bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal artery dissection as an overuse Injury
Authors: Grasso Sierra , Laurel Mia , Lewis Joseph , Naiyer Mohammad , Ricca Richard , Keckeisen George
Published: September 2020

The diagnosis of renal infarction is often convoluted due to its non-specific presentation. It can mimic disease processes as disparate as pyelonephritis, diverticulitis, or nephrolithiasis. This case is further complicated by the presence of a pelvic kidney with triplicate arterial input. It is difficult to estimate the incidence of pelvic kidneys as the numerous sources vary wildly in their estimations; however, the paucity information, in and of itself, speaks to the rarity of the condition. In this case, a 58-year-old male presents to the emergency department after experiencing sharp, sudden, and severe groin pain while swinging a golf club. The patient was noted to have an abnormally high systolic blood pressure in the 170s and hematuria, but all other initial labs and assessments were unremarkable. An initial computed tomography scan with intravenous contrast of the abdomen and pelvis showed partial necrosis of a pelvic kidney. Follow-up computed tomography angiography revealed that a dissection in one of the arteries supplying the kidney created an infarction and resultant necrosis. Vessel size, location and time between injury and diagnosis made endovascular intervention impractical. The patient was started on aspirin and Plavix, observed for 3 days and sent home.
The gathering anthropocene crisis
Authors: Kennel Charles F
Published: September 2020

Global society’s actions have created a planetary state whose dynamics are new to human experience-the Anthropocene. One consequence is that alarming climatic, ecological, and public health trends are unfolding with little evidence of abating. This essay argues that the convergence of these trends could lead to a comprehensive crisis where multiple risks materialize in reinforcing ways-the crisis of the Anthropocene. This crisis is likely to occur near the high population point of the demographic transition in progress. Ensuring that the demographic transition is also a transition to sustainability will require conceptualization and planning that internalizes the synergism of threats to society and nature.
Education, early life, and political participation: New evidence from a sibling model
Authors: Burden Barry C. , Herd Pamela , Jones Bradley M. , Moynihan Donald P.
Published: September 2020

Although educational attainment is one of the strongest correlates of mass political participation, researchers disagree about whether it has a causal impact on voter turnout. One prominent theory proposes the observed correlation between higher educational attainment and political participation is spurious, largely reflecting early-life factors such as genetics, family resources, and parental values. To test this claim we analyze siblings in a longitudinal survey to control for the pre-adult environmental effects on official measures of turnout among older adults. We find some support for spurious effects of education, particularly in a midterm election where the most politically engaged individuals are mobilized. Because patterns of political engagement are formed in childhood, early-life experiences may be more influential in midterm elections where fewer stimuli and resources are present to mobilize voters.
Sensitive Sharing on Social Media: Exploring Willingness to Disclose PrEP Usage Among Adolescent Males Who Have Sex With Males
Authors: Birnholtz Jeremy , Kraus Ashley , Zheng Weiwei , Moskowitz David A. , Macapagal Kathryn , Gergle Darren
Published: September 2020

Self-presentation, the process by which people disclose information about themselves to others, is fundamental to online interaction and research on communication technology. Technology often mediates the self-presentation process by obscuring who is in the audience via constrained cues and opaque feed algorithms that govern the visibility of social media content. This can make it risky to disclose sensitive or potentially stigmatizing information about oneself, because it could fall into the wrong hands or be seen by an unsupportive audience. Still, there are times when it is socially beneficial to disclose sensitive information, such as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and others) people expressing their identities or disclosing HIV status. Decisions about sensitive disclosure, moreover, can be even more complicated in today’s social media landscape with many platforms and audiences in play, particularly for younger users who often use many platforms. We lack a good understanding, however, of how people make these decisions. This article addresses questions about sensitive disclosure on social media through a survey study of adolescent men who have sex with men and their willingness to disclose on social media the use of pre-exposure prophylaxis (PrEP), an HIV prevention medication. Results suggest that perceived platform audience composition and platform features such as ephemerality play into disclosure decisions, as well as the perceived normativity of PrEP use among peers.
Temporomandibular joint pain and associated magnetic resonance findings: a retrospective study with a control group
Authors: Eriksen Elisabeth Schilbred , Hellem Sølve , Skartveit Liv , Brun Johan G , Bøe Olav E , Moen Ketil , Geitung Jonn Terje
Published: September 2020

Background

To better understand and evaluate clinical usefulness of magnetic resonance imaging (MRI) in diagnosis and treatment of temporomandibular disorders (TMD), parameters for the evaluation are useful.

Purpose

To assess a clinically suitable staging system for evaluation of MRI of the temporomandibular joint (TMJ) and correlate the findings with age and some clinical symptoms of the TMJ.

Material and Methods

Retrospective analysis of 79 consecutive patients with clinical temporomandibular disorder or diagnosed inflammatory arthritis. Twenty-six healthy volunteers were included as controls. Existing data included TMJ pain, limited mouth opening (<30 mm) and corresponding MRI evaluations of the TMJs.

Results

The patients with clinical TMD complaints had statistically significantly more anterior disc displacement (ADD), disc deformation, caput flattening, surface destructions, osteophytes, and caput edema diagnosed by MRI compared to the controls. Among the arthritis patients, ADD, effusion, caput flattening, surface destructions, osteophytes, and caput edema were significantly more prevalent compared to the healthy volunteers. In the control group, disc deformation and presence of osteophytes significantly increased with age, and a borderline significance was found for ADD and surface destructions on the condylar head. No statistically significant associations were found between investigated clinical and MRI parameters.

Conclusion

This study presents a clinically suitable staging system for comparable MRI findings in the TMJs. Our results indicate that some findings are due to age-related degenerative changes rather than pathological changes. Results also show that clinical findings such as pain and limited mouth opening may not be related to changes diagnosed by MRI.
Editorial and Critical Reflections on the future of identity moments and social media in China and beyond
Authors: Lim Tania , Lee Terence , Zhang Weiyu
Published: September 2020

This Special Issue of Global Media and China responds in part to Stuart Hall’s famous 1996 invocation, ‘Who needs identity?’ – to study ‘specific enunciative strategies’ utilized within ‘specific modalities of power’ so as to consider identity discourses of the present and of the future. This issue draws upon empirical observations presented and debated at the 2019 Chinese Internet Research Conference held in Singapore in May 2019, as well as theoretical contributions in identity politics and social media, the chosen site or ‘modality of power’. This editorial and critical essay reflects upon, complemented and supported by the papers in this issue, the critical and conceptual frameworks that are emerging to critique the global and local complexities, diversity and dynamics resulting from the deeper integration of social media into the everyday lives of Chinese Internet users. It presents an overview of the 2019 Chinese Internet Research Conference proceedings in terms of how social media is used to wrap personal politics into a widening range of identity groupings around gender, class, citizens, pop culture and religion in ways that signal the future of newer forms of identity politics among Internet users in China. Since social media posts and exchanges, while geographically sourced and situated, often transcend their boundaries, the arguments presented here goes beyond China and are global. The shareability of identity mediated by individual, state and public discourses on social and ‘anti-social’ media during the COVID-19 pandemic within China, Singapore and Australia leads to novel ways of understanding identity politics in globalizing China and strategic uses of Chinese identity.
Training Needs of Academics on Inclusive Education and Disability
Authors: Moriña Anabel , Perera Víctor H. , Carballo Rafael
Published: September 2020

The aim of this article is to analyze, from the academic staff’s perspective, the training needs they require to provide an inclusive education to students with disability. Academics from a Spanish university participated in this research. We used a qualitative methodology. We collected the information through semi-structured interviews and open-ended written questionnaires. We analyzed data using an inductive system of categories and codes. Three topics were addressed in the results: profile of academics according to their previous training, the importance of such training for them and the reasons for training, and the contents considered essential for training. In the conclusions section, the need for universities to design and implement training policies was addressed. In addition, the participants stated that they would be more sensitive and better prepared if they received training on disability-related issues. A clear conclusion of this study is that inclusive universities require the involvement of everyone.
Primary Care for Transgender Individuals: A Review of the Literature Reflecting a Canadian Perspective
Authors: Ziegler Erin , Valaitis Ruta , Carter Nancy , Risdon Cathy , Yost Jennifer
Published: September 2020

Literature related to transgender health in adults has focused on definitions, hormone therapy, and transgender-sensitive care provision. Further understanding is needed on the delivery of primary care for transgender adults. The aim of this review was to understand the primary-care needs and access to health care services for transgender adults in Canada. A state-of-the-art literature review was conducted. Thirteen research studies were included. There is limited literature on the delivery of primary care for transgender adults, particularly in Canada. Health care issues and access to care have been explored. However, there remains minimal Canadian content on primary-care delivery for transgender adults. Additional studies are needed to understand transgender primary-care needs in Canada. Further understanding can reduce the invisibility and disparities experienced by transgender individuals. With better understanding of transgender primary health care issues, primary-care practitioners can advocate for the heath needs of their patients and improve care delivery.
Risk of necrosis in the adjacent toe after one-toe fillet flap in diabetic foot: Retrospective study of 107 cases over 5 years
Authors: Kim Junhyung , Kim Kyubeom , Choi Jaehoon , Jeong Woonhyeok , Jo Taehee , Oh Sangho
Published: September 2020

Purpose:

Fillet flap is a “spare part” concept. This technique allows the defect to be covered without donor site morbidity. Over the past 5 years, there were 107 diabetic foot cases of one-toe fillet flap in our hospital. After the operation, in some patients, there was necrosis of the adjacent toe that required additional amputation. The aim of our study was to determine the cause of necrosis of the adjacent toe after fillet flap.

Methods:

The patients were divided into two groups. One group had no necrosis of the adjacent toe (group A) after the operation, and the other group had necrosis of the adjacent toe that required additional amputation after the operation (group B). Then, to confirm the cause of the additional necrosis of the adjacent toe, χ 2 tests, Fisher’s tests, and logistic regression tests were performed.

Results:

A total of 107 patients were included, and 48 patients needed additional amputation. The logistic regression test revealed that a fillet flap at the metatarsophalangeal joint (MTPJ), horizontal sutures, and a fillet flap at the second toe were significant risk factors for developing necrosis.

Conclusions:

If a fillet flap with a second toe, fillet flap on MTPJ level and horizontal closure after fillet flap is needed, the chance of developing necrosis of the adjacent toe and additional revisional surgery must be communicated preoperatively.
Biomechanical analysis of distraction forces on the posterior meniscal roots to optimize early rehabilitation protocols
Authors: Ellermann Sophia , Kittl Christoph , Frank Andre , Wermers Jens , Glasbrenner Johannes , Briese Thorben , Raschke Michael J. , Herbort Mirco , Herbst Elmar
Published: September 2020

Introduction:

The aim of this study was to investigate the distraction forces of the medial and lateral posterior meniscal roots after repair (PMMR, PLMR) at different degrees of flexion and axial load.

Hypotheses:

It was hypothesized that with increasing axial load and flexion angle, the distraction forces on the meniscal roots increase continuously.

Methods:

Eight fresh-frozen human cadaveric knees were axially loaded in a custom made kinematics rigs with 0 N, 200 N and 400 N throughout a continuous flexion-extension cycle (0°-90°). The distraction forces acting on the PMMR and PLMR were determined in three scenarios: 1) native knee joint, 2) after bilateral detachment of the posterior meniscal roots and following root repair, 3) after resection of the anterior cruciate ligament (ACL). To measure the distraction forces, the FiberWire No. 2 (Arthrex, Inc.) sutures used for the root repairs were shuttled transtibially through a 2.4 mm bone tunnel and tied over a force sensor mounted on the anterior tibia with a pretension of 2 N. Statistical analysis was performed using a repeated- measures ANOVA with a post-hoc Bonferroni correction (p < 0.05).

Results:

Overall, the different investigated knee states as well as the degree of flexion showed a significant effect on the distraction forces on the posterior meniscal roots (p <0.01). An axial load of 200 N and 400 N resulted in a significant increase of the distraction forces on both menisci over the entire range of motion compared to an unloaded state (p < 0.01). When no axial load was applied, the distraction forces after PMMR and PLMR refixation were not significantly affected by the degree of flexion (p > 0.05). With axial loading of 200 N and 400 N, the distraction forces on the PLMR were significantly higher at flexion angles between 15° and 90° compared to full extension (p <0.01). In contrast, the distraction forces on the PMMR were highest close to extension (0° -30°) and decreased significantly towards 90° of flexion when the knees were loaded with 200 N and 400 N (p <0.01). When the ACL was removed, a significant increase of the distraction forces at the posterior meniscal roots was observed (p < 0.001).

Conclusion:

Axial loading significantly increases the distraction forces after posterior meniscal root repair. Therefore, axial loading should be avoided in the early postoperative phase. Furthermore, data of this study shows that passive exercise between 0° and 90° flexion can be performed without significantly affecting the forces acting on the menisci.
Ten year results following HTO - analysis of clinical outcome and survival rates in terms of TKA revision
Authors: Bode Lisa , Brenner Anna-Sophie , Eberbach Helge , Kloos Ferdinand , Niemeyer Philipp , Schmal Hagen , Bode Gerrit
Published: September 2020

Introduction:

Varus deformity is a well-known risk factor for focal cartilage defects and even medial osteoarthritis of the knee due to increase of medial compartment peak pressure. High tibial osteotomy using angular-stable implants is an effective and standardized method unloading the medial compartment and resulting in pain reduction and excellent clinical follow-up. Until now only mid-term results have been published and little is known concerning conversion to total knee arthroplasty (TKA). Purpose of the present study is to examine long-term results with special focus on TKA convesion.

Hypotheses:

HTO results in good to excellent results in terms of functional outcome and TKA conversion even after ten years.

Methods:

All patients aged 18 – 65 years and treated with HTO due to focal cartilage lesions of the medial compartment or medial gonarthritis with underlying varus deformity between 01.01.2004 and 31.12.2013, were included in the present study. Lysholm score and visualized analog scale (VAS) were obtained pre- and postoperatively while Knee Osteoarthritis and Outcome Sccore (KOOS) and IKDC and TKA conversion rate were obtained postoperatively only. Statistical analysis was performed using SPSS Software 24.0 (IBM Corp. Armonk, USA).

Results:

125 patients with a mean age of 44,4 +- 10,17 (Range 18,9 - 66,9) years were included in the present study. Mean follow-up (FU) was 118,4 +- 27,3 (Range 73,0 - 171) months. Lysholm score and VAS significantly improved at FU in comparison to preoperative valus. Patients presented good functional outcom even after ten years (KOOSpain 82,9 +- 14,4; KOOS symp 78,6+-17,6, KOOS adl 87,8+-13,3; KOOSsport 53,1+#30,4; KOOSQOL 70,2+-21,4;KOOS4 71,2+-18,2). Patients requiered TKA conversion in 12.8%, resulting in 87.2% TKA free survival-rates ten years after HTO implantation.

Conclusion:

HTO is a safe and effective method resulting in good functional outcome and low conversion rates to TKA even after ten years.
Genetic Insights of Primary knee osteoarthritis
Authors: Subramanyam Krishna , Poornima Subhadra
Published: September 2020

Introduction:

Knee Osteoarthritis (KOA) is charecterised by focal loss of joint articular cartilage, osteophyte formation and sub chondral bone remodelling. Common clinical symptoms include pain, stiffness, limitation of the joint movement and swelling. OA is the most common joint disease worldwide and the knee is the common site involved. Classical risk factors of OA include age, gender, weight, joint injury, trauma. However, family history/Hereditary component is the one of the crucial factors. knee OA is a complex disease with environmental and genetic factors associated with its development and progression.

Hypotheses:

It is classified as primary when no discernible cause is evident and secondary when a triggering factor is apparent. However primary OA possesses significant genetic component. Despite the fact that OA is a late onset advanced age disease the increasing incidence of OA individuals below the age of 55 years and the fact that the several members of the same family are affected suggest a genetic predisposition. Hence, there is a need to identify molecular biomarkers associated with primary early knee osteoarthritis

Methods:

Several Genome wide association studies and candidate gene studies have identified genetic variants involved in the pathogenesis of OA like VDR, MMP, TGF, GDF5, COL11A1 and VEGF. Currently, the majority of genetic association studies on disease risk focused on identifying the individual’s effect on single nucleotide polymorphisms (SNPs).

Results:

In the present study, ten gene polymorphisms were studied in Indian population. They are COL21, CRTL1, CRTM, ACE, VDR, GDF5, COG5, CYBA, SREBP2 and TGFβ1 genes which were selected based on their role in cartilage maintenance and bone remodelling. This is the first study in India which looked at the gene polymorphisms. Altogether 100 clinically diagnosed and radiologically confirmed early primary knee OA (KOA) cases and 100 controls with no musculoskeletal diseases, were recruited and molecular analysis was performed by routine PCR - RFLP techniques. Results indicated that COL21, CRTL1, ACE, GDF5, COG5, CYBA, SREBP2 and TGFβ1gene polymorphisms showed an association with the disease where as CRTM and VDR lack of association.

Conclusion:

These gene polymorphisms can be used as molecular biomarkers for identifying the individuals who are at risk of developing the disease ( primary knee osteoarthritis) and these molecular genotypes helps us in planning tailored treatment and management. It also help us to identify individuals who are at risk of developing knee osteoarthritis and preventive measures can be planned accordingly. To the best of our knowledge this is the first study in India which assessed these ten gene polymorphisms with primary early knee osteoarthritis.
Length change pattern of the medial structures of the knee and related reconstructions
Authors: Olbrich Arne , Herbst Elmar , Domnick Christoph , Glasbrenner Johannes , Raschke Michael J. , Frank Andre , Herbort Mirco , Kittl Christoph
Published: September 2020

Introduction:

Aim of the study was to investigate the length changes of the medial structures and related reconstructions. It was assumed that the three fibre sections (anterior/middle/posterior) of the superficial medial collateral ligament (sMCL) have different length change patterns, which cannot be imitated by current reconstructions.

Hypotheses:

The three fibre sections (anterior/middle/posterior) of the superficial medial collateral ligament (sMCL) cannot be imitated by current reconstructions.

Methods:

Measurements were made on eight cadaveric knees. The knee joints were clamped in a custom-made open chain extension structure. For this purpose, the portions of the quadriceps and the iliotibial tract were aligned according to their fibre direction and statically loaded using hanging weights. The respective tibial and femoral insertion points of the sMCL anterior/middle/posterior fibres were marked by small pins. Similarly, pins were inserted at the tibial and femoral attachment sites of the posterior oblique ligament (POL). In order to imitate the Lind reconstruction, a pin was additionally inserted on the tibial semitendinosus insertion site. Pin combinations accounting for the anterior/middle/posterior sMCL, the POL, and the Lind reconstruction were connected using a high resistant suture. Then the length change patterns were measured using a rotary encoder from 0-120° knee flexion. Statistical analysis was performed using 2-way repeated-measures ANOVA and a post-hoc Bonferroni correction (p <0.05).

Results:

The anterior and posterior fibres of the sMCL showed a reciprocal behaviour (p< 0.001). The anterior fibres showed a length reduction (2%) up to a flexion of 20°, followed by an elongation of 5% at 120° flexion, which means that the anterior fibres are tight in knee flexion. Conversely, the posterior fibres of the MCL showed an initial length reduction of 4% at 20° flexion. This was followed by an isometric range (20° - 80°) and a further length reduction of 8% in deep flexion (120°). Thus, the posterior fibres of the MCL were tight in extension. The three parts of the POL showed a constant reduction of 25% between 0° and 120°. The Lind reconstruction with the tibial pin at the semitendinosus insertion site showed similar length changes compared to the sMCL (n.s.). Furthermore, the Lind reconstruction was dependent on the femoral placement of the pins (p <.001). The tibial placement had no significant influence.

Conclusion:

The anterior portion of the sMCL was tight in flexion, whereas the posterior portion was tight in extension. This reciprocal behavior could not be imitated by a single point to point reconstruction. When surgically applying these reconstructions, special attention should be paid to the femoral insertion.
Short-term results of primary total knee replacement: the experience of the Tashkent Medical Academy and Wiltze Memorial hospital
Authors: Madrakhimov Sarvar , Karimov Murodulla
Published: September 2020

Introduction:

To analyze and evaluate the short-term results of 82 patients after primary total knee replacement (TKR)

Methods:

A prospective study of 82 patients (54 women and 28 men) with 82 TEC operations was conducted at the Multidisciplinary clinic of the Tashkent Medical Academy (Tashkent, Uzbekistan) and the Wiltse Memorial hospital (Suwon, Republic of Korea) from November 2018 to January 2020. The age of patients ranged from 52 to 87 years (average age 61 years). The diagnosis of grade 3 – 4 osteoarthritis of the knee (Kellgren and Lawrence) was confirmed in all patients. The hospital for Special Surgery (HSS) scale, volume of movement, visual analog pain scale (VAS), and patient satisfaction questionnaire with the Knee Society Knee Scoring System were used as functional assessment criteria.

Results:

The mean duration of follow-up and hospitalization was 16 months (±6.7) and 11 days (±2.6), respectively. The average volume of movements was 100, 6⁰ (±4, 5⁰) at the end of the observation period. All patients demonstrated adequate knee stability and returned to their previous daily activities. YOUR average score was 1.8 (±3.3) points over a 6-month period. Satisfaction with the outcome of the operation was 82.7 % in the 12-month postoperative period. In the study, there was not a single case of postoperative mortality, periprosthetic infection, revision surgery.

Conclusion:

To date, in the course of clinical observation of patients with osteoarthritis of the knee who underwent primary TKR, the results were found to be satisfactory. Also, further research with a large cohort and subsequent long-term monitoring is needed, and the question of creating a single register and institutional databases is raised, in view of the expected increase in the number of revision interventions.
A comparative study of functional outcome of transtibial and transportal femoral tunneling techniques for arthroscopic ACL reconstruction
Authors: Date Sudeep
Published: September 2020

Introduction:

Acl reconstruction has revolutionarised the sports medicine world lately. Various methods of reconstruction have been advocated in the literature recently. ACL injury results in severe morbidity to an athletes career. The aim for anatomical reconstruction is to harvest the ACL graft at a more anatomical location on both the tibia and the femur. The purpose of this study is to compare the functional outcomes of the two methods of the graft harvestis to compare the functional outcomes of the two methods of the graft harvest

Hypotheses:

60 patients were included in the study with complete ACL tear and were assessed at 3 6 and 9 months on the basis of various scores and relevant elements.

Methods:

All patients who were planned for arthroscopic ACL reconstruction surgery from the OPD, who were willing and fit the inclusion criteria were included in the study. They were then examined clinically with special tests i.e. Lachman’s test, anterior drawer test, pivot shift test and McMurray’s test and the findings were recorded including any associated meniscal injuries. They were then evaluated using 3 different evaluation systems i.e. IKDC, Lysholm and pain VAS.

Results:

Average mean age of the patients undergoing ACL reconstruction was (26%) in Transtibial and 23.3%. 90% of them were males. Majority of them were males (58%). The average IKDC score of transportal patients was significantly higher than transtibial patients at 6 months followup [P=0.001]. The average Lysholm knee score of transportal patients was significantly higher than the transtibial patients [P=0.047]. The average pain on VAS score of transportal group was significantly lower than transtibial at 6 months followup [P<0.001]. Complication of instability was more common in transtibial patients, 11(36.7%), when compared to transportal patients, 9(30%), however this difference was not significant [P=0.58].

Conclusion:

Our study clearly stated that the transportal technique for acl reconstruction fetched superior results as compared to the transtibial technique in terms of knee instability, pain and other domains.
The Validation of a Pocket Worn Activity Tracker for Step Count and Physical Behavior in Older Adults during Simulated Activities of Daily Living
Authors: Ummels Darcy , Bijnens Wouter , Aarts Jos , Meijer Kenneth , Beurskens Anna J. , Beekman Emmylou
Published: September 2020

Purpose:

The purpose of this study was to validate optimized algorithm parameter settings for step count and physical behavior for a pocket worn activity tracker in older adults during ADL. Secondly, for a more relevant interpretation of the results, the performance of the optimized algorithm was compared to three reference applications

Methods:

In a cross-sectional validation study, 20 older adults performed an activity protocol based on ADL with MOXMissActivity versus MOXAnnegarn, activPAL, and Fitbit. The protocol was video recorded and analyzed for step count and dynamic, standing, and sedentary time. Validity was assessed by percentage error (PE), absolute percentage error (APE), Bland-Altman plots and correlation coefficients.

Results:

For step count, the optimized algorithm had a mean APE of 9.3% and a correlation coefficient of 0.88. The mean APE values of dynamic, standing, and sedentary time were 15.9%, 19.9%, and 9.6%, respectively. The correlation coefficients were 0.55, 0.91, and 0.92, respectively. Three reference applications showed higher errors and lower correlations for all outcome variables.

Conclusion:

This study showed that the optimized algorithm parameter settings can more validly estimate step count and physical behavior in older adults wearing an activity tracker in the trouser pocket during ADL compared to reference applications.
Perceived Impacts of the COVID-19 Pandemic on Pediatric Care in Canada: A Roundtable Discussion
Authors: Nicholas David B. , Belletrutti Mark , Dimitropoulos Gina , Katz Sherri Lynne , Rapoport Adam , Urschel Simon , West Lori , Zwaigenbaum Lonnie
Published: September 2020

Like other recipients of health care services, pediatric patients and their families/caregivers have been profoundly impacted by health care shifts and broader societal restrictions associated with the COVID-19 pandemic. An online roundtable discussion was facilitated with 7 pediatric clinicians and investigators of a current study examining the impacts of COVID-19 on pediatric care at multiple Canadian sites. Discussants represented a range of pediatric specialities: developmental disability, mental health, cardiac transplantation, respiratory medicine, hematology, and palliative care. We offer the transcript of the roundtable in which discussants reflected on clinical and programmatic experiences of the pandemic, including perceived impacts on children receiving care and their families, potential opportunities for improved health care delivery, impacts on health care providers, and recommendations as we move toward easing restrictions and pandemic recovery. Discussants convey a range of considerations that may have varying relevance for pediatric specialities in terms of practice and program planning.
The Pivotal Role of Host Organizations in Enhancing Mentoring in Internal Medicine: A Scoping Review
Authors: Chia Elisha Wan Ying , Tay Kuang Teck , Xiao Shiwei , Teo Yao Hao , Ong Yun Ting , Chiam Min , Toh Ying Pin , Mason Stephen , Chin Annelissa Mien Chew , Krishna Lalit Kumar Radha
Published: September 2020

In undergraduate and postgraduate medical education, mentoring offers personalized training and plays a key role in continuing medical education and the professional development of healthcare professionals. However, poor structuring of the mentoring process has been attributed to failings of the host organization and, as such, we have conducted a scoping review on the role of the host organization in mentoring programs. Guided by Levac et al’s methodological framework and a combination of thematic and content analysis, this scoping review identifies their “defining” and secondary roles. Whilst the “defining” role of the host is to set standards, nurture, and oversee the mentoring processes and relationships, the secondary roles comprise of supporting patient care and specific responsibilities toward the mentee, mentor, program, and organization itself. Critically, striking a balance between structure and flexibility within the program is important to ensure consistency in the mentoring approach whilst accounting for the changing needs and goals of the mentees and mentors.
Solid waste management practices and their meanings in ecologically conscious households
Authors: Munro Kirstin
Published: September 2020

This paper describes the household waste management practices of self-described sustainable households, focusing on the intentional actions the members of these households take to reduce environmental harm. Data from qualitative interviews about household waste management practices related to the disposal of trash, “packaging”, and recycling are analyzed using a Marxist-feminist model of household production. For the households in this study, packaging is a powerful reminder of their collusion with capital, eliciting powerful and unexpected negative reactions in interviews. At the same time, practices that involve allowing organic matter to decompose in the backyard, leaving urine unflushed, or placing human feces in the clothes washing machine or bathtub elicited few negative reactions, and recycling made people feel happy. Packaging and waste are necessary in capitalism because of the spatial division of labor and production, part of the constitutive contradiction between social needs and private production. I show how a division of labor and production that is necessary for accumulation manifests itself in an inherent antagonism toward human well-being in a discussion of the exhaustion, frustration, and conflict generated for highly ecologically oriented parents who are just trying to do their best to live a sustainable life in capitalist society despite the limits to the efficacy of these efforts.
Effect of Court-Type Thai Traditional Massage Versus Senokot Treatment on Chronic Constipation: A Randomized Controlled Trial
Authors: Boonruab Jurairat , Poonsuk Phiyaphon , Damjuti Watchara
Published: September 2020

Chronic constipation is the disturbances of intestinal motility which is a challenge in primary healthcare around the world. In this study, Court-type Thai traditional massage and Senokot, treatments were assessed and compared in terms of their efficacy in relieving constipation. Forty subjects diagnosed with constipation were recruited and randomized into the massage group and drug group. For 7 days, Thai traditional abdominal massage was provided regularly for the patients in the massage group, while the drug group was subjected to Senokot treatment only. The Bristol stool chart scale and demographics questionnaire were used as instruments. As a result, both court type Thai traditional massage and Senokot are effective in relieving constipation. However, although both treatment options can increase the frequency of defecations and the sensation of complete evacuation, the court type Thai traditional massage seems to be better since it leads to normal defecations rather than watery or entirely liquid defecations with no solid pieces ( p < 0.05). This randomized controlled trial suggested that Thai traditional abdominal massage can be used as an optional public health treatment for constipation.
Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study
Authors: Abuosi Aaron Asibi , Akoriyea Samuel Kaba , Ntow-Kummi Gloria , Akanuwe Joseph , Abor Patience Aseweh , Daniels Anita Anima , Alhassan Robert Kaba
Published: September 2020

Objective

To assess hand hygiene compliance in selected primary hospitals in Ghana.

Design

A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study.

Main outcome measures

The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics.

Results

The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable.

Conclusion

Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.
Advanced machining of miniature unmanned aircraft vehicle components using nanostructured cutting tools
Authors: Jackson M. J. , Burgess J. , Whitfield Michael , Whitt M. , DaSilva R. B. , DaSilva M. B. , Machado A. R. , Davis R.
Published: September 2020

The advanced machining of components used in miniature unmanned aircraft vehicles is the focus of this study. The finite element method (FEM) is used to predict forces and temperatures using cutting tool inserts with a thin nanostructured film of high integrity. Similarity models are used to validate the finite element results and to understand the influence of micromachining parameters on cutting temperatures generated when machining Al 380-0 alloy. The predicted results are compared to experimental forces and temperatures using a three-dimensional piezoelectric function dynamometer and a short-range infra-red wavelength thermal camera. Nanostructured thin layer coatings lower machining forces and temperatures, which are validated through FEM predictions and experimental observations. The experimental results suggest that increasing the cutting tool’s rake angle at higher depths of cut will reduce cutting temperatures, which are predicted using the similarity models for micromachining.
Network-based method for regions with statistically frequent interchromosomal interactions at single-cell resolution
Authors: Bulathsinghalage Chanaka , Liu Lu
Published: September 2020

Background

Chromosome conformation capture-based methods, especially Hi-C, enable scientists to detect genome-wide chromatin interactions and study the spatial organization of chromatin, which plays important roles in gene expression regulation, DNA replication and repair etc. Thus, developing computational methods to unravel patterns behind the data becomes critical. Existing computational methods focus on intrachromosomal interactions and ignore interchromosomal interactions partly because there is no prior knowledge for interchromosomal interactions and the frequency of interchromosomal interactions is much lower while the search space is much larger. With the development of single-cell technologies, the advent of single-cell Hi-C makes interrogating the spatial structure of chromatin at single-cell resolution possible. It also brings a new type of frequency information, the number of single cells with chromatin interactions between two disjoint chromosome regions.

Results

Considering the lack of computational methods on interchromosomal interactions and the unsurprisingly frequent intrachromosomal interactions along the diagonal of a chromatin contact map, we propose a computational method dedicated to analyzing interchromosomal interactions of single-cell Hi-C with this new frequency information. To the best of our knowledge, our proposed tool is the first to identify regions with statistically frequent interchromosomal interactions at single-cell resolution. We demonstrate that the tool utilizing networks and binomial statistical tests can identify interesting structural regions through visualization, comparison and enrichment analysis and it also supports different configurations to provide users with flexibility.

Conclusions

It will be a useful tool for analyzing single-cell Hi-C interchromosomal interactions.
LncRNA LUCAT1/miR-181a-5p axis promotes proliferation and invasion of breast cancer via targeting KLF6 and KLF15
Authors: Liu Yun , Cheng Teng , Du Yaying , Hu Xiaopeng , Xia Wenfei
Published: September 2020

Background

Long non-coding RNAs (lncRNAs) are novel regulatory molecules in breast cancer development. LncRNA LUCAT1 is a potential tumor promoter in human cancers. In this study, we aimed to explore the role of LUCAT1 in human breast cancer tissues and cells.

Methods

A total of 31 breast cancer patients who underwent tumor resection, but without chemo- or radiotherapy or acute lung/heart/kidney diseases, provided tumor and adjacent normal tissues. Bioinformatic analysis, qRT-PCR, and luciferase reporter assay were carried out during the study.

Results

qRT-PCR analysis indicated that, compared with the adjacent tissues and MCF-10A normal breast epithelial cells, LUCAT1 was markedly up-regulated in the breast cancer tissues and five BC cell lines, including MDA-MB-231, MDA-MB-468, MDA-MB-435, SKBR3, and MCF-7. The knockdown of LUCAT1, through the transfection of small interfering RNA (siRNA) specific to LUCAT1, resulted in inhibition of proliferation in breast cancer cells. The expression levels of miR-181a-5p were decreased in the breast cancer tissues and five BC cell lines. Bioinformatic analysis and luciferase reporter assay suggested the interaction between miR-181a-5p and LUCAT1. In addition, the effects of LUCAT1 on promoting cell proliferation were attenuated by overexpression of miR-181a-5p through the transfection of miR-181a-5p mimic. Moreover, bioinformatics and luciferase reporter assay confirmed that miR-181a-5p targeted the 3′-UTR region of KLF6 and KLF15 mRNA, which were two tumor suppressor genes. LUCAT1/miR-181a-5p axis regulated the expression of KLF6 and KLF15 both in vitro and in vivo.

Conclusions

Our data indicate that LUCAT1/miR-181a-5p axis can serve as a novel therapeutic target in breast cancer.
Correction to: Effectiveness and cost-effectiveness of treatment with additional enrollment to a homeopathic integrated care contract in Germany
Authors: Kass Benjamin , Icke Katja , Witt Claudia M. , Reinhold Thomas
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
The burden of tuberculosis and attributable risk factors in Brazil, 1990–2017: results from the Global Burden of Disease Study 2017
Authors: Martins-Melo Francisco Rogerlândio , Bezerra Juliana Maria Trindade , Barbosa David Soeiro , Carneiro Mariângela , Andrade Kleydson Bonfim , Ribeiro Antonio Luiz Pinho , Naghavi Mohsen , Werneck Guilherme Loureiro
Published: September 2020

Background

Tuberculosis (TB) continues to be an important cause of fatal and non-fatal burden in Brazil. In this study, we present estimates for TB burden in Brazil from 1990 to 2017 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017).

Methods

This descriptive study used GBD 2017 findings to report years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) of TB in Brazil by sex, age group, HIV status, and Brazilian states, from 1990 to 2017. We also present the TB burden attributable to independent risk factors such as smoking, alcohol use, and diabetes. Results are reported in absolute number and age-standardized rates (per 100,000 inhabitants) with 95% uncertainty intervals (UIs).

Results

In 2017, the number of DALYs due to TB (HIV-negative and HIV-positive combined) in Brazil was 284,323 (95% UI: 240,269–349,265). Among HIV-negative individuals, the number of DALYs was 196,366 (95% UI: 189,645–202,394), while 87,957 DALYs (95% UI: 50,624–146,870) were estimated among HIV-positive individuals. Between 1990 and 2017, the absolute number and age-standardized rates of DALYs due to TB at the national level decreased by 47.0% and 68.5%, respectively. In 2017, the sex–age-specific TB burden was highest among males and in children under-1 year and the age groups 45–59 years. The Brazilian states with the highest age-standardized DALY rates in 2017 were Rio de Janeiro, Pernambuco, and Amazonas. Age-standardized DALY rates decreased for all 27 Brazilian states between 1990 and 2017. Alcohol use accounted for 47.5% of national DALYs due to TB among HIV-negative individuals in 2017, smoking for 17.9%, and diabetes for 7.7%.

Conclusions

GBD 2017 results show that, despite the remarkable progress in reducing the DALY rates during the period, TB remains as an important and preventable cause of health lost to due premature death and disability in Brazil. The findings reinforce the importance of strengthening TB control strategies in Brazil through integrated and multisectoral actions that enable the access to prevention, early diagnosis, and timely treatment, with emphasis on high-risk groups and populations most vulnerable to the disease in the country.
Inequalities in infant mortality in Brazil at subnational levels in Brazil, 1990 to 2015
Authors: Szwarcwald Célia Landmann , Almeida Wanessa da Silva de , Teixeira Renato Azeredo , França Elisabeth Barboza , de Miranda Marina Jorge , Malta Deborah Carvalho
Published: September 2020

Background

In this study, infant mortality rate (IMR) inequalities are analyzed from 1990 to 2015 in different geographic scales.

Methods

The Ministry of Health (MoH) IMR estimates by Federative Units (FU) were compared to those obtained by the Global Burden of Disease (GBD) group. In order to measure the inequalities of the IMR by FU, the ratios from highest to lowest from 1990 to 2015 were calculated. Maps were elaborated in 2000, 2010, and 2015 at the municipality level. To analyze the effect of income, IMR inequalities by GDP per capita were analyzed, comparing Brazil and the FU to other same-income level countries in 2015, and the IMR municipal estimates were analyzed by income deciles, in 2000 and 2010.

Results

IMR decreased from 47.1 to 13.4 per 1000 live births (LB) from 1990 to 2015, with an annual decrease rate of 4.9%. The decline was less pronounced for the early neonatal annual rate (3.5%). The Northeast region showed the most significant annual decline (6.2%). The IMR estimates carried out by the GBD were about 20% higher than those obtained by the MoH, but in terms of their inequalities, the ratio from the highest to the lowest IMR among the 27 FU decreased from 4 to 2, for both methods. The percentage of municipalities with IMR higher than 40 per 1000 LB decreased from 23% to 2%, between 2000 and 2015. Comparing the IMR distribution by income deciles, all inequality measures of the IMR decreased markedly from 2000 to 2010.

Conclusion

The results showed a marked decrease in the IMR inequalities in Brazil, regardless of the geographic breakdown and the calculation method. Despite clear signs of progress in curbing infant mortality, there are still challenges in reducing its level, such as the concentration of deaths in the early neonatal period, and the specific increases of post neonatal mortality in 2016, after the recent cuts in social investments.