bluuebunny/crossref_metadata_2025 huggingface dataset:
Smart Urban Governance in Epidemic Control: Practices and Implications of Hangzhou
Authors: Zhao Wanxia , Zou Yonghua
Published: May 2022

Appropriate governance tools can facilitate urban governments’ effective responses to crises. Supported by information and communication technologies (ICTs), e-government infrastructure can be employed to achieve smart governance in epidemic control. Examining the case of Hangzhou, this paper discusses the Chinese megacity's adoption of e-government infrastructure as a means of combating the COVID-19 epidemic and stimulating recovering of the economy. This paper also summarizes several policy implications that may serve as points of reference for other cities when formulating their crisis response strategies. The paper concludes that smart governance rooted in the use of e-government infrastructure has exhibited great potential for public health crisis management.
Communication for Coproduction: The Informational Role of Nonprofit Organizations
Authors: Li Huafang
Published: May 2022

Governments and citizens need to coproduce a better response to the coronavirus pandemic. However, the unavailability and inaccessibility of essential information, the information asymmetry between governments and citizens, the misinformation, and the information overload all influence coproduction adversely. NPOs worldwide are making useful information available and accessible to governments and citizens, serving as information intermediaries to reduce the degree of information asymmetry, increasing information credibility to lighten the information overload, and clarifying misinformation. All these informational roles of NPOs are valuable to governments and citizens for fighting against the coronavirus and coproducing better health outcomes.
Inclusivity & Modification Attitudes in Collegiate Intramural Sport: A Pilot Study
Authors: Rougeau K.M. , Sakyi K.S. , Piletic C.K.
Published: May 2022

The purpose of this study was to evaluate college students’ inclusivity and openness for modifications made for those with physical disabilities in intramural sport. Participants were 268 students from two midwestern universities. Attitudes toward inclusivity and modification were assessed using the Collegian Attitudes toward Inclusive Recreation (CAICR) Scale. Data were analyzed using multiple linear regression. Results show that positive attitudes toward inclusivity increased as students got older, and male students were less likely to be inclusive compared to female students. Students majoring in education and human services fields had more positive attitudes toward inclusion than those in arts and sciences fields did. Being a non-traditional student was the only and strongest predictor of less positive attitudes toward modification. Findings demonstrate that students in the two midwestern colleges may have welcoming attitudes toward individuals with physical disabilities in intramural sports; however, they may be less willing to make modifications, particularly among non-traditional students.
Meeting Specific 24-Hour Movement Guidelines Is Associated With BMI Among University Students With Overweight/Obesity
Authors: Bailey Caitlin P. , DiPietro Loretta , Hayman Laura L. , Ahmad Zohaa , Napolitano Melissa A.
Published: May 2022

Background: Approximately 40% of college/university students have overweight/obesity; physical activity and sleep play a role. To address these interrelated behaviors, Canada recently released 24-Hour Movement Guidelines. This study aimed to determine (1) the percent of students with overweight/obesity meeting Canadian 24-Hour Movement Guidelines, (2) whether health behaviors differ by demographics, and (3) whether meeting guidelines is associated with BMI. Methods: University students 18–35 years (n = 459) enrolled in a randomized controlled weight management trial completed 1 week of ActiGraph measured activity, self-reported sleep duration, researcher-measured height/weight, and demographics at baseline. ANOVA and t-tests determined differences in student demographics and BMI among those meeting vs not meeting each guideline. Results: Of the analytic sample (n = 403), 341 (84.6%) met the MVPA guideline, 284 (70.5%) met the LIPA guideline, 236 (58.6%) met the sleep guideline, 62 (15.4%) met the sedentary time guideline, and 34 (8.4%) met all guidelines. Students meeting MVPA (30.8±4.3 vs 32.5±4.5, P = .008) or sleep (30.7±4.4 vs 31.6±4.3, P = .04) guidelines had significantly lower BMIs compared to those not meeting each guideline. Percent of students meeting sleep ( P = .039) or all guidelines ( P = .012) differed by race/ethnicity. Conclusion: Meeting MVPA/sleep guidelines is associated with lower BMI; these behaviors are important targets for future weight management programs.
Utilization of the Modified Lapidus Procedure for Correction of Moderate to Severe Hallux Valgus Deformity With Increased Distal Metatarsal Articular Angle
Authors: Shah Milaan , Stirling Brianna , Jackson J. Benjamin , Gonzalez Tyler
Published: May 2022

Background:

Hallux valgus, a common deformity treated by orthopaedic foot and ankle surgeons, can frequently present with an increased distal metatarsal articular angle (DMAA), which may require correction in addition to the hallux valgus deformity. Thus, we investigated the efficacy of the modified Lapidus procedure, a triplanar correction, in correcting the DMAA in hallux valgus surgery.

Methods:

A retrospective chart review was performed on patients who underwent the hallux valgus reconstruction with a modified Lapidus procedure between April 26, 2018, and November 19, 2020. Exclusion criteria included patients with inadequate follow-up. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and DMAA were measured on preoperative weight-bearing, 2-week postoperative non-weight-bearing, and at final follow-up weight-bearing radiographs.

Results:

The study included a total of 99 cases of modified Lapidus procedure for hallux valgus on 85 subjects. On radiologic assessment, the average DMAA decreased from 17.72 ± 6.18 degrees preoperatively to 9.19 ± 5.19 degrees 2 weeks postoperatively (P < .0001) and 9.79 ± 4.62 degrees at the final follow-up (P < .0001). The average HVA decreased from 31.34 ± 10.39 degrees preoperatively to 13.34 ± 6.16 degrees 2 weeks postoperatively (P < .0001) and 15.05 ± 7.43 degrees at final follow-up (P < .0001). Last, the IMA decreased from 14.99 ± 3.82 degrees preoperatively (P < .0001) to 4.66 ± 2.59 degrees 2 weeks postoperatively and 6.62 ± 3.46 degrees at final follow-up (P < .0001). The recurrence rate was 3.03%.

Conclusion:

The modified Lapidus procedure is an effective procedure in correcting the HVA, IMA, and DMAA in hallux valgus surgery without the need for additional distal or proximal metatarsal osteotomies. Surgeons should consider this technique in patients with moderate to severe hallux valgus deformity who may require correction of their DMAA.

Level of Evidence:

Level IV-Retrospective comparative study.
High Pain Catastrophizing Scale Predicts Lower Patient-Reported Outcome Measures in the Foot and Ankle Patient
Authors: Veljkovic Andrea , Gagne Oliver , Abuhantash Monther , Younger Alastair S. E. , Symes Michael , Penner Murray J. , Wing Kevin J. , Syed Khalid A. , Lau Johnny
Published: May 2022

Background:

Postoperative outcomes may be affected by the patient’s preoperative morbidity. It is hypothesized that patient’s pain catastrophization prior to foot and ankle surgery may affect their patient-reported outcomes. Methods: This study prospectively assessed a consecutive cohort of 46 patients undergoing foot and ankle reconstruction to describe the relationship between Pain Catastrophizing Scale (PCS) and patient-reported outcomes measured by 12-item Short Form Health Survey and Foot and Ankle Outcome Score (FAOS).

Results:

The 1-year postoperative FAOS pain, activities of daily living, and quality of life scores correlated significantly with all baseline PCS subcategories. We found that the mental domain of the SF-12 had a statistically significant correlation with the rumination and helplessness PCS subcategories.

Conclusion:

This study showed a significant association between a high preoperative PCS and a worse 1-year FAOS. As such, catastrophization could be screened for and potentially treated preoperatively to improve patient-reported outcomes in elective foot and ankle surgery.

Level of Evidence:

Therapeutic, Level III Evidence
Relapsed acute lymphoblastic leukaemia after allogeneic stem cell transplantation: a therapeutic dilemma challenging the armamentarium of immunotherapies currently available (case reports)
Authors: Poyer Fiona , Füreder Anna , Holter Wolfgang , Peters Christina , Boztug Heidrun , Dworzak Michael , Engstler Gernot , Friesenbichler Waltraud , Köhrer Stefan , Lüftinger Roswitha , Ronceray Leila , Witt Volker , Pichler Herbert , Attarbaschi Andishe
Published: May 2022

While survival rates in paediatric acute lymphoblastic leukaemia (ALL) nowadays exceed 90%, systemic ALL relapse, especially after haemopoietic stem cell transplantation (HSCT), is associated with a poor outcome. As there is currently no standardized treatment for this situation, individualized treatment is often pursued. Exemplified by two clinical scenarios, the aim of this article is to highlight the challenge for treating physicians to find a customized treatment strategy integrating the role of conventional chemotherapy, immunotherapeutic approaches and second allogeneic HSCT. Case 1 describes a 2-year-old girl with an early isolated bone marrow relapse of an infant KMT2A-rearranged B-cell precursor ALL after allogeneic HSCT. After bridging chemotherapy and lymphodepleting chemotherapy, chimeric antigen receptor (CAR) T-cells (tisagenlecleucel) were administered for remission induction, followed by a second HSCT from the 9/10 human leukocyte antigen (HLA)-matched mother. Case 2 describes a 16-year-old girl with a late, isolated bone marrow relapse of B-cell precursor ALL after allogeneic HSCT who experienced severe treatment toxicities including stage IV renal insufficiency. After dose-reduced bridging chemotherapy, CAR T-cells (tisagenlecleucel) were administered for remission induction despite a CD19- clone without prior lymphodepletion due to enhanced persisting toxicity. This was followed by a second allogeneic HSCT from the haploidentical mother. While patient 2 relapsed around Day + 180 after the second HSCT, patient 1 is still in complete remission >360 days after the second HSCT. Both cases demonstrate the challenges associated with systemic ALL relapse after first allogeneic HSCT, including chemotherapy-resistant disease and persisting organ damage inflicted by previous therapy. Immunotherapeutic approaches, such as CAR T-cells, can induce remission and enable a second allogeneic HSCT. However, optimal therapy for systemic ALL relapse after first HSCT remains to be defined.
Application of transfer learning for the prediction of blast impulse
Authors: Pannell Jordan J , Rigby Sam E , Panoutsos George
Published: May 2022

Transfer learning offers the potential to increase the utility of obtained data and improve predictive model performance in a new domain, particularly useful in an environment where data is expensive to obtain such as in a blast engineering context. A successful application in this respect will improve existing surrogate modelling approaches to allow for holistic and efficient strategies to protect people and structures subjected to the effects of an explosion. This paper presents a novel application of transfer learning for the prediction of peak specific impulse where we demonstrate that previous knowledge learned when modelling spherical charges can be transferred to provide a performance benefit when modelling cylindrical charges. To evaluate the influence of transfer learning, two artificial neural network architectures were stress tested for three levels of random data removal: the first model (NN) did not implement transfer learning whilst the second model (TNN) did by including a bolt-on network to a previously published NN model trained on the spherical dataset. It is shown the TNN consistently outperforms the NN, with this out-performance increasing as the proportion of data removed increases and showing statistically significant results for the low and high threshold with less variability in all cases. This paper indicates transfer learning applications can be used successfully with considerable benefit with respect to surrogate modelling in a blast engineering context.
Rural revitalization in China: Towards inclusive geographies of ruralization
Authors: Chen Ningning , Kong Lily
Published: May 2022

This commentary welcomes Gillen et al.'s geographies of ruralization as an alternative to the urban-centered analysis of socio-spatial transformation in post-reform China. We offer three perspectives to further develop such alternative articulation by drawing on China's most recent geographical experiences of rural revitalization. The first is the ‘top-down’ process of rural revitalization launched by different levels of Chinese state agents and how this is divergent from local needs or embedded in bottom-up engagement. The second is the temporal dimension of ruralization highlighting how uses of the past are implicated in and legitimize the state agenda of rural revitalization. The third directs attention to the entanglement of nature and culture – that is, how a harmonious human–nature approach to rural revitalization is produced in discourse and practice. We argue that these alternative insights offer possibilities of developing more inclusive geographies of ruralization in the Global South and beyond.
Monitoring haemodynamic changes in rodent models to better inform safety pharmacology: Novel insights from in vivo studies and waveform analysis
Authors: Van Daele Marieke , Cooper Samantha L , Pannucci Patrizia , Wragg Edward S , March Julie , de Jong Iwan , Woolard Jeanette
Published: May 2022

Animal models are essential for assessing cardiovascular responses to novel therapeutics. Cardiovascular safety liabilities represent a leading cause of drug attrition and better preclinical measurements are essential to predict drug-related toxicities. Presently, radiotelemetric approaches recording blood pressure are routinely used in preclinical in vivo haemodynamic assessments, providing valuable information on therapy-associated cardiovascular effects. Nonetheless, this technique is chiefly limited to the monitoring of blood pressure and heart rate alone. Alongside these measurements, Doppler flowmetry can provide additional information on the vasculature by simultaneously measuring changes in blood flow in multiple different regional vascular beds. However, due to the time-consuming and expensive nature of this approach, it is not widely used in the industry. Currently, analysis of waveform data obtained from telemetry and Doppler flowmetry typically examines averages or peak values of waveforms. Subtle changes in the morphology and variability of physiological waveforms have previously been shown to be early markers of toxicity and pathology. Therefore, a detailed analysis of pressure and flowmetry waveforms could enhance the understanding of toxicological mechanisms and the ability to translate these preclinical observations to clinical outcomes. In this review, we give an overview of the different approaches to monitor the effects of drugs on cardiovascular parameters (particularly regional blood flow, heart rate and blood pressure) and suggest that further development of waveform analysis could enhance our understanding of safety pharmacology, providing valuable information without increasing the number of in vivo studies needed.
Characteristics of non-fatal overdoses and associated risk factors in patients attending a specialist community-based substance misuse service
Authors: Ghose Riya , Cowden Fiona , Veluchamy Abirami , Smith Blair H , Colvin Lesley A
Published: May 2022

Introduction

There are concerns about rising drug-related deaths and the potential contribution of prescription analgesics. There is limited understanding regarding the role of prescription analgesics in non-fatal overdoses (NFODs), nor is there a good understanding of what factors are associated with more severe overdose.

Objectives

To explore risk factors and characteristics of NFODs among people attending a specialist community-based substance misuse service.

Methods

After Caldicott approval, data on NFODs, in people attending the Tayside Substance Misuse Service (TSMS), were extracted from the Scottish Ambulance Service database, along with opioid replacement therapy (ORT) prescribing data. Statistical analysis was performed using R studio and Microsoft Excel.

Results

557 people (78% [434/556] male, mean age ± standard deviation 38.4 ± 7.95) had an NFOD. Repeat NFODs were more likely in males compared to females ( p < .0065). Males were more likely to be administered naloxone (OR = 1.94, 95% CI = 1.10–3.40, p < .02). NFODs at home were more likely to be moderate to severe (categorized by Glasgow Comma Scale [ p < .02, OR = 4.95, 95% CI = 1.24–24.38]). Methadone (321/557, 57.63%), benzodiazepines (281/557, 50.45%) and heroin (244/557, 43.81%) were the commonest substances: prescribed methadone overdose was more likely than buprenorphine ( p < .00001). Opioids and benzodiazepines were often taken together (275/557, 49.40%), with almost all gabapentinoid NFODs also involving opioids (60/61, 98.40%).

Conclusions

Polysubstance use with opioids prescribed for ORT, such as methadone, is highly likely to be implicated in NFOD, with males being at the highest risk of severe and repeat NFOD. Future work should focus on strategies to further reduce NFODs.
The effect of diet counseling and physical activity on the components of metabolic syndrome in children: A Randomized Clinical Trial
Authors: Hakim Ashrafalsadat , Bagheri Roya , Ahmadi Angali Kambiz
Published: May 2022

Objective:

Metabolic syndrome is a collection of metabolic abnormalities that increase the risk of cardiovascular disease and diabetes. Therefore, this study investigated the effect of dietary and physical activities counseling on components of metabolic syndrome in school-age children with metabolic syndrome.

Methods:

This study is a randomized clinical trial on children aged 6–12 years ( n = 60) that was conducted with metabolic syndrome. The participants were divided into three groups, the intervention group (including dietary counseling, physical activity counseling, and diet and physical activity counseling group) and a control group. The data collection method in this study was based on interviews with parents and completing a physical activity and nutrition questionnaire appropriate to the group, measuring blood pressure, blood sugar, high-density lipoprotein, triglycerides, and anthropometric indicators including height, waist, and weight. The intervention was carried out for 4 months. Data analysis was performed using SPSS21.

Results:

The results showed that there was a statistically significant difference between the means of abdominal obesity, hypertension, fasting blood sugar, high-density lipoprotein, and triglycerides in the three experimental groups (diet, physical activity, diet, and physical activity) and the control group ( p < 0.001).

Conclusion:

According to the results of this study, counseling on diet and physical activity program execution is an essential base for controlling components of metabolic syndrome in children.
Whose Voices are Prioritised in Criminology, and Why Does it Matter?
Authors: Stockdale Kelly J. , Sweeney Rowan
Published: May 2022

This paper presents in-depth research into the reading lists used by a new criminology Bachelor of Arts degree programme at a post-92 English University. Previous research into structural inequalities in relation to race, ethnicity, and gender that exist within academia in relation to scholarly outlets, and that have focussed on scholarly influence, have charted the most cited or most significant texts in the field or explored gender and race discrepancies within elements of the publication process. In this paper we explore how scholarly work is included in our teaching practice and the impact reading lists have on the student experience of criminology. We highlight a distinct lack of representation and diversity within the authorship of texts in the context of both core and recommended reading for students. We found reading lists to be overwhelmingly white and male. Work by women and people of colour only tended to feature on distinct modules which focussed on gender or ethnicity, race, and crime. Voices from the global majority are excluded from fundamental concepts and criminological theory modules. This paper will discuss our research findings in depth, highlighting where Black and female voices are neglected, marginalised, and excluded in the criminology curriculum.
Bone Mineral Density T-Score is an Independent Predictor of Major Blood Loss in Adult Spinal Deformity Surgery
Authors: Harris Andrew B. , Wang Kevin Y. , Mo Kevin , Kebaish Floreana , Raad Michael , Puvanesarajah Varun , Musharbash Farah , Neuman Brian , Khanna Akhil Jay , Kebaish Khaled M.
Published: May 2022

Study Design

Retrospective Cohort Study.

Objective

The purpose of this study was to determine the effect of low bone mineral density (BMD), as assessed by preoperative Dual-energy X-ray Absorptiometry (DEXA) scans, on intraoperative blood loss following adult spinal deformity (ASD) surgery.

Methods

Patients who received spinal fusion for ASD (>5 levels fused) at a single academic center from 2010-2018 were included in this study. The lowest preoperative T-score was recorded for patients who had preoperative DEXA scans within a year of surgery. Patients with liver/kidney disease or on prescription anticoagulant medication were excluded. Major blood loss was a binary variable defined as above or below the 90th percentile of our cohort. Binomial regression was performed controlling for age, number of vertebrae fused, 3-column osteotomy, primary vs. revision surgery, preoperative platelet count, and if the patient was taking medication for osteoporosis.

Results

91 patients were identified in the cohort. Mean age was 63 ± 11.6 years, 81% female. 56 (62%) of cases included revision of previous instrumentation. Patients had a mean SVA of 9.6 ± 8.6 cm and median of 9 vertebrae fused (range 5-22). The average T-score was -1.2 ± 1.0. Each point lower T-score was associated with significantly higher odds of major blood loss (OR 2.5, 95% CI 1.0 – 5.9) when controlling for age, number of vertebrae fused, 3-column osteotomy, preoperative platelet count and primary vs. revision surgery.

Conclusions

Preoperative T-score is independently associated with increased odds of major blood loss in ASD surgery.
A Case of Adult Clival Osteomyelitis
Authors: Kayode-Ajala Fisayo , Williams Neil , Ejikeme Chidinma , Walji Ali , Farrer William
Published: May 2022

Clival osteomyelitis is a potentially life-threatening skull base infection. It is rare and generally challenging to diagnose and treat. Clival osteomyelitis is typically seen in the pediatric population and is very rare in the adult population. It occurs as a complication of recurring paranasal infections and malignant otitis externa. The exact pathophysiology of osteomyelitis of the clivus is relatively uncertain. Here, we describe a case of a 36-year-old man with medical history significant for hypertension and poorly controlled type 1 diabetes mellitus who experienced recurrent paranasal sinus infection for 2 years. He received multiple antibiotic treatments and underwent adenoidectomy without substantial improvement of symptoms. Ultimately, a diagnosis of the clival osteomyelitis through the help of a computed tomography (CT) scan of the paranasal sinus and neck was made. This diagnosis allowed for adequate intervention and treatment of our patient with subsequent resolution of his presenting symptoms. This case highlights the importance of high suspicion for clival osteomyelitis in patients with recurring sinus infections.
Clinical Outcomes After Suture Tape Augmentation for Ankle Instability: A Systematic Review
Authors: Mercer Nathaniel P. , Kanakamedala Ajay C. , Azam Mohammad T. , Hurley Eoghan T. , Samsonov Alan P. , Walls Raymond J. , Kennedy John G.
Published: May 2022

Background:

There is minimal literature on the use of suture tape augmentation in the treatment of chronic lateral ankle instability (CLAI), prompting an investigation on its use and effect during surgery of the lateral ankle.

Purpose:

To evaluate the evidence for the use of suture tape augmentation in the treatment of CLAI and the outcomes after this procedure.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A literature search was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they evaluated the use of suture tape for CLAI. Outcome measures included the Foot and Ankle Ability Measure, American Orthopaedic Foot and Ankle Society (AOFAS) score, return to play, and radiological improvement in anterior talar translation and talar tilt angle. Quantitative and qualitative analyses were performed.

Results:

There were 11 studies (2 with level 2 evidence, 1 with level 3, and 8 with level 4) including 334 patients (334 ankles) that underwent suture-tape augmentation. The mean age was 27.3 years, 67.3% were women, and the mean follow-up was 27.6 months (range, 11.5-38.5 months). The mean weighted postoperative AOFAS score was 95, and 87.7% were able to return to sports. Overall, 9 recurrent instability events (4.1%) were reported. In 3 studies that compared Broström repair and suture tape augmentation, there were no significant differences between the procedures in recurrent instability (mean difference [MD], 0.81 [95% CI, 0.19 to 3.50]; I 2 = 0%; P = .78), Foot and Ankle Ability Measure (MD, 1.24 [95% CI, –3.73 to 6.21]; I 2 = 66%; P = .63), talar tilt angle improvement (MD, –0.07 [95% CI, –0.68 to 0.54]; I 2 = 0%; P = .42), or anterior talar translation improvement (MD, –0.06 [95% CI, –0.69 to 0.56]; I 2 = 0%; P = .77).

Conclusion:

Suture tape augmentation did not significantly improve clinical or radiological outcomes in the setting of modified Broström repair for CLAI. There is currently insufficient evidence to recommend suture tape augmentation for all patients at this time.
Creating Our Gendered Selves—College Experiences, Work and Family Plans, Gender Ideologies, and Desired Work Amenities Among STEM Graduates
Authors: Peng Rui Jie , Glass Jennifer , Sassler Sharon
Published: May 2022

Studies often cite climate issues in science, technology, engineering, and mathematics (STEM) employment to explain the lack of diversity by gender and race. Yet, little research directly attends to gender and racial differences in the college experiences, expected family roles, and ideological beliefs about gender that create the racialized “gendered selves” graduates bring to STEM occupations. We examine the experiences and beliefs of graduating chemistry and chemical engineering majors at two U.S. universities, showing where they coalesced into intersectional gender groups whose work and family involvement and desired working conditions substantially differ. Gendered family expectations and workplace beliefs at labor market entry subsequently predict career confidence and family-based limits on job searching, both important factors affecting retention in STEM employment. We find that women at career entry are more likely to have lower confidence and more limits on their job search, though patterns differ by ethnicity. This occurs in part because both male and female graduates who report greater expected family responsibility also report lower confidence and more limits in job searching. Overall, aspirational fulfillment is easier for men whose intersectional gender identities fit the dominant STEM workplace culture, and harder for women and non-white graduates with more flexible gender ideologies and greater anticipated household responsibilities.
Osteochondral Allograft Transplantation for a Cartilage Defect of the Humeral Capitellum
Authors: Wagner Kyle R. , Hevesi Mario , Kaiser Joshua T. , Meeker Zachary D. , Cole Brian J.
Published: May 2022

Background:

Cartilage defects of the humeral capitellum most frequently present as osteochondritis dissecans (OCD) in young overhead athletes, such as baseball players. Historically, surgical options have included debridement, marrow stimulation, and osteochondral autograft transplantation. Fresh osteochondral allograft (OCA) transplantation comprises an additional treatment option that can structurally restore osteochondral defects and has demonstrated satisfactory outcomes without the donor-site morbidity associated with osteochondral autograft transplantation.

Indication:

OCA transplantation provides structural restoration of the articular surface and can be used for large (>1 cm diameter) lesions not amenable to refixation. Additionally, OCA transplantation can address both chondral and subchondral pathology and is suited for the treatment of failed previous surgical interventions, such as debridement or marrow stimulation.

Technique Description:

Following diagnostic arthroscopy, an anconeus splitting mini-open approach was performed to expose the capitellar defect. The defect was measured to be 10 mm, and a central guide pin was placed. A 10-mm reamer was used to prepare the defect bed to a depth of 8 mm. An OCA plug was then cut from a fresh femoral hemicondyle to match the prepared defect. The graft was soaked in bone marrow aspirate concentrate harvested from the iliac crest, and the plug was then inserted into the defect and tamped to be concentric with the surrounding articular cartilage.

Results:

OCA transplantation of the capitellum allows for the restoration of the articular surface with a structural graft and can be used for large defects and revision cases. While OCA transplantation is well described in the knee with long-term efficacy, the application of this technique to the capitellum is relatively recent. Recent case series for the capitellum have displayed significant improvements in patient-reported outcome measures and predictable return to sports.

Discussion/Conclusion:

OCA transplantation for the humeral capitellum provides an effective treatment option for large, unstable cartilage lesions not amenable to refixation. The procedure allows for restoration of the articular surface and can provide improvements in pain and function as well as return to sport.
Preparation and properties of jute stick particleboard using citric acid–glycerol mixture as a natural binder
Authors: Nitu Ireen Parvin , Rahman Summia , Islam Md. Nazrul , Ashaduzzaman Md. , Shams Md. Iftekhar
Published: May 2022

The application of citric acid and glycerol as natural binder was investigated for the manufacturing of jute stick particleboard in this study. The effects of citric acid content (0–30 wt%), citric acid and glycerol mixture (ratio of CA–G), and pressing temperatures on the properties of jute stick particleboard were investigated. Citric acid-bonded jute stick particleboard had good mechanical properties and dimensional stability when citric acid concentration was 20 wt% at pressing temperature of 200 °C. By addition of glycerol concentration (40/60), the properties were further increased. The modulus of rupture (MOR) and thickness swelling (TS) values of CA–G (40/60) bonded jute stick particleboard were 19.67 N/mm2 and 9%, respectively, which satisfy the minimum requirement for type-18 of particleboard JIS A 5908 (2003). FTIR analysis confirmed the formation of ester linkage by polymerization reaction between carboxyl groups and alcohol groups. Citric acid and glycerol polymer reacted with jute stick particles and produced cross-linked networks with enhanced properties, hence improved the adhesiveness during particleboard production. It could be concluded that citric acid and glycerol mixture can be a potential natural binder for the production of jute stick particleboard.
BEXCIS: Bayesian methods for estimating the degree of the skewness of X chromosome inactivation
Authors: Yu Wen-Yi , Zhang Yu , Li Meng-Kai , Yang Zi-Ying , Fung Wing Kam , Zhao Pei-Zhen , Zhou Ji-Yuan
Published: May 2022

Background

X chromosome inactivation (XCI) is an epigenetic phenomenon that one of two X chromosomes in females is transcriptionally silenced during early embryonic development. Skewed XCI has been reported to be associated with some X-linked diseases. There have been several methods measuring the degree of the skewness of XCI. However, these methods may still have several limitations.

Results

We propose a Bayesian method to obtain the point estimate and the credible interval of the degree of XCI skewing by incorporating its prior information of being between 0 and 2. We consider a normal prior and a uniform prior for it (respectively denoted by BN and BU). We also propose a penalized point estimate based on the penalized Fieller’s method and derive the corresponding confidence interval. Simulation results demonstrate that the BN and BU methods can solve the problems of extreme point estimates, noninformative intervals, empty sets and discontinuous intervals. The BN method generally outperforms other methods with the lowest mean squared error in the point estimation, and well controls the coverage probability with the smallest median and the least variation of the interval width in the interval estimation. We apply all the methods to the Graves’ disease data and the Minnesota Center for Twin and Family Research data, and find that SNP rs3827440 in the Graves’ disease data may undergo skewed XCI towards the allele C.

Conclusions

We recommend the BN method for measuring the degree of the skewness of XCI in practice. The R package BEXCIS is publicly available at https://github.com/Wen-YiYu/BEXCIS.
The DcPS1 cooperates with OSDLa during pollen development and 2n gamete production in carnation meiosis
Authors: Zhou Xuhong , Li Shuying , Yang Xiaomi
Published: May 2022

Background

Deciphering the mechanisms of meiosis has important implications for potential applications in plant breeding programmes and species evolution. However, the process of meiosis is poorly understood in carnation, which is famous for its cut flowers.

Results

We report that Dianthus caryophyllus parallel spindle 1 (DcPS1) regulates omission of second division like a (OSDLa) during pollen development and 2n gamete production in carnation meiosis. In DcPS1 and OSDLa RNAi lines, an absence of the second meiotic division and the abnormal orientation of spindles at meiosis II might be the main reason for dyad/triad formation, resulting in unreduced gametes. We also found that carnation OSDLa interacted with DcPS1 and DcRAD51D. In the DcPS1 RNAi lines, a decrease in OSDLa and DcRAD51D expression was observed. In the OSDLa RNAi lines, a decrease in DcPS1 and DcRAD51D expression was also observed. We propose that DcPS1 regulates OSDLa expression, allowing entry into meiosis II and the proper orientation of the metaphase II spindle in meiosis II. We also propose that OSDLa regulates DcRAD51D expression, allowing for homologous recombination.

Conclusions

These results suggest a critical role for DcPS1 and OSDLa in diplogamete production during meiosis and open a new pathway for meiosis-related studies.
Course of uncomplicated acute gastroenteritis in children presenting to out-of-hours primary care
Authors: Weghorst Anouk A. H. , Bonvanie Irma J. , Holtman Gea A. , de Boer Michiel R. , Berger Marjolein Y.
Published: May 2022

Background

The aim of this article is to describe the courses of vomiting, diarrhea, fever, and clinical deterioration, in children with uncomplicated gastroenteritis at presentation. This study was performed as a 7-day prospective follow-up study in an out-of-hours primary care service. The course of vomiting, diarrhea, and fever was analyzed by generalized linear mixed modeling. Because young children (≤ 12 months) and children with severe vomiting are at increased risk of dehydration, the potentially more complicated courses of these groups are described separately. The day(s) most frequently associated with deterioration and the symptoms present in children who deteriorated during follow-up were also described.

Results

In total, 359 children presented with uncomplicated acute gastroenteritis to the out-of-hours primary care service. Of these, 31 (8.6%) developed a complicated illness and needed referral or hospitalization. All symptoms decreased within 5 days in most children (> 90%). Vomiting and fever decreased rapidly, but diarrhea decreased at a somewhat slower pace, especially among children aged 6–12 months. Children who deteriorated during follow-up had a higher frequency of vomiting at presentation and higher frequencies of vomiting and fever during follow-up.

Conclusions

The frequency of vomiting, not its duration, appears to be the more important predictor of deterioration. When advising parents, it is important to explain the typical symptom duration and to focus on alarm symptoms. Clinicians should be vigilant for children with higher vomiting frequencies at presentation and during follow-up because these children are more likely to deteriorate.
Physical and mental health outcomes of an integrated cognitive behavioural and weight management therapy for people with an eating disorder characterized by binge eating and a high body mass index: a randomized controlled trial
Authors: Hay Phillipa , Palavras Marly Amorim , da Luz Felipe Quinto , dos Anjos Garnes Sérgio , Sainsbury Amanda , Touyz Stephen , Appolinario José Carlos , Claudino Angélica Medeiros
Published: May 2022

Background

Bulimia nervosa (BN) and binge eating disorder (BED) are eating disorders (EDs) characterized by recurrent binge eating. They are associated with medical complications, impaired adaptive function and often a high BMI, for which a multidisciplinary treatment approach may be needed. This study explored the efficacy of a novel intervention integrating Cognitive Behavioural Therapy- Enhanced (CBT-E) and weight management for people with recurrent binge eating episodes and high BMI with respect to physical, psychopathological and quality of life outcomes.

Methods

Ninety-eight adults diagnosed with BN, BED, or Other Specified/Unspecified Feeding or Eating Disorder (OSFED/UFED) and BMI ≥ 27 to <40 kg/m2 were randomized to a multidisciplinary approach, the Healthy APproach to weIght management and Food in Eating Disorders (HAPIFED) or to CBT-E. Metabolic parameters, health-related quality of life, general psychological and ED symptoms and ED diagnostic status outcomes are reported. Data were analyzed with mixed effects models adopting multiple imputed datasets where data were missing.

Results

Both HAPIFED and CBT-E showed statistical significance for the time effect, with reduction in stress (p < 0.001), improvement in mental health-related quality of life (p = 0.032), reduction in binge eating severity (p < 0.001), and also in global ED symptoms scores (p < 0.001), with the significant changes found at end of treatment and sustained at 12-month follow-up. However, no statistical significance was found for differences between the interventions in any of the outcomes measured. Despite a high BMI, most participants (> 75%) had blood test results for glucose, insulin, triglycerides and cholesterol within the normal range, and 52% were within the normal range for the physical component of quality of life at baseline with no change during the trial period.

Conclusion

Integrating weight and ED management resulted in comparable outcomes to ED therapy alone. Although adding weight management to an ED intervention had no adverse effects on psychological outcomes, it also had no beneficial effect on metabolic outcomes. Therefore, more intense weight management strategies may be required where indicated to improve metabolic outcomes. Safety will need to be concurrently investigated.

Trial registration

US National Institutes of Health clinical trial registration number NCT02464345, date of registration 08/06/2015. Changes to the present paper from the published protocol paper (Trials 18:578, 2015) and as reported in the Trial registration (clinicaltrials.gov) are reported in Supplementary File 1.
Metformin exerts an antitumor effect by inhibiting bladder cancer cell migration and growth, and promoting apoptosis through the PI3K/AKT/mTOR pathway
Authors: Shen Zhiyong , Xue Dong , Wang Kun , Zhang Facai , Shi Jiaqi , Jia Benzhong , Yang Dan , Zhang Qianjin , Zhang Shuai , Jiang Hongyu , Luo Daiqin , Li Xueying , Zhong Quliang , Zhang Junhao , Peng Zheng , Han Yu , Sima Chongyang , He Xiaozhou , Hao Lin
Published: May 2022

Background

To observe and explore the effect of metformin on the migration and proliferation of bladder cancer T24 and 5637 cells in vitro.

Methods

Bladder cancer T24 and 5637 cell lines were cultured in vitro, and were divided into group A (blank control group) and group B (metformin group: 5, 10, 15, and 20 mmol/L); both groups were plated on 6-well plates at the same time. Culture in 24-well plates was used for wound healing assays and in 96-well plates for Transwell migration and invasion, and Cell Counting Kit-8 proliferation experiments. We observed and detected the cell migration and proliferation ability of each group at 48 h, and calculated the cell migration area and survival rate. Flow cytometry was used to detect cell apoptosis in the groups. The apoptosis-related proteins, cleaved-caspase 3, cleaved-PARP, and the PI3K/AKT/mTOR signaling pathway member proteins PI3K, phosphorylated (p)-PI3K, AKT, p-AKT, mTOR, and p-mTOR were detected using western blotting.

Results

After 48 h of treatment with different concentrations of metformin, the cell migration and proliferation capabilities were significantly lower than those in the blank control group. The proliferation and migration abilities of T24 and 5637 cells decreased in a metformin concentration-dependent manner (P < 0.05). The apoptosis rate under different concentrations of metformin, as detected by flow cytometry, showed a significantly higher rate in the metformin group than in the control group (P < 0.05). Compared with that in the control group, the level of cleaved-caspase 3 and cleaved-PARP protein in the metformin group was increased in each treatment group, and the levels of p-mTOR, p-AKT, and p-PI3K decreased significantly compared with those in the control group (P < 0.05).

Conclusion

Metformin inhibited bladder cancer T24 and 5637 cell migration and proliferation, and induced their apoptosis. The mechanism might involve inhibition of the activation of the PI3K/AKT/mTOR signaling pathway.
Effect of GaAlAs 940 nm Photobiomodulation on palatal wound healing after free gingival graft surgery: a split mouth randomized controlled clinical trial
Authors: Morshedzadeh Ghazal , Aslroosta Hoori , Vafaei Mahsa
Published: May 2022

Background

The aim of this study was to evaluate the effects of photobiomodulation (PBM) on wound healing, pain, and discomfort at free gingival graft (FGG) donor sites.

Methods

Sixteen patients in need of bilateral FGG were selected for this randomized, controlled, triple-blinded, and split mouth clinical trial. The FGG donor sites in test group were treated with LLLT GaAlAs 940 nm, 5 J/cm2 immediately after surgery and every other day within the following ten days. The control group received sham irradiation. Remaining Wound Area (RWA), Epithelialization and color match were evaluated on the day of surgery and 7, 14, 21, 28, and 60 days after surgery. A questionnaire was administered to measure pain and bleeding in the first ten days after surgery.

Results

RWA was significantly smaller in the test than control group on the days 7 (p < 0.001) and 14 (p = 0.048) after the surgery. Bleeding was higher in the test group than in the control group on the day of surgery (p = 0.046). Pain and discomfort at the palatal donor site, however, had no significant difference between laser and control group during 11 days after the surgery (p > 0.05), nor did the Color match scores on the 28th and 60th days after the surgery (p > 0.05).

Conclusions

It can be concluded that PBM enhances FGG donor site wound healing one and two weeks after the surgery.

Trial registration

IRCT2017092036203N2, registered 01.11.2017.
Do palliative care patients and relatives think it would be acceptable to use Bispectral index (BIS) technology to monitor palliative care patients’ levels of consciousness? A qualitative exploration with interviews and focus groups for the I-CAN-CARE research programme
Authors: Krooupa Anna-Maria , Stone Patrick , McKeever Stephen , Seddon Kathy , Davis Sarah , Sampson Elizabeth L. , Tookman Adrian , Martin Jonathan , Nambisan Vinnie , Vivat Bella
Published: May 2022

Background

Bispectral index (BIS) monitoring uses electroencephalographic data as an indicator of patients’ consciousness level. This technology might be a useful adjunct to clinical observation when titrating sedative medications for palliative care patients. However, the use of BIS in palliative care generally, and in the UK in particular, is under-researched. A key area is this technology’s acceptability for palliative care service users. Ahead of trialling BIS in practice, and in order to ascertain whether such a trial would be reasonable, we conducted a study to explore UK palliative care patients’ and relatives’ perceptions of the technology, including whether they thought its use in palliative care practice would be acceptable.

Methods

A qualitative exploration was undertaken. Participants were recruited through a UK hospice. Focus groups and semi-structured interviews were conducted with separate groups of palliative care patients, relatives of current patients, and bereaved relatives. We explored their views on acceptability of using BIS with palliative care patients, and analysed their responses following the five key stages of the Framework method.

Results

We recruited 25 participants. There were ten current hospice patients in three focus groups, four relatives of current patients in one focus group and one individual interview, and eleven bereaved relatives in three focus groups and two individual interviews. Our study participants considered BIS acceptable for monitoring palliative care patients’ consciousness levels, and that it might be of use in end-of-life care, provided that it was additional to (rather than a replacement of) usual care, and patients and/or family members were involved in decisions about its use. Participants also noted that BIS, while possibly obtrusive, is not invasive, with some seeing it as equivalent to wearable technological devices such as activity watches.

Conclusions

Participants considered BIS technology might be of benefit to palliative care as a non-intrusive means of assisting clinical assessment and decision-making at the end of life, and concluded that it would therefore be acceptable to trial the technology with patients.