bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Outcomes and Predictive Factors for Failure With Isolated MPFL Reconstruction for Recurrent Patellar Instability: A Series of 211 Reconstructions With a Minimum Follow-up of 3 Years
Authors: Sappey-Marinier Elliot , Sonnery-Cottet Bertrand , O’Loughlin Padhraig , Ouanezar Herve , Reina Fernandes Levi , Kouevidjin Biova , Thaunat Mathieu
Published: May 2019

Background:

Reconstruction of the medial patellofemoral ligament (MPFL) is widely acknowledged as an integral part of the current therapeutic armamentarium for recurrent patellar instability. The procedure is often performed with concomitant bony procedures, such as distalization of the tibial tuberosity or trochleoplasty in the case of patella alta or high-grade trochlear dysplasia, respectively. At the present time, few studies have evaluated the clinical effectiveness of MPFL reconstruction as an isolated intervention.

Purpose:

To report the clinical outcomes of isolated MPFL reconstruction in cases of patellar instability and to identify predictive factors for failure.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective analysis of prospectively collected data was performed, including all patients who had undergone isolated MPFL reconstruction between January 2008 and January 2014. Preoperative assessment included the Kujala score, assessment of patellar tracking (“J-sign”), and radiographic features, such as trochlear dysplasia according to Dejour classification, patellar height with the Caton-Deschamps index (CDI), tibial tubercle–trochlear groove distance, and patellar tilt. The Kujala score was assessed postoperatively. Failure was defined by a postoperative patellar dislocation or surgical revision for recurrent patellar instability.

Results:

A total of 239 MPFL reconstructions were included; 28 patients (11.7%) were uncontactable and considered lost to follow-up. Thus, 211 reconstructions were analyzed with a mean follow-up of 5.8 years (range, 3-9.3 years). The mean age at surgery was 20.6 years (range, 12-48 years), and 55% of patients were male. Twenty-seven percent of patients had a preoperative positive J-sign, and 93% of patients had trochlear dysplasia (A, 47%; B, 25%; C, 15%; D, 6%). The mean CDI was 1.2 (range, 1.0-1.7); mean tibial tubercle–trochlear groove distance, 15 mm (range, 5-30 mm); and mean patellar tilt, 23° (range, 9°-47°). The mean Kujala score improved from 56.1 preoperatively to 88.8 ( P < .001). Ten failures were reported that required surgical revision for recurrent patellar instability (4.7%). Uni- and multivariate analyses highlighted 2 preoperative risk factors for failure: patella alta (CDI ≥1.3; odds ratio, 4.9; P = .02) and preoperative positive J-sign (odds ratio, 3.9; P = .04).

Conclusion:

In cases of recurrent patellar instability, isolated MPFL reconstruction would appear to be a safe and efficient surgical procedure with a low failure rate. Preoperative failure risk factors identified in this study were patella alta with a CDI ≥1.3 and a preoperative positive J-sign.
Effect of Posterior Capsule Tightness and Humeral Retroversion on 5 Glenohumeral Joint Range of Motion Measurements: A Cadaveric Study
Authors: Rosa Dayana P. , Camargo Paula R. , Borstad John D.
Published: May 2019

Background:

Altered glenohumeral joint range of motion can be caused by increased humeral retroversion (HR) and/or posterior capsule tightness (PCT). To make informed clinical decisions, it is vital to understand how HR and PCT alterations, individually and in combination, affect joint range of motion measurements.

Purpose:

To evaluate the effect of experimental tissue alterations on clinical range of motion measures.

Study Design:

Controlled laboratory study.

Methods:

Five clinical measurements were quantified in 8 fresh-frozen cadavers under 4 experimentally created conditions: baseline (no alterations), HR condition (20° increase in HR by transecting the bone), PCT condition (20% decrease in length via thermal energy), and PCT + HR combined. Clinical measurements included bicipital forearm angle, low flexion, glenohumeral internal and external rotation, and horizontal adduction. All measurements were taken by the same blinded tester. Separate 1-factor repeated measures analyses of variance were used to evaluate the effect of the alterations on each clinical measurement.

Results:

There was a significant main effect of condition for bicipital forearm angle ( P = .02, F = 4.03), low flexion ( P = .02, F = 3.86), internal rotation ( P = .03, F = 3.65), and external rotation ( P < .001, F = 15.15) but not for horizontal adduction ( P = .29, F = 1.33). The HR condition resulted in a decreased bicipital forearm angle of 16.1° and 15.8° as compared with the PCT and PCT + HR conditions, respectively. When compared with baseline, the PCT + HR condition decreased the low flexion test by 13.5°, and the HR condition decreased internal rotation range of motion by 14.2°. All conditions increased external rotation when compared with baseline.

Conclusion:

Greater measurement changes were noted in both HR conditions, suggesting that bony alterations influence motion to a greater extent than posterior capsule alterations.

Clinical Relevance:

Clinicians should be aware that humeral retroversion will influence the measurement of posterior shoulder tightness.
Journalists and mental health: The psychological toll of covering everyday trauma
Authors: Seely Natalee
Published: May 2019

Journalists are often first responders and eyewitnesses to violent news events. Trauma reporting can take its toll, resulting in mental health effects. Addressing the solution requires understanding the problem. This multimethod study used a national survey of journalists (N = 254) that shows that as trauma coverage frequency and intensity increase, so does the severity of post-traumatic stress disorder symptoms. In-depth interviews offer personal narratives of effects from traumatic reporting. Common coping mechanisms include disconnecting from work in various ways, purging emotions, talking about trauma, and remembering their jobs’ higher purposes. Suggestions include humanizing the newsroom and teaching about trauma reporting.
Parents’ Experiences and Nurses’ Perceptions of Decision-Making About Childhood Immunization
Authors: Mossey Sharolyn , Hosman Shelly , Montgomery Phyllis , McCauley Karen
Published: May 2019

Background

Immunization in Canada is recommended not mandated, granting parents discretionary decision-making power regarding their child’s immunization status. Uptake of childhood immunization at present falls below national targets. Nurses who interact with parents in the clinical setting may witness parents’ decision-making experiences, attitudes, and opinions inclusive of vaccine hesitancy.

Purpose

The aim of this study is to understand parents’ and nurses’ experiences of decision-making about childhood immunization, specifically measles-mumps-rubella and/or diphtheria-tetanus-acellular pertussis.

Methods

Thorne’s interpretative description approach was used to understand parents’ and nurses’ experiences and perspectives about immunization. The sample was 6 nurses and 16 parents residing in northeastern Ontario.

Results

Common to all participants was the goal of protection. Motivated by child protection, parents carried out three broad actions, searching for information, deliberating the information and sources to determine the relative benefits and risks of immunization, and bearing responsibility for their decision to accept, delay, or decline immunization. Nurses were motivated by child protection and population health.

Conclusion

Implications for nursing included integration of immunization competencies in nursing curricula, ongoing professional development, validation of parental actions for child protection, nurse-led education sessions, and engaging parents through social media to support access to reputable information.
Bioactive tetracalcium phosphate/magnesium phosphate composite bone cement for bone repair
Authors: Liu Jingxian , Liao Jianguo , Li Yanqun , Yang Zhengpeng , Ying Qiwei , Xie Yufen , Zhou Aiguo
Published: May 2019

In order to acquire a tetracalcium phosphate/magnesium phosphate (TTCP/MPC) composite bone cement that combines the excellent bioactivity of TTCP and high mechanical strength of MPC, the cement was made and the compressive strength, phase composition of hardened cement, degradation in vitro, and tissue responses in vivo by implantation of TTCP/MPC in bone defect of rabbits were investigated. The results showed that TTCP/MPC was with a markedly better mechanical property than MPC. Moreover, compared with MPC, TTCP/MPC showed significantly delayed degradability in simulated body fluid. To investigate the in vivo biocompatibility and osteogenesis, the TTCP/MPC samples were implanted into bone defects in rabbits. Histological evaluation displayed that the introduction of TTCP into MPC enhanced the efficiency of new bone formation. TTCP/MPC also showed good biocompatibility, biodegradability and osteoconductivity with host bone in vivo. The results suggested that TTCP/MPC meets the basic requirements of bone tissue engineering, has an obvious clinical advantage over MPC and is promising to be applied in orthopedic, reconstructive and maxillofacial surgery.
Liftoff behaviors and flame structure of dimethyl ether jet flame in CH4/air vitiated coflow
Authors: Fu Wei , Li Fengyu , Zhang Haitao , Yi Bolun , Liu Yanju , Lin Qizhao
Published: May 2019

The objective of this paper is to investigate the flame structure and liftoff behaviors of a dimethyl ether central jet in CH4/air vitiated coflow in a coflow burner. The liftoff behaviors of dimethyl ether jet flames in the air flow were studied firstly. The flame stability of the burner was analyzed by measuring the flow field temperature with thermocouples. By changing the coflow rate and CH4 equivalence ratio, the liftoff behaviors of dimethyl ether jet flames under different vitiated coflow environments were discussed. The jet flame structure was also analyzed qualitatively by high-speed photography.
Oxidative stress and vitamin D receptor BsmI gene polymorphism in Egyptian children with systemic lupus erythematosus: a single center study
Authors: Fouad Hend , Yahia Sohier , Elsaid Afaf , Hammad Ayman , Wahba Yahya , El-Gilany Abdel-Hady , Abdel-Aziz Abdel -Aziz Fatouh
Published: May 2019

Systemic lupus erythematosus (SLE) is an autoimmune disease with unknown exact etiology. Vitamin D receptor gene ( VDR) and oxidative stress play important roles in the pathogenesis of SLE. Here we investigated the genotypes and allelic frequencies of VDR BsmI polymorphism as well as their relationship with oxidative stress markers in Egyptian SLE children. We conducted a cross-sectional comparative study at Mansoura University Children's Hospital, Egypt from 2014 to 2018 including 100 SLE children and 100 controls. We investigated both groups for VDR BsmI polymorphism using polymerase chain reaction. Oxidative stress was assessed using malondialdehyde, glutathione S-transferase, superoxide dismutase, catalase and total antioxidant capacity. BB genotype frequency was found to be significantly higher in the SLE group ( p = 0.04, odds ratio (95% confidence interval) = 2.5 (1.01–5.9)). However, VDR B allele and b allele showed insignificant differences between SLE patients and controls ( p = 0.36, odds ratio (95% confidence interval) = 1.2 (0.8–1.8)). Lower levels of glutathione S-transferase, superoxide dismutase and total antioxidant capacity were found in the SLE group with statistically significant differences as regards glutathione S-transferase and superoxide dismutase ( p < 0.001). Serum malondialdehyde and catalase levels were significantly higher in the SLE group ( p < 0.001). No significant differences were found between VDR BsmI polymorphism (genotypes and alleles) and oxidative stress markers in the SLE group. In conclusion, BB genotype of VDR BsmI polymorphism is associated with an increased risk of SLE among Egyptian children. Oxidative stress may contribute in pathogenesis of SLE but is not associated with VDR BsmI polymorphism.
Right ventricular thrombus in a case of neonatal lupus: case report
Authors: Elnady B , Alqarni M M , Mostafa M A , Fouda E S
Published: May 2019

Neonatal thrombosis is considered a rare manifestation with unclear aetiology. We reported a neonatal lupus of a Sjogren’s syndrome mother with recurrent miscarriage secondary to antiphospholipid syndrome; seronegative to anticardiolipin antibodies, lupus anticoagulant and B2GP1. She was serologically positive to antiphosphatidylethanolamine and antiprothrombin antibodies, anti-SSA/Ro and anti-SSB/La. The neonate developed neonatal lupus complicated with right ventricular thrombus assumed to be induced by maternal transmission of antiphosphatidylethanolamine and antiprothrombin antibodies, treated successfully with tissue plasminogen activator and warfarin.
Cancer worry frequency vs. intensity and self-reported colorectal cancer screening uptake: A population-based study
Authors: Vrinten Charlotte , Stoffel Sandro , Dodd Rachael H , Waller Jo , Lyratzopoulos Yoryos , von Wagner Christian
Published: May 2019

Objectives

Many studies of cancer worry use items measuring frequency or intensity. Little is known about how each of these relate to cancer screening uptake. This study compared the association between worry frequency vs. intensity and colorectal cancer screening intention/uptake.

Methods

Across four surveys (2014–2016), we collected data from 2878 screening-eligible men and women (aged 60–70) in England. Measures included single-items assessing cancer worry frequency and intensity, and a derived combination of both. We also assessed self-reported past faecal occult blood testing uptake (ever vs. never), intention to participate when next invited (yes vs. no), and demographics. Using logistic regression, we compared a model containing sociodemographic characteristics (Model 1), with four models adding cancer worry frequency (Model 2), intensity (Model 3), both (Model 4), or the combined measure (Model 5).

Results

A model with cancer worry intensity and demographics (Model 3) explained significantly more variance in uptake and intention ( R2 = 0.068 and 0.062, respectively) than demographics alone (Model 1: R2 = 0.058 and 0.042; p < 0.001), or a model with demographics and cancer worry frequency (Model 2: R2 = 0.059 and 0.052; p < 0.001). The model was also equally as effective as models including both the frequency and intensity items (Model 4: R2 = 0.070 n.s. and 0.062 n.s.), or using the derived combination of both (Model 5: R2 = 0.063 n.s. and 0.053 n.s.).

Conclusion

A single item measure of cancer worry intensity appeared to be most parsimonious for explaining variance in colorectal cancer screening intention and uptake.
Pilar Cyst Pigmented Epithelial Remnants: A Potential Diagnostic Pitfall
Authors: AbdullGaffar Badr
Published: May 2019

Pilar cysts are common cutaneous cysts of follicular origin. They are easy to diagnose clinically and pathologically. Histologic diagnostic difficulties might arise in certain situations, however. Acute inflammation with total destruction of the cyst wall due to rupture with replacement by an abscess formation, foreign body giant cell reaction, and fibrosis could obscure their recognition. Cysts with hybrid lining epithelium could be confused with other cutaneous cysts. Epithelial remnants of the basal layer with loss of the squamous epithelium and shelled out cyst contents might mimic other epithelial cysts and vascular lesions. Few studies focused on the phenomenon of epithelial remnants or epithelial separation of pilar cysts. We report a case of a scalp cyst composed of a single layer of pigmented cuboidal lining epithelium. The initial differential diagnosis was hidrocystoma, solid-cystic hidradenoma, arteriovenous malformation, and lymphangioma. The intraepithelial pigment was melanin. The lining epithelium was positive for cytokeratin cocktail, CK5/6, CK8, CK19, p63, and D2-40 with scattered S-100 protein and melan-A positive melanocytes. Being unaware of the phenomenon of epithelial split in pilar cysts, it was mislabeled as a melanin-pigmented eccrine hidrocystoma. Surgical pathologists should be aware of pilar cysts’ epithelial remnants to avoid potential diagnostic pitfalls. An attention to certain histologic hints and knowledge of the immunoprofile of the basal layer should help pathologists avoid this pitfall.
What cancer patients actually know regarding medical cannabis? A cross-sectional survey with a critical analysis of the current attitudes
Authors: Cortellini Alessio , Porzio Giampiero , Cofini Vincenza , Necozione Stefano , Giusti Raffaele , Marchetti Paolo , Aloe Spiriti Maria A , Costanzi Andrea , Peris Flaminia , Ravoni Giulio , Spinelli Giuseppe , Ficorella Corrado , Verna Lucilla
Published: May 2019

Background

In Italy medical cannabis is a prescription drug since 1998. Even though it could not be considered a therapy as such, it is indicated as a symptomatic treatment also in cancer patients, to cure iatrogenic nausea/vomiting and chronic pain.

Patients and methods

We conducted a knowledge survey about medical cannabis among cancer patients referred to two outpatient cancer care centers and a home care service.

Results

From February to April 2018, 232 patient were enrolled; 210 patients were on active disease-oriented treatment (90.5%), while 22 (9.5%) not. Eighty-one percent of the patients have heard about medical cannabis, but only 2% from healthcare professionals. Thirty-four percent of responders thought about using cannabis to treat one or more of their own health problems, especially pain (55%). Despite that, 18% of the participants believe that medical cannabis could have negative effects on their own symptoms. Patients with high educational level better knew cannabis (odds ratio = 3.52; 95% confidence interval: 1.07–11.53), and medical cannabis (odds ratio = 3.21; 95% confidence interval: 1.48–6.98), when compared to patient with low educational level. Patients who were on active disease-oriented treatment better knew medical cannabis (odds ratio = 3.91; 95% confidence interval: 1.26–12.11) compared to “out of treatment” patients. Metastatic patients were less informed about medical cannabis compared to patients on adjuvant treatment.

Conclusions

Our survey shows that most of Italian cancer patients know medical cannabis and a third of them have considered using cannabis to treat one (or more) of their own health problems. In the same time, they are poorly informed and do not tend to ask for information about medical cannabis to healthcare professionals.
Early versus delayed administration of granulocyte-colony stimulating factor following chemotherapy in pediatric patients with Ewing sarcoma
Authors: Al-Momani Deema , Al-Qasem Wiam , Kasht Rawan , Sultan Iyad
Published: May 2019

Background

The optimal timing of initiating granulocyte-colony stimulating factor following chemotherapy in pediatric patients has not been clearly defined. This study aimed to compare the administration of granulocyte-colony stimulating factor on day 1 versus day 3 postchemotherapy in pediatric patients with Ewing sarcoma.

Method

A retrospective study of pediatric patients with Ewing sarcoma who received granulocyte-colony stimulating factor following chemotherapy between January 2016 and September 2018 at a comprehensive cancer center. The institution’s chemotherapy protocol for Ewing sarcoma was modified in April 2017 to include granulocyte-colony stimulating factor initiation on day 3 instead of day 1 post-chemotherapy. Febrile neutropenia requiring hospitalization, duration of hospital stay, and chemotherapy delay were compared for patients before and after the protocol change.

Results

Over the study period, 250 cycles were evaluated with day 1 granulocyte-colony stimulating factor and 221 cycles with day 3 granulocyte-colony stimulating factor. There were no differences between the day 1 and day 3 groups in the number of cycles associated with Febrile neutropenia requiring hospitalization (34 vs. 19, p = 0.086), and the length of Febrile neutropenia-related hospitalization (mean 4 ± 2.1 vs. 4.6 ± 1.8, p = 0.123). However, delay in chemotherapy due to neutropenia was reported in significantly more cycles in the day 1 group, compared to the day 3 group (37 vs. 16, p = 0.01).

Conclusions

Febrile neutropenia resulting in hospital admission and the length of hospital stay was not different between pediatric patients with Ewing sarcoma who received granulocyte-colony stimulating factor on day 1 or day 3 post-chemotherapy. Chemotherapy delay due to neutropenia was higher in patients who received granulocyte-colony stimulating factor on day 1. Larger studies are required to fully determine the impact of delayed initiation of granulocyte-colony stimulating factor.
The Myocardial Bridge: Potential Influences on the Coronary Artery Vasculature
Authors: Teragawa Hiroki , Oshita Chikage , Ueda Tomohiro
Published: May 2019

A myocardial bridge (MB) is an anatomical abnormality of the coronary artery and is characterized by the systolic narrowing of the epicardial coronary artery caused by myocardial compression during systole. An MB is frequently observed on cardiac computed tomography or coronary angiography and generally appears to be harmless in the majority of patients. However, the presence of MB is reportedly associated with abnormalities of the cardiovascular system, including coronary artery diseases, arrhythmia, certain types of cardiomyopathy, and cardiac death, indicating that MB serves a pivotal role in the occurrence and/or development of such cardiovascular events. Recently, there has been an increasing interest in the coexistence of MB and coronary spasm in research due to opposing aspects regarding their treatments. For example, monotherapy using β-blockers, which are effective in patients with MB, may worsen symptoms in patients with coronary spasm. By contrast, nitroglycerin, which is an effective treatment option for coronary spasm, may worsen symptoms in patients with MB. This review focuses on the pathophysiology and diagnosis of MB and MB-related cardiovascular diseases, including coronary spasm, and on the treatment strategies for MB.
Experimental research on marine oil-lubricated stern tube bearing
Authors: Litwin Wojciech
Published: May 2019

Bearings of propeller shafts are very crucial elements of the propulsion system of each of the ships. The safety of shipping depends on their durability and reliability. The new legal restrictions mean that today we are looking for environmentally friendly solutions. That is why water-lubricated bearings are becoming more and more popular. So, will oil-lubricated shaft bearings belong to the past? The bearing with a white metal bushing lubricated with mineral oil, which was subjected to experimental tests, has a number of advantages. First of all, it works in the area of full fluid friction, and in typical shipbuilding conditions it has a significant excess of hydrodynamic load capacity. Therefore, replacing mineral oil with an environmentally friendly lubricant with a similar viscosity seems to be a promising solution. Motion resistance larger than that in water-lubricated bearings compensates for the reliability and durability of this solution.
A qualitative study of the perceived effectiveness of refugee services among consumers, providers, and interpreters
Authors: Dubus Nicole , LeBoeuf Heidi Sue
Published: May 2019

This study explored the perceptions of accessibility and cultural effectiveness of refugee services in the northeast region of the United States from refugees, interpreters who work with refugees in accessing these services, and the providers of the refugee services. The study examined the perceptions of 51 refugees from 10 countries, five individual interviews with providers and 26 provider survey responses representing 31 different agencies, and four interviews from interpreters. Qualitative interviews were conducted using a semi-structured interview schedule, were audiotaped, and transcribed. Further data were collected through a survey. All data were analyzed using constant comparative analysis. Participants shared feelings of frustration that services seemed poorly coordinated among the agencies and that the agencies appeared ill-prepared for the unique experiences of separate refugee groups. The three perspectives of refugee service delivery, as a consumer, a provider, or an interpreter, shared the perception that there was not a mechanism for the different services to collaborate effectively with each other, to create a network of coordinated services that would enhance services while decreasing burdens on individual centers, nor was there a system to best prepare the centers for new refugees.
Workplace Theory: An anthropological approach to emotional labour, subjectivity and control/resistance processes
Authors: Guiamet Jaime
Published: May 2019

This article examines theories about the labour process that have become widespread during the last 30 years, focusing particularly on how subjective control/resistance processes play out in the workplace. My objective is to contribute to theories that highlight how employers’ incorporating worker subjectivity into management technologies cannot be simply understood as increased domination in the workplace; these new approaches introduce new variations in the entangled production of workers’ resistance and compliance. To understand the range of worker responses I argue for a processual power imbricated approach to the construction of subjectivity within the production process in service industries. My contribution to this discussion draws on the main conclusions of my research about the labour experiences of supermarket workers in the city of Rosario, Argentina. I specifically examine subjective control and its connection to the mobilization of the customer’s evaluation of workers.
Migrant gaming girls in Beijing: Urban solitude, play, and attempts to integrate
Authors: Chen Xiaoxu , Wang Chadwick
Published: May 2019

Individuals are said to be free to desire and free to choose their ‘urban dreams’ in China. This is not true. Drawing on participant observation and in-depth interviews with members of a WoW guild, we examine the lived stories and daily practices of these well-educated migrant gaming girls. The girls have usually been ‘taken’ to the metropolis, and their vulnerability lies in the fact they may not get adequate emotional or social support. It’s all because of their ‘outsider’ identities rather than lack of requisite suzhi (‘human quality’). A back-and-forth shuttling between popular massively multi-player online role-playing games (MMORPGs) like WoW and the ‘real world’ can help them regain or alter themselves. These enterprising-selves are ultimately thus accomplished. The desiring-selves part, to the contrary, is unable to be empowered by the digital real.
Cultural globalization from the periphery: Translation practices of English-speaking K-pop fans
Authors: Cruz Angela Gracia B. , Seo Yuri , Binay Itir
Published: May 2019

The international expansion of Korean popular music (K-pop) reflects the increasing dislocation of cultural globalization from Western centers, spurred by the rise of cultural, economic, and political institutions within different regions. This study adopts a translation theory perspective on how the meanings of such cultural products from the “periphery” become transculturally intelligible. In this endeavor, we analyze the role of online fan-generated paratexts in translating the global consumptionscape of K-pop. We reveal how translation practices enable cultural understanding and reinscribe transcultural identity politics, inverting and unsettling “traditional” center-periphery dynamics. Fan translation practices emerge as a key node in processes of cultural globalization, underscoring the role of consumer-as-translator and situating cultural globalization not only in localized spaces but also in the mediated transcultural space of the paratextual field.
Preventive effect of exercise training on diabetic kidney disease in ovariectomized rats with type 1 diabetes
Authors: Souza Cláudia Silva , de Sousa Oliveira Bianca Silva , Viana Geovanildo Nascimento , Correia Thiago Macêdo Lopes , de Bragança Ana Carolina , Canale Daniele , Oliveira Márcio Vasconcelos , de Magalhães Amélia Cristina Mendes , Volpini Rildo Aparecido , de Brito Amaral Liliany Souza , de Jesus Soares Telma
Published: May 2019

This study evaluated the effects of moderate regular physical exercise on lipid peroxidation, inflammation and renal function and structure in streptozotocin (STZ)-induced ovariectomized diabetic rats. Twenty-four Wistar rats were anesthetized and submitted to bilateral ovariectomy. The rats were divided into four experimental groups: ovariectomized control (OC), ovariectomized trained control (OTC), ovariectomized diabetic (OD), ovariectomized trained diabetic (OTD). The OTD and OTC groups were submitted to treadmill running for four weeks before to diabetes mellitus (DM) induction with STZ (40 mg/kg, i.v) or vehicle injection, respectively, and continued the training for another eight weeks after the injections. Urine samples were collected 24 h after the last training session, and blood samples and kidneys were collected after euthanasia. Our results showed that physical exercise attenuated the loss of body weight and postprandial glucose and improved physical capacity in the OTD group. Lower serum creatinine levels, glycosuria, and proteinuria were also observed in this group. There was no difference in 17β-estradiol levels between the experimental groups. The glomerular and tubulointerstitial changes were attenuated in the OTD group. Expressions of macrophages, lymphocytes, fibronectin, TGF-β1, and NF-κB were reduced in the glomeruli of OTD group. Exercise also reduced macrophages, lymphocytes, and TGF-β1 expression in the tubulointerstitial compartment of the renal cortex of this group. In addition, increased levels of TBARS in the renal cortex of diabetic rats were prevented by exercise in the OTD group. In conclusion, our study shows that physical exercise exerted a renoprotective effect against the progression of diabetic kidney disease in ovariectomized rats.

Impact statement

To date, no studies have been found evaluating the effects of physical exercise on renal function and structure changes in ovariectomized rats with type 1 diabetes. Therefore, this work emerges with an important tool for strengthening and expanding innovative research on exercise with potential for the prevention of renal diseases in ovariectomized diabetic rats, and future development of studies that seek to increase scientific knowledge about the beneficial effects of physical exercise on renal diseases in humans.
Thoracic Stent Graft Accompanied by Coil Embolization for Pulmonary Sequestration
Authors: Wilder Fatima G. , Minasyan Sarah Z.
Published: May 2019

Thoracic stent graft plus coil embolization is a promising option for management of pulmonary sequestrations. Here we present the case of a 43-year-old male with chronic recurrent chest pain and hemoptysis that was incidentally identified as having a Pryce Type I pulmonary sequestration. The patient had a known history of gastritis, alcohol abuse, chronic leg and back pain, and was incidentally found to have an anomalous artery from the descending thoracic aorta to the left lower lobe. Due to recurrent hemoptysis and refractory back pain with no other identifiable etiology, he was consented for coil embolization and thoracic endovascular aortic repair. In conjunction with interventional radiology, coil embolization of the aberrant thoracic artery was performed under fluoroscopic guidance with good graft coverage of the aberrant artery with an endovascular graft. The patient’s postoperative recovery was uneventful and he reported a decrease in his chest pain. Repeat imaging including chest X-ray and CT angiography were performed prior to discharge. CT angiography demonstrated good positioning of the coils as well as the stent graft. The patient was discharged on postoperative day 1. Surgical intervention with ligation of the anomalous vessel has historically been the primary intervention for patients with Pryce Type I sequestrations, and it has yielded satisfactory results. However, thoracic stent graft in addition to coil embolization is a minimally invasive management option that should be considered as the first line of treatment because of the minimal physiologic burden on the patient and quicker recovery as compared to traditional thoracotomy.
Optimal Approach to Lobectomy for Non-Small Cell Lung Cancer: Systemic Review and Meta-Analysis
Authors: Ng Calvin S.H. , MacDonald John K. , Gilbert Sebastien , Khan Ali Z. , Kim Young T. , Louie Brian E. , Blair Marshall M. , Santos Ricardo S. , Scarci Marco , Shargal Yaron , Fernando Hiran C.
Published: May 2019

Objective

Video-assisted thoracic surgery (VATS) lobectomy was introduced over 25 years ago. More recently, the technique has been modified from a multiport video-assisted thoracic surgery (mVATS) to uniportal (uVATS) and robotic (rVATS), with proponents for each approach. Additionally most lobectomies are still performed using an open approach. We sought to provide evidence-based recommendations to help define the optimal surgical approach to lobectomy for early stage non-small cell lung cancer.

Methods

Systematic review and meta-analysis of articles searched without limits from January 2000 to January 2018 comparing open, mVATS, uVATS, and rVATS using sources Medline, Embase, and Cochrane Library were considered for inclusion. Articles were individually scrutinized by ISMICS consensus conference members, and evidence-based statements were created and consensus processes were used to determine the ensuing recommendations. The ACC/AHA Clinical Practice Guideline Recommendation Classification system was used to assess the overall quality of evidence and the strength of recommendations.

Results and recommendations

One hundred and forty-five studies met the predefined inclusion criteria and were included in the meta-analysis. Comparisons were analyzed between VATS and open, and between different VATS approaches looking at oncological outcomes (survival, recurrence, lymph node evaluation), safety (adverse events), function (pain, quality of life, pulmonary function), and cost-effectiveness. Fifteen statements addressing these areas achieved consensus. The highest level of evidence suggested that mVATS is preferable to open lobectomy with lower adverse events (36% versus 42%; 88,460 patients) and less pain (IIa recommendation). Our meta-analysis suggested that overall survival was better (IIb) with mVATS compared with open (71.5% versus 66.7% 5-years; 16,200 patients). Different VATS approaches were similar for most outcomes, although uVATS may be associated with less pain and analgesic requirements (IIb).

Conclusions

This meta-analysis supports the role of VATS lobectomy for non-small cell lung cancer. Apart from potentially less pain and analgesic requirement with uVATS, different minimally invasive surgical approaches appear to have similar outcomes.
Bortezomib and metformin opposingly regulate the expression of hypoxia-inducible factor alpha and the consequent development of chemotherapy-induced painful peripheral neuropathy
Authors: Ludman Taylor , Melemedjian Ohannes K
Published: May 2019

Chemotherapy-induced painful peripheral neuropathy is a significant clinical problem that is associated with widely used chemotherapeutics. Unfortunately, the molecular mechanisms by which chemotherapy-induced painful peripheral neuropathy develops have remained elusive. The proteasome inhibitor, bortezomib, has been shown to induce aerobic glycolysis in sensory neurons. This altered metabolic phenotype leads to the extrusion of metabolites which sensitize primary afferents and cause pain. Hypoxia-inducible factor alpha is a transcription factor that is known to reprogram cellular metabolism. Furthermore, hypoxia-inducible factor 1 alpha protein is constantly synthesized and undergoes proteasomal degradation in normal conditions. However, metabolic stress or hypoxia stabilizes the expression of hypoxia-inducible factor 1 alpha leading to the transcription of genes that reprogram cellular metabolism. This study demonstrates that treatment of mice with bortezomib stabilizes the expression of hypoxia-inducible factor 1 alpha. Moreover, knockdown of hypoxia-inducible factor 1 alpha, inhibition of hypoxia-inducible factor 1 alpha binding to its response element, or limiting its translation by using metformin prevent the development of bortezomib-induced neuropathic pain. Strikingly, the blockade of hypoxia-inducible factor 1 alpha expression does not attenuate mechanical allodynia in mice with existing bortezomib-induced neuropathic pain. These results establish the stabilization of hypoxia-inducible factor 1 alpha expression as the molecular mechanism by which bortezomib initiates chemotherapy-induced painful peripheral neuropathy. Crucially, these findings reveal that the initiation and maintenance of bortezomib-induced neuropathic pain are regulated by distinct mechanisms.
Practitioners’ multi-disciplinary perspectives of soccer talent according to phase of development and playing position
Authors: Towlson Christopher , Cope Ed , Perry John L , Court David , Levett Nick
Published: May 2019

The study aimed to establish the perceived importance that academy soccer practitioners placed on technical/tactical, physical, psycho-social player attributes during player selection and explore whether perceptions change according to Elite Player Performance Plan phase. Seventy academy practitioners working within Elite Player Performance Plan programs (Category 1: n = 29; Category 2: n = 13 and Category 3: n = 28) completed an online survey. Psychological factors were rated significantly ( p ≤ 0.01) higher than sociological, technical/tactical, and physical factors, with recruitment staff specifically valuing psychological factors significantly ( p ≤ 0.01) more than medical staff. Youth Development phase practitioners valued sociological factors significantly ( p < 0.05) more than in the Foundation phase, which was also true for physical factors. Practitioners indicated significant positional differences for most physical and technical/tactical attributes. There was no playing position effect for relative age effect or maturity. Between playing position variance of outfield players for most technical and physical attributes increased according to advancing Elite Player Performance Plan phase. Attitudes to holistic talent identification criteria likely change according to practitioner role. Therefore, this study provides evidence to suggest that Elite Player Performance Plan practitioners place less perceived importance on enhanced maturity status and relative age of players but does indicate an enhancing and significant positional preference for physical and technical/tactical attributes. Suggesting that practitioners are less likely to (de)select players based on transient, maturity-related attributes and instead place greater emphasis on specialist physical/technical position-specific attributes as players navigate the Elite Player Performance Plan pathway towards professional status.
Identification of key performance characteristics of elite Australian football umpires
Authors: Kittel Aden , Larkin Paul , Elsworthy Nathan , Spittle Michael
Published: May 2019

This research aimed to present a hierarchy of key attributes for Australian football umpires. Elite Australian football umpires ( n = 19) and their coaches ( n = 5) participated in this study. A list of attributes necessary for sports officiating was obtained from past research and adapted specifically for Australian football umpires. Umpires were required to rate each attribute on a scale of 0–9 (least to most importance), and provide a justification of its importance to performance. A modified questionnaire was developed with attributes removed or added, according to the first survey round. This research identified two cognitive attributes: knowing the laws/interpretations and decision-making as the two highest rated attributes, respectively. Psychological attributes composure and concentration were rated highly by the umpires, ranked as number three and five, respectively. The game skill attribute of teamwork was rated as the fourth highest. Fitness was the only physical attribute to be rated in the most important category. Results highlight the importance of cognitive and psychological attributes to elite performance; however, participant feedback suggests that the integration of all attributes is critical. This knowledge establishes an understanding of the key attributes for expert performance, and this information could be used by coaches for the assessment and development of Australian football umpires.
Pigmented border as a new surface landmark for digital nerve blocks: a cross sectional anatomical study
Authors: Anthony Dimonge J. , Mathangasinghe Yasith , Samaranayake Udagedara M. J. E. , Basnayake Basnayaka M. O. D. , Malalasekera Ajith P.
Published: May 2019

The purpose of this study was to identify surface anatomy of digital nerves in relation to the pigmented border of digits. Three-hundred and sixty digital nerves in 36 preserved adult cadaveric hands were dissected under magnification. The digital nerves were constantly located anterior to the pigmented border. The median curvilinear distance along the skin from the pigmented border to the digital nerves of the index, middle, ring and little fingers was 1.4 mm. In the thumb, this distance was 2.4 and 3.7 mm on the radial and ulnar sides, respectively. The digital nerve was located 2.4 mm deep to the skin in all fingers. The median angle to the nerve from the skin at the pigmented border was 30°. These dimensions differed in the thumb compared with the rest of the fingers. We conclude that the pigmented border of digits is a reliable anatomical landmark to locate digital nerves.
Effects of enteral nutrition on pro-inflammatory factors and intestinal barrier function in patients with acute severe pancreatitis
Authors: Chen Ying-Jie , Zhuang Yao-Dong , Cai Zhe , Zhang You-Ni , Guo Sen-Ren
Published: May 2019

The main objective of this study was to explore the effect of enteral nutrition on serum pro-inflammatory cytokines, tumor necrosis factor, and intestinal barrier function in patients with acute severe pancreatitis. A total number of 140 patients were recruited and divided randomly into parenteral nutrition (PN) and enteral nutrition (EN) groups. They received parenteral nutrition and enteral nutrition, respectively. The levels of serum total protein (TP) and albumin (ALB) in peripheral blood were detected in the two groups. Interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα) in the two groups were comparatively analyzed. The levels of pro-inflammatory factors (IL-1β, IL-6, and TNFα) for both groups were same, and there was no significant difference ( P < 0.05) between the two groups before treatment. However, after treatment, a significant reduction was found in EN group which were 31.16 ± 1.95, 36.09 ± 9.44, and 29.21 ± 3.85 ng/L, respectively, showing significant lower values as compared to PN group. The levels of TP and ALB in EN group were 64.46 ± 3.77 and 27.19 ± 1.56 g/L, respectively, after treatment, showing significantly ( P < 0.05) elevated values than PN group. The incidence rates of pancreatic necrosis and pancreatic abscess in EN group were 28.57% and 11.43%, respectively, which were found to be lower significantly than PN group. Enteral nutrition is found to be more effective than parenteral nutrition in the treatment of severe acute pancreatitis, which can significantly reduce the level of pro-inflammatory factors as well as the degree of systemic inflammatory response and protect the intestinal barrier function; thus, this study is worthy for awareness and application in clinical practice.
Correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases in gingival crevicular fluid with peri-implantitis
Authors: Song Zhiming , Weigl Paul , Wang Bi
Published: May 2019

This study aimed to analyze the correlations of inflammatory cytokines, oxidative stress markers, and matrix metalloproteinases (MMPs) in gingival crevicular fluid (GCF) with peri-implantitis (PI). Forty patients receiving dental implantation were enrolled. There were 52 implants, which were divided into PI group (42 implants) and health implant (HI) group (10 implants). Fifty-two healthy teeth (HT) with the same names with affected teeth in the patients were selected as the control group. The periodontal status was recorded. The GCF was collected and quantified. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), MMP-13, and MMP-8 were detected using enzyme-linked immunosorbent assay (ELISA). Results showed that the probing depth, sulcus bleeding index, GCF volume, and TNF-α, IL-6, hs-CRP, MMP-8, and MMP-13 levels in GCF in PI group were significantly higher than HI and HT groups, respectively ( P < 0.01 or P < 0.05). The SOD and GSH-Px levels in PI group were significantly lower than HI and HT groups, respectively ( P < 0.05). Excepting hs-CRP, there was no significant difference of each index between HI and HT groups ( P > 0.05). In conclusion, TNF-α, IL-6, hs-CRP, SOD, GSH-Px, MMP-8, and MMP-13 are involved in the occurrence of PI, and they may be used as auxiliary indicators to evaluate the degree of PI. In addition, the clinical periodontal index probing depth and sulcus bleeding index are positively correlated with GCF volume, hs-CRP, MMP-8, and MMP-13.
Study on the correlation between the changes of TNFR1, TNF-α, and adiponectin in patients with gestational diabetes mellitus and insulin resistance
Authors: Xie Jie , Dai Lan , Tang Xiaolei
Published: May 2019

Gestational diabetes mellitus (GDM) refers to pregnant women with impaired glucose tolerance, which could bring high risk to the mother and fetus. However, the early diagnosis and treatment of GDM remained unclear. In this study, 60 patients with GDM were selected as the research group and 50 healthy pregnant women as the control group. Tumor necrosis factor receptor 1 (TNFR1), tumor necrosis factor-α (TNF-α), and adiponectin (ADP) in the serum were measured by enzyme-linked immunosorbent assays (ELISAs). The levels of fasting blood glucose (FBG), fasting insulin (FINS), and glycosylated hemoglobin (HbA1c) were also detected to calculate homeostasis model assessment insulin resistance index (HOMA-IR) and pancreatic β-cell function index (HOMA-HBCl). Compared with the control group, the serum levels of TNFR1, TNF-α, and HbA1c in research group were significantly increased ( P < 0.05), while ADP showed lower levels ( P < 0.01). Furthermore, FBG, FINS, and HOMA-IR were evidently increased ( P < 0.05), while homeostasis model assessment insulin secretion index (HOMA-β) and insulin sensitivity index (ISI) were decreased ( P < 0.05) in research group. TNFR and TNF-α were positively correlated with FBG, FINS, and HOMA-IR ( P < 0.05). In addition, there was a significant negative correlation between ADP and FINS and HOMA-IR ( P < 0.01). From logistic regression analysis, age, gestational age, FBG, FINS, TNFR1, TNF-α, and ADP ( P < 0.05) were shown to be risk factors to affect the function of islet β-cells. In conclusion, the high levels of TNFR1 and TNF-α and the low levels of ADP in the second trimester of pregnancy are the risk factors of GDM, which are related to the insulin resistance and impaired pancreatic β-cell function.