bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of phenylalanine tolerance in singleton and twin pregnancies in patients with phenylketonuria
Authors: Hozyasz Kamil Konrad , Żółkowska Joanna , Chyż Katarzyna
Published: September 2020

Objectives

Empirical determination of phenylalanine (Phe) tolerance in patients with phenylketonuria (PKU) relies on frequent assessment of blood Phe concentrations in relation to Phe intake from detailed meal records. This study aimed to determine Phe tolerance in twin pregnancies.

Methods

The reviewed cases included three women with PKU who each had a singleton and twin pregnancy (i.e., they were pregnant twice). All patients were under regular supervision to maintain Phe concentrations in a steady state and determine safe Phe intake. Restriction of Phe in the patient’s diet was determined depending on the amount of Phe intake, which allowed for stable blood Phe concentrations within the target range.

Results

In all three patients with PKU, the ratio of Phe tolerance during the course of the twin and singleton pregnancies was <1 for most of the pregnancy. The ratio of the increase in Phe tolerance between 29 and 34 weeks of gestation and that between 15 and 28 weeks of gestation was 0.66 and 1.17, 0.51 and 0.14, and 0.76 and 1.42 in the twin and singleton pairs of pregnancies, respectively.

Conclusions

Our study shows that Phe tolerance in a twin pregnancy is not greater than that in a singleton pregnancy.
SLC6A4 gene L/S polymorphism and susceptibility to pulmonary arterial hypertension: a meta-analysis
Authors: Zhang Feng , Yang Meiming , Xiao Ting , Hua Yan , Chen Yu , Xu Shasha , Ni Chunping
Published: September 2020

Objective

To investigate the association between the solute carrier family 6 member 4 ( SLC6A4) gene L/S polymorphism and pulmonary arterial hypertension (PAH).

Methods

The relevant literature was retrieved from the PubMed® database and the data were extracted. STATA® version 12.0 software was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CI).

Results

Eight case–control studies qualified for inclusion in the meta-analysis. These studies included 1215 cases and 936 control subjects. There was no significant association between the SLC6A4 gene L/S polymorphism and PAH risk in the total population (LL versus SS: OR 1.83, 95% CI 0.95, 3.51; LS versus SS: OR 1.37, 95% CI 0.93, 2.02; dominant model: OR 1.38, 95% CI 0.97, 1.97; recessive model: OR 1.54, 95% CI 0.84, 2.83). Subgroup analysis based on study quality scores and Hardy–Weinberg equilibrium also showed no significant association.

Conclusion

The findings of this meta-analysis suggest that the SLC6A4 gene L/S polymorphism is unlikely to be related to PAH risk. Well-designed studies with more participants will be required to validate these results.
Successful treatment of synovitis, acne, pustulosis, hyperostosis, and osteitis and paradoxical skin lesions by Tripterygium wilfordii hook f: a case report
Authors: Zhang Xinlu , Wu Xia , Li Chen
Published: September 2020

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoinflammatory disorder without standardized therapy. Anti-tumor necrosis factor (TNF)-α agents, which have been widely used in recent treatment of SAPHO syndrome, may elicit severe paradoxical psoriasiform lesions. Therefore, physicians must reverse the paradoxical skin lesions in affected patients, while improving their clinical symptoms of SAPHO syndrome. Herein, we describe a patient with SAPHO who exhibited TNF-α antagonist-induced paradoxical skin lesions and benefitted from treatment with Tripterygium wilfordii hook f (TwHF). A 58-year-old woman with SAPHO developed paradoxical psoriasiform lesions and exacerbation of primary palmoplantar pustulosis after 7 weeks of etanercept treatment. She then received TwHF treatment, which resulted in rapid and remarkable improvement in her skin lesions and osteoarticular pain. These findings suggest that TwHF might be a suitable treatment option for patients with SAPHO who exhibit TNF-α antagonist-induced paradoxical skin lesions.
Clinical efficacy of platelet-rich plasma as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury
Authors: Wang Yaodong , Yao Chi , Yang Zhuo , Guo Wenlai
Published: September 2020

Objective

The clinical efficacy of platelet-rich plasma (PRP) as adjuvant therapy in patients undergoing arthroscopic repair of meniscal injury remains controversial. This meta-analysis was performed to evaluate the clinical efficacy of PRP in the treatment of meniscal injury and provide evidence for the selection of clinical treatment options.

Methods

A computer-based search of the PubMed, Embase, and Cochrane Library databases was performed to retrieve articles using the search terms “platelet-rich plasma” and “menisci.” Quality evaluation and data extraction were performed. The combined effect was assessed using RevMan version 5.3 software.

Results

Three randomized controlled trials and three cohort studies involving 293 patients were included in the meta-analysis. There were no significant differences in the International Knee Documentation Committee score or Lysholm score between the experimental and control groups. The failure rate and visual analog scale score were significantly lower and the degree of active flexion was significantly higher in the experimental group than in the control group.

Conclusion

The findings of this meta-analysis suggest that PRP injection can effectively enhance the efficacy of arthroscopic repair of meniscal injury, reduce the failure rate and severity of pain, and improve active flexion.
Diagnosis of double-chambered left ventricle by contrast echocardiography: a case report
Authors: Jin Lin , Yuan Feifei , Li Ping , Wang Yingchun
Published: September 2020

Double-chambered left ventricle (DCLV) is a rare congenital cardiac abnormality. We retrospectively analyzed the diagnosis and treatment of a patient with DCLV who was admitted to Jiading Central Hospital of Shanghai Medical College in August 2019. The initial symptom of the 55-year-old male patient was stroke. He was preliminarily diagnosed with DCLV by echocardiography and this diagnosis was confirmed by contrast-enhanced echocardiography. Our findings indicate that contrast-enhanced echocardiography of the left heart is useful for clinical application in the clinical diagnosis, treatment, and prognosis of DCLV. We also review the relevant literature for our case.
Prediction model for anastomotic leakage after laparoscopic rectal cancer resection
Authors: Shiwakoti Enesh , Song Jianning , Li Jun , Wu Shanshan , Zhang Zhongtao
Published: September 2020

Objective

This study was performed to identify risk factors for anastomotic leakage (AL) and combine these factors to create a prediction model for the risk of AL after laparoscopic rectal cancer resection.

Methods

This retrospective study involved 185 patients with rectal cancer who underwent laparoscopic resection from March 2012 to February 2017. Five risk factors were analyzed by multivariate analysis. A prediction model was established by combining the risk factors from the multivariate analysis, and the accuracy of the model was evaluated by a receiver operating characteristic curve.

Results

The overall AL rate was 17.84%. The multivariate analysis identified the following independent risk factors for AL: high body mass index (odds ratio [OR], 3.009; 95% confidence interval [CI], 1.127–7.125), preoperative radiochemotherapy (OR, 3.778; 95% CI, 1.168–12.219), larger tumor size (OR, 2.710; 95% CI, 1.119–6.562), and longer surgical time (OR, 2.476; 95% CI, 1.033–5.932). We established a prediction model that can evaluate the risk of AL by determining the predictive probability. The area under the curve for the model’s predictive performance was 0.70 (95% CI, 0.598–0.795).

Conclusion

A prediction model was created to predict the risk of AL after laparoscopic rectal cancer resection.
Gastric schwannoma: a case report and literature review
Authors: Pu Changsheng , Zhang Keming
Published: September 2020

Background

Gastric schwannoma is a rarely seen gastric tumor accounting for only 0.2% of all gastric tumors. It is difficult to distinguish a gastric schwannoma from other gastric tumors preoperatively. Case presentation: A 30-year-old man with no significant medical history or physical examination findings presented with a 1-month history of right upper abdominal discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor, but the postoperative pathologic and immunohistochemical examinations confirmed a gastric schwannoma. The patient underwent laparoscopic wedge resection of the stomach without additional postoperative treatment, and his postoperative recovery was uneventful. No recurrence or metastasis was found at the 2-year follow-up examination.

Conclusion

Although gastric schwannomas are usually not malignant, they are difficult to distinguish from other malignant stromal tumors preoperatively. Surgical resection should be recommended when a schwannoma is malignant or considered to be at risk of becoming malignant.
Clinical outcomes for moderate and severe stroke survivors receiving early supported discharge: A quasi-experimental cohort study
Authors: Leach Kathleen , Neale Sharon , Steinfort Sarah , Hitch Danielle
Published: September 2020

Introduction

The aim of this study was to compare outcomes for functional independence, activities of daily living participation and balance achieved by moderate and severe stroke survivors receiving an early supported discharge model of care with those receiving standard treatment.

Method

A quasi-experimental cohort method was utilised, with a control group of convenience. Forty-one patients ( n = 28 early supported discharge group, n = 13 control group) who were medically stable post stroke, safe for discharge home, able to be treated in the home environment and requiring intensive rehabilitation from at least two disciplines participated.

Results

There was no significant difference in outcomes between early supported discharge and control groups for functional independence, activities of daily living participation or balance from baseline to 4 weeks, or 4 weeks to 8 weeks. However, patients receiving early supported discharge made further improvements across the study period, while those receiving standard care made limited improvement between 4 weeks and 8 weeks. All minimal clinically important differences on outcome measures were identified between baseline and 4 weeks.

Conclusions

Moderate and severe stroke survivors can achieve comparable outcomes when receiving early supported discharge or standard treatment. Early supported discharge models of care may also enhance ongoing improvement during the early phases of stroke recovery.
The geography of innovation as reflected by social media
Authors: Corradini Carlo
Published: September 2020

Capturing whether mysteries of trade are ‘in the air’ remains a central issue for understanding the spatial nature of innovative activities. We offer new insights on the intangible dimension of the geography of innovation comparing the spatial distribution of patenting rates and a novel measure of ‘innovative buzz’ from a 9-billion-word corpus based on 900 million geolocated tweets across US counties. We find the use of words connected to innovation and technology to be characterised by significant spatial concentration. The results show the presence of strong bivariate correlation in the spatial clustering between the two elements, pointing to stimulating opportunities in the use of big data from social media for economic geography research.
The effect of pituitary adenylate cyclase-activating peptide-38 and vasoactive intestinal peptide in cluster headache
Authors: Vollesen Anne Luise H , Snoer Agneta , Chaudhry Basit , Petersen Anja Sofie , Hagedorn Andreas , Hoffmann Jan , Jensen Rigmor H , Ashina Messoud
Published: September 2020

Background

Previously reported increases in serum levels of vasodilating neuropeptides pituitary adenylate cyclase-activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) during attacks of cluster headache could indicate their involvement in cluster headache attack initiation. We investigated the attack-inducing effects of PACAP38 and vasoactive intestinal peptide in cluster headache, hypothesising that PACAP38, but not vasoactive intestinal peptide, would induce cluster-like attacks in episodic active phase and chronic cluster headache patients.

Methods

In a double-blind crossover study, 14 episodic cluster headache patients in active phase, 15 episodic cluster headache patients in remission phase and 15 chronic cluster headache patients were randomly allocated to receive intravenous infusion of PACAP38 (10 pmol/kg/min) or vasoactive intestinal peptide (8 pmol/kg/min) over 20 min on two study days separated by at least 7 days. We recorded headache intensity, incidence of cluster-like attacks, cranial autonomic symptoms and vital signs using a questionnaire (0–90 min).

Results

In episodic cluster headache active phase, PACAP38 induced cluster-like attacks in 6/14 patients and vasoactive intestinal peptide induced cluster-like attacks in 5/14 patients ( p = 1.000). In chronic cluster headache, PACAP38 and vasoactive intestinal peptide both induced cluster-like attacks in 7/15 patients ( p = 0.765). In episodic cluster headache remission phase, neither PACAP38 nor vasoactive intestinal peptide induced cluster-like attacks.

Conclusions

Contrary to our hypothesis, attack induction was lower than expected and roughly equal by PACAP38 and vasoactive intestinal peptide in episodic active phase and chronic cluster headache patients, which contradicts the PAC1-receptor as being solely responsible for attack induction. Trial registration: clinicaltrials.gov (identifier NCT03814226).
Characteristics of Soccer Players Undergoing Primary Hip Arthroscopy for Femoroacetabular Impingement: A Sex- and Competitive Level–Specific Analysis
Authors: Marom Niv , Dooley Matthew S. , Burger Joost A. , Chang Brenda , Coleman Struan H. , Ranawat Anil S. , Kelly Bryan T. , Nawabi Danyal H.
Published: September 2020

Background:

Radiographic features of femoroacetabular impingement (FAI) are prevalent in kicking athletes, especially soccer players. However, there remains a paucity of data on the characteristics of symptomatic soccer players with an established diagnosis of FAI.

Purpose:

To report on patient demographics, injury, and clinical and radiographic characteristics in a large cohort of soccer players who underwent primary hip arthroscopy for FAI and to perform a sex- and competition level–specific analysis of these data.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

An institutional hip preservation registry containing 3318 consecutive primary hip arthroscopies for FAI performed between March 2010 and January 2016 was retrospectively reviewed for patients identified as soccer players. Patient demographics, injury characteristics, and clinical and radiographic findings were recorded, and sex- and competition level–specific differences were analyzed.

Results:

A total of 421 hips (336 soccer players) were identified, including 257 (61.0%) men and 164 (39.0%) women. Of these, 105 (24.9%) were reported as highly competitive, 194 (46.1%) as competitive, 75 (17.8%) as recreational, and 47 (11.2%) did not report a level. The majority of the 336 soccer players (231 hips; 55%) reported chronic hip pain lasting >6 months with no acute injury at the initial visit. Alpha angle, coronal center-edge angle, and femoral version on computed tomography scan measured 64.5°± 12°, 32.3°± 9°, and 13.7°± 10° (mean ± SD), respectively. There were 230 (55%) hips with a type 2 anterior inferior iliac spine (AIIS), 78 (18.5%) with a type 1 AIIS, and 19 (4.5%) with a type 3 AIIS. When compared with male athletes, female athletes had more hip internal rotation on physical examination (14.9° vs 8°; P < .001), lower alpha angles (57.5° vs 68.5°; P < .001), and lower-grade AIIS morphology ( P = .003). Acute injury as the reason for hip symptoms was most likely in the highly competitive group ( P < .001).

Conclusion:

Female soccer players were more likely to have less severe clinical and radiographic findings than were male soccer players. Acute injury as the cause of hip symptoms was more common in highly competitive players.

Clinical Relevance:

Focusing on soccer players with an established FAI diagnosis, the findings of this study suggest that there are sex- and competition level–based differences in the presentation, physical examination, and imaging characteristics among the players. These findings can better guide clinicians in the diagnostic evaluation of symptomatic soccer players with FAI and in tailoring treatment recommendations to specific cohorts.
A Review of Leadership and Capacity Gaps in Nutrition-Sensitive Agricultural Policies and Strategies for Selected Countries in Sub-Saharan Africa and Asia
Authors: Aryeetey Richmond , Covic Namukolo
Published: September 2020

Background:

Agriculture policies and strategies designed, purposefully, to address malnutrition are considered nutrition-sensitive and are a critical component of global efforts to address malnutrition in all its forms. However, limited evidence exists on extent and how nutrition is being integrated into agriculture sector policies, strategies, and programs. A review was conducted to address 2 questions: How nutrition-sensitive are agriculture policies, plans, and investments in selected Sub-Saharan African (SSA) and Asian countries? and Which capacity and leadership gaps limit scale up of nutrition-sensitive agriculture policy and programs?

Methods:

The review of existing policies was conducted for 11 selected focus countries (9 in SSA and 2 from Asia) of the CGIAR (Consultative Group on International Agricultural Research) Collaborative Research Programme on Agriculture for Nutrition and Health led by the IFPRI (International Food Policy Research Institute). The Food and Agriculture Organization (FAO)’s 10-point key recommendations for designing nutrition-sensitive agricultural interventions was used as an analytical framework. Additionally, a rapid systematic review of published peer-reviewed and grey literature was carried out to identify capacity gaps based on the United Nations Development Program’s capacity assessment framework.

Results:

We found that there is nutrition sensitivity of the policies and strategies but to varying degrees. There is limited capacity for optimum implementation of these policies, programs, and strategies. For most of the countries, there is capacity to articulate what needs to happen, but there are important capacity limitations to translate the given policy/program instruments into effective action.

Conclusions:

The gaps identified constitute important evidence to inform capacity strengthening of nutrition-sensitive actions for desired nutrition and health outcomes in Africa and Asia.
The impact of arteriovenous fistulas and tunneled cuffed venous catheters on morbidity and mortality in hemodialysis patients: A single center experience
Authors: Celik Serhat , Gok Oguz Ebru , Ulusal Okyay Gulay , Selen Tamer , Ayli Mehmet Deniz
Published: September 2020

Background/aim:

Hemodialysis is the most used renal replacement therapy option for patients with end-stage renal disease. Arteriovenous fistulas (AVFs) and tunnel-cuffed venous catheters (tCVC) are commonly used vascular access routes and have advantages and disadvantages compared to each other. This study focuses on the effects of AVFs and tCVCs on morbidity and mortality in hemodialysis patients.

Methods:

The records (between January 2015 and January 2017) of 110 patients (55 patients with AVF and 55 patients with tCVC) under hemodialysis therapy for at least 6 months were evaluated retrospectively. The data about blood tests, hospitalizations, and mortality were compared between patients with AVF and tCVC.

Findings:

Fifty-five patients (25 male, 58 ± 14 years old) were undergoing hemodialysis via AVF. Fifty-five patients (17 male, 63 ± 14 years old) were undergoing hemodialysis via tunneled CVCs. Thirty (54.5%) of the hospitalization patients had AVF and 46 (83.6%) had CVCs ( p < 0.01). The only independent predictor of hospitalization was the use of tCVC as vascular access, according to multivariate regression analysis ( p = 0.01). Seven (30%) of the dead patients had AVF and 16 (69.6%) had CVCs ( p = 0.035). Use of tCVC appeared to be a mortality predictor in univariate regression analysis ( p = 0.039). But the significance did not continue in multivariate model ( p = 0.578) in which the duration of hemodialysis appeared as the only significant factor ( p = 0.002).

Conclusion:

Patients undergoing hemodialysis via AVF had fewer all-cause hospitalizations and mortality rate than those using tunneled CVCs.
Márkus and the retrieval of the sociological Adorno
Authors: Jones Paul K.
Published: September 2020

Major sociological work related to the culture industry thesis was undertaken by Adorno during his period as a ‘refugee scholar’ in the USA. It has been charged with a ‘sociological deficit’ by leading figures within critical theory, typically without reference to that US context. A dialogue with Márkus’s work on Adorno and the Marxian production paradigm can redress failings in those critiques. However, such a task is complicated by the limitations of Márkus’s own major essay on this topic. This paper thus conducts an immanent critique of Márkus: ‘Márkus against Márkus’. Márkus’s proposals for the application of the Marxian production paradigm to aesthetic culture and his prospective vision for critical theory are so found to be very compatible with Adorno’s related work.
Is Savings Automation Helpful to Liquid Savings? It Depends on Whether You Have a Savings Habit
Authors: Newmeyer Casey , Warmath Dee , O’Connor Genevieve E. , Wong Nancy
Published: September 2020

In general, Americans are not savers, which contributes to their inability to absorb even small financial shocks and increases their potential for financial hardship. Savings automation has been promoted as a solution to overcome the behavioral constraints (or limitations) that hinder individual savings behavior. The result has been a proliferation of automated savings programs with the goal of helping people save money without their notice as a way to overcome their tendency to consume. However, scant research has examined the efficacy of this “save people from themselves” approach. This article explores the importance of having a saver mindset, regardless of income, in the success of savings automation. Results from two studies demonstrate that the benefits of automation for liquid savings accrue at a higher rate for individuals with lower incomes and that this benefit depends on the presence of a personal savings orientation. The findings suggest that savings programs should try to build a savings habit and mindset among consumers, especially for those with lower incomes.
Influence of calcium and EDTA on copper ion bioavailability in copper nanoparticle toxicity tests improves understanding of nano-specific effects
Authors: Boran Halis
Published: September 2020

Metal-based nanoparticles (NPs) can release metal ions that are toxic to aquatic organisms; however, whether the toxicity is from metal ions rather than unique “nano-scale” effects of the NPs is unresolved. The present study aimed to compare the toxicity of Cu2+ and Cu-NPs in larval zebrafish ( Danio rerio) to clarify whether toxic effects are attributable to release of Cu ions and to determine the effect of the chelating agent ethylenediaminetetraacetic acid (EDTA) and calcium hardness (as CaCO3) on the Cu toxicity. First, the acute toxicity (96-h lethality) of Cu-NPs was determined in comparison to aqueous Cu in larvae exposed to CuSO4, and subsequently, sublethal tests with Cu-NPs and CuSO4 were conducted with additions of EDTA or calcium ions to evaluate alterations in expression of metallothionein-2 ( MT2) gene transcripts (quantitative real-time polymerase chain reaction). Acute toxicity of Cu in larvae exposed to CuSO4 was greater (LC50 = 226 µg Cu/L) than for larvae exposed to Cu-NPs (LC50 = 648 µg Cu/L). The expression of MT2 increased with Cu concentration ( p < 0.05), and the slope of the linear regression was significantly greater in fish exposed to CuSO4 (slope = 0.090) compared to Cu-NPs (slope = 0.011). Cu2+ was 2.9-fold more toxic than Cu-NPs. The presence of 5 mg/L EDTA and 220 mg/L CaCO3 significantly reduced the expression of MT2 (1.8-fold for EDTA, 2.3-fold for CaCO3) in larvae exposed to CuSO4. For larvae exposed to Cu-NPs, the presence of EDTA reduced the expression of MT2 (1.7-fold) relative to Cu-NP concentration. While Cu-NPs induced MT2 expression, the differences in concentration relationships of MT2 expression between Cu-NPs and CuSO4 indicated that factors other than release of Cu ions from Cu-NPs influenced acute toxicity of Cu-NPs. The conclusion drawn from this ecotoxicological risk assessment was that EDTA and calcium significantly decreased Cu toxicity in freshwater fish.
Things are Getting Worse on Our Way to Catastrophe: Neoliberal Environmentalism, Repressive Desublimation, and the Autonomous Ecoconsumer
Authors: Stoner Alexander M.
Published: September 2020

The aim of neoliberal environmentalism was to unleash the market to protect the environment; but as it turns out, things are getting worse on our way to catastrophe. Despite persistent failures, neoliberal environmentalism remains prevalent—and apparently without alternative. This paper directs focus on an often-overlooked dimension of this apparent stasis: the nexus of self and society in advanced capitalism, as shown in the linkage between neoliberal environmentalism and the autonomous ecoconsumer. Marcuse’s concept of repressive desublimation is engaged to better understand how environmentalist desire is currently being thwarted in ways that inhibit movement toward socioecological emancipation. The paper provides an illustrative example of desublimated environmentalist desire in the current recycling crisis.
Measures to Protect the Health and Safety of Massachusetts Employees Who Must Work at the Workplace During the SARS-CoV-2 Pandemic
Authors: Sugerman-Brozan Jodi ,   Health Technical Committee of the Massachusetts Coalition for Occupational Safety and Health
Published: September 2020

The Massachusetts Coalition for Occupational Safety and Health (MassCOSH) developed workplace health and safety recommendations for Phase 2 of the Massachusetts plans to reopen the economy as the spread of SARS-CoV-2 novel coronavirus was reduced in the state. The governor’s plan included minimal measures for workplace health and safety protections during this pandemic. The MassCOSH recommendations are presented in this document.
Fostemsavir: A Novel Attachment Inhibitor for Patients With Multidrug-Resistant HIV-1 Infection
Authors: Hiryak Kayla , Koren David E.
Published: September 2020

Objective

To review the efficacy and safety of fostemsavir (FTR) for the treatment of multidrug-resistant HIV-1 infection in heavily treatment-experienced adults who are failing their current antiretroviral regimen.

Data Sources

Clinical trials and review articles were obtained through PubMed (2015 to July 2020) using the search terms fostemsavir, BMS-663068, and GSK3684934.

Study Selection and Data Extraction

All relevant articles, trials, and abstracts in the English language were included.

Data Synthesis

FTR demonstrates a novel mechanism of action, preventing virus attachment to the host CD4 receptor. FTR extended-release 600-mg tablets every 12 hours orally has proven beneficial in obtaining viral suppression for heavily treatment-experienced patients with multidrug-resistant infection refractory to other agents, as indicated in phase 3 trials. Treatment courses were evaluated to 96 weeks with significant viral load reductions noted within the first 24 weeks. Adverse events commonly reported include nausea, vomiting, diarrhea, fatigue, and headache. Serious events and fatality were not attributed to FTR and occurred because of advancement of HIV or other acute infection.

Relevance to Patient Care and Clinical Practice

FTR presents a new treatment option for patients with multidrug resistance and intolerability to other medications. The favorable adverse effect profile of FTR alongside the limited drug interaction profile makes it a viable option in a salvage regimen.

Conclusions

FTR provides an alternative agent when composing a regimen for patients with multidrug-resistant HIV-1 infection. It is generally well tolerated, with few significant interactions, and neither renal nor hepatic dose adjustments are required.
Effect of Dexamethasone in Peripheral Nerve Blocks on Recovery of Nerve Function
Authors: Gagne Oliver J. , Cheema Amar , Abuhantash Monther , Ree Ron , Penner Murray , Wing Kevin , Younger Alastair , Salat Peter , Veljkovic Andrea
Published: September 2020

Background:

Peripheral nerve blocks (PNBs) have revolutionized distal extremity surgery reducing pain and improving hospital efficiency. Perineural dexamethasone has been administered with PNBs to prolong their effects, although the safety of dexamethasone has not been established in the literature. This study aimed to determine if the addition of dexamethasone affected the postoperative neurological sensory status for foot and ankle surgeries and the recovery of nerve injuries. We hypothesized that the rate of persistent nerve injury would be higher in the dexamethasone group.

Methods:

This is a retrospective observational cohort study of prospectively collected data of all patients from a single foot and ankle surgeon’s practice. Perineural dexamethasone was routinely used as an adjunct by the regional anesthesia group until a clinical trend of increased paresthesia was found on short-term follow-up, which led to the discontinuation of its use. In this study, the cohort that received dexamethasone with ropivacaine was compared with the cohort that received ropivacaine alone. The primary outcome was a separate sensory nerve status sheet that was completed for every distal nerve territory for every patient at their follow-up visits at 2 weeks, 6 weeks, 3 months, and 6 months. Univariate analysis and a logistic regression model were used to determine the association between dexamethasone and delayed nerve recovery. A total of 250 patients were included in the study, with 117 patients in the dexamethasone group and 133 in the ropivacaine-only group.

Results:

The rates of nerve injuries were not different between the groups (72 [62%] in the dexamethasone group vs 79 [59%] in the ropivacaine-only group). However, nerve injury symptoms were more likely to persist and not fully recover in the dexamethasone group ( n = 47, 65%) compared with the ropivacaine-only group ( n = 32, 41%) (OR, 2.12; P = .006).

Conclusion:

Perineural dexamethasone added to PNBs may be associated with delayed nerve recovery after foot and ankle surgery. It may be prudent to avoid its use until its full safety profile is established in larger prospective trials.

Level of Evidence:

Level III, retrospective comparative study.
Risk Assessment in Juvenile and Young Adult Offenders: Predictive Validity of the SAVRY and SAPROF-YV
Authors: Kleeven Anneke T. H. , de Vries Robbé Michiel , Mulder Eva A. , Popma Arne
Published: September 2020

Most juvenile risk assessment tools heavily rely on a risk-focused approach. Less attention has been devoted to protective factors. This study examines the predictive validity of protective factors in addition to risk factors, and developmental differences in psychometric properties of juvenile risk assessment. For a national Dutch sample of 354 juvenile and young adult offenders (16-26 years) risk and protective factors were retrospectively assessed at discharge from seven juvenile justice institutions, using the Structured Assessment of Violence Risk in Youth (SAVRY) and Structured Assessment of Protective Factors for violence risk – Youth Version (SAPROF-YV). Results show moderate validity for both tools predicting general, violent, and nonviolent offending at different follow-up times. The SAPROF-YV provided incremental predictive validity over the SAVRY, and predictive validity was stronger for younger offenders. Evidently both the SAVRY and SAPROF-YV seem valid tools for the assessment of recidivism risk in juvenile and young adult offenders. Results highlight the importance of protective factors, especially in juvenile offenders, emphasizing the need for a balanced risk assessment.
Tracking control of cable-driven manipulator with adaptive fractional-order nonsingular fast terminal sliding mode control
Authors: Su Lianqing , Guo Xing , Ji Yude , Tian Yun
Published: September 2020

In this article, an adaptive nonsingular terminal sliding mode control scheme based on fractional order is proposed for a cable-driven manipulator with external disturbances, where the concentration is uncertain and the upper limit is known or unknown. Furthermore, a new adaptive fractional-order nonsingular fast terminal sliding mode algorithm with time-delay estimation is developed. The delay estimation unit can be used to properly compensate the centralized unknown dynamics of the system, thereby obtaining attractive model-free characteristics. A characteristic of the control scheme in this article is that by using the adaptive tuning law, the upper limit of the uncertainty is estimated only by the speed and position measurement so as to achieve the effects of rapid convergence, high accuracy, and vibration reduction. In addition, the proposed controller effectively eliminates the effects of jitter without losing robustness and accuracy. The simulation results show the effectiveness of the proposed control scheme.
A novel method for high-frequency non-sinusoidal vibration waveforms with uniaxial electro-hydraulic shaking table based on Fourier series
Authors: Wang He , Chen Zhen , Huang Jiahai
Published: September 2020

In this article, a rotary valve is developed to obtain accurate high-frequency sinusoidal vibration waveforms. Then, a uniaxial electro-hydraulic shaking table controlled by a set of parallel rotary valves is constructed, which can superpose the sinusoidal vibration waveforms. The non-sinusoidal vibration waveforms including triangular vibration waveform, rectangular vibration waveform, sawtooth vibration waveform and trapezoidal vibration waveform are generated by adjusting the spool rotation speed based on the Fourier series. The results show that with one rotary valve, the uniaxial electro-hydraulic shaking table can output accurate high-frequency sinusoidal vibration waveforms and the total harmonic distortion is less than 1% at high vibration frequency. Compared with the standard vibration waveform, the error of the generated vibration waveform is very small. For the rectangular vibration waveform and sawtooth vibration waveform, the error is less than 6%, and for the triangular vibration waveform and trapezoidal vibration waveform, the error is less than 3%. The impacts of the working conditions on the error of the generated vibration waveform are very small. The proposed method for the accurate high-frequency non-sinusoidal vibration waveform is very effective and can be applied in high vibration frequency and different load masses. With the increase of the supply pressure, the amplitude of the generated vibration waveforms increases, while the error changes in a rather narrow range. The amplitude can be adjusted by changing the supply pressure with almost no effect on the accuracy of the vibration waveform.
The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study
Authors: Dudley Nancy , Miller Jacqueline , Breslin Mary Lou , Chapman Susan A. , Spetz Joanne
Published: September 2020

The objective of this study was to explore how home care workers and the agencies that employ them interact with their state’s nurse practice act in the provision of care. Using a qualitative case study approach, we selected four states with varying levels of restrictiveness in their nurse delegation regulations. We conducted interviews ( N = 45) with state leaders, agency leaders, and home care workers to learn how these policies affect the home care workforce’s ability to perform care tasks for their clients in order to allow clients to remain in their own homes. We found that increased training and input from registered nurses is needed to identify appropriate health maintenance tasks to delegate to home care workers and support development of training strategies. The federal government could support the development of evidence-based guidelines for training and competency testing as well as for appropriate delegation of health maintenance tasks.
The Impact of Threat Type and Prior Abuse History on Perceptions of Intimate Partner Sexual Coercion
Authors: Jenkins Baylee D. , Le Grand Alexis M. , Golding Jonathan M. , Lynch Kellie R. , Wolbert Georgie
Published: September 2020

Intimate partner sexual victimization often involves perpetrators using threats to coerce victims into sexual activity. However, little research has investigated perceptions of this coercion. We presented 99 community members with intimate partner sexual coercion vignettes that varied abuse history (between-participants) and type of threat used to coerce the victim into sex (within-participants; that is, physical assault, financial, children taken). We found that physical assault threats led to higher pro-victim judgments than nonviolent threats. These findings provide insight into how sexual violence involving coercion is perceived in different contexts.
Masculinities, Sport, and Violence Against Women: The Contribution of Male Peer Support Theory
Authors: Schwartz Martin D.
Published: September 2020

Although there are active debates about the nature and role of masculinities and a rise of new masculinity formations in modern society, feminist analysis of the relationship between sport, masculinities, and violence against women has been somewhat quiescent lately. This article seeks to underline this connection through the use of male peer support theory, which has been expanded in recent years to include messages from women and from within the LGBTQ community, and to recognize the rise in newer masculinity formations and the influence of new technology.
Significant Improvement of Somatic Symptom Disorder With Brief Psychoeducational Intervention by PMHNP in Primary Care
Authors: Johnson Kim K. , Bennett Carole , Rochani Haresh
Published: September 2020

Objective:

Patients with somatic symptom disorders (SSD) are prevalent in primary care, urgent care, and emergency rooms and present with reduced quality of life, increased disability, and suicidality . Criteria for SSD include (1) somatic symptoms that cause distress and disrupt life; (2) concurrent physical illness with thoughts and feelings that are disproportionate to the seriousness of the illness; and (3) distress which is persistent and causes suffering. The frequency of SSD in the general population is 5% to 7%; however, in primary care, it is 5% to 35% . Because patients present with anxiety, depression, and/or pain, providers are flummoxed when diagnostic findings do not match symptom intensity. The purpose of this project was to provide an intervention for patients with SSD and measure its effectiveness on their somatic symptoms.

Method:

This study provided a single-session, 30-minute psychoeducational intervention for patients to explain brain pathways for pain and the body’s response to stress, including scientific benefits of exercise and healthy diet. Patients were asked questions using the motivational interviewing technique OARS (open-ended question, affirmation, reflection, summary) and were encouraged to talk about their concerns. The study used a pre- and post-intervention visual analogue scale and a self-reported Patient Health Questionnaire–15 both before and 3 weeks post-intervention.

Results:

Measurements showed significant symptom improvement immediately after the intervention with sustained improvement 3 weeks post-intervention.

Conclusions:

This intervention demonstrates an effective treatment for this insidious illness, which plagues up to 35% of patients in primary care.
The Impact of Police Attitudes Towards Offenders on Law-Enforcement Assisted Diversion Decisions
Authors: Schaible Lonnie , Gant Lauren , Ames Stephanie
Published: September 2020

Diversion is a prevalent alternative to traditional criminal justice processing, especially at the pre-trial stage. More recently, pre-arrest diversion has been implemented to avert the consequences of arrest, pre-trial proceedings, and future incarceration. Pre-booking diversion programs rely on the willingness of officers to use their discretionary authority to divert low-level offenders to community-based treatment programs in lieu of arrest, raising considerations about how law enforcement view offenders. Using data collected from a survey distributed during a Law Enforcement Assisted Diversion (LEAD) training session for officers in one jurisdiction in the Rocky Mountain West (N = 118), the current study examines the impact of officer attitudes toward offenders on their decision to divert individuals. Findings indicate that officers who hold an optimistic view toward offender rehabilitation are more likely to divert offenders. Results and their significance for practical implementation of law enforcement pre-arrest diversion efforts are discussed.
Modified head inversion technique for pterygium and pseudopterygium surgery combined with keratopigmentation
Authors: Bafna Rahul Kumar , Kalra Nidhi , Sinha Rajesh
Published: September 2020

Purpose:

We describe a single sitting modified technique of pterygium surgery along with corneal tattooing for combined cosmetic rehabilitation in eyes with corneal opacity and pterygium or pseudopterygium.

Method:

Five patients with corneal opacity due to healed keratitis/optically failed therapeutic grafts along with pterygium or pseudopterygium underwent combined pterygium surgery by head inversion technique and corneal tattooing in the same sitting. All patients had no visual prognosis in that eye and surgery was indicated for cosmetic reasons only.

Results:

At 6 months follow up no complications of pterygium surgery like recurrence, thinning, dellen, infections were noted in any patient. The dye was retained in the cornea and the cosmetic rehabilitation was excellent in all patients.

Discussion:

Corneal tattooing combined with pterygium/pseudopterygium surgery can be performed in a single sitting with this novel technique in eyes with no visual potential. This is particularly suitable for eyes with limbal stem cell deficiency or large pterygia/pseudopterygia where conjunctival autograft is not advisable. These patients are often apprehensive for an allograft from their only seeing other eye
Prognostic Score-based Clinical Factors and Metabolism-related Biomarkers for Predicting the Progression of Hepatocellular Carcinoma
Authors: Yan Jia , Shu Ming , Li Xiang , Yu Hua , Chen Shuhuai , Xie Shujie
Published: September 2020

Hepatocellular carcinoma (HCC) is a common malignant tumor representing more than 90% of primary liver cancer. This study aimed to identify metabolism-related biomarkers with prognostic value by developing the novel prognostic score (PS) model. Transcriptomic profiles derived from TCGA and EBIArray databases were analyzed to identify differentially expressed genes (DEGs) in HCC tumor samples compared with normal samples. The overlapped genes between DEGs and metabolism-related genes (crucial genes) were screened and functionally analyzed. A novel PS model was constructed to identify optimal signature genes. Cox regression analysis was performed to identify independent clinical factors related to prognosis. Nomogram model was constructed to estimate the predictability of clinical factors. Finally, protein expression of crucial genes was explored in different cancer tissues and cell types from the Human Protein Atlas (HPA). We screened a total of 305 overlapped genes (differentially expressed metabolism-related genes). These genes were mainly involved in “oxidation reduction,” “steroid hormone biosynthesis,” “fatty acid metabolic process,” and “linoleic acid metabolism.” Furthermore, we screened ten optimal DEGs (CYP2C9, CYP3A4, and TKT, among others) by using the PS model. Two clinical factors of pathologic stage (P < .001, HR: 1.512 [1.219-1.875]) and PS status (P <.001, HR: 2.259 [1.522-3.354]) were independent prognostic predictors by cox regression analysis. Nomogram model showed a high predicted probability of overall survival time, and the AUC value was 0.837. The expression status of 7 proteins was frequently altered in normal or differential tumor tissues, such as liver cancer and stomach cancer samples.We have identified several metabolism-related biomarkers for prognosis prediction of HCC based on the PS model. Two clinical factors were independent prognostic predictors of pathologic stage and PS status (high/low risk). The prognosis prediction model described in this study is a useful and stable method for novel biomarker identification.
Black skin, White theorists: Remembering hidden Black early childhood scholars
Authors: Broughton Anthony
Published: September 2020

As US schools become increasingly diverse, the population of teachers who serve them remains predominantly homogeneous. Teacher preparation programs must prepare pre-service teachers to draw from multicultural perspectives or multiple ways of knowing if they truly intend to cultivate effective culturally responsive educators. This article presents a clarion call for the remembering of hidden Black intellectual thoughts on early childhood, while reconceptualizing and expanding conceptions of foundational educational theorists in the field. The findings demonstrate that both the teacher educator and students developed and enhanced their cultural competence and critical consciousness.
Ethics and political imagination in feminist theory
Authors: Johansson Wilén Evelina
Published: September 2020

This article discusses three different conceptions of ethics within contemporary feminist theory and how they depict the connection between ethics and politics. The first position, represented by Wendy Brown, mainly describes ethics as a sort of anti-political moralism and apolitical individualism, and hence as a turn away from politics. The second position, represented by Saba Mahmood, discusses ethics as a precondition for politics, while the third position, represented by Vikki Bell, depicts it as the ‘external consciousness’ of the political, and as destabilising political discourse by confronting it with singularity and ‘radical’ difference. Though they represent distinct positions, the article argues, all three suffer from a tendency to reify ethics by failing to give a contextualised account of it. The article then introduces the ethical perspective of Judith Butler, arguing that she – while offering both a transhistorical and a contextualised dimension – tends to psychologise and individualise ethics and politics. The last part of the article introduces Terry Eagleton and what, in a Marxist vein, could be called a ‘materialist ethics’ or an ‘ethics of socialism’, and argues that this way of framing the relationship between ethics and politics provides a solution to the trap of reification identified in the three described positions. This part also discusses how Eagleton’s theory relates to – but also differs from – arguments made by Butler. One advantage of Eagleton’s work, the article argues, is that it does not psychologise and individualise ethics and politics as Butler’s work does.