bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of the RACER (Readiness for Adult Care in Rheumatology) transition instrument in youth with juvenile idiopathic arthritis
Authors: Spiegel Lynn , Tucker Lori , Duffy Karen Watanabe , Lalloo Chitra , Hundert Amos , Bourre-Tessier Josiane , Hazel Elizabeth , Luca Nadia , Mosher Dianne , Nguyen Cynthia , Stringer Elizabeth , Victor Charles , Stinson Jennifer
Published: June 2021

Background

Current evidence suggests that many adolescents with juvenile idiopathic arthritis (JIA) do not successfully transfer to adult care, which can result in adverse health outcomes. Although a growing number of clinical programs have been designed to support healthcare transition, there is a lack of psychometrically sound instruments to evaluate their impact on development of transition-related knowledge and skills in youth with JIA. The purpose of this study was to develop and validate RACER (Readiness for Adult Care in Rheumatology), a self-administered instrument designed to measure stages of readiness for key transition-related skills in adolescents with JIA.

Methods

A phased approach was used to develop and evaluate the validity and reliability of RACER. Phase 1 A was a consensus conference with 19 key stakeholders to inform instrument domains and items. Phase 1B determined initial content validity using a sample of 30 adolescents with JIA and 15 clinical and research experts. Finally, Phase 2 was a prospective cohort study with repeated measures to evaluate the internal consistency, test-retest reliability, construct validity and responsiveness of the instrument within a sample of adolescents with JIA.

Results

In Phase 1 A, initial item generation yielded a total of 242 items across six domains from the consensus conference, which was subsequently reduced to a 32-item instrument. Phase 1B established the content validity of the instrument in adolescents with JIA. In the Phase 2 study, with a sample of 96 adolescents, the RACER instrument exhibited good internal consistency in five of its six subscales (Cronbach’s α > 0.7), and strong test-retest reliability between the first two administrations (ICC = 0.83). It also showed robust convergent validity by highly correlating with measures of self-management (SMSAG, rho = 0.73) and transition (TRANSITION-Q, rho = 0.76). The RACER was not correlated with unrelated measures (discriminant validity; PedsQL, rho = 0.14). The RACER scores increased significantly over time as expected, supporting measure responsiveness.

Conclusions

The RACER is a reliable and valid instrument which is sensitive to change for assessing transition readiness in adolescents with JIA.
The effects of plant cysteine proteinases on the nematode cuticle
Authors: Njom Victor S. , Winks Tim , Diallo Oumu , Lowe Ann , Behnke Jerzy , Dickman Mark J. , Duce Ian , Johnstone Iain , Buttle David J.
Published: June 2021

Background

Plant-derived cysteine proteinases of the papain family (CPs) attack nematodes by digesting the cuticle, leading to rupture and death of the worm. The nematode cuticle is composed of collagens and cuticlins, but the specific molecular target(s) for the proteinases have yet to be identified.

Methods

This study followed the course of nematode cuticle disruption using immunohistochemistry, scanning electron microscopy and proteomics, using a free-living nematode, Caenorhabditis elegans and the murine GI nematode Heligmosomoides bakeri (H. polygyrus) as target organisms.

Results

Immunohistochemistry indicated that DPY-7 collagen is a target for CPs on the cuticle of C. elegans. The time course of loss of DPY-7 from the cuticle allowed us to use it to visualise the process of cuticle disruption. There was a marked difference in the time course of damage to the cuticles of the two species of nematode, with H. bakeri being more rapidly hydrolysed. In general, the CPs’ mode of attack on the nematode cuticle was by degrading the structural proteins, leading to loss of integrity of the cuticle, and finally death of the nematode. Proteomic analysis failed conclusively to identify structural targets for CPs, but preliminary data suggested that COL-87 and CUT-19 may be important targets for the CPs, the digestion of which may contribute to cuticle disruption and death of the worm. Cuticle globin was also identified as a cuticular target. The presence of more than one target protein may slow the development of resistance against this new class of anthelmintic.

Conclusions

Scanning electron microscopy and immunohistochemistry allowed the process of disruption of the cuticle to be followed with time. Cuticle collagens and cuticlins are molecular targets for plant cysteine proteinases. However, the presence of tyrosine cross-links in nematode cuticle proteins seriously impeded protein identification by proteomic analyses. Multiple cuticle targets exist, probably making resistance to this new anthelmintic slow to develop.

Graphical Abstract
Adequacy of prenatal care services and associated factors in Southern Ethiopia
Authors: Tadele Afework , Teka Bekelu
Published: June 2021

Background

Prenatal care is an important component for the continuum of care in maternal and child health services. Despite increased attention on prenatal care service coverage, the adequacy of service provision has not been well addressed in Ethiopia. Therefore, this study aimed to describe the status of the adequacy of prenatal care and its associated factors in Southern Ethiopia.

Method

A longitudinal study done by the Performance care Monitoring and Accountability (PMA2020) project was used. The study was conducted from August 2016 to January 2017 in Southern Ethiopia. A multistage stratified cluster design in which all enumeration areas were randomly selected using probability proportional to size and all households were screened to identify 324 pregnant women of six or more months. Questions regarding early attendance of prenatal care, enough visits, and sufficient services were asked to measure the adequacy of prenatal care. Finally, an ordered logistic regression analysis was employed to assess factors associated with the adequacy of prenatal care services.

Results

Of the total pregnant women 44.21 % attended enough visits, 84.10 % had early visits, and 42.03 % received sufficient services. The women residing in urban areas had 2.35 odds of having adequate prenatal care in reference to rural areas (adjusted odds ratio (aOR) 2.35 [95 % CI 1.05–5.31]). Women who attended primary and secondary education had 2.42(aOR 2.42 [95 % C.I. 1.04, 5.65]), and 4.18 (aOR 4.18 [95 % CI 1.32, 13.29]) odds of adequate prenatal care in reference with those who never attended education respectively. The women participating in one to five networks have 2.18 odds of adequate prenatal care in reference to their counterparts (aOR 2.78 [95 % CI 1.01, 7.71]).

Conclusions

The adequacy of prenatal care services in Southern Ethiopia is very low. The Ethiopian health care system should strengthen one to five networks to discuss on family health issues. Further research, should validate the tools and measure the adequacy of the services in different contexts of Ethiopia using a mixed method study for an in-depth understanding of the problem.
The hidden secrets of a neutral pH—blood gas analysis of postoperative patients according to the Stewart approach
Authors: Janssen Joost W. , van Fessem Joris M. K. , Ris Tijmen , Stolker Robert Jan , Klimek Markus
Published: June 2021

Background

The superiority of either the traditional or Stewart based approach to acid-base balance has focused primarily on analyzing metabolic acidemia, with little attention given to patients with neutral pH. In this study, we evaluate metabolic disturbances in patients in the immediate postoperative period focusing on patients with neutral pH, while comparing the Stewart and traditional approach.

Methods

We conducted a single center retrospective observational cohort study. Over a 17-month period, data on arterial blood gas analysis, electrolytes, and albumin on the morning after surgery were retrieved from patients admitted to the postsurgical high dependency unit (HDU). Albumin-corrected anion gap (AG), apparent (SIDa) and effective strong ion difference (SIDe), and strong ion gap (SIG) were calculated.

Results

Out of 1207 HDU admissions, 400 cases had a complete set of laboratory-data including albumin of which 281 presented with neutral pH (7.35 ≤ pH ≤ 7.45), 64 with acidemia (pH < 7.35) and 55 with alkalemia (pH > 7.45). In pH neutral patients, the following acidifying disturbances were found: SIDa was lowered in 101 (36%), and SIG was raised in 60 (21%). Base excess (BE) was decreased in 16 (6%) and corrected AG raised in 107 (38%). The alkalizing effect of hypoalbuminemia was present in 137 (49%). Out of 134 cases with normal BE and corrected AG, SIDa was lowered in 58 (43%). Out of 136 cases with normal SIDa and SIG, none had lowered BE and 28 increased AG (21%). Length of stay was significantly longer in patients with hypoalbuminemia, lowered SIDa, and increased corrected AG, but not decreased BE (hypoalbuminemia: 16 days vs. 10 days, P < 0.001; low SIDa: 15 days vs. 12 days, P = 0.015; increased AG: 16 days vs. 11 days, P < 0.001; low BE: 14 days vs. 13 days, P = 0.736).

Conclusions

Metabolic disturbances, characterized mainly by the presence of lowered SIDa, increased AG, and hypoalbuminemia, are frequent in our population with apparent neutral acid-base balance based on pH and base excess. These changes on the morning after surgery are associated with increased length of stay.
Case report of worsening of preexisting pericardial effusion after ASD device closure: is it calamitous?
Authors: Khajali Zahra , Firouzi Ata , Pouraliakbar Hamidreza , Hosseini Zahra , Jorfi Fateme
Published: June 2021

Background

Secundum-type atrial septal defects (ASD) constitute 8% to 10% of congenital heart defect. Secundum ASDs can be closed either percutaneously or surgically. However, ASD device closure has proven to be technically safe and feasible; it is not free of complications. These complications include device embolization/malposition which have been reported in 3.5% of cases, arrhythmia, and pericardial effusion in 2.6% and 0.5–1.5% respectively, device thrombus, residual shunting, and impingement of the device on the adjacent structures.

Case presentation

We introduce three patients with secundum ASD who had preexisting pericardial effusion, device closure was performed for them, and after the procedure, the effusion size progressed significantly. We used multimodality imaging to diagnose the cause of pericardial effusion (PE). Cardiac erosion was diagnosed in one of the patients that managed surgically. We did not found any specific procedure-related cause for worsening the pericardial effusion in the other two patients.

Conclusion

Several reasons include procedure-related complication and other systemic causes should be considered in patients who develop pericardial effusion after trans catheter closure of ASDs.
Using qualitative and participatory methods to refine implementation strategies: universal family psychosocial screening in pediatric cancer
Authors: Deatrick Janet A. , Kazak Anne E. , Madden Rebecca E. , McDonnell Glynnis A. , Okonak Katherine , Scialla Michele A. , Barakat Lamia P.
Published: June 2021

Background

Children with cancer and their families are at risk for short- and long-term psychosocial difficulties. Screening for psychosocial risk remains inconsistent, leading to inequitable access to psychosocial services. The Psychosocial Assessment Tool (PAT) is an evidence-based caregiver report screener of family psychosocial risk ready for implementation in a nationwide cluster randomized trial that will test two implementation strategies across 18 pediatric cancer centers. The current study, conducted in preparation for the trial, solicited the perspectives of key stakeholders about two proposed implementation strategies identified during previous research which focus on health equity and screening of all families (universal screening). Results were used to refine the implementation strategies for testing in the subsequent trial.

Methods

Semi-structured interviews with 19 key stakeholders (parents, health care providers, pediatric oncology organizations, and pediatric healthcare leaders) were conducted regarding the two implementation strategies. Strategy I is a training webinar; Strategy II is training + implementation enhanced resources, which includes a champion at each site and monthly peer support consultation calls. Data were analyzed using directed content analysis with deductively derived codes based on the Interactive Systems Framework and inductive codes based on emerging data.

Results

Stakeholder interviews provided rich data to rigorously modify the proposed implementation strategies. Implementation strategies were modified in consistent with these recommendations: engaging providers by framing family psychosocial screening as an opportunity for more efficient and effective practice; setting clear expectations about the importance of screening 100% of children and their families to achieve the goal of universal screening, equity of care, and reduction of disparities; and adapting successful strategies for systematic implementation of screening to ensure optimal engagement with children and their families throughout their care.

Conclusions

Stakeholder input strengthened implementation strategies by suggesting modifications that emphasized health equity and reduction in health disparities. Using implementation science methods to build on a long-standing program of research provided practical insights about immediate needs of families and historical insights regarding structural inequities such as language differences and access to services. Resulting strategies address all levels of the social ecology for children’s cancer care, including the patient, family, provider, healthcare system, and community.

Trial registration

NCT04446728 June 23, 2020
Rab7 is required for mesoderm patterning and gastrulation in Xenopus
Authors: Kreis Jennifer , Wielath Fee M. , Vick Philipp
Published: June 2021

Early embryogenesis requires tightly controlled temporal and spatial coordination of cellular behavior and signaling. Modulations are achieved at multiple levels, from cellular transcription to tissue-scale behavior. Intracellularly, the endolysosomal system emerges as an important regulator at different levels, but in vivo studies are rare. In the frog Xenopus, little is known about the developmental roles of endosomal regulators, or their potential involvement in signaling, especially for late endosomes. Here, we analyzed a hypothesized role of Rab7 in this context, a small GTPase known for its role as a late endosomal regulator. First, rab7 showed strong maternal expression. Following localized zygotic transcript enrichment in the mesodermal ring and neural plate, it was found in tailbud-stage neural ectoderm, notochord, pronephros, eyes and neural crest tissues. Inhibition resulted in strong axis defects caused by a requirement of rab7 for mesodermal patterning and correct gastrulation movements. To test a potential involvement in growth factor signaling, we analyzed early Wnt-dependent processes in the mesoderm. Our results suggest a selective requirement for ligand-induced Wnt activation, implicating a context-dependent role of Rab7.
Επισκοπική μελέτη κριτηρίων αξιολόγησης εκπαιδευτικών βίντεο
Authors: Σοφός Αλιβίζος (Λοίζος)
Published: June 2021

Έχοντας ως σημείο αναφοράς την όλο και αυξανόμενη σημασία των βίντεο για την εκπαίδευση, το ενδιαφέρον στο άρθρο αυτό εστιάζεται στα ιδιαίτερα χαρακτηριστικά ενός βίντεο που προορίζεται για την εκπαίδευση. Τα πορίσματα της μελέτης βασίζονται στην βιβλιογραφική ανασκόπηση από τον διεθνή χώρο. Από την έρευνα προκύπτουν οι βασικές ενέργειες για τη δημιουργία ενός εκπαιδευτικού βίντεο, οι οποίες θα πρέπει να είναι άμεσα συνδεμένες με τον εκπαιδευτικό σχεδιασμό. Στη συνέχεια παρουσιάζονται δύο προσεγγίσεις αναφορικά με τα κριτήρια αξιολόγησης της ποιότητας των εκπαιδευτικών βίντεο: η  πρώτη βασίζεται στη διατυπωμένη θεωρία της σύμφωνα με τον Meyer (2011) και εστιάζει στην πολυμεσική μάθηση του Mayer & Moreno (2003) η δεύτερη αναφέρεται στην πρόθεση των εκπαιδευτικών βίντεο και εστιάζει στο κατά πόσο ένα βίντεο είναι αποτελεσματικό. Το άρθρο ολοκληρώνεται με συμπεράσματα και με βασικές κοινές κατευθυντήριες, που είναι σκόπιμο να έχουν οι δημιουργοί των εκπαιδευτικών βίντεο.
The relationships between pancreatic T2* values and pancreatic iron loading with cardiac dysfunctions, hepatic and cardiac iron siderosis among Egyptian children and young adults with β-thalassaemia major and sickle cell disease: a cross-sectional study
Authors: Salama Khaled , Abdelsalam Amina , Eldin Hadeel Seif , Youness Eman , Selim Yasmeen , Salama Christine , Hassanein Gehad , Samir Mohamed , Zekri Hanan
Published: June 2021

Background: Cardiac, hepatic and pancreatic T2* measured by magnetic resonance imaging (MRI) has been proven to be an accurate and non-invasive method for measuring iron overload in iron overload conditions. There is accumulating evidence that pancreatic iron can predict cardiac iron in young children because the pancreas loads earlier than the heart. The aim of our study was to assess the relationships between pancreatic T2* values and pancreatic iron loading with cardiac dysfunctions and liver and cardiac iron among patients with β-thalassaemia major (βTM) and sickle cell disease (SCD).

Methods: 40 βTM and 20 transfusion-dependant SCD patients were included along with 60 healthy age and sex-matched controls. Echocardiography and Tissue Doppler Imaging were performed for all subjects as well as the control group.  Hepatic, cardiac and pancreatic iron overload in cases were assessed by MRI T2*.

Results:  The mean age of our patients was 13.7 years with mean frequency of transfusion/year 12. Mean cardiac T2* was 32.9 ms and mean myocardial iron concentration was 0.7 mg/g; One patient had cardiac iron overload of moderate severity. Mean pancreatic T2* was 22.3 ms with 20 patients having mild pancreatic iron overload.

Pancreatic T2* correlated positively peak late diastolic velocity at septal mitral annulus (r=0.269, p=0.038), peak early diastolic velocity at tricuspid annulus (r=0.430, p=0.001) and mitral annular plane systolic excursion (r=0.326, p=0.01); and negatively with end systolic pulmonary artery pressure (r=-0.343, p=0.007) and main pulmonary artery diameter (MPA) (r=-0.259, p=0.046). We couldn’t test the predictability of pancreatic T2* in relation to cardiac T2* as only one patient had cardiac T2*<20 ms.

Conclusion: There was a relationship between pancreatic iron siderosis with cardiac dysfunction in multi-transfused patients with βTM and SCD. No direct relation between pancreatic iron and cardiac siderosis was detected.
Prevalence of urinary tract infections and antibiogram of uropathogens isolated from children under five attending Bagamoyo District Hospital in Tanzania: A cross-sectional study
Authors: Sangeda Raphael Z. , Paul Franco , Mtweve Deus M.
Published: June 2021

Background: Urinary tract infection (UTI) is a common condition in children that recurs frequently. This study aimed to determine the prevalence of UTIs among children under five attending Bagamoyo District Hospital and determine its association with nutritional status.

Methods: This was a cross-sectional study that enrolled 214 children under five years old attending Bagamoyo District Hospital in Tanzania. Midstream urine was collected in sterile conditions and bottles. Samples were transported to the laboratory to isolate bacteria using cysteine lactose electrolyte deficient (CLED) agar.  Identification was undertaken using Gram staining, single iron agar test, sulfide-indole motility (SIM) test, and catalase and oxidase tests. A susceptibility test was done using the disc diffusion method. Anthropometric measurements were employed to assess malnutrition status and body mass index was determined using each child's weight and height.

Results: Of the 214 children under five enrolled in the study, 123 (57.4%) were girls and 91 (42.6%) were boys. A total of 35 children were confirmed UTI-positive, making the prevalence 16.4%. Of positive children, 17 (7.9%) were girls and 18 (8.4%) were boys. The UTI prevalence was higher in boys than in girls but not statistically significant (p=0.244). Among the isolated uropathogens, Escherichia coli were common bacteria accounting for 65.7% of all isolates. The rate of other uropathogens isolated was Klebsiella spp. (17.1%), Pseudomonas spp. Proteus spp (11.4%) and (2.9%) and Staphylococci spp. (2.9%). The antibiogram of the isolated bacterial uropathogens showed high in-vitro resistance ranging from 90-95% to erythromycin, trimethoprim-sulfamethoxazole and ampicillin.

Conclusion: The prevalence of UTI for children under five was 16.4%. The most common causative agent of UTI was Escherichia coli. There was no association between UTI status and malnutrition status of the children. High resistance to antibiotics calls for antimicrobial stewardship and surveillance to preserve antibiotics' effectiveness in treating uropathogens.
Prototype perception of physically active peers: result from a study among Hungarian university students
Authors: Tari-Keresztes Noemi , Piko Bettina , Gupta Himanshu , Decelis Andrew , Dely-Palinkas Aniko , Fejes Zsuzsanna
Published: June 2021

Introduction: Previous studies argued the role of social prototypes in making desicisions on healthy and unhealthy behaviors. Positive images associated with a certain behavior might increase the possibility of developing the behavior. While most of the studies focused on health risk behaviors, health promoting behaviors have been less investigated yet. However, young adults are more conscious about the social images associated with health behaviors compared with their younger equivalents; much of the relevant research has been conducted with the latter groups. Purpose: The main aim of this study was to (1) examine how university students perceive their physically active peers, (2) map the adjectives associated with the ‘physically active peers’ prototypes, (3) identify respondents’ categories based on their prototype perception, and (4) detect relationships between social images, sociodemographic variables, sporting habits and social attitudes. Material and Method: Cross-sectional, self-report data were obtained from a convenience sample of 515 respondents aged 18-31 years via a survey with students from a Hungarian university. Result: Cluster analyses detected three independent clusters: “Negative” image” group, “Positive appearance” group, “Positive appearance and personality” group. Age, gender, self-assessed SES, sporting friends, social support, social network, Internet use, competitiveness and the need to belonging seemed to make a difference along these groups of social images. Conclusion: Our findings suggested that social variables may play a moderate role in university students’ sport-related prototype formation.
Causal relationships between the parameters of gas discharge visualization and immunity
Authors: Babelyuk Valeriy , Gozhenko Anatoliy , Dubkova Galyna , Zukow Walery , Hubyts’kyi Viktor , Ruzhylo Sofiya , Fedyayeva Svitlana , Kovalchuk Galyna , Popovych Igor
Published: June 2021

Background. Earlier, we found a close canonical correlation between parameters of gas discharge visualization (GDV) and principal neuroendocrine factors of adaptation. The purpose of this study is to elucidate the relationship between GDV and immunity parameters. Material and research methods. We observed twice 10 women and 10 men aged 33-76 years without clinical diagnose. In the morning in basal conditions at first registered kirlianogram by the method of GDV by the device “GDV Chamber” (“Biotechprogress”, SPb, RF). For further analysis the following parameters were selected: Area, Shape Coefficient as ratio Square Length of outward contour gas discharge image to its Area as well as Entropy of contour in Right, Frontal and Left projections registered both with and without polyethylene filter. Estimated also Energy and Asymmetry of virtual Chakras. Then registered routine parameters of cellular and humoral Immunity. Results processed by method of canonical analysis, using the software package “Statistica 5.5”. Results. According to the value of the canonical correlation coefficient R with GDV parameters, the immunity parameters are arranged in the following order: IgA (0,716; p=0,005), CD8+CD3+ Tc-lymphocytes (0,646; p=0,004), IgG (0,645; p=0,002), IgM (0,622; p=0,0001), “active” T-lymphocytes (0,572; p=0,007), CD4+CD3+ Th-lymphocytes (0,566; p=0,003), CIC (0,491; p=0,018), 0-lymphocytes (0,457; p=0,036), CD16+ NK-lymphocytes (0,396; p=0,043), CD22+ B-lymphocytes (0,439; p=0,105). The integral canonical correlation between the parameters of GDV and Immunity was very strong (R=0,994; p
Health and functional benefits of yoga practice in times of the COVID-19 coronavirus pandemic
Authors: Smoleńska Olga Ilona , Pilarska Marta
Published: June 2021

The purpose of this article is to identify and quantify the benefits of yoga practice, particularly in the most severe of the coronavirus pandemic and related lockdown periods. The subject of the research was the form and quality of online yoga practice, which has become an alternative to sports and stationary activities. The most important health benefits of yoga practice are also discussed. Using the method of analysis of documents and sources, the role and importance of yoga in the health context and its advantages related to maintaining health during the coronavirus pandemic have been demonstrated.

The authors of the publication also made an original quantitative and qualitative analysis of individual forms of online yoga practice, according to the most popular and used tools and technologies in this discipline. An analysis of functionalities conducted on Facebook and Instagram social networking sites, live broadcasts, applications that can be installed on smartphones and channels on the YouTube website, publishing videos for joint yoga practice, was developed. Using own observation and SWOT analysis, all the strengths and weaknesses of online yoga practice, as well as its opportunities and threats, were presented.
Investigation and the Trial of Lt. Col. Bolesław Michał Nieczuja-Ostrowski
Authors: Wątor Agnieszka
Published: June 2021

This is another article devoted to Lt. Col. Bolesław Michał Nieczuja-Ostrowski “Bolko”, “Tysiąc” (1907-2008) who during the Second World War was an officer of the Polish Army, then of the underground Home Army (Armia Krajowa – AK), and since 1944 the commander of the great unit of the AK: the 106th Infantry Division. The article is associated with the investigations conducted against this man and with a trial as a result of which he was sentenced to death. The author used mainly the materials prepared by the functionaries of the Office of Public Security during the inquiry and the trial that were conducted. The information was compared and extended by the data contained in the publications of Lt. Col. Nieczuja-Ostrowski that appeared after 1989.Ostrowski was accused of participation in “illegal organisations” after 1945, and previously he was accused of the contacts that were maintained by the soldiers of the division that he commanded (the division operated on the areas of the AK “Maria” Regional Inspectorate) with the representatives of the German occupation authorities, as well as the supposed killings of Soviet soldiers, people of Jewish ethnicity and communist activists. In the years 1946-1956 he was arrested a number of times, he was repeatedly interrogated, imprisoned and as a result of this he was sentenced to death two times. After the amnesty his sentence was reduced to 12 years of prison (he spent a total of more than seven years in prison).
Hypodermic needle to guide Kirschner-wire placement in paediatric supracondylar humerus fractures: A technical trick
Authors: Schurko Brian M. , Shore Benjamin J. , Maier Stephen P. , Cidambi Emily , Watkins Colyn J.
Published: June 2021

Purpose

Supracondylar humerus fractures are among the most common injuries in the paediatric population, accounting for 16% of all paediatric fractures and roughly 60% to 70% of all paediatric elbow fractures. Typical treatment for displaced and unstable supracondylar humerus fractures is surgical intervention, often with percutaneous Kirschner-wire (K-wire) fixation. Timing of surgery is dependent on the patient's neurovascular status on presentation, with surgical emergencies being performed at all hours of day and night. Percutaneous fixation of paediatric elbow fractures can be challenging as a result of the propensity for the elbow to become quite swollen with these fractures, particularly in smaller and physiologically more immature elbows.

Methods

We have developed a simple operative technique to guide placement of percutaneous wires for supracondylar humerus fractures using a hypodermic needle as a reference marker.

Results

In our experience, trainees utilizing this technique demonstrate greater appreciation for start point and trajectory of wires during percutaneous pinning, with better communication amongst surgical team members about necessary adjustment for optimal placement of K-wires.

Conclusion

Utilization of this technique has the potential to refine surgical technique by minimizing errant wire passes, radiation and operative time when performing percutaneous pinning of reduced type III supracondylar humerus fractures.

Level of Evidence

V, Novel Surgical Technique
Developmental dysplasia of the hip screening during the lockdown for COVID-19: Experience from Northern Italy
Authors: Guindani Nicola , De Pellegrin Maurizio
Published: June 2021

Purpose

Developmental dysplasia of the hip (DDH) ultrasound screening (USS), which is usually performed in Italy as an outpatient, was halted for an indefinite period in most centres during lockdown. The aim of this study was to analyze the effect of COVID-19 on DDH-USS, in two paediatric orthopaedic centres in one of the most critical areas of the western World.

Methods

An academic teaching hospital and paediatric trauma centre (T) and a University hospital and DDH referral centre (H), classified as national COVID-19 hubs, were involved. Graf's method was applied in both centres. In T, paediatricians directly referred only patients with delayed DDH-USS or suspicious unstable hips; in H, paediatricians or parents could directly refer to the screening service.

Results

The mean age of the 95 patients (190 hips) who were referred for DDH-USS in T, was 3.85 months (0.1 to 7.4); 175 were type I, nine were type IIa (+ and -), five type D and one type IV. In H, the screened patients in 2020 were only 78% of the same period in 2019. A total of 28 patients with 32 hips (8 IIb, 5 IIc, 8 D, 11 III) had late diagnosis at a mean age of 114 days (96 to 146). In the same period in 2019 only eight patients with 11 hips (8 IIb, 1 D, 1 III, 1 IV) at a mean age of 142 days (92 to 305) had late diagnosis.

Conclusion

DDH-USS was the only screening in newborns which halted during lockdown. Few centres, which still performed diagnosis and treatment, were overloaded causing a delay in DDH management.

Level of evidence

IV.
Health-related quality of life after conservatively and surgically-treated paediatric proximal humeral fractures
Authors: Liebs Thoralf R. , Rompen Ingmar , Berger Steffen M. , Ziebarth Kai
Published: June 2021

Purpose

The health-related quality of life (HRQoL) after conservatively versus surgically treated paediatric proximal humeral fractures is poorly understood. We assessed the HRQoL after this injury and asked if HRQoL was associated with age, radiological classification or treatment chosen.

Methods

We identified 228 patients who were treated for proximal humeral fractures between 2004 and 2017. These patients completed the Quick Disabilities of the Arm, Shoulder and Hand (Quick-DASH) (primary outcome), the Paediatric Quality of Life Inventory (PedsQL) and questions regarding patient satisfaction. Fractures were classified radiologically following the Paediatric Comprehensive AO Classification.

Results

We were able to follow-up on 190 children; 147 (mean age 8.7 years (0.8 to 15.7)) sustained a metaphyseal and 43 (mean age 11.6 years (3.7 to 15.8)) sustained a Salter Harris type I or II injury. Most fractures (90%) were simple, 10% were multifragmentary. In total, 137 children (72%) were treated nonoperatively, 51 (27%) were treated by elastic stable intramedullary nailing (ESIN). After a median follow-up of 7.6 years (0.8 to 14.3) there was an overall mean Quick-DASH of 4.3 (SD 9.3) for girls and 1.2 (SD 3.1) for boys. The mean function score of the PedsQL was 94.7 (SD 11.1) for girls and 98.0 (SD 6.0) for boys. The mean psychosocial score of the PedsQL was 92.0 (SD 11.1) for girls and 94.1 (SD 11.6) for boys. Most children (79%) were very satisfied with the cosmetic result and 74% were very satisfied with the treatment overall. Surgery and female sex were associated with lower satisfaction.

Conclusion

In this cohort of 190 patients, where immobilization for mildly displaced fractures, and closed reduction and ESIN was used for displaced fractures, there was equally excellent mid- and long-term HRQoL when assessed by the Quick-Dash and the PedsQL.

Level of Evidence

Therapeutic, Level IV
Effect of carbazochrome sodium sulfonate combined with tranexamic acid on blood loss and inflammatory response in patients undergoing total hip arthroplasty
Authors: Luo Yue , Zhao Xin , Yang Zhouyuan , Yeersheng Releken , Kang Pengde
Published: June 2021

Aims

The purpose of this study was to examine the efficacy and safety of carbazochrome sodium sulfonate (CSS) combined with tranexamic acid (TXA) on blood loss and inflammatory responses after primary total hip arthroplasty (THA), and to investigate the influence of different administration methods of CSS on perioperative blood loss during THA.

Methods

This study is a randomized controlled trial involving 200 patients undergoing primary unilateral THA. A total of 200 patients treated with intravenous TXA were randomly assigned to group A (combined intravenous and topical CSS), group B (topical CSS), group C (intravenous CSS), or group D (placebo).

Results

Mean total blood loss (TBL) in groups A (605.0 ml (SD 235.9)), B (790.9 ml (SD 280.7)), and C (844.8 ml (SD 248.1)) were lower than in group D (1,064.9 ml (SD 318.3), p < 0.001). We also found that compared with group D, biomarker level of inflammation, transfusion rate, pain score, and hip range of motion at discharge in groups A, B, and C were significantly improved. There were no differences among the four groups in terms of intraoperative blood loss (IBL), intramuscular venous thrombosis (IMVT), and length of hospital stay (LOS).

Conclusion

The combined application of CSS and TXA is more effective than TXA alone in reducing perioperative blood loss and transfusion rates, inflammatory response, and postoperative hip pain, results in better early hip flexion following THA, and did not increase the associated venous thromboembolism (VTE) events. Intravenous combined with topical injection of CSS was superior to intravenous or topical injection of CSS alone in reducing perioperative blood loss. Cite this article: Bone Joint Res 2021;10(6):354–362.
Adaptive optics model characterizing turbulence mitigation for free space optical communications link budgets
Authors: Stotts Larry B. , Andrews Larry C.
Published: June 2021

Free-space optical communications (FSOC) is becoming an important option for both atmospheric and space-based high data rate networks. Long-range, mobile FSOC links in the former environments must mitigate the effects of turbulence if they are to provide reliable, high link availability under cloud-free atmospheric conditions. Adaptive optics (AO) has been proposed as one means of reducing link degradation in turbulence, but field validated AO performance models are few and not definitive. These models are important if credible FSOC high performance links are expected to be deployed using AO systems. This paper reviews the Strehl ratio for the Andrews AO model and provides comparisons between predicted AO-based FSOC link budgets and measured link performance derived from several field trials. These results suggest that AO systems perform well under weak turbulence or short range under 10 km, but only offer limited tip/tilt gain in moderate turbulence and no gain under high/saturation regime turbulence at longer ranges. Long range links close to the ground in high moderate turbulence may degrade AO performance further.
"Why did our baby die soon after birth?"—Lessons on neonatal death in rural Cambodia from the perspective of caregivers
Authors: Suzuki Ayako , Matsui Mitsuaki , Tung Rathavy , Iwamoto Azusa
Published: June 2021

Introduction

Neonatal deaths represent around half the deaths of children less than five-years old in Cambodia. The process from live birth to neonatal death has not been well described. This study aimed to identify problems in health care service which hamper the reduction of preventable neonatal deaths in rural Cambodia.

Methods

This study adopted a method of qualitative case study design using narrative data from the verbal autopsy standard. Eighty and forty villages were randomly selected from Kampong Cham and Svay Rieng provinces, respectively. All households in the target villages were visited between January and February 2017. Family caregivers were asked to describe their experiences on births and neonatal deaths between 2015 and 2016. Information on the process from birth to death was extracted with open coding, categorized, and summarized into several groups which represent potential problems in health services.

Results

Among a total of 4,142 children born in 2015 and 2016, 35 neonatal deaths were identified. Of these deaths, 74% occurred within one week of birth, and 57% were due to low-birth weight. Narrative data showed that three factors should be improved, 1) the unavailability of a health-care professional, 2) barriers in the referral system, and 3) lack of knowledge and skill to manage major causes of neonatal deaths.

Conclusion

The current health system has limitations to achieve further reduction of neonatal deaths in rural Cambodia. The mere deployment of midwives at fixed service points such as health centers could not solve the problems occurring in rural communities. Community engagement revisiting the principle of primary health care, as well as health system transformation, is the key to the solution and potential breakthrough for the future.
Treatment burden experienced by patients with obstructive sleep apnoea using continuous positive airway pressure therapy
Authors: Chou Michael S. H. , Ting Natasha C. H. , El-Turk Nicole , Harrington Zinta , Dobler Claudia C.
Published: June 2021

Background

Little is known about the treatment burden experienced by patients with obstructive sleep apnoea (OSA) who use continuous positive airway pressure (CPAP) therapy.

Participants

18 patients (33.3% males, mean age 59.7±11.8 years) with OSA who use CPAP therapy were interviewed.

Methods

Patients treated with CPAP for OSA at a tertiary hospital outpatient clinic in Sydney, Australia, were invited to participate in an interview in person or via phone. Semi-structured interviews were used to explore the treatment burden associated with using CPAP. The interviews were recorded, transcribed, and analysed using NVivo 12 qualitative analysis software.

Results

Four categories of OSA-specific treatment burden were identified: healthcare tasks, consequences of healthcare tasks, exacerbating and alleviating factors of treatment burden. Participants reported a significant burden associated with using CPAP, independently of how frequently they used their device. Common sources of their treatment burden included attending healthcare appointments, the financial cost of treatment, lifestyle changes, treatment-related side effects and general discomfort.

Conclusions

This study demonstrated that there is a significant treatment burden associated with the use of CPAP, and that treatment non-adherence is not the only consequence of treatment burden. Other consequences include relationship burden, stigma and financial burden. It is important for physicians to identify other negative impacts of treatment burden in order to optimise the patient experience.
World building: Creating alternate worlds as meaningful making in undergraduate education
Authors: Elias Mengist Nathanael , Sidibe Mariama , Biggs Heidi , Fox Tyler , Thurtle Phillip , Desjardins Audrey
Published: June 2021

In this article, we offer a description of and reflection on our 2019 ‘creating alternate worlds’ course as a model for critical making in twenty-first-century higher education. Open to arts and humanities undergraduate students interested in creative research, our course used world building as a central approach to imagining alternatives. We found that explicitly centring Black and Indigenous perspectives helped support non-dominant students in their striving to realize possibilities beyond settler colonial visions of the future. We share our position in relation to decolonization and decolonizing pedagogies before describing the course at a high level and through an in-depth case study of an author’s research project. Our analysis of the course is presented via three axiological allegiances and three performative pragmatics. By discussing our political stance and a conceptual innovation that we term, ‘transcosmic potentials’, we conclude with insights for fellow educators. This pluriversal learning community opened a multiplicity of ‘portals’ to heterogeneous worlds, each with the power to fundamentally and forever alter all who pass through.
Monster aesthetics as an expression of decolonizing the design body
Authors: Angelon Rafaela , van Amstel Frederick
Published: June 2021

Institutionalized design education aims at training the human body to become a design body, a subject capable of designing according to aesthetic canons. In colonized territories, the modern canon predominates over indigenous, vernacular and other forms of expression. Manichaeism, utilitarianism, universalism, methodologism and various modern values are inculcated in the design body as if it did not have any. The colonization of design bodies makes young designers believe that once they learn what good design is, they need to save others from bad design. This research reports on a series of democratic design experiments held in a Brazilian university that questioned these values while decolonizing the design body. Comparing the works of design produced in the experiment with some works of art from the Neoconcrete movement, we recognize a characteristic form of expression we call monster aesthetics: a positive affirmation of otherness and collectivity that challenges colonialists’ standards of beauty and goodness.
Seasonal effect on semen availability and quality of racing pigeon in Thailand
Authors: Wannaratana Suwarak , Olanratmanee Em-on , Charoenmuang Kuekaroon , Boriharnthanawuth Thanvarath , Tangtrongwanich Banpatee , Jongpattana Thanawan , Sukhor Yanita , Kongthip Arrita , Sananmuang Thanida
Published: June 2021

Background and Aim: Seasonal variations among geographical regions could influence pigeon semen quality differently. This study aimed to determine the seasonal effect on semen availability and quality of racing pigeons in Thailand to understand and improve breeding management in the country. Materials and Methods: Semen was collected from six fertile captive pigeons once a week during summer (March-June), monsoon (July-October), and winter (November-February) during 2019-2020. The success rate of semen collection and semen quality was determined in each season – by which changes in average temperature, humidity, and photoperiod were obtained. Results: Comparable success rates of semen collection were acquired among different seasons, while varied semen qualities were revealed. The percentages of total motility and progressive motility score of sperm were significantly lowest in summer (66.35±3.40 and 3.88±0.15, respectively) compared to monsoon (85.45±2.91 and 4.67±0.10, respectively) and winter (79.29±1.96 and 4.37±0.10, respectively), while its concentration (×109 sperm/mL) and outputs (×106 sperm) were significantly highest in winter (7.62±0.54 and 91.44±10.83, respectively) compared to summer (4.23±0.41 and 48.45±6.35, respectively) and monsoon (3.57±0.30 and 51.45±7.21, respectively). Besides, semen samples collected from birds housing at an average temperature of <29.5°C demonstrated better sperm motility sperm concentration and total sperm counts than those from at a higher temperature. Conclusion: Winter was regarded as the best season contributing the best semen quality, while summer was the worst. Due to the fluctuation of temperature during summer and winter, the seasonal temperature was implied as the major factor contributing to changes in sperm quality of racing pigeons in Thailand.
Minakjinggo Antara Stigma dan Konstruksi Identitas
Authors:   Universitas PGRI Banyuwangi, Nurullita Hervina , Efendi Yuli Kartika ,   Universitas PGRI Banyuwangi
Published: June 2021

Minakjinggo adalah tokoh fiktif. Minakjinggo adalah seorang tokoh dalam Serat Damarwulan. Belum diketahui secara pasti siapa penulis Serat Damarwulan. Pertunjukan Damarwulan diwujudkan dalam sebuah Kesenian Langendriyan di Yogyakarta dan Surakarta. Kepopuleran cerita ini menyebar ke berbagai daerah dan mewujud dalam berbagai bentuk seni dan sastra tentang cerita ini. Di Banyuwangi, cerita Damarwulan diwujudkan pada kesenian yang awalnya disebut juga dengan nama Damarwulan. Tetapi sekarang terkenal dengan sebutan Janger. Janger menjadi salah satu kesenian yang popular di Banyuwangi. Nanggap Janger menjadi salah satu prestise bagi beberapa kalangan masyarakat di Banyuwangi. Penggemar Janger-pun tidak bisa dianggap remeh. Jumlahnya banyak sekali, tiap grup Janger idolanya manggung berbondong-bondong menontonnya. Salah satu tokoh dalam Janger ini adalah Minakjinggo. Jika versi Yogyakarta dan Solo Minakjinggo digambarkan sebagai sosok antagonis, di Banyuwangi sebaliknya. Ada banyak karakter-karakter baik Minakjinggo yang perlu diteladani oleh masyarakat Banyuwangi. Ini dibuktikan dengan re-produksi tokoh Minakjinggo yang diyakini sebagai Raja Blambangan ke dalam berbagai bentuk patung, gambar bahkan pasemon dalam kehidupan masyarakat Banyuwangi.
Potential Use of Green Synthesized Al2O3 (Alumina) Nanoparticles from Guava Leaves
(Psidium guajava) for the Removal of Methylene Blue from Wastewater
Authors: Mondal Debasish , Mahata Dipankar , Hansda Kamala Mandy , Mondal Sourav , Das Ajit
Published: June 2021

Recently non-harmful nanomaterials have acquired critical significant attention in wastewater treatment
containing organic pollutants especially toxic and hazardous dyes. In this regard, a low cost and eco
friendly method has been investigated for the green synthesis of alumina nanoparticles (Al2O3 NPs).
The alumina nanoparticles were synthesized using an aqueous extract of Psidium guajava leaf as a
potential stabilizing agent. The UV-visible spectroscopy, Fourier-transform infrared spectroscopy
(FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM) and energy-dispersive
spectroscopy (EDS) techniques were used to characterize the synthesized nanoparticles. The absorption
at 281 nm confirmed the formation of alumina nanoparticles. The FTIR spectra and XRD analysis
confirmed the presence of various functional groups and crystalline structures of Al2O3 NPs during the
synthesis. The spectrum clearly indicates the organic moieties in Psidium guajava extract are responsible
for the biosynthesis of Al2O3 NPs. The suface morphology of Al2O3 NPs was confirmed by SEM and
EDS studies. Besides this, the removal of methylene blue through adsorption and kinetic study was
also reported.