bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction—a holistic approach to Indigenous peoples’ rights to cultural heritage
Authors: Porsanger Jelena , Virtanen Pirjo Kristiina
Published: January 2020

This introductory article examines key issues related to Indigenous conceptualisations of cultural heritage, especially intergenerational aspects, Indigenous concepts of time, Indigenous knowledge, heritage language, and relationships with the environment. It urges to reflect on how these aspects are integrated when legal mechanisms protecting and promoting Indigenous cultural heritage have been designed and developed. The article also discusses the ability to form resistance through Indigenous cultural heritage. Our examples, which primarily come from the Sámi and also from global Indigenous perspectives, all point to the importance of a holistic approach to guarantee Indigenous peoples’ rights to their cultural heritage. Finally, we discuss the crucial role of research and appropriate research methodologies in contributing to better protection of Indigenous cultural heritage.
Study of damage identification for bridges based on deep belief network
Authors: Guo Qi , Feng Lei , Zhang Ruyi , Yin Haijun
Published: January 2020

To solve the problem of poor anti-noise ability faced by traditional pattern recognition methods in damage identification field, a bridge damage identification method based on deep belief network was proposed. Taken the modal curvature difference as the damage index, three restricted Boltzmann machines were constructed for pre-training. Then, the Softmax classifier and neural network were used to identify the damage location and degree under the environmental cases of no noise, weak noise, and strong noise, respectively. Subsequently, the influence of incomplete measurement modal data on the method was studied. Finally, damage identification based on deep belief network was implemented to a continuous beam bridge and compared with that of the back propagation neural network. The results showed that the proposed method could be highly effective not only on damage location but also on degree identification. Compared with back propagation neural network, deep belief network method may possess better identification ability and stronger anti-noise ability. It also demonstrates good identification effect under the condition of incomplete measurement modal data.
Comparative numerical simulation of inhaled particle dispersion in upper human airway to analyse intersubject differences
Authors: Phuong Nguyen Lu , Khoa Nguyen Dang , Ito Kazuhide
Published: January 2020

This study predicted the total and regional deposition of particles in realistic upper human airways and demonstrated the effects of intersubject variations in deposition fraction. Two airway models were studied under flow rates ranging from 0.45 to 2.4 m3/h and particle aerodynamic diameters from 1 to 10 μm. The total deposition predictions were validated using in vivo and in vitro experimental data. The intricate airway structures generated heterogeneities of airflow distributions and corresponding particle dispersions and depositions in the models. Nevertheless, with modified inertial parameters, the total deposition fraction curves of the two human upper airway models, as functions of flow rates, converged to a single function. However, regional particle deposition fractions differed significantly among the two models. The surface pressure and wall-shear stress distribution were investigated to assess the relationship of surface pressure and wall-shear stress with hotspot locations in upper airways of both models. For one subject (model A), the central nasal passage regions were found to be sites of higher deposition over the range of particle sizes and flow rates targeted in this study. For the other subject (model B), higher deposition was mostly observed in the vestibule region, caused due to particle inertia as the airway consisted of curvatures. The accelerated flow regions acted as a natural filter to high inertial particles. The results indicated that both total and regional depositions exhibited significant intersubject differences.
Impact of thermal behaviour of different environmental conditions on ambient environment and thermal discomfort in Malaysia
Authors: Lee Yee Yong , Md Din Mohd Fadhil , Iwao Kenzo , Lee Yeong Huei , Anting Nickholas
Published: January 2020

Thermal behaviour of various urban environments may increase the surrounding temperature and induce the urban heat island phenomenon. This study carried out local climatic measurements on different urban environments and evaluated their thermal comfort performance. The monitoring sites were selected on the basis of the characteristics of vegetated area, built-up environment and open space areas. Results showed that the temperature variations between vegetated areas and open spaces were lower on average at about 5°C and 3.5°C, respectively. The higher temperatures in built-up areas may be due to higher solar radiation exposure and reflection of long wave radiation from adjacent buildings. Meanwhile, the open space faced the sky with no building obstructions and allowed a free flow of wind to cool down the surface temperature through convection and radiation. Furthermore, the discomfort index was calculated and its value lay within the category of ‘partially comfortable’ where people have adjusted to the local climate. Thus, urban greenery, the use of high albedo surface materials and proper implementation of urban geometry are important elements for a sustainable urban development with improved thermal comfort.
The impact of ‘unofficial trauma’ on a Major Trauma Centre: A service evaluation of accident and emergency department trauma team activations
Authors: Wright Alex , Mercer Simon J , Morton Ben
Published: January 2020

Introduction

Trauma remains a leading cause of death worldwide. In the UK, data for trauma patients are prospectively collected locally and collated by the Trauma Audit and Research Network. This study assesses and describes the subgroup of patients who triggered a trauma call but who subsequently did not meet criteria for Trauma Audit and Research Network.

Methods

A single centre, retrospective observational study of trauma calls between 1 June 2012 and 31 August 2018 was performed, determining which trauma calls had been submitted to Trauma Audit and Research Network by cross referencing with the submission database. Data were tested for normality (Shapiro–Wilk test) and appropriate statistical tests employed to determine differences between inclusion and non-inclusion groups. For categorical data, we used Chi-squared tests to examine for differences.

Results

There were 6529 trauma calls and over half (3837 (58.8%)) were not registered on Trauma Audit and Research Network. Patients excluded were significantly younger (mean 42.4 years SD 19.2) than those who met inclusion criteria (mean 50.3 years, SD 21.8), p < 0.001 and were significantly more likely to suffer from penetrating trauma (18.6% versus 8.2%, p < 0.001), the majority (77.8%, 553/713) caused by stabbings. Patients excluded were less likely to be involved in a road traffic accident (31.1% versus 35.3%, p < 0.001), less likely to have fallen downstairs (15.2% versus 18.7%, p < 0.001) and less likely to have fallen from a height > 2 m (8.1% versus 12.7%, p < 0.001).

Discussion

Patients who trigger a trauma call but who subsequently do not meet the criteria for Trauma Audit and Research Network inclusion place a significant burden on healthcare provision. To our knowledge this is the first investigation to specifically explore this group of at-risk patients. To enable medical planners a more accurate view of activity on the ‘shop floor’, particularly in reference to knife crime injuries we ask the question as to whether a separate database should now be held of trauma calls?
Rationalization of freeform space-frame structures: Reducing variability in the joints
Authors: Koronaki Antiopi , Shepherd Paul , Evernden Mark
Published: January 2020

In recent years, the application of space-frame structures on large-scale freeform designs has significantly increased due to their lightweight configuration and the freedom of design they offer. However, this has introduced a level of complexity into their construction, as doubly curved designs require non-uniform configurations. This article proposes a novel computational workflow that reduces the construction complexity of freeform space-frame structures, by minimizing variability in their joints. Space-frame joints are evaluated according to their geometry and clustered for production in compliance with the tolerance requirements of the selected fabrication process. This provides a direct insight into the level of customization required and the associated construction complexity. A subsequent geometry optimization of the space-frame’s depth minimizes the number of different joint groups required. The variables of the optimization are defined in relation to the structure’s curvature, providing a direct link between the structure’s geometry and the optimization process. Through the application of a control surface, the dimensionality of the design space is drastically reduced, rendering this method applicable to large-scale projects. A case study of an existing structure of complex geometry is presented, and this method achieves a significant reduction in the construction complexity in a robust and computationally efficient way.
Integrating photoacoustic microscopy, optical coherence tomography, OCT angiography, and fluorescence microscopy for multimodal imaging
Authors: Dadkhah Arash , Jiao Shuliang
Published: January 2020

We have developed a multimodal imaging system, which integrated optical resolution photoacoustic microscopy, optical coherence tomography, optical coherence tomography angiography, and confocal fluorescence microscopy in one platform. The system is able to image complementary features of a biological sample by combining different contrast mechanisms. We achieved fast imaging and large field of view by combining optical scanning with mechanical scanning, similar to our previous publication. We have demonstrated the capability of the multimodal imaging system by imaging a mouse ear in vivo.

Impact statement

Photoacoustic microscopy-based multimodal imaging technology can provide high-resolution complementary information for biological tissues in vivo. It will potentially bring significant impact on the research and diagnosis of diseases by providing combined structural and functional information.
A novel one-dimensional coordination polymer of cadmium(II)/triazine extending by di-chloro and di-iodo bridges
Authors: Shahmirzaei Shakiba , Mardani Zahra , Moeini Keyvan , Carpenter-Warren Cameron , Slawin Alexandra MZ , Woollins J Derek
Published: January 2020

A new triazine ligand salt, 2,2′,2″-(1,3,5-triazine-2,4,6-triyl)tris(hydrazin-1-ium) chloride [THT·(HCl)3], and the one-dimensional coordination polymer of cadmium, [Cd2( µ-THT)( µ-Cl)( µ-I)I2]·2(H2O), are prepared and characterized by elemental analysis, Fourier-transform infrared spectroscopy, 1H NMR spectroscopy, and single-crystal X-ray diffraction (for the cadmium polymer). X-ray analysis revealed that the polymeric backbone is extended alternatively by di-iodo and di-chloro bridges; this type of bridge is not observed previously between any metal atoms. There are two types of cadmium atoms in the polymer: cadmium of the polymeric chain and terminal cadmiums. The geometry around the first (CdN2Cl2I2) is octahedral, while the latter (CdN3I2) has an incline to square-pyramidal geometry. The triazine ligand of this structure also bridges two cadmium atoms and acts as an N3 donor toward the terminal cadmium atoms and as an N2 donor toward the cadmium atoms of the chain. In the crystal network of the cadmium polymer, the hydrogen bonds of N–H···X (X: O, N, I) form different hydrogen bond motifs, including [Formula: see text](8), [Formula: see text](10), [Formula: see text](14), [Formula: see text](18), [Formula: see text](20), [Formula: see text](24), [Formula: see text](28), and [Formula: see text](32).
A literature review exploring common factors contributing to Never Events in surgery
Authors: Koleva Stefka Ilieva
Published: January 2020

This literature review explores some common factors contributing to Never Events in surgery. Despite significant patient safety efforts, serious preventable surgical events that turn into Never Events continue to exist. Various search databases were used to collect relevant contemporary data within the time parameters 2008–2019. The literature revealed numerous studies from the United States of America and worldwide, and the need for more current research from the United Kingdom on the subject. The key findings emphasise that communication failure, situational awareness, fatigue, lack of healthcare professionals and surgical caseload are common contributing factors to Never Events. The implications of these findings for practice highlight that despite multidisciplinary approaches, technologies, policies and strategies, Never Events are a common phenomenon in surgery. To minimise their occurrence, more robust and reliable safety management systems need to be in place within healthcare organisations. In depth understanding of cognitive Human Factors and non-technical skills need to be encouraged through education, training and continuous evaluation of success and failure.
Same sized three-way indwelling urinary catheters from various manufacturers present different irrigation and drainage properties
Authors: Carneiro Arie , Wroclawski Marcelo Langer , Peixoto Guilherme Andrade , Cha Jonathan Doyun , Moran Natasha Kouvaleski Saviano , Chen Felipe Ko , Satkunas Henrique Nelson , Campos José Roberto Augusto , Garcia Alides Maria Mendes Rasabone , Monga Manoj , Lemos Gustavo Caserta
Published: January 2020

Background:

The three-way indwelling urinary catheter (IUC) is used for continuous bladder irrigation and is considered the cornerstone for clinical treatment of patients with macroscopic hematuria. Although there seems to be a logical relationship between catheter size and efficacy of irrigation and drainage, we often observe relevant variations in these parameters between different brands of catheters available on the market. The aim of this study was to compare the mechanical properties of different models of latex and silicone three-way catheters in an in vitro setting that resembles clinical use.

Methods:

Three different three-way catheters were evaluated: Gold Silicone-Coated Rusch® (Model A), 100% Silicone Rusch® (Model B) and X-Flow Coloplast® (Model C). Irrigation channel, drainage channel, and overall cross-sectional areas were all digitally measured. Irrigation and drainage channel flow rates were measured and correlated with their corresponding catheter cross-sectional area values.

Results:

Different catheter models of the same caliber have different internal irrigation port diameters, internal drainage port diameters and internal cuff port diameters. The Model C IUC internal irrigation port diameter is significantly larger than models A and B. When flows were evaluated, we found that in the same model, the increase in caliber of the IUC was related to an increased drainage flow, but not to an increased irrigation flow.

Conclusion:

Precise measurements of the internal architecture of the three-way catheter, rather than relying on the caliber itself, could assist surgeons in choosing the best product for each specific patient, while minimizing complications.
Work with me, not for me: Relationship between robotic assistance and performance in subacute and chronic stroke patients
Authors: Kager Simone , Hussain Asif , Budhota Aamani , Dailey Wayne D , Hughes Charmayne ML , Deshmukh Vishwanath A , Kuah Christopher WK , Ng Chwee Yin , Yam Lester HL , Xiang Liming , Ang Marcelo H , Chua Karen SG , Campolo Domenico
Published: January 2020

Introduction

Studies in robotic therapy which applied the performance enhancement approach report improvements in motor performance during training, though these improvements do not always transfer to motor learning.

Objectives

We postulate that there exists an assistance threshold for which performance saturates. Above this threshold, the robot’s input outweighs the patient’s input and likely learning is not fostered. This study investigated the relationship between assistance and performance changes in stroke patients to find the assistance threshold for performance saturation.

Methods

Twelve subacute and chronic stroke patients engaged in five sessions (over two weeks, each 60 min) in which they performed a reaching task with the rehabilitation robot H-Man in presence of varying levels of haptic assistance (50 N/m to 290 N/m, randomized order). In two additional sessions, a therapist manually tuned the assistance to promote maximal motor learning.

Results

Higher levels of assistance resulted in smoother and faster performance that saturated at assistance levels with K ≥  110 N/m. Also, the therapist selected assistance levels of K =  175 N/m or below.

Conclusion

The findings of the study indicate that low levels of assistance ( K ≤  175 N/m) can sufficiently induce a significant change in performance.
Development and Preliminary Validation of the Interest in Leadership Scale
Authors: Steele Andrea R. , Day David V.
Published: January 2020

Interest pertains to an individual’s psychological arousal toward a topic, which is thought to motivate effort allocation and attention. Interest in leadership has been identified as a potential antecedent of leader development; however, supporting empirical evidence has been hindered by the lack of a relevant scale to measure the construct. Study 1 outlines the development of the Interest in Leadership Scale (ILS) using Rasch scale development principles. Study 2 establishes the predictive validity of the ILS with self-rated leadership emergence and transformational leadership behaviors. This measure is likely to prove useful in the future measurement of and research into the topic of interest in leadership.
Borrowing Brands to Create a Brand: The Commercial Mediation of Paralympic Athletes
Authors: Jackson-Brown Carolyn
Published: January 2020

A transformational shift in recognition for Paralympic athletes occurred when media representations of disability were dramatically reframed for the UK’s coverage of the London 2012 Paralympic Games. The success of that media coverage was consolidated and built upon for Rio 2016 and has been attributed in huge part to the success of the marketing. Drawing on interviews with the key decision makers, conducted shortly after Channel 4’s historic 2012 Paralympic media coverage, my empirical material illuminates how the process of changing perceptions relied heavily on branded meanings. Alongside the unorthodox visual portrayals, partnerships with familiar brands were felt to be necessary to help resonate normal feelings for digital consumers and reinforce mainstream cultural acceptance. It was not enough to just change televisual representations of para-sports bodies and saturate the TV/online schedule with elite status programming, the producers knew they needed to use meanings associated with commodified brands to reassure the public as well. This study is based on corporate internal documentation as well as interviews with executive and creative decision makers working for the UK’s Paralympic broadcaster, Channel 4. It reveals a production practice that is not normally associated with bringing marginalised groups to the mainstream media attention.
Effects of continuing use of aspirin on blood loss in patients who underwent unilateral total knee arthroplasty
Authors: Hang Guanqi , Chen Jerry Yongqiang , Yew Andy Khye Soon , Pang Hee-nee , Jin Darren Tay Keng , Chia Shi-Lu , Lo Ngai Nung , Yeo Seng Jin
Published: January 2020

Purpose:

Concerning the ongoing debate on the effects of continuing aspirin therapy on blood loss in knee arthroplasty, we conducted a retrospective investigation to test the hypothesis that continuation of aspirin prior total knee arthroplasty (TKA) will not cause more blood loss.

Methods:

From a database of patients who underwent unilateral TKA between 2011 and 2016, we identified two groups: the aspirin group (patients continued aspirin during perioperative period) and the nonaspirin group (patients had no current or recent history of aspirin usage). We extracted and compared patient demographic information, comorbidity index, baseline serum hemoglobin (Hb), and creatinine level between the two groups. We also compared our primary outcomes, including the total blood loss, transfusion requirement, and length of hospitalization between the two groups. A multivariate logistic regression for analyzing the risk factors of requiring transfusion was performed.

Results:

We found that apart from preoperative serum creatinine level, there was no difference in the baseline Hb level, perioperative change in Hb, total blood loss, or length of hospitalization between the two groups. The percentage of transfusion utilization was also comparable between the two groups. Our regression analysis shows that the risk of requiring transfusion after TKA is not significantly associated with patients taking aspirin therapy before operation.

Conclusion:

Patients who underwent TKA with continuation of low-dose aspirin did not result in more blood loss. Current blood loss management has provided sufficient reduction of blood loss to accommodate aspirin therapy perioperatively. We suggest that it is safe to continue aspirin prior to TKA.
Reperfusion After Severe Frostbite: First Full-Thickness Necrosis After Initial Successful Thrombolysis
Authors: Al Yafi Mohamed Nazhat , izadpanah Ali , Danino Michel Alain , Coeugniet Edouard
Published: January 2020

A 36-year-old male who suffered severe frostbite injuries to both feet presented with an estimated total body surface area at around 4%. These injuries resulted from the patient travelling from his town by foot, with a temperature of −10°C during 4 days. On route, he received rewarming therapy followed by thrombolysis that was initiated as the duration of the warm ischemia period resided under 24 hours. Immediately after the procedure, the feet recovered clinically up to the distal toes. Saturation revealed normal values. Thrombolysis ceased after 9 hours and angiography showed adequate perfusion of the toes. Three hours later, pedal pulses at the toes were lost. Subsequently, the patient developed blisters and progressive necrosis of the toes to midfoot. Both feet were managed expectantly and were dressed, but the conditions of both feet worsened and the tissue turned into full-thickness necrosis. The decision was made to amputate a month after thrombolysis.
Interobserver Variability in the Diagnosis of High-Grade Prostatic Intraepithelial Neoplasia in a Tertiary Hospital in Northern Jordan
Authors: Aldaoud Najla , Hallak Amer , Abdo Nour , Al Bashir Samir , Marji Noor , Graboski-Bauer Ashley
Published: January 2020

Prostate intraepithelial neoplasia is described as a precursor lesion to prostatic adenocarcinoma. High-grade prostate intraepithelial neoplasia (HGPIN) is classified as both grade 2 and 3 prostate intraepithelial neoplasia due to inconsistency between pathologists’ findings. In our study, we assessed the interobserver variability in the diagnosis of HGPIN among genitourinary and nongenitourinary pathologists. All cases with prostate adenocarcinoma diagnosis on needle core biopsy, radical prostatectomy, and transurethral resection of prostate (TURP) between the years 2005 and 2014 were included. In total, 191 prostate cancer cases were included: 109 needle core biopsies, 45 radical prostatectomies, and 37 TURP. All were independently reviewed by 2 urologic pathologists for the presence of HGPIN. High-grade prostate intraepithelial neoplasia was diagnosed in 65 cases (34%), among which the lesion was recognized by the reporting pathologists in 36 (55%) of the cases and was missed in 29 (45%) of the cases with a κ coefficient of 0.53. There was a moderate interobserver agreement in the diagnosis of HGPIN. Consultation with genitourinary pathologist can improve HGPIN diagnosis.
Patient Satisfaction With Diabetes Care in a Student-Run Free Medical Clinic: A Quality Improvement Study
Authors: Schroeder Michelle N. , Hickey Maureen O.
Published: January 2020

Background: Diabetes prevalence continues to be a concern and the management of diabetes is important but costly. The prevalence of diabetes is greater among persons with a low income, including those who are uninsured or underinsured. Student-run free clinics (SRFC) are one resource to these patients who may otherwise lack access to medical care. Objective: The purpose of this study was to assess patient satisfaction with diabetes care at a SRFC in order to assist in identifying areas of improvement. Methods: A quality improvement survey was designed to assess patient satisfaction with overall care, as well as with routines and perception of care related to self-management, healthy eating, and exercise. Results: The survey was completed by 25 patients at a Toledo area SRFC. Established patients who were aged 18 years or older and diagnosed with diabetes, were invited to complete the survey. The majority of patients were satisfied with their diabetes care at the SRFC (88%). Fewer patients, however, reported satisfaction with the treatment for their diabetes (72%) and with their knowledge about diabetes (76%). Subanalyses of survey responses also showed significant differences when comparing sex, age, and length of diabetes diagnosis. Conclusions: The survey helped identify key areas in which the diabetes care provided at the SRFC could be improved. These areas included education about diabetes in general, as well as in understanding treatment, self-monitoring, and healthy eating and exercise options. Future research could explore survey results after specifying and implementing changes made to the education provided to the patients.
Treatment of venous thromboembolism in pediatric patients
Authors: Witmer Char , Raffini Leslie
Published: January 2020

Venous thromboembolism (VTE) is rare in healthy children, but is an increasing problem in children with underlying medical conditions. Pediatric VTE encompasses a highly heterogenous population, with variation in age, thrombosis location, and underlying medical comorbidities. Evidence from pediatric clinical trials to guide treatment of VTE is lacking so treatment is often extrapolated from adult trials and expert consensus opinion. Aspects unique to children include developmental hemostasis and the major role of central venous access devices. There is an absence of information regarding the optimal target levels of anticoagulation for neonates and infants and lack of suitable drug formulations. Anticoagulants, primarily low-molecular-weight heparin and warfarin, are used to treat children with symptomatic VTE. These drugs have significant limitations, including the need for subcutaneous injections and frequent monitoring. Randomized clinical trials of direct oral anticoagulants in pediatric VTE are ongoing, with results anticipated soon. These trials will provide new evidence and options for therapy that have the potential to improve care. International collaborative registries offer the ability to study outcomes of rare subgroups of pediatric VTE (eg, renal vein thrombosis), and will be important to ultimately guide therapy in a more disease-specific manner.
Metabolic syndrome increases risk of venous thromboembolism recurrence after acute deep vein thrombosis
Authors: Stewart Lauren K. , Kline Jeffrey A.
Published: January 2020

An improved understanding of which patients are at higher risk of recurrent venous thromboembolism (VTE) is important to designing interventions to reduce degraded quality of life after VTE. Although metabolic syndrome (MetS), the clustering of hypertension, hyperlipidemia, diabetes mellitus, and obesity has been associated with a hypofibrinolytic state, data linking VTE recurrence with MetS remain limited. The purpose of this study was to measure the prevalence of MetS in patients with deep vein thrombosis (DVT) across a large population and determine its effect on VTE recurrence. This was a retrospective analysis of a large statewide database from 2004 to 2017. We measured the frequency with which patients with DVT carried a comorbid International Coding of Diseases diagnosis of MetS components. Association of MetS with VTE recurrence was tested with a multiple logistic regression model and VTE recurrence as the dependent variable. Risk of VTE recurrence conferred by each MetS component was assessed by Kaplan-Meier curves with the log-rank statistic. A total of 151 054 patients with DVT were included in this analysis. Recurrence of VTE occurred in 17% overall and increased stepwise with each criterion for MetS. All 4 components of MetS had significant adjusted odds ratios (OR) for VTE recurrence, with hyperlipidemia having the largest (OR, 1.8), representing the 4 largest ORs of all possible explanatory variables. All 4 MetS variables were significant on Kaplan-Meier analysis for recurrence of VTE. These data imply a role for appropriate therapies to reduce the effects of MetS as a way to reduce risk of VTE recurrence.
MRI predicts 5-year joint bleeding and development of arthropathy on radiographs in hemophilia
Authors: Foppen Wouter , van der Schaaf Irene C. , Beek Frederik J. A. , Mali Willem P. T. M. , Fischer Kathelijn
Published: January 2020

Magnetic resonance imaging (MRI) is considered as the reference standard to assess early joint changes in hemophilia. However, the clinical relevance of MRI findings is still unknown. The aim of this prospective study was to assess the predictive value of MRI for 5-year joint bleeding and progression of arthropathy in patients with hemophilia. Both knees and ankles of patients with hemophilia and absent or limited arthropathy on radiographs were assessed by using MRI and radiographs. MRI scans were scored according to the International Prophylaxis Study Group MRI score for hemophilic arthropathy. Patients were followed up for 5 years, including assessment of joint bleeding and repeated radiographic assessment. Associations between baseline MRI findings with 5-year bleeding and progression of arthropathy were expressed as odds ratios (OR), adjusted for severity of disease and joint bleeding history. Baseline assessment included 104 joints of 26 patients with hemophilia (median age, 21 years). Four ankles with severe joint changes were excluded. Follow-up was available for 96 (92%) of 104 joints. During 5 years of follow-up, bleeding was reported for 36% of joints. Five-year bleeding was significantly increased in joints with synovial hypertrophy at 80% vs 27% in joints without synovial hypertrophy (OR, 10.1; 95% confidence interval, 3.4-31.3). In joints with normal baseline radiographs, any osteochondral or synovial changes on MRI were associated with radiographic changes 5 years later (positive predictive value, 75%; negative predictive value, 98%). Joints with synovial hypertrophy on MRI had a significantly higher chance of 5-year bleeding. All MRI changes, except effusion, were strong predictors for development of arthropathy on radiographs.
Multiset sparse partial least squares path modeling for high dimensional omics data analysis
Authors: Csala Attila , Zwinderman Aeilko H. , Hof Michel H.
Published: January 2020

Background

Recent technological developments have enabled the measurement of a plethora of biomolecular data from various omics domains, and research is ongoing on statistical methods to leverage these omics data to better model and understand biological pathways and genetic architectures of complex phenotypes. Current reviews report that the simultaneous analysis of multiple (i.e. three or more) high dimensional omics data sources is still challenging and suitable statistical methods are unavailable. Often mentioned challenges are the lack of accounting for the hierarchical structure between omics domains and the difficulty of interpretation of genomewide results. This study is motivated to address these challenges. We propose multiset sparse Partial Least Squares path modeling (msPLS), a generalized penalized form of Partial Least Squares path modeling, for the simultaneous modeling of biological pathways across multiple omics domains. msPLS simultaneously models the effect of multiple molecular markers, from multiple omics domains, on the variation of multiple phenotypic variables, while accounting for the relationships between data sources, and provides sparse results. The sparsity in the model helps to provide interpretable results from analyses of hundreds of thousands of biomolecular variables.

Results

With simulation studies, we quantified the ability of msPLS to discover associated variables among high dimensional data sources. Furthermore, we analysed high dimensional omics datasets to explore biological pathways associated with Marfan syndrome and with Chronic Lymphocytic Leukaemia. Additionally, we compared the results of msPLS to the results of Multi-Omics Factor Analysis (MOFA), which is an alternative method to analyse this type of data.

Conclusions

msPLS is an multiset multivariate method for the integrative analysis of multiple high dimensional omics data sources. It accounts for the relationship between multiple high dimensional data sources while it provides interpretable results through its sparse solutions. The biomarkers found by msPLS in the omics datasets can be interpreted in terms of biological pathways associated with the pathophysiology of Marfan syndrome and of Chronic Lymphocytic Leukaemia. Additionally, msPLS outperforms MOFA in terms of variation explained in the chronic lymphocytic leukaemia dataset while it identifies the two most important clinical markers for Chronic Lymphocytic Leukaemia

Availability

http://uva.csala.me/mspls.https://github.com/acsala/2018_msPLS
Exogenous hydrogen sulfide alleviates surgery-induced neuroinflammatory cognitive impairment in adult mice by inhibiting NO signaling
Authors: Yin Lijun , Gao Shunli , Li Changkun
Published: January 2020

Background

To investigate the effect and mechanisms of exogenous hydrogen sulfide in surgery-induced neuroinflammatory cognitive dysfunction.

Methods

C57BL/6 J male mice (n = 140) were used and randomly divided into seven groups: the sham group, surgery group, GYY4137 group, L-NAME group, surgery+GYY4137 group, surgery +L-NAME group, and surgery+GYY4137 + L-NAME group. After the interventions, open field tests (OFT) and the Morris water maze (MWM) test were conducted to evaluate learning and memory abilities in the mice. ELISAs, nitrate reductase assays, and Western blots (WB) were conducted to evaluate interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), nitric oxide (NO), inducible nitric oxide synthase (iNOS), malondialdehyde (MDA), and antioxidant enzyme superoxide dismutase (SOD) levels. Furthermore, the expression level of microglial marker ionized calcium binding adaptor molecule 1 (IBA) in the hippocampal CA1 and CA3 areas was detected by an immunohistochemical (IHC) assay and apoptotic cells were observed using terminal deoxynucleotidyl transferase dUTP end-labeling (TUNEL) staining kits.

Results

We found that surgery induced neuroinflammatory cognitive dysfunction, oxidative stress, microglial activation, and cell apoptosis in the hippocampus. Moreover, following surgery, NO and iNOS levels were elevated in the hippocampus. Notably, all the effects caused by surgery were reversed by the H2S donor GYY4137 or the iNOS inhibitor N(gamma)-nitro-L-arginine methyl ester (L-NAME). However, the combined application of GYY4137 and L-NAME was not superior to treatment with either agent alone and the effect of GYY4137 was similar to that of L-NAME.

Conclusion

The long-acting hydrogen sulfide donor GYY4137 had an ability to reversed the cognitive deficits and inflammation caused by carotid artery exposure surgery. This implies that NO signaling pathways might participate in this process. These results indicate that exogenous H2S may be a promising therapy for POCD.
Risk of falls and fear of falling in older adults residing in public housing in Ontario, Canada: findings from a multisite observational study
Authors: Pirrie Melissa , Saini Guneet , Angeles Ricardo , Marzanek Francine , Parascandalo Jenna , Agarwal Gina
Published: January 2020

Background

Falls in older adults is a widely researched topic. However, older adults residing in public housing are a vulnerable population that may have unique risk factors for falls. This study aims to describe the prevalence and risk factors for falls, fear of falling, and seeking medical attending for falls in this population.

Methods

Sociodemographic and health-related data was collected as part of a community-based health assessment program with older adults in public housing. Three pre-screening questions identified individuals at potential risk for falls; individuals who screened positive performed the objective Timed Up and Go (TUG) test. Logistic regression was used to evaluate risk factors for four outcome variables: falls in the past year, seeking medical attention for falls, fear of falling, and objectively measured fall risk via TUG test.

Results

A total of 595 participants were evaluated, of which the majority were female (81.3%), white (86.7%), did not have a high school diploma (50.0%), and reported problems in mobility (56.2%). The prevalence of falls in the past year was 34.5%, seeking medical attention for falls was 20.2% and fear of falling was 38.8%. The TUG test was completed by 257 participants. Notably, males had significantly reduced odds of seeking medical attention for a fall (OR = 0.50, 95%CI 0.25–0.98) and having a fear of falling (OR = 0.42, 95%CI 0.24–0.76); daily fruit and vegetable consumption was associated with decreased odds of having a fall in the past year (OR = 0.55, 95%CI 0.37–0.83), and alcohol consumption was associated with increased odds of fear of falling (OR = 1.72, 95%CI 1.03–2.88).

Conclusion

Older adults residing in public housing have unique risk factors associated with social determinants of health, such as low fruit and vegetable consumption, which may increase their risk for falls. The findings of this study can be used to inform falls interventions for this population and identify areas for further research.
MicroRNA-19b-3p promotes cell proliferation and osteogenic differentiation of BMSCs by interacting with lncRNA H19
Authors: Xiaoling Gan , Shuaibin Liu , Kailu Liang
Published: January 2020

Background

To investigated the role of miR-19b-3p in regulating bone marrow mesenchymal stem cell (BMSC) proliferation and osteoblast differentiation.

Methods

The expression of miR-19b-3p and lncRNA H19 were measured in postmenopausal osteoporosis patients and BMP-22 induced BMSCs using qRT-PCR. MiR-19b-3p mimic or inhibitor was transfected into BMP-2 induced BMSCs. Cell proliferation was measured by BrdU method. Protein expression of RUNX2 and COL1A1 were measured by western blot. PcDNA3.1-lncRNA H19 with or without miR-19b-3p mimic was transfected into BMP-2 induced BMSCs.

Results

The expression of miR-19b-3p was significantly up-regulated in postmenopausal osteoporosis patients and BMP-2 induced BMSCs. MiR-19b-3p overexpression dramatically elevated, while miR-19b-3p inhibition decreased cell proliferation of BMSCs. Additionally, protein expression levels of RUNX2 and COL1A1, as well as ALP activity were significantly promoted by miR-19b-3p mimic transfection and inhibited by miR-19b-3p inhibitor transfection. LncRNA H19 was obviously down-regulated in postmenopausal osteoporosis patients. H19 overexpression significantly decreased cell proliferation and differentiation by down-regulating miR-19b-3p. Moreover, the expression of miR-19b-3p was inhibited, while H19 elvated in 17β-estradiol (E2) treated BMSCs in a dose-dependent manner.

Conclusion

These data were the first to reveal the critical role of H19/miR-19b-3p in postmenopausal osteoporosis, and provided a new therapeutic target for OP.
Markedly increased ocular side effect causing severe vision deterioration after chemotherapy using new or investigational epidermal or fibroblast growth factor receptor inhibitors
Authors: Shin Eunhae , Lim Dong Hui , Han Jisang , Nam Do-Hyun , Park Keunchil , Ahn Myung-Ju , Kang Won Ki , Lee Jeeyun , Ahn Jin Seok , Lee Se-Hoon , Sun Jong-Mu , Jung Hyun Ae , Chung Tae-Young
Published: January 2020

Background

We sought to describe corneal epithelial changes after using epidermal (EGFR) or fibroblast growth factor receptor (FGFR) inhibitors as chemotherapy and to clarify incidence and prognosis.

Materials

Retrospective chart review.

Results

Among 6871 patients and 17 EGFR or FGFR inhibitors, 1161 patients (16.9%) referred for ophthalmologic examination. In total, 1145 patients had disease-related or unrelated ocular complications. Among 16 patients with treatment-related ocular complications, three patients had treatment-related radiation retinopathy and one patient showed treatment-related corneal ulcer. Finally the authors identified that, in 12 patients, three EGFR inhibitors and two FGFR inhibitors caused corneal epithelial lesions. Vandetanib, Osimertinib, and ABT-414 caused vortex keratopathy in nine patients, while ASP-5878 and FPA-144 caused epithelial changes resembling corneal dysmaturation in three patients. The mean interval until symptoms appeared was 246 days with vandetanib, 196 days with osimertinib, 30 days with ABT-414, 55 days with ASP-5878, and 70 days with FPA-144. The mean of the lowest logarithm of minimal angle of resolution visual acuity results of the right and left eyes after chemotherapy were 0.338 and 0.413. The incidence rates of epithelial changes were 15.79% with vandetanib, 0.5% with osimertinib, 100% with ABT-414, 50.0% with ASP-5878, and 18.2% with FPA-144. After excluding deceased patients and those who were lost to follow-up or still undergoing treatment, we confirmed the reversibility of corneal lesions after the discontinuation of each agent. Seven patients showed full recovery of their vision and corneal epithelium, while three achieved a partial level of recovery. Although patients diagnosed with glioblastoma used prophylactic topical steroids before and during ABT-414 therapy, all developed vortex keratopathy.

Conclusions

EGFR and FGFR inhibitors are chemotherapy agents that could make corneal epithelial changes. Contrary to the low probability of ocular complication with old EGFR drugs, recently introduced EGFR and FGFR agents showed a high incidence of ocular complication with severe vision distortion. Doctors should forewarn patients planning chemotherapy with these agents that decreased visual acuity could develop due to corneal epithelial changes and also reassure them that the condition could be improved after the end of treatment without the use of steroid eye drops.

Trial registration

This study was approved by the institutional review board (IRB) of Samsung Medical Center (IRB no. 2019–04-027) and was conducted according to the principles expressed in the Declaration of Helsinki.
Case report: what gives the myopic tilted disc an oval appearance?
Authors: Lee Kyoung Min , Kim Martha , Kim Seok Hwan
Published: January 2020

Background

Myopic tilted disc, observed as an oval disc, has been alleged to be a funduscopic en-face manifestation of excessive optic nerve head (ONH) sloping or tilting. Here, we report the case of a myopic child showing a developing oval disc in fundus photos during axial elongation, but without progressive tilting in spectral-domain optical coherence tomography (SD-OCT) images.

Case presentation

By merging B-scan SD-OCT images of the ONH and macula, the curvature of the posterior pole, including both the fovea and ONH, was reconstructed and compared before and after 2 years of axial elongation. Despite the marked increase of disc ovality, the posterior polar curvature was rarely changed. The preponderance of optic disc change was induced by the shift of the temporal disc margin in the nasal direction. This shifting alone imitated an increase of tilt angle but one that was still far smaller than the required degree of tilt for ONH-tilt-based disc ovality. To clarify, we calculated the required extent of axial elongation to obtain a substantial degree of ONH tilt when considering the adjacency of the fovea and the ONH. Without a focal increase of posterior polar curvature, which is to say posterior staphyloma, such change is not possible until the axial length increases extraordinarily.

Conclusion

The most prominent change in the development of myopic tilted disc, which change gives it an oval appearance and imitates a tilt when measured, is actually not a tilt but rather a shift of the temporal disc margin.
Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey
Authors: Rivenbark Joshua G. , Ichou Mathieu
Published: January 2020

Background

People in socially disadvantaged groups face a myriad of challenges to their health. Discrimination, based on group status such as gender, immigration generation, race/ethnicity, or religion, are a well-documented health challenge. However, less is known about experiences of discrimination specifically within healthcare settings, and how it may act as a barrier to healthcare.

Methods

Using data from a nationally representative survey of France (N = 21,761) with an oversample of immigrants, we examine rates of reported discrimination in healthcare settings, rates of foregoing healthcare, and whether discrimination could explain disparities in foregoing care across social groups.

Results

Rates of both reporting discrimination within healthcare and reporting foregone care in the past 12 months were generally highest among women, immigrants from Africa or Overseas France, and Muslims. For all of these groups, experiences of discrimination potentially explained significant proportions of their disparity in foregone care (Percent disparity in foregone care explained for: women = 17%, second-generation immigrants = 8%, Overseas France = 13%, North Africa = 22%, Sub-Saharan Africa = 32%, Muslims = 26%). Rates of foregone care were also higher for those of mixed origin and people who reported “Other Religion”, but foregone healthcare was not associated with discrimination for those groups.

Conclusions

Experiences of discrimination within the healthcare setting may present a barrier to healthcare for people that are socially disadvantaged due to gender, immigration, race/ethnicity, or religion. Researchers and policymakers should consider barriers to healthcare that lie within the healthcare experience itself as potential intervention targets.