bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Core outcome set for fetal Myelomeningocele (COSMiC): study protocol
Authors: Altoukhi Samar , Whitehead Clare L. , Ryan Greg , Deprest Jan , Joyeux Luc , Gallagher Katie , Drake James , Church Paige , Horn Daphne , Diambomba Yenge , Carvalho Jose C. A. , Van Mieghem Tim
Published: August 2020

Background

Open spina bifida (OSB) is one of the most common congenital central nervous system defects and leads to long-term physical and cognitive disabilities. Open fetal surgery for OSB improves neurological outcomes and reduces the need for ventriculoperitoneal shunting, compared to postnatal surgery, but is associated with a significant risk of prematurity and maternal morbidity. Fetoscopic surgery comes with less maternal morbidity, yet the question remains whether the procedure is neuroprotective and reduces prematurity. Comparison of outcomes between different treatment options is challenging due to inconsistent outcome reporting. We aim to develop and disseminate a core outcome set (COS) for fetal OSB, to ensure that outcomes relevant to all stakeholders are collected and reported in a standardised fashion in future studies.

Methods

The COS will be developed using a validated Delphi methodology. A systematic literature review will be performed to identify outcomes previously reported for prenatally diagnosed OSB. We will assess maternal (primary and subsequent pregnancies), fetal, neonatal and childhood outcomes until adolescence. In a second phase, we will conduct semi-structured interviews with stakeholders, to ensure representation of additional relevant outcomes that may not have been reported in the literature. We will include patients and parents, as well as health professionals involved in the care of these pregnancies and children (fetal medicine specialists, fetal surgeons, neonatologists/paediatricians and allied health). Subsequently, an international group of key stakeholders will rate the importance of the identified outcomes using three sequential online rounds of a modified Delphi Survey. Final agreement on outcomes to be included in the COS, their definition and measurement will be achieved through a face-to-face consensus meeting with all stakeholder groups. Dissemination of the final COS will be ensured through different media and relevant societies.

Discussion

Development and implementation of a COS for fetal OSB will ensure consistent outcome reporting in future clinical trials, systematic reviews and clinical practice guidelines. This will lead to higher quality research, better evidence-based clinical practice and ultimately improved maternal, fetal and long-term childhood outcomes.

Trial registration

International Prospective Register of Systematic Reviews (PROSPERO)CRD42018104880. Registered on December 5, 2018. Core Outcome Measures in Effectiveness Trials (COMET):1187
Efficacy, safety and cost-effectiveness of a web-based platform delivering the results of a biomarker-based predictive model of biotherapy response for rheumatoid arthritis patients: a protocol for a randomized multicenter single-blind active controlled clinical trial (PREDIRA)
Authors: Freites-Núñez Dalifer , Baillet Athan , Rodriguez-Rodriguez Luis , Nguyen Minh Vu Chuong , Gonzalez Isidoro , Pablos Jose Luis , Balsa Alejandro , Vazquez Monica , Gaudin Philippe , Fernandez-Gutierrez Benjamín
Published: August 2020

Background

Rheumatoid arthritis (RA) is one of the leading chronic inflammatory rheumatism. First-line therapy with synthetic disease-modifying antirheumatic drugs (sDMARD) is insufficiently effective in 40% of cases and these patients are treated with biotherapies. The increased use of these drugs each year is becoming a public health issue with considerable economic burden. This cost is 20 times higher than that of sDMARD. However, among patients treated with biotherapies, clinical practice shows that about one third will not respond to the selected drug. In nonresponse cases, practitioners currently have no choice but to perform an empirical switching between different treatments, because no tool capable of predicting the response or nonresponse to these molecules is currently available.

Methods

The study is a prospective, phase III, controlled, multicenter, and randomized, single-blind (patient) clinical trial, including RA patients with a previous failure to anti-TNF therapies. The main objective is the analysis of the clinical and pharmacoeconomic impact after 6 months of treatment. Intervention arm: prescription of biotherapy (rituximab, adalimumab, abatacept) using SinnoTest® software, a prediction software based on proteomic biomarkers. Control arm: prescription of biotherapy based on current practice, without the SinnoTest® software (any biotherapy). In addition, a substudy will be carried out within this trial to generate a biobank and further analyze the proteomic profile of the patients and their modification throughout the study.

Discussion

This clinical trial study will be the first validation study of a biotherapy response prediction software, bringing personalized medicine into the management of RA. We expect that the findings from this study will bring several benefits for the patient and the Health Care System.

Trial registration

ClincalTrials.gov NCT04147026. Registered on 31 October, 2019.
The Effect of Social Norm-based Intervention with Observable Behaviour on Physical Activity among Adolescents: A Randomized Controlled Trial
Authors: LEE Jia Jia , NADKARNI Nivedita Vikas , TEO Irene , OZDEMIR Semra
Published: August 2020

Background

The rising prevalence of childhood obesity in developing and developed countries poses a major public health challenge to policy makers and an effective strategy to promote physical activity among adolescents is warranted. This study aimed to evaluate the effectiveness of providing descriptive norms messages with personal identification in promoting physical activity among adolescents by measuring step counts via a randomized controlled trial (NCT03081013).

Methods

A total of 311 participants aged 13–16 were randomized into two study arms (Onymous and Anonymous Arms). Each arm consisted of 13 groups of 12 participants. During the trial, participants received weekly short message service (SMS) about their past week’s physical activity performance. Participants in the Anonymous Arm received information about step counts of group members ranked from highest to lowest. Participants in the Onymous Arm received the same information with the group members’ full names. Participants’ quality of life, depression, physical activity social support, self-efficacy and enjoyment before and after the intervention were also evaluated. This study adheres to the CONSORT guidelines.

Results

The number of steps was not higher when descriptive norm message was onymous compared to when it was anonymous. Scores in quality of life, depression, social support, self-efficacy, and enjoyment of physical activity were not significantly different between both arms (p > 0.05).

Conclusions

Our findings indicated that the effect of providing descriptive norms messages containing personal identification on physical activity promotion was not evident in the main analysis. Future studies may consider using a more relevant reference group to use social norms as a tool to increase physical activity among adolescents.

Trial registration

ClinicalTrials.gov - NCT03081013. Registered 15 Mar 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03081013
A deep analysis using panel-based next-generation sequencing in an Ecuadorian pediatric patient with anaplastic astrocytoma: a case report
Authors: García-Cárdenas Jennyfer M. , Zambrano Ana Karina , Guevara-Ramírez Patricia , Guerrero Santiago , Runruil Gabriel , López-Cortés Andrés , Torres-Yaguana Jorge P. , Armendáriz-Castillo Isaac , Pérez-Villa Andy , Yumiceba Verónica , Leone Paola E. , Paz-y-Miño César
Published: August 2020

Background

Anaplastic astrocytoma is a rare disorder in children from 10 to 14 years of age, with an estimated 0.38 new cases per 100,000 people per year worldwide. Panel-based next-generation sequencing opens new possibilities for diagnosis and therapy of rare diseases such as this one. Because it has never been genetically studied in the Ecuadorian population, we chose to genetically characterize an Ecuadorian pediatric patient with anaplastic astrocytoma for the first time. Doing so allows us to provide new insights into anaplastic astrocytoma diagnosis and treatment.

Case presentation

Our patient was a 13-year-old Mestizo girl with an extensive family history of cancer who was diagnosed with anaplastic astrocytoma. According to ClinVar, SIFT, and PolyPhen, the patient harbored 354 genomic alterations in 100 genes. These variants were mostly implicated in deoxyribonucleic acid (DNA) repair. The top five most altered genes wereFANCD2,NF1,FANCA,FANCI, andWRN.Even thoughTP53presented only five mutations, the rs11540652 single-nucleotide polymorphism classified as pathogenic was found in the patient and her relatives; interestingly, several reports have related it to Li-Fraumeni syndrome. Furthermore,in silicoanalysis using the Open Targets Platform revealed two clinical trials for pediatric anaplastic astrocytoma (studying cabozantinib, ribociclib, and everolimus) and 118 drugs that target the patient’s variants, but the studies were not designed specifically to treat pediatric anaplastic astrocytoma.

Conclusions

Next-generation sequencing allows genomic characterization of rare diseases; for instance, this study unraveled a pathogenic single-nucleotide polymorphism related to Li-Fraumeni syndrome and identified possible new drugs that specifically target the patient’s variants. Molecular tools should be implemented in routine clinical practice for early detection and effective preemptive intervention delivery and treatment.
Sex differences in brain atrophy in multiple sclerosis
Authors: Voskuhl Rhonda R. , Patel Kevin , Paul Friedemann , Gold Stefan M. , Scheel Michael , Kuchling Joseph , Cooper Graham , Asseyer Susanna , Chien Claudia , Brandt Alexander U. , Meyer Cassandra Eve , MacKenzie-Graham Allan
Published: August 2020

Background

Women are more susceptible to multiple sclerosis (MS) than men by a ratio of approximately 3:1. However, being male is a risk factor for worse disability progression. Inflammatory genes have been linked to susceptibility, while neurodegeneration underlies disability progression. Thus, there appears to be a differential effect of sex on inflammation versus neurodegeneration. Further, gray matter (GM) atrophy is not uniform across the brain in MS, but instead shows regional variation. Here, we study sex differences in neurodegeneration by comparing regional GM atrophy in a cohort of men and women with MS versus their respective age- and sex-matched healthy controls.

Methods

Voxel-based morphometry (VBM), deep GM substructure volumetry, and cortical thinning were used to examine regional GM atrophy.

Results

VBM analysis showed deep GM atrophy in the thalamic area in both men and women with MS, whereas men had additional atrophy in the putamen as well as in localized cortical regions. Volumetry confirmed deep GM loss, while localized cortical thinning confirmed GM loss in the cerebral cortex. Further, MS males exhibited worse performance on the 9-hole peg test (9HPT) than MS females. We observed a strong correlation between thalamic volume and 9HPT performance in MS males, but not in MS females.

Conclusion

More regional GM atrophy was observed in men with MS than women with MS, consistent with previous observations that male sex is a risk factor for worse disease progression.
An increasing variables singular system of fractional q-differential equations via numerical calculations
Authors: Samei Mohammad Esmael , Baleanu Dumitru , Rezapour Shahram
Published: August 2020

We investigate the existence of solutions for an increasing variables singular m-dimensional system of fractional q-differential equations on a time scale. In this singular system, the first equation has two variables and the number of variables increases permanently. By using some fixed point results, we study the singular system under some different conditions. Also, we provide two examples involving practical algorithms, numerical tables, and some figures to illustrate our main results.
An inertial based forward–backward algorithm for monotone inclusion problems and split mixed equilibrium problems in Hilbert spaces
Authors: Arfat Yasir , Kumam Poom , Ngiamsunthorn Parinya Sa , Khan Muhammad Aqeel Ahmad
Published: August 2020

Iterative algorithms are widely applied to solve convex optimization problems under a suitable set of constraints. In this paper, we develop an iterative algorithm whose architecture comprises a modified version of the forward-backward splitting algorithm and the hybrid shrinking projection algorithm. We provide theoretical results concerning weak and strong convergence of the proposed algorithm towards a common solution of the monotone inclusion problem and the split mixed equilibrium problem in Hilbert spaces. Moreover, numerical experiments compare favorably the efficiency of the proposed algorithm with the existing algorithms. As a consequence, our results improve various existing results in the current literature.
Consolidating RRI and Open Science: understanding the potential for transformative change
Authors: Shelley-Egan Clare , Gjefsen Mads Dahl , Nydal Rune
Published: August 2020

In European research and innovation policy, Responsible Research and Innovation (RRI) and Open Science (OS) encompass two co-existing sets of ambitions concerning systemic change in the practice of research and innovation. This paper is an exploratory attempt to uncover synergies and differences between RRI and OS, by interrogating what motivates their respective transformative agendas. We offer two storylines that account for the specific contexts and dynamics from which RRI and OS have emerged, which in turn offer entrance points to further unpacking what ‘opening up’ to society means with respect to the transformative change agendas that are implicit in the two agendas. We compare differences regarding the ‘how’ of opening up in light of the ‘why’ to explore common areas of emphasis in both OS and RRI. We argue that while both agendas align with mission-oriented narratives around grand societal challenges, OS tends to emphasize efficiency and technical optimisation over RRI’s emphasis on normative concerns and democracy deficits, and that the two agendas thus contrast in their relative legitimate emphasis ondoableoutcomes versusdesirableoutcomes. In our conclusion, we reflect on the future outlook for RRI and OS’ co-existence and uptake, and on what their respective ambitions for transformation might mean for science-society scholars and scholarship.
1-year impact of supervision, performance assessment, and recognition strategy (SPARS) on prescribing and dispensing quality in Ugandan health facilities
Authors: Trap Birna , Sembatya Moses N. , Imi Monica , Seru Morries , Wagner Anita K. , Ross-Degnan Dennis
Published: August 2020

Background

To strengthen appropriate medicine use (AMU) including the prescribing and dispensing quality at public sector health facilities in Uganda, the Ministry of Health introduced a multipronged approach known as the Supervision, Performance Assessment, and Recognition Strategy (SPARS). This paper assesses the impact of the first year of SPARS implementation on key AMU indicators.

Methods

District-based health workers trained as supervisors provide in-service training in medicines management complemented by indicator-based performance assessment and targeted supervision during each SPARS facility visit. From 2010 to 2013, health facilities that started the SPARS intervention were assessed during the first and last visit during a period of 12 months of implementing SPARS. This study examines 12 AMU indicators with 57 individual outcomes covering prescribing and dispensing quality. We also explored factors influencing 1-year improvement.

Results

We found an overall increase in AMU indicators of 17 percentage points (p < 0.000) between the first and last visit during a period of 12 months of supervisions, which was significant in all levels of health care facilities and in both government and private not-for-profit faith-based sectors. Appropriate dispensing (25 percentage points, p < 0.005) improved more than appropriate prescribing (12 percentage points, p = 0.13). Specific facilities that reached an average score of over 75% across all AMU measures within the first year of supervision improved from 3 to 41% from the first visit (baseline). The greatest overall impact on AMU occurred in lower-level facilities; the level of improvement varied widely across indicators, with the greatest improvements seen for the lowest baseline measures. Supervision frequency had a significant impact on level of improvement in the first year, and private not-for-profit faith-based health facilities had notably higher increases in several dispensing and prescribing indicator scores than public sector facilities.

Conclusions

The multipronged SPARS approach was effective in building appropriate medicine use capacity, with statistically significant improvements in AMU overall and almost all prescribing and dispensing quality measures after 12 months of supervision. We recommend broad dissemination of the SPARS approach as an effective strategy to strengthen appropriate medicine use in low-income countries.
Removal of an endobronchial lipoma via uniportal thoracoscopic right basal segmentectomy
Authors: Yazawa Tomohiro , Igai Hitoshi , Matsuura Natsumi , Ohsawa Fumi , Kamiyoshihara Mitsuhiro
Published: August 2020

Background

Endobronchial lipoma is a rare benign tumor. The standard treatment is bronchoscopic intervention or surgical resection. Here, we present a case of endobronchial lipoma treated by right basal segmentectomy via a uniportal thoracoscopic approach.

Case presentation

A 66-year-old female presented with a persistent cough and recurring high-grade fever 4 months in duration. Chest X-ray revealed an abnormal infiltration shadow in the right lower lung field. Chest computed tomography revealed a tumor that occluded the lateral segmental bronchus of the right lower lobe. Surgical resection was planned because we failed to diagnose the tumor via bronchoscopic biopsy. Finally, uniportal, thoracoscopic right basal segmentectomy, which is less invasive than lobectomy and allows preservation of the apical segment of the lower lobe, was successfully performed. The pathological diagnosis was of endobronchial lipoma. The cough and recurrent pneumonia improved after surgery.

Conclusions

Segmentectomy via a uniportal thoracoscopic approach could be a novel treatment option for endobronchial lipoma.
The effects of amino acid/protein supplementation in hemodialysis patients: study protocol for a systematic review and meta-analysis
Authors: Matsuzawa Ryota , Yamamoto Shohei , Suzuki Yuta , Abe Yoshifumi , Harada Manae , Shimoda Takahiro , Imamura Keigo , Yamabe Sachi , Ito Haruka , Yoshikoshi Shun , Matsunaga Atsuhiko
Published: August 2020

Background

Multiple factors including older age, comorbidities, inflammation, metabolic acidosis, dialysis-related hypercatabolism and anabolic resistance of skeletal muscle, extraction of circulating amino acids through hemodialysis and inadequate dietary protein intake due to anorexia, and strictly limited dietary phosphorus intake are likely to contribute to the high prevalence of malnutrition and metabolic abnormalities, more aptly called protein-energy wasting, in patients on hemodialysis. The consensus from the International Society of Renal Nutritional and Metabolism states that nutritional supplementation is effective for replenishing protein and energy stores. Although we hypothesize that amino acid/protein supplementation can overcome the anabolic resistance of skeletal muscle tissue and attenuate or even prevent the accelerated loss of skeletal muscle mass and strength through nutritional status improvement in patients on hemodialysis, whether amino acid and/or protein administration is associated with improvements in these outcomes is unknown. The main objective of this study is to systematically review the impact of amino acid/protein supplementation on skeletal muscle mass, muscle strength, physical function, and quality of life in end-stage renal disease patients requiring hemodialysis.

Methods

Published randomized controlled trials (RCTs) assessing the effectiveness of amino acid/protein supplementation in hemodialysis patients with respect to body composition, muscle mass, muscle strength, physical function, and quality of life will be included. The bibliographic databases include MEDLINE, the Web of Science, the Cochrane Central Register of Controlled Trials, and Embase. The risk of bias of the included RCTs will be assessed using the Cochrane Collaboration’s tool by two independent reviewers. The primary outcome will be skeletal muscle mass, muscle strength, and physical function, and the secondary outcome will be quality of life. This review protocol is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P) 2015 checklist.

Ethics and dissemination

Ethical approval is not required because this study does not include confidential personal data or involve patient interventions. This review is expected to inform readers on the effect of amino acid/protein supplementation in patients undergoing hemodialysis. The findings will be presented at conferences and submitted to a peer-reviewed journal for publication.

Trial registration

The trial registration number is (CRD42020181087), and the trial was registered on 5 July 2020.
Development and evaluation of a recombinase polymerase amplification assay for rapid detection of strawberry red stele pathogen
Authors: Munawar Mustafa Ahmad , Toljamo Anna , Martin Frank , Oksanen Elina , Kokko Harri
Published: August 2020

Phytophthora fragariae causes drastic damage in strawberry crops. P. fragariae infects strawberry roots and causes red stele root rot. Although P. fragariae is a quarantine organism, its spread in Finland continues as more and more fields contract the disease. The spread can be halted through developing rapid and reliable detection assays. We have developed a rapid recombinase polymerase amplification (RPA) assay for P. fragariae targeting the Phytophthora mitochondrial DNA intergenic atp9-nad9 marker. The assay is DNA-extraction free and capable of detecting as low as 10 fg of P. fragariae genomic DNA. We found the assay reliable for diagnosing field plants when samples are adequately collected. We also applied the RPA assay to the detection of the pathogen in the soil through coupling the assay with baiting with the host plant. The results suggest that if only a small number of samples are analysed, the baiting results will not be reliable.
Precision community: a mixed methods study to identify determinants of adoption and implementation of targeted cancer therapy in community oncology
Authors: Ball Jenna , Thompson Jeffrey , Wulff-Burchfield Elizabeth , Ellerbeck Edward , Kimminau Kim , Brooks Joanna Veazey , Petersen Shariska , Rotich Duncan , Kinney Anita Y. , Ellis Shellie D.
Published: August 2020

Background

Precision medicine has enormous potential to improve cancer outcomes. Over one third of the 1.5 million Americans diagnosed with cancer each year have genetic mutations that could be targeted with an FDA-approved drug to treat their disease more effectively. However, the current uptake of targeted cancer therapy in clinical practice is suboptimal. Tumor testing is not widely used, and treatments based on molecular and genomic profiling are often not prescribed when indicated. Challenges with the uptake of precision medicine may disproportionately impact cancer patients in rural communities and other underserved populations. The objective of this study is to identify the determinants of adoption and implementation of precision cancer therapy to design an implementation strategy for community oncology practices, including those in rural areas.

Methods

This study is an explanatory sequential mixed methods study to identify factors associated with the use of targeted cancer therapy. Levels of targeted therapy use will be ascertained by secondary analysis of medical records to identify concordance with 18 national guideline recommendations for use of precision medicine in the treatment of breast, colorectal, lung, and melanoma skin cancer. Concurrently, facilitators and barriers associated with the use of precision cancer therapy will be elicited from interviews with up to a total of 40 oncologists, administrators, pathology, and pharmacy staff across the participating sites. Qualitative analysis will be a template analysis based on the Theoretical Domains Framework. Quantitative data aggregated at the practice level will be used to rank oncology practices’ adherence to targeted cancer therapy guidelines. Determinants will be compared among high and low users to isolate factors likely to facilitate targeted therapy use. The study will be conducted in eight community oncology practices, with an estimated 4121 targeted therapy treatment decision-making opportunities over a 3-year period.

Discussion

Despite unprecedented investment in precision medicine, translation into practice is suboptimal. Our study will identify factors associated with the uptake of precision medicine in community settings. These findings will inform future interventions to increase equitable uptake of evidence-based targeted cancer treatment.
Gonadotropin Glycoforms Circulating in Women Using Progestins of the Levonorgestrel Family for Contraception
Authors: Eriksson Karin , Wide Leif
Published: August 2020

Context

The progestins of the levonorgestrel family are 13-ethylgonane progestins, commonly used for contraception in women. One contraceptive effect of these progestins is inhibition of ovulation, which may be a result of changes in gonadotropin glycosylation patterns. Gonadotropin glycoforms differ in number of glycans and bioactivity: more bioactive low-N-glycosylated glycoforms, diglycosylated luteinizing hormone (LHdi) and triglycosylated follicle-stimulating hormone (FSHtri), and less bioactive fully N-glycosylated glycoforms, LHtri and FSHtetra.

Objective

Characterize the glycosylation patterns on the circulating gonadotropin glycoforms in women using 13-ethylgonane progestins for contraception.

Design, Subjects, Main Outcome Measures

Serum samples, collected from 92 healthy women using 13-ethylgonane progestins for contraception, were included. Forty women used progestin-only continuously and 52 used progestins combined with ethinylestradiol (EE) for 3 weeks followed by a hormone-free week. Concentration, sulfonation, and sialylation of each glycoform were determined and compared with follicular phase values of normal menstrual cycles.

Results

The progestin-only group had significantly increased serum levels, decreased sulfonation, and increased sialylation of LHdi. The LHdi/FSHtri ratio was increased. The progestin+EE group had significantly decreased gonadotropin glycoform concentrations and decreased sialylation of FSHtri. The progestin+EE effect on sialylation of FSHtri occurred later during the treatment cycle in contrast to the effect on FSHtri concentration.

Conclusions

The 2 different progestin treatments induced different effects on the glycan synthesis and concentrations of more bioactive low-glycosylated gonadotropins. Progestin-only treatment increased sialylation and decreased sulfonation of LHdi molecules, contributing to sustained higher levels of bioactive LHdi molecules. Progestin+EE treatment decreased sialylation of FSHtri, contributing to a shorter half-life and decreased levels of bioactive FSHtri.
Class Struggle and Culture Wars in the Springtime of the French Revolution, Year II (1794)
Authors: Wahnich Sophie , Dunlop Alexander , Schafer Sylvia
Published: August 2020

In the spring of Year II (1794), the future of French society was uncertain. This article looks at the response to the uncertainty of three members of the Committee on Public Safety, who discussed the need to choose between a revolutionary political community and civil war, even as they disagreed about what form the future republic should take.
SDDP.jl: A Julia Package for Stochastic Dual Dynamic Programming
Authors: Dowson Oscar , Kapelevich Lea
Published: August 2020

We present SDDP.jl, an open-source library for solving multistage stochastic programming problems using the stochastic dual dynamic programming algorithm. SDDP.jl is built on JuMP, an algebraic modeling language in Julia. JuMP provides SDDP.jl with a solver-agnostic, user-friendly interface. In addition, we leverage unique features of Julia, such as multiple dispatch, to provide an extensible framework for practitioners to build on our work. SDDP.jl is well tested, and accessible documentation is available at https://github.com/odow/SDDP.jl .
Assessment of Leachate contaminated Groundwater Quality near Mandur Solid Waste Dumping Site, Bangalore
Authors: P RaviKumar , D. M Shridhar , K. L Prakash
Published: August 2020

Groundwater samples along with leachate were collected randomly around the municipal solid waste dumping at Mandur village, Bangalore. All the collected samples were analysed for physico-chemical parameters like pH, hardness, electrical conductivity, total dissolved solids, alkalinity, calcium, magnesium, sodium, potassium, chloride, nitrate, sulphate, phosphate using Standard APHA methods during April 2018 (pre-monsoon period). It is apparent from the results that 25.93, 33.34, 14.82 and 81.48 % of groundwater samples respectively recorded higher electrical conductivity (EC ≥ 1000 μS/cm), total dissolved solids ( TDS ≥ 500 mg/L), total hardness (TH ≥ 600 mg/L) and nitrate (NO3 ≥ 45 mg/L), attributed to an interaction between the leachate and the groundwater samples near the core zone. Remaining parameters were well below their respective drinking water quality standard limit.s The Sodium absorption ratio (SAR), Residual sodium carbonate (RSC) and percent sodium values illustrated the suitability of groundwater samples for agricultural practices. Though cluster analysis specified some sort of interaction to exist between leachate and few groundwater samples, analytical outcome of groundwater quality were against such interaction. Average concentration for various parameters in ground water samples were not much affected with leachate interaction. The unsuitability of groundwater for drinking purpose, removal of excess concentration and artificial recharge of groundwater by rainwater harvesting methods could reduce the groundwater pollution level.
Impact on Human Health Due to Ghaggar Water Pollution
Authors: Kant Pareek Ravi , Srivastava Prateek , S Khan Ambrina
Published: August 2020

The people living in Ghaggar river basin are facing various waterborne diseases due to polluted water of Ghaggar River. The quality of Ghaggar river water was tested and analysed during this study. A health survey was also conducted to strengthen the work. The results undoubtedly verify that the quality of Ghaggar river water is not suitable to withstand the aquatic life and not fit for domestic uses. The low dissolved oxygen level and other checked parameters are clearly indicating it. The observed maximum values of biochemical oxygen demand (BOD5), color, pH, total dissolved solids (TDS), chloride (Cl-),turbidity and chemical oxygen demand (COD) were 36 mg/l, 500 ptcu, 8.6, 1321 mg/l, 161 mg/l, 301 NTU and 265 mg/l respectively. Most probable number count of river was also carried out and it shows very high number and clearly indicating that the river has bad quality of water. To understand the possible relationship between the quality of river water and water-borne diseases amongst the locals, a questionnaire survey was also carried out. The waterborne diseases observed in the study area were Jaundice, Diarrhea, Typhoid, Hepatitis, Malaria etc.
Diversity of Tree Species in the District Science Centre Campus, Tirunelveli, Tamil Nadu
Authors: Priya P V , Rekha G S , Ganthi A Saravana
Published: August 2020

District Science Centre campus is not only a green lung for Tirunelveli City, but also aimed to create awareness about the biodiversity among the public. District Science Centre is committed towards developing a green campus, and established a Garden in achieving the commitment. It is the centre for higher learning, being both recreational and educative role; it will continually host a human population consisting of students and common public. The present study focused on tree diversity and their abundance in District Science Centre, Tirunelveli, Tamil Nadu, India. An extensive floristic survey was conducted in 2019. The results of tree diversity in District Science Centre campus showed 80 tree species. Among 80 species confined in 34 families and 68 genera, Polyalthia longofolia was the most dominant and frequent species in the study area. A total of 75 tree species represented by dicot and belong to 63 genera and 32 families were recorded. Out of the identified species, 5 tree species are monocot and belongs to 5 genera and 2 families. In the present study 14 families reported with only one species, 13 families represented by more than 2 species. During the study several anthropogenic activities exploited the tree population in the campus. Still Campus area is was still quite barren, so the entire campus should be lush greenery by new initiative on garden development.
Water Quality Assessment of Schools in Solan District of Himachal Pradesh
Authors: SHARMA AARTI , Aggarwal R K
Published: August 2020

Assessment of drinking water quality was done by selecting Nine Government senior secondary schools of three blocks in Solan district of Himachal Pradesh. The water quality parameters such as physical, chemical and biological parameters of water samples were analyzed. The water quality parameters such as temperature, pH, EC, TDS, temperature, BOD and COD ranged from 18.3 to 21.2°C,6.95 to 7.13, 0.24 to 0.51 dS m-1, 107.90 to 194.02 mg l-1, 0.69 to 2.26 mg l-1 and 56.50 to 119.75 mg l-1; trace elements (As, Cd, Zn, Pb, Cu, Mn and Ni) nil, 0.000 to 0.001 mg l-1, 0.001 to 0.003 mg l-1, 0.00 to 0.01 mg l-1, 0.00 to 0.02 mg l-1, 0.03 to 0.06 mg l-1 and 0.00 to 0.02 mg l-1respectively and biological parameters like total coliform as 20.00 to 54.00 MPN ml-1, which were within the permissible limits except Fe which ranged from 0.63 to 0.95 mg l-1 was above the permissible limits. The water quality index of drinking water for nine schools was in the rangeof 25.80 to 36.38,which categorized as excellent.
Posterior malleolar ankle fractures
Authors: Blom Robin P. , Hayat Batur , Al-Dirini Rami M. A. , Sierevelt Inger , Kerkhoffs Gino M. M. J. , Goslings J. Carel , Jaarsma Ruurd L. , Doornberg Job N. ,   EF3X-trial Study Group
Published: August 2020

Aims

The primary aim of this study was to address the hypothesis that fracture morphology might be more important than posterior malleolar fragment size in rotational type posterior malleolar ankle fractures (PMAFs). The secondary aim was to identify clinically important predictors of outcome for each respective PMAF-type, to challenge the current dogma that surgical decision-making should be based on fragment size.

Methods

This observational prospective cohort study included 70 patients with operatively treated rotational type PMAFs, respectively: 23 Haraguchi Type I (large posterolateral-oblique), 22 Type II (two-part posterolateral and posteromedial), and 25 (avulsion-) Type III. There was no standardized protocol on how to address the PMAFs and CT-imaging was used to classify fracture morphology and quality of postoperative syndesmotic reduction. Quantitative 3D-CT (Q3DCT) was used to assess the quality of fracture reduction, respectively: the proportion of articular involvement; residual intra-articular: gap, step-off, and 3D-displacement; and residual gap and step-off at the fibular notch. These predictors were correlated with the Foot and Ankle Outcome Score (FAOS) at two-years follow-up.

Results

Bivariate analyses revealed that fracture morphology (p = 0.039) as well as fragment size (p = 0.007) were significantly associated with the FAOS. However, in multivariate analyses, fracture morphology (p = 0.001) (but not fragment size (p = 0.432)) and the residual intra-articular gap(s) (p = 0.009) were significantly associated. Haraguchi Type-II PMAFs had poorer FAOS scores compared with Types I and III. Multivariate analyses identified the following independent predictors: step-off in Type I; none of the Q3DCT-measurements in Type II, and quality of syndesmotic reduction in small-avulsion Type III PMAFs.

Conclusion

PMAFs are three separate entities based on fracture morphology, with different predictors of outcome for each PMAF type. The current debate on whether or not to fix PMAFs needs to be refined to determine which morphological subtype benefits from fixation. In PMAFs, fracture morphology should guide treatment instead of fragment size. Cite this article: Bone Joint J 2020;102-B(9):1229–1241.
Increased fat depth is not associated with increased risk of surgical complications following total hip arthroplasty
Authors: Mayne Alistair I. W. , Cassidy Roslyn S. , Magill Paul , Diamond Owen J. , Beverland David E.
Published: August 2020

Aims

Previous research has demonstrated increased early complication rates following total hip arthroplasty (THA) in obese patients, as defined by body mass index (BMI). Subcutaneous fat depth (FD) has been shown to be an independent risk factor for wound infection in cervical and lumbar spine surgery, as well as after abdominal laparotomy. The aim of this study was to investigate whether increased peritrochanteric FD was associated with an increased risk of complications in the first year following THA.

Methods

We analyzed prospectively collected data on a consecutive series of 1,220 primary THAs from June 2013 until May 2018. The vertical soft tissue depth from the most prominent part of the greater trochanter to the skin was measured intraoperatively using a sterile ruler and recorded to the nearest millimetre. BMI was calculated at the patient’s preoperative assessment. All surgical complications occuring within the initial 12 months of follow-up were identified.

Results

Females had a significantly greater FD at the greater trochanter in comparison to males (median 3.0 cm (interquartile range (IQR) 2.3 to 4.0) vs 2.0 cm (IQR 1.7 to 3.0); p < 0.001) despite equivalent BMI between sexes (male median BMI 30.0 kg/m2 (IQR 27.0 to 33.0); female median 29.0 kg/m2 (IQR 25.0 to 33.0)). FD showed a weak correlation with BMI (R² 0.41 males and R² 0.43 females). Patients with the greatest FD (upper quartile) were at no greater risk of complications compared with patients with the lowest FD (lower quartile); 7/311 (2.3%) vs 9/439 (2.1%); p = 0.820 . Conversely, patients with the highest BMI (≥ 40 kg/m2) had a significantly increased risk of complications compared with patients with lower BMI (< 40 kg/m2); 5/60 (8.3% vs 18/1,160 (1.6%), odds ratio (OR) 5.77 (95% confidence interval (CI) 2.1 to 16.1; p = 0.001)).

Conclusion

We found no relationship between peritrochanteric FD and the risk of surgical complications following primary THA. Cite this article: Bone Joint J 2020;102-B(9):1146–1150.
Does screw position matter for guided growth in cerebral palsy hips?
Authors: Hsu Po-Jen , Wu Kuan-Wen , Lee Chia-Che , Lin Sheng-Chieh , Kuo Ken N. , Wang Ting-Ming
Published: August 2020

Aims

Guided growth has been used to treat coxa valga for cerebral palsy (CP) children. However, there has been no study on the optimal position of screw application. In this paper we have investigated the influence of screw position on the outcomes of guided growth.

Methods

We retrospectively analyzed 61 hips in 32 CP children who underwent proximal femoral hemi epiphysiodesis between July 2012 and September 2017. The hips were divided into two groups according to the transphyseal position of the screw in the coronal plane: across medial quarter (Group 1) or middle quarter (Group 2) of the medial half of the physis. We compared pre- and postoperative radiographs in head-shaft angle (HSA), Reimer’s migration percentage (MP), acetabular index (AI), and femoral anteversion angle (FAVA), as well as incidences of the physis growing-off the screw within two years. Linear and Cox regression analysis were conducted to identify factors related to HSA correction and risk of the physis growing-off the screw.

Results

A total of 37 hips in Group 1 and 24 hips in Group 2 were compared. Group 1 showed a more substantial decrease in the HSA (p = 0.003) and the MP (p = 0.032). Both groups had significant and similar improvements in the AI (p = 0.809) and the FAVA (p = 0.304). Group 1 presented a higher incidence of the physis growing-off the screw (p = 0.038). Results of the regression analysis indicated that the eccentricity of screw position correlated with HSA correction and increases the risk of the physis growing-off the screw.

Conclusion

Guided growth is effective in improving coxa valga and excessive femoral anteversion in CP children. For younger children, despite compromised efficacy of varus correction, we recommend a more centered screw position, at least across the middle quarter of the medial physis, to avoid early revision. Cite this article: Bone Joint J 2020;102-B(9):1242–1247.
Virtual congresses – the new normal? EFORT 2020 re-worked: The Virtual EFORT Congress (VEC) from 28 to 30 October 2020 is coming this way!
Authors: Overgaard Søren , Neyret Phillippe , Günther Klaus-Peter , Felländer-Tsai Li
Published: August 2020

Cite this article: EFORT Open Rev 2020;5:519-521. DOI: 10.1302/2058-5241.5.200300
Change Management System (CMS) Evaluation: A Case Study in a Multinational Manufacturing Company in Malaysia
Authors: Shariff S. Sarifah Radiah , Nasir K. N. M. Nasir , Ramli Noor Asiah , Zahari Siti Meriam
Published: August 2020

Changes can be defined as modification of the form, fit or function of an object such as a process or a product. Changes can be positive or negative but in general, making changes show that a company is progressing and improving. A company can choose to take initiative to change or just wait for external forces depending on its necessity or requirement. In some cases, change is not favourable unless it is really necessary as it involves time and money as well as other resources. Due to this, a good change management is necessary so that changes can be monitored effectively. A dynamic and timely change management is important in order to ensure that the company does not fall behind in being competitive in the industry. This study focuses on the evaluation of the change management system in a manufacturing company. Focus is given to the measurement of the change process which has been agreed to be due to cycle time in which an ideal cycle time for the change process is simulated. Based on Monte Carlo simulation, it is figured that the overall cycle time can be improved by 35%. At the same time, other effectiveness measure is also identified to improve the management system of the company.
L’experiència laerciana de Gonçalo M. Tavares: Una lectura de la tradició clàssica a "Histórias falsas"
Authors: Grau Sergi
Published: August 2020

Com ja ha estat prou sovint i encertadament assenyalat per la crítica, Histórias falsas (2005) forma part, juntament amb Os velhos também querem viver (2014), de la sèrie Estudos Clássicos, amb què Gonçalo M. Tavares, un dels escriptors portuguesos emergents més valorats dels darrers anys, encara la seva particular visió i aprofitament de la tradició clàssica. En aquest article proposem que l’experiència fonamental de l’autor per al plantejament i la construcció narrativa de bona part de les diverses peces breus que conformen l’obra fou la lectura de les Vides i doctrines dels filòsofs més il·lustres, de Diògenes Laerci.
Una visió epicúria de la vellesa a "El conte explicat pel mercader" de Geoffrey Chaucer
Authors: Jufresa Montserrat
Published: August 2020

“El conte explicat pel Mercader”, inclòs a Els contes de Canterbury de Geoffrey Chaucer, relata el casament entre  un vell cavaller, Gener, i una núvia jove, Maig. La història acaba feliçment, amb un adulteri de l’esposa acceptat pel marit. El caràcter del vell Gener està descrit amb els atributs d’un practicant de la doctrina epicúria, tal com aquesta era entesa a l’Edat Mitja.
El diàleg com a forma. Usos antics i moderns
Authors: Mestre Roca Francesca
Published: August 2020

És habitual llegir que el diàleg va ser inventat, com a forma escrita, a l’Atenes democràtica i que l’obra de Plató n’és l’origen tant des del punt de vista literari com filosòfic. Després de Plató, a l’antiguitat, la forma continua viva, sovint amb la voluntat de seguir l’autoritat que expressar-se com Plató representava, però no sempre, ja que diàlegs com els de Llucià, per exemple, són igualment celebrats però en realitat tenen ben poca cosa de l’esprit amb el qual Plató s’hi va posar. El propòsit d’aquesta comunicació és fer un breu repàs dels canvis que experimenta la forma del diàleg a la mateixa antiguitat i veure’n la petja en els diàlegs de Paul Valéry, amb l’objectiu d’escatir quina mena de tradició clàssica comporta la utilització d’aquesta forma.
L’‘epitafio’ di Argo. Osservazioni sul lessico funerario in Hom. Od. 17.291-327
Authors: Franceschini Alice
Published: August 2020

in Hom. Od. 17.291-327, l’episodio del riconoscimento di Odisseo da parte del cane Argo. Nei luoghi analizzati, la dizione omerica sembra essere debitrice di tradizionali formulari espressivi funerari e influenzare a sua volta alcuni carmi epigrafici di epoca successiva. Un’attenzione particolare viene dedicata a due passaggi significativi. Al v. 312 il cane è presentato come il sema vivente del padrone, mentre riguardo ai vv. 326-327 si avanza l’ipotesi che potessero essere percepiti dai fruitori come un ‘epitafio orale’ di Argo: vi si riconoscono un uso del verbo ἰδεῖν simile a quello reperibile in numerosi epigrammi funerari e altri elementi tematici e formali caratteristici delle iscrizioni tombali, analizzati nello studio.
244. A virada geopolítica no Brasil do século XXI observada a partir de telegramas diplomáticos vazados pelo Wikileaks
Authors: Barros Gabriel Teixeira
Published: August 2020

A virada geopolítica que ocorreu no Brasil a partir de 2016, com o impeachment da Presidente Dilma Rousseff, se relacionou com a rede financeira de poder mundial. Este estudo pretende demonstrar tal fato, apresentando dados sobre a ascensão das políticas neoliberais no Brasil, nos anos 1990, e sobre a gradual ruptura política iniciada em 2003, com o governo de Luís Inácio Lula da Silva. Tal ruptura foi evidenciada nos grampos de telegramas diplomáticos estadunidenses e outros documentos disponibilizados pelo Wikileaks, por meio do posicionamento diplomático dos EUA sobre as disputas eleitorais brasileiras que ocorreram em 2010 e em 2014, a legislação de Exploração e Produção (EP) das reservas de petróleo do Pré-sal, a cibervigilância interestatal e a criação do “Projeto Pontes”, anterior à Operação Lava Jato. Por meio de análise em documentos publicados pelo Wikileaks, é possível demonstrar como a política interna brasileira foi influenciada pelo uso de soft power, por agentes vinculados aos interesses geopolíticos estadunidenses, no período pesquisado.
Infracciones de la Ley Orgánica de Protección de Datos en el ámbito sanitario. Descripción estadística de las infracciones
Authors: Palomo Navarro Manuel
Published: August 2020

La Ley Orgánica de Protección de Datos (LOPD) es necesaria para garantizar el derecho a la intimidad reconocido en la Constitución Española. La gestión de los datos personales debe ser especialmente sensible en el ámbito sanitario por las características de los protegidos. Este trabajo revisa las resoluciones dictadas desde el 28 de octubre de 2005 hasta el 29 de octubre de 2018 por la Agencia Española de Protección de Datos (AEPD), agrupando las infracciones por frecuencia de infracción y describiendo las peculiaridades de algunas resoluciones. En la medida de la información aportada por la denuncia, se trata de valorar la intención de la misma.