bluuebunny/crossref_metadata_2025 huggingface dataset:
Students’ ability beliefs about running in physical education: Qualitative findings from longitudinal data
Authors: Xiang Ping , Liu Jiling , Li Weidong , Guan Jianmin
Published: September 2020

Students’ ability beliefs about running activities in physical education/athletics classes were investigated longitudinally from the perspectives of Nicholls’ conceptions of ability and Dweck’s implicit theories of ability. The data for this study were provided by 44 students (20 boys; 24 girls) who participated in a larger longitudinal project on students’ running motivation in schools. They were individually interviewed from fourth to eighth grade. All interviews were tape-recorded and transcribed verbatim for inductive analysis, revealing the criteria that students used to assess their own ability in running and reasons why they believed they could improve their ability in running. Frequencies and percentages were computed to determine changes in students’ ability assessment criteria over time. Results showed that students used ability, effort, task mastery, intra-individual comparisons, and social comparisons as criteria to assess their own ability in running as they progressed from the fourth to eighth grade. However, they increasingly used social comparison in assessment as they became older. Most students believed they could improve their ability in running, suggesting that they were incremental theorists. Ability/maturation, effort, experiences, and influences from significant others were cited as contributors to their beliefs about improving running ability. This study took the first step to provide longitudinal qualitative data on students’ ability beliefs about running in physical education/athletics classes. Findings of the study revealed students became more concerned with social comparisons in their ability assessments over time and held a belief that they could improve their own running ability. The implications of these findings for physical education teachers are discussed.
Look beyond the retinopathy: The incidental finding of a brain tumour
Authors: Vloka Caroline , Waxman Evan
Published: September 2020

We report the case of a 33-year-old woman who was found to have optic-nerve head swelling on fundus photographs obtained for telemedicine diabetic retinopathy screening. The patient was found to have a large vestibular schwannoma on brain imaging. This case shows the added benefit of implementing timely changes in management in response to significant incidental findings on tele-ophthalmology diabetic retinopathy screening, which can lead to potentially life- and vision-saving interventions.
Using the translanguaging space to facilitate poetic representation of language and identity
Authors: Dutton Janet , Rushton Kathleen
Published: September 2020

Australian students come from a wide range of linguistic and cultural backgrounds with each context providing unique challenges. Tensions however exist between the intentions to address diversity and the competing influence of a high-stakes context that prioritizes monolingual classroom practices and diminishes teachers’ use of engaging pedagogy. Viewed through the lens of socio-spatial theory, these tensions highlight how the ideal of education for diversity is re-shaped by the everyday practices in schools and systems. This can result in monolingual ‘firstspace’ practices that do little to develop the knowledge of language and culture that is central to students’ engagement with learning. This article reports ethnographic research in which secondary subject English teachers challenged routinized monolingual practices and re-imagined their classroom practices. The use of translanguaging and the reading and writing of poetry – translanguaging poetry pedagogy – created ‘space’ to support a dynamic process in which students could use all their linguistic resources to produce identity texts. The use of translanguaging and identity texts disrupts a transmission pedagogy that positions the student as a blank slate. Teachers reported how translanguaging poetry pedagogy moved from a ‘thirdspace’ practice to a ‘what we do’ or ‘firstspace’ practice as they came to see that using students’ full language repertoire is a way to return the power of language to their students. The resultant translanguaging space and the symbolic propensity of poetry helped students to develop powerful personal representations and reinforces the need for pedagogies that acknowledge students’ diverse backgrounds, and honor the languages and identity of all students.
Displacement response of submerged floating tunnel with flexible boundary under explosion load
Authors: Gang Luo , Shaokang Pan , Yulong Zhang , Yi Ren , Kai Xiong
Published: September 2020

In this study, a single-span submerged floating tunnel (SFT) is simplified as an elastic supporting beam model with movable ends. This model is used to analyze the displacement response of the SFT subjected to an underwater explosion in an ocean environment. The effects of the shock wave pressure and bubble pressure are considered simultaneously. The dynamic equilibrium equation was established based on D’Alembert’s principle. When the pipe segment of the SFT vibrates, the additional inertia force and the damping force of the surrounding water to the pipe are calculated using the Morison equation. The motion differential equation of an SFT under the load of an underwater explosion is obtained using the Galerkin method. The displacement analytical expressions of an SFT under four different stages of load are derived, and a comprehensive analysis is performed to assess the influence of key parameters, including the brace stiffness, damping, scaled distance, and bubble oscillation frequency, on the displacement of the SFT. It was observed that the key parameters mentioned above all significantly influence the displacement response of the SFT. Some reasonable suggestions for different parameters are proposed to provide a reference for the SFT design.
Influence of bridge parameters on monorail vehicle–bridge system— A research with multi-rigid body and multi-flexible body coupling theory and Park method
Authors: Jiang Yongzhi , Wu Pingbo , Zeng Jing , Wu Xingwen , He Qinglie , Wang Xing
Published: September 2020

The parameters of the monorail bridge, which have a significant effect on the vehicle, are analyzed in this paper. With Park method, a complicated solver of the second order with a variable step size, equations insolvable to traditional methods can be solved and a more complicated dynamic model could be built. Different from some traditional simulation of vehicle–bridge coupling system, the bridge is divided into the girder and piers. The finite element model of each part is created separately in Ansys and coupled with the vehicle system in UM, which helps the analysis of the interaction forces between flexible components and better simulation accuracy can be obtained. FIALA model is used to calculate the wheel force. These methods make the measurement more precise. The study shows that all the variables except for the stiffener thickness have little effect on the vibration of the vehicle due to the good vibration reduction performance of the vehicle system. The resonance of the girder could be avoided by changing the thickness of the stiffeners and web plates. In addition, high stiffness and damping of the connection point of the girder and pier are helpful in alleviating the vibration of the bridge.
Prognostic Value of Lymph Node Density in Patients With T3 and T4 Pyriform Sinus Carcinoma
Authors: Jia Lifeng , Li Jingya , Zhou Ziyuan , Yuan Wei
Published: September 2020

Background/Aim:

Lymph node density is a parameter used to more accurately predict tumor recurrence and patient survival. However, its association with surgical outcome in pyriform sinus carcinoma remains unclear. The purpose of this study was to assess the prognostic value of lymph node density in advanced pyriform sinus carcinoma.

Patients and Methods:

A total of 87 patients with pyriform sinus carcinoma treated between 2008 and 2015 were enrolled. Then, 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival, and 5-year regional recurrence-free survival were utilized to assess the prognostic significance of lymph node density.

Results:

With a median follow-up period of 31.8 months, 5-year overall survival, disease-specific survival, disease-free survival, and regional recurrence-free survival were 37.9%, 46.0%, 41.4%, and 54.0%, respectively. Univariate analysis revealed that lymph node density ≥ 0.093 was a significant predictor of poor 5-year overall survival ( P = .005), disease-specific survival ( P = .008), disease-free survival ( P = .0013), and regional recurrence-free survival ( P = .003). Furthermore, multivariate analysis demonstrated that lymph node density was negatively associated with adverse 5-year overall survival (hazard ratio = 1.62, 95% CI: 1.15-2.29, P = .006), disease-specific survival (hazard ratio = 1.86, 95% CI: 1.24-2.80, P = .003), disease-free survival (hazard ratio = 0.45, 95% CI: 0.24-0.85, P = .014), and regional recurrence-free survival (hazard ratio = 2.97, 95% CI: 1.43-6.17, P = .004).

Conclusion:

Taken together, these results reveal that lymph node density is a powerful prognostic factor for patients with T3 and T4 pyriform sinus carcinoma, and the median lymph node density cutoff values ≥ 0.093 are associated with a greater risk of recurrence and poorer survival.
Endovascular Internal Trapping by Low-Concentration N-butyl-2-Cyanoacrylate for a Ruptured Giant Common Carotid Artery Pseudoaneurysm
Authors: Harada Tomoaki , Fujita Atsushi , Sakata Junichi , Kohta Masaaki , Kohmura Eiji
Published: September 2020

Treating carotid blowout syndrome following rupture of giant pseudoaneurysms is difficult because the destroyed parent artery precludes conventional treatment. We present a patient with a ruptured giant pseudoaneurysm that we occluded using a modified internal trapping technique with low-concentration N-butyl-2-cyanoacrylate (NBCA) and a minimum number of coils. An 80-year-old man with a history of chemoradiation therapy for oropharyngeal cancer presented with several episodes of active bleeding from the subsequent tracheostomy site. Radiological examination revealed a giant right common carotid artery (CCA) pseudoaneurysm. Endovascular internal trapping was performed using both NBCA and coils under proximal flow control. We slowly injected 9 ml of low-concentration NBCA, which subsequently filled the entire pseudoaneurysm. We then injected an additional 2 ml of NBCA into the proximal CCA to achieve complete obliteration. No re-bleeding was observed during the 6-month follow-up. Endovascular internal trapping using low-concentration NBCA was feasible to treat a giant CCA pseudoaneurysm. The injected low-concentration NBCA filled the entire pseudoaneurysm without the risk of catheter entrapment.
Contextualizing Mathematical Problem-Solving Instruction for Secondary Students with Extensive Support Needs: A Systematic Replication
Authors: Root Jenny R. , Cox Sarah K. , Davis Kat , Hammons Nanette
Published: September 2020

Replication research provides evidence to establish, refute, or support evidence-based practices. Systematic replications are also necessary to determine “what works for whom when.” The purpose of this study was to conduct a conceptual systematic replication to evaluate the effectiveness of a multicomponent treatment package on multiplicative problem solving for middle school students with extensive support needs. Using a modified schema-based instructional strategy, three participants were taught to solve percent of change problems contextualized in real-world scenarios and a purchasing strategy (i.e., next-dollar strategy) to help them determine how much money was needed to pay for services/products. In addition, goal-setting and self-graphing activities supported development of self-determination skills. Findings from the multiple probe across participant design demonstrate a functional relation between the intervention and independent problem-solving behaviors of all three participants. Students also generalized problem-solving behaviors when presented with real-world stimuli of coupons and receipts. Implications for practice and future research are discussed.
Precision Liver Resection: Three-Dimensional Reconstruction Combined with Fluorescence Laparoscopic Imaging
Authors: Ni Zhong-Kai , Lin Da , Wang Zi-Qiang , Jin Hai-Min , Li Xiao-Wen , Li Ye , Huang Hai
Published: September 2020

Liver surgery has entered the era of precision surgery. Therefore, how to optimize the resection of lesions and reduce the unnecessary time of liver ischemia and hypoxia have become the focus. A total of 11 patients who underwent fluorescence laparoscopic liver mass resection and preoperative three-dimensional (3D) reconstruction between August 2018 and July 2020 were evaluated. Liver cirrhosis occurred in 3 patients. The mean intraoperative blood loss was 166.8 ± 105.7 mL. The average length of the operation time was 152.0 ± 45.3 minutes. The average intraoperative hilar occlusion time was 9.3 minutes (except for hilar cholangiocarcinoma). The liver function of all patients, except patients with hilar bile duct carcinoma, returned to the preoperative level at 72 hours, and no serious complications occurred. 3D reconstruction combined with fluorescence laparoscopic imaging is safe and effective for precision liver resection.
Novel Approach for Efficient Recovery for Spinal Cord Injury Repair via Biofabricated Nano-Cerium Oxide Loaded PCL With Resveratrol to Improve in Vitro Biocompatibility and Autorecovery Abilities
Authors: Dong Liang , Kang Xin , Ma Qiang , Xu Zhengwei , Sun Honghui , Hao Dingjun , Chen Xiujin
Published: September 2020

It is more difficult to develop the low-cost spinal cord injury repair materials with high stability and biocompatibility for the biomedical applications. Herein, for the first time, we demonstrated the functional restoration of an injured spinal cord by the nano CeO2 particles assembled onto poly (∊-caprolactone) (PCL)/resveratrol (RVL) were synthesized using the biocompatible ionic liquid. The as-prepared biocompatible nanomaterials were characterized and confirmed by using different instruments such as Fourier transform infra-red spectroscopy for functional groups identification, X-ray diffraction for crystalline nature, Scanning electron microscopy, transmission electron microscopy for morphological structure, Dynamic light scattering for size distribution of the nanoparticles and thermogravimetric analysis for thermal properties. The synergetic effect between the uniform distributions of nano-sized CeO2 particles onto the PCL polymer with RVL can remarkably enhance the catalytic performance. Biofabricated nano-cerium oxide loaded PCL with RVL revealed that treatment significantly preserved hydrogen peroxide and also good catalytic performance. This study presents a nano-sized cerium oxide particles loaded PCL with RVL biocompatible materials have been providing highly efficient regenerative activity and biocompatibility in spinal card regeneration.
The LNT Issue Is About Politics and Economics, Not Safety
Authors: Cuttler Jerry M.
Published: September 2020

The Sykes commentary advocates “a more sensible, graded approach for protection from low dose ionizing radiation” until the LNT dose-response issue is resolved. It urges scientists to stop criticizing the LNT model that links radiation to a risk of cancer and accept regulatory use of the threshold model to “protect” people, but with higher limits. It fails to mention the 120-year history of successful low-dose treatments of a wide variety of serious diseases, including cancers. The commentary ignores published evidence of a threshold at 1.1 Gy for radiogenic leukemia and a dose-rate threshold at about 0.6 Gy per year for lifespan shortening. LNT came from politicized science, replete with scientific misconduct and conflict of interest. Its acceptance created a false cancer scare that was likely intended to stop atomic bomb testing, but it has severely damaged human welfare. Many vitally important low-dose therapies were discarded when the radiation scare was disseminated in 1956. The rapid growth of nuclear energy ended with the media-inflamed public panic after the Three Mile Island accident in 1979. Extreme implementation of the precautionary principle made it uneconomic. Availability of a low-dose therapy for lung inflammation could have dramatically decreased the impact of the COVID-19 pandemic.
Breaking the breach in Latin America: A pilot study of mechanical thrombectomy in the public healthcare system in Chile
Authors: Rivera Rodrigo , Amudio Cristian , Brunetti Enzo , Catalan Pascual , Sordo Juan Gabriel , Badilla Lautaro , Echeverria Daniel , Cruz Juan Pablo , Ojeda Hector , Bravo Loreto , Bravo Fabian , Gonzalez Walter , Orellana Maria Luisa , Pinto Camila , Merino-Osorio Catalina , Oportus Monica , Salazar Alejandro , Nogueira Raul G
Published: September 2020

Background

Mechanical Thrombectomy (MT) is the standard of care for treatment of large vessel occlusion stroke. Until the beginning of 2020 MT was not funded nor widely implemented at the public healthcare level in Chile.

Objective

To describe the results of a pilot program created to provide access to public MT in Santiago - Chile.

Methods

Analysis from a prospectively collected database of MT cases performed between September 2017 and September 2019 in one center. A stroke network was developed with a single MT capable stroke center and five primary stroke centers. The primary efficacy endpoint was the rate of functional independence (mRS 0-2) at 90 days. Successful reperfusion was defined as 2 b-3 according to the thrombolysis in cerebral infarction scale. Safety outcomes include the rates of symptomatic intracranial hemorrhage and 90-day mortality.

Results

A total of 100 patients were treated over the study period. Their mean age was 62.8 ± 11.8 years and median baseline National Institute of Health Stroke Scale (NIHSS) measurement was 17. Seventy-seven percent of the patients received intra venous thrombolysis. Successful reperfusion was achieved in 95% of the cases. NIHSS at 24 hours showed a median drop of 7 points from baseline (p < 0.00001) and 50% of the follow-up patients were functionally independent at 90 days. Symptomatic Intracerebral hemorrhage occurred in 5% of the patients and 90-day all case mortality was 11%.

Conclusions

We demonstrated the feasibility of a publicly funded MT program in Chile, with similar results as other international randomized control trials.
Faculty promotion evaluation and gender equity in business schools
Authors: Dandalt Ed , Brutus Stephane
Published: September 2020

This article aims to address the fairness of promotion evaluation (appointments to the rank of full professor) process in Canadian business schools as perceived by tenured business female faculty. Our analysis is underscored by two studies with two different data collection methods (survey data analysis, policy content analysis) and driven by procedural justice as the main theoretical lens. The first study addresses the perspective of our survey participants ( N=198) by revealing that they believe the process of promotion evaluations is fair. Intrigued by this result, we undertook a second study to review the language of faculty collective agreements in these schools to explain partially why our participants believe in the fairness of promotion evaluations. The language of these faculty collective agreements suggests that the above result makes sense considering that they regulate promotion evaluations and decisions. However, this does not mean that the process of faculty promotions is free of gender discrimination as these faculty collective agreements have not addressed all the antecedents and predictors of gender inequity per se.

The findings of this article are relevant because the issue of the underrepresentation of female faculty as related to promotion in senior academic ranks in Canadian business schools is under-researched. The existing studies on faculty promotion evaluations are too general and have not specifically addressed the fairness of business schools’ faculty promotion evaluation systems from the perspective of tenured business female faculty. Plus, the relevance of the findings of this article lies in the fact that contrary to most general studies on female faculty experience with promotion evaluations at Canadian universities and internationally, these findings suggest that such experience in Canadian business schools is not always associated with gender discrimination and negative perspectives among female faculty.
Lower gastrointestinal bleeding in pregnancy: Differential diagnosis, assessment and management
Authors: Story L , Rafique S , Samadi N , Mawdsley J , Singh B , Banerjee A
Published: September 2020

Rectal bleeding is a common symptom experienced by pregnant women. Although the majority of cases are attributable to benign conditions such as haemorrhoids and anal fissures, other more serious diagnoses such as inflammatory bowel disease and malignancy should not be overlooked. Most investigations are safe during pregnancy and these should not be withheld as significant implications on both fetal and maternal morbidity may result. In these cases, a multidisciplinary team approach is essential. This review explores the differential diagnosis, investigation and management of rectal bleeding during pregnancy.
Isomalto-Oligosaccharides Produced by Endodextranase Shewanella sp. GZ-7 From Sugarcane Plants
Authors: Liu Xin , Deng Tian , Liu Xueqin , Lai Xiaohua , Feng Yanli , Lyu Mingsheng , Wang Shujun
Published: September 2020

Oligosaccharides have important alimental and medical applications. Dextranase has been used to produce isomalto-oligosaccharides (IMOs). In this study, we isolated dextranase-producing bacteria from sugarcane-cultivated soil. Identification of the isolate based on its phenotypical, physiological, and biochemical characteristics, as well as 16S ribosomal deoxyribonucleic acid gene sequencing yielded Shewanella sp. strain GZ-7. The molecular weight of the dextranase produced by this strain was 100-135 kDa. The optimum temperature and pH for dextranase production were 40 °C and 7.5, respectively. The enzyme was found to be stable at the pH range of 6.0-8.0 and the temperature range of 20 °C-40 °C. Thin-layer chromatography and high-performance liquid chromatography of the enzymolysis products of the substrate confirmed the enzyme to be endodextranase. Under the optimal conditions, the ratio of IMOs could reach 91.8% of the hydrolyzate. The final products were found to efficiently scavenge the 2,2-diphenyl-1-picrylhydrazyl, hydroxyl, and superoxide anion radicals. In general, dextranase and hydrolyzates have high potential prospects for application in the future.
Araliaarmoside: A New Triterpene Glycoside Isolated From the Leaves of Aralia armata
Authors: Yen Pham Hai , Cuc Nguyen Thi , Huong Phan Thi Thanh , Nhiem Nguyen Xuan , Hong Chuong Nguyen Thị , Lien Giang Thi Kim , Huu Tai Bui , Tuyen Nguyen Van , Van Minh Chau , Van Kiem Phan
Published: September 2020

One new oleanane-type triterpene glycoside, oleanolic acid-[28 -O-β-d-glucopyranosyl]-3 -O-[ β-d-glucopyranosyl(1→6)- β-d-glucopyranosyl](1→3)[ α-l-arabinofuranosyl(1→4)]- β-d-glucuronopyranoside (1), and 3 known ones {oleanolic acid-[28 -O-β-d-glucopyranosyl]-3 -O-[ β-d-galactopyranosyl(1→3)]-[ β-d-glucopyranosyl(1→2)]- β-d-glucuronopyranoside (2) chikusetsusaponin IVa methyl ester (3), and chikusetsusaponin IV (4)} were isolated from the leaves of Aralia armata. Their chemical structures were elucidated using a combination of high-resolution electrospray ionization mass spectrometry, 1-dimensional and 2-dimensional nuclear magnetic resonance (NMR) spectral data, as well as comparison with data in the previous literature. This is the first report of full NMR spectroscopic data of 2. Compounds 1-4 displayed weak cytotoxic activity toward KB and HepG2 cell lines, with half-maximal inhibitory concentration50 values ranging from 24.2 ± 0.3 to 32.6 ± 0.8 µM in in vitro assay.
Observational assessment of safety in seroquel (OASIS): a specialist cohort event monitoring (SCEM) study in England
Authors: Osborne Vicki , Davies Miranda , Evans Alison , Shakir Saad A. W.
Published: September 2020

Background:

This study was designed to monitor the short-term (up to 12 weeks) use and safety of quetiapine (Seroquel) extended release (XL) and quetiapine immediate release (IR) prescribed to patients with a clinical diagnosis of schizophrenia, and/or manic episodes associated with bipolar disorder by psychiatrists under normal conditions of use.

Methods:

A Specialist Cohort Event Monitoring (SCEM) study was conducted in England February 2010–April 2013. This observational cohort study recruited patients prescribed quetiapine XL within the secondary care setting by psychiatrists. A reference cohort of quetiapine IR users was also recruited. Baseline and 12 week observational data were collected from psychiatrists who abstracted information from medical records onto bespoke questionnaires. Data were collected on demographics, indication, past medical history, prescribing information and events of interest. Summary descriptive statistics were calculated.

Results:

The final cohort consisted of 869 eligible patients; 646 XL users and 223 IR users. The majority of XL and IR users were female (56.2% and 55.6%, respectively), with a median age of 40 (interquartile range [IQR]: 29, 49) and 39 (IQR: 28, 50) years, respectively. The most frequent indication for treatment was Manic episodes associated with Bipolar Affective disorder (53.4% XL and 49.8% IR). Median index dose was 200 mg/day (IQR: 100, 300) for XL users and 50 mg/day (IQR: 50, 100) for IR users, while median final maintenance dose was 400mg/day (IQR: 250, 600) and 300 mg/day (IQR: 100, 400), respectively. The most frequently reported event of interest in both cohorts was sedation ( n = 151, 23.9% XL cohort and n = 49, 23.0% IR cohort).

Conclusion:

Utilisation of quetiapine XL appeared to be in line with prescribing guidelines in terms of dose, and commonly reported events of interest were in concordance with the known safety profile. Overall, this SCEM study provided important information on the safety and utilisation of quetiapine XL in the secondary care setting in England.
Recurrent melanoma development in a Caucasian female with CDKN2A+ mutation and FAMMM syndrome: A case report
Authors: Gu Kaien , Velde Rochelle Van De , Pitz Marshall , Silver Shane
Published: September 2020

Melanoma is a form of skin cancer originating from melanocytes that has an increasing incidence over the past few decades. From 1992 to 2010, the overall incidence of melanoma was 12.29 cases per 100,000 person-years in Canada. Approximately 10% of cases are attributed to a hereditary component, with one of the most common being familial atypical multiple mole melanoma syndrome. In this case report, we highlight the atypical case of a middle-aged Caucasian female with familial atypical multiple mole melanoma syndrome, who has developed dozens of primary melanomas over the past decade. We highlight the management of her case, as well as the importance of monitoring by multiple other subspecialists given the propensity for the development of alternate malignancies.
Safety and efficacy of inferoposterior access approach to the renal pedicle during transperitoneal laparoscopic radical nephrectomy: A retrospective comparative analysis at a single institution
Authors: Cheng Xiao-Bao , Lam Wayne , Lu Zhen-Quan , Lo Richard
Published: September 2020

Purpose

To assess the safety and efficacy of transperitoneal laparoscopic radical nephrectomy using an inferoposterior approach to the renal pedicle.

Materials and methods

A retrospective review of 89 patients who underwent transperitoneal laparoscopic radical nephrectomy by a single surgeon between June 2014 and December 2019 at a single urological unit was carried out. Access to the renal pedicle was via the inferoposterior approach in 48 cases (study group) and 41 were approached via the conventional anterior approach (control group). Patient demographics, intra-operative anatomical findings, and procedural details including operative time on renal pedicles and post-operative outcomes were recorded. Post-operative complications were recorded and classified according to the Clavien-Dindo classification. A comparative analysis between the two groups was performed using Chi-square test and t-test.

Results

The inferoposterior approach group had a shorter operative time (132.85±26.65 min vs 153.46±39.94 min; p<0.01), which could be attributed to the shorter time spent operating on the renal vasculature (46.31±6.16 min vs 64.46±7.64 min; p<0.01). Lower average blood loss was also observed in the inferoposterior approach group (42 ml vs 62 ml; p<0.05). No significant difference was identified concerning the mean patient age, body mass index, tumor size, number of renal vessels identified, and post-operative length of stay between the two groups. None of the patients required conversion to open.

Conclusion

Inferoposterior approach to access the renal pedicle during transperitoneal laparoscopic radical nephrectomy is a safe and effective technique, which shortens the operative time when compared to the conventional anterior approach.

Level of evidence:

Level 3b.
Sustainability Reporting and Firm Performance: The Demonstration of Pakistani Firms
Authors: Hongming Xie , Ahmed Bilal , Hussain Arif , Rehman Alam , Ullah Irfan , Khan Farman Ullah
Published: September 2020

The nexus between sustainability and firm performance is an area of debate among researchers and academicians. The objective of this study is to examine the level and extent of sustainable financial reporting for non-financial firms in Pakistan and to assess the level of the impact of sustainable financial reporting on firm performance in Pakistan. This study is a novel research work as the sustainability practices are not mandatory in many Pakistani firms. Rather kinds of mix sustainability reporting practices are being practiced. The dilemma still exists whether sustainability practices affect the performance of Pakistani firms positively or not. We collect data from the sustainability reports as well as annual reports of 50 non-financial public limited companies listed in Pakistan Stock Exchange for the period 2013 to 2017. We calculate sustainability reporting index using content analysis procedure based on 42 indicators. The index is based on three subindices, namely, environmental, health and safety, and social indicators. We apply two regression models with a view to ascertain the individual effect of each indicator of the sustainability as well as the composite effect of sustainability reporting index on firm performance. The results confirm positive effects of all three individual indicators as well as the composite form of sustainability reporting index on firm performance. The findings of the study clearly outline the economic relevance for introducing the corporate sustainability reporting practices in corporate strategy.
Discrimination and Black Social Media Use: Sites of Oppression and Expression
Authors: Miller Gabe H. , Marquez-Velarde Guadalupe , Williams Apryl A. , Keith Verna M.
Published: September 2020

The authors investigate the association between self-reported experiences of discrimination and social media use among Black American adults. Experiences of discrimination were assessed using a 10-question scale of self-reported discrimination encounters. Data analysis was based on a sample of 220 Black American adult respondents residing in Texas. The results indicate that Black Americans reporting higher levels of discrimination use social media more frequently than those who report lower levels of discrimination. In addition, Black Americans who experience higher levels of discrimination are more likely to have accounts on Twitter or Facebook than those who experience lower levels of discrimination. Together, these findings suggest that social media sites such as Twitter serve as sites of expression for people of color to air their grievances, find community, and cope with online and offline forms of racism and discrimination.
Admiral Nursing—A Model of Specialist Dementia Care in Acute Hospitals
Authors: Aldridge Zena , Oliver Emily , Gardener Hannah , Dening Karen Harrison
Published: September 2020

Introduction

The rising prevalence of dementia has led to increased numbers of people with dementia being admitted to acute hospitals. This demand is set to continue due to an increasingly older population who are likely to have higher levels of dependency, dementia, and comorbidity. If admitted to the hospital, people with dementia are at higher risk of poor outcomes during and following a hospital admission. Yet, there remains a significant lack of specialist support within acute hospitals to support people with dementia, their families and hospital staff.

Methods

Admiral Nurses are specialists that work with families affected by dementia and provide consultancy and support to health and social care colleagues to improve the delivery of evidenced based dementia care. Historically, Admiral Nurses have predominantly been based in community settings. In response to the increasing fragmentation of services across the dementia trajectory, the Admiral Nurse model is evolving and adapting to meet the complex needs of families impacted upon by dementia inclusive of acute hospital care.

Results

The Admiral Nurse acute hospital model provides specialist interventions which improve staff confidence and competence and enables positive change by improving skills and knowledge in the provision of person-centred dementia care. The role has the capacity to address some of the barriers to delivering person centred dementia care in the acute hospital and contribute to improvements across the hospital both as a result of direct interventions or influencing the practice of others.

Conclusion

Improving services for people with dementia and their families requires a whole system approach to enable care coordination and service integration, this must include acute hospital care. The increasing numbers of people with dementia in hospitals, and the detrimental effects of admission, make providing equitable, consistent, safe, quality care and support to people with dementia and their families a national priority requiring immediate investment. The inclusion of Admiral Nursing within acute hospital services supports service and quality improvement which positively impacts upon the experience and outcomes for families affected by dementia.
Comparison of Lower Extremity EMG Muscle Testing With Hands-Free Single Crutch vs Standard Axillary Crutches
Authors: Dewar Cuyler , Martin Kevin D.
Published: September 2020

Background:

In order to maintain nonweightbearing restrictions of the lower extremity, an assistive device must be utilized. Currently most devices require the restricted limb to be held in a static position while the contralateral extremity provides forward propulsion. Atrophy and disuse conditions ensue rapidly, slowing healing and prolonging recovery. A hands-free single crutch (HFSC) utilizes both lower extremities, potentially reducing atrophy. The purpose of this study was to examine the electromyographic (EMG) differences between an HFSC and standard axillary crutches (SAC).

Methods:

A prospective, crossover study was performed using 21 healthy volunteers from an active duty foot and ankle clinic. Demographic data were obtained and then subjects were fitted with an HFSC and SAC. Wireless surface EMG sensors were applied to the belly of the rectus femoris (RF), vastus lateralis (VL), lateral gastrocnemius (LG), and the gluteus maximus (GM) by a board-certified orthopedic surgeon. Subjects then ambulated at a self-selected velocity for 30 m while 15 seconds of the gait cycle were recorded for each device. Mean muscle activity and the maximum voluntary isometric contraction (MVIC) were recorded.

Results:

The RF, GM, and LG showed significantly increased levels of muscle activity while using the HFSC compared to SAC (respectively P = .05, P = .03, P = .03). The VL did not show significantly higher muscle activity while using the HFSC ( P = .051). The RF, GM, and VL showed statistically significant higher MVIC percentages while using the HFSC compared with SAC (respectively P = .005, P = .005, P = .013). The LG did not show significantly higher MVIC percentage while using the HFSC ( P = .076).

Conclusion:

The HFSC subjects demonstrated increased muscle recruitment and intensity while maintaining cyclic contractions consistent with bipedal gait pattern. SAC demonstrated less recruitment and intensity with an isometric pattern regardless of the phase of gait.

Clinical Relevance:

Muscle atrophy following lower extremity immobilization.
Promises, Deceit and White-Collar Criminality Within the Theranos Scandal
Authors: Griffin O. Hayden
Published: September 2020

Theranos rose to prominence by selling a dream that a company could make blood testing less painful and more effective. The company strove to bring new technology to the laboratory industry that would make Americans healthier. After securing more than $700 million from investors, Theranos would eventually receive, at its height, a $9 billion company valuation. As it turned out, Theranos and its founder, Elizabeth Holmes, had mainly promised innovations predicated on proprietary technology that did not work. Eventually, Holmes, and former company president Ramesh Balwani, would be charged with fraud both by the SEC and the federal government. The Theranos scandal has multiple dimensions that make it an interesting case study for white-collar and corporate crime.
The Mechanism of Prune Belly Syndrome Development: A Sonographic Sequential Assessment
Authors: Bacha Raham , Gilani Syed Amir , Manzoor Iqra , Ahmad Iftikhar , Shah Syed Faisal Hanan
Published: September 2020

Prune belly syndrome is a rare disorder characterized by the absence of anterior abdominal wall muscles, bilateral cryptorchidism, and urinary tract malformations. The aim of this case study was to illustrate the developmental sequelae of prune belly syndrome, acquired through a series of antenatal sonography. A 20-year-old woman visited a diagnostic medical sonography center for an obstetrical sonogram. Her fetus was diagnosed with megacystis at 15 weeks’ gestation. The mother returned for repeated appointment and to observe fetal changes during the development of prune belly syndrome. First, the megacystis, hydroureter, and hydronephrosis were noted followed by hazy ascitic and amniotic fluid. The hemodynamics were altered in the umbilical artery, middle cerebral artery, and ductus venosus. Subsequently, the pressure was neutralized, but it was observed after birth that the newborn had cryptorchidism, a distended abdomen with wrinkled wall, and absent right kidney. In conclusion, prune belly syndrome could be caused by megacystis due to bladder outlet obstruction in otherwise normal karyotype fetuses. Megacystis leads to hydroureter, hydronephrosis, and abdominal distention. The persistent abdominal distention gives rise to the underdevelopment of anterior abdominal wall muscles and cryptorchidism.
Recombinant VWF fragments improve bioavailability of subcutaneous factor VIII in hemophilia A mice
Authors: Vollack-Hesse Nadine , Oleshko Olga , Werwitzke Sonja , Solecka-Witulska Barbara , Kannicht Christoph , Tiede Andreas
Published: September 2020

Conventional treatment of hemophilia A (HA) requires repetitive IV injection of coagulation factor VIII (FVIII). Subcutaneous administration of FVIII is inefficient because of binding to the extravascular matrix, in particular to phospholipids (PLs), and subsequent proteolysis. To overcome this, recombinant dimeric fragments of von Willebrand factor (VWF) containing the FVIII-stabilizing D3 domain were engineered. Two fragments, called VWF-12 and VWF-13, demonstrated high binding affinity to recombinant human FVIII (rhFVIII) and suppressed PL binding in a dose-dependent manner. High concentrations of VWF fragments did not interfere with the functional properties of full-length VWF in vitro. The HA mouse model was used to study the effects of VWF-12 or VWF-13 on the in vivo pharmacokinetics of rhFVIII, demonstrating (1) no significant impact on rhFVIII recovery or half-life after a single IV administration; (2) enhanced bioavailability (up to 18.5%) of rhFVIII after subcutaneous administration; and (3) slow absorption (peak concentration, 6 hours) and prolonged half-life (up to 2.5-fold) of rhFVIII after subcutaneous administration. Formation of anti-FVIII antibodies was not increased after administration of rhFVIII/VWF-12 subcutaneously compared with rhFVIII IV. A single subcutaneous dose of rhFVIII/VWF-12 provided protection in the HA tail-bleeding model for up to 24 hours. In summary, recombinant VWF fragments support FVIII delivery through the subcutaneous space into vascular circulation without interfering with VWF or FVIII function. Slow resorption and excretion of FVIII after subcutaneous administration highlight the potential application of VWF fragments for subcutaneous FVIII prophylaxis in HA.
Genomic subtypes may predict the risk of central nervous system recurrence in diffuse large B-cell lymphoma
Authors: Ollila Thomas A. , Kurt Habibe , Waroich Jozal , Vatkevich John , Sturtevant Ashlee , Patel Nimesh R. , Dubielecka Patrycja M. , Treaba Diana O. , Olszewski Adam J.
Published: September 2020

Ollila et al address a challenging problem: can the risk for central nervous system (CNS) relapse in patients with diffuse large B-cell lymphoma be predicted better on a molecular basis? They report that most tumors with CNS recurrence have recognizable molecular features that fall into two categories: those that resemble primary CNS lymphoma and those that resemble high-grade lymphoma. These data suggest that it is time to revisit identification of patients who may benefit from CNS prophylaxis, while highlighting how challenging that is.
Direct activation of the alternative complement pathway by SARS-CoV-2 spike proteins is blocked by factor D inhibition
Authors: Yu Jia , Yuan Xuan , Chen Hang , Chaturvedi Shruti , Braunstein Evan M. , Brodsky Robert A.
Published: September 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious respiratory virus that can lead to venous/arterial thrombosis, stroke, renal failure, myocardial infarction, thrombocytopenia, and other end-organ damage. Animal models demonstrating end-organ protection in C3-deficient mice and evidence of complement activation in humans have led to the hypothesis that SARS-CoV-2 triggers complement-mediated endothelial damage, but the mechanism is unclear. Here, we demonstrate that the SARS-CoV-2 spike protein (subunit 1 and 2), but not the N protein, directly activates the alternative pathway of complement (APC). Complement-dependent killing using the modified Ham test is blocked by either C5 or factor D inhibition. C3 fragments and C5b-9 are deposited on TF1PIGAnull target cells, and complement factor Bb is increased in the supernatant from spike protein–treated cells. C5 inhibition prevents the accumulation of C5b-9 on cells, but not C3c; however, factor D inhibition prevents both C3c and C5b-9 accumulation. Addition of factor H mitigates the complement attack. In conclusion, SARS-CoV-2 spike proteins convert nonactivator surfaces to activator surfaces by preventing the inactivation of the cell-surface APC convertase. APC activation may explain many of the clinical manifestations (microangiopathy, thrombocytopenia, renal injury, and thrombophilia) of COVID-19 that are also observed in other complement-driven diseases such as atypical hemolytic uremic syndrome and catastrophic antiphospholipid antibody syndrome. C5 inhibition prevents accumulation of C5b-9 in vitro but does not prevent upstream complement activation in response to SARS-CoV-2 spike proteins.
Ultra-rare cystic disease
Authors: Elia Davide , Torre Olga , Cassandro Roberto , Caminati Antonella , Harari Sergio
Published: September 2020

Diffuse cystic lung diseases include a group of heterogeneous disorders characterised by the presence of cysts within the lung parenchyma, sometimes showing a characteristic computed tomography scan pattern that allows diagnosis. The pathogenetic mechanisms underlying cyst formation in the lung are still not clear and a number of hypotheses have been postulated according to the different aetiologies: ball-valve effect, ischaemic dilatation of small airways and alveoli related to infiltration and obstruction of small vessels and capillaries that supply the terminal bronchioles and connective tissue degradation by matrix metalloproteases. A wide number of lung cyst diseases have been classified into six diagnostic groups according to the aetiology: neoplastic, congenital/genetic, lymphoproliferative, infective, associated with interstitial lung diseases, and other causes. This article focuses on lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis and Erdheim–Chester disease, Birt–Hogg–Dubé, follicular bronchiolitis and lymphocytic interstitial pneumonia, light-chain deposition disease and amyloidosis, congenital lung disease associated with aberrant lung development and growth, and cystic lung disease associated with neoplastic lesion. These cystic diseases are epidemiologically considered as ultra-rare conditions as they affect fewer than one individual per 50 000 or fewer than 20 individuals per million. Despite the rarity of this group of disorders, the increasing use of high-resolution computed tomography has improved the diagnostic yield, even in asymptomatic patients allowing prompt and correct therapy and management without the need for a biopsy.
A comparison of ice wrap and subacromial injection for postoperative pain and edema control following arthroscopic rotator cuff repair
Authors: Kara Yavuz Selim , Hapa Onur , Işın Yağmur , Kılıç Ali İhsan , Havitçioğlu Hasan
Published: September 2020

Background

Postoperative pain and edema are the most common problems associated with arthroscopic rotator cuff repair. The purpose of the present study was to compare ice wrap and subacromial injection (SI) as treatments for early postop pain and edema control and to contrast them with a control group.

Materials and methods

59 patients treated with arthroscopic rotator cuff repair were randomized into three groups: 23 patients who received an ice wrap, 20 patients who received a SI, and a control group of 16 patients.

Results

Patient demographics, comorbidities, tear retraction, degree of fatty muscle degeneration, surgical procedures, and amount of irrigation fluid were similar for the three groups, which also showed similar results regarding postoperative pain and edema control as well as analgesic consumption.

Conclusions

The present study failed to show any difference in effectiveness between the two most common pain management modalities, or between those modalities and the control group.

Level of evidence

IV, prospective observational study.