bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Two Different Kt/V Methods in Continuous Ambulatory Peritoneal Dialysis Patients
Authors: Sanlidag Canan , Ccedil;avdar Caner , Sifil Aykut , Hastaoglu Sadiye , üretmen Pinar , çamsari Taner
Published: February 2020

Dialysis adequacy has gained particular interest for the assessment of the quality of dialysis in patients undergoing hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). Kt/V is used as a test of dialysis adequacy in HD and CAPD patients.

The aim of this study was to compare two different Kt/V methods in CAPD patients. A practical method for the calculation of Kt/V will be suggested at the end of this prospective study. The study group included 28 patients. Each patient received CAPD therapy four times per day. During the study, CAPD dialysate samples for a period of 24 hours were obtained by two different methods. One is a modified method for obtaining samples by the patient at home; the other is the conventional method. For study purposes only, we told the patients using the modified method to bring all the bags to the center (contrary to the aim of the modified method).

In the first method (modified method), CAPD patients collected 24-hour dialysate and urine samples at home and brought all of the materials to the hospital. A 10 mm3 dialysate sample was drawn from each CAPD dialysate bag, and then a total of 40 mm3 dialysate was mixed in a beaker. A sample of 10 mm3 of dialysate was taken from the mixture in the beaker, and then this dialysate sample, urine, and 5 mm3 venous blood were sent to the laboratory for urea nitrogen (UN) and creatinine level determinations. In addition to these tests, 24-hour dialysate and urine volumes and the patients’ weight and height were measured, and Kt/V values were calculated.

In the second method (classic method), all the bags from the 24-hour period were collected and mixed in a big bucket, and then a 10 mm3 sample was taken. The remaining procedures were the same as for the first method.

Mean Kt/V values were calculated separately for the two methods and were found to be 2.48 by the modified method and 2.52 by the classic method. The results of the two methods were compared with the Wilcoxon paired t-test, which showed no statistically significant difference (p = 0.5228).

In conclusion, two different Kt/V methods can be used in CAPD patients. However, the modified method is easily performed, and CAPD patients can collect and take the dialysate and urine samples at home, and bring these materials to the renal unit without transportation problems.
Current Status of Peritoneal Dialysis in Korea: Efforts to Achieve Optimal Outcome
Authors: Han Dae-Suk , Hwang Jae-Ha , Kang Duk-Hee , Song Hyun-Yong , Noh Hyunjin , Shin Sug-Kyun , Lee Seoung-Woo , Kang Shin-Wook , Choi Kyu-Hun , Ha Sung-Kyu , Lee Ho-Yung
Published: February 2020

Since its introduction in 1981, peritoneal dialysis (PD) has become firmly established as an effective mode of renal replacement therapy and serves an increasing patient population in Korea. The latest registry data indicate that about 3700 end-stage renal disease patients are maintained on chronic PD, representing 24.1% of the country's dialysis population. The majority (93.3%) of these patients are on continuous ambulatory peritoneal dialysis (CAPD) using the two-bag disconnect system, while only 3.3% are on automated PD. Under current renal reimbursement policies, most dialysis patients have to pay 20% of dialysis fees. Thus CAPD patients on 4 x 2-L daily exchanges pay about US$200 per month, not including medication and travel costs.

Traditionally, most PD centers in Korea have used the “standard” prescription of 4 exchanges of 2 L of solution for most of their patients. A recent survey of 1467 patients who commenced CAPD in 1997 revealed that 84% of these patients were initially prescribed 4 x 2-L exchanges, while 12% were given a daily volume of 6 L. With this standard prescription, the percentages of Korean CAPD patients initially achieving the adequacy target of Kt/V urea ≥ 2.0 and standardized creatinine clearance (SCCr) ≥ 60 L/week/ 1.73 m2, were 74.4% and 82.1%, respectively. It is likely that, among current Korean CAPD patients, a much lower percentage will achieve the clearance targets compared to this initial outcome, but the precise data are not available. However, it is not clear whether the levels of small-solute clearance recommended for optimal PD outcomes, and proposed by the NKF-DOQI guidelines, will bring the expected benefits to Korean patients.

Overall survival of Korean PD patients appears to be as good as, or even better than, that in most other countries. Recently, a single large PD center reported patient survival of 92.1%, 85.6%, 81.4%, and 67.6% at 1, 2, 3, and 5 years respectively. Other centers also reported similar outcomes. As in other countries, cardiovascular deaths predominate among Korean patients: death was due to cardiac causes in 29%, to vascular causes in 21%, and to infectious causes in 24%.

Peritonitis is the most important barrier to prolonged use of CAPD in Korea, and more PD patients transfer to hemodialysis because of peritonitis than in other countries. To further reduce the morbidity and mortality of Korean PD patients, various control measures need to be implemented that can reduce or prevent peritonitis and other infectious complications. Also, to further improve long-term patient outcome, Korean nephrologists need to establish and practice optimal clearance targets in the chronic care of these patients.
Developing targeted HIV risk predictors for young black men who have sex with men: a two-city comparative study
Authors: Nguyen Anthony C , Young Lindsay E , Beymer Matthew R , Suen Sze-Chuan
Published: February 2020

HIV burden in the United States is geographically and demographically heterogeneous. While efforts over the last few decades have reduced HIV incidence, young black men who have sex with men (YBMSM) account for a significant portion of new HIV diagnoses compared to any other race and age group. The Centers for Disease Control and Prevention has allocated funding to help reduce HIV in the YBMSM community; however, their recommended screening/treatment criteria do not emphasize demographic specificity. To better guide more applicable screening guidelines specifically for YBMSM, we examine demographic, behavioral, sexual network, and biological predictors of HIV status among YBMSM in two demographically distinct cities with high HIV burden in the United States: Chicago, IL and Los Angeles, CA. We perform multivariable logistic regressions to identify predictors of HIV in these populations. We found that having a history of syphilis was the only statistically significant predictor across both cities despite inclusion of other characteristics previously shown to be associated with HIV among YBMSM. Syphilis history could be a powerful HIV risk indicator for YBMSM and, therefore, should be integrated into clinical screening practices for critical biomedical prevention options like HIV pre-exposure prophylaxis.
Overexpression of miR-146a inhibits the apoptosis of hippocampal neurons of rats with cerebral hemorrhage by regulating autophagy
Authors: Huan S , Jin J , Shi C-x , Li T , Dai Z , Fu X-j
Published: February 2020

In this study, to investigate the effect of overexpression of miR-146a on autophagy of hippocampal neurons in rats with intracerebral hemorrhage (ICH), 72 Sprague-Dawley rats were randomly divided into the sham, ICH, miR-146a agomir, and miR-146a agomir control groups. The ICH model was constructed by injection of collagenase VII. The apoptosis of hippocampal neurons was measured by TUNEL assay. The levels of LC3 and Beclin 1 were analyzed by immunohistochemistry. Mitochondrial autophagy was examined by transmission electron microscopy. The levels of LC3A, LC3B, Beclin 1, Bax, Bcl-2, and cleaved caspase 3 were examined by Western blot. Western blot was also used to evaluate the expression of nuclear factor κB signaling pathway-related factors. To examine the effect of autophagy inhibitor (3-methyladenine (3-MA)) on miR-146a-regulated apoptotic protein expression, 30 rats were further divided into the sham, ICH, miR-146a agomir, 3-MA, and miR-146a + 3-MA groups. The levels of Bax, Bcl-2, and cleaved caspase 3 were examined by Western blot. Compared with the sham group, the nerve function scores, brain water content, the percentage of apoptotic cells, and the expression levels of LC3, Beclin 1, Bax, cleaved caspase 3, and p-P65 in the hippocampus of rats in the ICH group were all significantly increased ( p < 0.05), whereas the expression levels of miR-146a, Bcl-2, and p-IκBα were markedly decreased ( p < 0.05). Mitochondrial autophagy was also evident. Furthermore, compared with the ICH group, the results of the abovementioned tests in the miR-146a agomir group were reversed. The overexpression of miR-146a inhibited the autophagy of hippocampal neurons in rats with ICH.
Yarn-reinforced hydrogel composite produced from woven fabrics by simultaneous dissolution and cross-linking
Authors: Koc Umit , Eren Recep , Aykut Yakup
Published: February 2020

Polyvinyl alcohol (PVA)/cotton (Co) woven fabrics were produced by constructing Co as warp yarns and PVA as weft yarns in the fabric structure. As-prepared PVA/Co fabrics were treated with borax/water solution. Because of the simultaneous dissolution and gelation of PVA yarn in the fabric and transformation of PVA molecules into cross-linked gel structures, gel penetrated among the yarns in the matrix form and hence Co yarn-reinforced composite hydrogels were obtained. The retention time of water by composite hydrogels was first increased and then decreased by increasing borax concentration in the cross-linker solution. With yarn reinforcing, the tensile strength of hydrogel structure significantly increased. Mechanical properties of hydrogel composites were very variable depending on water content in the structure and tensile strength tremendously increased when water evaporated from the structure. Thermal and chemical characterizations of yarn-reinforced hydrogel composites were conducted in addition to swelling and mechanical analysis to investigate the performance of the hydrogel composites.
Internationalization of Service SMEs: Perspectives from Canadian SMEs Internationalizing in Asia
Authors: Roberts Michael JD , Muralidharan Etayankara
Published: February 2020

This study investigates how service small and medium-sized enterprises (SMEs) overcome challenges of internationalizing when expanding to markets that are both institutionally and geographically distant. The data is qualitative and collected through a forum on the internationalization of service SMEs. We examine high tech service SMEs from Alberta, Canada where most internationalization has occurred within North American Free Trade Agreement (NAFTA). We develop an understanding of how these firms need to consider the unique environments in institutionally distant economies to successfully enter Asian markets. Using industry and country experts, we develop a 4P (Potential, Proposition, Presence and Policy) framework for service SME strategies to expand to China, India and Korea. The article contributes to the sparse literature on the internationalization of service SMEs into institutionally distant markets.
Case of pembrolizumab-induced myocarditis presenting as torsades de pointes with safe re-challenge
Authors: Lee Dae Hyun , Armanious Merna , Huang Jessica , Jeong Daniel , Druta Mihaela , Fradley Michael G
Published: February 2020

Introduction

Pembrolizumab is an immune checkpoint inhibitor targeting the programmed death receptor with clinical effect on multiple malignancies including sarcoma. Associated cardio-toxicities include myocarditis, cardiomyopathy, heart failure, and arrhythmias. Although in most cases of immune checkpoint inhibitor cardiotoxicity the offending agent is discontinued, we report a case of successful and safe re-challenge with a checkpoint inhibitor in a patient with mild myocarditis.

Case report

We describe a 37-year-old female with alveolar soft part sarcoma, metastatic to the lungs on cycle 13 of pembrolizumab who presented with dyspnea, cough, and vague chest discomfort. Telemetry showed bigeminal bradycardia that transitioned to self-terminating torsades de pointes. Cardiac MRI showed subtle patchy T2 signal increase within the left ventricular septum without late gadolinium uptake, suggesting mild focal myocarditis. Management and outcome: The patient was started on a steroid taper without additional arrhythmias. We have re-challenged the patient who safely tolerated re-challenge with pembrolizumab despite an episode of torsades de pointes and documented myocarditis. She continues to receive pembrolizumab at seven months after the initial event without further cardiovascular events.

Discussion

To the best of our knowledge, this is the first reported case of successful re-challenge of pembrolizumab after an episode of myocarditis. In patients with mild myocarditis and no evidence of left ventricular dysfunction, re-challenge may be a viable option. However, close monitoring for the development of heart failure, cardiomyopathy, or serious arrhythmias is necessary to ensure patient safety.
Collective Avoidance of Social and Health Venues and HIV Racial Inequities: Network Modeling of Venue Avoidance on Venue Affiliation, Social Networks, and HIV Risk
Authors: Fujimoto Kayo , Wang Peng , Li Dennis H. , Kuhns Lisa M. , Amith Muhammad , Schneider John A.
Published: February 2020

Many younger Black men who have sex with men (YBMSM) are exposed to homonegativity, societal stigma, and racial discrimination in their social environment. This study uses a social network modeling methodology to identify aspects of the social environment that are not often described, that is, the places and spaces or “venues” where YBMSM socialize or where they receive HIV prevention services. In particular, we identify the structural features of avoidance of these venues as an indicator of negative experiences, using bipartite exponential random graph models. Our study theorizes that YBMSM avoid certain venues en masse through information diffusion among social network members. We specify two social mechanisms of collective venue avoidance—(1) homophily (i.e., ego–alter similarity in venue avoidance) and (2) popular opinion leaders (as early adopters)—and test the corresponding hypotheses that (Hypothesis 1) socially connected individuals avoid venues together and that (Hypothesis 2) popular individuals would be more likely to avoid venues. Based on data collected from YBMSM aged 16 to 29 years between 2014 and 2016 in Houston, Texas ( N = 227) and Chicago, Illinois ( N = 241), results indicate that Hypothesis 1 was supported in both cities but that Hypothesis 2 was supported only in Chicago. The findings suggest that the structural patterns of venue avoidance are different between cities and may inform dissemination of prevention messages and delivery of venue- and social influence–based HIV interventions.
Integrating Complex Systems Methods to Advance Obesity Prevention Intervention Research
Authors: Hennessy Erin , Economos Christina D. , Hammond Ross A. , Sweeney Linda Booth , Brukilacchio Lisa , Chomitz Virginia R , Collins Jessica , Nahar Elizabeth , Rioles Nicole , Allender Steven , Swinburn Boyd , Gillman Matthew W. , Hovmand Peter , Kasman Matt , Nichols Melanie
Published: February 2020

Background. Whole-of-community interventions have been recommended and show promise for preventing obesity; however, research to understand the mechanisms underlying their success or failure is lacking. Complex systems approaches may be useful to address this gap. Purpose. To describe the evolution and utilization of qualitative and quantitative complex systems methods to understand and model whole-of-community obesity prevention interventions. Approach. We illustrate the retrospective qualitative development of a systems map representing community change dynamic within the Shape Up Somerville (SUS) intervention. We then describe how this systems map, and complementary work of other successful obesity prevention interventions (Romp & Chomp intervention), informed the COMPACT (childhood obesity modeling for prevention and community transformation) study. COMPACT’s design aligns complex systems science principles and community-engaged research to better understand stakeholders’ leadership roles in whole-of-community interventions. We provide an overview of the complex systems tools used in COMPACT: agent-based modeling, group model building, and social network analysis and describe how whole-of-community intervention stakeholders (“agents”) use their social networks to diffuse knowledge about and engagement with childhood obesity prevention efforts, laying the groundwork for community readiness for sustainable change. Conclusion. Complex systems approaches appear feasible and useful to study whole-of-community obesity prevention interventions and provide novel insights that expand on those gained from traditional approaches. Use of multiple methods, both qualitative and quantitative, from the complex systems toolkit working together can be important to success.
One-year results of gonioscopy-assisted transluminal trabeculotomy: Evaluation of prognostic factors
Authors: Cubuk Mehmet Ozgur , Unsal Erkan
Published: February 2020

Purpose:

To present the results and complications of gonioscopy-assisted transluminal trabeculotomy in adults with open-angle glaucoma using our different approaches during and after surgery.

Method:

A retrospective comparative study was designed. Patients with regular 12-month follow-up history were included. Two groups were defined: group 1 comprised patients with open-angle glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy surgery alone; group 2 included patients with open-angle glaucoma who underwent combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction. A 30% reduction in preoperative intraocular pressure or postoperative intraocular pressure below 18 mm Hg was considered as surgical success. The success rate, alteration in intraocular pressure, alteration in best-corrected visual acuity, alteration in the need for antiglaucomatous medications, surgical complications, and the need for additional glaucoma surgery were evaluated and compared between the groups. Multivariate logistic regression analysis was used to show the association between the surgical success and possible prognostic factors.

Results:

A total of 37 eyes fulfilled the inclusion criteria and were analyzed in this study. An overall mean decrease in intraocular pressure of 11.3 ± 9.3 mm Hg was shown at 12 months (p < 0.001). The medication-free surgical success rate was 37.8% (14/37), and the surgical success rate with medication was 91.8% (33/37) at 12 months. Surgical outcomes were similar between patients who underwent gonioscopy-assisted transluminal trabeculotomy alone and those who had combined gonioscopy-assisted transluminal trabeculotomy and cataract extraction (p > 0.05). The most common postoperative complication was hyphemia (89.1%). There were no complications that threatened best-corrected visual acuity. Multivariate logistic regression analysis revealed one significant association between the presence of blood in Schlemm’s canal and surgical success (odds ratio = 1.47; 95% confidence interval = 1.25–1.68; p = 0.047).

Conclusion:

This study showed that the gonioscopy-assisted transluminal trabeculotomy procedure is an effective and minimally invasive form of glaucoma surgery. Its effect was related to intraoperative blood in Schlemm’s canal.
Comparative Studies of Using Nano Zerovalent Iron, Activated Carbon, and Green Synthesized Nano Zerovalent Iron for Textile Wastewater Color Removal Using Artificial Intelligence, Regression Analysis, Adsorption Isotherm, and Kinetic Studies
Authors: Karam Ahmed , Zaher Khaled , Mahmoud Ahmed S
Published: February 2020

Daily, a big extent of colored, partially treated textile effluents drained into the sanitation systems causing serious environmental concerns. Therefore, the decolorization treatment process of wastewater is crucial to improve effluent quality. In the present study, 3 different sorbent materials, nano zerovalent iron (nZVI), activated carbon (AC), and green-synthesized nano zerovalent iron (GT-nZVI), have been prepared for raw textile wastewater decolourization. The prepared nanomaterials were characterized via X-ray diffraction (XRD) spectroscopy, scanning electron microscopy (SEM), energy dispersive X-ray (EDX) analysis, and UV-Vis absorption spectroscopy. In addition, the effect of different operating parameters such as pH, contact time, and stirring rate on the color removal efficiency was extensively studied to identify the optimum removal conditions. The reaction temperature, adsorbent dose, and initial color concentration were fixed during the experiments at room temperature, 0.7 g/L, and 350 and 50 mg/L Pt/Co color unit, respectively. Moreover, adsorption and reaction kinetics were analyzed using different isotherms and models. For simulating the adsorption process, artificial neural network (ANN) data were compatible with the result of regression analysis derived from response surface methodology (RSM) optimization. Our results showed the higher ability of nZVI, AC, and GT-nZVI in textile wastewater color removal. At pH 5, contact time 50 minutes, and stirring rate 150 rpm, nZVI showed good color removal efficiency of about 71% and 99% for initial color concentrations of 350 and 50 mg/L Pt/Co color unit, respectively. While slightly higher color removal ability of about 72% and 100% was achieved by using AC at pH 8, contact time 70 minutes, and stirring rate 250 rpm. Finally, the largest ability of color removal about 85% and 100% was recorded for GT-nZVI at pH 7, contact time 40 minutes, and stirring rate 150 rpm. This work shows the enhanced color removal ability of GT-nZVI as a potential textile wastewater decolourization material, opening the way for many industrial and environmental applications.
Heritage, education and processes of change in Vietnamese rural tourism: A case study from Hội An
Authors: Trinh Thu Thi , Ryan Chris , Bui Hung Duc
Published: February 2020

While the notion of farm tourism is not new in tourism studies, it continues to evolve and take forms not previously examined. This article describes the development of this form of tourism on the outskirts of Hội An (a World Heritage Site in Vietnam) as a farming sector seeks to build on a demand being created by visitors to the United Nations Educational, Scientific and Cultural Organization gazette site. Based on 27 informants, the article examines the nature of the agritourism products and their move towards sustainable tourism in response to demand. The article highlights (a) the nature of the products, (b) the opportunity provided by proximity to a World Heritage Site and (c) the educational background of the farmers and suggests that levels of education possess importance by enabling entrepreneurs to acquire business skills not previously available to earlier generations. In identifying this, the article contributes to a literature on how tourism products evolve in developing countries, for not only does education create skill sets but also creates an awareness of the commercial and social values of traditions and the need to retain this as expressions of cultural patterns of life.
Selective Nonoperative Management of Abdominal Stab Wounds with Isolated Omental Evisceration is Safe: A South African Experience
Authors: Kong V. Y. , Weale R. D. , Blodgett J. M. , Madsen A. , Laing G. L. , Clarke D. L.
Published: February 2020

Background and Aims:

Selective nonoperative management of abdominal stab wound is well established, but its application in the setting of isolated omental evisceration remains controversial. The aim of the study is to establish the role of selective nonoperative management in the setting of isolated omental evisceration.

Materials and Methods:

A retrospective study was conducted over an 8-year period from January 2010 to December 2017 at a major trauma center in South Africa to determine the outcome of selective nonoperative management.

Results:

A total of 405 consecutive cases were reviewed (91% male, mean age: 27 years), of which 224 (55%) cases required immediate laparotomy. The remaining 181 cases were observed clinically, of which 20 (11%) cases eventually required a delayed laparotomy. The mean time from injury to decision for laparotomy was <3 h in 92% (224/244), 3–6 h in 6% (14/244), 6–12 h 2% (4/244), and 12–18 h in 1% (2/244). There was no significant difference between the immediate laparotomy and the delayed laparotomy group in terms of length of stay, morbidity, or mortality. Ninety-eight percent (238/244) of laparotomies were positive and 96% of the positive laparotomies (229/238) were considered therapeutic.

Conclusion:

Selective nonoperative management for abdominal stab wound in the setting of isolated omental evisceration is safe and does not result in increased morbidity or mortality. Clinical assessment remains valid and accurate in determining the need for laparotomy but must be performed by experienced surgeons in a controlled environment.
Hands-on versus virtual: Reshaping the design classroom with blended learning
Authors: Fleischmann Katja
Published: February 2020

The heart of design studio teaching is traditionally linked to one-on-one teaching activities and to the exchange of feedback prompting many design educators to think it does not lend itself to online delivery. This study explored how design educators can translate the essence of design studio pedagogy into a blended learning environment. The four-year study involving 119 first-year undergraduate design students reports on the development, implementation, and iteration of a blended learning experience in an introductory design subject. The subject followed a flipped classroom model where video lectures, software tutorials, and additional readings were delivered online through a Learning Management System; practical face-to-face tutorials allowed students to work on their projects, present their work, and engage in the dialogical learning process. Student and design instructor feedback was collected to evaluate the changes and overall effectiveness of the design of the blended learning experience, which proved to be effective.
Accountability policy forms in European education systems: An introduction
Authors: Barbana Samir , Dumay Xavier , Dupriez Vincent
Published: February 2020

This article is an introduction to a European Educational Research Journal special issue on accountability policies and instruments in Europe. Two hypotheses grounded in the new institutionalist theory are presented to conceptualise and analyse the variety of national trajectories and forms of accountability in four European education systems (French-speaking Belgium, France, Spain and Portugal). The first hypothesis is that of path dependence, which privileges the prevalence of national histories despite the diffusion of global instruments. Strong resemblances between the countries, meanwhile, would favour the second hypothesis of a globalised field in which education systems are exposed to similar policy schemes.
Nutritional and Functional Indicators and Their Association With Mortality Among Older Adults With Alzheimer’s Disease
Authors: de Sousa O. Vicente , Mendes J. , Amaral T. F.
Published: February 2020

This study investigated how different nutritional and functional status indicators are associated with mortality in patients with Alzheimer’s disease (AD). A prospective cohort study was conducted among 79 community-dwelling older adults with AD. Follow-up was 60 months. Undernutrition status was evaluated by Mini Nutritional Assessment (MNA), body mass index, mid-arm muscle circumference (MAMC), calf circumference, and phase angle. Functional status was assessed by handgrip strength, and usual gait speed. Twenty-two participants died (27.8%). Results show that undernutrition (hazard ratio [HR] 5.69, 95% confidence interval [CI] 2.21-14.61), weight loss (HR 3.82, 95% CI 1.37-10.63), underweight (HR 3.24, 95% CI 1.18-8.82), low MAMC (HR 4.54, 95% CI 1.65-12.48), calf circumference ≤ 31 (HR 4.27, 95% CI 1.63-11.16), low HGS (HR 3.11, 95% CI 1.18-8.17), and low gait speed (HR 4.73, 95% CI 1.68-13.27) were all associated with mortality. In conclusion, a poor nutritional and functional status was associated with a higher risk of mortality, regardless of sex, age, marital status, education, and cognitive function.
Laboratory pullout test study on the influence zone of geosynthetics
Authors: Fei Jianbo , Jie Yuxin , Wu Haipeng , Zhou Ting
Published: February 2020

Conventional pullout test devices are mainly designed to measure the shear strength indices of the geosynthetics–soil interface. This article introduces a new model container to study the influence zone of geosynthetics in pullout test. Several basic image processing methods were employed to analyze the grain motion of two gravel compositions in pullout tests. The trajectories of grains in the gravel differ at different heights; specifically, a more active motion was observed if the grain was closer to the geosynthetics. Moreover, grains were found to move not only horizontally but also vertically as well as to rotate on pulling out the geosynthetics. The range of a grain on the move is almost constant during the pullout and determines the influence zone of the geosynthetics. Image processing revealed that the influence zone was eight times the average grain size above the geosynthetics and 4–5 times the average grain size below the geosynthetics. The boundary condition thus significantly affects the influence zone.
Out-of-Pocket Spending for Thumb Carpometacarpal Arthritis: Capitation Matters
Authors: Billig Jessica I. , Lu Yu-Ting , Kelley Brian P. , Chung Kevin C. , Sears Erika D.
Published: February 2020

Background: Patients are increasingly responsible for direct medical expenditures with a growth in out-of-pocket (OOP) expenses, which can impede access to care and affect treatment. This study aims to investigate the impact of capitation on OOP expenses for surgical and presurgical treatment for thumb carpometacarpal (CMC) joint arthritis. Methods: Patients with a diagnosis of thumb CMC arthritis who underwent surgery (2009-2016) comprised our study cohort. Sociodemographic data, total cost, and OOP expenses were collected at the time of surgery and 2 years prior. Patients were stratified by insurance type: fee-for-service (FFS), managed care (MC), Medicare-MC, and Medicare-FFS. Capitated plans were included in the MC and Medicare-MC groups. A generalized linear regression was performed to investigate the association between OOP expenses and insurance type. Results: Our cohort consisted of 7780 patients with FFS insurance, 953 with MC insurance, 2136 with Medicare-FFS, and 265 with Medicare-MC. There was no difference in total costs for FFS and MC (FFS $7281 vs. MC $7306, P = .73; Medicare-FFS $6663 vs. Medicare-MC $6183, P = .19). However, patients with FFS incurred significantly greater OOP costs (FFS $952 vs. MC $434, P < .01; Medicare-FFS $343 vs. Medicare-MC $232, P < .01). In the adjusted regression, MC, Medicare-FFS, and Medicare-MC had approximately 21% to 46% of the predicted OOP expenses of patients with FFS plans ( P < .01). Conclusion: Despite similar total costs, OOP expenses were significantly greater for patients with FFS or Medicare-FFS insurance. With healthcare costs transitioning to patients, providers should consider cost sharing when conferring care to help alleviate the financial burden placed on patients.
Novel photosensitizing properties of porphyrin–chrysin derivatives with antitumor activity in vitro
Authors: Liu Ding , Zhang Qizhi , Zhang Lang , Yu Wenmei , Long Huizhi , He Jun , Liu Yunmei
Published: February 2020

Photodynamic therapy is a promising cancer treatment with the advantages of low toxicity, high efficiency, and noninvasiveness. In this study, 23 novel porphyrin–chrysin derivatives are synthesized using alkyl carbon chains as bridges. We use human gastric cancer cells (MGC-803) and human cervical cancer cells to evaluate the in vitro antitumor activity of all the porphyrin–chrysin derivatives, with 5-fluorouracil (5-Fu) as a positive control. Several of the prepared compounds showed effective photodynamic killing effects, among which 5-hydroxy-2-phenyl-7-(2-(4-(10,15,20-tris(4-hydroxyphenyl)porphyrin-5-yl)phenoxy)ethoxy)-4 H-chromen-4-one shows the highest antiproliferation activity on human cervical cancer cells, with a half maximal inhibitory concentration of 26.51 ± 1.15 µM. Flow cytometry analysis showed that human cervical cancer cell apoptosis might be induced by G1 phase arrest.
From coordination polymer to carbon nanotube: Preparation, characterization and rapid adsorption capacity toward organic pollutants
Authors: Lin Hong-Yan , Wang Yi-Fei , Tian Yuan , Liu Guo-Cheng , Luan Jian
Published: February 2020

A CuI coordination polymer based on the N,N’-bis(3-pyridinecarboxamide)-1,4-butane (3-dpyb) ligand, namely [Cu(3-dpyb)0.5Cl], is hydrothermally synthesized and structurally characterized, and is used as a catalyst precursor to synthesize multi-walled carbon nanotubes. Interestingly, the as-grown multi-walled carbon nanotubes exhibit high performance in removing dyes from solution and can serve as a low-cost and fast adsorbent. In addition, the adsorption behavior of this new adsorbent fits well with the Freundlich isotherm and the pseudo-second-order kinetic model.
Ultrasound-Guided Proximal and Distal Tarsal Decompression: An Analysis of Pressures in the Tarsal, Medial Plantar, and Lateral Plantar Tunnels
Authors: Iborra Marcos Alvaro , Villanueva Martinez Manuel , Sanz-Ruiz Pablo , Barrett Stephen L. , Zislis George
Published: February 2020

Objectives. To analyze the reliability of measurements of tarsal tunnel and medial and lateral plantar tunnel pressures before and after ultrasound-guided release. Measurements taken were guided by ultrasound to improve reliability. This novel approach may help surgeons make surgical decisions. The second objective was to confirm that decompression using ultrasound-guided surgery as previously described by the authors is technically effective, reducing pressure to the tarsal and medial and lateral plantar tunnels. Methods. The study included 23 patients with symptoms compatible with idiopathic tarsal tunnel syndrome (TTS). The first step was to measure intracompartmental pressure of the tarsal tunnel, medial plantar tunnel, and lateral plantar tunnel preoperatively. The second step was ultrasound-guided decompression of the tibial nerve and its branches. Subsequently, pressure was measured again immediately after decompression in the 3 tunnels. Results. After surgery, the mean values significantly dropped to normal values. This represents a validation of effective decompression of the tibial nerve and its branches in TTS with ultra–minimally invasive surgery. Conclusions. The ultrasound-guided surgical technique to release the tibial nerve and its branches is effective, significantly reducing pressure in the tunnels and, thereby, decompressing the nerves.

Level of evidence: Level IV
Longitudinal Assessment of Quadriceps Muscle Morphology Before and After Anterior Cruciate Ligament Reconstruction and Its Associations With Patient-Reported Outcomes
Authors: Garcia Steven A. , Curran Michael T. , Palmieri-Smith Riann M.
Published: February 2020

Background:

Reductions in muscle size are common after anterior cruciate ligament reconstruction (ACLR) and may contribute to suboptimal patient outcomes. However, few studies have quantified postoperative alterations in muscle quality and evaluated its associations with patient-reported function.

Hypotheses:

Rectus femoris cross-sectional area (CSA) will decrease postoperatively but improve at return to activity (RTA), rectus femoris muscle quality (percentage fat [PF]) will increase postoperatively and be greater at RTA compared with preoperative values, and rectus femoris CSA and PF will be associated with International Knee Documentation Committee (IKDC) scores at both postoperative time points.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

A total of 26 individuals who sustained an ACL injury and underwent reconstructive surgery were evaluated preoperatively (T0), 9 weeks post-ACLR (T1), and at RTA. Rectus femoris CSA and PF were evaluated bilaterally via ultrasound imaging, and patient-reported function was assessed using the IKDC score.

Results:

Bilateral reductions in rectus femoris CSA were noted from T0 to T1 ( P < 0.01). Only the uninvolved limb returned to preoperative CSA ( P = 0.80), as the involved limb failed to return to preoperative levels at RTA ( P = 0.04). No significant changes in rectus femoris PF were observed across time points ( P > 0.05). Lesser PF ( P < 0.01) but not CSA ( P = 0.75) was associated with higher IKDC score at T1. Lesser PF ( P = 0.04) and greater CSA ( P = 0.05) was associated with higher IKDC score at RTA.

Conclusion:

Substantial atrophy occurs bilaterally after ACLR, and the involved limb does not return to preoperative muscle size despite the patient completing rehabilitation. Quadriceps muscle morphology is associated with patient-reported function and may be an important rehabilitation target after ACLR.

Clinical Relevance:

Quadriceps atrophy and poor muscle quality may contribute to suboptimal patient functioning and quadriceps dysfunction and may be important in RTA decision making. Assessing muscle morphology using ultrasound may be a feasible and clinically beneficial tool in patients after ACLR.
HLA-DRB1 allele impact on pediatric multiple sclerosis in a Hellenic cohort
Authors: Gontika Maria , Skarlis Charalampos , Artemiadis Artemios , Pons Roser , Mastroyianni Sotiria , Vartzelis George , Theodorou Virginia , Kilindireas Konstantinos , Stefanis Leonidas , Dalakas Marinos , Chrousos George , Anagnostouli Maria
Published: February 2020

Background

Pediatric-onset multiple sclerosis (POMS) is considered a complex disease entity with many genetic and environmental factors implicated in its pathogenesis. Linkage studies in Caucasian adult populations consistently demonstrate the major histocompatibility complex and its HLA (human leukocyte antigen) polymorphisms as the genetic locus most strongly linked to MS.

Objective

To investigate the frequencies and possible clinical and imaging correlations of HLA-DRB1 alleles in a Hellenic POMS sample.

Methods

Fifty POMS patients fulfilling the IPMSSG (International Pediatric Multiple Sclerosis Study Group) criteria were enrolled using 144 adult-onset MS (AOMS) patients and 246 healthy controls for comparisons. HLA genotyping was performed with standard low-resolution sequence-specific oligonucleotide (SSO) techniques. Clinical and imaging correlations with specific HLA-DRB1 alleles were also examined.

Results

The HLA-DRB1*03 genotype was significantly higher in POMS patients compared to both the AOMS population (26% vs. 12.5%, p = 0.042) and the general population (26% vs. 12.6%, p = 0.004). HLA-DRB1*03-positive POMS patients had significantly more relapses (6.9 ± 4.9 vs. 4.2 ± 4.4, p = 0.005) and more thoracic spinal cord lesions than HLA-DRB1*03-negative patients (61.5% vs. 27%, p = 0.043).

Conclusion

In our Hellenic population, HLA-DRB1*03 allele confers increased risk for POMS and it is also correlated with possibly increased disease activity, expanding the existing knowledge on HLA associations and POMS.
Experimental research in expatriation and its challenges: A literature review and recommendations
Authors: Noethen Daniela , Alcazar Rocio
Published: February 2020

Via a systematic literature review, this article draws attention to the alarming scarcity of experimental studies and the ensuing shortness of evidence for causality in the field of expatriate management. Only 17 articles could be identified, published over more than 20 years, which utilize randomized experiments or quasi-experiments on topics of expatriation. Moreover, these articles show specific patterns, such as dealing exclusively with pre-departure and on-assignment issues, or, in their majority, sampling individuals who interact with expatriates rather than expatriates themselves. This lack of experimental studies is problematic, as it is difficult to establish causality between different variables without conducting experimental studies. Yet many critical issues in expatriation are precisely questions of causality. Hence, in this article, we provide resources to help move the expatriation field toward a more balanced use of different research methodologies and, thus, a greater understanding of the many relationships uncovered in past research. First, we identify four main challenges unique to conducting experimental research in the context of expatriation: Challenging data access, global sample dispersion, restricted manipulability of variables, and cultural boundedness of constructs and interpretations. Second, we provide strategies to overcome these challenges, based on studies included in the review as well as taking ideas from neighboring fields such as cross-cultural psychology. The article concludes with a discussion of how experimental research can take the field of expatriation forward and improve the decision-making process of practitioners managing international assignees.
Entrepreneurship Education: Team Composition in Known Worlds and New Frontiers
Authors: Karlsson Tomas , Nowell Pamela
Published: February 2020

This article is about entrepreneurial teams and addresses specifically the relationship between the group value consensus and performance. It contributes to previous research on teams in three ways. First, this study addresses the effectiveness of team composition in two different tasks. By doing so, it lends insights into how to compose entrepreneurial teams for improved outcomes. Second, we look specifically at how value composition impacts team performance. Third, we investigate designed teams in a quasi-experimental setting as opposed to organically formed teams commonly found in other team composition studies. Our study finds that value heterogeneity is beneficial to external tasks while detrimental to internal tasks.
Research-to-Resource: The Importance of Aural Learning in the Strings Classroom
Authors: Chappell Elizabeth
Published: February 2020

String musicians put a high priority on ear training in order to be successful on their instruments. Research suggests that delaying music reading to teach by ear does not negatively affect sight-reading performance in the long term, may improve music literacy skills, and also may improve student perceptions of accomplishment. The pedagogy of learning by ear, which is distinctly different than learning by rote, may be unfamiliar to many string teachers, regardless of their experience in the classroom. The purpose of this research-to-resource article is to provide string teachers with strategies to teach repertoire by ear with the intention of strengthening students’ aural acuity, problem-solving skills, and knowledge of the fingerboard.
C-reactive protein is not a screening tool for late periprosthetic joint infection
Authors: Fink Bernd , Schlumberger Michael , Beyersdorff Julian , Schuster Philipp
Published: February 2020

Background

Preoperative diagnosis of periprosthetic joint infection (PJI) is important because of the therapeutic consequences. The aim of the present study is to investigate whether the serum C-reactive protein (CRP) level can be used as a screening tool for late PJI.

Materials and methods

A cohort of 390 patients with revision surgery of total hip prostheses (200) or total knee prostheses (190) was assessed for late PJI by determining CRP serum level and performing preoperative aspiration with cultivation and intraoperative tissue analyses with cultivation and histologic examination, using the Musculoskeletal Infection Society (MSIS) and International Consensus Meeting (ICM) criteria.

Results

A total of 180 joints were rated as PJI (prevalence 46%). Of these, 42.8% (77) showed a CRP level below 10 mg/L and 28.3% (51) showed a normal CRP level of less than 5 mg/L. The 76.9% of the cases with slow-growing bacteria showed a CRP level below 10 mg/L, and 61.5% showed a normal CRP level.

Conclusions

Serum CRP level should not be used as a screening tool to rule out late PJI.

Level of evidence

Level 2 (diagnostic study).
MOMO - multi-objective metabolic mixed integer optimization: application to yeast strain engineering
Authors: Andrade Ricardo , Doostmohammadi Mahdi , Santos João L. , Sagot Marie-France , Mira Nuno P. , Vinga Susana
Published: February 2020

Background

In this paper, we explore the concept of multi-objective optimization in the field of metabolic engineering when both continuous and integer decision variables are involved in the model. In particular, we propose a multi-objective model that may be used to suggest reaction deletions that maximize and/or minimize several functions simultaneously. The applications may include, among others, the concurrent maximization of a bioproduct and of biomass, or maximization of a bioproduct while minimizing the formation of a given by-product, two common requirements in microbial metabolic engineering.

Results

Production of ethanol by the widely used cell factory Saccharomyces cerevisiae was adopted as a case study to demonstrate the usefulness of the proposed approach in identifying genetic manipulations that improve productivity and yield of this economically highly relevant bioproduct. We did an in vivo validation and we could show that some of the predicted deletions exhibit increased ethanol levels in comparison with the wild-type strain.

Conclusions

The multi-objective programming framework we developed, called Momo, is open-source and uses PolySCIP (Available at http://polyscip.zib.de/). as underlying multi-objective solver. Momo is available at http://momo-sysbio.gforge.inria.fr