bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Dipeptidyl Peptidase-IV Inhibitor Use in Hospitalized Patients With Diabetes
Authors: Petite Sarah E. , Hill Maja C.
Published: February 2021

Background:

Glycemic control within goal blood glucose (BG) ranges is essential to minimize hospital complications for patients with type 2 diabetes mellitus (T2DM). Optimal treatment in the non–intensive care unit (ICU) setting includes a basal insulin containing regimen. Dipeptidyl peptidase-IV (DPP-IV) inhibitors have minimal hypoglycemia incidence and may be an appropriate bolus insulin replacement in the inpatient setting.

Objective:

To determine the effect of basal insulin plus DPP-IV inhibitor compared with basal plus bolus insulin in hospitalized patients with T2DM.

Methods:

This multicenter cohort study included adult patients with T2DM admitted to the non-ICU setting and prescribed either basal insulin plus DPP-IV inhibitor or basal plus bolus insulin. Propensity-score matching was performed for age, sex, Charlson Comorbidity Index, first BG reading during hospitalization, and hemoglobin A1C (A1C). The primary outcome was the difference in mean daily BG during hospitalization. Secondary outcomes included hospital length of stay (LOS), total daily dose (TDD) of insulin, hypoglycemic events, and mean daily BG in patients with an A1C >8%.

Results:

A total of 105 patients were included in each group. Mean daily BG during hospitalization was lower in the basal insulin plus DPP-IV inhibitor group (199.3 ± 52.5 vs 213.6 ± 45.8 mg/dL; P = 0.04). There was a significant difference in hospital LOS (5 [interquartile range = 3-8] vs 6 [4-11] days; P = 0.02) and short-acting insulin TDD (11.6 ± 9.1 vs 20.5 ± 21.2 units; P < 0.001). No differences were observed in basal insulin TDD and hypoglycemia. There was no difference in mean daily BG in the subgroup analysis of patients with a A1C >8%.

Conclusions and Relevance:

A significant difference in mean daily BG and hospital LOS was found with a basal insulin plus DPP-IV inhibitor regimen. Use of a DPP-IV inhibitor to replace bolus insulin in hospitalized patients with T2DM should be considered.
Impact of Intravenous Methadone Administered Intraoperatively on Postoperative Opioid Utilization
Authors: Petrosan Adina , Zassman Stefanie , Cohn Sara , Guerra Michael , Soares Karina , Kennedy James , Abdelghany Osama , Gutman Elena
Published: February 2021

Background:

Studies have shown that intravenous methadone intraoperatively can reduce opioid usage postoperatively.

Objective:

This study’s purpose was to evaluate the effect of intravenous methadone on postoperative opioid use.

Methods:

A prospective, single-center observational study was conducted to evaluate patients who received intravenous methadone intraoperatively. A control group was identified by matching procedure, gender, and age in a 1:3 ratio of methadone to control. Exclusion criteria included patients less than 18 years old or on methadone maintenance therapy. The primary outcome was morphine milligram equivalents (MME) administered 24h postoperatively. Secondary outcomes included MME administered 48h and 72h postoperatively, discharge prescription MME, daily mean postoperative pain scores, and length of hospital stay. A subgroup analysis was performed comparing opioid-naïve patients.

Results:

A total of 240 patients were included in the analysis. At 24h, postoperative MME was increased in the methadone group (142.6 vs 84.5; P = 0.0026). Postoperative MME was also increased in the methadone group at 48h and 72h. Daily pain scores were similar between both groups at all time intervals. Discharge prescription MME was reduced in the methadone group compared with controls, but not statistically significant. A subgroup analysis of opioid-naïve patients showed a significant reduction in MME at 48h ( P = 0.0240) and daily pain scores at 24h ( P = 0.0366) in the methadone group.

Conclusion and Relevance:

Intravenous methadone intraoperatively did not show a significant reduction in postoperative opioid use and discharge prescription MMEs when comparing all patients; however, benefit was seen when examining opioid-naïve patients.
Reliability of Differential Item Functioning in Alcohol Use Disorder: Bayesian Meta-Analysis of Criteria Discrimination Estimates
Authors: Vize Colin E. , Lane Sean P.
Published: February 2021

Numerous studies leverage item response theory (IRT) methods to examine measurement characteristics of alcohol use disorder (AUD) diagnostic criteria. Less work has examined the consistency of AUD IRT parameter estimates, an essential step for establishing measurement invariance, making statements about symptom diagnosticity, and validating the theoretical construct. A Bayesian meta-analysis of IRT discrimination values for AUD criteria across 33 independent samples (Total N = 321,998) revealed that overall consistency of AUD criteria discriminations was low (generalized intraclass correlation range = .105-.249). However, specific study characteristics accounted for substantial variability, suggesting that the unreliability is partially systematic. We replicated evidence of differential item functioning (DIF) via established factors (e.g., age, gender), but the magnitudes were small compared with DIF associated with assessment instrument. These results offer practical recommendations regarding which instruments to use when specific AUD criteria are of interest and which criteria are most sensitive when comparing demographic groups.
Material microstructure topology optimization of piezoelectric composite beam under initial disturbance for vibration suppression
Authors: Ding Haoqing , Xu Bin
Published: February 2021

This study proposes a material microstructure topology optimization model for a piezoelectric composite beam subject to initial disturbance. The optimization model is built through the Solid Isotropic Material with Penalization interpolation subject to the material volume fraction on the microlevel. And the objective function is to minimize the time integral about local structural response. By introducing the Lyapunov second equation, this time integral is simplified and does not need any numerical integration technique. It can also be used to measure the global vibration response instead of short time gap. Besides, different objectives such as a regional structural response can also be obtained by only changing the weight matrix form. And the sensitivity of the objective function with respect to the design variables are also deduced by solving the Lyapunov equation. A bidirectional evolutionary structural optimization algorithm is used to acquire the optimal results. Four numerical examples including multiphase material microstructure topology optimization verify the developed method that can effectively suppress local structural vibration level and obtain lighter structure.
Medical therapy for cardiovascular and limb-related risk reduction in critical limb ischemia
Authors: Giannopoulos Stefanos , Armstrong Ehrin J
Published: February 2021

Critical limb ischemia (CLI) constitutes the most advanced form of peripheral artery disease (PAD) and is characterized by ischemic rest pain, tissue loss and/or gangrene. Optimized medical care and risk factor modification in addition to revascularization could reduce the incidence of cardiovascular events and major adverse limb events, improving patients’ quality of life and promising higher survival rates. Adequate adherence to cardioprotective medications, including antithrombotic therapy (e.g., antiplatelets, anticoagulants), cholesterol-lowering agents (e.g., statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors), angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), and smoking cessation should be strongly encouraged for patients with CLI. This review examines these guideline-recommended therapies in terms of cardiovascular and limb-related risk reduction in patients with CLI.
Disordered eating in the postpartum period: Role of psychological distress, body dissatisfaction, dysfunctional maternal beliefs and self-compassion
Authors: O’Loghlen Elyse , Galligan Roslyn
Published: February 2021

The present cross-sectional study tested the affect regulation model of disordered eating for women in the postpartum period, whereby disordered eating is used to cope with psychological distress. Two hundred and two women who had given birth in the last two years completed an online survey of self-report measures of study variables. Path analyses supported the primary hypothesis: negative affect mediated relationships between body dissatisfaction, dysfunctional maternal beliefs, negative components of self-compassion and disordered eating behaviours, particularly binge eating. Results suggest that negative affect plays a central role in postpartum disordered eating. Interventions to address maladaptive emotion regulation strategies, specifically targeting body image distress and self-critical maternal thoughts may improve eating behaviours for this population.
Put MY mask on first: Mothers’ reactions to prioritizing health behaviours as a function of self-compassion and fear of self-compassion
Authors: Simpson Kaeley M , Semenchuk Brittany N , Strachan Shaelyn M
Published: February 2021

Self-compassion predicts mothers’ engagement in health behaviours yet some mothers fear self-compassion. We examined relationships between both self-compassion and fear of self-compassion with mothers’ reactions to prioritizing health behaviours. Mothers rated their self-compassion, fear of self-compassion, read a scenario about prioritizing health behaviours and rated adjectives describing themselves if they behaved as described in the scenario. Self-compassion was positively related to positive reactions to engaging in health behaviours in the midst of motherhood. Fear of self-compassion led to negative reactions. This research provides insight into why some mothers feel better about incorporating health behaviours into their lives than others.
Adults with autism spectrum disorder show atypical patterns of thoughts and feelings during rest
Authors: Simpraga Sonja , Weiland Ricarda F , Mansvelder Huibert D , Polderman Tinca JC , Begeer Sander , Smit Dirk JA , Linkenkaer-Hansen Klaus
Published: February 2021

Mind wandering constitutes a major part of everyday experience and is inherently related to how we feel and identify ourselves. Thus, probing the character and content of thoughts and feelings experienced during mind-wandering episodes could lead to a better understanding of the human mind in health and disease. How mind wandering and spontaneous thought processes are affected in disorders such as autism is poorly understood. Here, we used the eyes-closed rest condition to stimulate mind wandering and quantified the subjective experiences using the Amsterdam Resting-State Questionnaire—which quantifies subjective psychological states of resting-state cognition across 10 domains—in 88 adults with autism spectrum disorder and 90 controls. We observed an atypical pattern of both thoughts and feelings in the autism spectrum disorder cohort, specifically in the domains of Theory of Mind, Comfort, and Discontinuity of Mind. We propose that the use of the Amsterdam Resting-State Questionnaire as a standardized cognitive instrument could advance our understanding of thoughts and feelings in autism spectrum disorder as well as in a wide variety of other brain disorders and how these may change due to therapeutic interventions.

Lay abstract

Everyone knows the feeling of letting one’s mind wander freely in a quiet moment. The thoughts and feelings experienced in those moments have been shown to influence our well-being—and vice versa. In this study, we looked at which thoughts and feelings are being experienced by adults with autism spectrum disorder and compared them to adults without autism spectrum disorder. In total, 88 adults with autism spectrum disorder and 90 adults without autism spectrum disorder were asked to rest for 5 min with their eyes closed and let their mind wander. Directly after, they filled in the Amsterdam Resting-State Questionnaire, which probes what participants were feeling and thinking during the period of rest. We found that adults with autism spectrum disorder tend to think less about others, felt less comfortable, and had more disrupted thoughts during the rest compared to adults without autism spectrum disorder. Interestingly, autism spectrum disorder participants reporting lower levels of comfort during the rest also reported more autism spectrum disorder symptoms, specifically in social behaviors and skills, attention switching, and imagination. We propose to use the eyes-closed rest condition in combination with the Amsterdam Resting-State Questionnaire more widely to shed light on aberrant thoughts and feelings in brain disorders and to study the effect of therapeutic interventions.
Asexuals negotiate the ‘onslaught of the heteronormative’
Authors: Vares Tiina
Published: February 2021

Although theorizing and research about asexuality have increased in the past decade, there has been minimal attention given to the emotional impact that living in a hetero- and amato-normative cultural context has on those who identify as asexual. In this paper, I address this research gap through an exploration of the ‘work that emotions do’ (Sara Ahmed) in the everyday lives of asexuals. The study is based on 15 individual interviews with self-identified asexuals living in Aotearoa New Zealand. One participant in the study used the phrase, ‘the onslaught of the heteronormative’ to describe how he experienced living as an aromantic identified asexual in a hetero- and amato-normative society. In this paper I consider what it means and feels like to experience aspects of everyday life as an ‘onslaught’. In particular, I look at some participants’ talk about experiencing sadness, loss, anger and/or shame as responses to/effects of hetero- and amato-normativity. However, I suggest that these are not only ‘negative’ emotional responses but that they might also be productive in terms of rethinking and disrupting hetero- and amato-normativity.
Fault diagnosis of rolling element bearing using autonomous harmonic product spectrum method
Authors: Patil AP , Mishra BK , Harsha SP
Published: February 2021

Maintenance planning plays a critical role in the process industry, where any unplanned maintenance may lead to a significant loss. Condition monitoring happens to aid maintenance planning and has become an inherent part of the maintenance activity. Physical parameters such as vibration, acoustic emission, current, etc., are used for condition monitoring, out of which vibration is the most preferred parameter and is widely used in the industry. Vibration data is measured near to bearings, which themselves are monitored for their condition, and hence rolling element bearing (REB) is the focus of this study. REBs are monitored for the presence of a fault in them as well as for their severity. Fault diagnosis of REB using harmonic product spectrum (HPS) is proposed in this study. The proposed methodology's novelty lies in the signal pre-processing step, whose output is fed to the HPS method, which is used for defective raceway identification. The efficacy of HPS is assessed with parameter optimized Variational mode decomposition (VMD) and classical bandpass filtering method as pre-processors. It is observed that the HPS delivers better diagnostic results with the VMD method than the bandpass filtering method. Non-dominated sorting particle swarm optimization algorithm is deployed for parameter optimization of VMD. HPS combined with VMD as pre-processor forms an autonomous HPS(AHPS) algorithm, whose input is measured signal and output is defect frequency. The process is so designed that a raw signal, when fed to the algorithm, delivers the result as identification of a defective raceway. Unlike previously developed methods, the proposed method needs no manual intervention. Results obtained from simulated signals and signals recorded through experiments validate that the proposed methodology can be used effectively for fault diagnosis of REB.
The news expectation predicament: Comparing and explaining what audiences expect from the roles and reporting practices of reporters on right-wing extremism
Authors: Baugut Philip , Scherr Sebastian
Published: February 2021

News about right-wing extremism pertains to the media’s information and watchdog functions in democratic societies. Since audience orientation is important to the journalistic profession, it is important to know what different news audiences expect of journalists regarding their professional role and their reporting practices when it comes to media coverage of right-wing extremism. To bridge this research gap, by employing a quota sample representative of the general German population ( n = 1314) and an independent sample of Muslims living in Germany ( n = 248), we demonstrated that Muslims expect a more active role from journalists and even accept controversial reporting practices to combat right-wing extremism. More left-leaning individuals were found to expect more controversial reporting unless they were afraid of right-wing extremism. Among these more left individuals, fear of terrorism seems to activate the argument that a democratic society should not give up its core principles, including the professional autonomy of its journalists and ethical reporting practices.
Hospitality business longevity under COVID-19: The impact of COVID-19 on New Zealand’s hospitality industry
Authors: Hemmington Nigel , Neill Lindsay
Published: February 2021

The aim of this paper is to explore the impact of the COVID-19 pandemic on the New Zealand hospitality industry, within the context of business longevity theory using an on-line qualitative survey of 11 senior industry executives representing 105 restaurant, café and take-away outlets. The findings reveal that despite financial loss, COVID-19 provided an opportunity to engage in strategic innovation through two basic approaches; one mediated by technology, the other by direct personal contact. This internal innovation, flexibility and responsiveness is consistent with the RBV theory of the firm and the inertia and change perspective of organizational Population Ecology theory. The practical implications relate to business longevity and the financial impact across the industry, however, COVID-19 also provided an opportunity for strategic innovation through technology and direct personal customer contact. Innovations were mediated by two government COVID-19 related initiatives - the wage subsidy scheme, and government business loans. The social implications are significant and include a renewed sense of ‘self’ reflecting the need for business survival. Renewal has invigorated participants to differentiate the hospitality industry and its contribution to the national economy from that of tourism. That renewal and vibrancy provides the perfect scenario for the wider sociocultural embrace of a return to normal life and regular business in Aotearoa New Zealand. The limitations of this study include the focus on restaurants, cafes and take-aways - a wider hospitality industry study would provide a more industry representative perspective. The study is also focused on New Zealand as a unique case study; this would not necessarily be representative of the global industry. The qualitative approach and small sample is a strength in terms of depth of analysis, but could be supplemented through a wider quantitative study.
Diabetes, gender and deterioration in estimated glomerular filtration rate in patients with chronic heart failure: Ten-year prospective cohort study
Authors: Kearney Jessica , Drozd Michael , Walker Andrew MN , Slater Thomas A , Straw Sam , Gierula John , Paton Maria , Lowry Judith , Cole Charlotte , Witte Klaus K , Cubbon Richard M , Kearney Mark T
Published: February 2021

Introduction:

We aimed to evaluate the relationship between temporal changes in renal function and long-term mortality in patients with heart failure with reduced ejection fraction (HFrEF) and identify correlates of deteriorating renal function.

Methods:

A total of 381 patients with HFrEF enrolled in a prospective cohort study between 2006–2014 had eGFR measured at initial visit and at 1 year. Baseline characteristics were used in a multivariate analysis to establish variables that predict deterioration in eGFR. Follow-up data were used to assess whether declining eGFR was related to outcomes.

Results:

Patients were grouped into tertiles based on percentage change in eGFR. In a multivariate logistic regression analysis, male sex was associated with a 1.77-fold ([95% CI 1.01–2.89]; p = 0.045) and diabetes a 1.66-fold ([95% CI 1.02–2.70]; p = 0.041) greater risk of a decline in eGFR compared to those with stable/improving eGFR. Declining eGFR was associated with a 1.4-fold greater risk of death over 10 years ([95% CI 1.08–1.86]; p = 0.01) and a 3.12-fold ([1.44–6.75]; p = 0.004) greater risk of death at 1 year from second eGFR measurement.

Conclusions:

In patients with HFrEF diabetes and male sex are independent predictors of a decline in eGFR at 1 year. A decline eGFR over 1 year is associated with higher long-term all-cause mortality.
Dexterity of the Less Affected Hand in Children With Hemiplegic Cerebral Palsy
Authors: Burn Matthew B. , Gogola Gloria R.
Published: February 2021

Background:

To determine if the “unaffected” hand in children with hemiplegic cerebral palsy (CP) is truly unaffected.

Methods:

We performed a retrospective review of manual dexterity as measured by the Functional Dexterity Test (FDT) in 66 children (39 boys, 27 girls, mean age: 11 years 4 months) with hemiplegic CP. Data were stratified by Manual Ability Classification System (MACS) level, birth weight, and gestational age at birth, and compared with previously published normative values.

Results:

The FDT speed of the less affected hand is significantly lower than typically developing (TD) children ( P < .001). The development of dexterity is significantly lower than TD children (0.009 vs. 0.036 pegs/s/year, P < .001), with a deficit that increases with age. MACS score, birth weight, and age at gestation are not predictors of dexterity. The dexterity of the less affected hand is poorly correlated with that of the more affected hand.

Conclusions:

Both dexterity and rate of fine motor skill acquisition in the less affected hand of children with hemiplegic CP is significantly less than that of TD children. The less affected hand should be evaluated and included in comprehensive treatment plans for these children.
Fatigue life prediction of train wheel shaft based on load spectrum characteristics
Authors: Luo Jiao , Wang Shuci , Liu Xintian , Geng Shuanglong
Published: February 2021

Based on the analysis of load spectrum data, the loading sequence and the interaction between loads are considered, a fatigue life prediction model based on load spectrum is proposed. The load spectrum is preprocessed and the probability density function of mean and amplitude are fitted. The running condition of the train is analyzed, the one-dimensional program load spectrum of wheel and axle load is constructed by extrapolating the load spectrum. According to the modified fatigue cumulative damage method, the fatigue life of the axle is predicted with the one-dimensional program load spectrum. The relevant factors that affect the strength of the part are fully considers in the model. It more accurately reflects the objective facts of the component fatigue process. The result has more engineering reference significance and it provides a theoretical basis for the design and manufacture of train axles and ensuring safe operation.
Fatigue life assessment method of in-service mechanical structure
Authors: Ma Xiqiang , Yang Fang , Li Jishun , Xue Yujun , Guan Zhiqiang
Published: February 2021

The most usual failure mode of any mechanical structure is fatigue, which is characterized by an important feature of the decrease of elastic modulus of the material. In this paper, a fatigue life evaluation model based on equivalent elastic modulus is proposed for in-service mechanical structure. In the proposed model, parameters that represent the operating conditions of the mechanical structure, such as load, vibration, and shaft torque, etc., are used as the generalized load. To replace the fatigue stress, the statistical method is used here, which is also used in the conventional fatigue analysis method. The structural strain is also measured simultaneously. Using the statistical theory, the equivalent modulus of elasticity is formulated based on the relationship of stress, strain, and modulus of elasticity. To validate the proposed model, an online fatigue damage experiment has been conducted. The experimental results have been compared with that of the fatigue life prediction model with good agreement. It is expected that the methodology proposed in this paper will be widely used.
Study on the dynamic identification method of the weak part of the bar-shaped combined structure
Authors: Guo Tieneng , Meng Lingjun , Cao Jinxuan , Bai Chunsheng , Hua Xu , Zhou Cheng
Published: February 2021

The weak part of the stiffness of machine tool combined structure is the key to improve the stiffness of machine tool. To overcome the static deformation with difficulty acquisition, the paper chooses machine tool combined structure which can be equivalent to one-dimensional bar structure, and a weakness index (WI) is proposed to identify the weak part of the stiffness by means of the dynamic hammer test method. Based on the bar structure as a numerical example, the weak parts are modeled as EA reduction in stiffness while the mass is maintained at a constant value. Thorough finite element (FE) method simulations are performed to assess the robustness and limitations of the method in several scenarios with single and multiple weakness. On the crossbeam of gantry type machine tool, the sensors are used to collect vibration data, the structural modal parameters are obtained by singular value decomposition (SVD) technique, and the dynamic characteristics are systematically reconstructed by using modal state space method to obtain stiffness data at zero-frequency. Then, the weak part of the structural stiffness is identified by the weakness index. Finally, the comparison of FE simulations and experiment results are provided to illustrate the working of the method.
Multiobjective preimpact trajectory planning of space manipulator for self-assembling a heavy payload
Authors: Liu Yong , Du Zhe , Wu Zhe , Liu Fei , Li Xiaojun
Published: February 2021

To assemble a heavy payload to the spacecraft (free-floating base), the present study proposes a scheme of multiobjective trajectory planning for preimpact motion of redundant space manipulator (mounted on the base). Force impulse for self-assembly is derived as the function of joint angles/velocities, base pose, and impact direction. The trajectory planning problem is formulated as multiobjective optimization to minimize force impulse, base attitude disturbance, and energy consumption in the load-carrying process. A two-stage trajectory planning algorithm is proposed. To be specific, at the first stage, multiple desired configurations at the contact point are generated by position-level inverse kinematics with Newton–Raphson iterative method. At the second stage, joint trajectories satisfying joint angle limits and desired motion of the payload are parameterized by coefficients of sinusoidal polynomial functions. Multiobjective particle swarm optimization algorithm is adopted to solve the problem of multiobjective trajectory planning, and screening process is conducted to reserve nondominated solutions in limits of joint torques. The algorithm is implemented to a seven degrees of freedom space manipulator, and the effectiveness of the proposed method is verified by simulation results.
Preparation of pyrimido[4,5-b][1,6]naphthyridin-4(1H)-one derivatives using a zeolite–nanogold catalyst and their in vitro evaluation as anticancer agent
Authors: Eid Elshimaa M , Hassaneen Huwaida ME , Loutfy Samah A , Salaheldin Taher
Published: February 2021

Catalysis using supported gold nanoparticles has attracted significant research interest due to their unique properties and potential that is directly related to their particle size. An efficient one-pot, three-component procedure is developed for the preparation of pyrimido[4,5- b][1,6]naphthyridin-4( 1H)-one derivatives (4a–h) by cyclocondensation of 6-amino-2-thioxo-2,3-dihydropyrimidin-4( 1H)-one (1), aromatic aldehydes (2), and 1-benzylpiperidin-4-one (3) in the presence of zeolite-nano Au as a green catalyst in ethanol at 80 °C. The presented methodology has a number of advantages including a reusable catalyst, easy access, short reaction times, high yields, and an easy work-up. The nanogold catalyst is characterized by X-ray diffraction and transmission electron microscopy. The structures of the prepared compounds are established by elemental analyses and spectral data (infrared, mass spectrometry, 1H, and 13C NMR). While molecular docking studies show that products 4a and 4c have binding affinities with the active site of CDKs. A bio-evaluation assay revealed that some of the products exhibit strong to moderate effects against proliferation of Huh7 in an in vitro model of human liver cancer cells as confirmed by morphological alteration. Compounds 4c and 4a offer the lowest IC50 values at 22.5 and 39 µM, respectively.
Can surgeons optimize range of motion and reduce scapulohumeral impingements in reverse shoulder arthroplasty? A computational study
Authors: Gauci Marc-Olivier , Chaoui Jean , Berhouet Julien , Jacquot Adrien , Walch Gilles , Boileau Pascal
Published: February 2021

Background

Early glenohumeral impingement leads to poor range of motion and notching in reverse shoulder arthroplasty. The aim was to find from planning software which implant configuration provides the best motions in reverse shoulder arthroplasty.

Patients and Methods

Reverse shoulder arthroplasty planning (Glenosys) was made in 31 patients (12 men, 19 women, 76 ± 6 yo) and impingements were analyzed. Inlay (155°-inclined) and Onlay (145°-inclined) humeral designs were tested. Four configurations were tested for each shoulder: “INLAY”: non-lateralized glenoid-inlay humerus, “BIO-INLAY”: lateralized glenoid (BIO-RSA)-inlay humerus, “ONLAY”: non-lateralized glenoid-onlay humerus, and “BIO-ONLAY”: lateralized (BIO-RSA) glenoid-onlay humerus.

Results

BIO-ONLAY and BIO-INLAY groups presented a significantly better result in all tested motion ( p < 0.001 for all tests). BIO-ONLAY allowed a significantly better external rotation, extension and adduction than BIO-INLAY with decreased impingements with the pilar. BIO-INLAY presented a significantly better abduction. In abduction, an abutment of the greater tuberosity against the acromion was associated with a lower range of motion ( p < 0.0001) and did not depend on the lateralization.

Conclusion

Glenoid lateralization delays the glenohumeral impingement in reverse shoulder arthroplasty and gives the best rotations, adduction and extension when associated with neutral inclination and humeral 145° inclination. Greater tuberosity abutment has to be avoided in abduction and the Inlay design provides the best abduction.
Real-world analysis of the effect of gefitinib as a first-line therapy in patients with advanced non-small cell lung cancer with EGFR mutations
Authors: Van Luan Pham , Tien Nguyen Dinh , Hai Nguyen Minh , Tien Nguyen Dao , Duyen Thi Thi
Published: February 2021

Background:

There have been few studies on the efficacy of tyrosine kinase inhibitors in lung carcinomas. The purpose of this study was to evaluate the effect of gefitinib as a first-line therapy in patients with advanced non-small cell lung cancer (NSCLC) who were positive for epidermal growth factor receptor ( EGFR) mutations.

Methods:

This prospective analysis included 120 patients with advanced NSCLC with EGFR mutations who were administered gefitinib as the first-line therapy. Patient follow-up and evaluation were performed every 3 months or when there were symptoms of progressive disease. The main criteria for the analysis of response were progression-free survival (PFS) and overall response rate (ORR). The secondary criteria were overall survival (OS) and disease control rate (DCR). In addition, the relationship of OS with sex, smoking history, and performance status (PS), as well as gefitinib toxicity were analyzed.

Results:

The ORR and DCR were 59.2% and 95.8%, respectively. The median PFS was 14.5 months and the median OS was 33 months. The longer OS was statistically significant in women and non-smokers, and the patients had a good PS. Adverse events occurred in 59.2% patients, but most of them were grade 1 and 2 events.

Conclusion:

This study conducted in Vietnam suggests the effectiveness of gefitinib as a first-line treatment option in patients with advanced NSCLC and positive EGFR mutations regardless of whether the patients have a good PS or not. In particular, targeted therapy with gefitinib improved the OS in women and non-smokers.
Combining the Copenhagen Adduction Exercise and Nordic Hamstring Exercise Improves Dynamic Balance Among Male Athletes: A Randomized Controlled Trial
Authors: Saleh A. Al Attar Wesam , Faude Oliver , Husain Mohamed A. , Soomro Najeebullah , Sanders Ross H.
Published: February 2021

Background:

Copenhagen adduction exercise (CAE) and Nordic hamstring exercise (NHE) reduce the incidence of groin and hamstring injuries. Efficient dynamic balance can improve motor performance and reduce the risk of injuries in athletes. However, the effects of these exercises on dynamic balance have not been investigated.

Hypothesis:

CAE and NHE, as well as a combination of both exercises, would improve dynamic balance among amateur male athletes.

Study Design:

Randomized controlled trial.

Level of Evidence:

Level 1.

Methods:

A total of 200 male athletes aged 21.9 ± 2.4 years were included in the study and randomly assigned to 4 groups: CAE group (n = 50), NHE group (n = 50), CAE and NHE group (n = 50), and a control group (n = 50). A total of 177 male athletes completed the study. The primary outcome measure was the limit of stability (LoS), which was measured using the Biodex Stability System to assess the performance of the dynamic balance. The LoS of the athletes’ performance was measured pre- and postintervention after 6 weeks.

Results:

The LoS significantly improved in all treatment groups, including CAE (44.5% ± 5.3%), NHE (43.2% ± 5.3%), and CAE + NHE (48.4% ± 5.1%) groups when compared with the control group (28.3% ± 4.8%) after 6 weeks (all Ps < 0.01). The improvement of LoS was significantly greater in the CAE + NHE group compared with other groups (CAE, NHE, and control groups).

Conclusion:

There was a significant increase in dynamic balance performance postintervention among male athletes. CAE and NHE may improve injury prevention programs.

Clinical Relevance:

The results of this study provide evidence for athlete trainers and coaches to consider including the CAE and NHE as components of injury prevention programs to improve balance capacity and performance in athletes. Such improvements in balance may prevent injury risk and decrease absenteeism and injury-related financial burdens.
Changes in the extracellular microenvironment and osteogenic responses of mesenchymal stem/stromal cells induced by in vitro direct electrical stimulation
Authors: Srirussamee Kasama , Xue Ruikang , Mobini Sahba , Cassidy Nigel J , Cartmell Sarah H
Published: February 2021

Electrical stimulation (ES) has potential to be an effective tool for bone injury treatment in clinics. However, the therapeutic mechanism associated with ES is still being discussed. This study aims to investigate the initial mechanism of action by characterising the physical and chemical changes in the extracellular environment during ES and correlate them with the responses of mesenchymal stem/stromal cells (MSCs). Computational modelling was used to estimate the electrical potentials relative to the cathode and the current density across the cell monolayer. We showed expression of phosphorylated ERK1/2, c-FOS, c-JUN, and SPP1 mRNAs, as well as the increased metabolic activities of MSCs at different time points. Moreover, the average of 2.5 μM of H2O2 and 34 μg/L of dissolved Pt were measured from the electrically stimulated media (ES media), which also corresponded with the increases in SPP1 mRNA expression and cell metabolic activities. The addition of sodium pyruvate to the ES media as an antioxidant did not alter the SPP1 mRNA expression, but eliminated an increase in cell metabolic activities induced by ES media treatment. These findings suggest that H2O2 was influencing cell metabolic activity, whereas SPP1 mRNA expression was regulated by other faradic by-products. This study reveals how different electrical stimulation regime alters cellular regenerative responses and the roles of faradic by-products, that might be used as a physical tool to guide and control cell behaviour.
Biomaterials for corneal endothelial cell culture and tissue engineering
Authors: Parekh Mohit , Romano Vito , Hassanin Kareem , Testa Valeria , Wongvisavavit Rintra , Ferrari Stefano , Haneef Atikah , Willoughby Colin , Ponzin Diego , Jhanji Vishal , Sharma Namrata , Daniels Julie , Kaye Stephen B , Ahmad Sajjad , Levis Hannah J
Published: February 2021

The corneal endothelium is the posterior monolayer of cells that are responsible for maintaining overall transparency of the avascular corneal tissue via pump function. These cells are non-regenerative in vivo and therefore, approximately 40% of corneal transplants undertaken worldwide are a result of damage or dysfunction of endothelial cells. The number of available corneal donor tissues is limited worldwide, hence, cultivation of human corneal endothelial cells (hCECs) in vitro has been attempted in order to produce tissue engineered corneal endothelial grafts. Researchers have attempted to recreate the current gold standard treatment of replacing the endothelial layer with accompanying Descemet’s membrane or a small portion of stroma as support with tissue engineering strategies using various substrates of both biologically derived and synthetic origin. Here we review the potential biomaterials that are currently in development to support the transplantation of a cultured monolayer of hCECs.
Can it make me white again? A case report of 88% phenol as a depigmenting agent in vitiligo
Authors: Mahmood Farhan , Beach Renée A
Published: February 2021

Vitiligo is the most common depigmenting disorder. However, therapies prove to be time-consuming, costly, or slow to show efficacy. Here, we present a case of a 74-year-old female with vitiligo who underwent full-body depigmentation treatment 50 years ago. Brown patches of repigmentation appeared on the patient’s face and arms and were eventually treated with 88% phenol. Patient was later switched to compounded 3% glutathione cream for a more sustained effect. Phenol was an accessible, economical, and easily administrable therapeutic option that can result in short-term depigmentation.
Optimal Book-Value Debt Ratio
Authors: Tharavanij Piyapas
Published: February 2021

When a firm has a target capital structure, it is usually in a book-value term rather than a market-value one as normally assumed in standard finance textbooks. This article provides a systematic approach to determine the optimal book-value debt ratio. The proposed method balances both the tax benefit of debt and its associated bankruptcy cost and more importantly incorporates the aims to maintain a good credit rating, financial robustness in times of adverse shocks, and financial flexibility to seize good investment opportunities. In terms of methodology, our model incorporates the tax benefit of debt in the form of lower cost of capital, whereas the expected bankruptcy cost is reflected in a higher credit spread. We adjust the Hamada equation to take default risk into account by applying the method suggested by Cohen when adjusting the cost of equity as a debt ratio changes. The model is calibrated to data from the U.S. non-financial firms. It provides predictions concerning the effects of key variables such as profitability and growth. Our model reveals a negative relationship between growth opportunities and market debt ratios but no clear directional relationship with book debt ratios. In addition, our model points to the negative (positive) relationship between profitability and market (book) debt ratio. Interestingly, the two debt ratios move in the opposite directions. These predictions have support from existing empirical literature.
Case Management Strategies to Promote Employment for Transition-Age Youth With Disabilities
Authors: McCormick Sara T. , Kurth Noelle K. , Chambless Catherine E. , Ipsen Catherine , Hall Jean P.
Published: February 2021

Transitioning students with disabilities are at a disadvantage for post-school employment. This article explores ASPIRE case managers’ roles in promoting employment among transition-age youth with disabilities receiving SSI. Qualitative and quantitative studies examined programmatic factors related to employment. Results showed that higher rates of face-to-face case management meetings and early employment experiences were associated with improved employment outcomes. Effective case managers’ interactions with families were characterized by persistence, flexibility, and a holistic focus. Case management during the transition to adulthood, which crosses independent living, education, and employment domains, is important. A cross-domain case management model can be effective in mitigating multiple barriers to self-sufficiency experienced by families living with disability and poverty. Limitations and implications for research and practice are included.
Clinical Outcome and Histological Findings After Induced Leakage of PMMA Loaded With Methotrexate and Cisplatin During Vertebroplasty: Experimental Model in Pigs
Authors: González Alvaro Silva , Llombart-Blanco Rafael , Angulo Marcela Gallegos , Tomé Carlos Villas , Olmos-García Matías Alfonso
Published: February 2021

Study Design:

Animal experimental model.

Objective:

To study the clinical behavior and histological changes in the spinal cord, nerve roots and perivertebral muscles of the spine after induced leakage of polymethylmethacrylate (PMMA) loaded with antiblastic drugs during vertebroplasty in an animal model of pigs.

Methods:

We performed vertebroplasty on 25 pigs. The animals were divided into 3 groups: vertebroplasty with PMMA alone (control group), vertebroplasty with PMMA loaded with methotrexate (MTX) and vertebroplasty with PMMA loaded with cisplatin (CYS). At 2 vertebral levels, epidural and prevertebral, massive cement leaks were induced. Animals were evaluated daily. Two weeks later, the pigs were sacrificed, and the tissues that came in contact with the cement were analyzed.

Results:

The clinical results for each of the groups were reported. The control group had no clinical alterations. In the MTX group, 2 pigs died before 1 week due to pneumonitis. In the CYS group, 4 animals had motor impairment, and 3 of the 4 had paraplegia. The histological results were as follows: the control and MTX groups showed synovial metaplasia, inflammatory reaction, crystal deposits, and giant cell reaction in the dura mater and muscle and all the animals in the CYS group had spinal cord and muscular necrosis.

Conclusions:

Massive cement leak after vertebroplasty with PMMA loaded with cisplatin is extremely toxic to the spinal cord and muscles around the spine. Therefore, its use cannot be recommended for the treatment of vertebral metastases. Using PMMA loaded with methotrexate seems to be a safe procedure, but further research is needed.
Internal Medicine Trainee Understanding and Reaction to Out of Pocket Costs
Authors: Chidester Jeffrey , Vigen Rebecca , Das Sandeep R
Published: February 2021

Background:

Out-of-pocket costs are a serious barrier to care and drive suboptimal medical therapy. Understanding of these costs can lead to care oriented around the limits they generate. Despite this, there is minimal attention paid to these costs in post-graduate education.

Objective:

To define a potential knowledge gap regarding costs experienced by patients by surveying Internal Medicine residents at our large academic institution.

Methods:

We surveyed Internal Medicine residents in spring 2019 about knowledge and practices surrounding patient out-of-pocket costs. Participants answered questions considering their most recent inpatient panel and their clinic patient panel. Familiarity was ranked on a 5-point Likert scale, and for the purposes of presentation, was divided into “Poor” and “Moderate or Better.” Non-parametric analysis was used to test differences between outpatients and inpatients and by year of training.

Results:

Of 159 residents, 109 (67%) responded. Familiarity with patient insurance status was moderate or better in 85%. Reported understanding of costs associated with medications, testing, and clinic visits was less common. Respondents had higher familiarity with out-of-pocket costs for clinic patients compared with inpatients. Knowledge of cost of care was not an often-considered factor in decision making. There was no significant difference in response by year of training.

Conclusion:

Patient out-of-pocket costs are an important dimension of patient care which Internal Medicine Trainees at our institution do not confidently understand or utilize. Improvements in education around this topic may enable more patient-centered care.
Ban the (plastic) bag? Explaining variation in the implementation of plastic bag bans in Rwanda, Kenya and Uganda
Authors: Behuria Pritish
Published: February 2021

The environmental damage that plastic waste is causing has catalyzed government action against plastic bags around the world. Despite anti-plastic bag policies gaining traction globally, there has been limited investigation of why the implementation of bans has varied. The variation in implementing bans is particularly stark in East Africa, a region that has been at the forefront of plastic bag legislation. Rwanda’s implementation of a ban on plastic bags in 2008 has attracted widespread praise for its environmental leadership. Kenya adopted a plastic bag ban before Rwanda but implementation was consistently delayed until a stringent ban was finally imposed in 2018. In Uganda, despite bans being announced on four separate occasions, implementation continues to be delayed. This paper explains why some governments adopt and effectively enforce plastic bag bans while others reverse course or delay implementation. Existing literature has cited the comparative strength of plastic industries as the salient factor in explaining varied adoption of plastic bag bans. This paper argues that though the comparative business power of plastic industries explains whether bans are obstructed, it does not satisfactorily explain varied implementation. Instead, countries that pursue services-based development strategies, which prioritise externally dependent sectors like tourism, are more likely to implement plastic bag bans, which can help bolster their green credentials. For the Rwandan and Kenyan governments, presenting their countries as environmental leaders contributed to their goals of becoming a regional economic hub, reliant on services like tourism. The Kenyan government’s decision to eventually implement the ban was driven by a perceived need to compete with Rwanda for regional environmental leadership while supporting Kenya’s services-based economic development strategy. In contrast, Uganda’s comparatively larger discovery of oil and limited emphasis on services-based development explained the government’s lack of commitment to implementing a plastic bag ban.