bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary health care reform, dilemmatic space and risk of burnout among health workers
Authors: Freeman Toby , Baum Fran , Labonté Ronald , Javanparast Sara , Lawless Angela
Published: February 2017

Health system changes may increase primary health care workers’ dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government–managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community–controlled service) during a period of change and examined workers’ dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work ‘under the radar’, undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.
Secure girls: Class, sexuality, and self-esteem
Authors: Wilkins Amy C , Miller Sarah A
Published: February 2017

Public discourse is replete with talk about the fragility of young women’s self-esteem, linking poor self-concept to a range of social problems associated with girlhood. We know little about the impact of these ideas on young women. In this article, we examine interviews with 66 girls, aged 14–22, to understand how they talk about the link between self-esteem and sexual expression in everyday life. We find that girls’ talk about self-esteem uses classed meanings that unintentionally reinforce and extend the role of sexuality in girls’ status hierarchies, benefitting those with more class resources, while policing all girls’ abilities to claim sexual agency.
Some patients live after trauma: Re-examining the lethality of vertical deceleration injuries
Authors: Smith Michael R , Amberger Melissa A , Pavalonis Albert G , Onursal Elif M , Lee Sean , Phillips Patricia A , Edwards Joseph S
Published: February 2017

Background

Vertical deceleration injury is a unique urban phenomenon of blunt injury resulting in significant morbidity and mortality. Since evaluations began in the 1940s and more extensively in the 1980s through 2005, the fall height at which 50% of patients are expected to die (LD50) has been consistently estimated to be 40 ft (12.1 m) and historical reports suggest no patients were able to survive a fall greater than 50 ft (15.2 m). The aim of this study was to determine the current LD50 or survivable free fall height in comparison to historical reports.

Study design

The trauma database at an urban level one trauma center was reviewed for all falls from a significant height from January 2010 to December 2015. The data were stratified based upon the height of the fall. The height at which 50% of patients were expected to die was determined by logistic non-linear regression line plot.

Results

In total, 110 patients were identified, with 97 meeting criteria for inclusion into the study. Twelve patients fell from 60 ft (18.2 m) with six survivors. The calculated LD50 was 48 ft (14.8 m) when the heights of a story and floor were standardized to 10 ft (3 m); if the height was increased to 12 ft (3.7 m) per story, the LD50 would be 68 ft (20.1 m).

Conclusions

The survivable height, as well as the LD50 of vertical free falls, has increased as compared to previous studies. We assume that this is attributable to the advances in diagnostic imaging, interventional radiology therapies, critical care, and field management of these patients. A fall from 80 ft (24 m) exceeds the maximum threshold of force that the human body can withstand.
Journalism students’ professional identity in the making: Implications for education and practice
Authors: Williams Amanda , Guglietti Maria Victoria , Haney Sally
Published: February 2017

Changes in journalism spurred by technological shifts and industry restructuring have left observers questioning both the nature of the profession and what educators ought to do in order to prepare aspiring journalists. Despite attempts to rethink what it means to be a journalist and the educational experience needed to prepare students, few qualitative studies have emerged that track how learners are negotiating professional values. This article does precisely that by providing a case study of how students in an undergraduate Canadian university’s journalism program are conceptualizing the profession against the backdrop of changing practices and principles. Based on the data generated from 96 open-ended reflections, this investigation offers some important findings about the student professional identity experience within a 4-year program. More precisely, the results indicate that the ideals of ‘high modernism’ (especially those surrounding objectivity, the role of the public watchdog, and ethical practice) are being negotiated by journalists in training in important and meaningful ways.
Lumifoil and Tschumi: Virtual projections and architectural interventions
Authors: Bieg Kory , Odom Clay
Published: February 2017

This article introduces the theoretical and technical framework for the design of a temporary rooftop canopy on the red generator—one of the buildings designed by Bernard Tschumi for the Florida International University School of Architecture. The project, Lumifoil, was designed using both top-down and bottom-up computational techniques, including surface modeling via projected geometries and scripted cellular subdivisions and assemblies. Lumifoil attempts to synthesize these two often-conflicting design approaches into a generative design process which leverages context, form, surface, and structure as affective and effective actors. Lumifoil is the result of a design methodology which is both active and reactive to existing conditions of the site and new opportunities afforded by the program. It is contextual in its top-down relationship to Tschumi’s existing building and theory, generative in how details emerge bottom-up through scripts which lack any reference to site, and emergent in the resulting synthetic processes and effects which are produced. Through this methodological development, the project both tracks and responds to popular architectural theory and design from the mid-1990s to today. The theoretical underpinnings of the project build upon the idea that the actual (the real-life physical manifestation of matter) and the virtual (the potential for an object to be) are two constantly shifting paradigms in which design processes can intervene to help develop an architectural solution from a range of possibilities. The technical aspect of the project includes the collaborative workflow between the architecture offices of OTA+ and studio MODO with Arup Engineers to resolve structural issues using parametric modeling tools and structural analysis software. The final project is entirely parametric and fabrication is completely automated.
Energy-aware determination of compression for low latency in solar-powered wireless sensor networks
Authors: Kang Min Jae , Jeong Semi , Yoon Ikjune , Noh Dong Kun
Published: February 2017

There have been many studies performed about increasing network lifetime in wireless sensor networks that involve reducing data size, since the data transmission process takes up a large part of energy consumption. However, reducing data size results in increased delay time due to not only the compression computation time but also the waiting time to gather a sufficient amount of data for compression. Meanwhile, in solar-powered wireless sensor networks, the harvested energy may be surplus to the basic operations of sensor nodes. In this study, such surplus energy is utilized to reduce the delay time between nodes. Nodes with residual energy less than a certain threshold transfer data with compression in order to reduce energy consumption, and nodes with residual energy over the threshold (which means there is surplus energy) transfer data without compression to reduce the delay time between nodes by using the surplus energy. Simulation-based performance verifications show that the technique proposed in this study exhibits optimal performance in terms of both energy and delay times compared with traditional methods.
Attribution on a Work of Art, the Author, Identity and the Self in the Courtroom: the Case of Thwaytes v. Sotheby’s
Authors: Danil L. R.
Published: February 2017

The UK High Court case of Thwaytes v. Sotheby’s related to the attribution on a work of art alleged to be by Caravaggio. This article, consequent to a contextualization into the background and facts of the case, will argue that the case of Thwaytes not only provides a highly useful pedagogical prism through which to learn the minutiae of the authentication process of artworks and the problems that arise through that process – it also leads to the opportunity to examine in more depth the nature of the author, identity, the self, and the work of art itself. In so doing, it will specifically draw upon the work of Jacques Derrida.
Revisions to the Common Rule: A proposal in search of evidence
Authors: Nicholls Stuart G
Published: February 2017

Proposed changes to the Common Rule are proffered to save almost 7,000 reviews annually and consequently vast amounts of investigator and IRB-member time. However, the proposed changes have been subject to criticism. While some have lauded the changes as being imperfect, but nevertheless as improvements, others have contended that ‘neither the scientific community nor the public can be confident that improved practices will emerge from the regulatory changes mandated by the NPRM.’

In the present article, I discuss an important aspect that has been overlooked: the question of whether benefits will emerge is demonstrably empirical, yet data upon which to draw conclusions are conspicuous by their absence.

This is thrown into sharp relief when we consider the current environment in which health research is increasingly focused on providing evidence of need or benefit, where there is greater emphasis on evidence-based practice, and when we have the nascent field of implementation science.
Promoting police legitimacy among disengaged minority groups: Does procedural justice matter more?
Authors: Madon Natasha S , Murphy Kristina , Sargeant Elise
Published: February 2017

Procedural justice is known to enhance perceptions of police legitimacy. Studies show that procedural justice may be less effective for some individuals and groups, while others show it to be more effective. This study investigates the contingency of the procedural justice effect and considers the effectiveness of procedural justice for certain individuals through the concept of disengagement. Utilizing a survey of 1480 ethnic minority group members, the study tests whether or not disengagement moderates the effect of procedural justice on perceptions of police legitimacy. As expected, we find procedural justice is linked to enhanced perceptions of police legitimacy, while disengagement is associated with reduced perceptions of legitimacy. Interestingly, the study finds that procedural justice is more effective for building legitimacy for ethnic minority respondents who report being highly disengaged from police. These findings highlight how police might be able to improve perceptions of their legitimacy among disaffected minority communities.
Classification of congenital anomalies of the hand and upper limb
Authors: Tonkin M. A.
Published: February 2017

The Oberg, Manske, Tonkin Classification of congenital anomalies of the hand and upper limb utilizes dysmorphological concepts to distinguish Malformations from Deformations and Dysplasias. Malformations are abnormalities of Formation and/or Differentiation of tissues. Deformations are abnormalities which occur after tissue is formed. Dysplasias are abnormalities which result from a lack of normal organization of cells into tissue. Malformations are sub-grouped according to whether the abnormality affects the hand alone or the whole of the upper limb; and according to which, if any, of the three main axes of development are primarily involved. It is not possible to satisfy all criteria which would define an ideal classification. However, this system is practical in that it retains the surgical diagnoses and sub-classifications familiar to surgeons and is easily utilized; it is expandable and may be modified without destroying its structure; it may be used to accumulate prevalence data; and, in the future, gene and chromosomal defects which are identified for specific diagnoses may be incorporated into the system.
Tobramycin inhalation powder for the treatment of pulmonary Pseudomonas aeruginosa infection in patients with cystic fibrosis: a review based on clinical evidence
Authors: Hamed Kamal , Debonnett Laurie
Published: February 2017

Chronic airway infection with Pseudomonas aeruginosa is a major cause of increased morbidity and mortality in patients with cystic fibrosis (CF). The development and widespread use of nebulized antibacterial therapies, including tobramycin inhalation solution (TIS), has led to improvements in lung function and quality of life. However, the use of nebulizers is associated with various challenges, including extended administration times and the need for frequent device cleaning and disinfection. Multiple therapies are required for patients with CF, which poses a considerable burden to patients, and adherence to the recommended treatments remains a challenge. Tobramycin inhalation powder (TIP), delivered via the T-326 Inhaler, has been shown to have similar clinical efficacy and safety as compared to TIS, with improved patient convenience, satisfaction, and treatment adherence. Long-term safety studies have shown that TIP was well tolerated with no unexpected adverse events in patients with CF. This review of the TIP pivotal and postmarketing studies reinforces the well-established efficacy and safety profile of TIP and its ease of use.
Influenza outbreak in a Canadian correctional facility
Authors: Besney Jonathan , Moreau Danusia , Jacobs Angela , Woods Dan , Pyne Diane , Joffe A Mark , Ahmed Rabia
Published: February 2017

Correctional facilities face increased risk of communicable disease transmission and outbreaks. We describe the progression of an influenza outbreak in a Canadian remand facility and suggest strategies for preventing, identifying and responding to outbreaks in this setting. In total, six inmates had laboratory-confirmed influenza resulting in 144 exposed contacts. Control measures included enhanced isolation precautions, restricting admissions to affected living units, targeted vaccination and antiviral prophylaxis. This report highlights the importance of setting specific outbreak guidelines in addressing population and environmental challenges, as well as implementation of effective infection prevention and control (IPAC) and public health measures when managing influenza and other communicable disease outbreaks.
Assessment of cross-cultural adaptations of patient-reported shoulder outcome measures in Spanish: a systematic review
Authors: Gómez-Valero Sara , García-Pérez Fernando , Flórez-García Mariano Tomás , Miangolarra-Page Juan Carlos
Published: February 2017

Background

The present study aimed to conduct a systematic review of self-administered shoulder-disability functional assessment questionnaires adapted to Spanish, analyzing the quality of the transcultural adaptation and the clinimetric properties of the new version.

Methods

A search of the main biomedical databases was conducted to locate Spanish shoulder function assessment scales. The authors reviewed the papers and considered whether the process of adaptation of the questionnaire had followed international recommendations, and whether its psychometric properties had been appropriately assessed.

Results

The search identified nine shoulder function assessment scales adapted to Spanish: Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), Upper Limb Functional Index (ULFI), Simple Shoulder Test (SST), Shoulder Pain and Disability Index (SPADI), Oxford Shoulder Score (OSS), Shoulder Disability Questionnaire (SDQ), Western Ontario Rotator Cuff index (WORC), Western Ontario Shoulder Instability index (WOSI) and Wheelchair Users Shoulder Pain Index (WUSPI). The DASH was adapted on three occasions and the SPADI on two. The transcultural adaptation procedure was generally satisfactory, albeit somewhat less rigorous for the SDQ and WUSPI. Reliability was analyzed in all cases. Validity was not measured for one of the adaptations of the DASH, nor was it measured for the SDQ.

Conclusions

The transcultural adaptation was satisfactory and the psychometric properties analyzed were similar to both the original version and other versions adapted to other languages.
Reference values of manual dexterity using Minnesota Rate of Manipulation Test for Indian adults
Authors: Rane Shamita S , Paul Anila , Mullerpatan Rajani P
Published: February 2017

Introduction

Dexterity assessment is an integral component of hand function evaluation. The Minnesota Rate of Manipulation Test is a valid and reliable tool to evaluate manual dexterity and has been used to study prognosis of therapy. Information available on its reference values is limited. Reference values are required to interpret, set realistic treatment goals, and assess the ability to return to employment. Therefore, manual dexterity was studied in healthy Indian adults to generate reference values.

Methods

A descriptive study was conducted on 900 subjects divided into three groups: Group 1: 18–30 years ( n = 300): Group 2: 31–60 years (n = 300), and Group 3: ≥61 years ( n = 300). The Minnesota Rate of Manipulation Test was used to evaluate manual dexterity. All subjects performed three trials (one practice + two test trials) of the five subtests. The average of two test trials was used to compute the Minnesota Rate of Manipulation Test score.

Results

The total score of the Minnesota Rate of Manipulation Test in Groups 1, 2, and 3 was 275.7 ± 24.1 s, 299.3 ± 31.9 s, and 357.4 ± 48.6 s, respectively. Manual dexterity was moderately associated with age ( r = 0.707, p < 0.001); however, differences between males and females were nonsignificant ( p = 0.306).

Conclusion

Manual dexterity declined with advancing age; however, differences between genders were not significant. These reference values of manual hand dexterity for healthy adult Indian people will be relevant for clinical assessment of hand function.
Understanding the perceptions of network gatekeepers on bandwidth and online video streams in Ahmadu Bello University, Nigeria
Authors: Odigie Imoisili Ojeime , Gbaje Ezra Shiloba
Published: February 2017

Online video streaming is a learning technology used in today’s world and reliant on the availability of bandwidth. This research study sought to understand the perceptions of network gatekeepers about bandwidth and online video streams in Ahmadu Bello University, Nigeria. To achieve this, the interpretive paradigm and the Network Gatekeeping Theory were used as the theoretical framework and also a case study approach was employed to investigate the phenomenon. The study used a purposive sampling technique and a semi-structured interview to seek out opinions from the respondents who were the network gatekeepers within the university. A thematic analytical approach was done with the use of NVivo software, which yielded one hundred and seven codes, ten sub-categories and four major categories. The findings from the study indicated that: (1) perceptions of network managers were one sided; (2) no acceptable user policy was on ground and available bandwidth was limited; and (3) limitation of bandwidth, hindered user access to online video and mechanisms for gatekeeping had a role to play in the overall access to online video.
Follow‐up tricuspid annular plane systolic excursion predicts survival in pulmonary arterial hypertension
Authors: Mazurek Jeremy A. , Vaidya Anjali , Mathai Stephen C. , Roberts Justin D. , Forfia Paul R.
Published: February 2017

Few studies have examined the utility of serial echocardiography in the evaluation, management, and prognosis of patients with pulmonary arterial hypertension (PAH). Therefore, we sought to evaluate the prognostic significance of follow‐up tricuspid annular plane systolic excursion (TAPSE) in PAH. We prospectively studied 70 consecutive patients with PAH who underwent baseline right heart catheterization (RHC) and transthoracic echocardiogram, who survived to follow‐up echocardiogram after initiation of PAH therapy. Baseline TAPSE was 1.6 ± 0.5 cm which increased to 2.0 ± 0.4 cm on follow‐up (P < 0.0001). The cohort was dichotomized by TAPSE at one‐year follow‐up: Group 1 (n = 37): follow‐up TAPSE ≥ 2 cm; Group 2 (n = 33): follow‐up TAPSE < 2 cm. Group 1 participants were significantly more likely to reach WHO functional class I–II status and achieve a higher six‐minute walk distance on follow‐up. Of the 68 patients who survived more than one year, 18 died (26.5%) over a median follow‐up of 941 days (range, 3–2311 days), with significantly higher mortality in Group 2 versus Group 1 (41.9% vs. 13.5%; P = 0.003). While baseline TAPSE stratified at 2 cm did not predict survival in this cohort, TAPSE ≥ 2 cm at follow‐up strongly predicted survival in bivariable models (hazard ratio, 0.21; 95% confidence interval, 0.08–0.60). In conclusion, follow‐up TAPSE ≥ 2 cm is a prognostic marker and potential treatment target in a PAH population.
Characteristics of pediatric pulmonary hypertension trials registered on ClinicalTrials.gov
Authors: Awerbach Jordan D. , Krasuski Richard A. , Hill Kevin D.
Published: February 2017

The investigation of pediatric pulmonary hypertension (PH) drugs has been identified as a high priority by the United States National Institutes of Health (NIH). Studying pediatric PH is challenging due to the rare and heterogeneous nature of the disease. We sought to define the pediatric PH clinical trials landscape, to evaluate areas of trial success or failure, and to identify potential obstacles to the study of pediatric PH drugs. Interventional pediatric (ages 0–17 years) PH trials registered on ClinicalTrials.gov from June 2005 through December 2014 were analyzed. There were 45 pediatric PH trials registered during the study period. Median (IQR) projected trial enrollment was 40 (24–63), with seven trials (16%) targeting > 100 participants. Industry was the most common trial sponsor (n = 23, 50%), with only two (4.4%) NIH‐sponsored trials. Phosphodiesterase inhibitors were the most frequently studied drug (n = 18, 39%). Single group study designs were used in 44% (n = 20) with an active comparator (parallel, factorial, or cross‐over designs) in 25 trials, including 22 with randomization and ten that were double‐blinded. Study outcomes varied markedly with inconsistent use of known surrogate and composite endpoints. One‐third of trials (n = 15, 33%) were terminated, predominantly due to poor participant enrollment. Of the 17 completed trials, 11 had published results and only three efficacy trials met their primary endpoint. There are unique challenges to drug development in pediatric PH, including enrolling patients, identifying appropriate study endpoints, and conducting randomized, controlled, double‐blind trials where the likelihood of meeting the study endpoint is optimized.
The Modified Borg Dyspnea Scale does not predict hospitalization in pulmonary arterial hypertension
Authors: Banerjee Debasree , Kamuren Jane , Baird Grayson L. , Palmisciano Amy , Krishnan Ipsita , Whittenhall Mary , Klinger James R. , Ventetuolo Corey E.
Published: February 2017

Background

Breathlessness is the most common symptom reported by patients with pulmonary arterial hypertension (PAH). The Modified Borg Dyspnea Scale (MBS) is routinely obtained during the six‐minute walk test in the assessment of PAH patients, but it is not known whether the MBS predicts clinical outcomes such as hospitalizations in PAH.

Methods

We performed a retrospective study of World Health Organization (WHO) Group 1 PAH patients followed at our center. The dates of the first three MBS and hospitalizations that occurred within three months of a documented MBS were collected. Marginal Cox hazard regression modeling was used to assess for a relationship between MBS and all‐cause as well as PAH‐related hospitalization.

Results

A total of 50 patients were included; most (92%) were functional class III/IV, 44% and 65% were treatment‐naïve prior to their first MBS and hospitalization, respectively. The first recorded MBS was inversely correlated with the first recorded six‐minute walk distance (6MWD) (r = –0.41, P < 0.01) but did not track with WHO functional class (r = 0.07, P = 0.63). MBS did not predict all‐cause (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.76–1.08; P = 0.28) or PAH‐related hospitalization (HR, 1.04; 95% CI, 0.89–1.23; P = 0.61), though there was a strong relationship between 6MWD and PAH‐related hospitalization (P = 0.01). These findings persisted after multivariable adjustment.

Conclusions

Breathlessness as assessed by MBS does not predict all‐cause or PAH‐related hospitalization. Robust and validated patient‐reported outcomes are needed in pulmonary vascular disease.
Systematic review on risk factors of rotator cuff tears
Authors: Sayampanathan Andrew Arjun , Andrew Tan Hwee Chye
Published: February 2017

Purpose:

Rotator cuff tears (RCTs) occur commonly, especially among certain groups of individuals. In this meta-analysis, we aim to identify risk factors for RCTs.

Methods:

We searched MEDLINE for 210 articles. Seventeen articles were selected for systematic review, of which 10 were eligible for meta-analysis. Data was analysed with Review Manager 5.3, using Mantel–Haenszel statistics and random effect models.

Results:

A total of 6653 individuals were analysed. The odds of sustaining a RCT on the dominant hand was 2.30 times more than the non-dominant hand (95% confidence interval (CI): 1.01–5.25, Z = 1.99, p = 0.05; Heterogenity: τ2 = 0.38, χ2 = 8.84, df = 2 ( p = 0.01), I2 = 77%). The odds of an individual aged 60 years and above sustaining a RCT was 5.07 times higher than an individual less than 60 years old (95% CI: 2.45–10.51, Z = 4.37, p < 0.001; Heterogenity: τ2 = 0.47, χ2 = 25.24, df = 3 ( p < 0.001), I2 = 88%). Female gender was not a significant association, with an odds ratio of 0.98 when compared to the male gender (95% CI: 0.66–1.45, Z = 0.09, p = 0.93; Heterogenity: τ2 = 0.20, χ2 = 44.24, df = 5 ( p < 0.001), I2 = 89%).

Conclusions:

Hand dominance and older age are associated with RCTs. More studies are required for further assessment of associations and risk factors of RCTs.
Efficacy analysis of a novel sternoclavicular hook plate for treatment of unstable sternoclavicular joint dislocation or fracture
Authors: Zhang Chuanyi , Lin Lie , Liang Junbo , Wang Bin , Chen Guofu , Chen Haixiao
Published: February 2017

Purpose:

Sternoclavicular joint is an amphiarthrodial joint formed by the clavicle and sternal manubrium. This joint becomes chronically unstable in case of a medial clavicle dislocation or fracture, and improper treatment could cause malformation and pain. We aimed to determine the efficacy of a novel sternoclavicular hook plate for treatment of unstable sternoclavicular joint dislocation or fracture.

Methods:

Between June 2011 and December 2013, the sternoclavicular hook plate was used to surgically treat 32 adult patients with unstable sternoclavicular joint dislocation or fracture. Of these, 12 and 5 patients suffered from anterior and posterior dislocation of the sternoclavicular joint, respectively, 10 had medial clavicle fracture, and 5 had fracture dislocation. For anterior fracture dislocation, the standard sternoclavicular hook plate was used, while for the posterior dislocation, screws were added at the distal end of the hook plate, anterior to the sternal manubrium, to prevent postoperative redislocation.

Results:

No intraoperative complications were observed during the procedure. Postoperative X-ray and computed tomography revealed normal anatomical positions of sternoclavicular joints and excellent positions of internal fixation. About 3–6 months after surgery, all patients achieved primary healing without redislocation of the sternoclavicular joint along with satisfactory restoration of anatomical structures of the medial clavicle; nine patients had swelling but no pain around the sternoclavicular joints. Internal fixation was removed in 29 patients 6–12 months postoperatively and no sequelae were observed.

Conclusion:

This novel sternoclavicular hook plate demonstrated excellent efficacy and could provide a reliable therapeutic approach for this kind of trauma.
Can local infiltration analgesia increase satisfaction in postoperative short-term pain control in total knee arthroplasty?
Authors: Barastegui David , Robert I , Palau E , Haddad S , Reverte-Vinaixa M , Lorente L , Cots M
Published: February 2017

Background:

One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient’s early functional outcomes.

Objectives:

Compare length of stay (LOS) short-term pain control, and patients’ satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA.

Patients and methods:

Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups. The first group received an intraoperative LIA (150 mL mixture of ropivacaine 2.0 mg/mL + ketorolac 30 mg + adrenaline 10 μg/mL) combined to an FNB. The control group had only an FNB. Demographical data and visual analog scale (VAS) score were obtained preoperatively, at 36 h after surgery and at the 15-day follow-up. Patients’ satisfaction at 1 month was also evaluated. Statistical analysis data was performed.

Results:

No differences in demographical data and preoperative VAS score were observed between both groups. LIA group had a lower VAS score at 36 h after surgery (1.34 ± 1.31 vs. 3.68 ± 1.932 in the control group, p = 0.00), but these differences were not maintained at the 15-day follow-up (4.51 ± 1.889 vs. 4.11 ± 1.940 in the control group, p > 0.05). LOS and patients’ satisfaction were comparable between groups. Patients with LIA had no additional complications.

Conclusions:

LIA is a safe adjuvant to FNB to reduce perioperative pain during the first 36 h after TKA. Its effects wean with time, but do cover the first crucial hours of rehabilitation in a fast-track program. LIA seems don’t modify postoperative course nor patient’s satisfaction at short-term follow-up. The final impact of LIA on surgical outcome is still to be determined.
Is there a short-term benefit from an intra-articular steroid injection in female patients with adhesive capsulitis of the shoulder treated with physiotherapy?
Authors: Kumar Krishna , Thomas Ancy , Tetsworth Kevin , Hohmann Erik
Published: February 2017

Introduction:

The purpose of this retrospective study was to investigate the possible short-term benefit of a single intra-articular corticosteroid injection in those patients treated with physiotherapy when compared to a group of patients undergoing physiotherapy only (PT only).

Methods:

A retrospective chart review was conducted to identify eligible patients treated over a 4-year period. All female patients between 40 years and 60 years with a confirmed clinical diagnosis of idiopathic adhesive capsulitis who completed a prescribed physiotherapy program were considered eligible. Sixty-three patients fulfilled the inclusion criteria, but 22 were excluded because of missing data in the medical record. The remaining 41 patients comprise the study cohort; an experienced musculoskeletal physiotherapist assessed these patients both at initial presentation and at 12 weeks. Twenty patients with a mean age of 55.1 years underwent PT only and 21 patients with a mean age of 52.4 years received a single intra-articular dose of 40 mg methylprednisolone followed by physiotherapy. Outcome measures included the visual analogue scale (VAS) and measurement of range of motion.

Results:

At final assessment (12 weeks), significant between-group differences were identified for the ‘PT only’ group for flexion ( p = 0.01) and abduction ( p = 0.008). When comparing the mean change from the initial assessment, a significant between-group difference was observed for abduction ( p = 0.03).

Conclusions:

The results of this study suggest that the intra-articular injection of a single dose of cortisone has no significant short-term benefit in female patients with idiopathic adhesive capsulitis managed with physiotherapy.
Is C1 lateral mass screw placement safe for the Chinese, Indians, and Malays? An analysis of 180 computed tomography scans
Authors: Lee CK , Tan TS , Chan CYW , Kwan MK
Published: February 2017

Introduction:

C1 lateral mass (C1LM) screw is a common procedure in spine surgery. However, related studies are lacking in Asia. We aim to determine the safety of C1LM screw for the Chinese, Indians, and Malays.

Methods:

Three-dimensional computed tomographies of 180 subjects (60 from each ethnic) were analyzed. The length and angulations of C1LM screw and the location of internal carotid artery (ICA) in relation to C1LM were assessed and classified according to the classification by Murakami et al. The incidence of ponticulus posticus (PP) was determined and the differences among the population of these three ethnics were recorded.

Results:

The average base length was 8.5 ± 1.4 mm. The lengths within the lateral mass were between 14.7 ± 1.6 mm and 21.7 ± 2.3 mm. The prevalence of PP was 8.3%. 55.3% (199) of ICA were located in zone 0, 38.3% (138) in zone 1-1, 6.4% (23) in zone 1-2, and none in zone 1-3 and zone 2. The average angulation from the entry point to the ICA was 8.5° ± 6.4° laterally. The mean distance of ICA from C1 anterior cortex was 3.7 ± 1.7 mm (range: 0.6∼11.3). There was no difference in distribution of ICA in zone 1 among the three population (Chinese–47%, Indians–61%, and Malays–53%; p > 0.05).

Conclusions:

No ICA is located medial to the entry point of C1LM screw. If bicortical purchase of C1LM screw is needed, screw protrusion of less than 3 mm or medially angulated is safe for ICA. The incidence of PP is 8.3% with higher prevalence among the Indian population.
The Role of Chronic Stress in Anxious Depression
Authors: Ross Rachel A. , Foster Simmie L. , Ionescu Dawn F.
Published: February 2017

Depression is a heterogeneous disease with many different subtypes. Patients with the anxious depression—a common subtype of major depression—are at an increased risk for treatment-resistance to standard antidepressants, with resultant increases in morbidity. However, the underlying pathophysiology of anxious depression remains unknown. Without such knowledge, the development of targeted treatments towards this specific depression subtype will likely remain elusive. One method by which research into the neurobiology of anxious depression may prove fruitful is with the research domain criteria (RDoC). RDoC provides a framework for investigation into the underlying pathophysiology of mental illness. By studying disorders in terms of RDoC constructs—such as the sustained threat construct of the negative valence system—new insights may be gained into neurobiological mechanisms of disease. These mechanisms may be useful for the development of novel antidepressants that are based on specific brain targets. Specifically, we review the impact that sustained threat—or chronic stress—has on the eventual development of depression (especially anxious depression) through pathological changes to molecules, cells, neurocircuitry, physiology, and behavior.
Effect of annealing on gas permeability and mechanical properties of polylactic acid/talc composite films
Authors: Ghassemi Amir , Moghaddamzadeh Siavosh , Duchesne Carl , Rodrigue Denis
Published: February 2017

In this study, composite films based on polylactic acid and talc were prepared by extrusion film blowing to determine the effect of annealing temperature, annealing time, and talc content on the morphology and gas permeability, as well as thermal and mechanical properties. The results showed that annealing temperature, annealing time, and talc content have a direct effect on polylactic acid crystallinity leading to changes in gas permeability and gas diffusion coefficient, while gas solubility was constant. This effect is related to the talc particles and polylactic acid crystals producing higher tortuosity in the films. Finally, a direct relation between crystallinity level, mechanical properties and gas permeability was observed for all the conditions tested.
Acquired expression of CblQ367P in mice induces dysplastic myelopoiesis mimicking chronic myelomonocytic leukemia
Authors: Nakata Yuichiro , Ueda Takeshi , Nagamachi Akiko , Yamasaki Norimasa , Ikeda Ken-ichiro , Sera Yasuyuki , Takubo Keiyo , Kanai Akinori , Oda Hideaki , Sanada Masashi , Ogawa Seishi , Tsuji Kohichiro , Ebihara Yasuhiro , Wolff Linda , Honda Zen-ichiro , Suda Toshio , Inaba Toshiya , Honda Hiroaki
Published: February 2017

Key Points

Acquired expression of CblQ367P induces sustained proliferation of myelomonocytes, multilineage dysplasia, and splenomegaly resembling CMML. Combined inhibition of PI3K and JAK2 efficiently suppressed the growth of CblQ367P-induced CMML cells.
A histone H4 lysine 20 methyltransferase couples environmental cues to sensory neuron control of developmental plasticity
Authors: Delaney Colin E. , Chen Albert T. , Graniel Jacqueline V. , Dumas Kathleen J. , Hu Patrick J.
Published: February 2017

Animals change developmental fates in response to external cues. In the nematode Caenorhabditis elegans, unfavorable environmental conditions induce a state of diapause known as dauer by inhibiting the conserved DAF-2 insulin-like signaling (ILS) pathway through incompletely understood mechanisms. We have previously established a role for the C. elegans dosage compensation protein DPY-21 in the control of dauer arrest and DAF-2 ILS. Here, we show that the histone H4 lysine 20 methyltransferase SET-4, which also influences dosage compensation, promotes dauer arrest in part by repressing the X-linked ins-9 gene, which encodes a new agonist insulin-like peptide (ILP) expressed specifically in the paired ASI sensory neurons that are required for dauer bypass. ins-9 repression in dauer-constitutive mutants requires DPY-21, SET-4 and the FoxO transcription factor DAF-16, which is the main target of DAF-2 ILS. By contrast, autosomal genes encoding major agonist ILPs that promote reproductive development are not repressed by DPY-21, SET-4 or DAF-16/FoxO. Our results implicate SET-4 as a sensory rheostat that reinforces developmental fates in response to environmental cues by modulating autocrine and paracrine DAF-2 ILS.
Challenges in microbiological diagnosis of invasive Aspergillus infections
Authors: Alanio Alexandre , Bretagne Stéphane
Published: February 2017

Invasive aspergillosis (IA) has been increasingly reported in populations other than the historical hematology patients and there are new questions about the performance of microbiological tools. Microscopy and culture have been completed by biomarkers, either antigens or DNA, and in blood or respiratory specimens or both. First studied in hematology, the antigen galactomannan performance in serum is low in other patient populations where the pathophysiology of the infection can be different and the prevalence of IA is much lower. DNA detection with polymerase chain reaction (PCR) in blood or serum (or both) has reached a certain level of acceptance thanks to consensus methods based on real-time quantitative PCR (qPCR). When used on respiratory specimens, galactomannan and qPCR depend on standardization of the sampling and the diverse mycological procedures. Thus, culture remains the main diagnostic criterion in critically ill patients. The current trend toward more effective anti-mold prophylaxis in hematology hampers the yield of a screening strategy, as is usually performed in hematology. Therefore, circulating biomarkers as confirmatory tests should be considered and their performance should be reappraised in each new setting. The use of azole prophylaxis also raises the issue of selecting azole-resistanceAspergillus fumigatusisolates. Ideally, the biomarkers will be more efficient when individual genetic risks of IA are defined. Culture, though not standardized, remains a key element for the diagnosis of IA and has the advantage to easily detect molds other thanA. fumigatus. It is still unclear whether next-generation sequencing will replace culture in the future.
Recent advances in Major Histocompatibility Complex (MHC) class I antigen presentation: Plastic MHC molecules and TAPBPR-mediated quality control
Authors: van Hateren Andy , Bailey Alistair , Elliott Tim
Published: February 2017

We have known since the late 1980s that the function of classical major histocompatibility complex (MHC) class I molecules is to bind peptides and display them at the cell surface to cytotoxic T cells. Recognition by these sentinels of the immune system can lead to the destruction of the presenting cell, thus protecting the host from pathogens and cancer. Classical MHC class I molecules (MHC I hereafter) are co-dominantly expressed, polygenic, and exceptionally polymorphic and have significant sequence diversity. Thus, in most species, there are many different MHC I allotypes expressed, each with different peptide-binding specificity, which can have a dramatic effect on disease outcome.

Although MHC allotypes vary in their primary sequence, they share common tertiary and quaternary structures. Here, we review the evidence that, despite this commonality, polymorphic amino acid differences between allotypes alter the ability of MHC I molecules to change shape (that is, their conformational plasticity). We discuss how the peptide loading co-factor tapasin might modify this plasticity to augment peptide loading. Lastly, we consider recent findings concerning the functions of the non-classical MHC I molecule HLA-E as well as the tapasin-related protein TAPBPR (transporter associated with antigen presentation binding protein-related), which has been shown to act as a second quality-control stage in MHC I antigen presentation.
The challenges with the validation of research antibodies
Authors: Voskuil Jan L.A.
Published: February 2017

This article further discusses the reproducibility crisis in biomedical science and how poor conduct of commercial antibodies contribute to this. In addition, the way quality data are presented on product sheets by antibody vendors is scrutinized. The article proposes that there is a distinction between testing data and validation data, and special attention is asked for consistency between batches and aliquots. Moreover, the article separates the specifics, such as formulation, antigen and price, from the specifics on performance. Finally, a two-tier approach is discussed, enabling scientists to anticipate how an antibody is likely to perform when repeated purchases are required.
RNF4 interacts with multiSUMOylated ETV4
Authors: Aguilar-Martinez Elisa , Guo Baoqiang , Sharrocks Andrew D.
Published: February 2017

Protein SUMOylation represents an important regulatory event that changes the activities of numerous proteins. Recent evidence demonstrates that polySUMO chains can act as a trigger to direct the ubiquitin ligase RNF4 to substrates to cause their turnover through the ubiquitin pathway. RNF4 uses multiple SUMO interaction motifs (SIMs) to bind to these chains. However, in addition to polySUMO chains, a multimeric binding surface created by the simultaneous SUMOylation of multiple residues on a protein or complex could also provide a platform for the recruitment of multi-SIM proteins like RNF4. Here we demonstrate that multiSUMOylated ETV4 can bind to RNF4 and that a unique combination of SIMs is required for RNF4 to interact with this multiSUMOylated platform. Thus RNF4 can bind to proteins that are either polySUMOylated through a single site or multiSUMOylated on several sites and raises the possibility that such multiSIM-multiSUMO interactions might be more widespread.
Could Good Intentions Backfire? An Empirical Analysis of the Bank Deposit Insurance
Authors: Bao Weining , Ni Jian
Published: February 2017

The recent financial crisis led to the expansion of deposit-insurance coverage in many countries. We develop a structural model of the banking market in which banks act as financial intermediaries between consumers who have funds and businesses that seek loans, and explore the implications of such policies for banks and depositors. Our results indicate the policy could erode market discipline and increase banks’ moral hazard. As a result, banks extend their lending to riskier loans than they would have in the absence of the policy. We find this policy may even harm consumers. Moreover, market competition magnifies the lack of market discipline and induces additional moral hazard for excessive risk taking. Counterfactuals indicate banks may reduce their deposit interest rates by 2.7% in a duopoly market and almost triple their risk caps under the new policy. The estimated losses of depositors’ welfare are equivalent to at least a 3.27% drop in deposit interest rates.

Data are available at https://doi.org/10.1287/mksc.2016.1009 .
The Effect of Discretion on Procurement Performance
Authors: Coviello Decio , Guglielmo Andrea , Spagnolo Giancarlo
Published: February 2017

We run a regression discontinuity design analysis to document the causal effect of increasing buyers’ discretion on procurement outcomes in a large database for public works in Italy. Works with a value above a given threshold have to be awarded through an open auction. Works below this threshold can be more easily awarded through a restricted auction, where the buyer has some discretion in terms of who (not) to invite to bid. Our main result is that discretion increases the probability that the same firm wins repeatedly, and it does not deteriorate (and may improve) the procurement outcomes we observe. The effects of discretion persist when we repeat the analysis controlling for the geographical location, corruption, social capital, and judicial efficiency in the region of the public buyers running the auctions.

Data and the online appendix are available at https://doi.org/10.1287/mnsc.2016.2628 .

This paper was accepted by John List, behavioral economics.