bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoperative radiation exposure in hip arthroscopy: a systematic review
Authors: Shah Ajay , Nassri Mohammed , Kay Jeffrey , Simunovic Nicole , Mascarenhas Vasco V , Andrade Antonio J , Marin-Peña Óliver R , Ayeni Olufemi R
Published: November 2019

Fluoroscopy is used in hip arthroscopy (HA) for portal placement, instrument localisation, and guidance in bony resection. The recent increase in arthroscopic hip procedures may place patients and surgeons at risk for increased radiation exposure and radiation-induced complications. The purpose of the current systematic review was to assess intraoperative radiation exposure in HA.

The systematic review was conducted according to PRISMA guidelines; inclusion criteria were studies assessing radiation exposure in HA. 9 studies including 994 patients were included. Mean age was 38.6 years and 48% (436 of 906) were female. Mean time of fluoroscopy exposure was 0.58 minutes. Dose area product was 129.5 cGycm2. Mean intraoperative absorbed radiation dose studies was 12.6 mGy. Mean intraoperative effective dose was 0.48 mSv. The mean occupational exposure to the surgeon per case was 0.0031 mSv. Higher patient body mass index (BMI) correlated to greater patient effective and cumulative dose ( p < 0.05, r = 0.404), and greater occupational exposure ( p < 0.001, r = 0.460). Increasing surgeon experience decreased fluoroscopy time ( p = 0.039) and radiation dose ( p = 0.002).

Radiation dose and effective dose were well under the thresholds for deterministic effects (2 Gy) and annual radiation exposure for occupational workers (20 mSv). Intraoperative radiation exposure to patients and surgeons is within acceptable annual radiation limits. Ensuring careful selection of perioperative imaging modalities, proper protective shielding, specifically the use of leaded eyeglasses, and optimal C-arm positioning are key strategies to reduce radiation exposure to patients and surgeons alike.
Responding to the mental health consequences of the 2015–2016 terrorist attacks in Tunisia, Paris and Brussels: implementation and treatment experiences in the United Kingdom
Authors: Cyhlarova Eva , Knapp Martin , Mays Nicholas
Published: November 2019

Objectives

To explore whether the Screen and Treat Programme to support United Kingdom citizens potentially affected by terrorist attacks in Tunisia (2015), Paris (2015) and Brussels (2016) was effective in identifying and referring people to mental health services, to examine the programme’s acceptability to users and to understand how agencies involved worked together.

Methods

Individuals offered screening by the programme (n = 529) were invited to participate in the study and were sent a questionnaire. Follow-up interviews were conducted with questionnaire respondents who consented and with employees of agencies involved in the programme’s planning and delivery. Seventy-seven people affected by the attacks completed questionnaires, 35 of those were also interviewed, and 1 further person only participated in an interview. Eleven people from agencies organizing and delivering the programme and five clinician-managers were also interviewed.

Results

Most service users said the attacks had a major impact on their lives. Many reported anxiety, depression, difficulty going out or travelling, sleep problems, panic attacks, flashbacks and hyper-vigilance. A third had reduced their working hours and a similar proportion had taken sick leave. Two-thirds sought help from their General Practitioner (GP) before being contacted by the programme, but almost all thought their GP had not been helpful in dealing with post-traumatic stress disorder (PTSD) or referring to appropriate care. Several people were prescribed psychotropic medication; only a few were referred to mental health professionals. Many participants used help offered by organizations external to National Health Service, with mixed experiences. Waiting times for treatment varied from no delay to a few months. Most interviewees thought the programme should have started sooner and provided more information about sources of support. Most users found treatment received via the programme helpful. Professionals involved in organizing and delivering the programme thought that bureaucratic delays in setting it up were key limitations on effectiveness. Clinician interviewees thought an outreach approach was needed to identify at-risk individuals.

Conclusions

Users who took part in the programme were satisfied with their treatment, although many thought it should have been offered sooner. Funding and data sharing between agencies were the main barriers to timely contact with affected individuals. Self-referral, GP identification of PTSD and GP referral to appropriate care were regarded as ineffective, suggesting that people affected by similar future incidents should be supported better and assisted more promptly to access treatment.
Investigation on crushing behavior of laminated conical absorbers with different arrangements under axial loading
Authors: Akhavan Attar Ali , Kazemi Mahdi
Published: November 2019

Abstracts

In this paper, the crushing properties of conical tubes made of stainless steel 430 have been investigated with different arrangements under quasi-static axial load both experimentally and numerically. For numerical investigation, nonlinear finite element method simulation is conducted using LS-Dyna software. In the experimental tests, the specimens with the height, major diameter, minor diameter and thickness of 150, 70, 50 and 1 mm are considered, respectively. Different combinations of layers are prepared using different cross-sections. A total of seven different arrangements have been designed in three distinct groups with constant mass and the crushing behavior has been extracted for them. To ensure the validity of the simulation results, several specimens which have the thickness of 1 mm have been tested experimentally. Comparing the results indicates the consistency of the experimental and numerical data. According to the obtained results, it is observed that with increasing the number of layers, the energy absorption capacity is increased; moreover, the peak load is increased by 75.2%. In fact, with increasing the number of layers, increasing trend is observed in peak load, and contrary to the initial expectations, this trend is not linear. It is also observed that by changing the layer arrangement and the layer number, the mean crushing force can increase approximately three times.
Anti-conversion laws and violent Christian persecution in the states of India: a quantitative analysis
Authors: Saiya Nilay , Manchanda Stuti
Published: November 2019

Seven of India’s 29 states enforce ‘anti-conversion’ laws, which are designed to prevent individuals and groups from converting or attempting to convert, either directly or otherwise, persons through ‘forcible’ or ‘fraudulent’ means, including ‘allurement’ or ‘inducement.’ This might seem a noble enough goal; nevertheless, we argue that anti-conversion laws actually serve to generate violent anti-Christian persecution by creating a culture of vigilantism in the states where such laws exist. This article empirically tests this proposition, along with alternative hypotheses, using a time-series, negative binomial analysis of the Indian states from 2000 to 2015. Our analysis finds that states that enforce anti-conversion laws are indeed statistically more likely to give rise to violent persecution against Christians than states where such laws do not exist. The statistical analysis is supplemented with a brief case study of Madhya Pradesh.
Politicizing fashion: Inconspicuous consumption and anti-intellectualism during the Cultural Revolution in China
Authors: Zhang Weiwei
Published: November 2019

For many years, fashion has been an area of interest in consumer research, but scholars have paid little attention to how political ideology influences fashion. This article examines how Chinese consumers used fashion to seek identity and differentiate themselves during the Cultural Revolution. Furthermore, the study connects fashion and consumption and examines how Western fashion theories manifested themselves during this period. Based on my research, in contrast to trickle-down theory, when the lower social class adopted the fashion, the superordinate social class did not distinguish themselves by assuming a new trend. Furthermore, unlike conspicuous consumption theory, instead of showing off their wealth, consumers displayed their poverty during this era. Finally, different from other societies, having high cultural capital was neither popular nor fashionable during the Cultural Revolution.
Outcome Measures for Acute Submassive Pulmonary Embolisms at a Community-Based Hospital Using Ultrasound-Facilitated, Catheter-Directed, Low-Dose Fibrinolysis
Authors: Hooks Brandon , Sharma Vinay , Taylor Gavin , Wadhwani Sumeet , Ehtesham Muhammad
Published: November 2019

Purpose:

Ultrasound-facilitated, catheter-directed, low-dose fibrinolysis (USAT) appears to provide promising results for the management of acute submassive pulmonary embolisms (ASMPEs) at tertiary care centers. This study assessed outcome measures at a community-based hospital systems and compared results to known studies.

Materials and Methods:

This is a single-center, retrospective study assessing clinical outcomes of the EkoSonic Endovascular System intervention for ASMPEs performed by three surgical 3 subspecialties (interventional radiology, interventional cardiology, and vascular surgery) part of a pulmonary embolism response team (PERT). We reviewed 146 PERT activations from June 2013 to December 2017. Eighty-three patients with ASMPEs underwent USAT.

Results:

Our study showed greater differences ( P = .01) between baseline and follow-up pulmonary artery systolic pressures (20.9 ± 9.8 mm Hg [n = 14]) compared to the ULTIMA study (12.3 ± 10 mm Hg [n = 30]). Our length-of-stay measures were shorter (6.1 ± 5.1 [n = 83]; P = .0001) compared to the SEATTLE II study (8.8 ± 5.0 [n = 150]). Preprocedure transthoracic echocardiograms (TTEs) were performed for 54 (65%) of 83 patients. Postprocedure TTEs at 48 hours was performed for 52 (62%) of 83 patients. Use of TTEs before and after intervention did not change outcomes. Intracranial hemorrhage was not observed in our patient population. There was no difference in outcomes between the three subspecialties in our study.

Conclusions:

Use of USAT in a community-based hospital PERT has similar outcomes to tertiary care centers. Furthermore, similar outcomes were observed between the three subspecialties suggesting development of a comprehensive care team for management of ASMPEs.
Evaluating a Tool to Support the Integration of Gender in Programs to Promote Men’s Health
Authors: Struik Laura L. , Abramowicz Aneta , Riley Barbara , Oliffe John L. , Bottorff Joan L. , Stockton Lisa D.
Published: November 2019

Men’s disproportionate rate of suicide and substance use has been linked to problematic conformity to traditional masculine ideals. Mental health promotion interventions directed toward men should address the gender-specific needs of men; yet, no tools exist to provide such guidance. To address this need, the Check-Mate tool was developed as part of a global evaluation of the Movember Foundation’s Social Innovators Challenge (SIC). The tool provides an initial set of evidence-based guidelines for incorporating gender-related influences in men’s mental health promotion programs. This article describes the development of Check-Mate and an evaluation of its usability and usefulness. Using a qualitative descriptive approach, semistructured interviews were conducted with the leads for eight of the SIC projects; they used the tool for these. Data were analyzed using conventional content analysis. Overall, project leads found the tool user-friendly. Identified strengths of Check-Mate included its practicality, adaptability, usefulness for priming thinking on gender sensitization, and value in guiding program planning and implementation. With respect to limitations, project leads explained that the complexity of men’s mental health promotion programming may limit applicability of some or all approaches included in Check-Mate. They also expressed concern about how using Check-Mate might reinforce hegemonic masculine ideals. It was suggested that examples illustrating the use of Check-Mate would be a helpful accompaniment to the tool. Findings indicate that Check-Mate is a useful guide in men’s mental health promotion programming. In addition to future testing of the tool in different settings, links between the tool’s approaches and program outcomes should be explored.
A technical note on intra-arterial cone-beam computed tomography for the evaluation of flow-diverter stents: Image quality differences between diluted and non-diluted contrast medium
Authors: Kocer Naci , Kandemirli Sedat G , Ruijters Daniel , Mantatzis Michalis , Kizilkilic Osman , Islak Civan
Published: November 2019

Background

Design of flow-diverter stents for flexibility, tractability, and low profile limits their radiopacity on conventional digital subtraction angiography. Cone-beam computed tomography (CBCT) offers higher spatial resolution for the evaluation of flow-diverter stents. However, CBCT requires optimal dilution and timing of contrast medium for simultaneous visualization of the stent, arterial lumen, and vessel wall. There are only limited data on the effects of different contrast dilutions on CBCT image quality in neurointerventional applications.

Materials and methods

In our institution, intra-arterial CBCTs were acquired during stent deployment and at follow-ups with 10% diluted contrast. We had recently started acquiring intra-arterial CBCTs with non-diluted contrast. Retrospective analysis of our flow-diverter data identified eight cases with different aneurysm locations who had intra-arterial CBCT with 10% diluted contrast immediately after flow-diverter stent deployment and with non-diluted contrast technique during follow-ups. For each case, the image quality between diluted and non-diluted contrast techniques was compared qualitatively by assessing stent visualization and quantitatively by plotting gray-scale intensity values along the vessel lumen.

Results

In two sets of CBCT images per each case, there was no substantial difference between diluted and non-diluted CBTC techniques for the evaluation of stent architecture and lumen opacification. Gray-scale intensity values perpendicular to the lumen revealed similar intensity values along the neighboring parenchyma, vessel wall, and lumen for the two different contrast techniques.

Conclusion

Intra-arterial CBCT angiography can be performed without contrast dilution and still achieve adequate image quality in certain cerebral aneurysms treated with flow diverter. The non-diluted contrast technique avoids the time loss during preparation of diluted contrast and installation of diluted contrast to the injector in angiography suites with a single power injector.
Adaptive backstepping second-order sliding mode fuzzy control for three-phase active power filter
Authors: Chen Yun , Li Siyang , Fei Juntao
Published: November 2019

Because of the heavy use of electrical equipment, harmonic pollution is becoming more and more serious, which brings potential safety risks to our lives. In view of the fact that active power filters can effectively eliminate harmonics, an adaptive second-order sliding mode fuzzy control based on the backstepping method is proposed to eliminate harmonics in this article. The second-order sliding mode control can eliminate chattering in the system and results in a smoother controller. The uncertainties in the system are approximated by a fuzzy control system, and the adaptive laws are designed to ensure the stability of the system. Backstepping control can improve the stability and robustness of closed-loop systems. Simulation results show that the proposed method has better tracking effect, strong robustness, and stability and can effectively eliminate harmonics.
Methodological reporting in feasibility studies: a descriptive review of the nursing intervention research literature
Authors: Mailhot Tanya , Goulet Marie-Hélène , Maheu-Cadotte Marc-André , Fontaine Guillaume , Lequin Pierre , Lavoie Patrick
Published: November 2019

Background

In reaction to weaknesses in feasibility studies reporting, the Consolidated Standards of Reporting Trials (CONSORT) statement published an extension for feasibility studies in 2016.

Aim

The aim of this study was to systematically review and appraise the reporting of feasibility studies in the nursing intervention research literature based on the CONSORT statement extension for feasibility studies.

Method

Papers published prior to January 2018 that described feasibility studies of nursing interventions were retrieved. Components of feasibility studies were coded, and code frequencies were analysed.

Results

The review included 186 papers. Although most papers ( n = 142, 76.3%) included the label ‘pilot’ or ‘feasibility’ in their title, reporting for other components generally did not adhere to one or several CONSORT recommendations. Most papers reported objectives ( n = 116, 62.4%), designs ( n = 95, 51%), or rationales for sample size ( n = 165, 88.7%) that were incongruent with the purpose of feasibility studies.

Discussion

This review results in two main implications for nursing research. First, we noted that the reporting of feasibility studies is weak. While all papers described feasibility studies, almost half focused exclusively on testing the effectiveness of an intervention. Second, we identified rationales for sample size along with key references that could offer guidance in reporting feasibility studies while being coherent with the CONSORT recommendations.
Comparison of the capability of risk stratification evaluation between two‐ and three‐dimensional speckle‐tracking strain in pre‐capillary pulmonary hypertension
Authors: Liu Bing‐Yang , Wu Wei‐Chun , Zeng Qi‐Xian , Liu Zhi‐Hong , Niu Li‐Li , Tian Yue , Luo Qin , Zhao Zhi‐Hui , Quan Rui‐Lin , Lin Jing‐Ru , Wang Hao , He Jian‐Guo , Xiong Chang‐Ming
Published: November 2019

To investigate and compare the value of right ventricular longitudinal strain detected by two‐dimensional and three‐dimensional speckle‐tracking echocardiography in risk stratification evaluation in pre‐capillary pulmonary hypertension. We consecutively screened 66 patients diagnosed with pre‐capillary pulmonary hypertension in our center. According to the risk assessment recommended by 2015 European Society of Cardiology Guidelines, all participants were classified into low‐ and intermediate‐high‐risk group. Two‐dimensional and three‐dimensional strains were measured using off‐line softwares (GE EchoPAC version 201 and TomTec, 4D RV Function 2.0). Fifty‐seven pre‐capillary pulmonary hypertension patients (average 35 years old, 18 males and 39 females) were finally enrolled in our study, 32 (56.1%) were classified in low‐risk group, while 25 (43.9%) were in the intermediate‐high‐risk group. Clinical data associated with disease severity, such as N‐terminal pro‐brain natriuretic peptide (r = 0.574, P < 0.001), peak oxygen consumption (r = –0.484, P < 0.001), and 6‐min walking distance (r = –0.356, P = 0.008) were significantly correlated with two‐dimensional right ventricular longitudinal strain; while the correlations with three‐dimensional right ventricular longitudinal strain were weaker. Receiver operating characteristic curves for the detection of intermediate‐high risk stratification showed two‐dimensional right ventricular longitudinal strain had the best predictive capacity (area under curve, 0.82, 95% CI: 0.71–0.93, P < 0.001). Univariate and Multivariate Logistic regression analyses identified two‐dimensional right ventricular longitudinal strain as an independent predictor (OR: 1.42, 95% CI: 1.18–1.71, P < 0.001) of intermediate‐high risk stratification in this cohort of pre‐capillary pulmonary hypertension patients, the predictive capacity retained (OR: 1.45, 95% CI: 1.18–1.78, P < 0.001) after adjusted by age, gender, and body mass index, while three‐dimensional speckle‐tracking echocardiography parameters were not. In conclusion, when used for the detection of intermediate‐high risk stratification in pre‐capillary pulmonary hypertension, two‐dimensional right ventricular longitudinal strain was better than three‐dimensional right ventricular longitudinal strain.
The prognostic value of DLCO and pulmonary blood flow in patients with pulmonary hypertension
Authors: Stadler Stefan , Mergenthaler Nicoletta , Lange Tobias J.
Published: November 2019

Background

Cardiac output is a prognostic marker in patients with pulmonary hypertension. Pulmonary blood flow as a surrogate for cardiac output can be measured non‐invasively by inert gas rebreathing. We hypothesized that pulmonary blood flow can predict outcome in patients with pulmonary hypertension.

Methods

From January 2009 to January 2012, we measured pulmonary blood flow by inert gas rebreathing in outpatients with pulmonary hypertension. Patients with pulmonary hypertension confirmed by right heart catheterization and a valid inert gas rebreathing maneuver were followed until January 2016. The investigated outcome was all‐cause mortality.

Results

We included 259 patients (mean age 65 ± 13 years, 53% female) with pulmonary hypertension and classified into groups 1 (n = 103), 2 (n = 26), 3 (n = 80), and 4 (n = 50) according to the current pulmonary hypertension classification system. The median time between pulmonary hypertension diagnosis and inert gas rebreathing was 9 (IQR 0; 36) months. During a median follow‐up time of 51 (IQR 20; 68) months, 109 patients (42%) died. Parameters significantly associated with survival (in order of decreasing statistical strength) were diffusion capacity of the lung for carbon monoxide (DLCO), 6‐minute walk distance (6‐MWD), age, NTpro‐BNP, WHO functional class, group 3 pulmonary hypertension, and tricuspid annular plane systolic excursion (TAPSE), while baseline hemodynamics and pulmonary blood flow were not. In multivariable Cox regression analysis, DLCO, age, 6‐MWD, and TAPSE remained significant and independent predictors of the outcome. DLCO as the strongest parameter also significantly predicted survival in aetiological subgroups except for group 4.

Conclusions

DLCO is a strong and independent predictor for survival in patients with pulmonary hypertension of different aetiologies, while pulmonary blood flow measured by inert gas rebreathing is not.
SoundCloud and Bandcamp as Alternative Music Platforms
Authors: Hesmondhalgh David , Jones Ellis , Rauh Andreas
Published: November 2019

We examine two “producer-oriented” audio distribution platforms, SoundCloud and Bandcamp, which have been important repositories for the hopes of musicians, commentators, and audiences that digital technologies and cultural platforms might promote democratization of the cultural industries, and we compare their achievements and limitations in this respect. We show that the emancipatory elements enshrined in SoundCloud’s bottom-up abundance are compromised by two elements that underpin the platform: the problematic “culture of connectivity” of the social media systems to which it must remain integrally linked and the systems of intellectual property that the firm has been increasingly compelled to enforce. By contrast, it seems that Bandcamp has been relatively stable in financial terms while being at odds with some key aspects of “platformization,” and we explore the possibility that some of the platform’s apparent success may derive from how its key features makes it attractive to indie musicians and fans drawn to an independent ethos. Nevertheless, we argue that even while in some respects Bandcamp acts more effectively as a cultural alternative than does SoundCloud, Bandcamp is also congruent economically and discursively with how platforms capitalize on the activity of self-managing, self-auditing, specialist, worker-users.
Ephemeral Journalism: News Distribution Through Instagram Stories
Authors: Vázquez-Herrero Jorge , Direito-Rebollal Sabela , López-García Xosé
Published: November 2019

Social media are increasingly integrated into media routines as channels to gain access, verify and spread information. Likewise, as mobile news consumption is standardized, the media experiment with native formats for these platforms. This study analyzes how the media use Instagram Stories, to identify the strategies that they apply, as well as the adaptation and innovation features on this platform. A content analysis was conducted from a sample of 17 online media that use Instagram Stories, both legacy and digital native. The results show an upward potential in ephemeral news production, one that is increasingly developed and unique.
Reliability and Validity of the HIV Disability Questionnaire (HDQ) with Adults Living with HIV in the United States
Authors: O’Brien Kelly Kathleen , Kietrys David , Galantino Mary Lou , Parrott James Scott , Davis Tracy , Tran Quang , Aubry Rachel , Solomon Patricia
Published: November 2019

Objectives:

To assess measurement properties of the HIV Disability Questionnaire (HDQ) among adults with HIV in the United States.

Methods:

We administered the HDQ, World Health Organization Disability Assessment Schedule II (WHODAS 2.0), and a demographic questionnaire. For internal consistency reliability, we calculated Cronbach α and Kuder-Richardson-20 (KR-20) statistics for disability and episodic scores, respectively (≥0.80 acceptable). For test–retest reliability, we calculated intraclass correlation coefficients (>0.8 acceptable). For construct validity, we tested 15 a priori hypotheses assessing correlations between HDQ and WHODAS 2.0 scores.

Results:

Of the 128 participants, the majority were males (68%), median age 51 years, taking antiretroviral therapy (96%). Cronbach α ranged from 0.88 (social inclusion) to 0.93 (uncertainty). The KR-20 ranged from 0.86 (cognitive) to 0.96 (uncertainty). Intraclass correlation coefficients ranged from 0.88 (physical, cognitive, social inclusion) to 0.92 (mental–emotional). Of the 15 hypotheses, 13 (87%) were confirmed.

Conclusions:

The HDQ demonstrates internal consistency reliability, test–retest reliability, and construct validity when administered to a sample of adults with HIV in the United States.
Changes of Bipolar Bone Defect Size After Arthroscopic Bankart Repair for Traumatic Anterior Shoulder Instability: Evaluation Using a Scoring System and Influence on Postoperative Recurrence
Authors: Nakagawa Shigeto , Uchida Ryohei , Yokoi Hiroyuki , Sahara Wataru , Mae Tatsuo
Published: November 2019

Background:

The combination of a glenoid defect and a Hill-Sachs lesion in shoulders with traumatic anterior instability has been termed bipolar bone loss, and the preoperative size of these lesions has been reported to influence postoperative recurrence of instability after arthroscopic Bankart repair.

Purpose:

To investigate the influence of postoperative bipolar bone defect size on postoperative recurrence of instability.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 64 male collision/contact athletes (69 shoulders) were evaluated for a minimum of 2 years after surgery, and the pre- and postoperative sizes of both lesions (glenoid defect and Hill-Sachs) were evaluated retrospectively with 3-dimensional computed tomography. The sports played by the athletes included rugby (n = 28 shoulders), American football (n = 24 shoulders), and other collision/contact sports (n = 17 shoulders). Glenoid defects and Hill-Sachs lesions were classified into 5 size categories and assigned scores from 0 (no defect) to 4 (very large defect). Patients were then classified according to the total score (sum of the scores for both lesions). The influence of pre- and postoperative bipolar bone defect sizes on recurrence of instability was investigated by using the total scores for bipolar bone defects. The influence of postoperative glenoid morphology (normal preoperative glenoid, preoperative glenoid erosion, bone union after arthroscopic bony Bankart repair [ABBR], or nonunion after ABBR) was also investigated, as well as changes in shoulders with a preoperative off-track Hill-Sachs lesion.

Results:

Of 69 shoulders, 15 (21.7%) developed recurrent instability after surgery. The postoperative recurrence rate was 0% in shoulders with a total score ≤1, while the recurrence rate was consistently higher in shoulders with a total score ≥2 at both pre- and postoperative evaluation (mean, 28.8% and 32.6%, respectively). Postoperative recurrence was uncommon when there was a normal preoperative glenoid or bone union after ABBR, while it was frequent in shoulders with preoperative glenoid erosion or shoulders with nonunion after ABBR and a total score ≥2. An off-track lesion was recognized in 9 shoulders preoperatively. It was transformed to on-track lesions in 4 of the 5 shoulders showing bone union after ABBR, and there was no recurrence in the 5 shoulders with bone union. In contrast, postoperative recurrence of instability occurred in 3 of the 4 shoulders without bone union.

Conclusion:

Postoperative recurrence was influenced by the pre- and postoperative size of bipolar bone defects. Recurrence was uncommon if bone union was achieved after ABBR, even if there had been an off-track lesion preoperatively.
Improving the Pediatric Procedural Experience: An Analysis of Pain, Anxiety, and Satisfaction
Authors: Crumm Caitlin E , Camp Elizabeth A , Khalil Maha , Chumpitazi Corrie E
Published: November 2019

Objective:

The purpose of this investigation was to compare self-reported and perceived pain and anxiety among patients, caregivers, and providers before, during, and after common emergency department (ED) procedures while evaluating the impact of commonly used adjuncts on overall satisfaction.

Methods:

A prospective observational study of children undergoing painful procedures in an ED was conducted from January 2015 to March 2017. Before, during, and after the procedure, patients older than 3 years of age rated their pain and anxiety. At the same time points, the provider and caregiver rated their impression of the patient’s pain, and the caregiver also rated the patient’s anxiety. After the procedure, satisfaction was elicited from the caregiver and the provider.

Results:

A total of 257 children were enrolled: 150 for intravenous line placement, 53 for wound repair, and 44 for a variety of other procedures. Caregivers rated pain higher than providers before, during, and after the procedure ( P values <0.001, <0.001, and 0.003, respectively). Caregivers rated anxiety higher than patients before, during and after the procedure ( P values <0.001, 0.03, and 0.002, respectively). Providers were less satisfied with the 1- to 2-year age-group compared to the 8+ years age groups ( P values 0.01 and 0.002).

Conclusions:

Caregiver perception of pain and anxiety of the patient exceeds provider and sometimes patient reports. The youngest children present a challenge for caregivers and providers and have lower satisfaction compared to older groups.
Envisioning tropical environments: Representations of peatlands in Malaysian media
Authors: Manzo Kate , Padfield Rory , Varkkey Helena
Published: November 2019

At a time of international debate about the value of tropical peatlands in Malaysia and Indonesia, this paper explores continuities and changes in colonial representations of peatlands over time. The principal aim is to understand how arguments for both development and conservation are framed and expressed in relation to wider narratives about the suitability or unsuitability of tropical peatlands for commercial development. Of particular interest is the ways in which scientific findings (both for and against peatlands development) are communicated in popular media. The substantive focus of the paper is Malaysian media; we undertake a qualitative content analysis of representations of tropical peatlands in English-language Malaysian media over a 20-year period. Close attention to a particular form of linguistic expression, namely textual metaphor, emerged from a combination of secondary reading and the evident presence of different metaphors within the data set itself. Informed by relevant studies, these are classified as ontological, cybernetic, organic and aquatic. As well as differences, we find similar metaphorical expressions criss-crossing lines of debate. Land container (ontological) metaphors that envision tropical peatlands as receptacles of economically valuable natural resources are by far the most common. We conclude that market-centred conservation is the principle alternative to mainstream, extractive development in Malaysia (as elsewhere). At a time when the value of peatlands is expressed mainly in terms of economic use and exchange value, the circulation of counternarratives that emphasise intrinsic and/or future value thus remain equally crucial.
Experimental and numerical investigation of the flexural behavior of CFRP box girders
Authors: Ding Guoping , Zhang Yixuan , Zhu Yong
Published: November 2019

The advantages of carbon fiber-reinforced plastic (CFRP) box girders include good bending resistance, lightweight and high strength. Therefore, they are widely used in aerospace, rail transit, and other fields. When the CFRP box girder is subjected to bending load, the strength of the initial damage is usually used as the ultimate load. However, after the initial damage of the CFRP box girder, the load will be redistributed and structure still have a higher ultimate load. As the damage accumulates, it eventually leads to complete failure of the structure, which is a progressive damage. It turns out that the composite structure still has bending capacity after the initial damage, but the mechanical response at this stage has not been fully studied. To make full use of the ultimate bearing capacity of the CFRP box girder, this article adopts the theory of progressive damage of a composite material and programs the ABAQUS/Explicit user material subroutine (VUMAT) to analyze CFRP box girder progressive damage. This article also produces CFRP box girder specimens with five typical ply schemes and implements three-point bending tests to verify the bending strength of the CFRP box girder. In addition, this article designs strain measurement and ultrasonic scanning experiments to verify the difference between experiment and simulation. The final result shows that the progressive damage model established in this article is reliable, among the five typical ply schemes, when the 0° ply ratio is 60% and the ±45° ply ratio is 40%, the CFRP box girder has the greatest ultimate load carrying capacity.
Mauriziodiniite, NH4(As2O3)2I, the ammonium and iodine analogue of lucabindiite from the Torrecillas mine, Iquique Province, Chile
Authors: Kampf Anthony R. , Nash Barbara P. , Molina Donoso Arturo A.
Published: November 2019

The new mineral mauriziodiniite (IMA2019-036), NH4(As2O3)2I, was found at the Torrecillas mine, Iquique Province, Chile, where it is a secondary alteration phase associated with calcite, cuatrocapaite-(NH4), lavendulan, magnesiokoritnigite and torrecillasite on matrix consisting of native arsenic, arsenolite and pyrite. Mauriziodiniite occurs as hexagonal tablets up to ~300 μm in diameter. Crystals are colourless and transparent, with pearly to adamantine lustre and white streak. The Mohs hardness is ~1. Tablets are sectile and easily flexible, but not elastic. Fracture is curved, irregular and stepped. Cleavage is perfect on {001}. The calculated density is 3.916 g/cm3. Optically, mauriziodiniite is uniaxial (–) with ω = 2.07(calc) and ɛ = 1.770(5) (white light). The empirical formula, determined from electron microprobe analyses, is (NH4)0.94K0.03(As2O3)2I0.92Cl0.03. Mauriziodiniite is hexagonal, P6/mmm, a = 5.289(2), c = 9.317(2) Å, V = 225.68(18) Å3 and Z = 1. The structure, refined to R1 = 4.16% for 135 Io > 2σI reflections, contains three types of layers: (1) a planar neutral As2O3 (arsenite) sheet; (2) an NH4+ layer that links adjacent arsenite sheets via bonds to their O atoms; and (3) an I– layer that links adjacent arsenite sheets via bonds to their As atoms. The layer sequence is I–As2O3–NH4–As2O3–I. Mauriziodiniite is isostructural with lucabindiite and is structurally related to gajardoite, cuatrocapaite-(NH4), cuatrocapaite-(K) and torrecillasite.
Clonal dynamics in chronic lymphocytic leukemia
Authors: Gutierrez Catherine , Wu Catherine J.
Published: November 2019

Chronic lymphocytic leukemia has a highly variable disease course across patients, thought to be driven by the vast inter- and intrapatient molecular heterogeneity described in several large-scale DNA-sequencing studies conducted over the past decade. Although the last 5 years have seen a dramatic shift in the therapeutic landscape for chronic lymphocytic leukemia, including the regulatory approval of several potent targeted agents (ie, idelalisib, ibrutinib, venetoclax), the vast majority of patients still inevitably experience disease recurrence or persistence. Recent genome-wide sequencing approaches have helped to identify subclonal populations within tumors that demonstrate a broad spectrum of somatic mutations, diverse levels of response to therapy, patterns of repopulation, and growth kinetics. Understanding the impact of genetic, epigenetic, and transcriptomic features on clonal growth dynamics and drug response will be an important step toward the selection and timing of therapy.
Updated international consensus report on the investigation and management of primary immune thrombocytopenia
Authors: Provan Drew , Arnold Donald M. , Bussel James B. , Chong Beng H. , Cooper Nichola , Gernsheimer Terry , Ghanima Waleed , Godeau Bertrand , González-López Tomás José , Grainger John , Hou Ming , Kruse Caroline , McDonald Vickie , Michel Marc , Newland Adrian C. , Pavord Sue , Rodeghiero Francesco , Scully Marie , Tomiyama Yoshiaki , Wong Raymond S. , Zaja Francesco , Kuter David J.
Published: November 2019

Over the last decade, there have been numerous developments and changes in treatment practices for the management of patients with immune thrombocytopenia (ITP). This article is an update of the International Consensus Report published in 2010. A critical review was performed to identify all relevant articles published between 2009 and 2018. An expert panel screened, reviewed, and graded the studies and formulated the updated consensus recommendations based on the new data. The final document provides consensus recommendations on the diagnosis and management of ITP in adults, during pregnancy, and in children, as well as quality-of-life considerations.
Correction to: Long-term effectiveness and safety of self-management of oral anticoagulants in real-world settings
Authors: Menéndez-Jándula Bárbara , García-Erce José Antonio , Zazo Clara , Larrad-Mur Luis
Published: November 2019

After publication of the original article [1], we were notified that the name of the software mentioned in the Background section is TAONET and not Tao Net.
Lifestyle behaviours in patients with established cardiovascular diseases: a European observational study
Authors: Fernández Diana , Brotons Carlos , Moral Irene , Bulc Mateja , Afonso Mélanie , Akan Hülya , Pinto Susana , Vucak Jasna , da Silva Martins Carlos Manuel
Published: November 2019

Background

Patients who have experienced a cardiovascular clinical event such as a myocardial infarction or stroke qualify for intensive risk factor evaluation and management.

The aim of this study is to explore lifestyle changes as well as the achievement of targets for risk factors in patients with established cardiovascular disease.

Methods

Cross-sectional study conducted in primary care practices. The study was carried out in six European countries (Croatia, France, Portugal, Slovenia, Spain and Turkey). Patients with established cardiovascular disease (coronary heart disease and stroke) attended in primary care were selected and assessed from January to June 2016. Patients were recruited and assessed at the practice by research assistants between 6 months and 3 years after the event. Statistical comparisons were done with the unpaired two-sided Student’s t-test for continuous variables and Chi-square test for categorical variables.

Results

Nine hundred and seventy-three patients (32.4% females) were assessed. About 14% of them were smokers, 32% were physically inactive, and 30% had nutritionally poor eating behaviours. LDL cholesterol target value below 70 mg/dl was achieved in about 23% of patients, and in general, women were less cardio-protected by drugs than men.

Conclusions

Many patients with established cardiovascular disease who attended in general practice still fail to achieve the lifestyle, risk factor, and therapeutic targets set by European guidelines. These results are relevant to general practitioners because these patients have a high risk of subsequent cardiovascular events, including MI, stroke, and death.
Mycobacterium arosiense, an unexpected cause of osteomyelitis in a patient with sarcoidosis: a case report
Authors: Bang Didi , Rasmussen Erik Michael , Andersen Aase Bengaard
Published: November 2019

Background

Nontuberculous mycobacteria belonging to the Mycobacterium avium complex are recognized as opportunistic pathogens to humans. Mycobacterium arosiense is one of the novel members of the Mycobacterium avium complex. The organism has only rarely been reported in human clinical cases and may be routinely misidentified.

Case presentation

An adult male with a history of a discus prolapse and sarcoidosis presented with high fever and a strong back pain with projection to the extremities. A Magnetic Resonance Imaging scan of columna revealed a tumor suspect process at thoracic vertebrae 11/12 with changes at the second lumbar vertebra, which was partly removed by laminectomy. Biopsy smears revealed acid-fast bacilli and turned out to be Mycobacterium tuberculosis complex PCR negative. The routine line probe assay INNO-LiPa v2 (INNOGENETICS NV, Gent), which differentiates 16 mycobacterial species indicated the presence of a not readily identifiable NTM species. Whereas, the GenoType Mycobacterium CM v2.0 (HAIN Lifescience GmbH) that routinely differentiates 14 clinically relevant mycobacteria revealed a Mycobacterium intracellulare species. However, additional diagnostic sequencing of the 16S rRNA gene confirmed the presence of a Mycobacterium arosiense species.

Conclusions

This is the second unusual case of osteomyelitis with clinical significance ever to be reported, caused by Mycobacterium arosiense and complicated by an underlying sarcoidosis. Mycobacterium arosiense has rarely been reported clinically and the first description of the species was identified as the cause of osteomyelitis in a child with a hereditary partial interferon gamma deficiency. Symptoms attributed to sarcoidosis waned on Mycobacterium arosiense treatment and it is inconclusive whether the patient ever suffered from sarcoidosis. Mycobacterium arosiense was misidentified by the GenoType as Mycobacterium intracellulare and implicates that the diagnosis requires supplemental sequencing of the 16S rRNA gene.
Correction to: Characteristics of residual lymph nodes after six months of antituberculous therapy in HIV-negative individuals with cervical tuberculous lymphadenitis
Authors: Seok Hyeri , Jeon Ji Hoon , Oh Kyung Ho , Choi Hee Kyoung , Choi Won Suk , Lee Young Hen , Seo Hyung Suk , Kwon Soon Young , Park Dae Won
Published: November 2019

After publication of the original article [1], we were notified that an author’s name has been incorrectly spelled. Soon You Kwon’s correct full name is Soon Young Kwon.
Three easily-implementable changes reduce median door-to-needle time for intravenous thrombolysis by 23 minutes
Authors: Tran Demi , Zhu Zhu , Shafie Mohammad , Abcede Hermelinda , Stradling Dana , Yu Wengui
Published: November 2019

Background

The benefit of intravenous thrombolysis (IVT) for acute ischemic stroke is time dependent. Despite great effort, the median door-to-needle time (DNT) was 60 min at the United States stroke centers. We investigated the effect of a simple quality improvement initiative on DNT for IVT.

Methods

This is a single-center study of patients treated with IVT between 2013 and 2017. A simple quality improvement initiative was implemented in January 2015 to allow the Stroke team to manage hypertension in the emergency room, to make decision for IVT before getting blood test results unless patients were taking oral anticoagulants, and to give IVT in the CT suite. Baseline characteristics, DNT and outcomes at hospital discharge were compared between pre- and post-intervention groups.

Results

Ninety and 136 patients were treated with IVT in pre- and post-intervention groups, respectively. The rate of IVT was significantly higher in the post-intervention group (20% vs. 14.4%, p = 0.007). The median DNT with interquartile range (IQR) was reduced significantly by 23 min (63[53–81] vs. 40[29–53], p < 0.001) with more patients in the post-intervention group receiving IVT within 60 min (81.6% vs. 46.7%) and 45 min (64.0% vs.17.8%). There was no significant difference in symptomatic intracerebral hemorrhage rate (1.5% vs. 1.1%), modified Rankin Scale 0–1 (29.4% vs. 23.3%), and hospital mortality (7.4% vs. 6.7%) between the 2 groups.

Conclusions

Three easily-implementable quality improvement initiative increases IVT rate and reduces DNT significantly without increasing the rate of IVT-related complications in our comprehensive stroke center.
β2AR-HIF-1α-CXCL12 signaling of osteoblasts activated by isoproterenol promotes migration and invasion of prostate cancer cells
Authors: Huang Zhibin , Li Guihuan , Zhang Zhishuai , Gu Ruonan , Wang Wenyang , Lai Xiaoju , Cui Zhong-Kai , Zeng Fangyin , Xu Shiyuan , Deng Fan
Published: November 2019

Background

Chronic stress is well known to promote tumor progression, however, little is known whether chronic stress-mediated regulation of osteoblasts contributes to the migration and invasion of metastatic cancer cells.

Methods

The proliferation, migration and invasion of prostate cancer cells were assessed by CCK-8 and transwell assay. HIF-1α expression of osteoblasts and epithelial-mesenchymal transition (EMT) markers of prostate cancer cells were examined by Western blot. The mRNA level of cytokines associated with bone metastasis in osteoblasts and EMT markers in PC-3 and DU145 cells were performed by qRT-PCR. Functional rescue experiment of cells were performed by using siRNA, plasmid transfection and inhibitor treatment.

Results

Isoproterenol (ISO), a pharmacological surrogate of sympathetic nerve activation induced by chronic stress, exhibited no direct effect on migration and invasion of PC-3 and DU145 prostate cancer cells. Whereas, osteoblasts pretreated with ISO promoted EMT, migration and invasion of PC-3 and DU145 cells, which could be inhibited by β2AR inhibitor. Mechanistically, ISO increased the secretion of CXCL12 via the β2AR-HIF-1α signaling in osteoblasts. Moreover, overexpression of HIF-1α osteoblasts promoted migration and invasion of PC-3 and DU145 cells, which was inhibited by addition of recombinant knockdown of CXCR4 in PC-3 and DU145 cells, and inhibiting CXCL12-CXCR4 signaling with LY2510924 blunted the effects of osteoblasts in response to ISO on EMT and migration as well as invasion of PC-3 and DU145 cells.

Conclusions

These findings demonstrated that β2AR-HIF-1α-CXCL12 signaling in osteoblasts facilitates migration and invasion as well as EMT of prostate cancer cells, and may play a potential role in affecting bone metastasis of prostate cancer.