bluuebunny/crossref_metadata_2025 huggingface dataset:
Thoracic flexion provokes circumferential dysesthesia: A symptom of thoracic cord lesions in MS
Authors: Reder Anthony T
Published: June 2020

Thoracic flexion, a rapid forward flexion at the waist, can elicit a circumferential electrical sensation in some patients with multiple sclerosis. The clinical and radiographic features of this phenomenon are described here. This symptom is typically a sensory band around the T6-T7 dermatomes and is usually associated with recent thoracic cord lesions. It is clinically independent of cervical pathology and Lhermitte’s sign. Similar to the vertical radiation of symptoms upon neck flexion due to cervical cord lesions, this sign may help localize MS plaques to the thoracic cord, even when thoracic MRI is negative.
Rituximab in patients with pediatric multiple sclerosis and other demyelinating disorders of the CNS: Practical considerations
Authors: Ghezzi Angelo , Banwell Brenda , Bar-Or Amit , Chitnis Tanuja , Dale Russell C , Gorman Mark , Kornek Barbara , Krupp Lauren , Krysko Kristen M , Nosadini Margherita , Rostasy Kevin , Salzer Jonatan , Schreiner Teri , Tenembaum Silvia , Waubant Emmanuelle
Published: June 2020

Anti-CD20 therapies have established efficacy in the treatment of immune-mediated neurological and non-neurological diseases. Rituximab, one of the first B-cell-directed therapies, is relatively inexpensive compared to newer anti-CD20 molecules, is available in many countries, and has been used off-label in pediatric patients with neuroimmune conditions. The objective of this paper is to describe the experience with rituximab in pediatric multiple sclerosis and other inflammatory immune-mediated disorders of the central nervous system (CNS), and to define a protocol for its use in clinical practice, in particular addressing doses, interval of administration, duration of treatment, and tests to perform at baseline and during follow-up.
COVID–19-associated coagulopathy: An exploration of mechanisms
Authors: Colling Meaghan E , Kanthi Yogendra
Published: June 2020

An ongoing global pandemic of viral pneumonia (coronavirus disease [COVID-19]), due to the virus SARS-CoV-2, has infected millions of people and remains a threat to many more. Most critically ill patients have respiratory failure and there is an international effort to understand mechanisms and predictors of disease severity. Coagulopathy, characterized by elevations in D-dimer and fibrin(ogen) degradation products (FDPs), is associated with critical illness and mortality in patients with COVID-19. Furthermore, increasing reports of microvascular and macrovascular thrombi suggest that hemostatic imbalances may contribute to the pathophysiology of SARS-CoV-2 infection. We review the laboratory and clinical findings of patients with COVID–19-associated coagulopathy, and prior studies of hemostasis in other viral infections and acute respiratory distress syndrome. We hypothesize that an imbalance between coagulation and inflammation may result in a hypercoagulable state. Although thrombosis initiated by the innate immune system is hypothesized to limit SARS-CoV-2 dissemination, aberrant activation of this system can cause endothelial injury resulting in loss of thromboprotective mechanisms, excess thrombin generation, and dysregulation of fibrinolysis and thrombosis. The role various components including neutrophils, neutrophil extracellular traps, activated platelets, microparticles, clotting factors, inflammatory cytokines, and complement play in this process remains an area of active investigation and ongoing clinical trials target these different pathways in COVID-19.
Seismic response analysis of a first-story isolated reinforced concrete frame building with independent columns
Authors: Xu Liying , Lin Youqin , Wu Yingxiong
Published: June 2020

This study aims to better understand the seismic responses and isolation effect of a first-story, independent, column-top isolation structure with concrete frames. A series of shaking table tests and a numerical simulation were performed on a seven-story reinforced concrete–framed structure with first-story isolation, using rubber bearings. A non-isolated, structural model was used as a reference for comparison. The testing and numerical results showed that the story acceleration and inter-story displacement of the superstructure in the isolation model were significantly reduced, indicating the good damping effect of the isolation system. This system, which composed of rubber bearings, could absorb most of the seismic energy. The inter-story displacement of the substructure in the isolation model was also significantly reduced, while the acceleration was slightly reduced. The horizontal deformation of the column was not severe, and the seismic capacity of the substructure was higher than that of the superstructure. It is suggested that to guarantee the seismic security of reinforced concrete–framed structures with the first-story column-top isolation under extremely rare strong earthquakes, the stiffness of columns in the substructure should be further strengthened. Moreover, it is effective and reasonable to adopt the first-story column-top isolation method to improve the seismic capacity of reinforced concrete–framed structures with a weak first story.
Research productivity of sociology PhD candidates at interdisciplinary schools of social science at elite Australian universities, 2013–17: A gender perspective
Authors: Rajčan Adam , Burns Edgar A.
Published: June 2020

Gender data are presented from a study into sociology PhD completions and student research outputs during enrolment at Australian ‘Group of Eight’ interdisciplinary schools of social science. Findings confirm views and impressions offered by Australian sociology academic leaders. The present data contributes to this wider discussion by describing patterns in the contemporary cohort of sociology PhD students. First, we document a stable gender composition of the discipline in Australia reflective of the literature across several decades rather than a recent feminisation process. Second, we report for this cohort of contemporary PhD sociology completions in Australia women and men publish at similar rates during candidacy. Third, there is no significant gendered difference between students at any level of research output production. Fourth, methodological approaches used by sociology doctoral students confirm the epistemological domination of qualitative analysis in this current cohort of sociology PhD theses.
Theoretical study on the reaction between silacyclopropenylidene and three-membered heterocyclic compounds (azirane and oxirane): An alternative approach to the formation of heterocyclic silylene
Authors: Tan Xiaojun , Wu Mengyao , Wang Yilin , Shi Guizhi , Gu Jinsong
Published: June 2020

The reaction mechanism between silacyclopropenylidene and three-membered heterocyclic compounds (azirane and oxirane) has been systematically investigated at the B3LYP/6-311+G* level of theory in order to better understand the reactivity of unsaturated cyclic silylene. Geometry optimizations and vibrational analyses have been conducted for the stationary points on the potential energy surface of the system. Calculations show that the Si-spiroheterocyclic intermediate and four-membered heterocyclic silylene compound could be produced through the insertion process and subsequent dissociation process between silacyclopropenylidene and three-membered heterocyclic compounds. For the insertion process, it is easier for silacyclopropenylidene to insert into C-N bond of azirane than into C-O bond of oxirane. This study is helpful to understand the reactivity of silacyclopropenylidene, the evolution of silicon-bearing molecules in space, and to offer an alternative approach to the formation of enlarged heterocyclic silylene compound.
How television news disguises its racist representations: The case of Romanian Antena 1 reporting on the Roma
Authors: Breazu Petre , Machin David
Published: June 2020

Research shows that news media around the world tend to represent ethnic minorities in ways which nurture distorted views and invite negative attitudes. Scholars have also emphasised that, in contemporary societies, a political climate has emerged which has made overt racism unacceptable and social taboos leading to racist statements are increasingly being managed and disguised in order to avoid direct accusations. In this paper we use Multimodal Critical Discourse Analysis (MCDA) to carry out an in-depth analysis of a Romanian television news report—selected from a larger corpus—which addressed the situation of the Roma migrants in Norway. We show how this medium, with editing techniques, voice-overs, sound effects and captions, has its own subtleties for communicating racism in ways that are less obvious at a casual viewing. The case we analyse reports on a Norwegian/EU project to build a factory in Romania, so that Roma migrants can return home to work rather than live and beg on the streets of Oslo.
Sparse representation for damage identification of structural systems
Authors: Chen Zhao , Sun Hao
Published: June 2020

Identifying damage of structural systems is typically characterized as an inverse problem which might be ill-conditioned due to aleatory and epistemic uncertainties induced by measurement noise and modeling error. Sparse representation can be used to perform inverse analysis for the case of sparse damage. In this article, we propose a novel two-stage sensitivity analysis–based framework for both model updating and sparse damage identification. Specifically, an [Formula: see text] Bayesian learning method is first developed for updating the intact model and uncertainty quantification so as to set forward a baseline for damage detection. A sparse representation pipeline built on a quasi-[Formula: see text] method, for example, sequential threshold least squares regression, is then presented for damage localization and quantification. In addition, Bayesian optimization together with cross-validation is developed to heuristically learn hyperparameters from data, which saves the computational cost of hyperparameter tuning and produces more reliable identification result. The proposed framework is verified by three examples, including a 10-story shear-type building, a complex truss structure, and a shake-table test of an eight-story steel frame. Results show that the proposed approach is capable of both localizing and quantifying structural damage with high accuracy.
“Corporate governance” and performance in nonprofit organizations
Authors: Blevins Dane P , Ragozzino Roberto , Eckardt Rory
Published: June 2020

Corporate governance has received substantial scholarly attention for decades, although the focus of this research has by and large been on publicly traded for-profit organizations. However, agency problems are increasingly recognized in nonprofits. As such, we examine the application of corporate governance logic in the context of nonprofits. Our study relies on nearly a decade of data spanning 6853 US-based charities and comprising nearly US$346 billion in total revenue. Our results show that common corporate governance practices—such as independent boards, chief executive officer oversight, and transparency—enhance the degree to which donor contributions are allocated toward a charity’s mission. Overall, we assess the broader applicability and benefits of corporate governance and build on literature highlighting links between for-profit and nonprofit organizations. In doing so, we demonstrate the usefulness of governance in this economically and socially consequential context.
Mini Invasive Floating Metatarsal Osteotomy for Diabetic Foot Ulcers Under the First Metatarsal Head: A Case Series
Authors: Tamir Eran , Smorgick Yossi , Ron Guy Zvi , Gilat Ron , Agar Gabriel , Finestone Aharon S.
Published: June 2020

Diabetic foot ulcers under the first metatarsal head are difficult to treat and prevent recurrence. The aim of this study is to summarize the results of a distal first metatarsal minimally invasive floating osteotomy for ulcers under the first metatarsal head in patients with diabetic neuropathy. We reviewed files of patients with diabetic neuropathy undergoing a floating first metatarsal osteotomy. Demographic and clinical data were collected and analyzed to determine success and complications. We found records for 21 patients (mean age 64) with University of Texas 1A ulcers. The ulcer’s mean age was 11.2 months. Following surgery, the ulcer completely resolved after a mean of 3.7 (2 to 11) weeks in 19 patients. During the first year, there were 4 complications related to the surgery (including 3 infections). At latest follow-up, 17/21 (81%) patients had healed with satisfactory results. Minimal invasive floating distal osteotomy of the first metatarsal can cure and prevent recurrence of diabetic foot ulcers under the first metatarsal head in 80% of the patients, but the ability to provide close follow-up and prompt response are prerequisites.
Epilepsy Genetics: What Once Was Rare, Is Now Common
Authors: Calhoun Jeffrey Dennis , Carvill Gemma L.
Published: June 2020

[Box: see text]
A practical generalized propensity-score estimator for quantile continuous treatment effects
Authors: Alejo Javier , Galvao Antonio F. , Montes-Rojas Gabriel
Published: June 2020

In this article, we present a new command, qcte, that implements several methods for estimation and inference for quantile treatment-effects models with a continuous treatment. We propose a semiparametric two-step estimator, where the first step is based on a flexible Box–Cox model, as the default model of the command. We develop practical statistical inference procedures using bootstrap. We implement some simulations to show that the proposed methods perform well. Finally, we apply qcte to a survey of Massachusetts lottery winners to estimate the unconditional quantile effects of the prize amount, as a proxy of nonlabor income changes, on subsequent labor earnings from U.S. Social Security records. The empirical results reveal strong heterogeneity across unconditional quantiles.
Visualization strategies for regression estimates with randomization inference
Authors: Taylor Marshall A.
Published: June 2020

Coefficient plots are a popular tool for visualizing regression estimates. The appeal of these plots is that they visualize confidence intervals around the estimates and generally center the plot around zero, meaning that any estimate that crosses zero is statistically nonsignificant at least at the alpha level around which the confidence intervals are constructed. For models with statistical significance levels determined via randomization models of inference and for which there is no standard error or confidence intervals for the estimate itself, these plots appear less useful. In this article, I illustrate a variant of the coefficient plot for regression models with p-values constructed using permutation tests. These visualizations plot each estimate’s p-value and its associated confidence interval in relation to a specified alpha level. These plots can help the analyst interpret and report the statistical and substantive significances of their models. I illustrate using a nonprobability sample of activists and participants at a 1962 anticommunism school.
Testing for the presence of measurement error in Stata
Authors: Lee Young Jun , Wilhelm Daniel
Published: June 2020

In this article, we describe how to test for the presence of measurement error in explanatory variables. First, we discuss the test of such hypotheses in parametric models such as linear regressions and then introduce a new command, dgmtest, for a nonparametric test proposed in Wilhelm (2018, Working Paper CWP45/18, Centre for Microdata Methods and Practice, Institute for Fiscal Studies). To illustrate the new command, we provide Monte Carlo simulations and an empirical application to testing for measurement error in administrative earnings data.
vgets: A command to estimate general-to-specific VARs, Granger causality, steady-state effects, and cumulative impulse–responses
Authors: Asali Muhammad
Published: June 2020

Vector autoregression (VAR) estimation is a vital tool in economic studies. VARs, however, can be dimensionally cumbersome and overparameterized. The vgets command allows for a general-to-specific estimation of VARs— overcoming the potential overparameterization—and provides tests for Granger causality, estimates of the long-run effects, and the cumulative impulse–response of each variable in the system; it also offers diagnostics that facilitate a genuinecausality interpretation of the Granger causality tests.
Prevalence of Opportunistic Infections and Associated Factors in HIV-Infected Men Who Have Sex With Men on Antiretroviral Therapy in Bach Mai Hospital, Hanoi, Vietnam: A Case-Control Study
Authors: Dang Linh Vu Phuong , Nguyen Quan Hai , Ishizaki Azumi , Larsson Mattias , Vu Nhung Thi Phuong , Do Duy Cuong , Olson Linus , Dinh Thanh Thi
Published: June 2020

Objective:

To investigate the distribution of opportunistic infections (OIs) and factors associated with acquiring OIs in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) in comparison to those of heterosexual patients.

Method:

A cross-sectional study was conducted on 82 HIV-infected MSM and 120 HIV-infected heterosexual men in Bach Mai Hospital, Hanoi, Vietnam. Demographical characteristics and clinical data were collected and analyzed using appropriate statistics (Mann–Whitney, Chi-square, Fisher’s exact test, and logistic regression).

Results:

The prevalence of OIs among MSM and heterosexual patients were 63.4% and 81.7%, respectively. The most frequent OI in the MSM group was human papilloma virus (HPV) (11%), followed by hepatitis B virus (8.5%), mycobacterium tuberculosis (7.3%), and Talaromycosis (2.4%).

Conclusions:

Multivariate logistic regression analysis showed that buying sex (odds ratio (OR) = 4, 95% confidence interval (CI): 1.13–14.25) and injecting drugs (OR = 13.05, 95% CI: 2.39–71.21) were associated with increased odds of having OIs in heterosexual patients while increasing age (OR = 1.1, 95% CI: 1.01–1.24) was correlated to increased odd of acquiring OIs in the MSM group. HIV-infected MSM accumulates OIs with increasing age, while heterosexual individuals increase opportunistic infections by buying sex or injecting drugs.
S-shaped distal access catheter supported microcatheter navigation into the lenticulostriate artery feeders of brain arteriovenous malformations
Authors: Koizumi Satoshi , Shojima Masaaki , Ishikawa Osamu , Hasegawa Hirotaka , Miyawaki Satoru , Nakatomi Hirofumi , Saito Nobuhito
Published: June 2020

Background

Although the embolization of lenticulostriate artery feeders is often warranted in the treatment of brain arteriovenous malformations, it is technically challenging due to steep and repeated angulations. Here, we describe our novel technique of navigating a flow-guided microcatheter into lenticulostriate artery feeders using the strong support provided by an S-shaped distal access catheter.

Methods

We reviewed our retrospective cohort of brain arteriovenous malformations, in which lenticulostriate artery feeders were attempted to embolize.

Result

During the study period, endovascular embolization was performed in 25 arteriovenous malformations cases. Of these, eight lenticulostriate artery feeders were present in six cases (24%). In two cases, lenticulostriate artery feeder catheterization was avoided from the beginning due to the small diameters of the feeders. After all, microcatheter navigation for lenticulostriate artery feeders were attempted in four cases with six lenticulostriate artery feeders. In all the six feeders, the S-shaped distal access catheter was successful in supporting the microcatheter to advance distally to the lenticulostriate artery feeders, even if other approaches were unsuccessful. Of the six catheterized lenticulostriate artery feeders, four were embolized. Symptomatic infarction in the lenticulostriate artery territory and mild vasospasm occurred in two cases each, but they did not result in permanent neurological deficits.

Conclusion

Although some potential complications need to be considered, the S-shaped distal access catheter technique appears to be an effective alternative approach to gaining access to difficult feeders of arteriovenous malformations.
Lesbian, Gay, and Bisexual (LGB) Young Adults’ Relational Well-Being Before and After Taiwanese Legalization of Same-Sex Marriage: A Qualitative Study Protocol
Authors: Huang Yu-Te
Published: June 2020

In 2019, Taiwan became the first country in Asia to legalize same-sex marriage. Such an historic shift in the legal landscape toward marriage equality in Taiwan presents a timely and unique opportunity to investigate the interplay of a lesbian, gay, and bisexual (LGB)-affirmative policy (i.e., marriage equality) and the well-being of LGB people. Existing quantitative studies on same-sex marriage have yielded compelling evidence about its positive effects on LGB individuals’ psychosocial health. However, no research has examined the relational dimension of the effect associated with same-sex marriage policy. Furthermore, a relational focus requires a researcher to solicit narratives from LGB young adults’ significant others (e.g., parents). This research project seeks to address these gaps by addressing whether legalization of same-sex marriage in Taiwan will improve Taiwanese LGB young adults’ relational well-being. Qualitative data were collected from 30 in-depth, dyadic interviews with 15 LGB young Taiwanese adults aged between 18 and 39 years and their parents. Each participant took part in two interviews conducted before and after the passage of the legalization of same-sex marriage, respectively. Transcribed interviews will be analyzed following an interpretative phenomenological analysis (IPA) where we seek insight into a social actor’s inner perceptions in a wider context of social relationships. Multiple measures will be undertaken to ensure study rigor. Findings from this study will add to the evaluative endeavors of marriage equality policy enacted in Taiwan by highlighting relational well-being and the perspectives of LGB young adults’ relevant others.
Identification of time-varying systems with partial acceleration measurements by synthesis of wavelet decomposition and Kalman filter
Authors: Chen Siyi , Lu Jubin , Lei Ying
Published: June 2020

Structural systems often exhibit time-varying dynamic characteristics during their service life due to serve hazards and environmental erosion, so the identification of time-varying structural systems is an important research topic. Among the previous methodologies, wavelet multiresolution analysis for time-varying structural systems has gained increasing attention in the past decades. However, most of the existing wavelet-based identification approaches request the full measurements of structural responses including acceleration, velocity, and displacement responses at all dynamic degrees of freedom. In this article, an improved algorithm is proposed for the identification of time-varying structural parameters using only partial measurements of structural acceleration responses. The proposed algorithm is based on the synthesis of wavelet multiresolution decomposition and the Kalman filter approach. The time-varying structural stiffness and damping parameters are expanded at multi-scale profile by wavelet multiresolution decomposition, so the time-varying parametric identification problem is converted into a time-invariant one. Structural full responses are estimated by Kalman filter using partial observations of structural acceleration responses. The scale coefficients by the wavelet expansion are estimated via the solution of a nonlinear optimization problem of minimizing the errors between estimated and observed accelerations. Finally, the original time-varying parameters can be reconstructed. To demonstrate the efficiency of the proposed algorithm, the identification of several numerical examples with various time-varying scenarios is studied.
Strong inhibition of M-Protease activity of Coronavirus by using PX-12 inhibitor based on ab initio ONIOM calculations
Authors: Monajemi Hadieh , Zain Sharifuddin M
Published: June 2020

In this study, the interaction of seven potential inhibitors in complex with SARS-CoV-2’s M protease (Mpro) is modelled and optimized using ONIOM (Own N-layered Integrated molecular Orbital and molecular Mechanics; QM/MM) approach. Density functional theory is used for the small system and Universal Force Field is used for the rest of the molecule with ONIOM (m062x/6-311++G (d,p):UFF) model chemistry. The seven inhibitors that are used in this study are N3, ebselen, disulfiram, tideglusib, carmofur, shikonin and PX-12. The calculated interaction energy between the inhibitor and Mpro shows a strong inhibition of Mpro activity with N3, ebselen as well as PX-12 inhibitors. The two former inhibitors are previously reported as strong inhibitors; however, the strong inhibition effect of PX-12 has not been previously reported. The results of this study can provide useful insight into designing an effective inhibitor drug for SARS-nCoV, suggesting a better inhibition from PX-12 than ebselen.
Spontaneous head movements characterize losing athletes during competition
Authors: Drewes V , Neumann N , Konstantinidis I , Helmich I
Published: June 2020

Nonverbal movement behavior and emotions are closely linked processes; however, there is insufficient information about the spontaneous nonverbal expressions in response to experiencing positive and negative emotion, i.e., when winning or losing during sport competitions. Previous research showed that experienced tennis athletes detected losing behavior in athletes more accurately than winning behavior. However, it remained unclear what kind of nonverbal movements characterized losers because the actual movements have not been identified yet. Further research showed that head shaking occurred as an expression of doubt whereas head nodding appeared during successful actions. We therefore hypothesized that losing athletes nonverbally move more, and particularly execute more headshakes when compared to winners. The entire spontaneous nonverbal head movement behavior of professional tennis athletes was video-taped between points during competition and analyzed by two trained and certified raters using a standardized analysis system for nonverbal behavior in relation to won or lost points. The results showed that losers moved their head significantly more often, particularly executing more phasic upward, repetitive sideward (head shaking), and phasic sideward head movements when compared to winning athletes. The present results provide evidence that spontaneous nonverbal head movements differentiate winners from losers during competition. Losing a point in tennis is associated with to increased spontaneous head movement behavior, particularly in upward and sideward directions. Thus, we conclude that professional tennis athletes cannot inhibit their implicit nonverbal expressions that are related to negative emotions when losing.
Predicting elite success: Evidence comparing the career pathways of top 10 to 300 professional tennis players
Authors: Li Pingwei , Weissensteiner Juanita R , Pion Johan , Bosscher Veerle De
Published: June 2020

The aim of this research was to explore at what age professional tennis players at different ranking levels (top 10, 11-20, 21–50, 51–100, 101–200, 201–300) started playing tennis and had achieved their career ranking milestones, and to explore the viability of using age and ranking to predict a player’s future success. 373 top 300 ranked professional tennis players from 2010 to 2018, including 193 females (M = 32.3, SD = 3.5) and 180 males (M = 34.0, SD = 3.1) were examined. Descriptive methods and univariate analyses were used to compare player developmental trajectories by player peak ranking levels. Discriminant analyses were applied to explore to what extent age and early ranking milestones can be used to predict a player’s future peak rankings. Results revealed that there were no significant differences regarding the age at which players started playing tennis by players’ career peak ranking levels. Results showed that 75% of the top 300 players started playing tennis between the ages of 3 to 7 years, whilst 21% started between 7 to 10 years, and 4% started later between 10 to 13 years. Results further showed that professional rankings between 14 and 18 years were not reliable in predicting a player’s future ranking. Closer analyses revealed that age and early rankings have a relatively high value in “predicting” the ranking of higher-ranked (e.g., top 10) and lower-ranked (e.g., top 201–300) players, but not middle-ranked players (i.e. top 11–200), with nearly 60% of them not correctly classified and the top 51–100 ranked players having the lowest predictability.
Syndesmotic Screw Breakage May Be More Problematic Than Previously Reported: Increased Rates of Hardware Removal Secondary to Pain With Intraosseous Screw Breakage
Authors: Ibrahim Ishaq O. , Velasco Brian T. , Ye Michael Y. , Miller Christopher P. , Kwon John Y.
Published: June 2020

Background. The majority of retained syndesmotic screws will either loosen or break once the patient resumes weight-bearing. While evidence is limited, anecdotal experience suggests that intraosseous screw breakage may be problematic for some patients due to painful bony erosion. This study seeks to identify the incidence of intraosseous screw breakage, variables that may predict intraosseous screw breakage, and whether intraosseous screw breakage is associated with higher rates of implant removal secondary to pain. Methods. Five hundred thirty-one patients undergoing syndesmotic stabilization were screened, of which 43 patients (with 58 screws) experiencing postoperative screw breakage met inclusion criteria. Patient charts were retrospectively reviewed for demographic data, comorbidities, time to screw breakage, location of screw breakage, and implant removal. Several radiographic parameters were evaluated for their potential to influence the site of screw breakage. Results. Intraosseous screw breakage occurred in 32 patients (74.4%). Screw breakage occurred exclusively in the tibiofibular clear space in the remaining 11 instances (25.6%). Intraosseous screw breakage was significantly associated with eventual implant removal after breakage (P = .034). Screws placed further from the tibiotalar joint were at less risk for intraosseous breakage (odds ratio 0.818, P = .002). Screws placed at a threshold height of 20 mm or greater were more likely to break in the clear space (odds ratio 12.1, P = .002). Conclusion. Syndesmotic screw breakage may be more problematic than previously described. Intraosseous breakage was associated with higher rates of implant removal secondary to pain in this study. Placement of screws 20 mm or higher from the tibiotalar joint may decrease risk of intraosseous breakage.

Levels of Evidence: Level III: Retrospective study
PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials
Authors: Filardo Giuseppe , Previtali Davide , Napoli Francesca , Candrian Christian , Zaffagnini Stefano , Grassi Alberto
Published: June 2020

Objective

To evaluate effectiveness, in terms of patient-reported outcome measures, of platelet-rich plasma (PRP) injections for knee osteoarthritis compared to placebo and other intraarticular treatments.

Design

PubMed, Cochrane Library, Scopus, Embase, Web of Science, as well as the gray literature were searched on January 17, 2020. Randomized controlled trials (RCTs) comparing PRP injections with placebo or other injectable treatments, in any language, on humans, were included. Risk of bias was assessed following the Cochrane guidelines; quality of evidence was graded using the GRADE guidelines.

Results

Thirty-four RCTs, including 1403 knees in PRP groups and 1426 in control groups, were selected. WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score favored PRP, with a statistically and clinically significant difference versus placebo at 12-month follow-up ( P = 0.02) and versus HA (hyaluronic acid) at 6-month ( P < 0.001) and 12-month ( P < 0.001) follow-ups. A clinically significant difference favoring PRP versus steroids was documented for VAS (Visual Analogue Scale) pain ( P < 0.001), KOOS (Knee Injury and Osteoarthritis Outcome Score) pain ( P < 0.001), function in daily activities ( P = 0.001), and quality of life ( P < 0.001) at 6-month follow-up. However, superiority of PRP did not reach the minimal clinically important difference for all outcomes, and quality of evidence was low.

Conclusions

The effect of platelet concentrates goes beyond its mere placebo effect, and PRP injections provide better results than other injectable options. This benefit increases over time, being not significant at earlier follow-ups but becoming clinically significant after 6 to 12 months. However, although substantial, the improvement remains partial and supported by low level of evidence. This finding urges further research to confirm benefits and identify the best formulation and indications for PRP injections in knee OA.
Use of a myoelectric upper limb orthosis for rehabilitation of the upper limb in traumatic brain injury: A case report
Authors: Pundik Svetlana , McCabe Jessica , Kesner Samuel , Skelly Margaret , Fatone Stefania
Published: June 2020

Background

Upper limb motor deficits following traumatic brain injury are prevalent and effective therapies are needed. The purpose of this case report was to illustrate response to a novel therapy using a myoelectric orthosis in a person with TBI. Case description: A 42-year-old female, 29.5 years post-traumatic brain injury with diminished motor control/coordination, and learned nonuse of the right arm. She also had cognitive deficits and did not spontaneously use her right arm functionally.

Intervention

Study included three phases: baseline data collection/device fabrication (five weeks); in-clinic training (2×/week for nine weeks); and home-use phase (nine weeks). The orthosis was incorporated into motor learning-based therapy. Outcomes: During in-clinic training, active range of motion, tone, muscle power, Fugl-Meyer, box and blocks test, and Chedoke assessment score improved. During the home-use phase, decrease in tone was maintained and all other outcomes declined but were still better upon study completion than baseline. The participant trained with the orthosis 70.12 h, logging over 13,000 repetitions of elbow flexion/extension and hand open/close.

Discussion

Despite long-standing traumatic brain injury, meaningful improvements in motor function were observed and were likely the results of high repetition practice of functional movement delivered over a long duration. Further assessment in a larger cohort is warranted.
LINE as Super App: Platformization in East Asia
Authors: Steinberg Marc
Published: June 2020

This article examines the transformative effects of platforms on cultural production through an analysis of the LINE “super app.” Super apps are apps that do-everything; mega-platforms unto themselves. They are particularly prevalent in East Asia. Like China’s WeChat or South Korea’s KakaoTalk, Japan’s LINE has evolved from a single purpose chat app to the do-everything platform for everyday cultural and economic activities. It is also the very reason for the global proliferation of stickers or large-size emoji in other chat apps, from Apple’s iMessage to Facebook’s Messenger to Tencent’s WeChat. This article offers a close examination of LINE to highlight and theorize the process of the “platformization of cultural production.” To do so, it traces Japan’s longer history of platforms going back to the i-mode mobile platform launched in 1999, and examines LINE’s regionally specific sticker-oriented strategies in East Asia. With a focus on the entrepreneurial work of sticker designers as cultural producers, this article also mobilizes LINE to both highlight the specificities of this platform and contest the excessive attention paid to platforms from Silicon Valley, or, at best, their Chinese counterparts. LINE and the regional convergences of super apps in East Asia are a potent reminder of the need to analyze platforms outside of the bi-polar hegemony of the United States versus Chinese tech world—which increasingly frames journalistic discourse and academic research—and of the need to attend to the historical and regional particularities of platforms and their cultural impacts.
Does International Sporting Boycott Act as a Social Identity Threat? The Effects on the National Collective Self-Esteem of Pakistani Cricket Fans
Authors: Yousaf Salman , Laber Fahad
Published: June 2020

The present study theoretically advances the social identity threat construct, with the terrorist attacks of March 4, 2009, in the backdrop, by providing a compelling evidence on how international sporting isolation acts as a social identity threat due to emphatic consequences on spectator’s team identification and national collective self-esteem (CSE). Moreover, the study adheres to the rejection identification model, which accentuates profound identity by the socially devalued in-group members for preservation of self-esteem in instance of negative portrayal by an out-group. A total of 210 respondents were randomly assigned to one of the two experimental conditions. The results show that national team identification produced positive change in the CSE in threat condition making respondents assert significance to their group membership, self-concept, and private CSE. The two experimental conditions in this research delineate two diverse perspectives regarding identity level while adding useful contributions to the literature.
Inhaled Solvent Abuse Mimicking Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Authors: Thulasirajah Salini , Michaud Jean , Doja Asif , McMillan Hugh J.
Published: June 2020

Exposure to n-hexane or toluene-containing solvents such as glue or gasoline can produce clinical symptoms and neurophysiological findings that can mimic chronic inflammatory demyelinating polyneuropathy. The authors present a case of a boy with severe sensorimotor polyneuropathy with demyelinating features. Cerebrospinal fluid testing and magnetic resonance imaging spine did not show findings typical of chronic inflammatory demyelinating polyneuropathy. His lack of response to immunosuppressive therapy prompted a nerve biopsy which was instrumental in confirming a diagnosis of chronic organic solvent exposure, subsequently confirmed on history. This case highlights the importance of additional testing to ensure diagnostic certainty which allows appropriate treatment and/or disease management to be tailored appropriately including in this instance, the involvement of mental health counseling and avoidance of immunosuppressant medication.
The effectiveness of R&D subsidies in fostering firm innovation: The role of knowledge-sourcing activities
Authors: Afcha Sergio , Lucena Abel
Published: June 2020

This article presents a novel conceptual framework that uses the notion of knowledge sourcing to explain how firms realize benefits from R&D subsidies in terms of innovations. The study considers two dimensions of the firm’s knowledge sourcing: its R&D effort and level of openness to technology markets. This article proposes that the policy-induced effects of R&D subsidies on the knowledge-sourcing process increase firms’ innovation outcomes, thus making this policy intervention effective in promoting innovation. By using panel data from Spanish manufacturing firms, this article presents evidence consistent with the hypothesis that by changing the knowledge sourcing of firms, National R&D subsidy programs in Spain also favor more firm innovation, measured by patent applications and new product launches. It is also documented that the granting of R&D subsidies does not affect firm innovation directly but rather through inducing changes in the firm’s R&D effort and openness to technology markets.

JEL CLASSIFICATION: O32, O36, O38
Transition Experiences of Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: An Interpretive Description Study
Authors: Lam Annie , Ploeg Jenny , Carroll Sandra L. , Duggleby Wendy , McAiney Carrie , Julian Patricia
Published: June 2020

Introduction

Family caregivers provide most of the care for older persons living with dementia (PLWD) and multiple chronic conditions (MCCs) in the community. Caregivers experience transitions, such as changes to their health, roles, and responsibilities, during the process of caring. Transitions encompass a time when caregivers undergo stressful responses to change. However, we know little about the transition experiences of caregivers of persons living with both dementia and MCCs.

Objective

This qualitative study explored the transition experiences of caregivers of PLWD within the context of MCCs, from the perspective of both caregivers and practitioners. The research question was the following: What are the transition experiences of family caregivers in providing care to older PLWD and MCCs living in the community?

Methods

This study was conducted using an interpretive description approach. Semistructured interviews were conducted with 19 caregivers of older community-dwelling PLWD and MCCs and 7 health-care providers working with caregivers in Ontario, Canada. Concurrent data collection and inductive data analysis were used.

Results

Caregivers of older PLWD and MCCs experienced four key transitions: (a) taking on responsibility for managing multiple complex conditions, (b) my health is getting worse, (c) caregiving now defines my social life, and (d) expecting that things will change. Findings highlight how the coexistence of MCCs with dementia complicates caregiver transitions and the importance of social networks for facilitating transitions.

Conclusion

The study provided insight on the transition experiences of caregivers of older PLWD and MCCs. MCCs increased the care load and further complicated caregivers’ transition experiences. Health-care providers, such as nurses, can play important roles in supporting caregivers during these transitions and engage them as partners in care.
Investigations of film thickness variations in blown film extrusion when using air guiding systems
Authors: Kraus Lars , Hopmann Christian , Facklam Martin , Grüber Daniel
Published: June 2020

The mass throughput and thus the productivity of a blown film line strongly depends on heat transfer from the film. Existing cooling systems are therefore constantly being further developed. Usually, the film is convectively cooled by cooling rings, coupled with an internal bubble cooling (IBC) system to increase the surface area and the cooling rate. Convection has a major disadvantage which is a low cooling efficiency due to a low heat transfer coefficient. Against this background a flexible air guiding system was developed at the Institute for Plastics Processing (IKV), Aachen, Germany. This system encloses the bubble expansion zone and creates a flow gap between an air guiding flexible membrane and the film bubble. In this gap the cooling air velocity is increased, which leads to a higher cooling efficiency. The novel system can be adjusted to many bubble geometries during the extrusion process and increases the mass throughput by up to 62%. However, higher cooling air velocities lead to film movement in the bubble expansion zone and thus also to considerable film thickness variations. In this article the air guiding system influence on the thickness variations is investigated by quantifying the film movement versus the process parameters. For this purpose, a digital image processing system is used which corelates the film movement phenomena with the film thickness variations.
Optimized tandem CD19/CD20 CAR-engineered T cells in refractory/relapsed B cell lymphoma
Authors: Tong Chuan , Zhang Yajing , Liu Yang , Ji Xingyu , Zhang Wen-ying , Guo Yelei , Han Xiao , Ti Dongdong , Dai Hanren , Wang Chunmeng , Yang Qingming , Liu Wanli , Wang Yao , Wu Zhiqiang , Han Weidong
Published: June 2020

Chimeric antigen receptor T (CAR T) cells targeting CD19 have achieved breakthroughs in the treatment of hematological malignancies, such as relapsed/refractory non-Hodgkin lymphoma (r/rNHL); however, high rates of treatment failure and recurrence after CAR T cell therapy are considerable obstacles to overcome. In this study, we designed a series of tandem CARs (TanCARs) and found that TanCAR7 T cells not only showed dual antigen targeting of both CD19 and CD20 but also formed superior and stable immunological synapse (IS) structures, which may be related to their robust antitumor activity. In an open-label, single-arm phase I/IIa trial (ClinicalTrials.gov number NCT03097770), we enrolled 33 patients with r/rNHL, and a total of 28 patients received an infusion after conditioning chemotherapy. The primary objective was to evaluate the safety and tolerability of TanCAR7 T cells. Efficacy, progression-free survival and overall survival were evaluated as secondary objectives. Cytokine release syndrome (CRS) occurred in 14 patients (50%), with 36% grade 1 or 2 and 14% grade 3. No cases of CAR T cell-related encephalopathy syndrome (CRES) of grade 3 or higher were confirmed in any patient. One patient died from a treatment-associated severe pulmonary infection. The overall response rate was 79% (95% confidence interval [CI], 60 to 92), and the complete response rate was 71%. The progression-free survival rate at 12 months was 64% (95% CI, 43 to 79). In this study, TanCAR7 T cells elicited a potent and durable antitumor response but not grade 3 or higher CRES in patients with r/rNHL.
Line-selective macrophage activation with an anti-CD40 antibody drives a hemophagocytic syndrome in mice
Authors: Ingoglia Giada , Yalamanoglu Ayla , Pfefferlé Marc , Dubach Irina L. , Schaer Christian A. , Valkova Kristyna , Hansen Kerstin , Schulthess Nadja , Humar Rok , Schaer Dominik J. , Vallelian Florence
Published: June 2020

Hemophagocytic syndromes comprise a cluster of hyperinflammatory disorders, including hemophagocytic lymphohistiocytosis and macrophage activation syndrome. Overwhelming macrophage activation has long been considered a final common pathway in the pathophysiology of hemophagocytic syndromes leading to the characteristic cytokine storm, laboratory abnormalities, and organ injuries that define the clinical spectrum of the disease. So far, it is unknown whether primary macrophage activation alone can induce the disease phenotype. In this study, we established a novel mouse model of a hemophagocytic syndrome by treating mice with an agonistic anti-CD40 antibody (Ab). The response in wild-type mice is characterized by a cytokine storm, associated with hyperferritinemia, high soluble CD25, erythrophagocytosis, secondary endothelial activation with multiple organ vaso-occlusion, necrotizing hepatitis, and variable cytopenias. The disease is dependent on a tumor necrosis factor-α–interferon-γ–driven amplification loop. After macrophage depletion with clodronate liposomes or in mice with a macrophage-selective deletion of the CD40 gene (CD40flox/flox/LysMCre), the disease was abolished. These data provide a new preclinical model of a hemophagocytic syndrome and reinforce the key pathophysiological role of macrophages.