bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic issue emphasis in parties’ election campaign statements
Authors: Baumann Markus , Debus Marc , Gross Martin
Published: August 2019

Parties should develop a consistent issue profile during an electoral campaign. Yet, manifestos, which form the baseline for a party’s programmatic goals in the upcoming legislative period, are usually published months before Election Day. We argue that parties must emphasize policy issues that are of key relevance to their likely voters in the last weeks of the election campaign, in which an increasing share of citizens make up their minds in terms of which party they will choose. To test this notion empirically, we draw on a novel data set that covers information on party representatives’ statements made during the final weeks of an election campaign in nine European countries. Focusing on the campaign messages of social democratic and socialist parties, we find that these parties indeed intensify their emphasis of unemployment policy, which is a salient issue for their core voter clienteles, particularly in times of economic hardship.
Effectiveness of social media marketing on enhancing performance: Evidence from a casual-dining restaurant setting
Authors: Li Jun (Justin) , Kim Woo Gon , Choi Hyung Min
Published: August 2019

Social media sites serve as lead generators for achieving marketing communication and raising brand awareness for casual-dining restaurant firms. This study attempts to measure social media engagement across different social networking sites (SNSs) and promotional activities for the casual-dining restaurant industry. This study also explores the influence of the dimensionality of social media engagement on the performance of casual-dining restaurants. The findings show that the metrics of social media engagement are different across channels and promotional activities. The results also reveal that these metrics have significant positive impacts on casual-dining restaurant performance. Pragmatically, the findings provide an assessment that enables casual-dining restaurant marketers to select the most effective SNSs and implement the most appropriate promotional activities, given the limited marketing budget of small and medium-sized casual-dining restaurants.
Classroom teachers’ and administrators’ views of teaching health and physical education
Authors: Banville Dominique , Dyson Ben , Kulinna Pamela H , Stylianou Michalis
Published: August 2019

Teacher efficacy influences what and how they teach. This may be particularly important to consider in Aotearoa New Zealand contexts where primary classroom teachers teach health and physical education and use physical activity breaks with little training. It remains unclear how classroom teachers perceive this role and how to better support them. The purpose of this study was to investigate classroom teachers’ and administrators’ views of teaching health and physical education, including physical activity behaviours, in primary schools in Aotearoa New Zealand. Participants were 10 teachers and three administrators from two schools selected as a purposive sample. Data were collected through formal interviews, field notes, and photographs, and were analysed using inductive analysis and constant comparison. The findings are shared using four themes: (a) support for physical activity breaks; (b) support for curriculum content in health and physical education and ‘Kiwi’ sport culture; (c) teachers’ influence level; and (d) school environment. Overall, teachers and administrators felt very efficacious in their roles of creating healthy and active schools. These teachers also appeared to be confused regarding the difference between physical education, sport, and physical activity. They did feel, however, that instructional self-efficacy could be improved through enhanced content and pedagogy taught in teacher education programmes, and increased opportunities for professional learning and development. Potentially, this could lead to more time spent teaching the health and physical education content as well as a greater focus on the national curriculum for health and physical education being taught in Aotearoa New Zealand.
Prediction of railway wheel load unbalance induced by air suspension leveling valves using quasi-steady curve negotiation analysis procedure
Authors: Tanaka Takayuki , Sugiyama Hiroyuki
Published: August 2019

While air suspensions are widely utilized for passenger railway vehicles as secondary suspension, initial lever angle setting of the air spring levelling valve can make a non-negligible impact on the residual wheel load unbalance in curve negotiation on small radius curved tracks. To enable accurate and quick prediction of the levelling valve-induced residual wheel load unbalance for vehicle safety evaluation, this study proposes a new quasi-steady curve negotiation analysis procedure considering the detailed thermodynamic air suspension system model that accounts for the nonlinear airflow characteristics of levelling valve and differential pressure valves. This approach allows for eliminating a limitation of existing full dynamic simulation models associated with high computational intensity that prevents quick safety evaluation with long-distance simulation under actual railway operating scenarios. A co-simulation scheme for the quasi-steady vehicle motion solver is also proposed to further improve the computational efficiency with explicit force–displacement coupling. Several numerical examples are presented to demonstrate the proposed quasi-steady vehicle motion solver for prediction of levelling valve-induced residual wheel load unbalances in small radius curved tracks. The numerical results are compared with those of the dynamic simulation model and validated against the test data. It is demonstrated that computational time is substantially decreased by the proposed approach while accurately predicting the levelling valve-induced residual wheel load unbalance caused by the initial offset of lever angles on small radius curved tracks.
A call to find knowledge in our non-findings
Authors: Hill Aaron D , Bolton Joel F , White Margaret A
Published: August 2019

Management publications are dominated by studies that offer statistical evidence in support of theorized relationships (i.e. p < .05). We contend that important advancements to our understanding can be gained by well-conducted studies that result in so-called “non-findings” (i.e. p > .05). Our essay not only highlights the necessity of moving beyond current publication practices, but we also issue a call to begin publishing research studies that advance knowledge, effectively leverage data, and comprehensively emphasize implications for both scholars and practitioners.
Academic Success for Students in Postsecondary Education: The Role of Student Characteristics and Integration
Authors: Goegan Lauren D. , Daniels Lia M.
Published: August 2019

Academic success is an important issue as employers are looking for individuals with a postsecondary education. But there are many important indicators of success besides grades. We conceptualized academic success at postsecondary as grade point average, acquisition of knowledge and skills, and overall satisfaction and examined how each conceptualization was predicted by student characteristics (perceived academic ability and drive to achieve) and experiences (academic and social integration). Using a 1-year longitudinal design, we found that perceived academic ability had a positive direct effect on grade point average and acquisition of knowledge and skills but not satisfaction, whereas drive had no direct relationships with the outcomes. Academic integration positively predicted all three indicators of success grades, but social integration was not associated with grades. Indirect effects were also noted. Our discussion highlights actions that postsecondary institutions can take to support students and considers how researchers should conceptualize student success.
The Effect of Acupuncture in Breast Cancer–Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis
Authors: Chien Tsai-Ju , Liu Chia-Yu , Fang Ching-Ju
Published: August 2019

Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.
Barriers to a full scope of pharmacy practice in primary care: A systematic review of pharmacists’ access to laboratory testing
Authors: Donovan Jacqueline , Tsuyuki Ross T. , Al Hamarneh Yazid N. , Bajorek Beata
Published: August 2019

Objectives:

To describe primary care pharmacists’ current scope of practice in relation to laboratory testing.

Method:

A 2-tiered search of key databases (PubMed, EMBASE, MEDLINE) and grey literature with the following MeSH headings: prescribing, pharmacist/pharmacy, laboratory test, collaborative practice, protocols/guidelines. We focused on Canada, the United States, the United Kingdom, New Zealand and Australia for this review.

Results:

There is limited literature exploring primary care pharmacists’ scope of practice in relation to laboratory testing. The majority of literature is from the United States and Canada, with some from the United Kingdom and New Zealand and none from Australia. Overall, there is a difference in regulations between and within these countries, with the key difference being whether pharmacists access and/or order laboratory testing dependently or independently. Canadian pharmacists can access and/or order laboratory tests independently or dependently, depending on the province they practise in. US pharmacists can access and/or order laboratory tests dependently within collaborative practice agreements. In the United Kingdom, laboratory testing can be performed by independent prescribing pharmacists or dependently by supplementary prescribing pharmacists. New Zealand prescribing pharmacists can order laboratory testing independently. Most publications do not report on the types of laboratory tests used by pharmacists, but those that do predominantly resulted in positive patient outcomes.

Discussion/Conclusion:

Primary care pharmacists’ scope of practice in laboratory testing is presently limited to certain jurisdictions and is often performed in a dependent fashion. As such, a full scope of pharmacy services is almost entirely unavailable to patients in the United States, the United Kingdom, New Zealand and Australia. Just as in the case for pharmacists prescribing, evidence indicates better patient outcomes when pharmacists can access/order laboratory tests, but more research needs to be done alongside the implementation of local guidelines and practice standards for pharmacists who practise in that realm. Patients around the world deserve to receive a full scope of pharmacists’ practice, and lack of access to laboratory testing is one of the major obstacles to this. Can Pharm J (Ott) 2019;152:xx-xx.
Questionable authorship and the problem of dirty hands: throwing missing authorship into the ring. In response to both Bulow and Helgesson, and Tang
Authors: Ranieri Veronica
Published: August 2019

The unethical practice of gift authorship and hostage authorship was portrayed in detail in previous issues of Research Ethics. The aim of this short article is to explore the impact of penalising junior researchers for partaking in gift authorship, and the occurrence and implications of missing authorship in publication. It concludes with reflections on current guidelines and suggestions put forth by Bulow and Helgesson, and Tang, and potential strategies for counteracting the frequency with which both occur.
Chemical Constituents, Biological Properties, and Uses of Tribulus terrestris: A Review
Authors: Semerdjieva Ivanka B. , Zheljazkov Valtcho D.
Published: August 2019

Tribulus terrestris L. (TT) (puncturevine) is a common weed that grows in many countries worldwide and in some places is considered as a noxious weed. The plant has been used in traditional Chinese and Indian medicines and is now considered as one of the most popular aphrodisiacs. It is known for its healing properties for sexual difficulties, impotence, and human and animal hormonal imbalance. It is also used as a sexual booster. Because of the plant’s active substances that can be used for curing sexual and other disorders, interest in it is increasing, and it is currently one of the most studied medicinal plants. The products and preparations manufactured from the aboveground plant parts are especially popular among athletes and people with health issues and diseases such as hormonal imbalance, sexual problems, heart problems, and various kidney and skin diseases. The aim of this review is a comprehensive and critical assessment of the scientific publications involving TT, with special reference to its chemical constituents and biological properties that may facilitate current understanding and future studies of this fascinating plant species. The objectives of this review were (1) to find knowledge gaps, (2) to discuss critically relevant publications and issues with materials and methods that may be prerequisites for contradictory results, and (3) to identify research and development areas. It was found that some of the studies on TT extracts as aphrodisiacs are controversial. A significant number of research publications claim that TT extracts and nutritional supplements containing TT improve muscle tone, have a common biostimulating effect, and improve spermogenesis. However, there are a growing number of publications that dispute these claims, as there are no empirical data on commonly accepted mechanisms of action. The main biologically active substances in TT are steroidal saponins, flavonoids, alkaloids, and lignan amides, the most studied being the steroidal saponins. Multiyear data on the metabolic profile of the species are generally lacking. There are a variety of methods used for extracting plant material, differences in methodologies and saponin analyses, and scientific instruments that were used. Lack of common standards could be a reason for differences in the pharmacological activity and composition of the TT preparations. Development of standard procedures and methods for collection of plant material and analyses are recommended. Selection and breeding efforts and agronomic studies of promising clones of TT would need to be conducted in order to develop TT as a new crop. This will provide consistency of supply and quality of the feedstock for the pharmaceutical industry and could provide a new cash crop for growers.
First Clinical Application of Polyurethane Meniscal Scaffolds with Mesenchymal Stem Cells and Assessment of Cartilage Quality with T2 Mapping at 12 Months
Authors: Olivos-Meza Anell , Pérez Jiménez Francisco Javier , Granados-Montiel Julio , Landa-Solís Carlos , Cortés González Socorro , Jiménez Aroche Cesar Alejandro , Valdez Chávez Marco , Renán León Saúl , Gomez-Garcia Ricardo , Martínez-López Valentin , Ortega-Sánchez Carmina , Parra-Cid Carmen , Velasquillo Martinez Cristina , Ibarra Clemente
Published: August 2019

Background

Complex meniscal lesions often require meniscectomy with favorable results in the short term but a high risk of early osteoarthritis subsequently. Partial meniscectomy treated with meniscal substitutes may delay articular cartilage degeneration.

Purpose

To evaluate the status of articular cartilage by T2 mapping after meniscal substitution with polyurethane scaffolds enriched with mesenchymal stem cells (MSC) and comparison with acellular scaffolds at 12 months.

Methods

Seventeen patients (18-50 years) with past meniscectomies were enrolled in 2 groups: (1) acellular polyurethane scaffold (APS) or (2) polyurethane scaffold enriched with MSC (MPS). Patients in the MPS group received filgrastim to stimulate MSC production, and CD90+ cells were obtained and cultured in the polyurethane scaffold. The scaffolds were implanted arthroscopically into partial meniscus defects. Concomitant injuries (articular cartilage lesions or cartilage lesions) were treated during the same procedure. Changes in the quality of articular cartilage were evaluated with T2 mapping in femur and tibia at 12 months.

Results

In tibial T2 mapping, values for the MPS group increased slightly at 9 months but returned to initial values at 12 months ( P > 0.05). In the APS group, a clear decrease from 3 months to 12 months was observed ( P > 0.05). This difference tended to be significantly lower in the APS group compared with the MPS group at the final time point ( P = 0.18). In the femur, a slight increase in the MPS group (47.8 ± 3.4) compared with the APS group (45.3 ± 4.9) was observed ( P > 0.05).

Conclusion

Meniscal substitution with polyurethane scaffold maintains normal T2 mapping values in adjacent cartilage at 12 months. The addition of MSC did not show any advantage in the protection of articular cartilage over acellular scaffolds ( P > 0.05).
All Things Being Equal: Distinguishing Proportionality and Equity in Moral Reasoning
Authors: Skurka Chris , Winett Liana B. , Jarman-Miller Hannah , Niederdeppe Jeff
Published: August 2019

Moral foundations theory (MFT) has been a useful framework for understanding moral judgment and its relationship to political leaning. However, some have argued that MFT omits key domains of moral reasoning. We explored the utility of two candidate foundations (Proportionality and Equity) with a national sample of U.S. adults recruited through Nielsen’s Harris Panel, randomly split into calibration ( n = 1,499) and replication samples ( n = 1,499). We find that Proportionality and Equity are conceptually distinct from the original foundations (as measured in the Moral Foundations Questionnaire [MFQ]) but relate to them in predictable ways. Equity consistently predicted political leaning above and beyond covariates and the original foundations, but Proportionality only distinguished conservatives from liberals in the calibration sample, which suggests Proportionality may be highly relevant to moral judgments regardless of political ideology. Our findings also indicate potential bias when using one of the MFQ’s screener items to filter out unengaged participants.
Mutually reinforcing effects of genetic variants and interferon‐β 1a therapy for pulmonary arterial hypertension development in multiple sclerosis patients
Authors: Lerche Marianne , Eichstaedt Christina A. , Hinderhofer Katrin , Grünig Ekkehard , Tausche Kristin , Ziemssen Tjalf , Halank Michael , Wirtz Hubert , Seyfarth Hans‐Jürgen
Published: August 2019

Based on a small number of cases, interferon beta (IFN‐β) has been added to the list of drugs that might induce pulmonary arterial hypertension (PAH) in the current European guidelines for the diagnosis and treatment of pulmonary hypertension. Here, we propose that multiple sclerosis patients who are genetically predisposed to PAH may be at higher risk to develop disease when treated with IFN‐β. We included two patients with multiple sclerosis who developed a manifest PAH after five amd eight years on IFN‐β 1a therapy, respectively (without confirmed right heart catheterization). In both patients, PAH markedly improved after discontinuation of IFN‐β 1a and initiation of targeted PAH therapy. For genetic analysis, we used a PAH‐gene panel based on next‐generation sequencing of 16 PAH and 38 candidate genes. In one of the two patients, we could identify a nonsense variant in the PAH gene ATP13A3. The second patient showed a missense variant of the CYP1B1 gene, which might be linked to PAH predisposition. The results of this study support the hypothesis that multiple sclerosis patients who receive IFN‐β 1a therapy might be at higher risk for the development of manifest PAH, if they carry a pathogenic variant or sequence variant genetically predisposing to the disease. However, further studies are necessary to systematically investigate the presence of predisposing PAH gene variants in these patients.
Utility of tissue Xpert-Mtb/Rif for the diagnosis of intestinal tuberculosis in patients with ileocolonic ulcers
Authors: Bellam Balaji L , Mandavdhare Harshal S , Sharma Kusum , Shukla Siddharth , Soni Hariom , Kumar-M Praveen , Singh Harjeet , Prasad Kaushal K , Dutta Usha , Sharma Vishal
Published: August 2019

Introduction:

Data on the use of Xpert Mtb/Rif for the diagnosis of intestinal tuberculosis is sparse. We report on the utility of Xpert Mtb/Rif testing for diagnosis of intestinal tuberculosis (ITB) in patients with ileocecal ulcers

Methodology:

We performed a retrospective analysis of patients with ileocecal ulcers and suspected to have ITB and in whom testing of intestinal tissue for Xpert Mtb/Rif was performed. The patients were divided into two groups: those with a final diagnosis of intestinal tuberculosis and those with other diagnosis. These patients were compared for clinical features and presentation. The sensitivity, specificity, positive predictive value, and negative predictive value of Xpert Mtb/Rif for the diagnosis of ITB were calculated.

Results:

Of the 40 patients studied, 23 were women and the mean age was 32.92 ± 12.78 years. Abdominal pain was present in 33 (88.5%) patients and diarrhea in 12 (30%). A total of 25 patients had underlying ITB whereas 15 patients had other diagnoses (Crohn’s disease, amebiasis, nonspecific ileitis, etc.). The sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of GeneXpert-Mtb/Rif was 32% (CI: 14.95–53.50%), 100% (78.2–100), 46.88% (40.27–53.59%), 100 & 57.50 (40.89–72.89%) respectively.

Conclusion:

A positive GeneXpert-Mtb/Rif helps in the diagnosis of ITB, but the sensitivity is low.
Recruitment via social media: advantages and potential biases
Authors: Benedict Catherine , Hahn Alexandria L , Diefenbach Michael A , Ford Jennifer S
Published: August 2019

Background

Adolescent and young adult (AYA) cancer survivors are under-represented in research. Social media is increasingly used for recruitment given its ability to reach large audiences. Differences in participant characteristics and potential biases due to recruitment source are not well understood.

Purpose

This study aimed to: (a) compare recruitment strategies (hospital-based v. social media) in enrollment metrics, and (b) among enrolled participants, evaluate group differences in patient characteristics and patient reported outcomes (PROs).

Methods

Preliminary data from a cancer and fertility study with female AYAs were evaluated. Hospital-based recruitment used electronic medical records (EMR) to identify eligible patients. Social media recruitment involved posting on partner organizations’ social media outlets. PROs included validated measures related to the parent study. Descriptive statistics evaluated recruitment metrics. Independent samples t-tests and chi-square identified differences in participant characteristics and PROs based on recruitment.

Results

Social media yielded a higher enrollment rate (37%; n = 54/146) compared with hospital-based recruitment (7%; n = 21/289) and required fewer study resources. Compared with hospital-based recruitment, participants from social media were more likely to be White ( p = 0.01), with a longer time since treatment ( p = 0.03); and reported higher levels of reproductive concern ( p = 0.004) and negative mood ( p = 0.02), and more negative illness perceptions ( ps < 0.05).

Conclusion

Recruitment via social media may be a more effective and efficient strategy compared with hospital-based methods. However, group differences were identified that could bias findings and limit generalizability. Advantages of social media should be considered with an understanding of how methodology may impact enrollment and results.
Autonomic Cross-Innervation in Patients With Neurofibromatosis Type 2: Frey Syndrome and Unilateral Epiphora With Rhinorrhea
Authors: Evans Erica , Nascene David , Sommer Katherine , Moertel Christopher
Published: August 2019

The authors present 2 cases of cross-innervation in patients with neurofibromatosis type 2. In the first case, an iodine test was performed to demonstrate Frey syndrome in a 28-year-old female with neurofibromatosis type 2 who developed symptoms at age 10 years. The second patient is an 18-year-old female with neurofibromatosis type 2, 2 years status post left vestibular schwannoma subtotal resection who presented with paradoxical unilateral lacrimation and rhinorrhea triggered by heat stress and exercise. The pathophysiology of these cases is discussed.
Who Is Called by the Dog Whistle? Experimental Evidence That Racial Resentment and Political Ideology Condition Responses to Racially Encoded Messages
Authors: Wetts Rachel , Willer Robb
Published: August 2019

Do appeals that subtly invoke negative racial stereotypes shift whites’ political attitudes by harnessing their racial prejudice? Though widely cited in academic and popular discourse, prior work finds conflicting evidence for this “dog-whistle hypothesis.” Here we test the hypothesis in two experiments (total N = 1,797) in which white Americans’ racial attitudes were measured two weeks before they read political messages in which references to racial stereotypes were implicit, explicit, or not present at all. Our findings suggest that implicit racial appeals can harness racial resentment to influence policy views, though specifically among racially resentful white liberals. That dog-whistle effects would be concentrated among liberals was not predicted in advance, but this finding appears across two experiments testing effects of racial appeals in policy domains—welfare and gun control—that differ in the extent and ways they have been previously racialized. We also find evidence that the same group occasionally responded to explicit racial appeals even though these appeals were recognized as racially insensitive. We conclude by discussing implications for contemporary American politics, presenting representative survey data showing that racially resentful, white liberals were particularly likely to switch from voting for Barack Obama in 2012 to Donald Trump in 2016.
Patient empowerment and access to medicines: Insights from a scientist-patient suffering from erythropoietic protoporphyria
Authors: Barman-Aksözen Jasmin
Published: August 2019

Patient representation during the evaluation of medicines by key decision makers such as regulatory agencies, Health Technology Assessment bodies, and healthcare payers is increasingly considered to add value to the appraisals and empowers patients, which means that they gain a more powerful voice over decisions and actions affecting their own health. As I myself suffer from the ultra-rare condition erythropoietic protoporphyria (EPP), I have participated as a patient expert in several discussions on access to afamelanotide, which currently is the only treatment for EPP and was approved in the European Union (EU) in 2014. As a molecular biologist with a PhD in EPP research, I consider myself having the necessary requirements to meaningfully contribute to such assessments. In this article, I share my personal experiences with regard to the discussions on access in Germany and England at the respective national competent authorities, the Federal Joint Committee, and the National Institute for Health and Care Excellence, respectively. In addition, I discuss the insights of the International Porphyria Patient Network, a group of highly empowered EPP patients effectively supporting national patient communities in their efforts to enable access to the afamelanotide treatment in their countries.
Optimized clinical practice for superaged patients with hip fracture: significance of damage control and enhanced recovery program
Authors: Liu Zaiyang , Zhang Jun , He Kaiqi , Zhang Yumei , Zhang Yuan
Published: August 2019

With the advent of global aging, the incidence, mortality, and medical costs of hip fracture among aged patients are increasing annually. The number of controlled clinical studies and health economics analyses that conform to evidence-based medicine principles is growing day by day. However, unfortunately, no specific recommendations regarding the procedures for the treatment of hip fracture are available. Meanwhile, the existence of both traditional treatment systems and new treatment theories means that most doctors confront difficult choices in their daily practice. These factors make the therapeutic approach for aged patients, especially among superaged patients with hip fracture, extremely challenging. This study focuses on superaged patients (> 80 years as defined by the World Health Organization) with hip fracture and includes their preoperative pathological condition; therapeutic decision-making in terms of the benefit and risk ratio, damage control theory, and enhanced recovery after surgery were also investigated. These patients were discussed specifically by combining the current treatment strategies from several experts and the results of a meta-analysis published recently. The study presents some new ideas and approaches currently recognized in the field, such as preoperative assessment, surgical planning, safety consideration, complication intervention, and enhanced recovery implementation, and further presents some clear interpretations regarding misunderstandings in clinical practice. Finally, optimized treatment according to damage control principles and enhanced recovery after surgery during the perioperative period among superaged hip fracture patients is defined.
Automated microseismic event location by amplitude stacking and semblance
Authors: Zhang Chengwei , Qiao Wenxiao , Che Xiaohua , Lu Junqiang , Men Baiyong
Published: August 2019

Without the need to pick the arrival times of P- and S-waves, migration-based location methods, such as semblance-based and amplitude-stacking-based location methods, are best applied to microseismic events. By comparing and analyzing the advantages and disadvantages of these two methods, we have developed a new location method using amplitude information and semblance. First, we use the two-point ray-tracing method to calculate the traveltime of body waves from the trial point to each receiver, which determines the time-window positions of the P- and S-waves on all traces. Then, we calculate the semblance of the waveforms and the amplitude stacking of the ratio between the short-time average and the long-time average is computed upon the original waveform over the windows. Finally, the semblance weighted by amplitude stacking is used to image the spatial location of the microseismic events. Using experimental and synthetic data considering different factors that may affect the location result (e.g., the signal-to-noise ratio of the waveforms, the scale of the observation array, and the horizontal and vertical distances from the source to fracture zones), we perform microseismic event location with all three methods. According to the source imaging results from experimental and synthetic tests, the semblance method has great location uncertainty in the radial direction but it has good constraints in the circumferential direction; the amplitude-stacking method exhibits the opposite result; and the weighted-semblance method has good constraints in the circumferential and radial directions because it inherits the advantages of semblance-based and amplitude-stacking-based methods. Therefore, compared with existing migration-based location methods, our weighted-semblance method indicates stronger stability and lower location uncertainty, even when downhole monitoring is conducted with a limited aperture of the receiver array.
Genetic Risk Scores for Diabetes Diagnosis and Precision Medicine
Authors: Udler Miriam S , McCarthy Mark I , Florez Jose C , Mahajan Anubha
Published: August 2019

During the last decade, there have been substantial advances in the identification and characterization of DNA sequence variants associated with individual predisposition to type 1 and type 2 diabetes. As well as providing insights into the molecular, cellular, and physiological mechanisms involved in disease pathogenesis, these risk variants, when combined into a polygenic score, capture information on individual patterns of disease predisposition that have the potential to influence clinical management. In this review, we describe the various opportunities that polygenic scores provide: to predict diabetes risk, to support differential diagnosis, and to understand phenotypic and clinical heterogeneity. We also describe the challenges that will need to be overcome if this potential is to be fully realized.
Overeating Saturated Fat Promotes Fatty Liver and Ceramides Compared With Polyunsaturated Fat: A Randomized Trial
Authors: Rosqvist Fredrik , Kullberg Joel , Ståhlman Marcus , Cedernaes Jonathan , Heurling Kerstin , Johansson Hans-Erik , Iggman David , Wilking Helena , Larsson Anders , Eriksson Olof , Johansson Lars , Straniero Sara , Rudling Mats , Antoni Gunnar , Lubberink Mark , Orho-Melander Marju , Borén Jan , Ahlström Håkan , Risérus Ulf
Published: August 2019

Context

Saturated fatty acid (SFA) vs polyunsaturated fatty acid (PUFA) may promote nonalcoholic fatty liver disease by yet unclear mechanisms.

Objective

To investigate if overeating SFA- and PUFA-enriched diets lead to differential liver fat accumulation in overweight and obese humans.

Design

Double-blind randomized trial (LIPOGAIN-2). Overfeeding SFA vs PUFA for 8 weeks, followed by 4 weeks of caloric restriction.

Setting

General community.

Participants

Men and women who are overweight or have obesity (n = 61).

Intervention

Muffins, high in either palm (SFA) or sunflower oil (PUFA), were added to the habitual diet.

Main Outcome Measures

Lean tissue mass (not reported here). Secondary and exploratory outcomes included liver and ectopic fat depots.

Results

By design, body weight gain was similar in SFA (2.31 ± 1.38 kg) and PUFA (2.01 ± 1.90 kg) groups, P = 0.50. SFA markedly induced liver fat content (50% relative increase) along with liver enzymes and atherogenic serum lipids. In contrast, despite similar weight gain, PUFA did not increase liver fat or liver enzymes or cause any adverse effects on blood lipids. SFA had no differential effect on the accumulation of visceral fat, pancreas fat, or total body fat compared with PUFA. SFA consistently increased, whereas PUFA reduced circulating ceramides, changes that were moderately associated with liver fat changes and proposed markers of hepatic lipogenesis. The adverse metabolic effects of SFA were reversed by calorie restriction.

Conclusions

SFA markedly induces liver fat and serum ceramides, whereas dietary PUFA prevents liver fat accumulation and reduces ceramides and hyperlipidemia during excess energy intake and weight gain in overweight individuals.
Resting Energy Expenditure and Substrate Oxidation in Malnourished Patients With Type 1 Glycogenosis
Authors: Buscemi Silvio , Noto Davide , Buscemi Carola , Barile Anna Maria , Rosafio Giuseppe , Settipani Valentina , Giammanco Antonina , Averna Maurizio
Published: August 2019

Context

Type 1a and 1b glycogenosis [glycogen storage disorder (GSD)1a, GSD1b] are rare diseases generally associated with malnutrition. Although abnormal substrate oxidation rates and elevated energy expenditures might contribute to malnutrition, this issue has not been investigated.

Objective

To investigate whether abnormal resting energy expenditure (REE) and substrate oxidation rate characterize patients with GSD1.

Design

Cross-sectional study

Setting

Outpatient referral center for rare diseases and laboratory of clinical nutrition at the University Hospital of Palermo

Patients

Five consecutive patients with GSD1 (4 type a, 1 type b; 3 men, 2 women; age range, 19 to 49 years)

Main Outcome Measures

The usual clinical procedures for patients with malnutrition, including REE and basal substrate oxidation rate (both indirect calorimetry), body composition (bioimpedance method), muscle strength (hand-grip test), and the usual laboratory tests, were performed.

Results

Malnutrition was clearly diagnosed in 2 patients (1 GSD1a and 1 GSD1b), with REE elevated in all five patients, and especially, in the two malnourished patients (+124% and +32.1% vs predictive values using Harris-Benedict equations). The two malnourished patients also exhibited lower basal protein oxidation rates (7.7% and 6.6%) than the nourished patients (range, 12.1% to 24.7%), with higher carbohydrate or lipid oxidation rates. Additionally, the two malnourished patients exhibited higher blood concentrations of lactic acid than the nourished patients.

Conclusions

According to data obtained from our small sample of patients with GSD1, elevated REEs seem to be a common characteristic that might contribute to malnutrition. Low basal protein oxidation rates and elevated blood lactic acid concentrations appear to be associated with malnutrition.
Genetic Variation of the Vitamin D Binding Protein Affects Vitamin D Status and Response to Supplementation in Infants
Authors: Enlund-Cerullo Maria , Koljonen Laura , Holmlund-Suila Elisa , Hauta-alus Helena , Rosendahl Jenni , Valkama Saara , Helve Otto , Hytinantti Timo , Viljakainen Heli , Andersson Sture , Mäkitie Outi , Pekkinen Minna
Published: August 2019

Context

Single nucleotide polymorphisms (SNPs) of the vitamin D binding protein encoding the GC (group component) gene affect 25-hydroxyvitamin D (25OHD) concentrations, but their influence on vitamin D status and response to vitamin D supplementation in infants is unknown.

Objective

To study GC genotype–related differences in 25OHD concentrations and the response to supplementation during a vitamin D intervention study in infants.

Design

In this randomized controlled trial, healthy term infants received vitamin D3 (10 or 30 μg/d) from 2 weeks to 24 months of age. GC SNPs rs2282679, rs4588, rs7041, and rs1155563 were genotyped. rs4588/7041 diplotype and haplotypes of rs2282679, rs4588, and rs7041 (Haplo3SNP) and of all four SNPs (Haplo4SNP) were determined.

Main Outcome Measures

25OHD measured in cord blood at birth and at 12 and 24 months during intervention.

Results

A total of 913 infants were included. Minor allele homozygosity of all studied GC SNPs, their combined haplotypes, and rs4588/rs7041 diplotype 2/2 were associated with lower 25OHD concentrations at all time points in one or both intervention groups [analysis of covariance (ANCOVA) P < 0.043], with the exception of rs7041, which did not affect 25OHD at birth. In the high-dose supplementation group receiving 30 μg/d vitamin D3, but not in those receiving 10 µg/d, genotype of rs2282679, rs4588, and rs7041; diplotype; and Haplo3SNP significantly affected intervention response (repeated measurement ANCOVA Pinteraction < 0.019). Minor allele homozygotes had lower 25OHD concentrations and smaller increases in 25OHD throughout the intervention.

Conclusions

In infants, vitamin D binding protein genotype affects 25OHD concentration and efficiency of high-dose vitamin D3 supplementation.
Predictors of Poor Bone Microarchitecture Assessed by Trabecular Bone Score in Postsurgical Hypoparathyroidism
Authors: Sakane Eliane Naomi , Vieira Maria Carolina Camargo , Lazaretti-Castro Marise , Maeda Sergio Setsuo
Published: August 2019

Context

The effects of PTH deprivation on bone are still unclear. Our objective was to report the characteristics of patients with postsurgical hypoparathyroidism (PsH) at a specialized outpatient service and correlate their trabecular bone score (TBS) values to clinical, densitometric, and laboratory findings. A secondary objective was to evaluate the fracture rates and look for associations between these events and the collected data.

Results

Eighty-two patients were enrolled, of whom 70 (85.4%) were female and 17 (20.7%) had type 2 diabetes mellitus (T2DM). The median body mass index (BMI) was 27.7 kg/m2 and the median age was 59 years. Of 68 dual-energy x-ray absorptiometry (DXA) scans obtained, osteopenia and osteoporosis were present in 32.4% and 2.9%, respectively. In all, 62 lumbar scans were analyzed by using TBS. The mean TBS value (±SD) was 1.386 ± 0.140, and 32.2% of the results were <1.310. TBS values correlated negatively with BMI (mainly > 30 kg/m2), age (mainly > 60 years), and glycemia, whereas abnormal TBS correlated with osteopenia, T2DM, low-impact fracture, and menopause. Six female patients had low-impact fractures, which were associated with a lower TBS (1.178 ± 0.065 vs. 1.404 ± 0.130 in the group without fractures; P < 0.001), older age, higher BMI, impaired renal function, abnormal glycemia, and osteopenia.

Conclusion

The findings suggests that known risk factors for bone loss compromise the bone microarchitecture of individuals with PsH, regardless of DXA results. Menopausal women with PsH and older patients with PsH who have osteopenia, a higher BMI, or T2DM may be candidates for a more detailed assessment by using, for example, TBS.
National Treatment Practice for Adrenocortical Carcinoma: Have They Changed and Have We Made Any Progress?
Authors: Tierney John F , Chivukula Sitaram V , Poirier Jennifer , Pappas Sam G , Schadde Erik , Hertl Martin , Kebebew Electron , Keutgen Xavier
Published: August 2019

Background

Adrenocortical carcinoma (ACC) is a rare malignancy with a dismal prognosis. Two landmark trials published in 2007 and 2012 showed efficacy for adjuvant mitotane in resectable ACC and etoposide/doxorubicin/cisplatin plus mitotane for unresectable ACC, respectively. In this study, we used the National Cancer Database to examine whether treatment patterns and outcomes changed after these trials.

Methods

The National Cancer Database was used to examine treatment patterns and survival in patients diagnosed with ACC from 2006 to 2015. Treatment modalities were compared within that group and with a historical cohort (1985 to 2005). χ2 tests were performed, and Cox proportional hazards models were created.

Results

From 2006 to 2015, 2752 patients were included; 38% of patients (1042) underwent surgery alone, and 31% (859) underwent surgery with adjuvant therapy. Overall 5-year survival rates for all stages after resection were 43% (median, 41 months) in the contemporary cohort and 39% (median, 32 months) in the historical cohort. After 2007, patients who underwent surgery were more likely to receive adjuvant chemotherapy (P = 0.005), and 5-year survival with adjuvant chemotherapy improved (41% vs 25%; P = 0.02). However, survival did not improve in patients with unresectable tumors after 2011 compared with 2006 to 2011 (P = 0.79). Older age, tumor size ≥10 cm, distant metastases, and positive margins were associated with lower survival after resection (hazard ratio range: 1.39 to 3.09; P < 0.03).

Conclusions

Since 2007, adjuvant therapy has been used more frequently in patients with resected ACC, and survival for these patients has improved but remains low. More effective systemic therapies for patients with ACC, especially those in advanced stages, are desperately needed.
Safety and Efficacy of 5 Years of Treatment With Recombinant Human Parathyroid Hormone in Adults With Hypoparathyroidism
Authors: Mannstadt Michael , Clarke Bart L , Bilezikian John P , Bone Henry , Denham Douglas , Levine Michael A , Peacock Munro , Rothman Jeffrey , Shoback Dolores M , Warren Mark L , Watts Nelson B , Lee Hak-Myung , Sherry Nicole , Vokes Tamara J
Published: August 2019

Context

Conventional hypoparathyroidism treatment with oral calcium and active vitamin D is aimed at correcting hypocalcemia but does not address other physiologic defects caused by PTH deficiency.

Objective

To evaluate long-term safety and tolerability of recombinant human PTH (1-84) [rhPTH(1-84)].

Design

Open-label extension study; 5-year interim analysis.

Setting

12 US centers.

Patients

Adults (N = 49) with chronic hypoparathyroidism.

Intervention(s)

rhPTH(1-84) 25 or 50 µg/d initially, with 25-µg adjustments permitted to a 100 µg/d maximum.

Main Outcome Measure(s)

Safety parameters; composite efficacy outcome was the proportion of patients with ≥50% reduction in oral calcium (or ≤500 mg/d) and calcitriol (or ≤0.25 µg/d) doses, and albumin-corrected serum calcium normalized or maintained compared with baseline, not exceeding upper limit of normal.

Results

Forty patients completed 60 months of treatment. Mean albumin-corrected serum calcium levels remained between 8.2 and 8.7 mg/dL. Between baseline and month 60, levels ± SD of urinary calcium, serum phosphorus, and calcium-phosphorus product decreased by 101.2 ± 236.24 mg/24 hours, 1.0 ± 0.78 mg/dL, and 8.5 ± 8.29 mg2/dL2, respectively. Serum creatinine level and estimated glomerular filtration rate were unchanged. Treatment-emergent adverse events (AEs) were reported in 48 patients (98.0%; hypocalcemia, 36.7%; muscle spasms, 32.7%; paresthesia, 30.6%; sinusitis, 30.6%; nausea, 30.6%) and serious AEs in 13 (26.5%). At month 60, 28 patients (70.0%) achieved the composite efficacy outcome. Bone turnover markers increased, peaked at ∼12 months, and then declined to values that remained above baseline.

Conclusion

Treatment with rhPTH(1-84) for 5 years demonstrated a safety profile consistent with previous studies and improved key biochemical parameters.