bluuebunny/crossref_metadata_2025 huggingface dataset:
Gastric Sclerosing Epithelioid Fibrosarcoma Harboring a Rare FUS-CREM Fusion
Authors: Memon Raima A. , Granada Carlos N. Prieto , Patel Chirag , Manne Upender , Heslin Martin J. , Gbolahan Olumide B , Harada Shuko , Diffalha Sameer Al
Published: September 2020

Sclerosing epithelioid fibrosarcoma (SEF) is a rare, aggressive soft-tissue tumor, commonly occurring in upper and lower extremities, the limb girdle, and the head and neck, which shows morphologic and molecular overlap with low-grade fibromyxoid sarcoma. For SEF in soft tissues, 100 case reports have been published. To our knowledge, the present case is the first to be reported in English literature for a primary SEF of the stomach with a rare FUS-CREM fusion. We report a case of gastric SEF in a 35-year-old female who presented with nonspecific symptoms, including night sweat, cough, and iron deficiency anemia for the past few months. Further workup showed, on computed tomography, a large, heterogeneously enhancing and centrally necrotic left upper quadrant mass, which measured approximately 8.4 cm. A laparoscopic partial gastrectomy with distal pancreatectomy and splenectomy was performed. Histological examination and immunohistochemical staining suggested the diagnosis of primary gastric SEF, which was later confirmed by sarcoma fusion panel showing FUS-CREM fusion. In this article, we report this first case of SEF in the stomach with a rare FUS-CREM fusion, which has been previously reported only once in SEFs of soft tissue.
The Factorial Structure of the Tower Test From the Delis–Kaplan Executive Function System: A Confirmatory Factor Analysis Study
Authors: Trakoshis Stavros , Ioannou Myria , Fanti Kostas
Published: September 2020

The Tower of London (TOL) is a well-known, widely used task that captures executive function abilities. We examined the factorial structure and discriminant validity of three measures extracted from the Delis–Kaplan Executive Function System (D-KEFS) version of the TOL, namely the D-KEFS Tower Test, in 270 individuals from a publicly available release of the Enhanced Nathan Kline Institute—Rockland sample. Confirmatory factor analyses revealed a multidimensional three-factor solution of the measures extracted from the D-KEFS Tower Test; first-move-time, excess moves, and rule violations. This model was better than the unidimensional model, the two-factor model, the bifactor model and the model that included the total achievement scores. These results support the discriminant validity of the three latent factors, over their distinct relations to the total achievement score. The best fitting model was gender-invariant and age-variant. Overall, the multidimensionality of the measures extracted from the D-KEFS Tower Test reflects the need to use multiple metrics from this version of TOL to capture executive functions instead of a single score.
Science Communication Training in North America: Preparing Whom to Do What With What Effect?
Authors: Dudo Anthony , Besley John C. , Yuan Shupei
Published: September 2020

This study identifies key characteristics of current science communication training programs based in North America. We report findings from semistructured interviews conducted with science communication trainers ( N = 32) that examined programs’ curricula, trainees, and impacts. Findings suggest that the current landscape of science communication training is one where a range of well-intentioned individuals and groups provide guidance to mostly self-selecting scientists. Training typically involves helping scientists find and refine their own message and then expecting these individuals to find their own opportunities to communicate. Programs commonly emphasize technical communication skills more than strategy, rarely conduct robust evaluation, and are not typically designed to enhance inclusivity. Researcher-trainer partnerships can help maximize the reach and positive impacts of these programs.
Hidden Dramas of Masculinity: Women’s Perspectives on Intimate Violence in Different Social Classes
Authors: Ptacek James
Published: September 2020

While intimate violence against women occurs in all social classes, few studies have examined this abuse in the context of both class privilege and class disadvantage. This research investigates the experiences of women from all social classes who were abused by intimate male partners. One key issue in this study concerns masculinities. Drawing from in-depth interviews with 60 women, what kinds of masculinity do abusive men present in public? How do these public masculinities contrast with the masculinities they embody in private? What are abusive men’s attitudes toward women in general? And finally, what similarities and differences do women report across social classes? Women reported that the different faces of masculinity men displayed helped to conceal the abuse and caused them to feel trapped in abusive relationships. This is interpreted in the context of masculinities and social class.
The Use of Structural Intersectionality as a Method to Analyze How the Domestic Violence Civil Protective Order Process Replicates Inequality
Authors: Durfee Alesha
Published: September 2020

While protective orders remain a commonly used resource, multiply marginalized survivors are often unable to file for, obtain, serve, and enforce orders. I argue that using structural intersectionality as a method is the best way to reveal how the protective order process replicates broader social inequalities. I advocate for an alternative way of using structural intersectionality. I first identify the mechanisms by which inequalities exist and then describe how these can be traced back to intersecting social identities. In doing so, I highlight the importance of historical context and the blurring of the civil and criminal legal systems.
Nursing Care for Patients With Acute Mania: Exploring Experiential Knowledge and Developing a Standard of Good Care—Results of the Delphi Study
Authors: Goossens Peter J. J. , de Velde Harsenhorst Rita , van Lankeren Jacobine E. , Testerink Annelies E. , Daggenvoorde Thea H.
Published: September 2020

Background:

When patients diagnosed with bipolar disorder are suffering from acute mania (involuntary), hospitalization is often necessary. Patients are often quite disruptive, which makes it difficult to regulate their behavior and manage them in their current condition. The nursing team must also ensure the safety of the other patients on the ward. Nursing practice in this domain appears to draw primarily on tradition and experience.

Aims:

To achieve consensus on a standard for nursing practice for patients suffering from mania who are admitted to a closed psychiatric ward.

Methods:

Previously, professionals, patients, and informal caregivers in the Netherlands were interviewed about the nursing care and their lived experiences. Based on these findings and on the results of a literature review, 89 statements were formulated. A three-round Delphi study among professionals, patients, and informal caregivers was carried out. The accepted statements were summarized.

Results:

In the first round, 71 statements were accepted, none were rejected, and for 18 statements, no consensus could be reached. These were reformulated and presented in a second round. Thirteen of these statements were accepted, none were rejected, and five statements needed to be reformulated and were presented in the third and final round of this Delphi study. In this final round, all statements were accepted.

Conclusions:

Consensus was reached among professionals, patients, and informal caregivers in the Netherlands about essential and valuable components of nursing care for patients suffering from acute mania who are admitted to a closed psychiatric ward.
Secondary intra-arterial chemotherapy and/or intravitreal chemotherapy as salvage treatment for retinoblastoma
Authors: Mirzayev Ibadulla , Gündüz Ahmet Kaan , Yavuz Kıvılcım , Şekkeli Mehmet Zahid , Özalp Ateş Funda Seher , Ünal Emel , Taçyıldız Nurdan
Published: September 2020

Purpose:

To evaluate the results of secondary intra-arterial chemotherapy (IAC) and/or intravitreal chemotherapy (IVC) as a salvage treatment for retinoblastoma (RB).

Materials and Methods:

The medical records of 31 (20 male, 11 female) cases (with 38 eyes) who underwent secondary IAC and/or IVC between February 2010 and June 2019 were retrospectively reviewed.

Results:

Thirteen (41.9%) cases had unilateral and 18 (58.1%) had bilateral RB. According to the International Classification of RB, 6 (15.8%) eyes had group B, 9 (23.7%) eyes had group C, 16 (42.1%) eyes had group D, and 7 (18.4%) eyes had group E RB at diagnosis. All patients underwent six-cycle intravenous chemotherapy as primary treatment and 8 eyes received external radiotherapy before IAC/IVC. Secondary IAC was performed in 21 (55.3%) eyes, IVC in 10 (26.3%) eyes, and IAC + IVC in 7 (18.4%) eyes. External radiotherapy was applied in 2 (5.3%) eyes after IAC/IVC, one of which was later enucleated. In total, 17 (44.7%) eyes undergoing secondary IAC/IVC treatments were enucleated. Metastasis and death were not observed in any case during the mean follow-up period of 59.3 (median 61, range: 10–98) months.

Discussion:

Although 60.5% of the eyes undergoing IAC/IVC consisted of groups D and E RB, globe salvage and survival rates were 55.3% and 100.0%, respectively. External radiotherapy was required in 5.3% of the eyes after IAC/IVC. In conclusion, IAC and IVC are safe and effective treatment methods in eyes with RB unresponsive to other eye-preserving treatments and those demonstrating recurrence.
The anti-wear enhancement of boric acid + molybdenum disulfide derived tribofilm
Authors: Alper Yılmaz M , Özkan Doğuş
Published: September 2020

Additives are important components to reduce friction and wear of tribological systems. Zinc dithiophosphate (ZDDP), the most commonly used anti-wear additive prevents the tribological system from the friction and wear loss without any commercially available antagonist additive. However, its environmentally harmful content enforces to lubricating oil manufacturers to replace it with an alternative one. Therefore, in this study, the H3BO3 + MoS2 combination was tested in the boundary lubrication regime in a tribometer with a pin on flat reciprocating test module to be a possible alternative anti-wear additive against ZDDP. The friction and wear behavior of Boric acid (H3BO3) + Molybdenum Disulfide (MoS2), ZDDP, MoS2, and H3BO3 evaluated in terms of friction coefficient (COF), wear rate, surface energy and tribo-chemical analysis of tribofilms. SEM/EDX and XPS were employed to explore tribofilm formations on the wear scars. According to the results, the addition of MoS2 into H3BO3 presented a similar tribological performance to ZDDP by forming a strength tribofilm on the surface containing B2O3, MoO3, and metal sulfate.
In vivo imaging of chronic active lesions in multiple sclerosis
Authors: Calvi Alberto , Haider Lukas , Prados Ferran , Tur Carmen , Chard Declan , Barkhof Frederik
Published: September 2020

New clinical activity in multiple sclerosis (MS) is often accompanied by acute inflammation which subsides. However, there is growing evidence that a substantial proportion of lesions remain active well beyond the acute phase. Chronic active lesions are most frequently found in progressive MS and are characterised by a border of inflammation associated with iron-enriched cells, leading to ongoing tissue injury. Identifying imaging markers for chronic active lesions in vivo are thus a major research goal. We reviewed the literature on imaging of chronic active lesion in MS, focussing on ‘slowly expanding lesions’ (SELs), detected by volumetric longitudinal magnetic resonance imaging (MRI) and ‘rim-positive’ lesions, identified by susceptibility iron-sensitive MRI. Both SELs and rim-positive lesions have been found to be prognostically relevant to future disability. Little is known about the co-occurrence of rims around SELs and their inter-relationship with other emerging techniques such as dynamic contrast enhancement (DCE) and positron emission tomography (PET).
The complexity of control shift for learner autonomy: A mixed-method case study of Chinese EFL teachers’ practice and cognition
Authors: Wang Yi , Ryan Jonathon
Published: September 2020

The promotion of language learner autonomy has been recognized as being beneficial in various domains, from linguistic achievement to personal growth. Key to the development of learner autonomy is shifting control from the teacher to the learner. While much has been written about the construct of learner control, there has been little close examination of the practices with which language teachers release their command. This article reports on a study conducted in a Chinese private school intent on promoting learner autonomy, and explores ways in which teachers’ practices facilitated or hindered control shift and their perceptions of these actions. From a study of nine teachers within one English department, two case studies are explored in depth through analysis of classroom practices, interviews and post-lesson discussions. While the feasibility of promoting learner autonomy in non-Western contexts has previously been questioned, the present findings highlight the opportunities available within routine tasks, while stressing the delicacy of these opportunities.
Miniscrew-assisted single-tooth distraction osteogenesis to align an ankylosed infraoccluded maxillary central incisor: A case report
Authors: Shahroudi Atefe Saffar , Golmohammadi Shima
Published: September 2020

The ankylosis of permanent incisors is usually caused by trauma. In a growing patient, the ankylosed tooth fails to move along with the vertical growth of the remaining alveolar process, which results in an infraoccluded tooth, gingival margin disharmony and unaesthetic smile.

This case report presents an 23-year-old female patient whose maxillary right central incisor (tooth number 11) had been traumatised eight years earlier. A vertical discrepancy of about 4 mm was exhibited between teeth 11 and 12. To reposition the crown and gingival margins of the ankylosed tooth to an ideal level, single-tooth dento-osseous osteotomy and distraction of the block of bone containing the tooth was planned. In order to separate the roots of adjacent teeth for opening a space for osteotomy incision, fixed orthodontic treatment with multibracket appliances was initiated on her maxilla. After five weeks, a single-tooth dento-osseous osteotomy was performed using a piezoelectric device. To move the tooth in occlusal and buccal directions, two temporary anchorage devices (miniscrews) on her mandible and interarch elastics were applied. Approximately three weeks later, the ankylosed tooth successfully had an ideal position—relative to the adjacent teeth—and a harmonious gingival margin was achieved by minor gingivoplasty on all incisors.
Modelling of the electromechanical impedance technique for prediction of elastic modulus of structural adhesives
Authors: Tang Zi Sheng , Lim Yee Yan , Smith Scott T , Padilla Ricardo Vasquez
Published: September 2020

In order to strengthen and repair existing concrete structural elements, fibre-reinforced polymer composites are often externally bonded using structural adhesives. It is thus desirable to monitor the in situ performance of the sandwiched adhesive layer in such fibre-reinforced polymer–strengthened systems via its stiffness and strength gain throughout the curing process. The electromechanical impedance technique, which relies upon the utilisation of piezoelectric sensors, offers this capability. Although the technique has been verified experimentally in the laboratory, no known electromechanical impedance–based modelling study has been reported. This study, therefore, proposes the first electromechanical impedance–based finite element and analytical models to monitor the curing of structural adhesives. The dynamic elastic modulus of structural adhesives during curing can be determined from the developed models via a model updating process. Semi-empirical relationships were then developed to determine the tensile strength of structural adhesives from the resonance frequency obtained from the electromechanical impedance technique. This was made possible by correlation between static tensile tests on structural adhesives and the dynamic elastic modulus. These electromechanical impedance–based models were found to perform equally well when compared to the previously developed wave propagation–based models. This study shows the robustness of the electromechanical impedance technique for non-destructively predicting the dynamic elastic modulus and tensile strength of adhesives throughout the curing process.
Full-Time Students With Part-Time Benefits: How Being Denied On-Campus Housing Affects College Students With Criminal Records
Authors: McTier Terrence S. , Smith Chelsea T. , Smith Gabrielle , Hodges Ariel , Bah Samba
Published: September 2020

There are major assumptions that housing opportunities in higher education are equally accessible and available to all students. However, these accessible housing opportunities are not available to current and prospective students who possess a criminal record. Many college students with criminal records are deemed ineligible for adequate housing opportunities even before their applications are submitted. This study uses a qualitative layered analysis approach to explore how denials from on-campus housing affect college students with criminal records. Using the perspectives of this marginalized and invisible student population, we draw the reader’s attention to how students with criminal records are affected as a result of being denied on-campus housing, and we provide tangible recommendations for future research, housing practices, and housing policies in higher education.
Assessing the Necessity of Routine Crossmatching for Blood Transfusion in Renal Transplantation
Authors: Cheung Douglas , Reynolds Luke , Peng Melin , Lee Jason , Stewart Robert , Pace Kenneth , Honey R. John D’Arcy , Ordon Michael
Published: September 2020

Introduction:

Routine crossmatch of packed red blood cells (pRBCs) is completed preoperatively at many centers despite conflicting evidence on the incidence of blood transfusions with renal transplantation. In the current economic climate, resource adjudication should be judicious and medically appropriate. The objective of this study was to determine the incidence, timing, and predictors of early postoperative pRBC transfusion in patients undergoing renal transplantation.

Methods:

A retrospective review of all patients undergoing renal transplantation at our institution from January 2013 to May 2016 was performed. Demographic, biochemical, and clinical parameters were recorded. The primary outcome was early postoperative transfusion, defined as an intraoperative transfusion or within 2 days of surgery. Multivariable logistic regression was performed to identify associations with early postoperative transfusion.

Results:

We identified 428 patients during the study period (average age 55 years, 60% male, 30% obese, 67% deceased donor, and 43% preoperative antithrombotic use). Forty (9.3%) patients required early postoperative transfusion (mean: 2.8 pRBCs/transfusion) and most did not require blood urgently. Only 20 (4.7%) patients required a transfusion intraoperatively or on the same day of surgery. Lower preoperative hemoglobin (per g/L unit: odds ratio [OR]: 0.943), female gender (OR: 2.752), and preoperative antithrombotic use (OR 2.369) were associated with a need for early postoperative transfusion.

Conclusion:

Transfusion in the early postoperative period following renal transplantation was less than 10%, suggesting that routine crossmatch may not be necessary for all patients. Preoperative hemoglobin, female gender, and preoperative antithrombotic use were associated with increased risk and may be useful to risk-stratify patients who require crossmatch.
Analysis of Pregnancy Anti-Discrimination Policy in Kentucky: Application of Kingdon’s Multiple Streams Framework
Authors: Ray Robin
Published: September 2020

While several federal laws including the Pregnancy Discrimination Act, Family Medical Leave Act, and the Americans with Disabilities Act provide some freedom from discrimination due to pregnancy and breastfeeding-related conditions, many pregnant workers in Kentucky were not covered under these existing laws. The intent of Senate Bill 18, the Kentucky Pregnant Workers Act, was to provide clarity to employers about the protections afforded to pregnant workers by law as well as the need for employers to provide the same level of accommodations for pregnant workers that are available for those who are disabled. Similar bills had been filed during the 2015 to 2018 legislative sessions, and in 2019, Senate Bill 18 passed 87-5 and was signed by the Governor on April 9, 2019. The purpose of this article is to analyze a pregnancy anti-discrimination bill that passed during the 2019 Kentucky General Assembly utilizing Kingdon’s Multiple Streams Framework. This article also contains multiple policy alternatives, interest group involvement related to pregnancy anti-discrimination policy, unintended consequences of policy implementation as well as potential issues with enforcement of the Kentucky Pregnant Workers Act.
On Holding Various Truths to (Not) Be Self-Evident: Leading During the Dual Pandemics of 2020 as a Racialized Body
Authors: Endo Rachel
Published: September 2020

In this critical autoethnography, the author counter/narrates how she has navigated the dual pandemics of COVID-19 and structural racism predicated on over four centuries of racial oppression that reached a zenith on May 25, 2020, when George Floyd was murdered by a White police officer. As an Asian American woman dean of education at a White-dominated regional university, she weaves in between the past and present to discuss the multilayered intersections between the lives and livelihoods of Asian Americans and Black Americans by theorizing contemporary meanings of the historic slogan from the 1960s: “Yellow Peril Supports Black Power.” She reflects on a few critical moments during the dual pandemics where she has navigated predominantly White spaces that have attempted to center tired-old platitudes around justice for George Floyd despite the daily persistence of blatantly and subtly racist practices against individuals who are Black, Indigenous, and People of Color.
Neuromodulation: The Search Is On for the Most Effective Parameters
Authors: King-Stephens David
Published: September 2020

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The reliability and validity of novel clinical strength measures of the upper body in older adults
Authors: Legg Hayley S , Spindor Jeff , Dziendzielowski Reanne , Sharkey Sarah , Lanovaz Joel L , Farthing Jonathan P , Arnold Cathy M
Published: September 2020

Introduction

Research investigating psychometric properties of multi-joint upper body strength assessment tools for older adults is limited. This study aimed to assess the test–retest reliability and concurrent validity of novel clinical strength measures assessing functional concentric and eccentric pushing activities compared to other more traditional upper limb strength measures.

Methods

Seventeen participants (6 males and 11 females; 71 ± 10 years) were tested two days apart, performing three maximal repetitions of the novel measurements: vertical push-off test and dynamometer-controlled concentric and eccentric single-arm press. Three maximal repetitions of hand-grip dynamometry and isometric hand-held dynamometry for shoulder flexion, shoulder abduction and elbow extension were also collected.

Results

For all measures, strong test–retest reliability was shown (all ICC > 0.90, p < 0.001), root-mean-squared coefficient of variation percentage: 5–13.6%; standard error of mean: 0.17–1.15 Kg; and minimal detectable change (90%): 2.1–9.9. There were good to high significant correlations between the novel and traditional strength measures (all r > 0.8, p < 0.001).

Discussion

The push-off test and dynamometer-controlled concentric and eccentric single-arm press are reliable and valid strength measures feasible for testing multi-joint functional upper limb strength assessment in older adults. Higher precision error compared to traditional uni-planar measures warrants caution when completing comparative clinical assessments over time.
Analysis of the Essential Oils of Eucalyptus camaldulensis Dehnh. and E. viminalis Labill. as a Contribution to Fortify Their Insecticidal Application
Authors: Ebadollahi Asgar , Setzer William N.
Published: September 2020

The use of synthetic chemicals, with harmful effects on the environment and human health, is the principal strategy in the management of stored-product insect pests such as Oryzaephilus surinamensis and Sitophilus oryzae. Various studies in recent years have highlighted the possibility of using plant essential oils as available and low-risk factors in insect pest management. Therefore, in the present study, the possibility of controlling O. surinamensis and S. oryzae was investigated using Eucalyptus camaldulensis and Eucalyptus viminalis leaf essential oils. The essential oils were obtained by hydrodistillation of the leaves of the 2 Eucalyptus species, and the chemical compositions were determined by gas chromatographic-mass spectral analysis. The essential oil of E. camaldulensis was dominated by p-cymene (24.8%), cryptone (18.9%), and spathulenol (12.4%), while the major components in E. viminalis essential oil were 1,8-cineole (51.6%) and α-pinene (15.8%). The essential oils displayed promising fumigant toxicity against insect pests, which was positively dependent on utilized concentrations and exposure times. Oryzaephilus surinamensis, with low median lethal concentrations, was more susceptible than S. oryzae to the essential oils after 24, 48, and 72 hours. Also, E. viminalis essential oil, with a high level of insecticidal monoterpenes such as 1,8-cineole and α-pinene, was more toxic to insect pests than E. camaldulensis oil. According to the results of the current study, E. camaldulensis and E. viminalis essential oils, rich in insecticidal terpenes, can be alternative candidates to synthetic chemicals in the management of O. surinamensis and S. oryzae.
Re-imagining society and childhood: An analysis of cultural politics of childhood in Turkey
Authors: Toran Mehmet , Toprak Ziya
Published: September 2020

Neoliberalism along with other sites of cultural, social and political life has created deep impacts on childhood. With the rise of neoliberalisation of policies, childhood has come to be defined in terms of economic utility and wellbeing of society. In this paper, we examine the process of neoliberalisation through the changing role and meaning of childhood. We inquire the role of childhood in re-imagining of the Turkish society based on the data from the document of the strategic vision of the Turkish government. We seek to track the evolving notion of childhood and roles ascribed to it. By applying a critical discourse lens to the document of 8th Five Year Development Plan and Strategic Vision of 2023, we explain how the cultural politics of childhood work as tools of creating present and future workers. We examine the shifting place of childhood and instrumentalisation of childhood in neoliberal imagination of policy.
Diabetes Mellitus—A Risk Factor for the Development of Lumbar Disc Degeneration: A Retrospective Study of an Indian Population
Authors: Kakadiya Ghanshyam , Gandbhir Viraj , Soni Yogesh , Gohil Kushal , Shakya Akash
Published: September 2020

Study Design:

A retrospective study.

Objectives:

To determine the association between type-2 diabetes mellitus (T2DM) and the severity of lumbar disc degeneration disease (LDDD).

Methods:

We included 199 patients with low back pain (LBP) who visited our hospital from 2016 to 2018. All patients were divided into 3 groups as per inclusion criteria. Group A, patients without DM (n = 75); group B, patients with controlled DM (n = 72); and group C, patients with uncontrolled DM (n = 52). The patients were further subdivided into group B1, DM duration ≤10 years (n = 38); group B2, DM duration >10 years (n = 34); group C1 DM duration ≤10 years (n = 28); and group C2, DM duration >10 years (n = 24). Sex, age, body mass index, occupation, smoking history, alcohol use, and duration of T2DM were recorded. The severity of LDDD was evaluated using the 5-level Pfirrmann grading system. Operated patients’ disc materials were sent for histological examination.

Results:

Demographic data showed no difference among groups ( P > 0.5), except age. Patients with DM showed more severe disc degeneration compared with patients without DM. The average Pfirrmann scores between groups A and B1 had no difference; groups B2, C1, and C2 showed higher average Pfirrmann scores than group A ( P < 0.05). Groups B2 and C2 showed higher average Pfirrmann scores than groups B1 and C1 ( P < 0.05). Groups C1 and C2 showed higher average Pfirrmann scores than groups B1 and B2 ( P < 0.05). The severity of LDDD was significantly related to DM duration in both groups B and C ( P < 0.05). DM groups showed increased disc apoptosis and matrix aggrecan fragmentation, disc glycosaminoglycan content and histological analysis were significantly different; the results are similar to Pfirrmann score results.

Conclusions:

DM duration >10 years and uncontrolled DM were risk factors for LDDD.
Spinal Deformity Surgery in Pediatric Patients With Cerebral Palsy: A National-Level Analysis of Inpatient and Postdischarge Outcomes
Authors: Lee Nathan J. , Fields Michael , Boddapati Venkat , Mathew Justin , Hong Daniel , Sardar Zeeshan M. , Selber Paulo R. , Roye Benjamin , Vitale Michael G. , Lenke Lawrence G.
Published: September 2020

Study Design:

Retrospective cohort.

Objective:

To provide a national-level assessment of the short-term outcomes after spinal deformity surgery in pediatric patients with cerebral palsy.

Methods:

A national, prospectively collected database was queried to identify pediatric (≤18 years) patients with cerebral palsy, who underwent spinal fusion surgery from 2012 to 2017. Separate multivariate analyses were performed for the primary outcomes of interest including extended length of stay (>75th percentile, >8 days), and readmissions within 90 days after the index admission.

Results:

A total of 2856 patients were reviewed. The mean age ± standard deviation was 12.8 ± 2.9 years, and 49.4% of patients were female. The majority of patients underwent a posterior spinal fusion (97.0%) involving ≥8 levels (79.9%) at a teaching hospital (96.6%). Top medical complications (24.5%) included acute respiratory failure requiring mechanical ventilation (11.4%), paralytic ileus (8.2%), and urinary tract infections (4.6%). Top surgical complications (40.7%) included blood transfusion (35.6%), wound complication (4.9%), and mechanical complication (2.7%). The hospital cost for patients with a length of hospital stay >8 days ($113 669) was nearly double than that of those with a shorter length of stay ($68 411). The 90-day readmission rate was 17.6% (mean days to readmission: 30.2). The most common reason for readmission included wound dehiscence (21.1%), surgical site infection (19.1%), other infection (18.9%), dehydration (16.9%), feeding issues (14.5%), and acute respiratory failure (13.1%). Notable independent predictors for 90-day readmissions included preexisting pulmonary disease (odds ratio [OR] 1.5), obesity (OR 3.4), cachexia (OR 27), nonteaching hospital (OR 3.5), inpatient return to operating room (OR 1.9), and length of stay >8 days (OR 1.5).

Conclusions:

Efforts focused on optimizing the perioperative pulmonary, hematological, and nutritional status as well as reducing wound complications appear to be the most important for improving clinical outcomes.
Health Status and Burden in Caregivers of Patients With Multimorbidity
Authors: Schmaderer Myra , Struwe Leeza , Pozehl Bunny , Loecker Courtney , Zimmerman Lani
Published: September 2020

Caregivers of patients with multimorbidity are important for improving patient outcomes. This descriptive study examines health status and burden of 22 caregivers of patients with multimorbidity discharged from the hospital who were enrolled in a self-management intervention study. Caregivers did not receive an intervention. Factors that increased caregiver burden were financial issues, caring for others (e.g., family members), and home obligations. Caregivers averaged between 2 and 3 chronic conditions themselves. Perceived caregiver burden remained unchanged over time for the caregiver whether the patient was in the intervention or the usual care group. We recommend rigorous research with larger samples to better understand the caregiver role, needed resources and potential interventions to mitigate caregiver burden in the multimorbid population during and after care transitions. Longitudinal studies that include assessment and interventions for the caregivers of patients with multimorbidity are needed.
Testosterone versus hCG in Hypogonadotropic Hypogonadism – Comparing Clinical Effects and Evaluating Current Practice
Authors: Agarwal Swashti , Tu Duong D. , Austin Paul F. , Scheurer Michael E. , Karaviti Lefkothea P
Published: September 2020

Background. Gonadotropin therapy is not typically used for pubertal induction in hypogonadotropic hypogonadism (HH), however, represents a promising alternative to testosterone. It can potentially lead to the maintenance of future fertility in addition to testicular growth. We compared the pubertal effects of human chorionic gonadotropin (hCG) versus testosterone in adolescent males with HH. We evaluated the current practice, among pediatric endocrinologists, to identify barriers against gonadotropin use. Methods. In this retrospective review, we compared the effect of testosterone versus hCG therapy on mean testicular volume (MTV), penile length, growth velocity, and testosterone levels. We surveyed pediatric endocrinologists at our center, using RedCap. Results. Outcomes were assessed in 52 male patients with HH (hCG, n = 4; T, n = 48) after a mean treatment duration of 13.4 (testosterone) and 13.8 months (hCG; P = .79). Final MTV was higher with hCG (8.25 mL) than testosterone (3.4 mL; P < .001). The groups did not differ in penile length, growth velocity, or testosterone levels. Survey results showed that more than half the providers were aware of the benefits of gonadotropins, however, 91% were uncomfortable prescribing hCG. Commonly reported barriers to prescribing hCG were lack of experience (62%) and insurance coverage concerns (52%). Conclusions. Larger testicular volume predicts faster induction of spermatogenesis. Since hCG promoted better testicular growth, compared to testosterone, it may potentially improve future fertility outcomes in HH patients. Our results identify an opportunity to improve current practice among pediatric endocrinologists worldwide and reduce barriers to prescribing gonadotropins in the adolescent population.
Enhancing Mentoring in Palliative Care: An Evidence Based Mentoring Framework
Authors: Krishna Lalit Kumar Radha , Tan Lorraine Hui En , Ong Yun Ting , Tay Kuang Teck , Hee Jia Min , Chiam Min , Chia Elisha Wan Ying , Sheri Krish , Tan Xiu Hui , Teo Yao Hao , Kow Cheryl Shumin , Mason Stephen , Toh Ying Pin
Published: September 2020

Background:

Growing concerns over ethical issues in mentoring in medicine and surgery have hindered efforts to reinitiate mentoring for Palliative Care (PC) physicians following the easing of COVID-19 restrictions. Ranging from the misappropriation of mentee’s work to bullying, ethical issues in mentoring are attributed to poor understanding and structuring of mentoring programs, underlining the need for a consistent approach to mentoring practices.

Methods:

Given diverse practices across different settings and the employ of various methodologies, a novel approach to narrative reviews (NR)s is proposed to summarize, interpret, and critique prevailing data on novice mentoring. To overcome prevailing concerns surrounding the reproducibility and transparency of narrative reviews, the Systematic Evidenced Based Approach (SEBA) adopts a structured approach to searching and summarizing the included articles and employed concurrent content and thematic analysis that was overseen by a team of experts.

Results:

A total of 18 915 abstracts were reviewed, 62 full text articles evaluated and 41 articles included. Ten themes/categories were ascertained identified including Nature; Stakeholders; Relationship; Approach; Environment; Benefits; Barriers; Assessments; Theories and Definitions.

Conclusion:

By compiling and scrutinizing prevailing practice it is possible to appreciate the notion of the mentoring ecosystem which sees each mentee, mentor, and host organization brings with them their own microenvironment that contains their respective goals, abilities, and contextual considerations. Built around competency based mentoring stages, it is possible to advance a flexible yet consistent novice mentoring framework.
Endoscopic Treatment of Posterior Ankle Impingement Secondary to Os Trigonum in Recreational Athletes
Authors: Nikolopoulos Dimitrios , Safos George , Moustakas Konstantinos , Sergides Neoptolemos , Safos Petros , Siderakis Athanasios , Kalpaxis Dimitrios , Moutsios-Rentzos Andreas
Published: September 2020

Background:

The os trigonum (OT)—the most common accessory bone of the foot—although usually asymptomatic, may cause posterior ankle impingement syndrome (PAIS), which may be a severely debilitating problem for recreational or competitive athletes. The aim of the present study was to evaluate effectiveness of posterior ankle arthroscopy and to assess the outcome in the treatment of PAIS secondary to OT impingement or OT fractures within a group of young athletes and their return to previous sports level.

Methods:

From 2011 to 2018, a retrospective review of 81 recreational athletes of mean age 27.8 years was performed. All patients were diagnosed with PAIS due to OT pathology and were operated on endoscopically with resection of the OT. Pre- and postoperative clinical evaluation were performed at 3 months, 1 year, and 2 years based on visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the Foot & Ankle Disability Index (FADI) scores, in a follow-up of at least 2 years.

Results:

VAS score was significantly improved from an average of 7.5 (5-9) preoperatively to 1.9 (1-3) at 3 months postoperatively and to 0.6 (0-2) and 0.3 (0 -1) at 1 and 2 years postoperatively. Ankle ROM was significantly improved from an average of 24.8 (10-35) preoperatively to 58.0 (50-65) at 3 months postoperatively and to 64.0 (50-65) at 1 year and 64.7 (60-65) at 2 years postoperatively. AOFAS and FADI scores were significantly improved from 39.4 (18-55) and 49.7 (42.3-62.5) preoperatively to 85.2 (74-89) and 87.3 (81.7-88.5) postoperatively at 3 months to 97.7 (85-100) and 97.9 (93.3-100) postoperatively at 1 year, respectively ( P < .001). Only 5 patients dropped to a lower activity level. There were 5 complications (4 transient).

Conclusion:

Endoscopic treatment of PAIS due to OT pathology demonstrated excellent results. Posterior ankle arthroscopy was an effective treatment and allowed for a prompt return to a high activity level of their athletic performance.

Level of Evidence:

Level IV, therapeutic study / retrospective case series.
SiO2-GO nanofillers enhance the corrosion resistance of waterborne polyurethane acrylic coatings
Authors: Liu Liqi , Guo Xiaofeng , Shi Lei , Chen Liquan , Zhang Fangzhou , Li Aijun
Published: September 2020

Corrosion to metal is a great challenge to major industries. Anticorrosive coatings can effectively prevent metal corrosion. In this study, we propose a novel method to prepare silica nanoparticles-covered graphene oxide (SiO2-GO) nanohybrids and anticorrosion SiO2-GO/waterborne polyurethane acrylic (WPUA) coatings. Firstly, we obtained silane-functionalized graphene oxide (A-GO) via a simple covalent functionalization of graphene oxide (GO) with 3-aminopropyltriethoxysilane. Secondly, SiO2-GO was synthesized by a simple sol–gel method with tetraethoxysilane in water–alcohol solution. Finally, the obtained SiO2-GO nanofillers were added into WPUA to prepare SiO2-GO/WPUA coatings. GO, A-GO, and SiO2-GO nanohybrids could be confirmed by X-ray diffraction, Fourier transform infrared spectroscopy, Raman spectra, and transmission electron microscope. SiO2-GO nanohybrids showed small size compared with the unfunctionalized GO. Meanwhile, GO, A-GO, and SiO2-GO nanofillers were added into WPUA. The electrochemical impedance spectroscopy and field emission scanning electron microscope indicate that SiO2-GO nanohybrids can be homogeneously dispersed in the WPUA coatings at 0.4% loading level and the SiO2-GO/WPUA film exhibits excellent anticorrosion performance. SiO2-GO nanoparticles can effectively utilize in the area of anticorrosive nanofiller industry. This study provides a convenient method of anticorrosive coating production.
Correction to: Common bean resistance to Xanthomonas is associated with upregulation of the salicylic acid pathway and downregulation of photosynthesis
Authors: Foucher Justine , Ruh Mylène , Préveaux Anne , Carrère Sébastien , Pelletier Sandra , Briand Martial , Serre Rémy-Félix , Jacques Marie-Agnès , Chen Nicolas W. G.
Published: September 2020

An amendment to this paper has been published and can be accessed via the original article.
Construction of a high-density SNP-based genetic map and identification of fruit-related QTLs and candidate genes in peach [Prunus persica (L.) Batsch]
Authors: Shi Pei , Xu Ze , Zhang Shaoyu , Wang Xianju , Ma Xiaofei , Zheng Jicheng , Xing Libo , Zhang Dong , Ma Juanjuan , Han Mingyu , Zhao Caiping
Published: September 2020

Background

High-density genetic mapping is a valuable tool for mapping loci that control specific traits for perennial fruit trees. Peach is an economically important fruit tree and a model Rosaceae species for genomic and genetic research. In peach, even though many molecular markers, genetic maps and QTL mappings have been reported, further research on the improvement of marker numbers, map densities, QTL accuracy and candidate gene identification is still warranted.

Results

A high-density single nucleotide polymorphism (SNP)-based peach linkage map was constructed using specific locus amplified fragment sequencing (SLAF-seq). This genetic map consisted of 7998 SLAF markers, spanning 1098.79 cM with an average distance of 0.17 cM between adjacent markers. A total of 40 QTLs and 885 annotated candidate genes were detected for 10 fruit-related traits, including fruit weight (FW), fruit diameter (FD), percentage of red skin colour (PSC), eating quality (EQ), fruit flavour (FV), red in flesh (RF), red around pit (RP), adherence to pit (AP), fruit development period (FDP) and fruit fibre content (FFC). Eighteen QTLs for soluble solid content (SSC) were identified along LGs 1, 4, 5, and 6 in 2015 and 2016, and 540 genes were annotated in QTL intervals. Thirty-two QTLs for fruit acidity content (FA) were detected on LG1, and 2, 4, 5, 6, and 1232 candidate genes were identified. The expression profiles of 2 candidate genes for SSC and 4 for FA were analysed in parents and their offspring.

Conclusions

We constructed a high-density genetic map in peach based on SLAF-seq, which may contribute to the identification of important agronomic trait loci. Ninety QTLs for 12 fruit-related traits were identified, most of which overlapped with previous reports, and some new QTLs were obtained. A large number of candidate genes for fruit-related traits were screened and identified. These results may improve our understanding of the genetic control of fruit quality traits and provide useful information in marker-assisted selection for fruit quality in peach breeding programmes.
Underwater versus conventional endoscopic mucosal resection for small size non-pedunculated colorectal polyps: a randomized controlled trial
Authors: Zhang Zhixin , Xia Yonghong , Cui Hongyao , Yuan Xin , Wang Chunnian , Xie Jiarong , Tong Yarong , Wang Weihong , Xu Lei
Published: September 2020

Background

Underwater endoscopic mucosal resection (UEMR) is a recently developed technique and can be performed during water-aided or ordinary colonoscopy for the treatment of colorectal polyps. The objective of this clinical trial was to evaluate the efficacy and safety of UEMR in comparison with conventional endoscopic mucosal resection (CEMR) of small non-pedunculated colorectal polyps.

Methods

Patients with small size, non-pedunculated colorectal polyps (4–9 mm in size) who underwent colonoscopic polypectomy were enrolled in this multicenter randomized controlled clinical trial. The patients were randomly allocated to two groups, an UEMR group and a CEMR group. Efficacy and safety were compared between groups.

Results

In the intention-to-treat (ITT) analysis, the complete resection rate was 83.1% (59/71) in the UEMR group and 87.3% (62/71) in the CEMR group. The en-bloc resection rate was 94.4% (67/71) in the UEMR group and 91.5% (65/71) in the CEMR group (difference 2.9%; 90% CI − 4.2 to 9.9%), showed noninferiority (noninferiority margin − 5.7% < − 4.2%). No significant difference in procedure time (81 s vs. 72 s, P = 0.183) was observed. Early bleeding was observed in 1.4% of patients in the CEMR group (1/71) and 1.4% of patients in the UEMR group (1/71). None of the patients in the UEMR group complained of postprocedural bloody stool, whereas two patients in the CEMR group (2/64) reported this adverse event.

Conclusion

Our results indicate that UEMR is safer and just as effective as CEMR in En-bloc resection for the treatment of small colorectal polyps as such, UEMR is recommended as an alternative approach to excising small and non-pedunculated colorectal adenomatous polyps.

Trial registration

Clinical Trials.gov, NCT03833492. Retrospectively registered on February 7, 2019.