bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcineurin homologous protein isoform 2 supports tumor survival via the sodium hydrogen exchanger isoform 1 in non-small cell lung cancer
Authors: Cottle Wayne Taylor , Wallert Clarice Hayley , Anderson Kristine Kay , Tran Michelle Fang , Bakker Clare Loraine , Wallert Mark Anthony , Provost Joseph John
Published: July 2020

Maintaining intracellular pH is crucial for preserving healthy cellular behavior and, when dysregulated, results in increased proliferation, migration, and invasion. The Na+/H+ exchanger isoform 1 is a highly regulated transmembrane antiporter that maintains pH homeostasis by exporting protons in response to intra- and extracellular signals. Activation of Na+/H+ exchanger isoform 1 is exquisitely regulated by the extracellular environment and protein cofactors, including calcineurin B homologous proteins 1 and 2. While Na+/H+ exchanger isoform 1 and calcineurin B homologous protein 1 are ubiquitously expressed, calcineurin B homologous protein 2 shows tissue-specific expression and upregulation in a variety of cancer cells. In addition, calcineurin B homologous protein 2 expression is modulated by tumorigenic extracellular conditions like low nutrients. To understand the role of calcineurin B homologous protein 2 in tumorigenesis and survival in lung cancer, we surveyed existing databases and formed a comprehensive report of Na+/H+ exchanger isoform 1, calcineurin B homologous protein 1, and calcineurin B homologous protein 2 expression in diseased and non-diseased tissues. We show that calcineurin B homologous protein 2 is upregulated during oncogenesis in many adeno and squamous carcinomas. To understand the functional role of calcineurin B homologous protein 2 upregulation, we evaluated the effect of Na+/H+ exchanger isoform 1 and calcineurin B homologous protein 2 depletion on cellular function during cancer progression in situ. Here, we show that calcineurin B homologous protein 2 functions through Na+/H+ exchanger isoform 1 to effect cell proliferation, cell migration, steady-state pH i, and anchorage-independent tumor growth. Finally, we present evidence that calcineurin B homologous protein 2 depletion in vivo has potential to reduce tumor burden in a xenograft model. Together, these data support the tumor-promoting potential of aberrant calcineurin B homologous protein 2 expression and position calcineurin B homologous protein 2 as a potential therapeutic target for the treatment of non-small cell lung cancer.
Intersectionality of Resilience: A Strengths-Based Case Study Approach With Indigenous Youth in an Urban Canadian Context
Authors: Njeze Chinyere , Bird-Naytowhow Kelley , Pearl Tamara , Hatala Andrew R.
Published: July 2020

By bringing together two important areas of contemporary health research—resilience among Indigenous youth and intersectionality theory—this study advances an intersectionality of resilience framework that exposes intersecting forms of oppression within inner city urban contexts, while also critically reframing intersectionality to include strength-based perspectives of overlapping individual, social, and structural resilience-promoting processes. Drawing on Indigenous methodologies, a “two-eyed seeing” approach, and Stake’s case study methodology involving multiple data sources (i.e., four sharing circles, 38 conversational interviews, four rounds of photovoice, and naturalistic interactions that occurred with 28 youth over an entire year), this qualitative study outlines three intersecting processes that facilitate youth resilience and wellness in various ways: (a) strengthening cultural identity and family connections; (b) engagement in social groups and service to self and community; and (c) practices of the arts and a positive outlook. In the end, implications for research, clinical practice, and health or community interventions are also discussed.
Efficacy of a conversion from filgrastim to filgrastim-sndz in stem cell transplant patients undergoing mobilization
Authors: Curry Lauren D , Anders Brandi , Dressler Emily V , Kennedy LeAnne
Published: July 2020

During autologous stem cell transplant, granulocyte colony-stimulating factors (G-CSF) serve the integral role of mobilizing hematopoietic cells into the peripheral blood for subsequent collection by leukapheresis. Filgrastim (Neupogen®) is a G-CSF and affects hematopoietic cells by stimulating growth and differentiation of neutrophils. Filgrastim-sndz (Zarxio®), a biosimilar of filgrastim, received landmark approval as the first biosimilar product approved by the FDA in the United States. As a result of the recent FDA approval, our medical center made the conversion in August 2016 from using filgrastim to filgrastim-sndz to provide patients the same benefits of the filgrastim injection at a reduced cost. This retrospective, observational cohort study evaluated the comparative efficacy of the filgrastim-sndz biosimilar in 147 patients who underwent mobilization prior to stem cell transplant with filgrastim between 1 August 2015 and 31 July 2016 or filgrastim-sndz between 1 September 2016 and 30 November 2017. The mean number of CD34 cells collected during apheresis was 7.38 × 106 in the filgrastim group and 8.86 × 106 in the filgrastim-sndz group. Filgrastim-sndz was significantly non-inferior, as the difference between filgrastim and filgrastim-sndz was −1.48 × 106 with an upper 95% confidence bound equal to −0.24 × 106 that did not include the non-inferiority margin of 1 × 106 ( p = 0.0006). The median number of days of apheresis was 2 in both groups ( p= 0.3273). In conclusion, the biosimilar product was non-inferior for mobilization and the conversion from filgrastim to filgrastim-sndz afforded patients similar efficacy for mobilization in stem cell transplant at a reduced cost.
Differences in safety profiles of newly approved medications for multiple myeloma in real-world settings versus randomized controlled trials
Authors: Borrelli Eric P , McGladrigan Conor G
Published: July 2020

Background

Four new agents (elotuzumab, ixazomib, panobinostat, and daratumumab) were approved by the US Food and Drug Administration (FDA) in 2015 for the treatment of multiple myeloma. Our objective was to compare the safety profiles of these new medications in real-world settings and their randomized controlled trial(s).

Material and methods

An analysis was conducted of the FDA Adverse Event Reporting System (FAERS) for each drug consisting of the quarter that the drug received its FDA approval and the eight subsequent quarters. Reporting odds ratios and corresponding 95% confidence intervals were then calculated for each drug for each of the 10 most frequent adverse drug reactions. The randomized controlled trials that led to initial FDA approval for these medications were subsequently reviewed to assess the 10 most frequently reported adverse drug reactions in these trials.

Results

There were only two adverse drug reactions in the top 10 of both FAERS and its randomized controlled trials for elotuzumab (anaemia, diarrhoea) and for daratumumab (cough, back pain), five for ixazomib (diarrhoea, constipation, fatigue, nausea, peripheral neuropathy), and four panobinostat (diarrhoea, fatigue, nausea, constipation). Ixazomib had two adverse drug reactions with a significant reporting odds ratios greater than a 10-fold increased risk (plasma cell myeloma, peripheral neuropathy); elotuzumab had three adverse drug reactions (infusion site reaction, malignant neoplasm progression, deep vein thrombosis); daratumumab had three adverse drug reactions (infusion site reaction, bronchospasm, chills), while panobinostat had four (malignant neoplasm progression, decreased platelet count, diarrhoea, increased blood creatinine).

Conclusion

This analysis helps to highlight the importance of conducting postmarketing pharmacovigilance studies to better understand the potential adverse reactions of these medications.
Rapid desensitization to brentuximab vedotin after severe anaphylaxis in the treatment of refractory Hodgkin’s lymphoma
Authors: V. Villarreal-Gonzalez Rosalaura , N. Gonzalez-Diaz Sandra , E. de Lira-Quezada Cindy , Gómez-Almaguer David , Gómez-De León Andres , Acuña-Ortega Natalhie
Published: July 2020

Introduction

Brentuximab vedotin is a monoclonal antibody drug conjugate used for the treatment of patients with Hodgkin lymphoma. Hypersensitivity reactions to brentuximab vedotin may include cutaneous, cardiovascular, respiratory, gastrointestinal and neurological signs and symptoms.

Case report

We present the case of a 23-year-old Mexican female with stage IV progressive classical nodular sclerosing Hodgkin lymphoma who received multiple previous chemotherapy regimens. Brentuximab vedotin at 1.8 mg/kg (180 mg total dose), for 21-day cycles was indicated. Within 5 min of infusion of the 5th cycle of brentuximab, she developed severe anaphylaxis (hives, angioedema, diaphoresis, tachycardia, dyspnea, hypoxemia and loss of consciousness), which was successfully controlled with epinephrine, steroids and antihistamines. Management and outcome: Intradermal skin test at a concentration of 0.1 mg/ml was positive. Due to the severity of the symptoms and the lack of access to alternative treatments, we performed a desensitization protocol. A total of 180 mg of brentuximab was given in three bag solutions in 12 steps, with an initial concentration dose of 1/100 of the total dose in a course of 5.56 h with no hypersensitivity reactions.

Discussion

Severe anaphylaxis has been reported in 1.2% of patients receiving brentuximab vedotin. Patients who are treated by rapid drug desensitization with their first option therapy present a favorable survival rate with better cost-effectiveness in comparison to second-line treatment.
Gefitinib induced severe hyponatremia: A case report
Authors: Meena Durga Shankar , Kumar Deepak , Bohra Gopal Krishana , Midha Naresh
Published: July 2020

Introduction

Evolution of targeted molecular therapies has greatly improved patient survival in cancer. Gefitinib is an oral, reversible, epidermal growth factor receptor inhibitor used in advance non-small cell lung cancer. Skin rashes and diarrhea are common adverse effects associated with gefitinib. However, electrolytes disorders are rarely reported with gefitinib, particularly hyponatremia.

Case report

We describe a 65-year-old male with metastatic non-small cell lung cancer treated with gefitinib for the last three weeks. He presented to our hospital with complaints of acute onset drowsiness. On evaluation of drowsiness, patient was diagnosed with severe hyponatremia. Management and outcome: After ruling out other common causes of hyponatremia, gefitinib was attributed as a cause of hyponatremia. Gefitinib was immediately stopped and IV hypertonic saline (3% sodium chloride) was started due to severe symptomatic hyponatremia. After seven days of cessation of gefitinib, he became asymptomatic with normalisation of serum sodium levels.

Discussion

Hyponatremia in cancer patients is associated with poor prognosis and prolonged hospital stay. Possibility of gefitinib-induced hyponatremia should be considered in order to achieve early diagnosis and prevent significant mortality in cancer patients.
Health Literacy Toward Zoonotic Diseases Among Livestock Farmers in Vietnam
Authors: Cao Ba Khuong , Kaewkungwal Jaranit , Pacheun Oranut , Nguyen Thi To Uyen , Lawpoolsri Saranath
Published: July 2020

Background:

Zoonoses are an increasing concern worldwide, particularly in low- and middle-income countries. People with close contact with animals are at high risk for contracting and transmitting the zoonotic diseases.

Objectives:

To determine health literacy of livestock farmers toward biosecurity to prevent zoonotic diseases.

Methods:

This cross-sectional mixed-methods study was conducted in Thai Nguyen Province, Vietnam, where livestock and farming are the main occupation. The questionnaire survey was submitted to 218 farmers who have close contact with livestock. In addition, 8 farmers were invited to an in-depth interview to further explore the health literacy.

Results:

Half of the participants were men. The average age (standard deviation) of the participants was 49.3(11.5) years. The median years with experience in farming was 15 years. The majority (82.0%) of the participants had moderate health literacy level regarding zoonoses. Improper use of antibiotics was referred by 58.0% of participants, including antibiotic use as feeding supplements (34.0%) and the use of human antibiotics to treat sick animals (24.0%). Many participants were unaware of zoonotic prevention measures and due to this had practices such as not wearing protective equipment (60.0%), an absence of acaricides to prevent vector infestations (52.0%), an absence of disinfection measures (42.0%), low rate of rabies vaccination (54.0%), and do not quarantining sick animals (38.0%). In-depth interviews revealed great concern among farmers about a collective lack of participation from local veterinarians, health workers, and government authorities in zoonoses-prevention efforts. Statistical models showed that farm scale, ethnic groups, and perceived income were associated with the overall health literacy about zoonoses.

Conclusion:

Comprehensive health education related to zoonotic diseases is recommended to improve overall knowledge, including routes of transmission, symptoms and consequences of diseases, and antibiotic usage. In addition, guidance should be provided to farmers on how to treat sick animals, the appropriate use of antibiotics, and waste management. Local veterinarians and health workers are important contact points and should work closely with the farmers to prevent zoonotic diseases.
Can Serum Fibrinogen Predict ARDS?
Authors: Ubaldo Onion Gerald V , Lazaro Ma. Aurora E , Aventura Emily T , Cinco Jude Erric
Published: July 2020

Acute respiratory distress syndrome (ARDS) has a worldwide mortality of 10% to 30% with severe pneumonia being the primary cause. Diagnosis relies on clinical criteria which may lead to under-recognition and delayed evidence-based interventions. In previous studies, plasma fibrinogen was associated with progression to ARDS among patients with severe pneumonia. This is a prospective cohort study wherein we hypothesized that levels of plasma fibrinogen and change in levels of fibrinogen can predict development of ARDS among a cohort of patients with severe pneumonia based on the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) consensus criteria. After acquiring consent, plasma fibrinogen levels were extracted upon enrollment and after 48 hours. These extraction times were arbitrarily chosen to determine whether levels rise or decline in relation to the course of disease. A total of 47 patients were prospectively followed within 7 days of enrollment, then divided into 2 groups, which included those who developed ARDS (n = 12, 25%) and those who did not (n = 35, 75%). Fibrinogen levels at baseline had sensitivity and specificity of 41.7% and 57.1%, respectively ( P = .932) with an area under the curve (AUC) of 0.492; levels after 48 hours had sensitivity and specificity of 55.6% and 65.6%, respectively ( P = .729) with an AUC of 0.538; and delta fibrinogen levels had sensitivity and specificity of 55.6% and 62.5%, respectively ( P  = 0.581) with an AUC of 0.561. Based on this study, plasma fibrinogen is an unreliable biomarker for predicting ARDS development in patients with severe pneumonia. In setting up this study, we experienced limitations which we had to accept but realizations of these led to the discovery of potential research areas. To our knowledge, this is the first Philippine study attempting to discover a biomarker for ARDS progression. It is recommended that further investigation on local incidence and other biomarkers for ARDS should be done.
Changing health care with, for, or against the public: an empirical investigation into the place of the public in health service reconfiguration
Authors: Greer Scott L , Stewart Ellen , Ercia Angelo , Donnelly Peter
Published: July 2020

Objectives

This study sought to understand the different approaches taken to involving the public in service reconfiguration in the four United Kingdom health systems.

Methods

This was a multi-method study involving policy document analysis and qualitative semi-structured interviews in England, Northern Ireland, Scotland and Wales.

Results

Despite the diversity of local situations, interview participants tended to use three frames within which they understood the politics of service reconfigurations: an adversarial approach which assumed conflict over scarce resources (change against the public); a communications approach which defined the problem as educating the public on the desirability of change (change for the public); and a collaborative approach which attempted to integrate the public early into discussions about the shape and nature of desirable services (change with the public). These three framings involved different levels of managerial time, energy, and resources and called on different skill sets, most notably marketing and communications for the communications approach and community engagement for the collaborative approach.

Conclusions

We argue that these framings of public involvement co-exist within organisations. Health system leaders, in framing service reconfiguration as adversarial, communicative or collaborative, are deciding between conceptions of the relationship between health care organisations and their publics in ways that shape the nature of the debates that follow. Understanding the reasons why organisations adopt these frames would be a fruitful way to advance both theory and practice.
Exploring the impacts of national image, service quality, and perceived value on international tourist behaviors: A Nepali case
Authors: Zhang Juyan , Adhikari Dharma , Fahmy Shahira , Kang Seok
Published: July 2020

The dominant paradigm on tourist behaviors depicts a sequential relationship among image, quality, satisfaction, and post-purchase behavior while the alternative view argues that consumer behaviors are better understood through perceived value. Using Nepal as a case, we tested a synthetic model of tourist behaviors and applied the Fombrun-RI Country Reputation Index (CRI) that was developed in the field of nation branding to measure destination image, an elusive concept in tourism literature since long. Structural Equation Modeling (SEM) shows that the data largely supported the model, and national image has impacts on tourist behaviors. However, service quality is not a significant predictor of tourist behaviors. This corroborates the argument that perceived value is a better way to analyze tourist behaviors. The research has practical implications for nation branding programs in the less-developed nations.
Acceptability of transcranial direct current stimulation in children and adolescents with ADHD: The point of view of parents
Authors: Buchanan Derrick Matthew , D’Angiulli Amedeo , Samson André , Maisonneuve Alexander R , Robaey Philippe
Published: July 2020

Transcranial direct current stimulation (tDCS) is a novel treatment option for attention deficit hyperactivity disorder. To facilitate translation into clinical practice, we interviewed parents of children who have experienced experimental tDCS. A grounded theory approach using open, axial, and selective coding provided seven emergent themes for acceptability: tDCS provides hope for parents, safety tolerability and side effects of tDCS versus medication, burden of treatment, education and trust with care providers, cost and coverage, unestablished tDCS efficacy versus established medication effectiveness, perceived compliance of tDCS versus medication. Results suggest tDCS is acceptable but depends on evidence of effectiveness and regular availability.
‘21st Century Welfare’ in Historical Perspective: Disciplinary Welfare in the Depression of the 1930s and Its Implications for Today
Authors: Cooper Matthew
Published: July 2020

Since 2010, UK governments have intensified conditionality as part of a programme of ‘welfare reform’. Social scientists have undertaken much critical analysis but less attention has been paid to possible historical parallels. This article sheds new light on welfare reform through comparison with the depression of the 1930s. It undertakes a documentary analysis of policy in the 1930s informed by a governmentality perspective. In both periods, governments committed to liberal orthodoxies and feared the unemployed would become vulnerable to ‘demoralization’ and ‘dependency’; their behaviour and character were determinant of their rights to support. However, there are notable differences in what interventions have been considered appropriate. The article assesses the significance of continuities and contrasts, and argues in particular that the severity and ubiquity of behavioural regulation employed today is even greater than that seen in the ‘dark decade’ of the great depression.
A hybrid model for predicting window opening state in buildings based on non-intrusive monitoring
Authors: Liu Huifang , Zheng Hengjie , Li Fei , Cai Hao
Published: July 2020

Window opening behaviour is one of the most important factors for indoor air environment. The traditional models for window opening behaviour rarely focus on the window opening proportion, which has an important effect on optimal design of natural ventilation. A hybrid model combining the logistic regression model with a probability distribution model was proposed to analyse the window state distribution. A non-intrusive window monitoring method was used to sample window states, and the required sample size was analysed based on a pilot study. The Box-Cox data transformation was employed to establish a normal distribution model for the probability distribution of window opening state, and explore the relationship between outdoor temperature and the probability density function (PDF). The study found that the outdoor temperature, relative humidity and PM2.5 concentration had a significant effect on window opening states, and the outdoor temperature had a higher prediction accuracy (86.7%) for the logistic regression model. For different outdoor temperature, the parameters of PDF for window opening state were different. The mean and variance of the PDF were highest when the outdoor temperature was 20°C–25°C. This study can help to improve effective design and utilization of natural ventilation.
In-laws or outlaws? Associations between in-law family members’ and individuals’ convictions
Authors: Eichelsheim Veroni I. , van de Weijer Steve G.A. , Bijleveld Catrien C.J.H.
Published: July 2020

The association between individuals’ criminal behaviour and the criminal behaviour of their in-law family members is central to the current study. The criminality of extended family members may pose a risk of (persistence in) criminal behaviour. Data are used from the fourth generation of the Dutch Transfive Study, which contains demographical data as well as and conviction data on family members from consecutive generations of families. Results show a significant association between convictions of individuals and their in-law family members, over and above the effect of having a convicted partner. The strength of the association depends on the severity of the offense as well as on gender. Similarity in convictions before marriage as well as indications of continued similarity after marriage has been found.
JointSearch: Efficient parametric detailing preparation through user-defined and property-based joint type filtering
Authors: Haddal Mork John , Luczkowski Marcin
Published: July 2020

Detailing joints are important when designing structures. In this design process, a structure is divided into different joint types. Digital fabrication and algorithmic aided design have changed the conceptions and requirements of joint detailing. However, parametric tools that can efficiently identify joint types based on the solution space are not available. This article presents a methodology that efficiently generates topological relations and enables the user to assign joint instances to joint types. A series of property-based search criteria components is applied to define the solution space of a joint type. Valid joints are coherently filtered, deconstructed and outputted for detailing. The article explains both the methodology and programming-related aspects of the joint type filtering. The article concludes that the developed methodology offers the desired flexibility and may be suitable for other materials and applications.
A Systematic Review of Mental Health Disorders of Children in Foster Care
Authors: Engler Amy D. , Sarpong Kwabena O. , Van Horne Bethanie S. , Greeley Christopher S. , Keefe Rachael J.
Published: July 2020

Objectives:

This article summarizes the rate of mental health disorders of foster children, the specific types of disorders faced by this population, and how factors such as type of abuse or placement variables can affect mental health outcomes.

Method:

A search in PsycInfo Ovid, EMBASE Elsevier, and Cochrane Library Wiley resulted in 5,042 manuscripts that were independently reviewed by two authors, yielding 25 articles.

Inclusion criteria:

Published in or after 2000, written in English, and having a population sample of foster children (ages 0–18) in Western countries including the United States, Norway, Australia, and Canada.

Results:

Foster children have higher rates of mental health disorders than those of the general population. The most common diagnoses include oppositional defiant disorder/conduct disorder, major depressive disorder, post-traumatic stress disorder, and reactive attachment disorder. Variables such as type of maltreatment and type of placement predicted mental health outcomes.

Conclusions and implications of key findings:

Children in foster care experience more mental health disorders, as a response to either the circumstances that led to being removed from their homes or the experience of being placed in foster care. These results demonstrate the necessity for providers to consider mental health issues when caring for children in foster care and to perform appropriate screenings and assessments. With adequate trauma-informed training, providers can quickly become comfortable and competent in identifying mental health needs of children in foster care who have experienced trauma.
Nonliposuction Endoscopic Sentinel Lymph Node Biopsy Through the Periareolar Incision
Authors: Liang Yinghui , Xu Shuangta
Published: July 2020

Background. Sentinel lymph node biopsy (SLNB) has been an alternative to axillary lymph node dissection as a standard procedure for breast cancer patients with clinically negative lymph nodes. Endoscopic technique has been developed for over 20 years but remains to be mastered by a slice of surgeons. Suction and squeezing in the liposuction endoscopic procedures may increase risk of local recurrence and metastasis. In this study, we present our method of SLNB procedure through the periareolar incision which improves the shape of the breast-conserving surgery. Patients and Procedures. Twenty-eight breast cancer patients with clinically negative lymph nodes received this procedure. Methylene blue dye and technetium-99m sulfur colloid were used to be the tracker of sentinel lymph nodes (SLNs). Periareolar incision was the main surgical technique. The STORZ HD endoscopic system and some special instruments were used during the operation. Results. SLNs can be accurately located and biopsied under an endoscope without additional incisions. The SLNs detection rate, sensitivity, and false-negative rate are 88%, 80%, and 11.1%, respectively. And, the complications such as paresthesia and upper limb lymphedema are similar compared with traditional breast-conserving surgery (10.7% vs 9.8% and 7.1% vs 7.8%). Conclusion. Endoscopic technique can be used to accurately assess the status of SLNs in patients with breast cancer. Nonliposuction endoscopic breast-conserving surgery is one of the safe and alternative surgical procedures for early breast cancer.
Vascular and Bone Regeneration of the Donor Site After Corticoperiosteal Flap From the Medial Femoral Condyle
Authors: Guzzini Matteo , Lupariello Domenico , Argento Giuseppe , Arioli Leopoldo , Ferretti Andrea
Published: July 2020

Background: The aim of this study was to evaluate the morbidity and regeneration of descending genicular artery and bone on the donor site, the medial condyle of the femur, after harvesting the corticoperiosteal flap and to report the clinical, functional, and radiographic outcomes of the treatment of atrophic nonunions of upper limb with corticoperiosteal vascularized flap at 5-year follow-up. Methods: From January 2011 to January 2018, 36 patients (average age of 45.8 years) were enrolled and evaluated with clinical and radiographic follow-up (average time of 66 months). In 20 patients, magnetic resonance angiography was also performed preoperatively and postoperatively to investigate the fate of the descending genicular artery after harvesting the corticoperiosteal flap. Results: Radiographic evaluation demonstrated a success rate of 94.4% (average time of bone healing of 5.2 months). At the recipient site, clinical evaluation showed excellent results in 75% to 80% of cases, and at the donor site, no statistical differences were found between before and after surgery clinical condition. In all patients who underwent magnetic resonance imaging, images showed a complete recovery of the blood supply of the medial femoral condyle. Conclusions: Medial condyle corticoperiosteal flap represents a valid choice for the treatment of upper limb nonunions. This technique brings a very low morbidity on the donor site, with complete restoration of blood supply and bone tissue. The limit of this flap is its low mechanical support, which suggests performing this technique especially for the treatment of upper limb nonunions.
Leadership emergence and development: Organizations shaping leading in early childhood education
Authors: Gibbs Leanne
Published: July 2020

Early childhood education (ECE) effects positive outcomes for children, but outcomes depend upon the quality of the program with which children engage. Program quality is positively influenced by effective leadership; yet we do not fully understand how effective leadership emerges and develops within ECE sites. This lack of knowledge potentially compromises the development of effective leadership and, subsequently, a child’s right to high-quality ECE. This paper, therefore, contributes to the field of research on ECE leadership development by describing a qualitative Australian study that investigated leadership cultivation. The mini-ethnographic case study examined the emergence and development of leadership in three high-quality, diversely governed ECE settings. Findings of the study suggest the practice of leading is foundational for positional leadership roles and is enabled by the practice architectures of an organization. Practice architectures comprise cultural-discursive, material-economic and social-political arrangements. Arrangements, found within organizations, included cultures of trust, use of professional knowledge and language, collaborative development of philosophy, democratic allocation of resources, sharing of power and openness to activism, disruption and creativity. Such arrangements play an important role in the emergence and development of leading and therefore offer organizations alternative ways to consider leadership cultivation.
Reflective interventionist conversation analysis
Authors: O’Reilly Michelle , Kiyimba Nikki , Nina Lester Jessica , Muskett Tom
Published: July 2020

A distinction has been drawn between basic (pure) conversation analysis (CA) and applied CA. Applied CA has become especially beneficial for informing areas of practice such as health, social care and education, and is an accepted form of research evidence in the scientific rhetoric. There are different ways of undertaking applied CA, with different foci and goals. In this article, we articulate one way of conducting applied CA, that is especially pertinent for practitioners working in different fields. We conceptualise this as Reflective Interventionist CA (RICA). We argue that this approach to applied CA is important because of its emphasis on the reflective stance that is valuable to an understanding of research data, its commitment to collaboration with practitioners, and its inductive style. In this paper, we outline the core premises and benefits of this approach and offer empirical examples to support our argument. To conclude, we consider the implications for evidence-based practice.
History Looks Forward: Interdisciplinarity and Critical Emotion Research
Authors: Boddice Rob
Published: July 2020

The history of emotions has become a thriving focus within the discipline of history, but it has in the process gained a critical purchase that makes it relevant for other disciplines concerned with emotion research. The history of emotions is entangled with the history of the body and brain, and with cultural and political history. It is interested in the how and why of emotion change; with the questions of power and authority behind cultural scripts of expression, conceptual usages, and emotional practices. This work has reached a level of maturity and sophistication in its theoretical and methodological orientation, and in its sheer quantity of empirical research, that it contributes to emotion knowledge within the broad framework of emotion research.
Improved Cartilage Quality on Delayed Gadolinium-Enhanced MRI of Hip Cartilage after Subchondral Drilling of Acetabular Cartilage Flaps in Femoroacetabular Impingement Surgery at Minimum 5-Year Follow-Up
Authors: Schmaranzer Florian , Haefeli Pascal C. , Liechti Emanuel F. , Hanke Markus S. , Tannast Moritz , Büchler Lorenz
Published: July 2020

Objective

To assess whether subchondral drilling of acetabular cartilage flaps during femoroacetabular impingement (FAI) surgery improves (1) acetabular dGEMRIC indices and (2) morphologic magnetic resonance imaging (MRI) scores, compared with hips in which no additional treatment of cartilage lesions had been performed; and (3) whether global dGEMRIC indices and MRI scores correlate.

Design

Prospective cohort study of consecutive patients with symptomatic FAI treated with open surgery between 2000 and 2007. Patients with subchondral drilling of acetabular cartilage flaps were allocated to the study group, those without drilling to the control group. All patients underwent indirect 3-T MR arthrography to assess cartilage quality by dGEMRIC indices and a semiquantitative morphologic MRI score at minimum 5 years after surgery. dGEMRIC indices and morphologic MRI scores were compared between and among groups using analysis of covariance/paired t tests.

Results

No significant difference was found between the global dGEMRIC indices of the study group (449 ± 147 ms, 95% CI 432-466 ms) and the control group (428 ± 143 ms, 95% CI 416-442 ms; P = 0.235). In regions with cartilage flaps, the study group showed higher dGEMRIC indices (472 ± 160 ms, 95% CI 433-510 ms) compared with the control group (390 ± 122 ms, 95% CI 367-413 ms; P < 0.001). No significant differences were found for the morphologic MRI scores. A strong inversely linear correlation between the dGEMRIC indices and the morphologic MRI scores ( r = −0.727, P < 0.001) was observed.

Conclusions

Treatment of acetabular cartilage flaps with subchondral drilling leads to better cartilage quality in regions with cartilage flaps at minimum 5 years of follow-up.
Comparison of breast density assessments according to BI-RADS 4th and 5th editions and experience level
Authors: Gemici Aysegul Akdogan , Bayram Ersoy , Hocaoglu Elif , Inci Ercan
Published: July 2020

Background

Breast density is an important variable that can change the sensitivity of mammography. It can be analyzed with using the 4th and 5th editions of the Breast Imaging and Reporting Data System (BI-RADS) recommendations from the American College of Radiology (ACR).

Purpose

To define the intra- and inter-reader agreement levels of breast density assignments performed by readers with different experience levels using two versions of BI-RADS.

Material and Methods

The breast density assessments of 330 women were conducted by two readers with different levels of experience (one breast radiologist and one resident). Each reader independently defined the breast density four times—twice using the 4th edition and twice using the 5th edition. Assessments were analyzed on four- and two-category scales.

Results

The intra-reader agreement of the breast radiologist for the 4th and 5th editions of BI-RADS was almost perfect (k = 0.90 and k = 0.87, respectively.) The resident had similar results (k = 0.88 and k = 0.87, respectively). The agreement between the breast radiologist and resident for the 4th and 5th edition of BI-RADS was substantial (k = 0.70 and k = 0.63, respectively). There was a statistically significant difference with the two-category scale analysis between the dense and non-dense for both readers and versions of BI-RADS (McNemar’s test, P < 0.001).

Conclusion

Although there were high intra- and inter-reader agreement levels when using both versions, the percentage of women having dense breasts increased when using the 5th edition, and the difference was statistically significant. There were no differences found with regard to the readers’ level of experience in all analyses.
Trigger Finger? Just Shoot!
Authors: Merry Stephen P. , O’Grady Jason S. , Boswell Christopher L.
Published: July 2020

Trigger finger is a common condition usually curable by a safe, simple corticosteroid injection. Trigger finger results from a stenotic A1 pulley that has lost its gliding surface producing friction and nodular change in the tendon. This results in pain and tenderness to palpation of the A1 pulley, progressing to catching and then locking. Splinting for 6 to 9 weeks produces gradual improvement in most patients as does a quick steroid injection with the latter resulting in resolution of pain in days and resolution of catching or locking in a few weeks. Percutaneous or open release should be reserved for injection failures particularly those at high risk for continued injection failure including diabetics and those with multiple trigger fingers. We present a step-by-step method for injection with illustrations to encourage primary care providers to offer this easily performed procedure to their patients.
Demographics, Treatment, and Cost of Periprosthetic Femur Fractures: Fixation Versus Revision
Authors: Ragland Katelyn , Reif Rebecca , Karim Saleema , Sexton Kevin W. , Cherney Steven M. , Stambough Jeffrey B. , Mears Simon C.
Published: July 2020

Introduction:

Periprosthetic femur fractures (PPFX) are complications of both total hip and knee arthroplasty and may be treated with open reduction and internal fixation (ORIF) or revision arthroplasty. Differences in treatment and fracture location may be related to patient demographics and lead to differences in cost. Our study examined the effects of demographics and treatment of knee and hip PPFXs on length of stay (LOS) and cost.

Methods:

Of all, 932 patients were identified with hip or knee PPFXs in the National Inpatient Sample from January 2013 to September 2015. Age, gender, race, mortality, comorbidity level, LOS, total cost, procedure type, geographic region, and hospital type were recorded. A generalized linear regression model was conducted to analyze the effect of fracture type on LOS and cost.

Results:

Differences in gender (66% vs 83.7% female, P < .01), comorbidities (fewer in hips, P < .01), and costs (US$30 979 vs US$27 944, P < .01) were found between the hip and knee groups. Knees had significantly higher rates of ORIF treatment (80.7% vs 39.1%) and lower rates of revision arthroplasties (19.3% vs 60.9%) than hip PPFXs ( P < .01). Within both groups, patients with more comorbidities, revision surgery, and blood transfusions were more likely to have a longer LOS and higher cost.

Conclusion:

Periprosthetic femur fractures patients are not homogenous and treatment varies between hip and knee locations. For knee patients, those treated with ORIF were younger, with fewer comorbidities than those treated with revision. Conversely, hip patients treated with ORIF were older, with more comorbidities than those treated with revision. Hips had higher costs than knees, and cost correlated with revision arthroplasty and more comorbidities. In both hip and knee groups, longer LOS was associated with more comorbidities and being treated in urban teaching hospitals. Total cost had the strongest associations with revision procedures as well as number of comorbidities and blood product use.
Evaluation of Intra-Lesional Interleukin 2 for the Treatment of In-Transit Melanoma Disease: L’évaluation de l’interleukine-2 intralésionnelle pour traiter les mélanomes en transit
Authors: Lopez-Obregon Beatriz , Barreto Marcio P. , Fyfe Allison , McKinnon Greg , Webb Carmen , Temple-Oberle Claire
Published: July 2020

Background:

Intra-lesional interleukin 2 (IL-2) therapy trials for the treatment of in-transit melanoma using different treatment protocols have been published reporting varied results. This study assesses the results of IL-2 therapy in our institution and to evaluate the reproducibility of our response rates when using the same treatment protocol as another Canadian centre.

Methods:

A retrospective review was undertaken of patients with in-transit melanoma who were treated with intralesional IL-2 in a single institution from 2010 to 2016. Responses were evaluated using RECIST criteria. Demographic data, tumour characteristics, follow-up data, in-transit-free interval, and survival data were collected and analysed.

Results:

Forty-nine patients were identified. Overall tumour response rate was 72%, including complete response in 23 patients (47%) and partial response in 12 patients (24%). Stable disease was observed in 4% of patients and progressive disease in 25%. The main side effects were minor discomfort with injections and auto-limited flu-like symptoms. The presence of tumour-infiltrating lymphocytes may be a predictor of better response.

Conclusion:

This study confirms prior experience with intra-lesional IL-2, demonstrating it to be an effective, safe, and well-tolerated therapy for in-transit melanoma. Tumour-infiltrating lymphocytes as a predictor of better response warrant further study.
Utilizing Aligners to Solve the COVID-19-Affected Orthodontic Practice Conundrum!
Authors: Marya Anand
Published: July 2020

Dentists all around the world are facing a dilemma on whether to resume their practice or not and the ones who have made the effort to resume work, feel they are at high risk of getting infected by the coronavirus. A majority of dental treatments require the use of high-speed handpieces as well as ultrasonic scalers which can make it even more dangerous for the treating dentists and assistants as these release aerosols which could aid in virus transmission. High-quality personal protective equipment is hard to procure and, if so, is very expensive adding to the cost of running clinics during this period. One of the main issues plaguing dentists practicing orthodontics is the inability to see their patients regularly during this period, which can cause a lot of unwanted tooth movements. This is where aligners can be of big help as the entire treatment planning process can be done virtually and the treatment can be monitored without the need of the patient having to visit the clinic physically.
Theorizing the Change: A Neoclassical Realist Approach to Turkish Foreign Policy
Authors: Şahin Mehmet
Published: July 2020

The Turkish foreign policy (TFP) after the Cold War had been based on traditional institutionalized values. In 2009, the governing party consolidated its power and additionally, the international environment provided more space for decision-makers. As a result, the government seeks to change foreign policy preferences in accordance with its agenda. This article examines this change from a neoclassical realist perspective and argues that due to lack of systemic pressure, Turkey can seek new alignments in the Middle East, rather than overlapping its interests with the West.
Multiple Attachments of OSCs in Residential Care
Authors: Kozhumam Arthi Shankar , Chandrashekhar Riti , Rattani Ananya , Ariely Sumedha Gupta
Published: July 2020

This study describes evidence for multiple attachments by orphaned and separated children (OSC) to caregivers and explores predictive relationships between attachment and family social relationships. A sample of forty-three longitudinal children residing in residential care between 15 and 144 months at the time of assessment and forty-two newer-to-care children (entering one to thirteen months before testing) was interviewed in summer 2019. Caregiver attachment was measured using the IPPA Guardian scale, and family social relations were measured using the PROMIS Pediatric Family Relationships scale. Longitudinal children displayed similar attachment scores across a one-year time span regardless of whether they nominated the same or different favourite caretaker. Results are discussed in the context of evidence for multiple attachments and the way attachment can predict social relations for new but not longitudinal children. This paper supports that OSCs form multiple attachments to caregivers over time, with attachment starting and remaining relatively strong in the long-term.
A Qualitative Exploration to Understand Hospitalists’ Attitude Toward the Patient Experience Scoring System
Authors: Segon Ankur , Segon Yogita , Kumar Vivek , Kato Hirotaka
Published: July 2020

Patient’s perception of their inpatient experience is measured by the Center for Medical Services’ (CMS) administered Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS) survey. There is scant existing literature on physicians’ perceptions toward the HCAHPS scoring system. Understanding hospitalist knowledge and attitude toward the HCAHPS survey can help guide efforts to impact HCAHPS survey scores by improving the patient’s perception of their hospital experience. The goal of this study is to explore hospitalists’ knowledge and perspective of the physician communication domain of the HCAHPS survey at an academic medical center. Seven hospitalists at an academic medical center were interviewed for this report using a semistructured interview. Thematic analysis approach was used to analyze data. Open, line-by-line coding was performed on all 7 transcripts. Categories were derived in an inductive fashion. Categories were refined using the techniques of constant comparison and axial coding. We generated themes reflecting hospitalists’ knowledge of the HCAHPS scoring system, their perception of the HCAHPS scoring system and the impact of the HCAHPS scoring system on their practice. While hospitalists acknowledged physician–patient communication is a challenging area to study, they are unlikely to embrace the feedback provided by HCAHPS surveys. There is a need to deploy tactics that provide timely and actionable feedback to providers on their bedside communication skills.