bluuebunny/crossref_metadata_2025 huggingface dataset:
Outpatient vs Home Management Protocol Results for Plantar Fasciitis
Authors: Çil Elif Tuğçe , Şaylı Uğur , Subaşı Feryal
Published: August 2019

Background:

We compared the effectiveness of stretching and strengthening exercises combined with myofascial releasing and mobilization techniques to a stretching and strengthening only home program in plantar fasciitis (PF) management.

Method:

The study included 53 feet of 47 patients with plantar fasciitis (35 women / 12 men; mean age 48.9±11.2 years). Pain, disability, and activity restrictions were assessed by Foot Function Index (FFI), and first step pain was graded by visual analog scale (VAS). Ankle range of motion (ROM), gastrocnemius-soleus flexibility, proprioception, dynamic balance, and foot sensation were also considered. The patients were randomly divided into outpatient clinic treatment (Outpatient, n = 27 feet) and home rehabilitation groups (Home, n = 26 feet). Patient education was routine for all at the beginning of the management programs. In the Outpatient group, the foot-ankle-hip exercise program, myofascial releasing, and joint and soft tissue mobilization techniques were “hands on” at a clinic (twice a week for 8 weeks), whereas the Home group completed their home rehabilitation program on their own (8 weeks’ duration with follow-ups every week).

Results:

VAS, FFI, ROM, balance, proprioception, foot sense, and flexibility improved at the eighth week in both groups according to intragroup comparison ( P < .05). When the 2 groups were compared, the results of plantar flexion range, balance, proprioception, foot sensation, flexibility, FFI, and VAS showed significant improvements in the Outpatient vs the Home group ( P < .05). Also, the FFI and VAS scores at the sixth month were superior in the Outpatient group ( P < .05).

Conclusion:

A combined supervised management protocol had superior clinical results in plantar fasciitis management.

Level of Evidence:

Level II, comparative study.
Screw Fixation of the Posterior Malleolus Fragment in Ankle Fracture
Authors: Kang Chan , Hwang Deuk-Soo , Lee Jeong-Kil , Won Yougun , Song Jae-Hwang , Lee Gi-Soo
Published: August 2019

Background:

This study aimed to evaluate the outcomes of ankle fractures with posterior malleolus fragments (PMFs) involving <25% of the articular surface treated with or without screw fixation.

Methods:

Among patients with ankle fractures and PMFs who underwent surgery between March 2014 and February 2017, 62 with type 1 PMFs involving <25% of the articular surface were included. Of these 62 patients, 32 underwent screw fixation for PMFs and lateral and/or medial malleolar fracture fixation (group A) and 30 underwent internal fixation for malleolar fractures without screw fixation for PMFs (group B). Ankle joint alignment and fracture healing were measured using plain radiography and computed tomography (CT). Clinical outcomes were determined using the American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire, Short Form-36, and American Orthopaedic Foot & Ankle Society Scale.

Results:

Nonunion was not noted in either group. However, we detected union with a step-off of 2 mm or more in 2 cases from group B. With regard to ankle joint alignment, 1 case in group A and 3 cases in group B showed mild asymmetry of the medial and lateral clear spaces on CT at 12 months. Clinical outcomes at 6 and 12 months after surgery were better in group A than in group B.

Conclusion:

Screw fixation of PMFs was effective for fracture healing and maintaining ankle alignment. Additionally, it improved short-term clinical outcomes, which we believe was due to stabilization of ankle fractures with PMFs involving <25% of the articular surface.

Level of Evidence:

Level II, prospective comparative study.
Decomposing Trends in U.S. Health Care Spending Among Nonelderly Adults, 2007-2016
Authors: Blavin Fredric , Karpman Michael , Arnos Diane
Published: August 2019

Using the 2007 to 2016 Medical Expenditure Panel Survey–Household Component, this study analyzes trends in per capita health expenditures among nonelderly adults from the Great Recession to the period following full implementation of the Affordable Care Act. We find that the growth in total per capita spending—and specifically for prescription drug and emergency room spending—from 2007-2009 to 2014-2016 was largely driven by increases in expenditures per unit, that is, increases in per unit prices, quality, and/or intensity of treatment. We also find that changes in the health insurance distribution were the largest driver behind the increase in total per capita expenditures over this period, while changes in prevalence of chronic conditions explained a smaller portion of the increase. Identifying policies for containing health care spending growth requires a detailed understanding of the sources of that growth, particularly during periods of economic fluctuations, policy changes, and technological developments.
Intraoperative evaluation of acetabular cup position during anterior approach total hip arthroplasty: are we accurately interpreting?
Authors: Delagrammaticas Dimitri E , Ochenjele George , Rosenthal Brett D , Assenmacher Benjamin , Manning David W , Stover Michael D
Published: August 2019

Introduction:

Intraoperative radiographic evaluation during total hip arthroplasty (THA) has shown to improve the accuracy of acetabular component placement, however, differences in interpretation based on radiographic technique has not been established. This study aims to determine if differences exist in the interpretation of acetabular component abduction and anteversion between different radiographic projections.

Methods:

55 consecutive direct anterior THAs in 49 patients were prospectively enrolled. Target anteversion and abduction was defined by the Lewinnek zone. Fluoroscopy was used to direct acetabular component placement intraoperatively. After final cup implantation, fluoroscopic posterior-anterior hip and pelvis images were obtained for analysis. After completion of the procedure, an anterior-posterior plain pelvis radiograph was obtained in the operating room. Acetabulum component abduction and anteversion were postoperatively determined using specialised software on each of the 3 image acquisition methods.

Results:

Average acetabular cup abduction for intraoperative fluoroscopic posterior-anterior hip (FH), intraoperative fluoroscopic posterior-anterior pelvis (FP), and postoperative, standard, anteroposterior pelvis radiographs (PP) was 40.95° ± 2.87°, 38.87° ± 3.82° and 41.73° ± 2.96° respectively. The fluoroscopic hip and fluoroscopic pelvis tended to underestimate acetabular cup abduction compared to the postoperative pelvis ( p < 0.001). Average acetabular cup anteversion for FH, FP, and PP was 19.89° ± 4.87°, 24.38° ± 5.31° and 13.36° ± 3.52° respectively. Both the fluoroscopic hip and fluoroscopic pelvis overestimated anteversion compared to the AP pelvis, with a 6.38° greater mean value measurement for FH ( p < 0.001), and an 11° greater mean value measurement for FP ( p < 0.001).

Conclusions:

Fluoroscopic technique and differences between radiographic projections may result in discrepancies in component position interpretation. Our results support the use of the fluoroscopic posterior-anterior hip as the choice fluoroscopic imaging technique.
Lifestyle and Circadian Health: Where the Challenges Lie?
Authors: Gupta Neelu Jain
Published: August 2019

Modern life is facilitated by extended light hours at night and longer hours of eating. Compromised sleep, sedentary life, and modern diet adversely affect human health. Studies emphasizing importance of evidence-driven longitudinal studies on daily rhythms of human eating and sleeping behaviour provide a baseline for adequate insight into causal factors for circadian misalignment. Molecular chronobiology studies in animal models debrief endogenous regulation of organismal circadian clock; their regulation by environmental cues and how they segregate incompatible processes. But effective utilization of the knowledge needs randomized chrono-therapeutic intervention trials in humans. However, nutrition, activity, and lifestyle being society specific, baseline longitudinal studies must precede intervention trials as primary method to decipher circadian disruption. Our pilot survey studies investigating current lifestyle trends responsible for circadian rhythm disruption revealed that accelerated urban life, more than 8 hours work operations and long commutes to work inflict a sleep loss in Indian working women living in metropolitan cities. This sleep loss is sufficient to adversely impact their wellness. Besides, daily work routines and fast-food popularity have contributed to circadian disruption in daily rhythms of eating and sleep, enhancing disease consequences.
Sox2-Dependent 3D Chromatin Interactomes in Transcription, Neural Stem Cell Proliferation and Neurodevelopmental Diseases
Authors: Wei Chia-Lin , Nicolis Silvia K , Zhu Yanfen , Pagin Miriam
Published: August 2019

In our article, we asked whether Sox2, a transcription factor important in brain development and disease, is involved in gene regulation through its action on long-range interactions between promoters and distant enhancers. Our findings highlight that Sox2 shapes a genome-wide network of promoter-enhancer interactions, acting by direct binding to these elements. Sox2 loss affects the three-dimensional (3D) genome and decreases the activity of a subset of genes involved in Sox2-bound interactions. At least one of such downregulated genes, Socs3, is critical for long-term neural stem cell maintenance. These results point to the possibility of identifying a transcriptional network downstream to Sox2, and involved in neural stem cell maintenance. In addition, interacting Sox2-bound enhancers are often connected to genes which are relevant, in man, to neurodevelopmental disease; this may facilitate the detection of functionally relevant mutations in regulatory elements in man, contributing to neural disease.
Pathways, practices and architectures: Containing antimicrobial resistance in the cystic fibrosis clinic
Authors: Brown Nik , Buse Christina , Lewis Alan , Martin Daryl , Nettleton Sarah
Published: August 2019

Antimicrobial resistance and the adaptation of microbial life to antibiotics are recognised as a major healthcare challenge. Whereas most social science engagement with antimicrobial resistance has focussed on aspects of ‘behaviour’ (prescribing, antibiotic usage, patient ‘compliance’, etc.), this article instead explores antimicrobial resistance in the context of building design and healthcare architecture, focussing on the layout, design and ritual practices of three cystic fibrosis outpatient clinics. Cystic fibrosis is a life-threatening multi-system genetic condition, often characterised by frequent respiratory infections and antibiotic treatment. Preventing antimicrobial resistance and cross-infection in cystic fibrosis increasingly depends on the spatiotemporal isolation of both people and pathogens. Our research aims to bring to the fore the role of the built environment exploring how containment and segregation are varyingly performed in interaction with material design, focussing on three core themes. These include, first, aspects of flow, movement and the spatiotemporal choreography of cystic fibrosis care. Second, the management of waiting and the materiality of the waiting room is a recurrent concern in our fieldwork. Finally, we take up the question of air, the intangibility of airborne risks and their material mitigation in the cystic fibrosis clinic.
Children’s socialisation into literate practices through engaging in translation activities in immersion preschool
Authors: Kultti Anne , Pramling Niklas
Published: August 2019

In this empirical study, we analyse how five-year-old children are socialised into particular interpretive practices indicative of a literate mind. The data come from translation activities where children with their teacher listen to and then talk about how to understand the lyrics to a popular children’s song. The setting is a Finnish–Swedish immersion programme, where Finnish-speaking children are immersed in Swedish. Three such activities were audio recorded. These are analysed according to the principles of Interaction Analysis, that is, how participants sequentially respond to each other’s communicative actions. Theoretically, the study is informed by a sociocultural perspective, highlighting how intramental function, such as reasoning and problem-solving, are contingent on intermental communication. How participating children are introduced to literate distinctions and concepts of interpreting text is therefore premised to be critical to their emerging literate interpretive skills. The results highlight how the children are constantly challenged and supported by the teacher in a zone of proximal development where their abilities to interpret the lyrics discussed are stretched.
Constructing academic identity in the European higher education space: Experiences of early career educational researchers
Authors: Djerasimovic Sanja , Villani Marialuisa
Published: August 2019

This exploratory paper presents insights from a qualitative interview-based study of the academic identity-building among a group of early career researchers working in the field of education across the European higher education space. Set against a policy background framed by the initiatives in European higher education and research policy, geared towards a production of a mobile, entrepreneurial researcher in pursuit of ‘valuable’ knowledge, the respondents’ narratives reveal individual complexity, but also emerging patterns of professional identification.

We identify the traditional academic values of creating and sharing knowledge validated by an epistemic community, and pursuing autonomy and collegiality in research, as still dominant, however, find these interacting with the demonstration of a strong proactive, entrepreneurial spirit, and a lack of institutional attachment. The narratives indicate the availability of supportive, encouraging communities as being of high significance, and contest the notions of Europeanisation and the utility of geographic mobility in researchers’ identities. The paper discusses different types of academic identification driven by value orientation and social attachment that emerged from the early career researchers’ interviews, alongside pervasive issues around mobility raised in most narratives, and concludes with suggestions for further study.
The similarities and differences between pleuroparenchymal fibroelastosis and idiopathic pulmonary fibrosis
Authors: Ishii Hiroshi , Kinoshita Yoshiaki , Kushima Hisako , Nagata Nobuhiko , Watanabe Kentaro
Published: August 2019

The idiopathic form of pleuroparenchymal fibroelastosis (PPFE) is categorized as a rare idiopathic interstitial pneumonia in the current classification. The majority of PPFE cases are idiopathic, but many predisposing factors or comorbidities have been reported. Although histological PPFE is predominantly located in the upper lobes, which are less often affected by fibrosis in patients with idiopathic pulmonary fibrosis (IPF), the clinical course of PPFE is seemingly similar to that of IPF. However, upper lobe fibroelastosis has various clinical and physiological characteristics that differ from those of IPF, including a flattened thoracic cage and a marked decrease in the forced vital capacity (FVC) but with a preserved residual volume. Compared with IPF, the decrease in the walking distance is mild despite the markedly decreased FVC in PPFE, and chest radiograph more frequently shows the elevation of bilateral hilar opacities with or without tracheal deviation. The prognosis may be related to the development of fibrosing interstitial pneumonia in the lower lobes with elevated levels of serum Krebs von den Lungen-6; however, there is marked variation in the pathogenesis and clinical features in PPFE. A proposal of the diagnostic criteria for idiopathic PPFE with and without surgical lung biopsy, which has recently been published, may be useful.
Implications of Tennessee's Opioid Legislation for Neonatal Abstinence Syndrome
Authors: Shearer Jennifer N. , Erwin Paul Campbell , Davis Sharon K. , Anderson Joel G. , Lindley Lisa C.
Published: August 2019

Opioid use during pregnancy is on the rise in the United States. Neonatal abstinence syndrome (NAS), also known as newborn drug withdrawal, is a public health epidemic. Between 2004 and 2014, Tennessee experienced a fivefold increase in NAS hospitalizations, from 1.5 to 8.0 per 1,000 live births. Soaring increases in the number of newborns with NAS nationwide have caught the attention of many federal and state lawmakers, especially given the unknown burdens associated with medical and social services needed by those affected over time. Tennessee opioid-related regulations and laws enacted between 2000 and 2018 were systematically reviewed and analyzed to identify each law's purpose; effects on families and individuals; pros and cons in terms of social, practical, and legal factors; and implications for nursing practice. Our findings were that Tennessee's laws are intended to decrease the number of opioids prescribed, ensure access to continued prenatal care and substance abuse management for mothers with substance use disorders, and reduce the ease of obtaining opioids. We also found that Tennessee lawmakers have enacted laws and regulations aimed at decreasing the abuse of opioids, but not reducing the incidence of NAS. As new laws are considered, it is critical that health care providers and lawmakers work together to ensure that the developed and enacted laws strike a balance between safely managing the care of both pregnant women and their newborns without producing negative outcomes.
Microtubules: Evolving roles and critical cellular interactions
Authors: Logan Caitlin M , Menko A Sue
Published: August 2019

Microtubules are cytoskeletal elements known as drivers of directed cell migration, vesicle and organelle trafficking, and mitosis. In this review, we discuss new research in the lens that has shed light into further roles for stable microtubules in the process of development and morphogenesis. In the lens, as well as other systems, distinct roles for characteristically dynamic microtubules and stabilized populations are coming to light. Understanding the mechanisms of microtubule stabilization and the associated microtubule post-translational modifications is an evolving field of study. Appropriate cellular homeostasis relies on not only one cytoskeletal element, but also rather an interaction between cytoskeletal proteins as well as other cellular regulators. Microtubules are key integrators with actin and intermediate filaments, as well as cell–cell junctional proteins and other cellular regulators including myosin and RhoGTPases to maintain this balance.

Impact statement

The role of microtubules in cellular functioning is constantly expanding. In this review, we examine new and exciting fields of discovery for microtubule’s involvement in morphogenesis, highlight our evolving understanding of differential roles for stabilized versus dynamic subpopulations, and further understanding of microtubules as a cellular integrator.
A win ratio approach to the re-analysis of Multiple Risk Factor Intervention Trial
Authors: Kotalik Ales , Eaton Anne , Lian Qinshu , Serrano Carlos , Connett John , Neaton James D
Published: August 2019

Background:

Composite outcomes, which combine multiple types of clinical events into a single outcome, are common in clinical trials. The usual analysis considers the time to first occurrence of any event in the composite. The major criticisms of such an approach are (1) this implicitly treats the outcomes as if they were of equal importance, but they often vary in terms of clinical relevance and severity, (2) study participants often experience more than one type of event, and (3) often less severe events occur before more severe ones, but the usual analysis disregards any information beyond that first event.

Methods:

A novel approach, referred to as the win ratio, which addresses the aforementioned criticisms of composite outcomes, is illustrated with a re-analysis of data on fatal and non-fatal cardiovascular disease time-to-event outcomes reported for the Multiple Risk Factor Intervention Trial. In this trial, 12,866 participants were randomized to a special intervention group ( n = 6428) or a usual care ( n = 6438) group. Non-fatal outcomes were ranked by risk of cardiovascular disease death up to 20 years after trial. In one approach, participants in the special intervention and usual care groups were first matched on coronary heart disease risk at baseline and time of enrollment. Each matched pair was categorized as a winner or loser depending on which one experienced a cardiovascular disease death first. If neither died of cardiovascular disease causes, they were evaluated on the most severe non-fatal outcome. This process continued for all the non-fatal outcomes. A second win ratio statistic, obtained from Cox partial likelihood, was also estimated. This statistic provides a valid estimate of the win ratio using multiple events if the marginal and conditional survivor functions of each outcome satisfy proportional hazards. Loss ratio statistics (inverse of win ratios) are compared to hazard ratios from the usual first event analysis. A larger 11-event composite was also considered.

Results:

For the 7-event cardiovascular disease composite, the previously reported first event analysis based on 581 events in the special intervention group and 652 events in the usual care group yielded a hazard ratio (95% confidence interval) of 0.89 (0.79–0.99), compared to 0.86 (0.77–0.97) and 0.91 (0.81–1.02) for the severity ranked estimates. Results for the 11-event composite also confirmed the findings of the first event analysis.

Conclusion:

The win ratio analysis was able to leverage information collected past the first experienced event and rank events by severity. The results were similar to and confirmed previously reported traditional first event analysis. The win ratio statistic is a useful adjunct to the traditional first event analysis for trials with composite outcomes.
Navigating multisite research set-up and approvals: helping researchers on the ground—a commentary
Authors: Ranieri V. , Stynes H. , Kennedy E.
Published: August 2019

Confirming multisite studies presents an ongoing challenge for researchers based in England. Those wishing to set up a multisite study must undergo local Research & Development review, in addition to ethical review by a Research Ethics Committee. However, both the documentation required for multisite review and the length of time it takes to complete such a review can cause significant difficulty to researchers and add to research delays. This short article will examine the process of confirming multisite studies and the implications of current practice.
Beyond good and evil? Popular songs, mathemes and bus rides (art and transition in the region of the former Yugoslavia)
Authors: Bahun Sanja
Published: August 2019

Art production and art reception play a vital role in transitional societies. However, their actual operation and patterns of impact often appear ‘messy’ to those who use and evaluate art in transitional contexts: an artwork can serve as a catalyst for peace building and transitional justice processes, but it can also obstruct such processes, or impart ambiguous meanings to them; and its modes of operation (including the art producers’ awareness of their role in transitional justice processes), its reception trends and its influence on transitional society all vary over time. Framed by transitional justice theory and an interdisciplinary approach that incorporates the insights of psychosocial cultural studies, comparative arts and the phenomenology of embodiment, this article scrutinizes this ambivalent operation in relation to the fluctuating sphere of reception in the region of the former Yugoslavia since the establishment of the International Criminal Tribunal for the former Yugoslavia (ICTY) in 1993. The author juxtaposes art practices widely different in terms of expression, format, scope, reach and ambition, but comparable insofar as they all operate in the ‘open’ and appeal to senses and repetition engagement to create patterns of affiliation. These include various types of popular music (turbo-folk, rock, hip-hop, soft pop) and the public intervention activities of the Serbian DAH Theatre and pan-regional art and theory collective Monument Group. The article argues for the development of hermeneutic and axiological thinking that befits the complex functioning of art in transition: nuanced and multilevelled, challenging inherited hierarchies and paradigms while appreciating the prolonged life/impact of art practices and the sensorial, cognitive and ideological variation in their reception. It proposes moving beyond the binary assessments and adopting a more dynamic approach to the evaluation of artworks in transition for the benefit of both scholars and practitioners in the field.
Therapeutic approaches to osteosarcopenia: insights for the clinician
Authors: Fatima Mizhgan , Brennan-Olsen Sharon L. , Duque Gustavo
Published: August 2019

Osteopenia/osteoporosis and sarcopenia are both age-related conditions. Given the well-defined bone and muscle interaction, when osteopenia and sarcopenia occur simultaneously, this geriatric syndrome is defined as ‘osteosarcopenia’. Evidence exists about therapeutic interventions common to both bone and muscle, which could thereby be effective in treating osteosarcopenia. In addition, there are roles for common nonpharmacological strategies such as nutritional intervention and physical exercise prescription in the management of this condition. In this review we summarize the evidence on current and upcoming therapeutic approaches to osteosarcopenia.
Chemical Profiling of Volatile Components of the Gametophyte and Sporophyte Stages of the Hornwort Leiosporoceros dussii (Leiosporocerotaceae) From Panama by HS-SPME-GC-MS
Authors: Garrido Anette , Ledezma Jose Gudiño , Durant-Archibold Armando A. , Allen Noris Salazar , Villarreal A Juan Carlos , Gupta Mahabir P.
Published: August 2019

We report for the first time the chemical profiling of volatile organic compounds (VOCs) of gametophyte and sporophyte life stages of Leiosporoceros dussii, from Panama by using headspace-solid phase microextraction-gas chromatography-mass spectrometry in order to assess distinguishing chemical markers between the male and female gametophytes, and sporophytes of this hornwort. A total of 27 VOCs were identified in L. dussii. Furthermore, the gametophyte and sporophyte showed clear differences in the type and amount of VOCs. The main constituents of L. dussii female thalli were menthacamphor (17.8%), hexanol (12.3%), and menthyl acetate (12.3%), while the major compounds of the male thalli were hexanol (25.3%), β-ionone (21.1%), benzeneacetaldehyde (17.6%), and β-cyclocitral (14.0%). The main VOCs of the sporophytes were hexanal (19.3%), β-cyclocitral (17.6%), 2-nonenal (15.8%), hexanol (12.5%), and β-ionone (10.2%). Unique compounds found in the female thalli were 3-pentanone, 3-octenol, nonanol, estragole, and menthyl acetate, and in the male thalli were methyl heptenone, nonanal, neoisomenthol, and bornyl acetate. Isomenthol, thymol, isomenthol acetate, and β-methylnaphthalene were only found in the sporophyte. The characteristic VOCs identified in L. dussii suggest a difference between the chemical constituents of L. dussii and other hornworts species. The presence of simple VOCs when compared with compounds previously characterized in another hornwort genera may support the distinct genetic nature of this species.
Effect of Injury Prevention Programs on Lower Extremity Performance in Youth Athletes: A Systematic Review
Authors: Hanlon Colleen , Krzak Joseph J. , Prodoehl Janey , Hall Kathy D.
Published: August 2019

Background:

Understanding how existing youth injury prevention programs affect specific modifiable injury risk factors will inform future program development for youth athletes.

Objective:

To comprehensively evaluate the effects of injury prevention programs on the modifiable intrinsic risk factors associated with lower extremity performance in youth athletes.

Data Sources:

This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, EBSCOhost [including CINAHL, Medline, and SPORTDiscus], and PEDro). Secondary references were appraised for relevant articles. Article types included randomized or cluster randomized controlled trials and randomized cohort designs with youth athletes engaged in organized sports, along with outcomes that included at least 1 physical performance outcome measure.

Study Selection:

Eight studies met inclusion and exclusion criteria and were reviewed by 2 independent reviewers, with a third consulted in the case of disagreement, which was not needed.

Study Design:

Systematic review.

Level of Evidence:

Level 3.

Data Extraction:

Included studies underwent review of methodological quality using the Physiotherapy Evidence Database scale.

Results:

Studies included mixed-sex samples of youth athletes who predominantly participated in soccer at different skill levels. The FIFA 11+ series was the most commonly used injury prevention program. Among studies, the mean percentage of improvement identified was 11.3% for force generation, 5.7% for coordination, 5.2% for posture, and 5.2% for balance. The lowest mean percentage improvement was in speed (2.2%). Endurance was not significantly affected by any of the programs.

Conclusion:

This systematic review shows that injury prevention programs improve several modifiable intrinsic risk factors of lower extremity performance among youth athletes, particularly force generation. However, several intrinsic risk factors were either not significantly affected or specifically addressed by existing programs.
Can presidential misinformation on climate change be corrected? Evidence from Internet and phone experiments
Authors: Porter Ethan , Wood Thomas J. , Bahador Babak
Published: August 2019

Can presidential misinformation affect political knowledge and policy views of the mass public, even when that misinformation is followed by a fact-check? We present results from two experiments, conducted online and over the telephone, in which respondents were presented with Trump misstatements on climate change. While Trump’s misstatements on their own reduced factual accuracy, corrections prompted the average subject to become more accurate. Republicans were not as affected by a correction as their Democratic counterparts, but their factual beliefs about climate change were never more affected by Trump than by the facts. In neither experiment did corrections affect policy preferences. Debunking treatments can improve factual accuracy even among co-partisans subjected to presidential misinformation. Yet an increase in climate-related factual accuracy does not sway climate-related attitudes. Fact-checks can limit the effects of presidential misinformation, but have no impact on the president’s capacity to shape policy preferences.
Measuring Efforts of Nonprofit Hospitals to Address Opioid Abuse After the Affordable Care Act
Authors: Franz Berkeley , Cronin Cory E. , Wainwright Alexandra , Pagán José A.
Published: August 2019

Objectives: To assess the strategies that nonprofit hospitals are adopting to address opioid abuse after requirements for community engagement expanded in the Affordable Care Act. Methods: We constructed a dataset of implementation activities for a 20% random sample of nonprofit hospitals in the United States. Using logistic regression, we assessed the extent to which strategies adopted are new, existing, or primarily partnerships. Using negative binomial regression, we assessed the total number of strategies adopted. We controlled for hospital and community characteristics as well as state policies related to opioid abuse. Results: Most strategies adopted by hospitals were new and clinical in nature and the most common number of strategies adopted was one. Hospitals in the Northeast were more likely to adopt a higher number of strategies and to partner with community-based organizations. Hospitals that partner with community-based organizations were more likely to adopt strategies that engage in harm reduction, targeted risk education, or focus on addressing social determinants of health. Conclusions: Community, institutional, and state policy characteristics predict hospital involvement in addressing opioid abuse. These findings underscore several opportunities to support hospital-led interventions to address opioid abuse.
Use of Ayurveda in the Treatment of Type 2 Diabetes Mellitus
Authors: Gordon Allison , Buch Zankhana , Baute Vanessa , Coeytaux Remy
Published: August 2019

Background

Ayurveda is an ancient medicine practice that is emerging in the United States as a complementary and alternative treatment for chronic illness. Type 2 diabetes is a chronic illness that has major long-term implications for individuals suffering from the disease as well as the health-care system as a whole. Modifications in diet, exercise, and lifestyle are all important factors in successful treatment of type 2 diabetes and are incorporated into the ancient Indian medicinal practice of Ayurveda. Review Summary: This review summarizes the available evidence for the use of Ayurvedic therapies in the treatment of type 2 diabetes. For the treatment of type 2 diabetes, Ayurvedic practices primarily emphasizes the use of herbal supplements; however, exercise, weight management, and various supplemental procedures are included in Ayurvedic practices. The goal of Ayurvedic practices on the treatment of type 2 diabetes like in Western medicine focuses on bringing the hemoglobin A1c (HbA1c) value into a therapeutic range. Where Ayurveda differs is that it looks at the functionality of a person in the context of striking a balance between the life forces or doshas that each individual possesses. Finally, this article includes a case study received from AyurVAID clinic in Bangalore, India that details the specific Ayurvedic intervention used in a patient, bringing his HbA1c from a level of 11.2 to 5.7 over the course of 9 months.

Conclusion

Patients with type 2 diabetes may inquire about current complementary and alternative therapies available for the treatment of their disease. Awareness of such modalities is necessary for effective patient counseling and care. The benefits of offering a wide array of treatment options include possible reduction of HbA1c and of comorbidities with adjunct use of supplements and mind–body practices.
Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis
Authors: Ogura Yoji , Kobayashi Yoshiomi , Shinozaki Yoshio , Kitagawa Takahiro , Yonezawa Yoshiro , Takahashi Yoshiyuki , Yoshida Kodai , Yasuda Akimasa , Ogawa Jun
Published: August 2019

Study Design:

Retrospective cohort study.

Objectives:

Decompression without fusion is a standard surgical treatment for lumbar spinal stenosis (LSS) with reasonable surgical outcomes. Nevertheless, some studies have reported low patient satisfaction (PS) following decompression surgery. The cause of the discrepancy between reasonable clinical outcomes and PS is unknown; moreover, the factors associated with PS are expected to be complex, and little is known about them. This study aimed to identify satisfaction rate and to clarify the factors related to PS following decompression surgery in LSS patients.

Methods:

We retrospectively reviewed 126 patients who underwent lumbar decompression with a minimum follow-up of 1 year. Patients were divided into 2 groups based on the PS question. The Japanese Orthopaedic Association (JOA) scores, and the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness were compared between the 2 groups preoperatively and at the latest visit. To identify the prognostic factors for dissatisfaction, multiple logistic regression analysis was performed.

Results:

Overall satisfaction rate was 75%. The JOA recovery rate, NRS improvement, and Short Form–8 (SF-8) were significantly higher in the satisfied group. Postoperative NRS scores of LBP, leg pain, and leg numbness were significantly lower in the satisfied group. Multivariate logistic regression analysis showed that smoking and scoliosis were significant risk factors for dissatisfaction.

Conclusions:

Overall satisfaction rate was 75% in patients with LSS undergoing decompression surgery. This study found that smoking status and scoliosis were associated with patient dissatisfaction following decompression in LSS patients.
On the Need to Revisit the Ethical Structure of Economics in the Light of Advaita Vedānta
Authors: Sivakumar K. S.
Published: August 2019

The ethical structure of economics, based on the standard of economic maximization of satisfaction, explains all kinds of behaviour in terms of maximization of self-interest. This paper shows that interventions from the philosophy of Advaita Vedānta would enable economics to recognize and accommodate, within its ethical structure, the important role played by altruistic and moral commitments in the decision-making deliberations of individuals. The concept-based paper deduces the primary or basic causes for the limitations in the ethical structure of economics and, in this background, expounds the ethical philosophy of Advaita Vedānta, its important takeaways and implications for the ethical structure of economics. The ethical ideal offered by Advaita Vedānta, unlike that of economics, is based on the standard of self-purification through intention/duty. The ideal is neither committed to the naturalistic fallacy (the identification of the ‘good’ with ‘satisfaction/pleasure’) nor upholds a position of maximization of consequences.

By incorporating the perspectives of Advaita Vedānta into the ethical structure of economics, we may evolve an ethical standard that would exhibit, among other factors, the following implications: (a) the ethical standard would enlarge the scope of economics, without dismantling the present ethical structure of economics; (b) economic models built based on such an ethical standard would not only be comprehensive theoretical models and empirically- verifiable practical models, but more importantly, ethically-validated holistic models as well; and (c) the ethical standard and the models build upon it would also enrich other disciplines like management science, commerce, etc., which also share the strategies and models of economics.
Learning from Quality Audit in Higher Education Institutions: A Tool for Community Engagement Enhancement
Authors: Kooli Chokri , Jamrah Ahmad , Al-Abri Nasser
Published: August 2019

Higher education institutions (HEIs) are asked more and more to be community engaged. In fact, governments have become more sensitive regarding the role and the contributions of these institutions in the development of the society in general and students’ skills in specific. Community engagement (CE) has also become an important part of the quality accreditation framework in several countries. Through this, researchers tried to demonstrate a positive correlation between the publication of the quality audit reports and the generation of positive outcomes in terms of CE. The study notified a certain decrease in terms of recommendations related to the standard of CE in comparison with the other areas of quality assessment. However, it was not possible to establish a positive correlation between the publication of quality reports and the decrease of the number of recommendations. Researchers concluded that the institutional engagement in CE activities appears to be a more strategic imposed tool made under the constraints of the quality accreditation standards, rather than the self-awareness and self-engagement of the HEIs.
Cyberbullying, Mental Health, and Violence in Adolescents and Associations With Sex and Race: Data From the 2015 Youth Risk Behavior Survey
Authors: Alhajji Mohammed , Bass Sarah , Dai Ting
Published: August 2019

Background. Cyberbullying is a serious issue among adolescents, but little is known about how demographics are associated with mental health conditions and violent behaviors. The present study examined the association of cyberbullying victimization with mental health conditions and violent behaviors among adolescents, specifically examining potential differences by sex and race. Methods. National data obtained from a representative sample of 9th to 12th grade students (N = 15 465) in the United States were examined using bivariate and logistic regression analysis. Results. More than 15% of students reported cyberbullying victimization. Females were twice as likely to report victimization than males, and non-white students were 50% less likely to report cyberbullying victimization. Cyberbullying victimization was significantly more likely in students who reported depressive symptoms, suicidal ideation, suicide planning, carrying a weapon, and engaging in a physical fight. These associations were more pronounced in males. Conclusions. Our findings show that female and white adolescents are at increased risk of being cyberbullied. However, negative mental health outcomes and violent behaviors are more pronounced in males, indicating potential negative effects of being a cyberbullying victim based on sex. We envisage the best way to combat cyberbullying is to develop programs that are sensitive to potential demographic differences to empower students based on individual risks.
The JAK/STAT pathway is activated in systemic sclerosis and is effectively targeted by tofacitinib
Authors: Wang Wenxia , Bhattacharyya Swati , Marangoni Roberta Goncalves , Carns Mary , Dennis-Aren Kathleen , Yeldandi Anjana , Wei Jun , Varga John
Published: August 2019

Rationale:

Fibrosis leads to failure of the skin, lungs, and other organs in systemic sclerosis; accounts for substantial morbidity and mortality; and lacks effective therapy. Myofibroblast activation underlies organ fibrosis, but the key extracellular cues driving persistence of the process remain incompletely characterized.

Objectives:

The objectives were to evaluate activation of the IL6/JAK/STAT axis associated with fibrosis in skin and lung biopsies from systemic sclerosis patients and effects of the Food and Drug Administration–approved JAK/STAT inhibitor, tofacitinib, on skin and lung fibrosis in animal models.

Methods:

Bioinformatic analysis showed that IL6/JAK/STAT3 and tofacitinib gene signatures were aberrant in biopsies from systemic sclerosis patients in four independent cohorts. The results were confirmed by JAK and STAT3 phosphorylation in both skin and lung biopsies from patients with systemic sclerosis. Furthermore, treatment of mice with the selective JAK inhibitor tofacitinib not only prevented bleomycin-induced skin and lung fibrosis but also reduced skin fibrosis in TSK1/+ mice.

Conclusion:

These findings implicate the JAK/STAT pathway in systemic sclerosis skin and lung fibrosis and identify tofacitinib as a potential antifibrotic agent for the treatment of systemic sclerosis and other fibrotic diseases.
Yosprala: Coordinated Delivery of a Proton Pump Inhibitor and Aspirin
Authors: Ingram Courtney A. , Giang Gracie , McCrory Katie , Wensel Terri M.
Published: August 2019

Objective: Review the pharmacology, pharmacokinetics, efficacy, and safety of Yosprala (aspirin and omeprazole). Data Sources: A literature search was conducted using PubMed with the terms “Yosprala,” “PA8140,” and “PA32540” from the initial year through May, 2019. Additional sources were gathered through bibliographies. Aralez Pharmaceuticals Inc was contacted for manufacturer information. Study Selection and Data Extraction: The sources were narrowed to studies done in English language between 1990 and 2019. All viable clinical trials for the use of Yosprala in the secondary prevention of cardiovascular events were included. Data Synthesis: Yosprala is a coordinated delivery system of immediate-release omeprazole 40 mg and enteric-coated aspirin (325 mg or 81 mg). In 2016, the Food and Drug Administration approved Yosprala for the secondary prevention of cardiovascular or cerebrovascular events (ie, stroke or myocardial infarction). While it is recommended that patients take low-dose aspirin for secondary prevention of these events, many patients cannot tolerate the gastrointestinal (GI) adverse effect profile of the drug. Phase 3 clinical trials have proven that Yosprala significantly lowers the occurrence of GI bleeds and ulcers versus aspirin alone (3.2% and 8.6%, respectively; P ≤ .001). The most common adverse effects include infection, diarrhea, and dyspepsia. Conclusion: Yosprala significantly reduces the occurrence of GI ulcers and seems to be a safe and effective option for the secondary prevention of cardiovascular events.
Insights into determinants of spleen injury in sickle cell anemia
Authors: El Hoss Sara , Cochet Sylvie , Marin Mickaël , Lapouméroulie Claudine , Dussiot Michael , Bouazza Naïm , Elie Caroline , de Montalembert Mariane , Arnaud Cécile , Guitton Corinne , Pellegrino Béatrice , Odièvre Marie Hélène , Moati Frédérique , Le Van Kim Caroline , Aronovicz Yves Colin , El Nemer Wassim , Brousse Valentine
Published: August 2019

Spleen dysfunction is central to morbidity and mortality in children with sickle cell anemia (SCA). The initiation and determinants of spleen injury, including acute splenic sequestration (ASS) have not been established. We investigated splenic function longitudinally in a cohort of 57 infants with SCA enrolled at 3 to 6 months of age and followed up to 24 months of age and explored the respective contribution of decreased red blood cell (RBC) deformability and increased RBC adhesion on splenic injury, including ASS. Spleen function was evaluated by sequential 99mTc heated RBC spleen scintigraphy and high-throughput quantification of RBCs with Howell-Jolly bodies (HJBs). At 6 and 18 months of age, spleen filtration function was decreased in 32% and 50% of infants, respectively, whereas the median %HJB-RBCs rose significantly (from 0.3% to 0.74%). An excellent correlation was established between %HJB-RBCs and spleen scintigraphy results. RBC adhesion to laminin and endothelial cells increased with time. Adhesion to endothelial cells negatively correlated with splenic function. Irreversibly sickled cells (ISCs), used as a surrogate marker of impaired deformability, were detected at enrollment and increased significantly at 18 months. %ISCs correlated positively with %HJB-RBCs and negatively with splenic uptake, indicating a relationship between their presence in the circulation and spleen dysfunction. In the subgroup of 8 infants who subsequently experienced ASS, %ISCs at enrollment were significantly higher compared with the asymptomatic group, suggesting a major role of impaired deformability in ASS. Higher levels of %HJB-RBCs were observed after the occurrence of ASS, demonstrating its negative impact on splenic function.