bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Outcomes of Pedicled Gastrocnemius Flaps in Total Knee Arthroplasty
Authors: Houdek Matthew T. , Wagner Eric R. , Wyles Cody C. , Harmsen William S. , Hanssen Arlen D. , Taunton Michael J. , Moran Steven L.
Published: May 2018

Background:

Deficient soft tissue following total knee arthroplasty (TKA) can jeopardize outcome. The gastrocnemius flap is an important means of providing coverage of a knee with deficient soft tissue. There is a paucity of long-term studies on the use of the gastrocnemius flap in the setting of TKA. The purpose of this study was to review the outcomes after the use of pedicled gastrocnemius flaps for coverage of a soft-tissue defect at the time of TKA.

Methods:

Eighty-three patients in whom a gastrocnemius flap had been used to cover the site of a primary (n = 18) or revision (n = 65) TKA over a 25-year period were identified. There were 48 women (58%) and 35 men (42%) with a mean age and body mass index (BMI) of 65 years and 32.6 kg/m2. The mean wound size was 49 cm2, and the wound was most commonly located over the anterior aspect of the knee/patellar tendon (n = 33). Patients were followed to the time of implant or flap revision, amputation, or death or for a minimum of 2 years (mean, 8 years). Clinical outcomes were assessed using the Knee Society Score (KSS) for pain and the KSS for function. The Kaplan-Meier method was used to assess revision and amputation-free survival. Risk factors for amputation and revision were identified with Cox regression.

Results:

The 10-year revision and amputation-free survival rates following gastrocnemius flap coverage were 68% and 79%, respectively. The risk of implant failure was increased by morbid obesity (BMI of ≥40 kg/m2) (hazard ratio [HR] = 2.82, 95% confidence interval [CI] = 1.09 to 7.32, p = 0.03) and ≥5 prior surgical procedures on the knee (HR = 2.68, 95% CI = 1.04 to 6.88, p = 0.04). The risk of amputation was increased in patients with ≥5 prior surgical procedures (HR = 10.76, 95% CI = 2.38 to 48.58, p = 0.002), an age of ≥65 years (HR = 4.94, 95% CI = 1.10 to 22.09, p = 0.03), and a wound size of ≥50 cm2 (HR = 3.29, 95% CI = 1.14 to 9.53, p = 0.02). Preoperatively the mean KSSs for pain and function were 46 and 28, and these scores significantly (p < 0.05) improved to 78 and 43, respectively, at the time of follow-up.

Conclusions:

The gastrocnemius flap reliably provides coverage of components used in complex knee reconstruction. A history of multiple surgical procedures on the knee and larger soft-tissue defects increase the risk of revision TKA and of amputation.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Profiles of Practicing Female Orthopaedists Caring for Medicare Patients in the United States
Authors: Chapman Talia R. , Zmistowski Benjamin , Purtill James J. , Chen Antonia F.
Published: May 2018

Background:

The increase in the percentage of women in orthopaedics in the United States over the last half century has been substantially slower than in every other surgical specialty. While this percentage has improved recently, the current demographic and practice characteristics of female orthopaedic surgeons are not well known. This study defines the landscape of practicing female orthopaedic surgeons caring for Medicare patients.

Methods:

Publicly available Medicare billing data sets from 2012 to 2014 were utilized to identify practicing orthopaedic surgeons. We analyzed demographics, medical training, practice characteristics, case volume, specialization, and procedure profiles of orthopaedic surgeons. Representative Current Procedural Terminology (CPT) codes were utilized for each subspecialty. Multivariate analysis was performed to confirm the independent characteristics that were associated with female orthopaedic surgeons after identification by univariate statistics.

Results:

The percentage of practicing female orthopaedic surgeons caring for Medicare patients increased significantly from 4.7% (1,043 of 22,038) in 2012 to 5.2% (1,179 of 22,510) in 2014. Women had graduated from medical school in more recent years than men (mean, 14.9 versus 22.5 years, respectively; p < 0.001), and were more likely to have attended a top-25 medical school (27.5% versus 24.5%, respectively; p = 0.01). Women were more likely to be part of larger practices (median, 49.5 versus 24 partners, respectively; p < 0.001), and were more likely to leave practice (4.4% versus 3.1% in 2013, respectively; p = 0.02). Women submitted fewer claims for billing per year (median, 528 versus 1,193, respectively; p < 0.001), and performed 6.8% (9,852 of 144,492) of hand procedures compared with 1.5% (10,043 of 651,856) of all other common procedures (p < 0.001). Multivariate analysis demonstrated that despite confounders, gender was an independent predictor of number of claims, the likelihood of leaving clinical practice, and Medicare reimbursement.

Conclusions:

There are significant differences between female and male orthopaedic surgeons caring for Medicare patients in terms of subspecialty choices, education, billing practices, and attrition rates. Despite the recent increase in the number of female orthopaedic surgeons, there are significant gender differences within the specialty.
Short-Term Effect of Low-Dose, Electromyography-Guided Botulinum Toxin A Injection in the Treatment of Chronic Lateral Epicondylar Tendinopathy
Authors: Creuzé Alexandre , Petit Hervé , de Sèze Mathieu
Published: May 2018

Background:

Botulinum toxin A (BoNT-A) is a novel treatment for chronic lateral epicondylar tendinopathy. Preliminary studies have demonstrated promising results; however, confirmation of the effectiveness of BoNT-A treatment and further assessment of its side effects are required. This study investigated the analgesic effects of BoNT-A in the treatment of chronic lateral epicondylar tendinopathy.

Methods:

This was a phase-III, single-center, randomized, double-blinded, placebo-controlled study including 60 patients with chronic lateral epicondylar tendinopathy that had been resistant to treatment for >6 months. Patients received either a 40-IU injection of BoNT-A or saline solution placebo into the extensor carpi radialis brevis (ECRB) muscle, aided by electromyographic (EMG) stimulation. Follow-up was 3 months. The primary assessment criterion was the percentage of patients whose pain was reduced by >50% at 90 days after injection. Secondary outcomes, including pain intensity, pain frequency, interference with quality of life, sick leave taken, maximum grip strength, and side effects, were assessed at days 30 and 90, and the number of participants per group requesting additional therapies at day 90 was recorded.

Results:

Twenty-nine patients in the BoNT-A group and 28 patients in the placebo group were included in the day-90 analysis. Fifteen (51.7%) of the patients who were administered BoNT-A and 7 (25%) of the patients who received placebo reported a >50% reduction in initial pain intensity at day 90 (p = 0.005). Pain intensity and the effect on quality of life, measured using visual analog scales, were both significantly lower in the group treated with BoNT-A compared with placebo at day 90 (p < 0.05). The rate of clinically detected transitory paresis of the third finger on extension was 17.2% in the BoNT-A group, with no associated functional impairment.

Conclusions:

BoNT-A at 40 IU injected into the ECRB is an effective treatment for chronic lateral epicondylar tendinopathy that has been otherwise resistant to medical treatment. The rate of paresis of the third finger was low, with no associated functional impairment.

Level of Evidence:

TherapeuticLevel I. See Instructions for Authors for a complete description of levels of evidence.
Health-Related Quality of Life in Adulthood in Untreated and Treated Individuals with Adolescent or Juvenile Idiopathic Scoliosis
Authors: Diarbakerli Elias , Grauers Anna , Danielsson Aina , Gerdhem Paul
Published: May 2018

Background:

Health-related quality of life in adults with idiopathic scoliosis diagnosed before maturity has been reported to be similar between brace-treated and surgically treated individuals. The aim of this study was to compare health-related quality of life in untreated, brace-treated, and surgically treated adults with idiopathic scoliosis diagnosed before skeletal maturity. Subgroup analyses were performed on the basis of age at the time of the study, age of onset, surgical characteristics, and curve magnitude.

Methods:

We included 1,187 adults with juvenile or adolescent idiopathic scoliosis with a mean age (and standard deviation) of 38.8 ±12.7 years. Of these, 347 were untreated, 459 had been brace-treated, and 381 had been surgically treated. The Scoliosis Research Society-22r (SRS-22r) and EuroQol 5-Dimensions (EQ-5D) were used. Statistical analyses were performed using analysis of covariance.

Results:

The mean SRS-22r subscore was 4.15 ± 0.59 points for the untreated group, 4.10 ± 0.57 points for the previously braced group, and 4.01 ± 0.64 points for the surgically treated group (p = 0.007 adjusted for age and sex). The EQ-5D index was 0.82 ± 0.20 for the untreated group, 0.82 ± 0.20 for the previously brace-treated group, and 0.79 ± 0.24 for the surgically treated group (p = 0.026, adjusted for age and sex). Brace cessation was at the mean age of 16.2 ± 1.5 years, and the surgical procedure had been performed at the mean age of 15.3 ± 2.1 years. A more caudal fusion was associated with a lower SRS-22r subscore and EQ-5D index. No differences were observed when comparing individuals with juvenile or adolescent onset scoliosis (all p > 0.05).

Conclusions:

Untreated adults with idiopathic scoliosis had similar health-related quality of life to previously brace-treated individuals, and they had marginally higher health-related quality of life compared with surgically treated individuals. Therefore, both surgical and brace treatments for idiopathic scoliosis could be considered successful from a health-related quality-of-life point of view in adulthood. The age of onset of idiopathic scoliosis does not seem to influence quality of life in adulthood.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Impact of Clinical Practice Guidelines on Use of Intra-Articular Hyaluronic Acid and Corticosteroid Injections for Knee Osteoarthritis
Authors: Bedard Nicholas A. , DeMik David E. , Glass Natalie A. , Burnett Robert A. , Bozic Kevin J. , Callaghan John J.
Published: May 2018

Background:

The efficacy of corticosteroid and hyaluronic acid injections for knee osteoarthritis has been questioned. The purpose of this study was to determine the impact of the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines on the use of these injections in the United States and determine if utilization differed by provider specialty.

Methods:

Patients with knee osteoarthritis were identified within the Humana database from 2007 to 2015, and the percentage of patients receiving a knee injection relative to the number of patients having an encounter for knee osteoarthritis was calculated and was trended for the study period. The impact of each edition of the AAOS clinical practice guidelines on injection use was evaluated with segmented regression analysis. Injection trends were also analyzed relative to the specialty of the provider performing the injection.

Results:

Of 1,065,175 patients with knee osteoarthritis, 405,101 (38.0%) received a corticosteroid injection and 137,005 (12.9%) received a hyaluronic acid injection. The rate of increase in hyaluronic acid use, per 100 patients with knee osteoarthritis, decreased from 0.15 to 0.07 injection per quarter year (p = 0.02) after the first clinical practice guideline, and the increase changed to a decrease at a rate of −0.12 injection per quarter (p < 0.001) after the second clinical practice guideline. After the first clinical practice guideline, the rate of increase in utilization of corticosteroids, per 100 patients with knee osteoarthritis, significantly lessened to 0.12 injection per quarter (p < 0.001), and after the second clinical practice guideline, corticosteroid injection use plateaued (p = 0.72). The trend in use of hyaluronic acid injections by orthopaedic surgeons and pain specialists decreased with time following the second-edition clinical practice guideline but did not change for primary care physicians or nonoperative musculoskeletal providers.

Conclusions:

Subtle but significant changes in hyaluronic acid and corticosteroid injections occurred following the publication of both clinical practice guidelines. Although the clinical practice guidelines did impact injection use, given the high costs of these injections and their questionable clinical efficacy, further interventions beyond publishing clinical practice guidelines are needed to encourage higher-value care for patients with knee osteoarthritis.
A 20-Year Prospective Longitudinal Study of Degeneration of the Cervical Spine in a Volunteer Cohort Assessed Using MRI
Authors: Daimon Kenshi , Fujiwara Hirokazu , Nishiwaki Yuji , Okada Eijiro , Nojiri Kenya , Watanabe Masahiko , Katoh Hiroyuki , Shimizu Kentaro , Ishihama Hiroko , Fujita Nobuyuki , Tsuji Takashi , Nakamura Masaya , Matsumoto Morio , Watanabe Kota
Published: May 2018

Background:

Few studies have addressed in detail long-term degenerative changes in the cervical spine. In this study, we evaluated the progression of degenerative changes of the cervical spine that occurred over a 20-year period in an originally healthy cohort. We also sought to clarify the relationship between the progression of cervical degenerative changes and the development of clinical symptoms.

Methods:

For this prospective follow-up investigation, we recruited 193 subjects from an original cohort of 497 participants who had undergone magnetic resonance imaging (MRI) of the cervical spine between 1993 and 1996. The subjects were asked about the presence or absence of cervical spine-related symptoms. Degenerative changes of the cervical spine were assessed on MRI using an original numerical grading system. The relationship between the progression of degenerative changes and the onset of clinical symptoms was evaluated by logistic regression analysis.

Results:

Degeneration in the cervical spine was found to have progressed in 95% of the subjects during the 20-year period. The finding of a decrease in signal intensity of the intervertebral disc progressed in a relatively high proportion of the subjects in all age groups and occurred with similar frequency (around 60%) at all intervertebral disc levels. The rate of progression of other structural failures on MRI increased with age and was highest at C5-C6. The progression of foraminal stenosis was associated with the onset of upper-limb pain (odds ratio, 4.71 [95% confidence interval, 1.02 to 21.7]).

Conclusions:

A progression of degenerative changes in the cervical spine on MRI over the 20-year period was detected in nearly all subjects. There was no relationship between the progression of degeneration on MRI and the development of clinical symptoms, with the exception of an association found between foraminal stenosis and upper-limb pain.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity
Authors: Waters Peter M. , Yang Brian W. , White Doreen , Barth Ellen , Chiang Vincent , Mizrahi-Arnaud Arielle , Sparks William
Published: May 2018

Background:

Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety.

Methods:

In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year. Nonemergency, non-multitrauma operative fracture cases presenting to our tertiary care facility emergency department or orthopaedic clinic were considered for satellite referral. Eligible patients required clearance for transfer via orthopaedic, emergency department, and anesthesia checklists. An opt-out policy was established for provider judgment or patient family concern to overrule transfer decisions. Selected patients were discharged home with satellite OR scheduling or approved for same-day satellite location admission. Short elective cases were performed when openings existed in the schedule.

Results:

From June 1, 2016, through June 30, 2017, 480 cases (372 trauma, 108 elective) were completed in our satellite OR. The most common trauma cases that were treated in the satellite OR were type-II supracondylar humeral fractures (n = 76). Summer months averaged 41.75 trauma cases and 11.25 elective cases per month, with 3.15 trauma cases and 0.85 elective cases per day. Nonsummer months averaged 22.78 trauma cases and 7.00 elective cases per month, with 2.93 trauma and 0.90 elective cases per day. Of the 17 postoperative issues, the greatest number (n = 7 [41%]) involved symptomatic hardware. The remaining complications were not surgeon or geographic-site-specific. There were no intraoperative complications, compartment syndrome episodes, or patients who required transfer back to our tertiary care facility for unexpected or serious medical issues.

Conclusions:

With the proper screening protocols in place for appropriate patient selection, the use of a dedicated satellite orthopaedic trauma OR can increase capacity without compromising patient safety.
Interlanguage Pragmatic Motivation in EFL Context
Authors: Perdhani Widya Caterine
Published: May 2018

This research sets out to explore the Interlanguage pragmatic motivation in EFL to their pragmatic production. This research is focus on the construct and impact of Interlanguage pragmatic motivation in EFL to their pragmatic production. The participants of the study were the university students chosen randomly from among intermediate EFL learners. There are three instruments in this study; there will be different types of analyses. Both general and speech-act-specific motivation questionnaires will be analysed by using factor analysis on a five-point Likert scale (1-5). Skewness and kurtosis will be calculated to investigate whether the questionnaires and the WDCT items fell within the normal range. Regression analysis will be done to measure how well general pragmatic motivation and Speech-act-specific motivation could predict pragmatic production. Several conclusions can be drawn from the resent study. First, language learners possess a specific type of motivation for the acquisition of interlanguage pragmatics, called pragmatic motivation, which refers to two interrelated types of motivation: general pragmatic motivation and speech-act-specific motivation. Second, EFL learners are strongly motivated to acquire and develop English pragmatic features, i.e. their pragmatic motivation is high; however, they do not have the necessary pragmatic knowledge. Third, predicting EFL learners’ pragmatic production based on their speech-act-specific motivation is somehow possible since both pragmatic production and speech-act-specific motivation focus on learners’ illocutionary competence, i.e. language functions and speech acts.
Using the Mistake Buster Technique to Improve the English Grammar Mastery
Authors: Syam Andi Tenrisanna
Published: May 2018

This research aims at finding out whether or not the use of mistake buster technique is able to improve the English grammar mastery and finding out the students’ interest toward the use of mistake buster technique. The research employs a quasi-experimental research method. The population and sample consist of 66 students which belong to two groups; 33 students in experimental group and 33 students in control group. The research data are collected using grammar test and questionnaire which are analyzed by inferential and descriptive statistics through SPSS 17.0 and Likert Scale.  The research result indicates that the use of mistake buster technique is more effective than non-mistake buster technique in improving English grammar mastery of the ten grade students of SMA Negeri 3 Makassar in academic year 2014/2015. The students’ result of posttest for experimental group is higher than the students’ result of posttest for control group. It is proven by the mean score of posttest of experimental group is higher than the control group in grammar test (63.87 > 40.00). The difference of those mean score is statistically significant; it is based on t-test value at significant level 0.05, the probability value is lower than significant level (0.00 < 0.05). Then, analysis using Likert Scale shows that the students’ interested to learn grammar by using mistake buster technique. It is proved by 60.6% students were in very interested category.
A Study of e-Learning, Blended learning, and Traditional Teaching Methods to Motivate Autonomous Learning in English Reading Comprehension of Thais Learners
Authors: Saeheng Pornpimon
Published: May 2018

The purposes of this study were to examine the differences in learners’ satisfaction of using e-Learning, blended learning, and traditional teaching methods for TR and HI students and to study learners’ autonomy after receiving three different kinds of teaching methods. The informants were 90, second year students majoring in Tourism and Hospitality Industry which were divided by purposive sampling method into three groups of 30 learners, Group A received e-Learning method, Group B received Blended Learning method, and Group C received Traditional teaching style. The research instruments used for data collection were lesson plans, e-Learning program, learners’ perception questionnaires, interview questions, and English Reading Comprehension test (Pretest and Posttest). Quantitative data were collected and analyzed by mean, standard deviation.  The interview data was read, reread, and then coded. Coding organized the raw data into meaningful categories. The results of this study indicated that the overall of students’ satisfaction and autonomous learning rate after receiving their teaching delivery methods were at “good.”  Additionally, the interview results showed that the students were positively satisfied with e-Learning and blended learning. The students have become autonomous learning. Recommendations were made and presented in two categories: benefits of future practice and further research.
The Effect of Self Regulated Strategy Development on Students’ Skill to Write Persuasive Text
Authors: Sartika Dewi , Rachmanita Rachmanita
Published: May 2018

Writing is one of the four skills taught in the school which is used as communication in daily life. It is considered as a difficult subject by the eleventh grade of the senior high school students because of the limitation of the time provided and some aspects of language to be considered. Therefore, the purpose of this study was to find out whether or not there was a significant difference in students’ writing achievement of persuasive text between the students who were taught by using Self-Regulated Strategy Development and that of those who were not. By conducting a quasi-experimental investigation at senior high school level in South Sumatera, Indonesia, two classes consisting of thirty students in each class at SMA Negeri 1 Kandis were chosen as the samples by using purposive sampling method. To analyze the data, the t-test was used. The result findings showed that t-obtained (3.29) was higher than t-table (2.0017) at the significance level of p-value was lower than 0.05. It indicated that there was a significant difference in students’ writing achievement of writing persuasive text between the students who were taught by using Self-Regulated Strategy Development and that of those who were not. The students who were taught by using Self-Regulated Strategy Development had better improvement in their writing persuasive text because the students could write the persuasive text well based on the Self-Regulated Strategy Development which applied POW (pick, organize, write)  and TREE  (topic, reasons, explanation, ending).
China y la construcción de un régimen internacional de Cooperación Sur-Sur
Authors: Domínguez Rafael
Published: May 2018

El artículo analiza en perspectiva histórica el reciente proceso de construcción de un régimen internacional de Cooperación Sur-Sur (CSS). La hipótesis predictiva principal es que China está construyendo un régimen internacional de cooperación alternativo al del Comité de Ayudaal Desarrollo (CAD) de la OCDE, que, de acuerdo a una lógica de isomorfismo institucional, se sustenta en tres pilares: organizaciones internacionales de carácter financiero y político, instrumentos financieros de carácter concesional, y un sistema de monitoreo y evaluación. Como hipótesis subordinada se mantiene que, tras la experiencia  fracasada de la década de 1970, el intento de construcción de un régimen internacional alternativo al del CAD, y, por tanto, un cambio de régimen, tendrá éxito esta vez por la creciente fortaleza de China como potencia ascendente en términos económicos, militares y culturales y de liderazgo político. Este nuevo régimen estará integrado por el primer pilar de las organizaciones internacionales financieras (el Banco Asiático de Inversión en Infraestructura) y políticas (la recién creada Agencia Estatal de Cooperación Internacional para el Desarrollo); el segundo pilar de la financiación ampliada del desarrollo; y el tercer pilar del sistema de monitoreo y evaluación.
Spatial differences and influencing factors of regional agricultural water use efficiency in Heilongjiang Province, China
Authors: Xiangda Zhang , Shuai Zhu
Published: May 2018

Improving the water use efficiency in agriculture is an important way to solve the problem of water shortage in agricultural areas and to improve the efficiency of water resource utilization. An evaluation indicator system of regional agricultural water use efficiency was constructed using data from 13 cities in Heilongjiang Province from 2013 to 2015. In addition, the comprehensive ranking of agricultural water use efficiency in each year was obtained by using an iterative combination method to correct the evaluation of individual models, including the analytic hierarchy process), matter element model and projection pursuit model (PPM). The results showed that the agricultural water use efficiency in Heilongjiang Province exhibited some regional differences in the 3 years evaluated spatially. And then, factors that influenced agricultural water use efficiency were analysed according to various criteria, and the rankings of cities and strategies were proposed to improve the agricultural water use efficiency according to this analysis. The results of the present study will have important theoretical and practical significance for guiding the scientific and rational formulation of agricultural water use strategies and improving the efficiency of agricultural water use in Heilongjiang Province.
Biological and In silico Studies on Synthetic Analogues of Tyrosine Betaine as Inhibitors of Neprilysin - A Drug Target for the Treatment of Heart Failure
Authors: Kawano Daniel Fabio , de Carvalho Marcelo Rodrigues , Machado Mauricio Ferreira Marcondes , Carmona Adriana Karaoglanovic , Braga Gilberto Ubida Leite , Carvalho Ivone
Published: May 2018

Background:

Fungal secondary metabolites are important sources for the discovery of new pharmaceuticals,
as exemplified by penicillin, lovastatin and cyclosporine. Searching for secondary metabolites of the
fungi Metarhizium spp., we previously identified tyrosine betaine as a major constituent.

Methods:

Because of the structural similarity with other inhibitors of neprilysin (NEP), an enzyme explored for
the treatment of heart failure, we devised the synthesis of tyrosine betaine and three analogues to be subjected to
in vitro NEP inhibition assays and to molecular modeling studies.

Results:

In spite of the similar binding modes with other NEP inhibitors, these compounds only displayed moderate
inhibitory activities (IC50 ranging from 170.0 to 52.9 µM). However, they enclose structural features required
to hinder passive blood brain barrier permeation (BBB).

Conclusions:

Tyrosine betaine remains as a starting point for the development of NEP inhibitors because of the
low probability of BBB permeation and, consequently, of NEP inhibition at the Central Nervous System, which is
associated to an increment in the Aβ levels and, accordingly, with a higher risk for the onset of Alzheimer's disease.
Carboxymethyl-hexanoyl Chitosan Nanodroplets for Ultrasonic Imaging and Drug Delivery to Tumor
Authors: Jinsui Yu , Bing Situ , Muhua Luo , Yue Li , Jianyi Liao , Meng Du , Kuan Cai , Chaopin Yang , Hui Zhang , Zhiyi Chen
Published: May 2018

Introduction: Although a great many strategies have been proposed for tumor-targeted chemotherapy,
current delivery methods of anticancer drugs present limited success with inevitable systemic toxicity. The aim of
this study was to develop a new kind of theranostic carrier for targeted tumor therapy.

Methods:

Prior to prepare CHC-PFP-DOX, carboxymethyl-hexanoyl chitosan (CHC) was synthesized by acylation
of carboxymethyl chitosan. To develop CHC-PFP, perfluoropentane (PFP), an ultrasound gas precursor, was
simultaneously encapsulated into the hydrophobic inner cores of pre-formulated CHC micelle in aqueous phase
via using the oil in water (O/W) emulsion method. The size distribution and surface charges of these nanodroplets
were measured and the morphology was observed by transmission electron microscopy (TEM). For ultrasound
imaging application, in vitro model was established to evaluate the imaging of CHC-PFP-DOX under different
concentration and mechanical index. After that, the anti-tumor effect of ultrasound combined with CHC-PFPDOX
on ovarian cancer cells was investigated.

Results:

The resulting CHC-PFP-DOX had a nano-sized particle structure, with hydrophobic anticancer
DOX/PFP inner cores and a hydrophilic carboxymethyl chitosan polymer outer shell. The favorable nano-scaled
size offers the potential to extravagate from veins and accumulate in tumor tissues via enhanced permeation and
retention (EPR) effect. Additionally, CHC-PFP-DOX showed the ability to serve as ultrasound imaging agent at
body temperature. Notably, it exhibited an ultrasound-triggered drug release profile through the external ultrasound
irradiation. Further study demonstrated that ultrasound combined with CHC-PFP-DOX can improve the
killing effect of chemotherapy for tumor.

Conclusion:

CHC-PFP-DOX holds great promise in simultaneous cancer-targeting ultrasound imaging and ultrasound-
mediated delivery for cancer chemotherapy.
Similar and Distinct Mechanisms in the Protective Processes of Upper and Lower Gastrointestinal Tract
Authors: Gyires K. , Laszlo Sz. B. , Lazar B. , Zadori Z. S.
Published: May 2018

Gastrointestinal (GI) mucosal integrity is based on the balance of aggressive and protective mechanisms.
Mucosal damage may occur when the injurious factors become dominant or the mucosal defensive processes
are impaired. The main target of the therapy against GI mucosal injury is the reduction of aggressive factors,
however, the therapeutic possibilities for stimulation of mucosal defensive processes are rather limited. This
overview focuses on the gastric and intestinal mucosal protective mechanisms and discusses the main targets that
increase protective processes and increase the mucosal resistance to injurious stimuli at pre-epithelial, epithelial
and sub-epithelial levels.
First Total Synthesis of ω-Phenyl Δ6 Fatty Acids and their Leishmanicidal and Anticancer Properties
Authors: Carballeira Nestor M. , Morales-Guzman Christian , Alvarez-Benedicto Ester , Torres-Martinez Zally , Delgado Yamixa , Griebenow Kai H. , Tinoco Arthur D. , Reguera Rosa M. , Perez-Pertejo Yolanda , Carbajo-Andres Ruben , Balana-Fouce Rafael
Published: May 2018

Introduction: The first total synthesis of ω-phenyl Δ6 fatty acids (FA) and their cytotoxicity
(A549) and leishmanicidal (L. infantum) activities are described. The novel 16-phenyl-6-hexadecynoic
acid (1) and the known 16-phenylhexadecanoic acid (2) were synthesized in 7-8 steps with overall
yields of 46 % and 41 %, respectively. The syntheses of the unprecedented 10-phenyl-6-decynoic acid
(3), 10-cyclohexyl-6-decynoic acid (4) and 10-(4-methoxyphenyl)-6-decynoic acid (5) was also performed
in 3 steps with 73-76 % overall yields. The use of lithium acetylide coupling enabled the 4-step
synthesis of 10-phenyl-6Z-decenoic acid (6) with a 100 % cis-stereochemistry. The cytotoxicity of
these novel FA was determined against A549 cells and L. infantum promastigotes and amastigotes.
Among the ω-phenylated FA, the best cytotoxicity towards A549 was displayed by 1, with an IC50 of
18 ± 1 μM. On the other hand, among the C10 acids, the ω-cyclohexyl acid 4 presented the best cytotoxicity
(IC50 = 40 ± 2 μM) towards A549.

Results:

Based on caspase-3/7 studies neither of the FA induced apoptosis in A549, thus implying other
mechanisms of cell death.

Conclusion:

The antileishmanial studies were performed with the top Leishmania donovani topoisomerase
IB (LdTopIB) inhibitors, namely 1 and 2 (EC50 between 14 and 36 μM, respectively), acids
that did not stabilize the cleavage complexes between LdTopIB and DNA. Acids 1 and 2 displayed cytotoxicity
towards L. infantum amastigotes (IC50 = 3-6 μM) and L. infantum promastigotes (IC50 = 60-
70 μM), but low toxicity towards murine splenocytes. Our results identified 1 as the optimum ω-
phenylated acid of the series.
Physicochemical Characteristics and In Vitro Starch Digestibility of Spontaneously Combined Submerged and Solid State Fermented Cassava (Manihot esculenta Crantz) Flour
Authors: Indrastuti Erning , Estiasih Teti , Zubaidah Elok , Harijono
Published: May 2018

Background:

High cyanide varieties of cassava must be detoxified before consumption.
Several studies showed detoxification of cassava by slicing, submerged fermentation (soaking), solid
state fermentation, and drying. One of traditional detoxification is combination of submerged and solid
state fermentation and the effect of this processing on cyanide reduction and food properties has not
been evaluation yet.

Objective:

This research studied the effect of solid state fermentation time on physicochemical, starch
granule morphology, and in vitro starch digestibility of cassava flour from high cyanide varieties of
Malang 4, Malang 6, and Sembung.

Methods:

Three varieties of high cyanide grated cassavas were soaked for 3 days in ratio of water to
cassava 1:1. After draining for 1 hour, grated cassava was placed in a bamboo container and put in a
humid place for 3-day solid state fermentation. Fermented grated cassavas were then dried, milled,
and analyzed.

Results:

Solid state fermentation similarly affected cyanide reduction and characteristics of cassava
flour for three high cyanide varieties. The detoxification process reduced cyanide to 89.70-93.42% and
produced flour with a total cyanide of 8.25-10.89 mg HCN eq/kg dry matters, which is safe to consume.
Fermentation decreased cyanide, starch content, titratable acidity, swelling power, and solubility;
meanwhile pH, amylose content, water absorption, oil absorption, and in vitro starch digestibility
increased in all three varieties studied. Submerged fermentation reduced the pH thus inhibiting the
degradation of linamarin and cyanohydrin into free HCN. pH value was increased by solid state fermentation,
from 4.43 to 6.90 that optimum for linamarin and cyanohydrin degradation into free HCN.
The submerged and solid-state fermentation indeuce spontaneous microbial growth that affected
chemical composition of cassava flour. The changes of structure and morphology of starch granules
affected pasting properties, and Increased in vitro starch digestibility due to damaged granules.

Conclusion:

Solid-state fermentation reduced cyanide content of all three cassava varieties into the
safe level for consumption, and aiso changed chemical, physical, and functional characteristics and
starch digestibility of cassava flour.
Analysis of babA, cagE and cagA Genes in Helicobacter pylori from Upper Gastric Patients in the North of Iran
Authors: Asl Saba Fakhrieh , Pourvahedi Mehrnaz , Mojtahedi Ali , Shenagari Mohammad
Published: May 2018

Objective:

Helicobacter pylori is a Gram-negative bacterium which has a serious effect on up to half of the world’s population and has been related to different gastric diseases. The goal of this study was to assess the frequency of babA, cagE and cagA genotypes among H. pylori strains isolated from gastric biopsies of endoscopic patients in the north of Iran.

Methods:

The present study was performed on 90 strains of H. pylori isolated from patients with gastric diseases (Gastric ulcer (GU), Duodenal ulcer (DU), Gastritis (G), Non-ulcer dyspepsia (NUD) and Gastric adenocarcinoma (GC)). DNA was extracted from all isolated strains and PCR method was performed to detect the prevalence of babA2, cagE and cagA genes using specific primers.

Results:

Among 90 samples of H. pylori, babA2, cagE, and cagA genes were detected in 42.2%, 30% and 82.2% of strains respectively. The statistical analysis showed that the prevalence of cagA gene in GU, G, DU, and NUD was significantly higher than other genes. Moreover, cagA, and babA2 genes were significantly more prevalent in GC patients compared to cagE gene. Our isolates exhibited 8 distinct arrangements of virulence patterns. The occurrence of cagA (35.6%) was the most prevalent pattern followed by cagA/babA2 (20%) and cagA/babA2/cagE (14.4%).

Conclusion:

In summary, as first report from Guilan province in the north of Iran, we showed significant association between the presence of babA2, cagE, and cagA genes in different types of gastric disorders.
Protective Effects of Crocetin on Depression-like Behavior Induced by Immobilization in Rat
Authors: Farkhondeh Tahereh , Samarghandian Saeed , Samini Fariborz , Sanati Ali Rajabpour
Published: May 2018

Background & Objective:

Crocetin, an active ingredient of saffron, has been recognized as
a potent antioxidant. Plant extracts or their components may be useful in ameliorating the various
diseases, including neurodegenerative disorders. This study investigated the effects of crocetin on
oxidative damage induced by chronic restraint stress in the rat brain. For this reason, rats were kept in
the restrainers for 1 hour every day, for 21 consecutive days. The animals were injected crocetin (20,
40, 60 mg/kg) or vehicle daily for 21 days. Findings showed that the immobility time significantly increased
in the rodents subjected to the chronic stress compared with the normal group. However, the
number of crossing beams in the rats submitted to the chronic stress significantly decreased versus the
non-stress rats. Treatment with crocetin ameliorated the immobility time and the number of crossing in
the chronic restraint stress rats versus the non-treated stress group. Crocetin also reverted the levels of
MDA and GSH and also the activities of antioxidant enzymes to the normal levels in the stress groups.

Conclusion:

The present study suggests that crocetin may be useful for the management of depressantlike
effects induced by chronic stress through decreasing oxidative damage in the brain.
Modernizing Extremism: A Case of New Age Militancy in Kashmir
Authors: Ganaie Nasir Ahmad
Published: May 2018

The research article delivers enlightenment on the New Age Militancy in Kashmir in which the new energetic and vigorous faces arose to enter militancy and for the stated design the usage of contemporary and improvised ways are drawn to recruit youngsters in the valley. Known to the outer world as tech-savvy militants who are hailing from the rich educational backgrounds and they do believe in autochthonous viewpoint of militancy irrespective of different names of the terror outfits. Besides this, there is a new trend of “Arms Snatching” which has been prevalent in the valley mostly from last three years to arm the newly recruits. The article also analyses the impact of the social media usage in branding the New Age Militancy.
Women and Iranian Criminal Justice System
Authors: Rahmdel Mansour
Published: May 2018

To understand the predicament of women in Iran, it is necessary to look to both the religion and strong social and cultural forces, which shape their position in society. Islam is often held responsible for the inequitable and sometimes violent treatment of women in Iran. Considering the women situation before Islam, they have gained more rights after Islam. But, no doubt that the differences and strong social and cultural forces regarding women arise from Islam in the Iranian society. The justifications of these differences mainly is that before Islam the women had so little rights and even they were buried alive, but Islam has rescued them and given them some rights. While this view point in per se is completely un-right, but the point is that, it was 1400 years ago and in addition, why Islam has not completed the protection against all differences. The simple answer is that in that social situation it was impossible to convenience the men to accept the equality of men and women. Problems in attaining the full recognition and enjoyment of all human rights and fundamental freedoms for women in Iranian criminal justice system are the main theme of the present article.
Student Impression Management in the Classroom
Authors: Haber Julita , Tesoriero Robert
Published: May 2018

With the growing shift from lecture-style teaching methods to interactive and experiential group exercises, instructors need to know more about their students, such as their desired impressions, to adequately engage and support students’ social interactions. This study addresses this need by providing an overall understanding of the types of images that are important for students to project when interacting with others in a classroom. After a concise review of impression management literature and grounding our reasoning in cybernetic theory (Bozeman & Kacmar, 1997) this study offers an insight of the positive impressions students desire to project in front of their peers and professors and the negative impressions students aim to avoid. With a two-part survey based on 269 responses, we measured students’ ranking of specific images and the effort level they exerted towards achieving or avoiding them. We offer suggestions of how these findings can be integrated into teaching for improved student learning and experiences.
Lime Fertilizer with Prolonged Balanced Effect Period
Authors: Loide Valli , Nikolajeva Julia , Rani Ahto
Published: May 2018

Soil acidification and decalcification are mostly continuous. From the aspect of soil quality maintenance and improvement, the soil requires stable calcium content. The more acidic is the soil and the finer are the lime fertilizer particles, the easier they dissolve, and the soil becomes poor in calcium. In order to modify the rate and duration of lime fertilizer dissolution, this work included investigation of solubility and dissolution rates of various fractions of limestone. Based on the dissolution rates of particles with different sizes, the content of different fractions can be calculated so as to make the solubility of lime fertilizer more stable and long-term. A long-term uniform solubility provides a more stable available calcium content in the soil, which facilitates the formation and development of beneficial soil characteristics. In the field trials, upon liming with a fertiliser with prolonged effect time, the content of available Ca in soil was more stable and remained at optimum level also in 4rd-5th year.
Editorial
Authors: Hernández Castorena Octavio
Published: May 2018

Posterior a la Segunda Guerra Mundial, el Dr. Hiroyuki Hirano, de origen japonés, generó una filosofía que a la fecha ha permeado no solo la industria automotriz, sino todas las áreas posibles incluyendo instituciones de orden educativo (Hirano, 2000), a esta filosofía le llamó 5’s. Son 5’s porque se compone de 5 dimensiones y están identificadas con nombres que inician con «s»: Seiri (Selección), Seiton (Organización), Seiso (Limpieza), Seiketsu (Disciplina) y Shitsuke (Educación). Es enToyota donde se evidenció la utilidad e importancia que tiene esta filosofía (Baltazar, 2003). Sin embargo, para la percepción de Hirano no ha sido suficiente el aprendizaje y practica de estas 5’s, en particular en América Latina, por lo cual genera las 4’s restantes: Shikari (Constancia), Shitsukoku (Compromiso), Seisho (Coordinación) y Seido (Estandarización), a las cuales identifica con la parte actitudinal de las personas (Hernández, 2007).
The mediterranean diet: culture and its impact on consumer habits in Barcelona restaurant
Authors: Sánchez-Torres Javier , Arroyo-Cañada Francisco Javier , Solé-Moro María Lluisa , Argila-Irurita Ana
Published: May 2018

This article studies the importance of the Mediterranean diet in the menus of restaurants in the city of Barcelona. It is based on a review of previous studies about the great influence of the Mediterranean culture on daily aspects such as food. A qualitative study was conducted and a sample of experts—head chefs at restaurants in Barcelona—was selected. The results show that the Mediterranean diet is positioned in the minds of their customers; therefore, all the decisions related to the purchase of products and the planning of menus and dishes are made following the guidelines of the Mediterranean diet. This study is an important contribution to the research field of culture in consumption habits, because it confirms that the Mediterranean diet still is strongly preferred over new foods, dishes and foreign menus. The habits of consumers remain true to their culinary traditions.
Strength in Numbers: Opportunities for Enhancing the Development of Effective Treatments for Type 1 Diabetes—The TrialNet Experience
Authors: Greenbaum Carla J. , Speake Cate , Krischer Jeffrey , Buckner Jane , Gottlieb Peter A. , Schatz Desmond A. , Herold Kevan C. , Atkinson Mark A.
Published: May 2018

The early to mid-1980s were an inflection point in the history of type 1 diabetes research. Two landmark events occurred: the initiation of immune-based interventions seeking to prevent type 1 diabetes and the presentation of an innovative model describing the disorder’s natural history. Both formed the basis for hundreds of subsequent studies designed to achieve a dramatic therapeutic goal—a means to prevent and/or reverse type 1 diabetes. However, the need to screen large numbers of individuals and prospectively monitor them using immunologic and metabolic tests for extended periods of time suggested such efforts would require a large collaborative network. Hence, the National Institutes of Health formed the landmark Diabetes Prevention Trial-Type 1 (DPT-1) in the mid-1990s, an effort that led to Type 1 Diabetes TrialNet. TrialNet studies have helped identify novel biomarkers; delineate type 1 diabetes progression, resulting in identification of highly predictable stages defined by the accumulation of autoantibodies (stage 1), dysglycemia (stage 2), and disease meeting clinical criteria for diagnosis (stage 3); and oversee numerous clinical trials aimed at preventing disease progression. Such efforts pave the way for stage-specific intervention trials with improved hope that a means to effectively disrupt the disorder’s development will be identified.