bluuebunny/crossref_metadata_2025 huggingface dataset:
Higher Education Centers and College Towns: A Typology of the US Metropolitan Geography of Higher Education
Authors: Ehlenz Meagan M. , Mawhorter Sarah
Published: November 2020

Colleges and universities are vital institutions at the heart of many US cities. Yet existing research offers only partial insights into the US metropolitan geography of HEIs. We use institutional and metro-level data to offer a novel perspective on the geography of single- and multi-HEI metropolitan compositions. Using Latent Profile Analysis, we develop a typology of Higher Education Metros (HEMs), identifying two main classes: Higher Education Centers and College Towns, with finer delineations based on the type and intensity of HEIs. We then assess macro- and micro-level patterns in the HEM types across US metro areas, and examine meso-level representative cases. Our study provides a framework for understanding the metropolitan geography of HEI configurations, serving as a complement to emergent literature examining the relational geography of HEIs. It enables a wider, systematic perspective that generates new insights about the spatial nature of higher education in the US.
Eye Tracking During a Continuous Performance Test: Utility for Assessing ADHD Patients
Authors: Lev Astar , Braw Yoram , Elbaum Tomer , Wagner Michael , Rassovsky Yuri
Published: November 2020

Objective:

The use of continuous performance tests (CPTs) for assessing ADHD related cognitive impairment is ubiquitous. Novel psychophysiological measures may enhance the data that is derived from CPTs and thereby improve clinical decision-making regarding diagnosis and treatment. As part of the current study, we integrated an eye tracker with the MOXO-dCPT and assessed the utility of eye movement measures to differentiate ADHD patients and healthy controls.

Method:

Adult ADHD patients and gender/age-matched healthy controls performed the MOXO-dCPT while their eye movements were monitored ( n = 33 per group).

Results:

ADHD patients spent significantly more time gazing at irrelevant regions, both on the screen and outside of it, than healthy controls. The eye movement measures showed adequate ability to classify ADHD patients. Moreover, a scale that combined eye movement measures enhanced group prediction, compared to the sole use of conventional MOXO-dCPT indices.

Conclusions:

Integrating an eye tracker with CPTs is a feasible way of enhancing diagnostic precision and shows initial promise for clarifying the cognitive profile of ADHD patients. Pending replication, these findings point toward a promising path for the evolution of existing CPTs.
Is post-trabeculectomy serous choroidal detachment a risk factor for failure in the long term
Authors: Yadgari Maryam , Hassanpour Kiana , Nassiri Nader
Published: November 2020

Background:

To investigate the long-term effect of serous choroidal detachment on the success of trabeculectomy in glaucoma patients.

Methods:

In this case-control study, 17 patients who underwent trabeculectomy and developed choroidal detachment, and completed at least 3 years of follow-up were included. The controls were matched based on age, sex, preoperative intraocular pressure, and glaucoma type, and lack of choroidal detachment. Surgical success was defined based on two definitions of 5 < IOP < 16 and 20% reduction from the baseline and no need for further glaucoma surgery and all the same but 5 < IOP < 22.

Results:

The mean estimated duration of survival ±SD was 2.73 ± 0.35 years (CI 95% 2.1, 3.4), which was significantly shorter than 3.98 ± 0.38 years (CI 95% 3.3, 4.7) in the control group. (LogRank = 5.03 p = 0.02). Cumulative probability of success was 76.5%, 52.9%, 29.4%, 17.6%, and 11.8% in year 1, 2, 3, 4, and 5 in the case group, respectively. Corresponding values were 88.2%, 82.4%, 68.6%, 58.8%, and 47.1%. In the control group, respectively. At baseline, average IOP was 22.3 ± 2.7 and 23.8 ± 8.3 mmHg in the case and control groups, respectively ( p = 0.17). Mean IOP was significantly higher in the case group than in the control group in years 2, 3, 4, and 5.

Conclusion:

Serous choroidal detachment affects the long-term surgical success of trabeculectomy, especially in patients with advanced glaucoma when lower target pressure is required.
Utilisation of calcium sulphate beads in one-stage aseptic revision total hip arthroplasty
Authors: Mohamed Nequesha S , Dávila Castrodad Iciar M , Etcheson Jennifer I , George Nicole E , Aitken James S , Kelemen Margaret N , Nace James , Delanois Ronald E
Published: November 2020

Introduction:

Periprosthetic joint infection (PJI) affects many revision total hip arthroplasty (THA) patients, contributing to a concomitant rise in revision costs. Means of decreasing the risk of PJI include the use of antibiotic adjuncts, such as calcium sulphate beads (CSBs). Mixed with antibiotics, the potential benefits of CSBs include dissolvability and antibiotic drug elution. However, information comparing them in aseptic revision is scarce. Therefore, this study investigated CSB utilisation for infection prevention in aseptic revision THA. Specifically, we compared (1) infection rates; (2) lengths of stay; (3) subsequent infection procedures; and (4) final surgical outcome in 1-stage aseptic revision THA patients who did received CSBs to 1-stage aseptic revision THA patients who did not.

Methods:

A retrospective chart review was performed to identify all patients who underwent an aseptic revision THA between January 2013 and December 2017. Patients who received CSBs ( n = 48) were compared to non-CSB patients ( n = 58) on the following outcomes: postoperative infections, lengths of stay (LOS), subsequent irrigation and debridements (I+Ds), and final surgical outcome, classified as successful THA reimplantation, retained antibiotic spacer, or Girdlestone procedure. Chi-square and t-testing were used to analyse the variables.

Results:

There was no significant differences found between CSB patients and non-CSB patients in postoperative infections ( p = 0.082), LOS ( p = 0.179), I+Ds ( p = 0.068), and final surgical outcome ( p = 0.211).

Conclusion:

This study did not find any statistical difference between CSBs and standard of care in infection rates and surgical outcomes. The advantage of these beads for 1-stage aseptic revisions is questionable.
Neuraxial anaesthesia is associated with improved outcomes and reduced postoperative complications in patients undergoing aseptic revision total hip arthroplasty
Authors: Wei Chapman , Gu Alex , Muthiah Arun , Fassihi Safa C , Sculco Peter K , Nunley Ryan M , Bernstein Brad A , Liu Jiabin , Berger Jeffrey S
Published: November 2020

Background:

As the incidence of primary total hip arthroplasty (THA) continues to increase, revision THA (rTHA) is becoming an increasingly common procedure. rTHA is widely regarded as a more challenging procedure, with higher complication rates and increased medical, social and economic burdens when compared to its primary counterpart. Given the complexity of rTHA and the projected increase in incidence of these procedures, patient optimisation is becoming of interest to improve outcomes. Anaesthetic choice has been extensively studied in primary THA as a modifiable risk factor for postoperative outcomes, showing favourable results for neuraxial anaesthesia compared to general anaesthesia. The impact of anaesthetic choice in rTHA has not been studied previously.

Methods:

A retrospective study was performed using the American College of Surgeons National Surgical Quality Improvement Program database. Patients who underwent rTHA between 2014 and 2017 were divided into 3 anaesthesia cohorts: general anaesthesia, neuraxial anaesthesia, and combined general-regional (neuraxial and/or peripheral nerve block) anaesthesia. Univariate and multivariate analyses were used to analyse patient characteristics and 30-day postoperative outcomes. Bonferroni correction was applied for post-hoc analysis.

Results:

In total, 5759 patients were identified. Of these, 3551 (61.7%) patients underwent general anaesthesia, 1513 (26.3%) patients underwent neuraxial anaesthesia, and 695 (12.1%) patients underwent combined general-regional anaesthesia. On multivariate analysis, neuraxial anaesthesia was associated with decreased odds for any-one complication (OR 0.635; p  < 0.001), perioperative blood transfusion (OR 0.641; p  < 0.001), and extended length of stay (OR 0.005; p = 0.005) compared to general anaesthesia.

Conclusions:

Relative to those receiving general anaesthesia, patients undergoing neuraxial anaesthesia are at decreased risk for postoperative complications, perioperative blood transfusions, and extended length of stay. Prospective controlled trials should be conducted to verify these findings.
CDX2 Expression and Prognostic Factors of Resectable Pulmonary Large Cell Neuroendocrine Carcinoma
Authors: Mori Ryo , Yamashita Shin-ichi , Midorikawa Kensuke , Abe Sosei , Inada Kazuo , Yoneda Satoshi , Okabayashi Kan , Nabeshima Kazuki
Published: November 2020

Background and Aim:

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare neoplasm, and its clinical features and management are still limited. We evaluated the clinicopathological factors, including CDX2 immunohistochemical expression, to predict survival in patients with LCNEC.

Patients and Methods:

In all, 50 patients with LCNEC who underwent surgery at 4 institutes between 2001 and 2017 were included. Clinicopathological characteristics were evaluated for prognostic factors and statistically analyzed by Kaplan-Meier curve with a log-rank test or Cox regression models. We used immunohistochemical (IHC) analysis to determine the expressions of CDX2 and compared them with clinicopathological factors and survival.

Results:

Sixteen of the 50 cases (32%) were CDX2 positive. No correlation was found between the CDX2 expression by IHC and clinicopathological factors. Multivariate analysis identified adjuvant chemotherapy (hazard ratio [HR] =2.86, 95% confidence interval [CI] = 1.04-8.16, P = .04) and vascular invasion (HR = 4.35, 95% CI = 1.21-15.63, P = .03) as being associated with a significantly worse rate of recurrence-free survival.

Conclusion:

CDX2 was expressed in 1/3 of LCNEC but not associated with prognostic factor. Adjuvant chemotherapy and vascular invasion were associated with a negative prognostic factor of LCNEC.
Distribution of conformal contact pressure in spherical plain bearings considering friction and free-edge effects
Authors: Yuan Li , Bao Han , Yao Xuefeng , Lu Jianguo , Liu Jie
Published: November 2020

The pressure distribution of conformal contact in spherical plain bearings is studied adopting both theoretical methods and finite element simulations. The effects of normal loads and friction coefficients on the distribution of both axial and circumferential contact stress are investigated. The results show that the circumferential stress can be exactly described with the complete spherical conformal contact theory while the axial one presents strong free-edge effects, mainly caused by the compressive strain. In addition, the distribution of contact stress tends to be uniform with the increase of the load and the friction coefficient, referring to a decrease of contact pressure in the central region and a rise on both edges of the outer ring, which can be attributed to the obstruction effects of friction on the deformation of bearings and the corresponding alteration of contact area.
Reflexive discourse analysis: A methodology for the practice of reflexivity
Authors: Alejandro Audrey
Published: November 2020

How to implement reflexivity in practice? Can the knowledge we produce be emancipatory when our discourses recursively originate in the world we aim to challenge? Critical International Relations (IR) scholars have successfully put reflexivity on the agenda based on the theoretical premise that discourse and knowledge play a socio-political role. However, academics often find themselves at a loss when it comes to implementing reflexivity due to the lack of adapted methodological and pedagogical material. This article shifts reflexivity from meta-reflections on the situatedness of research into a distinctive practice of research and writing that can be learned and taught alongside other research practices. To do so, I develop a methodology based on discourse: reflexive discourse analysis (RDA). Based on the discourse analysis of our own discourse and self-resocialisation, RDA aims to reflexively assess and transform our socio-discursive engagement with the world, so as to render it consistent with our intentional socio-political objectives. RDA builds upon a theoretical framework integrating discourse theory to Bourdieu’s conceptual apparatus for reflexivity and practices illustrated in the works of Comte and La Boétie. To illustrate this methodology, I used this very article as a recursive performance. I show how RDA enabled me to identify implicit discriminative mechanisms within my discourse and transform them into an alternative based on love, to produce an article more in line with my socio-political objectives. Overall, this article turns reflexivity into a critical methodology for social change and demonstrates how to integrate criticality methodologically into research and writing.
Prolonged Standing Task Affects Adaptability of Postural Control in People With Parkinson’s Disease
Authors: Moretto Gabriel Felipe , Santinelli Felipe Balistieri , Penedo Tiago , Mochizuki Luis , Rinaldi Natalia Madalena , Barbieri Fabio Augusto
Published: November 2020

Background

Studies on short-term upright quiet standing tasks have presented contradictory findings about postural control in people with Parkinson’s disease (pwPD). Prolonged trial durations might better depict body sway and discriminate pwPD and controls.

Objective

The aim of this study was to investigate postural control in pwPD during a prolonged standing task.

Methods

A total of 26 pwPD and 25 neurologically healthy individuals performed 3 quiet standing trials (60 s) before completing a constrained prolonged standing task for 15 minutes. Motion capture was used to record body sway (Vicon, 100 Hz). To investigate the body sway behavior during the 15 minutes of standing, the analysis was divided into three 5-minute-long phases: early, middle, and late. The following body sway parameters were calculated for the anterior-posterior (AP) and medial-lateral (ML) directions: velocity, root-mean-square, and detrended fluctuations analysis (DFA). The body sway area was also calculated. Two-way ANOVAs (group and phases) and 1-way ANOVA (group) were used to compare these parameters for the prolonged standing and quiet standing, respectively.

Results

pwPD presented smaller sway area ( P < .001), less complexity (DFA; AP: P < .009; ML: P < .01), and faster velocity (AP: P < .002; ML: P < .001) of body sway compared with the control group during the prolonged standing task. Although the groups swayed similarly (no difference for sway area) during quiet standing, they presented differences in sway area during the prolonged standing task ( P < .001).

Conclusions

Prolonged standing task reduced adaptability of the postural control system in pwPD. In addition, the prolonged standing task may better analyze the adaptability of the postural control system in pwPD.
Statewide School Redesign: Integrating Design Thinking and the Four Disciplines of Execution as a Continuous School Improvement Process
Authors: Liang Jia “Grace” , Mitchell Tamra , Scott Jay
Published: November 2020

Sixty-six school districts and more than 150 schools in the state of Kansas are participating in the Kansans Can Redesign Project. In this article, we present a case study of using Design Thinking as a systemic process to structure continuous school improvement. The collage of real-life scenarios presented in our case shows the integration of Design Thinking and the Four Disciplines of Execution and highlights the nuances and delicacies involved in the process as the major change agents work together and engage theory-to-practice applications of design thinking for change. Also illustrated in the case are the struggles and successes experienced by schools as they venture into the unfamiliar terrains of the design thinking process and enact on the integrated principles to school redesign.
Model predictive control for comfort optimization in assisted and driverless vehicles
Authors: Luciani Sara , Bonfitto Angelo , Amati Nicola , Tonoli Andrea
Published: November 2020

This paper presents a method to design a Model Predictive Control to maximize the passengers’ comfort in assisted and self-driving vehicles by achieving lateral and longitudinal dynamic. The weighting parameters of the MPC are tuned off-line using a Genetic Algorithm to simultaneously maximize the control performance in the tracking of speed profile, lateral deviation and relative yaw angle and to optimize the comfort perceived by the passengers. To this end, two comfort evaluation indexes extracted by ISO 2631 are used to evaluate the amount of vibration transmitted to the passengers and the probability to experience motion sickness. The effectiveness of the method is demonstrated using simulated experiments conducted on a subcompact crossover vehicle. The control tracking performance produces errors lower than 0.1 m for lateral deviation, 0.5° for relative yaw angle and 1.5 km/h for the vehicle speed. The comfort maximization results in a low percentage of people who may experience nausea (below 5%) and in a low value of equivalent acceleration perceived by the passenger (below 0.315 [Formula: see text]“not uncomfortable” by ISO 2631). The robustness at variations of vehicle parameters, namely vehicle mass, front and rear cornering stiffness and mass distribution, is evaluated through a sensitivity analysis.
What silence can teach us about race and leadership
Authors: Spiller Chellie , Evans Michelle , Schuyler Kathryn Goldman , Watson Lemuel W
Published: November 2020

Silence is laden when it comes to race and leadership. We believe it is critical to reclaim the kind of silence that supports conscious transformation. Our contribution in this endeavor is twofold. Firstly, we distinguish between fear-based silence and sacred silence. Fear-based silence can be a running away from discomfort, a covering up of trepidation and anxiety. It can lead to collective amnesia and willful ignorance, a hoarding of status, privilege, and power, and forge deep divides between people. This is the world of masks and performativity, and at its worst harbors prejudice, hate, and destruction. Leadership tolerant of fear-based silence permits a festering of racism. Sacred silence by contrast heals and raises consciousness. For the kind of leadership required to consistently and indefatigably push for change and disruption to racism, we need a practice of sacred silence. Sacred silence cultivates the courage to look fearlessly within personal shadows and bravely at what is required to make the world a safe, secure, and just place for all. Secondly, we present four themes that emerged from our reflexive inquiry into race, leadership, and silence: listening dialogue, returning to Mother Earth wisdom, honoring potential, and practicing mindfulness in a context of collective wisdom.
Acidic hydrolysis of astilbin and its application for the preparation of taxifolin from Rhizoma Smilacis Glabrae
Authors: Qiu Xiao-Lin , Zhang Qing-Feng
Published: November 2020

The acidic hydrolysis of astilbin to produce its aglycone, taxifolin, was investigated in this study. The effects of aq. HCl concentration and temperature on the reaction were studied, and the kinetic parameters were calculated. The results showed that with higher aq. HCl concentration and temperature, the hydrolysis of astilbin became faster. The activation energy of the hydrolysis reaction under 1 mol L−1 aq. HCl was calculated with a value of 148.6 kJ mol−1. The reaction was successfully applied to produce taxifolin from a sample of Rhizoma Smilacis Glabrae. A simple method for the purification of taxifolin from Rhizoma Smilacis Glabrae was developed with purity of 97.5%.
Experimental and an electrolyte non-random two-liquid model to predict the vapor–liquid equilibrium of CO2 in aqueous solutions of diethylenetriamine
Authors: Zhang Ruilei , Tang Yandong , Shan Weifeng , Liu Haijun , Li Haijun , Chen Jian
Published: November 2020

The absorption and desorption data of CO2 in aqueous solutions with a mass fraction of 10% and 20% of diethylenetriamine are measured at 313.15, 343.15, 373.15, and 393.15 K. The electrolyte non-random two-liquid theory is developed using Aspen V9.0 to correlate and predict the vapor–liquid equilibrium of CO2 in aqueous diethylenetriamine solutions. The model predicted the heat capacity and saturated vapor pressure data of diethylenetriamine, the mixed heat of a diethylenetriamine–H2O binary system, and the vapor–liquid equilibrium data of a diethylenetriamine–H2O–CO2 ternary system. The physical parameters and the interaction parameters of the model system are calculated. The model predicted CO2 solubility showing a 10% average absolute deviation from experimental data. The calculated values of the model are basically consistent with the experimental values.
Clinical decision making in the provision of audiovisual care for upper limb trauma: a survey of UK experiences
Authors: McMullen Emily , Robson Megan , Brewin Mark Paul , Valand Poonam , Sayed Leela , Steele Jessica
Published: November 2020

Introduction

For many patients, audio-visual appointments have provided a timely and efficient way of seeking advice, assessment and treatment for their hand injuries during the NHS response to COVID-19. This study aimed to explore the experience of hand units across the UK in determining the safe and judicious use of audio-visual outpatient care for the management of acute upper limb trauma.

Methods

An online cross-sectional survey was sent to the therapy leads of hand units across the UK. Questions focused on the experience of using audio-visual technology in the management of upper limb trauma, and the relevant factors in determining its appropriate use. A deductive mixed methods analysis was used to identify both common themes and capture community experience and characteristics.

Results

A total of 51 out of 76 hand therapy units completed the survey; a response rate of 67%. Of these, 82% (42/51) reported using audio-visual technology to manage upper limb trauma during the UK COVID-19 lockdown. When determining patient suitability for audio-visual consultations, 73% (37/51) of respondents reported the use of COVID-19 guidelines, but only 35% (18/51) reported the use of a clinical decision-making tool. In agreement with our experience at Salisbury Hospital Foundation Trust, 92% (47/51) had concerns relating to the use of audio-visual care.

Conclusion

The choice of safely managed remote care or in-person consultation has, to date, largely relied on the discretion of the clinician. A carefully designed clinical decision-making tool for the management of upper limb trauma is needed for use both in clinical practice and in future service planning.
Microfragmented Adipose Tissue (M-FATS) for Improved Healing of Surgically Repaired Achilles Tendon Tears: A Preliminary Study
Authors: Ferracini Riccardo , Artiaco Stefano , Daghino Walter , Falco Mara , Gallo Alessandra , Garibaldi Riccardo , Tiraboschi Emilia , Guidotti Claudio , Bistolfi Alessandro
Published: November 2020

Introduction

Tendon healing is a complicated process that results in inferior structural and functional properties when compared with healthy tendon; the purpose of this study was to assess the effects of the adjunct of microfragmented adipose tissue (M-FATS) after the suture of a series of Achilles tendons.

Methods

After complete Achilles tendon tear, 8 patients underwent open suture repair in conjunction with perilesional application of a preparation of M-FATS rich in mesenchymal stem cells. Results were compared with a similar group of patients treated with conventional open suture. Outcomes were evaluated based on range of motion, functional recovery, and complications according to the American Orthopedic Foot and Ankle Society (AOFAS) score and Foot and Ankle Disability Index (FADI). Achilles tendons were examined by ultrasound (US) at 3 months.

Results

The AOFAS and FADI scores showed no differences between the 2 groups. US evaluation showed quicker tendon remodeling in the M-FATS group. Adverse events were not documented for both procedures.

Conclusions

The combined application of derived M-FATS for tendon rupture is safe and presents new possibilities for enhanced healing.

Levels of Evidence

Level IIIb: Case control study
Future developments in the MECKI score initiative
Authors: Coats Andrew JS
Published: November 2020

The Metabolic Exercise combined with Cardiac and Kidney Indexes [MECKI) score is a validated prognostic score for heart failure with reduced ejection fraction which combines commonly available clinical and metabolic parameters with two cardiopulmonary exercise test derived prognostic measurements. It has been validated to predict prognosis and to aid clinical decision making and it has been shown to be superior in predicting mortality compared with other commonly used prognostic scores for heart failure. In the future it would be valuable to establish whether the score holds true also in other settings, and in particular in under-represented groups – the elderly, women, and people of different ethnic backgrounds – and in other heart failure syndromes. In future it may be extended to assess its value in the presence of a range of co-morbidities such as chronic obstructive pulmonary disease, pulmonary hypertension and frailty and cachexia as well as in other conditions such as hypertrophic cardiomyopathy, amyloid, asymptomatic left ventricular dysfunction and hypertension. It may also be a candidate end-point for adaptive trials designed to prove an improvement in the MECKI score as an approvable interim end-point whilst larger mortality and morbidity trials are still underway.
The feasibility of using smartphone apps to manage self-harm and suicidal acts in adolescents admitted to an inpatient mental health ward
Authors: Muscara Frank , Ng Olivia , Crossley Louise , Lu Sinh , Kalisch Lauren , Melvin Glenn , Gronow Sam , Prakash Chidambaram , Anderson Vicki
Published: November 2020

Objective

The aim of this study is to assess the feasibility (uptake, retention and adherence) and acceptability of a combination of smartphone apps to deliver a digitized safety plan, BeyondNow, and personalized management strategies, BlueIce, with adolescents discharged from a mental health inpatient ward following self-harm, suicidal ideation and/or behavior.

Methods

Participants in this pre-post pilot study included 20 adolescents between 13–18 years, presenting with self-harming or suicidal behaviors in an inpatient psychiatric ward at a tertiary pediatric hospital. Participants were familiarized with the apps and completed baseline measures prior to discharge. They used the apps for six weeks before completing the follow-up survey, which measured feasibility and acceptability of the apps, as well as suicide resilience.

Results

Seventeen participants completed the pilot. Most of the sample accessed both apps at least once, three accessed the BeyondNow safety plan five times or more, and six used the BlueIce toolbox five times or more. A total of 73.5% of the sample that experienced a crisis used at least one of the apps at least once. Forty seven percent felt that the apps would not keep them safe when in crisis, although almost all of the sample rated both apps as easy to use (94% for BeyondNow, and 82% for BlueIce). Medium to large effect sizes were also found with regard to improvements in suicide resilience.

Conclusion

Both apps were found to be feasible and acceptable in this population, and easy to use, although no conclusions can be drawn regarding the clinical efficacy of the apps.
Prevalence of Sarcopenia in Older South African Patients Following Surgery for Fragility Fractures of the Hip
Authors: Laubscher Cornelius V. , Burger Marilize C. , Conradie Maria M. , Conradie Magda , Jordaan Jacobus D.
Published: November 2020

Introduction:

Geriatric patients with a fragility fracture of the hip (FFH) are especially prone to sarcopenia with poor functional outcomes and quality of life. We assessed the prevalence of sarcopenia in older South African patients with FFH. Risk factors for sarcopenia were also investigated.

Materials and Methods:

From August 1 to November 30, 2018, all older patients with FFH were invited to participate. Sarcopenia was diagnosed based on the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Handgrip strength (HGS) and muscle strength were assessed. Muscle quantity was determined by dual-energy X-ray absorptiometry. Demographic information was collected, and 25-hydroxyvitamin D (25[OH]D) status was determined.

Results:

Of the 100 hip fracture cases, 65 were enrolled, and 52% (34/65) were sarcopenic (women: 62%; men: 38%). HGS accurately identified sarcopenia (sensitivity and specificity: 100%). Patients >80 years of age had a prevalence of sarcopenia twice (18/21 [83%]) that of younger patients (18/44 [36%]). Women with sarcopenia were smaller than those without (weight: p < 0.001; height: p < 0.001; body mass index: p = 0.018). Low 25(OH)D was almost universally present, with median 25(OH)D levels significantly lower in the patients with sarcopenia (27 nmol/L [interquartile range {IQR}: 20–39] vs. 40 nmol/L [IQR: 29–53]). Several risk factors, including advanced age; female sex; a smaller body size, especially among women; limited physical activity; and low 25(OH)D levels, were identified.

Discussion:

The accuracy of HGS testing in this cohort underscores EWGSOP2’s recommendation that muscle strength is key to sarcopenia. Further study and follow-up are required to determine the clinical relevance of sarcopenia among FFH patients.

Conclusion:

The prevalence of sarcopenia in our FFH population is high. Sarcopenia is associated with poor patient outcomes following surgical intervention. Orthopaedic surgeons should therefore be cognizant of the presentation and associated risk of sarcopenia as our patient populations age.
Examining the Measurement Model of International Posture and How It Relates to Personality Traits
Authors: Toyama Michiko , Yamazaki Yoshitaka
Published: November 2020

This study had two aims: to attempt to verify the construct validity of the measure of international posture—which refers to attitudes toward the international community—in foreign language education and to explore how international posture structurally relates to personality traits. A total of 163 Japanese undergraduate students participated in the study. To examine the first aim, exploratory factor analysis was conducted, followed by confirmatory factor analysis. Results of the exploratory factor analysis showed that three latent constructs were extracted from 23 items of the measure. Next, confirmatory factor analysis confirmed the constructs with the fit indices except the chi-square score. To investigate the second aim, structural equation modeling was used. It showed that two personality traits—openness to experience and extraversion—were strongly associated with international posture. Furthermore, our study indicated a second-order configuration structured in the verified measure in relation to the two personality traits.
Renal limited ANCA-positive vasculitis: a rare manifestation of a rare disease
Authors: Khan Ali Jawad Jang , Khan Noman Ahmed Jang
Published: November 2020

Pauci-immune crescentic glomerulonephritis is the most common variant of rapidly progressive glomerulonephritis, accounting for approximately 80% of total cases. Most of the cases are associated with the presence of anti-neutrophil cytoplasmic antibody (ANCA) and are usually referred to as ANCA-associated vasculitis. A 68-year-old male with no previous renal history presented with complaints of shortness of breath, cough, and bilateral leg swelling for 2 weeks. Initial workup was significant for creatinine elevated at 2.9 mg/dL, blood urea nitrogen at 65 mg/dL, and glomerular filtration rate of 27 mL/min. Further workup was unremarkable for any significant abnormality. Subsequently patient’s kidney function worsened, and temporary hemodialysis was started. Kidney biopsy was performed, which later came back significant for necrotizing arteritis, multifocal, with focal necrotizing and crescentic glomerulonephritis, pauci-immune type. High-dose corticosteroids were administered, and good clinical response was noticed. This is a very rare case of renal limited pauci-immune crescentic glomerulonephritis with annual incidence of 7 to 10 cases per million every year in the United States. The absence of involvement of other organs makes our case even rarer. Mortality is as high as 90% in untreated patients and aggressive therapy with glucocorticoids and cyclophosphamide or rituximab are the mainstay of treatment. The presence of significant renal impairment in the absence of other organs involvement in our patient makes it a very unique presentation of ANCA-positive vasculitis.
Locked into Emissions: How Mass Incarceration Contributes to Climate Change
Authors: McGee Julius Alexander , Greiner Patrick Trent , Appleton Carl
Published: November 2020

The phenomenon of mass incarceration has dramatically altered the economic and infrastructural landscape of the United States. These changes have numerous implications regarding the use of fossil fuels, which are the single largest contributor to climate change. The present study argues that mass incarceration creates three social patterns that result in significant increases in industrial emissions. (1) Mass incarceration incentivizes further industrial development through the construction of new prisons and the continued maintenance of existing prisons to house prisoners. (2) The needs of the millions of individuals currently incarcerated in the United States incentivize industrial expansion through the production of goods and materials used inside prisons. (3) Incarcerated individuals are being used to reduce the cost of labor, which expands economic growth. We construct several fixed-effects panel regression models with robust standard errors predicting industrial emissions for U.S. states from 1997 to 2016 to assess how increases in the number of individuals in U.S. state, federal, and private prisons is correlated with industrial emissions over time. We find that increases in incarceration within states are associated with increases in industrial emissions, and that increases in incarceration lead to a more tightly coupled association between gross domestic product per capita and industrial emissions.
Parry Romberg disease with En Coup de Sabre Scleroderma: Effect of tocilizumab on periodontal bone inflammation
Authors: Meneghetti Thaís Cugler , Silva Juliana Yassue Barbosa da , Kluppel Lúcio Eduardo , Carvalho Vânia Oliveira de
Published: November 2020

Parry Romberg disease and En Coupe de Sabre Scleroderma are frequently associated disorders that affect the face and can cause severe aesthetic and functional impairment. Systemic immunosuppression is the gold standard of first-line treatment in the pediatric rheumatology standpoint although it is often delayed in the pediatric dermatology clinics and more often used in cases of refractory neurological impairment. We report on a case with dental root resorption and severe periodontal bone inflammation detected on magnetic resonance imaging, which was successfully treated with the anti-IL-6 agent tocilizumab.
Linear oblique craniectomy: A novel method of minimally invasive subdural grid insertion
Authors: Howard Calvin W , Aboelnazar Nader S , Salem Noor , Syed Naweed , Willetts Lian
Published: November 2020

Background:

Many countries rely upon subdural grid electroencephalography in the planning of epilepsy surgeries. However, craniotomy for subdural grid implantation is known to result in a variety of complications and requires diligence from the surgical team. We describe a minimally invasive method of subdural grid insertion, termed the linear oblique craniectomy, designed to mitigate complications and increase ease of subdural grid insertion.

Objective:

To demonstrate feasibility of minimally invasive subdural grid insertion utilizing skull anatomy.

Methods:

Three fresh frozen and embalmed human cadavers underwent surface landmarking and craniectomy to introduce a 4 × 5 cm2 subdural grid over the Sylvian fissure. Anteroposterior lens-shaped craniectomy measured 5 cm in length with 1 cm maximal width. The dura mater was longitudinally incised, and subdural grids were introduced over the Sylvian fissure.

Results:

The total area of the craniectomy created by the linear oblique approach consists of only approximately 20% of the total area removed by the traditional approach to access the Sylvian fissure for mesial temporal epilepsy monitoring/preoperative planning. The locations of the grids were evaluated by MRI and computed tomography scans postoperatively to ensure accurate alignment with the Sylvian fissure.

Conclusion:

In this cadaveric study, we demonstrate the linear oblique craniectomy procedure that provides an alternative approach to subdural grid implantation with significantly decreased invasiveness. This surgical approach has the potential of reducing complication rates of subdural grid insertion for surface monitoring of the brain activity and/or neuromachine interface analysis and is associated with significant reduction of surgical time.
Decreased IDO1-dependent tryptophan metabolism in aged lung during influenza
Authors: Cho Soo Jung , Hong Kyung Sook , Schenck Edward , Lee Stefi , Harris Rebecca , Yang Jianjun , Choi Augustine M.K. , Stout-Delgado Heather
Published: November 2020

Influenza epidemics remain a leading cause of morbidity and mortality worldwide. In the current study, we investigated the impact of chronological ageing on tryptophan metabolism in response to influenza infection.

Examination of metabolites present in plasma collected from critically ill patients identified tryptophan metabolism as an important metabolic pathway utilised specifically in response to influenza. Using a murine model of influenza infection to further these findings illustrated that there was decreased production of kynurenine in aged lung in an indoleamine-pyrrole 2,3-dioxygenase-dependent manner that was associated with increased inflammatory and diminished regulatory responses. Specifically, within the first 7 days of influenza, there was a decrease in kynurenine pathway mediated metabolism of tryptophan, which resulted in a subsequent increase in ketone body catabolism in aged alveolar macrophages. Treatment of aged mice with mitoquinol, a mitochondrial targeted antioxidant, improved mitochondrial function and restored tryptophan metabolism.

Taken together, our data provide additional evidence as to why older persons are more susceptible to influenza and suggest a possible therapeutic to improve immunometabolic responses in this population.
Lumacaftor/ivacaftor-associated health stabilisation in adults with severe cystic fibrosis
Authors: King Susannah J. , Keating Dominic , Williams Elyssa , Paul Eldho , Borg Brigitte M. , Finlayson Felicity , Button Brenda M. , Wilson John W. , Kotsimbos Tom
Published: November 2020

Introduction

Lumacaftor/ivacaftor (LUM/IVA) has been shown to improve clinical outcomes in cystic fibrosis (CF) patients homozygous for Phe508del with forced expiratory volume in 1 s (FEV1) % pred >40%. We assessed the clinical utility of LUM/IVA in all eligible adult CF patients with FEV1% pred <40% treated for at least 1 year under a single-centre managed access programme.

Methods

Following clinical optimisation, eligible patients (n=40) with FEV1% pred <40% were commenced on LUM/IVA and monitored for tolerance and clinical outcomes, including health service utilisation, pulmonary function, weight and body composition. 24 patients reached 1 year of treatment by the time of evaluation. Six patients discontinued due to adverse events (five for increased airways reactivity) and three underwent lung transplantation.

Results

In comparison with the year prior to LUM/IVA commencement, significant reductions (median per year) were observed in the treatment year in the number of pulmonary exacerbations requiring hospitalisation (from 3 to 1.5; p=0.0002), hospitalisation days (from 27 to 17; p=0.0002) and intravenous antibiotic (IVAB) usage days (from 45 to 27; p=0.0007). Mean±sdchange in FEV1% pred was −2.10±1.18% per year in the year prior, with the decline reversed in the year following (+1.45±1.13% per year; p=0.035), although there was significant heterogeneity in individual responses. Mean±sdweight gain at 1 year was 2.5±4.1 kg (p=0.0007), comprising mainly fat mass (mean 2.2 kg). The proportion of patients severely underweight (body mass index <18.5 kg·m−2) decreased from 33% at baseline to 13% at 1 year (p=0.003).

Conclusion

This real-world evaluation study demonstrated benefits over several clinical domains (infective exacerbations requiring hospitalisation, IVABs, pulmonary function decline and nutritional parameters) in CF patients with severe lung disease.
Chronic infection by nontypeable
Haemophilus influenzae
fuels airway inflammation
Authors: Saliu Fabio , Rizzo Giulia , Bragonzi Alessandra , Cariani Lisa , Cirillo Daniela M. , Colombo Carla , Dacc� Valeria , Girelli Daniela , Rizzetto Sara , Sipione Barbara , Cigana Cristina , Lor� Nicola I.
Published: November 2020

Nontypeable
Haemophilus influenzae
(NTHi) is commonly isolated from airways of patients suffering from chronic respiratory diseases, such as COPD or cystic fibrosis (CF). However, to what extent NTHi long-term infection contributes to the lung inflammatory burden during chronic airway disease is still controversial.

Here, we exploited human respiratory samples from a small cohort of CF patients and found that patients chronically infected with NTHi had significantly higher levels of interleukin (IL)-8 and CXCL1 than those who were not infected. To better define the impact of chronic NTHi infection in fuelling inflammatory response in chronic lung diseases, we developed a new mouse model using both laboratory and clinical strains. Chronic NTHi infection was associated with chronic inflammation of the lung, characterised by recruitment of neutrophils and cytokine release keratinocyte-derived chemokine (KC), macrophage inflammatory protein 2 (MIP-2), granulocyte colony-stimulating factor (G-CFS), IL-6, IL-17A and IL-17F) at 2 and 14 days post-infection. An increased burden of T-cell-mediated response (CD4
+
and ?d cells) and higher levels of pro-matrix metalloproteinase 9 (pro-MMP9), known to be associated with tissue remodelling, were observed at 14 days post-infection. Of note we found that both CD4
+
IL-17
+
cells and levels of IL-17 cytokines were enriched in mice at advanced stages of NTHi chronic infection. Moreover, by immunohistochemistry we found CD3
+
, B220
+
and CXCL-13
+
cells localised in bronchus-associated lymphoid tissue-like structures at day 14.

Our results demonstrate that chronic NTHi infection exerts a pro-inflammatory activity in the human and murine lung and could therefore contribute to the exaggerated burden of lung inflammation in patients at risk.
Validation of a diagnosis-agnostic symptom questionnaire for asthma and/or COPD
Authors: Karlsson Niklas , Atkinson Mark J. , Müllerová Hana , Alacqua Marianna , Keen Christina , Hughes Rod , Janson Christer , Make Barry , Price David , Reddel Helen K. ,   NOVELTY study investigators
Published: November 2020

Background

The Respiratory Symptoms Questionnaire (RSQ) is a novel, four-item patient-reported diagnosis-agnostic tool designed to assess the frequency of respiratory symptoms and their impact on activity, without specifying a particular diagnosis. Our objective was to examine its validity in patients with asthma and/or chronic obstructive pulmonary disease (COPD).

Methods

Baseline data were randomly sampled from patients who completed the RSQ in the NOVELTY study (ClinicalTrials.gov:NCT02760329). The total sample (n=1530) comprised three randomly selected samples (n=510 each) from each physician-assigned diagnostic group (asthma, asthma+COPD and COPD). The internal consistency and structural validity of the RSQ were evaluated using exploratory and confirmatory factor analyses; psychometric performance was observed using Classical Test Theory and Item Response Theory analyses.

Results

For the total sample, the mean±sdRSQ score was 5.6±4.3 (range 0–16). Irrespective of diagnosis, the internal consistency of items was uniformly adequate (Cronbach's α=0.76–0.80). All items had high factor loadings and structural characteristics of the measure were invariant across groups. Using the total sample, RSQ items informatively covered the θ score range of –2.0 to 2.8, with discrimination coefficients for individual items being high to very high (1.7–2.6). Strong convergent correlations were observed between the RSQ and the St George's Respiratory Questionnaire (0.77, p<0.001).

Conclusions

The RSQ is a valid, brief, patient-reported tool for assessing respiratory symptoms in patients across the whole spectrum of asthma and/or COPD, rather than using different questionnaires for each diagnosis. It can be used for monitoring respiratory symptoms in clinical practice, clinical trials and real-world studies.
Genomics and lipidomics analysis of the biotechnologically important oleaginous red yeast Rhodotorula glutinis ZHK provides new insights into its lipid and carotenoid metabolism
Authors: Li Chun-Ji , Zhao Die , Cheng Ping , Zheng Li , Yu Guo-Hui
Published: November 2020

Background

Rhodotorula glutinis is recognized as a biotechnologically important oleaginous red yeast, which synthesizes numerous meritorious compounds with wide industrial usages. One of the most notable properties of R. glutinis is the formation of intracellular lipid droplets full of carotenoids. However, the basic genomic features that underlie the biosynthesis of these valuable compounds in R. glutinis have not been fully documented. To reveal the biotechnological potential of R. glutinis, the genomics and lipidomics analysis was performed through the Next-Generation Sequencing and HPLC-MS-based metabolomics technologies.

Results

Here, we firstly assemble the genome of R. glutinis ZHK into 21.8 Mb, containing 30 scaffolds and 6774 predicted genes with a N50 length of 14, 66,672 bp and GC content of 67.8%. Genome completeness assessment (BUSCO alignment: 95.3%) indicated the genome assembly with a high-quality features. According to the functional annotation of the genome, we predicted several key genes involved in lipids and carotenoids metabolism as well as certain industrial enzymes biosynthesis. Comparative genomics results suggested that most of orthologous genes have underwent the strong purifying selection within the five Rhodotorula species, especially genes responsible for carotenoids biosynthesis. Furthermore, a total of 982 lipids were identified using the lipidomics approaches, mainly including triacylglycerols, diacylglyceryltrimethylhomo-ser and phosphatidylethanolamine.

Conclusion

Using whole genome shotgun sequencing, we comprehensively analyzed the genome of R. glutinis and predicted several key genes involved in lipids and carotenoids metabolism. By performing comparative genomic analysis, we show that most of the ortholog genes have undergone strong purifying selection within the five Rhodotorula species. Furthermore, we identified 982 lipid species using lipidomic approaches. These results provided valuable resources to further advance biotechnological applications of R .glutinis.