bluuebunny/crossref_metadata_2025 huggingface dataset:
Protective effects of Huang-Lian-Jie-Du-Tang against Aβ25–35-induced memory deficits and oxidative stress in rats
Authors: Wu Wenbin , He Xiaojing , Xie Shuling , Li Bin , Chen Jinxin , Qu Yanqin , Li Baiyang , Lei Ming , Liu Xuehui
Published: March 2020

Objective

Huang-Lian-Jie-Du-Tang (HLJDT), a traditional Chinese medicine, improves cognitive ability in rat models of Alzheimer’s disease (AD). The objective of this study was to evaluate the protective effects of HLJDT on learning and memory impairment that are caused by Aβ25–35.

Methods

Rats were randomly assigned to the following groups: control (water), Aβ25–35, donepezil hydrochloride 1.05 mg/kg, HLJDT 6 g/kg, HLJDT 3 g/kg, and HLJDT 1.5 g/kg and the corresponding drugs were administered for 28 days by oral gavage. HLJDT for the prevention of Aβ25–35-induced injury in rats and the underlying mechanisms were assessed. Aβ25–35 and amyloid precursor protein (APP) levels were measured in the hippocampal specimens. Total superoxide dismutase (T-SOD), glutathione (GSH), and malondialdehyde (MDA) levels in the hippocampus were also measured. The ultrastructure of CA1 hippocampal region was observed using electron microscopy.

Results

HLJDT treatment ameliorated impaired learning and memory significantly, decreased Aβ25–35, and APP levels in the hippocampus, increased T-SOD and GSH activity and decreased the MDA concentration, and alleviated the nuclear and cytoplasmic abnormalities of the hippocampal CA 1 region that were induced by Aβ25–35 injection.

Conclusions

HLJDT might decrease hippocampal vulnerability to Aβ25–35, suggesting its potential neuroprotective effect in AD.
High expression of the CKIP-1 gene might promote apoptosis through downregulation of the Ras/ERK signalling pathway in the intestinal type of gastric cancer
Authors: Ma Liang , Cao Ying , Hu Jianjun , Chu Mingliang
Published: March 2020

Objective

To investigate the effect of the casein kinase 2 interacting protein 1 (CKIP-1) on the apoptosis of the intestinal type of gastric cancer (GC).

Methods

The levels of CKIP-1 protein and the rates of apoptosis were measured in tissue samples of the intestinal type of GC and human GC cell lines. The rate of apoptosis and the protein levels of B cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), cleaved cysteinyl aspartate specific protease 3 (cleaved caspase-3), cleaved caspase-9, rat sarcoma (Ras), extracellular signal-regulated kinase 1 and 2 (ERK1/2) and phosphorylated extracellular signal-regulated kinase 1 and 2 (p-ERK1/2) were analysed in SGC7901 cells expressing CKIP-1 short hairpin RNA (shRNA; knockdown) and SGC7901 cells overexpressing CKIP-1.

Results

The levels of CKIP-1 protein were significantly lower in the intestinal type of GC tissues compared with the samples of intestinal metaplasia. Both the levels of CKIP-1 protein and the levels of apoptosis decreased gradually with decreasing cell differentiation in the intestinal type of GC tissue and cell lines; and they were positively correlated. In the CKIP-1 shRNA group, the rate of apoptosis and the levels of Bax, cleaved caspase-3 and cleaved caspase-9 were decreased; and the levels of Bcl-2, Ras and the ratio of p-ERK/ERK were increased, compared with the control group. Opposite results were observed in the CKIP-1 overexpression group.

Conclusion

High levels of CKIP-1 protein may promote apoptosis in the intestinal type of GC, possibly via the downregulation of the Ras/ERK signalling pathway.
Hyperamylasemia as an early predictor of mortality in patients with acute paraquat poisoning
Authors: Huang Changbao , Bai Lina , Xue Xiang , Peng Liangfei , Jiang Jinghan , Zhang Xigang
Published: March 2020

Objective

This study aimed to evaluate the relationship between elevated serum amylase levels and the prognosis of paraquat poisoning.

Methods

Patients were categorized into the elevated and non-elevated serum amylase groups according to serum amylase levels. Demographics, mortality, risk factors of elevated serum amylase levels, and injury to the pancreas were analyzed.

Results

A total of 457 patients were enrolled in this study and the overall mortality rate was 51.9%. Patients in the elevated group had worse indices than those in the non-elevated group. Kaplan–Meier survival analysis showed that the mortality rate in the elevated group was significantly higher than that in the non-elevated group (hazard ratio: 10.65, 95% confidence interval [CI]: 7.55–15.02). Multivariate Cox proportional hazards analysis showed that elevated serum amylase levels were related to mortality (hazard ratio: 2.066, 95% CI: 1.239–3.444). The receiver operating characteristic curve showed that the area under the curve was 0.724 (95% CI: 0.666–0.783) for serum amylase levels with 70.4% sensitivity and 74.0% specificity.

Conclusion

Elevated serum amylase levels are observed in PQ poisoning. This elevation might be one of the most accurate early prognostic factors for predicting severity and mortality.
Timing of Return to Batting Milestones After Ulnar Collateral Ligament Reconstruction in Professional Baseball Players
Authors: Erickson Brandon J. , Chalmers Peter N. , D’Angelo John , Ma Kevin , Sheridan Scott , Schickendantz Mark , Romeo Anthony A.
Published: March 2020

Background:

Ulnar collateral ligament reconstruction (UCLR) is a common procedure in professional baseball position players. Timing of return to hitting after UCLR is unknown.

Purpose/Hypothesis:

The purpose was to determine the time to return to batting milestones after UCLR as well as the effect of UCLR upon batting performance in professional baseball players. The hypothesis was that position players would return to batting in an in-season game before fielding in an in-season game, and hitting performance would remain unchanged after UCLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All professional position players who underwent UCLR between 2010 and 2018 were included. Time to batting milestones after UCLR was analyzed. Batting performance before and after UCLR was compared and analyzed.

Results:

Overall, 141 UCLRs (96% performed on the dominant arm) in 137 position players were included (86% Minor League players). Four players underwent revision, all within 1 year of the primary UCLR. With regard to position, catchers and shortstops were overrepresented. With regard to batting side, 57% batted from the right and 12% batted as switch-hitters. Of the surgeries, 76% were on the trail/back arm. While 91% of players returned to some form of throwing, there was a progressive gradual decline as the rehabilitation process progressed, as only 77% were able to return to hitting in a real game and 75% were able to return to fielding in a real game. The first dry swing occurred at 150 ± 49 days after surgery, the first batting practice occurred at 195 ± 58 days after surgery, the first hitting in a real game occurred at 323 ± 92 days after surgery, and the first fielding in a real game occurred at 343 ± 98 days after surgery. However, players generally saw a decrease in their utilization, with fewer at bats ( P < .001) translating into fewer hits ( P < .001) and runs ( P < .001).

Conclusion:

Professional position players begin swinging at 150 days (approximately 5 months) after UCLR, while they do not hit in batting practice until 195 days (approximately 6.5 months) and do not hit in a real game until 323 days (approximately 10.7 months) after UCLR. Players see a decrease in hitting utilization after UCLR. On average, players hit in a real game 20 days before fielding in a real game.
An Evaluation of the Content of Canadian and American Nuclear Medicine Fellowship Websites
Authors: Hamid Saira , Gibney Brian , Niu Bonnie , Phord-Toy Rachel , Murray Nicolas , Vijayasarathi Arvind , Nicolaou Savvas , Khosa Faisal
Published: March 2020

Background:

Radiology trainees frequently use the Internet to research potential fellowship programs across all subspecialties. For a field like nuclear medicine, which has multiple training pathways, program websites can be an essential resource for potential applicants. This study aimed to analyze the online content of Canadian and American Nuclear Medicine fellowship websites.

Materials and Methods:

The content of all active Canadian and American Nuclear Medicine fellowship websites was evaluated using 26 criteria in the following subdivisions: application, recruitment, education, research, clinical work, and incentives. Fellowships without websites were excluded from the study. Scores were summed per program and compared by geographic region and ranking.

Results:

A total of 42 active Canadian and American Nuclear Medicine fellowship programs were identified, of which 39 fellowships had dedicated fellowship websites available for the analysis. On average, fellowship websites contained 34.4% (9 ± 3.3) of the 26 criteria. Programs did not score differently on the criteria by geographical distribution ( P = .08) nor by ranking ( P = .18).

Conclusion:

Most Canadian and American Nuclear Medicine fellowship websites are lacking content relevant to prospective fellows. Addressing inadequacies in online content may support programs to inform and recruit residents into fellowship programs.
Urgent-start dialysis: Comparison of complications and outcomes between peritoneal dialysis and haemodialysis
Authors: Dias Dayana Bitencourt , Mendes Marcela Lara , Caramori Jacqueline Teixeira , Falbo dos Reis Pâmela , Ponce Daniela
Published: March 2020

Background:

Few studies have evaluated the viability and outcomes between peritoneal dialysis (PD) and haemodialysis (HD) in urgent-start renal replacement therapy (RRT). This study aimed to compare infectious and mechanical complications related to urgent-start PD and HD. Secondary outcomes were to identify risk factors for complications and mortality related to urgent-start dialysis.

Methods:

A quasi-experimental study with incident patients receiving PD and HD in a Brazilian university hospital, between July 2014 and December 2017. Subjects included individuals with final-stage chronic kidney disease who required immediate RRT, that is, HD through central venous catheter or PD in which the catheter was implanted by a nephrologist and utilized for 72 h, without previous training. Patients with PD were subjected, initially, to high-volume PD for metabolic compensation. After hospital discharge, they remained in intermittent PD in the dialysis unit until training was completed. Mechanical and infectious complications were compared, as well as the recovery of renal function and survival.

Results:

In total, 93 patients were included in PD and 91 in HD. PD and HD groups were similar regarding age (58 ± 17 vs. 60 ± 15 years; p = 0.49), frequency of diabetes mellitus (37.6% vs. 50.5%; p = 0.10), other comorbidities (74.1% vs. 71.4%; p = 0.67) and biochemical parameters at the beginning of RRT, that is, creatinine (9.1 ± 4.1 vs. 8.0 ± 2.8; p = 0.09), serum albumin (3.1 ± 0.6 vs. 3.3 ± 0.6; p = 0.06) and haemoglobin (9.5 ± 1.8 vs. 9.8 ± 2.0; p = 0.44). After a minimum follow-up period of 180 days and a maximum follow-up period of 2 years, there was no difference regarding mechanical complications (24.7% vs. 37.4%; p = 0.06) or bacteraemia (15.0% vs. 24.0%; p = 0.11); however, there was a difference regarding infection of the exit site (25.8% vs. 39.5%; p = 0.04) and diuresis maintenance [700 (0–1500) vs. 0 (0–500); p < 0.001], with better results in the PD group. There was better phosphorus control at 180 days in the PD group (62.4% vs. 41.8%; p = 0.008), with a lower requirement for phosphate binder usage (28% vs. 55%; p < 0.001), erythropoietin (18.3% vs. 49.5%; p < 0.001) and anti-hypertensives (11.8% vs. 30.8%; p = 0.003). Time to death was similar between groups. In the multivariate analysis, PD was a predictor of renal function recovery [odds ratio: 3.95 (1.01–15.4)].

Conclusion:

PD is a viable and safe alternative to HD in a scenario of urgent-start RRT with complication rates and outcomes similar to those of HD, highlighting the results regarding renal function recovery.
Unsteady flow mechanism of the integrated aggressive inter-turbine duct in low Reynolds number condition
Authors: Liu Hongrui , Liu Jun , Du Qiang , Liu Guang , Wang Pei
Published: March 2020

Aggressive inter-turbine duct, which has ultra-high bypass ratio and ultra-short axial length, is widely applied in the modern turbofan engine because it can reduce engine weight and improve low-pressure rotor dynamic characteristics. However, the aggressive inter-turbine duct that has swirling flow, wake, shock, and tip clearance leakage flow of upstream high-pressure turbine, and even has structs in its flow channel, is liable to separate, especially in high-altitude low Reynolds number (Re) condition. In addition, its downstream low-pressure turbine is on the edge of separation too. In this paper, an integrated aggressive inter-turbine duct embedded with wide-chord low-pressure turbine nozzle is adopted to eliminate the aggressive inter-turbine duct's end-wall separation. Since there are many studies on suppressing the blade suction surface's separation by upstream wake, in this study inherent wake is utilized to suppress the boundary layer separation on low-pressure turbine nozzle's suction surface in the integrated aggressive inter-turbine duct. The paper studies the unsteady flow mechanisms of the integrated aggressive inter-turbine duct (especially the separation and transition mechanisms of low-pressure turbine nozzle's suction surface boundary layer) by the computatioinal simulation method.
Catastrophic antiphospholipid syndrome following the introduction of rivaroxaban
Authors: Stammler Romain , Legendre Paul , Cacoub Patrice , Blanche Philippe , Piette Jean -Charles , Costedoat -Chalumeau Nathalie
Published: March 2020

Summary

Catastrophic antiphospholipid syndrome is the most severe complication of antiphospholipid syndrome. Vitamin K antagonists are the reference treatment for preventing relapsing thrombotic complications in patients with antiphospholipid syndrome. Direct oral anticoagulants are nonetheless sometimes used in this setting. We report two cases of women who were triple-positive for antiphospholipid antibodies and developed catastrophic antiphospholipid syndrome in the week after the introduction of rivaroxaban. The first patient, who had had a previous thrombotic event, had multiorgan failure 3 days after vitamin K antagonists was replaced by rivaroxaban, and the second developed a similar clinical presentation 7 days after introduction of the same treatment. Both catastrophic antiphospholipid syndrome episodes were successfully treated with heparin followed by vitamin K antagonists, corticosteroids, and plasmapheresis. These two cases highlight for the inefficacy of rivaroxaban preventing severe thrombotic events such as catastrophic antiphospholipid syndrome and thus provide further support for recommendations that vitamin K antagonists must remain the reference anticoagulant in patients with triple-positive antiphospholipid antibodies.
Therapeutic Effect of Human Amniotic Epithelial Cells in Rat Models of Intrauterine Adhesions
Authors: Bai Xuechai , Liu Jia , Yuan Weixin , Liu Yang , Li Wei , Cao Siyu , Yu Luyang , Wang Liang
Published: March 2020

As a refractory fibrosis disease, intrauterine adhesions (IUAs) is defined as fibrosis of the physiological endometrium. Although hysteroscopic adhesiolysis is widely recommended as an effective treatment, prognosis and recurrence remain poor in severe cases. Recently, stem cell therapy has been promoted as a promising treatment for IUAs. The ability of human amniotic epithelial cells (hAECs), emerging as a new candidate for stem cell therapy, to treat IUAs has not been demonstrated. To study the potential effects of hAECs on IUAs, we created an IUA rat model using mechanical injury and injected cultured primary hAECs into the rats’ uteri. Next, we observed the morphological structure of endometrial thickness and glands using hematoxylin and eosin staining, and we detected extracellular-matrix collagen deposition using Masson staining. In addition, we performed immunohistochemical staining and reverse-transcription polymerase chain reaction (RT-PCR) to investigate potential fibrosis molecules and angiogenesis factors 7 d after hAECs transplantation. Finally, we detected estrogen receptor (ER) and growth factors via RT-PCR to verify the molecular mechanism underlying cell therapy. In the IUA rat models, endometrial thickness and endometrial glands proliferated and collagen deposition decreased significantly after hAEC transplantation. We found that during the recovery of injured endometrium, the crucial fibrosis marker transforming growth factor-β (TGF-β) was regulated and angiogenesis occurred in the endometrial tissue with the up-regulation of vascular endothelial growth factor. Furthermore, hAECs were shown to promote ER expression in the endometrium and regulate the inflammatory reaction in the uterine microenvironment. In conclusion, these results demonstrated that hAEC transplantation could inhibit the progression of fibrosis and promote proliferation and angiogenesis in IUA rat models. The current study suggests hAECs as a novel stem cell candidate in the treatment of severe IUA.
Fidelity Assessment of a Social Work–Led Intervention Among Patients With Firearm Injuries
Authors: Lyons Vivian H. , Benson Lina R. , Griffin Elizabeth , Floyd Anthony S. , Kiche Sharon W. , Haggerty Kevin P. , Whiteside Lauren , Conover Sarah , Herman Daniel B. , Rivara Frederick P. , Rowhani-Rahbar Ali
Published: March 2020

Purpose:

To support future development and refinement of social work–led intervention programs among patients with firearm injuries and to demonstrate how a fidelity assessment can be used to adjust and refine intervention delivery in an ongoing trial.

Method:

We conducted a fidelity assessment of a randomized controlled trial of a social work–led intervention among patients with a firearm injury.

Results:

We found that our study intervention was well implemented, meeting 70% of the fidelity assessment score items, however, noted lower fidelity with client-based items.

Discussion:

As a result of fidelity assessment findings, we refined intervention delivery to improve implementation fidelity including beginning to review cases of all patients each month rather than focusing on patients in crisis. Our fidelity assessment process and findings offer insight into the challenges of implementing an intervention among patients with firearm injuries and highlight the value of monitoring intervention fidelity during an ongoing trial.
Lived Experiences and Life Satisfaction of ChildFree Women in Late Life
Authors: Stahnke Brittany , Blackstone Amy , Howard Heather
Published: March 2020

The purpose of this study was to gain a deeper understanding of the overall life satisfaction of older adult women who have not had children. We explore the following questions: (1) What is the overall sense of life satisfaction of childfree women over 65 years of age? (2) What is the lived experience of being a childfree woman in U.S. society? and (3) How does being childfree inform women’s overall life satisfaction? Using a phenomenological research design to analyze data from interviews with 14 childfree women over the age of 65, we found that nearly all participants report a high life satisfaction and many report a strong sense of resiliency, though they also report an awareness of the stigma associated with their status as nonmothers. Implications for both theory and practice are considered.
Specifying Location-Scale Models for Heterogeneous Variances as Multilevel SEMs
Authors: McNeish Daniel
Published: March 2020

Standard multilevel models focus on variables that predict the mean while the within-group variability is largely treated as a nuisance. Recent work has shown the advantage of including predictors for both the mean (the location submodel) and the variability (the scale submodel) within a single model. Constrained versions of the model can be fit in standard mixed effect model software, but the most general version with random effects in each of the location and scale submodels has been noted for being difficult to fit and estimate in software. However, the latest release of Mplus includes new capabilities that facilitate fitting the general version of the model as a multilevel structural equation model (SEM). This article introduces the general form of the model that includes location and scale random effects (called the location-scale model) and notes how it can be envisioned as a multilevel SEM. We provide a tutorial with example analyses and Mplus code for the model with two-level cross-sectional data and three-level repeated measures data and discuss how such a model has potential to extend recent developments in organizational science.
Robust model reconstruction for intelligent health monitoring of tunnel structures
Authors: Xu Xiangyang , Yang Hao
Published: March 2020

Advanced robotic systems will encounter a rapid breakthrough opportunity and become increasingly important, especially with the aid of the accelerated development of artificial intelligence technology. Nowadays, advanced robotic systems are widely used in various fields. However, the development of artificial intelligence-based robot systems for structural health monitoring of tunnels needs to be further investigated, especially for data modeling and intelligent processing for noises. This research focuses on integrated B-spline approximation with a nonparametric rank method and reveals its advantages of high efficiency and noise resistance for the automatic health monitoring of tunnel structures. Furthermore, the root-mean-square error and time consumption of the rank-based and Huber’s M-estimator methods are compared based on various profiles. The results imply that the rank-based method to model point cloud data has a comparative advantage in the monitoring of tunnel, as well as the large-area structures, which requires high degrees of efficiency and robustness.
Sitagliptin (Januvia) patent litigation: Another link in the judicial train of ‘Proactive Infringement’ of patented rights in developing countries
Authors: Iqbal Zarina , Sadaf Saima
Published: March 2020

Driven by increasing instances of successful ‘at-risk’ launch of patented drugs in America and Europe, the strategy of using ‘proactive infringement’ as a legal tool is now getting-in, in developing countries. The rationale behind launch-at-risk is to counterbalance the innovator companies’ strategies of getting the patented product life extended through protecting improvement innovations and maintain market exclusivity even after the expiration of the compound patent. The battle for market and drive for higher profits between generics and innovator drug companies has extended the application of at-risk launch of the generic drugs even when compound patent is still running. Sitagliptin (Januvia) may be ranked at top of the drugs that have been fiercely litigated in the developing countries during their patent term. This article reviews the outcome of sitagliptin patent litigation and impact on the market exclusivity in some developing countries. This takes the position that the existing conflict between the innovators and generics can be resolved by diluting the misconception that patents on improvement innovations are misuse of patent system or inappropriate extension of patented product life on the part of innovator companies. Whether trivial, simplified or complex, if novel and non-obvious, further improvements in the precursor drugs are patentable within the legal framework of the patent system. The real issue is the scope of monopoly granted to the secondary or follow-on patents. Once the compound patent has expired, follow-on patents on improvements relating to the same compound should not be allowed to use as legal-barrier for the generic medicines entry to the market.
Utstein recommendation for emergency stroke care
Authors: Rudd AG , Bladin C , Carli P , De Silva DA , Field TS , Jauch EC , Kudenchuk P , Kurz MW , Lærdal T , Ong MEH , Panagos P , Ranta A , Rutan C , Sayre MR , Schonau L , Shin SD , Waters D , Lippert F
Published: March 2020

Background

Recent advances in treatment for stroke give new possibilities for optimizing outcomes. To deliver these prehospital care needs to become more efficient.

Aim

To develop a framework to support improved delivery of prehospital care. The recommendations are aimed at clinicians involved in prehospital and emergency health systems who will often not be stroke specialists but need clear guidance as to how to develop and deliver safe and effective care for acute stroke patients.

Methods

Building on the successful implementation program from the Global Resuscitation Alliance and the Resuscitation Academy, the Utstein methodology was used to define a generic chain of survival for Emergency Stroke Care by assembling international expertise in Stroke and Emergency Medical Services (EMS). Ten programs were identified for Acute Stroke Care to improve survival and outcomes, with recommendations for implementation of best practice.

Conclusions

Efficient prehospital systems for acute stroke will be improved through public awareness, optimized prehospital triage and timely diagnostics, and quick and equitable access to acute treatments. Documentation, use of metrics and transparency will help to build a culture of excellence and accountability.
A review of the interaction between the striker and the goalkeeper at the individual tactical level in football
Authors: Peterson Scott William , Bruton Michaela Rose
Published: March 2020

Recent performance analysis techniques have attempted to move beyond a narrow focus on game outcomes by considering the game, team, group and individual tactical levels. Goals are decisive in football, yet the extent to which the individual goalkeeper had been studied was unknown. We therefore systematically searched the literature to determine the extent of studies that included actions related to the goalkeeper; of 711 titles retrieved, six met the full inclusion criteria. Despite sound study design in general, the use of World Cup matches might limit the generalisability of findings. Only 21% of the outcome variables extracted were comparable across studies, with 58 different variables used to describe actions involving the goalkeeper, which suggested significant conceptual disparity. Of greater concern, no studies presented the striker and goalkeeper interaction in relative terms. The development of an analytic model that quantifies this relationship is necessary to adequately characterise tactics and inform the practical requirements of goalkeeping tactical training.
“If the People Do Not Raise the Issue, the Officials Will Not Investigate”: Moral Citizenship among China’s Fake-Fighters
Authors: Kuever Erika
Published: March 2020

Are China’s fake-fighters (打假, dajia) heroic consumer activists or morally dubious profit-seekers? Do they make the marketplace safer for ordinary consumers by using the law to “fight” fake, dangerous and falsely advertised goods, or benefit only themselves through the exploitation of legal loopholes? Since the 1994 Consumer Protection Law introduced a fiscal incentive that made fake-fighting a viable career, its practitioners have struggled to define their work against these stereotypical characterisations. In this empirical article, I show that fake-fighters reject criticisms of their motivations while at the same time avoiding censure by party-state authorities wary of activism couched in terms of rights by framing their work as a practice of moral citizenship. Fake-fighters believe it is their responsibility to highlight potential dangers in the marketplace, disseminate legal knowledge, and, crucially, prompt the government to enforce pre-existing laws to better protect consumers and advance national development.
Negotiating belonging and place: an exploration of mestiza women’s everyday resistance in Cajamarca, Peru
Authors: Boudewijn Inge A. M.
Published: March 2020

Since 1993, the Cajamarca region of Peru has been home to the Yanacocha gold mine, associated with environmental degradation, negative health impacts, and socio-economic consequences. In 2012, large-scale protests broke out across the region over the newly proposed Conga mine. Increasingly, scholarship is devoted to recognizing socio-environmental struggles outside of mass-mobilization and public protests, at the local, household and everyday level, often performed over much longer timescales. In this context, I critically explore the everyday resistance of mestiza-identifying women in Cajamarca city. Through a discussion of how their on-going resistance critically constructs who/what belongs in place and who/what is ‘other’/‘stranger’, I analyse how they mobilize gendered local values and knowledge to continue opposing large-scale mining in the aftermath of the Conga conflict.
Care of patients with pulmonary arterial hypertension during the coronavirus (COVID‐19) pandemic
Authors: Ryan John J. , Melendres‐Groves Lana , Zamanian Roham T. , Oudiz Ronald J. , Chakinala Murali , Rosenzweig Erika B. , Gomberg‐Maitland Mardi
Published: March 2020

The COVID‐19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension. The COVID‐19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary arterial hypertension, where pulmonary arterial hypertension‐specific treatments are used. It is important to balance the ongoing care and evaluation of pulmonary arterial hypertension patients with “exposure risk” to COVID‐19 for patients coming to clinic or the hospital. If there is a morbidity and mortality benefit from starting pulmonary arterial hypertension therapies, for example in a patient with high‐likelihood of pulmonary arterial hypertension, then it remains important to complete the thorough evaluation. However, the COVID‐19 outbreak may also represent a unique time when pulmonary hypertension experts have to weigh the risks and benefits of the diagnostic work‐up including potential exposure to COVID‐19 versus initiating targeted pulmonary arterial hypertension therapy in a select high‐risk, high likelihood World Symposium Pulmonary Hypertension Group 1 pulmonary arterial hypertension patients. This document will highlight some of the issues facing providers, patients, and the pulmonary arterial hypertension community in real‐time as the COVID‐19 pandemic is evolving and is intended to share expected common clinical scenarios and best clinical practices to help the community at‐large.
Changing trends in the use of novel oral anticoagulants and warfarin for treating non-valvular atrial fibrillation
Authors: Birkinshaw Alexander , Fry Christopher H , Fluck David , Sharma Pankaj , Han Thang S
Published: March 2020

Background

Prevention of thromboembolism by novel oral anticoagulants is increasing, whilst use of vitamin K antagonists is on the decline. We assessed changes in the use of these anticoagulants in treating non-valvular atrial fibrillation between 2014 and 2018.

Methods

One-hundred and sixty-two consecutive patients (95 men, 67 women) with non-valvular atrial fibrillation, mean age 72.3 years (standard deviation = 11.0), underwent cardiac assessment in a single cardiac unit. Use of anticoagulants at the time of investigation was documented: overall 83 (51.2%) patients were prescribed novel oral anticoagulants and 79 (48.8%) warfarin treatment. Trends in treatment rates with either anticoagulant class over time were characterised by calculating the average annual percentage change using a Joinpoint Regression Program 4.7.0.0.

Results

There were diverging trends in anticoagulant treatment from 2014 to 2018 without join points: yearly increase in novel oral anticoagulant treatment (41.9, 45.5, 53.7, 53.1 and 72.7%, average annual percentage change = 16.2%, 95% confidence interval = 5.8% to 27.5%, p < 0.001), and decrease in warfarin treatment (57.1, 54.5, 46.3, 46.9 and 27.3%, average annual percentage change = −14.4%, 95% confidence interval = −25.2% to −2.1%, p < 0.001).

Conclusions

Changing trends in treatment with anticoagulants for patients with non-valvular atrial fibrillation observed within less than two years provide important information to healthcare services to estimate future pharmaco-economic costs for such treatments.
What motivates the sharing of consumer-generated genomic information?
Authors: Hendricks-Sturrup Rachele M , Lu Christine Y
Published: March 2020

Genomic medicine is an emerging practice that followed the completion of the Human Genome Project and that considers genomic information about an individual in the provision of their clinical care. Large and start-up direct-to-consumer genetic testing companies like Ancestry, 23andMe, Luna DNA, and Nebula Genomics have capitalized on findings from the Human Genome Project by offering genetic health testing services to consumers without a clinical intermediary. Genomic medicine is thus further propelled by unprecedented supply and demand market forces driven by direct-to-consumer genetic testing companies. As government entities like the National Human Genome Research Institute question how genomics can be implemented into routine medical practice to prevent disease and improve the health of all members of a diverse community, we believe that stakeholders must first examine how and scenarios in which stakeholders can become motivated to share or receive genomic information. In this commentary, we discuss consumers three scenarios: satisfying personal curiosity, providing a social good, and receiving a financial return. We examine these motivations based on recent events and current avenues through which have engaged or can engage in genomic data sharing via private, secure (e.g. centralized genomic databases and de-centralized platforms like blockchain) and public, unsecure platforms (e.g. open platforms that are publicly available online). By examining these scenarios, we can likely determine how various stakeholders, such as consumers, might prefer to extract value from genomic information and how privacy preferences among those stakeholders might vary depending on how they seek to use or share genomic information. From there, one can recommend best practices to promote transparency and uphold privacy standards and expectations among stakeholders engaged in genomic medicine.
Suppurative arthritis of hip in a walking child: Effect of patient’s age, delay in surgical drainage, and organism virulence
Authors: Agarwal Anil , Kumar KH Vimal
Published: March 2020

Introduction:

We undertook a retrospective study to stratify the effect of patient’s age, delay in surgical drainage, and Staphylococcus aureus (SA) virulence on expected clinicoradiological outcomes following suppurative arthritis of hip joint in a walking child.

Materials and methods:

The study was conducted in 18 children over 2 years of age who suffered from joint fluid culture-positive SA arthritis of hip joint and treated with open arthrotomy. Outcomes were defined on the following criteria: age of child (≥5 years or <5 years), duration of symptoms elapsed before surgical intervention (≥5 days or <5 days), and virulence of SA (methicillin-resistant Staphylococcus aureus (MRSA)/methicillin-sensitive Staphylococcus aureus)). The final clinical results were graded according to Moon’s clinical criteria and radiologically by types described by Choi et al.

Results:

The mean patient age was 6.22 years at the time of index procedure. The average delay in surgery was 17.06 days. Follow-up averaged 15.28 months. Five patients had associated with osteomyelitis femur in preoperative radiographs. MRSA culture was grown in 8 hips (44.4%) of 18 hips. Unsatisfactory clinical results according to Moon’s criteria were obtained in 55.6% patients with 38.9% being MRSA infected. Unsatisfactory Choi’s radiological results were present in 33.3% patients, 27.8% under MRSA category. Our study did not find age to be a significant factor either in clinical or radiological outcome. The clinical results were unsatisfactory in 81.8% patients with surgical delays when compared to early surgery ( p < 0.05).

Conclusions:

The clinicoradiological outcome in suppurative hip arthritis of walking children was unsatisfactory when there was delay in treatment beyond 5 days, and the causative organism was virulent (MRSA). The presence of preoperative joint incongruency or osteomyelitis of proximal femur was another risk factor.
Glenoidplasty With Posterior Labral Reattachment for Posterosuperior Glenoid Impingement
Authors: Nourissat Geoffroy , Provost Julien , Vigan Marie , Cammas Claire
Published: March 2020

Background:

Posterosuperior glenoid impingement (PSGI), also known as shoulder internal impingement, is a cause of shoulder pain in athletes involved in overhead-throwing sports. PSGI is a condition mostly treated by rehabilitation. Surgery is indicated after unsatisfactory nonoperative management. However, with most of the surgical techniques proposed, the shoulder remains persistently painful during sport activity.

Hypothesis:

We aimed to evaluate the efficiency of adding posterior labral reattachment to glenoidplasty as a surgical treatment for PSGI. Our hypothesis was that posterior labral reattachment would have a positive effect on shoulder pain. To our knowledge, this combined procedure has not been previously described.

Study Design:

Case series; Level of evidence, 4.

Methods:

We retrospectively reviewed 11 male patients with PSGI treated with glenoidplasty and posterior labral reattachment at a single institution during a 7-year period and with a minimum 30-month follow-up after surgery. Most patients were recreational athletes, with 5 of them practicing at the national level and 1 being a professional athlete. Patients completed an online questionnaire consisting of the Simple Shoulder Test (SST), the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire, and a specific PSGI survey. Pre- and postoperative shoulder pain were analyzed using the paired t test, with significance set at P < .05.

Results:

All 11 patients investigated sought surgery because of persistent shoulder pain while practicing their sport. The patients underwent glenoidplasty and posterior labral fixation, and data for 9 patients were available for analysis (mean age, 29 years; range, 24-42 years). At a minimum 30-month follow-up, most patients (77.8%) showed decreased pain, and 8 patients were able to return to their previous sports activities, with 7 returning at the same or higher level. There was 1 patient who had to change sports because of a lack of force, while a second patient temporarily changed sport and then returned to his sport but at an inferior level. Pre- and postoperative pain differed significantly ( P < .05). Surgery did not impair daily life in all patients.

Conclusion:

Glenoidplasty associated with posterior labral reattachment significantly diminished shoulder pain in athletes involved in throwing sports. Most patients were able to return to their previous sport at the same or higher level. Posterior labral fixation may improve the benefit of glenoidplasty by decreasing pain.
Establishing User Error on the Patient-Reported Component of the American Shoulder and Elbow Surgeons Shoulder Score
Authors: Bourget-Murray Jonathan , Frederick Ariana , Murphy Lisa , French Jacqui , Barwood Shane , LeBlanc Justin
Published: March 2020

Background:

The American Shoulder and Elbow Surgeons (ASES) score is a patient-reported outcome (PRO) questionnaire developed to facilitate communication among international investigators and to allow comparison of outcomes for patients with shoulder disabilities. Although this PRO measure has been deemed easy to read and understand, patients may make mistakes when completing the questionnaire.

Purpose:

To evaluate the frequency of potential mistakes made by patients completing the ASES score.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A prospective cross-sectional study was performed for 600 ASES questionnaires completed by patients upon their first visit to 1 of 2 clinic locations (Australian vs Canadian site). Two categories of potential errors were predefined, and then differences in error rates were compared based on demographics (age, sex, and location). To determine whether these methods were reliable, an independent, third reviewer evaluated a subset of questionnaires separately. The interrater reliability was evaluated through use of the Cohen kappa.

Results:

The mean patient age was 49.9 years, and 63% of patients were male. The Cohen kappa was high for both evaluation methods used, at 0.831 and 0.918. On average, 17.9% of patients made at least 1 potential mistake, while an additional 10.4% of patients corrected their own mistakes. No differences in total error rate were found based on baseline demographics. Canadians and Australians had similar rates of error.

Conclusion:

To ensure the accuracy of the ASES score, this questionnaire should be double checked, as potential mistakes are too frequently made. This attentiveness will ensure that the ASES score remains a valid, reliable, and responsive tool to be used for further shoulder research.
Revision Arthroscopic Bankart Repair in the Military
Authors: Slaven Sean E. , Tardif Robert , Foley Kevin , Cameron Kenneth L. , Posner Matthew A. , Dickens Jonathan F.
Published: March 2020

Objectives:

There is no consensus on the optimal method of stabilization (arthroscopic or open) for revision anterior shoulder stabilization. The purpose of this study was to determine the success of revision arthroscopic stabilization at preventing further recurrence in active duty military patients.

Methods:

53 revision arthroscopic stabilizations were performed at our institution between 2005-2016 for recurrent anterior shoulder instability after an arthroscopic Bankart index procedure. Shoulders with glenoid bone loss >20% were excluded from the study. The primary outcome of interest was the ability to return to activity/duty without subsequent instability. Patients were followed for time to a subsequent instability event and repeat revision arthroscopic stabilization following return to duty/activity.

Results:

Patient age at revision surgery averaged 22.9 ± 4.3 years. Mean follow up was 6.1 years (range 0.4-12.9). 34 out of 53 patients (64%) returned to duty without recurrent instability following revision arthroscopic anterior stabilization. 19 patients (36%) experienced recurrent instability following return to duty after revision arthroscopic stabilization. Glenoid bone loss averaged 7.8% ± 8.0% in the successful group and 6.5 % ± 6.5% in the failure group (p=0.573). Durability of the index surgery was significantly longer in the successful group (38.1 ± 31.3 months vs. 20.5 ± 17.8 months, p=.029). There was no difference between groups in patient age or number of anchors used in the index or revision stabilization procedures.

Conclusion:

Revision arthroscopic stabilization of failed primary arthroscopic Bankart repair has a failure rate of 36% in a young active duty military population, which is substantially higher than primary arthroscopic Bankart repair in this population and higher than revision arthroscopic Bankart repair in other patient populations. The similar amounts of bone loss between groups indicates that bone loss is not the primary determinant of failure in revision arthroscopic stabilization.
Staging Israel/Palestine: The geopolitical imaginaries of international tourism
Authors: Yang Connie
Published: March 2020

This article argues that the curation of particular geopolitical imaginaries of Israel/Palestine for international tourists can legitimize and naturalize the violence of the Israeli state project. Juxtaposing the cases of Tel Aviv-Jaffa and the West Bank, I analyze the discourses and embodied practices that produce imaginative geographies through processes of spatial distancing and temporal fixing. The dominant imaginary in Tel Aviv-Jaffa incorporates Israel into a westernized geography of Europe, while the dominant imaginary of the West Bank emphasizes its location in an Orientalized Middle East. The cultivation of these tourist landscapes as entirely disparate places works to obscure how both are constitutive of a single Israeli regime, contributing to the public secret that separates the occupation of the West Bank from Israel as a democratic state. By examining how seemingly apolitical tourist practices are entangled with geopolitical violence, this article reveals the complicity of international tourism in sustaining Israeli settler colonial dispossession and military occupation.
Molecular Crosstalk Between Non-SMN-Related and SMN-Related Spinal Muscular Atrophy
Authors: Šoltić Darija , Fuller Heidi R
Published: March 2020

Most cases of spinal muscular atrophy are caused by functional loss of the survival of motor neuron 1 ( SMN1) gene, while less than 5% of cases are attributed to genes other than SMN. Mutations in LMNA, the lamin A/C encoding gene, cause an adult form of spinal muscular atrophy (SMA), and in our recent work, we highlight a role for lamin A/C in SMN-related SMA pathways. Here, we discuss this apparent molecular crosstalk between different types of SMA in context with previous work, showing that dysregulation of proteins produced by other SMA-causing genes, including UBE1, GARS, and SETX, are also implicated in SMN-related SMA pathways. The perturbation of UBE1, GARS, and lamin A/C help explain mechanisms of tissue-specific pathology in SMA, and we propose Wnt/β-catenin signalling as a common molecular pathway on which they each converge. Therapeutic strategies directed at these proteins, or their convergent pathways, may therefore offer a new approach to targeting tissue-specific pathology in SMN-related SMA.
Modeling nonlinear site effects in physics-based ground motion simulations of the 2010–2011 Canterbury earthquake sequence
Authors: de la Torre Christopher A , Bradley Brendon A , Lee Robin L
Published: March 2020

This study examines the performance of nonlinear total stress one-dimensional (1D) wave propagation site response analysis for modeling site effects in physics-based ground motion simulations of the 2010–2011 Canterbury, New Zealand earthquake sequence. This approach explicitly models three-dimensional (3D) ground motion phenomena at the regional scale, and detailed site effects at the local scale. The approach is compared with a more commonly used empirical VS30-based method of computing site amplification for simulated ground motions, as well as prediction via an empirical ground motion model. Site-specific ground response analysis is performed at 20 strong motion stations in Christchurch for 11 earthquakes with 4.7≤ MW≤7.1. When compared with the VS30-based approach, the wave propagation analysis reduces both overall model bias and uncertainty in site-to-site residuals at the fundamental period, and significantly reduces systematic residuals for soft or “atypical” sites that exhibit strong site amplification. The comparable performance in ground motion prediction between the physics-based simulation method and empirical ground motion models suggests the former is a viable approach for generating site-specific ground motions for geotechnical and structural response history analyses.