bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel associations between sex hormones and diabetic vascular complications in men and postmenopausal women: a cross-sectional study
Authors: Wang Chiyu , Zhang Wen , Wang Yuying , Wan Heng , Chen Yi , Xia Fangzhen , Zhang Kun , Wang Ningjian , Lu Yingli
Published: July 2019

Background

Associations between sex hormones and vascular remodeling have been extensively studied, but the results vary widely among different races and sex. We aimed to investigate whether total testosterone (TT), estrogen (E2), and dehydroepiandrosterone (DHEA) associate with macrovascular complications and diabetic kidney disease (DKD) among community-dwelling patients with diabetes.

Methods

A total of 4720 participants with type 2 diabetes were recruited from Shanghai, China. Common carotid artery (CCA) plaques and diameter were assessed by ultrasound. Cardiovascular disease (CVD) was defined by prior diagnosis of coronary heart disease, myocardial infarction or stroke. DKD was defined according to the ADA Guidelines.

Results

(1) In men, TT was negatively associated with CCA diameter (regression coefficient (β) − 0.044, 95% CI − 0.087, 0). E2 levels were positively associated with CVD and CCA plaque prevalence (OR 1.151, 95% CI 1.038, 1.277 and OR 1.13, 95% CI 1.017, 1.255, respectively). DHEA was negatively associated with CVD (OR 0.809, 95% CI 0.734, 0.893). In postmenopausal women, TT levels were negatively associated with CCA diameter (β − 0.046, 95% CI − 0.083, − 0.010) and positively associated with CVD (OR 1.154, 95% CI 1.038, 1.284). (2) In both men and postmenopausal women, TT levels were negatively associated with the albumin/creatinine ratio and DKD (β − 0.098, 95% CI − 0.154, − 0.043 and OR 0.887, 95% CI 0.790, 0.997 vs. β − 0.084, 95% CI − 0.137, − 0.031 and OR 0.822, 95% CI 0.731, 0.924, respectively) and DHEA levels were positively associated with DKD (OR 1.167, 95% CI 1.038, 1.313 vs. OR 1.251, 95% CI 1.104, 1.418, respectively).

Conclusions

Our study indicates that macrovascular complications were associated with low TT, DHEA and high E2 in men and with high TT in postmenopausal women. DKD was associated with low TT and high DHEA levels in both genders. Sex hormone replacement therapy requires careful and comprehensive consideration.

Trial registration ChiCTR1800017573, http://www.chictr.org.cn. Registered 04 August 2018
Neonatal Eating Assessment Tool - Mixed Breastfeeding and Bottle-Feeding (NeoEAT - Mixed Feeding): factor analysis and psychometric properties
Authors: Pados Britt Frisk , Thoyre Suzanne M. , Galer Kara
Published: July 2019

Background

Early identification of feeding difficulty in infancy is critical to supporting breastfeeding and ensuring optimal nutrition for brain development. The Neonatal Eating Assessment Tool (NeoEAT) is a parent-report assessment that currently has two versions: NeoEAT – Breastfeeding and NeoEAT – Bottle-feeding for use in breast and bottle-fed infants, respectively. There are currently no valid and reliable parent-report measures to assess feeding through a combination of both breast and bottle delivery. The purpose of this study was to conduct a factor analysis and test the psychometric properties of a new measure, the NeoEAT – Mixed Breastfeeding and Bottle-Feeding (NeoEAT – Mixed Feeding), including internal consistency reliability, test-retest reliability, construct validity and known-groups validity.

Methods

Parents of infants younger than 7 months who had fed by both bottle and breast in the previous 7 days were invited to participate. Internal consistency reliability was tested using Cronbach’s α. Test-retest reliability was tested between scores on the NeoEAT – Mixed Feeding completed 2 weeks apart. Construct validity was tested using correlations between the NeoEAT – Mixed-Feeding, the Infant Gastroesophageal Reflux Questionnaire - Revised (I-GERQ-R), and the Infant Gastrointestinal Symptoms Questionnaire (IGSQ). Known-groups validation was tested between healthy infants and infants with feeding problems.

Results

A total of 608 parents participated. Exploratory factor analysis revealed a 68-item scale with 5 sub-scales. Internal consistency reliability (Cronbach’s α = .88) and test-retest reliability (r = 0.91; p < .001) were both acceptable. Construct validity was demonstrated through correlations with the I-GERQ-R (r = 0.57; p < .001) and IGSQ (r = 0.5; p < .001). Infants with feeding problems scored significantly higher on the NeoEAT – Mixed Feeding, indicating more problematic feeding symptoms, than infants without feeding problems (p < .001), supporting known-groups validity.

Conclusions

The NeoEAT – Mixed Feeding is a 68-item parent-reported measure of breast- and bottle-feeding behavior for infants less than 7 months old that now has evidence of validity and reliability for use in clinical practice and research. The NeoEAT – Mixed Feeding can be used to identify infants with problematic feeding, guide referral decisions, and evaluate response to interventions.
Validation of a Cyclic Algorithm to Proxy Number of Lines of Systemic Cancer Therapy Using Administrative Data
Authors: Weymann Deirdre , Costa Sarah , Regier Dean A.
Published: July 2019

PURPOSE

Researchers are automating the process for identifying the number of lines of systemic cancer therapy received by patients. To date, algorithm development has involved manual modifications to predefined classification rules. In this study, we propose a supervised learning algorithm for determining the best-performing proxy for number of lines of therapy and validate this approach in four patient groups.

MATERIALS AND METHODS

We retrospectively analyzed BC Cancer pharmacy records from patients’ cancer diagnosis until end of follow-up (cohort-specific, 2014/2015). We created and validated a cyclic algorithm in patients with advanced cancers of varying histologies, diffuse large B-cell lymphoma, follicular lymphoma, and chronic lymphocytic leukemia. To assess internal and external validity, we used a split-sample approach for all analyses and considered lines of therapy identified through manual review as our criterion standard. We measured agreement using correlation coefficients, mean squared error, nonparametric hypothesis testing, and quantile-quantile plots.

RESULTS

Cohorts comprised 91 patients with advanced cancers, 121 with chronic lymphocytic leukemia, 440 with follicular lymphoma, and 679 with diffuse large B-cell lymphoma. Number of lines of therapy received and patients’ treatment period length varied substantially across cohorts. Despite these differences, our algorithm successfully identified a best-performing proxy for number of lines of therapy for each cohort, which was moderate to highly correlated with (within-sample: 0.73 ≤ Pearson correlation ≤ 0.84; out-of-sample: 0.52 ≤ Pearson correlation ≤ 0.76) and whose distribution did not significantly differ from the criterion standard within or out of sample ( P > .10).

CONCLUSION

Supervised learning is an ideal tool for generating a best-performing proxy that recognizes prescription drug patterns and approximates number of lines of therapy. Our cyclic approach can be used in jurisdictions with access to administrative pharmacy data.
HDAC3 and HDAC8 are required for cilia assembly and elongation
Authors: Park Seon-ah , Yoo Hyunjeong , Seol Jae Hong , Rhee Kunsoo
Published: July 2019

Cilia are extended from mother centrioles in quiescent G0/G1 cells and retracted in dividing cells. Diverse posttranslational modifications play roles in the assembly and disassembly of the cilium. Here, we examined class I histone deacetylases (HDACs) as positive regulators of cilia assembly in serum-deprived RPE1 and HK2 cells. We observed that the number of cells with cilia was significantly reduced in HDAC3- and HDAC8-depleted cells. The ciliary length also decreased in HDAC3- and HDAC8-depleted cells compared to that in control cells. A knockdown-rescue experiment showed that wild-type HDAC3 and HDAC8 rescued the cilia assembly and ciliary length in HDAC3- and HDAC8-depleted cells, respectively; however, deacetylase-dead HDAC3 and HDAC8 mutants did not. This suggests that deacetylase activity is critical for both HDAC3 and HDAC8 function in cilia assembly and ciliary length control. This is the first study to report that HDACs are required for the assembly and elongation of the primary cilia.
The ventral epithelium of Trichoplax adhaerens deploys in distinct patterns cells that secrete digestive enzymes, mucus or diverse neuropeptides
Authors: Mayorova Tatiana D. , Hammar Katherine , Winters Christine A. , Reese Thomas S. , Smith Carolyn L.
Published: July 2019

The disk-shaped millimeter-sized marine animal, Trichoplax adhaerens, is notable because of its small number of cell types and primitive mode of feeding. It glides on substrates propelled by beating cilia on its lower surface and periodically pauses to feed on underlying microorganisms, which it digests externally. Here a combination of advanced electron and light microscopic techniques are used to take a closer look at its secretory cell types and their roles in locomotion and feeding. We identify digestive enzymes in lipophils, a cell type implicated in external digestion and distributed uniformly throughout the ventral epithelium except for a narrow zone near its edge. We find three morphologically distinct types of gland cell. The most prevalent contains and secretes mucus, which is shown to be involved in adhesion and gliding. Half of the mucocytes are arrayed in a tight row around the edge of the ventral epithelium while the rest are scattered further inside, in the region containing lipophils. The secretory granules in mucocytes at the edge label with an antibody against a neuropeptide that was reported to arrest ciliary beating during feeding. A second type of gland cell is arrayed in a narrow row just inside the row of mucocytes while a third is located more centrally. Our maps of the positions of the structurally distinct secretory cell types provide a foundation for further characterization of the multiple peptidergic cell types in Trichoplax and the microscopic techniques we introduce provide tools for carrying out these studies.
Reducing Medical Spending of the Publicly Insured: The Case for a Cash-Out Option
Authors: Pashchenko Svetlana , Porapakkarm Ponpoje
Published: July 2019

Individuals’ medical spending has both necessary and discretionary components, which are not, however, separately observable. This paper studies ways to improve upon existing public health insurance policies by using a framework where both the discretionary and necessary components of medical spending are explicitly modeled. First, using a simple theoretical framework, the paper shows that the key to reducing discretionary medical spending is to introduce a trade-off between nonmedical and medical consumption. Next, using a rich quantitative life-cycle model, the paper shows that this trade-off can be successfully implemented by introducing an option to substitute public health insurance with cash transfers. (JEL D91, G22, H51, I13, I18, I38)
Life-Cycle Consumption Patterns at Older Ages in the United States and the United Kingdom: Can Medical Expenditures Explain the Difference?
Authors: Banks James , Blundell Richard , Levell Peter , Smith James P.
Published: July 2019

This paper documents significantly steeper declines in nondurable expenditures at older ages in the United Kingdom compared to the United States, in spite of income paths being similar. Several possible causes are explored, including different employment paths, housing ownership and expenses, levels and paths of health status, number of household members, and out-of-pocket medical expenditures. Among all the potential explanations considered, those relating to levels and age paths in medical expenses and medical expenditure risk— can fully account for the steeper declines in nondurable consumption in the United Kingdom compared to the United States. (JEL D14, D15, I11, J14)
Voter Response to Peak and End Transfers: Evidence from a Conditional Cash Transfer Experiment
Authors: Galiani Sebastian , Hajj Nadya , McEwan Patrick J. , Ibarrarán Pablo , Krishnaswamy Nandita
Published: July 2019

In a Honduran field experiment, sequences of cash transfers to poor households varied in amount of the largest (peak) and last (end) transfers. Larger peak-end transfers increased voter turnout and the incumbent party’s vote share in the 2013 presidential election, independently of cumulative transfers. A plausible explanation is that voters succumbed to a common cognitive bias by applying peak-end heuristics. Another is that voters deliberately used peak-end transfers to update beliefs about the incumbent party. In either case, the results provide experimental evidence on the classic non-experimental finding that voters are especially sensitive to recent economic activity. (JEL C93, D72, I32, O15, O17)
How Do Tax Incentives Affect Investment and Productivity? Firm-Level Evidence from China
Authors: Liu Yongzheng , Mao Jie
Published: July 2019

China initiated a major reform for capital taxation in 2004. Completed in 2009, it introduced permanent tax incentives for firms’ investment in fixed assets. We explore a unique firm-level dataset from years 2005–2012 and utilize a quasi-experimental design to test the impacts of the reform on firms’ investment and productivity. We find that, on average, the reform raised investment and productivity of the treated firms relative to the control firms by 38.4 percent and 8.9 percent, respectively. We also show that the positive effects tend to be strengthened for firms with financial constraints. (JEL D24, D25, G31, H25, O25, P31, P35)
The Long-Run Effects of Teacher Collective Bargaining
Authors: Lovenheim Michael F. , Willén Alexander
Published: July 2019

We analyze how exposure to teacher collective bargaining affects long-run outcomes for students, exploiting the timing of state duty-to-bargain law passage in a cross-cohort difference-in-difference framework. Among men, exposure to a duty-to-bargain law in the first 10 years after passage depresses annual earnings by $2,134 (3.93 percent), decreases weekly hours worked by 0.42, and reduces employment and labor force participation. The earnings estimate implies that current duty-to-bargain laws reduce earnings by $213.8 billion annually. Effects grow with time since law passage, are largest among nonwhites, and are not evident for women. Duty-to-bargain laws reduce male noncognitive skills, supporting the labor market findings. (JEL I21, J22, J31, J45, J51, J52, K31)
Validation of Region of Interest Measurements for the Objective Assessment of Post-Contrast Enhancement of Renal Lesions on MRI
Authors: Al Salmi Ishaq Sulaiman , Halperin Joshua , Al-Douri Faten , Leung Vincent , Patlas Michael , Alabousi Abdullah
Published: July 2019

Objective:

The aim of this study was to validate the use of region of interest (ROI) measurements in MRI to objectively assess for enhancement in suspected solid renal masses and to determine a minimum threshold value for true enhancement.

Methods:

Contrast-enhanced renal MRI studies performed between January 2015 and December 2017 for patients with a known renal mass who had subsequent biopsy, or partial/radical nephrectomy were included. Two body imaging fellows independently measured the mean ROI values of renal masses, normal renal parenchyma, the ipsilateral psoas muscle and external air on the pre- and post-contrast sequences. The absolute and percentage changes in the mean ROI values were calculated. The readers were blinded to the pathology results.

Results:

104 patients were included in this study (mean age of 65 years; 58 males and 46 females). 74 patients (71%) had a diagnosis of renal cell carcinoma (RCC). Pathology showed clear-cell RCC in 55%, papillary RCC in 22%, and other RCC subtypes in 23%. There were 30 non-RCC renal lesions (29%), including oncocytoma, renal papillary adenoma, and renal metastasis. The minimum percentage change in ROI values in the pre- versus post-contrast images for all pathology-proven RCCs was 23% (range: 23–437%, mean: 143%); this represents relative enhancement and was referred to as the Signal Intensity Index (SII). The percentage change for normal renal parenchyma ranged from 32–317%. The maximum percentage change in ROI values for pathology proven renal cysts was 13% (range: −5–13%, mean: 3.5%). There was excellent inter observer agreement between the two readers [Intra-class correlation coefficient (r) 0.81].

Conclusion:

The percentage change in ROI values (SII) can be a helpful tool in the objective assessment of true enhancement of renal masses and can supplement subtraction images. The minimum threshold for enhancement in our study was 23%.

Advances in knowledge:

Enhancement of a renal lesion can be determined using the objective tool of ROI measurements in the pre- and post-contrast MR images with a percentage change of 20% or above indicating enhancement. This is an additional objective tool, which in conjunction with the subtraction images may improve detection and appropriate diagnosis of renal lesions. It could also be helpful in cases where the subtraction images are degraded by motion artefact.
Patulous eustachian tubes and an unusual case of fused retropharangeal internal carotid arteries with an aberrant course through the clivus and dorsum sellae
Authors: Menyatsoe Ignatious Tshegofatso IT , Khan Nausheen N
Published: July 2019

Aberrant course of internal carotid arteries (ICA) is rarely seen. In patients who are asymptomatic, anomalies may be detected incidentally during head and neck examination. Symptomatic patients may present with hearing loss, pulsatile tinnitus, dysphagia or a foreign body sensation in the posterior pharynx. If the retropharyngeal course of ICA remains undiagnosed, accidental biopsy or surgical intervention can result in life threatening complications. The abnormal course of ICA results from a complex defect in embryological development and is unlikely to be an acquired process. Previously, bilateral and unilateral agenesis, hypoplastic, retropharyngeal tortuous ICA and kissing sellar ICA have been described in literature. We used various imaging techniques to describe this first case of fused ICA with an aberrant course through the clivus and dorsum sellae. The patient also presented with patulous Eustachian tubes on both the left and right side.
Giardia sp. and Cryptosporidium sp. in Iberian Wolf
Authors: PEREIRA A.L. , MATEUS T. L. , LLANEZ L. , DUARTE S. D.
Published: July 2019

A subsample consisting of fifty fecal samples from wild Iberian Wolf (Canis lupus signatus), from the northwest of Spain were collected in the field. The samples were analyzed for cysts of Giardia sp. and oocysts of Cryptosporidium sp. using a direct immunofluorescence antibody test (IFA). Giardia sp. and Cryptosporidium sp. were found in 20.0 % of the samples examined. Simple infections were more frequent (90.0 %) with seven (14.0 %) positive for Giardia sp. and two (4.0 %) positive for Cryptosporidium sp. To the authors’ knowledge, this is the first report of occurrence of Cryptosporidium sp. in Iberian Wolf.
Uterine stump adenocarcinoma in a bitch with an ovarian remnant: A case report
Authors: KOKKINOS P. , VERVERIDIS CH. , PATSIKAS M. , KRITSEPI-KONSTANTINOU M. , KAZAKOS G. M. , PSALLA D.
Published: July 2019

A 3-year-old female spayed dog was presented with a history of sanguineous vaginal discharge of 2 month duration. The dog was spayed 1.5 years before presentation. Clinical examination revealed a large, solid, ovoid mass in the caudal abdomen, recognized by diagnostic imaging as an enlargement at the top of the uterine stump. Additionally, high serum progesterone concentration was measured, confirming the presence of functional ovarian tissue in dioestrus. With a suspicion for a related uterine stump pyometra or less likely, for other enlargements, a cοeliotomy was performed. A mass at the apex of the uterine body and a right side ovarian remnant were found. Both structures and the remaining uterine stump were excised. The uterine remnant mass was histologically diagnosed as uterine adenocarcinoma, herein detected for the first time at the uterine stump in the bitch. Unsuccessful, incomplete ovariohysterectomy may permit even neoplastic transformation of uterine stump tissues.
Symptoms related to the visual system in migraine
Authors: van Dongen Robin M. , Haan Joost
Published: July 2019

Migraine is a common headache disorder characterized by often-severe headaches that may be preceded or accompanied by a variety of visual symptoms. Although a typical migraine aura is not difficult to diagnose, patients with migraine may report several other visual symptoms, such as prolonged or otherwise atypical auras, “visual blurring”, “retinal migraine”, “ophthalmoplegic migraine”, photophobia, palinopsia, and “visual snow”. Here, we provide a short overview of these symptoms and what is known about the relationship with migraine pathophysiology. For some symptoms, the association with migraine is still debated; for other symptoms, recent studies indicate that migraine mechanisms play a role.
Methodology of accounting and analytical support of the innovation management system
Authors: Пласкова Наталия , Plaskova Nataliya , Полянская Татьяна , Polyanskaya Tat'yana , Проданова Наталья , Prodanova Natal'ya
Published: July 2019

The monograph presents theoretical, methodological and methodological developments aimed at improving the system of information support of innovation at the micro, meso and macro levels of management. The terminological and structured conceptual-specific apparatus of the study is formed, the place, purpose and objectives of the accounting and analytical management function are justified to ensure the internal management of innovative enterprises and external entities making investment decisions regarding the financing of innovative projects, as well as entities exercising control over the use of public and private financial resources that stimulate innovative directions of the country's economy.
International oil and gas business
Authors: Линник Юрий , Linnik Yuriy , Линник Владимир , Linnik Vladimir , Байкова Оксана , Baykova Oksana , Созаева Джамиля , Sozaeva Dzhamilya
Published: July 2019

For the first time in the domestic literature of recent decades, a range of issues related to international business and trade in the oil and gas industry will be touched upon. Considerable attention is paid to the forms and methods of international business and trade, characterized by the world oil and natural gas markets at the present stage of their development, considered fiscal measures and legal issues of interstate regulation of the oil and gas market, as well as methods of payments and calculations, the necessary documentation, various types of contracts practiced in the world oil markets.
Chassis Leasing and Selection Policy for Port Operations
Authors: Gifford Ted , Gremley Robert
Published: July 2019

The authors present a solution methodology they implemented to address two decision problems that port operators face. Their methodology represents a novel approach that combines elements of predictive, prescriptive, and descriptive analytics, and of simulation.
Reexamining How Utility and Weighting Functions Get Their Shapes: A Quasi-Adversarial Collaboration Providing a New Interpretation
Authors: Alempaki Despoina , Canic Emina , Mullett Timothy L. , Skylark William J. , Starmer Chris , Stewart Neil , Tufano Fabio
Published: July 2019

In a paper published in Management Science in 2015, Stewart, Reimers, and Harris (SRH) demonstrated that shapes of utility and probability weighting functions could be manipulated by adjusting the distributions of outcomes and probabilities on offer as predicted by the theory of decision by sampling. So marked were these effects that, at face value, they profoundly challenge standard interpretations of preference theoretic models in which such functions are supposed to reflect stable properties of individual risk preferences. Motivated by this challenge, we report an extensive replication exercise based on a series of experiments conducted as a quasi-adversarial collaboration across different labs and involving researchers from both economics and psychology. We replicate the SRH effect across multiple experiments involving changes in many design features; importantly, however, we find that the effect is also present in designs modified so that decision by sampling predicts no effect. Although those results depend on model-based inferences, an alternative analysis using a model-free comparison approach finds no evidence of patterns akin to the SRH effect. On the basis of simulation exercises, we demonstrate that the SRH effect may be a consequence of misspecification biases arising in parameter recovery exercises that fit imperfectly specified choice models to experimental data. Overall, our analysis casts the SRH effect in an entirely new light.

This paper was accepted by Yuval Rottenstreich, judgment and decision making
Lottery-Related Anomalies: The Role of Reference-Dependent Preferences
Authors: An Li , Wang Huijun , Wang Jian , Yu Jianfeng
Published: July 2019

Previous empirical studies find that lottery-like stocks significantly underperform their non-lottery-like counterparts. Using five different measures of the lottery features in the literature, we document that the anomalies associated with these measures are state dependent: the evidence supporting these anomalies is strong and robust among stocks where investors have lost money, whereas among stocks where investors have gained profits, the evidence is either weak or even reversed. Several potential explanations for such empirical findings are examined, and we document support for the explanation based on reference-dependent preferences. Our results provide a unified framework to understand the lottery-related anomalies in the literature.

This paper was accepted by Tyler Shumway, finance.
Memorial
Authors: Loreto Mariz Cecília
Published: July 2019

Este memorial foi defendido em 21 de maio de 2018. A banca examinadora foi compostapelos Profs. Patrícia Birman (presidente), Otávio Velho, Carlos Steil, Marcelo Camurça e JoséReginaldo Gonçalves.
Dental Mentoring Conference 2019
Authors: Brooks Janine
Published: July 2019

Mentoring is invaluable in learning and honing new skills. Here, Janine Brooks talks about a conference designed to broaden your horizons
‘Patients are more than reference numbers’
Authors: Lambert Xyanthe
Published: July 2019

Xyanthe Lambert, senior dental nurse, on why fundraising in the community adds value to your role
Ethical concepts: what does best interests actually mean?
Authors: Ellis Peter
Published: July 2019

Healthcare professionals must consider the best interests of their patients. In this article, Peter Ellis looks at how best interests are defined and how they are best served for the benefit of the kidney care patient
Mismatch ‘never events’ in hip and knee arthroplasty
Authors: Odgaard A. , Laursen M. B. , Gromov K. , Troelsen A. , Kristensen P. W. , Schrøder H. , Madsen F. , Overgaard S.
Published: July 2019

Aims

The aim of this study was to give estimates of the incidence of component incompatibility in hip and knee arthroplasty and to test the effect of an online, real-time compatibility check.

Materials and Methods

Intraoperative barcode registration of arthroplasty implants was introduced in Denmark in 2013. We developed a compatibility database and, from May 2017, real-time compatibility checking was implemented and became part of the registration. We defined four classes of component incompatibility: A-I, A-II, B-I, and B-II, depending on an assessment of the level of risk to the patient (A/B), and on whether incompatibility was knowingly accepted (I/II).

Results

A total of 26 524 arthroplasties were analyzed. From 12 307 procedures that were undertaken before implementation of the compatibility check, 21 class A incompatibilities were identified (real- or high-risk combinations; 0.17%; 95% confidence interval (CI) 0.11 to 0.26). From 5692 hip and 6615 knee procedures prior to implementation of the compatibility check, we found rates of class A-I incompatibility (real- or high-risk combinations unknowingly inserted) of 0.14% (95% CI 0.06 to 0.28) and 0.17% (95% CI 0.08 to 0.30), respectively. From 14 217 procedures after the introduction of compatibility checking (7187 hips and 7030 knees), eight class A incompatibilities (0.06%; 95% CI 0.02 to 0.11) were identified. This difference was statistically significant (p = 0.008).

Conclusion

Our data presents validated estimates of the baseline incidence of incompatibility events for hip and knee arthroplasty procedures and shows that a significant reduction in class A incompatibility events is possible using a web-based recording system. Cite this article: Bone Joint J 2019;101-B:960–969.
Mapping recovery in simple and complex tibial plateau fracture fixation
Authors: Ramoutar D. N. , Lefaivre K. , Broekhuyse H. , Guy P. , O’Brien P.
Published: July 2019

Aims

The aim of this study was to determine the trajectory of recovery following fixation of tibial plateau fractures up to five-year follow-up, including simple (Schatzker I-IV) versus complex (Schatzker V-VI) fractures.

Patients and Methods

Patients undergoing open reduction and internal fixation (ORIF) for tibial plateau fractures were enrolled into a prospective database. Functional outcome, using the 36-Item Short Form Health Survey Physical Component Summary (SF-36 PCS), was collected at baseline, six months, one year, and five years. The trajectory of recovery for complex fractures (Schatzker V and VI) was compared with simple fractures (Schatzker I to IV). Minimal clinically important difference (MCID) was calculated between timepoints. In all, 182 patients were enrolled: 136 (74.7%) in simple and 46 (25.3%) in complex. There were 103 female patients and 79 male patients with a mean age of 45.8 years (15 to 86).

Results

Mean SF-36 PCS improved significantly in both groups from six to 12 months (p < 0.001) and one to five years (simple, p = 0.008; complex, p = 0.007). In both groups, the baseline scores were not reached at five years. The SF-36 PCS was significantly higher in the simple group compared with the complex group at both six months (p = 0.007) and 12 months (p = 0.01), but not at five years (p = 0.17). Between each timepoint, approximately 50% or more of the patients in each group achieved an MCID in their score change, indicating a significant clinical change in condition. The complex group had a much larger drop off in the first six months, with comparable proportions achieving MCID at the subsequent time intervals.

Conclusion

Tibial plateau fracture recovery was characterized overall by an initial decline in functional outcome from baseline, followed by a steep improvement from six to 12 months, and ongoing recovery up to five years. In simple patterns, patients tended to achieve a higher functional score by six months compared with the complex patterns. However, comparable functional scores between the groups achieved only at the five-year point suggest later recovery in the complex group. Function does not improve to baseline by five years in either group. This information is useful in counselling patients about the course of prospective recovery. Cite this article: Bone Joint J 2019;101-B:1009–1014.
Can spinopelvic mobility be predicted in patients awaiting total hip arthroplasty?
Authors: Innmann M. M. , Merle C. , Gotterbarm T. , Ewerbeck V. , Beaulé P. E. , Grammatopoulos G.
Published: July 2019

Aims

This study of patients with osteoarthritis (OA) of the hip aimed to: 1) characterize the contribution of the hip, spinopelvic complex, and lumbar spine when moving from the standing to the sitting position; 2) assess whether abnormal spinopelvic mobility is associated with worse symptoms; and 3) identify whether spinopelvic mobility can be predicted from static anatomical radiological parameters.

Patients and Methods

A total of 122 patients with end-stage OA of the hip awaiting total hip arthroplasty (THA) were prospectively studied. Patient-reported outcome measures (PROMs; Oxford Hip Score, Oswestry Disability Index, and Veterans RAND 12-Item Health Survey Score) and clinical data were collected. Sagittal spinopelvic mobility was calculated as the change from the standing to sitting position using the lumbar lordosis angle (LL), sacral slope (SS), pelvic tilt (PT), pelvic-femoral angle (PFA), and acetabular anteinclination (AI) from lateral radiographs. The interaction of the different parameters was assessed. PROMs were compared between patients with normal spinopelvic mobility (10° ≤ ∆PT ≤ 30°) or abnormal spinopelvic mobility (stiff: ∆PT < ± 10°; hypermobile: ∆PT > ± 30°). Multiple regression and receiver operating characteristic (ROC) curve analyses were used to test for possible predictors of spinopelvic mobility.

Results

Standing to sitting, the hip flexed by a mean of 57° (sd 17°), the pelvis tilted backwards by a mean of 20° (sd 12°), and the lumbar spine flexed by a mean of 20° (sd 14°); strong correlations were detected. There was no difference in PROMs between patients in the different spinopelvic mobility groups. Maximum hip flexion, standing PT, and standing AI were independent predictors of spinopelvic mobility (R2 = 0.42). The combined thresholds for standing was PT ≥ 13° and hip flexion ≥ 88° in the clinical examination, and had 90% sensitivity and 63% specificity of predicting spinopelvic stiffness, while SS ≥ 42° had 84% sensitivity and 67% specificity of predicting spinopelvic hypermobility.

Conclusion

The hip, on average, accounts for three-quarters of the standing-to-sitting movement, but there is great variation. Abnormal spinopelvic mobility cannot be screened with PROMs. However, clinical and standing radiological features can predict spinopelvic mobility with good enough accuracy, allowing them to be used as reliable screening tools. Cite this article: Bone Joint J 2019;101-B:902–909.
Classification of combined partial knee arthroplasty
Authors: Garner A. , van Arkel R. J. , Cobb J.
Published: July 2019

Aims

There has been a recent resurgence in interest in combined partial knee arthroplasty (PKA) as an alternative to total knee arthroplasty (TKA). The varied terminology used to describe these procedures leads to confusion and ambiguity in communication between surgeons, allied health professionals, and patients. A standardized classification system is required for patient safety, accurate clinical record-keeping, clear communication, correct coding for appropriate remuneration, and joint registry data collection.

Materials and Methods

An advanced PubMed search was conducted, using medical subject headings (MeSH) to identify terms and abbreviations used to describe knee arthroplasty procedures. The search related to TKA, unicompartmental (UKA), patellofemoral (PFA), and combined PKA procedures. Surveys were conducted of orthopaedic surgeons, trainees, and biomechanical engineers, who were asked which of the descriptive terms and abbreviations identified from the literature search they found most intuitive and appropriate to describe each procedure. The results were used to determine a popular consensus.

Results

Survey participants preferred “bi-unicondylar arthroplasty” (Bi-UKA) to describe ipsilateral medial and lateral unicompartmental arthroplasty; “medial bi-compartmental arthroplasty” (BCA-M) to describe ipsilateral medial unicompartmental arthroplasty with patellofemoral arthroplasty; “lateral bi-compartmental arthroplasty” (BCA-L) to describe ipsilateral lateral unicompartmental arthroplasty with patellofemoral arthroplasty; and tri-compartmental arthroplasty (TCA) to describe ipsilateral patellofemoral and medial and lateral unicompartmental arthroplasties. “Combined partial knee arthroplasty” (CPKA) was the favoured umbrella term.

Conclusion

We recommend bi-unicondylar arthroplasty (Bi-UKA), medial bicompartmental arthroplasty (BCA-M), lateral bicompartmental arthroplasty (BCA-L), and tricompartmental arthroplasty (TCA) as the preferred terms to classify CPKA procedures. Cite this article: Bone Joint J 2019;101-B:922–928.
Profil Sindrom Aspirasi Mekonium pada Bayi Baru Lahir di RSUD Dr. Soetrasno Rembang
Authors: Anindita Ahimsa Yoga , Hidayah Dwi , Hafidh Yulidar , Moelyo Annang Giri , Dewi Mayasari
Published: July 2019

Introduction: The presence of meconium in amniotic fluid occurs in 13% of live births in developing countries. This condition develops when the gestational age increases at delivery. Meconium aspiration syndrome occurs in 5% of newborns in meconium stained amniotic fluid. The aim of this study is to determine the profile of newborns who experience meconium aspiration syndrome (MAS) who are treated at Dr. Soetrasno Hospital, Rembang and its outcome.

Methods: Prospective study, data were obtained from medical records of Dr. Soetrasno Hospital, Rembang during September to October 2018, on newborns with MAS.

Results: Of 12 newborns with MAS were obtained, consisting of 7 (58.3%) male and 5 (41.7%) female. All cases were term infants (gestational age above 37 weeks) and normal birth weight (above 2500 grams). Based on the first minute APGAR score, there were 4 newborns had score 1 and 2, respectively (33.3%). Based on the fifth minute APGAR score, there were 7 newborns had score 3 (58.3%). The outcome of newborns with MAS were 7 alive (58.3%) and 5 died (41.7%).

Conclusion: There were 12 newborns suffering from MAS (54.5%) of 22 babies hospitalized at the NICU dr. Soetrasno Hospital Rembang. All newborns with MAS were term infants and normal birth weight. There were 5 newborns with MAS which required invasive mechanical ventilation (intubation) and all died (41.7%).

 
Evaluating Tiered Hemolysis Thresholds to Facilitate Rapid Reporting of High-Sensitivity Cardiac Troponin
Authors: Turner Katherine A , Kaleta Erin J , Harnish Tanya L , Madani Zahra , Snozek Christine L H
Published: July 2019

Background

Cardiac troponin (cTn) assays are used for the diagnosis of acute myocardial infarction and frequently require serial measurements. Recollection of unacceptable specimens for hemolysis can delay results and disrupt timing of serial measurements. This study was designed to assess the influence of hemolysis on a high-sensitivity cTnT assay in granular detail at clinically important concentrations. These were used in consultation with the clinical practice to evaluate risk-based thresholds for acceptable amounts of hemolysis.

Methods

Plasma pools ranging from <10 to >100 ng/L cTnT were spiked with hemolysate to various degrees of hemolysis and measured using the Elecsys Troponin T Gen 5 STAT assay. The impact of accepting expanded hemolysis thresholds was completed using retrospective data of 12225 serial cTnT results and an additional 4651 baseline cTnT results.

Results

The mean percent change in cTnT was consistent for a given degree of hemolysis regardless of the initial nonhemolyzed cTnT concentration. Tiered hemolysis thresholds were evaluated for low-risk patients (apparent cTnT ≤8 ng/L), intermediate-risk patients (thresholds for 9–37 ng/L, 38–66 ng/L, and 67–99 ng/L cTnT), and high-risk patients (≥100 ng/L cTnT). The influence of tiered hemolysis thresholds was calculated for patients with serial (0 and 2 h) cTnT results, which demonstrated that the majority of 2-h delta interpretations were unchanged. Implementation of tiered thresholds dramatically decreased recollections for hemolyzed cTnT samples.

Conclusion

Tiered hemolysis cutoffs minimized disruption to patient care for low- and high-risk patients, while maintaining the integrity of serial measurements for those with intermediate cTnT concentrations.
Para uma conceptualização evolucionista de Saúde Mental
Authors: Urbano Pedro
Published: July 2019

O problema epistemológico do critério de demarcação (entre o que é e o que não é doença mental), constitui um dos problemas mais centrais e mais fundamentais da Psicopatologia. Ao longo de um percurso acidentado e demorado de milénios de história documentada, foram-se sucedendo várias formas de conceptualizar a doença e a doença mental, desde a tradição sobrenatural até, no caso específico desta última, ao omnipresente manual DSM, que se veio a impor a nível mundial como a classificação oficial dos transtornos psiquiátricos. Todavia, nenhuma forma se revelou até agora verdadeiramente satisfatória para a discriminação e caracterização de tais transtornos. Nem sequer o manual DSM, afinal uma espécie de glossário construído sobre consensos validados estatisticamente, que no fundo traduz a liderança (ou mesmo o poder hegemónico) do pragmatismo norte-americano sobre a Psiquiatria e a Psicologia, e que parte de pressupostos discutíveis, em particular a assunção de que as diferentes entidades de diagnóstico que define possuem uma realidade subjacente natural e universal.

É necessário prosseguir o caminho. Um caminho iniciado por Karl Jaspers, no que diz respeito à via compreensiva (e não apenas descritiva) dos fenómenos em causa. Um caminho que só fará sentido percorrer se se procurar conhecer melhor as realidades naturais que possam existir, quando existam, subjacentes aos transtornos psiquiátricos; procurando ao mesmo tempo reconhecer que partes das definições de tais transtornos são culturalmente definidas e procurando, ainda, articular as diferentes ordens de factores (naturais e sociais) que, juntas, formarão uma nova conceptualização e compreensão de doença e de doença mental. Isto é, procurando por um lado conhecer o funcionamento natural dos mecanismos psicológicos, tais como foram «programados» ou «desenhados» pela evolução da espécie humana; procurando conhecer igualmente as condições ambientais (sociais, culturais, etc.) que fazem disparar tais mecanismos, necessariamente contextuais, de forma disfuncional; e, por fim, incorporando tais conhecimentos nos valores culturais que vêm definindo, ao longo dos séculos e das civilizações, os comportamentos desviantes que se consideram ser doença mental. Tal conceptualização, evolucionista pela sua natureza, poderá vir a trazer enfim uma solução para o problema fundamental de definir critérios de demarcação (entre o que é e o que não é doença mental) que permitam, por sua vez, encontrar explicações adequadas e satisfatórias para a compreensão dos fenómenos psiquiátricos.
La Izquierda social y el Islam político: la experiencia argelina
Authors: Topper Ilya U.
Published: July 2019

El islamismo político alcanza proyección mundial con la revolución contra el shah en Irán en 1979 en la que colaboran colectivos marxistas e islamistas. Aunque acto seguido, Jomeini destruyó la izquierda iraní, el islamismo se considera hasta hoy una ideología asociada a la izquierda por su discurso antiestadounidense. Se hace fuerte en los países al sur del Mediterráneo gracias al respaldo de regímenes autoritarios que fomentan su expansión como contrapeso a la oposición izquierdista, algo especialmente visible en Argelia. Durante la Primavera Árabe, que surge de planteamientos laicos, los islamistas se hacen con el protagonismo (Egipto, Siria) o forman alianzas (Marruecos). Sin embargo, una coalición entre demócratas e islamistas suele acabar con la destrucción de los primeros: el islamismo busca imponer normas divinas incuestionables, algo especialmente visible en el papel que se reserva a la mujer. Las fuerzas demócratas en la actual rebelión de Argelia deberán evitar esta alianza.
Estimativa da concentracão de sedimentos em suspensão por meio de um velocímetro acústico doppler
Authors: Cabral Helenesio Carlos , Sanagiotto Daniela Guzzon , Dias de Paiva João Batista
Published: July 2019

A avaliação da concentração de sedimentos em suspensão (CSS) ainda representa uma tarefa desafiadora, associada a processos experimentais compostos por várias etapas. Este trabalho busca contribuir na avaliação do potencial de uso do velocímetro acústico Doppler (ADV) para quantificar concentração de sedimentos em suspensão. Este equipamento pode representar uma alternativa mais rápida e econômica para a avaliação de CSS. Também se busca verificar a sensibilidade do equipamento na distinção de partículas de diferentes dimensões. Para tanto, desenvolveu-se um sistema de medição em laboratório, caracterizado por um recipiente de forma cilíndrica de 30 cm de diâmetro e 30 cm de altura, conectado a um sistema de bombeamento. Este sistema permitiu a mistura e homogeneização de diferentes proporções de água+solo, gerando amostras de características conhecidas, para posterior avaliação com o ADV. Realizaram-se ensaios com amostras com oito CSS e cinco faixas granulométricas de cinco tipos de solo, totalizando 200 configurações testadas. Para cada teste coletaram-se três amostras, totalizando 600 ensaios. Para visualização dos dados e pós processamento, utilizou-se o programa WinADV, aplicando o filtro PSTM. Os resultados obtidos apontaram o aumento do SNR (relação sinal-ruído) obtido com o ADV com o acréscimo da CSS para os diferentes tipos de solo para as cinco granulometrias, tendo as melhores correlações entre o eco e a CSS nos ensaios com os solos 2, 3 e 4. Para as condições testadas a faixa granulométrica não interferiu nas leituras do ADV. Esse estudo demonstra que há boas perspectivas para a utilização do ADV para a quantificação da CSS, mas ressalta a importância de estudos complementares.
PRACTICAL USE OF MODERN INVESTIGATION AND MONITORING METHODS IN POLISH LANDSLIDE REMEDIATION PROJECTS
Authors: Bednarczyk Zbigniew
Published: July 2019

This paper discusses exemplary landslide investigations in natural Carpathian and man-made opencast mine slopes. Research methods included mapping, core drilling, laboratory testing, GPR scanning, on-line inclinometer, piezometer, and pore pressure monitoring and also numerical modelling. Landslide triggers were complex and diverse. On flysch slopes movements were activated by heavy rainfalls and in opencast mines, by exploiting the parameters of clayey soils. Precise prediction of landslide activation is impossible. Identification of landslide triggers for mitigation measures requires a multiple analysis of integrated external and internal variables.
A HEADRACE TUNNEL RECONSTRUCTION IN TURKEY
Authors: Hilar Matouš , Srb Martin , Nosek Jakub
Published: July 2019

The operation of a hydro power project in North Turkey started in 2015, included the 12km long headrace tunnel. An 8km long lower tunnel section was excavated by double shield TBM technology with 8.7m ID. Due to problems with the mechanised excavation, a 4km long upper tunnel section was excavated conventionally by the Drill and Blast method with single shell lining generated from fibre reinforced sprayed concrete and rock bolts. Significant operational problems were observed in September 2016. The flooded tunnel was investigated by underwater Remotely Operated Vehicle which indicated significant collapses. Operation of the power station had to be stopped and water from a supply dam at the headrace tunnel inlet had to be discharged to enable dewatering and inspection of the tunnel. Consequent investigation revealed three major collapses and a considerable variety of other damages in the D&B section of the tunnel. Repair and strengthening of the tunnel was completed in October 2017.
3D FEM ANALYSIS OF THE CONSTRUCTION PIT FOR A TBM-DRIVEN FLOOD DISCHARGE GALLERY
Authors: Hohberg Jörg-Martin
Published: July 2019

As one speciality of the Swiss hydraulic engineering tradition, several torrent diversion schemes were undertaken dating from the 18th century, with the aim of using the natural lake as a retention basin. The recent project of flood protection of the lower Sihl valley and the City of Zurich features a gallery of 2.1km length with a 6.6m inner diameter designed for a 330m3/s free flow, discharging into Lake Zurich in an HQ500 event. After a short presentation of the main features of the project, the paper concentrates on the target construction pit of the TBM drive close to a major railway line at the built-up lakeside.