación de un atenuador de impacto delantero a escala para un vehículo tipo sedán, para lo cual se realizó el modelado en el software SolidWorks y la simulación a través del software Ansys Workbench con el fin de analizar el comportamiento y absorción de energía del componente durante el impacto. Por último, se realizó la impresión del atenuador de impacto a escala para validar el modelo Metodología: En este trabajo se presenta el diseño y simulación especializada mediante modelado de elementos finitos para un problema de deformación plana de un atenuador de impacto en estado de deformación. Se realizó la simulación de impacto frontal en el módulo Explicit Dynamics del software Ansys Workbench empleando dos tipos materiales; uno es el PP-GF45 que viene originalmente en el vehículo Chevrolet Optra 1.8 tipo sedán y el otro material es el PLA-CF30. Se tomó como referencia los ensayos realizados por la Latin NCAP y la norma de colisiones UN R94 en que se rigen esta compañía para la aprobación de vehículos respecto a seguridad en latinoamérica. Luego se complementó el estudio con los ensayos de impacto Charpy hechos en el laboratorio de la Facultad de Mecánica de la Escuela Superior Politécnica de Chimborazo según la normativa ASTM D6110-04 . para ello, fue necesario extraer cinco probetas por cada material
 
Resultados:
En el análisis de los resultados se evaluó la ligereza, deformación, esfuerzos y absorción de energía. Los resultados obtenidos por medio del software y el ensayo de impacto Charpy en el laboratorio de la absorción de energía tienen una relación coherente entre los dos materiales por lo que nos da certeza de que los resultados encontrados son confiables.
 
Conclusiones:
Mediante la simulación del impacto frontal en el módulo de Explicit Dynamics del software Ansys Workbench se pudo evaluar el modelo virtual, simulando las condiciones en la que se da un choque frontal real. Así se determinó que la geometría y el material seleccionado cumplen los requisitos para la implementación en un vehículo.
Financiamiento: Financiamiento propio de los autores
Reducción de emisiones de carbono por deforestación evitada en bosques del Espinal (Entre Ríos, Argentina)
Authors: Sione Silvana María José , Andrade Hernán Jair , Wilson Marcelo Germán , Rosenberger Leandro Javier , Sasal María Carolina , Ledesma Silvia Gabriela , Gabioud Emmanuel Adrián
Published: July 2021

Se estimó el carbono (C) almacenado en la biomasa aérea de bosques nativos del Espinal (Distrito del Ñandubay, provincia de Entre Ríos, Argentina) y la reducción de emisiones de CO2 por deforestación evitada. Se utilizó la información reportada en el Primer Inventario Nacional de Bosques Nativos del año 2007. Los bosques del área evaluada almacenaban a 2007 un total de 54.48 Tg C, con un promedio de 38.82 Mg.ha-1. En un escenario de deforestación cero a partir del año 2020 se lograría una reducción de emisiones del orden de 17.7 Tg CO2 para el 2030, que representa un 3.7% de la meta nacional propuesta por Argentina de no superar, al año 2030, la emisión neta de 483 Tg CO2 (Contribución Nacionalmente Determinada). La conservación de los bosques del Espinal constituye, además, un mecanismo de gran potencial para generar y comercializar créditos de C según los estándares del mecanismo REDD+.
Experiencias psicosociales en la transición hacia la paz profunda en Colombia
Authors: Estrada-Mesa Ángela María , Arias-Rodríguez Gina Marcela , Cabrera-Lozano Aida Milena , Gutiérrez-Velasco Alexandra , Díaz-Gómez Alvaro , Ortiz-Gordillo Andrés Felipe , Carvajal-Sánchez Angélica Paola , Díaz-Pérez Ivonne Leadith , Zabala-Sandoval Juan David , Bravo María de los Ángeles , Montañez-Holguín Melissa , Ayala-Rodríguez Nelly , Molina-Valencia Nelson , Carmona-Marín Olga Lucía , Patiño Sandra Carolina
Published: July 2021

The chapters in this book show a reflection on some challenges faced by the psychosociological research with a view to the accompaniment, support and even orientation of the processes and psychosocial dynamics of peace building. It is inspired by the set of works included here, but not based on them exclusively or as a priority; rather, it seeks to offer a set of criteria for critical reflection in a unique historical moment by the advocacy opportunities that open up for the improvement of psychosociological research. In turn, it is expected to encourage new reflective practices that contribute to increase the relevance and pertinence of this type of research, to choose fruitful paths both for the definition of research programs and crucial curricular decisions for the advanced training of new generations of professionals who contribute to the coming years to this fundamental challenge of building real and durable peace in Colombia. The book is a contribution to epistemological, methodological, and ethical reflections at a historical and political crucial time for the country, in which unfortunately the desire for peace in rural Colombia is not materialized yet. But, even during vicissitudes and promises for having a stable and lasting peace, psychosociological knowledge becomes meaningful and more relevant.