bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomics Links Inflammation With Neurocognitive Impairment in Children Living With Human Immunodeficiency Virus Type-1
Authors: Rawat Pratima , Brummel Sean S , Singh Kumud K , Kim Jihoon , Frazer Kelly A , Nichols Sharon , Seage George R , Williams Paige L , Van Dyke Russell B , Harismendy Olivier , Trout Rodney N , Spector Stephen A
Published: December 2020

Background

We identified host single-nucleotide variants (SNVs) associated with neurocognitive impairment (NCI) in perinatally HIV-infected (PHIV) children.

Methods

Whole-exome sequencing (WES) was performed on 217 PHIV with cognitive score for age (CSA) < 70 and 247 CSA ≥ 70 (discovery cohort [DC]). SNVs identified in DC were evaluated in 2 validation cohorts (VC). Logistic regression was used to estimate adjusted odds ratios (ORs) for NCI. A human microglia NLRP3 inflammasome assay characterized the role of identified genes.

Results

Twenty-nine SNVs in 24 genes reaching P ≤ .002 and OR ≥ 1.5 comparing CSA < 70 to CSA ≥ 70 were identified in the DC, of which 3 SNVs were identified in VCs for further study. Combining the 3 cohorts, SNV in CCRL2 (rs3204849) was associated with decreased odds of NCI (P < .0001); RETREG1/FAM134B (rs61733811) and YWHAH (rs73884247) were associated with increased risk of NCI (P < .0001 and P < .001, respectively). Knockdown of CCRL2 led to decreased microglial release of IL-1β following exposure to ssRNA40 while knockdown of RETREG1 and YWHAH resulted in increased IL-1β release.

Conclusions

Using WES and 2 VCs, and gene silencing of microglia we identified 3 genetic variants associated with NCI and inflammation in HIV-infected children.
The Use of UAS to Release the Egg ParasitoidTrichogrammaspp. (Hymenoptera: Trichogrammatidae) Against an Agricultural and a Forest Pest in Canada
Authors: Martel Véronique , Johns Rob C , Jochems-Tanguay Laurence , Jean Frédéric , Maltais Alexandre , Trudeau Simon , St-Onge Mylène , Cormier Daniel , Smith Sandy M , Boisclair Josée
Published: December 2020

The egg parasitoid Trichogramma spp. (Hymenoptera: Trichogrammatidae) is a widely used biocontrol agent against lepidopteran pests. Historically, Trichogramma were deployed either by plane or by using cardboard cards on which parasitized eggs are glued and manually installed at sites. Plane deployment is costly and card installation is time consuming, but the use of Trichogramma has been shown to be efficient against several pests. In 2016 and 2017, a research project investigated the potential use of unmanned aerial system for distributing Trichogramma as biocontrol agents against two major pests: an agricultural pest of maize, the European corn borer, Ostrinia nubilalis (Hübner) (Lepidoptera: Crambidae), and a forest pest, the eastern spruce budworm, Choristoneura fumiferana (Clemens) (Lepidoptera: Tortricidae). Exposure duration of parasitized eggs to field conditions (temperature, predation, etc.) in maize fields influenced the Trichogramma’s emergence rate, suggesting that timing of parasitoid releases with their emergence is essential. Although parasitism of naturally occurring eggs in maize fields could not be compared due to the low density of the European corn borer, parasitism of sentinel eggs by Trichogramma was more prominent in plots with unmanned aircraft systems (UAS)-releases compared to control plots. For spruce budworm, treatment with Trichogramma increased egg parasitism and there was no difference between the deployment by UAS and by Trichocards. We discuss these results in the context of pest biology and management. We also discuss the advantages and shortcomings of both methods and offer insights into where future work might go to further leverage the use of UAS in managing these important pests.
Equality in the Informed Consent Process: Competence to Consent, Substitute Decision-Making, and Discrimination of Persons with Mental Disorders
Authors: Scholten Matthé , Gather Jakov , Vollmann Jochen
Published: December 2020

According to what we propose to call “the competence model,” competence is a necessary condition for valid informed consent. If a person is not competent to make a treatment decision, the decision must be made by a substitute decision-maker on her behalf. Recent reports of various United Nations human rights bodies claim that article 12 of the Convention on the Rights of Persons with Disabilities involves a wholesale rejection of this model, regardless of whether the model is based on a status, outcome, or functional approach to competence. The alleged rationale of this rejection is that denying persons the right to make their own treatment decisions based on an assessment of competence necessarily discriminates against persons with mental disorders. Based on a philosophical account of the nature of discrimination, we argue that a version of the competence model that combines supported decision-making with a functional approach to competence does not discriminate against persons with mental disorders. Furthermore, we argue that status- and outcome-based versions of the competence model are discriminatory.
The Journey of Recovery: Caregivers’ Perspectives From a Hip Fracture Telerehabilitation Clinical Trial
Authors: Ariza-Vega Patrocinio , Castillo-Pérez Herminia , Ortiz-Piña Mariana , Ziden Lena , Palomino-Vidal Jerónimo , Ashe Maureen C
Published: December 2020

Objective

The objective was to explore family caregivers’ perspectives of the recovery process of older adults with hip fracture and describe experiences from caregivers who: (1) used the online intervention, or (2) received home-based care provided by the Andalusian Public Health Care System.

Methods

This was an exploratory secondary study with informal family caregivers who had an older adult family member with hip fracture enrolled in a novel telerehabilitation (telerehab) clinical trial. Forty-four caregivers of older adults with hip fracture were interviewed at 6 to 9 months after their family member’s hip fracture.

Results

Caregivers shared concerns of family members’ survival and recovery; they recounted increased stress and anxiety due to the uncertainty of new tasks associated with providing care and the impact on their lifestyle. Although most caregivers were satisfied with the health care received, they made suggestions for better organization of hospital discharge and requests for home support. The main reasons why caregivers and their family member chose the telerehab program were to enhance recovery after fracture, gain knowledge for managing at home, and because of the convenience of completing the exercises at home. There were more family caregivers in the control group who expressed a high level of stress and anxiety, and they also requested more social and health services compared with caregivers whose family member received telerehab.

Conclusion

Family caregivers are an essential component of recovery after hip fracture by providing emotional and physical support. However, future clinical interventions should evaluate person-centered interventions to mitigate possible stress and anxiety experienced by family caregivers.

Impact

Family caregivers’ perspectives are necessary in the co-design of management strategies for older adults after hip fracture.
Fecal Microbiota Transplantation is Safe and Effective for C. Difficile Infection
Authors: Rosenberg Karen
Published: December 2020

According to this study:

In standard clinical practice, fecal microbiota transplantation has a high success rate in patients with refractory Clostridioides difficile infection. In most cases, cure can be achieved with only one treatment.
The Importance of Time
Authors: Huycke LaRae
Published: December 2020

Early in the pandemic, a telehealth appointment with a long-term counseling patient takes a terrifying turn.
Transvaginal ultrasound cervical length for prediction of spontaneous labor at term
Authors: Wu Lirong , Lei Gang , Tan Ming
Published: December 2020

Purpose:

To evaluate the predictive accuracy of transvaginal ultrasound (TVU) cervical length (CL) for spontaneous onset of labor in singleton gestation enrolled at term by a meta-analysis.

Materials and methods:

This protocol established in this study has been reported following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Web of Science, PubMed, EMBASE, and the Cochrane Library were searched for all clinical trials assessing the accuracy of TVU CL in prediction of spontaneous onset of labor in singleton gestations with vertex presentation who were enrolled at term until August 15, 2020. We will use a combination of Medical Subject Heading and free-text terms with various synonyms to search based on the eligibility criteria. Two investigators independently reviewed the included studies and extracted relevant data. The 95% confidence intervals (CIs) of was used as effect estimate. I-square (I
2) test, substantial heterogeneity, sensitivity analysis, and publication bias assessment will be performed accordingly. Stata 15.0 and Review Manger 5.3 are used for meta-analysis and systematic review.

Results:

The results will be published in a peer-reviewed journal.

Conclusion:

The results of this review will be widely disseminated through peer-reviewed publications and conference presentations. This evidence may also assess the accuracy of TVU CL in prediction of spontaneous onset of labor in singleton gestations with vertex presentation.

Registration number:

INPLASY202080065
Cognitive behavior therapy for dizziness
Authors: Li Lin , Gao Xiaoping , Liu Jianguo , Qi Xiaokun
Published: December 2020

Objectives:

To investigate the association between cognitive behavior therapy (CBT) and dizziness.

Methods:

The databases including PubMed, Embase, Cochrane Library and Web of science will be searched for randomized controlled trials. Weighted mean difference and 95% confidence interval will be utilized to calculate the effect of CBT on dizziness between the 2 groups.

Conclusions:

This meta-analysis will provide a high-quality synthesis from existing evidence for the relationship between CBT and dizziness.

OSF registration number:

10.17605/OSF.IO/YNH5W
Massage treatment of hyperplasia of mammary glands
Authors: Ma Dehui , Liu Guochao , Zhang Xiaolin , Zhang Qi , Gao Tianjiao , Liu Mingjun
Published: December 2020

Background:

With the accelerated pace of life, the problems of residence, diet, and environment have occurred frequently in recent years. External factors are easily to cause endocrine disorders and hormone sensitivity of breast tissue, which can lead to mammary hyperplasia. The incidence rate of hyperplasia of mammary glands is increasing year by year, and the age of onset is also getting lower and lower. If not treated in time, there is a crisis of breast cancer.

Clinical studies have found that massage is widely used in clinical treatment of mammary hyperplasia recently, but the efficacy of massage in the treatment of mammary hyperplasia has not been systematically reviewed. The purpose of this study is to explore the efficacy, safety and effectiveness of massage in the treatment of hyperplasia of mammary glands.

Methods:

We will search PubMed, Cochrane Central Register of controlled trials (central), ScienceNet, EMBASE, CBM, CNKI, VIP and Wanfang databases. The retrieval date was October 20, 2020. RevMan 5.3 software was used to evaluate the quality and risk of included studies. The efficacy, recurrence rate, and symptom score of breast hyperplasia were analyzed, and the results were observed and measured.

Results:

This study will be from the clinical efficiency, improvement rate, pain symptoms disappear rate, tumor size improvement rate and other aspects of the existing evidence for a high quality synthesis, as well as massage adverse events.

Conclusion:

the conclusion of this review will provide the basis for judging whether massage is safe and effective in the treatment of hyperplasia of mammary glands.

Ethics and dissemination:

This systematic will evaluate the effectiveness and safety of massage in the treatment of hyperplasia of mammary glands. As all data used in this systematic review and meta-analysis have been published, ethical approval is not required for this review.

Protocol registration number:

INPLASY2020100066
Association of toll-like receptor polymorphisms with acquisition of HIV infection and clinical findings
Authors: Shi Han , He Hongyan , Sun Changfeng , Fu Juan , Ghosh Dipritu , Deng Cunliang , Sheng Yunjian
Published: December 2020

Background:

To find the relationship between toll-like receptor (TLR) gene variants and human immunodeficiency virus (HIV) infection and clinical findings, which could inform clinical decisions and vaccination strategies.

Method:

Four databases were searched for articles that were published on or before Jul.1, 2020. Review Manager 5.3 software was applied to perform meta-analysis to explore.

Results:

A total of 10 studies involving 20 genes, 3697 cases, and 6498 controls were included in this systematic review. TLR2 –196 to –174 Ins/Del (odds ratio [OR] = 1.562;P = .002), TLR4 rs4986790 (OR = 2.05;P = .002), TLR3 rs3775291 (OR = 0.25;P = .03), TLR7 rs179008 (P = .002), TLR7 rs2074109 (OR = 0.27,P = .019) were found associated with HIV infection. TLR2 –196 to –174, TLR4 rs4986790, TLR7 rs179008, TLR8 rs3764880, TLR9 rs352140 were found associated with clinical findings of HIV infection. We identified 5 case-control studies in meta-analysis, involving 695 cases and 729 controls on TLR7 rs179008 polymorphism, totaling 652 cases and 614 controls on TLR9 rs352140 polymorphism. In meta-analysis, we employed various genetic models. The T allele of TLR7 rs179008 was conferred the risk of HIV infection (T vs A: OR = 1.25,PA = .02). An increased risk of HIV infection was found for individuals with the TLR9 rs352140 GG genotype (GG vs AA: OR = 1.50,PA = .04).

Conclusions:

The systematic review indicated that TLR7 rs179008 T allele provides risk effects for HIV infection. TLR9 rs352140 GG genotype may associate with HIV infection.
Chinese herbal medicine for small cell lung cancer patients
Authors: Mi Xue , Zhang Xiwen , He Shulin , Zhang Zhenhua , Qi Runzhi , Jiang Juling , Chen Shuntai , Zheng Honggang , Hua Baojin
Published: December 2020

Background:

Small cell lung cancer (SCLC) is an aggressive disease. Chemotherapy is the standard treatment for SCLC, but the resistance and the adverse effects of Chemotherapy still remains a major problem. Although Chinese herbal medicine (traditional Chinese medicine) is wildly applied for patients with SCLC in China, the evidence of traditional Chinese medicine in the treatment for SCLC is limited.

Method:

We conducted a systematic search of PubMed, EMBASE, the Chinese National Knowledge Infrastructure, the VIP Information Database, and the Wanfang Database for relevant studies. Only randomized controlled trials were included. Two investigators independently reviewed the included studies and extracted relevant data. The effect estimate of interest was the relative risk or mean difference with 95% confidence intervals.

Ethics and dissemination:

Ethical approval is not required, as this study is based on the review of published research. This review will be published in a peer-reviewed journal and disseminated both electronically and in print.

INPLASY registration number:

INPLASY2020110055
Relationship of the lunar cycle with Down's syndrome screening and its effects
Authors: Yan Kun , Men Juan , Wang Yang , Zhong Lanjun
Published: December 2020

The present study aimed to analyze the positive rate of Down syndrome in second-trimester pregnant women in 1 lunar cycle and calculate variation coefficients of daily person numbers and daily positive rates in this population so as to explore the relationship of the lunar cycle with Down syndrome screening and its effects.

Data and laboratory results of 51,450 second-trimester pregnant women who underwent Down syndrome screening between May 2013 and June 2017 of the Chinese lunar calendar were collected. The patients were allocated into groups according to the time period of the lunar cycle based on the start date of their last menstruation. In the Chinese lunar calendar, 1 lunar cycle is divided into eight time periods. The positive rate of Down syndrome in pregnant women with the same start date of last menstruation and changes in their variation coefficients of daily person numbers and daily positive rates were analyzed.

The findings displayed the lowest positive rate of Down syndrome in the group of pregnant women who had the start date of last menstruation within the full-moon time period. The greatest variation coefficients of daily person numbers and daily positive rates were also found in the same group.

The study showed that the moon indeed affected pregnant women, and the effect reached the peak by the full moon. The effect interfered with the body homeostasis of pregnant women to a certain degree. Therefore, the relationship of the lunar cycle with Down syndrome screening reflected the interaction of the moon with the homeostasis of pregnant women.
Efficacy and safety of Shenkang injection as adjuvant therapy in patients with diabetic nephropathy
Authors: Wang Yanping , Li Mingzhu , Li Chenyun , Xu Sheng , Wu Jiangfeng , Zhang Gaochuan , Cai Yuanyuan
Published: December 2020

Background:

Diabetic nephropathy is a frequent microvascular complication of diabetes mellitus that causes end-stage renal disease most of the time. In China, Shenkang injection is one of widely used traditional Chinese medicine for treating chronic kidney disease, but its efficacy and safety have not yet been clarified. We will systematically review the current randomized controlled trial (RCT) evidence to summarize the efficacy and safety of Shenkang injection in treating diabetic nephropathy.

Methods:

We will search 7 literature databases including PubMed, EMBASE, Cochrane Library, Sinomed, Chinese National Knowledge Infrastructure, Wanfang, and VIP. Two trial registry platforms will also be searched. The time frame of the search will be from the inceptions of the databases to December 31, 2020. RCTs assessing Shenkang injection combined with basic treatments versus basic treatments alone for treating diabetic nephropathy will be included. The risk of bias within the individual RCTs will be evaluated using criteria proposed by the Cochrane Handbook 5.1.0. The primary outcomes to be investigated are glomerular filtration rate and serum creatinine; the secondary outcome will include 24-hour urine albumin excretion rate, blood urea nitrogen, fasting blood glucose, postprandial blood glucose, hemoglobin A1c, total cholesterol, triglyceride, response to treatment, and incidence of adverse events. The effect data of individual RCTs by performing random-effects model meta-analysis. Statistical heterogeneity will be measured by the Cochran Q test and I-squared statistics. Three subgroup analyses, set based on clinical experience, will be performed to explore the sources of heterogeneity. Sensitivity analyses excluding RCTs with high risk of bias and using fixed effect model will be done to test the robustness of the meta-analytic results. Publication bias across included RCTs will be evaluated by funnel plots and Egger test.

Results:

This study will provide systematic review on the efficacy and safety of Shenkang Injection as adjuvant therapy in patients with diabetic nephropathy by rigorous quality assessment and reasonable data synthesis. The results will be submitted to a peer-reviewed journal for publication.

Conclusion:

This systematic review will provide the best evidence currently on Shenkang Injection as adjuvant therapy in patients with diabetic nephropathy.

INPLASY registration number:

INPLASY2020110014.
Altered serum levels of IL-36 cytokines (IL-36α, IL-36β, IL-36γ, and IL-36Ra) and their potential roles in Guillain-Barré syndrome
Authors: Zhao Zhikang , Zhang Rui , Gao Xinxin , Li Hui , Liu Hongbo
Published: December 2020

Guillain-Barré syndrome (GBS) is an acute autoimmune neurological disorder mainly involving the peripheral nerves. Currently, various cytokines have been shown to be involved in the pathogenesis of GBS. Because of their similar biological structures, interleukin (IL)-36α, IL-36β, IL-36γ, and IL-36 receptor antagonist (Ra) were all renamed and collectively called IL-36 cytokines. The roles of IL-36 cytokines in GBS currently remain unclear.

Forty-two patients with GBS and 32 healthy volunteers were included in our study. Serum IL-36α, β, γ, and interleukin-36 receptor antagonist (IL-36Ra) levels of patients with GBS in the acute and remission phases and healthy volunteers were measured by enzyme-linked immunosorbent assay (ELISA). In addition, we examined the serum levels of other inflammatory factors that have been shown to be involved in GBS pathogenesis, represented by IL-17 and tumor necrosis factor-α (TNF-α). Furthermore, the correlations between the serum levels of IL-36 cytokines and different clinical data or the serum levels of other inflammatory factors in GBS patients were analyzed.

Significantly higher serum IL-36α and IL-36γ levels were measured in the acute phase than in the remission phase and in healthy control (HC) subjects (P < .05), while lower serum IL-36Ra levels were measured in the acute phase than in the remission phase and in HC subjects (P < .05). Serum IL-36α and IL-36γ levels were positively correlated with GBS disability scale scores (GDSs), while serum IL-36Ra levels were negatively correlated with GDSs. Correlation analyses among inflammatory factors showed that serum IL-36α and IL-36γ levels in GBS patients were positively correlated with serum IL-17 and TNF-α levels, while serum IL-36Ra levels were negatively correlated with the levels of these 2 inflammatory factors. Similar results were observed in cerebrospinal fluid (CSF), IL-36α and IL-36γ levels in CSF were positively correlated with GDSs, while IL-36Ra levels in CSF were negatively correlated with GDSs. Additionally, the serum and CSF levels of IL-36α and IL-36γ in the axonal subtype of GBS patients were higher than those in the demyelination subtype.

Based on our findings, IL-36 cytokines may be involved in the pathogenesis of GBS and some of these cytokines may help predict the disease severity and other clinical characteristics of GBS.
Comorbidities associated with different levels of total cholesterol in male and female acute ischemic stroke patients
Authors: Brechtel Leanne , Poupore Nicolas , Stoikov Teodora , Roley Laurie Theriot , Emerson John F. , Nathaniel Thomas
Published: December 2020

Men and women differ in their clinical risk factors with respect to various predictors of severity in acute ischemic stroke (AIS). High cholesterol is a risk factor for AIS and the mechanism by which high cholesterol levels lead to an AIS is well established. However, the specific relationship between demographic, clinical risk factors, total cholesterol, and the resulting gender difference in AIS patients is yet to be investigated. This study recruited AIS patients between January 2000 and June 2016 classified into normal, borderline or high total cholesterol (TC). Normal was defined as ≤200 mg/dl, borderline 200 to 239 mg/dl and high ≥240 mg/dl based on Adult Treatment Panel III (ATP III) Guidelines for the classification of TC levels. The logistic regression model was used to predict clinical risk factors associated within men and women AIS patients with different levels of TC. A total of 3532 AIS patients presented with normal TC, 760 patients with borderline TC and 427 patients with high TC. The high total cholesterol group was more likely to be women with increasing age (OR = 1.028, 95% CI, 1.006–1.052,P = .014), body mass index (BMI) (OR = 1.052, 95% CI, 1.004–1.102,P = .033), and high-density lipoprotein cholesterol (HDL-C) (OR = 1.039, 95% CI, 1.019–1.060,P < .001), while those with coronary artery disease (OR = 0.435, 95% CI, 0.234–0.809,P = .003), history of drug or alcohol abuse (OR = 0.261, 95% CI, 0.079–0.867,P = .028), increasing INR (OR = 0.187, 95% CI, 0.047–0.748,P = .018), and elevated diastolic blood pressure (OR = 0.982, 95% CI, 0.970–0.995,P = .006) were associated with being a male AIS patient. There were disparities in demographic and clinical risk factors associated with high TC levels in men when compared to women and more clinical risk factors were associated with high TC levels in men when compared to women with AIS. It is important to take into account specific clinical risk factors associated with gender-related differences in total cholesterol in AIS population to facilitate personalizing their therapeutic actions.
Intravenous vs intraosseous adrenaline administration in cardiac arrest
Authors: Zhang Wei , Liu Yi , Yu Jing , Li Dongze , Jia Yu , Zhang Qin , Gao Yongli , Liao Xiaoyang
Published: December 2020

Introduction:

Cardiac arrest refers to the sudden termination of cardiac ejection function due to various causes. Adrenaline is an important component of resuscitation among individuals experiencing cardiac arrest. The adrenaline delivery method chiefly involved intraosseous infusion and intravenous access. However, the impact of different adrenaline delivery methods on cardiac arrest has been unclear in previous research. Thus, the present study aimed to synthesize the available evidence regarding intravenous vs intraosseous adrenaline administration in cardiac arrest.

Methods and analysis:

We will search PubMed, EMBASE, Cochrane Library, Wanfang, and China National Knowledge Infrastructure. As per the inclusion criteria, randomized controlled trials (RCTs) on adrenaline administration in cardiac arrest were selected. The primary outcome was prehospital restoration of spontaneous circulation (ROSC); the secondary endpoints were survival, favorable neurological outcome at discharge, and poor neurological outcome at ≥3 mon.

We plan to use the Cochrane Collaboration's tool for assessing the bias risk for RCTs. The Grading of Recommendations Assessment, Development and Evaluation approach will grade the certainty of the evidence for all the outcome measures across studies. RevMan 5.3.5 will be used for meta-analysis. If the heterogeneity tests show slight or no statistical heterogeneity, the fixed effects model will be used, in other cases, the random effect model will be used for data synthesis.

Results and conclusion:

This protocol will determine which epinephrine delivery method is the optimal in the management of cardiac arrest. Our findings will help clinicians and health professionals in making accurate clinical decisions about adrenaline administrations in cardiac arrest.

Ethics and dissemination:

Ethical approval was not required because this study was planned as a secondary analysis. The results will be disseminated in peer-reviewed publications, journals, and academic.

INPLASY registration number:

INPLASY202090100 (DOI:10.37766/inplasy2020.9.0100).
Clinical evaluation of arthrodesis with Ilizarov external fixator for the treatment of end-stage ankle osteoarthritis
Authors: Ma Nan , Li Zhi , Li Delei , Hu Yehua , Sun Ning
Published: December 2020

To analyze the efficacy of arthrodesis with Ilizarov external fixator for the treatment of end-stage ankle osteoarthritis.

This retrospective study included 88 patients with end-stage (stage-3) ankle osteoarthritis according to Morrey–Wiedeman classification who underwent arthrodesis with Ilizarov external fixator from January 2016 to January 2019. There were 47 males and 41 females with a mean age of (57.21 ± 7.12) years old (range 49–76). Outcomes were measured by the American Orthopaedic Foot and Ankle society (AOFAS) Ankle Hindfoot Scale, Visual Analog Scale (VAS) pain scores, complications, subjective satisfaction, ankle function, correction of deformity, and complications.

With an average follow-up of (13.50 ± 5.41) months (range 10–21), all 88 patients returned for final follow-up. All patients achieved bony healing with a success rate of 100%. Mean postoperative healing time (3.56 ± 1.04) months (range 3–6). Two patients developed sinus tract infection, delayed healing in 1 patient, and 2 patients had pain and swelling again in the ankle joint. No serious complications occurred in other patients. All the patients evaluated with the VAS scores and AOFAS scores at final follow-up showed significant improvement (P < .05). Through imaging analysis, medical tibial talar angle (MTTA) improved from (85.76 ± 6.01) degrees to (88.98 ± 1.35) degrees postoperative. Lateral talar station (LTS) decreased from (5.32 ± 3.81) mm to (2.71 ± 2.62) mm after operation (P < .05). The overall satisfaction of patients is 88.64%.

In the treatment of end-stage ankle osteoarthritis, arthrodesis with Ilizarov external fixator can achieve good radiological and clinical outcomes with low prevalence of ankle joint malalignment and high fusion rates and satisfaction.
Evidence of Widespread Mechanical Hyperalgesia but Not Exercise-Induced Analgesia in Athletes With Mild Patellar Tendinopathy Compared With Pain-Free Matched Controls
Authors: Plinsinga Melanie Louise , Meeus Mira , Brink Michel , Heugen Nienke , van Wilgen Paul
Published: December 2020

Objective

The aim of the study was to assess centrally induced pain processing with pressure pain thresholds bilaterally and remotely in active volleyball and basketball athletes with mild patellar tendinopathy compared with asymptomatic control athletes. Secondary objective was to explore the role of exercise-induced analgesia during a training session in athletes with patellar tendinopathy.

Design

In this exploratory study, pressure pain thresholds of 21 patellar tendinopathy athletes and 16 age- and sex-matched asymptomatic team members were measured by a blinded assessor bilaterally on the patellar tendon and unilaterally on the elbow extensor tendon with a pressure algometer before, during, and after a regular training session.

Results

Patellar tendinopathy athletes had a significantly higher average body mass index compared with asymptomatic athletes (mean difference 1.75 kg/m2; 95% confidence interval = 0.35–3.15, P = 0.02). At baseline, athletes with patellar tendinopathy showed lowered pressure pain thresholds in the affected knee (P = 0.001), unaffected knee (P < 0.001), and elbow (P = 0.01) compared with controls. No clear patterns were identified to explain between-group differences in pressure pain thresholds before, during, and after exercise.

Conclusions

This exploratory study found primary and secondary mechanical hyperalgesia in athletes with patellar tendinopathy compared with asymptomatic athletes. Further research is required on the effects of an acute exercise bout on pain thresholds in this population.
A Randomized Controlled Trial Examining the Impact of an Anorectal Surgery Multimodal Enhanced Recovery Program on Opioid Use
Authors: Reif de Paula Thais , Nemeth Samantha K. , Kurlansky Paul A. , Simon Hillary L. , Miller Lydia K. , Keller Deborah S.
Published: December 2020

Background:

Anorectal cases may be a common gateway to the opioid epidemic. Opioid reduction is inherent in enhanced recovery after surgery (ERAS) protocols, but little work has evaluated ERAS in these cases.

Objective:

To determine if ERAS could reduce postoperative opioid utilization in ambulatory anorectal surgery without sacrificing patient pain or satisfaction.

Methods:

A randomized controlled trial assigned ambulatory anorectal patients to ERAS (experimental) or routine care (surgeon's choice) for pain management (control) over 30-days postoperatively. Primary outcome was overall days of opioid use. Secondary outcomes included pain and satisfaction scores over multiple time points and new persistent opioid use. The Visual Analog Scale, Functional Pain Scale, and EQ-5D-3L measured patient-reported pain and satisfaction. Univariate analysis compared outcomes overall and at individual time points. Two-way mixed ANOVA evaluated pain and satisfaction measures between groups and over time.

Results:

Thirty-two patients were randomized into each arm (64 total). The control group consumed significantly more opioids after discharge (median 121.3MME vs 23.5MME, P < 0.001). Significantly more control patients requested additional narcotics (P  =  0.004), made unplanned calls (P = 0.009), and had unplanned clinic visits (P = 0.003). The control group had significantly more days on opioids (mean 14.4 vs 2.2, P < 0.001). Three control patients (9.4%) versus no experimental patients had new persistent opioid use. The mean global health, EQ5D-3L, Visual Analog Scale, and Functional Pain scores were comparable between groups over time.

Conclusions:

An ERAS protocol in ambulatory anorectal surgery is feasible, and resulted in reduced opioid use, and healthcare utilization, with no difference in pain or patient satisfaction. This challenges the paradigm that extended opioids are needed for effective postoperative pain management.
Is Initial Board Certification Associated With Better Early Career Surgical Outcomes?
Authors: Kendrick Daniel E. , Chen Xilin , Jones Andrew T. , Clark Michael , Fan Zhaohui , Bandeh-Ahmadi Hoda , Wnuk Greg , Kopp Jason P. , Moreno Beatriz Ibanez , Scott John W. , Sandhu Gurjit , Buyske Jo , Dimick Justin B. , George Brian C.
Published: December 2020

Objective:

To determine if initial American Board of Surgery certification in general surgery is associated with better risk-adjusted patient outcomes for Medicare patients undergoing partial colectomy by an early career surgeon.

Background:

Board certification is a voluntary commitment to professionalism, continued learning, and delivery of high-quality patient care. Not all surgeons are certified, and some have questioned the value of certification due to limited evidence that board-certified surgeons have better patient outcomes. In response, we examined the outcomes of certified versus noncertified early career general surgeons.

Methods:

We identified Medicare patients who underwent a partial colectomy between 2008 and 2016 and were operated on by a non-subspecialty trained surgeon within their first 5 years of practice. Surgeon certification status was determined using the American Board of Surgery data. Generalized linear mixed models were used to control for patient-, procedure-, and hospital-level effects. Primary outcomes were the occurrence of severe complications and occurrence of death within 30 days.

Results:

We identified 69,325 patients who underwent a partial colectomy by an early career general surgeon. The adjusted rate of severe complications after partial colectomy by certified (n = 4239) versus noncertified (n = 191) early-career general surgeons was 9.1% versus 10.7% (odds ratio 0.83, P = 0.03). Adjusted mortality rate for certified versus noncertified early-career general surgeons was 4.9% versus 6.1% (odds ratio 0.79, P = 0.01).

Conclusion:

Patients undergoing partial colectomy by an early career general surgeon have decreased odds of severe complications and death when their surgeon is board certified.
Microbe Profile: Aquifex aeolicus: an extreme heat-loving bacterium that feeds on gases and inorganic chemicals
Authors: Guiral Marianne , Giudici-Orticoni Marie-Thérèse
Published: December 2020

The bacterium ‘

Aquifex aeolicus

’ is the model organism for the deeply rooted phylum

Aquificae

. This ‘water-maker’ is an H2-oxidizing microaerophile that flourishes in extremely hot marine habitats, and it also thrives on the sulphur compounds commonly found in volcanic environments. ‘

A. aeolicus

’ has hyper-stable proteins and a fully sequenced genome, with some of its essential metabolic pathways deciphered (including energy conservation). Many of its proteins have also been characterized (especially structurally), including many of the enzymes involved in replication, transcription, RNA processing and cell envelope biosynthesis. Enzymes that are of promise for biotechnological applications have been widely investigated in this species. ‘

A. aeolicus

’ has also added to our understanding of the origins of life and evolution.
Isolated sulfite oxidase deficiency: a founder mutation
Authors: Mhanni Aizeddin A. , Greenberg Cheryl R. , Spriggs Elizabeth L. , Agatep Ronald , Sisk Reena Ray , Prasad Chitra
Published: December 2020

Isolated sulfite oxidase deficiency is a rare autosomal recessive inborn error of sulfur metabolism. Clinical features generally include devastating neurologic dysfunction, ectopia lentis, and increased urinary excretion of sulfite, thiosulfate, and S-sulfocysteine. Missed diagnosis is not unusual because of variability in the sensitivity of the urinary sulfite and thiosulfate screening test. We present clinical, biochemical, and molecular data on two unrelated patients with isolated sulfite oxidase deficiency. The two patients belong to an Indigenous genetic isolate in Manitoba, Canada. Both patients (one male and one female, both now deceased) developed neonatal seizures and demonstrated progressive neurodevelopmental delay. Based on increased urinary excretion of sulfite, thiosulfate, and S-sulfocysteine and normal serum uric acid levels, sulfite oxidase deficiency was suspected. Both patients have a homozygous 4-bp deletion, 1347–1350delTTGT in the sulfite oxidase gene (SUOX), predicting a premature termination of the sulfite oxidase protein leading to absence of the carboxy-terminal third portion of the protein. This domain contains most of the contact sites essential for enzyme dimerization. This deletion mutation resulted in sulfite oxidase deficiency with early-onset severe clinical phenotype.
Green energy platform economics – understanding platformization and sustainabilization in the energy sector
Authors: Menzel Tobias , Teubner Timm
Published: December 2020

Purpose

This paper aims to present a conceptual framework for the emerging field of green energy platform economics.

Design/methodology/approach

The authors develop a conceptual framework based on a careful review of the existing literature, and research into the current provider landscape and insights from academic and industry experts. The authors also examine the implications for the energy sector’s value chain and derive a research agenda based on those areas where research still needs to be pursued.

Findings

The framework combines the spatial characteristics of platform models (residential/mobile) with the different types of platform business model (B2C/C2C/C2Grid). Using this framework, the authors illustrate how green energy platforms can fundamentally disrupt the conventional electricity value chain by enabling prosumers to market their assets, creating new arenas for trading and collaboration, and by increasing transparency and competition in the sector. The authors also identify areas where more research is required, particularly empirical studies into energy forms other than electricity and analyses of currently underrepresented aspects such as user interfaces and social interactions.

Social implications

Green energy platforms have the potential to contribute meaningfully to the energy sector’s decarbonization, digitalization and decentralization, and hence to the deceleration of climate change.

Originality/value

This paper is among the first to provide a holistic perspective on platformization in the energy sector. It also offers a new perspective on platform economics in general that is based on the unique characteristics of energy as an economic good (intangibility, homogeneity, credence good).
CEO's education and investment–cash flow sensitivity: an empirical investigation
Authors: Gupta Gaurav , Mahakud Jitendra , Verma Vivek
Published: December 2020

Purpose

The purpose of this study is to examine the impact of financial and technical education of chief executive officer (CEO) on investment–cash flow sensitivity (ICFS) of Indian manufacturing firms.

Design/methodology/approach

The study uses the dynamic panel data model and more specifically, the system-generalized method of moments (GMM) technique to investigate the effect of CEOs' education on ICFS of Indian manufacturing firms during the period 1998–1999 to 2016–2017.

Findings

The study shows that financial (technical) education of CEOs does (not) affect ICFS. The results explain that the role of the CEO's education in ICFS is highly significant during the crisis period. The robustness test depicts that the influence of financial education on ICFS is less (more) for group-affiliated and large-sized firms (stand-alone and small-sized firms). Further, the CEO's education is significantly associated with corporate investment decisions.

Research limitations/implications

Due to the unavailability of the CEO's compensation data for the selected sample, future research could explore the impact of CEO's education with respect to CEO's compensation on ICFS.

Practical implications

First, the authors find that financially educated CEOs affect ICFS; therefore, firms should take care of CEO's education during recruitment of CEOs. Second, lending agencies should also consider the educational background of the CEO before approval of funding to make it safe. Third, investors should keep in mind the educational background of the CEO for the growth of their investment as it may be easier for financially educated CEOs to borrow from the market at the time of requirement.

Originality/value

This study contributes to the existing literature by providing empirical evidence through analyzing the impact of a CEO's education on ICFS in the context of India. This study is very unique in itself as it uses the sample of manufacturing sectors of India, which are growing very fast and attracting global investors to create a global hub of manufacturing in India. This study also considers different types of education such as financial and technical education of CEOs in the context of a developing economy like India. This study made its findings robust across company characteristics and periods based on the financial crisis.
Impact of Big Five personality traits on authentic leadership
Authors: Shahzad Khurram , Raja Usman , Hashmi Syed Danial
Published: December 2020

Purpose

The bulk of the current research on authentic leadership focuses on the examination of its consequences. Little attention has been paid to the predictors of authentic leadership. We examined how the Big Five personality traits can predict an authentic leadership style.

Design/methodology/approach

Using multisource time-lagged data from 305 leader–subordinate dyads, we examined how the Big Five traits (extraversion, agreeableness, consciousness, openness to experience and neuroticism) are related to authentic leadership. While leader personality was measured through self-reports, we measured authentic leadership style through subordinate reported data.

Findings

We found good support for the proposed hypotheses. While extraversion, agreeableness, conscientiousness and openness to experience were positively related to authentic leadership style, neuroticism was negatively related to it.

Practical implications

The findings support the trait view of leadership, suggesting that the personality traits of a leader can predict his/her authentic leadership style. These findings hold promise for managers in that they can use personality inventories and tests in the selection and evaluation process to select and train potential authentic leaders.

Originality/value

We proposed a unique idea and tested it using leader–subordinate dyadic data that are time-lagged to test our hypotheses.
Farm Diversification: Drivers, Barriers and Future Growth Potential
Authors: Jack Claire , Ashfield Austen , Adenuga Adewale Henry , Mullan Conall
Published: December 2020

Family farm businesses throughout Europe are facing new economic, environmental and social challenges. In order to deliver a more resilient primary agriculture sector, national and regional governments are identifying mechanisms to support farm businesses to adapt to these changing demands. This qualitative study explored the drivers of and barriers to farm diversification and its potential as a strategy to make farms more sustainable. Although there are a range of farm diversification strategies being pursued regionally, farm diversification is under‐exploited as an opportunity to achieve additional household income. Areas considered to have the potential for growth included, agri‐tourism, care services (including social farming), professional services and developing artisan food products. Beyond the need to generate new income sources, creating employment for other family members was considered an important motivation. Those factors identified as constraints to diversification included internet access, planning, business rates, support around skills development, networks and a farmer's own fear of failure. For smaller scale, family farm businesses located in more marginal areas, there is a need to identify a range of policy levers which support local farming systems and capture the multifaceted nature of the products and services that these farm businesses could provide and may be asked to deliver in the future.
Reaching under‐screened/never‐screened indigenous peoples with human papilloma virus self‐testing: A community‐based cluster randomised controlled trial
Authors: MacDonald Evelyn Jane , Geller Stacie , Sibanda Nokuthaba , Stevenson Kendall , Denmead Lorna , Adcock Anna , Cram Fiona , Hibma Merilyn , Sykes Peter , Lawton Bev
Published: December 2020

Background

Indigenous women in the high‐income countries of Canada, Australia, New Zealand and USA, have a higher incidence and mortality from cervical cancer than non‐Indigenous women. Increasing cervical screening coverage could ultimately decrease cervical cancer disparities.

Aims

To increase cervical screening for under‐screened/never‐screened Māori women.

Materials and Methods

This study was a cluster randomised controlled trial. Inclusion criteria were women aged 25–69, last screened ≥4 years ago, in Northland, New Zealand. The intervention arm was the offer of a human papilloma virus (HPV) self‐test and the control arm was the usual offer of standard care – a cervical smear. The primary outcome was rate of cervical screening in the intervention group compared to control in Māori, the Indigenous peoples of New Zealand. Six primary care clinics were randomly allocated to intervention or control.

Results

Of 500 eligible Māori women in the intervention arm, 295 (59.0%) were screened. Of 431 eligible Māori women in the control arm, 94 (21.8%) were screened. Adjusting for age, time since last screen, deprivation index, Māori women in the intervention arm were 2.8 times more likely to be screened than women in the control arm (95% CI: 2.4–3.1, P‐value <0.0001).

Conclusions

Offer of HPV self‐testing could potentially halve the number of under‐screened/never‐screened Māori women and decrease cervical morbidity and mortality. These results may be generalisable to benefit Indigenous peoples facing similar barriers in other high‐income countries.