bluuebunny/crossref_metadata_2025 huggingface dataset:
Spinning Futures: Interrogating Feminist Pedagogy and Methodology With Speculative Fiction
Authors: Flint Maureen A. , Melchior Shelly , Guyotte Kelly W. , Shelton Stephanie Anne
Published: October 2021

In this article, we interrogate our experiences as four women academics with two short stories written in conversation with one another: The Ones Who Walk Away From Omelas by Ursula K. Le Guin, and “The Ones Who Stay and Fight,” written by N. K. Jemisin. Both Le Guin and Jemisin’s stories evoke questions about ethics and responsibility in the face of oppression. More specifically, both stories offer complicated and nuanced considerations for how we respond methodologically and pedagogically to systemic oppressions and violence as feminist subjects.
The Emotional Geographies of Being Stranded Due to COVID-19: A Poetic Autoethnography of an International Doctoral Student
Authors: Phan Anh Ngoc Quynh
Published: October 2021

This poetic critical autoethnography paper studies my own experiences of disrupted mobility as a Vietnamese doctoral student in New Zealand who was stuck in Vietnam. Through the lens of space and place, I investigate the issues of sense of belonging and sense of place that were reconfigured in different spaces. The article highlights my agency to reinforce and reconnect with my sense of belonging. As the article focuses on immobility, it challenges the mobility bias in international education scholarship, arguing that new forms of mobility can be produced out of immobility and that identity reconstruction can be enabled through respatialization.
Radioactive Seed Strand Efficacy in Superior Vena Cava Stenting Due to Non-small-cell Lung Cancer Obstruction
Authors: Yuan Fu-Kang , Fu Yu-Fei , Shi Yi-Bing , Yang Ning
Published: October 2021

Purpose

This study aims to determine the clinical effectiveness of a stent with radioactive seed strand (RSS) inserted in patients with superior vena cava (SVC) obstruction (SVCO) secondary to non-small-cell lung cancer (NSCLC).

Methods

Between January 2013 and December 2019, 63 patients with SVCO related to NSCLC received stent implantation with (n = 30) or without (n = 33) RSS insertion at our center. The clinical efficacy, stent patency duration, and overall survival (OS) were compared between these two groups.

Results

Both groups achieved 100% clinical and technical success rates. There were no obstacles associated with the procedure performed for the patients. Two patients in the RSS group and 7 patients in the stent-alone group experienced stent re-stenosis. The rate of re-stenosis between the two groups was not significantly different ( P = .099). Patients in the RSS group had significantly longer median patency than those in the stent-alone group (381 vs 309 days, P = .045). All patients died because of the development of tumors during the follow-up. Patients in the RSS group had a significantly longer median OS than those in the stent-alone group (229 vs 178 days, P = .026). During the follow-up, no patient in the RSS group suffered RSS migration or brachytherapy-related complications.

Conclusion

For patients with SVCO secondary to NSCLC, a stent with RSS insertion is efficacious and safe, and it may improve stent patency and OS.
Percutaneous transluminal angioplasty and stenting in acute stroke caused by basilar artery steno-occlusive disease: The experience of a single stroke centre
Authors: Machado Manuel , Borges de Almeida Gonçalo , Sequeira Marta , Pedro Filipa , Fior Alberto , Carvalho Rui , Fragata Isabel , Reis João , Nunes Ana Paiva
Published: October 2021

Background

Percutaneous transluminal angioplasty and stenting in acute stroke due to severe basilar artery stenosis or basilar artery occlusion remain a matter of debate. The higher risk of stroke recurrence in patients with vertebrobasilar stenosis compared to anterior circulation atherosclerotic disease creates high expectations concerning endovascular approaches. This study aims to review our experience with percutaneous transluminal angioplasty and stenting in acute stroke caused by basilar artery steno-occlusive disease.

Methods

Our prospective database from June 2014 until December 2020 was screened and patients with acutely symptomatic severe (>80%) basilar artery stenosis or acute basilar artery occlusion who underwent percutaneous transluminal angioplasty and stenting were analysed.

Results

Twenty-five patients included: 72% men (mean age 68.6 years), all with prior modified Rankin Scale <2. Twelve presented with acute basilar artery occlusion and were submitted to mechanical thrombectomy before percutaneous transluminal angioplasty and stenting, while the remaining had severe basilar artery stenosis. Successful stent placement was achieved in 22 (88%). Procedure-related complications included new small ischemic lesions (16%), basilar artery dissection (8%), vertebral artery dissection (12%) and death (12%). At 3 months post-percutaneous transluminal angioplasty and stenting, 10 out of 23 patients (43.5%) were independent (mRS ≤ 2) and six died. Fourteen patients underwent transcranial Doppler ultrasound 3 months post-percutaneous transluminal angioplasty and stenting: 12 showed residual stenosis, one significant stent restenosis and one presented stent occlusion.

Conclusions

Percutaneous transluminal angioplasty and stenting showed to be a technically feasible and reasonably safe procedure in selected patients. However, good clinical outcomes may be difficult to achieve as only 43.5% of the patients remained independent at 3 months. Randomized studies are needed to confirm the efficacy and safety outcomes of percutaneous transluminal angioplasty and stenting in acute stroke caused by basilar artery steno-occlusive disease.
Remembering spatial words: Sensorimotor simulation affects verbal recognition memory
Authors: Kumcu Alper , Thompson Robin L.
Published: October 2021

Previous evidence shows that words with implicit spatial meaning or metaphorical spatial associations are perceptually simulated and can guide attention to associated locations (e.g., bird—upward location). In turn, simulated representations interfere with visual perception at an associated location. The present study investigates the effect of spatial associations on short-term verbal recognition memory to disambiguate between modal and amodal accounts of spatial interference effects across two experiments. Participants in both experiments encoded words presented in congruent and incongruent locations. Congruent and incongruent locations were based on an independent norming task. In Experiment 1, an auditorily presented word probed participants’ memory as they were visually cued to either the original location of the probe word or a diagonal location at retrieval. In Experiment 2, there was no cue at retrieval but a neutral encoding condition in which words normed to central locations were shown. Results show that spatial associations affected memory performance although spatial information was neither relevant nor necessary for successful retrieval: Words in Experiment 1 were retrieved more accurately when there was a visual cue in the congruent location at retrieval but only if they were encoded in a non-canonical position. A visual cue in the congruent location slowed down memory performance when retrieving highly imageable words. With no cue at retrieval (Experiment 2), participants were better at remembering spatially congruent words as opposed to neutral words. Results provide evidence in support of sensorimotor simulation in verbal memory and a perceptual competition account of spatial interference effect.
Judging the past: Memory, others, and intergenerational responsibility among the Japanese youth
Authors: Fukuoka Kazuya , Takita-Ishii Sachiko
Published: October 2021

The past continuously haunts Japan. It has been more than 75 years since the end of the last war and Japan has never fully reconciled with its Asian neighbors, especially China and South Korea, over the question of how to commemorate Japan’s past wrongs and atone for the physical as well as the psychological wounds it caused in Asia. In this context, also problematized is the question of intergenerational responsibility. Can the members of current generations feel responsibility and obligation to make restitution for wrongs perpetrated before they were born? If so, how? If not, why not? As it is reported that the Japanese public’s sense of affinity toward China and South Korea greatly deteriorated in the 2010s due to a series of memory disputes, it seems imperative to delve into the Japanese youth’s sense of the past. In this exploratory study, by following Barry Schwartz and his colleagues’ Judging the Past framework, we conducted college student surveys (N = 320) in 2017/2018 and interviews (N = 31) in 2017 and explored the cognitive connection between the Japanese youth’s sense of nation and their perceptions of moral responsibility for Japan’s militaristic past.
Effect of symptom-based alpha-blocker treatment on lower urinary tract symptoms in women: systematic review and meta-analysis
Authors: Kang Tae Wook , Kim Su Jin , Chang Ki Don , Kim Myung Ha , Chung Hyun Chul
Published: October 2021

Aims:

The aim of this study was to evaluate the effects of alpha blockers in women with lower urinary tract symptoms.

Methods:

We conducted systematic review and meta-analysis on published a priori protocols. We searched multiple data sources for published and unpublished randomized controlled trials in any language. Primary outcomes included urologic symptom scores, quality of life, and overall adverse events. We performed meta-analysis using RevMan 5.3 and rated the certainty of evidence using Grading of Recommendations, Assessment, Development, and Evaluation.

Results:

Alpha blockers likely reduced urological symptom score (mean difference: −1.50, 95% confidence interval: −2.91 to −0.09; moderate certainty of evidence). Alpha blockers may improve quality of life (standardized mean difference: −0.35, 95% confidence interval: −0.85 to 0.15; low certainty of evidence) and have little to no difference in overall adverse events (risk ratio: 1.09, 95% confidence interval: 0.55 to 2.15; low certainty of evidence). Based on five studies comparing combination therapy with alpha blockers and anticholinergics to anticholinergic monotherapy, combination therapy likely results in little to no difference in urological symptom score (mean difference: −0.35, 95% confidence interval: −1.98 to 1.27; moderate certainty of evidence) and quality of life (mean difference: −0.11, 95% confidence interval: −0.48 to 0.27; moderate certainty of evidence). We are very uncertain about the effect of combination therapy on overall adverse events (risk ratio: 1.07, 95% confidence interval: 0.40 to 2.84; very low certainty of evidence).

Conclusion:

Alpha blocker monotherapy for the women with lower urinary tract symptoms regardless of the underlying cause likely has satisfactory efficacy compared with placebo. However, combination therapy with anticholinergics likely has no additional effect on urologic symptom score and quality of life compared with anticholinergic monotherapy.
Social distancing during COVID-19: threat and efficacy among university students in seven nations
Authors: Guidry Jeanine P. D. , Perrin Paul B. , Bol Nadine , Song BaoBao , Hong Cheng , Lovari Alessandro , Coman Ioana A. , O’Donnell Nicole H. , Alkazemi Mariam , Niu Jing , Pabian Sara J. R. , Linn Annemiek J. , Miller Carrie A. , Carlyle Kellie E.
Published: October 2021

COVID-19 has been spreading fast worldwide, and until effective and safe vaccines have been widely adopted, preventive measures such as social distancing are crucial to keep the pandemic under control. The study’s research questions asked which psychosocial factors predict social distancing behavior and whether there are country-level differences in social distancing? Using the Extended Parallel Process Model (EPPM) as a theoretical lens, we examined the predictive effects of threat and efficacy and demographic variables on adherence to the COVID-19 preventive behavior of social distancing using a survey among an international sample of university students. Using path modeling and analysis of covariance, we confirmed the predictive effects of the EPPM on social distancing behavior. Our final model showed that perceived susceptibility to COVID-19 was both directly and indirectly (through response efficacy) associated with social distancing behavior; that perceived severity of COVID-19 yielded a significant indirect effect on social distancing behavior through both self-efficacy and response efficacy; that perceived susceptibility is indirectly and positively associated with social distancing behavior through response efficacy; and that self-efficacy and response efficacy were directly associated with social distancing behavior. Additionally, there were country-level differences in social distancing. Possible explanations for and implications of these findings are discussed.
Development of a risk classification system combining TN-categories and circulating EBV DNA for non-metastatic NPC in 10,149 endemic cases
Authors: Chen Fo-Ping , Lin Li , Liang Jin-Hui , Tan Sze Huey , Ong Enya H.W. , Luo Ying-Shan , Huang Luo , Sim Adelene Y.L. , Wang Hai-Tao , Gao Tian-Sheng , Deng Bin , Zhou Guan-Qun , Kou Jia , Chua Melvin L.K. , Sun Ying
Published: October 2021

Background:

The objective of this study was to construct a risk classification system integrating cell-free Epstein-Barr virus (cfEBV) DNA with T- and N- categories for better prognostication in nasopharyngeal carcinoma (NPC).

Methods:

Clinical records of 10,149 biopsy-proven, non-metastatic NPC were identified from two cancer centers; this comprised a training ( N = 9,259) and two validation cohorts ( N = 890; including one randomized controlled phase 3 trial cohort). Adjusted hazard ratio (AHR) method using a two-tiered stratification by cfEBV DNA and TN-categories was applied to generate the risk model. Primary clinical endpoint was overall survival (OS). Performances of the models were compared against American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) 8th edition TNM-stage classification and two published recursive partitioning analysis (RPA) models, and were validated in the validation cohorts.

Results:

We chose a cfEBV DNA cutoff of ⩾2,000 copies for optimal risk discretization of OS, disease-free survival (DFS) and distant metastasis-free survival (DMFS) in the training cohort. AHR modeling method divided NPC into six risk groups with significantly disparate survival ( p  < 0.001 for all): AHR1, T1N0; AHR2A, T1N1/T2-3N0 cfEBV DNA  < 2,000 (EBVlow); AHR2B, T1N1/T2-3N0 cfEBV DNA ⩾ 2,000 (EBVhigh) and T1-2N2/T2-3N1 EBVlow; AHR3, T1-2N2/T2-3N1 EBVhigh and T3N2/T4N0 EBVlow; AHR4, T3N2/T4 N0-1 EBVhigh and T1-3N3/T4N1-3 EBVlow; AHR5, T1-3N3/T4 N2-3 EBVhigh. Our AHR model outperformed the published RPA models and TNM stage with better hazard consistency (1.35 versus 3.98–12.67), hazard discrimination (5.29 versus 6.69–13.35), explained variation (0.248 versus 0.164–0.225), balance (0.385 versus 0.438–0.749) and C-index (0.707 versus 0.662–0.700). In addition, our AHR model was superior to the TNM stage for risk stratification of OS in two validation cohorts ( p  < 0.001 for both).

Conclusion:

Herein, we developed and validated a risk classification system that combines the AJCC/UICC 8th edition TN-stage classification and cfEBV DNA for non-metastatic NPC. Our new clinicomolecular model provides improved OS prediction over the current staging system.
Implementers as Filters of Fit and Quality: Toward Indigenous and Locally Responsive Leadership Preparation Program in Ethiopia
Authors: Tekleselassie Abebayehu , DeCuir Amaarah
Published: October 2021

This empirical study of Ethiopia school leadership examines the nation’s leadership preparation programs through the lens of school leaders and a document analysis of national policies as well as narrated accounts of university preparation programs. To meet the expectations of the Millennium Development Goals of 2000, Ethiopia undertook significant education reforms including decentralizing educational governance while establishing a uniform, national curriculum for education leadership preparation, with content largely borrowed from the West. The findings of our study reveal that Ethiopian school leaders confront challenges specific to East African contexts such as addressing complications of abject poverty and multiple inequities, intense political scrutiny, while satisfying external political demands, and managing school operations with minimal resources. Using an asset-driven lens, we describe strategies and tools utilized by school leaders as they craft creative and indigenous solutions for local problems but are often overlooked in national preparation programs. As effective leadership programs are tethered to the local context, we sought to add the voices of Ethiopian leaders to increase the fit between preparation and work demands. At the same time, we advocate for widening the discourse of national policy reform to include local school improvement necessary to advance Ethiopia’s national education priorities.
Olfactory-related Quality of Life Adjustments in Smell Loss during the Coronavirus-19 Pandemic
Authors: Liu David T. , Prem Bernhard , Besser Gerold , Renner Bertold , Mueller Christian A.
Published: October 2021

Background

Previous studies provided the first evidence that the importance of olfaction decreases with the duration of olfactory dysfunction (OD).

Objective

To evaluate differences in olfactory-related quality of life (QoL) between patients with new-onset and persistent smell loss (>4 weeks) during the coronavirus-19 (COVID-19) pandemic and patients with persistent postinfectious OD (PIOD) that were recruited before the pandemic.

Methods

This was a retrospective study that included 149 patients with self-reported OD. The olfactory-related QoL was measured using the questionnaire of OD (QOD). The QOD measures the degree to which patients (i) adjust and cope with smell loss (QOD-positive statement [QOD-PS]), (ii) suffer from distorted odor perceptions (QOD-parosmia [QOD-PAR]), and (iii) suffer from smell loss in general (QOD-negative statement [QOD-NS]). Self-perceived chemosensory function, demographics, olfactory function, and duration of smell loss were evaluated. Analyses of variance were used to depict differences in QoL-outcomes between different OD groups.

Results

All patients included during the COVID-19 pandemic reported an extensive loss of chemosensory functions of smell, taste, and flavor perception. Psychophysical retronasal screening testing showed olfactory impairments in more than half of these patients. One-way analysis of variance and posthoc tests revealed that the QOD-NS was significantly higher in the new-onset OD group than the PIOD group. At the same time, the QOD-PS score was significantly higher in the PIOD and the persistent COVID-19 OD group than in the new-onset OD group.

Conclusion

We showed that patients with persistent OD experienced better olfactory-related adjustment and lower QoL-impairment scores than those with recent-onset smell loss, suggesting that the olfactory-related QoL might change as a function of time after symptom onset.
Nasal trumpet as a long-term remedy for obstructive sleep apnea syndrome in a child
Authors: Yau Tammy , Bansal Ruchi , Hardin Kimberly , Senders Craig , Nandalike Kiran
Published: October 2021

We present a case of successful long-term use of nasal trumpet for severe obstructive sleep apnea syndrome in a child with cerebral palsy and complex medical issues. Obstructive sleep apnea syndrome is frequently seen in pediatric patients with cerebral palsy due to their abnormal airway tone and pulmonary vulnerability. Identifying children with cerebral palsy who are at risk for obstructive sleep apnea syndrome is important because its treatment can improve quality of life and seizure control. Although first-line treatment for obstructive sleep apnea syndrome is adenotonsillectomy, children with cerebral palsy are more likely to have residual obstructive sleep apnea syndrome postoperatively. Other options such as positive airway pressure therapy and other upper airway surgeries may pose significant challenges and tolerance issues, as in our patient. As demonstrated in our report, the low rate of complications and ease of use make nasal trumpets a potential long-term treatment option for children with obstructive sleep apnea syndrome who fail or cannot comply with the traditional treatment options.
Biomechanical Strength of a Novel Tendon Splicing Open Book Technique Compared to the Pulvertaft Method Using Unembalmed Human Cadaveric Tissue
Authors: McKee Desirae , Wait Eric , Lierly Micah , Ghosh Niloy , Sizer Phillip S. , Cox Cameron , Gilbert Kerry K.
Published: October 2021

Background: Extensor pollicis longus (EPL) tendon rupture is a known complication of distal radius fractures. The Pulvertaft graft technique is currently used for tendon transfer of extensor indicis proprious (EIP) to EPL. This technique can produce unwanted tissue bulkiness and cosmetic concerns as well as hinder tendon gliding. A novel “open book” technique has been proposed, but relevant biomechanical data are limited. We designed a study to examine the biomechanical behaviours of the “open book” versus Pulvertaft techniques. Methods: Twenty matched forearm-wrist-hand samples were harvested from 10 fresh frozen cadavers (2 female, 8 male) with a mean age of 61.7 (±19.25) years. The EIP was transferred to EPL using the Pulvertaft versus “open book” techniques for each matched pair (sides randomly assigned). The repaired tendon segments were mechanically loaded using a Materials Testing System to examine graft biomechanical behaviours. Results: Mann-Whitney U test outcomes demonstrated that there was no significant difference between “open book” versus Pulvertaft techniques for peak load, load at yield, elongation at yield, or repair width. The “open book” technique demonstrated a significantly lower elongation at peak load and repair thickness, as well as significantly higher stiffness when compared with the Pulvertaft technique. Conclusions: Our findings support the use of the “open book” technique, producing comparable biomechanical behaviours compared to the Pulvertaft technique. Incorporating the “open book” technique potentially requires smaller repair volume, producing size and appearance that is more anatomic when compared with the Pulvertaft.
Association of Patient-Reported Physician Awareness of Complementary Medicine, Medical Care Experience and Care Quality
Authors: Roydhouse Jessica K. , Wilson Ira B. , Gutman Roee , Wallace Robert B. , Berman Tara , Keating Nancy L.
Published: October 2021

The aim was to examine the association of patient-reported physician awareness of biological CAM use and patient perceptions of care experience and quality with a population-based study of patients with incident lung and colorectal cancer. This was a secondary data analysis using regression models. Outcomes of interest were patient reports of medical care experience and quality ratings. Among 716 patients who reported biological CAM use, 69% reported their physicians were aware of this. Patients who reported physician awareness of biological CAM use had higher adjusted scores for medical care experience ( + 5.4, 95%CI:2.3,8.6) and care quality ( + 3.6, 95%CI:−0.3, + 7.5). These associations suggest that physicians should be encouraged to inquire about biological CAM use.
Long-term psychological consequences of stroke (OX-CHRONIC): A longitudinal study of cognition in relation to mood and fatigue after stroke: Protocol
Authors: Demeyere Nele , Williams Owen A , Milosevich Elise , Chiu Evangeline G , Drozdowska Bogna A , Dillon Avril , Dawes Helen , Thomas Shirley , Kuppuswamy Annapoorna , Pendlebury Sarah T , J Quinn Terence
Published: October 2021

Background

The long-term psychological consequences of stroke and how cognitive problems change over time after the first-year following stroke remain unclear. Particularly, trajectories of domain-specific and domain-general cognitive functions and how cognition interacts with mood, fatigue and quality of life are not well described.

Aims

To determine the prevalence, trajectories and wider impact of domain-specific cognitive impairment in long-term stroke survivors, in relation to mood, fatigue and quality of life.

Methods

Participants who previously took part in the Oxford Cognitive Screening study, completed the 6-month follow-up with cognitive, mood, fatigue and quality of life assessments and agreed to be contacted for future research will be recruited into OX-CHRONIC. The eligible cohort is between 2- and 9-years post-stroke. Cognition will be assessed with a detailed neuropsychological battery, alongside questionnaire measures of mood, fatigue, activities of daily life and quality of life measures at two timepoints, 1 year apart. Additionally, medical records will be accessed to extract further clinical information about the stroke and patients may opt-in to wear an activity monitor for 1 week to provide fine-grained measures of sleep and activity. The study protocol and study materials were approved by the national ethics committee (REC Ref: 19/SC/0520).

Planned outputs

OX-CHRONIC will provide detailed data on the evolving cognitive profiles of stroke survivors over several years post-stroke. Estimates of long-term prevalence as well as the effect of changes in cognitive profiles on mood, fatigue and quality of life will be examined. This study is funded by a Priority Programme Grant from the Stroke Association (SA PPA 18/100032).
Point-of-care high-sensitivity assay on PATHFAST as the backup in the emergency room
Authors: Osredkar Joško , Krivic Katja , Fabjan Teja , Kumer Kristina , Tršan Jure , Poljančič Laura , Finderle Petra , Možina Hugon
Published: October 2021

Aim:

Although the levels of cardiac troponin I (cTnI) have proved to be a useful diagnostic biomarker of acute myocardial infarction, there are a wide variety of point-of-care (POC) analysers, which provide measurements of cTnI. The aim of this study was to compare the results obtained by the ADVIA Centaur ultra-assay cTnI assay (us-cTnI), ADVIA Centaur high-sensitive cTnI assay (hs-cTnI) and a POC high-sensitivity assay using PATHFAST. We also aimed to explore total turnaround time (TAT) for laboratory results using the POC PATHFAST analyser.

Methods:

Samples from 161 patients were taken. Of these samples, 129 were tested with all three assays (us-cTnI, hs-cTnI and PATHFAST), and 32 samples were tested on PATHFAST for the comparison of whole blood, serum and plasma.

Results:

Comparison of the POC testing methods in this study demonstrated that there are strong linear relationships between all three cTnI assays (us-cTnI, hs-cTnI and POC on PATHFAST). Furthermore, we also show there are strong linear relationships between the two high-sensitive cTnI assays (hs-cTnI and PATHFAST) for blood serum samples, as determined by Passing–Bablok regression analyses. In our comparison of our new data with our older study, the TAT went down.

Conclusion:

The timeliness of laboratory results is, in addition to accuracy and precision, one of the key indicators of laboratory performance, and at the same time has a significant impact on the course of the patient’s condition. It is therefore important that the laboratory strives to meet the expectations of clinicians regarding the time from the order to the result of the analysis.
Treatment of Severe Avascular Necrosis of the Talus Using a Novel Keystone-Shaped 3D-Printed Titanium Truss Implant
Authors: Ramhamadany Eamon , Chadwick Carolyn , Davies Mark B.
Published: October 2021

Background:

Avascular necrosis (AVN) of the talus most commonly occurs secondary to trauma. Significant bone loss and collapse in severe talar AVN remains an operative challenge. Tibiotalocalcaneal arthrodesis (TTC) using femoral head allograft is at risk of collapse and subsidence. The use of a void-filling titanium truss can mitigate against this. This study describes the use of a novel keystone shaped 3D-printed titanium truss for treatment of severe talar AVN.

Methods:

Three patients with end-stage AVN of the talus were included. Each patient underwent a TTC arthrodesis with a custom-made, 3D-printed, keystone-shaped, truss implant in conjunction with a hindfoot intramedullary nail. Modified patient American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded at the preoperative, 6-month, 12-month, and annual postoperative timepoints.

Results:

All patients progressed to satisfactory radiological union by one year. Mean follow up time was 32 months (24-48 months). Mean preoperative modified AOFAS score was 5. There was progressive improvement in AOFAS scores from 6 months postoperatively. Mean modified AOFAS score improved from 28 at 6 months to 37 at 2 years postoperatively.

Conclusion:

Custom-made 3D-printed titanium trusses provide promising outcomes for treating severe AVN of the talus. The “keystone” design is advantageous as it allows for bone stock preservation and conforms to the shape of the native calcaneum. All patients showed progressive improvements in outcomes at sequential time intervals postoperatively. The implant provides a strong mechanical structure resisting collapse and subsidence during the arthrodesis process.

Level of Evidence:

Level IV, retrospective case series.
Comparative transcriptome analysis identified important genes and regulatory pathways for flower color variation in Paphiopedilum hirsutissimum
Authors: Li Xiuling , Fan Jizheng , Luo Shuming , Yin Ling , Liao Hongying , Cui Xueqiang , He Jingzhou , Zeng Yanhua , Qu Junjie , Bu Zhaoyang
Published: October 2021

Background

Paphiopedilum hirsutissimumis a member of Orchidaceae family that is famous for its ornamental value around the globe, it is vulnerable due to over-exploitation and was listed in Appendix I of the Convention on International Trade in Endangered Species of Wild Fauna and Flora, which prevents its trade across borders. Variation in flower color that gives rise to different flower patterns is a major trait contributing to its high ornamental value. However, the molecular mechanism underlying color formation inP. hirsutissimumstill remains unexplored. In the present study, we exploited natural variation in petal and labellum color of Paphiopedilum plants and used comparative transcriptome analysis as well as pigment measurements to explore the important genes, metabolites and regulatory pathways linked to flower color variation inP. hirsutissimum.

Result

We observed that reduced anthocyanin and flavonoid contents along with slightly higher carotenoids are responsible for albino flower phenotype. Comparative transcriptome analysis identified 3287 differentially expressed genes (DEGs) among normal and albino labellum, and 3634 DEGs between normal and albino petals. Two genes encoding for flavanone 3-hydroxylase (F3H) and one gene encoding for chalcone synthase (CHS) were strongly downregulated in albino labellum and petals compared to normal flowers. As both F3H and CHS catalyze essentially important steps in anthocyanin biosynthesis pathway, downregulation of these genes is probably leading to albino flower phenotype via down-accumulation of anthocyanins. However, we observed the downregulation of major carotenoid biosynthesis genes including VDE, NCED and ABA2 which was inconsistent with the increased carotenoid accumulation in albino flowers, suggesting that carotenoid accumulation was probably controlled at post-transcriptional or translational level. In addition, we identified several key transcription factors (MYB73, MYB61, bHLH14, bHLH106, MADS-SOC1, AP2/ERF1, ERF26 and ERF87) that may regulate structural genes involved in flower color formation inP. hirsutissimum.Importantly, over-expression of some of these candidate TFs increased anthocyanin accumulation in tobacco leaves which provided important evidence for the role of these TFs in flower color formation probably via regulating key structural genes of the anthocyanin pathway.

Conclusion

The genes identified here could be potential targets for breedingP. hirsutissimumwith different flower color patterns by manipulating the anthocyanin and carotenoid biosynthesis pathways.
Antioxidant gene expression analysis and evaluation of total phenol content and oxygen-scavenging system in tea accessions under normal and drought stress conditions
Authors: Rahimi Mehdi , Kordrostami Mojtaba , Mohamadhasani Fereshteh , Chaeikar Sanam Safaei
Published: October 2021

Background

Abiotic and biotic stresses induce oxidative processes in plant cells that this process starts with the production of ROSs which cause damage to the proteins. Therefore, plants have increased their antioxidant activity to defend against this oxidative stress to be able to handle stress better. In this research, 14 different tea accessions in a randomized complete block design with two replications were evaluated in two normal and drought stress conditions, and their antioxidant activity was measured by DPPH-free radicals’ assay and gene expression analysis.

Results

The results of gene expression analysis showed that the 100 and 399 accessions and Bazri cultivar had high values for most of the antioxidant enzymes, ascorbate peroxidase, superoxide dismutase, catalase, and peroxidase under drought stress conditions while the 278 and 276 accessions had the lowest amount of antioxidant enzymes in the same situation. Results showed that the IC50 of the BHT combination was 90.12 μg/ ml. Also, The IC50 of accessions ranged from 218 to 261 μg/ml and 201–264 μg/ml at normal and drought stress conditions, respectively. The 100 and 399 accessions showed the lowest IC50 under normal and drought stress conditions, while 278 and 276 accessions had the highest value for IC50. The antioxidant activity of tea accession extracts under normal conditions was ranged from 25 to 69% for accessions 278 and 100, respectively. While, the antioxidant activities of extracts under drought stress condition was 12 to 83% for accessions 276 and 100, respectively. So, according to the results, 100 and 399 accessions exhibited the least IC50 and more antioxidant activity under drought stress conditions and were identified as stress-tolerant accessions. However, 278 and 276 accessions did not show much antioxidant activity and were recognized as sensitive accessions under drought stress conditions.

Conclusions

These results demonstrate that total phenol content, antioxidant activity, and the oxygen-scavenging system can be used as a descriptor for identifying drought-tolerant accessions.
Incentive delivery timing and follow-up survey completion in a prospective cohort study of injured children: a randomized experiment comparing prepaid and postpaid incentives
Authors: Millar Morgan M. , Olson Lenora M. , VanBuren John M. , Richards Rachel , Pollack Murray M. , Holubkov Richard , Berg Robert A. , Carcillo Joseph A. , McQuillen Patrick S. , Meert Kathleen L. , Mourani Peter M. , Burd Randall S.
Published: October 2021

Background

Retaining participants over time is a frequent challenge in research studies evaluating long-term health outcomes. This study’s objective was to compare the impact of prepaid and postpaid incentives on response to a six-month follow-up survey.

Methods

We conducted an experiment to compare response between participants randomized to receive either prepaid or postpaid cash card incentives within a multisite study of children under 15 years in age who were hospitalized for a serious, severe, or critical injury. Participants were parents or guardians of enrolled children. The primary outcome was survey response. We also examined whether demographic characteristics were associated with response and if incentive timing influenced the relationship between demographic characteristics and response. We evaluated whether incentive timing was associated with the number of calls needed for contact.

Results

The study enrolled 427 children, and parents of 420 children were included in this analysis. Follow-up survey response did not differ according to the assigned treatment arm, with the percentage of parents responding to the survey being 68.1% for the prepaid incentive and 66.7% with the postpaid incentive. Likelihood of response varied by demographics. Spanish-speaking parents and parents with lower income and lower educational attainment were less likely to respond. Parents of Hispanic/Latino children and children with Medicaid insurance were also less likely to respond. We found no relationship between the assigned incentive treatment and the demographics of respondents compared to non-respondents.

Conclusions

Prepaid and postpaid incentives can obtain similar participation in longitudinal pediatric critical care outcomes research. Incentives alone do not ensure retention of all demographic subgroups. Strategies for improving representation of hard-to-reach populations are needed to address health disparities and ensure the generalizability of studies using these results.
Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol
Authors: Dadashaliha Masoumeh , Fallah Somayeh , Mirzadeh Monirsadat
Published: October 2021

Background

This study attempts to evaluate the safety and effectiveness of 50μgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women.

Methods

This study is designed as a parallel clinical trial study. Three hundred and fifteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4 h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed. Data were analyzed using SPSS software. A significance level of p <  0.05 was considered for statistical analyses.

Findings

Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p <  0.05) cervical participants proceeded to vaginal births. This figure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10 h. Time from start of medication to the active phase of labor and childbirth was 3.01 ± 0.86 and 6.1 ± 1.3 h in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 h in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 h in the vaginal group respectively (p < 0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p = 0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Furthermore, no maternal and neonatal complications were observed.

Conclusion

In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μgm appears to be an effective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment.

Trial registration

This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT20190415043278N1. Registration date was on May 13, 2019 and May 27, 2019 respectively (http://www.irct.ir).
Association of four gene polymorphisms in Chinese Guangxi population with diabetic retinopathy in type 2 diabetic patients
Authors: Jin He , Jiang Dongdong , Ding Zhixiang , Xiong Yu , Zeng Xinsheng , Liao Miaoyun , Zheng Liu , Yang Binbin
Published: October 2021

Abstracts

Background

Diabetic retinopathy (DR) is one of the most common chronic microvascular complications of diabetes. Many studies have suggested that genetic factors are important in the context of DR. This study evaluated the associations of GWAS (Genome-wide association study) -identified DR-associated SNPs in a Chinese population in Guangxi Province with type 2 diabetes mellitus (T2DM).

Methods

A total of 386 hospitalized T2DM patients without proliferative diabetic retinopathy (PDR) and 316 hospitalized T2DM patients with PDR were included in this case–control study. Four tag SNPs, including rs1800896 in the IL-10 gene, rs2010963 in the VEGFA gene, rs2070600 in the RAGE gene and rs2910164 in the miR-146a gene, were examined using KASP (kompetitive allele specific PCR) genotyping assays.

Results

There were no significant differences in the genotype or allele frequencies of the miR-146a polymorphism (rs2910164) between subjects with PDR and those without DR. The TC genotype of rs1800896 was determined to be associated with an increased risk of PDR (the odds ratio (OR) was 2.366, with a 95% confidence interval (CI) ranging from 1.144 to 4.894). The CG genotypes of rs2010963 was associated with an decreased risk of PDR (the OR was 0.588, with a 95% CI ranging from 0.366 to 0.946). Regarding rs2070600, 2 genotypes (TT and CT) were associated with a decreased risk of PDR (the OR of the TT genotype was 0.180, with a 95% CI ranging from 0.037 to 0.872, and the OR of the CT genotype was 0.448, with a 95% CI ranging from 0.266 to 0.753).

Conclusions

The rs1800896 polymorphisms in the IL-10 gene, rs2010963 in the VEGFA gene and rs2070600 in the RAGE gene are associated with the risk of PDR in the Han Chinese population of Guangxi Province. Our findings provide suggestive evidence that these polymorphisms may be involved in the pathogenesis of PDR and should be investigated further.
Excellent clinical and radiological outcome following locking compression plate fixation of displaced medial clavicle fractures
Authors: Wurm Markus , Siebenlist Sebastian , Zyskowski Michael , Pflüger Patrick , Biberthaler Peter , Beirer Marc , Kirchhoff Chlodwig
Published: October 2021

Background

Treatment of medial clavicle fractures is still controversially discussed in the community of upper extremity surgeons. An increasing number of symptomatic non-unions following conservative treatment of displaced fractures led to the development of various surgical approaches. Aim of this study was to evaluate the clinical and radiological outcome following operative treatment of displaced medial end clavicle fractures.

Methods

Patients who presented with a displaced fracture of the medial clavicle between September 2012 and December 2019 were retrospectively enrolled in this study. All patients were operatively treated with open reduction and internal fixation (ORIF) using an anatomically precontoured locking compression plate (LCP) originally designed for the lateral clavicle (Synthes®, Umkirch, Germany). Functional outcome was recorded using the American Shoulder and Elbow Surgeons (ASES) Score, the Munich Shoulder Questionnaire (MSQ), Shoulder Pain and Disability Index (SPADI) and Constant Score.

Results

Overall 18 patients with a mean age of 54.5 ± 23.5 years suffering from a displaced fracture of the medial clavicle were identified. The mean follow-up was 40.9 ± 26.2 months. The mean ASES accounted for 88.3 ± 20.8 points, the mean MSQ was 83.1 ± 21.7 points, the mean SPADI was 85.6 ± 22.5 and a mean normative age- and sex-specific Constant Score of 77.5 ± 19.1 points resulted. No minor or major complications were observed. Radiologic fracture consolidation was achieved in all patients after a mean of 6.4 months.

Conclusion

Surgical treatment of displaced medial clavicle fractures using an anatomically precontoured locking plate originally designed for the lateral clavicle led to very good to excellent clinical and functional results.

Trial registration

No:DRKS00024813, retrospectively registered 19.03.2021 (www.drks.de).
Developing a social prescribing local system in a European Mediterranean country: a feasibility study to promote active and healthy aging
Authors: Costa A. , Lopes J. , Sousa C. J. , Santos O. , Virgolino A. , Nogueira P. , Henriques A. , Seabra P. , Capitão C. , Martins R. , Arriaga M. , Alarcão V.
Published: October 2021

Background

Social Prescribing (SP) is an innovative strategy to respond to the non-clinical health needs of the population. A Social Prescribing Local System (SPLS) can be defined as a set of joined community, health, and social organizations to foster SP-oriented activities. This study aimed to develop and assess the feasibility of an SPLS implemented in a Mediterranean country, to promote health and wellbeing and contribute to active and healthy aging.

Methods

A mixed-methods approach was followed, including three sequential components: 1) Cross-sectional online survey targeting health professionals (HP) working in a primary health care cluster, Portugal’s southern region; 2) Pilot study implementing an on-the-job training program for HP, designed to meet identified training needs in the survey; 3) Focus group (FG) with the HP who participated in the pilot study, two individual interviews, with an elderly patient and a community provider for assessing the satisfaction with the pilot test.

Results

Sixty-five HP completed the survey; of these, 13 completed the theoretical part of the on-the-job training program; and six (out of these 13) completed the full program. Five HP participated in the FG, one patient and one community provider were interviewed. The surveyed HP perceived as facilitators to implement SP: an automatic system of notifications to prompt the use of SP, contribute to patient satisfaction, human and community resources’ stability. The survey also highlighted barriers to SP implementation: length of appointments, shortage of human resources, data records confidentiality, low patient adherence rates, bureaucratic issues, time constraints, and financial costs. Participants were satisfied with the training. Identified SPLS implementation benefits were grouped into four dimensions (from the qualitative approach): gains for patients’ health and wellbeing, support for the health services, sustainability of the community resources, and HP’ professional satisfaction.

Conclusions

Our study took the first steps towards the implementation of an SPLS. Findings reinforce that training HP in SP and on-the-job training seems feasible. This approach was well received and appears to represent a suitable and sustainable strategy. It can promote professional satisfaction, support health services, contribute to the stability of community resources, improve health and promote active and healthy aging.