bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring what a screening programme does
Authors: Raffle Angela E. , Mackie Anne , Gray J. A. Muir
Published: July 2019

This chapter gives understanding of measuring evidence about consequences of screening programmes, at a level needed by public health practitioners interpreting evidence for setting screening policy, or for ensuring high quality programme delivery. It takes a practical approach, illustrating with real-life case histories and examples, ranging from infant neuroblastoma to abdominal aortic aneurysm screening. The issues covered are Three Main Biases (healthy screenee effect, length time effect including overdiagnosis, lead time effect); Three Main Evaluation Methods (randomised control trials, time trend analyses, case control studies, and mention of rare conditions); Test Performance (sensitivity and specificity, positive and negative predictive value, receiver operator characteristic curves); Two Additional Sources of Information (pilot or demonstration projects, modelling); Summarising Information on all Outcomes (the numbers in the flow diagram, and decision aids) and finishing with A Note on Sound Science. Careful use of terminology is emphasised, and pitfalls with use of jargon terms (true and false, positive and negative) and misleading labels (early, late, pre-symptomatic, carcinoma in situ) are explained. The issue of overdiagnosis of inconsequential conditions is explained.
Implementing screening programmes
Authors: Raffle Angela E. , Mackie Anne , Gray J. A. Muir
Published: July 2019

This chapter gives the reader an understanding of the essential tasks involved in setting up a good quality screening programme. Newborn hearing screening is used as a case study. There is an old saying that all you have to do to create an effective service is choose the right things to do, then do them right. Choosing the right screening involves assessing the evidence and making policy. Doing screening right means setting up a well ordered programme for screening that is of value, ensuring that the service is always of high quality, dealing effectively with problems. It also means making sure that when there is no evidence that benefits would outweigh harms, then screening is vest avoided. Different health care systems have very different ways of planning, delivering, and funding their screening programmes. The chapter focuses on matters that are essential if screening is to achieve public health improvement - irrespective of where, and in what type of health system, it is being delivered.
Making policy on screening programmes
Authors: Raffle Angela E. , Mackie Anne , Gray J. A. Muir
Published: July 2019

This chapter shows how resources, values, beliefs, and commercial factors all influence screening policy, and gives clear insight into some of the ethical dilemmas involved. Case histories include celebrity selling of HPV testing, the USA ‘Mammography Wars’ incident, the Cartwright Inquiry into events at National Women’s Hospital in Auckland in the 1960s and genetic testing. The chapter strongly emphasises the value of following robust and explicit processes when making screening policy, and argues that this is best done at national level. The reasons why screening policy-making can be difficult are explored in detail, and clear lessons are drawn from the case examples. The chapter addresses the technical aspects of using evidence, and also explains the power of the cultural belief that all screening must automatically be a good thing and of commercial, professional and institutional interests, often enacted through invisible lobbying using ‘third party’ techniques. The ethical conflicts inherent within screening are described and explored.
Modelling 3D magnetic networks in a realistic solar atmosphere
Authors: Gent Frederick A , Snow Ben , Fedun Viktor , Erdélyi Robertus
Published: July 2019

The magnetic network extending from the photosphere (solar radius ≃ R⊙) to the lower corona ($\mathrm{ R}_\odot +10\, {\rm Mm}$) plays an important role in the heating mechanisms of the solar atmosphere. Here we develop further the models of the authors with realistic open magnetic flux tubes, in order to model more complicated configurations. Closed magnetic loops and combinations of closed and open magnetic flux tubes are modelled. These are embedded within a stratified atmosphere, derived from observationally motivated semi-empirical and data-driven models subject to solar gravity and capable of spanning from the photosphere up into the chromosphere and lower corona. Constructing a magnetic field comprising self-similar magnetic flux tubes, an analytic solution for the kinetic pressure and plasma density is derived. Combining flux tubes of opposite polarity, it is possible to create a steady background magnetic field configuration, modelling a solar atmosphere exhibiting realistic stratification. The result can be applied to the Solar and Heliospheric Observatory Michelson Doppler Imager (SOHO/MDI), Solar Dynamics Observatory Helioseismic and Magnetic Imager (SDO/HMI) and other magnetograms from the solar surface, for which photospheric motions can be simulated to explore the mechanism of energy transport. We demonstrate this powerful and versatile method with an application to HMI data.
Gone after one orbit: How cluster environments quench galaxies
Authors: Lotz Marcel , Remus Rhea-Silvia , Dolag Klaus , Biviano Andrea , Burkert Andreas
Published: July 2019

The effect of galactic orbits on a galaxy’s internal evolution within a galaxy cluster environment has been the focus of heated debate in recent years. To understand this connection, we use both the $(0.5 \,$Gpc)3 and the Gpc3 boxes from the cosmological hydrodynamical simulation set Magneticum Pathfinder. We investigate the velocity anisotropy, phase space, and the orbital evolution of up to ∼5 × 105 resolved satellite galaxies within our sample of 6776 clusters with $M_{\mathrm{vir}}\,\, \gt\,\, 10^{14} \, \mathrm{M_{\odot }}$ at low redshift, which we also trace back in time. In agreement with observations, we find that star-forming satellite galaxies inside galaxy clusters are characterized by more radially dominated orbits, independent of cluster mass. Furthermore, the vast majority of star-forming satellite galaxies stop forming stars during their first passage. We find a strong dichotomy both in line-of-sight and radial phase space between star-forming and quiescent galaxies, in line with observations. The tracking of individual orbits shows that the star formation of almost all satellite galaxies drops to zero within $1 \, \mathrm{Gyr}$ after infall. Satellite galaxies that are able to remain star forming longer are characterized by tangential orbits and high stellar mass. All this indicates that in galaxy clusters the dominant quenching mechanism is ram-pressure stripping.
Predictions for the abundance of high-redshift galaxies in a fuzzy dark matter universe
Authors: Ni Yueying , Wang Mei-Yu , Feng Yu , Di Matteo Tiziana
Published: July 2019

During the last decades, rapid progress has been made in measurements of the rest-frame ultraviolet (UV) luminosity function (LF) for high-redshift galaxies (z ≥ 6). The faint-end of the galaxy LF at these redshifts provides powerful constraints on different dark matter (DM) models that suppress small-scale structure formation. In this work we perform full hydrodynamical cosmological simulations of galaxy formation using an alternative DM model composed of extremely light bosonic particles (m ∼ 10−22 eV), also known as fuzzy dark matter (FDM), and examine the predictions for the galaxy stellar mass function and LF at z ≥ 6 for a range of FDM masses. We find that for FDM models with bosonic mass m = 5 × 10−22 eV, the number density of galaxies with stellar mass $\rm M_* \sim 10^7 M_{\odot }$ is suppressed by $\sim 40\, {\rm per\, cent}$ at z  = 9, $\sim 20\, {\rm per\, cent}$ at z  = 5, and the UV LFs within magnitude range of −16 < MUV < −14 is suppressed by $\sim 60\, {\rm per\, cent}$ at z = 9, $\sim 20\, {\rm per\, cent}$ at z = 5 comparing to the cold dark matter counterpart simulation. Comparing our predictions with current measurements of the faint-end LFs (−18 ≤ MUV ≤ −14), we find that FDM models with m22 < 5 × 10−22 are ruled out at 3σ confidence level. We expect that future LF measurements by James Webb Space Telescope, which will extend down to MUV ∼ −13 for z ≲ 10, with a survey volume that is comparable to the Hubble Ultra Deep Field would have the capability to constrain FDM models to m  ≳ 10−21 eV.
Elemental and molecular abundances in comet 67P/Churyumov-Gerasimenko
Authors: Rubin Martin , Altwegg Kathrin , Balsiger Hans , Berthelier Jean-Jacques , Combi Michael R , De Keyser Johan , Drozdovskaya Maria , Fiethe Björn , Fuselier Stephen A , Gasc Sébastien , Gombosi Tamas I , Hänni Nora , Hansen Kenneth C , Mall Urs , Rème Henri , Schroeder Isaac R H G , Schuhmann Markus , Sémon Thierry , Waite Jack H , Wampfler Susanne F , Wurz Peter
Published: July 2019

Comets are considered to be some of the most pristine and unprocessed Solar system objects accessible to in situ exploration. Investigating their molecular and elemental composition takes us on a journey back to the early period of our Solar system and possibly even further. In this work, we deduce the bulk abundances of the major volatile species in comet 67P/Churyumov-Gerasimenko, the target of the European Space Agency’s (ESA) Rosetta mission. The basis are measurements obtained with the ROSINA instrument suite on board the Rosetta orbiter during a suitable period of high outgassing near perihelion. The results are combined with both gas and dust composition measurements published in the literature. This provides an integrated inventory of the major elements present in the nucleus of 67P/Churyumov-Gerasimenko. Similar to comet 1P/Halley, which was visited by ESA’s Giotto spacecraft in 1986, comet 67P/Churyumov-Gerasimenko also shows near-solar abundances of oxygen and carbon, whereas hydrogen and nitrogen are depleted compared to solar. Still, the degree of devolatilization is lower than that of inner Solar system objects, including meteorites and the Earth. This supports the idea that comets are amongst the most pristine objects in our Solar system.
Not gone with the wind: Planet occurrence is independent of stellar galactocentric velocity
Authors: McTier Moiya A S , Kipping David M
Published: July 2019

We demonstrate that planet occurrence does not depend on stellar galactocentric velocity in the Solar neighbourhood. Using Gaia DR2 astrometry and radial velocity data, we calculate 3D galactocentric velocities for 197 090 Kepler field stars, 1647 of which are confirmed planet hosts. When we compare the galactocentric velocities of planet hosts to those of the entire field star sample, we observe a statistically significant (KS p-value  = 10−70) distinction, with planet hosts being apparently slower than field stars by ∼40 km s−1. We explore some potential explanations for this difference and conclude that it is not a consequence of the planet–metallicity relation or distinctions in the samples’ thin/thick disc membership, but rather an artefact of Kepler’s selection function. Non Kepler-host stars that have nearly identical distances, temperatures, surface gravities, and Kepler magnitudes to the confirmed planet hosts also have nearly identical velocity distributions. Using one of these identical non-host samples, we consider that the probability of a star with velocity vtot hosting a planet can be described by an exponential function proportional to $e^{(-v_{\mathrm{tot}}/v_0)}$. Using a Markov Chain Monte Carlo sampler, we determine that v0 >976 km s−1 to 99 per cent confidence, which implies that planets in the Solar neighbourhood are just as likely to form around high-velocity stars as they are around low-velocity stars. Our work highlights the subtle ways in which selection biases can create strong correlations without physical underpinnings.
Interleukin-1β inhibits estrogen receptor-α, progesterone receptors A and B and biomarkers of human endometrial stromal cell differentiation: implications for endometriosis
Authors: Yu Jie , Berga Sarah L , Zou Wei , Taylor Robert N
Published: July 2019

Human blastocyst nidation in the uterus and successful pregnancy require coordinated endometrial expression of estrogen receptor (ER)-α, progesterone receptors (PR)-A and -B and the gap junction protein, connexin (Cx)43. Our prior work established that inflammation associated with conditions of reduced fecundity, particularly endometriosis, can perturb eutopic decidual function. In the current studies, we have modeled endometrial decidualization in primary human endometrial stromal cell cultures derived from normal controls (NESC) and from the eutopic endometria of women with endometriosis (EESC) to test the hypothesis that a proinflammatory cytokine, interleukin (IL)-1β, can disrupt stromal cell differentiation. The cells were grown under a standard protocol with hormones (10 nM 17β-estradiol, 100 nM progesterone and 0.5 mM dibutyryl cAMP) for up to 7 days in the absence or presence of IL-1β. Time-course experiments showed that IL-1β compromised decidual function in both NESC and EESC, which was accompanied by rapid phosphorylation of ER-α, PR and Cx43 and their cellular depletion. Inhibition of the extracellular signal-regulated kinase (ERK)1/2 pathway by a selective pharmacological blocker (PD98059) or siRNA interference, or the addition of hormones themselves, blocked the phosphorylation of ERK mediators; increased the production of steroid receptors, Cx43, prolactin, insulin-like growth factor binding protein-1 (IGFBP)-1 and vascular endothelial growth factor (VEGF) and accelerated the differentiation. The results indicate that inhibition of IL-1β can enhance decidualization in NESC and EESC in vitro. Strategies to interfere with this pathway might be implemented as an in vivo approach to enhance fertility in women with endometriosis and, potentially, other inflammatory pathologies.
The general mRNA exporters Mex67 and Mtr2 play distinct roles in nuclear export of tRNAs in Trypanosoma brucei
Authors: Hegedűsová Eva , Kulkarni Sneha , Burgman Brandon , Alfonzo Juan D , Paris Zdeněk
Published: July 2019

Transfer RNAs (tRNAs) are central players in protein synthesis, which in Eukarya need to be delivered from the nucleus to the cytoplasm by specific transport receptors, most of which belong to the evolutionarily conserved beta-importin family. Based on the available literature, we identified two candidates, Xpo-t and Xpo-5 for tRNA export in Trypanosoma brucei. However, down-regulation of expression of these genes did not disrupt the export of tRNAs to the cytoplasm. In search of alternative pathways, we tested the mRNA export complex Mex67-Mtr2, for a role in tRNA nuclear export, as described previously in yeast. Down-regulation of either exporter affected the subcellular distribution of tRNAs. However, contrary to yeast, TbMex67 and TbMtr2 accumulated different subsets of tRNAs in the nucleus. While TbMtr2 perturbed the export of all the tRNAs tested, silencing of TbMex67, led to the nuclear accumulation of tRNAs that are typically modified with queuosine. In turn, inhibition of tRNA nuclear export also affected the levels of queuosine modification in tRNAs. Taken together, the results presented demonstrate the dynamic nature of tRNA trafficking in T. brucei and its potential impact not only on the availability of tRNAs for protein synthesis but also on their modification status.
AGO-unbound cytosolic pool of mature miRNAs in plant cells reveals a novel regulatory step at AGO1 loading
Authors: Dalmadi Ágnes , Gyula Péter , Bálint Jeannette , Szittya György , Havelda Zoltán
Published: July 2019

RNA interference (RNAi) is mediated by small, 20-24-nt-long, non-coding regulatory (s)RNAs such as micro (mi) and small interfering (si) RNAs via the action of ARGONAUTE (AGO) proteins. High-throughput sequencing of size-separated sRNA pools of plant crude extracts revealed that the majority of the canonical miRNAs were associated with high molecular weight RNA-induced silencing complexes co-migrating with AGO1 (HMW RISC). In contrast, the majority of 24-nt-long siRNAs were found in association with low molecular weight complexes co-migrating with AGO4 (LMW RISC). Intriguingly, we identified a large set of cytoplasmic sRNAs, including mature miRNA sequences, in the low molecular size range corresponding to protein-unbound sRNAs. By comparing the RISC-loaded and protein-unbound pools of miRNAs, we identified miRNAs with highly different loading efficiencies. Expression of selected miRNAs in transient and transgenic systems validated their altered loading abilities implying that this process is controlled by information associated with the diverse miRNA precursors. We also showed that the availability of AGO proteins is a limiting factor determining the loading efficiency of miRNAs. Our data reveal the existence of a regulatory checkpoint determining the RISC-loading efficiencies of various miRNAs by sorting only a subset of the produced miRNAs into the biologically active RISCs.
A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents
Authors: Beeckman Melanie , Simons Laura E , Hughes Sean , Loeys Tom , Goubert Liesbet
Published: July 2019

Objective

This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain.

Methods

Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor.

Results

Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement.

Conclusions

This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.
The Generationing of Social Assistance Receipt and “Welfare Dependency” in Ontario, Canada
Authors: Gazso Amber , Baker Collins Stephanie , Smith-Carrier Tracy , Smith Carrie
Published: July 2019

Adopting a life course perspective, we explore, qualitatively, how receipt of social assistance in Ontario is generationally experienced. Data are drawn from a study of family and generational relationships with Ontario Works (OW), which included in-depth interviews with 31 participants who also had a child or parent on social assistance; we drew from three Canadian cities: Hamilton, London, and Toronto, Ontario. Our thematic analysis reveals that generation matters and in ways less confined than the ideation embedded in the discourse of welfare dependency. Through a life course lens, we find that while older and younger kin may concurrently access assistance, any generation’s entrance onto it must be understood as varying by social, historical, and structural context, which itself varies over their individual life courses. We define this process as the “generationing” of social assistance receipt. We further reveal how this generationing interacts with gender, race, Indigeneity, and class. We therefore argue that the generationing of social assistance receipt prompts re-conceptualization of taken-for-granted ideation in the discourse of welfare dependency and, thus, is replete with policy implications.
Life-history traits and description of the new gonochoric amphimictic Mesobiotus joenssoni (Eutardigrada: Macrobiotidae) from the island of Elba, Italy
Authors: Guidetti Roberto , Gneuß Elisa , Cesari Michele , Altiero Tiziana , Schill Ralph O
Published: July 2019

Comparative analyses of life-history theory studies are based on the characteristics of the life cycles of different species. For tardigrades, life-history traits are available only from laboratory cultures, most of which have involved parthenogenetic species. The discovery of a new gonochoristic bisexual Mesobiotus species in a moss collected on the island of Elba (Italy) provides us with the opportunity to describe Mesobiotus joenssoni sp. nov. and to collect data on the life-history traits of cultured specimens to increase our knowledge of the life-history strategies present in tardigrades. This new species is differentiated from all other species of the genus by the presence of granules (~1 µm in diameter) on the dorsal cuticle of the last two body segments, two large bulges (gibbosities) on the hindlegs and long, conical egg processes. The species exhibits sexual dimorphism in body length, with females being longer than males of the same age. The mean lifespan of specimens was 86 days, with a maximum of 150 days. The mean age at first oviposition was 19.8 days and the mean egg hatching time 15.4 days. The life-cycle traits correspond to those collected for the only other two macrobiotid species with gonochoric amphimictic reproduction examined so far.
Latitudinal gradients in body size in marine tardigrades
Authors: Bartels Paul J , Fontaneto Diego , Roszkowska Milena , Nelson Diane R , Kaczmarek Łukasz
Published: July 2019

Homeotherms and many poikilotherms display a positive relationship between body size and latitude, but this has rarely been investigated in microscopic animals. We analysed all published records of marine Tardigrada to address whether microscopic marine invertebrates have similar ecogeographical patterns to macroscopic animals. The data were analysed using spatially explicit generalized least squares models and linear models. We looked for latitudinal patterns in body size and species richness, testing for sampling bias and phylogenetic constraints. No latitudinal pattern was detected for species richness, and sampling bias was the strongest correlate of species richness. A hump-shaped increase in median body size with latitude was found, and the effect remained significant for the Northern Hemisphere but not for the Southern. The most significant effect supporting the latitudinal gradient was on minimum body size, with smaller species disappearing at higher latitudes. Our results suggest that biogeographical signals were observed for body size, albeit difficult to detect in poorly studied groups because of swamping from biased sampling effort and from low sample size. We did not find a significant correlation with the latitudinal pattern of body size and ecologically relevant net primary productivity.
Evidence for shared molecular pathways of dysregulated decidualization in preeclampsia and endometrial disorders revealed by microarray data integration
Authors: Rabaglino Maria Belen , Conrad Kirk P.
Published: July 2019

Microarray data of chorionic villous samples (CVSs) obtained from women of ~11.5 gestational weeks who developed preeclampsia with severe features (sPE; PE‐CVS) revealed a molecular signature of impaired endometrial maturation (decidualization) before and during early pregnancy. Because endometrial disorders are also associated with aberrant decidualization, we asked whether they share molecular features with sPE. We employed microarray data integration to compare the molecular pathologies of PE‐CVS and endometrial disorders, as well as decidua obtained postpartum from women with sPE. Eight public databases were reanalyzed with R software to determine differentially expressed genes (DEGs) in pathologic tissues relative to normal controls. DEGs were then compared to explore overlap. Shared DEGs were examined for enriched Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Principal component and network analyses were subsequently applied to selected DEGs. There was significant overlap of DEGs changing in the same direction for PE‐CVS and endometrial disorders, suggesting common molecular pathways. Shared DEGs were enriched for cytokine‐cytokine receptor interaction. Genes in this pathway revealed expression patterns forming 2 distinct clusters, one for normal and the other pathologic endometrium. The most affected hub genes were related to decidualization and NK cell function. Few DEGs were shared by PE‐CVS, and PE decidua obtained postpartum. sPE may be part of a biologic continuum of “endometrial spectrum disorders.”—Rabaglino, M. B., Conrad, K. P. Evidence for shared molecular pathways of dysregulated decidualization in preeclampsia and endometrial disorders revealed by microarray data integration. FASEB J. 33, 11682‐11695 (2019). www.fasebj.org
Is Negative-Pressure Wound Therapy a “Bridge to Reconstruction” for Poststernotomy Mediastinitis? A Systematic Review
Authors: White Brad M. , Meyer Dustin L. , Harlin Stephen L.
Published: July 2019

OBJECTIVE:

To assess the efficacy of negative-pressure wound therapy (NPWT) in preparing sternal wounds for flap reconstruction.

METHODS:

Investigators searched standard research databases with terms including “post-sternotomy mediastinitis,” “deep sternal wound infection,” “negative pressure wound therapy,” “vacuum assisted closure,” and “VAC.” Of 434 reports, 14 studies described patients diagnosed with poststernotomy mediastinitis who underwent NPWT followed by flap reconstruction. Eligible studies were assessed for length of stay, mortality, manufacturer involvement, and methodological rigor.

MAIN RESULTS:

Among a total 429 patients, median length of stay was 29 (±16) days. There were 41 deaths in this inpatient group (10%). Seventy-one percent of the reports were nonrandomized, and 36% of the studies accurately accounted for baseline differences in severity, whereas 14% failed to report diagnostic criteria. Only one study reported follow-up results. Nine studies (64%) failed to make a statement regarding conflicts of interest. In this analysis of quality, 48% (n = 8) of the studies were of very low to low quality. One study was of high quality.

CONCLUSIONS:

Investigators failed to find ample support for routine use of NPWT as a “bridge to reconstruction.” Serious complications related to the use of NPWT including right ventricular rupture, atrial fibrillation, respiratory arrest, recurrent infection, and a retained sponge were reported in this group of studies. Rigorous evaluative studies that assess the true effectiveness of NPWT as a “bridge to reconstruction” must precede its adoption.
How Will Recent Abortion Legislation Affect Women's Health?
Authors: Zolot Joan
Published: July 2019

Limits on abortion may further increase U.S. maternal morbidity and mortality.
Task Force Changes Lead Screening Advice for Children and Pregnant Women
Authors: Potera Carol
Published: July 2019

No level of lead is safe, although evidence for routine screening is lacking.
Relationship Between Diet, Tinnitus, and Hearing Difficulties
Authors: Dawes Piers , Cruickshanks Karen J. , Marsden Antonia , Moore David R. , Munro Kevin J.
Published: July 2019

Objectives:

Diet may affect susceptibility of the inner ear to noise and age-related effects that lead to tinnitus and hearing loss. This study used complementary single nutrient and dietary pattern analysis based on statistical grouping of usual dietary intake in a cross-sectional analysis of tinnitus and hearing difficulties in a large population study sample.

Design:

The research was conducted using the UK Biobank resource. Tinnitus was based on report of ringing or buzzing in one or both ears that lasts more than five minutes at a time and is currently experienced at least some of the time. Identification of a hearing problem was based on self-reported difficulties with hearing. Usual dietary intake and dietary patterns (involving statistical grouping of intake to account for how foods are combined in real-life diets) were estimated based on between two and five administrations of the Oxford Web-Q 24-hour dietary recall questionnaire over the course of a year for 34,576 UK adult participants aged 40 to 69.

Results:

In a multivariate model, higher intake of vitamin B12 was associated with reduced odds of tinnitus, while higher intakes of calcium, iron, and fat were associated with increased odds (B12, odds ratio [OR] 0.85, 95% confidence interval [CI] 0.75 to 0.97; Calcium, OR 1.20, 95% CI 1.08 to 1.34; Iron, OR 1.20, 95% CI 1.05 to 1.37; Fat, OR 1.33, 95% CI 1.09 to 1.62, respectively, for quintile 5 versus quintile 1). A dietary pattern characterised by high protein intake was associated with reduced odds of tinnitus (OR 0.90, 95% CI 0.82 to 0.99 for quintile 5 versus quintile 1). Higher vitamin D intake was associated with reduced odds of hearing difficulties (OR 0.90, 95% CI 0.81 to 1.00 for quintile 5 versus quintile 1), as were dietary patterns high in fruit and vegetables and meat and low in fat (Prudent diet: OR 0.89, 95% CI 0.83 to 0.96; High protein: OR 0.88, 95% CI 0.82 to 0.95; High fat: OR 1.16, 95% CI 1.08 to 1.24, respectively, for quintile 5 versus quintile 1).

Conclusions:

There were associations between both single nutrients and dietary patterns with tinnitus and hearing difficulties. Although the size of the associations was small, universal exposure for dietary factors indicates that there may be a substantial impact of diet on levels of tinnitus and hearing difficulties in the population. This study showed that dietary factors might be important for hearing health.
Hearing Impairment and Prevalence of Mild Cognitive Impairment in Japan: Baseline Data From the Aidai Cohort Study in Yawatahama and Uchiko
Authors: Miyake Yoshihiro , Tanaka Keiko , Senba Hidenori , Ogawa Susumu , Suzuki Hiroyuki , Fujiwara Yoshinori , Okada Masahiro , Takagi Daiki , Teraoka Masato , Yamada Hiroyuki , Nobuhara Takashi , Matsuura Bunzo , Hato Naohito
Published: July 2019

Objectives:

Hearing impairment (HI) in midlife may increase the risk of dementia. However, epidemiological research on the association between HI and mild cognitive impairment (MCI) is very limited.

Design:

The present cross-sectional study investigated the relationship between HI and MCI using baseline data from the Aidai Cohort Study. Study subjects were 995 Japanese adults aged 36 to 84 years. We used the audiometric definition of HI adopted by the World Health Organization, which identifies the speech-frequency pure-tone average hearing thresholds at 0.5, 1, 2, and 4 kHz tones. HI was defined as present when pure-tone average was >25 dB HL in the better hearing ear. MCI was defined as being present when a subject had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, sex, smoking status, alcohol consumption, leisure time physical activity, hypertension, dyslipidemia, diabetes mellitus, history of depression, body mass index, waist circumference, employment, education, and household income.

Results:

Among the 995 study subjects, the prevalence values of HI and MCI were 24.3% and 44.5%, respectively. HI was independently positively associated with MCI: the multivariate-adjusted odds ratio (95% confidence interval) was 1.86 (1.32 to 2.62). HI was independently related to a higher prevalence of MCI in those aged 60 to 69 years and those aged 70 years or older: the multivariate-adjusted odds ratios (95% confidence intervals) were 1.64 (1.03 to 2.62) and 2.30 (1.04 to 5.27), respectively.

Conclusions:

HI may be associated with a higher prevalence of MCI.
Comparison of axillary lateral radiography with computed tomography in the preoperative characterization of glenohumeral wear patterns and the effects of body mass index on quality of imaging
Authors: Mulligan Ryan P. , Feldman John J. , Bonnaig Nicolas S. , Weller William J. , Miller Robert H. , Azar Frederick M. , Throckmorton Thomas W.
Published: July 2019

Background:

Preoperative imaging is important in planning glenoid component placement in shoulder arthroplasty. This study compared preoperative axillary lateral radiography with CT to determine which was more effective in characterization of glenoid erosion and subluxation and in measurement of glenoid version. We also sought to determine the effect of body mass index (BMI) on image quality.

Methods:

Eighty-eight patients who had shoulder arthroplasty for primary glenohumeral osteoarthritis were included. The Walch and Mayo classifications as well as glenoid version measurements were used. Kappa coefficients were obtained for interclass and intraclass reliabilities. Intraclass and interclass correlation coefficients were calculated for glenoid version measurements.

Results:

For glenoid erosion and subluxation, intraobserver and interobserver reliabilities indicated moderate (k=0.19-0.28) and fair agreement (k=0.41-0.50), respectively, which were similar for both imaging modalities and classifications. For glenoid version, interobserver reliability was good for both modalities, but intraobserver reliability showed substantial agreement for CT and only good agreement for radiographs (k=0.77, k=0.91, k=0.65-0.7, respectively). Increased BMI negatively affected image quality in both but more so on radiographs (P<0.0001).

Conclusions:

Both modalities had similar intraobserver and interobserver agreement; however, CT provided significantly more precise measurements of glenoid version regardless of classification used. A high BMI significantly affected the observers’ ability to judge classifications, especially on radiographs.
Effect of Surgeon and Hospital Volume on Complications After Operative Tarsal Fracture Repair
Authors: Stewart Christopher C. , Brodke Dane J. , Morshed Saam
Published: July 2019

Objective:

To determine whether increased surgeon and hospital volume is associated with lower rates of complications after tarsal fractures.

Design:

Retrospective cohort study of the State Inpatient Databases.

Setting:

Two hundred ninety-nine hospitals in Florida (2005–2012) and New York (2006–2008).

Patients/Participants:

Four thousand one hundred thirty-two tarsal fractures that underwent fixation by 1223 surgeons.

Intervention:

Surgical repair of tarsal fractures.

Main Outcome Measurements:

Composite of readmission for infection requiring operative treatment, wound dehiscence, nonunion, avascular necrosis, or amputation within 2 years of the index procedure.

Results:

The mean age was 44 (±15) years, a majority were men (70%) and white (69%), and the mean number of Charlson comorbidities was 0.21 (±0.58). Multivariable logistic regression demonstrated a reduction in the likelihood of complications by 9% for each 5 additional surgeries performed by the operating surgeon [odds ratio (OR), 0.91 per 5 surgeries; 95% confidence interval (CI), 0.82–0.99]. Other factors associated with complications included increased age (OR, 1.23 per 10 years; 95% CI, 1.10–1.36), male sex (OR, 1.56; 95% CI, 1.12–2.17), open fractures (OR, 2.84; 95% CI, 1.92–4.19), number of Charlson comorbidities (OR, 1.23; 95% CI, 1.02–1.48), income quartile (OR, 1.48; 95% CI, 1.00–2.17), uninsured (OR, 2.47; 95% CI, 1.39–4.39), and other government program insurance (OR, 1.52; 95% CI, 1.06–2.18).

Conclusions:

We observed a significant inverse relationship between surgeon volume and complication rates when controlling for patient and injury characteristics. In contrast to previous research, a volume–outcome relationship was not observed at the hospital level. These results suggest that such complex injuries should be triaged to the most experienced providers.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Maintenance of Compression With a Positional Screw Versus Compression Generated With a Lag Screw
Authors: Srinivasan Aditya , Young Matthew , Ambrose Catherine , Kellam James
Published: July 2019

Objective:

To determine whether a position screw will maintain the interfragmentary compression force obtained by a reduction clamp across an anatomically reduced cortical bone fracture and determine whether this compressive force is equivalent to that generated by a lag screw (LS).

Methods:

Oblique fractures were created in 6 composite cortical bone models. Interfragmentary compression was measured using force sensors within the fracture after reduction with a clamp. A position screw was then placed perpendicular to the fracture, and force measurements were repeated with both the clamp and the screw. Finally, the clamp was removed, and force measurements were taken with the screw only to measure maintenance of initial compression. After these measurements, the screw was removed, and the near fragment was overdrilled to allow LS placement by technique. Compression force measurements were repeated for clamp only, clamp + screw, and screw only.

Results:

The mean force of clamp alone across all 12 trials was 139.77 N. Application of an LS increased the compression across the fracture (P= 0.01) which was unchanged when the clamp was removed. The position screw had the opposite effect, reducing compression, and the removal of the clamp further reduced the compression (P= 0.013).

Conclusions:

A reduction clamp will initially compress a fracture to an average of 139 N. An LS will significantly increase this interfragmentary compression. A position screw will not maintain the compression created by the clamp and in fact will significantly decrease interfragmentary compression.
Clavicles continue to grow beyond skeletal maturity: radiographic analysis of clavicle length in adolescents and young adults
Authors: Hosseinzadeh Pooya , Pokala Naveen , Meyer Zachary , Minaie Arya , Brea Christina , Gonzalez Derek , Kiebzak Gary M.
Published: July 2019

There has been minimal research regarding the clavicle’s growth and its clinical implications in the late adolescent and early adult population. Previous studies have evaluated postnatal clavicle growth to age 18 without analysing growth through the age of secondary ossification center closure. The purpose of this study was (1) to determine clavicle length and age-related growth in males and females from age 12 to 25 years and (2) to specifically analyse clavicle growth in late adolescence. This was a retrospective analysis of chest radiographs in patients aged 12–25 years. The ruler tool was used to measure clavicle length. Mean values were tabulated for each year of age in males (n = 697) and females (n = 672). Mean right clavicle growth significantly increased from age 12 to 25 in both males and females (P < 0.0001). In males, the increase from age 16 to 25 was 17.5 mm, representing 10.6% of total clavicle length (P < 0.0001). In females, the increase from age 14 to 25 was 7.7 mm, representing 5.2% of total clavicle length (P < 0.0001). We found that from skeletal maturity to the closure of the secondary ossification center, growth was 17.5 mm (10.6% of total clavicle length) in males and 7.7 mm (5.2% of total clavicle length) in females. During their growth spurts, the adolescent male and female clavicle have growth potentials very similar to previous studies of radius growth. Understanding these clavicular growth potentials can influence operative vs. nonoperative management decisions by orthopaedic surgeons. Level of evidence: Level III.
One-stage release by double surgical approach for neglected congenital vertical talus: results in a series of walking children in Tanzania
Authors: Sanzarello Ilaria , Nanni Matteo , Perna Fabrizio , Traina Francesco , Faldini Cesare
Published: July 2019

Congenital vertical talus is an uncommon rigid flatfoot deformity present at birth, producing pain and disability if untreated. This study reports results and complications in a series of walking children affected by neglected congenital vertical talus treated by one-stage release through a double surgical approach in a hospital sited in the Tanzanian rural outback. Between 2009 and 2014, nine consecutive congenital vertical talus were observed in five patients (three males and two females) aged between 2 and 4 years. In two children, the deformity was idiopathic, in two it was associated to distal arthrogryposis and in one to Larsen syndrome. The surgical procedure was performed through a posteromedial and a lateral incision and included extensive soft tissue release and reduction of talo-navicular and subtalar joint, pinned with percutaneous Kirschner wires. The talar axis-first metatarsal base angle (TAMBA) was measured preoperatively and at follow-up. Results were summarized using the Adelaar score and the PODCI (Pediatric Outcomes Data Collection Instrument) questionnaire. The mean follow-up was 2.6 years (2–4). No major intraoperative complications were observed. The TAMBA passed from 74.4° (range 68–82°) to 20.2° (range 18–24°). No talar osteonecrosis was observed. The results were excellent in three cases, good in five cases and fair in one (Adelaar score). The mean postoperative PODCI score was 48 (range 38–60). None of the patients underwent further surgery. In case of neglected congenital vertical talus and limited health resources, this surgical technique has proved to be a viable option, providing satisfactory results, with low rate of surgical and postsurgical complications.
Urine Klotho Is Lower in Critically Ill Patients With Versus Without Acute Kidney Injury and Associates With Major Adverse Kidney Events
Authors: Neyra Javier A. , Li Xilong , Mescia Federica , Ortiz-Soriano Victor , Adams-Huet Beverley , Pastor Johanne , Hu Ming-Chang , Toto Robert D. , Moe Orson W.
Published: July 2019

Objectives:

Klotho and fibroblast growth factor-23 were recently postulated as candidate biomarkers and/or therapeutic targets in acute kidney injury. We examined whether urine Klotho and serum intact fibroblast growth factor-23 levels were differentially and independently associated with major adverse kidney events in critically ill patients with and without acute kidney injury.

Design:

Single-center, prospective, case-control study.

Setting:

ICU in a tertiary medical center.

Patients:

Fifty-four acute kidney injury patients and 52 controls without acute kidney injury admitted to the ICU.

Interventions:

None.

Measurements and Main Results:

Acute kidney injury was defined by Kidney Disease: Improving Global Outcomes criteria and included only acute kidney injury stage greater than or equal to 2. Controls were matched by age, gender, and baseline estimated glomerular filtration rate. Paired serum and urine samples were obtained 24–48 hours after acute kidney injury diagnosis (cases) or ICU admission (controls). The primary outcome was 90-day major adverse kidney events, which was the composite of all-cause death, dependence on renal replacement therapy, or a 50% or higher decrease in estimated glomerular filtration rate from baseline. Major adverse kidney events, which was the composite of all-cause death, dependence on renal replacement therapy, or a 50% or higher decrease in estimated glomerular filtration rate from baseline. Major adverse kidney events developed in 44 patients (41.5%). Patients in whom major adverse kidney events developed had more comorbidity, higher acuity of illness scores, and more prevalent acute kidney injury. Levels of urine Klotho adjusted by creatinine were lower, and serum intact fibroblast growth factor-23 levels were higher in acute kidney injury patients versus ICU controls. In adjusted models, the highest versus lowest tertile of urine Klotho/creatinine was independently associated with an overall 95% lower risk of major adverse kidney events (81% lower risk in patients with acute kidney injury). The highest versus lowest tertile of serum intact fibroblast growth factor-23 was associated with more than 300% higher risk of major adverse kidney events.

Conclusions:

Urine Klotho/creatinine levels were significantly lower and serum intact fibroblast growth factor-23 levels were significantly higher in critically ill patients with acute kidney injury versus matched controls without acute kidney injury. When measured in the first 48 hours of ICU admission or acute kidney injury diagnosis, urine Klotho/creatinine independently associated with major adverse kidney events, particularly in patients with acute kidney injury. These results show promise for testing these biomarkers—individually or in combination—as part of novel risk prediction models of renal outcomes in the ICU.
Epidemiology and Outcomes of Cancer-Related Versus Non–Cancer-Related Sepsis Hospitalizations*
Authors: Hensley Matthew K. , Donnelly John P. , Carlton Erin F. , Prescott Hallie C.
Published: July 2019

Objective:

Cancer and its treatment are known to be important risk factors for sepsis, contributing to an estimated 12% of U.S. sepsis admissions in the 1990s. However, cancer treatment has evolved markedly over the past 2 decades. We sought to examine how cancer-related sepsis differs from non–cancer-related sepsis.

Design:

Observational cohort.

Setting:

National Readmissions Database (2013–2014), containing all-payer claims for 49% of U.S. population.

Patients:

A total of 1,104,363 sepsis hospitalizations.

Interventions:

We identified sepsis hospitalizations in the U.S. National Readmissions Database using explicit codes for severe sepsis, septic shock, or Dombrovskiy criteria (concomitant codes for infection and organ dysfunction). We classified hospitalizations as cancer-related versus non–cancer-related sepsis based on the presence of secondary diagnosis codes for malignancy. We compared characteristics (site of infection and organ dysfunction) and outcomes (in-hospital mortality and 30-d readmissions) of cancer-related versus non–cancer-related sepsis hospitalizations. We also completed subgroup analyses by age, cancer types, and specific cancer diagnoses.

Measurements and Main Results:

There were 27,481,517 hospitalizations in National Readmissions Database 2013–2014, of which 1,104,363 (4.0%) were for sepsis and 4,150,998 (15.1%) were cancer related. In-hospital mortality in cancer-related sepsis was 27.9% versus 19.5% in non–cancer-related sepsis. The median count of organ dysfunctions was indistinguishable, but the rate of specific organ dysfunctions differed by small amounts (e.g., hematologic dysfunction 20.1% in cancer-related sepsis vs 16.6% in non–cancer-related sepsis; p < 0.001). Cancer-related sepsis was associated with an adjusted absolute increase in in-hospital mortality ranging from 2.2% to 15.2% compared with non–cancer-related sepsis. The mortality difference was greatest in younger adults and waned with age. Patients (23.2%) discharged from cancer-related sepsis were rehospitalized within 30 days, compared with 20.1% in non–cancer-related sepsis (p < 0.001).

Conclusions:

In this cohort of over 1 million U.S. sepsis hospitalizations, more than one in five were cancer related. The difference in mortality varies substantially across age spectrum and is greatest in younger adults. Readmissions were more common after cancer-related sepsis.