bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal Adductor Avulsion: A Biomechanical Comparison of Suture Anchor Repair Techniques
Authors: Golan Elan J. , Yohe Nicholas , Schilders Ernest M. J. , Bharam Srino
Published: July 2019

Objectives:

Acute avulsion of the proximal fibrocartilaginous origin of the adductor longus (AL) is an injury mostly occurring in individuals that perform cutting and rapid lateral movements such as in hockey, soccer, and rugby. Especially in competitive athletes, recent trends have advocated for surgical repair of these acute injuries. However, while multiple repair configurations have been proposed, the current literature lacks biomechanical data to guide surgical technique. Therefore, the purpose of this study was to determine load-to-failure values for two proximal adductor repair techniques and to compare their strength to that of a native, uninjured proximal adductor tendon.

Methods:

Seventeen cadaveric fresh frozen pelvic specimens were dissected to preserve the proximal adductor tendon and the fibrocartilage attachment to the pubis. The specimens were then divided into three groups: an intact AL tendon(baseline control), and ‘torn’ tendons repaired with either a 2-suture anchor or 4-suture anchor technique. Once repaired, specimens were cyclically loaded on a custom jig to simulate a maximal effort soccer-style kick. Testing endpoints included suture anchor pull-out, loss of clamp fixation, or catastrophic tendon failure. To control for individual differences, values were reported both in terms of gross force and as load-to-displacement ratios. Following collection, data from each of the three groups were recorded and analyzed via Kruskal-Wallis and multiple comparison tests.

Results:

The mean load to failure for the 4-anchor group was 83.74±19.28 N, which was significantly greater than for either the intact (25.43±3.46 N, p <0.05) or 2-anchor repair (20.58±1.33 N, p <0.001) conditions. All intact and 4-anchor repair specimens failed via disruption distal to the adductor’s musculotendinous junction, with no failure at the bone-anchor interface noted in either of these groups. In contrast, 80% of 2-anchor repairs failed at the bone to anchor interface. In this group, following initial pullout, failure of a secondary anchor occurred with 41.4% less force than for the index failure (p < 0.001).

Conclusion:

This study provides biomechanical data which identifies a 4-anchor repair as being much more resistant to surgical-site failure than a 2-anchor construct. Further, the 4-anchor group failed at the same anatomic location as the intact adductor group, suggesting that a 4-anchor construct results in a repair that acts similar to an uninjured control. Based on this finding, a 4-anchor repair construct should be preferentially used in proximal adductor repair whenever clinically feasible. [Figure: see text][Figure: see text]
Minimum 5-Year Outcomes of Arthroscopic Hip Labral Reconstruction with Nested Matched-Pair Benchmarking Against a Labral Repair Control Group
Authors: Domb Benjamin G. , Battaglia Muriel R. , Perets Itay , Lall Ajay C. , Chen Austin , Ortiz-Declet Victor , Maldonado David R.
Published: July 2019

Objectives:

Labral reconstruction has demonstrated short-term benefit for the treatment of irreparable labral tears. Nonetheless, there is a scarcity of evidence for mid-term outcomes of this treatment. The purpose of our study was to report 5-year outcomes in patients who underwent segmental labral reconstruction. In addition, we compared 5-year outcomes of patients who underwent primary segmental labral reconstruction (PLRECON) with a matched-pair control group that underwent primary labral repair (PLREPAIR). We hypothesized that arthroscopic segmental reconstruction in the setting of irreparable labral tears would show improvement in patient-reported outcomes (PROs) and high patient satisfaction at minimum 5-year follow-up. Secondly, PLRECON would experience similar improvement in PROs at minimum 5-year follow-up when compared to a matched-pair PLREPAIR control group.

Methods:

Data from February 2008 to April 2013 was retrospectively reviewed. Patients were included if they underwent hip arthroscopy for segmental labral reconstruction in the setting of irreparable labral tear and femoro-acetabular impingement (FAI), with minimum 5-year follow-up for modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and Visual Analogue Scale (VAS) for pain. Exclusion criteria were Tönnis osteoarthritis grade >1, prior hip conditions, or Workers’ Compensation claims. PLRECON were matched in a 1:3 ratio to a PLREPAIR group based on age ±5 years, gender, and body mass index (BMI) ±5 kg/m2.

Results:

Twenty-eight patients were eligible for the study, of which 23 (82.14%) had minimum 5-year follow-up. We found significant improvement from preoperative to latest follow-up in all outcome measures recorded: 17.8-point increase in mHHS (P=0.002), 22-point increase in NAHS (P<0.001), 25.4-point increase in HOS-SSS (P=0.003), and a 2.9-point decrease in VAS pain ratings (P<0.001). Average patient satisfaction was 7.1 out of 10. In the nested matched-pair analysis, 17 PLRECON were matched to a control group of 51 PLREPAIR patients. PLRECON demonstrated comparable survivorship and comparable improvements in all PROs with the exception of patient satisfaction.

Conclusion:

Hip arthroscopy with segmental labral reconstruction resulted in significant improvement in PROs at minimum 5-year follow-up. PLRECON reached comparable functional outcomes when compared to a benchmark PLREPAIR control group, but demonstrated lower patient satisfaction at latest follow-up. [Figure: see text]
Acetabular Debridement Demonstrates Similar Outcomes and Survival to Microfracture in Hip Arthroscopy: A Multi-Center Analysis
Authors: Hevesi Mario , Bernard Christopher D. , Hartigan David Edward , Levy Bruce A. , Domb Benjamin G. , Krych Aaron John
Published: July 2019

Objectives:

Hip arthroscopy is becoming more advanced and commonly performed. However, significant controversy exists regarding whether high grade acetabular cartilage lesions should be treated with debridement or microfracture. In addition, patients treated with microfracture are subject to extended partial weight-bearing rehabilitation in order to mitigate risk of subchondral plate fracture and protect fibrocartilage tissue formation. The purpose of this study was to determine the mid-term patient-reported outcomes and failure rate and patient-reported outcomes of Grade 3 and 4 acetabulum labrum articular disruption (ALAD) lesions managed with microfracture or debridement.

Methods:

Primary arthroscopic labral repair cases at two centers from November 2008 to April 2016 were reviewed in patients aged < 55 years with unipolar ALAD Grade 3 and 4 pathology. Patients undergoing microfracture and debridement were compared using visual analog pain scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score - Sports Specific Subscale (HOS-SSS) to determine predictors of outcomes and failure.

Results:

127 hips in 123 patients (47 M, 76 F, mean age 34.7 ± 11.1) undergoing debridement (n = 95) or microfracture (n = 32) were followed for a mean of 4.9 years (range 2.0 - 8.5). Patients undergoing debridement achieved 3.5 point mean improvements in VAS (p < 0.01), 20.9 point improvements in mHHS (p < 0.01), and 25.5 point improvements in HOS-SSS (p < 0.01), which was statistically similar to that observed in microfracture patients (p ≥ 0.19). Five-year survival free of revision surgery was 83.0% in the debridement group and 85.6% in the microfracture group (p = 0.85). Cartilage treatment technique was found not to be predictive of revision risk during both univariate (p = 0.84) and multivariate (p = 0.84) analysis.

Conclusion:

Patients undergoing debridement of high grade unipolar acetabular cartilage lesions demonstrate similar patient reported outcome scores and revision rates compared to patients undergoing microfracture. These outcomes support debridement of acetabular lesions in order to optimize recovery while maintaining established positive outcomes following hip arthroscopy. [Table: see text]
Role of the Long Head of the Biceps During Active Pitching in Healthy Collegiate Athletes: An Electromyographic Evaluation
Authors: Gowd Anirudh K. , Luchetti Timothy , Birlingmair Jacob , Verma Nikhil N. , Romeo Anthony A. , Zaferiou Antonia
Published: July 2019

Objectives:

Supraphysiologic forces placed on the glenohumeral joint during pitching leads to a high incidence of bicipital-labral pathology in competitive pitchers. Heavy debate in operative management between biceps tenodesis, labral repair, and debridement warrants further study in the role of the biceps during pitching. The purpose of this study was to evaluate the recruitment of the long and short heads of the biceps utilizing electromyographic evaluation and correlate activity with pitch velocity.

Methods:

Seventeen healthy, competitive, pitchers were recruited and consented to pitch in a controlled laboratory setting, under electromyographic observation. Surface electromyography (sEMG) was performed via electrodes placed on either head of the biceps, deltoid, infraspinatus, and latissimus dorsi, band pass filtered between 10-500 Hz and sampled at a rate of 1500 Hz during the pitching motion. sEMG was normalized to maximal volumetric isometric contraction (MVIC) via manual muscle testing (MMT). Pitch velocity was measured using a Speedster III radar gun, and then correlated to sEMG readings.

Results:

Average age of recruited subjects was 19.8 ± 1.4 years old. Average number of years pitched was 10.3 ± 3.6 years. Fourteen players reported their highest level of play was college, while two reported semi-professional, and one reported high-school. Average pitch velocity from included pitches was 70.6 ± 4.0 (range: 61 - 79). sEMG signals were interpreted in three modalities: median signal, integral sum of all signals, and time spent (ms) above 10% MVIC. Pitch velocity did not correlate to any sEMG analysis (p>0.05) by bivariate linear regression. Coefficient of variation was greater between pitchers than within pitchers. Greater than 80% of pitchers demonstrated statistically different activation of the long head of biceps muscle (LHBM) versus short head of biceps muscle (SHBM) (Figure 1). Three players had significantly greater short head activation, while 12 players had significantly greater long head activation.

Conclusion:

The long and short heads of the biceps are consistently activated during pitching, suggested they have a role during the late cocking and deceleration phase of pitching, although not correlated to ball acceleration. Preferential recruitment of either long or short head biceps suggest variability in fast ball pitching styles, that warrant further research for clinical implications. [Figure: see text]
Little Leaguer’s Shoulder Caused Severe Humeral Retroversion: Ultrasonographic Analysis
Authors: Mihata Teruhisa , Neo Masashi
Published: July 2019

Objectives:

The increased humeral retroversion on the dominant side in throwing athletes is thought to result from repetitive throwing motion. In the previous studies, the degree of increased humeral retroversion was various, suggesting that other factors may affect humeral retroversion. Little Leaguer’s shoulder, which is rotational stress fracture of the proximal humeral epiphyseal plate, may change humeral retroversion. The purpose of this study was to investigate effect of Little Leaguer’s shoulder on humeral retroversion.

Methods:

Ten high-school baseball players (average, 16.6 years; range, 16 to 18 years), who had had Little Leaguer’s shoulder during elementary or junior high schools (average, 12.6 years; range, 11 to 15 years), were enrolled in the study. As a control group, 22 high-school baseball players (average, 16.9 years; range, 16 to 18 years), who have never had shoulder or elbow pain, were included in this study. Humeral retroversion was ultrasonographically measured on the dominant and non-dominant sides. Humeral retroversion was compared between dominant and non-dominant shoulders with paired t-test. Side-to-side difference in humeral retroversion was compared between Little Leaguer’s shoulders and control group with unpaired t-test.

Results:

Humeral retroversion was significantly greater on the dominant side than on the non-dominant side in both Little Leaguer’s shoulder (Dominant, 104°±8°; Non-dominant, 84°±12°; P < .001) and control groups (Dominant, 91°±13°; Non-dominant, 81°±10°; P < .001). The side-to-side difference in humeral retroversion in Little Leaguer’s shoulder group (20°±10°) was significantly greater than that in control group (10°±10°, P = .02).

Conclusion:

Humeral retroversion was increased with repetitive throwing motion without any symptom in the shoulder and elbow joint. Additional increase in humeral retroversion was made when the players had had Little Leaguer’s shoulder in elementary or junior high school.
Microvascular hand surgery for digital ischemia in scleroderma
Authors: Satteson Ellen S , Chung Melody P , Chung Lorinda S , Chang James
Published: July 2019

Periarterial sympathectomy and arterial bypass are microsurgical techniques which the literature suggests can provide improvement in digital pain and ulceration in patients with systemic sclerosis who have persistent symptoms despite medication management. This review summarizes the relevant anatomy, medical therapies, operative techniques, and surgical outcomes and complications associated with the management of the vascular manifestations of systemic sclerosis in the hand. Multidisciplinary collaboration between dermatology, rheumatology, and hand surgery can facilitate optimal medical and surgical management for systemic sclerosis patients.
Central retinal vein occlusion associated with platelet activation
Authors: Citirik Mehmet
Published: July 2019

Purpose:

The aim of this article is to determine and compare the platelet activation by three main platelet activation parameters: mean platelet volume, platelet distribution width, and plateletcrit in patients with central retinal vein occlusion and control subjects.

Methods:

This study included 30 patients with nonischemic central retinal vein occlusion and 30 control subjects. The levels of mean platelet volume, platelet distribution width, and plateletcrit were measured in all groups.

Results:

The mean serum level of mean platelet volume was 10.01 ± 0.89 fl in central retinal vein occlusion group and 8.74 ± 1.45 fl in control group. The mean serum level of platelet distribution width was 14.31 ± 1.49% and 11.65 ± 1.81% in central retinal vein occlusion group and control group, respectively. Mean serum plateletcrit value was 0.27 ± 0.07% in central retinal vein occlusion group and 0.23 ± 0.07% in control group. Mean platelet volume, platelet distribution width, and plateletcrit levels were significantly higher in central retinal vein occlusion patients than controls ( p < 0.05).

Conclusion:

Subclinical platelet activation reflected by mean platelet volume, platelet distribution width, and plateletcrit may have an impact on the genesis of vessel occlusion in central retinal vein occlusion. The results may be important for the clinical management of patients with central retinal vein occlusion.
Premature Ejaculation: Do We Need to Address the Issue Differently?
Authors: M. Shivalingaiah , S. Anuradha , Bhat Gajanan S.
Published: July 2019

Introduction: Premature ejaculation is a complex condition with controversial management modalities. We decided to assess the treatment-seeking behavior of affected couples, which is an indirect indicator of the efficacy of the present management modalities of premature ejaculation.

Materials and Methods: Couples, who reported premature ejaculation at our outpatient clinics between January 2015 and December 2016, were enrolled in the study. Patients with acquired causes for premature ejaculation were excluded. Both the partners were administered premature ejaculation diagnostic tool (PEDT) questionnaire separately at the time of initiation of the study and after 1 month. They were asked to report intravaginal ejaculatory latency time (IELT) and their treatment-seeking behavior at these time intervals. The couples were counselled regarding their diagnosis and offered treatment with dapoxetine 30 mg as and when required.

Results: A total of 117 couples with an average married life of 5.4 years were enrolled for the study. Among these, 68 had premature ejaculation (PE), 30 had probable PE and 19 had no PE as estimated on PEDT. Post treatment, 55% of couples with PE, 47% of couples with probable PE and 55% of couples without PE wanted to continue treatment seeking despite improvement. Female partners had the desire to seek treatment despite the male partner reporting otherwise.

Conclusion: The treatment seeking behavior of the affected couple indicates the inefficacy of the present management modalities of PE. As specialized health care providers, we need to address these concerns to provide a comprehensive solution to their problems.
Polycystic Ovary Syndrome (PCOS) and Sexual Dysfunctions
Authors: Koneru Amulya , S Priyanka
Published: July 2019

Objectives: Polycystic ovary syndrome (PCOS) is a very common endocrine disorder affecting 5% to 10% of women in reproductive age all over the world. Many comorbidities have been associated with PCOS including infertility, obesity, depression, anxiety, hirsutism, alopecia, and sexu al dysfunctions. In this paper, we have reviewed the available Indian and international literature regarding psychiatric and sexual comorbidities of PCOS.

Methods: PubMed, Cochrane, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘polycystic ovary syndrome’, ‘PCOS’, ‘infertility and PCOS’, ‘sexual dysfunctions and PCOS’, etc.

Results: For this review, we could find about 90 papers pertaining to the subject. Most of them focused on the effect of infertility and symptoms of PCOS such as hirsutism on body image and sexual dysfunctions. Meta-analyses showed that women with PCOS had poor rates of sexual desire, orgasm, and lubrication. Body image often had a negative impact on sexual thoughts and fantasies.

Conclusion: Focus on sexual dysfunctions in PCOS has been emphasized only recently after high rates of its prevalence have been found. Hence, management of PCOS involves a multidisciplinary approach where proper assessment and management of sexual dysfunctions should be given its due importance.
A randomised controlled trial to investigate the use of high-frequency airway oscillations as training to improve dyspnoea in COPD
Authors: Daynes Enya , Greening Neil , Siddiqui Salman , Singh Sally
Published: July 2019

Introduction

Chronic obstructive pulmonary disease (COPD) is characterised by expiratory flow limitation resulting in symptomatic dyspnoea, sputum retention and ventilation heterogeneity. Changes in breathing mechanics affect the ability of respiratory muscles to respond to the ventilatory demands, increasing the sensation of dyspnoea. A high-frequency airway oscillating device has been developed to combine respiratory muscle training and oscillations to improve dyspnoea and sputum retention within COPD.

Methods and analysis

Patients with symptomatic COPD (Medical Research Council Breathlessness scale grade ≥2) will be recruited to a double-blind, randomised, sham-controlled trial. Both groups will follow an 8-week intervention phase using the device three times per day for 5 min at a time. This will be recorded in a self-reported diary. The device applies a flow resistive load and oscillations for combined training. Those receiving the sham device will follow the same protocol; however, the mechanism of action will be removed from the device. Improvements in the Chronic Respiratory Questionnaire-Dyspnoea domain will be the primary outcome measure. Secondary outcomes will explore respiratory muscle function, health-related quality of life, exercise capacity and physical activity. The Lung Clearance Index will be an exploratory outcome. Outcomes will be explored using the most appropriate statistical test, dependent on the sample distribution. Focus groups will be an exploratory outcome and analysed by thematic analysis.

Ethics and dissemination

Ethical approval has been obtained from the East Midlands-Leicester South Research Ethics Committee and the trial has been registered through the ISRCTN Registry. The study results will be disseminated to the appropriate stakeholders through presentations, conferences and peer-reviewed journals.
Home-based tuberculosis contact investigation in Uganda: a household randomised trial
Authors: Davis J. Lucian , Turimumahoro Patricia , Meyer Amanda J. , Ayakaka Irene , Ochom Emma , Ggita Joseph , Mark David , Babirye Diana , Okello Daniel Ayen , Mugabe Frank , Fair Elizabeth , Vittinghoff Eric , Armstrong-Hough Mari , Dowdy David , Cattamanchi Adithya , Haberer Jessica E. , Katamba Achilles
Published: July 2019

Introduction

The World Health Organization (WHO) recommends household tuberculosis (TB) contact investigation in low-income countries, but most contacts do not complete a full clinical and laboratory evaluation.

Methods

We performed a randomised trial of home-based, SMS-facilitated, household TB contact investigation in Kampala, Uganda. Community health workers (CHWs) visited homes of index patients with pulmonary TB to screen household contacts for TB. Entire households were randomly allocated to clinic (standard-of-care) or home (intervention) evaluation. In the intervention arm, CHWs offered HIV testing to adults; collected sputum from symptomatic contacts and persons living with HIV (PLWHs) if ≥5 years; and transported sputum for microbiologic testing. CHWs referred PLWHs, children <5 years, and anyone unable to complete sputum testing to clinic. Sputum testing results and/or follow-up instructions were returned by automated SMS texts. The primary outcome was completion of a full TB evaluation within 14 days; secondary outcomes were TB and HIV diagnoses and treatments among screened contacts.

Results

There were 471 contacts of 190 index patients allocated to the intervention and 448 contacts of 182 index patients allocated to the standard-of-care. CHWs identified 190/471 (40%) intervention and 213/448 (48%) standard-of-care contacts requiring TB evaluation. In the intervention arm, CHWs obtained sputum from 35/91 (39%) of sputum-eligible contacts and SMSs were sent to 95/190 (50%). Completion of TB evaluation in the intervention and standard-of-care arms at 14 days (14%versus15%; difference −1%, 95% CI −9% to 7%, p=0.81) and yields of confirmed TB (1.5%versus1.1%, p=0.62) and new HIV (2.0%versus1.8%, p=0.90) diagnoses were similar.

Conclusions

Home-based, SMS-facilitated evaluation did not improve completion or yield of household TB contact investigation, likely due to challenges delivering the intervention components.
Low dose chloroquine decreases insulin resistance in human metabolic syndrome but does not reduce carotid intima-media thickness
Authors: McGill Janet B. , Johnson Mariko , Hurst Stacy , Cade William T. , Yarasheski Kevin E. , Ostlund Richard E. , Schechtman Kenneth B. , Razani Babak , Kastan Michael B. , McClain Donald A. , de las Fuentes Lisa , Davila-Roman Victor G. , Ory Daniel S. , Wickline Samuel A. , Semenkovich Clay F.
Published: July 2019

Background

Metabolic syndrome, an obesity-related condition associated with insulin resistance and low-grade inflammation, leads to diabetes, cardiovascular diseases, cancer, osteoarthritis, and other disorders. Optimal therapy is unknown. The antimalarial drug chloroquine activates the kinase ataxia telangiectasia mutated (ATM), improves metabolic syndrome and reduces atherosclerosis in mice. To translate this observation to humans, we conducted two clinical trials of chloroquine in people with the metabolic syndrome.

Methods

Eligibility included adults with at least 3 criteria of metabolic syndrome but who did not have diabetes. Subjects were studied in the setting of a single academic health center. The specific hypothesis: chloroquine improves insulin sensitivity and decreases atherosclerosis. In Trial 1, the intervention was chloroquine dose escalations in 3-week intervals followed by hyperinsulinemic euglycemic clamps. Trial 2 was a parallel design randomized clinical trial, and the intervention was chloroquine, 80 mg/day, or placebo for 1 year. The primary outcomes were clamp determined-insulin sensitivity for Trial 1, and carotid intima-media thickness (CIMT) for Trial 2. For Trial 2, subjects were allocated based on a randomization sequence using a protocol in blocks of 8. Participants, care givers, and those assessing outcomes were blinded to group assignment.

Results

For Trial 1, 25 patients were studied. Chloroquine increased hepatic insulin sensitivity without affecting glucose disposal, and improved serum lipids. For Trial 2, 116 patients were randomized, 59 to chloroquine (56 analyzed) and 57 to placebo (51 analyzed). Chloroquine had no effect on CIMT or carotid contrast enhancement by MRI, a pre-specified secondary outcome. The pre-specified secondary outcomes of blood pressure, lipids, and activation of JNK (a stress kinase implicated in diabetes and atherosclerosis) were decreased by chloroquine. Adverse events were similar between groups.

Conclusions

These findings suggest that low dose chloroquine, which improves the metabolic syndrome through ATM-dependent mechanisms in mice, modestly improves components of the metabolic syndrome in humans but is unlikely to be clinically useful in this setting.

Trial registration ClinicalTrials.gov (NCT00455325, NCT00455403), both posted 03 April 2007
The middle fossa approach with self-drilling screws: A novel technique for BONEBRIDGE implantation
Authors: You Peng , Siegel Lauren H. , Kassam Zahra , Hebb Matthew , Parnes Lorne , Ladak Hanif M. , Agrawal Sumit Kishore
Published: July 2019

Background

Bone conduction implants can be used in the treatment of conductive or mixed hearing loss. The BONEBRIDGE bone conduction implant (BB-BCI) is an active, transcutaneous device. BB-BCI implantation can be performed through either the transmastoid or retrosigmoid approach with their respective limitations. Here, we present a third, novel approach for BB-BCI implantation.

Objective

Describe the detailed surgical technique of BB-BCI implantation through a middle fossa approach with self-drilling screws and present preliminary audiometric outcome data following this approach.

Methods

A single institution, retrospective chart review was completed for patients implanted with the BB-BCI via the middle fossa approach. Preoperative planning and modelling were performed using 3D Slicer. Audiological testing was performed pre- and post-operatively following standard audiometric techniques.

Results

Forty patients underwent BB-BCI implantation using the middle fossa approach. Modelling techniques allowed for implantation through the use of external landmarks, obviating the need for intraoperative image guidance. The surgical technique was refined over time through experience and adaptation. Mean follow-up was 29 months (range 3–71 months) with no surgical complications, favourable cosmesis, and expected audiometric outcomes. An average functional gain of 39.6 dB (± 14.7 SD) was found.

Conclusion

The middle fossa technique with self-drilling screws is a safe and effective option for BONEBRIDGE implantation. As a reference for other groups considering this approach, an annotated video has been included as a supplement to the study.
Epoxidized methyl ricinoleate bio-plasticizer with a pendant acetate ester for PVC artificial material: circumventing existing limit on achievable migration resistance
Authors: Pan Siyu , Hou Delong , Yang Gaofu , Xie Qiuping , Yan Sunxian , Zeng Qi , Wang Zhonghui , Chen Yi , Fan Haojun
Published: July 2019

Processing polyvinyl chloride (PVC) artificial material requires plasticizer that softens the PVC coating. Currently, utilizing unsaturated fatty acid methyl esters to obtain epoxidized fatty acid methyl ester (EFAME) bio-plasticizers constitutes an environmentally responsible solution to substitute conventional ortho-phthalates that are endocrine disruptors or probable carcinogens. However, commercial EFAMEs, even with the highest epoxy value (ca. 5.5–5.8%) so far, still suffer from fast leaching from the PVC matrix, burdening the environment and shortening lifespan of the artificial material. Here, we report a proof-of-principle demonstration of a new strategy to obtain migration-resistant EFAME that harnesses the midchain hydroxyl of methyl ricinoleate and covalently attachment of a pendant acetate ester. Despite a low epoxy value (3.0%), the engineered bio-plasticizer displays significantly suppressed migration in multiple scenarios compared with one conventional EFAME with much higher epoxy value (5.8%). Circumventing the limit confronting previous strategy that highlights the sole contribution of epoxy value to achievable migration resistance, the rationale herein may provide guidance for designing new EFAMEs with comparable performance to ortho-phthalates, thus bringing the old and oft-maligned PVC artificial material industry one step closer to sustainability.
Parkinson Disease
Authors: Zesiewicz Theresa A.
Published: July 2019

PURPOSE OF REVIEW

Parkinson disease is a common neurodegenerative disorder that affects millions of people worldwide. Important advances in the treatment, etiology, and the pathogenesis of Parkinson disease have been made in the past 50 years. This article provides a review of the current understanding of Parkinson disease, including the epidemiology, phenomenology, and treatment options of the disease.

RECENT FINDINGS

Parkinson disease is now recognized to be a heterogeneous condition marked by both motor and nonmotor symptoms. It is composed of preclinical, prodromal, and clinical phases. New medications with improved ease of administration have been approved for its treatment. Innovative surgical therapies for Parkinson disease may be used when motor symptoms persist despite optimal medical management.

Parkinson disease is a complex, heterogeneous neurodegenerative disorder. Considerable progress has been made in its treatment modalities, both pharmacologic and surgical. While its cure remains elusive, exciting new research advances are on the horizon.
Raining Blood: Spiritual Power, Gendered Violence, and Anticolonial Lives in the Nineteenth-Century Dominican Borderlands
Authors: Eller Anne
Published: July 2019

This essay offers an intellectual history of the armed mobilizations that traversed the highlands and valleys of the Dominican Republic's southern borderlands during the last decades of the nineteenth century, finding at their very heart a spiritually grounded defense of autonomy within an embattled geography of community and freedom. The residents of these highlands and the San Juan Valley mounted repeated guerrilla movements against the island's two capitals in service of defending the whole island's independence; unlike borderlands struggles elsewhere, residents forged these campaigns long before any capital transformations encroached on their own territory. The essay analyzes the spiritual, political, and geographic logic of self-rule that these individuals invoked and also, critically, the gendered cost of violence that these campaigns fostered. The success of these anticolonial struggles highlights the profound fugitive history of the center island, just as it rewrites narratives of exclusivist Dominican nationalism in the present day.
Back to Agriculture?
Authors: Freni Giuseppe , Salvadori Neri , Signorino Rodolfo
Published: July 2019

Malthus’s main economic argument against free corn trade in his Essay on Population concerned the issue of structural change triggered by international trade. Malthus claimed that, in the long run, agricultural countries will develop their domestic industrial sectors and cut both their corn exports and their imports of foreign industrial goods. We critically assess Malthus’s views and compare them with Torrens 1815 and Ricardo 1822. We argue that the weak point of Malthus’s reasoning lies in his inability to perceive that an international trade-induced structural change process is at work both in agricultural and manufacturing countries. Moreover, we show that, notwithstanding the broad similarity of their conclusions, Torrens and Ricardo followed two analytically different paths.
Neoliberalism and Embodied Precarity
Authors: Shildrick Margrit
Published: July 2019

The term neoliberalism has appeared in the policies of the Global North for several decades, with the concept of precarity in employment practices coming from the same period. In the last few years, however, precarity has been embodied and personalized, coming to signify not only an epistemological category but something more akin to an ontological state that raises complex questions of identity. My contribution uses it in that latter sense and will take the links between precarity, debility, and more specifically disability as central concerns. In feminist thought in particular, precarity mobilizes both a critical perspective on neoliberalism and a transformative prospective. It allows us to both acknowledge and go beyond a concern with inequities of power, which so strongly signal an expectation of negativity and lack of social justice, to ask how the notion of precarious bodies might already signal a potential for communality and promote the strength of relationality. Rather than following the familiar path of putting the globalization of inequality center stage and calling for new social and political rights for disabled people that take account of their asymmetric specificities, I want to disturb some of the issues—and not least the unproblematized resort to identity categories—through thinking the phenomenological implications of global intercorporeality. As one highly significant aspect of contemporary globalization, neoliberalism pursues a policy of putative self-dependency and rational self-management that seem at odds with the widely recognized capacity of globalization to undermine the certainties of spatial and temporal orientations. While the latter clearly has its own risks, it would be a mistake, I think, to equate the two movements as though both were equally damaging. Instead we should ask how new configurations of time and space are operationalized, and new flows of energy enhanced. What can be gained from the apparent precarity of disorientation, and the entry into what Gilles Deleuze and Félix Guattari call zones of proximity? For feminist and disability scholars, the task is surely to think new horizons by considering how we might multiply possibilities of revitalization.
State Repression, Hostel Capitalism, and Black Resistance in Italy
Authors: Braude Richard
Published: July 2019

Resistance by the newly arrived black working class in Italy takes on forms that often leave little or no trace; the work of the historian must be to listen carefully to the silences in order to recover these acts. This contribution focuses on the resistance with asylum seeker hostels. Beginning with an examination of the resistance and repression of Bobb Alagie, it explains the reasons for the increase in these acts of resistance following the implementation of the hotspot approach, as well as the important role that the resisting subject produced by this situation has had within the formation of the new Italian right. Finally, questions are raised about the potential for future progressive alliances in the new political context.
Dchs1-Fat4 regulation of osteogenic differentiation in mouse
Authors: Crespo-Enriquez Ivan , Hodgson Tina , Zakaria Sana , Cadoni Erika , Shah Mittal , Allen Stephen , Al-Khishali Ayman , Mao Yaopan , Yiu Angela , Petzold Jonna , Villagomez-Olea Guillermo , Pitsillides Andrew A. , Irvine Kenneth D. , Francis-West Philippa
Published: July 2019

In human, mutations of the protocadherins FAT4 and DCHS1 result in Van Maldergem syndrome, which is characterised, in part, by craniofacial abnormalities. Here, we analyse the role of Dchs1-Fat4 signalling during osteoblast differentiation in mouse. We show that Fat4 and Dchs1 mutants mimic the craniofacial phenotype of the human syndrome and that Dchs1-Fat4 signalling is essential for osteoblast differentiation. In Dchs1/Fat4 mutants, proliferation of osteoprogenitors is increased and osteoblast differentiation is delayed. We show that loss of Dchs1-Fat4 signalling is linked to increased Yap-Tead activity and that Yap is expressed and required for proliferation in osteoprogenitors. In contrast, Taz is expressed in more-committed Runx2-expressing osteoblasts, Taz does not regulate osteoblast proliferation and Taz-Tead activity is unaffected in Dchs1/Fat4 mutants. Finally, we show that Yap and Taz differentially regulate the transcriptional activity of Runx2, and that the activity of Yap-Runx2 and Taz-Runx2 complexes is altered in Dchs1/Fat4 mutant osteoblasts. In conclusion, these data identify Dchs1-Fat4 as a signalling pathway in osteoblast differentiation, reveal its crucial role within the early Runx2 progenitors, and identify distinct requirements for Yap and Taz during osteoblast differentiation.
Laboratories of Democracy: Policy Experimentation under Decentralization
Authors: Cheng Chen , Li Christopher
Published: July 2019

We develop a model of policy experimentation in which the policy decisions of local and national politicians are driven by career concerns. When politicians’ payoffs are convex in their reputation and policy-making is opaque, local politicians experiment by introducing more diverse policies than national politicians do. The welfare implications of decentralization depend on homogeneity between districts. In particular, learning about policies is greater under decentralization if and only if the districts are sufficiently homogeneous. The model delivers novel testable hypotheses. Decentralization should be positively correlated with more diverse (uniform) local policies among countries with opaque (transparent) policymaking. (JEL D72, D78, D83)
An Experimental Comparison of Risky and Riskless Choice—Limitations of Prospect Theory and Expected Utility Theory
Authors: Chung Hui-Kuan , Glimcher Paul , Tymula Agnieszka
Published: July 2019

Prospect theory, used descriptively for decisions under both risk and certainty, presumes concave utility over gains and convex utility over losses; a pattern widely seen in lottery tasks. Although such discontinuous gain-loss reference-dependence is also used to model riskless choices, only limited empirical evidence supports this use. In incentive-compatible experiments, we find that gain-loss reflection effects are not observed under riskless choice as predicted by prospect theory, even while in the same subjects gain-loss reflection effects are observed under risk. Our empirical results challenge the application of choice models across both risky and riskless domains. (JEL C91, D12, D81)
3D-cinematic rendering for dental and maxillofacial imaging
Authors: Stadlinger Bernd , Valdec Silvio , Wacht Lorenz , Essig Harald , Winklhofer Sebastian
Published: July 2019

Objectives:

Aim of this technical note is to show the applicability of cinematic rendering (CR) for a photorealistic 3-dimensional (3D) visualization of maxillofacial structures. The focus is on maxillofacial hard tissue pathologies.

Methods:

High density maxillofacial pathologies were selected in which CR is applicable. Data from both, CT and cone beam CT (CBCT) were postprocessed using a prototype CR software.

Results:

CR 3D postprocessing of CT and CBCT imaging data is applicable on high density structures and pathologies such as bones, teeth, and tissue calcifications. Image reconstruction allows for a detailed visualization of surface structures, their plasticity, and 3D configuration.

Conclusions:

CR allows for the generation of photorealistic 3D reconstructions of high density structures and pathologies. Potential applications for maxillofacial bone and tooth imaging are given and examples for CT and CBCT images are displayed.
Do you cov me? Effect of coverage reduction on species identification and genome reconstruction in complex biological matrices by metagenome shotgun high-throughput sequencing
Authors: Cattonaro Federica , Spadotto Alessandro , Radovic Slobodanka , Marroni Fabio
Published: July 2019

Shotgun metagenomics sequencing is a powerful tool for the characterization of complex biological matrices, enabling analysis of prokaryotic and eukaryotic organisms and viruses in a single experiment, with the possibility of reconstructing de novo the whole metagenome or a set of genes of interest. One of the main factors limiting the use of shotgun metagenomics on wide scale projects is the high cost associated with the approach. We set out to determine  if it is possible to use shallow shotgun metagenomics to characterize complex biological matrices while reducing costs. We measured the variation of several summary statistics simulating a decrease in sequencing depth by randomly subsampling a number of reads. The main statistics that were compared are alpha diversity estimates, species abundance, and ability of reconstructing de novo the metagenome in terms of length and completeness. Our results show that diversity indices of complex prokaryotic, eukaryotic and viral communities can be accurately estimated with 500,000 reads or less, although particularly complex samples may require 1,000,000 reads. On the contrary, any task involving the reconstruction of the metagenome performed poorly, even with the largest simulated subsample (1,000,000 reads). The length of the reconstructed assembly was smaller than the length obtained with the full dataset, and the proportion of conserved genes that were identified in the meta-genome was drastically reduced compared to the full sample. Shallow shotgun metagenomics can be a useful tool to describe the structure of complex matrices, but it is not adequate to reconstruct—even partially—the metagenome.
An interactive application for malaria elimination transmission and costing in the Asia-Pacific
Authors: Celhay Olivier J. , Silal Sheetal Prakash , Maude Richard James , Gran Mercado Chris Erwin , Shretta Rima , White Lisa Jane
Published: July 2019

Leaders in the Asia-Pacific have endorsed an ambitious target to eliminate malaria in the region by 2030. The emergence and spread of artemisinin drug resistance in the Greater Mekong Subregion makes elimination urgent and strategic for the global goal of malaria eradication. Mathematical modelling is a useful tool for assessing and comparing different elimination strategies and scenarios to inform policymakers. Mathematical models are especially relevant in this context because of the wide heterogeneity of regional, country and local settings, which means that different strategies are needed to eliminate malaria. However, models and their predictions can be seen as highly technical, limiting their use for decision making. Simplified applications of models are needed to allow policy makers to benefit from these valuable tools. This paper describes a method for communicating complex model results with a user-friendly and intuitive framework. Using open-source technologies, we designed and developed an interactive application to disseminate the modelling results for malaria elimination. The design was iteratively improved while the application was being piloted and extensively tested by a diverse range of researchers and decision makers. This application allows several target audiences to explore, navigate and visualise complex datasets and models generated in the context of malaria elimination. It allows widespread access, use of and interpretation of models, generated at great effort and expense as well as enabling them to remain relevant for a longer period of time. It has long been acknowledged that scientific results need to be repackaged for larger audiences. We demonstrate that modellers can include applications as part of the dissemination strategy of their findings. We highlight that there is a need for additional research in order to provide guidelines and direction for designing and developing effective applications for disseminating models.
Using the MR-Base platform to investigate risk factors and drug targets for thousands of phenotypes
Authors: Walker Venexia M , Davies Neil M , Hemani Gibran , Zheng Jie , Haycock Philip C , Gaunt Tom R , Davey Smith George , Martin Richard M
Published: July 2019

Mendelian randomization (MR) uses genetic information to strengthen causal inference concerning the effect of exposures on outcomes. This method has a broad range of applications, including investigating risk factors and appraising potential targets for intervention. MR-Base has become established as a freely accessible, online platform, which combines a database of complete genome-wide association study results with an interface for performing Mendelian randomization and sensitivity analyses. This allows the user to explore millions of potentially causal associations. MR-Base is available as a web application or as an R package. The technical aspects of the tool have previously been documented in the literature. The present article is complimentary to this as it focuses on the applied aspects. Specifically, we describe how MR-Base can be used in several ways, including to perform novel causal analyses, replicate results and enable transparency, amongst others. We also present three use cases, which demonstrate important applications of Mendelian randomization and highlight the benefits of using MR-Base for these types of analyses.
Advising Student-Athletes for Success: Predicting the Academic Success and Persistence of Collegiate Student-Athletes
Authors: Brecht April A. , Burnett Dana D.
Published: July 2019

Stakeholders at institutions across the United States are continuously looking for ways to improve the academic success and retention of students. We used logistical regression in an examination of noncognitive, cognitive, and demographic factors as predictors of academic success and retention of Division I first-year student-athletes. The results indicated that high school GPA is the best predictor for academic success. The Transition to College Inventory index, self-confidence, institutional commitment, and independent activity focus can be used in the prediction of academic success. Retention was most accurately predicted by students' first-year cumulative GPA. University advisors can use the results of this study to enhance the resources designed to improve the academic performance and persistence of student-athletes.
Hazardous Agricultural Tasks Completed by Youth as Part of their Supervised Agricultural Experience (SAE): A Descriptive Study
Authors: Mann Andrew J. , Jepsen S. Dee
Published: July 2019

Abstract. This study describes tasks that middle school and high school youth, ages 13 to 18 years, completed during the 2015-2016 academic year as part of their supervised agricultural experience (SAE). The overarching goal was to collect information useful in directing classroom instruction to better prepare youth prior to engaging in agricultural tasks identified as hazardous by the U.S. Department of Labor. Using a list of eleven tasks currently identified as hazardous and 17 tasks proposed as hazardous, teachers were asked how many of their students engaged in each of the 28 tasks as part of their SAE. The 320 teachers from four U.S. geographic regions reported that students most frequently completed SAEs in the areas of livestock production (f = 6746, 26.6%), agricultural mechanics (f = 2695, 10.6%), home and/or community development (f = 2296, 9.0%), and crop production (f = 2250, 8.9%). Students often engaged in tasks associated with ATV/UTV operation (f = 7618, 10.3%), tractor operation (f = 5554, 7.5%), and assisting tractor operation (f = 5,081, 6.9%) as part of their SAE. All of these tasks are well documented in the literature as contributing to injuries and fatalities of both youth and adults. Keywords: Hazardous tasks, Safety, School-based agricultural education, Supervised agricultural experience, Youth.