bluuebunny/crossref_metadata_2025 huggingface dataset:
Wide Resection versus Curettage with Adjuvant Therapy for Giant Cell Tumour of Bone
Authors: Kamal Achmad Fauzi , Simbolon Edi Leonardo , Prabowo Yogi , Hutagalung Errol Untung
Published: January 2017

Purpose

To determine the association between type of surgery (wide resection versus curettage with adjuvant therapy) and outcome in patients with giant cell tumour (GCT) of bone.

Methods

Records of 30 male and 52 female consecutive patients aged 10 to 62 years who underwent wide resection (n=57) or curettage with adjuvant therapy (n=25) for primary GCT of bone were reviewed. The surgical decision was based on patient age, tumour location, functional demand, and patient preference. The median tumour size was 8.5 cm. Tumours were classified as stage 1 (n=4), stage 2 (n=60), and stage 3 (n=18), and 25%, 68.3%, and 83.3% of them were treated with wide resection, respectively. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) score; the maximum score was 30.

Results

The wide resection and curettage with adjuvant therapy groups were comparable in terms of patient age, gender, tumour size, location, symptoms, tumour stage, type of biopsy, and MSTS score. The MSTS score was excellent in 50.2% of patients, good in 38.7% of patients, and fair and poor in the remaining patients. The MSTS score was not associated with tumour stage or type of surgery. Four patients in the wide resection group had metastasis to the lung. They also had lower haemoglobin level (10.6 vs. 12.7 g/dl, p=0.020) and higher percentage of stage-3 tumour (100% vs. 17.9%, p=0.001) but had no recurrence (0% vs. 6.4%, p=0.774), compared with those without metastatsis. All died from massive haemoptysis and respiratory failure. Eight patients died; their haemoglobin level was lower than that of patients who were still living (11.2 vs. 12.7 g/dl, p=0.032). Mortality was associated with metastasis (100% vs 5.2%, p<0.001) but not recurrence or complication. Two patients in each group had recurrence; recurrence was not associated with type of surgery.

Conclusion

There was no association between type of surgery and tumour recurrence, metastasis, or outcome. Curettage with adjuvant therapy was more commonly performed for stage 1 and 2 tumours, whereas wide resection was more for stage 3 tumours. Metastasis was associated with stage 3 tumour and mortality but not recurrence.
Alloreactivity and Immunosuppressive Properties of Articular Chondrocytes from Osteoarthritic Cartilage
Authors: Abe Satomi , Nochi Hitoshi , Ito Hiroshi
Published: January 2017

Purpose

To determine whether articular chondrocytes derived from osteoarthritic knee joints could evoke alloreactive proliferation of peripheral blood mononuclear cells (PBMC) and inhibit mitogenic activity of polyclonally activated CD4+ major histocompatibility complex (MHC) class II–restricted T cells in vitro.

Methods

Osteoarthritic cartilages of 17 patients aged 61 to 85 years were harvested during total knee arthroplasty. Chondrocytes were cultured for experiments. PBMCs, CD4+ T cells, CD8+ T cells, and CD14+ monocytes from healthy subjects were also used. To investigate the allogeneic response and immunosuppressive properties of chondrocytes, assays for one-way mixed lymphocyte reaction (MLR), apoptosis, activated CD4+ T-cell proliferation, and cytotoxic CD8+ T-cells were performed. Chondrocyte cell-surface antigens were examined using flow cytometry.

Results

Chondrocytes failed to trigger an allogeneic PBMC reaction and did not induce apoptosis of allogeneic PBMCs in the MLR assay. Chondrocytes inhibited the proliferation of polyclonally activated CD4+ T cells via cell-cell contact and escaped the allogeneic cytotoxic reactivity of CD8+ T cells. Chondrocytes expressed MHC class I but not MHC class II molecules or B7-1/-2-positive co-stimulatory molecules.

Conclusion

Chondrocytes from osteoarthritic knees in older patients exhibited similar immunomodulatory properties in vitro to those in juveniles or adults.
Acute Bacterial Osteomyelitis in Children
Authors: Chou Andrew Chia Chen , Mahadev Arjandas
Published: January 2017

Purpose

To review the records of 24 paediatric patients treated for acute bacterial osteomyelitis.

Methods

Records of 14 male and 10 female paediatric patients (mean age, 9.4 years) who underwent medical treatment alone (n=3) or combined with surgery (n=21) for acute bacterial osteomyelitis were reviewed. Medical treatment included use of antibiotics and supportive care. Surgery was indicated when the largest dimension of fluid collection was >1 cm.

Results

Of the 24 patients, Staphylococcus aureus was isolated in 18, group-D salmonella in 3, and no organism in 3. The mean time from admission to diagnosis was 1.87 days. For those treated surgically, the mean time from diagnosis to surgery was 1.19 days and the mean time from admission to surgery was 2.86 days. Four patients underwent multiple surgeries, 2 of whom developed chronic osteomyelitis and also had negative culture and delayed surgery by >10 days previously. No other patient had any complications.

Conclusion

Early surgical intervention for acute bacterial osteomyelitis in children increased diagnostic yield with cultures. For patients with fluid collection <1 cm in the largest dimension, medical treatment alone was effective. Patients with complications were characterised by negative culture, multiple surgeries, and delayed surgery.
Mid-Term Outcome of Total Elbow Replacement for Rheumatoid Arthritis
Authors: Williams Huw , Madhusudhan Thayur , Sinha Amit
Published: January 2017

Purpose

To review the outcome of total elbow replacement (TER) in 21 patients after a mean of 64 months.

Methods

Records of 12 women and 9 men aged 32 to 78 (mean, 59.1) years who underwent 22 TERs for rheumatoid arthritis by a single surgeon were reviewed. Functional outcome was assessed using the disability of the arm, shoulder and hand (DASH) questionnaire. The range of movement and Kaplan-Meier survival curve was determined. Adequacy of cementation was assessed on immediate postoperative radiographs. Aseptic loosening was assessed on radiographs using the Mayo clinic scoring system.

Results

After a mean follow-up of 64 (range, 10–145) months, the mean DASH score improved from 72.3 to 46.8, mean flexion improved from 96.9° to 128.1°, and mean extension lag from 37.3° to 24.0°. The 5-year survival rate with symptomatic aseptic loosening as the end point was 100%, and the revision rate for all reasons was 69%. Cement mantle was adequate in 17, marginal in 4 (most lacked cement around the prosthesis tip), and inadequate in one who was clinically asymptomatic. At the latest follow-up, 4 patients had a type-1 radiolucent line and one had a type-2 radiolucent line of both components; all remained clinically asymptomatic. Two patients developed transient radial nerve neuropraxia. One patient underwent revision for peri-operative fracture. One patient underwent a 2-stage revision for deep infection. One patient underwent revision for bilateral periprosthetic fracture. One patient underwent revision for symptomatic aseptic loosening. No patient had elbow dislocation.

Conclusion

TER is a viable option for pain relief and functional improvement in patients with rheumatoid arthritis.
Tibial Plateau Slopes in Indian Patients with or without Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging Study
Authors: Sundar Shyam , Patnaik Sarthak , Ubaydullaev Bobur , Kolandavelu Vinodh , Rajan David
Published: January 2017

Purpose

To compare anterior cruciate ligament (ACL)–injured and ACL-intact patients as well as males and females in terms of tibial plateau slopes to determine their association with ACL injury.

Methods

Magnetic resonance images (MRI) of the knee of 310 male and 179 female skeletally mature Indian patients (mean age, 40 years) with (n=170+29) or without (n=140+150) ACL injury were reviewed. Their medial and lateral tibial plateau slopes (MTPS and LTPS), medial tibial plateau depth (MTPD), and lateral tibial plateau height (LTPH) were measured using MRI.

Results

The ACL-injured and ACL-intact groups were comparable in terms of MTPS (6.72° vs. 6.73°, p=0.07), LTPS (5.68° vs. 5.70°, p=0.09), MTD (1.74 vs. 1.73 mm, p=0.356), and LTH (2.21 vs. 2.22 mm, p=0.393). Males and females were also comparable in terms of MTPS and LTPS in both ACL-injured and ACL-intact groups.

Conclusion

ACL-injured and ACL-intact patients as well as males and females were comparable in terms of the tibial plateau slope parameters.
Outcome in Total Knee Arthroplasty with a Medial-Lateral Balanced versus Unbalanced Gap
Authors: Jawhar Ahmed , Hutter Karolin , Scharf Hanns-Peter
Published: January 2017

Purpose

To evaluate the clinical outcome in 108 total knee arthroplasty (TKA) patients with a medial-lateral balanced versus unbalanced gap after a mean follow-up of 34 months.

Methods

64 women and 44 men (mean age, 69.5 years) underwent computer-assisted TKA for osteoarthritis using a cemented fixed-bearing cruciate-retaining prosthesis. The medial-lateral gap difference (measured with the prosthesis in situ and the patella reduced) was balanced (≤2 mm) in 81 patients and unbalanced (>2 mm) in 27 patients. After a mean follow-up of 34 months, patients were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire for pain, stiffness, and physical function. Scores were normalised to 0% (worst) to 100% (best).

Results

The balanced and unbalanced gap groups were comparable in terms of age, severity of osteoarthritis, and proportion of pre- and postoperative mechanical alignment. Compared with the balanced gap group, the unbalanced gap group had a larger medial-lateral extension gap difference (0.75±0.57 vs. 2.02±1.15 mm, p=0.001) and medial-lateral flexion gap difference (0.79±0.63 vs. 2.98±2.13 mm, p=0.001) and lower normalised total WOMAC score (84.9±18 vs. 74.8±20.8, p=0.017).

Conclusion

WOMAC score is better in TKAs with a medial-lateral balanced (<2 mm) gap.
Risk Factors for Fear of Falling in Elderly Patients with Severe Knee Osteoarthritis before and One Year after Total Knee Arthroplasty
Authors: Tsonga Theano , Michalopoulou Maria , Kapetanakis Stylianos , Giovannopoulou Eirini , Malliou Paraskevi , Godolias George , Soucacos Panagiotis
Published: January 2017

Purpose

To evaluate the regression of fear of falling (FOF) and identify its risk factors in patients with severe knee osteoarthritis before and one year after total knee arthroplasty (TKA).

Methods

11 men and 57 women with a mean age of 73 years and a mean body mass index of 30.36 kg/m2 who had severe (grade 3 or 4) knee osteoarthritis and knee pain of ≥1 year were included. Two weeks before and one year after TKA, patients were asked about their FOF status and falls history. Patients were asked to complete the Physical Activity Scale for the Elderly, Short Form 36 (SF-36), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaires. Clinical performance was assessed using the Berg Balance Scale and Timed Up and Go (TUG) test.

Results

Of the 68 patients, 56 (82.4%) had FOF preoperatively and 30 (44.1%) had FOF one year after TKA (p<0.001). The strongest predictors for FOF preoperatively were fallers (odds ratio [OR]=9.83, p=0.028), mental component summary (MCS) score of SF-36 (OR=0.88, p=0.024), and TUG (OR=3.4, p=0.013). The strongest predictors for FOF one year postoperatively were fallers (OR=16.51, p=0.041), patients with ≥2 chronic diseases (OR=17.33, p=0.011), physical function score of WOMAC (OR=1.015, p=0.005), and MCS score of SF-36 (OR=0.86, p=0.015).

Conclusion

TKA positively affected FOF and gradually reduced the FOF rate over a year period after TKA in an elderly population.
Cell Morphology, Viability, Osteocalcin Activity, and Alkaline Phosphatase Activity in Milled versus Unmilled Surface of the Femoral Head
Authors: Rhyu Kee Hyung , Cho Chang Hoon , Yoon Kyung Sik , Chun Young Soo
Published: January 2017

Purpose

To evaluate cellular activity in milled versus unmilled surface of the femoral head in 21 patients who underwent robot-assisted total hip arthroplasty (THA).

Methods

The femoral head of 21 consecutive patients who underwent robot-assisted THA for osteonecrosis was used. 10 cc of trabecular bone from the entire milled surface was obtained using a curette. The same amount of trabecular bone was obtained at least 1 cm away from the milled surface and served as a matched control. Cell morphology, viability, osteocalcin activity, and alkaline phosphatase activity in milled versus unmilled surface were assessed.

Results

Cell morphology of the milled or unmilled surface was comparable; cells were smaller in the milled surface. Cell viability was a mean of 40% higher in the milled surface (107.4% vs. 67.2%, p<0.001); cell viability at 5 time points was comparable in each group. Osteocalcin activity of cells was slightly higher in the milled surface (1.43 vs. 1.24 ng/ml, p=0.69). Alkaline phosphatase activity of cells was slightly higher in the unmilled surface (150 105 vs. 141 789 U/L, p=0.078).

Conclusion

The milled and unmilled surfaces of the femoral head were comparable in terms of cell morphology, viability, osteocalcin activity, and alkaline phosphatase activity.
Double Intertrochanteric Osteotomy for Trochanteric Overgrowth and a Short Femoral Neck in Adolescents
Authors: Akgul Turgut , Şen Cengiz , Balci Halil Ibrahim , Polat Gokhan
Published: January 2017

Purpose

To review the outcome of Wagner double intertrochanteric osteotomy for trochanteric overgrowth and a short femoral neck in 7 adolescents.

Methods

Records of one male and 6 females aged 15 to 20 years who underwent modified Wagner osteotomy for trochanteric overgrowth and a short femoral neck by a single senior surgeon were reviewed. The diagnoses were coxa vara (n=2), developmental dysplasia of the hip (n=3), Leg-Calve-Perthes (n=1), and proximal femoral focal deficiency (n=1). Radiological indication for double intertrochanteric osteotomy included a neck-shaft angle (NSA) <120° or a centre trochanter distance (CTD) <28 mm. Function was evaluated using the Children's Hospital Oakland Hip Evaluation Scale (CHOHES). The articulotrochanteric distance (ATD), CTD, NSA, and the distance between the centre of the femoral head and the centre of the acetabulum (MZ) were measured on radiographs.

Results

The mean follow-up duration was 61 (range, 28–86) months. The ATD improved from 16±11.5 mm to −6.3±10.2 mm (p=0.018), the CTD from 27.9±3.5 mm to 36.4±7.1 mm (p=0.018), the NSA from 112°±24.4° to 131°±16° (p=0.028), the MZ from 12.7±6.5 mm to 7.7±4.2 mm (p=0.028), and the CHOHES score from 62.1±8.7 to 84±9.6 (p=0.017). One patient had delayed union. Two patients had persistent Trendelenburg gait. Two patients declined second-stage surgery for acetabular dysplasia after solving the femoral side problems at the first stage. One of them developed hip arthrosis.

Conclusion

Double intertrochanteric osteotomy is a viable treatment option for adolescents with trochanteric overgrowth and a short femoral neck.
Partnership between a central agency and its schools
Authors: Shaari Imran , Hung David
Published: January 2017

Central coordination characterises centralised education systems. Centralised systems pride themselves on efficient systemic planning for strategic foresightedness. This study investigates how educators fostered partnerships towards lateral networking propensities or laterality in a centralised system with hierarchical tendencies. A qualitative method was applied in examining newly formed centrally initiated, yet interest-based partnerships that were supported by central agency affordances. The concept of ‘champion resource’ – that is, teacher-leaders who champion particular innovations – is introduced to explain the integration of individual resources and collective efforts that can benefit teachers in their learning process through the appropriation of pedagogical innovations. We argue that tenets of partnerships drawn from studies conducted in decentralised systems can inform the dynamics of laterality in centralised systems. In our study, developing laterality starting from champion resource/teacher dyads was witnessed, and the aim is that the dyadic relationships can grow to multi-connected teacher-to-teacher laterality. We argue that the growth of this laterality is both cultivated by the ‘champion resource’ and afforded through centralised coordination efforts, which we will illustrate through the data from this study. We are in a unique position to study partnerships in a centralised system from the early stages of inception and towards laterality. This study has begun to clarify the possibilities of developing these partnerships systematically, and recommendations are made on how to advance partnerships in centralised systems.
Effects of JWH015 in cytokine secretion in primary human keratinocytes and fibroblasts and its suitability for topical/transdermal delivery
Authors: Bort Alicia , Alvarado-Vazquez Perla A , Moracho-Vilrriales Carolina , Virga Kristopher G , Gumina Giuseppe , Romero-Sandoval Alfonso , Asbill Scott
Published: January 2017

Background

JWH015 is a cannabinoid (CB) receptor type 2 agonist that produces immunomodulatory effects. Since skin cells play a key role in inflammatory conditions and tissue repair, we investigated the ability of JWH015 to promote an anti-inflammatory and pro-wound healing phenotype in human primary skin cells.

Methods

Human primary keratinocytes and fibroblasts were stimulated with lipopolysaccharide. The mRNA expression of cannabinoid receptors was determined using RT-PCR. The effects of JWH015 (0.05, 0.1, 0.5, and 1 µM) in pro- and anti-inflammatory factors were tested in lipopolysaccharide-stimulated cells. A scratch assay, using a co-culture of keratinocytes and fibroblasts, was used to test the effects of JWH015 in wound healing. In addition, the topical and transdermal penetration of JWH015 was studied in Franz diffusion cells using porcine skin and LC-MS.

Results

The expression of CB1 and CB2 receptors (mRNA) and the production of pro- and anti-inflammatory factors enhanced in keratinocytes and fibroblasts following lipopolysaccharide stimulation. JWH015 reduced the concentration of major pro-inflammatory factors (IL-6 and MCP-1) and increased the concentration of a major anti-inflammatory factor (TGF-β) in lipopolysaccharide-stimulated cells. JWH015 induced a faster scratch gap closure. These JWH015’seffects were mainly modulated through both CB1 and CB2 receptors. Topically administered JWH015 was mostly retained in the skin and displayed a sustained and low level of transdermal permeation.

Conclusions

Our findings suggest that targeting keratinocytes and fibroblasts with cannabinoid drugs could represent a therapeutic strategy to resolve peripheral inflammation and promote tissue repair.
Athletic performance, training characteristics, and orthopedic indications in junior tennis Davis Cup players
Authors: Fett Janina , Ulbricht Alexander , Wiewelhove Thimo , Ferrauti Alexander
Published: January 2017

Our study aimed to examine athletics, training characteristics, and prevalence of musculoskeletal symptoms of male junior tennis Davis Cup players (DC) in comparison with their regional counterparts, as well as to evaluate the impact of age and performance level on training characteristics. Twelve junior DC (male) and two samples of regional squad players (RS1 n = 60 males, n = 47 females; RS2 n = 59 males) participated in a physical testing, an interview for data evaluation on training characteristics, and a questionnaire survey of orthopedic injury frequency. Results indicate higher physical performance levels (effect size (ES) 0.75–1.26) and training volumes in DC (ES 1.23–1.66). In DC, significant relationships were found between total training volume and tennis ranking ( r = −0.78), age and physical training volume ( r = 0.82), and age and total training volume ( r = 0.62). Injury frequencies showed moderate to high prevalence with no differences ( p > 0.05) between DC and RS. Given the demands of elite tennis and the important role of service in the modern game, more efforts are necessary to develop training prescription for both performance enhancement and prevention strategies.
Reliability analysis of hybrid multi-carrier energy systems based on entropy-based Markov model
Authors: Zhao Xilin , Liu Fei , Fu Bo , Fang Na
Published: January 2017

Various new technologies for conversion between different forms of energy promote the appearance of hybrid multi-carrier energy system. For the purpose of optimized dispatch of multi-carrier energy and the security requirement of energy system, the reliability of this kind of energy system needs to be discussed. This article proposes a method based on entropy-based Markov model to analyze the reliability of hybrid multi-carrier energy system. First, the method to obtain the reliability of individual energy carrier is discussed. Second, the characteristic of entropy-based Markov model is analyzed. The method is shown to be an effective technique to obtain the reliability of the whole multi-carrier energy system depending on the reliability of individual energy carrier. Then, the fusion process to obtain the reliability of whole multi-carrier energy system is described. The result indicates that the reliability of the whole system is the reliability synthesized of individual energy supply and can be treated as a factor for the optimized process of multi-carrier energy dispatch. The effectiveness of the method is demonstrated by some examples.
Thermodynamics as a fundamental science of reliability
Authors: Imanian Anahita , Modarres Mohammad
Published: January 2017

Cumulative hazard and cumulative damage are important models for reliability and structural integrity assessment. This article reviews a previously developed thermodynamic entropy–based damage model and derives and demonstrates an equivalent reliability function. As such, a thermodynamically inspired approach to developing new definitions of cumulative hazard, cumulative damage, and life models of structures and components based on the second law of thermodynamics is presented. The article defines a new unified measure of damage in terms of energy dissipation associated with multiple interacting irreversible processes that represent the underlying failure mechanisms that cause damage and failure. Since energy dissipation leads to entropy generation in materials, it has been shown and experimentally demonstrated that the use of the total entropy generated in any degradation process is measurable and can ultimately be used to represent the time of failure of structures and components. This description therefore connects the second law of thermodynamics to the conventional models of reliability used in life assessment. Any variability in the entropic endurance to failure and uncertainties about the parameters of the entropic-based damage model lead to the time-to-failure distribution. In comparison with the conventional probabilistic reliability methods, deriving the reliability function in terms of the entropy generation can offer a general and more fundamental approach to representation of reliability. The entropic-based theory of damage and the equivalent reliability approach are demonstrated and confirmed experimentally by applying the complex interactive corrosion-fatigue degradation mechanism to samples of aluminum materials.
A new method for obtaining P-S-N curves under the condition of small sample
Authors: Gao Jianxiong , An Zongwen , Liu Bo
Published: January 2017

The P- S- N curves are the traditional tool for design against fatigue, which can be transformed into straight lines in the double logarithm coordinate system. There is a widely accepted assumption that the P- S- N curves will intersect at one point if they are extended to the high-stress or low-fatigue life zone. Based on this assumption and from a perspective of geometry, a new method for obtaining P- S- N curves under the condition of small sample is proposed. The proposed method makes it possible to obtain the P- S- N curves by a unified mathematical expression. The validity of the proposed method is verified by the fatigue test data of aluminum alloy 2524-T3. The result indicates that the P- S- N curves obtained by the proposed method with 17 samples agree well with those obtained by the traditional group test method with 59 samples. By comparison, the number of samples and the fatigue test time are reduced by 71.19%, while the average relative error is less than 5%.
Technology and journalism: ‘Dissolving’ social media content into disaster reporting on three Chinese disasters
Authors: Tong Jingrong
Published: January 2017

This article examines how three Chinese and two British newspapers sourced content from social media in their coverage of the 2008 Wenchuan Earthquake, the 2013 Ya'an Earthquake, and the 2015 Tianjin Explosion. The media outlets citing of social media content present different patterns in line with their political and commercial interests, ideologies, and journalistic values. Diverse images of the three disasters as revealed on social media (social media reality) were constructed in the newspapers' coverage. Journalists gate-keep information from social media and dissolve it into daily disaster reporting, accepting selected aspects of social media reality but rejecting others. Especially in the case of the Chinese newspapers, meeting the needs of domestic political and commercial interest groups, journalists endorse social media content that is favorable to these groups. In so doing, social media technologies are used and tailored to meet the needs of journalism.
Color multi-focus image fusion algorithm based on fuzzy theory and dual-tree complex wavelet transform
Authors: Sun Yan , Jiang Ling
Published: January 2017

This paper puts forward a new color multi-focus image fusion algorithm based on fuzzy theory and dual-tree complex wavelet transform for the purpose of removing uncertainty when choosing sub-band coefficients in the smooth regions. Luminance component is the weighted average of the three color channels in the IHS color space and it is not sensitive to noise. According to the characteristics, luminance component was chosen as the measurement to calculate the focus degree. After separating the luminance component and spectrum component, Fisher classification and fuzzy theory were chosen as the fusion rules to conduct the choice of the coefficients after the dual-tree complex wavelet transform. So fusion color image could keep the natural color information as much as possible. This method could solve the problem of color distortion in the traditional algorithms. According to the simulation results, the proposed algorithm obtained better visual effects and objective quantitative indicators.
The effect of polymeric formula on enterocyte differentiation
Authors: Budd Gabrielle R , Aitchison Alan , Day Andrew S , Keenan Jacqueline I
Published: January 2017

Exclusive enteral nutrition is established as an initial therapy to induce remission in active Crohn’s disease (CD), especially in children, but the mechanisms of action of this therapy are yet to be fully defined. Intestinal alkaline phosphatase (IAP), a recognised marker of enterocyte differentiation, is implicated in the innate gut immune response to enteric pathogens. Using the Caco-2 human adenocarcinoma cell line, this study showed that the incubation of human cells with a polymeric formula (PF) resulted in a dose-dependent increase in the expression of IAP on the cell surface. While further investigation is required to determine the pathway(s) involved, this finding suggests that cell surface-associated IAP may be an aspect of the gut’s innate immune response to pathogenic bacteria that is strengthened by PF in the setting of CD.
Outbreak Column 20: are outbreaks man-made disasters that display intertwined errors of human judgement and behaviour?
Authors: Curran Evonne T
Published: January 2017

Man-made disasters are reported to have five intertwined errors of human judgement and behaviour. As outbreaks are essentially man-made disasters, the cited intertwined errors of engineering overreach, smooth sailing fallacy, insider view, risk-seeking incentives and social-herding were looked for in five notable outbreaks of Clostridium difficile infection. Engineering overreach was found to be the most identifiable error. The purpose of this reflective exercise was to turn hindsight into foresight and determine the intertwined levels of safety behaviour needed to prevent any future pathogen emerging to produce healthcare disasters.
Tension band suture fixation for olecranon fractures
Authors: Phadnis Joideep , Watts Adam C
Published: January 2017

Olecranon fractures are common and often require surgical treatment when displaced. Traditional methods of stabilization using tension band wire fixation and plate fixation achieve adequate union and function but are associated with a high rate of re-operation and wound problems because of prominent metalwork. The purpose of the present article is to describe an all suture technique for fixation of simple olecranon fractures that maintains inter-fragmentary compression, provides bony union and reduces the rate of re-operation caused by prominent metalwork.
Integration of wave energy and other marine renewable energy sources with the needs of coastal societies
Authors: Manasseh Richard , Sannasiraj SA , McInnes Kathleen L , Sundar V , Jalihal Purnima
Published: January 2017

Marine renewable energy has the potential to solve both the energy-security and coastal-protection problems affecting coastal societies. In this article, the potential benefits arising from the combination of marine renewable energy technologies with infrastructural needs for coastal protection and other local needs are analysed. Classifications of technologies are developed to inform future coastal planning. Explanations of the resources and technologies are presented in layperson’s term. The threat of coastal inundation under climate-change scenarios is a major global issue. The investment in new infrastructure demanded by cities, ports and communities at risk of inundation could very substantially reduce the levelised cost of electricity from renewable sources, provided the infrastructure is designed with the dual purpose of power generation and coastal protection. Correspondingly, the sale of electricity from such infrastructure could defray the long-term cost of installing coastal protection. Furthermore, many marine renewable energy technologies provide a platform on which other forms of renewable energy generation could be mounted. It is noted that the complex geophysical and engineering issues arising from this opportunity must be assessed considering socio-economic factors.
An Analysis of the Average Waiting Time during the Patient Discharge Process at Kashani Hospital in Esfahan, Iran: A Case Study
Authors: Ajami Sima , Ketabi Saeedeh
Published: January 2017

Strategies for improving the patient discharge process have a beneficial effect on many hospital activities. The main objective of this research was to analyse the discharge process at Kashani Hospital in Esfahan, Iran in the fall of 2004. This study took the form of a case study in which data were collected by questionnaire, observation and checklist. SPSS and Operations Research (O.R.) methods were used to analyse data. The results showed that the average time for patients to complete the discharge process was 4.93 hours. The hospital personnel involved identified the main factors affecting average waiting time as patients' financial problems and distance between different wards. The longest hospital stay was 5.7 days in the Neurology ward. Findings showed there was a queue in completing medical records at the nursing and medical equipment stations.
Improvement of structure and quality of nanoscale multilayered composite coatings, deposited by filtered cathodic vacuum arc deposition method
Authors: Vereschaka Alexey A , Vereschaka Anatoly S , Batako Andre DL , Mokritskii Boris J , Aksenenko Anatoliy Y , Sitnikov Nikolay N
Published: January 2017

This article studies the specific features of cathode vacuum arc deposition of coatings used in the production of cutting tools. The detailed analysis of the major drawbacks of arc-Physical Vapour Deposition (PVD) methods has contributed to the development of the processes of filtered cathodic vacuum arc deposition to form nanoscale multilayered composite coatings of increased efficiency. This is achieved through the formation of nanostructure, increase in strength of adhesion of coating to substrate up to 20%, and reduction of such dangerous coating surface defects as macro- and microdroplets up to 80%. This article presents the results of the studies of various properties of developed nanoscale multilayered composite coating. The certification tests of carbide tool equipped with cutting inserts with developed nanoscale multilayered composite coating compositions in longitudinal turning (continuous cutting) and end symmetric milling, and intermittent cutting of steel C45 and hard-to-cut nickel alloy of NiCr20TiAl showed advantages of tool with nanoscale multilayered composite coating as compared to the tool without coating. The lifetime of the carbide inserts with developed NMCC based on the system of Ti–TiN–(NbZrTiCr)N (filtered cathodic vacuum arc deposition) was increased up to 5–6 times in comparison with the control tools without coatings and up to 1.5–2.0 times in comparison with nanoscale multilayered composite coating based on the system of Ti–TiN–(NbZrTiCr)N (standard arc-PVD technology).
Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release
Authors: Grle Maki , Vrgoc Goran , Bohacek Ivan , Hohnjec Vladimir , Martinac Marko , Brkic Iva , Stefan Lovro , Jotanovic Zdravko
Published: January 2017

Purpose: The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). Methods: We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society’s Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. Results: After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. Conclusion: Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR.

Levels of Evidence: Therapeutic, Level III: Retrospective comparative study
Experienced Adversity in Life Is Associated With Polarized and Affirmed Political Attitudes
Authors: Randles Daniel , Heine Steven J. , Poulin Michael , Silver Roxane Cohen
Published: January 2017

Many studies find that when made to feel uncertain, participants respond by affirming importantly held beliefs. However, while theories argue that these effects should persist over time for highly disruptive experiences, almost no research has been performed outside the lab. We conducted a secondary analysis of data from a national sample of U.S. adults ( N = 1,613) who were followed longitudinally for 3 years. Participants reported lifetime and recent adversities experienced annually, as well as their opinions on a number of questions related to intergroup hostility and aggression toward out-groups, similar to those used in many lab studies of uncertainty. We anticipated that those who had experienced adversity would show more extreme support for their position. There was a positive relationship between adversity and the tendency to strongly affirm and polarize their positions. Results suggest that adverse life events may lead to long-lasting changes in one’s tendency to polarize one’s political attitudes.
What’s So Great About Self-Control? Examining the Importance of Effortful Self-Control and Temptation in Predicting Real-Life Depletion and Goal Attainment
Authors: Milyavskaya Marina , Inzlicht Michael
Published: January 2017

Self-control is typically viewed as a key ingredient responsible for effective self-regulation and personal goal attainment. This study used experience sampling, daily diary, and prospective data collection to investigate the immediate and semester-long consequences of effortful self-control and temptations on depletion and goal attainment. Results showed that goal attainment was influenced by experiences of temptations rather than by actively resisting or controlling those temptations. This study also found that simply experiencing temptations led people to feel depleted. Depletion in turn mediated the link between temptations and goal attainment, such that people who experienced increased temptations felt more depleted and thus less likely to achieve their goals. Critically, results of Bayesian analyses strongly indicate that effortful self-control was consistently unrelated to goal attainment throughout all analyses.
What Is the Implicit Gender-Science Stereotype? Exploring Correlations Between the Gender-Science IAT and Self-Report Measures
Authors: Zitelny Hila , Shalom Michal , Bar-Anan Yoav
Published: January 2017

Implicit measures of the gender-science stereotype are often better than explicit measures in predicting relevant outcomes. This finding could reflect a discrepancy between implicit and explicit stereotypes, but an alternative is that the implicit measure is sensitive to constructs other than the stereotype. Analyzing an archival data set (total N = 478,550), we found that self-reported liking of science versus liberal arts was the best predictor of the gender-science implicit association test (IAT). In a reanalysis of a previous study and a replication of another study, we found that evidence for the IAT’s advantage over explicit stereotypes in predicting relevant outcomes disappeared when controlling for self-reported liking. Therefore, perhaps the IAT has often outperformed the explicit stereotype because the gender-science IAT captures personal attraction, whereas the explicit stereotype does not. It is premature to conclude that implicit constructs are superior to explicit constructs in predicting science-related plans and behavior.
New monoclonal antibodies on the horizon in multiple myeloma
Authors: O’Donnell Elizabeth K. , Raje Noopur S.
Published: January 2017

Across all cancers, monoclonal antibodies have emerged as a potential strategy for cancer therapy. Monoclonal antibodies target antigens expressed on the surface of cancer cells and accessory cells. This targeted approach uses the host’s immune system to promote the killing of cancer cells. Multiple myeloma (MM) is the second most common hematologic malignancy that remains incurable in the majority of patients. The treatment of MM has evolved dramatically over the past decade and continues to evolve with the approval of four new drugs in 2015. Most recently the United States Food and Drug Administration (US FDA) approved two monoclonal antibodies for the treatment of this disease. Monoclonal antibodies are generally well-tolerated and offer a novel method of action for treated relapsed and refractory disease and are now being studied in the upfront setting. In this article, we review the evidence for the existing approved monoclonal antibodies and discuss promising targeted therapies and innovative strategies for the treatment of MM.
A Glossy Simultaneous Contrast: Conjoint Measurements of Gloss and Lightness
Authors: Hansmann-Roth Sabrina , Mamassian Pascal
Published: January 2017

Interactions between the albedo and the gloss on a surface are commonplace. Darker surfaces are perceived glossier (contrast gloss) than lighter surfaces and darker backgrounds can enhance perceived lightness of surfaces. We used maximum likelihood conjoint measurements to simultaneously quantify the strength of those effects. We quantified the extent to which albedo can influence perceived gloss and physical gloss can influence perceived lightness. We modeled the contribution of lightness and gloss and found that increasing lightness reduced perceived gloss by about 32% whereas gloss had a much weaker influence on perceived lightness of about 12%. Moreover, we also investigated how different backgrounds contribute to the perception of lightness and gloss of a surface placed in front. We found that a glossy background reduces slightly perceived lightness of the center and simultaneously enhances its perceived gloss. Lighter backgrounds reduce perceived gloss and perceived lightness. Conjoint measurements lead us to a better understanding of the contextual effects in gloss and lightness perception. Not only do we confirm the importance of contrast in gloss perception and the reduction of the simultaneous contrast with glossy backgrounds, but we also quantify precisely the strength of those effects.
Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report
Authors: Amiri Hassan , Zamani Nasim , Hassanian-Moghaddam Hossein , Shadnia Shahin
Published: January 2017

Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1–2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.
Renal ischemia/reperfusion-induced cardiac hypertrophy in mice: Cardiac morphological and morphometric characterization
Authors: Cirino-Silva Rogério , Kmit Fernanda V , Trentin-Sonoda Mayra , Nakama Karina K , Panico Karine , Alvim Juliana M , Dreyer Thiago R , Martinho-Silva Herculano , Carneiro-Ramos Marcela S
Published: January 2017

Background

Tissue remodeling is usually dependent on the deposition of extracellular matrix that may result in tissue stiffness and impaired myocardium contraction.

Objectives

We had previously demonstrated that renal ischemia/reperfusion (I/R) is able to induce development of cardiac hypertrophy in mice. Therefore, we aimed to characterize renal I/R-induced cardiac hypertrophy.

Design

C57BL/6 J mice were subjected to 60 minutes’ unilateral renal pedicle occlusion, followed by reperfusion (I/R) for 5, 8, 12 or 15 days. Gene expression, protein abundance and morphometric analyses were performed in all time points.

Results

Left ventricle wall thickening was increased after eight days of reperfusion (p < 0.05). An increase in the number of heart ventricle capillaries and diameter after 12 days of reperfusion (p < 0.05) was observed; an increase in the density of capillaries starting at 5 days of reperfusion (p < 0.05) was also observed. Analyses of MMP2 protein levels showed an increase at 15 days compared to sham (p < 0.05). Moreover, TGF-β gene expression was downregulated at 12 days as well TIMP 1 and 2 (p < 0.05). The Fourier-transform infrared spectroscopy analysis showed that collagen content was altered only in the internal section of the heart (p < 0.05); such data were supported by collagen mRNA levels.

Conclusions

Renal I/R leads to impactful changes in heart morphology, accompanied by an increase in microvasculature. Although it is clear that I/R is able to induce cardiac remodeling, such morphological changes is present in only a section of the heart tissue.
Etravirine combined with antiretrovirals other than darunavir/ritonavir for HIV-1-infected, treatment-experienced adults: Week 48 results of a phase IV trial
Authors: Arathoon Eduardo , Bhorat Asad , Silaghi Rodica , Crauwels Herta , Lavreys Ludo , Tambuyzer Lotke , Van Baelen Ben , Vanveggel Simon , Opsomer Magda
Published: January 2017

Objective:

VIOLIN (TMC125IFD3002; NCT01422330) evaluated the safety, tolerability, and pharmacokinetics of etravirine with antiretrovirals other than darunavir/ritonavir in HIV-1-infected patients.

Methods:

In a 48-week, phase IV, single-arm, multicenter study, patients on prior antiretroviral therapy (⩾8 weeks) who needed to change regimen for virologic failure (viral load ⩾ 500 copies/mL) or simplification/adverse events (viral load < 50 copies/mL) received etravirine 200 mg bid with ⩾1 other active antiretroviral, excluding darunavir/ritonavir or only nucleoside/tide reverse transcriptase inhibitors.

Results:

Of 211 treated patients, 73% (n = 155) had baseline viral load ⩾ 50 copies/mL and 27% (n = 56) had baseline viral load < 50 copies/mL. Protease inhibitors were the most common background antiretrovirals (83%). Diarrhea was the most frequent adverse event (17%). Serious adverse events (no rash) occurred in 5% of patients; none were etravirine related. Overall, median etravirine AUC12h was 5390 ng h/mL and C0h was 353 ng/mL (N = 199). Week 48 virologic response rates (viral load < 50 copies/mL; Food and Drug Administration Snapshot algorithm) were 48% (74/155) (baseline viral load ⩾ 50 copies/mL) and 75% (42/56) (baseline viral load < 50 copies/mL). Virologic failure rates were 42% and 13%, respectively. The most frequently emerging etravirine resistance-associated mutations in virologic failures were Y181C, E138A, and M230L. Virologic response rates for patients with baseline viral load ⩾ 50 copies/mL were 38% (30/79) (non-adherent) versus 64% (44/69) (adherent subset).

Conclusion:

Etravirine 200 mg bid in combination with antiretrovirals other than darunavir/ritonavir was well tolerated in the studied treatment-experienced HIV-1-infected population. The overall etravirine safety and tolerability profile and pharmacokinetics (specifically in those patients who were adherent) were similar to those previously observed for etravirine in HIV-1-infected adults. The relatively high level of non-adherence, also observed in the pharmacokinetic assessments, negatively impacted virologic response, especially in patients with ⩾50 copies/mL at baseline.
Early-onset Hirayama disease in a female
Authors: Baumann Matthias , Finsterer Josef , Gizewski Elke R , Löscher Wolfgang N
Published: January 2017

Objectives:

Hirayama disease is a rare myelopathy, occurring predominantly in males with onset in the teens.

Methods and results:

Here, we report a young female patient who developed the first signs of Hirayama disease at 10.5 years of age. Prior to onset, she had experienced a growth spurt and grew about 8 cm. The disease progressed over 3 years and the typical clinical, electrophysiological, and neuroimaging signs of Hirayama disease were found. After this period and achievement of her final height, no further progression was noticed.

Conclusions:

This case highlights that pediatric neurologists should be aware of Hirayama disease, which can also occur in girls in early adolescence.