bluuebunny/crossref_metadata_2025 huggingface dataset:
Don’t Forget About the Frontline Employee During the COVID-19 Pandemic: Preliminary Insights and a Research Agenda on Market Shocks
Authors: Voorhees Clay M. , Fombelle Paul W. , Bone Sterling A.
Published: July 2020

The COVID-19 pandemic has transformed the way services are delivered. In this editorial, we shine a light on how frontline service employees are coping with the changing work environment. Leveraging insights from a critical incident technique data collection, we identify challenges related to employee morale, interfacing with service consumers, and transformational negative events. We then offer suggestions for future research on these topics. Moreover, we discuss how the business model transformations caused by COVID-19 could impact the role of technology in future service interactions as well as new challenges related to demand planning. We hope this editorial can serve as a platform to positively impact future research on how service is being delivered amidst the COVID-19 pandemic and future market shocks.
Heterogeneity of Resources and Performance in the Hotel Industry
Authors: Arbelo Antonio , Arbelo-Pérez Marta , Pérez-Gómez Pilar
Published: July 2020

Resource heterogeneity is a key aspect of one of the most important theories of strategic management: the resource-based view of the firm. This theory suggests that the performance effects of a firm’s strategy depend on the firm’s individual resources and capabilities and the setting within which it is operating. In this article, we argue that the current methods for measuring hotel performance and its determinants may be inconsistent with this theory. To measure efficiency, hotels should be viewed as heterogeneous firms, and the relationships between determinants and performance must be assessed for each individual hotel rather than as an average across hotels. Accordingly, we use a random-effect Bayesian stochastic frontier model to estimate the profit frontier and the effect function of the inefficiency for each hotel. The results indicate that hotels tend to choose strategies based on the heterogeneous resources that maximize their performance in their individual statuses.
Pharmacology, Phytochemistry, and Toxicity Profiles of Phytolacca dodecandra L’Hér: A Scoping Review
Authors: Beressa Tamirat Bekele , Ajayi Clement Olusoji , Peter Emanuel L , Okella Hedmon , Ogwang Patrick Engeu , Anke Weisheit , Tolo Casim Umba
Published: July 2020

Introduction:

Phytolacca dodecandra L’Hér. is a native plant of sub-Saharan Africa and Madagascar which is traditionally used for various ailments. Concerned with the scope of the available evidence, we designed a scoping review to critically analyze scientific evidence on P dodecandra’s pharmacology, toxicity, and phytochemistry to validate its ethnomedical use.

Methods:

We searched without language restriction in MEDLINE, Google Scholar, Scopus, Embase, and Web of Science through December 2019. Both published and unpublished articles were assessed for relevance and reviewed.

Results:

Of 600 articles retrieved through database search, a total of 48 articles were finally included. The butanol extract of berries was more potent molluscicidal than aqueous extract. The berries had also miracidial, anthelmintic, antifungal activity, and antibacterial effect against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Salmonella spp. The methanol extracts of roots had an antifungal effect against Candida albicans, Cryptococcus neoformans, Microsporum gypseum, and Trichophyton mentagrophytes. Phytolacca dodecandra was toxic to aquatic invertebrate and fish. The fishes were up to 4 times more sensitive than snails. Saponins were the main phytoconstituent isolated from berries. Terpenoid and phenolic were abundant in leaves and bark extracts.

Conclusions:

Studies validated the traditional use of P dodecandra against snails, worms, and various bacterial and fungal infections. Limited phytochemical data call for future research to focus on isolation of compounds; test their toxicity and activity; and establish mechanism of action.
Communicating information packages in institutional face-to-face consultations
Authors: Herijgers Marloes , van Charldorp Tessa
Published: July 2020

Drawing on Dutch mortgage orientation consultations, the present study uncovers how mortgage advisors communicate information packages to laypersons. These information packages are jointly constructed by advisors and customers as a distinct activity within a professional advisory setting. We name this activity ‘explicative telling’. Through a systematic analysis of 57 of such explicative tellings we will demonstrate that this explicative telling activity consists of (1) doing preliminary work; (2) a body in which (a) general, official information about a specific mortgage topic is given and (b) information is applied to the customer’s situation; and (3) (pre-)closing sequences. Essential to the explicative telling activity is the recipient orientation of mortgage information, and also the advisors’ display of accountability for providing eligible information. This is supported by the irreversibility of the preliminary phase and by the presence of news deliverer upshot formulations during the body of the telling.
What are the elements needed to create an effective visual art intervention for people with dementia? A qualitative exploration
Authors: Shoesmith Emily K , Charura Divine , Surr Claire
Published: July 2020

Background

This article aimed to advance the understanding of ‘what works’ in visual art interventions from the perspective of key stakeholders, including people with dementia, their family members and visual art professionals.

Method

Semi-structured interviews were conducted with 22 participants, exploring their perceptions on barriers, facilitators, perceived benefits, experiences of delivering/attending a visual art intervention and any recommendations for implementation.

Results

Five factors were identified within the interviews that indicated important considerations for intervention structure and implementation, including benefits of group work, a skilled facilitator, participant choice, artistic ability and activity content. While art therapists expressed a clear protection of professional boundaries, the success of all of the visual art interventions was largely attributed to the supportive facilitator who possessed certain core values such as empathy and compassion and had knowledge in both artistic practice and the impact of living with dementia. It was clear the group dynamic was valued, and it was important to provide enjoyable, failure-free activity content with a strong focus on the creative process.

Conclusion

These findings offer a direction for evidence-based practice when implementing visual art interventions.
Scaffolding spatial literacy: Palestinian-Israeli mothers teach their children to read social relations in Israeli society/spaces
Authors: Erdreich Lauren , Golden Deborah
Published: July 2020

This article looks at how Palestinian-Israeli middle-class mothers, who enjoy the advantages of the middle class yet belong to a geographically and socially marginalized minority, educate their children in and about socio-spatial reality. The study brings the field of geographies of parenting into dialogue with relevant insights from literacy studies. Building on the concept of spatial literacy developed through previous ethnographic research with Palestinian-Israeli women university-students, we analyze recent interviews on mothering and education carried out with the same population more than a decade later. Borrowing Vygotsky’s concept of scaffolding, findings reveal three major ‘scaffolding strategies’ used by the women to teach their children to read social relations in Israeli society: shaping the learning environment, directing spatial proficiency and supporting spatial proficiency. Throughout, we juxtapose the women’s elaboration of spatial literacy as students and of scaffolding strategies as mothers. The study contributes to geographies of parenting by elucidating how parent-child interactions may serve as a context for learning about space and social relations.
Simulation and characterization of the mechanical properties of knitted esophageal stents using finite element and mathematical models
Authors: Yekrang Javad , Semnani Dariush , Seyghlani Amin Zadbagher
Published: July 2020

Esophageal stents are used as a clinical method for the treatment of a wide variety of esophageal diseases. Knitted mesh stents have such advantages as high flexibility and ease of production. In this study, an analytical approach was applied to simulate the weft knitted esophageal stents and to investigate the mechanical behavior of these tubular structures against the axial and circumferential stresses by using finite element (FE) and mathematical models. Then, the mechanical properties of the knitted structures were evaluated while the simulated food bolus was passed through the stent channel. The results demonstrated that the FE model had a good performance in simulating the mechanical properties of the esophageal knitted stents. The error of the prediction performance of the FE models was between (10–16)% and (7–11)% for the longitudinal and circumferential directions, respectively. Simulation of the food bolus passage also demonstrated that the esophageal PGA stent wall could tolerate a 7.96 kPa force and a strain of 65% by food bolus; so, it could mimic the real state of esophagus during its application. This model could be applied to design and investigate the mechanical behavior of the knitted stents in clinical application conditions.
White Media Attitudes in the Trump Era
Authors: Thompson Jack
Published: July 2020

Scholars and political commentators point to Trump’s war on the media since the 2016 election as an unprecedented attack on a vital check to Presidential power. However, little attention has been paid to the role that White audiences play in this critical debate. In this article, I examine the relationship between Trump, the media, and White audiences. Using data taken from the American Trends Panel, I show that affect for Trump is conditional on Whites’ selective partisan exposure to conservative news media. My analysis also shows that exposure to political and election news directly from Trump intensifies the relationship between Whites’ perceptions of media bias and their distrust of national news organizations. The findings provide a novel and unique contribution to the existing scholarship by demonstrating the causal effect of selective exposure to conservative media outlets on affect for Trump.
Long Noncoding RNA Maternally Expressed Gene 3 Is Downregulated, and Its Insufficiency Correlates With Poor-Risk Stratification, Worse Treatment Response, as Well as Unfavorable Survival Data in Patients With Acute Myeloid Leukemia
Authors: He Chunling , Wang Xinmei , Luo Jing , Ma Yinghua , Yang Zhen
Published: July 2020

Objective:

Our study aimed to investigate the correlation of long noncoding RNA maternally expressed gene 3 expression with clinical features, treatment response, and survival profiles in patients with acute myeloid leukemia.

Methods:

Bone marrow samples of 122 de novo patients with acute myeloid leukemia (prior to treatment) and 30 healthy donors (after enrollment) were collected, and long noncoding RNA maternally expressed gene 3 expression was detected by reverse transcription quantitative polymerase chain reaction. According to median value of long noncoding RNA maternally expressed gene 3 expression in patients with acute myeloid leukemia, they were divided into long noncoding RNA maternally expressed gene 3 high expression and low expression patients (which were further categorized as low---, low--, and low- expression patients).

Results:

Long noncoding RNA maternally expressed gene 3 expression was decreased in patients with acute myeloid leukemia compared to healthy donors. Besides, receiver operating characteristic curve displayed that long noncoding RNA maternally expressed gene 3 distinguished patients with acute myeloid leukemia from healthy donors. In patients with acute myeloid leukemia, long noncoding RNA maternally expressed gene 3 low expression was associated with poor-risk stratification but was not correlated with age, gender, French-American-Britain classification, or white blood cell level. For prognosis, complete remission rate was lowest in long noncoding RNA maternally expressed gene 3 low--- expression patients, followed by long noncoding RNA maternally expressed gene 3 low-- expression patients, long noncoding RNA maternally expressed gene 3 low- expression patients, and was highest in long noncoding RNA maternally expressed gene 3 high expression patients; Kaplan-Meier curves displayed that lower long noncoding RNA maternally expressed gene 3 expression was associated with reduced event-free survival and overall survival; Cox regression analysis showed that lower long noncoding RNA maternally expressed gene 3 expression independently predicted decreased event-free survival and worse overall survival in patients with acute myeloid leukemia.

Conclusion:

Long noncoding RNA maternally expressed gene 3 may function as a novel marker for effective surveillance and management of acute myeloid leukemia.
Patency Rates After Successful Arteriovenous Fistula Thrombectomy: Relevance of the Flow/d-Dimer Ratio in the Decision-Making
Authors: Gumus Fatih
Published: July 2020

Objectives:

Surgical thrombectomy for acute arteriovenous fistula (AVF) thrombosis is one of the primary salvage intervention. The independent risk factors affecting the patency of AVF after a successful thrombectomy are yet unknown. Here, the author aimed to report the results of surgically corrected AVFs and the independent risk factors which may cause early failure following the surgical salvage.

Methods:

The study cohort comprised 24 patients who had acute AVF thrombosis and underwent successful surgical thrombectomy in the first 24 to 48 hours between January 2016 and April 2020 in our center. The study group was divided into patients with recurrent AVF thrombosis (n = 11, 45.8%) and without recurrent AVF thrombosis (n = 13, 54.1%) following surgical thrombectomy with a follow-up of 22.4 ± 6.8 months. Postthrombectomy primary and secondary patency of AVF were also evaluated.

Results:

The mean age of the cohort was 58.1 ± 15.2 years. A simple thrombectomy was performed for all cases. Only 2 cases have required a revision at the anastomosis due to severe intimal hyperplasia. Postthrombectomy primary patency rate was 45.5% for 18 months. Receiver operating characteristic analysis was performed with a resulting area under the curve value of 0.81 (95% CI: 0.35-0.94, P = .006) for flow (mL)/d-dimer (ng/mL) <0.63 in predicting recurrent AVF thrombosis following surgical thrombectomy.

Conclusions:

Flow (mL)/d-dimer (ng/mL) <0.63 was independent predictor of recurrent thrombosis (RT) of a surgically salvaged AVF. The patients at risk for RT or who may benefit from further intervention should be identified with predictive parameters.
Ulnar footprints of the distal radioulnar ligaments: a detailed topographical study in 21 cadaveric wrists
Authors: Maniglio Mauro , Lin Charles C. , Flueckiger Remy , Zumstein Matthias A. , McGarry Michelle H. , Lee Thay Q.
Published: July 2020

Understanding of the exact topography of the distal radioulnar ligaments insertions remains limited. An anatomical study was performed in 21 fresh frozen cadaveric wrists, where the superficial and deep ligaments were sequentially transected sharply at their ulnar insertions. The relationships between the distal radioulnar ligament footprints relative to the bony landmarks of the ulnar styloid were digitized. Our study demonstrated that in the coronal plane, the superficial distal radioulnar ligaments inserted at an average of 87% of the styloid height proximally to the styloid tip distally. The deep distal radioulnar ligaments inserted at an average of 81% of the styloid height distally to the fovea proximally. The superficial footprint had an area of 10.6 mm2 on the ulnar styloid. The deep distal radioulnar ligaments attachment was asymmetric and generally had two separate footprints. This study adds important topographical knowledge about the footprint of the distal radioulnar ligaments and may contribute to understanding the consequences of ulnar styloid fractures and distal radioulnar ligaments lesions.
Are Weightbearing Restrictions Required After Microfracture for Isolated Chondral Lesions of the Knee? A Review of the Basic Science and Clinical Literature
Authors: Jain Deeptee , Belay Elshaday S. , Anderson John A. , Garrett William E. , Lau Brian C.
Published: July 2020

Context:

A strict rehabilitation protocol is traditionally followed after microfracture, including weightbearing restrictions for 2 to 6 weeks. However, such restrictions pose significant disability, especially in a patient population that is younger and more active.

Evidence Acquisition:

An extensive literature review was performed through PubMed and Google Scholar of all studies through December 2018 related to microfracture, including biomechanical, basic science, and clinical studies. For inclusion, clinical studies had to report weightbearing status and outcomes with a minimum 12-month follow-up.

Study Design:

Clinical review.

Level of Evidence:

Level 3.

Results:

Review of biomechanical and biology studies suggest new forming repair tissue is protected from shear forces of knee joint loading by the cartilaginous margins of the defect. This margin acts as a shoulder to maintain axial height and allow for tissue remodeling up to at least 12 months after surgery, well beyond current weight bearing restriction trends. A retrospective case-control study showed that weightbearing status postoperatively had no effect on clinical outcomes in patients who underwent microfracture for small chondral (<2 mm2) defects. In fact, 1 survey showed that many orthopaedic surgeons currently do not restrict weightbearing after microfracture.

Conclusion:

This clinical literature review suggests that weightbearing restrictions may not be required after microfracture for isolated tibiofemoral chondral lesions of the knee.

Strength of Recommendation Taxonomy:

C.
Dismantling the products of global flows: A model for a children’s global (un)makerspace
Authors: Velicu Anca , Giannis Greg
Published: July 2020

This article discusses one specific form of makerspace for children – hereafter, referred to as (un)makerspace – whose activities consist mainly in dismantling discarded toys and electronics, characterised as a global makerspace. The article presents the activities of children participating in a number of makerspaces in Melbourne, Australia. The ‘materials’ children engaged with, mostly discarded toys and electronics, the detritus of global capitalist flows, became of prime importance and active agents in activities undertaken. The participants’ engagement consisted predominantly of dismantling of the ‘waste’ and creating new assemblages from the remains. Aiming to answer the question of how much playing, creativity and learning opportunities could children encounter in an (un)makerspace, the article will be theoretically framed by posthumanism and new materialism theory. We end with the proposition that (un)makerspaces present underrepresented and underappreciated pedagogical and civic-engagement opportunities.
Play culture across makerspaces: Connecting into a global makerspace online
Authors: Pedersen Louisa Haugaard
Published: July 2020

This article is based on a school experiment of three local makerspaces that connected and turned into a global makerspace online. The three municipal schools were from Australia, United Kingdom and Denmark and participated in the Global Makerspace project, which was a part of the European Union project Makerspaces in the early years: Enhancing digital literacy and creativity. The Global Makerspace project was conducted over 4 days in the Autumn 2018. The schools’ participating teachers and pupils belonged to the first years of primary level. In this article, the Danish experiences from the project are explored. The data collection analysed draws on a micro-ethnographic study of the experiences from the Danish makerspace completed by the Danish facilitator from the project Makerspaces in the early years: Enhancing digital literacy and creativity. The article identifies the teachers’ and pupils’ maker activities out from a play cultural point of view and reckon making as connecting to describe how offline maker communities connected into one online maker community. The baseline of the school experiment was to explore and stress the potential of how communities like teachers and pupils across time and space in collaboration can transform and develop play cultures with different combinations of technologies by sharing local maker activities into global activities online.
Granulomatous and systemic inflammatory reactions from tattoo ink: Case report and concise review
Authors: Bose Reetesh , Sibley Christopher , Fahim Simone
Published: July 2020

Tattoo pigment can precipitate numerous inflammatory states, and granulomatous tattoo reactions are a diagnostically challenging form. The skin is the most common site of inflammation, but systemic inflammation can occur. Reactions to black tattoo ink have a broad differential of cutaneous and systemic conditions. Sarcoidosis is an important consideration because it is unclear whether it is a separate entity. Here we present a 31-year-old male who developed an inflammatory eruption where he had black tattoos. He also developed circular patches of scalp alopecia, monocular uveitis, and an enlarged axillary lymph node, initially thought to represent lymphoma. Tissue biopsy of the skin and lymph node revealed findings consistent with granulomatous tattoo reaction. Investigations for other diagnoses, including sarcoidosis, were negative. He was treated with systemic corticosteroids and then with topical corticosteroids and oral hydroxychloroquine. This case report demonstrates the diagnostic challenge associated with granulomatous tattoo ink reactions. Further studies are needed to improve characterization and management of this condition.
“No disease for the others”: How COVID-19 data can enact new and old alterities
Authors: Pelizza Annalisa
Published: July 2020

The COVID-19 pandemic invites a question about how long-standing narratives of alterity and current narratives of disease are entwined and re-enacted in the diagnosis of COVID-19. In this commentary, we discuss two related phenomena that, we argue, should be taken into account in answering this question. First, we address the diffusion of pseudoscientific accounts of minorities’ immunity to COVID-19. While apparently praising minorities’ biological resistance, such accounts rhetorically introduce a distinction between “Us” and “Them,” and in so doing produce new and re-enact old narratives of alterity. Second, these unsubstantiated narratives thrive on fake news and scarcity of data. The second part of this commentary thus surveys the methods through which the COVID-19 test is administered in various countries. We argue that techniques used for data collection have a major role in producing COVID-19 data that render contagion rates among migrants and other minorities invisible. In the conclusion, we provide two recommendations about how COVID-19 data can instead potentially work towards inclusion.
Improving Identification of Cognitive Impairment in Fragility Fracture Patients: Impact of Educational Guidelines on Current Practice
Authors: Kennedy Grace E. M. , Mohandas Parvathy , Anderson Lesley A. , Kennedy Maurice , Shirley Denise S. L.
Published: July 2020

Introduction:

Cognitive impairment can hinder a fracture patient’s capacity to consent to surgery and negatively impact their postoperative recovery and rehabilitation. National guidelines recommend screening for cognitive impairment upon admission, and the Abbreviated Mental Test Score (AMTS) is a commonly used tool for this. This project aimed to assess current practice regarding documentation of AMTS among frail fracture patients upon admission and to improve AMTS documentation following a simple intervention.

Methods:

Baseline data were obtained by inpatient chart review throughout November to December 2018 in a district general hospital with emergency fracture services. All patients admitted with a fragility hip fracture and patients over 65 years with any fracture were included. National guidelines and baseline results were then distributed among junior doctors. Following an intervention, further data were collected throughout January to February 2019.

Results:

Preintervention, 40 suitable patients (mean age: 82 years) were identified; 9 (22.0%) of whom had an AMTS recorded upon admission. Among the hip fracture subgroup (n = 25), 7 (26.9%) had an AMTS recorded. Postintervention, 39 patients (mean age: 80 years) were identified; 15 (38.5%) of whom had an AMTS recorded. Among the hip fracture subgroup (n = 30), 11 (36.7%) had an AMTS recorded. Statistical analysis demonstrated a significant improvement in AMTS documentation both among the overall cohort ( P = .001) and hip fracture patients ( P = .019). No significant association was found between AMTS documentation and patient age ( P = .566), grade of admitting doctor ( P = .058), or prior cognitive/mental health disorder ( P = .256).

Discussion:

A small yet significant improvement in AMTS documentation among elderly/hip fracture patients was observed following distribution of educational material. Further work should explore the effect of cognitive impairment on outcomes related to orthopedic injuries beyond hip fractures.
Diet and Mental Health During Emerging Adulthood: A Systematic Review
Authors: Collins Sam , Dash Sarah , Allender Steven , Jacka Felice , Hoare Erin
Published: July 2020

Previous research has reported associations between diet and risk of depression and anxiety; however, this is underexplored in emerging adulthood (EA; 18–29 years). This systematic review examined associations between diet quality and common mental disorders and their related symptomatology in the published EA literature. A systematic search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted for articles published between 2009 and 2019. Grading of evidence was performed using an established quality assessment tool for quantitative studies. Sixteen studies were included for review. Findings supported EA as a risk period for both poor mental health and low diet quality. There was moderate support for associations between diet quality and depression, anxiety, positive/negative affect, suicide ideation, and psychological health. Methodological quality overall was weak. EA appears to be a critical period for both diet quality and mental health. Further research is needed to better understand diet and mental health associations among EAs.
Xeloda Oral, Trastuzumab, and Pertuzumab Combined Drug Therapy Reduced Cervical Lymphadenopathy and Dermal Involvement in Patient With Recurrent Breast Cancer: Case Report
Authors: Saure Sarría Victor Manuel , Arencibia Ariel D. , D’Afonseca Vívian
Published: July 2020

We report the case of a 42-year-old woman who was diagnosed with breast cancer that recurred 3 years later, with supraclavicular lymphadenopathy and dermal involvement. The main drug used in the therapy was trastuzumab; however, the association of this drug with docetaxel was not able to decrease or cease the effect of the inflammatory BCA component with erythema and thickening of the skin as well as the supraclavicular lymphadenopathy previously diagnosed. Thus, a combined therapy was required. The patient was started on 6 cycles (1 per month) of trastuzumab subcutaneous 600 mg, pertuzumab intravenous 840 mg (as an attack dose, later on 420 mg), and xeloda oral 1000 mg. As a result, the patient showed a significant improvement in erythema and thickening of the skin in the neck and the right part of her trunk, besides decrease in supraclavicular lymphadenopathy. After 6 cycles, her skin was almost restored. Intravenous trastuzumab can be an effective single agent; however, its association with other chemotherapies—such as pertuzumab—can present a synergic effect, which can increase the survival expectations of metastatic HER2+ patients. Additionally, as reported in the literature, the use of xeloda plays a key role in restoring the skin health of patients with breast cancer presenting with skin metastasis. Our findings suggest that trastuzumab, pertuzumab, and xeloda combined therapy, following the schedule and posology handled in this study, can be a good treatment for recurrent HER2+ breast cancer with signs of supraclavicular lymphadenopathy and severe inflammatory BCA component with erythema and thickening of the skin.
An Injury Prevention Program for Professional Ballet: A Randomized Controlled Investigation
Authors: Vera Angelina M. , Barrera Bene D. , Peterson Leif E. , Yetter Thomas R. , Dong David , Delgado Domenica A. , McCulloch Patrick C. , Varner Kevin E. , Harris Joshua D.
Published: July 2020

Background:

Few investigations have examined dance-specific injury prevention programs (IPPs), and no published randomized controlled trials are available that evaluate IPPs for dance.

Hypothesis:

The implementation of an IPP will significantly reduce the risk of injury in professional ballet dancers.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

A randomized controlled trial was designed that entailed a superiority model for the intervention group. All professional dancers from a single ballet company were eligible to participate. Randomization and allocation were performed before the start of the season. The control group practiced and performed without change to preexisting standard operating practice. The IPP group was instructed to perform a 30-minute exercise program 3 times per week over the 52-week study period. Injuries were recorded. Standard continuous and categorical data comparisons and correlations were used. Cox proportional hazards regression models for recurrent failures were used wherein the hazard ratio indicates the relative likelihood of injury in the control versus intervention groups.

Results:

Of the 52 eligible dancers, 75% (n = 39) participated. Of these 39 dancers, 19 (9 males, 10 females; mean age, 26.6 ± 4.0 years) were randomized to the control group and 20 (11 males, 9 females; mean age, 25.1 ± 5.1 years) to the IPP group. No significant ( P > .05) difference was found in baseline demographics between groups. A total of 116 injuries were recorded for the entire study population (49 IPP; 67 control). Traumatic and chronic injuries accounted for 54% and 46% of injuries, respectively. The injury rate was 82% less (IPP hazard ratio, 0.18; z = –2.29; P = .022) in the IPP group after adjustment for confounding variables, and time between injuries was 45% longer (IPP hazard ratio, 0.55; z = –2.20; P = .028) than for controls.

Conclusion:

The present study is the first prospective randomized controlled investigation of an IPP for professional ballet. The results showed an 82% decrease in injury rate for the intervention group and an extended period from previous injury to subsequent injury.

Registration:

NCT04110002 ( ClinicalTrials.gov identifier ).
Clinical Outcomes of Osteochondral Lesions of the Talus With Large Subchondral Cysts Treated With Osteotomy and Autologous Chondral Grafts: Minimum 2-Year Follow-up and Second-Look Evaluation
Authors: Bai Lu , Guan Siyao , Liu Sanbiao , You Tian , Xie Xiaoxiao , Chen Peng , Zhang Wentao
Published: July 2020

Background:

Osteochondral lesions of the talus (OLTs) with large subchondral cysts are challenging to treat.

Purpose:

To determine the safety and efficacy of autologous chondral grafting and malleolus osteotomy for treating OLTs associated with large subchondral cysts.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 19 patients underwent autologous chondral grafting and malleolus osteotomy. We obtained the visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, and magnetic resonance observation of cartilage repair tissue (MOCART) scores at 1 and 2 years postoperatively. The International Cartilage Repair Society (ICRS) score was collected 2 years postoperatively during second-look arthroscopic surgery.

Results:

In all patients, the osteotomy site healed without nonunion or malunion. Only 1 patient developed joint space narrowing. No donor site complications occurred. The mean AOFAS score significantly improved at 1 year (from 72.8 ± 4.8 preoperatively to 93.7 ± 4.6; t = –13.708; P < .0001). The 1- and 2-year AOFAS scores were similar ( t = –0.755; P = .455), indicating stable improvement. The mean VAS score significantly decreased at 1 year (from 4.68 ± 0.67 preoperatively to 0.47 ± 0.69; t = 18.974; P < .0001). The 1- and 2-year VAS scores were similar ( t = –0.705; P = .455), as were the 1- and 2-year MOCART scores (64.2 ± 7.5 vs 67.4 ± 7.3, respectively; t = –1.312; P = .198). The ICRS scores were as follows: 7 points (abnormal) in 1 (5.2%) patient, 8 to 11 points (nearly normal) in 9 (47.4%) patients, and 12 points (normal) in 9 (47.4%) patients.

Conclusion:

Osteotomy combined with autologous osteochondral transplantation provided good functional outcomes in patients with OLTs and large subchondral cysts. Second-look arthroscopic surgery showed healthy cartilage healing.
Prevalence of Burnout and Associated Factors Among Family Medicine Residency in Thailand
Authors: Charoentanyarak Achariya , Anothaisintawee Thunyarat , Kanhasing Ruankwan , Poonpetcharat Panitee
Published: July 2020

Objectives:

To assess the prevalence of burnout and associated factors among family medicine residents in Thailand.

Materials and Methods:

This cross-sectional study was conducted by all Thai Family Medicine residents year 1 to 3 during February 2019. Self-reported questionnaires, including demographic data, and the Thai version of the Maslach Burnout Inventory were distributed to 703 residents via electronic transmissions, including e-mail, Facebook, and Line instant communication application. Burnout was diagnosed by the following criteria: high-level emotional exhaustion, high-level depersonalization, and low-level personal accomplishment. Factors associated with burnout were explored by the univariate logistic regression model. Multivariate logistic regression analysis was applied to examine the independent risk factors of burnout among Thai Family Medicine residents.

Results:

There were 149 residents who participated in this study, with a response rate of 21% (n = 703). As no residents diagnosed with burnout using the proposed criteria, burnout was, therefore, redefined as residents reporting high-level emotional exhaustion and high-level depersonalization. The prevalence of burnout in family medicine residents in this study was 10.74% (95% confidence interval [CI]: 6.26%-16.85%). Our study found that having relationship problems with patients, having relationship problems with colleagues, and having thought of resigning from the training program were independently associated with burnout with odds ratios of 6.93 (95% CI: 1.64-29.27), 6.31 (95% CI: 1.89-21.12), and 4.16 (95% CI: 1.09-15.81), respectively.

Conclusions:

Burnout at high level in emotional exhaustion and high level in depersonalization can occur among family medicine residents. Concerning factors were found to be patient and colleague relationship problems and having thought of resigning from the residency program. Other factors that may contribute to burnout were type of training programs, insufficient income, and family relationship. We recommend that the training institute should be able to monitor residents’ stress level and to help prevent those who have burnout and reduce its impact.
Evaluation of In Vivo Antidiabetic, In Vitro α-Amylase Inhibitory, and In Vitro Antioxidant Activity of Leaves Crude Extract and Solvent Fractions ofBersama abyssinicaFresen (Melianthaceae)
Authors: Kifle Zemene Demelash , Enyew Engidaw Fentahun
Published: July 2020

Background.

The leaves of Bersama abyssinica are used for the treatment of diabetes mellitus in folk medicine system of Ethiopia. The present study was done based on the traditional claim of B abyssinica for the treatment of diabetes mellitus.

Methods.

The α-amylase inhibition and antioxidant activities of B abyssinica extracts were evaluated by using 3,5-dinitrosalicylic acid method and diphenyl-2-picrylhydrazyl assay model, respectively. Blood glucose lowering activity of the extracts was studied in 4 animal models; normoglycemic, oral glucose loaded, and streptozotocin-induced diabetic mice models.

Results.

Among the extracts, the crude extract showed the highest α-amylase enzyme inhibition activity with an IC50of 6.57 μg/mL. The water fraction showed the strongest antioxidant activity with an IC50of 3.43 μg/mL. The crude extract at doses of 200, and 400 mg/kg showed significant ( P < .05) hypoglycemic activity in normoglycemic mice. All doses of the crude extract significantly ( P < .05) reduced blood glucose levels of oral glucose-loaded mice. In streptozotocin-induced diabetic mice models, both the crude and solvent fractions showed a significant ( P < .05) blood glucose lowering effect as compared with the negative control group post 8 hour treatment.

Conclusion.

The results demonstrated the beneficial biochemical effects of B abyssinica extract by inhibiting α-amylase and scavenging the free radicals. The crude extract and solvent fractions of B abyssinica had significant blood glucose lowering effect in all animal models.
The prevention and control of tuberculosis: an analysis based on a tuberculosis dynamic model derived from the cases of Americans
Authors: Wu Yan , Huang Meng , Wang Ximei , Li Yong , Jiang Lei , Yuan Yuan
Published: July 2020

Background

Tuberculosis (TB), a preventable and curable disease, is claimed as the second largest number of fatalities, and there are 9,025 cases reported in the United States in 2018. Many researchers have done a lot of research and achieved remarkable results, but TB is still a severe problem for human beings. The study is a further exploration of the prevention and control of tuberculosis.

Methods

In the paper, we propose a new dynamic model to study the transmission dynamics of TB, and then use global differential evolution and local sequential quadratic programming (DESQP) optimization algorithm to estimate parameters of the model. Finally, we use Latin hypercube sampling (LHS) and partial rank correlation coefficients (PRCC) to analyze the influence of parameters on the basic reproduction number ($\mathcal R_{0}$

R

0

) and the total infectious (including the diagnosed, undiagnosed and incomplete treatment infectious), respectively.

Results

According to the research, the basic reproduction number is computed as 2.3597 from 1984 to 2018, which means TB is also an epidemic in the US. The diagnosed rate is 0.6082, which means the undiagnosed will be diagnosed after 1.6442 years. The diagnosed will recover after an average of 1.9912 years. Moreover, some diagnosed will end the treatment after 1.7550 years for some reason. From the study, it’s shown that 2.40% of the recovered will be reactivated, and 13.88% of the newborn will be vaccinated. However, the immune system will be lost after about 19.6078 years.

Conclusion

Through the results of this study, we give some suggestions to help prevent and control the TB epidemic in the United States, such as prolonging the protection period of the vaccine by developing new and more effective vaccines to prevent TB; using the Chemoprophylaxis for incubation patients to prevent their conversion into active TB; raising people’s awareness of the prevention and control of TB and treatment after illness; isolating the infected to reduce the spread of TB. According to the latest report in the announcement that came at the first WHO Global Ministerial Conference on Ending tuberculosis in the Sustainable Development Era, we predict that it is challenging to control TB by 2030.
Health-related quality of life following minimally invasive totally endoscopic mitral valve surgery
Authors: Huang Ling-chen , Chen Dao-zhong , Chen Liang-wan , Xu Qi-chen , Zheng Zi-he , Dai Xiao-fu
Published: July 2020

Background

To compare the impact of two different types of mitral valve surgery on health-related quality of life, we conducted a retrospective study comparing modified totally endoscopic mitral valve surgery with median sternotomy mitral valve surgery.

Methods

A total of 163 patients who underwent mitral valve surgery at our institution between January 1, 2019 and December 31, 2019 were enrolled. For these 163 patients, mitral valve surgery was performed using either a modified totally endoscopic approach or median sternotomy approach. We used the numerical rating scale and the Scar Cosmesis Assessment and Rating Scale to measure pain intensity and the aesthetic appearance of the surgical incision and used the MOS 36-item Short-Form Health Survey to assess health-related quality of life.

Results

Seventy-eight patients underwent the modified totally endoscopic mitral valve surgery, and eighty-five patients underwent the median sternotomy mitral valve surgery. The two groups of patients were similar in terms of demographics and echocardiography findings. The number of bioprosthetic valve replacements performed was significantly higher in the totally endoscopic group than in the median sternotomy group (p = 0.04), whereas the subvalvular apparatus was less preserved in only 33 cases in the totally endoscopic group (p = 0.01). The rate of postoperative adverse events was similar between the two groups. The pain was mild and aesthetic appearance was significantly better in the totally endoscopic approach group than in the sternotomy approach group. Significant differences in the scores for the bodily pain and mental health subscales of the MOS 36-item Short-Form Health Survey were found between the two groups.

Conclusions

Compared with median sternotomy mitral valve surgery, totally endoscopic mitral valve surgery has an equally good treatment effect, improving patient’s health-related quality of life with a better cosmetic appearance and a lower pain intensity. Our study suggested that the totally endoscopic approach is superior to the median sternotomy approach in terms of pain intensity, aesthetic appearance and health-related quality of life.
Cardiac injury associated with severe disease or ICU admission and death in hospitalized patients with COVID-19: a meta-analysis and systematic review
Authors: Li Xinye , Pan Xiandu , Li Yanda , An Na , Xing Yanfen , Yang Fan , Tian Li , Sun Jiahao , Gao Yonghong , Shang Hongcai , Xing Yanwei
Published: July 2020

Background

Cardiac injury is now a common complication of coronavirus disease (COVID-19), but it remains unclear whether cardiac injury-related biomarkers can be independent predictors of mortality and severe disease development or intensive care unit (ICU) admission.

Methods

Two investigators searched the PubMed, EMBASE, Cochrane Library, MEDLINE, Chinese National Knowledge Infrastructure (CNKI), Wanfang, MedRxiv, and ChinaXiv databases for articles published through March 30, 2020. Retrospective studies assessing the relationship between the prognosis of COVID-19 patients and levels of troponin I (TnI) and other cardiac injury biomarkers (creatine kinase [CK], CK myocardial band [CK-MB], lactate dehydrogenase [LDH], and interleukin-6 [IL-6]) were included. The data were extracted independently by two investigators.

Results

The analysis included 23 studies with 4631 total individuals. The proportions of severe disease, ICU admission, or death among patients with non-elevated TnI (or troponin T [TnT]), and those with elevated TnI (or TnT) were 12.0% and 64.5%, 11.8% and 56.0%, and 8.2% and. 59.3%, respectively. Patients with elevated TnI levels had significantly higher risks of severe disease, ICU admission, and death (RR 5.57, 95% CI 3.04 to 10.22, P < 0.001; RR 6.20, 95% CI 2.52 to 15.29, P < 0.001; RR 5.64, 95% CI 2.69 to 11.83, P < 0.001). Patients with an elevated CK level were at significantly increased risk of severe disease or ICU admission (RR 1.98, 95% CI 1.50 to 2.61, P < 0.001). Patients with elevated CK-MB levels were at a higher risk of developing severe disease or requiring ICU admission (RR 3.24, 95% CI 1.66 to 6.34, P = 0.001). Patients with newly occurring arrhythmias were at higher risk of developing severe disease or requiring ICU admission (RR 13.09, 95% CI 7.00 to 24.47, P < 0.001). An elevated IL-6 level was associated with a higher risk of developing severe disease, requiring ICU admission, or death.

Conclusions

COVID-19 patients with elevated TnI levels are at significantly higher risk of severe disease, ICU admission, and death. Elevated CK, CK-MB, LDH, and IL-6 levels and emerging arrhythmia are associated with the development of severe disease and need for ICU admission, and the mortality is significantly higher in patients with elevated LDH and IL-6 levels.

Graphical abstract
A novel temporal identity window generates alternating Eve+/Nkx6+ motor neuron subtypes in a single progenitor lineage
Authors: Seroka Austin , Yazejian Rita M. , Lai Sen-Lin , Doe Chris Q.
Published: July 2020

Background

Spatial patterning specifies neural progenitor identity, with further diversity generated by temporal patterning within individual progenitor lineages. In vertebrates, these mechanisms generate “cardinal classes” of neurons that share a transcription factor identity and common morphology. In Drosophila, two cardinal classes are Even-skipped (Eve)+ motor neurons projecting to dorsal longitudinal muscles, and Nkx6+ motor neurons projecting to ventral oblique muscles. Cross-repressive interactions prevent stable double-positive motor neurons. The Drosophila neuroblast 7–1 (NB7–1) lineage uses a temporal transcription factor cascade to generate five distinct Eve+ motor neurons; the origin and development of Nkx6+ motor neurons remains unclear.

Methods

We use a neuroblast specific Gal4 line, sparse labelling and molecular markers to identify an Nkx6+ VO motor neuron produced by the NB7–1 lineage. We use lineage analysis to birth-date the VO motor neuron to the Kr+ Pdm+ neuroblast temporal identity window. We use gain- and loss-of-function strategies to test the role of Kr+ Pdm+ temporal identity and the Nkx6 transcription factor in specifying VO neuron identity.

Results

Lineage analysis identifies an Nkx6+ neuron born from the Kr+ Pdm+ temporal identity window in the NB7–1 lineage, resulting in alternation of cardinal motor neuron subtypes within this lineage (Eve>Nkx6 > Eve). Co-overexpression of Kr/Pdm generates ectopic VO motor neurons within the NB7–1 lineage – the first evidence that this TTF combination specifies neuronal identity. Moreover, the Kr/Pdm combination promotes Nkx6 expression, which itself is necessary and sufficient for motor neuron targeting to ventral oblique muscles, thereby revealing a molecular specification pathway from temporal patterning to cardinal transcription factor expression to motor neuron target selection.

Conclusions

We show that one neuroblast lineage generates interleaved cardinal motor neurons fates; that the Kr/Pdm TTFs form a novel temporal identity window that promotes expression of Nkx6; and that the Kr/Pdm > Nkx6 pathway is necessary and sufficient to promote VO motor neuron targeting to the correct ventral muscle group.