bluuebunny/crossref_metadata_2025 huggingface dataset:
The Multiple Stories in Finnish Roma Schooling
Authors: Stenroos Marko , Helakorpi Jenni
Published: February 2021

Regardless of the good reputation of the Finnish basic education system, Finnish Roma children fall behind the overall average in their performance of academic skills: Roma children face more challenges completing basic education and have more repeated school years. Furthermore, compared to the average, Roma youth apply less for upper secondary education and thus their general level of education remains low. However, looking at Roma education solely through problematic representations only provides a partial picture. In this article, based on two separate sets of fieldwork among Finnish Kaale Roma, we examine how teachers, Roma activists and mediators perceive the educational trajectories of Finnish Roma children and youth. The article seeks to scrutinize Finnish Roma schooling within the framework of the Finnish National Policy on Roma (NRIS). The analysis highlights the multiplicity of voices in the field, discusses the possibilities, and thus problematizes the single-aspect discourse on Roma education. Many countries in Central and Eastern Europe struggle with school and residential segregation, but Finnish Roma face different challenges.
Key Factors to Educational Continuity and Success of Ciganos in Portugal
Authors: Magano Olga , Mendes Maria Manuela
Published: February 2021

The goal of this article is to analyse the impact of specific public policies on the school trajectories of socially vulnerable Ciganos (Gypsies/Roma) who reside/live in the Metropolitan Areas of Lisbon and Porto. Through carrying out qualitative research, the analysis of key factors will allow us to understand the reasons behind school continuity and educational success of Ciganos, as well as the identity (re)configuration processes associated with the education paths of these individuals. We find that trajectories are not only intertwined with public policies and programmes, but also with other explanatory factors inherent to the individual, to the type of support he/she receives from his/her family, the presence of key figures in their lives, and the importance of peers and institutional factors inherent to the way public schools operate.
Some Background, and a South African Study on Sexuality
Authors: Hunt Xanthe , Swartz Leslie , Braathen Stine Hellum , Carew Mark T. , Chiwaula Mussa , Rohleder Poul
Published: February 2021

In this chapter, we introduce central concepts and theories relevant to thinking about disability and sexuality in the global South. We discuss what we mean by physical disability, sexuality, gender, and embodiment, and provide a brief description of the research study on which this book is based. Here, too, we provide a rationale and outline for the book.
The Meaning of Participation: Reflections on Our Study
Authors: Hunt Xanthe , Swartz Leslie , Braathen Stine Hellum , Carew Mark T. , Chiwaula Mussa , Rohleder Poul
Published: February 2021

In Chapter 1 we provided a discussion of participatory research as a method for doing research, and provided an outline of what we did in the research project upon which this book is based. In this final chapter, we reflect back on our experiences of doing a participatory research project of this kind.
Cleone’s Story
Authors: Jordan Cleone
Published: February 2021

In this chapter, Cleone, a project participant, writes about how acquiring a physical disability in her early adulthood impacted on her sense of femininity and sexuality. Cleone was a model prior to acquiring a physical disability and she writes about attractiveness and the body, and her journey to reclaim her sense of femininity and sexuality.
Bongani’s Story
Authors: Mapumulo Bongani
Published: February 2021

In this chapter, Bongani writes about growing up with a disability in a Zulu family, as well as in the context of a school for children with disabilities. He reflects on what physical disability has meant for his developing sense of himself as a young man, his sexuality and relationships, and his wishes for the future.
Die Superstars der Firmen und die Lohnquote
Authors: Jäggi Adrian
Published: February 2021

Die Superstars unter den Firmen dominieren die Wirtschaft. Sie sind überaus innovativ, besetzen als Erste den Markt und erzielen überdurchschnittlich hohe Gewinnspannen. Mit viel Knowhow und einer hoch qualifizierten, aber sehr kleinen Belegschaft dominieren sie die Branchen und erzielen den Löwenanteil der Wertschöpfung. Die gesamtwirtschaftliche Lohnquote fällt, wenn sich die Wertschöpfung von den übrigen Unternehmen mit höherer Lohnquote zu den Superstars mit geringem Lohnanteil verschiebt. Gerade in den innovativsten Branchen sind die Konzentrationstendenzen und der Rückgang der Lohnquote am stärksten. Die Wettbewerbspolitik ist neu gefordert, um den richtigen Ertrag der Innovation zu sichern, aber übermässige Gewinne durch Ausnutzung von Marktmacht zulasten der Konsumenten zu verhindern und den Zutritt neuer Anbieter zu erleichtern.

David Autor, David Dorn, Lawrence F. Katz, Christina Patterson und John Van Reenen (2017), The Fall of the Labor Share and the Rise of Superstar Firms, NBER Working Paper No. 23396.
Wenn Frauen mehr als ihre Männer verdienen
Authors: Koch Roberta Maria
Published: February 2021

Die Frauen haben aufgeholt. Die steigenden Löhne der Frauen und ihre zunehmende Erwerbstätigkeit zeigen ihre wachsende Bedeutung in Wirtschaft und Gesellschaft. Der Trend setzt sich in den Familien fort. Die Familien, in denen die Frauen sich im Beitrag zum Familieneinkommen den Männern annähern, werden immer häufiger. Sobald jedoch die Frauen mehr als ihre Männer verdienen, nimmt der Anteil dieser Haushalte in der gesamten Bevölkerung schlagartig ab. Auch die Scheidungsraten nehmen in dieser Konstellation zu. Hoch qualifizierte Frauen machen bisweilen kostspielige Kompromisse, um Konflikten auszuweichen. Es scheint schwierig, mit traditionellen Rollenbildern zu brechen. Diesen Prozess zu beschleunigen, würde nicht nur der Qualität des Familienlebens nützen, sondern auch Wirtschaft und Gesellschaft zugutekommen.

Marianne Bertrand, Emir Kamenica und Jessica Pan (2015), Gender Identity and Relative Income Within Households, Quarterly Journal of Economics 130(2), 571–614.
Handel und Innovation: Chance oder Gefahr
Authors: Diebold Céline
Published: February 2021

Handel und Innovation lösen einen starken Strukturwandel aus. Sie sind Chance und Gefahr zugleich. Innovative Unternehmen erschliessen in China und anderswo neue Märkte, expandieren und schaffen mehr Beschäftigung. Andere müssen der Importkonkurrenz weichen. Die Konsumenten profitieren von günstigen Preisen und einer grösseren Auswahl. Handel und Innovation ermöglichen grosse Wohlstandsgewinne, aber nur, wenn Arbeit und Kapital erfolgreich von schrumpfenden zu expandierenden Unternehmen wandern. Wie ist inklusives Wachstum möglich, an dem möglichst alle teilhaben können? Den Strukturwandel aufzuhalten würde den Fortschritt blockieren. Die Politik braucht ein Programm, das die besonders betroffenen Arbeitenden absichert und darin aktiv unterstützt, mit neuen Qualifikationen anderswo eine neue Beschäftigung mit besseren Perspektiven zu finden.

Autor, David H., David Dorn und Gordon H. Hanson (2015), Untangling Trade and Technology: Evidence from Local Labor Markets, Economic Journal 125, 621–646.
F&E-Steueranreize stärken Unternehmensgründungen
Authors: Gogola Gerald
Published: February 2021

Mit innovativen Ideen erlangen junge Unternehmen Wettbewerbsvorteile und legen den Grundstein für weiteres Wachstum. Sie schaffen überdurchschnittlich viele Arbeitsplätze und tragen zur Erneuerung der Wirtschaft bei. F&E-Steueranreize helfen, Finanzierungsengpässe zu überwinden und regen die Gründungsaktivitäten an. Regionen mit F&E-Steueranreizen können daher mehr Gründungen verzeichnen als andere. Damit können Staaten und Regionen nicht nur das innovationsgetriebene Wachstum beschleunigen, sondern auch ihre internationale Wettbewerbsfähigkeit stärken.

Fazio, Catherine, Jorge Guzman und Scott Stern (2019), The Impact of State-Level R&D Tax Credits on the Quantity and Quality of Entrepreneurship, NBER WP 26099.
Remark about T-duality of Dp-branes
Authors: Klusoň Josef
Published: February 2021

Abstract

This note is devoted to the analysis of T-duality of Dp-brane when we perform T-duality along directions that are transverse to world-volume of Dp-brane.
The Internet of Bodies—alive, connected and collective: the virtual physical future of our bodies and our senses
Authors: Boddington Ghislaine
Published: February 2021

This paper is going to discuss, what will be called, ‘The Internet of Bodies’. Our physical and virtual worlds are blending and shifting our understanding of three key areas: (1) our identities are diversifying, as they become hyper-enhanced and multi-sensory; (2) our collaborations are co-created, immersive and connected; (3) our innovations are diverse and inclusive. It is proposed that our bodies have finally become the interface.
Short note: Least fixed points versus least closed points
Authors: Jäger Gerhard
Published: February 2021

This short note is on the question whether the intersection of all fixed points of a positive arithmetic operator and the intersection of all its closed points can proved to be equivalent in a weak fragment of second order arithmetic.
Convergence of least squares estimators in the adaptive Wynn algorithm for some classes of nonlinear regression models
Authors: Freise Fritjof , Gaffke Norbert , Schwabe Rainer
Published: February 2021

The paper continues the authors’ work (Freise et al. The adaptive Wynn-algorithm in generalized linear models with univariate response.arXiv:1907.02708, 2019) on the adaptive Wynn algorithm in a nonlinear regression model. In the present paper the asymptotics of adaptive least squares estimators under the adaptive Wynn algorithm is studied. Strong consistency and asymptotic normality are derived for two classes of nonlinear models: firstly, for the class of models satisfying a condition of ‘saturated identifiability’, which was introduced by Pronzato (Metrika 71:219–238, 2010); secondly, a class of generalized linear models. Further essential assumptions are compactness of the experimental region and of the parameter space together with some natural continuity assumptions. For asymptotic normality some further smoothness assumptions and asymptotic homoscedasticity of random errors are needed and the true parameter point is required to be an interior point of the parameter space.
Intestinal and hepatic effects of iron oxide nanoparticles
Authors: Voss Linn , Hoché Elisa , Stock Valerie , Böhmert Linda , Braeuning Albert , Thünemann Andreas F. , Sieg Holger
Published: February 2021

Iron oxide nanoparticles gain increasing attention due to their broad industrial use. However, safety concerns exist since their effects on human cells are still under investigation. The presence of iron oxide nanoparticles in the food pigment E172 has been shown recently. Here, we studied four iron oxide nanoparticles, one food pigment E172 and the ionic control FeSO4 regarding dissolution in biological media, uptake and transport, and cellular effects in vitro in human intestinal Caco-2 and HepaRG hepatocarcinoma cells. The iron oxide nanoparticles passed the gastrointestinal passage without dissolution and reached the intestine in the form of particles. Minor uptake was seen into Caco-2 cells but almost no transport to the basolateral site was detected for any of the tested particles. HepaRG cells showed higher particle uptake. Caco-2 cells showed no alterations in reactive oxygen species production, apoptosis, or mitochondrial membrane potential, whereas two particles induced apoptosis in HepaRG cells, and one altered mitochondrial membrane potential at non-cytotoxic concentrations. No correlation between physicochemical particle characteristics and cellular effects was observed, thus emphasizing the need for case-by-case assessment of iron oxide nanoparticles.
Outcomes of Adrenalectomy and the Aldosteronoma Resolution Score in the Black and Hispanic Population
Authors: Romero‐Velez Gustavo , Laird Amanda M. , Barajas Manuel E. , Sierra‐Salazar Mauricio , Herrera Miguel F. , Libutti Steven K. , Parides Michael K. , Pereira Xavier , McAuliffe John C.
Published: February 2021

Background

Outcomes after adrenalectomy in patients with primary aldosteronism (PA) are variable. The aldosteronoma resolution score (ARS) uses preoperative variables to calculate a score that identifies those patients that are more likely to have resolution of hypertension after adrenalectomy. We aim to determine the efficacy of adrenalectomy and whether the ARS accurately predicts clinical success in a Black and Hispanic population.

Methods

We reviewed patients who underwent adrenalectomy for PA from 2004 to 2018 at two academic centers treating primarily Hispanic and Black patients. Postoperative outcomes were evaluated based on the primary aldosteronism surgical outcome consensus criterion. Retrospectively, the accuracy of ARS was determined by a receiver operating characteristic curve and the area under the curve (AUC).

Results

Forty‐three Hispanic and 10 Black patients underwent adrenalectomy for PA. Twenty‐two patients (41.5%) had complete clinical success. Variables associated with complete clinical success in the univariate analysis were female gender (p = 0.026), younger age (p = 0.001), lower preoperative aldosterone (p = 0.035), lower preoperative systolic blood pressure (p = 0.001), fewer number of preoperative antihypertensive medications (p = 0.007) and a higher ARS (p = 0.003). On multivariate analysis, only fewer number of preoperative antihypertensive medications was independently associated with complete clinical success (p = 0.026). The AUC of the ARS was 0.746.

Conclusion

The rate of clinical success from adrenalectomy is good for Hispanic and Black patients with PA. Our analysis shows that the ARS is an accurate test of clinical success in Hispanic and Black patients. The ARS may be utilized preoperatively to frame expectations after adrenalectomy in these populations.
Ligaments of the os trigonum: an anatomical study
Authors: Szaro Paweł , Ghali Gataa Khaldun , Polaczek Mateusz
Published: February 2021

Purpose

The aim of the study was to examine the ligaments of the os trigonum.

Methods

The ankle joint magnetic resonance imaging (MRI) of 104 patients with the os trigonum (experimental group) and 104 patients without the os trigonum (control group) were re-reviewed. The connections of the os trigonum and posterior talofibular ligament (PTFL), the fibulotalocalcaneal ligament (FTCL), the paratenon of the Achilles tendon, the posterior talocalcaneal ligament (PTCL), the osteofibrous tunnel of the flexor hallucis longus (OF-FHL) and the flexor retinaculum (FR) were studied.

Results

The os trigonum is connected to structures. The posterior part of the PTFL inserted on the os trigonum in 85.6% of patients, whereas in all patients in the control group, the posterior part of the PTFL inserted on the posterior talar process (p < 0.05). The connection of the PTCL was seen in 94.2% of patients in the experimental group, while it was seen in 90.4% of patients in the control group (p > 0.05). The connection to the FTCL in the experimental group was 89.4%, while in the control group, it was 91.3% (p > 0.05). The communication with the paratenon was seen more often in the control group compared to that in the experimental group (31.7% vs. 63.8%, p < 0.001). The FTCL was prolonged medially into the FR in 85.6% of patients in the experimental group and in 87.5% of patients in the control group (p > 0.05). The flexor hallucis longus (FHL) run at the level of articulation between the os trigonum 63.5% and the posterior process of the talus 25% and less often on the os trigonum 11.5%.

Conclusion

The os trigonum is connected with all posterior ankle structures and more connections than previously reported.
Use of the novel curved GOKU balloon catheter for acute-angled lesions in palliative surgery for congenital heart disease: comparison with a conventional straight balloon
Authors: Fujii Takanari , Tomita Hideshi , Nagaoka Kota , Shimizu Takeshi , Oyama Nobuo , Kise Hiroaki , Tarui Suguru , Miyahara Yoshinori , Ishino Kozo
Published: February 2021

Obstruction develops commonly at the acute-angled portion of the vessels following palliative surgery, such as systemic–pulmonary shunt (SP shunt), right ventricle–to–pulmonary artery shunt (RV–PA shunt) in the Norwood–Sano procedure for hypoplastic left heart syndrome, and cavopulmonary (Glenn) anastomosis. Although balloon angioplasty is a treatment option, dilation with existing straight balloons is sometimes ineffective and technically complicated because of balloon slippage and target vessel distortion. In this study, we investigated the effectiveness of a curved GOKU balloon catheter for balloon angioplasty in postoperative acute-angled lesions associated with palliative surgery for congenital heart disease. We reviewed patients who underwent balloon angioplasty for angled lesions complicated by SP shunt, RV–PA shunt, or Glenn anastomosis, using the novel curved GOKU or a conventional balloon catheter, such as a Sterling balloon catheter. We evaluated patients’ backgrounds, balloon specifications, target lesion anatomical features and angles, and short-term outcomes. We evaluated 45 procedures in 18 patients. A curved GOKU was used in 20 procedures, and a Sterling balloon in 25 procedures. The angulation of the lesions at maximum balloon inflation was significantly smaller using a curved GOKU vs a Sterling balloon [70–120 (mean ± standard deviation, 97 ± 40) degrees vs 110–180 (149 ± 46) degrees, respectively; p < 0.001], while the original angle was similar between the groups. Patients’ short-term outcomes with the curved GOKU were excellent, with a significantly better percent increase in minimum lumen diameter of 0–220% (92% ± 66%) vs 0–46% (18% ± 15%) with the Sterling balloon (p < 00.1) and with less frequent balloon slippage. The curved GOKU was more effective in balloon angioplasty for acute-angled lesions compared with a conventional straight balloon, likely because of better conformability to the lesion angle and slip resistance.
Correction to: Atmospheric blocking events in the North Atlantic: trends and links to climate anomalies and teleconnections
Authors: Wazneh Hussein , Gachon Philippe , Laprise René , de Vernal Anne , Tremblay Bruno
Published: February 2021

The article: Atmospheric blocking events in the North Atlantic: trends and links to climate anomalies and teleconnections, written by Hussein Wazneh, Philippe Gachon, René Laprise, Anne de Vernal, Bruno Tremblay was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 5 January 2021 without open access.
Effects of gastrointestinal delivery of non-caloric tastants on energy intake: a systematic review and meta-analysis
Authors: Klaassen Tim , Keszthelyi Daniel , Troost Freddy J. , Bast Aalt , Masclee Adrian A. M.
Published: February 2021

Purpose

Taste receptors are expressed throughout the gastrointestinal tract. The activation of post-oral taste receptors using tastants could provide a non-invasive treatment option in combating the obesity epidemic. The aim of this review was to examine the effect of post-oral delivery of non-caloric tastants on eating behavior reflected by primary outcome energy intake and secondary outcomes GI symptoms and perceptions and potential underlying mechanisms. This review was conducted according to the PRISMA guidelines for systematic reviews.

Methods

A systematic literature search of the Cochrane, PubMed, Embase, and Medline databases was performed. This systematic review and meta-analysis was registered in the PROSPERO database on 26 February 2020 (ID: CRD42020171182). Two researchers independently screened 11,912 articles and extracted information from 19 articles. If at least two studies investigated the effect of the same taste compound on primary outcome energy intake, a meta-analysis was performed to determine pooled effect sizes.

Results

Nineteen papers including healthy volunteers were included. In the 19 papers analyzed, effects of various tastants were investigated in healthy volunteers. Most extensively investigated were bitter tastants. The meta-analysis of effects of bitter tastants showed a significant reduction in energy intake of 54.62 kcal (95% CI − 78.54 to − 30.69, p = 0.0014).

Conclusions

Bitter stimuli are most potent to influence eating behavior. Energy intake decreased after post-oral delivery of bitter tastants. This highlights the potential of a preventive role of bitter tastants in battling the obesity epidemic.
Associations between red meat, processed red meat and total red and processed red meat consumption, nutritional adequacy and markers of health and cardio-metabolic diseases in British adults: a cross-sectional analysis using data from UK National Diet and Nutrition Survey
Authors: Hobbs-Grimmer D. A. , Givens D. I. , Lovegrove J. A.
Published: February 2021

Purpose

To determine the association between red meat (RM), processed red meat (PRM) and total red and processed red meat (TRPRM) consumption on nutritional adequacy and markers of health and cardio-metabolic diseases in British adults.

Methods

In this cross-sectional study of adults (19–64 y) from the National Diet and Nutrition Survey (NDNS) (n = 1758), RM and PRM consumption were assessed from 4 day estimated food diaries. Anthropometric measures, blood pressure (BP), pulse pressure (PP), plasma glucose, HbA1c, C-reactive protein, TAG, TC, LDL-C and HDL-C from the NDNS were used.

Results

43% of adults (men 57% and women 31%) consumed more than the 70 g/d TRPRM guidelines. Fewer adults in the highest tertile of TRPRM intake were below lower reference nutrient intakes (LRNIs), particularly for zinc and iron, respectively. In model 3 (controlled for age, energy intake, socioeconomic classification, number of daily cigarettes, BMI, dietary factors), higher RM consumption was associated with being significantly taller (model 3: P-ANCOVA = 0.006; P-T3/T1 = 0.0004) in men and lower diastolic BP (model 3: P-ANCOVA = 0.004; P-T3/T2 = 0.002) in women. Higher PRM in men was associated with significantly higher plasma ferritin concentration (model 3: P-ANCOVA = 0.0001; P-T2/T1 = 0.0001), being taller (P-ANCOVA = 0.019; P-T1/T2 = 0.047, T1/T3 = 0.044), increased body weight (model 3: P-ANCOVA = 0.001; P-T1/T3 = 0.0001), BMI (model 3: P-ANCOVA = 0.007; P-T1/T3 = 0.006) and smaller hip circumference (model 3: P-ANCOVA = 0.006; P-T3/T1 = 0.024; P-T2/T1 = 0.013) and in women significantly higher TC (model 3: P-ANCOVA = 0.020; P-T3/T2 = 0.016), LDL-C (P-ANCOVA = 0.030; P-T3/T2 = 0.025), HbA1c (model 3: P-ANCOVA = 0.0001; P-T2/T1 = 0.001; P-T3/T2 = 0.001) and higher PP (model 3: P-ANCOVA = 0.022; P-T3/T1 = 0.021).

Higher PRM consumption was associated with significantly higher BMI and hip circumference in men, and higher TC, LDL-C, HbA1c and PP in women, which was not observed for RM consumption.
Periphery and brain, innate and adaptive immunity in Parkinson’s disease
Authors: Harms Ashley S. , Ferreira Sara A. , Romero-Ramos Marina
Published: February 2021

Parkinson’s disease (PD) is a neurodegenerative disorder where alpha-synuclein plays a central role in the death and dysfunction of neurons, both, in central, as well as in the peripheral nervous system. Besides the neuronal events observed in patients, PD also includes a significant immune component. It is suggested that the PD-associated immune response will have consequences on neuronal health, thus opening immunomodulation as a potential therapeutic strategy in PD. The immune changes during the disease occur in the brain, involving microglia, but also in the periphery with changes in cells of the innate immune system, particularly monocytes, as well as those of adaptive immunity, such as T-cells. This realization arises from multiple patient studies, but also from data in animal models of the disease, providing strong evidence for innate and adaptive immune system crosstalk in the central nervous system and periphery in PD. Here we review the data showing that alpha-synuclein plays a crucial role in the activation of the innate and adaptive immune system. We will also describe the studies suggesting that inflammation in PD includes early changes in innate and adaptive immune cells that develop dynamically through time during disease, contributing to neuronal degeneration and symptomatology in patients. This novel finding has contributed to the definition of PD as a multisystem disease that should be approached in a more integratory manner rather than a brain-focused classical approach.
Does early surgery improve outcomes for periprosthetic fractures of the hip and knee? A systematic review and meta-analysis
Authors: Farrow L. , Ablett A. D. , Sargeant H. W. , Smith T. O. , Johnston A. T.
Published: February 2021

Introduction

Previous evidence has established that early surgery is beneficial to improve outcomes for individuals with native hip fractures in the elderly population. Patients who sustain a periprosthetic fracture have been demonstrated to have similar demographics and outcomes as those with native fractures around the hip and knee. We therefore set out to determine if there is a similar difference in perioperative outcomes between early and delayed surgery for periprosthetic fractures of the hip and knee through a systematic review and meta-analysis.

Methods

Literature search outputs were screened for studies meeting the inclusion criteria. The groups of early surgery and delayed surgery were defined by study authors. The primary outcome measure was 30 day mortality. Where there was sufficient study homogeneity, a random-effects meta-analysis was performed. Individual study risk of bias was assessed using the ROBINS-I criteria, with the GRADE criteria used for independent outcome evaluation. The review protocol was registered on PROSPERO prior to commencement (Registration number CRD42019149360).

Results

The inclusion criteria was met in 11 studies (n = 3006). Mean time to surgery from admission for reporting studies was 64 h. 59.6% patients underwent early surgery as defined by the study authors. We identified a significantly lower risk of 30 day mortality for those with early surgery versus delayed surgery (RR 0.21; 95% CI 0.05, 0.90; p = 0.04, n = 2022). There were also significantly better outcomes for early versus delayed surgery regarding: medical complications, length of stay, transfusion risk, and reoperation. The quality of evidence for all the individual outcomes was low or very low.

Conclusions

There is evidence that delaying surgery in those with periprosthetic fractures of the hip and knee has a deleterious impact on mortality and other important patient outcomes. There are, however, notable limitations to the existing available literature, with further appropriately designed large-scale studies required to confirm these findings.
BiPOD arthroscopically assisted bidirectional stabilisation technique for high-grade acromioclavicular joint injury: two-year clinical and radiological outcomes
Authors: Murphy Richard J. , Ambuehl Benedikt , Schaer Michael O. , Weihs Johannes , Moor Beat K. , Zumstein Matthias A.
Published: February 2021

Purpose

The purpose of this study was to evaluate the intermediate-term clinical and radiological outcomes for acute, unstable acromioclavicular joint (ACJ) injuries treated with the arthroscopically assisted BiPOD stabilisation technique.

Methods

Twenty-three patients who sustained acute, unstable ACJ injuries were included in this prospective study. We recorded demographics, injury classification, time to surgery, clinical scores, radiological outcomes and complications; each patient completed a minimum of 2 years post-operative observation.

Results

Mean follow-up was 26 months (range, 24—34). Clinical outcomes scores demonstrated good 2-year results: relative Constant score, 97.9/100; ACJ Index, 89.4/100; Subjective Shoulder Value, 92.4/100 and Taft = 11.1/12. Final C–C distance showed a mean of 0.7 mm (SD ± 1.8 mm) at 2 years. Complication rate was 9%.

Conclusion

The BiPOD technique shows excellent, reliable intermediate-term results with a favourable complication rate compared to existing techniques; it provides a comprehensive surgical option for the stabilisation of acute ACJ injuries restoring both vertical and horizontal stability.
Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis
Authors: Fatoye F. , Yeowell G. , Wright J. M. , Gebrye T.
Published: February 2021

Purpose

Osteoarthritis is the single most common cause of pain and disability in older adults. This review addresses the question of the clinical effectiveness and cost-effectiveness of physiotherapy interventions following total knee replacement (TKR).

Methods

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, CINAHL, AMED, DARE, HTA and NHS EED databases were searched from inception to 02 May 2020. Search terms related to the clinical and cost-effectiveness of physiotherapy interventions were used. Studies meeting the inclusion criteria were identified and key data were extracted. Random effect meta-analysis was conducted for pain, physical function and range of motion (ROM).

Results

In total, 1467 studies were identified. Of these, 26 studies were included; methodological quality of most studies was adequate. Physiotherapy interventions were more effective than control for function, SMD − 0.166 [95% Confidence Interval (CI) − 0.420 to 0.088.] and ROM, SMD − 0.219 [95% CI − 0.465 to 0.028] for a follow-up of 2 or 3 months. Patients in the intervention group showed improvement in pain at 12–13 weeks, SMD − 0.175 [95% CI − 0.416 to 0.067]. No evidence on the pooled estimate of cost-effectiveness of physiotherapy interventions was found.

Conclusions

This is the first systematic review and meta-analysis that has examined the clinical and cost-effectiveness of physiotherapy interventions following TKR. The findings of this review suggest that physiotherapy interventions were effective for improving physical function, ROM and pain in a short-term follow-up following TKR. Insufficient evidence exists to establish the benefit of physiotherapy in the long term for patient with TKR. Further study should examine the long-term effectiveness and cost-effectiveness of physiotherapy interventions.
Standard radiographic assessments of distal radius fractures miss involvement of the distal radioulnar joint: a diagnostic study
Authors: Hruby Laura A. , Haider Thomas , Laggner Roberta , Gahleitner Claudia , Erhart Jochen , Stoik Walter , Hajdu Stefan , Thalhammer Gerhild
Published: February 2021

Introduction

Distal radius fractures account for one-fifth of all fractures in the emergency department. Their classification based on standard radiographs is common practice although low inter-observer reliabilities and superiority of computer tomography (CT) scanning in evaluation of joint congruency have been reported.

Materials and methods

We retrospectively analyzed 96 displaced distal radius fractures scheduled for open reduction and internal fixation using standard radiographic assessment. The radiographs were classified with the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA), Fernandez and Frykman classifications by three observers and inter-rater reliabilities were calculated. Additional CT scanning was performed in all cases and the following parameters were assessed: radiocarpal joint involvement, fracture extent into the radial sigmoid notch, i.e. the distal radio-ulnar joint, comminution of the metaphysis, and concomitant ulnar styloid fracture. The CT scans were used as a reference standard to determine sensitivity and accuracy of standard radiographic assessment in evaluation of distal radius fractures.

Results

The inter-rater agreement for the AO classification was 35.4%, 68.8% for the Fernandez and 38.5% for the Frykman classification. Fracture extension into the radiocarpal joint was present in 81 cases (84.4%). Sigmoid notch involvement was found in 81 fractures (84.4%). Involvement of both joints was present in 72 cases (75%). The sensitivity of standard radiographs regarding radiocarpal joint involvement was 93.8%. Considering involvement of the distal radio-ulnar joint the false-negative rate using standard radiographs was 61.7% and the test’s accuracy for sigmoid notch involvement was 45.8%.

Conclusion

This study demonstrates that involvement of the sigmoid notch is frequently missed in standard radiographs. The presented data support the frequent use of CT imaging to allow the holistic illustration of a fracture’s complexion and to ensure optimal pre-operative planning.
Acceptance and adoption of transoral robotic surgery in Germany
Authors: Mandapathil Magis , Meyer Jens E.
Published: February 2021

Purpose

Since its introduction over a decade ago, the use of robotic surgery (RS) in head and neck surgery has widely spread around the globe, with very differential adoption of this novel surgical technique in different parts of the world. In this study, we analyze the acceptance and adoption of robotic surgery in the head and neck in Germany.

Materials and methods

A cross-sectional analysis using a questionnaire evaluating the acceptance and adoption of RS was performed. Questionnaires were distributed to all chairmen /-women of Otorhinolaryngology, Head and Neck Surgery Departments in Germany.

Results

A total of 107 respondents completed the questionnaire (65.2%). At university hospitals, 71.4% of the respondents indicated that a robotic system was available, and 21.4% responded that robotic surgery was performed at their institution; 22.7% and 0.04%, respectively, at non-university hospitals. The overall adoption rate was 0.8%. The most common cases performed were TORS resection in the oropharynx. Main reasons for not adopting this technique were costs, lack of interest and available co-operations.

Conclusion

This study provides evidence of the extent of adoption of TORS in Germany; main perceived barriers to adoption are costs with lack of cost-covering reimbursement and insufficient co-operations with other disciplines as well as hospital administration resulting in a very low adoption rate of this technique over the past decade. Results from this study may assist in decision-making processes on adopting this technique in the future.
Gene variants associated with obstructive sleep apnea (OSA) in relation to sudden infant death syndrome (SIDS)
Authors: Kerz J. , Schürmann P. , Rothämel T. , Dörk T. , Klintschar M.
Published: February 2021

Background

Both obstructive sleep apnea (OSA) and (at least a fraction of) sudden infant death syndrome (SIDS) are associated with impaired respiration. For OSA, an association with several gene variants was identified. Therefore, our hypothesis is that these polymorphisms might be of relevance in SIDS as well.

Methods

Twenty-four single nucleotide polymorphisms (SNPs) in 21 candidate genes connected to OSA, were genotyped in a total of 282 SIDS cases and 374 controls. Additionally, subgroups based on factors codetermining the SIDS risk (age, sex, season, and prone position) were established and compared as well.

Results

Two of the analyzed SNPs showed nominally significant differences between SIDS and control groups: rs1042714 inADRB2(adrenoceptor beta 2) and rs1800541 inEDN1(endothelin 1). In the subgroup analyses, 10 further SNPs gave significant results. Nevertheless, these associations did not survive adjustment for multiple testing.

Conclusions

Our results suggest that there might be a link between SIDS and OSA and its resulting respiratory and cardiovascular problems, albeit this predisposition might be dependent on the combination with other, hitherto unknown gene variants. These findings may encourage replication studies to get a better understanding of this connection.
Objectively characterizing Huntington’s disease using a novel upper limb dexterity test
Authors: Woodgate Samuel , Morgan-Jones Philippa , Clinch Susanne , Drew Cheney , Playle Rebecca , Bennasar Mohamed , Hicks Yulia , Holt Catherine , Bachoud-Lévi Anne-Catherine , Massart Renaud , Craufurd David , Kirby Nigel , Hamana Katy , Schubert Robin , Reilmann Ralf , Rosser Anne , Busse Monica
Published: February 2021

Background

The Clinch Token Transfer Test (C3t) is a bi-manual coin transfer task that incorporates cognitive tasks to add complexity. This study explored the concurrent and convergent validity of the C3t as a simple, objective assessment of impairment that is reflective of disease severity in Huntington’s, that is not reliant on clinical expertise for administration.

Methods

One-hundred-and-five participants presenting with pre-manifest (n = 16) or manifest (TFC-Stage-1 n = 39; TFC-Stage-2 n = 43; TFC-Stage-3 n = 7) Huntington’s disease completed the Unified Huntington’s Disease Rating Scale and the C3t at baseline. Of these, thirty-three were followed up after 12 months. Regression was used to estimate baseline individual and composite clinical scores (including cognitive, motor, and functional ability) using baseline C3t scores. Correlations between C3t and clinical scores were assessed using Spearman’s R and visually inspected in relation to disease severity using scatterplots. Effect size over 12 months provided an indication of longitudinal behaviour of the C3t in relation to clinical measures.

Results

Baseline C3t scores predicted baseline clinical scores to within 9–13% accuracy, being associated with individual and composite clinical scores. Changes in C3t scores over 12 months were small ($$\Omega$$
Ω
≤ 0.15) and mirrored the change in clinical scores.

Conclusion

The C3t demonstrates promise as a simple, easy to administer, objective outcome measure capable of predicting impairment that is reflective of Huntington’s disease severity and offers a viable solution to support remote clinical monitoring. It may also offer utility as a screening tool for recruitment to clinical trials given preliminary indications of association with the prognostic index normed for Huntington’s disease.
Shift work, low-grade inflammation, and chronic pain: a 7-year prospective study
Authors: Christensen Jan Olav , Nilsen Kristian Bernhard , Hopstock Laila Arnesdatter , Steingrímsdóttir Ólöf Anna , Nielsen Christopher Sivert , Zwart John-Anker , Matre Dagfinn
Published: February 2021

Objectives

We investigated prospective associations of shift work with chronic pain and C‐reactive protein (CRP), an indicator of inflammation. Furthermore, we elucidated CRP as a possible mediator and/or moderator of effects of shift work on pain.

Methods

Data from a 7 years follow‐up study were analyzed (N = 2323). Shift work and chronic pain of “neck/shoulder”, “arm/hand”, “upper back”, “low back”, “hip/leg/feet”, and “other regions” were measured by questionnaires. “Chronic widespread pain”, “number of chronic pain sites”, and “any chronic pain” were computed. CRP was measured in serum samples. Logistic and Poisson regressions were conducted. Mediation was assessed by casual mediation analyses and moderation by the Relative Excess Risk due to Interaction (RERI).

Results

Shift work was not associated with any chronic pain variable and no mediation was detected. CRP was associated with low back pain, hip/leg pain, and “number of pain sites”, and also with the combination of shift work and CRP of 1–2.99 mg/L (compared to: no shiftwork and CRP < 1). Additionally, shiftwork and CRP 1–2.99 mg/L was associated with risk of “any chronic pain” (OR: 1.76, 95% CI: 1.12, 2.85), which was not associated with CRP alone. Moderation analyses suggested the risks for “any chronic pain” and “number of pain regions” increased when individuals with elevated CRP worked shifts—beyond what the separate effects of CRP and shift would suggest.

Conclusions

We found no evidence of shift work in general affecting CRP or chronic pain. However, shift work and elevated CRP combined may influence chronic pain.
Totally implantable venous access port insertion via open Seldinger approach of the internal jugular vein—a retrospective risk stratification of 500 consecutive patients
Authors: Becker Felix , Wurche Lennart A. , Darscht Martina , Pascher Andreas , Struecker Benjamin
Published: February 2021

Purpose

Modern oncological treatment algorithms require a central venous device in form of a totally implantable venous access port (TIVAP). While most commonly used techniques are surgical cutdown of the cephalic vein or percutaneous puncture of the subclavian vein, there are a relevant number of patients in which an additional strategy is needed. The aim of the current study is to present a surgical technique for TIVAP implantation via an open Seldinger approach of the internal jugular vein and to characterize risk factors, associated with primary failure as well as short- (< 30 days) and long-term (> 30 days) complications.

Methods

A total of 500 patients were included and followed up for 12 months. Demographic and intraoperative data and short- as well as long-term complications were extracted. Primary endpoint was TIVAP removal due to complication. Logistic regression analysis was used to analyze associated risk factors.

Results

Surgery was primarily successful in all cases, while success was defined as functional (positive aspiration and infusion test) TIVAP which was implanted via open Seldinger approach of the jugular vein at the intended site. TIVAP removal due to complications during the 1st year occurred in 28 cases (5.6%) while a total of 4 (0.8%) intraoperative complications were noted. Rates for short- and long-term complications were 0.8% and 6.6%, respectively.

Conclusion

While the presented technique requires relatively long procedure times, it is a safe and reliable method for TIVAP implantation. Our results might help to further introduce the presented technique as a secondary approach in modern TIVAP surgery.
Occupation-related effects on motor cortex thickness among older, cognitive healthy individuals
Authors: Lenhart Lukas , Nagele Melanie , Steiger Ruth , Beliveau Vincent , Skalla Elisabeth , Zamarian Laura , Gizewski Elke R. , Benke Thomas , Delazer Margarete , Scherfler Christoph
Published: February 2021

Both, decline of sensorimotor functions and cortical thickness are known processes in healthy aging. Physical activity has been suggested to enhance the execution of daily routine activities and to extend the time of functional independence in advanced age. We hypothesized that cortical thickness of motor areas in retired individuals could be related to physical demands of the profession carried out during working life. Depending on their former occupations, 69 cognitively healthy individuals (range 70–85 years) were divided into higher and lower physically complex occupations (HPCO n = 27 and LPCO n = 42) according to the international standard classification of occupations (ISCO-08). Participants underwent a high-resolution 3T T1-weighted MRI scan. Surface-based analysis revealed higher cortical thickness in the left precentral (P = 0.001) and postcentral gyrus (P < 0.001) and right postcentral gyrus (P = 0.001) for the HPCO relative to the LPCO group (corrected for multiple comparisons, sex, age and leisure activities in the past 20 years). Physical leisure activities associated with exertion were positively correlated with cortical thickness in the left pre- and postcentral gyrus (P = 0.037) of the LPCO group. Time since retirement was negatively associated with cortical thickness in the left postcentral gyrus (P = 0.004) of the HPCO group. Executing a higher physically complex occupation before retirement was related to relative higher cortical thickness in the primary motor and somatosensory cortex in later life, supporting the hypothesis that physical activity contributes to neural reserve in these regions. However, these benefits appear to vanish when physical activity is reduced due to retirement.
Flexor hallucis longus hypertrophy secondary to Achilles tendon tendinopathy: an MRI-based case–control study
Authors: Wirth Stephan H. , Andronic Octavian , Aregger Fabian , Jungwirth-Weinberger Anna , Jentzsch Thorsten , Hecker Andreas
Published: February 2021

Purpose

The purpose of this study was to outline an indirect sign of advanced Achilles tendinopathy on magnetic resonance imaging (MRI), based on the hypothesis that these patients would present with secondary hypertrophy of the flexor hallucis longus muscle (FHL).

Methods

MRI scans of Achilles tendon were analyzed retrospectively in two cohorts. The study group consisted of consecutive patients presenting with clinical signs of Achilles tendinopathy and no previous surgeries, while the control group were patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4–5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the FHL muscle. Ratios (FHL/TS) were calculated for area (Ar) and diameter (Dm) measurements. Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both ratios to assess potential cutoff points to differentiate between the groups.

Results

A total of 60 patients for each study group were included. Both ratios Ar(FHL/TS) and Dm(FHL/TS) showed significant higher values in the tendinopathy group (p < 0.001). There were strong to very strong intraclass correlation coefficients (ICC = 0.75–0.93). A diameter ratio Dm (FHL/TS) of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy.

Conclusion

In our patient cohort, FHL hypertrophy was observed in patients with Achilles tendinopathy as a possible compensatory mechanism. Measuring a diameter ratio Dm(FHL/TS) of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.