bluuebunny/crossref_metadata_2025 huggingface dataset:
Public financial management reform: an ongoing journey towards good governance
Authors: Alkaraan Fadi
Published: October 2018

Purpose

This paper aims to provide a better understanding of the influence of contextual factors on public financial management reform (PFMR) process. It provides a comprehensive analytical view of PFMR in the UAE over the period (2003-2016).

Design/methodology/approach

The paper is based on a case study approach as a research methodology. It draws on archival data as well as interviews with key staff of the Ministry of Finance (MoF). A contingency model is used as conceptual framework to examine PFMR in the UAE.

Findings

Finding of this study show that the PFMR process cannot be viewed as an isolated initiative, rather, as part of a set of broader NPM reforms to strengthen public accountability for performance. The transition process creates major organisational changes; strategy, structure (new rules and roles), culture (core values about organisational vision, mission, and objectives). Benchmarks and milestones have been set in the accompanying monitoring matrix, though in practice, delays have typically occurred in the implementation of reforms. Challenges ahead facing the MoF are addressed.

Research limitations/implications

The findings should be understood in the economic, social and historical contexts of the UAE. Given the narrow scope of this paper, a single case study was conducted. Crucial themes for future research including how public sector executives employ effective independent measures of outcomes. The impact of basic supporting subsystems in translating strategic priorities and integrating them into the federal budget.

Practical implications

Research on PFMR is inherently practical. Essential factors for successful implantation of PFMR include government strategy, regulatory framework, information communication technology, technical experience, strong leadership, long-term political and administrative commitments, strategic pre-decision control mechanisms and accurate performance measurement.

Originality/value

This paper contributes to the limited studies on PFMR in Middle East and North Africa (MENA) countries. Lessons of this study may be valid for other countries considering similar developments in their PFMR.
Significance of race in the US undergraduate public relations educational landscape
Authors: Waymer Damion , Brown Kenon A.
Published: October 2018

Purpose

The purpose of this study is to address a practical question and problem: what can explain the small number of underrepresented racial and ethnic practitioners in the public relations industry? By placing race at the center of this study via critical race theory, the authors sought to answer the previously mentioned practical question. The authors focused on the undergraduate environment as a pipeline to the profession. The goal was to determine whether issues of race in the undergraduate public relations environment played a role in students’ ability to succeed in their public relations coursework and in their ability to secure internships, network with professionals, etc.

Design/methodology/approach

The authors interviewed 22 practitioners with five or fewer years of industry experience. The authors used email interviews to gather data from young professionals. Although email interviews are impersonal in nature, because of a lack of the use of social cues and non-verbal communication (Hunt & McHale, 2007), email interviews are more cost-effective, expand the range of participants that one could interview, and this method allows participants to reflect longer on their answers, which could result in more detail – whereby participants might share information they would not normally share face-to-face.

Findings

The findings reveal that half of the Latina, African American and Asian American participants noted that being underrepresented was not necessarily a hindrance to their academic success; rather, being underrepresented was uncomfortable for them at times, as they believed they had to prove themselves more than whites. Additional findings reveal that in terms of developing social skills for the profession, participants did not experience negative or positive effects of race. Findings are used to gain insight into how to increase diversity in the profession and to gauge the extent to which racial identity plays a role in public relations students’ collegiate development.

Originality/value

This study asks racially and ethnically underrepresented applied communication students to reflect on their experiences as undergraduates as a means of refining the undergraduate educational experience to make that experience more attractive for and conducive to academic success for current and future underrepresented applied communication undergraduate students. It's a first of its kind in that regard.
Stigma towards individuals who self harm: impact of gender and disclosure
Authors: Lloyd Brendan , Blazely Alexandra , Phillips Lisa
Published: October 2018

Purpose

Non-suicidal self-injury (NSSI) is reasonably common, particularly among young people with prevalence rates of up to 25 per cent reported. Many factors contribute towards NSSI, including depression, anxiety and history of abuse and NSSI is a risk factor for suicide. Many people who engage in NSSI do not seek help, potentially due to concern about sigmatising attitudes. The purpose of this paper is to investigate the impact of gender and disclosure on stigmatising attitudes towards individuals who engage in NSSI.

Design/methodology/approach

Participants were 384 first-year university students (77.4 per cent female; mean age 19.50 years (SD=3.53)) who completed measures of stigmatising attitudes in response to vignettes featuring individuals who engaged in self-harming behaviour. Vignettes varied in the gender of the individual as well as whether the NSSI was disclosed or not.

Findings

The results support the attribution model of public discrimination in relation to NSSI stigma. Perceptions of higher personal responsibility for NSSI behaviour and higher levels of danger and manipulation were positively associated with stigmatizing attitudes and behaviours. Male research participants reported significantly higher levels of stigmatizing attitudes and behaviours than females.

Social implications

The level of stigmatising attitudes towards individuals who engage in NSSI is significant and may impact on help-seeking behaviour.

Originality/value

Between 10 and 25 per cent of adolescents engage in some form of NSSI, but only a minority seek help to address this behaviour. This study suggests that attitudes by peers may influence help-seeking. Further research is required outside of tertiary education settings.
Acceleration of mackerel fish sauce fermentation via bromelain addition
Authors: Rabie Mohamed A. , Namir Mohammad , Rabie Nourhan A. , Hassanien Mohamed Fawzy Ramadan
Published: October 2018

Purpose

The purpose of this study was to accelerate the fermentation process of minced mackerel fish (Scomber scombrusL.) mixed thoroughly with 20 per cent salt (w/w) and hydrolyzed by 0.2 and 0.4 per cent bromelain at 37°C.

Design/methodology/approach

S. scombrusL. was mixed thoroughly with 20 per cent salt (w/w) and hydrolyzed by the bromelain at levels of 0.2 and 0.4 per cent at 37°C. The physicochemical and sensory properties were evaluated after 60 and 90 days.

Findings

In a comparison of all of the aforementioned treatments, the results showed that the samples with higher bromelain levels (0.4 per cent) had higher concentrations of formal nitrogen (622 mg/100 mL) and total volatile base nitrogen (TVB-N, 0.3 g/dL) after 90 days of fermentation (p <0.01) . The sample with 0.4 per cent bromelain showed total free amino acids content of 13.3 g/100 g after 90 days of fermentation (p <0.01). High levels of total fatty acids (15.6 mg/100 g) were found in samples treated with 0.4 per cent bromelain and allowed to ferment for 90 days (p <0.01). The sauce colour became significantly highly saturated (p <0.01) with the increase in fermentation time. Chroma was significantly increased by 44 and 66 per cent in fermented sauce samples with 0.2 and 0.4 per cent bromelain during fermentation for as long as 90 days (p <0.01). Moreover, the addition of bromelain (0.4 per cent) resulted in mackerel fish sauce that was organoleptically preferred at the end of fermentation.

Originality/value

The results showed that an acceptable fish sauce could be produced from mackerel fish with supplementation with 0.4 per cent of bromelain, which reduced the fermentation time to 90 days and resulted in the most satisfactory results without compromising the product quality.
Patrol career interest and perceptions of barriers among African-American criminal justice students
Authors: Rossler Michael T. , Scheer Charles , Suttmoeller Michael J.
Published: October 2018

Purpose

The purpose of this paper is to evaluate whether black and African-American criminal justice students perceive barriers to a police patrol career differently than white students, and whether the perceptions of these barriers impact desire to enter a police patrol career.

Design/methodology/approach

The current inquiry uses a self-administered survey of over 630 undergraduate students in criminal justice classes across five public universities.

Findings

Findings suggest that African-American students differ significantly from white students in perceived social disapproval of patrol careers, respect for police and perceptions of whether the police engage in racial profiling. These perceptions display a significant indirect relationship indicating lower patrol career interest for black and African-American students compared to all other races.

Research limitations/implications

Research limitations of the current inquiry include the lack of a nationally representative sample, the use of four-year university students as a sample to represent the potential police patrol applicant pool, and the use of a survey instrument to gauge respondent beliefs about patrol careers as opposed to actions they would take in pursuit of a police career.

Practical implications

Findings from the current inquiry indicate that departments may need to focus more on improving global perceptions of the police and discussing the nature of the career with recruit social support structures. Police recruiters should focus on techniques such as addressing social isolation experienced by the police rather than on decreasing standards for background checks or simply increasing awareness of police careers.

Originality/value

The current inquiry is one of the first to explore perceptions of barriers to entering a patrol career among CJ students. It is also among the first to examine the impact these perceptions have on patrol career interest. The findings may also help criminal justice instructors more fully discuss these barriers with students of color.
Composing identities: using digital documentary shorts to explore social issues
Authors: Pytash Kristine , Hawley Todd , Morgan Kate
Published: October 2018

Purpose

The purpose of this paper is to explore the potential of using digital shorts (Pytash et al., 2017) focusing on social issues in social studies classrooms.

Design/methodology/approach

Qualitative case study is used in this study.

Findings

Digital shorts focused on important social issues, and included their beliefs and perspectives about their social issue, as well as insights into their developing identities as citizens. The authors’ findings demonstrate how this assignment can be the gateway for discussions regarding social issues, how students perceive their identities tied to contemporary social issues, and how they make sense of these issues within multimodal compositions.

Research limitations/implications

The findings from this research have implications for researching the effectiveness of digital media production analysis for students’ learning of social issues.

Practical implications

The findings from this research have implications for exploring how digital media production analysis can be incorporated into social studies courses.

Originality/value

Although the push for social studies teachers to provide spaces for students to demonstrate these capacities, few examples exist in the literature.
Is the free press free? Using truth claims to examine fake news
Authors: Clabough Jeremiah , Pearcy Mark
Published: October 2018

Purpose

The purpose of this paper is to discuss the relationship dynamics between the executive office and the free press; and how these dynamics have been altered under the Trump administration. Donald Trump has questioned the validity and accuracy of claims, even going as far to call some organizations (CNN and The New York Times) “fake news.” The authors discuss the historically contentious relationship between the executive office and the free press as well as the ways in which Donald Trump has altered the dynamics of this relationship.

Design/methodology/approach

In this paper, the authors explore the role of the free press in American politics. The authors designed two classroom-ready activities by drawing on the best teaching practices advocated for in the C3 Framework. To elaborate, both activities allow students to research and analyze arguments made by Donald Trump and challenge false claims. This enables students to engage in the four dimensions of the Inquiry Arc in the C3 Framework.

Findings

The authors provide two activities that can be utilized in the high school social studies classroom to enable students to dissect American politicians’ messages. These two activities can be adapted and utilized to enable students to examine political candidate’s messages. By completing the steps of these two activities, students are better prepared to be critical consumers of political media messages and take civic action to challenge false claims.

Originality/value

Donald Trump has attempted to undermine the free press in the USA. He objects to stories that do not paint his administration in a positive light. This manuscript uses the media literacy position statement from NCSS and Ochoa-Becker’s framework for truth claims to explore Trump’s statements and claims.
Social studies teacher educators who do race work
Authors: Demoiny Sara B.
Published: October 2018

Purpose

The purpose of this paper is to explore how 11 social studies teacher educators (SSTEs) incorporated race into their social studies methods courses. It examines the instructional practices of the SSTEs using racial-pedagogical-content-knowledge (RPCK) as an analytical framework.

Design/methodology/approach

The paper is a qualitative interview study. The data sources included two 40–90 min semi-structured interviews per participant, methods course syllabi and reading lists, and university documents such as departmental mission statements and program course requirements. Data were analyzed using three cycles of coding: descriptive coding, focused coding and analytic generalizations.

Findings

The paper illustrates how the SSTEs incorporated race into their social studies methods courses through developing counter-narrative content knowledge, modeling the application of critical race theory tenets through pedagogical content knowledge, and cultivating a working racial knowledge among pre-service teachers.

Originality/value

This paper extends the literature of the RPCK framework through illustrating many ways each component of RPCK can be applied within a social studies methods course.
Martin’s Big Words: The Life of Dr Martin Luther King, Jr Lesson
Authors: Miller KayLaura , Hubbard Janie
Published: October 2018

Purpose

Martin’s Big Words: The Life of Dr Martin Luther King, Jr is a timeless book well-known among K-6 teachers, students, librarians and book-lovers throughout the USA. This multi-award winning picture book provides readers with insight into Dr Martin Luther King Jr’s life and the oppression and progress of African Americans before and during an era known as the modern US Civil Rights Movement (CRM). The biography outlines the period’s equity issues, and serves as a springboard for this upper elementary lesson. While Dr King played an iconic role, there were many other individuals involved in the CRM, most of whom students do not know. The purpose of this paper is to offer varying perspectives related to lesser known CRM leaders, protesters, advocates, perpetrators and bystanders.

Design/methodology/approach

Technology is incorporated through online research, videos and productions; thus, students actively engage in making connections to various individuals’ points of view, those both supportive and oppositional. Students conduct research while responding to higher-order, critical-thinking questions regarding groups and forces of the CRM. Then, they expand knowledge through jigsaw research activities by collecting information, responding to inquiry questions and presenting relevant evidence-based information about CRM contributors, perpetrators and bystanders.

Findings

This is a National Council for the Social Studies (NCSS) Notable Tradebook Lesson Plan.

Originality/value

This is a NCSS Notable Tradebook Lesson Plan.
Association between nutrient patterns and serum lipids in Chinese adult women: A cross‐sectional study
Authors: Zhang Jian , Tan Shengjie , Zhao Ai , Wang Meichen , Wang Peiyu , Zhang Yumei
Published: October 2018

Aim

To investigate the association between patterns of nutrient intake and serum lipids in Chinese women aged 18–80 years.

Methods

In the present study, cross‐sectional data were analysed from 2886 female participants aged 18–80 years from the China Health and Nutrition Survey wave 2009. Nutrient patterns were identified using factor analysis combined with cluster analysis based on the data of nutrient intake for three consecutive days. Multivariate linear regression models were used to estimate the association of nutrient patterns with serum lipids.

Results

Four nutrient patterns were identified in Chinese adult women, which were the plant‐based pattern, carbohydrate and animal fat pattern, plant fat and sodium pattern, and the animal‐based pattern. Participants following different patterns varied significantly in sociodemographic characteristics, lifestyle behaviours and food consumption. Compared with the plant‐based pattern, the carbohydrate and animal fat pattern was positively associated with low‐density lipoprotein cholesterol (β = 4.57, 95% CI: 0.29–8.85, P = 0.036) and total cholesterol (β = 4.89, 95% CI: 0.34–9.44, P = 0.035). The corresponding rises for the animal‐based pattern were 4.91 (95% CI: 0.99–8.82, P = 0.014) and 4.98 (95% CI: 0.82–9.15, P = 0.019), respectively.

Conclusions

Nutrient patterns with a high intake of animal fat and a low intake dietary fibre and with high intakes of animal fat, animal protein and cholesterol may increase the serum cholesterol in Chinese women.
Scientific Evidence on Functional Food and Its Commercial Communication: A Review of Legislation in Europe and the USA
Authors: González‐Díaz Cristina , Gil‐González Diana , Álvarez‐Dardet Carlos
Published: October 2018

This study aims at understanding how scientific evidence to substantiate nutrition and health claims in food commercial communication is regulated in Europe and the USA. A literature review was performed on the scientific evidence required by the European Food Safety Authority and the US Food and Drug Administration to substantiate food nutrition and health claims. Studies published in Scopus, Medline, Scirus, and Google Scholar from 2007 to 2012 were reviewed as well as documents released by both agencies. A total of 38 documents met our inclusion criteria out of 743 documents initially identified during our search. These agencies provide general guidelines on how to conduct food and health studies, intended to demonstrate a cause‐and‐effect relationship between a given food and a benefit to health. Despite this, they need to broaden the depth and scope of the guidelines provided to companies seeking to substantiate their claims and to provide further and more precise information concerning the evaluation of studies and application processes. No review has hitherto specifically focused on the subject of scientific evidence required by EU and US food agencies to substantiate health claims. This research thus leads to significant recommendations on how to improve current food industry guides.
‘Our late most excellent viceroy’: Irish Responses to the Death of the Duke of Rutland in 1787
Authors: Wilson Rachel
Published: October 2018

On 24 October 1787 Ireland's lord lieutenant, Charles Manners, fourth duke of Rutland, died. This article examines the reaction of the Irish to his loss and the ways in which they treated his body and memory. It reveals that his funeral procession mimicked and even surpassed those staged in London to mark royal deaths, yet retained an unmistakably Irish tone. This send‐off was inspired by three factors: affection for Rutland, national vanity and self‐esteem, and the political climate of the time, which prompted some to emphasise their loyalty to the British regime and others to promote Irish patriotism and independence.
Effectiveness and safety of hydroxychloroquine therapy with or without corticosteroid in patients with systemic lupus erythematosus
Authors: Miyagawa Ippei , Nakano Kazuhisa , Nakayamada Shingo , Iwata Shigeru , Hanami Kentaro , Fukuyo Shunsuke , Kubo Satoshi , Inoue Yoshino , Ueno Masanobu , Tanaka Yoshiya
Published: October 2018

Aim

The effectiveness and safety of hydroxychloroquine (HCQ) have not been fully validated in Japanese patients with systemic lupus erythematosus (SLE) in the clinical setting. This study evaluated the short‐term effectiveness and continuation rate of HCQ therapy in Japanese patients with SLE in the clinical setting for 12 months.

Methods

The primary endpoint was defined as the continuation rate up to 12 months after the introduction of HCQ in 122 patients with SLE. The secondary endpoints included changes in the SLE Disease Activity Index (SLEDAI) and the British Isles Lupus Assessment Group (BILAG) index, and the effect on concomitant corticosteroid (CS) dose reduction.

Results

The primary endpoint, continuation rate up to 12 months after the introduction of HCQ, was 79.5%. Of 25 patients who discontinued HCQ, 23 patients terminated the therapy within 2 months. The secondary endpoints (SLEDAI, BILAG index, and concomitant CS dose [mg/day, prednisolone equivalent]) all showed a significant decrease. SLEDAI and BILAG index scores indicated significant improvement during the remission induction phase, maintenance phase, and HCQ monotherapy phase.

Conclusions

The results of this study suggested that, with attention paid to possible adverse events immediately after initiation, HCQ may be initiated as a mainstay of SLE therapy in Japanese patients, either as a concomitant medication in the remission induction phase, as a maintenance therapy, or as a monotherapy.
Prevalence and predictive value of high‐positive rheumatoid factor and anti‐citrullinated protein antibody levels in nonarthritic patients with chronic hepatitis C infection
Authors: Lin Ko‐Ming , Chen Wei‐Ming , Tung Shui‐Yi , Wei Kuo‐Liang , Shen Chein‐Heng , Chang Te‐Sheng , Chang Pey‐Jium
Published: October 2018

Aim

In order to increase diagnostic sensitivity for early disease in rheumatoid arthritis (RA), new classification criteria were approved in 2010 by the American College of Rheumatology and the European League Against Rheumatism. One of the criteria, a high‐positive rheumatoid factor (RF) or anti‐citrullinated protein antibody (ACPA) level, was given a high score of 3. However, the increased prevalence of RF in patients with chronic hepatitis C virus (HCV) infection markedly diminishes the diagnostic specificity of serum RF for RA in these patients. There are no published data on the prevalence and predictive value of high‐positive RF and ACPA; thus, we investigated high‐positive RF and ACPA levels in nonarthritic patients with chronic HCV infection.

Method

Anti‐citrullinated protein antibody and total RF were determined in serum from nonarthritic patients with chronic HCV infection (all had HCV RNA viremia).

Result

In 271 HCV‐infected patients, positive RF, positive ACPA, high‐positive RF, and high‐positive ACPA were detectable in 47.2%, 1.1%, 8.9% and 1.1%, respectively. In these patients, fatty liver was an independent factor for high‐positive RF.

Conclusion

In contrast to RF, ACPA is not increased in HCV infection. High‐positive RF is not unusually present in nonarthritic patients with chronic HCV infection. ACPA may have improved value for the diagnosis of RA in this patient population. In patients with HCV infection, fatty liver may be a risk factor for high‐positive RF.
Influence of total glucosides of paeony on PD‐1/PD‐L1 expression in primary Sjögren's syndrome
Authors: Chen Yueyue , Wang Yue , Xu Lei , Zhu Weina , Xu Changsong , Xu Meimei , Guo Liang , Hu Wei , Xu Dake , Jing Rongyue , Zhu Yamei , He Jing , Xu Bo
Published: October 2018

Aim

To study the influence of total glucosides of paeony (TGP) on the expression of peripheral blood programmed cell death protein 1 (PD‐1) and its ligand (PD‐L1) in patients with primary Sjögren's syndrome (pSS).

Method

Ten patients with new‐onset pSS were selected as the experimental group and were treated with 1.8 g of TGP (the main ingredient is Radix Paeoniae Alba) daily for 3 months; furthermore, 10 physically healthy individuals were selected as the control group. Peripheral blood mononuclear cells were isolated, and flow cytometry was used to detect PD‐1 expression on the surface of CD4+ T and CD8+ T lymphocytes and PD‐L1 expression on the surface of CD14+ monocytes and CD19+ B cells before and after treatment in the experimental and control groups. Furthermore, plasma levels of soluble PD‐1 (sPD‐1), interleukin (IL)‐10, and IL‐17A were also determined using enzyme‐linked immunosorbent assay.

Results

The PD‐1 expression on the surface of CD4+ T and CD8+ T lymphocytes in the peripheral blood of patients with pSS were significantly higher than in the control group (P < 0.001). However, PD‐L1 expression on the surface of CD14+ monocytes declined but not significantly (P > 0.05), and PD‐L1 expression on the surface of CD19+ B cells increased significantly (P < 0.001). Moreover, sPD‐1 and IL‐17A levels in the plasma of the experimental group were significantly higher than in the control group (P < 0.001), but the IL‐10 level was significantly lower than in the control group (P < 0.001). After TGP treatment, PD‐1 expression on the surface of CD4+ T and CD8+ lymphocytes in the peripheral blood of patients with pSS had decreased significantly (P < 0.001); the PD‐L1 expression on the surface of CD19+ cells had decreased significantly (P < 0.001); and the PD‐L1 expression on the surface of CD14+ monocytes did not differ significantly (P > 0.05). Furthermore, the levels of sPD‐1 and IL‐17A in plasma had decreased (P < 0.01) and IL‐10 levels had increased after TGP treatment (P < 0.01).

Conclusion

PD‐1/PD‐L1 molecules expressed on the surface of T cells, B cells, and monokaryon participated in the pathogenesis and development of SS through interactions. Therefore, TGP, which may increase the expression of PD‐1 and its relevant ligand PD‐L1 in the peripheral blood mononuclear cells, may play a role in the pathogenesis and development of SS through the PD‐1/PD‐L1 pathway by regulating regulatory T cells/T helper cell 17.
Risk of incident gout in kidney transplant recipients: A retrospective cohort study
Authors: Simbolon Fransiska Romana , Lee Su‐Shin , Tsai Yi‐Chun , Tsai Wen‐Chan , Lin Gau‐Tyan , Tung Yi‐Ching , Tu Hung‐Pin
Published: October 2018

Aim

Gout is a common complication in kidney transplant recipients. This study evaluated the association between kidney transplant recipients and the long‐term risk of incident gout.

Method

For this age‐matched and sex‐matched retrospective cohort study, the Catastrophic Illness Certificate Database and the National Health Insurance Research Database were combined between 1997 and 2010. The study included 5917 patients with kidney transplants and 23 668 matched kidney transplant‐free subjects. Hazard ratio (HR) for risk of incident gout was calculated using the Cox proportional hazards regression.

Results

In this study, of the 5917 kidney transplant recipients, 521 (8.8%) had gout. The kidney transplant group had a higher risk of incident gout than those in the matched kidney transplant‐free group (adjusted HR = 1.55, 95% confidence intervals [CI] = 1.36‐1.77), particularly within 3 years following kidney transplant recipients (adjusted HR = 2.61, 95% CI = 2.13‐3.20). We observed that at the >3 to 6 years and the >6 to 9 years follow‐up, patients with kidney transplant did not have a significant association with risk of incident gout (adjusted HR = 0.92, P = 0.4806 and adjusted HR = 1.26, P = 0.1901, respectively).

Conclusion

These findings revealed that risk of incident gout increased within 3 years following kidney transplant recipients and the individual's long‐term risk of incident gout between kidney transplant recipients and the general population remained similar.
Target setting for lower limb joint surgery using the Timed Up and Go test in patients with rheumatoid arthritis: A prospective cohort study
Authors: Kojima Toshihisa , Ishikawa Hajime , Tanaka Sakae , Haga Nobuhiko , Nishida Keiichiro , Yukioka Masao , Hashimoto Jun , Miyahara Hisaaki , Niki Yasuo , Kimura Tomoatsu , Oda Hiromi , Asai Shuji , Funahashi Koji , Kojima Masayo , Ishiguro Naoki
Published: October 2018

Objective

This prospective observational cohort study aimed to set targets for lower limb joint surgery based on the Timed Up and Go test (TUG), an objective functional outcome measure, in patients with established rheumatoid arthritis (RA).

Methods

We validated TUG as an outcome measure of lower limb joint surgery and compared it with changes in patient‐reported outcomes, including the Health Assessment Questionnaire Disability Index (HAQ‐DI) and European Quality of life scale with five dimensions (EQ‐5D). Changes in these outcomes were compared by performed surgery and by achievement of the minimal clinically important difference (MCID) for EQ‐5D using univariate analysis of variance. Associations between TUG and HAQ remission (HAQ‐DI ≤0.5) were determined using logistic regression analysis. Cut‐off values of TUG at baseline and 6 months after surgery for HAQ remission were determined using receiver operating characteristic curves.

Results

A total of 126 patients were analyzed. Mean age, HAQ‐DI, and TUG were 65.4 years, 1.036, and 12.8 seconds, respectively. After surgery, patients showed improvements in TUG as well as HAQ‐DI. TUG at 6 months after surgery was significantly associated with HAQ remission (adjusted OR: 0.78; 95% CI: 0.65‐0.93). TUG cut‐off values at baseline and 6 months after surgery for achieving HAQ remission were 12.1 and 8.8 seconds, respectively. Significant improvements in TUG (∆TUG, 3.7 seconds) were associated with achievement of the MCID for EQ‐5D (≥0.05) at 6 months after surgery.

Conclusion

Timed Up and Go test is a useful tool for assessing the outcome of lower limb joint surgery in RA patients. We propose that TUG ≤9 seconds could be an objective target for achieving good physical function after lower limb joint surgery.
Burden and depression in caregivers of patients with rheumatoid arthritis in China
Authors: Ru Jinli , Ma Jing , Niu Hongqing , Chen Ying , Li Li , Liu Yanqiong , Li Xuxu , Lian Fengping , Wang Xiuli
Published: October 2018

Aim

Caregivers of patients with rheumatoid arthritis (RA) often experience a sense of burden and depression. This study aimed to determine the degree of burden and depression on caregivers of RA patients and identify characteristics of both patients and caregivers that may contribute to that distress.

Methods

A convenience sample of 195 patients with RA and their caregivers completed a demographic questionnaire, Zarit Care Burden Scale, Center Depression Self Rating Scale, Health Assessment Questionnaire Disability Index, and the Short Form Health Survey. Univariate and multivariate regression analysis were used to evaluate contributing factors.

Results

Overall, caregivers' feelings of burden and depression were moderate, with 52 (26.7%) feeling depression and 156 (80%) feeling burdened. Caregivers with poorer health (OR = 4.393; 95% CI = 1.155‐16.708; P = 0.030) and less education (OR = 6.458; 95% CI = 1.675‐24.895; P = 0.007) experienced greater burdens than those with better health and more education. The greatest degree of stress occurred during the first 6 months of providing care and after 5 years of caregiving.

Conclusions

Overall occurrence of depression among caregivers is low. Caregivers with poorer health, less education and closer relationship with the patient bear a heavier burden. Healthcare professionals should be aware of these potential problems and provide information and support to ensure the best quality of life for both RA patients and their caregivers.
Is granulomatosis with polyangiitis in Asia different from the West?
Authors: Naidu Godasi S. R. S. N. K. , Misra Durga Prasanna , Rathi Manish , Sharma Aman
Published: October 2018

The incidence and clinical features of antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV) have been shown to vary according to geographical areas, with granulomatosis with polyangiitis (GPA) being more common in northern Europe and microscopic polyangiitis (MPA) being more common in Asian countries. The annual incidence of GPA among Asians varies between 0.37/million to 2.1/million population. The prevalence of GPA has been estimated to be 1.94/100 000 in a Chinese population. Polymorphisms in class II major histocompatibility genes and ETS1 proto‐oncogene has been shown in Asian patients with GPA. There is a difference in mean age at onset and proteinase 3 (PR3) or myeloperoxidase (MPO) positivity in GPA patients from different Asian countries. Those from India had mean age of 40 years and those from Japan had mean age of 65 years. Sixty percent of GPA patients from China and Japan were MPO ANCA positive while the majority of patients from India and Korea were PR3 positive. Geographical variation with lower frequency of renal involvement in Indian studies and higher frequency in Chinese patients has also been noted. Treatment outcomes have been similar to those reported from other parts of the world. Remission was achieved in about two‐thirds of patients while relapses were noted in one‐third to half of the patients. Apart from minor differences in the organ systems involved, MPO‐ANCA GPA and PR3‐ANCA GPA had similar rates of remission and relapses.
Impact of subclinical synovitis in ankles and feet detected by ultrasonography in patients with rheumatoid arthritis
Authors: Inamo Jun , Kaneko Yuko , Sakata Komei , Takeuchi Tsutomu
Published: October 2018

Objective

To investigate the impact of subclinical synovitis detected by ultrasonography (US) on the ankles and feet of patients with rheumatoid arthritis.

Methods

We retrospectively reviewed the data of patients (n = 59) who underwent US.

Results

The functional ability and quality of life (QoL) of patients in the subclinical group were impaired. While the physician visual analog scale (VAS) scores significantly decreased in the subclinical group, patient and pain VAS scores significantly decreased only in patients without synovitis.

Conclusion

US‐detected subclinical foot and ankle synovitis considerably affected patient functional status and QoL; however, it was often unnoticed by physicians.
Relationship between neutrophil‐lymphocyte, platelet‐lymphocyte ratio and disease activity in rheumatoid arthritis treated with rituximab
Authors: Sargin Gokhan , Senturk Taskin , Yavasoglu Irfan , Kose Reyhan
Published: October 2018

Background

Neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) may be used as indicators of inflammatory markers and disease activity due to inflammatory changes in neutrophils, platelets and lymphocytes. Our aim is to investigate the relationship between NLR, PLR ratio and disease activity in RA patients treated with rituximab.

Methods

Thirty‐eight patients (8 male, 30 female, mean age 56.8 ± 11.8 years) diagnosed with RA and 30 healthy controls were included in the study. Disease Activity Score of 28 joints ‐ erythrocyte sedimentation rate (DAS28‐ESR), lymphocyte, neutrophil, platelet counts, ESR, C‐reactive protein (CRP), PLR, and NLR were evaluated before and after rituximab in RA patients. The relationship between all parameters was assessed by Pearson's correlation, Wilcoxon signed‐rank, Mann‐Whitney U and paired t tests.

Results

The levels of CRP, ESR, and DAS28‐ESR decreased significantly at 6 months of rituximab treatment compared to pre‐treatment. NLR and PLR ratios were higher in patients with RA than the control group. The median levels were 33.5 mm/hour, 5.7 mg/dL, and 3.7 respectively after 6 months of rituximab treatment. And, the levels were lower than baseline treatment. There was a significant correlation between the levels of DAS28‐ESR and NLR, DAS28‐ESR and PLR before and after treatment.

Conclusions

The NLR and PLR were higher than healthy controls and correlated with DAS28‐ESR in patients with RA. These parameters which are indicative of disease activity decrease with rituximab and correlate with disease activity at 6 months. The NLR and PLR may be useful indices to evaluate RA disease activity treated with rituximab.
Incidence and risk factors for reactivation from resolved hepatitis B virus in rheumatoid arthritis patients treated with biological disease‐modifying antirheumatic drugs
Authors: Watanabe Toshiyuki , Fukae Jun , Fukaya Shinji , Sawamukai Norifumi , Isobe Masato , Matsuhashi Megumi , Shimizu Masato , Akikawa Kazumasa , Tanimura Kazuhide , Atsumi Tatsuya , Koike Takao
Published: October 2018

Aim

To identify the incidence and risk factors for hepatitis B virus (HBV) reactivation in rheumatoid arthritis (RA) patients with resolved HBV receiving biological disease‐modifying antirheumatic drugs (bDMARDs).

Method

Rheumatoid arthritis patients in whom bDMARD therapy was initiated in our departments from April 2009 to July 2016 were reviewed. The patients diagnosed with resolved HBV and whose HBV‐DNA levels had been repeatedly measured were enrolled. The endpoint was HBV reactivation (a positive conversion of HBV‐DNA or unquantifiable cases with positivity <20 IU/mL). Nucleic acid analogues (NAAs) were administered when the HBV‐DNA levels increased beyond 20 IU/mL. The associations between HBV reactivation and the clinical findings were retrospectively analyzed.

Results

One hundred and fifty‐two RA patients with resolved HBV were enrolled; 133 (88%) patients had antibodies against HBV surface antigen (anti‐HBs). The medicines that were administered included: abatacept (n = 29), golimumab (n = 26), etanercept (n = 25), tocilizumab (n = 25), adalimumab (n = 19), infliximab (n = 17) and certolizumab pegol (n = 11). During the observation period (15 [interquartile range 4.0‐34] months), 7 (4.6%) patients developed HBV reactivation. In 5 of these patients, the HBV‐DNA levels became negative or remained at <20 IU/mL (+) without NAA therapy. HBV‐DNA levels of >20 IU/mL were observed in 2 patients but the HBV‐DNA levels became negative after NAA treatment. Patients who were negative for anti‐HBs showed a significantly higher incidence of HBV reactivation (P = 0.013).

Conclusion

HBV reactivation occurred in 4.6% of RA patients with resolved HBV during the treatment with bDMARDs and the absence of anti‐HBs may be a risk factor for the reactivation of resolved HBV.
Piezosurgical management of sealer extrusion‐associated mental nerve anaesthesia: A case report
Authors: Szalma József , Soós Balázs , Krajczár Károly , Lempel Edina
Published: October 2018

The present report describes a case where sealer extrusion (Sealapex) occurred during root canal obturation of a left lower second premolar tooth, and the patient experienced sudden pain and followed by complete anaesthesia of the lower lip. After 3 weeks of conservative therapy and an unaltered anaesthesia period, piezosurgical removal of the extruded sealer and root‐end resection was performed despite the direct contact with the mental neurovascular bundle. At suture removal, 1 week after surgery, there was no improvement in sensation. Two weeks after the operation, the patient reported some changes, including a short paraesthesia period alternating with anaesthesia. At the fourth post‐operative week, neurosensory function recovered completely. This case represents successful use of the piezoelectric technique for mental nerve decompression and periapical surgery of a lower second premolar with close contact of the mental nerve.
An assessment of endodontic treatment completion rate in a University‐based student clinic and the factors associated with incomplete treatment
Authors: Krishnan Unni , Huang Hejie Jessica , Moule Alex , Lalloo Ratilal
Published: October 2018

Incomplete endodontic treatment is potentially a public health issue. The aim of this retrospective study was to evaluate the endodontic treatment completion rate at a University student clinic and to identify the factors associated with completion rates. The records of all patients who commenced an endodontic treatment (code 415) from January 2015 to December 2015 were extracted. A total of 783 records were available for analysis of which 86% received complete endodontic treatment. Maxillary first molars were significantly associated with incomplete endodontic treatment (IET). Patients requiring an additional visit (code 455) were 1.5 times more likely to have an IET. The endodontic treatment completion rate at the School of Dentistry at the University of Queensland is higher than those reported in other international university‐based student clinics. Focus group surveys of students and supervisors are required to identify the reasons for higher IET with maxillary first molars and code 455.
The effect of bleaching agents on the compressive strength of calcium silicate‐based materials
Authors: Keskin Cangül , Sariyilmaz Evren , KeleŞ Ali
Published: October 2018

The present study aimed to evaluate the effect of sodium perborate on the compressive strength of calcium silicate‐based materials. ProRoot wMTA, MTA Plus, NeoMTA Plus and Biodentine discs with 5 mm thickness and 4 mm diameter were prepared. Thirty discs from each material were used for compressive strength testing and divided into two groups: control and bleaching (n = 15). The sodium perborate was mixed with 30% hydrogen peroxide in a creamy consistency and placed on the surface of the specimens. Specimens were tested in an Instron machine, and compressive strength values were recorded and compared. The data were analysed using one‐way anova and post hoc Tukey tests. Compressive strength of all tested materials significantly decreased after bleaching (P < 0.05). SEM examination revealed deterioration on materials’ surfaces after bleaching. Application of sodium perborate and hydrogen peroxide reduced the compressive strength of ProRoot wMTA, MTA Plus, NeoMTA Plus and Biodentine.
Endodontic management of a maxillary first molar with two palatal roots: A case report
Authors: Schryvers Alexander , Govaerts Dries , Politis Constantinus , Lambrechts Paul
Published: October 2018

This case report describes the endodontic treatment of a maxillary first molar with two palatal roots. Both of the palatal canals had separate canal orifices and separate foramina. A cone beam computed tomography scan was taken prior to treatment to visualise any abnormalities seen on a periapical radiograph. The shaping procedure of the root canal treatment was performed using reciprocating instruments. The obturation was performed using matched gutta percha points and a resin based sealer in a warm vertical compaction manner. Complete bone healing of the periapical area was visualised on intra‐oral radiographs taken one year after the treatment. No canals were unfilled nor untreated.
Genome‐wide identification of microRNAs in decidual natural killer cells from patients with unexplained recurrent spontaneous abortion
Authors: Li Dandan , Li Jian , Jia Bin , Wang Yue , Zhang Juxin , Liu Guangzhi
Published: October 2018

Problem

This study revealed miRNA regulation and functional microarray‐based profiles of miRNAs in the natural killer (NK) cells of the decidual tissue obtained from patients with unexplained recurrent spontaneous abortion (URSA).

Method of Study

Patients with URSA were categorized based on the occurrence of at least two or more successive spontaneous abortions between 7th and 10th gestational week. Total RNA was isolated from the NK cells of the decidual tissue obtained from patients with induced abortion at about the 8th gestational week. The potential contribution of regulatory miRNAs to a genetic predisposition to URSA was characterized by comparison with healthy and fertile controls and bioinformatics analyses.

Results

Analysis of the miRNA expression profiles identified 50 miRNAs that were differentially expressed, including one down‐regulated and 49 up‐regulated miRNAs in the URSA group. MiRNA‐Gene‐Network, miRNA‐GO‐Network and miRNA‐Gene‐TF‐Network were constructed. The key miRNAs, genes, GOs and core TFs in the network were determined.

Conclusion

Our results suggest that a close relationship exists between the aberrant miRNAs and URSA. Furthermore, these findings support the notion that altered expression of miRNAs may contribute to the clinical diagnosis of URSA and the potential to develop novel strategies for therapeutic targets against URSA.
Physical activity and eye diseases. The Beijing Eye Study
Authors: Wang Ya Xing , Wei Wen Bin , Xu Liang , Jonas Jost B.
Published: October 2018

Purpose

To assess associations between the amount of physical activity and the prevalence of ocular diseases.

Methods

The participants of the population‐based Beijing Eye Study underwent a detailed ophthalmological examination and an interview. Physical activity was assessed in a standardized questionnaire.

Results

Out of 3468 study participants, information on their physical activity was available for 3031 (87.4%) individuals (age: 64.6 ± 9.7 years; range: 50–93 years). In multivariate analysis (regression coefficient r: 0.41), higher physical activity was associated with a lower prevalence of diabetic retinopathy [p = 0.009; standardized regression coefficient beta: −0.05; non‐standardized regression coefficient B: −15.7; 95% confidence interval (CI): −27.6, −3.90] after adjusting for younger age, rural region of habitation, lower level of education, lower blood concentrations of triglycerides and low‐density lipoproteins and higher blood concentrations of high‐density lipoproteins, higher systolic blood pressure, lower body mass index and lower depression score. Other major ocular diseases such as open‐angle glaucoma (p = 0.25), angle‐closure glaucoma (p = 0.59), nuclear cataract (p = 0.78), cortical cataract (p = 0.54), posterior subcapsular cataract (p = 0.96), retinal vein occlusions (p = 0.93) and central serous choroidopathy (p = 0.39) were not statistically associated with physical activity in that model. The association between higher physical activity and prevalence of age‐related macular degeneration (p = 0.04; β: 0.04; B: 4.87; 95% CI: 0.25, 9.50) was marginally significant.

Conclusions

Higher physical activity and less sedentary lifestyle were associated with a lower prevalence of diabetic retinopathy, while the occurrence of other major ocular diseases such as any type of cataract and of glaucoma, retinal vein occlusions and central serous choroidopathy was statistically independent of physical activity or a more sedentary lifestyle.