bluuebunny/crossref_metadata_2025 huggingface dataset:
How not to evaluate a psychological measure: Rebuttal to criticism of the Defining Issues Test of moral judgment development by Curzer and colleagues
Authors: Thoma Stephen J , Bebeau Muriel J , Narvaez Darcia
Published: March 2016

In a 2014 paper in Theory and Research in Education, Howard Curzer and colleagues critique the Defining Issues Test of moral judgment development according to eight criteria that are described as difficulties any measure of educational outcomes must address. This article highlights how Curzer et al. do not consult existing empirical evidence, misunderstand the model and method associated with the Defining Issues Test, and thereby reach conclusions that are unwarranted, incomplete, and ultimately indefensible. To address these shortcomings, we present an overview of the Defining Issues Test and note relevant criteria for evaluating a measure of moral judgment development.
Original Research: Acute chest syndrome in sickle cell disease: Effect of genotype and asthma
Authors: Pahl Kristy , Mullen Craig A
Published: March 2016

Sickle cell disease is a severe hemoglobinopathy caused by mutations in the beta globin genes. The disorder has protean manifestations and leads to severe morbidity and early mortality. Acute chest syndrome (ACS) is a common complication and in the USA is the leading cause of death in patients with sickle cell disease. Care of patients with sickle cell disease is complex and typically involves both primary care physicians and hematology subspecialists. The purpose of this study was first to attempt to validate in a pediatric sickle cell patient cohort associations between ACS and sickle cell disease genotype and between ACS and asthma as a comorbidity. The second purpose of the study was to study in a typical community the frequency with which asthma associated with ACS was addressed in terms of electronic medical record integration, pulmonary subspecialty consultation for management of asthma, and completion of pulmonary function testing (PFTs). A retrospective study of the electronic medical record of a children’s hospital that provides most of the medical care for children in a portion of western New York state was performed. We found that ACS was more common in the sickle cell disease genotypes SS and S/beta-thalassemia-null, and that ACS was more frequent in patients treated for asthma. We also found that despite the use of a comprehensive electronic medical record, there was poor documentation of ACS and asthma episodes in the problem lists of patients with sickle cell disease, and that most patients with sickle cell disease with ACS or asthma failed to receive formal consultation services from pediatric pulmonary subspecialists.
Minireview: Genetic basis of heterogeneity and severity in sickle cell disease
Authors: Habara Alawi , Steinberg Martin H
Published: March 2016

Sickle cell disease, a common single gene disorder, has a complex pathophysiology that at its root is initiated by the polymerization of deoxy sickle hemoglobin. Sickle vasoocclusion and hemolytic anemia drive the development of disease complications. In this review, we focus on the genetic modifiers of disease heterogeneity. The phenotypic heterogeneity of disease is only partially explained by genetic variability of fetal hemoglobin gene expression and co-inheritance of α thalassemia. Given the complexity of pathophysiology, many different definitions of severity are possible complicating a full understanding of its genetic foundation. The pathophysiological complexity and the interlocking nature of the biological processes underpinning disease severity are becoming better understood. Nevertheless, useful genetic signatures of severity, regardless of how this is defined, are insufficiently developed to be used for treatment decisions and for counseling.
Guild Wars 2, the Frankfurt School and Dialectical Fairy Scenes: A Critical Approach Towards Massively Multiplayer Online Video Games
Authors: van Ommen Mattias
Published: March 2016

In this study, I use a revised approach of the Frankfurt School in order to critically assess a recent massively multiplayer online video game, Guild Wars 2. Starting with a brief historical overview of the Frankfurt School, I proceed by applying a revision of the school’s main contributions to analyzing Guild Wars 2. This includes an integration of processes of production and distribution, various levels of textual analysis, and audience reception. My main method of investigation is long-term participant observation, and throughout the article, I will argue for the use of such qualitative methods in the critical study of video games. Doing this, I have found that Guild Wars 2 offers a complex experience with enormous appeal and creative potential, while at other times being surprisingly restrictive, culminating in what Walter Benjamin would call a dialectical fairy scene.
Family members’ or friends’ involvement in self-care for patients with depressive symptoms and co-morbid chronic conditions
Authors: Sussman Tamara , Mccusker Jane , Yaffe Mark , Belzile Eric , Sewitch Maida , Cole Martin , Strumpf Erin
Published: March 2016

Objectives

To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F.

Methods

One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided.

Results

30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient use of self-care materials when examined alongside all F/F support variables (Proportional Odds Ratio = 1.21; 95% C.I. = 1.01, 1.45). F/F perceived less involvement in the self-care intervention than patients.

Discussion

Patients engaged in a self-care intervention for depressive symptoms use more self-care materials when they perceive F/F involvement in the intervention. Patients and F/F may perceive involvement differently and benefit from discussions about potential F/F roles.
Understanding factors that facilitate the inclusion of pain education in undergraduate curricula: Perspectives from a UK survey
Authors: Carr Eloise CJ , Briggs Emma V , Briggs Michelle , Allcock Nick , Black Pauline , Jones Derek
Published: March 2016

Background:

Studies in Europe, North America and Australasia suggest that one in five adults suffer from pain. There is increasing recognition that pain, particularly chronic pain, represents a global health burden. Many studies, including two national surveys exploring the content of undergraduate curricula for pain education, identify that documented pain education in curricula was limited and fragmentary.

Methods:

The study design used a questionnaire which included an open text comment box for respondents to add ‘further comments’ as part of larger study previously published. The sample consisted of 19 UK universities that offered 108 undergraduate programmes in the following: dentistry, medicine, midwifery, nursing (adult, child, learning disabilities and mental health branches), occupational therapy (OT), pharmacy, physiotherapy and veterinary science. An inductive content analysis was performed, and the data were managed using NVivo 10 software for data management.

Results:

A total of 57 participants across seven disciplines (dentistry, medicine, midwifery, nursing, pharmacy, physiotherapy and OT) completed the open text comment box (none were received from veterinary science). Analysis revealed two major themes of successes and challenges. Successes included expansion (extending coverage and/or increased student access), multidimensional curriculum content and diversity of teaching methods. Challenges included difficulties in identifying where pain is taught in the curriculum, biomedical versus biopsychosocial definitions of pain, perceived importance, time, resources and staff knowledge, and finally a diffusion of responsibility for pain education.

Conclusion:

This study identifies new insights of the factors attributed to successful implementation of pain education in undergraduate education. Many of the challenges previously reported were also identified. This is one of the first studies to identify a broad range of approaches, for pain education, that could be deemed as ‘successful’ across a range of health disciplines.
Medication regimen complexity and readmissions after hospitalization for heart failure, acute myocardial infarction, pneumonia, and chronic obstructive pulmonary disease
Authors: Abou-Karam Nada , Bradford Chad , Lor Kajua B , Barnett Mitchell , Ha Michelle , Rizos Albert
Published: March 2016

Objectives:

Readmission rate is increasingly being viewed as a key indicator of health system performance. Medication regimen complexity index scores may be predictive of readmissions; however, few studies have examined this potential association. The primary objective of this study was to determine whether medication regimen complexity index is associated with all-cause 30-day readmission after admission for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease.

Methods:

This study was an institutional review board–approved, multi-center, case–control study. Patients admitted with a primary diagnosis of heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease were randomly selected for inclusion. Patients were excluded if they discharged against medical advice or expired during their index visit. Block randomization was utilized for equal representation of index diagnosis and site. Discharge medication regimen complexity index scores were compared between subjects with readmission versus those without. Medication regimen complexity index score was then used as a predictor in logistic regression modeling for readmission.

Results:

Seven hundred and fifty-six patients were randomly selected for inclusion, and 101 (13.4%) readmitted within 30 days. The readmission group had higher medication regimen complexity index scores than the no-readmission group ( p < 0.01). However, after controlling for demographics, disease state, length of stay, site, and medication count, medication regimen complexity index was no longer a significant predictor of readmission (odds ratio 0.99, 95% confidence interval 0.97–1.01) or revisit (odds ratio 0.99, 95% confidence interval 0.98–1.02).

Conclusion:

There is little evidence to support the use of medication regimen complexity index in readmission prediction when other measures are available. Medication regimen complexity index may lack sufficient sensitivity to capture an effect of medication regimen complexity on all-cause readmission.
Sphingosine kinase 1 inhibition improves lipopolysaccharide/D‐galactosamine‐induced acute liver failure by inhibiting mitogen‐activated protein kinases pathway
Authors: Tian Tao , Tian Weiliang , Yang Fan , Zhao Risheng , Huang Qian , Zhao Yunzhao
Published: March 2016

Background

Sphingosine kinase 1 (SphK1)/sphingosine‐1‐phosphate (S1P)/sphingosine‐1‐phosphate receptors (S1PRs) signaling plays a key role in inflammatory responses. Lei et al. showed that SphK1 inhibition presented a hepatoprotective effect on acute liver damage via decreasing hepatic high‐mobility group box 1 (HMGB1) cytoplasmic translocation.

Objective

We aim to determine whether SphK1 or S1PRs inhibition improves lipopolysaccharide (LPS)/D‐galactosamine (GalN)‐induced acute liver failure by inhibiting the mitogen‐activated protein kinases (MAPKs) pathway.

Methods

A mouse model of acute liver failure was induced by LPS/GalN. Male C57BL/6J mice (6–8 weeks) were randomly distributed into five groups: control group, LPS/GalN group, SphK1 inhibition group (LPS/GalN+SKI‐5c), S1PR1 inhibition group (LPS/GalN+W146), and S1PR3 inhibition group (LPS/GalN+CAY10444).

Results

We confirmed the findings of Lei et al. that hepatic SphK1 expression was upregulated; serum transaminase activity (AST, ALT), as well as serum TNF‐α and IL‐6, were decreased by SphK1 inhibition. We further showed that the expression of S1PR1 and S1PR3 was augmented in response to LPS/GalN. SphK1 inhibition improves hepatic hemorrhage, and the activities of hepatic caspase‐3 and myeloperoxidase (MPO). Furthermore, the activation of the MAPKs family (JNK, ERK and p38) was suppressed by SphK1 inhibition. However, S1PR1 or S1PR3 inhibition did not protect the mouse against liver damage, though S1PR1 or S1PR3 inhibition reduced serum TNF‐α and IL‐6, and partially attenuated the phosphorylation of the MAPKs signaling.

Conclusions

SphK1 inhibition improves LPS/GalN‐induced liver injury by inhibiting activation of MAPKs signaling.
Qualitative research and implementation science: Informing the acceptability and implementation of a trial of a conditional cash transfer intervention designed to reduce drug use and HIV risk
Authors: Dixon Thomas Crewe , Stein Ellen , Ngak Song , Srean Chhim , Maly Phou , Sokunny Muth , Carrico Adam , Page Kimberly , Maher Lisa
Published: March 2016

HIV risk remains high among Cambodian female entertainment and sex workers, driven by amphetamine-type substance use and sexual risk. Conditional cash transfer is an evidence-based approach to reduce stimulant use and optimize HIV/AIDS prevention, but questions remain regarding implementation in resource-limited settings. We conducted formative qualitative research to enhance acceptability of a conditional cash transfer intervention aimed at reducing amphetamine-type substance use and HIV risk among female entertainment/sex workers and inform implementation as part of a large cluster randomized trial. We conducted in-depth interviews with 30 female entertainment/sex workers. Interviews were digitally recorded and conducted and transcribed in Khmer. English transcripts were read for emerging themes and an initial coding scheme was developed. Data were coded using open and axial coding to clarify and consolidate initial themes. While most participants expressed enthusiasm for the intervention, financial and transportation issues emerged as key barriers to participation. The proposed incentive of USD$1 per screen was regarded as unacceptable and participants identified a need for transportation assistance. Participants also expressed concerns about directly observed urine specimen collection. Finally, while most participants found the 4-week aftercare program acceptable, the need for enjoyable as well as educational content was emphasized. Revisions to the protocol taking these data into account were made to optimize the acceptability of the intervention and the implementation of the trial. Findings identified key concerns and preferences that were taken into account in the final trial protocol. In particular, financial and transportation issues were identified as critical barriers to participation, with the potential to impact both intervention uptake and trial feasibility. Results demonstrate the value of formative qualitative research for clinical trial planning and implementation, particularly in settings where little is known about acceptability of interventions or willingness to participate.
ZombieApocalypse: Modeling the social dynamics of infection and rejection
Authors: Riebling Jan R , Schmitz Andreas
Published: March 2016

In this article, we propose a model that we call ZombieApocalypse and that relies on agent-based simulation on a dynamic network topology. We simulate three strategies common to the zombie mythology and the sociology of figurational dynamics by Norbert Elias: cutting ties, being sentimental, and stigmatization. The simulation results are analyzed on two dimensions: the outcome for the populations of zombies and humans as well as the resulting changes in topology. We show that the introduction of social dynamics into these models leads to unexpected outcomes. Implications for more “serious” research on general models of infection and social dynamics are discussed.
An area-based nonparametric spatial point pattern test: The test, its applications, and the future
Authors: Andresen Martin A
Published: March 2016

The analysis of spatial point patterns is a critical component of the geographic information analysis literature. Most of the tests for these data are concerned with random, uniform, and clustered patterns. However, knowing whether a spatial point pattern is similar to these theoretical data-generating processes is not always instructive: most human activity is clustered, so finding that some component of human activity is clustered is not really new information. In this article, a recently developed spatial point pattern test is discussed that compares the similarity of two different data sets. This comparison can be comparisons of different phenomena (different types of crime or public health issues) or the same phenomenon over time, for example. The discussion revolves around the test itself, its varied applications, and the future developments expected for this spatial point pattern test.
Adventures of an accidental methodologist
Authors: Scott John
Published: March 2016

This article reflects on the attempt to introduce and extend two innovative methodological considerations: social network analysis and documentary research. Documentary research is widely used but little discussed in methodological literature and I show how my own methodological reflections arose from practical concerns with the use of documents. Social network analysis as a formal technique has been little used and I show how my attempts to popularise it as a methodology also grew out of practical research concerns. These are the adventures of an accidental methodologist.
Radiographic Osteoarthritis, Clinical Outcomes and Re-Injury 20 Years after ACL Reconstruction
Authors: Pinczewski Leo , Salmon Lucy , Thompson Simon , Waller Alison , Linklater James , Roe Justin
Published: March 2016

Objective:

This prospective longitudinal study compares the outcome of isolated endoscopic ACL reconstruction utilizing 4-strand hamstring tendon (HT) and patellar tendon (PT) autograft over a 20-year period.

Method:

Observational Series. 90 consecutive patients with isolated ACL rupture were reconstructed with a PT autograft and 90 patients received HT autograft, with an identical surgical technique. Patients were assessed at 2, 5, 7, 10, 15 and 20 years. Assessment included the IKDC Knee Ligament Evaluation including radiographic evaluation, KT1000, Lysholm Knee Score, kneeling pain, and clinical outcomes.

Results:

Subjects who received the PT graft had significantly worse outcomes compared to those who received the HT graft at 20 years for the variables of radiologically detectable osteoarthritis (59% v 39%, p=0.01), kneeling pain (38% v 20%, p=0.02), and incidence of contralateral ACL injury (30% v 14%, p=0.04). There was no significant difference between the HT and PT groups in overall IKDC grade (p=0.23), or IKDC subjective score (p=0.18). Subgroup gender differences were identified. The female PT group had significantly lower mean IKDC subjective scores (p=0.05), and more difficulty with kneeling (p=0.04) compared to the other subgroups. ACL graft rupture occurred in 18% of HT and 10% of the PT (p=0.13), and was associated with males (Hazard Ratio(HR)=3.9, p=0.007), age <18 years (HR=4.6, p=0.003), and non ideal radiological tunnel placement (HR=3.6, p=0.02). Contralateral ACL injury was associated with age <18 years (HR=3.4, p=0.001), and the PT graft (HR=2.2, p=0.02).

Conclusion:

At 20 years both HT and PT autografts continue to provide good subjective outcomes and objective stability. However, ACL reconstruction using the PT graft is associated with persisting kneeling pain and radiological osteoarthritis, compared to the HT graft. Risk factors for ACL graft rupture include males, young age, and those with tunnel malposition. This information may help in the counseling of patients undergoing this procedure and stratifying their individual risk of re-injury.
Anterior Cruciate Ligament Reconstruction of the Knee Using Double Bundle Hamstring Autograft - Is the Remnant Preservation Technique Superior to the Standard Procedure in Terms of Long-Term Graft Failure Rate, the Need for Revision Operation, and Associated Clinical Dysfunction?
Authors: Annear Peter , Rohr E
Published: March 2016

Background:

Anterior cruciate remnant preservation may be beneficial in Anterior Cruciate Ligament Reconstruction (ACLR). Gohil, Annear & Breidahl (Sept, 2007) used a grade 1 randomised controlled trial to compare the two methods and at short term follow-up, the minimal debridement technique demonstrated earlier revascularisation within the ACL graft at 2 months, and suggested improved strength at 6 months based on radiological imaging. Unfortunately, this did not translate through to clinical benefits in the early 12 month post operative period. Zhang, L et al. (May, 2013) and Naylor, AJ et al. (2013) reiterated that remnant preservation may improve graft revascularization and knee proprioception. Takazawa Y et al. (Sept, 2013) demonstrated that minimal debridement may facilitate recovery of function and decreased graft rupture at two years post primary reconstruction. However, studies have yet to show consistent significant clinical advantages and follow-up has only been analysed over 1-2 years.

Purpose:

This current study reported results over a long-term follow-up of 10 years post operation for the same participants from the Gohil, Annear & Breidahl (2007) study.

Study Design:

The review was based on level 1 randomised controlled trial chart review.

Methods:

All 49 participants (25 standard – group 1, and 24 remnant preserving group – group 2) from the previous study have been included for investigation. The chart review recorded demographic data, graft rupture, re-operation rates, and associated clinical failures of the ACLR. The review presents comparative data between the two groups.

Results:

At 10 year follow-up, the remnant retention ACLR group only had better outcomes for ipsilateral graft rupture (2 patients versus 3 patients). Standard ACLR group had improved outcomes for contralateral graft rupture (2 versus 3), ipsilateral other knee post operative surgery (5 versus 10), ipsilateral knee post operative complaints (7 versus 12), and other non-knee post operative issues (3 versus 4). Non of the differences were statistically significant.

Conclusion:

Overall our results suggested no statistically significant difference between the remnant retaining and standard technique for ACLR in these 49 subjects using chart review endpoints of graft revision and knee reoperation rates. The review is limited by a small study group and a chart only review. A larger study group with long term clinical outcome measures may offer more definitive conclusions as to the advantages of remnant sparing ACLR. In this 10 year follow-up post ACL reconstruction there has been no distinct advantage identified for either procedure.
The Diameter of Single Bundle, Hamstring Autograft Does Not Significantly Influence Re-rupture or Clinical Outcomes After Anterior Cruciate Ligament Reconstruction at 7 Years
Authors: MacDessi Samuel , Wernecke Gregory , Seeto Bradley , Chen Darren
Published: March 2016

Objectives:

Increased graft diameters in ACL reconstruction have recently gained popularity as several studies have suggested that this may reduce graft failure rate in young patients, especially those with graft diameters less than 8mm. The purpose of this study was to review the revision rates and outcomes following ACL reconstruction in relation to graft diameter and determine whether increasing graft diameter reduces failure risk.

Methods:

A retrospective analysis of 786 consecutive ACL reconstructions from January 2007 to August 2015 was undertaken. Only cases where a single bundle hamstring autograft reconstruction were included. The surgical technique involved suspensory femoral fixation, tibial screw fixation or cortical button fixation, and a transportal femoral drilling technique. Patients were excluded if there were associated fractures, multiple ligament injuries and previous surgery to the knee. A research database with prospectively recorded data was used for the analysis. The primary outcome measure was graft revision with secondary endpoints being KOOS, IKDC and Tegner Activity Score.

Results:

786 consecutive cases were identified with 76 lost to follow up for outcome scores at 2 years. The overall graft revision rate was 5.98% at 7 years. There was no significant difference between responders and non-responders with regards to age, gender and BMI. Mean graft diameter for the males was 7.99mm and 7.56mm for females (p<0.0001). Graft diameter did not correlate with revision when controlled for age, gender, concurrent meniscal pathology and Tegner activity score (N=348). Only grafts <7mm in diameter had a trend towards higher revision rate (5.6 versus 13.5%) but this did not reach significance (p= 0.063). No difference in functional outcomes between small and large grafts was noted. Age < 20 had a significant impact on revision risk (12.3% revision rate < 20, 4.2% > 20 years old). There was no significant difference in rupture rates at any dichotomous graft size for those under 20.

Conclusion:

In this series, graft diameter did not correlate with ACL graft revision for failure. The increasingly popular concept that large diameter grafts offer a protective benefit to revision risk was not found. This study once again highlights that age remains a major determinant of graft failure and factors that can reduce risk in this age group need to be addressed.
Total Knee Replacement with an Oxidised Zirconium Femoral Component
Authors: Roe Justin , Ahmed Isaac , Salmon Lucy , Watanabe Hiroki , Pinczewski Leo
Published: March 2016

Objectives:

Oxidized zirconium was introduced as a material for femoral components in total knee replacement (TKR) to reduce polyethylene wear. However the long term survival of this prosthesis is not known.

Methods:

A series of 303 consecutive oxidised zirconium TKR were performed over a 3 year period and prospectively included in a database. Subjects were assessed preoperatively and 10 years after TKR. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score (KOOS), radiographic evaluation and a patient satisfaction.

Results:

A total of 303 consecutive TKRs were performed in 278 patients with a mean age of 68 years (range 45 to 89 years). The ten year survival rate from the Kaplan–Meier predicted survivorship was 97% (95% CI 94 - 99) with revision for any reason as the endpoint. There were no revisions for loosening, osteolysis or implant failure. There was a significant improvement in all components of the WOMAC score at final follow up (p<0.001). The mean individual components of the KOOS score for symptoms (82.4 points), pain (87.5 points), activities of daily life (84.9 points) and quality of life (71.4 points) were all at higher end of the scale.

Conclusion:

The oxidized zirconium TKR is associated with favourable survival rates and excellent functional outcomes at ten years.
Objective Measure of Activity Level After Total Knee Arthoplasty with The Use of the ‘Fitbit’ Device
Authors: Roe Justin , Salmon Lucy , Twiggs Joshua
Published: March 2016

Objectives:

The commercial release of non invasive, light weight, low cost accelerometers has great potential to more accurately assess activity level before and after knee arthroplasty from a small light weight wrist strap. These devices have been shown to be valid and reliable assessment tools for activity levels in normal subjects. This study examines activity levels before and after knee arthroplasty using a modern commercially available accelerometer known as a “FitBit”.

Methods:

Observational Series. Subjects undergoing knee arthroplasty under the care of the senior surgeon were invited to participate and wear the accelerometer for 5-7 days at 4 times periods: before surgery, day 1-3, 6 weeks and 12 month after arthroplasty. Preoperatively and at 12 months after TKR subjects completed the Knee injury and Osteoarthritis Outcome Score (KOOS), WOMAC Assessment, and British Orthopaedic Association Patient Satisfaction Scale.

Results:

54 subjects were recruited to the study over a 12 month period. Prior to total knee arthroplasty, the mean number of recorded steps per day was 6600. Post arthroplasty the mean number of steps per day was 1200 in the first 3 days, 5700 at 6 weeks and 7200 at 1 year. Preoperative activity level was significantly correlated with preoperative Pain Score (p=0.003). Activity level within the first 3 days after surgery was correlated with 6 weeks activity level (0.473, p=0.004), and 1 year activity level (0.593, p=0.02), but not 1 year KOOS scores.

Conclusion:

Modern accelerometers present a novel way to objectively measure activity level before and after knee arthroplasty. Preoperative activity level is significantly associated with post operative activity level. One year after knee arthroplasty the mean number of steps per day is 7200, and 50% of subjects taking more than 7000 steps per day, which is the recommended daily average for those age 65+ years.
Use of Supercritical Sterilized Bone Allograft in Two Stage Revision ACL Reconstruction
Authors: Roe Justin , Rutten Sjoerd , Bonnar Fiona , Salmon Lucy , Pinczewski Leo
Published: March 2016

Objectives:

Revision ACL-reconstruction can be compromised by bone loss as result of tunnel widening or poorly placed tunnels. Two-stage revision ACL consist of initial removal of the old fixation hardware and remaining ACL-graft tissue, followed by bone grafting of the tunnels. After a period of graft incorporation and bone remodeling, an ACL-reconstruction is performed. Our primary aim is to examine the use of supercritical carbon dioxide sterilized bone allograft for tunnel grafting in order to determine the bone quality, graft incorporation and remodeling, by using histology and histomorphometric analysis. Secondarily, we aimed to determine whether the histological findings correlate with the timing of the second stage revision procedure.

Methods:

Case Series. 12 subjects underwent 2-stage revision ACL reconstruction. Femoral and tibial tunnels were bone grafted with supercritical carbon dioxide sterilized bone allograft (Australian Biotechnologies). Mean time from bone grafting to 2nd stage was 8.8 months (range, 5.6 to 21.3 months). Bone biopsies were taken at the time of the 2nd surgery and decalcified and embedded in paraffin. Sections were hematoxylin and eosin stained for microscopic analysis.

Results:

The graft material was easily identified by its necrotic appearance with empty osteocytes lacunes within the lamellar trabecular bone. In all tissue samples predominately lamellar host bone apposition was seen on the surface of graft fragments known as creeping substitution. Separate bone graft fragments were bridged by newly formed woven bone. In the histological sections of 2 subjects some small islands of chondral cell differentiation were seen, which may relate to endochondral ossification. Active bone remodeling and resorption through combined osteoclastic and osteoblastic activity was present in 2 subjects (7.0 and 6.3 months post grafting), suggesting more advanced phases of graft incorporation. Mean bone volume was 68% over tissue volume (range 33-92%), and graft volume over bone volume was 41% (range 19-70%). Subgroup analysis for graft volume to time of second stage could not demonstrate a difference in 6 to 9 months (mean 44%, range 19-70 %) and >10 months (mean 34%, range 19-48%).

Conclusion:

The osteoconductive supercritical sterilized bone allograft acted as an effective structural framework, allowing for successful graft incorporation through creeping substitution. Although cancellous grafts may remodel completely with time, the initial bone apposition on and bridging of graft fragments provides early mechanical strengths to facilitate 2-stage revision ACL reconstruction. Bone volume and graft volume varied among subjects, but no beneficial effect was demonstrated for graft incorporation and bone remodeling in delaying the 2nd stage procedure for more than 6 months.
Partial Anterior Cruciate Ligament Knee Reconstruction with Accelerated Anterior Cruciate Ligament Rehabilitation
Authors: Annear Peter , Henderson AJY
Published: March 2016

Objectives:

The primary purpose of this study is to determine whether or not a partial Anterior Cruciate Ligament (ACL) reconstruction with accelerated rehabilitation produced similar outcomes to that of the conventional ACL reconstruction with its traditional rehabilitation program timeframe. An improved understanding of these outcomes can change the way partial ACL injuries are treated surgically and return patients back to their chosen activities quicker without compromising their graft.

Methods:

Level III, therapeutic, retrospective study. Participants who were two years post partial ACL reconstruction with accelerated rehabilitation by were contacted. They filled out IKDC, Modified Cincinatti and Tegner Lysholm knee score questionnaires and were measured using a KT-1000 arthrometer for side-to-side instrumented laxity >2 mm as well as indicating if there partial ACL reconstruction had re-ruptured, requiring further surgical intervention.

Results:

All three measurements in this study, including re-rupture rates, side – to – side instrumental laxity and satisfaction scores via questionnaires, were statistically significant, thus showing a partial ACL reconstruction with accelerated rehabilitation is a viable choice for the treatment of a patient with a partial ACL tear of his knee.

Conclusion:

Partial ACL reconstruction with accelerated rehabilitation is a viable choice for the treatment of a patient with a partial ACL tear of his knee.
Acute ACL Surgery Decreases First Year Socio Economic Costs Compared to Delayed Reconstruction
Authors: Eriksson Karl , von Essen Christoffer , Barenius Björn
Published: March 2016

Objectives:

Clinical practice has been to avoid acute ACL reconstruction due to the risk of complications, especially arthrofibrosis. Thus, a general rule has been to wait with reconstruction until he knee is “calm” which usually means 4-8 weeks following injury. Furthermore there is often also a prolonged waiting time due to operating space and other logistic factors. Since most of the patients undergoing ACL reconstruction are of working age, there is a potentially large socio-economic loss due to the fact that many of these patients are unable to work from the time of injury to the time of reconstruction. The aim of this study was to assess and compare the total number of sick leave days caused by the knee injury from the day of injury and over the first year between sub acute and delayed reconstruction.

Methods:

70 patients with high recreational activity level, Tegner level of 6 or more, who presented with an acute ACL injury were randomized to acute reconstruction within 8 days from the injury or delayed reconstruction 6-10 weeks post injury. Four surgeons performed the ACL reconstructions with quadrupled semitendinosus tendon grafts. Patients were assessed at 6,12 and 24 months and these follow ups included Biodex strength test, Lachman, Rolimeter, pivot shift, one leg hop, IKDC, KOOS, Lysholm and Tegner activity level. With data from the Swedish Social Insurance Agency (Försäkringskassan) information about the number of sick leave days from the day of the knee injury and over the following twelve months was collected. The data was recalled based on diagnostic numbers related to the specific knee-injury and compared between the two groups.

Results:

Seventy percent of the patients were males, mean age at the time of inclusion was 27 years (18 -41) and the pre-injury median Tegner level was 9 (5-10), with no differences between the groups. 15/70 patients were students without registered compensation for sick leave, 5 in the acute and 10 in the delayed group. 4 patients in the acute group and 1 in the delayed group were neither students nor registered for any compensation for sick leave from work. One patient from the delayed group resigned from the study before surgery. The remaining 49 patients, 26 patients in the acute and 23 in the delayed group received compensation for sick leave due to the injury. The number of sick leave days for the acute group was significantly lower, mean 57 (median 53) days compared to the delayed group, mean 99 (median 66) days (p<0.05).

Conclusion:

Acute ACL reconstruction seems to significantly reduce socio economic costs (compensation for sick leave) compared to delayed reconstruction. From a nation based perspective this could have major implications in health care spending.
Predicting Hamstring Graft Diameter Using MRI and Anthropometry
Authors: Fritsch Brett A , Mhaskar Vikram A , An Vincent Vinh Gia , Scholes Corey
Published: March 2016

Objectives:

Graft diameter is one variable that may affect outcome of ACL reconstruction. The ability to predict the size of a graft in a given patient pre-operatively may help guide graft selection and preparation technique. Various papers have correlated anthropometric data and MRI tendon measurements to intraoperative graft diameter, although no papers have investigated these together. The intra-operative diameter of a hamstring autograft will be influenced by graft preparation technique. Our study aimed to investigate the prediction of intraoperative graft diameter of 2 different graft construct techniques (4-strand semitendinosus versus quadrupled semitendinosus) using anthropometry and MRI measurements.

Methods:

Retrospective review of two groups of ACL reconstruction using different graft preparation techniques was performed. “Conventional” 4-strand gracilis + semitendinosus with fixed suspension at the femur and screw fixation at the tibia were compared with quadrupled semitendinosus grafts with adjustable suspensory fixation at each end (Graftlink). Cross-sectional areas (XSA) of the semitendinosus and gracilis tendons was measured in the axial slice of a T2 weighted MRI image using a region-of-interest tool. Stepwise linear regression using intraoperative graft diameter as the dependant variable was performed using MRI XSA of the semitendinosus and gracilis tendons, gender and height as predictors.

Results:

129 ACL Reconstruction in 127 patients were done in the time period, 89 of which were done conventionally, and 40 which employed the Graftlink construct. The median graft diameter in the Graftlink group (8.5mm IQR8-9) was greater than that of the conventional group (8mm, IQR 7.5-8) (p < 0.001). MRI XSA of semitendinosus and height were statistically significant predictors of diameter in the Graftlink group (R2 = 51%), whilst MRI XSA of semitendinosus + gracilis and gender were predictors in the conventional group (R2 = 36%).

Conclusion:

Graftlink ACLRs produced a greater graft diameter than conventional 4-strand semitendinosus and gracilis constructs. Gender and tendon XSA were statistically significant predictors of graft diameter in conventional four-tailed ACLRs, whilst height and tendon XSA predicted Graftlink ACLRs. A greater degree of the graft diameter variance could be predicted pre-operatively in the Graftlink group compared to the conventional construct.
Immigration or Welfare? The Progressive’s Dilemma Revisited
Authors: Kulin Joakim , Eger Maureen A. , Hjerm Mikael
Published: March 2016

Previous cross-national research on the link between immigration and the welfare state has focused exclusively on the relationship between the size of a country’s foreign-born population and support for redistribution, neglecting that people vary in their responses to immigration. In this article, the authors revisit the progressive’s dilemma by testing its theoretical proposition—that immigration and welfare are incompatible—in two novel ways. First, the authors conduct an individual-level analysis that demonstrates that, for most Europeans, supporting both immigration and welfare is unlikely. Second, the authors assess whether country-level immigration is associated with the salience of different immigration-welfare attitudes but find little evidence that immigration measured at the country level produces the most exclusive attitudes.
PLZF mutation alters mouse hematopoietic stem cell function and cell cycle progression
Authors: Vincent-Fabert Christelle , Platet Nadine , Vandevelde Amelle , Poplineau Mathilde , Koubi Myriam , Finetti Pascal , Tiberi Guillaume , Imbert Anne-Marie , Bertucci François , Duprez Estelle
Published: March 2016

Key Points

Inactivation of PLZF promotes phenotype of HSC aging. PLZF controls HSC cell cycle.
PLA2G5 regulates transglutaminase activity of human IL-4-activated M2 macrophages through PGE2 generation
Authors: Yamaguchi Munehiro , Zacharia Jennifer , Laidlaw Tanya M , Balestrieri Barbara
Published: March 2016

Phospholipases A2 are enzymes that liberate membrane-bound lipids in a tissue and cell-specific fashion. Group V secretory phospholipase A2 is necessary for the development of M2 macrophages and their effector functions in a mouse model of the T-helper-2 allergic airway inflammation. However, the function of group V phospholipase A2 in human M2 activation and T-helper-2 inflammation is ill-defined. Transglutaminase-2, a protein cross-linking enzyme, is a newly identified marker of both human and mouse interleukin-4-activated M2 macrophages and is also found in the lungs of patients with asthma. We report that group V phospholipase A2 and transglutaminase-2 colocalized in macrophages of human nasal polyp tissue obtained from patients with T-helper-2 eosinophilic inflammation, and their coexpression positively correlated with the number of eosinophils in each tissue specimen. We demonstrate that in human monocyte-derived macrophages activated by interleukin-4, group V phospholipase A2 translocated and colocalized with transglutaminase-2 in the cytoplasm and on the membrane of macrophages. Moreover, knocking down group V phospholipase A2 with small interfering ribonucleic acid reduced macrophage transglutaminase activity, whereas mass spectrometry analysis of lipids also showed reduced prostaglandin E2 production. Finally, exogenous prostaglandin E2 restored transglutaminase activity of group V phospholipase A2-small interfering ribonucleic acid–treated macrophages. Thus, our study shows a novel function of group V phospholipase A2 in regulating the transglutaminase activity of human interleukin-4–activated M2 macrophages through prostaglandin E2 generation and suggests that group V phospholipase A2 is a functionally relevant enzyme that may have therapeutic value for the treatment of human T-helper-2 inflammatory disorders.
Mechanisms Linking the Gut Microbiome and Glucose Metabolism
Authors: Utzschneider Kristina M. , Kratz Mario , Damman Chris J. , Hullarg Meredith
Published: March 2016

Context:

Type 2 diabetes mellitus is associated with gastrointestinal dysbiosis involving both compositional and functional changes in the gut microbiome. Changes in diet and supplementation with probiotics and prebiotics (ie, fermentable fibers) can induce favorable changes in gut bacterial species and improve glucose homeostasis.

Objective:

This paper will review the data supporting several potential mechanisms whereby gut dysbiosis contributes to metabolic dysfunction, including microbiota driven increases in systemic lipopolysaccharide concentrations, changes in bile acid metabolism, alterations in short chain fatty acid production, alterations in gut hormone secretion, and changes in circulating branched-chain amino acids.

Methods:

Data for this review were identified by searching English language references from PubMed and relevant articles.

Conclusions:

Understanding the mechanisms linking the gut microbiome to glucose metabolism, and the relevant compositional and functional characteristics of the gut microbiome, will help direct future research to develop more targeted approaches or novel compounds aimed at restoring a more healthy gut microbiome as a new approach to prevent and treat type 2 diabetes mellitus and related metabolic conditions.
Reproductive Labor at the Intersection of Three Intimate Industries: Domestic Work, Sex Tourism, and Adoption
Authors: Constable Nicole
Published: March 2016

This article explores, ethnographically and critically, migrant women's contributions to three intersecting sectors of “intimate industries” in Asia: domestic work, sex tourism, and adoption. These three sectors are normally understood as separate and distinct, and in the cases discussed below, women are paid formal wages only as domestic workers. Yet focusing on the intersections between these sectors illustrates the critical ongoing significance of global and regional class hierarchies and the intersections of gender, race, and nationality within the context of global capitalism. They simultaneously raise critical questions about why some intimate and reproductive activities are considered “work” while others are not. These intersections are especially pertinent for understanding the construction of less-valued forms of immaterial labor that have been largely overlooked by Michael Hardt and Antonio Negri in their influential work on late global capitalism and empire. Moreover, these three sectors highlight the current significance of what the author calls “intimate surplus labor”—adapting Karl Marx's nineteenth-century concept of the production of profits for a range of capitalist beneficiaries who depend on paying low or no wages to their workers—to the provision of intimate feminized reproductive labor within the contemporary political economy.
Deferential Surrogates and Professional Others: Recruitment and Training of Migrant Care Workers in Taiwan and Japan
Authors: Lan Pei-Chia
Published: March 2016

This article compares Taiwan's guest worker program and Japan's Economic Partnership Agreements (EPAs) program to examine how intimate labor and affective labor are culturally defined and institutionally regulated in different ways. Facing the similar problems of population aging and care deficit, Taiwan and Japan have nevertheless adopted divergent approaches to recruiting and training migrant care workers (“deferential surrogates” vs. “professional others”). This comparison demonstrates national diversity in the intersecting formation of care regime and migration regime. It also shows that cultural values and social practices associated with care, such as familism and gendered division of care work, are subject to transformation under the influence of state intervention and transnational outsourcing.
Conceptual Framework for Methodology of Vertically Integrated Company’s Innovation Development Program Formation
Authors: Чернятин  , Chernyatin S.
Published: March 2016

The large businesses role in the current Russian and world’s innovation activity practice is considered in

this paper. Priority guidelines for the improvement of innovation development programs (IDP) technology

relating to vertically integrated companies have been identified in the frame of Russian partially governmentowned

companies’ IDP analysis. In particular, key principles for corporate IDP formation, which defined

requirements to this document, as well as methods for their accounting, have been presented. An integrating

stage of the corporate IDP formation process, consisting in the development of a specific methodological

approach to the implementation of the above principles and requirements in the frame of selected methods

for their accounting has been considered in details.