bluuebunny/crossref_metadata_2025 huggingface dataset:
Workplace inclusion of employees with back pain and mental health problems: A focus group study about employees’ experiences
Authors: Ree Eline , Johnsen Tone Langjordet , Harris Anette , Malterud Kirsti
Published: October 2018

Aim: To explore how employees experience workplace inclusion of their colleagues or themselves when having back pain or mental health problems. Methods: Three focus group interviews with a sample of 16 kindergarten employees were conducted. Systematic Text Condensation was used for analysis. Results: The participants emphasized that it was easier to include colleagues whose health problems were specific, especially when they were open about having problems and expressed their needs for accommodation clearly. Discussions revealed difficulties of acceptance and accommodating colleagues with longstanding health problems, when the burden on the other staff members was heavy, and if it had negative consequences for the kindergarten children. Some of the participants had experienced health problems themselves, which was also described as challenging. Having health problems at work often induced feelings of guilt, being a burden to their colleagues, and experiencing a disparity between the ideals and the realities of inclusion practices. Conclusions: Workplace inclusion of employees is difficult when their health problems are unspecific, longstanding, and lead to negative consequences for children or colleagues. System level efforts are necessary to reduce negative stereotypes about employees with health problems and facilitate inclusion practices.
Evaluating sociocultural influences affecting participation and understanding of academic support services and programs (SSPs): Impacts on notions of attrition, retention, and success in higher education
Authors: Weuffen Sara , Fotinatos Nina , Andrews Tulsa
Published: October 2018

While no major change in relation to student attrition and retention data has been recorded over the past 20 years, the increasingly neoliberal agenda imposed on Australian higher education institutions has led to increased scrutiny around such data. In this case study, we explore discourses of attrition and retention to understand better the unique needs of students, and influences of targeted student support programs, as they transition to a regional higher education learning environment. We applied a mixed methods approach via a poststructuralist lens to identify frequency of nodes in relation to dimensions of the Kahu’s conceptual framework of engagement, antecedents and consequences model and present staff ( n=6) and student ( n=7) perceptions about the tangible value of knowledge, engagement, participation, and reportable outcomes of student support programs. Our findings indicate that staff tend to view student support programs from deficit discourses, whereas students view them as empowering.
Ultrashort-Segment Embolization of High-Flow Vessels Using a Coil Packing Technique in an Amplatzer Vascular Plug
Authors: Katada Yoshiaki , Onozawa Shiro , Takahashi Shoichi , Suzuki Shigeru
Published: October 2018

Purpose: To report an experimental study and clinical case using a coil packing technique that hastens occlusion of an Amplatzer Vascular Plug 1 (AVP1) in short-segment embolization of high-flow target vessels. Technique: An experimental vascular stenosis model was made of 12-mm soft polyvinyl chloride tubing. Under continuous pulsatile flow, a 12-mm AVP1 was deployed in the 4-mm-diameter stenosis. Before detachment of the AVP1, a 2.2-F microcatheter was inserted into the AVP1 through its mesh via a 6-F delivery guiding sheath in parallel with the delivery wire. Hydrogel microcoils were deployed tightly in the AVP1 and the plug was detached. After the procedure, the pulsatile saline flow was nearly obliterated. In the first clinical case, a 64-year-old man with a thoracic aortic stent-graft and single vessel debranching for type B aortic dissection developed a residual type II endoleak via the left subclavian artery. This coil packing technique in an AVP1 was employed to successfully embolize the leak. Conclusion: Based on the experimental study and the first experience in vivo, tight coil packing of an AVP1 might be a robust technique for ultrashort-segment embolization.
Effects of Hand Exercise on Eating Action in Patients With Alzheimer’s Disease
Authors: Chen Li-Li , Li Hong , Chen Xiao-Huan , Jin Shuang , Chen Qiu-Hua , Chen Mei-Rong , Li Na
Published: October 2018

We aim to investigate whether a popular hand exercise could be used to improve the action of eating in patients with Alzheimer’s disease (AD). A 6-month intervention was conducted in 60 patients with AD who live in a nursing home. They were divided into hand exercise and control groups. Patients of the control group maintained their daily routine. The improvement of Edinburgh Feeding Evaluation in Dementia scale in hand exercise group was significantly greater than in the control group ( P = .003). Significant differences in time of autonomous eating and time of simulated eating between patients in the hand exercise and control groups ( P < .05) were noted. The improvements in accuracy of eating action and coordination of eating action from baseline were significant in hand exercise group compared to the control group ( P = .020 and .014, respectively). Hand exercise is a safe and effective intervention to improve the feeding and eating of people with AD.
Financial Problems of the First Order: What Cuts to Make Before the District Runs Out of Cash
Authors: Baule Steven M.
Published: October 2018

This case provides a summary of a situation in which a newly appointed superintendent and his new chief financial officer of a midsized urban school district uncover a massive set of fiscal problems which had been previously hidden from the Board and most other stakeholders. How do the district’s top leaders make decisions about how to address the issues, inform a variety of constituent groups, and determine if legal action should be considered? Teaching notes and suggested class activities are included.
Beyond Peer Influence and Selection: A Gendered Pathways Analysis of Social Environmental Predictors of Change in Child and Peer Delinquency
Authors: Walters Glenn D.
Published: October 2018

The purpose of this study was to determine whether maternal closeness and participation in unstructured routine activities differentially predicted change in child and peer delinquency for female and male youth above and beyond the effects of peer influence and selection. Participants were 3,370 (1,759 boys, 1,611 girls) members of the Fragile Families and Child Welfare Study. When regression analyses were performed on boys and girls separately, unstructured routine activities effectively predicted a rise in child and peer delinquency in boys and maternal closeness successfully predicted a drop in child and peer delinquency in girls, findings consistent with gendered pathways theory.
An efficient numerical simulation method for evaluations of uncertainty analysis and sensitivity analysis of system with mixed uncertainties
Authors: Li Shun , Tang Zhang-Chun
Published: October 2018

This article investigates uncertainty analysis for system with aleatory and epistemic uncertainties and defines a sensitivity analysis indicator to measure the effect of imprecise parameter with epistemic uncertainty on system output, and an efficient numerical simulation methodology is proposed to evaluate the uncertainty analysis and sensitivity analysis indicator. System inputs have aleatory uncertainties defined by probability density functions, and distribution parameters of probability density functions are imprecise due to epistemic uncertainties and are defined by fuzzy sets with membership functions. System will fail to operate when output is less than or equal to zero, and we define membership function of reliability index as system output for uncertainty analysis, and sensitivity analysis indicator associated with an imprecise parameter is defined by absolute difference between original membership function and conditional membership function of reliability index when eliminating epistemic uncertainty relevant to the parameter of interest. Direct evaluation is a time-consuming coupled several-loop Monte Carlo sampling procedure. Thus, we propose an improved importance sampling method for efficient evaluation of uncertainty analysis and sensitivity analysis indicator. Using the proposed improved importance sampling method, only one importance sampling run with a set of input–output importance sampling samples is required to solve uncertainty analysis and sensitivity analysis indicator. Three examples are employed to demonstrate computational efficiency of the proposed method.
Parallel robot with fuzzy neural network sliding mode control
Authors: Xu Jiangmin , Wang Qi , Lin Qing
Published: October 2018

With the advancement in research on parallel robots, control theory is increasingly applied in the field of robotics. Owing to its robustness, sliding mode variable structure control is extensively used in parallel robots. This article presents an adaptive sliding mode control method for nonlinear systems. A parallel robot control model with adaptive fuzzy sliding mode control was designed based on a fuzzy neural network control theory, and simulation results demonstrate its effectiveness of the method.
Fluid-film lubrication computing with many-core processors and graphics processing units
Authors: Wang Nenzi , Chen Hsin-Yi , Chen Yu-Wen
Published: October 2018

The advancement of modern processors with many-core and large-cache may have little computational advantages if only serial computing is employed. In this study, several parallel computing approaches, using devices with multiple or many processor cores, and graphics processing units are applied and compared to illustrate the potential applications in fluid-film lubrication study. Two Reynolds equations and an air bearing optimum design are solved using three parallel computing paradigms, OpenMP, Compute Unified Device Architecture, and OpenACC, on standalone shared-memory computers. The newly developed processors with many-integrated-core are also using OpenMP to release the computing potential. The results show that the OpenACC computing can have a better performance than the OpenMP computing for the discretized Reynolds equation with a large gridwork. This is mainly due to larger sizes of available cache in the tested graphics processing units. The bearing design can benefit most when the system with many-integrated-core processor is being used. This is due to the many-integrated-core system can perform computation in the optimization-algorithm-level and using the many processor cores effectively. A proper combination of parallel computing devices and programming models can complement efficient numerical methods or optimization algorithms to accelerate many tribological simulations or engineering designs.
The Rationality of (Over)imitation
Authors: Keupp Stefanie , Behne Tanya , Rakoczy Hannes
Published: October 2018

Imitation is a powerful and ubiquitous social learning strategy, fundamental for the development of individual skills and cultural traditions. Recent research on the cognitive foundations and development of imitation, though, presents a surprising picture: Although even infants imitate in selective, efficient, and rational ways, children and adults engage in overimitation. Rather than imitating selectively and efficiently, they sometimes faithfully reproduce causally irrelevant actions as much as relevant ones. In this article, we suggest a new perspective on this phenomenon by integrating established findings on children’s more general capacities for rational action parsing with newer findings on overimitation. We suggest that overimitation is a consequence of children’s growing capacities to understand causal and social constraints in relation to goals and that it rests on the human capacity to represent observed actions simultaneously on different levels of goal hierarchies.
Evaluation of a score for the prehospital distinction between cerebrovascular disease and stroke mimic patients
Authors: Geisler Frederik , Ali Syed F , Ebinger Martin , Kunz Alexander , Rozanski Michal , Waldschmidt Carolin , Weber Joachim E , Wendt Matthias , Winter Benjamin , Schwamm Lee H , Audebert Heinrich J
Published: October 2018

Background

Patients with a sudden onset of focal neurological deficits consistent with stroke, who turn out to have alternative conditions, have been labeled stroke mimics.

Aims

We assessed a recently validated telemedicine-based stroke mimic score (TeleStroke mimic score; TM-score) and individual patient characteristics with regard to its discriminative value between cerebrovascular disease and stroke mimic patients in the in-person, pre-hospital setting.

Methods

We evaluated patients cared for in a mobile stroke unit in Berlin, Germany. We investigated whether the TM-score (comprising six parameters), Face Arm Speech Time test, and individual patient characteristics were able to differentiate cerebrovascular disease from stroke mimic patients.

Results

We included 423 patients (299 (70.7%) cerebrovascular disease and 124 (29.3%) stroke mimic) in the final analysis. A TM-score > 30 indicated a high probability of a cerebrovascular disease and a score ≤15 of a stroke mimic. The TM-score performed well to identify stroke mimics (area under the curve of 0.74 under receiver-operating characteristic curve analysis). The cerebrovascular disease patients were older (74.8 vs. 69.8 years, p = 0.001), had more often severe strokes (NIHSS > 14 25.8% vs. 11.3%, p = 0.001), presented more often with weakness of the face (70.9% vs. 42.7%, p = 0.001) or arm (60.9% vs. 33.9%, p = 0.001), dysarthria (59.5% vs. 40.3%, p < 0.001), history of atrial fibrillation (38.1% vs. 21.0%, p = 0.001), arterial hypertension (78.9% vs. 53.2%, p < 0.001), and less often with seizure (0.7% vs. 21.0%, p < 0.001).

Conclusions

The TM-score and certain patient characteristics can help paramedics and emergency physicians in the field to identify stroke mimic patients and select the most appropriate hospital destination.
Survey assessment of organizational resiliency potential of a group of Seveso organizations in Turkey
Authors: Şengül Hatice , Marşan Dilem , Gün Tuğçe
Published: October 2018

Organizational resilience is vital for long-term value creation in organizations, as they continuously face many obstacles due to fast evolving, complex, and uncertain environments. Resilience is also important for managing hazmat and oil spill risks, given the expected increase in frequency and magnitude of natural disasters due to climatic extremes. Organizations with higher resiliency potential are more likely to manage these challenges effectively. Recently developing literature indicates that development of dynamic capabilities, which are different from ordinary capabilities, leads to greater organizational resiliency potential. This study assesses organizational resiliency potential of a group of Seveso organizations in Turkey via a 5-point Likert-type-scale survey designed toward measuring four important dimensions of dynamic capabilities including anticipation capabilities, adaptive culture, networking capabilities, and organizational learning. Cluster analysis of survey results revealed that there are significant differences in organizational resiliency potential among organizations, as evidenced by the distance plot. While participating organizations have scored relatively high resiliency potentials, there are areas that need improvement including increasing anticipation and networking capabilities and strengthening employee engagement to further enhance resilience of organizations. In the second phase of the study, the effect of three factors on organizational resiliency potential that includes socioeconomic level and earthquake risk of the region that the organization is located, and Seveso Directive status of the organization were assessed. While organizational resiliency potential scores among groups of organizations that fall under different categories for these three factors did not show any statistically significant difference, follow-up focused interview revealed that respondents believed there may be differences in resiliency potential. Both survey and follow-up focused interview assessments showed the complexity and multiple aspects involved in developing adequate organizational resiliency potential. Organizational resiliency potential research is still in its infancy and both theoretical and technical sides of the equation requires further development.
Sensor selection for fault diagnostics using performance metric
Authors: Reeves J , Remenyte-Prescott R , Andrews J
Published: October 2018

As technology advances, modern systems are becoming increasingly complex, consisting of large numbers of components, and therefore large numbers of potential component failures. These component failures can result in reduced system performance, or even system failure. The system performance can be monitored using sensors, which can help to detect faults and diagnose failures present in the system. However, sensors increase the weight and cost of the system, and therefore, the number of sensors may be limited, and only the sensors that provide the most useful system information should be selected. In this article, a novel sensor performance metric is introduced. This performance metric is used in a sensor selection process, where the sensors are chosen based on their ability to detect faults and diagnose failures of components, as well as the effect the component failures have on system performance. The proposed performance metric is a suitable solution for the selection of sensors for fault diagnostics. In order to model the outputs that would be measured by the sensors, a Bayesian Belief Network is developed. Sensors are selected using the performance metric, and sensor readings can be introduced in the Bayesian Belief Network. The results of the Bayesian Belief Network can then be used to rank the component failures in order of likelihood of causing the sensor readings. To illustrate the proposed approach, a simple flow system is used in this article.
Effect of a soccer ball’s surface texture on its aerodynamics and trajectory
Authors: Hong Sungchan , Goff John Eric , Asai Takeshi
Published: October 2018

The effect of a soccer ball’s surface texture on its aerodynamics and flight trajectory is not definitively known. For this study, five soccer balls were used, each having 32 panels with different surface textures. Their aerodynamics were examined via wind-tunnel experiments and then several non-spin trajectories were calculated for each ball. The results showed that the aerodynamic forces acting on a soccer ball change significantly depending on the surface texture of the ball, which in turn influences flight trajectories. The study contributes to an understanding of how a soccer ball’s surface influences the aerodynamics, which may impact the future design and development of soccer balls.
Saudi Arabia: A prince’s revolution
Authors: Chara Jihan
Published: October 2018

Over the past decades, the member states of the Gulf Cooperation Council have emerged as the leaders of the Middle East and North Africa region. They have also proved to be the safest Arab allies for the EU due to their stability and prosperity, despite being the only regimes in the region whose leaders are not elected by universal direct suffrage. In recent months, Saudi Arabia, in particular, has been anxious to re-establish its leadership in the region through disruptive structural changes. Even though it remains difficult to make sense of these reforms, many analysts have speculated about their purported future relevance. This article argues that the changes undermine the social contract that has prevailed in the kingdom for decades, whereby citizens enjoy material comfort in exchange for their loyalty to the regime. Thus these changes threaten to destabilise the country, with potential lasting effects on the region and collateral consequences for Europe.
Radicalisation in Europe after the fall of Islamic State: Trends and risks
Authors: Brzuszkiewicz Sara
Published: October 2018

The so-called Islamic State of Iraq and Syria (ISIS) has experienced repeated defeats since 2017. To develop more effective counter-radicalisation and de-radicalisation strategies, the counterterrorism community has started to focus on the possible consequences in Europe of these defeats. The goal of this article is twofold. First, it aims to address the resilience of jihadism and the major challenges that Europe has to face in dealing with it. Second, it gives an overview of the best practices that should be adopted to face the persistent risks that will have to be addressed in the short and medium terms. Moreover, it argues that understanding the concepts of re-Qaedisation—the process that might cause ISIS-affiliated cells to bear a greater resemblance to the al-Qaeda model—and old-style recruitment—a set of recruitment patterns based on face-to-face interaction, pre-existing bonds and a shared radical milieu—will be crucial to reaching the above-mentioned objectives.
Brain magnetic resonance imaging findings in postpartum headache
Authors: Shobeiri Elham , Torabinejad Behnam
Published: October 2018

Objectives

The objectives were to determine the frequency of abnormal magnetic resonance imaging findings in patients with postpartum headache and related factors.

Methods

A total of 102 patients with postpartum headache underwent brain magnetic resonance imaging study. The images were examined by a blinded radiologist. The related demographic, obstetric and headache-related factors were recorded. The multiple logistic regression model was used to determine the predictive factors.

Results

Abnormal magnetic resonance imaging findings were observed in 42 of 102 patients (41.2%, 95% confidence interval = 31.6 to 50.7%). The most common finding was sinusitis (10 of 42 patients, 23.8%, 95% confidence interval = 15.5 to 32%). Then, posterior reversible encephalopathy syndrome (six of 42 cases, 14.2%, 95% confidence interval = 7.4 to 20.9%), cerebral venous thrombosis (four of 42 cases, 9.5%, 95% confidence interval = 3.8 to 15.1%), and subarachnoid hemorrhage (four of 42 cases, 9.5%, 95% confidence interval = 3.8 to 15.1%) were most prevalent findings. Convulsions (odds ratio of 3.39) and initiation of headache earlier than 5 days postpartum (odds ratio of 0.29) were significant predictive factors.

Conclusion

Abnormal brain magnetic resonance imaging findings were seen in a considerable number of patients with postpartum headache. When headache starts in the first 5 days postpartum and accompanied by convulsions, there are likely to be abnormal magnetic resonance imaging findings.
Atypical clinical and laboratory features of fish-tank granuloma: A case report
Authors: Sander Michael , Isaac-Renton Judith L , Sander Megan A
Published: October 2018

We report a case of cutaneous Mycobacterium marinum infection with the unusual reported features of pruritus and paresthesia. In addition, we report a lack of in-vivo response to antibiotics based on in-vitro susceptibility testing.
Use of QuantiFERON-TB Gold to determine the aetiology of idiopathic erythema induratum: A case report
Authors: Brandon Alisa , Mufti Asfandyar , Sibbald R. Garry
Published: October 2018

Although rare, erythema induratum is the most common entity presenting as lobular panniculitis with vasculitis. It is usually caused by a hypersensitivity reaction to Mycobacterium tuberculosis, although other aetiologies have been reported. We present a case of a 73-year-old male with multiple recurring tender erythematous nodules on the backs of both calves and shins. Prior to arrival in our clinic, the patient underwent a 9-month course of isoniazid with no improvement and subsequently received a diagnosis of idiopathic erythema induratum. We performed an interferon-gamma release assay QuantiFERON-TB Gold which was positive for M. tuberculosis infection. The patient was successfully treated with ethambutol 1.6 g for 1 month; pyrazinamide 2 g for 2 months; and isoniazid 300 mg, vitamin B6 25 mg, and rifampin 600 mg for 6 months. This case highlights the utility of using interferon-gamma release assay QuantiFERON-TB Gold and a multidrug regiment over isoniazid in erythema induratum.
Embodying justice: Situating college student articulations of social justice in critical consciousness
Authors: Jones Alexander Harris
Published: October 2018

Many American evangelical college students today enter into college with a new awareness of justice-related issues. However, situating student commitments to justice in a larger discourse on critical-consciousness development is necessary for educators to assist students in their justice development. This article reviews the literature on critical-consciousness development and places it in conversation with Deleuzian affect theory, suggesting that extant theory does not take into account the affective domain of critical-consciousness growth. This article also demonstrates common ways Christian college students might portray themselves as critically aware through distinctly Christian tropes that express their passion for and commitment to justice. These tropes, which commonly include human trafficking, diverse friend groups, and being globally-minded, actually have an adverse impact on social justice. By better understanding these tropes as masquerading critical consciousness and by understanding how students become critically aware through affect theory, educators and mentors can more adequately guide students in their attempts to seek justice.
Ethnoracial Attitudes and Identity-Salient Experiences Among Indigenous Mexican Adolescents and Emerging Adults
Authors: Gonzalez Elizabeth
Published: October 2018

This interdisciplinary study drew on Critical Latinx Indigeneities and Nigrescence Theory to conduct a mixed-method analysis of the ethnoracial attitudes and identity-salient experiences of Indigenous Oaxaqueño adolescents and emerging adults living in the United States. Results revealed that compared to emerging adults, adolescents endorsed higher self-hatred and lower multiculturalist inclusive attitudes. The ethnoracial attitudes of adolescents’, but not of emerging adults’, were correlated with their reported discrimination from mestizo Mexican peers. Narrative analysis revealed four types of experiences that defined what it means to be Oaxaqueño: cultural practices, ethnoracial discrimination, connection, and a disconnect with an Indigenous identity. Findings highlight the need for existing ethnoracial identity theories and scales to consider the multiracial and colonial structure within which Latinx youth develop their identities.
The Effect of Symptom Duration on Outcomes After Fusion for Degenerative Spondylolisthesis
Authors: Fleming John , Glassman Steven D. , Miller Adam , Dimar John R. , Djurasovic Mladen , Carreon Leah Y.
Published: October 2018

Study Design:

Longitudinal comparative cohort.

Objectives:

To determine if the duration of symptoms in patients with degenerative spondylolisthesis affects postoperative outcomes after 1- or 2-level decompression and fusion.

Methods:

Patients undergoing primary surgery for grade 1 degenerative spondylolisthesis at a single Quality Outcomes Database (QOD) participating site were identified. Demographic, surgical and patient-reported outcomes (PROs) data, including baseline and 12-month postoperative Oswestry Disability Index (ODI), back pain (BP, 0-10), leg pain (LP, 0-10), and EuroQOL-5D (EQ-5D) scores were collected. Individual medical records were reviewed for data on duration of symptoms prior to surgery. Patients were stratified into 3 cohorts—those with preoperative symptom duration of less than 1 year, 1 to 2 years, or greater than 2 years.

Results:

Complete data was available in 123 patients. Significant improvement in ODI, BP, and LP scores were observed in all groups. At 12-month follow-up improvement in ODI, BP, or LP was similar among the cohorts; with a trend toward significance with better improvement in LP scores in patients with a symptom duration of less than 1 year to those with symptom duration greater than 2 years ( P = .058).

Conclusions:

The duration of symptoms up to 2 years prior to surgery may not be a useful predictor of improvement of back pain or disability scores in patients with spondylolisthesis requiring decompression and fusion. Although there was a positive trend for improvement in leg pain for those with a shorter duration of symptoms, this did not reach statistical significance in our study.
The Development of an Entrepreneurship Index for Low-Income Households
Authors: Ibrahim Mohamed Dahlan , Mamun Abdullah Al , Othman Norasmah , Yusoff Mohd Nor Hakimin , Samy Naresh Kumar , Baba Suria , Ismail Ahmad Syakir Junoh , Mahmood Tengku Mohd Azizuddin Tuan , Abdullah Nik Nor Hafizah Nik
Published: October 2018

The Entrepreneurship Index (EI) serves as a measurement tool that effectively determines if one possesses the prospect of becoming a successful entrepreneur by assessing several essential aspects, such as entrepreneurial orientation, personality, leadership, motivation and knowledge, pertaining to functional skills. Hence, the cross-sectional design was adopted in this study and quantitative data were gathered from some randomly selected 800 Asnafs (those eligible for zakat—donation for the poor) listed under the Kelantan Islamic Religious and Customs Council. The outcomes of this study that classify the aspects of EI are grouped into three categories: low, medium, and high EI. As a result, the variances between high class and both medium and low classes have been double and triple, respectively. Furthermore, participants from Bachok, on an average, obtained higher scores on EI, in comparison to those from other districts. These findings can be turned into an essential measurement tool to indicate both entrepreneurial potentials and readiness among those from rural low-income households, which can be employed by relevant bodies in their attempt to aid those with entrepreneurial prospects and higher possibilities of attaining success in the business arena.
Efficacy of the Adductor Canal Approach to Saphenous Nerve Block for Anterior Cruciate Ligament Reconstruction With Hamstring Autograft: A Randomized Controlled Trial
Authors: Kejriwal Ritwik , Cooper Jeremy , Legg Andrew , Stanley Jeremy , Rosenfeldt Michael P. , Walsh Stewart J.
Published: October 2018

Background:

For reconstruction of the anterior cruciate ligament (ACL) with hamstring autograft, perioperative analgesia can be achieved with multimodal analgesia and intra-articular local anesthesia infiltration with or without additional regional blocks. Saphenous nerve block (SNB) via the adductor canal is commonly used in our practice, but its benefit has not been well established in the literature.

Purpose:

To assess the efficacy of SNB in ACL reconstruction with hamstring autograft.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

Consecutive patients undergoing arthroscopic ACL reconstruction with hamstring autograft were randomized into a control group (no SNB) and an intervention group (SNB). All patients received standardized anesthetic induction and maintenance agents with perioperative analgesia, per study protocol, with local anesthetic infiltration of the graft harvest site and intra-articular infiltration.

Results:

Sixty patients were randomized into the 2 groups (n = 30 each). There was no statistically significant difference in total opiate consumption between the groups (control, 34 mg; SNB, 31 mg; P = .40). There was no statistically significant difference in visual analog scale scores for pain at 0, 8, and 24 hours postsurgery, and no difference in overall satisfaction score. The control group had a significantly higher visual analog scale score at 4 hours postsurgery (3.0 vs 1.9, P = .04).

Conclusion:

SNB has a minimal effect on postsurgical care for ACL reconstruction with hamstring autograft in the presence of multimodal analgesia and local anesthetic infiltration.
Structure and dynamics of the platelet integrin-binding C4 domain of von Willebrand factor
Authors: Xu Emma-Ruoqi , von Bülow Sören , Chen Po-Chia , Lenting Peter J. , Kolšek Katra , Aponte-Santamaría Camilo , Simon Bernd , Foot Jaelle , Obser Tobias , Schneppenheim Reinhard , Gräter Frauke , Denis Cécile V. , Wilmanns Matthias , Hennig Janosch
Published: October 2018

Von Willebrand factor (VWF) is a key player in the regulation of hemostasis by promoting recruitment of platelets to sites of vascular injury. An array of 6 C domains forms the dimeric C-terminal VWF stem. Upon shear force activation, the stem adopts an open conformation allowing the adhesion of VWF to platelets and the vessel wall. To understand the underlying molecular mechanism and associated functional perturbations in disease-related variants, knowledge of high-resolution structures and dynamics of C domains is of paramount interest. Here, we present the solution structure of the VWF C4 domain, which binds to the platelet integrin and is therefore crucial for the VWF function. In the structure, we observed 5 intra- and inter-subdomain disulfide bridges, of which 1 is unique in the C4 domain. The structure further revealed an unusually hinged 2-subdomain arrangement. The hinge is confined to a very short segment around V2547 connecting the 2 subdomains. Together with 2 nearby inter-subdomain disulfide bridges, this hinge induces slow conformational changes and positional alternations of both subdomains with respect to each other. Furthermore, the structure demonstrates that a clinical gain-of-function VWF variant (Y2561) is more likely to have an effect on the arrangement of the C4 domain with neighboring domains rather than impairing platelet integrin binding.
A PET-positive rapidly growing mass of the abdominal wall after cesarean section with an unexpected diagnosis of vernix caseosa granuloma: a case report
Authors: Macciò Antonio , Kotsonis Paraskevas , Lavra Fabrizio , Chiappe Giacomo , Mura Ester , Melis Luca , Madeddu Clelia
Published: October 2018

Background

Abdominal wall tumors are rare and include heterogeneous diseases. Among them, desmoid tumors are the most frequent and are often diagnosed in young women during or early after pregnancy; inflammatory response after trauma or microtrauma, such as after cesarean section, may favor their growth.

Results

A 37-year-old woman presented with a progressive mass in the abdominal wall after a cesarean section. Positron emission tomography imaging confirmed a positive mass with a high maximum standardized uptake value; a biopsy suggested a myofibroblastic tumor. With continued tumor growth and worsening symptoms, the mass resembled a desmoid tumor; therefore, we proceed with its resection. The final diagnosis was foreign body granuloma as a reaction to the spillage of meconium and keratinous material in the amniotic fluid during cesarean section.

Conclusions

The present case provides information on an abdominal wall foreign body granuloma arisen from meconium and vernix caseosa after cesarean section, which presented an atypical clinical picture, mimicking a desmoid, thus requiring a careful diagnostic and treatment approach.
Combination therapy to checkmate Glioblastoma: clinical challenges and advances
Authors: Ghosh Debarati , Nandi Saikat , Bhattacharjee Sonali
Published: October 2018

Combination therapy is increasingly becoming the cornerstone of current day antitumor therapy. Glioblastoma multiforme is an aggressive brain tumor with a dismal median survival post diagnosis and a high rate of disease recurrence. The poor prognosis can be attributed to unique treatment limitations, which include the infiltrative nature of tumor cells, failure of anti‐glioma drugs to cross the blood–brain barrier, tumor heterogeneity and the highly metastatic and angiogenic nature of the tumor making cells resistant to chemotherapy. Combination therapy approach is being developed against glioblastoma with new innovative combination drug regimens being tested in preclinical and clinical trials. In this review, we discuss the pathophysiology of glioblastoma, diagnostic markers, therapeutic targeting strategies, current treatment limitations, novel combination therapies in the context of current treatment options and the ongoing clinical trials for glioblastoma therapy.
Adjuvant transcatheter arterial chemoembolization after curative resection for hepatocellular carcinoma patients with solitary tumor and microvascular invasion: a randomized clinical trial of efficacy and safety
Authors: Wei Wei , Jian Pei‐En , Li Shao‐Hua , Guo Zhi‐Xing , Zhang Yong‐Fa , Ling Yi‐Hong , Lin Xiao‐Jun , Xu Li , Shi Ming , Zheng Lie , Chen Min‐Shan , Guo Rong‐Ping
Published: October 2018

Background

The optimal strategy for adjuvant therapy after curative resection for hepatocellular carcinoma (HCC) patients with solitary tumor and microvascular invasion (MVI) is controversial. This trial evaluated the efficacy and safety of adjuvant transcatheter arterial chemoembolization (TACE) after hepatectomy versus hepatectomy alone in HCC patients with a solitary tumor ≥ 5 cm and MVI.

Methods

In this randomized, open‐labeled, phase III trial, HCC patients with a solitary tumor ≥ 5 cm and MVI were randomly assigned (1:1) to receive either 1–2 cycles of adjuvant TACE after hepatectomy (Hepatectomy‐TACE) or hepatectomy alone (Hepatectomy Alone). The primary endpoint was disease‐free survival (DFS); the secondary endpoints included overall survival (OS) and adverse events.

Results

Between June 1, 2009, and December 31, 2012, 250 patients were enrolled and randomly assigned to the Hepatectomy‐TACE group (n = 125) or the Hepatectomy Alone group (n = 125). Clinicopathological characteristics were balanced between the two groups. The median follow‐up time from randomization was 37.5 months [interquartile range 18.3–48.2 months]. The median DFS was significantly longer in the Hepatectomy‐TACE group than in the Hepatectomy Alone group [17.45 months (95% confidence interval [CI] 11.99–29.14) vs. 9.27 months (95% CI 6.05–13.70), hazard ratio [HR] = 0.70 (95% CI 0.52–0.95), P = 0.020], respectively. The median OS was also significantly longer in the Hepatectomy‐TACE group than in the Hepatectomy Alone group [44.29 months (95% CI 25.99–62.58) vs. 22.37 months (95% CI 10.84–33.91), HR = 0.68 (95% CI 0.48–0.97), P = 0.029]. Treatment‐related adverse events were more frequently observed in the Hepatectomy‐TACE group, although these were generally mild and manageable. The most common grade 3 or 4 adverse events in both groups were neutropenia and liver dysfunction.

Conclusion

Hepatectomy followed by adjuvant TACE is an appropriate option after radical resection in HCC patients with solitary tumor ≥ 5 cm and MVI, with acceptable toxicity.
Superresolution stacking based on sparse Radon transform
Authors: Ma Yue , Luo Yi , Kelamis Panos
Published: October 2018

Normal moveout (NMO) correction is routinely applied to each common-midpoint (CMP) gather before forming a stack section. Trace stretching is inherent in the conventional NMO correction, causing frequency distortion and temporal resolution degradation in the stacked image. We have developed a novel method to compute a superresolution stack directly from CMP gathers by solving an optimization problem that leads to an [Formula: see text]-norm minimization of the model based on compressive sensing principles. Our algorithm is able to recover the superposition of signals in a specialized parallel-shifted hyperbolic Radon-transform domain. The superresolution stacking result is then extracted directly from the transform domain without inversely transforming back to the time-offset domain. The effectiveness of the developed methodology in producing superresolution stack images was tested on a synthetic data set and a land data set from central Saudi Arabia. Test results clearly indicate that our method reduces the stretch effect, enhances the signal, attenuates multiples and noise, and results in a substantial improvement on the temporal and spatial resolutions of the stack image especially in regions dominated by noise.
Lats inactivation reveals hippo function in alveolar type I cell differentiation during lung transition to air breathing
Authors: Nantie Leah B. , Young Randee E. , Paltzer Wyatt G. , Zhang Yan , Johnson Randy L. , Verheyden Jamie M. , Sun Xin
Published: October 2018

Lung growth to its optimal size at birth is driven by reiterative airway branching followed by differentiation and expansion of alveolar cell types. How this elaborate growth is coordinated with the constraint of the chest is poorly understood. Here we investigate the role of Hippo signaling, a cardinal pathway in organ size control. Unexpectedly, we found that epithelial loss of the Hippo kinase genes Lats1 and Lats2 (Lats1/2) leads to a striking reduction of lung size due to an early arrest of branching morphogenesis. This growth defect is accompanied by abnormalities in epithelial cell polarity, cell division plane, extracellular matrix deposition and precocious and increased expression of markers for type 1 alveolar epithelial cell (AEC1), a terminal differentiation marker. Increased AEC1s was also observed in transgenics with overexpression of a constitutive nuclear form of downstream transcriptional effector YAP. Conversely, loss of Yap and Taz led to decreased AEC1s, demonstrating that the canonical Hippo signaling pathway is both sufficient and necessary to drive AEC1 fate. These findings together revealed unique roles of Hippo-LATS-YAP signaling in the developing lung.
The balance of poly(U) polymerase activity ensures germline identity, survival and development in Caenorhabditis elegans
Authors: Li Yini , Maine Eleanor M.
Published: October 2018

Poly(U) polymerases (PUPs) catalyze 3′ uridylation of mRNAs and small RNAs, a modification often correlating with decreased RNA stability. We have investigated the importance of three proteins with in vitro PUP activity, PUP-1/CDE-1, PUP-2 and PUP-3, in C. elegans germline development. Genetic analysis indicates that PUP-1/CDE-1 and PUP-2 are developmentally redundant under conditions of temperature stress during which they ensure germline viability and development. Multiple lines of evidence indicate that pup-1/-2 double mutant germ cells fail to maintain their identity as distinct from soma. Consistent with phenotypic data, PUP-1 and PUP-2 are expressed in embryonic germ cell precursors and throughout germline development. The developmental importance of PUP activity is presumably in regulating gene expression as both a direct and indirect consequence of modifying target RNAs. PUP-3 is significantly overexpressed in the pup-1/-2 germline, and loss of pup-3 function partially suppresses pup-1/-2 germline defects. We conclude that one major function of PUP-1/-2 is to limit PUP-3 expression. Overall, the balance of PUP-1, PUP-2 and PUP-3 activities appears to ensure proper germline development.
Apolipoprotein E deficiency accelerates atherosclerosis development in miniature pigs
Authors: Fang Bin , Ren Xueyang , Wang Ying , Li Ze , Zhao Lihua , Zhang Manling , Li Chu , Zhang Zhengwei , Chen Lei , Li Xiaoxue , Liu Jiying , Xiong Qiang , Zhang Lining , Jin Yong , Liu Xiaorui , Li Lin , Wei Hong , Yang Haiyuan , Li Rongfeng , Dai Yifan
Published: October 2018

Miniature pigs have advantages over rodents in modeling atherosclerosis because their cardiovascular system and physiology are similar to that of humans. Apolipoprotein E (ApoE) deficiency has long been implicated in cardiovascular disease in humans. To establish an improved large animal model of familial hypercholesterolemia and atherosclerosis, the clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 9 system (CRISPR/Cas9) was used to disrupt the ApoE gene in Bama miniature pigs. Biallelic-modified ApoE pigs with in-frame mutations (ApoEm/m) and frameshift mutations (ApoE−/−) were simultaneously produced. ApoE−/− pigs exhibited moderately increased plasma cholesterol levels when fed with a regular chow diet, but displayed severe hypercholesterolemia and spontaneously developed human-like atherosclerotic lesions in the aorta and coronary arteries after feeding on a high-fat and high-cholesterol (HFHC) diet for 6 months. Thus, these ApoE−/− pigs could be valuable large animal models for providing further insight into translational studies of atherosclerosis.
Unsymmetrical Tetra-Acceptor-Substituted Alkenes as Polyfunctionalized Building Blocks: A Divergent Synthesis of Densely Functionalized Pyrrolizines
Authors: Asahara Haruyasu , Kawakami Shu , Yoshioka Kotaro , Tani Shinki , Umezu Kazuto , Nishiwaki Nagatoshi
Published: October 2018

Various tetra-acceptor-substituted alkenes possessing unsymmetrical substituents have been effectively synthesized from vicinal tricarbonyl compounds. The alkenes have polyfunctionality and high electron deficiency. In addition, they easily react with pyrroles to give divergent pyrrolizine derivatives via the conjugate addition of pyrroles followed by intramolecular cyclization. We successfully controlled the chemoselectivity of the intramolecular cyclization (ester/ketone attack) to afford a wide range of valuable pyrrolizine derivatives.
Recent Advances in Chiral Plasmonics — Towards Biomedical Applications
Authors: Kumar Jatish , Liz-Marzán Luis M
Published: October 2018

The field of chirality has seen a strong rejuvenation due to the observation of nanoscale chirality in plasmonic nanoparticles. This account presents recent advances in the field of plasmonic chirality. The various top-down and bottom-up methods adopted for the synthesis of optically active plasmonic nanomaterials are briefly discussed. After achieving significant progress in the synthesis and mechanistic understanding of chirality at the nanoscale, the major focus of researchers is currently set on finding suitable applications for the synthesized nanomaterials. While different applications such as circular polarizers, chiral sensing and catalysis have been proposed, we propose that plasmon-enhanced chiral signals have great potential for use in the detection and therapy of diseases. We therefore introduce recent developments in the use of chiral plasmonic responses in the biomedical field.
Self-Assembling Peptide-Based Nanoarchitectonics
Authors: Zhao Luyang , Zou Qianli , Yan Xuehai
Published: October 2018

Self-assembly is omnipresent in nature. While natural self-assembly systems are complicated in structure, the simplification of natural systems while maintaining their inherent functionalities has proven to be a highly promising route towards artificial nanoarchitectonics with great potential for application. In this review, we summarize our recent works on self-assembling peptide-based nanoarchitectonics, where peptides with a simple molecular structure can modulate the assembly of various species in a flexible and controllable way and efficiently construct nanoarchitectonics with desired functionalities. Our recent findings regarding the applications of self-assembling peptides in the fields of biomimetic photosystems, oriented microtubes for optical waveguiding, and phototherapy are discussed in detail. In addition, the self-assembly mechanism and the effects of peptides on self-assembly are reviewed. This review is expected to provide an understanding of the role of peptides in the assembly of nanoarchitectonics and guidance towards the future design and application of novel functional peptide-modulated self-assembling materials.