bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical investigation of marine diesel engine turbocharger compressor tonal noise
Authors: Liu Chen , Cao Yipeng , Liu Yang , Zhang Wenping , Ming Pingjian
Published: April 2019

The compressor tonal noise of a low-speed marine diesel engine turbocharger is investigated with numerical method. Nine operating conditions on four different rotating speed lines are analyzed; the conditions include near-choke conditions, near-surge conditions, and peak efficiency conditions. Numerical predictions of compressor global variables are compared with experimental measurements, and a good agreement is achieved. The pressure fluctuation at all operating conditions presents strong periodicity, and the prominent peaks of pressure amplitude appear at the blade passing frequency and its harmonics after Fast Fourier transform algorithm. Furthermore, the fluctuation strength varies with the changes in operating conditions. Then, the pressure fluctuation is used to acquire the aero-acoustic source, and the compressor tonal noise and the compressor broadband noise are calculated by the boundary element method. The compressor tonal noise increases with operating conditions shift to high rotating speed and the surge line. The acoustic directivity of radiated tonal noise at inlet duct nozzle is obvious, which is particularly detectable at the blade passing frequency. The further analysis shows that the acoustic directivity is greatly influenced by the frequency, compressor rotating speed, and total-to-total pressure ratio.
Yesterday’s News: A Temporal Discontinuity in the Sting of Inferiority
Authors: Kristal Alexander C. , O’Brien Ed , Caruso Eugene M.
Published: April 2019

Reactions to other people who get desirable outcomes should be a simple function of how much one desires those outcomes. Four studies ( N = 4,978) suggest that one’s reactions depend on the temporal location of outcome acquisition: Observers care more (e.g., feel more envy) right before, versus right after, other people have identical experiences (Studies 1, 2a, and 2b). For example, participants’ envy in February rose as Valentine’s Day approached (as a peer’s enviable date loomed in the future) but abruptly plateaued come February 15 onward (after the date occurred). Further, the passing of time specifically assuaged the pain of comparison (whereas positive reactions, such as feeling inspired, remained high; Studies 3a, 3b, and 3c); therefore, taking a past perspective can be used to regulate negative emotions in the present (Study 4). Time asymmetrically shapes the experience of upward comparison, despite other people’s desirable outcomes indeed being achieved. Other people’s good lives sting less if they have already lived them.
Arthroscopic Treatment of Osteochondral Lesions of the Talus in a Suspended Position With the Patient in a Prone Position
Authors: Wang Chenyu , Kang Min Wook , Kim Hyong Nyun
Published: April 2019

Background:

The purpose of this study was to evaluate the clinical results and the safety of arthroscopic microfracture with the ankle suspended on a shoulder-holding traction frame for simultaneous anterior and posterior ankle arthroscopy in the prone position.

Methods:

Between May 2010 and January 2016, 31 patients with posterior osteochondral lesions of the talus (OLTs) were treated with arthroscopic microfracture in a suspended position with the patient prone. Ankle distraction was achieved by suspending the affected ankle on a shoulder-holding traction frame. The 100 mm visual analog scale (VAS) and the Foot Function Index (FFI) were checked preoperatively and at final follow-up. Postoperative complications related to the suspended position were analyzed. Lower leg intramuscular compartment pressure was checked after the surgery to determine if there was any risk of compartment syndrome.

Results:

The mean 100-mm VAS score, and FFI improved from 62.8 ±11.3 and 48.5 ± 12.1, respectively, preoperatively to 15.8 ± 10.4 and 16.4 ± 9.2, respectively, at final follow-up ( P = .025, and P = .005, respectively). The mean anterior, lateral, superficial posterior, and deep posterior compartment pressures were 7.3 ± 1.5, 8.1 ± 1.1, 5.6 ± 1.9, and 9.2 ± 2.4 mmHg, respectively. No compartment syndrome occurred.

Conclusion:

Arthroscopic treatment of OLT in a prone position with the ankle suspended on a shoulder-holding traction frame allowed the use of simultaneous anterior and posterior portals for viewing and instrumentation without major operative complications, such as compartment syndrome.

Level of Evidence:

Level IV, retrospective case series.
Identification of Postoperative Step-Offs and Gaps With Brodén’s View Following Open Reduction and Internal Fixation of Calcaneal Fractures
Authors: Looijen Rosalie C. , Misselyn Dominique , Backes Manouk , Dingemans Siem A. , Halm Jens A. , Schepers Tim
Published: April 2019

Background:

To date, there is no consensus regarding which postoperative imaging technique should be used after open reduction and internal fixation of an intra-articular calcaneal fracture. The aim of this study was to clarify whether Brodén’s view is sufficient as postoperative radiologic examination to assess step-offs and gaps of the posterior facet.

Methods:

Six observers estimated the size of step-offs and gaps on Brodén’s view in 42 surgically treated intra-articular calcaneal fractures. These findings were compared to postoperative CT scans (gold standard). Inter- and intraobserver reliability were calculated and compared using intraclass correlation coefficients (ICCs).

Results:

An accuracy of approximately 75% for both step-offs and gaps was found in foot and ankle experts. Less experienced observers correctly identified step-offs and gaps in approximately 62% of cases on fluoroscopy and in 48% on radiographs. Interobserver reliability for intraoperative fluoroscopy as well as postoperative radiographs was fair for step-offs, whereas interobserver reliability for gaps was excellent. Intraobserver reliability showed a low level of agreement for intraoperative fluoroscopy, in contrast to postoperative radiographs with excellent agreement for step-offs and good agreement for gaps.

Conclusion:

Our results show that especially for more experienced foot and ankle surgeons, in the majority of fractures, Brodén’s view accurately showed step-offs and gaps following open reduction and internal fixation. Interobserver reliability showed a fair level of agreement for step-offs and excellent agreement for gaps. Intraobserver reliability was only enough for radiographs, not for fluoroscopy.

Level of Evidence:

Level IV, case series.
Digressive Methodologies: Inviting the Aesthetic and Material Into the Phenomenological
Authors: Thiel Jaye Johnson , Hofsess Brooke Anne
Published: April 2019

In this article, we invite the concept of digression into methodological endeavors through the phenomenological tradition of postintentional phenomenology. Using five modes of inquiry—unsettle, unrest, untether, unearth, unfold—and the premise that “(m)ail art is a catalyst,” we invite readers to reconsider methodologies as joyfully and generatively digressive, while also unearthing possibilities to abandon the confines of hypercapitalism found within academia.
Design of the functional requirements of a smartphone app for patients receiving oral antineoplastic agents: The e-OncoSalud® app
Authors: Collado-Borrell Roberto , Escudero-Vilaplana Vicente , Ribed Almudena , Anglada-Martínez Helena , Martín-Conde Maite , Herranz-Alonso Ana , Codina-Jané Carlos , Sanjurjo-Sáez María
Published: April 2019

Objective

To design a mobile app based on the needs of the onco-hematological patient receiving oral antineoplastic agents.

Methods

A multidisciplinary working group (pharmacy–oncology–hematology) was created to design the app. The study was developed in three phases: first, we analyzed the features of patients receiving oral antineoplastic agents. We then analyzed available apps for cancer patients. Finally, we designed the app's functionalities.

Results

We included 51 patients with middle-advanced age (68.7 years (SD=10.7)). They were polymedicated (mean: 5.3 (SD = 2.7), with numerous drug–drug interactions and adverse effects (all patients presented adverse effects). We then analyzed 166 apps. Most apps had more than one use, the most frequent being information (39.8%) and diagnosis (38.6%). Ten apps (6%) were for registering and monitoring treatment and adverse effects. Almost half of the apps (48.8%) were developed by healthcare organizations. Finally, we designed an app (e-OncoSalud®) with the following functionalities: (a) agenda; (b) treatment and drug interactions checker; (c) continuous recording of self-controls (weight, blood pressure, general condition) and adverse effects. The management of the adverse effects are based on an algorithm which provides different recommendations according to the adverse effects severity; (d) patient–pharmacist messaging in real-time; (e) education.

Conclusions

After analysis of the main problems affecting these patients and the needs not covered by the existing apps, we designed e-OncoSalud®. It integrates relevant information about their treatment, focused on drug interactions identification and the prevention, and management of adverse effects.
Nivolumab-induced type 1 diabetes mellitus as an immune-related adverse event
Authors: Yilmaz Mesut
Published: April 2019

Background

Immune checkpoint inhibitors are medications that activate anti-tumor responses by disrupting the inhibitory signaling to T cells. Nivolumab is an immune checkpoint inhibitor that selectively blocks the programmed cell death-1 (PD-1). Anti-PD-1 agents can breach immunologic tolerance. Fulminant diabetes is an immune endocrinopathy that results from a violent immune attack leading to complete destruction of pancreatic beta cells. We present a rare case of fulminant diabetes precipitated by anti-PD-1 immunotherapy.

Case

A 49-year-old male with a body mass index of 26.4 kg/m2, a history of Dandy–Walker syndrome and epilepsy, and no personal or family history of diabetes underwent left radical nephrectomy and retroperitoneal lymph node dissection for stage IV metastatic renal cell carcinoma (metastases to lungs). He received first-line sunitinib treatment for three months. He developed new hepatic metastasis, and a second-line treatment with nivolumab 3 mg/kg every two weeks was introduced. At 10 months of nivolumab, before the 22nd infusion, the patient suddenly complained of severe asthenia, somnolence, weight loss, polydipsia, and polyuria. Laboratory tests revealed potassium 4.2 mmol/L, sodium 138 mmol/L, bicarbonate 17.8 mmol/L, blood glucose 801 mg/dL, and arterial blood pH 7.27. He was diagnosed with diabetic ketoacidosis. Hemoglobin A1C was 10.9%. C-peptide was so low as 0.24. Glutamic acid decarboxylase autoantibodies, insulin autoantibodies and islet cell antibodies were all negative.

Conclusion

Anti-PD-1 immunotherapy is effective in the treatment of cancers. These agents can precipitate autoimmune disorders. As the use of anti-PD-1 agents is expected to rise, physicians should be educated about the potential side effects.
Managing the Paradoxes of Place to Foster Regeneration
Authors: Slawinski Natalie , Winsor Blair , Mazutis Daina , Schouten John W. , Smith Wendy K.
Published: April 2019

Organizations face and contribute to mounting social problems and environmental degradation. Regenerative organizations seek to reverse this damage, emphasizing how to help local places flourish. Drawing on a six-year inductive study of one such regenerative organization, we derive an empirically grounded model which argues that regeneration depends on effectively managing place-based tensions paradoxically. Shorefast built social enterprises aimed at redeveloping the cultural and economic resilience of Fogo Island, Canada, a community devastated by the collapse of the North Atlantic cod fishery. They triggered place-based tensions and managed them paradoxically by creating conditions for meaningful exchange and by taking a patient approach. Together, these efforts facilitated both the discovery of place-based opportunities and the regeneration of place. Our model challenges organizational researchers studying place to move beyond considering place-based tensions as conflicts and, instead, to study their paradoxical nature and management. To paradox research, we contribute insight into paradoxes of place.
Interneuron Diversity: Toward a Better Understanding of Interneuron Development In the Olfactory System
Authors: Yang Chi-Jen , Tsai Kuo-Ting , Liou Nan-Fu , Chou Ya-Hui
Published: April 2019

The Drosophila olfactory system is an attractive model for exploring the wiring logic of complex neural circuits. Remarkably, olfactory local interneurons exhibit high diversity and variability in their morphologies and intrinsic properties. Although olfactory sensory and projection neurons have been extensively studied of development and wiring; the development, mechanisms for establishing diversity, and integration of olfactory local interneurons into the developing circuit remain largely undescribed. In this review, we discuss some challenges and recent advances in the study of Drosophila olfactory interneurons.
Addressing sleep problems and fatigue within child and adolescent mental health services: A qualitative study
Authors: Higson-Sweeney Nina , Loades Maria Elizabeth , Hiller Rachel , Read Rebecca
Published: April 2019

Background:

Both fatigue and sleep difficulties are common symptoms of mental health presentations such as depression and anxiety. Despite this, little is known about how psychologists in Child and Adolescent Mental Health Services (CAMHS) assess and treat these common symptoms.

Method:

Qualitative interviews with nine psychologists working in CAMHS analysed using thematic analysis.

Results:

Fatigue and sleep problems do not tend to be the focus of assessment because they are seen to be part of other presentations and not accorded priority. Psychologists struggled to differentiate fatigue from sleep problems, with greater clarity about sleep problems, which appear to be more routinely assessed. A number of barriers to addressing fatigue and sleep problems were identified, including lack of motivation from young people to make behavioural changes to address fatigue and/or sleep difficulties. Psychologists wished for more training, access to information for young people and families and more service integration with paediatric physical health settings.

Conclusion:

Sleep problems and fatigue may not be thoroughly assessed and addressed in CAMHS and are often conflated, with the focus on enquiring about sleep, not fatigue. Further research is required to elucidate whether the themes identified are more pervasive. Potential interventions include training and information provision.
The therapeutic alliance in cognitive-behavioral therapy for school-aged children with autism and clinical anxiety
Authors: Klebanoff Sami M , Rosenau Kashia A , Wood Jeffrey J
Published: April 2019

Little is known about the alliance between therapists and children with autism spectrum disorder who are receiving psychological therapies in outpatient treatment settings. This study examined the therapeutic alliance in children with autism spectrum disorder and clinical anxiety, who were receiving cognitive behavioral therapy in a randomized, controlled trial. The Therapeutic Alliance Scale for Children was administered to a sample of children and youth with autism spectrum disorder and anxiety ( N = 64; aged 7–14) as well as to their parents and therapists. A comparison sample of typically developing youth with clinical anxiety ( N = 36; aged 5–12) was included. The child-therapist alliance was more positive among typically developing children than among children with autism spectrum disorder; correspondingly, the parent-therapist alliance was also more positive among parents of typically developing children. Therapist reports of positive child-therapist alliance predicted post-treatment reductions in anxiety among children with autism spectrum disorder, although child reports of this alliance did not. Parent reports of positive parent-therapist alliance also predicted post-treatment reductions in the child’s anxiety in the group with autism spectrum disorder. A strong therapeutic alliance appears to be associated with better treatment outcomes in children with autism spectrum disorder receiving cognitive behavioral therapy, although a thoughtful and diagnostically sensitive approach is advisable to promote a positive alliance with children with autism spectrum disorder.
A social identity perspective on the social-class achievement gap: Academic and social adjustment in the transition to university
Authors: Veldman Jenny , Meeussen Loes , van Laar Colette
Published: April 2019

First-generation students show lower academic performance at university compared to continuing-generation students. Previous research established the value in taking a social identity perspective on this social-class achievement gap, and showed that the gap can partly be explained by lower compatibility between social background and university identities that first- compared to continuing-generation students experience. The present paper aimed to increase insight into the processes through which this low identity compatibility leads to lower academic achievement by examining first-year university students’ adjustment to university in two key domains: the academic and the social domain. These were examined as two routes through which the social-class achievement gap may arise, and hence perpetuate this group-based inequality. Adjustment was examined both through students’ actual integration in the academic and social domains, and their internally experienced concerns about these domains at university. A longitudinal study among 674 first-year university students (13.6% first-generation) showed that first-generation students experienced lower identity compatibility in their first semester, which was in turn related to lower social, but not academic, integration. Lower identity compatibility was also related to more concerns about the social and academic domains at university. Low identity compatibility was directly related to lower academic achievement 1 year later, and this relationship was mediated only by lower social integration at university. These findings show that to understand, and hence reduce, the social-class achievement gap, it is important to examine how low identity compatibility can create difficulties in academic and particularly social adjustment at university with consequences for achievement.
Social influences of interest: Conceptualizing group differences in education through a self-regulation of motivation model
Authors: Thoman Dustin B. , Lee Garam A. , Zambrano Jeanette , Geerling Danielle M. , Smith Jessi L. , Sansone Carol
Published: April 2019

Understanding group-based inequalities in education requires attention not only to performance and achievement outcomes, but also to whether and how students sustain motivation for their educational and career paths over long periods of time. The self-regulation of motivation (SRM) model describes how students’ choices to persist are driven by the dynamic interaction between goals-defined motivation, which typically guides choices to start or reengage in an activity, and experience-defined motivation (or interest), which becomes a proximal predictor of persistence once engaged in the activity. Social influences can shape both kinds of motivations in ways that systematically contribute to differences in student persistence across groups and in how people self-regulate motivation. In this paper, we detail the ways in which social roles and group norms, interpersonal bias, and institutional structural barriers can shape motivational experiences and persistence of underrepresented groups of students through several specified processes within the SRM model. We describe how the model might illumine underlying causes of differential participation rates in certain fields, and we discuss key directions for future research.
PUMILIO1 Links Epilepsy to Spinocerebellar Ataxia
Authors: Lyman Kyle A. , Chetkovich Dane M.
Published: April 2019

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The Ambiguous Nature of Fast Ripples in Epilepsy Surgery
Authors: King-Stephens David
Published: April 2019

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When Epilepsy Grows Up…
Authors: Boyer Katrina
Published: April 2019

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Modeling Cell Reactions to Ionizing Radiation: From a Lesion to a Cancer
Authors: Dobrzyński L. , Fornalski K. W. , Reszczyńska J. , Janiak M. K.
Published: April 2019

This article focuses on the analytic modeling of responses of cells in the body to ionizing radiation. The related mechanisms are consecutively taken into account and discussed. A model of the dose- and time-dependent adaptive response is considered for 2 exposure categories: acute and protracted. In case of the latter exposure, we demonstrate that the response plateaus are expected under the modelling assumptions made. The expected total number of cancer cells as a function of time turns out to be perfectly described by the Gompertz function. The transition from a collection of cancer cells into a tumor is discussed at length. Special emphasis is put on the fact that characterizing the growth of a tumor (ie, the increasing mass and volume), the use of differential equations cannot properly capture the key dynamics—formation of the tumor must exhibit properties of the phase transition, including self-organization and even self-organized criticality. As an example, a manageable percolation-type phase transition approach is used to address this problem. Nevertheless, general theory of tumor emergence is difficult to work out mathematically because experimental observations are limited to the relatively large tumors. Hence, determination of the conditions around the critical point is uncertain.
Retrieval in prospective memory: Multiple processes or just delay?
Authors: Anderson Francis T. , McDaniel Mark A.
Published: April 2019

In prospective memory (PM) research, a common finding is that PM accuracy is greater using focal, rather than nonfocal, cues. Under the multiprocess framework, the high PM performance for focal cues (cues that facilitate noticing of the target), often in the absence of task interference, reflects people’s ability to rely on spontaneous retrieval processes. By contrast, nonfocal cues (cues that do not facilitate noticing) require monitoring. A competing explanation suggests that a single process underlies focal versus nonfocal PM: People adjust their delay in ongoing responding to allow enough time for PM information to reach awareness (delay theory). Participants’ lower nonfocal performance arises because they fail to delay responding to a sufficient degree; with focal cues, the PM information accumulation rate is fast enough that no delay is necessary (and thus most everyone performs well). We sought to improve nonfocal PM performance by pairing a PM task with fast information accumulation to an ongoing task for which the requisite information accumulated more slowly. Reasoning from delay theory, we expected PM accuracy levels in this nonfocal PM task to approximate that observed in a focal PM task (for which the PM tasks were identical). In contrast to this expectation, the focal condition displayed significantly higher PM accuracy (despite demonstrating a reliably shorter response delay). In light of these findings, we concluded that the multiprocess interpretation is favoured.
Outcomes of decreasing versus increasing cardiac troponin in patients
admitted with non-ST-segment elevation myocardial infarction: the
Atherosclerosis Risk in Communities Surveillance Study
Authors: Arora Sameer , Cavender Matthew A , Chang Patricia P , Qamar Arman , Rosamond Wayne D , Hall Michael E , Rossi Joseph S , Kaul Prashant , Caughey Melissa C
Published: April 2019

Background

The fourth universal definition of myocardial infarction requires an increase or decrease in cardiac troponin for the classification of non-ST-segment elevation myocardial infarction. We sought to determine whether the characteristics, management, and outcomes of patients admitted with non-ST-segment elevation myocardial infarction differ by the initial biomarker pattern.

Methods

We identified patients in the Atherosclerosis Risk in Communities Surveillance Study admitted with chest pain and an initially elevated cardiac troponin I, who presented within 12 hours of symptom onset and were classified with non-ST-segment elevation myocardial infarction. A change in cardiac troponin I required an absolute difference of at least 0.02 ng/mL on the first day of hospitalization, prior to invasive cardiac procedures.

Results

A total of 1926 hospitalizations met the inclusion criteria, with increasing cardiac troponin I more commonly observed (78%). Patients with decreasing cardiac troponin I were more often black (45% vs. 35%) and women (54% vs. 40%), and were less likely to receive non-aspirin antiplatelets (44% vs. 63%), lipid-lowering agents (62% vs. 80%), and invasive angiography (38% vs. 64%). Inhospital mortality was 3%, irrespective of the cardiac troponin I pattern. However, patients with decreasing cardiac troponin I had twice the 28-day mortality (12% vs. 5%; P=0.01). Fatalities within 28 days were more often attributable to non-cardiovascular causes in those with decreasing versus increasing cardiac troponin I (75% vs. 38%; P=0.01).

Conclusion

Patients presenting with chest pain and an initially elevated cardiac troponin I which subsequently decreases are less often managed by evidence-based therapies and have greater mortality, primarily driven by non-cardiovascular causes. Whether associations are attributable to type 2 myocardial infarction or a subacute presentation merits further investigation.
Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea
Authors: Gutierrez Jeydith , Tedaldi Ellen M , Armon Carl , Patel Vaidahi , Hart Rachel , Buchacz Kate
Published: April 2019

Objective:

To evaluate sleep disturbances in a diverse, contemporary HIV-positive patient cohort and to identify demographic, clinical, and immune correlates.

Methods:

A convenience sample of 176 patients from a racially and ethnically diverse HIV-positive patient cohort in an urban population. This was a cross-sectional, epidemiologic study. We surveyed participants using multiple standardized instruments to assess depression, sleep quality, and risk for sleep apnea. We analyzed demographic, behavioral, and clinical correlates.

Results:

A total of 56% of participants were female, 75% Black and 64% had heterosexual HIV risk. The median age was 49 years. Poor sleep quality (Pittsburgh Sleep Quality Index > 5) was reported by 73% of patients and 52% met insomnia diagnosis criteria. A single question about self-reported sleep problems predicted a Pittsburgh Sleep Quality Index > 5 with a sensitivity and specificity of 82% and 81%, respectively. Female sex was significantly associated with higher risk of poor sleep quality, depression, and insomnia, whereas higher risk of obstructive sleep apnea was significantly associated with older age, male sex, obesity (body mass index ⩾ 30 kg/m2), and metabolic comorbidities. High risk for obstructive sleep apnea, high rate of depression, and poor sleep hygiene represent treatment targets for sleep problems in HIV patients.

Conclusion:

Sleep disturbances were common in this patient cohort, although largely undiagnosed and untreated. Sleep problems are linked to worse disease progression and increased cardiovascular mortality. Screening for sleep problems with a single question had high sensitivity and specificity. In those patients with self-reported sleep problems, screening for obstructive sleep apnea, depression, and sleep hygiene habits should be part of routine HIV care.
A truth commission did not tell the truth: A rejoinder to Manrique-Vallier and Ball
Authors: Rendon Silvio
Published: April 2019

Rendon (2019) showed that the indirect estimation of total killings in the Peruvian Truth and Reconciliation Commission introduced a distortion. Two of the original analysts, Manrique-Vallier and Ball (2019), provide an indirect defense of their work using new data, and argue that this supports their unprecedented indirect method over the direct estimator. In this rejoinder I show that their new figure of 17,687 killings by the Shining Path is closer to the direct estimate of 18,341 than to their indirect estimate of 31,331 killings. I also show that the indirect method systematically produces impossible negative predicted killings and overfits massively. I reiterate my conclusion that their indirect estimates are unreliable and should be retracted.
CD3, CD4, CD8, CD19 and CD16/CD56 positive cells in tuberculosis infection and disease: Peculiar features in children
Authors: Venturini Elisabetta , Lodi Lorenzo , Francolino Ilaria , Ricci Silvia , Chiappini Elena , de Martino Maurizio , Galli Luisa
Published: April 2019

Pathogenesis of mycobacterial infection has been extensively studied determining the fundamental role of host immunocompetence in disease progression. Cellular adaptive immunity, in particular CD4+ cells, has shown to be crucial in the host defence. A role of cytotoxic lymphocytes and humoral immunity has also been established. However, few studies have been performed in low endemic countries on immunological correlates of tuberculosis in paediatric patients. The present study aims to fill this gap analysing the distribution and the absolute values of the main lymphocyte subpopulations (CD3+, CD4+, CD8+, CD19+ and CD16+/CD56+) in the different stages of tubercular infection in human immunodeficiency virus–negative children living in low tubercular endemic countries. Results obtained in children with latent tuberculosis, active tuberculosis and healthy controls were compared. Moreover, quantitative analysis of interferon-γ levels of mitogen-induced response was carried out within the different study groups. The aim of this analysis was to enforce the comprehension of immune modifications subsequent to Mycobacterium tuberculosis infection. The major finding of our study was CD3+ and CD4+ absolute and percentage depletion in children with active tuberculosis versus healthy controls. Moreover, severe forms of active tuberculosis showed a marked reduction in the CD4+ percentage in the context of a systemic impairment which affects globally the absolute count of all peripheral lymphocyte subsets tested. A relative increase of natural killer cells was proved in infected patients, whereas no differences in B cells among the study groups were detected. Mitogen-induced interferon-γ levels were significantly higher in children with latent tuberculosis when compared to active tuberculosis and healthy controls, demonstrating effective immune activation in those patients able to control the infection.
Sociodemographic Determinants of Tobacco Use in India: Risks of Risk Factor—An Analysis of Global Adult Tobacco Survey India 2016-2017
Authors: Ruhil Rohini
Published: April 2019

Tobacco use habit is generally viewed as a sole responsibility of an individual, and the entire onus of being or not being a tobacco user is put on the individual himself or herself. But no man lives in isolation and his behavior is constantly determined by various social dynamics surrounding him since his birth and constantly exerting pressures on him. The article is a secondary data analysis of Global Adult Tobacco Survey (GATS) India 2016-2017 having a sample size of 74,037 adults aged greater than 15 years. The smoking and smokeless tobacco use behavior of individuals is studied as a dependent variable in relation to their sociodemographic characteristics (age group, gender, residence, marital status, caste, religion, education, occupation, and material deprivation). A material deprivation index was created and was analyzed in relation to tobacco use habits. The results have shown all these independent variables as very significant determinants of tobacco use (smoking or smokeless) behavior. In India, males are more likely to use tobacco, as compared with females. Also individuals in rural areas are more likely to use tobacco as compared with urban areas. Individuals with no formal education are more likely to use tobacco (smoking or smokeless) as compared with individuals with various levels of education. Moreover, higher the educational levels of individuals, lower the likelihood of using tobacco by them in any form. Material deprivation has also emerged as a strong determinant of tobacco use where higher the levels of material deprivation, more likely individuals were to use tobacco in any form. To conclude, sociodemographic characteristics of individuals as age group, gender, residence, marital status, caste, religion, education, occupation, and material deprivations are major social determinants of tobacco use habit including both smoking and smokeless forms of tobacco use.
Clinical outcomes of dual 3.5-mm locking compression plate fixation for humeral shaft fractures: Comparison with single 4.5-mm locking compression plate fixation
Authors: Seo Joong-Bae , Heo Kang , Yang Jong-Heon , Yoo Jae-Sung
Published: April 2019

Background:

Recently, several in vitro biomechanical studies that used dual small locking plate fixation for humeral shaft fractures have investigated. However, in vivo studies about dual plate fixation for humeral shaft fractures are limited. The purpose of our study was to report the outcomes of dual small plating for humeral shaft fractures in comparison with those of single large fragment plating.

Methods:

Sixty consecutive patients who underwent an open reduction internal fixation for humeral shaft fractures at our institution from September 2014 to December 2017 were included. Single 4.5-mm locking compression plate (LCP) fixation was used in the first 40 cases, and dual 3.5-mm LCP fixation was used in the final 20 consecutive cases. Data were collected to define patient characteristics, injury mechanism, clinical outcomes, time to surgery, operative time, estimated blood loss, and complications. Using simple radiography during the follow-up period (6, 12, 24, and 52 weeks after surgery), the shoulder and elbow joint ranges of motion (ROM) were also evaluated.

Results:

Demographic data, time to surgery, surgical time, and estimated blood loss had no significant differences between the two groups. No significant differences were observed in nonunion rate and union rate 3 months after surgery. However, two patients (5%) in the single 4.5-mm LCP fixation group showed metal failure and breakage. No significant differences were found in postoperative shoulder and elbow ROM. Three patients (7.5%) in the single plating group and one patient (5%) in the dual plating group developed radial nerve palsy after surgery. No vascular injury and deep infection were observed in either group.

Conclusion:

For diaphyseal humeral fractures, dual 3.5-mm LCP fixation to the humerus is a possible treatment choice. This method showed satisfactory union rate, ROM, and complication rate, without increasing surgical time, in comparison with the conventional single 4.5-mm LCP fixation. Level of evidence: III
Coculturing of mesenchymal stem cells of different sources improved regenerative capability of osteochondral defect in the mature rabbit: An in vivo study
Authors: Mahmoud Elhussein Elbadry , Adachi Nobuo , Mawas Amany Sayed , Gaarour Osama Samir , Ochi Mitsuo
Published: April 2019

Purpose:

Choosing a therapeutic cell source for osteochondral repair remains a challenge. The present study investigated coculturing mesenchymal stem cells (MSCs) from different sources to provide an improved therapeutic cell option for osteochondral repair.

Methods:

Dutch and Japanese white rabbits were used in this study, the first for isolating MSCs and the second for creating an osteochondral model in the medial femoral condyle. The 26 rabbit knees were divided randomly into four groups: control ( n = 6), bone marrow-derived MSCs (BMSCs) ( n = 7), synovial tissue MSCs (SMSCs) ( n = 7), and cocultured MSCs ( n = 6). Tissue repair was assessed using the Fortier scale, and colony-forming assay was performed.

Results:

At different cell densities, cocultured and SMSCs formed larger colonies than BMSCs, indicating their high proliferative potential. After 2 months, complete filling of the defect with smooth surface regularity was detected in the cocultured MSC group, although there was no significant difference among the therapeutic groups macroscopically. Also, tissue repair was histologically better in the cocultured MSC group than in the control and SMSC groups, due to repair of the subchondral bone and coverage with hyaline cartilage. Additionally, toluidine blue and collagen-II staining intensity in the repaired tissue was better in the cocultured MSC group than in the remaining groups.

Conclusion:

Our results suggest that cocultured MSCs are a suitable option for the regeneration capability of osteochondral defects due to their enhanced osteochondrogenic potential.
Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship
Authors: Yoon Kyoung Ho , Kim Jung Suk , Kim Sang Jun , Park Moonsu , Park Soo Yeon , Park Sang Eon
Published: April 2019

Purpose:

To compare the long term outcomes of transtibial nonanatomic single-bundle (SB) and double-bundle (DB) anterior cruciate ligament (ACL) reconstruction.

Methods:

Between January 2008 and September 2010, we retrospectively evaluated 377 patients who underwent primary ACL reconstruction and who were available at 8 years of follow-up. Patients who received transtibial nonanatomic SB ACL reconstruction ( n = 263) were assigned to group SB and DB ACL reconstruction ( n = 114) to group DB. The patients were assessed with the International Knee Documentation Committee (IKDC), the Lysholm scores, Tegner activity score, knee joint stability tests, and patellofemoral osteoarthritis (OA) findings using the Kellgren–Lawrence (K-L) classification. Contralateral ACL (CACL) injury was also evaluated.

Results:

Thirteen patients underwent revision ACL surgery during the follow-up. Ultimately, 256 patients in group SB and 108 patients in group DB were available at the 8-year follow-up. At final follow-up, the IKDC subjective score ( p = 0.04) and Lysholm score ( p = 0.02) showed significantly superior results in group DB compared to group SB. However, there was no significant difference of Tegner activity score ( p = 0.30), range of motion ( p = 0.81), and knee joint stability tests. There was significant progression of patellofemoral OA between preoperative and final follow-up in ipsilateral knee of both groups but not significant progression in contralateral knee. However, there was no significant difference between the two groups at the follow-up. There were 2.7% ipsilateral ACL graft failure in group SB, compared with 5.2% in group DB ( p = 0.12) and 6.4% CACL tear in group SB, compared with 5.2% in group DB ( p = 0.65). The mean survivorship of ACL graft was 9.47 ± 0.05 years (95% confidence interval (CI), 9.36–9.58) in group SB and 9.87 ± 0.16 years (95% CI, 9.54–10.20) in group DB, and there was no significant difference ( p = 0.25).

Conclusion:

DB ACL reconstruction resulted in significantly better clinical IKDC subjective scores and Lysholm scores. However, most of the differences in clinical scores were small, and the clinical relevance of this difference is unknown. In addition, there was no significant difference in Tegner activity score, knee joint stability tests, patellofemoral OA, and survivor rate of the ACL graft and CACL after reconstruction after a minimum of 8-year follow-up. Level of Evidence: Cohort study; level of evidence, 3.
A Comparison of Team Sport Volume Surveyed Between High School and Club Sport Coaches
Authors: Post Eric G. , Schaefer Daniel A. , Biese Kevin M. , Watson Andrew M. , McGuine Timothy A. , Brooks M. Alison , Bell David R.
Published: April 2019

Background:

Club sport participation is increasingly common among high school athletes. Sport participation characteristics may vary widely between the high school and club sport settings. However, there have been no large-scale comparisons of sport participation volume between high school and club teams from similar sports.

Purpose/Hypothesis:

The purpose of this study was to compare the sport participation characteristics of high school and high school–aged club teams. We hypothesized that club team athletes would participate in more months per year and hours per week and would take more overnight trips than high school athletes and that club team coaches would be less likely to track their athletes’ sport volume than high school coaches.

Study Design:

Cross-sectional study.

Methods:

A total of 769 coaches (266 female; 34.6%) from 3 sports (basketball, volleyball, soccer) completed an anonymous online questionnaire regarding their team’s sport volume and their knowledge, attitudes, and beliefs regarding sport specialization. Coaches were eligible to participate if they had served as the head or assistant coach of a high school sport team or high school–aged club sport team in the past 12 months.

Results:

Overall, 64.6% (n = 497) were coaches of a high school team, and 35.4% (n = 272) were coaches of a club team with high school–aged athletes. Club coaches’ teams played more months out of the year and took more overnight trips for competitions than high school coaches’ teams but participated in fewer hours per week of practices or competitions during their season. There were no differences between club and high school coaches in tracking their athletes’ sport volume, with most coaches in both settings reporting that they do not track the amount of time that their athletes participate in other sports.

Conclusion:

Significant differences in sport participation volume exist between the teams of high school and club coaches.
Targeting CD47 in Sézary syndrome with SIRPαFc
Authors: Johnson Lisa D. S. , Banerjee Swati , Kruglov Oleg , Viller Natasja Nielsen , Horwitz Steven M. , Lesokhin Alexander , Zain Jasmine , Querfeld Christiane , Chen Robert , Okada Craig , Sawas Ahmed , O’Connor Owen A. , Sievers Eric L. , Shou Yaping , Uger Robert A. , Wong Mark , Akilov Oleg E.
Published: April 2019

Sézary syndrome (SS), the leukemic variant of cutaneous T-cell lymphoma, has limited treatment options and rare occurrences of long-term remission, thus warranting research into new treatment approaches. CD47 has emerged as a promising target for multiple tumor types, but its role in SS remains unknown. Here, we show that CD47 is highly expressed on Sézary cells in the peripheral blood and skin, and the high level of CD47 expression correlates with worse overall survival (OS) in patients with SS. We also demonstrate that CD47 expression on Sézary cells is under the influence of interleukin 4 (IL-4), IL-7, and IL-13. Signal regulatory protein αFc (SIRPαFc; TTI-621), a novel CD47 decoy receptor, triggers macrophage-mediated phagocytosis of Sézary cells and, when administered in clinical trial settings, results in significant tumor load reduction. We conclude that inhibition of the CD47-SIRPα signaling pathway has therapeutic benefit for patients with SS. This trial was registered at www.clinicaltrials.gov as #NCT02663518.
Nebulised lipid–polymer hybrid nanoparticles for the delivery of a therapeutic anti-inflammatory microRNA to bronchial epithelial cells
Authors: Vencken Sebastian , Foged Camilla , Ramsey Joanne M. , Sweeney Louise , Cryan Sally-Ann , MacLoughlin Ronan J. , Greene Catherine M.
Published: April 2019

Modulation of microRNAs (miRNAs), endogenous regulators of gene expression, is a promising strategy for tackling inflammatory lung diseases. In this proof-of-concept study, we tested delivery of miR-17 to bronchial epithelial cells (BECs) using nebulised lipid–polymer hybrid nanoparticles (LPNs). The primary aim was to reduce the induced secretion of miR-17's target,i.e.the pro-inflammatory chemokine interleukin (IL)-8.

Synthetic miR-17 mimics were loaded into LPNs composed of poly(dl-lactic-co-glycolic acid) (PLGA) and the cationic lipid 1,2-dioleoyloxy-3-(trimethylammonium)propane (DOTAP) using a double emulsion solvent evaporation method and nebulised using the Aerogen Solo nebuliser. The physicochemical, aerosol, inflammatory and cytotoxic properties of LPNs were characterised. The effect of LPNs on lipopolysaccharide (LPS)-induced IL-8 production from human NuLi-1 BECs was tested by ELISA.

Thez-average, polydispersity index and ζ-potential of the LPNs and the aerodynamic properties of nebulised suspensions were in a range optimal for deposition in the bronchi and bronchioles post-inhalation. Cytotoxic and pro-inflammatory effects were minimal for LPNs loaded with a model cargo. Nebulisation did not affect the physicochemical or functional properties of the LPNs. Nebulised miR-17-loaded LPNs downregulated LPS-induced IL-8 secretion by >40% in BECs.

This study suggests that DOTAP-modified PLGA LPNs are efficient and well-tolerated carriers for delivery of miRNA mimics to BECs.
Functional morphology of endurance swimming performance and gait transition strategies in balistoid fishes
Authors: George Andrew B. , Westneat Mark W.
Published: April 2019

Triggerfishes and filefishes (Balistoidea) use balistiform locomotion to power steady swimming with their dorsal and anal fins and transition to a gait dominated by body and caudal fin (BCF) kinematics at high speeds. Fin and body shapes are predicted to be strong determinants of swimming performance and gait transitions. The goal of this study was to combine morphometrics and critical swimming tests to explore relationships between fin and body shapes and swimming performance in a phylogenetic context in order to understand the evolution of balistiform swimming. Among 13 species of balistoid fishes, those with high aspect ratio fins tended to achieve higher critical swimming speeds than fishes with low aspect ratio fins. Species with long, large median fins and wide caudal peduncles used the balistiform gait alone for a larger percentage of their total critical swimming speed than fishes with short, small median fins and narrow caudal peduncles. Although analyses revealed overall positive relationships between median fin aspect ratios and gait transition speeds, fishes on both ends of the aspect ratio spectrum achieved higher swimming speeds using the balistiform gait alone than fishes with median fins of intermediate aspect ratios. Each species is specialized for taking advantage of one gait, with balistiform specialists possessing long, large median fins capable of the large power requirements of high-speed swimming using the median fins alone, while BCF specialists possess short, small median fins, ill-suited for powering high-speed balistiform locomotion, but narrow caudal peduncles capable of efficient caudal fin oscillations to power high-speed locomotion.