bluuebunny/crossref_metadata_2025 huggingface dataset:
Expansion of Renewable Energy in Federal Settings: Austria, Belgium, and Germany in Comparison
Authors: Wurster Stefan , Hagemann Christian
Published: November 2019

In the face of accelerating climate change, the transition towards a nonnuclear renewable energy system represents a key political challenge, which can be aggravated by the increasing energy supply uncertainty created by the shift away from fossil fuels. In this article, we conduct a comparison of the expansion of renewable energy sources in Austria, Belgium, and Germany at the level of their subnational units (federal states), thereby covering three economically very important central European federal European Union members. We consider potentially influential factors in a fuzzy-set qualitative comparative analysis: In addition to state-specific socioeconomic and geographical characteristics, political factors, such as parties in government, and specific energy-related policy instruments are included in the analysis. We find that a high potential for renewable electricity expansion in combination with low financial prosperity is most likely to lead to a successful expansion of renewable electricity production from wind and photovoltaics.
Platelet Aggregation Testing on a Routine Coagulation Analyzer: A Method Comparison Study
Authors: Stratmann Jan , Karmal Lida , Zwinge Birga , Miesbach Wolfgang
Published: November 2019

Platelet function (PF) plays a pivotal role in both hemostasis and thrombosis, and manual light transmission aggregometry (LTA) is considered the standard of care for platelet function testing but is an error-prone and time-consuming procedure. We aimed to test the agreement regarding maximum aggregation (MA), velocity (VEL), and lag-phase (LagP) of platelet aggregation of the automated Sysmex CS-2100 i analyzer (Siemens, Germany) against the APACT 4004 (Elitech, France) in samples derived from healthy participants and patients with hemostaseologic disorders. In total, 123 patient-derived samples were investigated, including 42 patients with acetylsalicylic acid and/or clopidogrel intake and 20 patients with other hemostaseologic disorders. Both MA and VEL showed good or excellent intermethod correlation. Agreement between the testing methods was only partially achieved, and values were indicative for a systematic bias to lower measurements below a threshold of 50% MA with the CS-2100 i compared to the APACT 4004. All patients with impaired PF in the APACT 4004 were successfully identified with the CS-2100 i, and reference values for automated LTA are provided. Conclusively, automated LTA with the CS-2100 i is a highly standardized and reliable PF testing method and represents a decisive step in the simplification of platelet function testing in clinical routine.
Characterization of viscoelastic properties of minced beef meat thawed by ohmic and conventional methods
Authors: Cevik Mutlu , Icier Filiz
Published: November 2019

Frozen minced meat samples having fat contents of 2%, 10% and 18% were thawed using different methods (refrigeration thawing at ambient temperature of +4 ℃, under running cold water (+4 ℃) thawing, ohmic thawing for 10, 13 and 16 V/cm). Viscoelastic properties were determined by using rheological tests (oscillation and creep/recovery tests). Storage modulus, loss modulus, complex modulus, loss tangent, dynamic viscosity and complex viscosity values of minced meat samples increased as fat content increased. As frequency value increased, the modulus values of meat samples increased but dynamic and complex viscosity values of the samples decreased. The minced meat samples thawed by different methods had recoverable compliance values. The compliance values of meat samples during creep region can be well characterized by Burgers model. Ohmic thawing can be used as an alternative thawing method since it resulted in similar rheological properties of minced meat samples compared to refrigeration thawing at ambient temperature of +4 ℃ and under running cold water (+4℃) thawing.
Is Empathy the Default Response to Suffering? A Meta-Analytic Evaluation of Perspective Taking’s Effect on Empathic Concern
Authors: McAuliffe William H. B. , Carter Evan C. , Berhane Juliana , Snihur Alexander C. , McCullough Michael E.
Published: November 2019

We conducted a series of meta-analytic tests on experiments in which participants read perspective-taking instructions—that is, written instructions to imagine a distressed persons’ point of view (“imagine-self” and “imagine-other” instructions), or to inhibit such actions (“remain-objective” instructions)—and afterwards reported how much empathic concern they experienced upon learning about the distressed person. If people spontaneously empathize with others, then participants who receive remain-objective instructions should report less empathic concern than do participants in a “no-instructions” control condition; if people can deliberately increase how much empathic concern they experience, then imagine-self and imagine-other instructions should increase empathic concern relative to not receiving any instructions. Random-effects models revealed that remain-objective instructions reduced empathic concern, but “imagine” instructions did not significantly increase it. The results were robust to most corrections for bias. Our conclusions were not qualified by the study characteristics we examined, but most relevant moderators have not yet been thoroughly studied.
Opioid-Related Adverse Events: Incidence and Impact in Patients Undergoing Cardiac Surgery
Authors: Allen Keith B. , Brovman Ethan Y. , Chhatriwalla Adnan K. , Greco Katherine J. , Rao Nikhilesh , Kumar Avinash , Urman Richard D.
Published: November 2019

Purpose. Opioid-related adverse drug events (ORADEs) increase patient length of stay (LOS) and health care costs. However, ORADE rates may be underreported. This study attempts to understand the degree to which ORADEs are underreported in Medicare patients undergoing cardiac surgery. Materials and Methods. The Center for Medicare and Medicaid Services administrative claims database was used to identify ORADEs in 110 158 Medicare beneficiaries who underwent cardiac valve (n = 50 525) or coronary bypass (n = 59 633) surgery between April 2016 and March 2017. The International Classification of Disease (ICD)-10 codes specifically linked to ORADEs were used to identify an actual ORADE rate, while additional ICD codes, clinically associated with butas not specific to adverse drug events were analyzed as potential ORADEs. Length of stay (LOS) and hospital daily revenue were analyzed among patients with or without a potential ORADE. Results. Among patients undergoing valve or bypass surgery, the documented ORADE rate was 0.7% (743/110 158). However, potential ORADEs may have occurred in up to 32.4% (35 658/110 158) of patients. In patients with a potential ORADE, mean LOS was longer (11.4 vs 8.2 days; P < .0001) and mean Medicare revenue/day was lower ($4016 vs $4412; P < .0001). The mean net difference in revenue/day between patients with and without an ORADE varied between $231 and $1145, depending on the Diagnosis-Related Group analyzed. Conclusions. ORADEs are likely underreported following cardiac surgery. ORADEs can be associated with increased LOS and decreased hospital revenue. Understanding the incidence and economic impact of ORADEs may expedite changes to postoperative pain management. Adopting multimodal pain management strategies that reduce exposure to opioids may improve outcomes by reducing complications, side effects, and health care costs.
Classifications of diabetic macular edema
Authors: Jampol Lee M
Published: November 2019

Diabetic retinopathy is a major cause worldwide of vision loss from diabetic maculopathy or proliferative retinopathy. Without widely accepted classifications of diabetic retinopathy and diabetic maculopathy, it is difficult to compare results of clinical trials or monitor clinical care. The European School of Advanced Studies in Ophthalmology has developed an international classification of diabetic maculopathy based upon spectral domain optical coherence tomography, which could be helpful for both initial evaluation and subsequent follow-up of diabetic patients in both clinical practice and experimental trials.
Peripheral retinal neovascularization in a patient with pilocytic astrocytoma
Authors: Murro Vittoria , Mucciolo Dario Pasquale , Giorgio Dario , Sodi Andrea , Giansanti Fabrizio , Virgili Gianni , Rizzo Stanislao
Published: November 2019

We described a case of papilledema complicated by peripheral retinal vessels in a 12-year-old boy affected by cerebellar astrocytoma. Opportunity to treat with photocoagulation or intravitreal anti-VEGF (vascular endothelial growth factor) injections was discussed with the parents and no treatment was done. After 5 years from surgery, retinal neovascularization was stable without vitreal hemorrhages or retinal complications, more specifically fibrosis of the neovessels increased and leakage phenomena were reduced at the fluorescein angiography. To our knowledge, this is a unique case of papilledema complicated by peripheral retinal vessels in a patient affected by cerebellar astrocytoma.
A double-blind, randomized, placebo-controlled pilot trial to evaluate safety and efficacy of vorapaxar on arteriovenous fistula maturation
Authors: Olivier Christoph B , Sundaram Vandana , Chertow Glenn M , Shashidhar Sumana , McDonnell Lori K , Ding Victoria Y , Desai Manisha , Mahaffey Kenneth W , Mell Matthew
Published: November 2019

Background:

Protease-activated receptor-1 antagonism by vorapaxar could facilitate arteriovenous fistula maturation but may increase bleeding risk.

Objective:

The primary objective of the Vorapaxar Study for Maturation of arteriovenous fistula for Hemodialysis Access (VorapAccess) was to determine if vorapaxar improves arteriovenous fistula functional maturation in patients with end-stage renal disease.

Methods:

VorapAccess was a randomized, placebo-controlled, double-blind pilot trial comparing 2.5 mg vorapaxar per day with placebo for twelve weeks starting on day two after arteriovenous fistula creation. The primary outcome was time to functional maturation defined as successful cannulation for six hemodialysis sessions within three weeks. The planned sample size was 50 participants. The study was terminated early after withdrawal of planned financial support. Given the small number of randomized patients, we performed descriptive analyses without inference testing.

Results:

A total of 13 participants were randomly allocated study drug (six vorapaxar and seven placebo). The median age was 56 years and seven participants (54%) were female. The median (minimum–maximum) days to functional maturation were 169 (77–287) days in the vorapaxar group and 145 (48–198) days in the placebo group. Six of the 13 (46%) participants had arteriovenous fistula functional maturation within 180 days; two of six (33%) in the vorapaxar group and four of seven (57%) in the placebo group. There was one bleeding event in the placebo group.

Conclusion:

Fewer than half of participants had functional maturation within 180 days after surgery, suggesting a major need for agents or strategies that enhance arteriovenous fistula maturation.
Context collapse and anonymity among queer Reddit users
Authors: Triggs Anthony Henry , Møller Kristian , Neumayer Christina
Published: November 2019

This article maps out how people in queer communities on Reddit navigate context collapse. Drawing upon data from interviews with queer Reddit users and insights from other studies of context collapse in digital media, we argue that context collapse also occurs in anonymity-based social media. The interviews reveal queer Reddit users’ practices of context differentiation, occurring at four levels: somatic, system, inter-platform and intra-platform. We use these levels to map out how lesbian, gay, bisexual, transgender and queer or questioning (LGBTQ) people express their identities and find community on Reddit while seeking to minimize the risks imposed by multiple impending context collapses. Because living an authentic queer life can make subjects vulnerable, we find that despite Reddit’s anonymity, sophisticated practices of context differentiation are developed and maintained. We argue that context collapse in an era of big data and social media platforms operates beyond the control of any one user, which causes problems, particularly for queer people.
Image substitutes and visual fake history: historical images of atrocity of the Ukrainian famine 1932–1933 on social media
Authors: Zhukova Ekatherina
Published: November 2019

This article analyses how pre-internet historical images of atrocity are used on social media in the era of misinformation, disinformation and a rising radical right. Combining scholarship in cultural sociology, media studies and communication, and history, the article introduces two concepts: image substitute and visual fake history. Image substitute is an image of an historical event from a particular time or place, which is used to represent a tragedy from a different decade or geographical location. Visual fake history is a combination of truth, misinformation and disinformation about past events through reliance on historical images as image substitutes and accompanying narratives. These concepts are developed empirically on the basis of images representing the Ukrainian famine of 1932–1933, circulated on Instagram under #holodomor between 2012–2018. It is shown that the Ukrainian famine was visualized through images of Soviet and South Asian famines and the Holocaust, which were embedded in anti-communist and anti-Semitic narratives.
Ergonomics Analysis for Subjective and Objective Fatigue Between Laparoscopic and Robotic Surgical Skills Practice Among Surgeons
Authors: Rodrigues Armijo Priscila , Huang Chun-Kai , Carlson Tyson , Oleynikov Dmitry , Siu Ka-Chun
Published: November 2019

Introduction. Our aim was to determine how self-reported and objectively measured fatigue of upper limb differ between laparoscopic and robotic surgical training environments. Methods. Surgeons at the 2016 SAGES Conference Learning Center and at our institution were enrolled. Two standardized surgical tasks (peg transfer [PT] and needle passing [NP]) were performed twice in each surgical skills practical environments: (1) laparoscopic training-box environment (Fundamentals of Laparoscopic Surgery [FLS]) and (2) Mimic dV-trainer (MIMIC). Muscle activation of upper trapezius (UT), anterior deltoid (AD), flexor carpi radialis, and extensor digitorum were recorded using surface electromyography (EMG; Trigno, Delsys, Inc, Natick, MA). Subjective fatigue was self-reported using Piper Fatigue Scale-12. Analysis was done using SPSS v25.0, α = .05. Results. Demographics were similar between FLS (N = 14) and MIMIC (N = 12). For PT, MIMIC had a significant increase in EMGRMS of UT ( P < .001) and AD ( P < .001). Conversely, FLS led to significant decreased muscle fatigue in UT ( P = .015). For NP, MIMIC had a significant increase in EMGRMS for UT ( P = .034) and AD ( P = .031), but FLS induced more muscle fatigue for AD ( P = .004). There was significant decrease in self-reported fatigue after performing FLS tasks ( P = .030) but not after MIMIC ( P = .663). Conclusion. Our results showed that practice with MIMIC resulted in greater activation of shoulder muscles, while FLS caused more significant muscle fatigue in the same muscles. This could be due to ergonomic disadvantages and nonoptimal ergonomic settings. Further studies are needed to understand the optimal ergonomics and its impact on fatigue and muscle activation during use of both the FLS and MIMIC training systems.
Thermally affected stiffness matrix of angular contact ball bearings in a high-speed spindle system
Authors: Sy Truong Dinh , Kim Byung-Sub , Park Jong-Kweon
Published: November 2019

Bearing stiffness directly affects the dynamic characteristics in a high-speed spindle system and plays an important role in terms of manufacturing quality. We developed a new approach for predicting the thermal behavior of a high-speed spindle, calculated the thermal expansion, and generated a bearing stiffness matrix for angular contact ball bearings. The heat convection of spindle housing in air, the balls in lubricant, the spindle shaft in quiescent air, and the bearing inner ring surfaces were determined. Heat sources such as bearing friction, and the heat contributed by the built-in motor, were simulated using an analysis systems (ANSYS) steady-state thermal model. The results were imported into a static ANSYS structural model. Ball thermal expansion was calculated based on changes in the coordinates of nodal points on the ball surface. Finally, a thermally affected bearing stiffness matrix was generated by applying the Newton–Raphson technique. Decreases in the bearing radial, axial, angular, and coupling stiffness values as rotational spindle speed increased were calculated. Also, the stiffness coefficients at a specific speed increased significantly caused by the thermal effects. Finally, for validation, the bearing stiffness was compared to that calculated using an earlier thermal network approach.
The (In)voluntary follower
Authors: Blom Martin , Lundgren Mikael
Published: November 2019

An important assumption when it comes to leader–follower relationships is that compliance and subordination are basically voluntary. In this article, we problematize and develop this assumption and discuss different circumstances in which voluntariness in terms of followership may be compromised. Based on this discussion, we also suggest a tentative model of follower voluntariness, indicating dimensions in which voluntariness can be infringed upon and followership corroded and when it might be more productive to depict an asymmetrical relationship as something else than followership.
Mirror, mirror on the wall: Shifting leader–follower power dynamics in a social media context
Authors: Gilani Parisa , Bolat Elvira , Nordberg Donald , Wilkin Claudia
Published: November 2019

The democratisation made possible by social media presents leadership studies with an opportunity to re-evaluate the often-neglected role of power in leader–follower dynamics. Drawing on Critical Leadership Studies and using a hybrid qualitative methodology, we discover that relationships between social media leaders and followers are co-produced and largely accompanied by continuous shifts and re-negotiation of power between social media leaders and social media followers. We show that social media platforms and their metrics play an important role in such power shifts by granting equal access to communication whilst potentially tilting information asymmetries in favour of the follower. The study also shows how these relationships can affect and even pervert the leaders’ problematic search for a ‘true self’. From this observation we draw attention to wider challenges in the social media context, which poses important questions for the leadership field.
Constrained leader autonomy: You are the stoker in hell—No matter what you do, you are wrong!
Authors: Lund Anne Kamilla
Published: November 2019

This study explores how formal leaders at various levels experience and respond to exercising their own autonomy in relationships with superiors and staff in a knowledge-dominated healthcare organization. Proposing the notion of constrained autonomy, the study suggests a way of understanding how formal leaders in mid-level positions work within autonomy–authority tensions. Based on interviews with formal leaders, I argue that formal leaders are highly aware of and deal with the autonomy tensions that occur in contradictions between structural requirements, ability to lead, and decision-making power in such complex ways that tensions are upheld and left more ambiguous than they first appeared. Thereby, the study develops literature on autonomy tensions and leadership. It also contrasts research suggesting that formal leaders sometimes deny tensions, are unaware of them, or seek to control or eliminate them and questions the sharp division between autonomy and authority often found in literature. The notion of constrained autonomy may also assist formal leaders navigate daily workplace tensions in knowledge-dominated healthcare contexts.
Discourse analysis as a tool for uncovering the lived experience of dementia: Metaphor framing and well-being in early-onset dementia narratives
Authors: Castaño Emilia
Published: November 2019

The aim of this article is to explore how metaphor is mobilized to frame and describe the lived experience of dementia in a corpus of illness narratives compiled from 10 blogs initiated and maintained by individuals diagnosed with early-onset dementia. The article is set against the background of contemporary healthcare practices and discourse around chronic illness and focuses on the metaphors that patients use to communicate about their dementia experience in relation to three basic psychological needs: autonomy, competence and relatedness, which are essential for human well-being and are heavily challenged in complex medical situations. Results are discussed in terms of the framing metaphors provide of the emotional, psychological impact of dementia and their implications for patient-centered care. This study expands prior work by researching metaphors used for a condition that has been scarcely explored from this point of view and by focusing on the patient’s perspective exclusively.
Unsteady aerodynamics of a pitching NACA 0012 airfoil at low Reynolds number
Authors: Kurtulus Dilek Funda
Published: November 2019

The present paper aims to investigate numerically small amplitude oscillation of NACA 0012 airfoil at Re = 1000. The airfoil is sinusoidally pitching around the quarter chord point with 1° pitch amplitude about a mean angle of attack. The computations are performed for mean angles of attack ranging from 0° to 60° and for pitching frequencies of 1 Hz and 4 Hz. The effect of the mean angle of attack and pitching frequency on the instantaneous forces as well as the vortex structure is investigated in comparison with the non-oscillatory conditions. It was shown that airfoil oscillations at the investigated conditions change the amplitude of oscillation of the aerodynamic loads. The instantaneous drag coefficient is always positive for pitching airfoil at 1 Hz. In the meantime, there are time intervals where instantaneous drag coefficient becomes negative for pitching motion at 4 Hz for mean angles of attack from 3° to 36°.
Chemical Composition of Intergeneric Hybrids Between Ligularia and Cremanthodium Collected in Sichuan Province of China
Authors: Okamoto Yasuko , Fukui Arisa , Hashida Takuya , Shiojiri Kosuzu , Kuroda Chiaki , Tori Motoo , Gong Xun , Hanai Ryo
Published: November 2019

Two intergeneric hybrids between Ligularia nelumbifolia and Cremanthodium stenoglossum were examined with respect to the chemical composition of root extracts and the sequences of neutral DNA regions. The DNA data showed that the direction of hybridization was different between the individuals. Eremophilane sesquiterpenes were found in both hybrids and deduced to have come from their Cremanthodium parents, because sesquiterpenes were detected in C. stenoglossum but not in L. nelumbifolia.
Diversity in Eremophilane Components of Ligularia dictyoneura in Yunnan and Sichuan Provinces of China
Authors: Hanai Ryo , Watanabe Shizuka , Matsushima Mika , Nagano Hajime , Kuroda Chiaki , Gong Xun
Published: November 2019

The chemical composition of 3 samples of Ligularia dictyoneura was studied. Nine furanoeremophilanes 1 to 9 and bakkenolide A (10) were isolated, among which compound 6 was a new furanoeremophilane-15,6-olide. These results, together with our previous results on 20 L. dictyoneura samples, show that furanoeremophilane is the major compound in the peripheries of the plant’s distribution area, while eremophilan-8-one, in the center. DNA analysis suggests that a furanoeremophilane producer in the center, an exception, is introgressed; namely, the ability to produce furanoeremophilane in the sample may have its origin in some other plant.
Iliac venous stenting for outflow obstruction does not significantly change the quality of life of patients with severe chronic venous insufficiency
Authors: Shiferson Alexander , Aboian Edouard , Shih Michael , Pu Qinghua , Jacob Theresa , Rhee Robert Y
Published: November 2019

Purpose

Percutaneous endovenous iliac stenting has emerged as a new modality in the treatment of advanced chronic venous insufficiency with outflow obstruction. However, the effect of this intervention on the quality of life remains unclear. We examined the impact of iliac venous stenting for outflow obstruction as compared to conservative medical management on the quality of life in severe chronic venous insufficiency patients.

Methods

Medical records of all patients with CEAP class 5 and 6 disease (N = 172) who underwent ilio-caval venography with intravascular ultrasonography (IVUS) at a single institution over a seven-year period, were reviewed for this case–control study. Quality of life evaluation was performed utilizing the Chronic Venous Insufficiency Quality of Life Questionnaire (CIVIQ-20) one year after the index procedure.

Results

Of the 172 severe chronic venous insufficiency patients, 109 were stented and 63 patients were treated medically based on their venography and IVUS results. The indication for stenting was confirmation of IVUS determined surface area or diameter outflow stenosis of greater than 50% within the common or external iliac venous systems. Eighty patients (47%) responded with completed CIVIQ-20 questionnaires for analysis. Of these, 47 were from the stented group and 33 from the non-stented group. At least moderate persistent pain or discomfort post-procedure was reported by 20 (43%) stented group patients and 19 (58%) non-stented group patients. Scores for all the other criteria in the CIVIQ-20 were similar between the groups. The mean total CIVIQ-20 score was 45.23 and 47.13, respectively, in stented group and non-stented group patients. ( p = 0.678).

Conclusion

There was no significant difference in the quality of life reported by CEAP 5 and 6 patients who underwent iliac venous stenting versus those who were treated medically for presumed iliac outflow obstruction. Prospective studies are needed to determine the true value of iliac venous stenting based on IVUS criteria in the management advanced chronic venous insufficiency.
Serum levels of ferritin and transferrin serve as prognostic factors for mortality and survival in patients with end‐stage liver disease: A propensity score‐matched cohort study
Authors: Meier Jörn Arne , Bokemeyer Arne , Cordes Friederike , Fuhrmann Valentin , Schmidt Hartmut , Hüsing‐Kabar Anna , Kabar Iyad
Published: November 2019

Background

Patients with end‐stage liver disease are known to suffer from a significantly high risk of mortality, but accurate prediction of the course of disease is challenging.

Objective

The study aim was to evaluate the independent prognostic and clinical importance of serum levels of ferritin and transferrin for 90‐day survival of patients with liver disease.

Methods

Patients with end‐stage liver disease treated during a 2‐year period were enrolled retrospectively in a single‐centre study. Unmatched and propensity score matching (PSM) analyses were applied.

Results

The study cohort comprised 286 patients with end‐stage liver disease, of which 22.9% died during the observational period. High serum ferritin levels and low serum transferrin levels were associated significantly with increased 90‐day mortality in the unmatched (p  < 0.001) and PSM study population (p  = 0.017). Serum levels of ferritin and transferrin had high prognostic capability to predict 90‐day survival similar to the Model for End‐stage Liver Disease. Patients with serum ferritin values >1030.5 µg/l had a 50% risk of dying within 11 days after measurement, which translated up to a 90‐day mortality of 83%.

Conclusion

Serum levels of ferritin and transferrin have independent and excellent capabilities to determine prognosis in patients with end‐stage liver disease. Ferritin measurements can reliably identify those with high mortality in daily practice.
Leadership political action committee donations and party status: A technical and theoretical extension
Authors: Jordan Soren
Published: November 2019

A recent study by Aldrich, Ballard, Lerner, and Rohde (2017) examines whether a specific type of money—donations from leadership political action committees—is systematically related to party goals outside of policy influence. Their model is theoretically incomplete, as leadership political action committees donate considerable money to candidates who do not help the party win new seats or maintain ideological cohesion. I account for this behavior by introducing a new conditional predictor: incumbency. When modeled as a triple interaction with party status and ideological fit, incumbency helps better explain the donating behavior of leadership political action committees. This interaction is paired with a technical extension, more directly modeling the multiplicity of races in which leadership political action committees do not make a donation in a campaign cycle. I find that extending the study with a more appropriate model allows us to draw better inferences about the behavior of leadership political action committees.
Effect of arthroscopic surgery combined with platelet-rich plasma in the treatment of discoid meniscus injury of knee joint and its influence on serum inflammatory factors
Authors: Liu Jia
Published: November 2019

This study was to observe the effect of arthroscopic surgery combined with platelet-rich plasma (PRP) in the treatment of discoid meniscus injury of knee joint and its influence on serum inflammatory factors. A total of 80 patients with discoid meniscus injury in our hospital from June 2014 to June 2016 were enrolled and divided into study group and control group randomly with 40 patients in each group. The control group was treated with arthroscopy alone, and the study group was treated with arthroscopy combined with PRP. The clinical efficacy of the two groups was observed, and the Lysholm scores, Knee injury and Osteoarthritis Outcome Score (KOOS scores), and serum inflammatory factors (IL-1, TNF-α, and IL-6) were compared between the two groups before and after treatment. Six months after the treatment, the improvement rate, defined as (Excellent + Good)/total*100, of the study group was 97.5%, significantly higher than that of the control group, which was 87.5% ( P < 0.05); before treatment, there was no significant difference in both Lysholm scores and KOOS scores between the two groups ( P > 0.05); and 6 months later, the Lysholm scores and KOOS scores in the two groups were both significantly higher than those before, and the scores in the study group increased more significantly compared with those of the control group ( P < 0.05); the values of serum IL-1, TNF-α, and IL-6 in the two groups were both significantly lower than those before, and the values in the study group decreased more significantly compared with those of the control group ( P < 0.05). In conclusion, arthroscopic surgery combined with PRP therapy can effectively improve the clinical symptoms and reduce the level of serum inflammatory factors in patients with discoid meniscus injury of the knee, which is worthy of promotion and application.
China–Africa Education Cooperation: From FOCAC to Belt and Road
Authors: King Kenneth
Published: November 2019

Purpose:

The article discusses the relationship between the human resource traditions of the Forum on China–Africa Cooperation (FOCAC) and those supported by the Belt and Road Initiative (BRI), and in particular by the Education Action Plan for the Belt and Road Initiative, issued by the Chinese Ministry of Education (MOE) in 2016.

Design/Approach/Methods:

The article draws upon discourse analysis of both the FOCAC VI and VII documents and the key MOE 2016 Action Plan.

Findings:

Given the trans-continental coverage of the BRI, it is suggested that its ambitious pledges in respect of education and human resource development (HRD) actually complement or even exceed the commitments made by FOCAC VI and VII.

Originality/Value:

This is the first article explicitly to compare the HRD pledges of FOCAC with those associated with BRI’s Education Action Plan.
Does a Partial Rotator Cuff Tear Affect Pitching Ability? Results From an MRI Study
Authors: Park Jin-Young , Kim Junhyun , Lee Jae-Hyung , Oh Kyung-Soo , Chung Seok Won , Park Hyunjun
Published: November 2019

Background:

Numerous studies have examined changes in the athletic performance of baseball pitchers after rotator cuff surgery. However, only a few studies have evaluated changes in athletic performance caused by partial rotator cuff tears that are not treated surgically.

Purpose:

To examine the course of partial-thickness rotator cuff tears and its possible effect on the athletic performance of professional pitchers.

Study Design:

Case series; Level of evidence, 4.

Method:

Of 191 professional pitchers who attended our clinic between January 2009 and October 2018, 52 individuals had partial-thickness tears with at least 2 years of follow-up magnetic resonance imaging (MRI) scans and were included in this study. All initial MRI examinations were performed when a season was finished or during the off-season for regular medical check-up purposes. Hence, any abnormal finding on MRI, which suggests damage to the rotator cuff tendon, was assumed to have occurred during the previous season. The mean follow-up MRI period was 40.8 months (range, 24.4-100.9 months). We defined the year before an athlete’s first MRI at our clinic as the year of damage, and we evaluated athletic performance during the season before the damage (pre-damage year 1), the season of the damage (damage year), and 1 and 2 seasons after the damage (post-damage years 1 and 2). We evaluated the changes in 5 statistical performance indicators: earned run average (ERA), fielding independent pitching (FIP), walks plus hits divided by innings pitched (WHIP), winning percentage (WPCT), and innings pitched (IP).

Results:

The partial-thickness tears progressed in 39 of 52 (75%) patients. Of these 39 patients, 34 (87%) were grade 1 in severity and 5 (12.8%) were grade 2 or higher. The ERA of the pitchers did not increase significantly immediately after damage or at post-damage years 1 and 2. WPCT increased significantly compared with pre-damage year 1 ( P < .001), and IP decreased significantly during the follow-up period ( P < .001). Although no significant decrease in pitching ability was noted based on these 3 indices, significant increases were observed for FIP and WHIP.

Conclusion:

A partial-thickness rotator cuff tear does not have significant influence on the athletic performance of professional baseball pitchers in the short term based on conventional performance indicators. Our findings suggest that WHIP and IP decline significantly at 2 years after damage is noticed.
Bone–Patellar Tendon–Bone Autografts Versus Hamstring Autografts Using the Same Suspensory Fixations in ACL Reconstruction: A Systematic Review and Meta-analysis
Authors: Chen Wenbo , Li Hong , Chen Yuzhou , Jiang Fangyi , Wu Yang , Chen Shiyi
Published: November 2019

Background:

Bone–patellar tendon–bone (BPB) autografts and hamstring tendon (HT) autografts are 2 popular choices for anterior cruciate ligament reconstruction (ACLR). Although existing meta-analyses have explored the clinical outcomes between BPB and HT autografts, none have based their analysis on studies with just femoral suspensory fixation methods.

Purpose:

To evaluate and compare clinical outcomes, particularly graft failure and knee stability, of ACLR with BPB or HT autografts with suspensory femoral fixation.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search was conducted of studies reporting single-bundle ACLR with BPB autografts and HT autografts with suspensory fixation with a minimum 24-month follow-up. Graft failure rate, knee stability, and clinical outcomes were compared for BPB versus HT autografts. Knee stability was measured with the Lachman test, pivot-shift test, and KT-1000/2000 arthrometer side-to-side difference (SSD). Clinical outcomes were measured with Lysholm scores and the Tegner activity scale, as well as rate of return to preinjury sports. Donor site morbidity among included studies was reviewed. A random-effects model was used for calculations of summary estimates. Subgroup, sensitivity, and trial sequential analyses were conducted.

Results:

Five studies were included. Graft failure was seen more often in the HT group than the BPB group, and this was statistically significant ( P = .03). However, the trial sequential analysis outcome indicated that the included sample size was not large enough to support a solid positive finding. The analysis showed no significant difference in SSD, Lachman test, pivot-shift test, rate of return to sports, Lysholm score, or Tegner score between groups. Subgroup analyses found no significant difference between groups.

Conclusion:

This meta-analysis demonstrated no significant differences in knee stability and knee functional outcomes between BPB and HT autografts with suspensory fixation. More evidence is needed to prove the lower risk of failure with use of BTB autograft with suspensory fixation.
Prevalence of Asymptomatic Intra-articular Changes of the Knee in Adult Professional Soccer Players
Authors: Bezuglov Eduard Nikolayevich , Lyubushkina Anastasiya Vladimirovna , Khaitin Vladimir Yurevich , Tokareva Alisa Viktorovna , Goncharov Evgeny Nikolayevich , Gorinov Artem Valerievich , Sivakova Elena Yurevna , Sereda Andrey Petrovitch
Published: November 2019

Background:

Currently, there are few data on the association between participation in soccer and the condition of the knee joints in adult professional players.

Hypothesis:

A high percentage of professional soccer players will have asymptomatic intra-articular changes of the knee.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The condition of the intra-articular structures (osteophytes, cartilage, and menisci) in 94 knee joints of 47 adult professional soccer players (mean ± SD age, 25.7 ± 4.6 years; body mass index, 22.8 ± 1.4 kg/m2) was analyzed. A 1.5-T magnetic resonance imaging scanner was used to perform the imaging, and the anonymized data were analyzed by 2 experienced radiologists.

Results:

Cartilage of both knee joints was affected in 97.9% of soccer players. Meniscal lesions were detected in 97.8% of joints, affecting both joints in 93.6% of athletes. Grade 2 cartilage lesions were the most prevalent (36%-60% depending on the lesion site), and grade 4 lesions were detected in 12.7% of joints. The medial femoral condyle and medial tibial plateau were most frequently affected by cartilage lesions (85.1%). Among meniscal lesions, grade 2 lesions were the most prevalent, being detected in 71% of the cases. Grade 3 lesions were detected in 13.8% of the joints. The posterior horn of the lateral meniscus was the most common site of meniscal lesions (affected in 95.7% of the joints). Osteophytes were detected in 4.2% of joints.

Conclusion:

The prevalence of asymptomatic cartilage and meniscal lesions in the knees of adult professional soccer players is extremely high and is not associated with the reduction of sports involvement. This research should promote the correct interpretation of magnetic resonance imaging data obtained from soccer players with acute trauma and the reduction of the number of unwarranted surgical procedures.
Single Bundle ACL Reconstruction: Step by Step
Authors: Nagib Isa An
Published: November 2019

An Anterior Cruciate Ligament (ACL) tear is the most common ligamentous injury of the knees. ACL reconstruction restore stability and kinematics of the knee joint, by improving knee stability. There are so many surgical techniques in ACL reconstruction. One of the most common technique is Single Bundle ACL reconstruction with the hamstring autograft. A good knowledge about operating technique and step by step approach are crucial for successfully procedure. The first step is patient positioning, including the leg holder should be placed proximal enough to allow full knee flexion and extension during procedure, it should be checked before starting the procedure. The second step is graft harvest, the autograft is prepared from the affected knee hamstring muscles, make a proper identification of the Gracilis and Semitendinosus tendon. The third step is portal placement, make a good native ACL attachment identification. Fourth step is femoral tunnel creation, avoid posterior wall blowout. Fifth step is tibial tunnel creation, remaining ACL fibers should be a landmark of the native ACL insertion site. Preserve the meniscal root insertion to prevent iatrogenic meniscus root avulsion. Sixth step is fixation, cycle the knee several times while applying traction to remove any slack out of the graft and to make sure there is non-impingement when fix the graft.
Meniscus Root Repair
Authors: Hasan Jafri
Published: November 2019

Meniscal root tears defined as bony or soft tissue root avulsion injuries or radial tears within 1cm of the meniscal root attachment. If it is not treated properly can cause early development of osteoarthritis. The meniscal root tears leading to compromised hoop stress and decreased tibiofemoral contact area and increased contact pressures in the involved compartment. To confirm the diagnosis is through arthroscopic as a diagnostic and treatment and through magnetic resonance imaging. Not all meniscal root tears can be treated surgically, especially if they have multiple comorbidities or advanced age, severe osteoarthritis, non-symptomatic chronic meniscal root tears and significant mal-alignment of the affected compartment then the treatment of choice is to give a symptomatic treatment like non-steroid anti-inflammatory drug, and activity modification. Meniscectomy has been found to induce a high rate of arthritis progression postoperatively. There are two most common meniscal root repair techniques which are trans-tibial pullout repair and suture anchor repair that now preferred over meniscectomy. The most important thing to consider when repairing the meniscal root is the right anatomically repair. It has been proven that non-anatomical meniscal root repair will not able to restore to the normal function because the conversion of femorotibial loads into circumferential tension may be altered, with functional impairment of the knee. Anchor suture technique shows a greater degree of healing and better biomechanical outcome. The suture anchor technique uses “all-inside" fixation and avoids the need for a distal fixation which potentially places abrasive forces on the sutures used. The trans-tibial pullout repair can restore the attachment and contact pressure near normal value, also the tunnel drilling stimulating growth factors and progenitor cells from bone marrow and facilitate the ability of meniscus to convert axial load into hoop stress. The concern of trans-tibial pullout repair is its ‘bungee effect’ and repetitive loading resulted in the displacement of this repair complex and might compromise healing because of decreased stiffness and micromotion of the meniscus-suture complex.
Anatomy and Biomechanic of the Shoulder
Authors: Panjaitan Troydimas
Published: November 2019

The shoulder is one of the most complex joints of the human body. Consequently, they are susceptible to injury and degeneration. Mechanical shoulder pathology typically results when overuse, extremes of motion, or excessive forces overwhelm intrinsic material properties of the shoulder complex resulting in tears of the rotator cuff, capsule, and labrum.

The fundamental central component of the shoulder complex is the glenohumeral joint. It has a ball-and-socket configuration with a surface area ratio of the humeral head to glenoid fossa of about 3:1 with an appearance similar to a golf ball on a tee. Overall, there is minimal bony covering and limited contact areas that allow extensive translational and rotational ability in all three planes.

The glenohumeral joint has 2 groups of stabilizers, which are static (passive) and dynamic (active) restrains. Static stabilizers include the concavity of the glenoid fossa, glenoid fossa retroversion and superior angulation, glenoid labrum, the joint capsule, and glenohumeral ligaments, and a vacuum effect from negative intra-articular pressure.

Dynamic stabilization is merely the coordinated contraction of the rotator cuff muscles that create forces that compress the articular surfaces of the humeral head into the concave surface of the glenoid fossa.

During upper extremity movement, the effects of static stabilizers are minimized and dynamic or active stabilizers become the dominant forces responsible for glenohumeral stability

The simple act of arm elevation is a complex task that occurs via the combination of glenohumeral and scapulothoracic motion, together known as scapulohumeral rhythm. In the first 1200, glenohumeral arm abduction, the supraspinatus and deltoid work together and create a force couple that promotes stability, while raising the arm (deltoid contraction).

In addition, the humerus must undergo 450 external rotation to not only clear the greater tuberosity posteriorly but also loosen the inferior glenohumeral ligament (IGHL) to allow maximum elevation.

There are several anatomical updates regarding the rotator cuff and capsular footprint. The footprint of the supraspinatus on the greater tuberosity is much smaller than previously believed, and this area of the greater tuberosity is actually occupied by a substantial amount of the infraspinatus. The superior-most insertion of the subscapularis tendon extends a thin tendinous slip, which attaches to the fovea capitis of the humerus. The teres minor muscle inserts to the lowest impression of the greater tuberosity of the humerus and additionally inserts to the posterior side of the surgical neck of the humerus.
Review Article: Zirconia surface bone graft implant with Ultraviolet Stimulation works toward Accelerating Bone Healing
Authors: Haryono Adriel Benedict , Ismiarto Yoyos Dias
Published: November 2019

Biomedical zirconia was introduced in 1969 into medicine to solve the problem of alumina brittleness in hip replacement procedures and has since been used for various joint replacement appliances in orthopedic surgery. The most frequently-studied material is yttrium-stabilized zirconia, which is also known as tetragonal zirconia polycrystal (TZP). Y-TZP presents various interesting characteristics, such as low porosity, high density and high bending and compression strength, proving that it is suitable for biomedical application. UV-treated zirconia surfaces exhibited an enhanced osteoblast response, which was characterized by an accelerated and augmented cell attachment, accelerated cell spread and cytoskeletal development with increased proliferation. The purpose of this paper is to identify which method of treatment of zirconia material implant & ultraviolet stimulation effect for bone healing is the most effective and efficient based on literature review. Bone grafts are available in a variety of substances. These bone substitutes can be biological (natural) or synthetic. Re-absorption is also essential for bone growth. Specific cells continuously break down bones and rebuild them. Substitutes that break down too quickly are not suitable for bone grafts, as they do not allow enough time for the new bone to grow. From our literature review, Zirconia is one of the biomaterials that have a bright future because of its high mechanical strength and fracture toughness. Zirconia ceramics have several advantages over other ceramic materials due to the transformation toughening mechanisms operating in their microstructure that can be expressed in components made out of them. UV treatment substantially enhances the osteogenesis process, resulting in a greater amount of peri-implant bone, as well as an increased strength of bone-zirconia integration.