bluuebunny/crossref_metadata_2025 huggingface dataset:
Protecting the privacy of technology users who have cognitive disabilities: Identifying areas for improvement and targets for change
Authors: Cobigo Virginie , Czechowski Konrad , Chalghoumi Hajer , Gauthier-Beaupre Amelie , Assal Hala , Jutai Jeffery , Kobayashi Karen , Grenier Amanda , Bah Fatoumata
Published: September 2020

Introduction

Information Technologies (IT) may serve assistive roles that facilitate the interaction of people living with cognitive disabilities (CD) within their environments. However, there are some notable concerns related to privacy threats associated with the use of IT. The purpose of this study was to examine how assistive technology developers may best adapt over time to develop their IT to be resilient against threats to privacy. We therefore focused on the following areas: (1) developers’ knowledge and practices related to privacy protection; (2) challenges when applying recommended practices, and; (3) preferred channels to acquire knowledge.

Method

We conducted semi-structured interviews with ten technology developers who are members of the AGE-WELL network undertaking research and development of assistive technologies to be used by people who have cognitive disabilities. We used an inductive-deductive method for the analysis of qualitative data to examine participant responses and generate themes related to the study goals.

Results

Principal themes that emerged from the data include practices specific to populations with CD, challenges to obtaining consent to use of information, and preferred channels to acquire knowledge.

Conclusion

We identify areas of focus for developing a knowledge mobilization strategy to improve relevant policies and practices.
The entrepreneurial labor of reinvention in Beijing’s Zhongguancun high-tech district
Authors: Zhang Lin
Published: September 2020

Deploying the concept of the entrepreneurial labor of reinvention, this article contrasts the experiences of elite and grassroots IT entrepreneurs as they navigated China’s post-2008 economic restructuring centered around IT innovation and entrepreneurship in Beijing’s Zhongguancun high-tech district, also known as China’s Silicon Valley. By situating the changing labor practices and subjectivities of a new generation of Zhongguancun IT entrepreneurs in the history of the post-Mao evolution of IT labor and entrepreneurship, this article emphasizes the specificities of digital work that both continue from and reinvent historically situated local labor practices. It also deconstructs the universalism of the state-led entrepreneurialization campaign to highlight its regime of inequalities and persisting politics of exclusion.
Algorithmic precarity in cultural work
Authors: Duffy Brooke Erin
Published: September 2020

While work in the media and cultural industries has long been considered precarious, the processes and logics of platformization have injected new sources of instability into the creative labor economy. Among the sources of such insecurity are platforms’ algorithms, which structure the production, circulation, and consumption of cultural content in capricious, enigmatic, even biased ways. Accordingly, cultural producers’ conditions and experiences are increasingly wrought by their understandings—and moreover their anticipation—of platforms’ ever-evolving algorithmic systems. Against this backdrop, I urge fellow researchers of digital culture and society to consider how this mode of “algorithmic precarity” exacerbates the instability of cultural work in the platform era. Considering the volatility of algorithms and the wider cross-platform ecology can help us to develop critical interventions into a creative economy marked by a profoundly uneven allocation of power between platforms and the laborers who populate—and increasingly—power them.
Human diamine oxidase is readily released from activated neutrophils ex vivo and in vivo but is rarely elevated in bacteremic patients
Authors: Boehm Thomas , Karer Matthias , Matzneller Peter , Buchtele Nina , Ratzinger Franz , Petroczi Karin , Schoergenhofer Christian , Schwameis Michael , Burgmann Heinz , Zeitlinger Markus , Jilma Bernd
Published: September 2020

During human diamine oxidase (DAO) ELISA development we noticed that in serum DAO concentrations appear to be higher when compared to plasma. Neutrophils contain DAO in the specific granules and we hypothesized that DAO is released from neutrophils during serum coagulation. If activation of neutrophils can release DAO, its concentrations might be elevated in vivo after lipopolysaccharide (LPS) administration and in bacteremic patients. Using blood from healthy volunteers DAO concentrations were measured ex vivo in serum, citrate, EDTA and heparin plasma over several hours and after activation of neutrophils. Lipopolysaccharide and granulocyte-colony stimulating factor (G-CSF) were administered to 15 and 8 healthy volunteers, respectively and DAO concentrations were measured at different timepoints. DAO antigen levels were also determined in three different subcohorts of patients with culture-proven bacteremia and high C-reactive protein (CRP) levels. DAO concentrations were elevated in a time-dependent manner in serum but not in EDTA or citrate plasma ( P < 0.01). Neutrophil activation using phorbol myristate acetate (PMA) and zymosan dose-dependently caused DAO concentrations to be elevated more than 10-fold at both 22°C and 37°C (both P-values <0.001). Administration of LPS to healthy volunteers released DAO from neutrophils ( P < 0.001). Of the 55 different bacteremic patients selected from three independent cohorts only 3 (5.4%) showed highly elevated DAO concentrations. Serum DAO concentrations do not accurately reflect circulating enzyme levels but coagulation-induced neutrophil activation and consequently DAO release. Only a few bacteremic patients show high DAO concentrations able to degrade histamine rapidly.
“The Big Women”: A textual analysis of Chinese viewers’ perception toward femvertising vlogs
Authors: Duan Xu
Published: September 2020

Video blogging (vlogging), a type of short video that people produce by recording and editing their daily lives, has become an emerging form of digital cultural production on social media platforms in China. With the profound growth of video marketing on social platforms, brands have increasingly leveraged vloggers to promote female-targeted products. This phenomenon becomes especially paradoxical when marketers bring the narrative of female empowerment into the discourse. This case study employed textual analysis to understand how Chinese viewers make sense of Bobbi Brown’s “The Big Women” vlog endorsed by the female vlogger Zhuzi on Weibo. A typology of viewers’ response was generated: (1) reciprocity of self-disclosure; (2) perceived interconnectedness with the vlogger; and (3) perceived women empowerment and advertisement effectiveness. The findings of this article articulate a symbolic form of relationship between content creators, brands, and consumers that promotes women empowerment. This study argues, however, that this perception of women empowerment may obscure the implicit consumerism embedded in the femvertising contents, while promoting the myth of self-empowerment through consumption. The findings of the study shed light on the rise of (pseudo-)feminism ethos constructed by the consumer market in contemporary China and beyond.
Does Exposure to Primary Care Early in the Didactic Phase of the Physician Assistant (PA) Curriculum Influence Field Choice Post-Graduation?
Authors: Gruver Michelle , Gamber Michelle
Published: September 2020

Background

Over the past 10 years, the nation has witnessed a significant increase in the number of physician assistant (PA) education programs. Primary care shortages throughout the United States have reached a staggering deficiency. The purpose of this project was to expand the primary care workforce in the Commonwealth of Virginia by increasing exposure to primary care setting early in the academic didactic year of physician assistant schooling.

Methods

This innovative research project originated in 2017 and was inclusive of PA students ranging from 20 to 44 years of age, across multiple demographics, conducted during the first year of didactic studies. This cross-sections study examined a total size of 115 students over from three different cohort years that participated in the free medical clinic completed a pre/post exposure survey.

Results

This study highlighted that an increased exposure to primary care in the early didactic phase of physician assistant graduate studies yielded a moderate increase in the interest to pursue a career in primary care upon graduation. Throughout the 2016 to 2017, 2017 to 2018, and 2018 to 2019 academic cohorts, 19% more from baseline indicated at the end of their primary care experience that they were more likely to practice in the field of primary care following the free medical clinic experience.

Conclusions

This study demonstrates a positive influence of early exposure to primary care for Physician Assistant students with the increased affinity to practice in the field upon graduation and has set a foundation for continuation of data collection in future PA cohorts.
Exploring the Potential of Artificial Intelligence and Machine Learning to Combat COVID-19 and Existing Opportunities for LMIC: A Scoping Review
Authors: Naseem Maleeha , Akhund Ramsha , Arshad Hajra , Ibrahim Muhammad Talal
Published: September 2020

Background:

In the face of the current time-sensitive COVID-19 pandemic, the limited capacity of healthcare systems resulted in an emerging need to develop newer methods to control the spread of the pandemic. Artificial Intelligence (AI), and Machine Learning (ML) have a vast potential to exponentially optimize health care research. The use of AI-driven tools in LMIC can help in eradicating health inequalities and decrease the burden on health systems.

Methods:

The literature search for this Scoping review was conducted through the PubMed database using keywords: COVID-19, Artificial Intelligence (AI), Machine Learning (ML), and Low Middle-Income Countries (LMIC). Forty-three articles were identified and screened for eligibility and 13 were included in the final review. All the items of this Scoping review are reported using guidelines for PRISMA extension for scoping reviews (PRISMA-ScR).

Results:

Results were synthesized and reported under 4 themes. (a) The need of AI during this pandemic: AI can assist to increase the speed and accuracy of identification of cases and through data mining to deal with the health crisis efficiently, (b) Utility of AI in COVID-19 screening, contact tracing, and diagnosis: Efficacy for virus detection can a be increased by deploying the smart city data network using terminal tracking system along-with prediction of future outbreaks, (c) Use of AI in COVID-19 patient monitoring and drug development: A Deep learning system provides valuable information regarding protein structures associated with COVID-19 which could be utilized for vaccine formulation, and (d) AI beyond COVID-19 and opportunities for Low-Middle Income Countries (LMIC): There is a lack of financial, material, and human resources in LMIC, AI can minimize the workload on human labor and help in analyzing vast medical data, potentiating predictive and preventive healthcare.

Conclusion:

AI-based tools can be a game-changer for diagnosis, treatment, and management of COVID-19 patients with the potential to reshape the future of healthcare in LMIC.
Critical Success Factors for Neutralization of Airborne Threats
Authors: Naseem Afshan , Ahmad Yasir
Published: September 2020

Decisions regarding neutralizing airborne threats in the combat environment require comprehensive knowledge of resources at hand and enemy intentions. The complexity of the situation has resulted in the emergence of various models encompassing important factors of threat neutralization. Various characteristics of airborne threats considered important for their assessment have already been identified in previous literature, which include speed, distance, approach angle, maneuverability, and so on. Due to the possible extent of loss to critical assets, literature has emphasized on identifying as many useful characteristics of threats as possible. This study is also a step in this direction to improve the weapon assignment for threat neutralization. Weapon assignment based on a well-calculated threat index is a key to success in military conflicts. The purpose of this article is to identify new factors through the involvement of experts. In this study, a set of factors has been identified through a survey of relevant literature and semi-structured interviews followed by its refinement through a three-round Delphi study. The results suggest that airborne threats are considered different from other threats due to their lethality and consequences. The top-level decision-makers require a comprehensive understanding of the criticality of the situation and the effects of poor decisions. Besides other factors, weapon stock, supply chain information, and analysis of vulnerable assets/points in threat neutralization are critical to accomplish higher efficiency. The shortlisted factors yield a foundation of a comprehensive framework for decision making in a highly dynamic environment of air defense.
Central Tokyo’s Low Response Rate to the 2015 Population Census and Its Related Factors
Authors: Hanibuchi Tomoya , Yamauchi Masakazu
Published: September 2020

Recently, there has been an increase in the number of “unreported” cases in the Population Census of Japan caused by nonresponses to the survey. Subsequently, this has led to data reliability challenges. In light of this problem, the factors related to the low response rate of the 2015 Population Census in the central Tokyo area are examined in the present study. An online survey was conducted among individuals residing in the three Special Wards of Tokyo to inquire about their responses (submitted or not submitted) to the previous census. The statistical analyses demonstrated that particularly in central Tokyo, middle-aged (35–49 years) people and those who did not own a single-family residence were more likely to be nonrespondents, while most of the other characteristics were similar to the results reported in a previous nationwide study. However, further studies are required to fully understand the high rates of unreported cases in central Tokyo.
Possibility and Constraint in the Lives of Young Rural Workers in the United States: The Psychology of Working and Post-Trauma Vocational Trajectories
Authors: San Antonio Donna Marie , Kaplan-Bucciarelli Janet
Published: September 2020

Work and wellness have long been linked in the field of psychology, but few researchers have studied this topic with rural emerging adults without a high school diploma. Overall, rural areas in the United States have higher rates of poverty and lower educational attainment than nonrural areas. This narrative inquiry illuminates how precariousness in home and school contexts influenced the work trajectories and aspirations of ten 20- to 25-year-old research participants. Findings contribute to the psychology of working theory by illuminating the individual and contextual factors that generated possibility and constraint in the lives of young workers with limited education and significant adverse experiences. While traumatic experiences continued to trouble the lives of research participants, there was also evidence of post-traumatic growth, the construction of aspirational narratives, and positive future orientation. Community mentors, including teachers and employers, made a difference. Implications for educators and counselors are discussed.
The fate of femoral head autograft in acetabular reconstruction in dysplastic hips at midterm
Authors: Hamrayev Arif Jan , Buyukkuscu Mehmet Ozbey , Misir Abdulhamit , Gursu Sukru Sarper
Published: September 2020

Purpose:

To evaluate the acetabular cup and graft survival in patients who underwent total hip arthroplasty (THA) with the diagnosis of dysplastic hip osteoarthritis and received a femoral head autograft due to acetabular coverage deficiency.

Methods:

Between January 2005 and December 2016, 83 hip prostheses of 80 patients who underwent THA using femoral head autografts and were followed up for at least 2 years were retrospectively evaluated. Seventy-four hips of the remaining 71 patients (57 female (80%)) were included. Mean patient age at surgery was 51 ± 16 (range 18–76) years. The mean follow-up duration was 76 ± 25 (range 25–161) months. Acetabular inclination and graft thickness, contact length, percentage of coverage, and graft resorption were examined on postoperative and final follow-up radiographs. The presence of a radiolucent area around the acetabular and femoral components indicating loosening was also evaluated.

Results:

The mean postoperative acetabular component inclination was 44 ± 5.1° (range 30–48°) with mean graft coverage of 34 ± 4.8% (range 24–46%). In all patients, autograft union with the pelvis was seen and the lateral overflow was remodeled. Fifteen patients (20%) underwent revision surgery due to aseptic acetabular component loosening in four, nontraumatic recurrent dislocations in eight, periprosthetic infection in one, acetabular component protrusion in one, and traumatic hip dislocation in one.

Conclusion:

In patients with osteoarthritis secondary to developmental hip dysplasia, the use of femoral head autografts to eliminate acetabular coverage deficiency during THA achieves acceptable midterm postoperative radiological outcomes. Increased acetabular bone stock may be beneficial in possible future revision surgeries.
Tibial crest alignment technique-an effective technique to improve coronal alignment of tibial component in tka for arthritic knees
Authors: Dalal Shaival , Aminake Ghislain , Chandratreya Amit , Kotwal Rahul
Published: September 2020

Introduction:

Long term survivorship in Total Knee Arthroplasty is significantly dependent on prosthesis alignment.Accuracy of component positioning relies on alignment guides for making precise and accurate bone cuts.

Hypotheses:

The aim of this study was to determine, compare and analyse the coronal alignment of the tibial component of a single implant system using 3 different techniques.

Methods:

Retrospective study of cases from a prospectively collected database. Radiological assessment included measurement of the coronal alignment of tibial components of total knee arthroplasties, and its deviation from the mechanical axis. A comparison study of intramedullary, extramedullary and tibial crest alignment methods was performed.

Results:

66 consecutive patients (3 groups of 22 each). Mean BMI was 26. The mean angle of deviation from the mechanical axis was significantly lesser (p< 0.05) in the Tibial crest alignment group patients compared to the other 2 groups. Moreover, the number of outliers (+/-3 degrees) were 2 and 4 in the intra and extramedullary group, whereas there were none in the tibial crest group. The inter and intraclass correlation coefficient was 0.8 and 0.9 respectively.

Conclusion:

The Tibial Crest Alignment Technique is an effective technique to produce consistent results to achieve optimal coronal alignment of the tibial component in TKA, even in patients with high BMI.
Three-dimensional realignment and slope reducing osteotomy with anatomic ACL reconstruction in patients with revision anterior cruciate ligament deficiency
Authors: Imhoff Andreas B. , Feucht Matthias , Achtnich Andrea , Imhoff Florian , Herbst Elmar , Diermeier Theresa
Published: September 2020

Introduction:

Current incidence of recurrent anterior cruciate ligament (ACL) instability is 5%, but revision surgery is challenging and requires a thorough analysis of potential risk factor. Moreover, recurrent and chronic ACL instability can result in medial tibio-femoral osteoarthritis (OA). Beside various soft tissue patterns, bony morphologies like a steep posterior tibial slope are associated with an increased anterior tibial translation (ATT) and rotatory instability in the ACL deficient knee. To address the instability and the osteoarthritis a combined procedure is necessary in these patients, however, little is known about the efficacy of such combined procedures. Therefore, the objective of this study was to evaluate the patient reported outcomes and knee stability following combined high tibial osteotomy (HTO) with ACL reconstruction in middle-aged patients with recurrent or chronic cruciate ligament deficiency and mild to moderate medial compartment osteoarthritis (OA). Hypotheses:

Methods:

Surgical reports and prospectively collected patient reported outcome scores (IKDC, Lysholm, WOMAC, VAS for pain, and Tegner activity score) as well as clinical examination were evaluated retrospectively with a mean follow up of 45.2 ± 14.7 months. Inclusion criteria were 1) high tibial osteotomy with concomitant anatomic ACL reconstruction. Data at final followup were compared to baseline values using the Wilcoxon signed rank test (p < 0.05).

Results:

44 patients met the inclusion criteria. 16/44 suffered a graft failure after primary ACL reconstruction, and 8/44 had chronic ACL instability, but had a previous subtotal medial meniscus resection. Mean patient age at surgery was 38.2 ± 10.5 years (range: 18 – 63) with a mean varus alignment of 4.5° ± 1.5°. All patient reported significantly improved outcome scores at final follow-up (VAS 4.3 to 1.5, Lysholm 52.4 to 73.5, IKDC 56.5 to 70.9). However, the change in Tegner score at final follow-up (3.4 to 4.5) was not significant. At final followup 25/44 patients had a removal of the fixation plate.

Conclusion:

The results of this study indicate, that high tibial osteotomy combined with anatomic single bundle ACL reconstruction is a good treatment option in active middle aged patients suffering from recurrent or chronic ACL deficiency with mild to moderate medial compartment OA. At a median follow-up of 24 months patient reported outcome scores were improved. Especially in patients with multiple ACL reconstruction failures realignment osteotomies should be considered.
Effect of tranexamic acid on the timing of drainage tube removal in total knee arthroplasty
Authors: Jinliang Wang , Xuan Wei
Published: September 2020

Introduction:

To investigate the effect of tranexamic acid on the removal time of drainage tube in the first unilateral total knee arthroplasty.

Hypotheses:

The timing of removing the drinage system can be changed when using TXA.

Methods:

From June 2017 to December 2018, 182 patients (42 males and 140 females) who planned to undergo primary unilateral total knee replacement were included.Age (68.1±7.1) years (60-76 years).According to the random number table method, it was divided into four groups: 45 cases of Tranexamic acid group 1 (TXA1), 46 cases of Tranexamic acid group 2 (TXA2), 46 cases of Tranexamic acid group 3 (TXA3) and None Tranexamic acid group (NTXA).TXA1-3 group intraoperative intravenous infusion combined with local application of tranexamic acid;NTXA group was locally perfused in the joint cavity with 100ml normal saline only after surgery.Differences in drainage volume, total blood loss, invisible blood loss, degree of postoperative joint swelling, Hospital for special surgery (HSS) and visual analogue scale (VAS) of pain were compared among the four groups.

Results:

The postoperative drainage volume of TXA1˜3 groups was 85.5±34.3ml, 189.4±72.3ml and 215.3±93.4ml, respectively, which was less than that of the non-tranexamic acid group (351.3±113.5ml). The overall difference was statistically significant (F=11.5,P=0.005). The postoperative drainage volume of tranexamic acid 1 group was less than that of tranexamic acid 2 and 3 groups.The total postoperative blood loss was 699.0±255.7ml, 710.4±296.1ml, and 715.8±248.2ml in the tranexamic acid 1-3 groups, respectively, which was less than 1130.5±354.2ml in the non-tranexamic acid group, and the overall difference was statistically significant (F=13.1,P=0.001).On the 4th day after the operation, the knee swelling degree of the tranexamic acid 1- 3 groups was 1.25±0.07, 1.13±0.12, and 1.12±0.13, respectively, which were smaller than that of the non-tranexamic acid group (1.43±0.22), and the overall difference was statistically significant (F=8.23, P=0.015).There were 2 cases of positive bacterial culture in non-tranexamic acid group and tranexamic acid group.There were 3 cases of hematoma in the non-tranexamic acid group,and 1 case of delayed wound healing.

Conclusion:

The application of tranexamic acid after TKA can reduce postoperative drainage volume, latent blood loss and total blood loss.The removal of the drainage tube 18h after the operation can not only fully drain,relieve pain, promote the recovery of knee joint function, but also effectively reduce the risk of infection caused by the drainage tube.
First clinical results after lateral epicodyle osteotomy and meniscus subluxation in the repair of tibial plateau fractures
Authors: Korthaus Alexander , Ballhause Tobias Malte , Kolb Jan-Philipp , Krause Matthias , Frosch Karl-Heinz , Hartel Maximilian J.
Published: September 2020

Introduction:

Recently, a novel extended approach for comminuted lateral tibial plateau fractures was introduced. It includes a lateral epicondyle osteotomy and meniscus subluxation allowing for an almost complete overview of the lateral tibial plateau. First clinical results are presented.

Hypotheses:

We hypothesized, that a superior visualization using the novel approach in demanding cases leads to improved radiologic and clinical outcomes.

Methods:

A consecutive case series of ten in which the approach was used was followed prospectively. The cases were classified using the “10-segment classification” and the “AO classification”. To evaluate the clinical and radiological results, the Rasmussen score was applied.

Results:

Excellent to good clinical and radiological results were encountered after a median follow-up of 8,6 (IQR 4,3) months. The clinical score amounted to a median of 25 (IQR 2,8) and the radiological score a median of 17 (IQR 2,0).

Conclusion:

The early results after the treatment of demanding cased with a high degree of joint comminution presented are promising with excellent to good results, only. At the same time, despite an extended surgical procedure, no complications were encountered in the cohort. As suggested by the authors before, tibial plateau fractures should be managed using a stepwise approach with extension of the approach as individually required.
Megaprosthesis as a treatment modality for persistent distal femoral nonunion in middle aged adults
Authors: Agarwal Shashank , Pawar Inder , Kumar Anil , Verma Anjul , Kumar Pawan
Published: September 2020

Introduction:

Managing distal femur non-union can be a struggle for any orthopedician as it brings along many perplexities which may not lead to satisfactory patient outcome. The target in these cases should be to reduce the morbidity and allow early rehabilitation of the patient and to accomplish this, megaprostheses can be a feasible option. The orthodox use of megaprostheses is in the musculo-skeletal oncologic surgeries but its use can be extended to traumatic etiologies. These can be offered as a single stage definite procedure in patients who have already undergone several previous surgeries. Here we report a series of four cases of persistent non-union of distal femur treated with megaprostheses and recommend this modality for achieving the desired goal but the indication should be meticulously selected.

Hypotheses:

Megaprosthesis as a definitive treatment option in persistent distal femur non-union and prevention of repeated surgical intervention.

Methods:

Four cases of persistent distal femur nonunion with failed osteosynthesis were selected who were initially treated with a distal femur locking plate. Results were assessed in terms of range of motion, limb length discrepancy, knee society score and osteointegration of the components.

Results:

The mean age of the patients at the time of DFEPR was 49 years (42-55). The mean follow up of patients was for approximately 2 years, with the longest follow up being 3.5 years for the first operated case of the series. The range of motion was from full extension to about 105 degrees of flexion with two patients having an extension lag of 10 degrees. Patients were ambulatory without support. Postoperatively, the mean knee society score was 83 (78–88) at last follow-up as compared to 29 (21-36) in the pre-operative period. No case of infection or loosening was reported. There was 1 cm of shortening in one patient in the operated limb which was compensated by giving shoe raise. Good osseointegration of the megaprosthesis was revealed on both anteroposterior and lateral radiographs.

Conclusion:

Although there are very limited studies on the use of megaprosthesis for traumatic cases, it can be considered as an alternative when we are left with only arthrodesis or amputation as the final option. Despite the operative challenges, there is marked improvement in pain and functional capacity as experienced by these severely limited patients, which are the hallmarks of a successful salvage. The use of distal femur mega-prosthesis is a novel acumen in cases, where bone stock at the fracture site at distal end of femur is so severely compromised that traditional revision osteosynthesis would not provide stable and durable fixation. The indications for this surgery must be rigorously selected and should only complement osteosynthesis procedures, which remain the reference treatment option.
First clinical experiences with an anatomical meniscus prosthesis
Authors: van Tienen Tony , Defoort Koen , Emans Pieter , van der Groes Sebastiaan , van der Zanden Maarten
Published: September 2020

Introduction:

Meniscus loss is a known cause for medial compartment joint pain related to knee osteoarthritis (KOA). The cartilage in knee joints of KOA patients degenerates over time, resulting in accumulative complaints and reduced quality of life. When the osteoarthritis progresses knee arthroplasty is often the eventual treatment once they have reached the eligible age. In case of low grade KOA and an absent meniscus, the orthopedic surgeon currently has no established surgical procedure at hand to restore the knee mechanics and provide pain relief.

Methods:

A durable medial meniscus prosthesis has been developed to overcome this treatment gap. This anatomically shaped polymer prosthesis is based on a decade of pre-clinical work at the Radboudumc. The Trammpolin meniscus prosthesis is currently being evaluated in a First in Human clinical trial in three orthopedic centers in the Netherlands. The first results and next steps will be shared in this presentation.
Clinical Effect of Open-wedge High Tibial Osteotomy in Treatment of Kellgren-lawrence IV Knee Osteoarthritis Associated with Varus Tibial Deformity
Authors: Sha Yu , Yan Lei
Published: September 2020

Objectives:

The purpose of this study is to evaluate the clinical efficacy of open-wedge high tibial osteotomy (HTO) in treatment of kellgren- lawrence IV anterior medial knee osteoarthritis with varus tibia.

Methods:

Between 2016 and 2018, 56 patients with kellgren -lawrence IV knee osteoarthritis associated with varus tibial deformity who underwent a medial open-wedge high tibial osteotomy at a tertiary hospital were prospectively followed up. The surgical effect and postoperative complications were observed and analyzed. Meanwhile, the hospital for special surgery (HSS) scores of knee function before operation and at the last follow-up after operation was compared.

Results:

The median follow up was 19.8 months (range, 18 to 24 months). At the last follow-up, there was 40 excellent cases, 14 good cases, 2 fair case and 0 poor case. There were no complications such as vascular and nerve injury, internal fixation fracture and infection. The HSS score of knee function (89.6±3.9) at the last follow-up after operation was higher than (63.2±6.4) points before operation, and the difference was statistically significant ( P ＜0.05).

Conclusion:

Medial opening high tibial osteotomy shows remarkable therapeutic effect for patients with knee osteoarthritis associated with varus tibial deformity, and it can effectively relief the pain of knee joint with less postoperative complications.
The application of Patient specific Instrument （PSI ）in total knee arthroplasty with valgus knee
Authors: Yuehui Wang , Shiping Zou , Liangliang Cao , Wenzhong Chen
Published: September 2020

Introduction:

To invest the auxiliary role of Patient specific Instrument(PSI) used as osteotomy guide plate in total knee arthroplasty(TKA) with valgus knee.

Hypotheses:

PSI osteotomy guide plate is applicable for total knee arthroplasty with valgus knee.

Methods:

A retrospective analysis was performed on 21 patients with valgus knee, including 5 males and 16 females, who underwent TKA in joint surgery department I of ZhengZhou Orthopaedic Hospital from March 2016 to February 2018. All the operations were performed with the assistance of PSI, and the radiographic and clinical evaluations including femoral tibial joint ectropion angle(FTA) before and after operation, range of motion(ROM) and the Hospital for Special Surgery (HSS) knee score were reviewed, and surgical complications were recorded.

Results:

All the 21 patients werefollowed up for 10 ˜ 26 months (mean 16 months).All the incisions healed by first intention. The FTA was reduced significantly to 6.3 °±1.2° after operation from 17.6 ° + 5.7 °(P < 0.05), the ROM was improved significantly from preoperative 71.3° ±5.8° to postoperative 102.4°±7.5° (P < 0.05), the HSS score at the last follow-up was improved from 38.2±5.7 to 87.5-3.5(P < 0.05). During the follow-up, no complications such as infection, loosening, sinking and valgus were observed.

Conclusion:

Providing accurate osteotomy, effective correction of the force line, simple operation and satisfactory clinical effect, the PSI osteotomy guide plate is applicable for total knee arthroplasty with valgus knee.
Clinical and functional outcomes of ACL reconstruction with tibial attachment preserving quadrupled hamstring graft
Authors: Dalal Shaival , Aminake Ghislain , Guro Randy , Chandratreya Amit , Kotwal Rahul
Published: September 2020

Introduction:

Recent literature supports the preservation of tibial attachment of hamstring grafts to enhance ‘‘ligamentization’’ process and prevent the potential problems of free graft such as pull-out or rupture in the early post-operative period. Another factor that has gained attention in recent days is graft diameter, which can be variable and is thought to be a factor contributing to graft failure in biomechanical and clinical studies. Numerous studies have shown conflicting evidence of graft diameter directly influencing the graft failure.

Hypotheses:

The aim of this study is to present our results of ACL reconstruction with preservation of the tibial attachment of the hamstring grafts along with loop-stitched quadrupled hamstring grafts fixed with Endobutton on the femoral side and an interference screw and staple on the tibial side.

Methods:

Prospective single-surgeon case-series evaluating patients undergoing surgery by this technique. Patients were followed up clinically and using PROMS from NLR with EQ-5D, KOOS, IKDC and Tegner scores. Paired two-tailed student t-tests were used to assess significance.

Results:

45 patients had associated meniscal tear with 73.3 % undergoing repair. 3 cases (4.6 %) returned to theatre including, MUA for arthrofibrosis (n=1) and meniscal repair for recurrent medial meniscus tear (n=2). Incidence of graft re-rupture was seen in 1 patient. At a mean follow-up of 2.3 years, 80% (n=51) had complete peri-operative PROMS scores. Mean peri-operative EQ-5D VAS, EQ-5D Index, KOOS, IKDC and Tegner activity scores showed significant improvement (p<0.001). Multiple regression analysis does not find any correlation between PROMS and graft diameter.

Conclusion:

ACL reconstruction using tibial attachment preserving hamstring graft is a simple and , reproducible, and cost-effective technique that gives consistent clinical and functional outcomes, irrespective of the graft diameter . The natural tibial side insertion provides secure fixation and adds biology to the anatomic reconstruction, possibly reducing the re-rupture and failure rate.
Nurse-Led Call Back Program to Improve Patient Follow-Up With Providers After Discharge From the Emergency Department
Authors: Luciani-McGillivray Ines , Cushing Julie , Klug Rebecca , Lee Hang , Cahill Jennifer E
Published: September 2020

Phone calls to patients after discharge from the emergency department (ED) serve as reminders to schedule medical follow-up, support adherence to discharge instructions, and reduce revisits to already-crowded EDs. An existing, nurse-administered, call-back program contacted randomly selected ED patients 24 to 48 hours following discharge. This program did not improve patient follow-up (48.68%) nor reduce the ED revisit rate (6.7% baseline vs 6.0% postimplementation). Plan-Do-Study-Act methodology tested a modification to the existing program consisting of a second, scripted phone call from a trained volunteer at 72 to 96 hours postdischarge. Volunteers utilized a patient list and script, and nurses provided expertise to eliminate identified barriers to follow-up. Follow-up rate and ED revisit were monitored through the electronic medical record. A total of 894 patients participated between October 2017 and June 2018. Follow-up increased from 48.68% to 65.5% ( P < .0001) and ED revisit decreased significantly (4.5% vs 8.6%, P < .001). This innovative nurse-led, systematic postdischarge call-back program utilizing hospital volunteers increased patient compliance with post-ED medical follow-up while significantly reducing the rate of patient revisit to the ED within 7 days of discharge.
A Qualitative Study of Health Care Providers’ Views on Integrating Oral Health into Prenatal Care
Authors: Adeniyi A. , Donnelly L. , Janssen P. , Jevitt C. , von Bergman H. , Brondani M.
Published: September 2020

Objective:

Providing preventive oral health during prenatal care is a recognized strategy for improving pregnant women’s access to oral health care. This study sought to qualitatively explore the views of health care providers in British Columbia (BC), Canada, on strategies for integrating preventive oral health into prenatal care.

Methods:

Twenty-four purposefully selected health care providers (13 oral health and 11 prenatal care providers) in Vancouver and Surrey BC participated in audio-recorded semistructured interviews. Interviews lasted from 31 to 61 min, were transcribed verbatim, and were analyzed using an inductive thematic analysis with N-Vivo software. Study validity was ensured via memoing, fieldnotes, member checking, and external audit.

Results:

Thematic analysis revealed 5 major themes: perception of integrated care, relevance of integrated prenatal oral health, strategies for achieving integrated prenatal oral health, drivers of the integration process, and barriers to integrating oral health during pregnancy. Interprofessional collaboration based on information sharing and communication was identified as a critical factor for integrated care. Oral health checks should be a component of prenatal assessments for achieving integrated prenatal oral health. Participants recommended that prenatal providers should offer oral health education and use screening questions to identify the pregnant woman’s oral health needs. The establishment of referral systems was advocated, while dental assessments and oral prophylaxis via the medical services plan were proposed. The inclusion of dental providers in prenatal teams and educating health care providers on interprofessional collaboration were also supported.

Conclusion:

Oral health and prenatal providers in BC are positively disposed to adopting integrated preventive prenatal oral health care based on interprofessional collaborative practices. The inclusion of oral health providers in prenatal teams was suggested.

Knowledge Transfer Statement:

The results of this study can be used by policymakers for advocacy and decision making when planning care delivery programs for women during pregnancy. Including the suggested strategies could lead to increased access to, and utilization of, oral health services among pregnant women.
The ambivalent political work of emotions in the defence of territory, life and the commons
Authors: González-Hidalgo Marien
Published: September 2020

The increasing focus that political ecologists are putting in the role of emotions and affect in environmental conflict, commoning and mobilisation is enriching mainstream analyses that tended to mask the everyday emotional engagements of environmental movements, collectives and communities associated to being exposed to conflict as well as being active in it. By directing attention to two different ways in which grassroots movements and communities in Chile and Mexico facilitate emotional expression in the context of the conflicts in which they are embedded in, I discuss what different roles emotion plays in the defence of the commons, and what political opportunities these different roles imply for movements and collectives. I found a persistent and unresolved tension between the role of emotions as channels for the subversion of hegemonic power, and their role in reproducing hegemonic power dynamics. I suggest that this reveals ‘the emotional’ as a space of power and conflict, and that acknowledging the ambivalent political work of emotions offers opportunities for both researchers and movements to better understand and transform the power inequalities associated to the defence and practice of being-in-common while being exposed to conflict and dispossession.
COVID-19 War: United Kingdom’s Strategy During the First Wave
Authors: Bhatia Mrigesh , Bhatia Charusheela , Bhatia Vilomi
Published: September 2020

This opinion piece is a reflection on the UK government’s policy response to the war against the COVID-19 pandemic. In the initial stages, concerns were raised with respect to a lack of effective personal protective equipment, availability of ventilators and diagnostic tests. The early defective strategy based on the flawed assumption of building herd immunity in the population was quickly replaced with isolation and social distancing. Subsequently, testing and contact tracing were adopted which too has been criticised for being ‘too little, too late’. With the possibility of the second wave, the concern is the extent to which the United Kingdom has learnt lessons from the first wave and is in a position to effectively respond to the second wave of COVID-19.
T follicular helper phenotype predicts response to histone deacetylase inhibitors in relapsed/refractory peripheral T-cell lymphoma
Authors: Ghione Paola , Faruque Promie , Mehta-Shah Neha , Seshan Venkatraman , Ozkaya Neval , Bhaskar Shakthi , Yeung James , Spinner Michael A. , Lunning Matthew , Inghirami Giorgio , Moskowitz Alison , Galasso Natasha , Ganesan Nivetha , van der Weyden Carrie , Ruan Jia , Prince H. Miles , Trotman Judith , Advani Ranjana , Dogan Ahmet , Horwitz Steven
Published: September 2020

Histone deacetylase inhibitors (HDACi) are active agents for peripheral T-cell lymphoma (PTCL). Anecdotally angioimmunoblastic T-cell lymphoma (AITL) appears to respond better than PTCL–not otherwise specified (NOS) to HDACi. The new World Health Organization classification shows that a subgroup of PTCL carries similarities in phenotype and gene expression profiling to AITL, comparable to T follicular helper (TFH) cells. The disease might behave similarly to AITL when treated with HDACi. We analyzed 127 patients with AITL or PTCL-NOS treated with HDACi at relapse as a single agent or in combination. We re-reviewed the pathology of all PTCL-NOS to identify the TFH phenotype. Patients received HDACi at relapse as a single agent in 97 cases (76%, 59 TFH, 38 non-TFH) or in combination in 30 cases (24%, 18 TFH, 12 non-TFH) including duvelisib, lenalidomide, lenalidomide plus carfilzomib, and pralatrexate. Seven PTCL-NOS had TFH phenotype; 2 PTCL-NOS were reclassified as AITL. Overall response rate (ORR) was 56.5% (28.9% complete response [CR]) in TFH and 29.4% (19.6% CR) in non-TFH phenotype patients (P = .0035), with TFH phenotype being an independent predictor of ORR (P = .009). Sixteen patients sufficiently responded to HDACi or HDACi in combination with another agent to proceed directly to allogeneic transplantation; 1 of 16 responded to donor lymphocyte infusion (12 TFH, 4 non-TFH). Our results, although retrospective, support that HDACi, as a single agent or in combination, may have superior activity in TFH-PTCL compared with non-TFH PTCL. This differential efficacy could help inform subtype-specific therapy and guide interpretation of HDACi trials.
Major adverse cardiovascular and limb events in patients with diabetes and concomitant peripheral artery disease treated with sodium glucose cotransporter 2 inhibitor versus dipeptidyl peptidase-4 inhibitor
Authors: Lee Hsin-Fu , Chen Shao-Wei , Liu Jia-Rou , Li Pei-Ru , Wu Lung-Sheng , Chang Shang-Hung , Yeh Yung-Hsin , Kuo Chi-Tai , Chan Yi-Hsin , See Lai-Chu
Published: September 2020

Background

Whether sodium glucose co-transporter 2 inhibitors (SGLT2i) are associated with a lower risk of cardiovascular as well as adverse lower limb events in patients with type-2 diabetes mellitus (T2DM) and concomitant peripheral artery disease (PAD) is unclear.

We aimed to evaluate the risk of cardiovascular and limb events, and death associated with the use of SGLT2i compared with dipeptidyl peptidase-4 inhibitors (DPP4i) among a longitudinal and national cohort of patients with T2DM.

Methods

In this nationwide retrospective cohort study based on the Taiwan National Health Insurance Research Database, we identified a total of 11,431 and 93,972 consecutive T2DM patients with PAD taking SGLT2i and DPP4i, respectively, from May 1, 2016, to December 31, 2017. We used 1:1 propensity score matching (PSM) to balance covariates across study groups. Patients were followed from the drug index date until the occurrence of clinical outcomes, death, discontinuation of the index drug, or the end of the study period, whichever occurred first.

Results

Overall, 56% and 44% of the patients were treated with dapagliflozin and empagliflozin, respectively. The use of SGLT2i had comparable risks of ischemic stroke and acute myocardial infarction, and was associated with lower risks of congestive heart failure (CHF) [hazard ratio (HR): 0.66; 95% confidence interval (CI) 0.49–0.89; p = 0.0062], lower limb ischemia requiring revascularization (HR: 0.73; 95% CI 0.54–0.98; p = 0.0367) or amputation (HR: 0.43; 95% CI 0.30–0.62; p < 0.0001), and cardiovascular death (HR: 0.67; 95% CI 0.49–0.90; p = 0.0089) when compared with the DDP4i group after PSM. The subgroup analysis revealed consistent results for CHF and major adverse limb outcomes for SGLT2i versus DPP4i among patients aged ≥ 75 years, the presence of chronic kidney disease and established cardiovascular disease was consistent with the main analysis.

Conclusions

SGLT2i were associated with lower risks of CHF and adverse lower limb events compared with DPP4i among patients with T2DM and PAD in real-world practice.