bluuebunny/crossref_metadata_2025 huggingface dataset:
Serial Magnetic Resonance Imaging (MRI) in Pyruvate Dehydrogenase Complex Deficiency
Authors: Shelkowitz Emily , Ficicioglu Can , Stence Nicholas , Van Hove Johan , Larson Austin
Published: October 2019

Objectives:

To report 2 additional cases of pyruvate dehydrogenase complex deficiency with reversible deep gray matter lesions following initiation of ketogenic diet and to perform a literature review of serial imaging in patients with pyruvate dehydrogenase complex.

Methods:

Clinical data on 3 previously unpublished cases of patients with pyruvate dehydrogenase complex deficiency and with serial magnetic resonance imagings (MRIs) before and after institution of ketogenic diet were reported. A systematic literature review was performed to search for published cases of patients with confirmed pyruvate dehydrogenase complex deficiency who underwent serial MRIs.

Results:

The 3 subjects in this series demonstrated clinical improvement on ketogenic diet. Two subjects showed reversal of some brain lesions on repeat MRI following initiation of ketogenic diet. Of the 21 published cases with serial MRIs, 13 patients underwent some form of treatment, and of this smaller subset 4 patients had repeat MRIs that showed definitive improvement. In both our described cases and those published in the literature, improvement occurred in lesions in the basal ganglia.

Conclusions:

In patients with pyruvate dehydrogenase complex deficiency, basal ganglia lesions on MRI are reversible with treatment in some cases and could serve as a biomarker for measuring response to treatment.
Socioeconomic Differences in Access to Neighborhood and Network Social Capital and Associations With Body Mass Index Among Black Americans
Authors: Child Stephanie T. , Kaczynski Andrew T. , Walsemann Katrina M. , Fleischer Nancy , McLain Alexander , Moore Spencer
Published: October 2019

Purpose:

To examine associations between socioeconomic status and two forms of social capital, namely, neighborhood and network measures, and how these distinct forms of capital are associated with body mass index (BMI) among Black residents of low-income communities.

Design:

Respondent-driven sampling was used to engage residents in a household survey to collect data on the respondents’ personal network, perceptions about their neighborhood environment, and health.

Setting:

Eight special emphasis neighborhoods in Greenville, South Carolina.

Participants:

N = 337 black/African American older adults, nearly half of whom have a household income of less than $15 000 and a high school education, were included.

Measures:

Neighborhood capital was assessed via three scales on social cohesion, collective efficacy, and social support from neighbors. Network capital was calculated via a position generator, common in egocentric network surveys. Body mass index was calculated with self-reported height and weight.

Analysis:

Multilevel linear regression models were used to examine the association between neighborhood and network capital and obesity among respondents within sampling chains.

Results:

Higher household income was associated with greater neighborhood capital, whereas higher educational attainment was associated with greater network capital. Social cohesion was negatively associated with BMI ( b = −1.25, 95% confidence interval [CI]: −2.39 to −0.11); network diversity was positively associated with BMI ( b = 0.31, 95% CI: 0.08 to 0.55).

Conclusion:

The findings shed light on how social capital may be patterned by socioeconomic status and, further, how distinct forms of capital may be differentially associated with health among black Americans.
The seventy-two elders of Aristeas: An evaluation of speculation
Authors: Macdonald A D
Published: October 2019

The Letter of Aristeas recounts the translation of the Jewish Law into Greek by seventy-two Jewish elders. That number of elders (seventy-two) has been the subject of considerable discussion, and several competing explanations for the origin of the number have been proposed. Some scholars claim the number is derived from Hellenistic (specifically grammatical or arithmological) traditions, whereas others see precedent for the number seventy-two in the details of Exod 24 or Num 11. This paper evaluates several such hypotheses (most of them relatively recent), showing most to be speculative and lacking explanatory power. Rejecting such hypotheses, this paper argues that the number seventy-two emerges from a compromise between two of Pseudo-Aristeas’s interests—a hypothesis rendered all the more plausible by its appearance in Epiphanius. All this justifies an appeal for scholars to exercise both diligence and restraint regarding Jewish and Christian engagement with exodus traditions.
End-of-Life Communication Between Providers and Family Caregivers of Home Hospice Patients in a Rural US-Mexico Border Community: Caregivers’ Retrospective Perspectives
Authors: Ko Eunjeong , Fuentes Dahlia
Published: October 2019

Introduction:

Family caregiver–provider communication is essential to making an effective hospice care transition for patients. Despite the importance of this topic, there is little information about how caregivers in rural US-Mexico border regions navigate hospice care transition and their needs. This study explores the family caregivers’ experience relating to their end-of-life (EOL) communication and needs for hospice care transition.

Methods:

In-depth interviews using qualitative methods were conducted with 28 informal caregivers of patients who are enrolled in home hospice care in a rural US-Mexico border region. Thematic analysis was applied to analyze the data.

Results:

Qualitative themes that emerged include (1) lack of/insufficient EOL communication and (2) informational needs, including (a) signs of symptom changes, (b) EOL treatment options and goals of care, and (c) hospice care and its benefits. Limited caregiver–provider EOL communication was observed, in which the majority of the caregivers (n = 22, 78.6%) were informed of the patient’s terminal condition, but only half (n = 15, 53.6%) had a discussion with the providers about hospice care.

Conclusion:

Timely EOL communication between caregivers and the providers is key to the patient’s optimal transition to hospice care. Providers need to be aware of the caregivers’ informational needs relating to patient symptoms and health condition as well as hospice care. It is important to be aware of the impact of cultural values on hospice care placement. A clear explanation about the purpose and functions of hospice care and its benefit can better guide the family caregivers in making hospice care decisions.
The Role of Biofilms and Material Surface Characteristics in Microbial Adhesion to Maxillary Obturator Materials: A Literature Review
Authors: Lyons Karl M. , Cannon Richard D. , Beumer John , Bakr Mahmoud M. , Love Robert M.
Published: October 2019

Background:

Maxillofacial prosthetics includes restoration of maxillary defects resulting from resection of palate and nasosinus neoplasms with obturator prostheses which may be colonized by microorganisms and function as a reservoir of infection. Patients with neoplasms commonly also require radiotherapy that can result in changes in saliva quality and quantity and changes in the oral microbial flora. The altered flora, in individuals immunocompromised from cancer therapy, increases their risk of prosthesis-related infections.

Objectives:

In this review article, we explore microbial biofilms, their main components, mechanisms of microbial adhesion, and stages of biofilm development. We also discuss the different materials that are used for manufacturing maxillary obturators, their characteristic features, and how these can affect microbial adhesion. Furthermore, we shed some light on the factors that affect microbial adhesion to the surface of maxillary obturators including tissue proteins, protein adsorption, and the acquired enamel pellicle.

Conclusions:

The conclusions drawn from this literature review are that it is imperative to minimize the risk of local and systemic infections in immunocompromised patients with cancer having maxillary defects. It is also important to determine the role of saliva in microbial adhesion to obturator materials as well as develop materials that have a longer life span with surface characteristics that promote less microbial adhesion than current materials.
Provision of Care for Families Affected by Craniofacial Conditions: The Views of Nonspecialist Health Professionals
Authors: Stock Nicola Marie , Costa Bruna ,   The VTCT Foundation Research Team at the Centre for Appearance Research
Published: October 2019

Objective:

A diagnosis of a congenital craniofacial condition can have a significant impact on the psychological well-being of the affected family. As the first health professionals likely to come into contact with families, nonspecialists, such as diagnostic sonographers, midwives, and health visitors play a crucial role in facilitating familial adjustment. Yet, previous research has demonstrated parental dissatisfaction with the care delivered by nonspecialists. The aim of this study was to investigate the provision of care for families affected by craniofacial conditions from the perspective of nonspecialist health professionals, with a view to informing the development of educational materials.

Design:

Individual semistructured telephone interviews (n = 14) were conducted with 3 diagnostic sonographers, 2 fetal medicine consultants, 3 midwives, 4 health visitors, and 2 children’s nurses.

Results:

Participants identified a range of barriers to the delivery of optimal care, including dealing with parental reactions, time pressure, hospital protocols and resources, a lack of contact with specialist craniofacial teams, and the emotional impact of delivering a diagnosis. Most participants had received no prior training in the area of congenital craniofacial conditions, while those who had felt current training materials were insufficient. All participants expressed a desire for further training and provided guidance regarding preferred content and format.

Conclusions:

This study provides insight into the challenges faced by nonspecialists, as well as a range of information and training needs that could improve their knowledge and confidence. Suggestions for the development of educational materials for nonspecialist health professionals are made.
Morphological Characteristics of Os Subfibulare Related to Failure of Conservative Treatment of Chronic Lateral Ankle Instability
Authors: Lee Doo Jae , Shin Hyuck Soo , Lee Jae Hee , Kyung Min Gyu , Lee Kyoung Min , Lee Dong Yeon
Published: October 2019

Background:

The os subfibulare is usually asymptomatic and found incidentally on radiographs. However, sometimes it may cause subfibular pain and may be associated with chronic lateral ankle instability (CLAI). We hypothesized that os subfibulare could interrupt the talofibular space causing impingement, resulting in chronic pain and functional instability around the lateral malleolus. The purposes of this study were to analyze morphologic characteristics of os subfibulare, and to evaluate the clinical significance of the os subfibulare in patients with CLAI.

Methods:

Between November 2011 and April 2015, 70 patients who had both computed tomography (CT) and magnetic resonance imaging (MRI) among 252 patients who visited our hospital with the symptom of lateral ankle instability were included in this study. The location of the ossicle was classified into 3 zones in reference to the attachment site of the lateral ankle ligaments. The impingement was classified into 2 groups according to the presence of talofibular encroachment. Digital radiographs were used to measure the ossicle width and shape determined by the length and width on an magnetic resonance (MR) image.

Results:

The most common shape of ossicles was oval, and the most common location of ossicles was at the anterior talofibular ligament (ATFL) attachment site. Sixty-one percent of patients showed talofibular impingement on coronal MR images. In 48 cases, the dimension of fibula plus os subfibulare was larger than that of the contralateral normal fibula. The larger size and talofibular impingement of the ossicle were associated with greater need for operative treatment in patients with ankle instability.

Conclusion:

The morphologic analysis of the os subfibulare revealed that there might be impingement of the talofibular space by the ossicle in some patients. We suggest that morphologic characteristics of the os subfibulare should be considered when selecting treatment options in patients with CLAI and os subfibulare.

Level of Evidence:

Level III, retrospective comparative series.
Rasch Analysis of Reliability and Validity of Scores From the Foot and Ankle Ability Measure (FAAM)
Authors: Matheny Lauren M. , Clanton Thomas O.
Published: October 2019

Background:

The purpose of this study was to determine the reliability and validity of scores from the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) and Sports scales in patients who have a variety of ankle injuries.

Methods:

All patients who underwent surgical treatment for an ankle injury and completed the FAAM ADL and Sport scales were included in this study ( n = 456; 192 females, 264 males). The average age was 47.6 years (range, 18-79 years). The average time to follow-up was 3.8 years (range, 2.0-7.7 years). All data were collected prospectively and reviewed retrospectively. A reliability and validity analysis, utilizing the Rasch measurement model, a special case of item response theory (IRT), was conducted.

Results:

Reliability was very good. For FAAM ADL, person reliability was 0.87 and item reliability was 0.99. For FAAM Sport, person reliability was 0.89 and item reliability was 1.0. Infit mean square (MNSQ) values, which assess internal scale validity, were examined. For FAAM ADL, items 11 (coming up on your toes) and 10 (squatting) were high (2.27 and 2.08, respectively). All other infit values were within the acceptable range of 0.5 to 1.7. For FAAM Sport, all infit values were within the acceptable range. Outfit MNSQ values, which assess the FAAM ADL and Sport rating scale function, were examined. Three items from FAAM ADL were beyond the acceptable range. Items 10 and 11 from FAAM ADL had high outfit MNSQ values (2.15 and 1.98, respectively). Item 19 (light to moderate work) item had a marginally low outfit MNSQ of 0.48. For FAAM Sport, all outfit values were within the acceptable range.

Conclusion:

There was very good evidence of the reliability and validity of FAAM ADL and FAAM Sport scores. Two FAAM ADL items may indicate the need for further scale development for use in a diverse surgical ankle population.

Level of Evidence:

Level III, comparative series.
Effect of the Modified Lapidus Procedure for Hallux Valgus on Foot Width
Authors: Conti Matthew S. , MacMahon Aoife , Ellis Scott J. , Cody Elizabeth A.
Published: October 2019

Background:

Despite the importance of shoe wear to patients with hallux valgus (HV), few studies have investigated changes in foot width following surgery in this population. The purpose of our study was to determine if the modified Lapidus procedure would effectively decrease foot width in patients with HV.

Methods:

Thirty-one feet (19 left, 12 right) in 30 patients (29 females, 1 male) who underwent a modified Lapidus procedure in combination with a modified McBride and Akin osteotomy for treatment of HV were included in the study. All patients had preoperative and at least 5-month postoperative imaging, consisting of both weightbearing radiographs and computed tomography (WBCT) scans, which were used to measure bony and soft tissue foot widths pre- and postoperatively by 2 independent observers.

Results:

Intraclass correlation coefficients (ICCs) demonstrated high interobserver reliability (all ICCs >0.90). Bony foot width decreased significantly, by a mean of 8.9 mm (9.1%) on radiographs and 7.9 mm (8.4%) on WBCT scans ( P < .001). The soft tissue foot width also decreased significantly, by a mean of 6.9 mm (6.3%) on radiographs and 6.7 mm (6.4%) on WBCT scans ( P < .001). Changes in the hallux valgus angle and intermetatarsal angle correlated with changes in bony foot width on WBCTs (both r > 0.4, P < .02).

Conclusions:

The modified Lapidus procedure in combination with a modified McBride and Akin osteotomy resulted in statistically significant changes in both bony and soft tissue foot width. Patients should be counseled that foot width decreases, on average, by 0.5 to 1 cm.

Level of Evidence:

Level III, comparative series.
Novel adaptive methods for output-only recursive identification of time-varying systems subject to gross errors
Authors: Ma Zhi-Sai , Ding Qian , Zhou Si-Da
Published: October 2019

Gross errors are generally used to model intermittent sensor failures and occasional data packet losses or corruption, which arise in many engineering communities. In this work, we propose to deal with the problem of output-only recursive identification of time-varying systems subject to gross errors by using an adaptive weighting and forgetting combined strategy. Under the assumption that gross errors are unknown and can be of arbitrarily large magnitude, time-dependent autoregressive model-based adaptive recursive identification methods are proposed by minimizing the sum of norm errors and achieving a sparse prediction error sequence. The adaptive weighting strategy is used to deemphasize data observations contaminated by gross errors, and the forgetting mechanism is used to deemphasize data from the remote past, allowing the proposed methods to track time-varying dynamics of the system subject to gross errors. The proposed methods are numerically and experimentally tested, and the comparative results demonstrate the superior time-varying tracking capability of the proposed methods in extremely challenging gross error circumstances.
Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly
Authors: Teder-Braschinsky Anneli , Märtson Aare , Rosenthal Marika , Taba Pille
Published: October 2019

Objectives:

Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group.

Methods:

A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures.

Results:

Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m.

Conclusions:

Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.
The Relationship Between the Width of the Frontal Recess and the Frontal Recess Cells in Japanese Patients
Authors: Makihara Seiichiro , Kariya Shin , Okano Mitsuhiro , Naito Tomoyuki , Uraguchi Kensuke , Matsumoto Junya , Noda Yohei , Nishizaki Kazunori
Published: October 2019

Objective:

The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined.

Materials and methods:

Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis.

Results:

The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs.

Conclusion:

A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.
Investigating Postpartum Depression in the Adolescent Mother Using 3 Potential Qualitative Approaches
Authors: Ladores Sigrid , Corcoran Jessica
Published: October 2019

Adolescent mothers are twice as likely as their adult counterparts to have postpartum depression (PPD). Left undiagnosed and untreated, PPD can have significant consequences for the mothers, infants, families, communities, and society. Although the epidemiology has been well studied, there is a scarcity in the number of qualitative research studies being conducted to study this unique group of young women. Qualitative research is a perfect match to elicit the voices of adolescent mothers having PPD because the qualitative approach offers a way to gain insight, meaning, and understanding of a phenomenon that is still largely misunderstood and unaddressed. This article will discuss 3 major qualitative approaches (phenomenology, ethnography, and participatory action research) that may be employed to study PPD in the adolescent mother.
eSupport: Feasibility trial of telehealth support group participation to reduce loneliness in multiple sclerosis
Authors: Leavitt Victoria M , Riley Claire S , De Jager Philip L , Bloom Sharonna
Published: October 2019

Background:

Loneliness is a risk factor for increased morbidity and mortality. Persons with multiple sclerosis (pwMS) are at increased risk for loneliness. Support groups facilitate meaningful social connections.

Objective:

To conduct a feasibility trial of eSupport: online support groups.

Methods:

Participants engaged in 1 hour/week eSupport or eJournal (active control). Primary outcome was feasibility (completion and adherence). We evaluated loneliness and depressive symptoms for preliminary efficacy.

Results:

Feasibility outcomes were met: completion rate was 96.4%; 88.9% were adherent. Loneliness and depression showed trend-level decreases in both conditions.

Conclusion:

Feasibility of telehealth support group participation for pwMS was supported. eSupport is accessible, affordable, acceptable, and scalable. Results warrant a randomized controlled trial to support efficacy.
Labour immigration and union strength
Authors: Finseraas Henning , Røed Marianne , Schøne Pål
Published: October 2019

Is labour mobility in the European Union a threat to the strength of unions? We argue that the combination of cheap labour, workforce heterogeneity and low unionisation among labour immigrants is a potential challenge for unions. The challenge will be severe if immigration affects natives’ unionisation. We use Norwegian administrative data in a natural experiment framework to examine this claim. The 2004 European Union expansion led to a rapid increase in labour migration to the building and construction industry, but licensing demands protected some workers from the labour supply shock. We show negative labour market effects for workers exposed to labour immigration, but no effect on union membership. Our results question theories of unionisation and are relevant for research on immigration, political behaviour and collective action.
Juggling Multiple Identities: The Untold Stories Behind a PhD Ethnographic Study
Authors: Hou Junxia , Feng Anwei
Published: October 2019

This article explores the fluidity and dynamicity of a Chinese PhD student’s research experience in negotiating her identities in a longitudinal ethnographic study, first in China and then in the UK. It adopts retrospective and reflexive document analysis of research journals written by her over a 5-year period of overseas study. The analytical framework for the critical reflection of knowledge production synthesizes key concepts of ontology, epistemology, reflexivity, positionality, serendipity, and intersectionality to describe and interpret the researcher’s struggles between insider and outsider, uncertain feelings about different values and beliefs, and emotions due to changing circumstances of family life. The reflexive analysis indicates that PhD students who undertake qualitative studies would function in a far more fluid manner than the often simplistically documented binary roles between an “insider” participant and an outsider researcher in their theses. The article argues that this fluidity in identity shifts and complexity in data collection and analysis are in most cases part and parcel of the research process, which is crucial for researchers to be aware of. Researchers should feel confident to tell the “messy stories” reflexively so as to enhance credibility and trustworthiness of the research findings.
Partnership Research: A Pathway to Realize Multistakeholder Participation
Authors: Numans Wilma , Van Regenmortel Tine , Schalk René
Published: October 2019

Partnership research projects between academic researchers, service providers, policy makers, and persons from vulnerable populations are increasingly promoted as a means to inform and improve research and practice. Key elements in partnership research are the participation of multiple stakeholders and a shared responsibility and control over ideas, processes, and outcomes. This sounds clear, yet it is susceptible to various interpretations and coloring, creating the risk of unbalanced power between stakeholders and researcher. In this article, we present a case study in which partnership research is applied in the form of multistakeholder participation. In combination with theoretical concepts, we provide insight into how a partnership based on a nonhierarchical relationship between stakeholders and researcher is developed. We highlight three issues, being the reach, the depth of participation, and the power dynamics between stakeholders and researcher. The findings presented here focus on the partnership research process and the participation of multiple stakeholders as partners. Further research is needed to gain insight in the effectiveness of partnership research, that is, in how a partnership succeeds or fails to reach research goals, for example, improvement of practice, impact, and empowerment of stakeholders.
Assessment of peripheral endothelial function predicts future risk of solid-tumor cancer
Authors: Toya Takumi , Sara Jaskanwal D , Corban Michel T , Taher Riad , Godo Shigeo , Herrmann Joerg , Lerman Lilach O , Lerman Amir
Published: October 2019

Aims

Cardiovascular health metrics predict the risk not only of cardiovascular diseases but also of several types of cancers. Microvascular endothelial dysfunction can predict future cardiovascular adverse events, but the predictive value of microvascular endothelial dysfunction for future risk of solid-tumor cancer has not been characterized.

Methods

A total of 488 patients who underwent microvascular endothelial function assessment using reactive hyperemia peripheral arterial tonometry were included in this study. Microvascular endothelial dysfunction was defined as a reactive hyperemia peripheral arterial tonometry index ≤2.0.

Results

Of 221 patients with a baseline reactive hyperemia peripheral arterial tonometry index ≤2.0, 21 patients (9.5%) were diagnosed with incident solid-tumor cancer during follow-up, whereas of 267 patients with a baseline reactive hyperemia peripheral arterial tonometry index >2.0, 10 patients (3.7%) were diagnosed with incident solid-tumor cancer during follow-up ( p = 0.009). Patients with a reactive hyperemia peripheral arterial tonometry index ≤2.0 had lower solid-tumor cancer-free survival compared to patients with a reactive hyperemia peripheral arterial tonometry index >2.0 (log-rank p = 0.017) (median follow-up 6.0 (3.0–9.1) years). Cox proportional hazard analyses showed that a reactive hyperemia peripheral arterial tonometry index ≤2.0 predicted the incidence of solid-tumor cancer, with a hazard ratio of 2.52 (95% confidence interval 1.17–5.45; p = 0.019) after adjusting for age, sex, and coronary artery disease, 2.83 (95% confidence interval 1.30–6.17; p = 0.009) after adjusting for diabetes mellitus, hypertension, smoking status, and body mass index >30 kg/m2, 2.79 (95% confidence interval 1.21–6.41; p = 0.016) after adjusting for fasting plasma glucose, systolic blood pressure, smoking status (current or former), and body mass index, and 2.43 (95% confidence interval 1.10–5.34; p = 0.028) after adjusting for Framingham risk score.

Conclusion

Microvascular endothelial dysfunction, as defined by a reactive hyperemia peripheral arterial tonometry index ≤2.0, was associated with a greater than two-fold increased risk of solid-tumor cancer. Microvascular endothelial dysfunction may be a useful marker to predict the future risk of solid-tumor cancer, in addition to its known ability to predict cardiovascular disease. Further research is necessary to develop adequate cancer screening strategies for patients with microvascular endothelial dysfunction.
Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis
Authors: Feng Sijia , Song Yujie , Li Hong , Chen Jun , Chen Jiwu , Chen Shiyi
Published: October 2019

Background:

Arthroscopic repair of combined Bankart/superior labral anteroposterior (SLAP) lesions is commonly performed to treat anterior shoulder instability, the clinical outcomes of which have not been widely studied.

Purpose:

To compare the clinical outcomes for arthroscopic repair of combined Bankart/SLAP lesions in the treatment of anterior shoulder instability and to ascertain whether it is inferior to isolated Bankart repair.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review of the literature was performed through use of the MEDLINE, EMBASE, and Cochrane Library databases according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study bias was assessed using the MINORS (Methodological Index for Non-Randomized Studies) scoring system. Randomized controlled trials, prospective or retrospective cohort studies, and case-control studies were included, whereas systematic reviews, literature reviews, conference abstracts, case reports, case series, and non-peer-reviewed studies were excluded to guarantee the quality of the study. Data on outcomes including recurrence rate, functional scores, and range of motion (ROM) were pooled, with statistical analysis performed. A P value of <.05 was considered statistically significant.

Results:

The review included 7 studies with a total of 520 patients. The pooled recurrence rate after combined Bankart/SLAP repair was 6.47% (9/139). Significant improvements of postoperative versus preoperative functional scores were observed, including a reduction in the visual analog scale score for pain (mean ± SD: 0.99 ± 1.36 vs 4.13 ± 2.26; P < .00001) and an increase in mean Rowe score (89.56 ± 11.46 vs 43.16 ± 8.87; P < .00001) and mean Constant score (91.41 ± 7.57 vs 59.70 ± 5.63; P < .00001). In terms of ROM, no reduction was found in external rotation (66.56° ± 13.33° vs 67.22° ± 14.27°; P = .21), and a significant increase in abduction was found (157.67° ± 4.11° vs 144.18° ± 8.28°; P < .00001). No statistically significant difference was found between arthroscopic repair of combined Bankart/SLAP lesions and isolated Bankart repair regarding recurrence rate, functional scores, or ROM.

Conclusion:

Of the pooled data, patients who underwent arthroscopic repair of combined Bankart/SLAP lesions in treatment of anterior shoulder instability showed a low recurrence rate, favorable functional scores, and no significant restriction on ROM, all of which were not significantly worse than outcomes of isolated Bankart repair. Therefore, combined repair was proven to be a viable option for extensive labral lesions.
Epidemiology of Lumbar Spine Injuries in Men’s and Women’s National Collegiate Athletic Association Basketball Athletes
Authors: Makovicka Justin L. , Deckey David G. , Patel Karan A. , Hassebrock Jeffrey D. , Chung Andrew S. , Tummala Sailesh V. , Hydrick Thomas C. , Pena Austin , Chhabra Anikar
Published: October 2019

Background:

Lumbar spine injuries (LSIs) are common in both men’s and women’s National Collegiate Athletic Association (NCAA) basketball players and can frequently lead to reinjuries and persistent pain.

Purpose:

To describe the epidemiology of an LSI in collegiate men’s and women’s basketball during the 2009-2010 through 2013-2014 academic years.

Study Design:

Descriptive epidemiology study.

Methods:

The incidence and characteristics of LSIs were identified utilizing the NCAA Injury Surveillance Program (ISP). Rates of injury were calculated as the number of injuries divided by the total number of athlete-exposures (AEs). AEs were defined as any student participation in 1 NCAA-sanctioned practice or competition. Incidence rate ratios (IRRs) were then calculated to compare the rates of injury between season, event type, mechanism, injury recurrence, and time lost from sport.

Results:

The NCAA ISP reported 124 LSIs from an average of 28 and 29 men’s and women’s teams, respectively. These were used via validated weighting methodology to estimate a total of 5197 LSIs nationally. The rate of LSIs in women was 2.16 per 10,000 AEs, while men suffered LSIs at a rate of 3.47 per 10,000 AEs. Men were 1.61 times more likely to suffer an LSI compared with women. In men, an LSI was 3.48 times more likely to occur in competition when compared with practice, while in women, an LSI was 1.36 times more likely to occur in competition than in practice. Women suffered the highest LSI rate during the postseason, while the highest rate in men was during the regular season. The majority of both female (58.9%; n = 1004) and male (73.1%; n = 2353) athletes returned to play within 24 hours of injury.

Conclusion:

To date, this is the largest study to characterize LSIs in NCAA basketball and provides needed information on the prevalence and timing of these injuries. The majority of injuries in both sexes were new, and most athletes returned to play in less than 24 hours. Injury rates were highest during competition in both sexes.
Visibly Invisible: TribalCrit and Native American Segregated Schooling
Authors: Martinez-Cola Marisela
Published: October 2019

The significant racial project known as Brown v. Board of Education has been the subject of numerous articles related to critical race theory scholarship and sociological analysis. But what of the racial projects represented in other racial groups, specifically, Native Americans? Through comparative historical case study and legal storytelling, I introduce five cases involving Native American plaintiffs into the segregated schooling narrative. Using a blend of TribalCrit (Native American critical race theory) and Omi and Winant’s theories on racial projects and racialization, I analyze the court opinions and argue that these cases represent more than racial projects. They are colonizing racial projects that offer very complicated contributions to the historical, legal, and social construction of race in the United States.
Cranberry A-type proanthocyanidins selectively target acute myeloid leukemia cells
Authors: Bystrom Laura M. , Bezerra Daniel P. , Hsu Hsiao-Ting , Zong Hongliang , Lara-Martínez Luis A. , De Leon Jeanne P. , Emmanuel Megan , Méry David , Gardenghi Sara , Hassane Duane , Neto Catherine C. , Cunningham-Rundles Susanna , Becker Michael W. , Rivella Stefano , Guzman Monica L.
Published: October 2019

Key Points

A-PACs target primary AML cells, sparing healthy CD34+ cord blood cells in vitro and reducing AML tumor burden with in vivo treatment. NF-κB activation plays a role in A-PAC–induced cell death.
Associations between hematology/oncology fellows’ training and mentorship experiences and hematology-only career plans
Authors: Masselink Leah E. , Erikson Clese E. , Connell Nathan T. , De Castro Laura M. , Dent Georgette A. , Marshall Ariela L. , Naik Rakhi P. , Nelson Marquita , O’Connell Casey L. , Rajasekhar Anita , Sharma Deva , Smith Melody , Lee Alfred Ian
Published: October 2019

Key Points

Clinical, research and mentorship experiences in hematology are positively associated with fellows' plans to pursue hematology-only careers.
Relationship of obstructive sleep apnoea severity and subclinical systemic atherosclerosis
Authors: Kim Soriul , Lee Ki Yeol , Kim Nan Hee , Abbott Robert D. , Kim Cherry , Lee Seung Ku , Kim Seong Hwan , Shin Chol
Published: October 2019

Obstructive sleep apnoea (OSA) is a common form of sleep disordered breathing. Untreated OSA might accelerate atherosclerosis, potentially increasing the cardiovascular disease burden in patients. The present study aimed to evaluate the association between objectively measured OSA severity and the presence of subclinical systemic atherosclerosis using noninvasive measurements, including tomographic quantification of the calcium burden.

A total of 2157 participants of the Korean Genome and Epidemiology Study, who were free of structural heart disease and underwent both in-home polysomnography and chest computed tomography, were cross-sectionally analysed. Participants were divided into three groups based on the severity of OSA: no OSA (apnoea–hypopnoea index (AHI) <5 events·h−1, n=1096), mild OSA (AHI 5– <15 events·h−1, n=700) and moderate-to-severe OSA (AHI ≥15 events·h−1, n=361). Calcium deposits in the thoracic aorta and coronary arteries were measured by the Agatston score.

Participants with moderate-to-severe OSA were 1.6 times (95% CI 1.18–2.15 times; p=0.002) more likely to have ascending thoracic aorta calcification (≥100 units) than those without OSA, after adjustment for cardiovascular risk factors. In addition, the association between moderate-to-severe OSA and ascending thoracic aorta calcification of subjects with higher epicardial fat volume was slightly stronger than that in patients without OSA and in the lowest epicardial fat volume tertile (OR 2.11, 95% CI 1.30–3.43).

Severity of OSA in the general population was independently associated with subclinical systemic atherosclerosis. These findings highlight the potential importance of severe OSA, especially in subjects with higher epicardial fat, as a possible predictive factor for systemic atherosclerosis and cardiovascular disease.
Antitumor agent yatein from Calocedrus formosana Florin leaf induces apoptosis in non-small-cell lung cancer cells
Authors: Ho Shang-Tse , Lin Chi-Chen , Wu Tung-Lin , Tung Yu-Tang , Wu Jyh-Horng
Published: October 2019

Calocedrus formosanaFlorin is a softwood tree species with high economic value in Taiwan. Several bioactivities of the extracts ofC. formosanahave been reported; however, only one study focused on the anti-non-small-cell lung cancer cells’ (anti-NSCLC) effect ofC. formosanaextract and its active phytocompound. In the present study, the anti-lung cancer effects ofC. formosanaleaf extract and its active derivative yatein were evaluated. The results revealed that then-hexane fraction of the crude extract exhibited the highest cytotoxicity potential against two non-small-cell lung cancer (NSCLC) cell lines, namely A549 and CL1-5. Yatein, isolated from then-hexane fraction, exhibited the highest cytotoxicity in the A549 and CL1-5 cells. In addition, the CL1-5 cells were more sensitive than the A549 cells after yatein treatment. Flow cytometry results revealed that yatein induced apoptosis in the two cell lines. Furthermore, expression of regulatory proteins related to apoptosis, such as caspase 3, caspase 8, caspase 9, and poly (ADP-ribose) polymerase (PARP), increased in the A549 and CL1-5 cells after yatein treatment. These findings provide insight into the in vitro anti-lung tumor efficacy of yatein, thus rendering this phytocompound a potential anticancer lead compound for NSCLC treatment.
Trained facilitators’ experiences with structured advance care planning conversations in oncology: an international focus group study within the ACTION trial
Authors:   On behalf of the ACTION consortium, Zwakman M. , Pollock K. , Bulli F. , Caswell G. , Červ B. , van Delden J. J. M. , Deliens L. , van der Heide A. , Jabbarian L. J. , Koba-Čeh H. , Lunder U. , Miccinesi G. , Arnfeldt C. A. Møller , Seymour J. , Toccafondi A. , Verkissen M. N. , Kars M. C.
Published: October 2019

Background

In oncology, Health Care Professionals often experience conducting Advance Care Planning (ACP) conversations as difficult and are hesitant to start them. A structured approach could help to overcome this. In the ACTION trial, a Phase III multi-center cluster-randomized clinical trial in six European countries (Belgium, Denmark, Italy, the Netherlands, Slovenia, United Kingdom), patients with advanced lung or colorectal cancer are invited to have one or two structured ACP conversations with a trained facilitator. It is unclear how trained facilitators experience conducting structured ACP conversations. This study aims to understand how facilitators experience delivering the ACTION Respecting Choices (RC) ACP conversation.

Methods

A qualitative study involving focus groups with RC facilitators. Focus group interviews were recorded, transcribed, anonymized, translated into English, and thematically analysed, supported by NVivo 11. The international research team was involved in data analysis from initial coding and discussion towards final themes.

Results

Seven focus groups were conducted, involving 28 of in total 39 trained facilitators, with different professional backgrounds from all participating countries. Alongside some cultural differences, six themes were identified. These reflect that most facilitators welcomed the opportunity to participate in the ACTION trial, seeing it as a means of learning new skills in an important area. The RC script was seen as supportive to ask questions, including those perceived as difficult to ask, but was also experienced as a barrier to a spontaneous conversation. Facilitators noticed that most patients were positive about their ACTION RC ACP conversation, which had prompted them to become aware of their wishes and to share these with others. The facilitators observed that it took patients substantial effort to have these conversations. In response, facilitators took responsibility for enabling patients to experience a conversation from which they could benefit. Facilitators emphasized the need for training, support and advanced communication skills to be able to work with the script.

Conclusions

Facilitators experienced benefits and challenges in conducting scripted ACP conversations. They mentioned the importance of being skilled and experienced in carrying out ACP conversations in order to be able to explore the patients’ preferences while staying attuned to patients’ needs.

Trial registration

International Standard Randomised Controlled Trial Number registry 63110516 (ISRCTN63110516) per 10/3/2014.
Radial endobronchial ultrasound-guided transbronchial biopsy for peripheral pulmonary malignancy: biopsy- or brushing-first?
Authors: Huang Chun-Ta , Tsai Yi-Ju , Ho Chao-Chi , Yu Chong-Jen
Published: October 2019

Background

Radial endobronchial ultrasound (R-EBUS)-guided transbronchial biopsy (TBB) is a common diagnostic modality for peripheral pulmonary lesions; however, there is uncertainty about the optimal sequence of TBB and bronchial brushing during the procedure. Thus, we aimed to investigate whether a biopsy-first or brushing-first strategy confers a better diagnostic yield and safety signal for R-EBUS-guided procedures for peripheral pulmonary malignancy.

Methods

From January 2017 to June 2018, consecutive patients referred for R-EBUS-guided TBB and bronchial brushing of peripheral pulmonary lesions and with a final malignant diagnosis were included. Patients were placed in a biopsy-first (biopsy followed by brushing) or a brushing-first (brushing followed by biopsy) group. The outcomes of interest were the diagnostic yield and complication profile of the procedures. Multivariate logistic regression and subgroup analysis were used to assess the impact of the procedure strategy.

Results

A total of 438 patients were included and the diagnostic yield of R-EBUS-guided TBB plus brushing for peripheral pulmonary malignancy was 73%. The diagnostic yield was associated with the solid lesion appearance (odds ratio [OR] 2.01; 95% confidence interval [CI] 1.08–3.75) and R-EBUS probe position within the lesion (OR 1.92; 95% CI 1.08–3.42), and the yield rates were comparable between the biopsy-first and brushing-first strategies. Moreover, the safety signal did not differ between the two groups.

Conclusions

The two procedure strategies were indistinguishable in terms of diagnostic efficacy and adverse events for patients with peripheral pulmonary malignancy. Current evidence indicates that in patients with peripheral pulmonary lesions suspected of being malignant, either biopsy-first or brushing-first is a viable and acceptable diagnostic strategy during R-EBUS-guided procedures.
GLIPR1L1 is an IZUMO-binding protein required for optimal fertilization in the mouse
Authors: Gaikwad Avinash S. , Anderson Amanda L. , Merriner D. Jo , O’Connor Anne E. , Houston Brendan J. , Aitken R. John , O’Bryan Moira K. , Nixon Brett
Published: October 2019

Background

The sperm protein IZUMO1 (Izumo sperm-egg fusion 1) and its recently identified binding partner on the oolemma, IZUMO1R, are among the first ligand-receptor pairs shown to be essential for gamete recognition and adhesion. However, the IZUMO1-IZUMO1R interaction does not appear to be directly responsible for promoting the fusion of the gamete membranes, suggesting that this critical phase of the fertilization cascade requires the concerted action of alternative fusogenic machinery. It has therefore been proposed that IZUMO1 may play a secondary role in the organization and/or stabilization of higher-order heteromeric complexes in spermatozoa that are required for membrane fusion.

Results

Here, we show that fertilization-competent (acrosome reacted) mouse spermatozoa harbor several high molecular weight protein complexes, a subset of which are readily able to adhere to solubilized oolemmal proteins. At least two of these complexes contain IZUMO1 in partnership with GLI pathogenesis-related 1 like 1 (GLIPR1L1). This interaction is associated with lipid rafts and is dynamically remodeled upon the induction of acrosomal exocytosis in preparation for sperm adhesion to the oolemma. Accordingly, the selective ablation of GLIPR1L1 leads to compromised sperm function characterized by a reduced ability to undergo the acrosome reaction and a failure of IZUMO1 redistribution.

Conclusions

Collectively, this study characterizes multimeric protein complexes on the sperm surface and identifies GLIPRL1L1 as a physiologically relevant regulator of IZUMO1 function and the fertilization process.