bluuebunny/crossref_metadata_2025 huggingface dataset:
Experience With Unfavorable Iliac Access When Performing Fenestrated/Branched Endovascular Aneurysm Repair
Authors: Hertault Adrien , Bianchini Aurélia , Daniel Guillaume , Martin-Gonzalez Teresa , Sweet Birgit , Sgorlon Giada , Fabre Dominique , Sobocinski Jonathan , Haulon Stéphan
Published: February 2021

Purpose:

To review a single-center experience with fenestrated and branched endovascular aneurysm repair (f/bEVAR) in patients with challenging iliac anatomies.

Materials and Methods:

A retrospective review of the department’s database identified 398 consecutive patients who underwent complex endovascular repair f/bEVAR between January 2010 and June 2018; of these, 67 had challenging accesses. The strategies implemented to overcome access issues were reviewed, using a dedicated scoring system to evaluate the access (integrating diameter, tortuosity, calcification, and previous open or endovascular repair).

Results:

In this subgroup of patients, the most common graft design was a 4-vessel fenestrated endograft (27, 40.3%). Hostile access was due to small diameter (<7 mm) in 25 patients (37.3%) and/or concentric calcifications in 19 patients (26.9%). Mean iliac diameter was 5.5±2.6 mm on the right side and 6.0±2.5 mm on the left side. Previous open or endovascular aortoiliac repair had been performed in 15 patients (22.4%), and 20 patients (29.9%) had a stent previously implanted in at least 1 iliac artery, resulting in the inability to perform standard fenestrated repair with access from both sides. Five patients (7.5%) had a single patent iliac access. Eight distinctive strategies were identified to overcome these access issues, including the use of preloaded renal catheters in the endograft delivery system, angioplasty, graft modification (branches instead of fenestrations or 4 preloaded fenestrations), a conduit via a retroperitoneal approach, iliac artery recanalization, and/or the multiple puncture technique. Technical success was achieved in 62 cases (92.5%). Four patients had access complications and 1 died in the early postoperative period of multiorgan failure. Median follow-up was 24.6 months (IQR 7.2, 41.3). Clinical success at the end of follow-up was achieved in 57 patients (85.1%). During follow-up, 14 patients died, including 4 from an aorta-related cause.

Conclusion:

Dedicated strategies can be implemented to overcome hostile iliac access in patients with complex aneurysms when f/bEVAR is required. Typically, these maneuvers are associated with favorable outcomes.
MicroRNA-936 Targets JAG1 and Inhibits the Proliferation of Hepatocellular Carcinoma Cells
Authors: Tian Junmei , Zhao Yongfei , Li Li , Cui Yanling , Wu Yang
Published: February 2021

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Investigating the underlying molecular mechanism is essential for the treatment and prognosis of HCC. Emerging evidence suggests that microRNAs (miRNAs) play pivotal roles in cancer progression. Down-regulation of miR-936 has been found in several cancers, which serves as a tumor suppressor to inhibit the development of cancers. However, the clinical significance and functional roles of miR-936 in HCC have not been determined. To explore this, the expression of miR-936 in HCC tissues and cells was detected by RT-qPCR. Cell Counting Kit-8 (CCK-8) assay, cell migration and cell cycle analysis were performed to evaluate the effects of miR-936 on the growth of HCC cells. The targets of miR-936 were predicted using the miRDB database and confirmed by luciferase reporter experiments. The protein expression of targets was determined by western blot. The results showed that miR-936 was significantly decreased in HCC tissues and cell lines. Low expression of miR-936 was associated with the advance progression and poor survival of HCC patients (P = 0.0036). Functional study revealed that overexpression of miR-936 inhibited the proliferation, migration (decreased to ∼0.26 fold) and induced cell cycle arrested in G1 phase (from 35.3% to 44.7%) of HCC cells. Additionally, miR-936 targeted the 3′-untranslated region (UTR) of jagged-1 (JAG1) and reduced the expression of JAG1 (decreased to ∼0.35 fold). JAG1 was found to be up-regulated in HCC tissues and was inversely correlated with the expression of miR-936 (Pearson r = −0.4633; P = 0.0007). The anti-cancer effects of miR-936 on the proliferation of HCC cells were partially reversed by the rescue of JAG1. Therefore, these results suggested that miR-936 might be a potential target for HCC treatment.
MicroRNA-144 Suppresses Prostate Cancer Growth and Metastasis by Targeting EZH2
Authors: Sun Xin-bo , Chen Yong-wei , Yao Qi-sheng , Chen Xu-hua , He Min , Chen Cong-bo , Yang Yong , Gong Xiao-xin , Huang Li
Published: February 2021

Background:

Prostate cancer is a common malignant tumor with a high incidence. MicroRNAs (miRNAs) have been shown to be important post-transcriptional regulators during tumorigenesis. This study aimed to explore the effect of miR-144 on PCa proliferation and apoptosis.

Material and Methods:

The expression of miR-144 and EZH2 were examined in clinical PCa tissues. PCa cell line LNCAP and DU-145 was employed and transfected with miR-144 mimics or inhibitors. The correlation between miR-144 and EZH2 was verified by luciferase reporter assay. Cell viability, apoptosis and migratory capacity were detected by CCK-8, flow cytometry assay and wound healing assay. The protein level of EZH2, E-Cadherin, N-Cadherin and vimentin were analyzed by western blotting.

Results:

miR-144 was found to be negatively correlated to the expression of EZH2 in PCa tissues. Further studies identified EZH2 as a direct target of miR-144. Moreover, overexpression of miR-144 downregulated expression of EZH2, reduced cell viability and promoted cell apoptosis, while knockdown of miR-144 led to an inverse result. miR-144 also suppressed epithelial-mesenchymal transition level of PCa cells.

Conclusion:

Our study indicated that miR-144 negatively regulate the expression of EZH2 in clinical specimens and in vitro. miR-144 can inhibit cell proliferation and induce cell apoptosis in PCa cells. Therefore, miR-144 has the potential to be used as a biomarker for predicting the progression of PCa.
A Novel 10-Gene Signature Predicts Poor Prognosis in Low Grade Glioma
Authors: Liu Wentao , Zou Jiaxuan , Ren Rijun , Liu Jingping , Zhang Gentang , Wang Maokai
Published: February 2021

Aim:

Low grade glioma (LGG) is a lethal brain cancer with relatively poor prognosis in young adults. Thus, this study was performed to develop novel molecular biomarkers to effectively predict the prognosis of LGG patients and finally guide treatment decisions.

Methods:

survival-related genes were determined by Kaplan-Meier survival analysis and multivariate Cox regression analysis using the expression and clinical data of 506 LGG patients from The Cancer Genome Atlas (TCGA) database and independently validated in a Chinese Glioma Genome Atlas (CGGA) dataset. A prognostic risk score was established based on a linear combination of 10 gene expression levels using the regression coefficients of the multivariate Cox regression models. GSEA was performed to analyze the altered signaling pathways between the high and low risk groups stratified by median risk score.

Results:

We identified a total of 1489 genes significantly correlated with patients’ prognosis in LGG. The top 5 protective genes were DISP2, CKMT1B, AQP7, GPR162 and CHGB, the top 5 risk genes were SP1, EYA3, ZSCAN20, ITPRIPL1 and ZNF217 in LGG. The risk score was predictive of poor overall survival and relapse-free survival in LGG patients. Pathways of small cell lung cancer, pathways in cancer, chronic myeloid leukemia, colorectal cancer were the top 4 most enriched pathways in the high risk group. SP1, EYA3, ZSCAN20, ITPRIPL1, ZNF217 and GPR162 were significantly up-regulated, while DISP2, CKMT1B, AQP7 were down-regulated in 523 LGG tissues as compared to 1141 normal brain controls.

Conclusions:

The 10-gene signature may become novel prognostic and diagnostic biomarkers to considerably improve the prognostic prediction in LGG.
Differences of EEG Frequency and Spatial Parameters in Depressive Female Adolescents With Suicidal Attempts and Non-suicidal Self-injuries
Authors: Iznak Andrey F. , Iznak Ekaterina V. , Damyanovich Elena V. , Oleichik Igor V.
Published: February 2021

Background. Both non-suicidal self-injuries (NSSIs) and suicidal attempts (SAs) in adolescence represent significant risk factors for consequent suicide, but neurophysiological markers and predictors of these two forms of auto-aggressive behavior have been studied insufficiently. Objective. The aim of the study was to identify the differences of electroencephalographic (EEG) frequency and spatial parameters between depressive female adolescents with solely NSSI, and with combined NSSI + SA behavior in their history. Methods. The study included 45 female depressive in-patients aged 16-25 years. Baseline resting EEG spectral power, asymmetry, and coherence were analyzed in 8 narrow frequency sub-bands. Results. In the NSSI + SA subgroup (n = 24), the spectral power of parietal–occipital alpha-2 (9-11 Hz) was higher than in the NSSI subgroup, its focus was localized in the right hemisphere, and alpha-3 (11-13 Hz) spectral power was higher than alpha-1 (8-9 Hz). In the NSSI subgroup (n = 21) alpha-1 spectral power was higher than alpha-3, and foci of alpha-2 and alpha-3 were localized in the left hemisphere. EEG coherence was also higher in the NSSI + SA subgroup than in the NSSI subgroup, especially in frontal–central–parietal regions. Conclusions. The spatial distribution of the EEG frequency components in the NSSI + SA subgroup reflects the greater activation of the left hemisphere that is more typical for the EEG of individuals with an increased risk for suicide. In the NSSI subgroup, the right hemisphere is relatively more activated, and EEG coherence is lower, which is more typical for EEG in depressive disorders. The results obtained suggested the use of EEG to clarify the degree of suicidal risk in depressive female adolescents with NSSI.
A model for predicting stress distribution and strain-force characteristics in regular braided ropes
Authors: Yujing Zhang , Zhuo Meng , Chengjie Du , Linlin Yao , Yize Sun
Published: February 2021

Owing to the good mechanical properties of braided structures, regular braided ropes are increasingly being used in various fields, including marine exploration, aloft work, recreation activities, and oil prospecting. However, under certain severe conditions, they could break, a situation that is absolutely undesired. Thus, predicting their stress distribution and strain-force characteristics when they are subjected to different tensile loads is a pre-requisite for their application. Therefore, in this study, a mathematical model for ropes with regular braided structures is developed, and based on the model, this study reveals that uneven stress distributions in the different strands of regular braided ropes generate different stress distributions and strain-force characteristics in each of the strands. Additionally, the uneven stress distributions in the different strands also induce mechanical failure more readily. Finally, to ensure the reliability of braided ropes in different applications, different strand parameters are compared.
Secondary school principals and liminality in Polish Upper Silesia (1919-1939)
Authors: Venken Machteld
Published: February 2021

Establishing and implementing rules that would teach young people to become active citizens became a crucial technique for turning those spots on the map of Europe whose sovereignty had shifted after World War I into lived social spaces. This article analyses how principals of borderland secondary schools negotiated transformation in Polish Upper Silesia with the help of Arnold Van Gennep’s notion that a shift in social statuses possessed a spatiality and temporality of its own. The article asks whether and how school principals were called on to offer elite training that would make Polish Upper Silesia more cohesive with the rest of Poland in terms of the social origins of pupils and the content of the history curriculum. In addition, it examines the extent to which borderland school principals accepted, refuted, or helped to shape that responsibility. The social origins of pupils are detected through a quantitative analysis of recruitment figures and the profiles of pupils’ parents. This analysis is combined with an exploration of how school principals provided a meaningful explanation of the recent past (World War I and the Silesian Uprisings). The article demonstrates that while school principals were historical actors with some room to make their own decisions when a liminal space was created, changed, and abolished, it was ultimately a priest operating in their shadows who possessed more possibilities to become a master of ceremonies leading elite education through its rites of passage.
Absent hyperdense middle cerebral artery sign is associated with poor functional outcome after mechanical thrombectomy
Authors: Ume Kiddy L , Dandapat Sudeepta , Weber Matthew W , Zevallos Cynthia B , Fifer Amber , Levy Abigail , Delfino Kristin , Ortega-Gutierrez Santiago , Siddiqui Fazeel M
Published: February 2021

Background

The hyperdense middle cerebral artery sign on computed tomography indicates proximal middle cerebral artery occlusion. Recent reports suggest an association between the hyperdense sign and successful reperfusion. The prognostic value of the hyperdense middle cerebral artery sign in patients receiving mechanical thrombectomy has not been extensively studied.

Aims

Our study aims to evaluate the association between the hyperdense middle cerebral artery sign and functional outcome in patients with M1 occlusions that had undergone mechanical thrombectomy.

Methods

We conducted a single-center retrospective observational cohort study of 102 consecutive patients presenting with acute M1 occlusions that had undergone mechanical thrombectomy. Patients were stratified into cohorts based on the presence of hyperdense middle cerebral artery sign visually assessed on computed tomography by two readers. The outcomes of interests were functional disability measured by the ordinal Modified Rankin Scale (mRS) at 90 days, mortality, reperfusion status and hemorrhagic conversion.

Results

Out of the 102 patients with M1 occlusions, 71 had hyperdense middle cerebral artery sign. There was no significant difference between the cohorts in age, baseline mRS, NIHSS, ASPECTS, and time to reperfusion. The absence of hyperdense middle cerebral artery sign was associated with increased odds of being dependent or dying (higher mRS) (OR: 3.24, 95% CI: 1.30–8.06, p = 0.011) after adjusting for other significant predictors, including age, female sex, hypertension, presenting serum glucose, ASPECTS, CTA collateral score, and successful reperfusion.

Conclusion

The absence of hyperdense middle cerebral artery sign is associated with worse functional outcome in patients presenting with M1 occlusions undergoing thrombectomy.
Silence, joint enterprise and the legal trap
Authors: Hulley Susie , Young Tara
Published: February 2021

The so-called ‘wall of silence’ presents a threat to successful police investigations and criminal trials. Explanations for it have focused on cultural narratives, including distrust in the police, a ‘no snitching’ culture and manipulative ‘professional criminals’. Drawing on a study of serious multi-handed violence and ‘joint enterprise’ as a legal response, this article highlights the role of the law, and its agents, in generating silence among young suspects, whose primary concern is the legal risks of talking. Yet, these young people face a precarious trap, as their silence is interpreted as guilt by the police, propelling them towards charge. This article concludes that to avoid over-charging and to encourage young people with knowledge of serious violence to talk, structural change is needed. The system must reverse the legal rules regarding silence and reform the law on secondary liability to reduce the legal risks of talking.
Understanding risk discourse through the lens of Vietnamese women
Authors: Van Nguyen Hoang
Published: February 2021

Motivated by a call for risk discourse research in non-Western settings, this study examines how Vietnamese road safety video advertisements are constructed and interpreted. Following a literature review of risk and gender, the study first sets out socio-semiotic multimodal analysis of video advertisements to detail how concepts of risk and gender are constructed. Afterwards, I take an ethnographic-based approach in a series of interviews with professional Vietnamese women to gain insights into these concepts. Findings of the study reveal the expected female roles as wives and mothers in Vietnamese advertising as interpreted by Vietnamese women. The study contributes to an understanding of risk in this Asian setting and opens up the potential for a critical, interpretive approach to risk discourses that are grounded in lived experiences.
Grassroots, Astroturf, or Something in Between? Semi-Official WeChat Accounts as Covert Vectors of Party-State Influence in Contemporary China
Authors: Neagli Jackson Paul
Published: February 2021

This article explores a facet of the Chinese propaganda apparatus that has yet to receive sufficient academic attention: the murky ecosystem of “semi-official” party-state presences on Chinese social media. With a particular focus on WeChat public accounts, this investigation responds to two critical research questions: first, what differentiates official party-state social media presences from semi-official presences, and second, what unique role do semi-official WeChat accounts play in the contemporary Chinese propaganda apparatus? This article samples content published by five dyads of official and semi-official WeChat public accounts during the first fifteen days of June 2019. The results of this comparative, case-study-based discourse analysis support two conclusions. First, semi-official WeChat accounts posture as independent from the party-state in order to attract large followings and gain credibility. Second, semi-official WeChat public accounts operate as “astroturfed influencers,” enabling the Chinese propaganda apparatus to covertly manipulate online discourse with extraordinary efficiency.
Two New Sesquiterpenoids Isolated From Cyperus rotundus L
Authors: Wang Qiang , Yi Chundie , Duan Wenlan , Duan Yunfeng , Lou Jiahao , Zeng Guangzhi , Yin Junlin
Published: February 2021

Two new sesquiterpenoids, isocyperotundone (1) and 1,4-epoxy-4-hydroxy-4,5-seco-guain-11-en-5-one (2), together with 6 known sesquiterpenoids, cyperotundone (3), cyperenoic acid (4), sugetriol triacetate (5), cyperusol A3 (6), cyperusol A2 (7), and cyperusol A1 (8), were isolated from the methanol extract of the rhizomes of Cyperus rotundus L. High-resolution electrospray ionization mass spectrometry and 1-dimensional (1D) and 2D nuclear magnetic resonance spectroscopy were used to establish the structures of all the compounds. All the compounds were tested for activity on nuclear factor kappa-light-chain-enhancer of activated B cells (NF- κB) signaling. Compounds 1-7 exhibited inhibitory activity on tumor necrosis factor- α-induced activation of the NF- κB pathway, with half-maximal inhibitory concentration values ranging from 34.5 to 73.7 μmol/L.
Effect of Spatial Ambiances on the Patient Satisfaction and Well-Being in Hospitals: The Case of UHC Ibn Sina Annaba and UHC Benbadis Constantine—Algeria
Authors: Talantikite Soundouss I. , Bencherif Meriama
Published: February 2021

Objectives:

In this work, we aim to have a better understanding of the impact of the architectural ambiance on patient well-being, by exploring patient’s perception of physical ambiantal factors in their rooms.

Background:

Perception of ambiantal factors is beginning to be relatively documented in space psychology, including health. There is no research in this field in Algeria; therefore, we would like to fill this gap and draw attention to the importance of the ambiantal physical factors in our hospitals.

Methods:

We conducted a practical study via a 19-item questionnaire at the neurology hospitalization department of two hospitals. This is complemented by in situ observations and reactivated observations. Descriptive, principal component analysis and statistical tests were applied on the responses.

Results:

Thirteen ambiantal physical items studied were all classified relatively medium with mean scores ranging between −0.55 < mean < 1.34, with SD 0.765, on a scale of −2 to 2. Patients therefore consider the room ambiance medium. Patients’ satisfaction and well-being results meet with findings about ambiantal physical factors. Neurological diseases affect patient cognition, which increase the importance of space-sensitive perception. The bad general condition of the building is negatively pointed in all testimonies of the questioned, especially spatial organization with multiple occupation room.

Conclusion:

The results indicate that reflection should be oriented on the design of single or double rooms, taking into account the emotional (sensitive) state of the patient, by integrating ambiantal physical factors (natural lighting variable, sound variable, thermal variable, olfactory variable), to contribute significantly to their well-being.
Upregulated Expression of Toll-Like Receptor 7 in Peripheral Blood Basophils of Patients With Allergic Rhinitis
Authors: Wang Lihong , Zhan Mengmeng , Wang Junling , Chen Dong , Zhao Nan , Wang Ling , Wang Wei , Zhang Xiaowen , Huang Yixia , Zhang Huiyun , He Shaoheng
Published: February 2021

Background

Recently, it has been reported that Toll-like receptor 7 (TLR7) agonists can improve allergic rhinitis (AR) symptoms by up-regulation of Th1 cytokine release and suppression of Th2 cell functions. However, little is known of the expression of TLR7 in basophils of AR.

Objective

To explore the expression of TLR7 in basophils of AR, and influence of allergens on TLR7 expression.

Methods

The expression levels of TLR7 in basophils of patients with AR were determined by flow cytometry, and the influence of allergens on TLR7 expression was examined by real time (q) PCR.

Results

The percentages of TLR7+CCR3+ cells ( P < 0.001 and P = 0.011), TLR7+CD123+HLA-DR− cells ( P = 0 .016 and P = 0.042) and TLR7+CCR3+CD123+HLA-DR− cells ( P = 0.046 and P = 0.035) in blood granulocyte and mononucleated cell populations of the patients with AR were increased, respectively compared with HC subjects. TLR7 MFI on CCR3+ cells ( P = 0.050 and P = 0.043), CD123+HLA-DR− cells ( P < 0.001 and P = 0.002) and CCR3+CD123+HLA-DR− cells ( P < 0.001 and P = 0.003) were enhanced compared with HC subjects. Allergens Der p1 and OVA provoked upregulation of TLR7 expression at both protein and mRNA levels and IL-13 production in KU812 cells. House Dust Mite extract (HDME), Artemisia sieversiana wild allergen extract (ASWE), IL-31, IL-33, IL-37, and TSLP provoked elevation of IL-6 release from KU812 cells following 2 h incubation period.

Conclusions

The percentage of TLR7+ basophils and TLR7 expression intensity in a single basophil are both increased in the blood of patients with AR, indicating that basophils likely contribute to the pathogenesis of AR via TLR7.
Insulinoma in pregnancy (a case presentation and systematic review of the literature)
Authors: Dobrindt Eva M , Mogl Martina , Goretzki Peter E , Pratschke Johann , Dukaczewska Agata K
Published: February 2021

Insulinomas are rare, benign and functional tumors that coincidentally may become overt during pregnancy or in the post-partum period. As the general symptoms of a pregnancy might cover the clinical presentation, diagnosing remains challenging. We present one additional case of a post-partum insulinoma, combined with a systematic review of the literature to sum up relevant details in diagnosis and treatment. A systematic request of Pubmed/Medline was conducted using the following terms: “insulinoma AND pregnancy” and “insulinoma” for a second request of ClinicalTrials.gov. All publications concerning pregnant or post-partum women with insulinoma were included. Thirty-six cases could be identified for analysis. Each publication was reviewed for demographic, diagnostic and therapeutic data. The most frequent clinical signs were unconsciousness and neurological symptoms. 64.9% were diagnosed during early pregnancy and 35.1% post-partum. 91.9% underwent surgery with a third resected during pregnancy without severe influence on fetal or maternal outcome. Three patients died of metastatic disease or misdiagnosing, two of them miscarried. Insulinoma in pregnancy is rare but should be considered in case of unclear hyperinsulinemic hypoglycemia. Surgery can be performed during the second trimester or post-partum with promising outcome.
Xp11.2 translocation renal cell carcinoma with osseous metaplasia
Authors: Zondo Mfundiso , Mukendi Alain Mwamba , Dhoodhat Faizel , Mtshali Nompumelelo , Mosiane Pulane
Published: February 2021

Xp11.2 translocation renal cell carcinoma is an uncommon and distinctive subtype of renal neoplasm. Osseous metaplasia with renal cell carcinoma is extremely rare and only less than 20 cases have been reported in the literature distinctly in clear cell, papillary and chromophobe subtypes. There has only been one report of Xp11.2 translocation renal cell carcinoma with osseous metaplasia in an elderly woman. We present the first case of this unusual renal neoplasm associated with osseous metaplasia in an adolescent male with no history of previous exposure to chemotherapy who presented with symptomatic anemia due to painless haematuria.

Level of evidence: Level 4.
Brain atrophy and clinical characteristics predicting SDMT performance in multiple sclerosis: A 10-year follow-up study
Authors: Jacobsen Cecilie , Zivadinov Robert , Myhr Kjell-Morten , Dalaker Turi O , Dalen Ingvild , Benedict Ralph HB , Bergsland Niels , Farbu Elisabeth
Published: February 2021

Objectives

To identify Magnetic Resonance Imaging (MRI), clinical and demographic biomarkers predictive of worsening information processing speed (IPS) as measured by Symbol Digit Modalities Test (SDMT).

Methods

Demographic, clinical data and 1.5 T MRI scans were collected in 76 patients at time of inclusion, and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. For the primary outcome of analysis, SDMT was used.

Results

Worsening SDMT at 5-year follow-up was predicted by baseline age, Expanded Disability Status Scale (EDSS), SDMT, whole brain volume (WBV) and T2 lesion volume (LV), explaining 30.2% of the variance of SDMT. At 10-year follow-up, age, EDSS, grey matter volume (GMV) and T1 LV explained 39.4% of the variance of SDMT change.

Conclusion

This longitudinal study shows that baseline MRI-markers, demographic and clinical data can help predict worsening IPS. Identification of patients at risk of IPS decline is of importance as follow-up, treatment and rehabilitation can be optimized.
Trends and developments in hip and knee arthroplasty technology
Authors: Marsh Martin , Newman Simon
Published: February 2021

The developments in hip and knee arthroplasty over recent years have aimed to improve outcomes, reduce complications and improve implant survival. This review describes some of the most interesting trends and developments in this important and fast-moving field. Notable developments have included ceramic hip resurfacing, mini hip stems, cementless knee replacement and the wider adoption of the dual mobility articulation for hip arthroplasty. Advances in additive manufacturing and the surface modification of joint replacements offer increasing options for more challenging arthroplasty cases. Robotic assisted surgery is one of the most interesting developments in hip and knee surgery. The recent growth in the use of this technology is providing data that will help determine whether this approach should become the standard of care for hip and knee arthroplasty in the future.
Discrepancy rates of preliminary and final reports for after-hours pediatric teleradiology interpretations
Authors: Pfeifer Cory M , Dinh Mary L
Published: February 2021

Background

Children’s hospitals often do not have a high enough volume to justify providing radiologist staffing overnight, leading to hospitals employing teleradiology services to offer preliminary reports. There is limited literature related to discrepancies between preliminary teleradiology pediatric radiologists and final interpretations.

Purpose

The purpose of this study is to examine discrepancy rates for teleradiologists preliminarily interpreting pediatric exams at a children’s hospital.

Material and Methods

Eight thousand seven hundred seventy-eight consecutive preliminary reports issued by pediatric teleradiologists were reviewed. The hospital utilized a system in which local onsite radiologists rated the preliminary reports of teleradiologists following the interpretations as part of standard operating procedure. Discrepancies were also rated according to whether the discrepancy was actionable (judged to alter patient management by the final rater) or not. Rates were stratified by modality, preliminary teleradiologist reader, and final rater and compared to each using a normal approximation. The mean discrepancy rates were compared using a z test for proportions. Linear regression was applied to the effect of years of radiologist experience on the total and actionable discrepancy rates.

Results

The overall actionable discrepancy rate was 1.6%, similar to inter-observer discrepancy rates reported in other studies. There were no significant differences in the actionable discrepancy rates among teleradiologists. There was no correlation between years of experience and discrepancy rate for either the teleradiologists or the final raters.

Conclusion

Pediatric subspecialty teleradiologists issue reports that mirror discrepancy rates typical of radiologists who issue reports for emergent adult studies. Years of radiologist experience is not a predictor of discrepancy rate.
Risk Factors for Discharge to a Non-Home Destination and Reoperation Following Outpatient Total Hip Arthroplasty (THA) in Medicare-Eligible Patients
Authors: Gordon Adam M. , Malik Azeem Tariq , Khan Safdar N.
Published: February 2021

Introduction:

The Centers for Medicare and Medicaid Services removed total hip arthroplasty (THA) from the inpatient-only (IO) list in January 2020. Given this recommendation, we analyzed Medicare-eligible patients undergoing outpatient THA to understand risk factors for nonroutine discharge, reoperations, and readmissions.

Materials and Methods:

The 2015-2018 American College of Surgeons–National Surgical Quality Improvement Program database was queried using Current Procedural Terminology code 27130 for Medicare eligible patients (≥ 65 years of age) undergoing outpatient THA. Postoperative discharge destination was categorized into home and non-home. Multivariate logistic regression models were used to evaluate risk factors associated with non-home discharge disposition. Secondarily, we evaluated rates and risk factors associated with 30-day reoperations and readmissions.

Results:

A total of 1095 THAs were retrieved for final analysis. A total of 108 patients (9.9%) experienced a non-home discharge postoperatively. Patients were discharged to rehab (n = 47; 4.3%), a skilled care facility (n = 47; 4.3%), a facility that was “home” (n = 8; 0.7%), a separate acute care facility (n = 5; 0.5%), or an unskilled facility (n = 1; 0.1%). Independent factors for a non-home discharge were American Society of Anesthesiologists Class >II (odds ratio [OR] 2.74), operative time >80 minutes (OR 2.42), age >70 years (OR 2.20), and female gender (OR 1.67). Eighteen patients (1.6%) required an unplanned reoperation within 30 days. A total of 40 patients (3.7%) required 30-day readmissions, with 35 readmissions related to the original THA procedure. Independent risk factors for 30-day reoperation were COPD (OR 5.85) and HTN (OR 5.24). Independent risk factors for 30-day readmission were HTN (OR 4.35) and Age >70 (OR 2.48).

Discussion:

The current study identifies significant predictors associated with a non-home discharge, reoperation, and readmission in Medicare-aged patients undergoing outpatient THA.

Conclusion:

Providers should consider preoperatively risk-stratifying patients to reduce the costs associated with unplanned discharge destination, complication or reoperation.
Hepatitis A
Authors: Hammond Stephanie
Published: February 2021

Hepatitis A is a vaccine preventable liver infection caused by the hepatitis A virus. The occupational health nurse should be aware of the signs and symptoms of the virus, educate workers about the infection, and recommend immunization for workers traveling or working in high-risk areas for hepatitis A.
Sports Fanship Changes Across the Lifespan
Authors: Gantz Walter , Lewis Nicky
Published: February 2021

Using two studies and two theoretical perspectives—socioemotional selectivity theory (SST) and social identity theory—this article examines the intensity of sports fanship across the adult lifespan. It is proposed that as adults age, emotional well-being increases, negative affect decreases, life satisfaction is enhanced, and self-identity is less dependent on group affiliation. All of these are likely to diminish the importance of sports fanship for most individuals over time. Adults aged 40 to 87 were surveyed in three data collections (combined N = 2,524). Study 1 used a 17-item measure to identify changes in sports fanship. Study 2 analyzed participants’ responses to an open-ended item that asked why their sports fanship decreased or increased over time. Results determined that most participants’ fanship significantly diminished with age. Key factors for this were lack of time, shifting priorities, and increasing maturity levels, with the latter marked by decreased passion. A minority of participants reported an increase in fanship, primarily because of a stronger connection to teams and the opportunity sports afforded them to spend time with their family and friends. Gender also mattered. The majority whose fanship decreased were male; the majority of those whose fanship increased were female.
Increasing trend of serum antimullerian hormone level after long term follow up of endometrioma resection
Authors: Haghgoo Ameneh , Shervin Adel , Chaichian Shahla , Ghahremani Mehran , Mehdizadeh Kashi Abolfazl , Akhbari Farnaz
Published: February 2021

Background:

Endometriosis is a chronic disease mostly affecting women at reproductive age. Some evidence suggests that surgery of ovarian endometrioma may have a detrimental effect on ovarian reserve. The aim of this study was to evaluate the changes of serum antimullerian hormone (AMH) levels in patients with endometrioma after cystectomy.

Methods:

A prospective study was performed at Nikan hospital on 58 patients with endometrioma who underwent laparoscopic cystectomy. Of them, 30 had unilateral endometrioma and 28 had bilateral endometrioma. Complete excision was done, pelvic endometriosis implants as well as deep infiltrative endometriosis was resected. Sutures were made for the closure of ovarian parenchyma and bleeding control. We did not use any hot energy devices such as cautery on ovaries for ablation, coagulation or resection of endometrioma. Serum AMH levels were measured preoperatively, 3, 9, and 15 months postoperatively.

Results:

Serum AMH levels decreased significantly from the preoperative sample (2.98 ± 2.47 ng/ml) to 3 months after laparoscopy (1.07 ± 1.06 ng/ml), then gradually increased 9 months (1.47 ± 1.16 ng/ml) and 15 months (1.95 ± 1.85 ng/ml) after surgery, without returning to the preoperative levels during the follow-up time of study.

Conclusion:

There is a fluctuation pattern in AMH levels from preoperative to 15-month follow-up after endometrioma surgery using only suture for ovarian hemostasis. Firstly, there is decline in AMH level 3 months after surgery, then an increasing trend was observed gradually up to 15 months after surgery. Controlled studies are needed to compare the effects of various cystectomy methods on the ovarian reserve after endometrioma surgery
Treatment of displaced fractures of the patella: Tension band wiring technique with the one-end or both-ends K-wire bending fixation method
Authors: Huang Po-Hua , Hsu Chi-Hsiang , Hsu Shan-Ling , Liu Hao-Chen
Published: February 2021

Purpose:

Tension band wiring technique has been widely used for treating patellar fracture. Conventional techniques are associated with some complications and several modifications have been introduced to increase stabilization. The purpose of this study was to compare two different fixation techniques, the one-end and both-ends Kirschner wire bending fixation methods.

Methods:

We retrospectively reviewed patient data from 2013 to 2017, including the age, sex, body height, body weight, BMI, lesion of injury, trauma mechanism, fracture displacement and classification, type of fixation, fracture healing duration, length of follow-up, clinical results and complications. The surgical outcome was assessed using the pain score (VAS), Lysholm knee score, and knee joint ROM. Plain radiographs were used to evaluate radiographic outcomes and assess the fracture union duration and hardware complications. We performed statistical analysis to compare these two different fixation techniques.

Results:

There were no significant differences between the two groups in terms of demographic data, fracture healing duration, level of the K-wires, distance between the K-wires, or length of the K-wires over the patella length (all p > 0.05). There were significant differences in the VAS score, K-wire migration, flexion degree, ROM, and Lysholm score (all p < 0.001) between the two different fixation methods.

Conclusion:

The both-ends K-wire bending fixation method has a lower complication rate and results in a better clinical outcome than the one-end K-wire bending fixation method. This revised technique can effectively control both ends of the K-wires, thus eliminating the possibility of K-wire migration and improving the fixation stability.
In Vitro Effects of Fluoride, Hydroxyapatite, and Bromelain-Containing Toothpaste Types on Surface Roughness of Different Restorative Materials
Authors: Telatar Gül Yıldız , Bedir Fatih
Published: February 2021

Aim:

To examine the effects of fluoride, hydroxyapatite, and bromelain-containing toothpaste types on the surface roughness of nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers.

Materials and Methods:

A total of 160 specimens were fabricated using nanohybrid, nanofilled, flowable, and bulk-fill composites; conventional, light-curing, and low-viscosity glass ionomers; and compomers. Each material group was divided into four subgroups ( n = 5) as follows: Control (C), fluoride toothpaste (FT), bromelain toothpaste (BT), and hydroxyapatite toothpaste (HT). Surface roughness values of all specimens were examined using an optical profilometer and a scanning electron microscope at 500, 1,000, and 3,500 magnifications.

Results:

The highest average roughness value (Ra; µm) was obtained from the conventional glass ionomer material ( P < .001). While the mean Ra value was 0.155±0.116 µm at baseline, it was 0.262±0.203 µm in the fluoride group, 0.237±0.192 µm in the hydroxyapatite group, 0.260±0.293 µm in the bromelain group, and 0.198± 0.187 µm in the control group ( P < .001).

Conclusion:

We have found that brushing with various types of toothpaste containing fluoride, bromelain, and hydroxyapatite may not result in obtaining different surface roughness values from different types of restorative materials. Differences in surface roughness values of restorative materials may be found at different magnifications under scanning electron microscope.
The Top 100 Most Cited Articles on Anterior Cruciate Ligament Reconstruction: A Bibliometric Analysis
Authors: Tang Ning , Zhang Wenchao , George Daniel M. , Su Yang , Huang Tianlong
Published: February 2021

Background:

The concept of anterior cruciate ligament (ACL) reconstruction (ACLR) has become widely accepted, gaining increased attention in recent years and resulting in many research achievements in this field.

Purpose:

The aim of this study was to determine which original articles on ACLR have been most influential in this field by identifying and analyzing the characteristics of the 100 most cited articles.

Study Design:

Cross-sectional study.

Methods:

Articles on ACLR were identified via the Thomson ISI Web of Science database on November 30, 2019. The 100 most cited articles were identified based on inclusion and exclusion criteria. The data extracted from each article for the subsequent analysis included title, date of publication, total citations, average citations per year (ACY), journal name, first author, institutions, themes, level of evidence, and keywords.

Results:

The total number of citations was 29,629. The date of publication ranged from 1975 to 2015. A majority of the articles originated from the United States (58%) and were published in the 1990s (32%) and 2000s (48%). The mean ACY was 18.43 ± 9.51. Of the selected articles, nearly one-half were published in the American Journal of Sports Medicine (42%). The most prolific co-author and first author were Freddie H. Fu (n = 13) and K. Donald Shelbourne (n = 5), respectively. The most productive institution was the University of Pittsburgh (14%). Material comparison (19%) and technique comparison (16%) were the 2 most popular themes. More than one-quarter of articles were level 4 evidence (37%). Moreover, the keywords ACL, ACL reconstruction, ACL rupture, knee joint, knee injuries, and human showed the highest degree of centrality.

Conclusion:

By analyzing the characteristics of articles, this study demonstrated that ACLR is a growing and popular area of research, with the focus of research varying through timeline trends. Studies on anatomic reconstruction and biomechanics might be areas of future trends.
Cumulative Disparities in the Dynamics of Working Poverty for Later Career U.S. Workers (2002–2012)
Authors: Hale Jo Mhairi , Dudel Christian , Lorenti Angelo
Published: February 2021

Many more Americans experience working poverty than unemployed poverty, a situation that was only exacerbated by the Great Recession. The consequences of working poverty for later career workers, who should be at their highest earning ages, are particularly dire. The authors expect that later career workers are especially vulnerable in terms of the risk and duration of working poverty and that those who have accumulated disadvantages over their life courses, in terms of the intersecting dimensions of race/ethnicity, gender, early-life disadvantage, and educational attainment, will suffer disproportionately. The authors use incidence-based Markov-chain multistate models to analyze the U.S. Health and Retirement Study, which is representative of the U.S. population aged 50 years and older. The results reveal that Black women and men, Latinx, those who experienced more early-life disadvantages, and people with lower education have higher risk and longer durations in working poverty over the period from 2002 to 2012. The findings also suggest that when confronted with economic hardship (the Great Recession) later career workers who originate in lower socioeconomic statuses, especially Blacks and Latinx, are in more precarious economic positions. Important from a policy perspective, educational attainment only partially mediates the association between race/ethnicity and working poverty; disparities persist.
Repertoires of Terror: News Media Classification of Militant Groups, 1970 to 2013
Authors: Schoon Eric W. , Beck Colin J.
Published: February 2021

The authors examine how print news media classify militant groups as terrorist. Drawing on a relational view of news media and contentious politics, the authors develop a theory of repertoires of contention and classification. The authors argue that news media interpret the social standing of actors from the categories implied by the tactics they use and that variation in tactical repertoires explains the variation in classification among different groups and within individual groups over time. Using newly collected annual data on media coverage of 746 groups across 589,779 news articles from 1970 through 2013, statistical analyses support the authors’ argument. Moreover, consistent with scholarship on the evolution of political violence, the authors show that the effects of repertoires are sensitive to historical developments and vary in relation to key events, further supporting a relational repertoire view of the classification of terrorism.
Risk of intracerebral haemorrhage from hypertension is greatest at an early age
Authors: Stanton Robert , Demel Stacie L , Flaherty Matthew L , Antzoulatos Eleni , Gilkerson Lee A , Osborne Jennifer , Behymer Tyler P , Moomaw Charles J , Sekar Padmini , Langefeld Carl , Woo Daniel
Published: February 2021

Introduction

The risk of intracerebral haemorrhage (ICH) associated with hypertension (HTN) is well documented. While the prevalence of HTN increases with age, the greatest odds ratio (OR) for HTN as a risk for ischemic stroke is at an early age. We sought to evaluate if the risk for ICH from HTN was higher in the youngest patients of each race.

Patients and methods

The Ethnic/Racial Variations of ICH (ERICH) study is a prospective multicenter case-control study of ICH among whites, blacks, and Hispanics. Participants were divided into age groups based on race-specific quartiles. Cases in each race/age group were compared to controls using logistic regression (i.e., cases and controls unmatched). The probability of ICH among cases and controls for each race were compared against independent variables of HTN, quartile of age and interaction of quartile and age also using logistic regression.

Results

Overall, 2033 non-lobar ICH cases and 2060 controls, and 913 lobar ICH cases with 927 controls were included. ORs were highest in the youngest age quartile for non-lobar haemorrhage for blacks and Hispanics and highest in the youngest quartile for lobar haemorrhage for all races. The formal test of interaction between age and HTN was significant in all races for all locations with the exception of lobar ICH in whites (p = 0.2935).

Discussion

Hypertension is a strong independent risk factor for ICH irrespective of location among persons of younger age, consistent with the hypothesis that first exposure to HTN is a particularly sensitive time for all locations of ICH.
Why are designs for urban governance so often incomplete? A conceptual framework for explaining and harnessing institutional incompleteness
Authors: Durose Catherine , Lowndes Vivien
Published: February 2021

This article asks why institutional designs for urban governance are so often incomplete and what a critical perspective on incompleteness may offer. We develop a novel conceptual framework distinguishing between incompleteness as description (a deficit to be ‘designed-out’), action (‘good enough’ design to be worked with and around), and prescription (an asset to be ‘designed-in’). An extended worked example of city regional devolution in England illuminates the three types of incompleteness in practice, whilst also identifying hybrid forms and cross-cutting considerations of power, time and space. Perceiving institutional incompleteness as a design logic in its own right, held in tension with completeness, could help augment institutional design repertoires and even enhance democratic values.