bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomized pilot study of a special education advocacy program for Latinx/minority parents of children with autism spectrum disorder
Authors: Luelmo Paul , Kasari Connie ,   Fiesta Educativa, Inc
Published: April 2021

This study reports on a randomized controlled pilot intervention study examining the effectiveness and feasibility of a low-intensity (i.e. three sessions), low-cost, parent advocacy intervention. The intervention study employed community-partnered research methods and targeted a low-income community of mostly Latinx, immigrant-origin parents of children with autism spectrum disorder. The study was designed to test a parent-to-parent advocacy mentorship program in order to increase parent’s special education advocacy knowledge and empowerment. The educational intervention was delivered in Spanish to Spanish-speaking parents. Results indicated significantly increased in parent’s knowledge in the immediate intervention group, but this knowledge did not lead to greater sense of parent’s empowerment. Increases in knowledge about special education rights of their children are the first step toward advocating for services for their children. While parents from low-income, racial/ethnic minority backgrounds, particularly Latinx parents, can significantly increase their advocacy skills with a low-intensity, low-cost program, they may need more support in changing their self-perceptions of empowerment and advocacy.

Lay abstract

Persistent racial and ethnic disparities in obtaining an autism spectrum disorder diagnosis and services have been documented for Latinx children and other racial/ethnic minorities. This study reports on an educational intervention examining the effectiveness and feasibility of a low-intensity (i.e. three sessions), low-cost, parent advocacy for Latinx and other minority parents of children with autism. Results indicated significantly increased parental knowledge and in the immediate intervention group, but this knowledge did not lead to greater empowerment. While parents from low-income, racial/ethnic minority backgrounds, particularly Latinx parents, can significantly increase their advocacy skills with a low-intensity, low-cost program, they may need more support in changing their self-perceptions of empowerment and advocacy.
The two-sided spectacle at the border: Frontex, NGOs and the theatres of sovereignty
Authors: Franko Katja
Published: April 2021

The Southern Mediterranean border has in the past decade become one of the most deeply contested political spaces in Europe and has been described as a site of the border spectacle. Drawing on textual and visual analysis of Twitter messages by two of the most prominent actors in the field, the European Border and Coast Guard Agency, Frontex, and the humanitarian and medical NGO Médecins Sans Frontières, the article examines the split nature of the Mediterranean border which is, among others, visible in radically different narratives about migrants’ journeys, border deaths and living conditions. The findings challenge previous scholarship about convergence of humanitarianism and policing. The two actors are waging a fierce media battle for moral authority, where they use widely diverging strategies of claiming authority, each of which carries a particular set of ethical dilemmas.
The effect of the TMD on the vibration of an offshore wind turbine considering three soil-pile-interaction models
Authors: Robinson Mouafo Teifouet Armand , Wang Zhenyu
Published: April 2021

In this paper we propose the use of the power series method and the Newmark-Beta algorithm to study the mitigation by the tuned mass damper (TMD) of an offshore wind turbine(OWT). The monopile of the OWT is taken as slender beam buried in a homogeneous soil while the tower is considered as tapered slender beam. Mathematically, both monopile and tower are modeled as elastic Euler-Bernoulli beams, with a point mass at the tower top representing the rotor nacelle assembly (RNA). First of all, the power series method is utilized to calculate the first natural frequencies of AF and CS models. The obtained results are compared with the first natural frequency of DS model obtained from FEM-Abaqus with good satisfaction. Next, the obtained mode shapes are used to establish the system of ordinary differential equations (ODE) governing the dynamic of OWT subjected to a TMD. Afterwards, the Newmark-Beta algorithm is employed to solve the ODE. Accuracy of the introduced approach is verified by setting a comparison between our results with those obtained using FEM-Abaqus. Finally, the influence of several parameters on the performance of TMD is shown in some plots.
A mechanism-based assessment framework for masonry arch bridges under scour-induced support rotation
Authors: George Jofin , Menon Arun
Published: April 2021

Increase in the frequency of flash floods owed to climate change, excessive sand mining, and urbanisation of watersheds has accelerated the need to quantify the structural effect of scour-induced structural damages in masonry arch bridges. The structural effects of scour-induced rotation are unaddressed in literature. In this context, a mechanism-based framework based on limit state principles is developed for masonry arch bridges subjected to scour-induced rotation. Critical collapse mechanisms caused by scour-induced rotation are identified, and analysis framework is developed using rigid-body kinematics. The spectrum of bridges under consideration is classified into subsets, and an assessment scheme is developed using fragility curves as a function of scouring location as well as bridge typology.
Subjective health complaints in early adolescence reflect stress: A study among adolescents in Western Sweden
Authors: Corell Maria , Friberg Peter , Löfstedt Petra , Petzold Max , Chen Yun
Published: April 2021

Aims: Mental health problems are common among Swedish adolescents and are sometimes referred to as ‘stress-related’. The overall aim of this study is to do an analysis of subjective health complaints (SHCs) and perceived general stress among adolescents in Sweden, both their prevalence and association, by gender, migration background, family structure and socioeconomic conditions. Methods: Data from the baseline (comprising 2283 adolescents aged 13) of the STudy of Adolescence Resilience and Stress (STARS) study in Västra Götaland in Sweden were used. SHCs were measured by the Psychosomatic Problems Scale (PSP-scale) and self-reported stress was measured by Cohen’s Perceived Stress Scale (PSS-10). Socioeconomic conditions were measured with the Family Affluence Scale (FAS) and the MacArthur Scale of Subjective Social Status (SSS). Statistical analyses included Student’s t-tests and ANOVAs of means, linear and logistic regression analyses and Pearson’s correlations. Results: Social inequalities in both SHCs and self-reported stress were found; levels were higher among girls, adolescents living with one parent or in families with less favourable socioeconomic conditions. Self-reported stress and SHCs were found to be strongly correlated ( r=0.70). Correlations with self-reported stress were stronger for psychological complaints ( r=0.71) than for somatic complaints ( r=0.52). Correlations did not vary with socioeconomic conditions of the family. Conclusions: SHCs do reflect general stress among adolescents, and it is appropriate to address the complaints as ‘stress-related’. Measures to improve adolescents’ mental health by reducing levels of SHCs should pay special attention to stressors in adolescents’ daily lives and strengthening adolescent’s coping resources and strategies.
Multivariable model predictive control of a compound power-split hybrid electric vehicle during the tip-in/out process
Authors: Gao Ji , Lou Diming , Zhang Tong , Fang Liang , Zhang Yunhua
Published: April 2021

For a compound power split hybrid system, such as the Corun hybrid system (CHS), a frequently encountered problem is determining how to compensate for the inertia torque of the transmission via the torque distribution of the two motors. The equivalent inertia of the transmission is variable and depends on the angular acceleration. According to the traditional control scheme, the target torque of the motors is distributed by simplifying the output angular acceleration to 0. This simplification introduces deviations in the torque distribution, and it is difficult to guarantee the quality of the two control quantities simultaneously. Recent research has also focused only on the control quality of one of the outputs. To solve this problem, a direct MIMO control scheme is proposed in this paper that directly calculates the target torques of the two motors based on control deviations. A multivariable model predictive controller (MPC) was designed for the control of transient processes. The simulation results showed that the proposed control method can improve the control accuracy of two objectives significantly, and it has an excellent ability to reject torque disturbances.
Researching death, dying and bereavement: tales of grounded theory, reflexivity and compassion
Authors: Kennedy Carla Jane , Gardner Fiona
Published: April 2021

Immersing researchers in sensitive and emotive topics such as death, dying and bereavement may result in periods of conflicting logical thoughts and subjective feelings that need to be acknowledged and supported.

The question to be answered in this research was ‘How do we create compassionate schools?’ which led to the interviewing of bereaved school community members in regional areas in Victoria, Australia. As anticipated, Carla, one of the researchers who had experienced recent family deaths was challenged by particular issues arising in interviews and through the transcribing process. Therefore, the purpose of this article is to discuss this complexity, with grounded theory as a conduit, reflexivity and critical reflection as combined tools and compassion as a way forward. We draw upon Carla’s methodological reflective journal and current health literature concerning sensitive topics in qualitative research.

Recommendations of how to support researchers and research teams managing sensitive topics are provided and suggestions of how compassion can be achieved and extended to researchers are offered.
Damage cross detection between bridges monitored within one cluster using the difference ratio of projected strain monitoring data
Authors: Cao Jianxin , Liu Yang , Li Changping
Published: April 2021

The bridges monitored within one cluster refer to several medium- and small-span beam bridges with the same or similar structural characteristics located in a local road network, and these bridges suffer the similar traffic and environmental loads. It is still little research on how to detect the damage of all bridges monitored within one cluster utilizing the above-mentioned characteristics of these bridges. To address this issue, a method is proposed for the damage cross-detection between bridges monitored within one cluster by using the difference ratio of projected strain monitoring data under time-varying environmental temperatures. First, a damage feature is established by using the difference ratio of projected strain monitoring data obtained from the same cross-section position of any two bridges monitored within one cluster that have similar or identical structural characteristics. On this basis, the relationship between the statistical characteristics of the proposed damage feature and the degree of structural similarity between two bridges are discussed in detail. Second, a damage detection index is presented by calculating the subspace angle between two damage features. Then, combined with kernel density estimation and a cross-validation strategy, the proposed index is implemented to detect the damage of all bridges monitored within one cluster. Finally, numerical simulation examples are utilized to analyse and discuss the application limitations, noise resistance performance and structural damage sensitivity of the proposed method. Moreover, the effectiveness of the proposed method is also demonstrated by using the strain monitoring data obtained from actual bridges monitored within one cluster.
Experimental simulation of bending damage of silicon nitride yarn during 3D orthogonal fabric forming process
Authors: Wu Ning , Li Shuai , Han Meiyue , Zhu Chao , Jiao Yanan , Chen Li
Published: April 2021

The aim of this study executed on Silicon Nitride (Si3N4) yarn is to examine some bending damage behaviors and fracture mechanisms that occur during the 3D orthogonal fabric forming process. A three point bending experiment device has been developed in order to simulate the Z-binder yarn bending condition. The effects of weft density, fabric thickness, and yarn tension have been studied. The Weibull analysis of the tensile strength show that the bending damage increases with the increase of weft density, fabric thickness, and yarn tension. The resulting bending damage causes a reduction in yarn strength of between 2.5 and 17.2% depending on the bending parameters of yarn. The growth of the fibrillation area also reflects similar trends with tensile strength loss rate. The fibrillation length produced by the yarns is mostly distributed within the range of 0.3 to 0.9 mm. A comparison of the calculation result to experimental data shows the bending fracture probability of filaments inside yarn are less than that of monofilament. The tensile and bending fracture of Si3N4 filaments exhibit typical brittle fracture characteristics.
The Role of Home-Based Exercise in Maintaining Skeletal Muscle During Preoperative Pancreatic Cancer Treatment
Authors: Parker Nathan H. , Gorzelitz Jessica , Ngo-Huang An , Caan Bette J. , Prakash Laura , Garg Naveen , Petzel Maria Q. B. , Schadler Keri , Basen-Engquist Karen , Katz Matthew H. G.
Published: April 2021

Loss of skeletal muscle and inferior muscle quality are associated with poor prognosis in patients undergoing preoperative treatment for pancreatic cancer, so maintaining skeletal muscle health before surgery may help accelerate patients’ functional recovery and improve their quality of life following surgery. While exercise helps maintain or increase skeletal muscle in individuals undergoing cancer treatment, its efficacy during pancreatic cancer treatment is unclear. Accordingly, in this study we compared changes in skeletal muscle quantity (skeletal muscle index [SMI]) and quality (skeletal muscle density [SMD]) during preoperative pancreatic cancer treatment in participants in a home-based exercise program (EP) and a historical cohort of patients who received the usual care (UC) with no formal exercise programming. Recommendations for the EP cohort included both aerobic and resistance exercise. We assessed changes in SMI and SMD using computed tomography scans administered at treatment planning (T0, prior to EP enrollment) and preoperative restaging (T1) for 33 EP and 64 UC patients and compared changes between groups. The UC patients had statistically significant SMI decreases from T0 to T1 (−1.4 ± 3.8 cm2/m2; p = .005), while the EP patients did not (0.2 ± 3.2 cm2/m2; p = .7). The SMI loss was significantly worse for the UC than for the EP patients ( p = .03). Neither group demonstrated statistically significant changes in SMD from T0 to T1, nor did the groups differ in the amount of change in SMD. An adjusted linear regression model demonstrated that EP participation was significantly associated with better SMI maintenance ( p = .02). These results suggest that participation in a home-based EP during preoperative treatment may help improve skeletal muscle health and clinical and quality of life outcomes for pancreatic cancer survivors.
Strategies for facilitating the delivery of cluster randomized trials in hospitals: A study informed by the CFIR-ERIC matching tool
Authors: Weir Arielle , Presseau Justin , Kitto Simon , Colman Ian , Hatcher Simon
Published: April 2021

Background

Recruitment and engagement of clusters in a cluster randomized controlled trial can sometimes prove challenging. Identification of successful or unsuccessful strategies may be beneficial in guiding future researchers in conducting their cluster randomized controlled trial. This study aimed to identify strategies that could be used to facilitate the delivery of cluster randomized controlled trials in hospitals.

Methods

The study employed the Consolidated Framework for Implementation Research–Expert Recommendations for Implementing Change matching tool. The barriers and enablers to cluster randomized controlled trial conduct identified in our previously conducted studies served as a means of determinant identification for the conduct of cluster randomized controlled trials. These determinants were mapped to Consolidated Framework for Implementation Research constructs and then matched to Expert Recommendations for Implementing Change compilation strategies using the Consolidated Framework for Implementation Research–Expert Recommendations for Implementing Change matching tool.

Results

The Expert Recommendations for Implementing Change strategies matched to at least one determinant Consolidated Framework for Implementation Research construct were as follows: (1) ‘Identify and prepare champions’, (2) ‘Conduct local needs assessment’, (3) ‘Conduct educational meetings’, (4) ‘Inform local opinion leaders’, (5) ‘Build a coalition’, (6) ‘Promote adaptability’, (7) ‘Develop a formal implementation blueprint’, (8) ‘Involve patients/consumers and family members’, (9) ‘Obtain and use patients/consumers and family feedback’, (10) ‘Develop educational materials’, (11) ‘Promote network weaving’, (12) ‘Distribute educational materials’, (13) ‘Access new funding’ and (14) ‘Develop academic partnerships’.

Conclusion

This study was intended as a step in the research agenda aimed at facilitating cluster randomized controlled trial delivery in hospitals and can act as a resource for future researchers when planning their cluster randomized controlled trial, with the expectation that the strategies identified here will be tailored to each context.
There can be only one truth: Ideological segregation and online news communities in Ukraine
Authors: Urman Aleksandra , Makhortykh Mykola
Published: April 2021

The paper examines ideological segregation among Ukrainian users in online environments, using as a case study partisan news communities on Vkontakte, the largest online platform in post-communist states. Its findings suggest that despite their insignificant numbers, partisan news communities attract substantial attention from Ukrainian users and can encourage the formation of isolated ideological cliques – or ‘echo chambers’ – that increase societal polarisation. The paper also investigates factors that predict users’ interest in partisan content and establishes that the region of residence is the key predictor of selective consumption of pro-Ukrainian or pro-Russian partisan news content.
Relevance of monitoring transmural disease activity in patients with Crohn’s disease: current status and future perspectives
Authors: Wilkens Rune , Novak Kerri L. , Maaser Christian , Panaccione Remo , Kucharzik Torsten
Published: April 2021

Treatment targets of inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn’s disease (CD) have evolved over the last decade. Goals of therapy consisting of symptom control and steroid sparing have shifted to control of disease activity with endoscopic remission being an important endpoint. Unfortunately, this requires ileocolonoscopy, an invasive procedure. Biomarkers [C-reactive protein (CRP) and fecal calprotectin (FCP)] have emerged as surrogates for endoscopic remission and disease activity, but also have limitations. Despite this evolution, we must not lose sight that CD involves transmural inflammation, not fully appreciated with ileocolonoscopy. Therefore, transmural assessment of disease activity by cross-sectional imaging, in particular with magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS), is vital to fully understand disease control. Bowel-wall thickness (BWT) is the cornerstone in assessment of transmural inflammation and BWT normalization, with or without bloodflow normalization, the key element demonstrating resolution of transmural inflammation, namely transmural healing (TH) or transmural remission (TR). In small studies, achievement of TR has been associated with improved long-term clinical outcomes, including reduced hospitalization, surgery, escalation of treatment, and a decrease in clinical relapse over endoscopic remission alone. This review will focus on the existing literature investigating the concept of TR or residual transmural disease and its relation to other existing treatment targets. Current data suggest that TR may be the next logical step in the evolution of treatment targets.
A review of bone grafting techniques for glenoid reconstruction
Authors: Zhang Jeffrey A , Lam Patrick H , Beretov Julia , Murrell George AC
Published: April 2021

Background

Traumatic anterior shoulder dislocations can cause bony defects of the anterior glenoid rim and are often associated with recurrent shoulder instability. For large glenoid defects of 20–30% without a mobile bony fragment, glenoid reconstruction with bone grafts is often recommended. This review describes two broad categories of glenoid reconstruction procedures found in literature: coracoid transfers involving the Bristow and Latarjet procedures, and free bone grafting techniques.

Methods

An electronic search of MEDLINE and PubMed was conducted to find original articles that described glenoid reconstruction techniques or modifications to existing techniques.

Results

Coracoid transfers involve the Bristow and Latarjet procedures. Modifications to these procedures such as arthroscopic execution, method of graft attachment and orientation have been described. Free bone grafts have been obtained from the iliac crest, distal tibia, acromion, distal clavicle and femoral condyle.

Conclusion

Both coracoid transfers and free bone grafting procedures are options for reconstructing large bony defects of the anterior glenoid rim and have had similar clinical outcomes. Free bone grafts may offer greater flexibility in graft shaping and choice of graft size depending on the bone stock chosen. Novel developments tend towards minimising invasiveness using arthroscopic approaches and examining alternative non-rigid graft fixation techniques.
The sonographic identification of cortical bone interruptions in rheumatoid arthritis: a morphological approach
Authors: Cipolletta Edoardo , Smerilli Gianluca , Di Matteo Andrea , Di Battista Jacopo , Di Carlo Marco , Grassi Walter , Filippucci Emilio
Published: April 2021

Bone erosions are the hallmark of structural damage in rheumatoid arthritis (RA). Among imaging techniques, ultrasonography (US) has emerged as an accurate, reliable, repeatable, low-cost and non-invasive imaging modality to detect erosive changes in RA. However, small interruptions of the cortical bone detectable by last generation US equipment do not necessarily represent bone erosions. According to the available data, in addition to cortical bone interruption itself, only a few morphological US findings have been proposed to define RA bone erosions. However, other additional features may be considered to facilitate the interpretation of US cortical bone interruptions in RA. These could be summarised using the following four domains: size, site, shape and scenery. This hypothesis article provides a critical literature review of US features characteristic of RA bone erosions and pictorial evidence supporting the potential role of a morphological analysis in the US identification of bone erosions in RA patients.

Plain language summary

The ultrasonographic morphology of cortical interruptions is helpful for the identification of bone erosions in rheumatoid arthritis: the “four Ss” approach Bone erosions are characteristic features of rheumatoid arthritis. They are associated with a more aggressive disease and with irreversible physical disability. In recent years, ultrasonography has emerged as an accurate and reliable technique for the detection of bone erosions, that appear as interruptions of the cortical bone with variable size. However, cortical bone interruptions do not necessarily represent bone erosions. Since bone erosions represent the earliest evidence of the destructive behaviour of RA, their identification is crucial. Besides the cortical interruption itself, only a few morphological ultrasonographic features were proposed to characterise bone erosions in rheumatoid arthritis. We believe that a morphological approach, including size, site, shape and scenery, may be considered to facilitate the interpretation of ultrasonographic cortical bone interruptions in rheumatoid arthritis. In this hypothesis article we carried out a critical review of the scientific literature and provided extensive pictorial evidence of the ultrasonographic spectrum of cortical interruptions supporting the potential role of considering the “four Ss” for the ultrasonographic identification of bone erosions in rheumatoid arthritis.
A Longitudinal Perspective on User Uptake of an Electronic Personal Health Record for Diabetes, With Respect To Patient Demographics
Authors: Conway Nicholas T , Bluett Michael , Shields Cathy , Taylor Andrew , Wake Deborah J , Cunningham Scott G
Published: April 2021

Introduction:

The growing prevalence of diabetes has increased the need for scalable technologies to improve outcomes. My Diabetes My Way (MDMW) is an electronic personal health record (ePHR) available to all people with diabetes in Scotland since 2010, associated with improved clinical outcomes among users. MDMW pulls data from a national clinician-facing informatics platform and provides self-management and educational information. This study aims to describe MDMW user demographics through time with respect to the national diabetes population, with a view to addressing potential health inequalities.

Methods:

Aggregate data were obtained retrospectively from the MDMW database and annual Scottish Diabetes Survey (SDS) from 2010 to 2020. Variables included diabetes type, sex, age, socioeconomic status, ethnicity, and glycemic control. Prevalence of MDMW uptake was calculated using corresponding SDS data as denominators. Comparisons between years and demographic sub-groups were made using Chi- Squared tests.

Results:

Overall uptake of MDMW has steadily increased since implementation. By 2020, of all people with T1D or T2D in Scotland, 13% were fully enrolled to MDMW (39,881/312,326). There was proportionately greater numbers of users in younger, more affluent demographic groups (with a clear social gradient) with better glycemic control. As uptake has increased through time, so too has the observed gaps between different demographic sub-groups.

Conclusions:

The large number of MDMW users is encouraging, but remains a minority of people with diabetes in Scotland. There is a risk that innovations like MDMW can widen health inequalities and it is incumbent upon healthcare providers to identify strategies to prevent this.
Effects of Exercise Training Alone and in Combination With Kinesio Taping on Pain, Functionality, and Biomarkers Related to the Cartilage Metabolism in Knee Osteoarthritis
Authors: Oğuz Ramazan , Belviranlı Muaz , Okudan Nilsel
Published: April 2021

Objective

To investigate the effects of exercise training alone and in combination with kinesio taping on pain, functionality, and circulating cartilage oligomeric matrix protein (COMP), and matrix metalloproteinase (MMP)-1, and -3 at rest and immediately after walking exercise in knee osteoarthritis (OA).

Design

A total of 22 female patients diagnosed with knee OA were randomly divided into the exercise training (ET) or exercise training plus kinesio taping (ET + KT) groups. The patients in the ET performed exercise training for 6 weeks. The patients in the ET + KT group were applied with kinesio tape in addition to the exercise training for 6 weeks. In both groups, 20 minutes of walking exercise were performed before and after the interventions. The pain and functional status of the patients were assessed using visual analogue scale (VAS) and Western Ontario McMasters Osteoarthritis Index (WOMAC) before and after the intervention at rest, respectively. Blood samples were taken at rest and immediately after the walking exercise before and after the interventions for the analysis of COMP, MMP-1, and MMP-3 levels.

Results

In both groups, pain and functionality scores were significantly improved after the interventions ( P < 0.05). COMP, MMP-1 and MMP-3 levels were higher immediately after walking exercise when compared with rest in both groups before and after the intervention ( P < 0.05).

Conclusions

Exercise training and exercise training plus kinesio taping improved pain and physical function; however, the COMP, MMP-1, and MMP-3 levels did not change.
High-Density Lipoprotein Cholesterol and Apolipoprotein A1 in Synovial Fluid: Potential Predictors of Disease Severity of Primary Knee Osteoarthritis
Authors: Zhang Kaibin , Ji Yisheng , Dai Hanhao , Khan Abdul Aleem , Zhou Yang , Chen Ran , Jiang Yiqiu , Gui Jianchao
Published: April 2021

Objectives

The aim of this study was to detect levels of common lipid species in serum and synovial fluid (SF) of primary knee osteoarthritis (OA) patients and investigate their correlations with disease severity.

Materials and Methods

The study enrolled 184 OA patients receiving arthroscopic debridement or total knee arthroplasty and 180 healthy controls between April 2012 and March 2018. Total triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1), and apolipoprotein B (ApoB) levels were analyzed in serum and SF of OA patients, and in serum of healthy individuals. The Noyes rating criteria, Kellgren-Lawrence (KL) grading system, and Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores were, respectively, used to assess cartilage damage, radiographic severity, and symptomatic severity of OA.

Results

No significant differences were found in serum TG and ApoB levels between the 2 groups, while OA patients had higher TC and LDL-C levels and lower HDL-C and ApoA1 levels ( P < 0.05). Pearson correlation analysis revealed SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage scores, KL grades as well as WOMAC scores ( P < 0.05), which were still significant after adjusting for confounding factors ( P < 0.05). Receiver operating characteristic curve analysis revealed SF HDL-C (area under the curve [AUC]: 0.816) and ApoA1 (AUC: 0.793) were also good predictors of advanced-stage OA ( P < 0.001).

Conclusion

SF HDL-C and ApoA1 levels were negatively correlated with cartilage damage, radiographic severity, and symptomatic severity of primary knee OA, emerging as potential biomarkers for radiographic advanced-stage OA, which may serve as predictors of disease severity.
On pain – Virginia Woolf and the language of poets and patients
Authors: Bantel Carsten , Sörös Peter
Published: April 2021

Influenced by Virginia Woolf pain is traditionally believed to be a private object that defies language. However, our analysis of classical and contemporary works of British and American poets, in addition to our own clinical experiences, leads us to challenge this notion. In accordance with Wittgenstein we instead view pain as a concept and objective experience that should encourage interaction. Reasons why patients and healthcare providers often assume language to be insufficient to grasp the complexity of pain are manifold. Based on neuro-cognitive mechanisms we propose an important contributor might be that patients in pain speak a different language than their pain-free peers and doctors.
Association between glycosylated haemoglobin and outcomes for patients discharged from hospital with diabetes: A health informatics approach
Authors: Robbins Tim , Sankaranarayanan Sailesh , Randeva Harpal , Keung Sarah N Lim Choi , Arvanitis Theodoros N
Published: April 2021

Aims/Objectives

Extensive research considers associations between inpatient glycaemic control and outcomes during hospital admission; this cautions against overly tight glycaemic targets. Little research considers glycaemic control following hospital discharge. This is despite a clear understanding that people with diabetes are at increased risk of negative outcomes, following discharge. We evaluate absolute and relative Hba1c values, and frequency of Hba1c monitoring, on readmission and mortality rates for people discharged from hospital with diabetes.

Methods

All discharges (n = 46,357) with diabetes from a major tertiary referral centre over 3 years were extracted, including biochemistry data. We conducted an evaluation of association between Hba1c, mortality and readmission, statistical significance and standardised Cohen’s D effect size calculations.

Results

399 patients had a Hba1c performed during their admission. 3,138 patients had a Hba1c within 1 year of discharge. Mean average Hba1c for readmissions was 57.82 vs 60.39 for not readmitted (p = 0.009, Cohen’s D 0.28). Mean average number of days to Hba1c testing in readmitted was 97 vs 113 for those not readmitted (p = 0.00006, Cohen’s D 0.39). Further evaluation of mortality outcomes, cohorts of T1DM and T2DM and association of relative change in Hba1c was performed.

Conclusions

Lower Hba1c values following discharge from hospital are significantly associated with increased risk of readmission, as is a shorter duration until testing. Similar patterns observed for mortality. Findings particularly prominent for T1DM. Further research needed to consider underlying causation and design of appropriate risk stratification models.
Minocycline improves the recovery of nerve function and alleviates blood-brain barrier damage by inhibiting endoplasmic reticulum in traumatic brain injury mice model
Authors: Wang Bingbin , Lin Wendong , Zhu Haiping
Published: April 2021

Traumatic brain injury (TBI) is a clinical emergency with a very high incidence, disability, and fatality rate. Minocycline, a widely used semisynthetic second-generation tetracycline antibiotic, has anti-inflammatory and bactericidal effects. However, minocycline has not been explored as a therapeutic drug in TBI and if effective, the related molecular mechanism is also unclear. In this study, we examined the neuroprotective effect and possible mechanism of minocycline, in mice TBI model by studying the trauma-related functional and morphological changes. Also, in vitro cell studies were carried out to verify the animal model data. We found that minocycline significantly improved the neurobehavioral score, inhibited apoptosis, repaired the blood-brain barrier, and reduced the levels of inflammatory factors Interleukin-6 and tumor necrosis factor-α in TBI mice. In vitro, upon oxygen and glucose deprivation, minocycline reduced the levels of cellular inflammatory factors and increased the levels of tight junction and adherens junction proteins, thereby significantly improving the cell viability. Moreover, Mino treatment prevented the loss of tight junction and adherens junction proteins which were markedly reversed by an ER stress activator (tunicamycin) both in vivo and in vitro. Our findings set an effective basis for the clinical use of Mino to treat Traumatic brain injury-induced neurological deficits.
Differences in Adolescents With Down Syndrome and Asperger in a Social Skills Training Program
Authors: Robles-Bello María Auxiliadora , Sánchez-Teruel David , Valalencia-Naranjo Nieves , Barba Colmenero Francisca
Published: April 2021

Background/Objective: Researchers have traditionally reported that individuals with Down syndrome possess a strength in their social development, yet the opposite occurs with Asperger’s syndrome. Based on this premise, we sought to assess effectiveness of the social skills training program. Method: Thirty adolescents aged 11 to 14 years with Down syndrome and Asperger’s syndrome participated in the study. Results: Significant differences between both groups were detected in the posttreatment measures and a connection was found between adolescents’ learning potential and the benefits gained. Conclusions: The training program is effective at improving the social skills under evaluation in adolescents with Down syndrome; however, this benefit is greater among adolescents with Asperger’s syndrome.
The Technical and Allocative Efficiency of the Regional Public Galleries in the Czech Republic
Authors: Vrabková Iveta , Bečica Jiří
Published: April 2021

The regional public galleries in the Czech Republic belong to the most important and the biggest institutions of their kind. The article deals with the assessment of the technical and allocation efficiency of 19 regional public galleries for the period between 2011 and 2015 from the perspective of the static as well as the dynamic efficiency. For the estimation of the efficiency according to the specific inputs and outputs, the Data Envelopment Analysis model and the Malmquist Index were used. In 2015, four galleries were fully technically efficient, and the average efficiency of the set being assessed was 70%. In 2015, in comparison with 2011, 11 public galleries improved their productivity. In 2015, seven galleries reached the full allocation efficiency, and the average efficiency was 90%. In 2015, in comparison with 2011, 12 public galleries improved their efficiency.
Development of Professional Identity and Related Metacognitive Thinking Procedures of English Language Teachers Through Spontaneous Collaboration for Pedagogical Problem-Solving
Authors: Han Insuk
Published: April 2021

This research explores potential benefits of the spontaneous collaboration of a small group of teachers regarding their professional identity (PI) and related metacognitive thinking procedures. The researcher conceptualizes the co-operation of PI and metacognition via interactive pedagogical problem-solving and presents spontaneous collaboration processes of a beginning teacher (BT) and an experienced teacher (ET) of English. Based on the qualitative approach, it was revealed that the BT often referred to the ET’s meanings constituting her PI, but through pedagogic experimentations and dialogic meaning negotiations, BT gradually improved her meanings/PI and related metacognitive thinking procedures as identified BT becoming more self-critical and pursuing professionalism. The ET reshaped her meanings/PI through constant monitoring and regulations, stimulated by the BT, and elaborated these and metacognitive thinking procedures by focusing on what to improve. Implications of the findings are discussed in relation to professional development.
Factors Affecting Adoption of a Technology-Based Tool for Diabetes Self-Management Education and Support Among Adult Patients with Type 2 Diabetes in South Texas
Authors: Baek Juha , Lin Sherry , Bolin Jane N. , Ory Marcia , Flores Starr , Kash Bita A.
Published: April 2021

Purpose

The purpose of this study is to describe a novel computerized diabetes education tool and explore factors influencing self-selection and use among primarily Hispanic patients diagnosed with type 2 diabetes in south Texas.

Methods

Study participants included 953 adult patients with type 2 diabetes enrolled in a diabetes education program between July 1, 2016, and June 30, 2017. Participants were asked to choose either a new technology-based diabetes education tool with a touch-screen device or a traditional face-to-face education method. Multivariate logistic regression analysis was applied to identify factors associated with adopting the computerized diabetes education tool among the patients.

Results

When comparing technology-based tool adopters and nonadopters, several demographic and health-related factors differentiated technology use in bivariate analyses. The multivariate logistic regression model showed that Hispanic patients were less likely to choose a technology-based tool. Patients who perceived their health status as excellent/good were more likely to adopt the technologic education method than those with fair/poor perceived health status. A1C level was negatively associated with self-selection of technology.

Conclusions

Specific demographic and health-related characteristics are significant contributing factors to patients’ adoption of a technology-based diabetes education tool. Health care providers can utilize these findings to target and refer specific patients to a computerized diabetes education tool for more effective diabetes care and to optimize technology adoption success.
Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with chronic lymphocytic leukemia
Authors: Herishanu Yair , Avivi Irit , Aharon Anat , Shefer Gabi , Levi Shai , Bronstein Yotam , Morales Miguel , Ziv Tomer , Shorer Arbel Yamit , Scarfò Lydia , Joffe Erel , Perry Chava , Ghia Paolo
Published: April 2021

Patients with chronic lymphocytic leukemia (CLL) have an increased risk for severe COVID-19 disease and mortality. The goal of this study was to determine the efficacy of COVID-19 vaccine in patients with CLL. We evaluated humoral immune responses to the BNT162b2 messenger RNA (mRNA) COVID-19 vaccine in patients with CLL and compared responses with those obtained in age-matched healthy control subjects. Patients received 2 vaccine doses, 21 days apart, and antibody titers were measured by using the Elecsys Anti-SARS-CoV-2 S assay after administration of the second dose. In a total of 167 patients with CLL, the antibody response rate was 39.5%. A comparison between 52 patients with CLL and 52 sex- and aged-matched healthy control subjects revealed a significantly reduced response rate among patients (52% vs 100%, respectively; adjusted odds ratio, 0.010; 95% confidence interval, 0.001-0.162; P < .001). The response rate was highest in patients who obtained clinical remission after treatment (79.2%), followed by 55.2% in treatment-naive patients and 16.0% in patients under treatment at the time of vaccination. In patients treated with either Bruton’s tyrosine kinase inhibitors or venetoclax ± anti-CD20 antibody, response rates were considerably low (16.0% and 13.6%). None of the patients exposed to anti-CD20 antibodies <12 months before vaccination responded. In a multivariate analysis, the independent predictors of response were younger age, female sex, lack of currently active treatment, immunoglobulin G levels ≥550 mg/dL, and immunoglobulin M levels ≥40 mg/dL. In conclusion, antibody-mediated response to the BNT162b2 mRNA COVID-19 vaccine in patients with CLL is markedly impaired and affected by disease activity and treatment. This trial was registered at www.clinicaltrials.gov as #NCT04746092.
Total hip arthroplasty for dysplastic coxarthrosis using a cementless Wagner Cone stem
Authors: Solarino Giuseppe , Vicenti Giovanni , Piazzolla Andrea , Maruccia Francesco , Notarnicola Angela , Moretti Biagio
Published: April 2021

Background

Total hip arthroplasty (THA) is currently the best surgical option for hip osteoarthritis secondary to developmental hip dysplasia (DDH); it may be extremely challenging, because of the hypoplasic proximal metaphysis, pathological anteversion, and excessive cervico-diaphyseal angle of the neck at the femoral side. The purpose of this retrospective study was to evaluate the long-term survival and clinical and radiological results of Conus uncemented stems, implanted in patients affected by hip osteoarthritis with Crowe not-type IV secondary to DDH.

Material and methods

We identified 100 consecutive THAs performed for DDH in 63 women and 24 men, with an average age of 53 years in a single center. Thirteen patients underwent bilateral hip replacement. The patients’ mean body mass index was 29.8 kg/m2(range 27.1–35.6 kg/m2). The main indications for surgery were severe hip pain and considerable functional impairment: the preoperative Harris Hip Score was 29.5 on average (range 22–61). Radiologically, 8 hips were classified as Crowe I, 43 hips as Crowe II, and 49 hips as Crowe III. In all cases, we implanted the Wagner femoral cone prosthesis using the direct lateral approach; in the attempt to reestablish native hip biomechanics, 66 stems were 135° and 34 were 125°.

Results

The mean follow-up of the study was 11.7 years (range 2.2–21.8 years). Harris Hip Score increased to a mean value of 71.5 points (range 52–93 points). Radiographic evaluation demonstrated osteointegration of the implant with stable bone growth observed at the stem–endosteum interface; signs of bone readaptation and thinning of the femoral calcar were present in nine hips. None of the patients underwent revision for septic or aseptic loosening of the stem; none sustained a periprosthetic fracture.

Conclusions

This study confirms the theoretical advantages that suggest the choice of the Wagner cone when technical difficulties during prosthetic surgery are expected owing to abnormal proximal femoral anatomy.

Level of evidence

Level IV, retrospective case study
Chondroitin Sulfate/Polycaprolactone/Gelatin Electrospun Nanofibers with Antithrombogenicity and Enhanced Endothelial Cell Affinity as a Potential Scaffold for Blood Vessel Tissue Engineering
Authors: Kong Xiangqian , He Yuxiang , Zhou Hua , Gao Peixian , Xu Lei , Han Zonglin , Yang Le , Wang Mo
Published: April 2021

Electrospun polymer nanofibers have gained much attention in blood vessel tissue engineering. However, conventional nanofiber materials with the deficiencies of slow endothelialization and thrombosis are not effective in promoting blood vessel tissue repair and regeneration. Herein, biomimetic gelatin (Gt)/polycaprolactone (PCL) composite nanofibers incorporating a different amount of chondroitin sulfate (CS) were developed via electrospinning technology to investigate their effects on antithrombogenicity and endothelial cell affinity. Varying CS concentrations in PG nanofibers affects fiber morphology and diameter. The CS/Gt/PCL nanofibers have suitable porosity (~ 80%) and PBS solution absorption (up to 650%). The introduction of CS in Gt/PCL nanofibers greatly enhances their anticoagulant properties, prolongs their coagulation time, and facilitates cell responses. Particularly, 10%CS/Gt/PCL nanofibers display favorable cell attachment, elongation, and proliferation. Thus, the Gt/PCL nanofibers containing a certain amount of CS could be excellent candidates as a promising tissue-engineering scaffold in blood vessel repair and regeneration.