bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting the High John experiment through a contemporary lens
Authors: Cress Laurier L.
Published: February 2021

In 1967, the University of Maryland’s School of Library and Information Services created a public library in Prince George’s County, Maryland, named the High John Experiment, to give Librarianship and Information Science students experience serving disadvantaged communities and to discover new methods to better serve these communities. From the creation of High John to the present day, University of Maryland publications and unaffiliated works credit High John as a groundbreaking experiment that propelled interests in diversity and inclusion in public libraries. High John’s creators published a 73 paged report for the United States’ Office of Education, accompanied by published articles, that confirms a violation of ethics toward the community High John served. The community was not involved in the implementation or planning of the library and many of the services and materials the library offered were based on prejudiced assumptions instead of community input or research. Although High John garnered supporters, the validity and ethicality behind High John’s intent and methods were called into question during the experiment. The controversy led to debates within the field that resulted in conversations about Librarianship and Information Science pedagogy and appropriate methods in outreach and community engagement for disadvantaged communities. Now that the passionately fueled debates on High John have ceased, the experiment is a distant memory. Although this experiment led to debates about diversity, inclusion, and equity in information access within the United States, this experiment is relevant to information readers on a global scale. Because Librarianship and Information Science has a history rooted in elitism and oppression worldwide, High John warrants further exposure and examination from a diverse pool of contemporary perspectives. Through the application of modern community outreach and engagement practices, this article builds on a critical historical analysis of the experiment and argues High John failed in its mission and violated the community’s trust that it purported to serve.
Feasibility of Umbilical Cord Blood Collection in Neonates at Risk of Brain Damage—A Step Toward Autologous Cell Therapy for a High-risk Population
Authors: Segler Angela , Braun Thorsten , Fischer Hendrik Stefan , Dukatz Ricarda , Weiss Claire-Rachel , Schwickert Alexander , Jäger Carsten , Bührer Christoph , Henrich Wolfgang
Published: February 2021

Evidence for umbilical cord blood (UCB) cell therapies as a potential intervention for neurological diseases is emerging. To date, most existing trials worked with allogenic cells, as the collection of autologous UCB from high-risk patients is challenging. In obstetric emergencies the collection cannot be planned. In preterm infants, late cord clamping and anatomic conditions may reduce the availability. The aim of the present study was to assess the feasibility of UCB collection in neonates at increased risk of brain damage. Infants from four high-risk groups were included: newborns with perinatal hypoxemia, gestational age (GA) ≤30 + 0 weeks and/or birthweight <1,500 g, intrauterine growth restriction (IUGR), or monochorionic twins with twin-to-twin transfusion syndrome (TTTS). Feasibility of collection, quantity and quality of obtained UCB [total nucleated cell count (TNC), volume, sterility, and cell viability], and neonatal outcome were assessed. UCB collection was successful in 141 of 177 enrolled patients (hypoxemia n = 10; GA ≤30 + 0 weeks n = 54; IUGR n = 71; TTTS n = 6). Twenty-six cases were missed. The amount of missed cases per month declined over the time. Volume of collected UCB ranged widely (median: 24.5 ml, range: 5.0–102 ml) and contained a median of 0.77 × 108 TNC (range: 0.01–13.0 × 108). TNC and UCB volume correlated significantly with GA. A total of 10.7% (19/177) of included neonates developed brain lesions. To conclude, collection of UCB in neonates at high risk of brain damage is feasible with a multidisciplinary approach and intensive training. High prevalence of brain damage makes UCB collection worthwhile. Collected autologous UCB from mature neonates harbors a sufficient cell count for potential therapy. However, quality and quantity of obtained UCB are critical for potential therapy in preterm infants. Therefore, for extremely preterm infants alternative cell sources such as UCB tissue should be investigated for autologous treatment options because of the low yield of UCB.
Primary Mucinous Cystadenocarcinoma of the Breast: A Rare Case Report With Review of Literature
Authors: Jain Ekta , Kumar Abhishek , Jain Raajul , Sharma Shivani
Published: February 2021

Primary mucinous cystadenocarcinoma (MCA) of the breast is a rare variant of breast carcinoma known to have a favorable prognosis despite showing a basal-like phenotype. We describe a case of MCA breast in a 45-year-old female with a palpable mass in the breast. On the basis of the histopathological and immunohistochemical evaluation of a lumpectomy specimen with the absence of mass anywhere else on whole-body imaging, a diagnosis of primary MCA was rendered. Mismatch repair protein evaluation showed this tumor to be microsatellite stable. Molecular testing revealed the absence of Kirsten rat sarcoma viral oncogene homolog (KRAS), neuroblastoma RAS viral oncogene homolog (NRAS), and v-raf murine sarcoma viral oncogene homolog B1 (BRAF) mutations. To date only 27 cases of MCA breast have been reported. To the best of our knowledge, ours is the first case documenting diffuse Cytokeratin 20 (CK20) positivity, microsatellite stability, and the absence of KRAS, NRAS, and BRAF mutations in these tumors. The rarity of this tumor further evokes an interest in this case. A better understanding of the disease warrants a review of more cases with longer follow-ups.
Midfoot Function Before and After Total Ankle Arthroplasty
Authors: DiLiberto Frank E. , Haddad Steven L. , Miller Steven A. , Vora Anand M.
Published: February 2021

Background:

Information regarding the effect of total ankle arthroplasty (TAA) on midfoot function is extremely limited. The purpose of this study was to characterize midfoot region motion and power during walking in people before and after TAA.

Methods:

This was a prospective cohort study of 19 patients with end-stage ankle arthritis who received a TAA and 19 healthy control group participants. A motion capture and force plate system was used to record sagittal and transverse plane first metatarsal and lateral forefoot with respect to hindfoot motion, as well as sagittal plane midfoot region positive and negative peak power during walking. Parametric or nonparametric tests to examine differences and equivalence across time were conducted. Comparisons to examine differences between postoperative TAA group and control group foot function were also performed.

Results:

Involved-limb midfoot function was not different between the preoperative and 6-month postoperative time point in the TAA group (all P ≥ .17). Equivalence testing revealed similarity in all midfoot function variables across time (all P < .05). Decreased first metatarsal and lateral forefoot motion, as well as positive peak power generation, were noted in the TAA group postoperative involved limb in comparison to the control group (all P ≤ .01).

Conclusion:

The similarity of midfoot function across time, along with differences in midfoot function in comparison to controls, suggests that TAA does not change midfoot deficits by 6 months postoperation.

Level of Evidence:

Level II, prospective cohort study.
Prognostic Roles of N6-Methyladenosine METTL3 in Different Cancers: A System Review and Meta-Analysis
Authors: Liu KuangZheng , Gao Yue , Gan Kai , Wu YuQing , Xu Bin , Zhang LiHua , Chen Ming
Published: February 2021

Background:

Recent studies have shown that methyltransferase-like 3, a catalytic enzyme that is predominant in the N6-methyladenosine methyltransferase system, is abnormally expressed in various types of carcinoma and is correlated with poorer prognosis. However, the clinical functions of methyltransferase-like 3 in the prognosis of tumors are not fully understood.

Methods:

We identified studies by searching PubMed, Web of Science, and MedRvix for literature (up to June 30, 2020), and collected a total of 9 studies with 1257 patients for this meta-analysis. The cancer types included gastric cancer, breast cancer, non-small cell lung cancer, bladder cancer, colorectal cancer and ovarian. We further used The Cancer Genome Atlas dataset to validate the results.

Results:

High methyltransferase-like 3 expression clearly predicted a worse outcome (high vs. low methyltransferase-like 3 expression group; hazard ratio = 2.09, 95% confidence interval 1.53–2.89, P = 0.0001). Moreover, methyltransferase-like 3 expression was associated with differentiation (moderate + poor vs. well, pooled odds ratio = 1.76, 95% confidence interval 1.32–2.35, P = 0.0001), and gender (male vs. female, pooled odds ratio = 0.73, 95% confidence interval 0.55-0.97, P = 0.029).

Conclusion:

Our results suggest that methyltransferase-like 3 upregulation is significantly associated with poor prognosis and could potentially function as a tumor biomarker in cancer prognosis.
Stability and vibration analysis of an axially moving thin walled conical shell
Authors: Abolhassanpour Hossein , Ashenai Ghasemi Faramarz , Shahgholi Majid , Mohamadi Arash
Published: February 2021

This article deals with the analysis of free vibration of an axially moving truncated conical shell. Based on the classical linear theory of elasticity, Donnell shell theory assumptions, Hamilton principle, and Galerkin method, the motion equations of axially moving truncated conical shells are derived. Then, the perturbation method is used to obtain the natural frequency of the system. One of the most important and controversial results in studies of axially moving structures is the velocity detection of critical points. Therefore, the effect of velocity on the creation of divergence instability is investigated. The other important goal in this study is to investigate the effect of the cone angle. As a novelty, our study found that increasing or decreasing the cone angle also affects the critical velocity of the structure in addition to changing the natural frequency, meaning that with increasing the cone angle, the instability occurs at a lower velocity. Also, the effect of other parameters such as aspect ratio and mechanical properties on the frequency and instability points is investigated.
Nonclinical Development of Biologics: Integrating Safety, Pharmacokinetics, and Pharmacodynamics to Create Smarter and More Flexible Nonclinical Safety Programs Optimizing Animal Use
Authors: Hey Adam , Baumann Andreas , Kronenberg Sven , Blaich Guenter , Mohl Silke , Fagg Rajni , Ulrich Peter , Rattel Benno , Richter Wolfgang F. , Kiessling Andrea , Weir Lucinda
Published: February 2021

Safety assessment of biological drugs has its challenges due to the multiple new different modalities, for example, antibody-drug conjugates, bispecifics, nanobodies, fusion proteins and advanced therapy medicinal products (ATMPs), their different pharmacokinetic and pharmacodynamic properties, and their ability to trigger immunogenicity and toxicity. In the public and in the pharmaceutical industry, there is a strong and general desire to reduce the number of animals used in research and development of drugs and in particular reducing the use of nonhuman primates. Important discussions and activities are ongoing investigating the smarter designs of early research and dose range finding studies, reuse of animals, and replacing animal experiments with in vitro studies. Other important challenges include absence of a relevant species and design of studies and developing genetically modified animals for special investigative toxicology studies. Then, the learnings and challenges from the development of the first ATMPs are available providing valuable insights in the development path for these new potentially transformative treatments. Finally, development of strategies for assessment of immunogenicity and prediction of translation of immunogenicity and associated findings to the clinic. On this, the eighth meeting for the European BioSafe members, these challenges served as the basis for the presentations and discussions during the meeting. This article serves as the workshop report reviewing the presentations and discussions at the meeting.
Impact of Covid-19 pandemic on Ophthalmic Emergency Department in an Italian tertiary eye centre
Authors: Franzolin Elia , Casati Stefano , Albertini Ottavia , Antonelli Giulio , Marchetti Pierpaolo , Bonora Antonio , Marchini Giorgio
Published: February 2021

Purpose:

To evaluate the effects of the COVID-19 pandemic on the Ophthalmic Emergency Department (OED) activity of the tertiary eye centre of Verona.

Methods:

OED reports of patients visited during lockdown (COVID-period) and in the corresponding period of 2017, 2018 and 2019 (COVID-free period) have been retrieved to draw a comparison. Patients’ demographic and clinical data recorded and analysed are the following: age, gender, previous ocular history, aetiology, symptoms onset, type of symptoms, discharge diagnosis, urgency and severity of diagnosis.

Results:

OED consultations dropped from 20.6 ± 7.3 visits/day of the COVID-free period to 8.6 ± 4.6 visits/day of the COVID-period. In the COVID-period patients waited longer before physically going to the OED, lamented more vision loss and less redness and reported a higher percentage of traumatic events when compared to the COVID-free period. A significant reduction of ocular surface conditions occurred, while vitreo-retinal disorders increased. Overall, both urgency and severity of diagnosed diseases raised significantly in the COVID-period.

Conclusion:

The COVID-19 pandemic drove a significant reduction of the overall OED activity. People with less urgent and milder conditions preferred to wait and endure their ocular discomfort for a few days rather than leaving home and risking to contract the infection. Our analysis highlights how several times the OED is used improperly by patients diagnosed with non-urgent disorders. A more accurate use of the OED would allow a reduction of management costs and the avoidance of overcrowding, which can lead to delays in the care of patients that really need assistance.
The addition of a conjunctival flap to a posterior lamella auricular cartilage graft: A technique to avoid corneal complications
Authors: Barrancos Constanza , García-Cruz Ignacio , Ventas-Ayala Beatriz , Sales-Sanz Marco
Published: February 2021

Purpose:

To present the benefits of the addition of a conjunctival flap when correcting lower eyelid retraction using an auricular cartilage graft.

Methods:

An auricular cartilage graft was obtained either from the concha o the scaphoid fossa. When preparing the receiving bed, the conjunctival incision was made 2 mm below the inferior margin of the lower eyelid tarsus, therefore, a conjunctival flap arising from the inferior border of the tarsus was obtained. The cartilage graft was placed in the lower eyelid. The inferior border of the graft was sutured to the retractors and conjunctiva using absorbable sutures. The superior border was sutured to the inferior tarsus, so that de conjunctival flap covered the superior portion of the graft.

Results:

Fourteen patients underwent the surgical technique. No corneal complications were observed in the early or late postoperative period. Donor site complications were not encountered.

Conclusions:

The confection of a conjunctival flap that lines the superior portion of an auricular cartilage graft in the lower eyelid provides protection against corneal postoperative complications until the graft is epithelized.
The Synergistic Effect of PARP Inhibitors and Immune Checkpoint Inhibitors
Authors: Wu Zhaozhen , Cui Pengfei , Tao Haitao , Zhang Sujie , Ma Junxun , Liu Zhefeng , Wang Jinliang , Qian Yuanyu , Chen Shixue , Huang Ziwei , Zheng Xuan , Huang Di , Hu Yi
Published: February 2021

Poly (ADP-ribose) polymerase (PARP) inhibitors have demonstrated great promise for treating cancers with homologous recombination (HR) defects, such as germline BRCA1/2 mutation. Further studies suggest that PARP inhibitors (PARPi) can also exhibit efficacy in HR-competent cancers, by amplifying the DNA damage and inducing immunogenic cell death, and PARPi lead to increasing tumor neoantigen, upregulation of interferons and PD-L1, and modulation of the tumor microenvironment, which may facilitate a more profound antitumor immune response. Immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 or CTLA-4 have achieved impressive success in the treatment of different malignancies. However, only a subset of populations derive clinical benefit, and the biomarkers and resistance mechanisms are not fully understood. Therefore, given that PARPi could potentiate the therapeutic effect of ICIs, PARPi combined with ICIs are becoming an alternative for patients who cannot benefit from ICI monotherapy. In this review, we focus on the mechanisms and immune role of PARPi and discuss the rationale and clinical studies of this combined regimen.
Autistic adults’ subjective experiences of hoarding and self-injurious behaviors
Authors: Goldfarb Yael , Zafrani Osnat , Hedley Darren , Yaari Maya , Gal Eynat
Published: February 2021

Restrictive and Repetitive Behaviors and Interests represent a core feature of autism since the earliest conceptualization of the condition. Related behaviors, such as hoarding and self-injurious behaviors, are under-researched in adulthood, resulting in limited knowledge about their various manifestation through the life span. This study expands our understanding of hoarding and self-injurious behaviors through subjective experiences shared by autistic adults. Ten adults with an autism diagnosis (aged 18–55 years, five females) participated in semi-structured, in-depth interviews. Thematic analysis identified a cluster of behaviors related to hoarding and self-injurious behaviors. Further analysis sub-categorized each theme according to the underlying purpose of the behavior. Hoarding behaviors were motivated by (1) a need for emotional aids, (2) disposing difficulties, and (3) collecting items related to special interests. Reasons for engaging in self-injurious behaviors were (1) an urge for sensory stimulation and (2) emotional regulation purposes. Discussion focuses on the underlying motives of the participants for engaging in these behaviors, in respect to current research knowledge. Relations to the general construct of Restrictive and Repetitive Behaviors and Interests are discussed along with implications for research and practice.

Lay abstract

Hoarding and self-injurious behaviors are relatively common in autism, but knowledge about their expressions in adulthood is scarce. Through interviews collecting subjective experiences of autistic adults, these behaviors were explored, and categorized to their underlying purposes. Findings portray the occurrence of these behaviors in the lives of autistic adults, their self-regulatory purposes, and their relationship to other behaviors in the domain of Restrictive and Repetitive Behaviors and Interests.
Introduction to special issue: The logic of victimhood
Authors: Chouliaraki Lilie , Banet-Weiser Sarah
Published: February 2021

This special issue aims to identify the social and affective dynamics that circulate and attach to the ‘master’ signifier of victimhood in liberal public spheres. Drawing on cutting-edge work by leading scholars across theoretical traditions, the issue illuminates the ways in which victimhood emerges as a dominant communicative logic in three distinct but interrelated domains of liberal publicity: its histories, politics and aesthetics.
(Re)Made in America: Survivorship after the Shoah
Authors: Cole Alyson
Published: February 2021

Until the l970s, ‘survivor’ referred predominantly to individuals who outlived others in the aftermath of disaster, or stood to inherit the remains of an estate; it was not imbued with evaluative connotations. In the United States today, however, survivorship abounds with positive meanings. This transvaluation rests on three intersecting trajectories that together transformed survivorship from denoting that one sustained or was spared a hardship to signifying a superior social status. The first trajectory follows the aftermath of the Shoah, when survivors acquired moral authority as victims of and public witnesses to a new violation, ‘crimes against humanity’. The second tracks the stigmatization of the term ‘victim’ in American public discourse. A consequence of struggles over the welfare state and other progressive policies, victimhood is now associated less with specific harms or injuries, and more with the supposed negative attributes of the victim herself. The third traces how survivorship became integral to the recuperative strategies of new therapeutic disciplines addressing the traumatized – from war veterans and rape victims to cancer patients. These three processes coalesced to create and legitimize a hierarchical opposition between ‘victims’ and ‘survivors’, transforming these terms into political categories and emblems of personal and group identity. In this essay, I argue that the victim/survivor binary constitutes one juncture where neoliberalism converges with Trump-era populism.
Sprint performance and force-velocity profiling does not differ between artificial turf and concrete
Authors: Shahab Samad , Steendahl Ida B , Ruf Ludwig , Meyer Tim , Van Hooren Bas
Published: February 2021

Purpose

Force-velocity-power (F-v-P) profiling can illustrate an individual’s sprinting capabilities, but no study has explored the effect of different running surfaces on F-v-P outcomes.

Method

Twelve elite youth football players (age 16.3 ± 0.5 years, mass 67.3 ± 5.4 kg, height 176.2 ± 4.6 cm) performed two 30 m sprints on concrete and artificial turf in a randomised order on two testing days. Differences between surfaces were determined using repeated-measures ANOVA (P < 0.05), whilst the coefficient of variation (CV), smallest worthwhile change and standard error of measurement were calculated to quantify reliability.

Results

No significant differences were found between surfaces over the average of two days. High reliability was evident for 30 m sprint time, theoretical maximum horizontal velocity and ratio of force on both surfaces (CV≤∼5%), while the remaining outputs were not reliable (CV >10%).

Conclusion

These findings show that F-v-P profiling does not differ between concrete and artificial turf. However, higher variability on the more unfamiliar concrete surface suggests that the testing surface should match the playing surface. Since the standard error of measurement is larger than the smallest worthwhile change, the ability of this method to monitor seasonal changes may be limited in youth elite soccer players.
Agreement and reliability of magnetic, angular rate, and gravity (MARG) sensors to assess multiple body segment’s external loads during off-road running
Authors: Rojas-Valverde Daniel , Pino-Ortega José , Timón Rafael , Gutiérrez-Vargas Randall , Sánchez-Ureña Braulio , Olcina Guillermo J
Published: February 2021

The extensive use of wearable sensors in sport medicine, exercise medicine, and health has increased the interest in their study. That is why it is necessary to test these technologies’ efficiency, effectiveness, agreement, and reliability in different settings. Consequently, the purpose of this article was to analyze the magnetic, angular rate, and gravity (MARG) sensor’s test-retest agreement and reliability when assessing multiple body segments’ external loads during off-road running. A total of 18 off-road runners (38.78 ± 10.38 years, 73.24 ± 12.6 kg, 172.17 ± 9.48 cm) ran two laps (1st and 2nd Lap) of a 12 km circuit wearing six MARG sensors. The sensors were attached to six different body segments: left (MPLeft) and right (MPRight) malleolus peroneus, left (VLLeft) and right (VLRight) vastus lateralis, lumbar (L1-L3), and thorax (T2-T4) using a special neoprene suit. After a principal component analysis (PCA) was performed, the total data set variance of all body segments was represented by 44.08%–70.64% for the 1st PCA factor considering two variables, Player LoadRT and Impacts, on L1-L3, respectively. These two variables were chosen among three total accelerometry-based external load indicators (ABELIs) to perform the agreement and reliability tests due to their relevance based on PCAs for each body segment. There were no significant differences between laps in the Player LoadRT or Impacts ( p > 0.05, trivial). The intraclass correlation and lineal correlation showed a substantial to almost perfect over-time test consistency assessed via reliability in both Player LoadRT and Impacts. Bias and t-test assessments showed good agreement between Laps. It can be concluded that MARGs sensors offer significant test re-test reliability and good agreement when assessing off-road kinematics in the six different body segments.
High-dose tamoxifen in high-hormone-receptor-expressing advanced breast cancer patients: a phase II pilot study
Authors: Su Yanhong , Zhang Yarui , Hua Xin , Huang Jiajia , Bi Xiwen , Xia Wen , Wang Xinyue , Huang Zhangzan , Song Chenge , Zhong Yongyi , Shi Yanxia , Wang Shusen ,   South China Breast Cancer Group (SCBCG), Fan Wei , Yuan Zhongyu
Published: February 2021

Background:

Tumor progression following endocrine therapy is considered to indicate resistance to endocrine drugs due to a variety of mechanisms. An insufficient dose of endocrine drugs is one of the causes for treatment failure in some patients with high hormone-receptor (HR)-expressing advanced breast cancer. This study aimed to explore the efficacy of high-dose tamoxifen (TAM) treatment in patients with advanced breast cancer with highly expressed HR.

Materials & methods:

This was a single-arm, phase II pilot study that enrolled patients with advanced breast cancer with high HR expression (estrogen receptor ⩾60% and/or progesterone receptor ⩾60%) following routine endocrine therapy. All enrolled patients received a high-dose of TAM (100 mg/day) until disease progression. The primary endpoint was progression-free survival (PFS). The secondary endpoints included objective response rate (ORR), clinical benefit rate (CBR), overall survival (OS), and safety. Exploratory endpoints included the predictive value of 16α-18F-17β-fluoroestradiol quantitative positron emission tomography/computed tomography (18F-FES PET/CT) for treatment efficacy.

Results:

A total of 30 patients were enrolled between September 2017 and February 2019. The median PFS was 6 months [95% confidence interval (CI) 4.9–7.1] and the median OS was 15.6 months (95% CI 8.3–22.9). Five patients experienced a partial response (PR) and none experienced a complete response (CR), with an ORR of 16.7% and CBR of 33.3%. No severe adverse events were observed. Lesions with 18F-FES maximum standardized uptake value (SUVmax) ⩾4 had a significantly longer PFS [median 9.2 months, (95% CI 6.9–11.6)] compared with lesions with a 18F-FES SUVmax <4 [median 4.8 months, (95% CI 3.9–5.6); p = 0.022].

Conclusion:

A high-dose of TAM is effective and safe for patients with advanced breast cancer with high HR expression. 18F-FES SUVmax values may predict the local clinical benefits of high-dose TAM .

Trial Registration:

[ClinicalTrials.gov identifier: NCT0304565]
Antioxidant Activity and Hepatoprotective Effect of Exopolysaccharides From Cultivated Ophiocordyceps Sinensis Against CCl4-Induced Liver Damages
Authors: Nguyen Quang-Vinh , Vu Thi-Tuoi , Tran Minh-Trang , Ho Thi Phuong Tham , Thu Huynh , Le Thi Thuy Hang , Chuyen Hoang Van , Dinh Minh-Hiep
Published: February 2021

Cordyceps is a well-known and valuable fungal Chinese medicine and health food. The polysaccharides from C. sinensis have been reported as the main bioactive components, which possess antioxidant, anti-aging, and liver protective activities. This study aimed to investigate the in vitro antioxidative and protective effects of exopolysaccharides (EPS) from cultivated Ophiocordyceps sinensis (O. sinensis) on rats with liver damage induced by CCl4. The results indicated that cultivated O. sinensis EPS possess moderate ABTS and hydroxyl radical scavenging abilities with IC50 values of 2.00 and 3.78 mg/mL, respectively. EPS and the positive control (silymarin) could also protect rat liver from the oxidative effect induced by CCl4 via increasing GSH levels, reducing MAD levels and decreasing serum AST and ALT activities. Moreover, the changes in histopathological liver tissue showed that EPS significantly reduced the damage induced by CCl4 in the liver. The findings suggest that EPS possesses a significant hepatoprotective effect against hepatotoxicity induced by CCl4 in rats.
Modeling SARS-CoV-2 infection in individuals with opioid use disorder with brain organoids
Authors: Willner Moshe J , Xiao Yang , Kim Hye Sung , Chen Xuejing , Xu Bin , Leong Kam W
Published: February 2021

The COVID-19 pandemic has aggravated a preexisting epidemic: the opioid crisis. Much literature has shown that the circumstances imposed by COVID-19, such as social distancing regulations, medical and financial instability, and increased mental health issues, have been detrimental to those with opioid use disorder (OUD). In addition, unexpected neurological sequelae in COVID-19 patients suggest that COVID-19 compromises neuroimmunity, induces hypoxia, and causes respiratory depression, provoking similar effects as those caused by opioid exposure. Combined conditions of COVID-19 and OUD could lead to exacerbated complications. With limited human in vivo options to study these complications, we suggest that iPSC-derived brain organoid models may serve as a useful platform to investigate the physiological connection between COVID-19 and OUD. This mini-review highlights the advances of brain organoids in other neuropsychiatric and infectious diseases and suggests their potential utility for investigating OUD and COVID-19, respectively.
Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk
Authors: Said Marwa S. , El Sayed Inas T. , Ibrahim Eman E. , Khafagy Ghada M.
Published: February 2021

Introduction:

Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors.

Aim:

The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD).

Methods:

It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention.

Results:

The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively.

Conclusion:

Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.
Newborns and Under-5 Mortality in Ethiopia: The Necessity to Revitalize Partnership in Post-COVID-19 Era to Meet the SDG Targets
Authors: Tefera Yonas Getaye , Ayele Asnakew Achaw
Published: February 2021

The Sustainable Development Goals (SDGs) were adopted during the United Nations meeting in 2015 to succeed Millennium Development Goals. Among the health targets, SDG 3.2 is to end preventable deaths of newborns and children under 5 years of age by 2030. These 2 targets aim to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births. Ethiopia is demonstrating a great reduction in child mortality since 2000. In the 2019 child mortality estimation which is nearly 5 years after SDGs adoption, Ethiopia’s progress toward reducing the newborns and under-5 mortality lie at 27 and 50.7 per 1000 live births, respectively. The generous financial and technical support from the global partners have helped to achieve such a significant reduction. Nevertheless, the SDG targets for newborns and under-5 mortality reduction are neither attained yet nor met the national plan to achieve by the end of 2019/2020. The partnership dynamics during COVID-19 crisis and the pandemic itself may also be taken as an opportunity to draw lessons and spur efforts to achieve SDG targets. This urges the need to reaffirm a comprehensive partnership and realignment with other interconnected development goals. Therefore, collective efforts with strong partnerships are required to improve the determinants of child health and achieving SDG target reduction until 2030.
Prior Admissions as a Risk Factor for Readmission in Patients Surgically Treated for Femur Fractures: Implications for a Potential Hip Fracture Bundle
Authors: Erlichman Robert , Kolodychuk Nicholas , Gabra Joseph N. , Dudipala Harshitha , Maxhimer Brook , DiNicola Nicholas , Elias John J.
Published: February 2021

Introduction:

Hip fractures are a significant economic burden to our healthcare system. As there have been efforts made to create an alternative payment model for hip fracture care, it will be imperative to risk-stratify reimbursement for these medically comorbid patients. We hypothesized that patients readmitted to the hospital within 90 days would be more likely to have a recent previous hospital admission, prior to their injury. Patients with a recent prior admission could therefore be considered higher risk for readmission and increased cost.

Methods:

A retrospective chart review identified 598 patients who underwent surgical fixation of a hip or femur fracture. Data on readmissions within 90 days of surgical procedure and previous admissions in the year prior to injury resulting in surgical procedure were collected. Logistic regression analysis was used to determine if recent prior admission had increased risk of 90-day readmission. A subgroup analysis of geriatric hip fractures and of readmitted patients were also performed.

Results:

Having a prior admission within one year was significantly associated (p < 0.0001) for 90-day readmission. Specifically, logistic regression analysis revealed that a prior admission was significantly associated with 90-day readmission with an odds ratio of 7.2 (95% CI: 4.8-10.9).

Discussion:

This patient population has a high rate of prior hospital admissions, and these prior admissions were predictive of 90-day readmission. Alternative payment models that include penalties for readmissions or fail to apply robust risk stratification may unjustly penalize hospital systems which care for more medically complex patients.

Conclusions:

Hip fracture patients with a recent prior admission to the hospital are at an increased risk for 90-day readmission. This information should be considered as alternative payment models are developed for hip fracture care.
The Consequences Are Black and White: Race and Poor Health Following Incarceration
Authors: Kuper Julie L. , Turanovic Jillian J.
Published: February 2021

Incarceration is a health damaging experience that disproportionately impacts Black Americans. Although existing research has explored broader racial disparities in the health consequences of imprisonment, little research has examined within-individual changes in health declines following incarceration. Accordingly, in this study, we examine whether the negative health effects of incarceration are more pronounced for Black versus White individuals. Data from Waves I through IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) and hierarchical generalized linear models (HGLM) are used to estimate within-person changes to self-rated health following first incarceration ( N = 23,627 person-waves) for non-Hispanic Black and non-Hispanic White individuals. Findings indicate that Black respondents reported within-person health declines that were more substantial than those of Whites after first incarceration. Additional analyses revealed that these race differences were more pronounced among Black males. Taken together, this study adds to the literature highlighting the racialized and negative health impacts of incarceration. Efforts to reduce imprisonment and increase access to quality health care in Black communities are needed.
Tibia vara in Asians: Myth or fact? Verification with three-dimensional computed tomography
Authors: Ho Jade Pei Yuik , Merican Azhar Mahmood , Ayob Khairul Anwar , Sulaiman Shahrul-Hisham , Hashim Muhammad Sufian
Published: February 2021

Background:

There is a common perception among surgeons that Asian tibiae are significantly more varus compared to non-Asians, contributed both by an acute medial tibial proximal angle (MPTA) and diaphyseal bowing. Insight into the normative morphology of the tibia allows generation of knowledge towards disease processes and subsequently planning for corrective surgeries.

Methods:

Computed tomography (CT) scans of 100 normal adult knees, aged 18 years and above, were analysed using a 3-dimensional (3D) analysis software. All tibiae were first aligned to a standard frame of reference and then rotationally aligned to the tibial centroid axis (TCAx) and the transmalleolar axis (tmAx). MPTA was measured from best-fit planes on the surface of the proximal tibia for each rotational alignment. Diaphyseal bowing was assessed by dividing the shaft to three equal portions and establishing the angle between the proximal and distal segments.

Results:

The mean MPTA was 87.0° ± 2.2° (mean ± SD) when rotationally aligned to TCAx and 91.6° ± 2.7° when aligned to tmAx. The mean diaphyseal bowing was 0.1° ± 1.9° varus when rotationally aligned to TCAx and 0.3° ± 1.6° valgus when aligned to tmAx. The mean difference when the MPTA was measured with two different rotational alignments (TCAx and tmAx) was 4.6° ± 2.3°. No statistically significant differences were observed between males and females. Post hoc tests revealed statistically significant difference in MPTA between different ethnic sub-groups.

Conclusion:

The morphology of the proximal tibiae in the disease-free Asian knee is inherently varus but not more so than other reported populations. The varus profile is contributed by the MPTA, with negligible diaphyseal bowing. These implications are relevant to surgical planning and prosthesis design.
The Recenter: an augmented Bankart. Results with a minimum follow-up of 2 years
Authors: Picard Kevin , Werthel Jean-David , Toussaint Bruno , Bauer Thomas , Hardy Alexandre
Published: February 2021

Objectives:

The objective was to evaluate the clinical results of a new surgical technique to improve the Bankart repair by adding a prosthetic block called the Recenter.

Methods:

Thirty-two patients were retrospectively included in this multicenter study. Five patients were lost to follow-up. The surgical indications were similar to those for a standard Bankart repair. A metal implant called a Recenter was inserted in the anterior inferior glenoid and fixed with two TightRopes. A Bankart repair was then performed over the implant. All the patients had a follow-up CT scan and a clinical examination. The mean follow-up period was 37 months (29-47). The mean ISIS score was 2.42 (0-6).

Results:

Twenty-six patients aged 33.9 ± 10.2 (16-50) years were included. Patients presented with an average of 2.4 ± 3.2 (0-12) true dislocations prior to surgery and 6.1 ± 8.5 (0-30) subluxations. The time that had elapsed between the occurrence of the first symptoms and surgery was 6.8 ± 6.9 years. The last follow-up showed a residual VAS score of 1.3. The mean Walch-Duplay score was 78.9 ± 21.4 - SD (range 5-100), the mean ROWE score, 88.5 ± 15.9 - SD (30-100) and the mean SST score, 90.6 ± 14.5 - SD (41.6-100). 77.8% of the patients (n=21) had no apprehension, 11.1% (n=3) were apprehensive, 7.4% (n=2) were afraid of the possibility of luxation and 3.7% (n=1) had a recurrence. In terms of satisfaction, 59.3% were very satisfied, 33.3% satisfied and 7.4% dissatisfied with their operation. Concerning the CT study, we found no shifting of material or ballooning of the TightRope tunnels.

Conclusion:

The Recenter showed a recurrence rate of 4% (1 patient) with an average follow-up of 3 years. Despite a small number of patients, the Recenter appears to be a worthwhile addition to the arthroscopic Bankart technique.
Discoid lateral meniscus instability in children. Part I - Clinical presentation of instability combined with MRI and arthroscopic findings
Authors: Vandergugten Simon , Bauwens Paul-Henri , Fiquet Charles , Raux Sebastien , Chotel Franck
Published: February 2021

Objectives:

The initial clinical presentation of the discoid lateral meniscus (DLM) in children is highly variable and can be difficult to assess. The aim of this study was to focus on the meniscal instability associated with DLM and to correlate clinical, MRI and arthroscopic data.

Methods:

Between 2008 and 2018, 93 children and adolescents with 114 DLMs who underwent surgery in a referral center were included. Based on the anamnesis and clinical data, three types of meniscal instability of increasing severity were defined: occasional ("lock"), regular ("clock") and permanent ("block") instability. These findings were correlated with preoperative MRI data and arthroscopic findings according to Ahn’s classification, and as a result we were able to propose a DLM classification based on clinical or MRI data or both combined.

Results:

A wide variety of presentations was noted with 18 different types when clinical, MRI and arthroscopic characteristics were combined. 94% of the symptomatic DLMs for which surgery was performed showed instability due to meniscocapsular separation. Clinically, there were "lock", "clock" and "block" instability in 2%, 50% and 31% of DLMs respectively. Preoperative MRI indicated no meniscal shift and an anterocentral, posterocentral or central shift in 41%, 9%, 22% and 28% of the DLMs, respectively. Arthroscopic findings indicated no lesions, or an MC-A, MC-P or PLC type lesion in 6%, 46%, 15% and 33% of DLMs respectively. The most frequent presentations were “clocked” knees with MC-A lesions and “blocked” knees with PLC lesions. Only in 60% of the cases was a good level of correspondence noted between the different data.

Conclusion:

The association of meniscal instability and symptomatic DLM in children should be accepted as a certainty. “Locked”, “clocked” and “blocked” knees could represent different stages of increasing severity in the natural history of DLM instability.
The use of ultrasound during Anterolateral Ligament (ALL) reconstruction improves femoral positioning
Authors: Cavaignac Etienne , Mouarbes Dany , Castoldi Marie , Berard Emilie , Nicolas Reina
Published: February 2021

Objectives:

We developed a minimally invasive technique for ALL reconstruction with the gracilis tendon folded in two strands. This is done by palpating the bone contours or under ultrasound control. Our hypothesis is that ultrasound control improves the positioning of the graft.

Methods:

We conducted a prospective controlled before-after study. All the patients who had an anatomical ALL reconstruction surgery were included. Patients for whom the postoperative control radiographs of a strict cross-section of the knee did not meet the quality criteria were excluded. The first 60 patients included were palpated for lateral epicondyle location, and for the next 60 patients ultrasound was used. The primary endpoint was the distance measured along an antero-posterior and proximo-distal axis between the graft insertion point and the theoretical ALL insertion point. The comparative analysis was carried out by student’s t-test. We determined the number of subjects to be included at 60 per group by assuming a minimum of 90% of grafts ≤5 mm in the "US" group versus 50% in the "palpation" group.

Results:

120 patients were included in 2 groups of 60 (US vs. palpation) with no statistical difference. The mean anteroposterior distance between the theoretical point and the point identified in the palpation group was 6.3 mm (+/- 2.4) and 1.2 mm (+/- 1.1) in the ultrasound group (p<0.001).

Conclusion:

Our hypothesis was confirmed. Ultrasound control improves the positioning of the ALL graft.
Should postoperative thromboprophylaxis be used after anterior cruciate ligament reconstruction?
Authors: Iniguez Xavier Bayle , Cassard Xavier , Vinciguerra Bruno , Murgier Jérôme
Published: February 2021

Objectives:

Anterior cruciate ligament (ACL) reconstruction is the ligament surgery that is performed most often in France. The French Society of Anesthesia-Resuscitation (SFAR) recommends systematic thromboprophylaxis in the postoperative period. The objective of this study was to evaluate the incidence of symptomatic phlebitis after ACL reconstruction. The hypothesis was that it is the same with or without thromboprophylaxis.

Methods:

This was a retrospective multicentric, multi-operator, case control study. Of the four operators concerned, two did not prescribe postoperative thromboprophylaxis except in special cases (major risk factors) and two prescribed low molecular weight heparin for ten days. All patients who underwent primary ACL reconstruction surgery between 1 July 2018 and 15 February 2020 were followed up by telephone within a minimum of 3 months. All follow-up letters were also consulted to cross-check information. All patients with a history of thromboembolic events (TE) or those who had undergone multiple ligament surgery were excluded.

Results:

249 patients were re-contacted in the anticoagulant free group and 221 in the anticoagulant group. The 2 groups were similar. The mean age was 29 years. 60% were male. There were 2 cases of phlebitis in each group. The initial hypothesis was therefore confirmed with an equivalent incidence of symptomatic phlebitis with or without postoperative anticoagulation. In fact, the incidence of symptomatic TE reported with or without thromboprophylaxis in the different Swedish, American and English registries varied from 0.2 to 0.5%, whereas in studies to identify asymptomatic TE, the incidence was 9 to 14%. Our study has some limitations, notably due to the retrospective nature and the absence of ultrasound analysis. However, loss of information is low given that the study is recent and considering the study population. Furthermore, we identified no risk factors.

Conclusion:

The incidence of symptomatic phlebitis after ACL reconstruction is equivalent with or without thromboprophylaxis. This raises the question of the need for postoperative thromboprophylaxis, particularly in patients without risk factors. National recommendations could be made based on these findings and those in the international literature.