bluuebunny/crossref_metadata_2025 huggingface dataset:
Building a Strategic Trade and Industrial Policy for Puerto Rico in the Context of Colonial Exclusion and Lack of a Development Strategy
Authors: Aponte-García Maribel , Orengo-Serra Karen
Published: April 2020

Given Puerto Rico’s colonial exclusion from Latin American and Caribbean regionalism and its ruling parties’ disregard for stimulating an industrial base of small and medium-sized local enterprises rather than U.S. multinational corporations, Puerto Rico needs to construct new pathways to inclusive socioeconomic development. One approach is articulating strategic and industrial policies to stimulate these enterprises from below by promoting value chains focused on exports or export potential. A proposed systematization draws on the experience gained in a project carried out under an agreement between the University of Puerto Rico and Puerto Rico’s Trade and Export Company to generate strategic export plans and map value chains for small and medium-sized enterprises.

Dada la exclusión colonial de Puerto Rico del regionalismo latinoamericano y caribeño y el desprecio de sus partidos gobernantes por estimular una base industrial de pequeñas y medianas empresas locales en lugar de corporaciones multinacionales estadounidenses, Puerto Rico necesita construir nuevas vías hacia el desarrollo socioeconómico inclusivo. Un enfoque es articular políticas estratégicas e industriales para estimular a estas empresas desde abajo mediante la promoción de cadenas de valor centradas en las exportaciones o el potencial de exportación. La sistematización propuesta se basa en la experiencia adquirida en un proyecto llevado a cabo en virtud de un acuerdo entre la Universidad de Puerto Rico y la Compañía de Comercio y Exportación de Puerto Rico para generar planes estratégicos de exportación y mapear cadenas de valor para pequeñas y medianas empresas.
Subjective social class, perceived quality of social relationships, and happiness: A case of mediation and moderation across gender
Authors: Kim Jae-Woo , Lim Chaeyoon , Falci Christina
Published: April 2020

This study investigates the link between social relationship and subjective well-being in the context of social stratification. The authors examine how perceived quality of social relationships and subjective social class are linked to self-reported happiness among men and women in South Korea. The study finds that one’s perception of relative social standing is positively associated with happiness independently of objective indicators of socioeconomic status, while social relationship quality strongly predicts the happiness among both men and women. However, the mediation pathway and moderating effects vary by gender. For men, the nexus between subjective social class and happiness is partially mediated by the quality of interpersonal relationships. No similar mediating effect is found among women. The study also finds gender difference in whether the link between social relationship quality and happiness varies by subjective social class. The happiness return to positive social relationships increases as men’s subjective social status becomes higher, which is consistent with the resource multiplication hypothesis. No similar moderation effect is found among women. Combined, these results reveal potentially different pathways to happiness across gender in Korea, where social status competition, collectivistic culture, and patriarchal gender relations are salient in daily life.
The miR-25-3p/Sp1 pathway is dysregulated in ovarian endometriosis
Authors: Shen Licong , Hong Xiaxia , Liu Yang , Zhou Wenjun , Zhang Yi
Published: April 2020

Objective

The transcription factor Specificity protein 1 (Sp1) plays important roles in many critical biological functions; however, its expression and underlying functions in endometriosis remain undefined. Bioinformatics has suggested that Sp1 is potentially regulated by miR-25-3p. This study investigated Sp1 and miR-25-3p expression and their interaction during the pathogenesis of endometriosis.

Methods

Fifteen women with American Fertility Society stage III/IV ovarian endometriosis and 14 disease-free controls were included. Sp1 expression was detected by qPCR, immunohistochemistry, and western blotting. Using both bioinformatics and genetics, we identified that Sp1 was a potential target of miR-25-3p. Then, the relationship between miR-25-3p and Sp1 was investigated by knockdown and overexpression experiments.

Results

Sp1 mRNA and protein levels were increased in ectopic and eutopic endometrium compared with normal endometrium samples, with the highest expression in ectopic endometrium samples. In vitro experiments and luciferase reporter assays demonstrated that Sp1 was upregulated when miR-25-3p was depleted and that Sp1 was a direct target of miR-25-3p, respectively.

Conclusions

Our study revealed increased Sp1 expression in ovarian endometriosis and subsequently demonstrated that miR-25-3p directly targets Sp1. This suggests a novel miRNA/Sp1 pathway in the pathogenesis of endometriosis, which should be further explored for other potential therapeutic targets.
Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Belk John W. , Kraeutler Matthew J. , Houck Darby A. , Goodrich Jesse A. , Dragoo Jason L. , McCarty Eric C.
Published: April 2020

Background:

Platelet-rich plasma (PRP) and hyaluronic acid (HA) are 2 nonoperative treatment options for knee osteoarthritis (OA) that are supposed to provide symptomatic relief and help delay surgical intervention.

Purpose:

To systematically review the literature to compare the efficacy and safety of PRP and HA injections for the treatment of knee OA.

Study Design:

Meta-analysis of level 1 studies.

Methods:

A systematic review was performed by searching PubMed, the Cochrane Library, and Embase to identify level 1 studies that compared the clinical efficacy of PRP and HA injections for knee OA. The search phrase used was platelet-rich plasma hyaluronic acid knee osteoarthritis randomized. Patients were assessed via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and Subjective International Knee Documentation Committee (IKDC) scale. A subanalysis was also performed to isolate results from patients who received leukocyte-poor and leukocyte-rich PRP.

Results:

A total of 18 studies (all level 1) met inclusion criteria, including 811 patients undergoing intra-articular injection with PRP (mean age, 57.6 years) and 797 patients with HA (mean age, 59.3 years). The mean follow-up was 11.1 months for both groups. Mean improvement was significantly higher in the PRP group (44.7%) than the HA group (12.6%) for WOMAC total scores ( P < .01). Of 11 studies based on the VAS, 6 reported PRP patients to have significantly less pain at latest follow-up when compared with HA patients ( P < .05). Of 6 studies based on the Subjective IKDC outcome score, 3 reported PRP patients to have significantly better scores at latest follow-up when compared with HA patients ( P < .05). Finally, leukocyte-poor PRP was associated with significantly better Subjective IKDC scores versus leukocyte-rich PRP ( P < .05).

Conclusion:

Patients undergoing treatment for knee OA with PRP can be expected to experience improved clinical outcomes when compared with HA. Additionally, leukocyte-poor PRP may be a superior line of treatment for knee OA over leukocyte-rich PRP, although further studies are needed that directly compare leukocyte content in PRP injections for treatment of knee OA.
Occupational Heterogeneity in Healthcare Workers’ Misgivings about Organizational Change
Authors: VanHeuvelen Jane S. , Grace Matthew K.
Published: April 2020

Past research on organizational change has explored how workers embrace change in some scenarios, resist it in others, and in some cases, subtly circumvent change efforts by feigning conformity. What remains unclear is the role of occupations in explaining workers’ responses to change. Using survey data ( N = 226) and in-depth interviews with workers ( N = 33) in a neonatal intensive care unit as it transitioned from a multiple-occupancy ward design to single-patient rooms, this study examines occupational discrepancies in reactions to the change. Findings reveal that misgivings about the move vary considerably across groups and illustrate the enduring significance of occupational identity.
Studying Children using Ethnography: Heightened Challenges and Balancing Acts
Authors: Harvey Peter Francis , Lareau Annette
Published: April 2020

Scholars have debated how to carry out research with children, particularly about how to generate the most accurate data in an ethically-sensitive fashion. But there has been limited discussion of the practicalities of such research. Relying on our own ethnographic studies with children and families, conducted two decades apart, we argue that studying children heightens routine research challenges and requires the constant balancing of pressures. Our studies highlight difficulties in two broad arenas: the simultaneous management of procedural obligations to children and their gatekeepers (‘the double act’), and the need to juggle satisfying adult norms of interaction while generating and maintaining rapport with children (‘walking the tightrope’). These heightened challenges cannot be solved through use of the “right” method. Rather, they should be acknowledged and met with flexibility, reflexivity, and perseverance. More broadly, open discussion of the difficulties faced while conducting research should not be seen as revealing failings, but as a vital way for scholars to advance the field.
eHealth interventions to support patients in delivering and managing peritoneal dialysis at home: A systematic review
Authors: Cartwright Emma J , ZS Goh Zack , Foo Marjorie , Chan Choong M , Htay Htay , Griva Konstadina
Published: April 2020

Peritoneal dialysis (PD) requires patients to develop a variety of self-management skills in order to effectively deliver and manage their dialysis at home. eHealth interventions may provide patients with accessible information to develop the skills and knowledge they require to manage their treatment. This review aims to identify and evaluate ‘active’ eHealth interventions in supporting patients on PD. Six databases were included within the review using the terms Peritoneal Dialysis, eHealth, telemedicine and remote consultation. Studies which explored patients who were delivering PD, an intervention where the main component involved a digital device and required active engagement from patients were included. The primary outcomes examined were identified using the core outcomes recommended by the Standardised Outcomes in Nephrology in Peritoneal Dialysis initiative (PD infection, cardiovascular disease, mortality, PD failure and life participation). Hospitalisation rates were also considered as a primary outcome. Secondary outcomes included quality of life, patient skills, patient knowledge and satisfaction. Using the inclusion criteria, 15 studies (1334 participants) were included in the study. The effectiveness of eHealth interventions was mixed. Due to high heterogeneity, a meta-analysis was not possible, and quality of evidence was low. Risk of bias across the randomised studies was unclear but bias across non-randomised studies was identified as critical. There were no reported adverse effects of eHealth interventions within the included studies. Despite the high interest of eHealth interventions in PD, good quality evidence is needed to explore their effectiveness before a wider application of eHealth interventions.
Influence of tubercles’ spanwise distribution on swept wings for unmanned aerial vehicles
Authors: Papadopoulos Charalampos , Katsiadramis Vasilis , Yakinthos Kyros
Published: April 2020

In this work, a 3D numerical study on the influence of the spanwise distribution of tubercles on a unmanned aerial vehicle wing is presented. The idea of using tubercles in aeronautics comes from the humpback whale (Megaptera novaeangliae) which has a characteristic flipper, with a spanwise scalloped leading edge, creating an almost sinusoidal shape, consisting of bumps called tubercles. The whale uses this layout in order to achieve high underwater maneuverability. Early experimental research showed a great potential in enhancing the 3D aerodynamic characteristics of a wing. Most of the existing experimental results concern infinite wings (2D) models and are accompanied with substantial loss in lift and increase in drag in pre-stall region. On the other hand, 3D finite models have displayed a better overall aerodynamic performance (increased lift and moment, but also, decreased drag). At a range of Reynolds number between 500,000 and 1,000,000 (based on the mean chord of the flipper), tubercles act as virtual fences, introducing a pair of counter rotating vortices that delays the stall of the flipper, a phenomenon that the whales exploit to perform sharp turns and catch their prey. The aforementioned Reynolds number range is the same as the operational Reynolds number for typical unmanned aerial vehicles. To assess the influence of the tubercles installation on UAV wings, a full 3D computational study is carried-out with the use of CFD tools which at a first phase are validated and calibrated with the available literature experimental data. Then, computations are performed for different spanwise tubercles distributions. The results show that there is a noticeable potential on controlling the flow on the wings of a UAV operating in a Reynolds number range between 500,000 and 1,000,000 (based on UAV’s wing mean chord), which can lead to an aerodynamic performance and efficiency increase.
Technological advances: Have they improved standards? Review of outcomes from the Welsh cervical screening programme
Authors: Castanon Alejandra
Published: April 2020

Objectives

Introduction of new technologies into cervical screening programmes has allowed more efficient programmes with less resources. We present an overview of screening technologies introduced into the Cervical Screening Wales programme and their evolution over time.

Methods

Data from the programme’s statistical report were used to evaluate its performance over a 17-year period between 2001/02 and 2017/18.

Results

The introduction of liquid-based cytology has had a substantial impact on reducing inadequate sample rates and on increasing the positive predictive value of cytology. Inadequate rates have increased following the implementation of human papilloma virus testing as a triage test for cytology. Further knock-on effects on standard reporting ranges are expected following the introduction of human papilloma virus testing as the primary screening test. New performance standards have been introduced to better reflect the performance of the programme at a time when disease prevalence is expected to fall as women vaccinated against human papilloma virus reach screening age.

Conclusions

Improvements to this cervical cancer screening programme as illustrated through performance indicator ranges suggest a major role played by technology.
The Emergence of a Transgender Community in Manipur: The Case of the Nupi Maanbis
Authors: Yumkhaibam Rubani
Published: April 2020

Transgender subjects in Manipuri society have experienced cultural legitimacy as well as prejudice and therefore have had an ambiguous status from early to modern times. From their early prototypes, pheitas, to their modern counterparts, nupi sabis, transgender subjects have played vital roles in the administrative, cultural and artistic life of Manipuri society. Legitimacy as well as stigma marked their participation in social and economic life. This article traces the emergence of the nupi maanbi community, a community of man-to-woman transgender subjects and argues that the current nupi maanbi identity, embedded in this distinct community, is firmly located in the economic niche that the subjects inhabit as professionals in the increasingly popular fashion and beauty parlours in contemporary Manipur.
Book review: Sheri Berman, Democracy and Dictatorship in Europe: From the Ancien Régime to the Present Day
Authors: D’Cunha Neville
Published: April 2020

Sheri Berman, Democracy and Dictatorship in Europe: From the Ancien Régime to the Present Day. Oxford University Press, 2019, pp. 560, US$34.95. ISBN: 9780199373192 (Hardback).
Examining Board Gameplay and Learning: A Multidisciplinary Review of Recent Research
Authors: Bayeck Rebecca Yvonne
Published: April 2020

Background

Recent years have seen the resurgence of board games designed for entertainment, and to teach or explicate real life problems. The revival of board gameplay has been discussed in mainstream media, and has drawn the attention of researchers. Yet, in the field of games studies, the conception of games as learning spaces is mostly emphasized through digital/video games.

Aim

This literature review reveals the current knowledge regarding the learning potential of board games in various settings, subjects, and diverse learners.

Results

Board games are spaces for mathematical learning and learning spaces that can enable the learning of various contents. Board games allow for various interactions that result in players engaging in computational thinking, teamwork, and creativity.

Conclusion

The relationship between board gameplay and learning is evidenced across disciplines and countries. Board games simplify complex issues and systems, which make them appropriate to further explore learning and concepts such as motivation and computational thinking in formal and informal settings. Furthermore, there is need to expand research on learning in commercial board games.
Sound environment quality in nursing units in Chinese nursing homes: A pilot study
Authors: Xie Hui , Zhong Bingzhi , Liu Chang
Published: April 2020

Recent studies have investigated sound environment in nursing homes. However, there has been little research on the sound environment of nursing units. This research sought to address this gap. Subjective evaluations were gathered using questionnaire surveys of 75 elderly residents and 30 nursing staff members in five nursing units of five nursing homes in Chongqing, China. Background noise level and reverberation time were measured in five empty bedrooms, five occupied bedrooms and five occupied nursing station areas, in five nursing units. The subjective evaluation results indicate that the residents stay in the nursing units for most of their waking hours. The residents and nursing staff had strong preferences for natural sounds, with the lowest perceptions of these in the nursing units. The background noise level in all the occupied bedrooms exceeded Chinese standards for waking and sleeping hours. Only 20% of the occupied nursing station areas were below the allowable noise level for recreation and fitness room during sleeping hours. The nursing station area was identified as the main source of noise in the unit during waking hours. The average background noise level of the occupied bedrooms was 3–12 dBA higher than that of the empty bedrooms during sleeping hours. Attention should be given to the implementation of noise specifications for sleeping hours. The reverberation time of the bedrooms was within the range of 0.44–0.68 s, and in the nursing station areas it was 0.63–1.54 s.
‘Surveying was a kind of writing on the land’: The economics of land division as town planning
Authors: Lai Lawrence WC , Davies Stephen NG
Published: April 2020

This article is about the economic role of the primaeval layouts (plats) for a new development area as a conscious act of physical planning. It explains that these foundational layouts of a town or country in the ‘new world’ were traditionally the work of a surveyor, the impacts of which have been lasting. Typically following a grid iron pattern, with roots in ancient history, the layout of the surveyor may not look attractive. Yet, it has stood the test of time and continued to condition modern development. It serves two significant economic functions. First, it reduces several types of transaction costs, namely, those of competition for land, valuation allocation, identification and subdivision of land as well as revising a layout. Second, it serves to achieve agglomeration, establish a proprietary and common setting and provide vital information as different forms of public good.
Simulating impairment through virtual reality
Authors: McIntosh Jacqueline , Marques Bruno , Harkness Robyn
Published: April 2020

Research on architectural technology for health care has rapidly increased in recent years; however, little research has been conducted on the use of virtual reality for simulating impairment. This exploratory research maps the experiences of people with impairments in the often-overlooked corridors and waiting rooms of an emergency department. It questions whether the experience of an impairment can be usefully simulated for empathetic design. While using participatory processes to develop a virtual reality simulation of waiting areas, this research applies three representative impairments and then surveys 30 architectural designers to find the emotional responses of the unimpaired to the design intervention. While this research is preliminary, it is particularly valuable for the comprehension of proposed designs during the early planning and design phases, without costly and time-consuming use of full participatory processes. It finds there is significant potential for the use of virtual reality as a technology to simulate the experiences of these spaces by individuals with impairment, enabling empathetic design, and offers direction for future research.
Experimental study on the structure and properties of modified nonwoven filter fibers by impregnation with carbon black
Authors: Zhang Xin , Fan Yue-sheng , Wang Huan , Zhang Jiaxin , Wei Shuxuan , Tian Guo-ji , Xie Wei
Published: April 2020

With the increasingly serious air pollution, it is urgent to build a good indoor environment. How to improve performance of filter fiber materials has become the mainstream approach. In this article, the structure and filtration performances of nonwoven filter fibers before and after impregnation with carbon black were tested and analyzed. The results showed that a carbon black coating layer was wrapped on the surfaces of the changed nonwoven fabric filter fibers. The porosity of fibers decreased from 97.81% to 95.35%. The filtration efficiency of PM1.0, PM2.5, and PM10 increased by 16.8%, 28.0%, and 11.7%, respectively, at the best filtration velocity of 0.8 m/s. The filtration efficiency of PM2.5 had the most significant improvement. But the resistance increased by 1.18 times at the same time. The matching between filtration efficiency and resistance should be considered in using. This study provides reference value for the synthesis and application of new filter materials.
Curriculum analysis of educational leadership master’s programs in the university system of Maryland
Authors: Fanoos Azra , He Yuan
Published: April 2020

In the USA, university-based educational leadership programs, usually referred to as principal preparation programs, have traditionally been the sole source of preparing aspiring school leaders for the job. In response to criticisms from time to time, the programs have been reformed and redesigned. This research was an attempt to investigate the current status of educational leadership programs regarding their missions, goals, and objectives, the curriculum design, and the incorporation of standards. Findings indicated that the programs’ missions, goals, and objectives focused on the knowledge, skills, and dispositions as articulated in the Interstate School Leadership Licensure Consortium and Educational Leadership Constituent Council Standards in the form of expectations for school leaders. The courses aligned with the standards were designed to equip candidates with the basic knowledge and processes of administration and instructional leadership along with awareness of the current issues, application of research tools to make informed decisions, use of modern technology, and developmental and cultural understanding. Moreover, the internship component of the programs was meant to provide authentic opportunities for candidates to apply theory into practice and to devise and practice their own leadership style
Targeting spinal TRAF6 expression attenuates chronic visceral pain in adult rats with neonatal colonic inflammation
Authors: Weng Rui-Xia , Chen Wei , Tang Jia-Ni , Sun Qian , Li Meng , Xu Xue , Zhang Ping-An , Zhang Ying , Hu Chuang-Ying , Xu Guang-Yin
Published: April 2020

Background

Irritable bowel syndrome is one of the most common gastrointestinal disorders. It is featured by abdominal pain in conjunction with altered bowel habits. However, the pathophysiology of the syndrome remains largely unknown. Tumor necrosis factor receptor-associated factor 6 (TRAF6) has been reported to be involved in neuropathic pain. The aim of this study was to investigate roles and mechanisms of TRAF6 in the chronic visceral hypersensitivity.

Methods

Visceral hypersensitivity was induced by neonatal colonic inflammation and was identified by colorectal distention. The protein level, RNA level, and cellular distribution of TRAF6 and its related molecules were detected with Western blot, quantitative polymerase chain reaction, and immunofluorescence. In vitro spinal cord slice recording technique was performed to determine the synaptic transmission activities.

Results

Neonatal colonic inflammation rats displayed visceral hypersensitivity at the age of six weeks. The expression of TRAF6 was obviously upregulated in spinal cord dorsal horn of neonatal colonic inflammation rats at the age of six weeks. Immunofluorescence study showed that TRAF6 was dominantly expressed in spinal astrocytes. Intrathecal injection of TRAF6 small interfering RNA (siRNA) significantly reduced the amplitude of spontaneous excitatory postsynaptic currents at the spinal dorsal horn level. Furthermore, knockdown of TRAF6 led to a significant downregulation of cystathionine β synthetase expression in the spinal dorsal horn of neonatal colonic inflammation rats. Importantly, intrathecal injection of TRAF6 siRNA remarkably alleviated visceral hypersensitivity of neonatal colonic inflammation rats.

Conclusions

Our results suggested that the upregulation of TRAF6 contributed to visceral pain hypersensitivity, which is likely mediated by regulating cystathionine β synthetase expression in the spinal dorsal horn. Our findings suggest that TRAF6 might act as a potential target for the treatment of chronic visceral pain in irritable bowel syndrome patients.
Comparison of the effects of intravenous propofol and propofol with low-dose ketamine on preventing postextubation cough and laryngospasm among patients awakening from general anaesthesia: A prospective randomised clinical trial
Authors: Chungsamarnyart Yanipan , Pairart Jiranun , Munjupong Sithapan
Published: April 2020

Background

Coughing and laryngospasm are undesirable consequences occurring when patients awaken from general anaesthesia. The objective of the study aimed to compare the effects of intravenous propofol and propofol with low-dose ketamine on preventing postextubation cough and laryngospasm.

Methods

In all, 120 patients scheduled surgery under general anaesthesia were randomly assigned into three groups. Patients in the control group (C-group) received intravenous 0.9% NaCl, while patients in the propofol group (P-group) received intravenous 0.25mg/kg propofol and patients in the propofol combined with ketamine group (PK-group) received intravenous 0.25mg/kg of propofol plus 0.15mg/kg of ketamine. Drugs were administered before extubation. Incidence and severity of coughing and laryngospasm were recorded by a blinded anaesthesiologist.

Results

Subjects of the PK-group (25%) experienced significantly reduced incidence of postoperative cough than that in the P-group (55%) and C-group (72.5%) (all P < 0.05). The severity of cough in the PK-group was significantly less than that in the P-group and C-group (P = 0.039 and P < 0.001, respectively). No significant difference was found in the incidence and severity of laryngospasm between comparison groups.

Conclusion

Intravenous combination of propofol and low-dose ketamine significantly reduced the incidence and severity among patients awakening from general anaesthesia.
How to translate artificial intelligence? Myths and justifications in public discourse
Authors: Roberge Jonathan , Senneville Marius , Morin Kevin
Published: April 2020

Automated technologies populating today’s online world rely on social expectations about how “smart” they appear to be. Algorithmic processing, as well as bias and missteps in the course of their development, all come to shape a cultural realm that in turn determines what they come to be about. It is our contention that a robust analytical frame could be derived from culturally driven Science and Technology Studies while focusing on Callon’s concept of translation. Excitement and apprehensions must find a specific language to move past a state of latency. Translations are thus contextual and highly performative, transforming justifications into legitimate claims, translators into discursive entrepreneurs, and power relations into new forms of governance and governmentality. In this piece, we discuss three cases in which artificial intelligence was deciphered to the public: (i) the Montreal Declaration for a Responsible Development of Artificial Intelligence, held as a prime example of how stakeholders manage to establish the terms of the debate on ethical artificial intelligence while avoiding substantive commitment; (ii) Mark Zuckerberg’s 2018 congressional hearing, where he construed machine learning as the solution to the many problems the platform might encounter; and (iii) the normative renegotiations surrounding the gradual introduction of “killer robots” in military engagements. Of interest are not only the rational arguments put forward, but also the rhetorical maneuvers deployed. Through the examination of the ramifications of these translations, we intend to show how they are constructed in face of and in relation to forms of criticisms, thus revealing the highly cybernetic deployment of artificial intelligence technologies.
Medial Opening Wedge High Tibial Osteotomy Decreases Medial Meniscal Extrusion and Improves Clinical Outcomes and Return to Activity
Authors: Astur Diego Costa , Novaretti Joao Victor , Gomes Marcelo Lins , Rodrigues Adilson Góes , Kaleka Camila Cohen , Cavalcante Elton Luiz Batista , Debieux Pedro , Amaro Joicemar Tarouco , Cohen Moises
Published: April 2020

Background:

Medial meniscal extrusion (MME) is defined as displacement of the meniscus that extends beyond the tibial margin. Knee varus malalignment increases MME.

Purpose/Hypothesis:

The purpose of this study was to quantify MME before and after medial opening wedge high tibial osteotomy (HTO) and to correlate the reduction of MME with clinical outcomes and return to activity. It was hypothesized that MME would decrease after HTO and that patients with lower MME after surgery would have improved clinical outcomes and return to activity at short-term follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 66 patients who underwent HTO to correct the anatomic axis with a minimum follow-up of 2 years. MME was measured using magnetic resonance imaging preoperatively and 6 weeks after surgery (study protocol). Patients were assessed preoperatively and postoperatively with the Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) score for pain, and Tegner score.

Results:

The mean ± SD preoperative and postoperative MME values were 3.9 ± 0.6 mm and 0.9 ± 0.5 mm, respectively. At 2 years after surgery, KOOS, pain VAS, and Tegner scores were higher than those found preoperatively ( P < .001). Patients with less than 1.5 mm of MME after surgery had better clinical outcomes and return to activity compared with patients who had MME of 1.5 mm or more ( P < .05).

Conclusion:

Medial opening wedge HTO decreased MME after 6 weeks and improved clinical outcomes and return to activity at a minimum 2-year follow-up. Additionally, patients with postoperative MME of less than 1.5 mm had better clinical outcomes and return to activity compared with patients who had postoperative MME of 1.5 mm or more.
The mitochondrial outer membrane protein SYNJ2BP interacts with the cell adhesion molecule TMIGD1 and can recruit it to mitochondria
Authors: Hartmann Christian , Schwietzer Ysabel Alessa , Kummer Daniel , Kirschnick Nils , Hoppe Esther , Thüring Eva-Maria , Glaesner-Ebnet Mark , Brinkmann Frauke , Gerke Volker , Reuter Stefan , Nakayama Masanori , Ebnet Klaus
Published: April 2020

Background

Transmembrane and immunoglobulin domain-containing protein 1 (TMIGD1) is a recently identified cell adhesion molecule which is predominantly expressed by epithelial cells of the intestine and the kidney. Its expression is downregulated in both colon and renal cancer suggesting a tumor suppressive activity. The function of TMIGD1 at the cellular level is largely unclear. Published work suggests a protective role of TMIGD1 during oxidative stress in kidney epithelial cells, but the underlying molecular mechanisms are unknown.

Results

In this study, we address the subcellular localization of TMIGD1 in renal epithelial cells and identify a cytoplasmic scaffold protein as interaction partner of TMIGD1. We find that TMIGD1 localizes to different compartments in renal epithelial cells and that this localization is regulated by cell confluency. Whereas it localizes to mitochondria in subconfluent cells it is localized at cell-cell contacts in confluent cells. We find that cell-cell contact localization is regulated by N-glycosylation and that both the extracellular and the cytoplasmic domain contribute to this localization. We identify Synaptojanin 2-binding protein (SYNJ2BP), a PDZ domain-containing cytoplasmic protein, which localizes to both mitochondria and the plasma membrane, as interaction partner of TMIGD1. The interaction of TMIGD1 and SYNJ2BP is mediated by the PDZ domain of SYNJ2BP and the C-terminal PDZ domain-binding motif of TMIGD1. We also find that SYNJ2BP can actively recruit TMIGD1 to mitochondria providing a potential mechanism for the localization of TMIGD1 at mitochondria.

Conclusions

This study describes TMIGD1 as an adhesion receptor that can localize to both mitochondria and cell-cell junctions in renal epithelial cells. It identifies SYNJ2BP as an interaction partner of TMIGD1 providing a potential mechanism underlying the localization of TMIGD1 at mitochondria. The study thus lays the basis for a better understanding of the molecular function of TMIGD1 during oxidative stress regulation.
Higher blood pressure in elderly hypertensive females, with increased arterial stiffness and blood pressure in females with the Fibrillin-1 2/3 genotype
Authors: Åström Malm Ida , Alehagen Urban , Blomstrand Peter , Dahlström Ulf , De Basso Rachel
Published: April 2020

Background

Elderly patients have a relatively high cardiovascular risk due to increased arterial stiffness, elevated blood pressure and decreased amounts of elastin in the arteries. The composition of the media layer in the arterial wall, comprising elastin, collagen, smooth muscle cells, proteoglycans, fibronectin and fibrillin-1, influences its mechanical properties. Mutations in the fibrillin-1 gene leads to increased aortic stiffness, elevated pulse pressure and aortic root dilatation. This study investigates whether there is a sex difference among hypertensive elderly patients regarding blood pressure, arterial stiffness and fibrillin-1 genotypes.

Methods

A total of 315 hypertensive subjects (systolic blood pressure > 140 mmHg) were included in this study (155 men and 160 women aged 71–88 years). Aortic pulse wave velocity and augmentation index were determined using SphygmoCor, and brachial blood pressure was measured using an oscillometric technique. Fibrillin-1 was genotyped by polymerase chain reaction and with a capillary electrophoresis system.

Results

Females showed a significantly higher peripheral mean arterial pressure (females; 107.20 mmHg, males 101.6 mmHg,p = 0.008), central mean arterial pressure (females; 107.2 mmHg, males 101.6 mmHgp = 0.008), central systolic blood pressure (females; 148.1 mmHg, males 139.2 mmHg,p <  0.001) and central pulse pressure (females; 68.9 mmHg, males 61.6 mmHg,p = 0.035) than males. Females with the Fibrillin-1 2/3 genotype showed a significantly higher augmentation index (FBN1 2/3; 39.9%, FBN1 2/2 35.0%, FBN1 2/4 35.8,p = 0.029) and systolic blood pressure (FBN1 2/3; 174.6 mmHg, FBN1 2/2168.9 mmHg, FBN1 2/4169.9 mmHg,p = 0.025) than females with the 2/2 and 2/4 genotypes.

Conclusion

The findings of this study may indicate that hypertensive elderly females, especially elderly females with Fibrillin-1 2/3, have increased systolic blood pressure and arterial stiffness.
Correction to: Serum magnesium, mortality and disease progression in chronic kidney disease
Authors: Azem Rami , Daou Remy , Bassil Elias , Anvari Eva Maria , Taliercio Jonathan J. , Arrigain Susana , Schold Jesse D. , Vachharajani Tushar , Nally Joseph , Nakhoul Georges N.
Published: April 2020

Following publication of the original article [1], we have been notified that the name of one author was spelled incorrectly as Georges N. Na khoul, when the correct spelling is Georges N. Nakhoul.
Healthcare access and adverse family impact among U.S. children ages 0–5 years by prematurity status
Authors: Lindly Olivia J. , Crossman Morgan K. , Shui Amy M. , Kuo Dennis Z. , Earl Kristen M. , Kleven Amber R. , Perrin James M. , Kuhlthau Karen A.
Published: April 2020

Background

Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely.

Methods

This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children’s Health data. The sample included 19,482 U.S. children ages 0–5 years including 242 very low birthweight (VLBW) and 2205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., < 1500 g at birth) and LBW/PTB (i.e., 1500–2499 g at birth and/or born at < 37 weeks with or without LBW). Healthcare access measures were adequate health insurance, access to medical home, and developmental screening receipt. Adverse family impact measures were ≥ $1000 in annual out-of-pocket medical costs, having a parent cut-back or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB).

Results

Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cut-back or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cut-back or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1000 in annual out-of-pocket costs, having a parent cut-back or stop work, and parental aggravation among children born prematurely.

Conclusions

This study’s findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0–5 years born prematurely. Population health initiatives should target children born prematurely and their families.
Factors influencing the perceived importance of oral health within a rural Aboriginal and Torres Strait Islander community in Australia
Authors: Tynan Anna , Walker David , Tucker Taygan , Fisher Barry , Fisher Tarita
Published: April 2020

Background

Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception.

Methods

The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities’ Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed.

Results

Twenty-seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities.

Conclusion

This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.
Primary malignant melanoma of the lung: a case report and literature review
Authors: Deng Shuangshuang , Sun Xiaobo , Zhu Zhen , Lu Jingjing , Wen Guanghua , Chang Xuejiao , Gao Hui , Hua Yanfei , Wang Lumei , Gao Jinli
Published: April 2020

Background

Malignant melanoma (MM) generally presents as a primary neoplasm of the skin, and most MM cases of the respiratory system are metastatic. Primary MM of the lung (PMML) is quite rare, and its diagnosis is relatively difficult.

Case presentation

We report the case of a 57-year-old male patient with PMML who denied any history of tumours. His initial complaint was frequent coughs with bloody sputum for 4 days. Chest radiography demonstrated a high-density shadow in the lower lobe of the right lung, which was suspected to be a large space-occupying lesion on subsequent computed tomography (CT) and to be a hypermetabolic tumour by positron emission tomography–CT. To confirm the diagnosis, exploratory surgery was performed. Finally, we confirmed the diagnosis of PMML.

Conclusions

PMML is extremely rare and easily misdiagnosed as lung cancer. Because of its morphological and immunophenotypic variations, the diagnosis of PMML remains difficult. This case report discusses the diagnosis and case management of a patient while referring to the existing literature.
Understanding the utilisation of a novel interactive electronic medication safety dashboard in general practice: a mixed methods study
Authors: Jeffries Mark , Gude Wouter T. , Keers Richard N. , Phipps Denham L. , Williams Richard , Kontopantelis Evangelos , Brown Benjamin , Avery Anthony J. , Peek Niels , Ashcroft Darren M.
Published: April 2020

Background

Improving medication safety is a major concern in primary care settings worldwide. The Salford Medication safety dASHboard (SMASH) intervention provided general practices in Salford (Greater Manchester, UK) with feedback on their safe prescribing and monitoring of medications through an online dashboard, and input from practice-based trained clinical pharmacists. In this study we explored how staff working in general practices used the SMASH dashboard to improve medication safety, through interactions with the dashboard to identify potential medication safety hazards and their workflow to resolve identified hazards.

Methods

We used a mixed-methods study design involving quantitative data from dashboard user interaction logs from 43 general practices during the first year of receiving the SMASH intervention, and qualitative data from semi-structured interviews with 22 pharmacists and physicians from 18 practices in Salford.

Results

Practices interacted with the dashboard a median of 12.0 (interquartile range, 5.0–15.2) times per month during the first quarter of use to identify and resolve potential medication safety hazards, typically starting with the most prevalent hazards or those they perceived to be most serious. Having observed a potential hazard, pharmacists and practice staff worked together to resolve that in a sequence of steps (1) verifying the dashboard information, (2) reviewing the patient’s clinical records, and (3) deciding potential changes to the patient’s medicines. Over time, dashboard use transitioned towards regular but less frequent (median of 5.5 [3.5–7.9] times per month) checks to identify and resolve new cases. The frequency of dashboard use was higher in practices with a larger number of at-risk patients. In 24 (56%) practices only pharmacists used the dashboard; in 12 (28%) use by other practice staff increased as pharmacist use declined after the initial intervention period; and in 7 (16%) there was mixed use by both pharmacists and practice staff over time.

Conclusions

An online medication safety dashboard enabled pharmacists to identify patients at risk of potentially hazardous prescribing. They subsequently worked with GPs to resolve risks on a case-by-case basis, but there were marked variations in processes between some practices. Workload diminished over time as it shifted towards resolving new cases of hazardous prescribing.