bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancing Evaluation and Learning on Transformational Change: Lessons From the Climate Investment Funds’ Transformational Change Learning Partnership
Authors: Williams Anna , Dickman Joseph , Smurthwaite Regan
Published: November 2020

Inspiring the transformational changes required to address the climate crisis, as well as other global challenges, requires acting boldly and taking risks. New approaches that integrate transformational change thinking and concepts into evaluations, and that further deepen the nexus of evaluation and learning, are urgently needed. In 2017, Climate Investment Funds established the Transformational Change Learning Partnership (TCLP) within its Evaluation and Learning Initiative to facilitate an evidence-based learning collaboration on transformational change in climate action. The TCLP developed and implemented a set of frameworks for evaluating transformational change, including dimensions, stages, and signals of transformational change in climate action. Building on this work, we have arrived at several reflections related to making evaluation a more potent tool in understanding transformation. Let us embrace this challenge and leverage the potential of evaluation to contribute to a safer, more sustainable, and more prosperous world for all.
Quality of domestic cat semen collected by urethral catheterization after the use of different alpha 2-adrenergic agonists
Authors: Madrigal-Valverde Mónica , Bittencourt Rodrigo F , Ribeiro Filho Antonio DL , Barbosa Vivian F , Vieira Catharina A , Romão Elton A , Carneiro Isabella B , Azevedo Milena C , Araujo Gediendson R
Published: November 2020

Objectives

We compared the effects of two alpha (α)2-adrenergic agonists on semen traits.

Methods

In this study, 13 adult domestic cats were divided into two experimental groups, according to the chemical ejaculation protocol used: the first group received medetomidine hydrochloride (100 µg/kg) and ketamine (5000 µg/kg); the second group received dexmedetomidine hydrochloride (25 µg/kg) and ketamine (5000 µg/kg), both by the intramuscular route.

Results

The animals responded positively ( P >0.05) to chemical collection. Seminal parameters evaluated included volume, sperm vigor, total motility, progressive motility, sperm concentration, and the structural and functional integrity of the plasma membrane; sperm morphology values did not differ between groups ( P >0.05).

Conclusions and relevance

The results indicated that dexmedetomidine is a more viable and economical alternative to medetomidine in domestic cats submitted to semen collection by urethral catheterization. Semen collection by urethral catheterization after using α2-adrenergic agonists is a recently developed technique in feline species that is considered to be quick and highly applicable to assisted reproduction programs in felids.
Under the punitive aegis: Dependency and the family justice center model
Authors: Piehowski Victoria
Published: November 2020

The San Diego Family Justice Center (FJC) model seeks to lessen the burden on domestic violence victims by co-locating social service agencies, law enforcement, and prosecution at one site. Shortly following the inception of the model in 2002, it gained widespread acclaim (and federal funding), spreading the model across the country. Using visual and textual discourse analysis, this paper examines the promotional and procedural material produced by proponents of the San Diego FJC model. FJC materials construct victimhood using discourses of crime control and therapeutic intervention. The resulting discursive formation is that of the passive, dependent battered woman, curable only through robustly punitive state intervention. In this way, FJC materials not only advance a distinct construction of victimhood but also a particular agenda for punishment policy. Extending Jonathan Simon’s contentions regarding the resonance of victim discourse within American society, I argue that therapeutic discourse can bolster the effectiveness of punitive campaigns.
Raciolinguistic border-making and the elasticity of assessment and believeability in the UK citizenship process
Authors: Khan Kamran
Published: November 2020

Citizenship testing in the UK assesses the applicant’s knowledge of English and of life in the UK as part of a legal requirement. This testing is one part of the British citizenship process which also creates other forms of assessment for applicants that function as bordering techniques. This paper demonstrates how these non-test forms of assessment emerge, in some cases, before the citizenship test through pre-arrival language testing for non-EU spouses and family reunification. They also take place after the citizenship test through citizenship ceremonies and post-ceremony passport interviews. The data is drawn from a four year project examining the experiences of those experiencing the citizenship process. Using the notion of raciolinguistic perspectives and Derrida’s metaphor of the Shibboleth, I show how the individual may stand in the face of judgment in various forms through their interactions with the State. The multiple assessment points in the naturalisation process beyond the main test itself enforce the need for ‘believeability’ of the applicant who must submit themselves to be assessed – in some cases, repeatedly.
Identification of two molecular subtypes of dysregulated immune lncRNAs in ovarian cancer
Authors: Liu Xiaojun , Gao Jinghai , Wang Jing , Chu Jing , You Jiahao , Jin Zhijun
Published: November 2020

Long non-coding RNA (lncRNA) has increasingly been identified as a key regulator in pathologies such as cancer. Multiple platforms were used for comprehensive analysis of ovarian cancer to identify molecular subgroups. However, lncRNA and its role in mapping the ovarian cancer subpopulation are still largely unknown. RNA-sequencing and clinical characteristics of ovarian cancer were acquired from The Cancer Genome Atlas database (TCGA). A total of 52 lncRNAs were identified as aberrant immune lncRNAs specific to ovarian cancer. We redefined two different molecular subtypes, C1(188) and C2(184 samples), in “iClusterPlus” R package, among which C2 grouped ovarian cancer samples have higher survival probability and longer median survival time ( P <0.05) with activated IFN-gamma response, Wound Healing and Cytotoxic lymphocytes signal; 456 differentially expressed genes were acquired in C1 and C2 subtypes using limma (3.40.6) package, among which 419 were up-regulated and 37 were down-regulated, in TCGA dataset. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analysis revealed that these genes were actively involved in ECM-receptor interaction, PI3K-Akt signaling pathway interaction KEGG pathway. Compared with the existing immune subtype, the Cluster2 sample showed a substantial increase in the proportion of the existing C2 immune subtype, accounting for 81.37%, which was associated with good prognosis. Our C1 subtype contains only 56.49% of the existing immune C1 and C4, which also explains the poor prognosis of C1. Furthermore, 52 immune-related lncRNAs were used to divide the TCGA-endometrial cancer and cervical cancer samples into two categories, and C2 had a good prognosis. The differentially expressed genes were highly correlated with immune-cell-related pathways. Based on lncRNA, two molecular subtypes of ovarian cancer were identified and had significant prognostic differences and immunological characteristics.
Evaluation of knitted suit fabric style based on fuzzy neural network
Authors: Li Xintong , Cong Honglian , Gao Zhe
Published: November 2020

In order to better judge the fabric style of knitted suit fabrics and improve the production quality of knitted suit fabrics, we use principal component analysis and cluster analysis methods to process fabric samples and evaluation indicators, and use neural network technology to establish The fuzzy neural network model outputs comprehensive evaluation values to judge knitted suit fabrics. The results show that the predicted value of the model output is above 0.6. The style of knitted suit fabric is close to that of traditional woven suit fabric, the flexural stiffness is between 5 and 20 μN• m, the extensibility is between 10% and 20% and the shear stiffness is between 50 N/m. The value of wool and polyester fabric is basically above 0.7, and the style is similar to the woven suit fabric, followed by knitted suit fabrics of cotton and polyester.
Nonlinear friction dynamic modeling and performance analysis of flexible parallel robot
Authors: Zhao Lei , Zhao Xin-hua , Li Bin , Yang Yu-wei , Liu Liang
Published: November 2020

The article presents a friction dynamic modeling method for a flexible parallel robot considering the characteristics of nonlinear friction. An approximate friction model which is proposed by Kostic et al. is applied to establish the dynamic model with Lagrange method. Parameters identification is completed by least square method, and the tracking accuracy and the stability of the robot are systematically analyzed before and after dynamic compensation at different speeds. Its position error of the robot after compensation is only 0.98 mm at low speed. The accuracy is improved 10 times than that before compensation. In addition, the peak velocity errors are 3.97 mm·s−1 and 1.49 mm·s−1 at high and low speed, respectively, which are reduced 2.5 times than that before compensation. The experimental data also indicate that velocity tracking curve has no obvious peak error compared with the common method based on Coulomb and viscous friction model. The curve is much smoother with proposed model, and the motion stability of robot at high speed has been greatly improved. The proposed method just needs the robot to collect some positions before path tracing, and the parameters identification of dynamic model can be completed quickly. The compensation effect is much more better than common method. So the proposed method can be extended to complete the dynamic identification for complex robot with more joints. It is helpful to further improve the stability and the accuracy at high speed.
The effects of easy goals versus difficult goals on acquisition and retention of a sport skill in children with intellectual disability
Authors: Mohammadi Mohadeseh , Borujeni Mehdi Rafei , Movahedi Ahmadreza , Salehi Hamid
Published: November 2020

The purpose of the present study was to examine the effects of easy goals versus difficult goals on acquisition and retention of basketball free throws in children with intellectual disability. Twenty-one children with intellectual disability were randomly assigned to an easy goals or difficult goals group. The participants were required to improve their basketball free throws according to their own scores in the previous exercise session. More difficult goals were set for the difficult goals group than for the easy goals group. The groups exercised the task for nine sessions. Both groups performed pretest, acquisition, and retention tests. Results showed that participants with easy goals improved their performance while the participants with difficult goals failed to improve their performance. These findings indicate that providing children with intellectual disability with easy goals facilitates the process of sport skill learning.
Management of scapholunate advanced collapse and scaphoid nonunion advanced collapse without proximal row carpectomy or four corner fusion
Authors: Zhang Yiyang , Gillis Joshua A. , Moran Steven L.
Published: November 2020

Four corner arthrodesis and proximal row carpectomy are the most common techniques for the management of advanced radiocarpal arthritis due to longstanding scapholunate instability and scaphoid nonunion. The advantages and short comings of each technique have been well defined in the literature. Advancements in joint replacement and arthroscopic surgery have resulted in new operations to manage radiocarpal and midcarpal arthritis. Most of these new procedures are modifications of the two classical operations, but some use modern implants and newer materials. New individualized options, like osteochondral grafting in combination with proximal row carpectomy or (arthroscopic) distal resection of the scaphoid, allowed us to improve our treatment and offer patients less invasive but equally effective procedures. We consider that four corner arthrodesis and proximal row carpectomy should not always be standard management for advanced radiocarpal arthritis.
Distinguishing Between Lambdoid Craniosynostosis and Deformational Plagiocephaly: A Review of This Paradigm Shift in Clinical Decision-Making and Lesson for the Future
Authors: Birgfeld Craig B. , Heike Carrie
Published: November 2020

The cause of occipital asymmtery can be either extrinsic or intrinsic. Intrinsic causes include lambdoid craniosynsotosis. This condition is generally treated with cranial vault expansion surgery. Extrinsic causes include deformational plagiocephaly, which became commonplace after the "Back to Sleep Campaign" instituted in the 1980s by the American Academy of Pediatrics. The treatment of this condition is non surgical. Dr. Joseph Gruss was instumental in differentiating between these conditions and reducing the number of unnecessary surgeries that were previously being performed.
Resolution of Vertical Gaze Following a Delayed Presentation of Orbital Floor Fracture With Inferior Rectus Entrapment: The Contributions of Charles E. Iliff and Joseph S. Gruss in Orbital Surgery
Authors: Gowda Arvind U. , Manson Paul N. , Iliff Nicholas , Grant Michael P. , Nam Arthur J.
Published: November 2020

Introduction:

Orbital floor fractures occur commonly as a result of blunt trauma to the face and periorbital region. Orbital floor fractures with a “trapdoor” component allow both herniation and incarceration of contents through a bone defect into the maxillary sinus as the bone rebounds faster than the soft tissue, trapping muscle, fat, and fascia in the fracture site. In children, the fractured floor, which is often hinged on one side, tends to return toward its original anatomical position due to the incomplete nature of the fracture and elasticity of the bone. The entrapment of the inferior rectus muscle itself is considered a true surgical emergency—prolonged entrapment frequently leads to muscle ischemia and necrosis leading to permanent limitation of extraocular motility and difficult to correct diplopia. For this reason, prompt surgical intervention is recommended by most surgeons. In adults, true entrapment of the muscle itself is not as common because the orbital floor is not as elastic and fractures are more complete.

Methods:

We present an adult patient with an isolated orbital floor fracture with clinical and radiologic evidence of true entrapment of the inferior rectus muscle itself.

Results:

Despite the delayed surgical repair (4 days after the injury), the patient’s inferior rectus muscle function returned to near normal with mild upward gaze diplopia.

Conclusions:

Inferior rectus entrapment in adults may more likely be associated with immobilization of the muscle without total vascular compression/incarceration significant enough to lead to complete ischemic necrosis.
Situated Embodiment: When Physical Weight Does and Does Not Inform Judgments of Importance
Authors: Hauser David J. , Schwarz Norbert
Published: November 2020

Bodily sensations impact metaphorically related judgments. Are such effects obligatory or do they follow the logic of knowledge accessibility? If the latter, the impact of sensory information should be moderated by the accessibility of the related metaphor at the time of sensory experience. We manipulated whether “importance” was on participants’ minds when they held a physically heavy versus light book. Participants held the book while making an importance judgment versus returned it before making the judgment (Study 1) or learned prior to holding the book that the study was about “importance evaluations” versus “graphics evaluations” (Study 2). In both studies, the same book was judged more important when its heft was increased but only when importance was on participants’ minds at the time of sensory experience. We conclude that sensory experiences only impact metaphorically related judgments when the applicable metaphor is highly accessible at the time of experience.
Pancreatic metastases and first reported gallbladder metastasis from phyllodes tumor of the breast
Authors: Nasri Salsabil , Hamila Fehmi , Bourigua Rym , Mestiri Sarra , Elghali Mohamed Amine
Published: November 2020

Distant metastases from breast phyllodes tumor (PT) are very rare. They usually occur in lung and bones. We report a case of a 51-year-old woman who was hospitalized in the digestive surgical department for atypical epigastric pain. Her medical history started 2 years ago when she underwent a curative left mastectomy for a malignant PT of the breast. Radical surgery was indicated to her resectable pancreatic tumor diagnosed on computed tomography. Histological exam confirmed that it was pancreatic metastases of her breast PT. Adjuvant chemotherapy was indicated. Three months after the surgery, the patient developed gallbladder and brain metastases. She died 5 weeks later. With this case, we enrich the literature with another example of pancreatic metastasis from PT and we report, for the first time, gallbladder metastasis. The very high aggressiveness of this tumor suggests that markers of tumor malignancy need to be sought after by subsequent studies.
Two‐year effectiveness and safety of golimumab in ulcerative colitis: An IG‐IBD study
Authors: Pugliese Daniela , Privitera Giuseppe , Rogai Francesca , Variola Angela , Viola Anna , Laterza Lucrezia , Privitera Antonino C. , Allocca Mariangela , Bossa Fabrizio , Cappello Maria , Daperno Marco , Lorenzon Greta , Mazzuoli Silvia , Principi Mariabeatrice , Sablich Renato , Moser Luisa , Ferronato Antonio , Traini Sara , Tapete Gherardo , Bodini Giorgia , Di Girolamo Maria , Grossi Laurino , Mocci Giammarco , Ricci Chiara , Saibeni Simone , Festa Stefano , Spagnuolo Rocco , Cortelezzi Claudio C. , Mocciaro Filippo , Rizzello Fernando , Armuzzi Alessandro ,   The Italian Group for the Study of Inflammatory Bowel Disease (IG‐IBD)
Published: November 2020

Background

Few data exist regarding the long‐term effectiveness of golimumab in ulcerative colitis. No data have been reported on real‐world continuous clinical response.

Objective

This study aimed to describe the long‐term outcomes in a large cohort of patients on golimumab who had ulcerative colitis.

Methods

Consecutive patients with active ulcerative colitis, started on golimumab, were enrolled and prospectively followed up. The primary end point was to evaluate the long‐term persistence on golimumab therapy.

Results

A total of 173 patients with ulcerative colitis were studied. Of these, 79.2% were steroid dependent, and 46.3% were naïve to anti‐tumour necrosis factor alpha agents. The median duration of golimumab therapy was 52 weeks (range: 4–142 weeks). The cumulative probability of maintaining golimumab treatment was 47.3% and 22.5% at 54 and 108 weeks, respectively. Biological‐naïve status (odds ratio [OR] = 3.02, 95% confidence interval [CI]: 1.44–6.29; p = 0.003) and being able to discontinue steroids at Week 8 (OR = 3.32, 95% CI: 1.34–8.30; p = 0.010) and Week 14 (OR = 2.94, 95% CI: 1.08–8.02; p = 0.036) were associated with longer persistence on therapy. At Week 54, 65/124 (52.4%) postinduction responders were in continuous clinical response. A continuous clinical response was associated with a lower likelihood of golimumab discontinuation throughout the subsequent year of therapy (p < 0.01). Overall, 40 (23.1%) patients were in clinical remission at the last follow‐up visit. Twenty‐six adverse events were recorded, leading to golimumab withdrawal in 9.2% of patients.

Conclusions

: Biological‐naïve status and not requiring steroids at Weeks 8 and 14 seem to be associated with a longer persistence on golimumab therapy in ulcerative colitis.
COVID-19: Understanding Testing
Authors: Cadet Myriam Jean
Published: November 2020

Occupational health nurses need to understand tests for COVID-19 infection and antibodies, how to interpret results, and where to find credible information and resources.
Combined Anterior Osteophytectomy and Cricopharyngeal Myotomy for Treatment of DISH-Associated Dysphagia
Authors: Hines Kevin , Elmer Nicholas , Detweiler Maxwell , Fatema Umma , Gonzalez Glenn A. , Montenegro Thiago S. , Franco Daniel , Prasad Srinivas , Jallo Jack , Sharan Ashwini , Heller Joshua , Boon Maurits , Spiegel Joseph , Harrop James
Published: November 2020

Study Design:

Retrospective observational case series.

Objective:

To assess the outcome of patients with diffuse idiopathic skeletal hyperostosis (DISH) with dysphagia who underwent cricopharyngeal myotomy (CPM) in conjunction with anterior osteophytectomy (OP).

Methods:

This is a retrospective observational study of 9 patients that received combined intervention by neurosurgeons and otolaryngologists. Inclusion criteria for surgery consisted of patients who failed to respond to conservative treatments for dysphagia and had evidence of both upper esophageal dysfunction and osteophyte compression. We present the largest series in literature to date including patients undergoing combined OP and CPM.

Results:

A total of 88.9% (8/9) of the patients who underwent OP and CPM showed improvement in their symptoms. Of the aforementioned group, 22.2% of these patients had complete resolution of their symptoms, 11.1% did not improve, and only 2 patients showed recurrence of their symptoms. None of the patients in whom surgery was performed required reoperation or suffered serious complication related to the surgical procedures.

Conclusion:

Based on the literature results, high rate of improvements in dysphagia, and low rate of complications, combined OP and CPM procedures may be beneficial to a carefully selected group of patients.
Hospital Burdens of Patients With Cerebral Palsy Undergoing Posterior Spinal Fusion for Scoliosis
Authors: Anastasio Albert T. , Guisse Ndeye F. , Farley Kevin X. , Rhee John M.
Published: November 2020

Study Design:

Retrospective cohort study.

Objectives:

Many patients undergoing posterior spinal fusion (PSF) for scoliosis have concurrent cerebral palsy (CP), which is associated with many medical comorbidities and inherent operative risk. We aimed to quantify the contribution of CP to increased cost, length of stay (LOS), and complication rates in patients with scoliosis undergoing PSF.

Methods:

Using the National Inpatient Sample database, we collected data regarding patient demographics, hospital characteristics, comorbidities, in-hospital complications, and mortality. Primary outcomes included complications, hospital LOS, and total hospital costs. Multivariate regression models assessed the contribution of CP to in-hospital complications, discharge status, and mortality. Linear regression identified the contribution of a diagnosis of CP on hospital LOS and inflation-adjusted cost.

Results:

Cerebral palsy was an independent predictor of several complications. The most striking differences were seen for mortality (odds ratio [OR]: 3.40, P < .001), a postoperative requirement for total parenteral nutrition (OR: 3.16, P < .001), urinary tract infection (OR: 2.75, P < .001), surgical site infection (OR: 2.67, P < .001), and pneumonia (2.21, P < .001). Patients with CP ultimately cost an additional $13 482 ( P < .001) with a 2.07-day greater LOS ( P < .001) than patients without CP.

Conclusion:

Most complications were seen in higher rates in the CP cohort, with higher cost and LOS in patients with CP versus those with idiopathic scoliosis (IS). Our findings represent important areas of emphasis during preoperative consultations with patients with CP and their families. Extra care in patient selection and multifaceted treatment protocols should continue to be implemented with further investigation on how to mitigate common complications.
Iatrogenic L5 Nerve Injury Following Decortication of the Sacral Ala in Posterolateral Lumbosacral Fusion Surgery
Authors: Tahvildari Babak Pourabbas , Oveisee Maziar , Farsimadan Mohammad , Fereidooni Mehran , Zarenezhad Mohammad
Published: November 2020

Study Design:

Cadaver study.

Objectives:

To investigate the risk of the L5 nerve injury following sacral ala decortication performed during lumbosacral posterolateral fusion surgery.

Methods:

Fourteen fresh cadaver pelvises were dissected through an anterior approach and the L5 nerves on both sides were explored and macroscopically examined by direct observation. Then, the corticotomy of the sacral ala was performed at 0°, 20°, and 30° angles to the sagittal plane through the posterior approach. The site of sacral ala decortication was checked on each side and its distance to the L5 nerve root was measured.

Results:

The tip of the osteotome was in the danger zone (5 mm medial to 5 mm lateral to the L5 nerve) in all cases (100%) where the osteotome had 0° angle to the sagittal plane. For those with a 20° angle, the osteotome tip laid in the danger zone in 83% and intermediate zone (between 6 to 15 mm lateral to the nerve) in 17% of cases. For those with a 30° angle, the tip was in the safe zone (>15 mm lateral to the nerve) in all cases (100%).

Conclusion:

Osteotomy of the sacral ala with <30° angle to the sagittal plane risks injury to the L5 nerve; whereas osteotomy angle >30° would not cause any injury to the nerve. It should be considered as a possible cause of iatrogenic L5 nerve injury in patients undergoing posterolateral lumbosacral fusion.
Comparison of Short-Term Radiographical and Clinical Outcomes After Posterior Lumbar Interbody Fusion With a 3D Porous Titanium Alloy Cage and a Titanium-Coated PEEK Cage
Authors: Makino Takahiro , Takenaka Shota , Sakai Yusuke , Yoshikawa Hideki , Kaito Takashi
Published: November 2020

Study Design:

Clinical case series.

Objectives:

To compare the short-term (≤1 year) radiographical and clinical outcomes between posterior lumbar interbody fusion (PLIF) with a titanium-coated poly-ether-ether-ketone (TCP) cage and PLIF with a three-dimensional porous titanium alloy (PTA) cage.

Methods:

Overall, 63 patients who had undergone 1- or 2-level PLIF since March 2015 were enrolled (median age, 71 years). The first 34 patients underwent PLIF with TCP cages (until June 2017) and the next 29 patients with PTA cages. Fusion status, vertebral endplate cyst formation (cyst sign: grade 0, none; grade 1, focal; and grade 2, diffuse), cage subsidence (grade 0, <1 mm; grade 1, 1–3 mm; and grade 2, >3 mm), and patient-reported quality of life (QOL) outcomes based on the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were compared at 6 months and 1 year postoperatively between the 2 cage groups.

Results:

Cyst sign and cage subsidence grades were significantly lower in the PTA cage group than in the TCP cage group at 6 months postoperatively (cyst sign, p = 0.044; cage subsidence, p = 0.043). In contrast, the fusion rate and surgery effectiveness based on JOABPEQ at both 6 months and 1 year postoperatively were not different between the 2 groups.

Conclusions:

Patient-reported QOL outcomes were similar between the TCP and PTA cage groups until 1 year postoperatively. However, a higher incidence and severity of postoperative vertebral endplate cyst formation in patients with the TCP cage was a noteworthy radiographical finding.
Disability, Health-Related Quality of Life and Mortality in Lumbar Spine Fusion Patients—A 5-Year Follow-Up and Comparison With a Population Sample
Authors: Toivonen Leevi , Pekkanen Liisa , Neva Marko H. , Kautiainen Hannu , Kyrölä Kati , Marttinen Ilkka , Häkkinen Arja
Published: November 2020

Study Design:

Prospective follow-up study.

Objectives:

We aimed to assess the effect of lumbar spine fusion (LSF) on disability, health-related quality of life and mortality in a 5-year follow-up, and to compare these results with the general population.

Methods:

523 consecutive LSF operations were included in a prospective follow-up. Disability was assessed by the Oswestry Disability Index (ODI), and HRQoL by the 36-item Short Form (SF-36) questionnaire using the physical and mental summary scores (PCS and MCS). The patients were compared with an age-, sex-, and residential area matched general population cohort.

Results:

The preoperative ODI in the patients was 46 (SD 16), and the change at 5 years was −26 (95% CI: −24 to −28), p < 0.001. In the population, ODI (baseline 13, SD 16) remained unchanged. The preoperative PCS in the patients was 27 (SD 7), in the population 45 (SD 11), and the increase in the patients at 5 years was 8 (95% CI: 7 to 9), p < 0.001. The patients did not reach the population in ODI or PCS. The baseline MCS in the patients was 47 (SD 13), and the change at 5 years 4 (95% CI: 3 to 7), p < 0.001. MCS of the females reached the population at 5-year follow-up. When analyzing short and long fusions separately, comparable changes were seen in both subgroups. There was no difference in mortality between the patients (3.4%) and the population (4.8%), hazard ratio (HR) 0.86.

Conclusions:

Although the patients who had undergone LSF benefited from surgery still at 5 years, they never reached the physical level of the population.
Reflecting on Corporate Crime and Control: The Wells Fargo Banking Saga
Authors: Shichor David , Heeren John W.
Published: November 2020

In September, 2016 it was publicly revealed that Wells Fargo, one of the nation’s top banks, was involved in fraudulent business practices for years harming thousands of its clients. This article analyses the nature of and the reasoning behind these violations, the ways the executives related to them and how they are handled by the regulatory system. It reviews some of the challenges of actual and potential formal and informal attempts of forestalling or at least reducing future similar crimes. In this vein, a theoretical framework suggesting a possible way for better control of future similar victimization is explored.
Chaotic activation of developmental signalling pathways drives idiopathic pulmonary fibrosis
Authors: Froidure Antoine , Marchal-Duval Emmeline , Homps-Legrand Meline , Ghanem Mada , Justet Aurélien , Crestani Bruno , Mailleux Arnaud
Published: November 2020

Idiopathic pulmonary fibrosis (IPF) is characterised by an important remodelling of lung parenchyma. Current evidence indicates that the disease is triggered by alveolar epithelium activation following chronic lung injury, resulting in alveolar epithelial type 2 cell hyperplasia and bronchiolisation of alveoli. Signals are then delivered to fibroblasts that undergo differentiation into myofibroblasts. These changes in lung architecture require the activation of developmental pathways that are important regulators of cell transformation, growth and migration. Among others, aberrant expression of profibrotic Wnt-β-catenin, transforming growth factor-β and Sonic hedgehog pathways in IPF fibroblasts has been assessed. In the present review, we will discuss the transcriptional integration of these different pathways during IPF as compared with lung early ontogeny. We will challenge the hypothesis that aberrant transcriptional integration of these pathways might be under the control of a chaotic dynamic, meaning that a small change in baseline conditions could be sufficient to trigger fibrosis rather than repair in a chronically injured lung. Finally, we will discuss some potential opportunities for treatment, either by suppressing deleterious mechanisms or by enhancing the expression of pathways involved in lung repair. Whether developmental mechanisms are involved in repair processes induced by stem cell therapy will also be discussed.
I-Impute: a self-consistent method to impute single cell RNA sequencing data
Authors: Feng Xikang , Chen Lingxi , Wang Zishuai , Li Shuai Cheng
Published: November 2020

Background

Single-cell RNA-sequencing (scRNA-seq) is becoming indispensable in the study of cell-specific transcriptomes. However, in scRNA-seq techniques, only a small fraction of the genes are captured due to “dropout” events. These dropout events require intensive treatment when analyzing scRNA-seq data. For example, imputation tools have been proposed to estimate dropout events and de-noise data. The performance of these imputation tools are often evaluated, or fine-tuned, using various clustering criteria based on ground-truth cell subgroup labels. This limits their effectiveness in the cases where we lack cell subgroup knowledge. We consider an alternative strategy which requires the imputation to follow a “self-consistency” principle; that is, the imputation process is to refine its results until there is no internal inconsistency or dropouts from the data.

Results

We propose the use of “self-consistency” as a main criteria in performing imputation. To demonstrate this principle we devised I-Impute, a “self-consistent” method, to impute scRNA-seq data. I-Impute optimizes continuous similarities and dropout probabilities, in iterative refinements until a self-consistent imputation is reached. On the in silico data sets, I-Impute exhibited the highest Pearson correlations for different dropout rates consistently compared with the state-of-art methods SAVER and scImpute. Furthermore, we collected three wetlab datasets, mouse bladder cells dataset, embryonic stem cells dataset, and aortic leukocyte cells dataset, to evaluate the tools. I-Impute exhibited feasible cell subpopulation discovery efficacy on all the three datasets. It achieves the highest clustering accuracy compared with SAVER and scImpute.

Conclusions

A strategy based on “self-consistency”, captured through our method, I-Impute, gave imputation results better than the state-of-the-art tools. Source code of I-Impute can be accessed at https://github.com/xikanfeng2/I-Impute.
Wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia for transforaminal lumbar interbody fusion: a retrospective study
Authors: Li Kunpeng , Ji Changbin , Luo Dawei , Feng Hongyong , Yang Keshi , Xu Hui
Published: November 2020

Background

Surgical procedure usually causes serious postoperative pain and poor postoperative pain management negatively affects quality of life, function and recovery time. We aimed to investigate the role of wound infiltration with ropivacaine as an adjuvant to patient controlled analgesia (PCA) in postoperative pain control for patients undergoing transforaminal lumbar interbody fusion.

Methods

One hundred twelve patients undergoing lumbar fusion were retrospectively reviewed and divided into two groups (ropivacaine and control groups) according to whether received wound infiltration with ropivacaine or not. Visual Analogue Scale (VAS) score, analgesics consumption, number of patients requiring rescue analgesic, hospital duration and incidence of complications were recorded. Surgical trauma was assessed using operation time, intraoperative blood loss and incision length.

Results

The amount of sufentanil consumption in ropivacaine group at 4 h postoperatively was lower than that of control group (24.5 ± 6.0 μg vs 32.1 ± 7.0 μg, P < 0.001) and similar results were observed at 8, 12, 24, 48 and 72 h postoperatively(P < 0.001). Fewer patients required rescue analgesia within 4 to 8 h postoperatively in ropivacaine group (10/60 vs 19/52, P = 0.017). Length of postoperative hospital durations were shorter in patients receiving ropivacaine infiltration compared to control cohorts (6.9 ± 0.9 days vs 7.4 ± 0.9 days, P = 0.015). The incidence of PONV in ropivacaine group was lower than that in control group (40.4% vs 18.3%, P = 0.01). However, VAS scores were similar in two groups at each follow-up points postoperatively, and no difference was observed(P > 0.05).

Conclusion

Wound infiltration with ropivacaine effectively reduces postoperative opioid consumption and PONV and may be a useful adjuvant to PCA to improve recovery for patients undergoing lumbar spine surgery.
Collaborative care for depression and anxiety disorders: results and lessons learned from the Danish cluster-randomized Collabri trials
Authors: Curth Nadja Kehler , Brinck-Claussen Ursula Ødum , Hjorthøj Carsten , Davidsen Annette Sofie , Mikkelsen John Hagel , Lau Marianne Engelbrecht , Lundsteen Merete , Csillag Claudio , Christensen Kaj Sparle , Jakobsen Marie , Bojesen Anders Bo , Nordentoft Merete , Eplov Lene Falgaard
Published: November 2020

Background

Meta-analyses suggest that collaborative care (CC) improves symptoms of depression and anxiety. In CC, a care manager collaborates with a general practitioner (GP) to provide evidence-based care. Most CC research is from the US, focusing on depression. As research results may not transfer to other settings, we developed and tested a Danish CC-model (the Collabri-model) for depression, panic disorder, generalized anxiety disorder, and social anxiety disorder in general practice.

Methods

Four cluster-randomized superiority trials evaluated the effects of CC. The overall aim was to explore if CC significantly improved depression and anxiety symptoms compared to treatment-as-usual at 6-months’ follow-up. The Collabri-model was founded on a multi-professional collaboration between a team of mental-health specialists (psychiatrists and care managers) and GPs. In collaboration with GPs, care managers provided treatment according to a structured plan, including regular reassessments and follow-up. Treatment modalities (cognitive behavioral therapy, psychoeducation, and medication) were offered based on stepped care algorithms. Face-to-face meetings between GPs and care managers took place regularly, and a psychiatrist provided supervision. The control group received treatment-as-usual. Primary outcomes were symptoms of depression (BDI-II) and anxiety (BAI) at 6-months’ follow-up. The incremental cost-effectiveness ratio (ICER) was estimated based on 6-months’ follow-up.

Results

Despite various attempts to improve inclusion rates, the necessary number of participants was not recruited. Seven hundred thirty-one participants were included: 325 in the depression trial and 406 in the anxiety trials. The Collabri-model was implemented, demonstrating good fidelity to core model elements. In favor of CC, we found a statistically significant difference between depression scores at 6-months’ follow-up in the depression trial. The difference was not significant at 15-months’ follow-up. The anxiety trials were pooled for data analysis due to inadequate sample sizes. At 6- and 15-months’ follow-up, there was a difference in anxiety symptoms favoring CC. These differences were not statistically significant. The ICER was 58,280 Euro per QALY.

Conclusions

At 6 months, a significant difference between groups was found in the depression trial, but not in the pooled anxiety trial. However, these results should be cautiously interpreted as there is a risk of selection bias and lacking statistical power.

Trial registration

ClinicalTrials.gov, ID:NCT02678624andNCT02678845. Retrospectively registered on 7 February 2016.
Spirometry in chronic obstructive pulmonary disease in Norwegian general practice
Authors: Tollånes Mette C. , Sjaastad Geir E. , Aarli Bernt B. , Sandberg Sverre
Published: November 2020

Background

General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study was to investigate how GPs interpret a case history and spirometry recordings of a patient with chronic obstructive pulmonary disease (COPD), and their knowledge about their own spirometer.

Methods

A web-based survey, consisting of a case history and spirometry recordings of a patient with COPD, was distributed to the 4700 members of the Norwegian GP Association. In addition to background information about themselves and their spirometer, topics included whether they requested, and how they interpreted, a spirometry reversibility-test, identification of the of most likely diagnosis, and recognition of the spirometry parameters used to diagnose COPD and grade airway obstruction. Immediate feedback was provided for educational purposes.

Results

Six hundred thirty GPs responded. Twenty six percent would not request a reversibility test, but 81% identified COPD as the most likely diagnosis. Less than 50% correctly identified the spirometry parameters used for diagnosis of COPD and grading the airway obstruction. One in five (21%) did not know which spirometer was used in their own practice, and 49 and 61% did not know which reference values were used for adults and children, respectively. Participants evaluated the survey as useful (average 74 points on a 0–100 scale) and would like more case-based surveys concerning use of spirometry in the future (average 91 points).

Conclusion

In this cohort of self-selected GPs, probably more interested in respiratory medicine than the average GP, we identified several problem areas and gaps in knowledge regarding the use of spirometry.
Map the apps: a rapid review of digital approaches to support the engagement of older adults in strength and balance exercises
Authors: McGarrigle Lisa , Boulton Elisabeth , Todd Chris
Published: November 2020

Background

Exercise interventions, particularly those targeting strength and balance, are effective in preventing falls in older people. Activity levels are generally below recommended levels and reduce with age. There is concern that exercise levels may be further reduced in the context of the COVID-19 pandemic. Digital approaches may offer a means for older people to engage in strength and balance exercises independently in their own homes. The objective of this review was to identify and evaluate existing apps and websites to support independent engagement in strength and balance exercises by older people.

Methods

We conducted a rapid review of apps and websites, following PRISMA guidelines. We searched for available apps in the Android and iOS app stores, and performed a database search (MEDLINE and EMBASE) for apps in development. We searched for websites using the Google search engine. Apps and websites were evaluated in terms of existing evidence for effectiveness, use of behaviour change techniques (BCTs), and quality.

Results

We evaluated 13 apps and 24 websites on the basis of our selection criteria. Considering the evidence-base, quality and BCT scores, four apps and six websites are recommended for use by older people who wish to engage in exercise independently in their own homes. No apps or websites have been to RCT evaluation at the time of review.

Conclusions

Apps and websites have the potential to provide a convenient, cost-effective, and accessible means for many older adults to engage in strength and balance training and reduce falls risk.
Wilson disease, ABCC2 c.3972C > T polymorphism and primary liver cancers: suggestions from a familial cluster
Authors: Brandi Giovanni , Rizzo Alessandro , Deserti Marzia , Relli Valeria , Indio Valentina , Bin Sofia , Pariali Milena , Palloni Andrea , De Lorenzo Stefania , Tovoli Francesco , Tavolari Simona
Published: November 2020

Background

Polymorphisms in genes modulating xenobiotics metabolism, in particular the ABCC2 c.3972C > T single nucleotide polymorphism (SNP) at exon 28, have been suggested to increase primary liver cancer (PLC) risk. Conversely, the occurrence of PLCs in Wilson disease patients is a rare event, in contrast with the occurrence observed in other chronic liver diseases. Here we report the clinical case of five siblings carrying the ABCC2 c.3972C > T SNP; three of them were affected by Wilson disease and two brothers with Wilson disease also developed PLCs.

Methods

The presence of the ABCC2 c.3972C > T SNP was assessed by Sanger sequencing and the exposure of PLC risk factors by standardized questionnaires.

Results

Notably, PLCs occurred only in the two brothers with the ABCC2 c.3972C > T SNP and Wilson disease who resulted exposed to asbestos and cigarette smoking, but not in the other siblings with the ABCC2 c.3972C > T SNP, alone or in association with Wilson disease, not exposed to these carcinogens and/or to other known risk factors for PLCs.

Conclusions

These findings suggest that ABCC2 c.3972C > T SNP and WD, also in association, may not represent a sufficient condition for PLC development, but that co-occurrence of further host/exogenous risk factors are needed to drive this process, reinforcing the notion that liver carcinogenesis is the result of a complex interplay between environmental and host genetic determinants. Due to the sporadic cases of this study and the paucity of data currently available in literature on this issue, future investigations in a larger population are needed to confirm our findings.
Early childhood infections, antistreptococcal and basal ganglia antibodies in adult ADHD: a preliminary study
Authors: Oliva Francesco , di Girolamo Giulia , Malandrone Francesca , Iaia Noemi , Biasi Fiorella , Maina Giuseppe
Published: November 2020

Background

To explore the relationship between adult Attention Deficit/ Hyperactivity Disorder (ADHD), antistreptococcal titers, ABGA, and recurrent infections during early childhood.

Method

Childhood history of recurrent infections and a blood sample were collected in a sample of DSM-IV adult outpatients with ADHD. The anti-streptolysin O (ASO), anti-deoxyribonuclease B (anti-DNase B), and anti-basal ganglia antibodies (ABGA) titers were determined in patient plasma by enzyme-linked immunosorbent assay (ELISA). Titers positivity was evaluated following manufacturer’s specifications. Absolute titers were also collected as continuous variables.

Results

Fourteen out of 22 (63.6%) have had recurrent infections in childhood (i.e., seven, 31.8%, have had tonsillitis or adenoiditis and seven, 31.8%, have had any other infections). Eighteen patients (81.9%) were positive for anti-DNase B, five (22.7%) for ASO, and 4 (18.2%) were positive for both of them. Five participants (22.7%) were ABGA positive, whereas only two (9.1%) were positive for all three antibodies.

Conclusions

patients with ADHD might be more prone to infections during childhood and subclinical streptococcal infections during adulthood. Moreover, they seem to have an increased risk for basal ganglia autoimmunity in adulthood. Both infections and the ensuing acquired autoimmunity could influence the neurodevelopmental process, by contributing, at least in part, to the ADHD pathogenesis.