bluuebunny/crossref_metadata_2025 huggingface dataset:
Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature
Authors: Buldt Andrew K. , Menz Hylton B.
Published: July 2018

Background

Correct footwear fitting is acknowledged as being vitally important, as incorrectly fitted footwear has been linked to foot pathology. The aim of this narrative review was to determine the prevalence of incorrectly fitted footwear and to examine the association between incorrectly fitted footwear, foot pain and foot disorders.

Methods

A database search of Ovid MEDLINE and CINAHL yielded 1,681 citations for title and abstract review. Eighteen articles were included. Findings were summarised under the categories of (i) children, (ii) adults, (ii) older people, (iii) people with diabetes and (iii) occupation‐ or activity‐specific footwear. Differences in footwear fitting between sexes were also explored.

Results

Between 63 and 72% of participants were wearing shoes that did not accommodate either width or length dimensions of their feet. There was also evidence that incorrect footwear fitting was associated with foot pain and foot disorders such as lesser toe deformity, corns and calluses. Specific participant groups, such as children with Down syndrome and older people and people with diabetes were more likely to wear shoes that were too narrow (between 46 and 81%).

Conclusion

A large proportion of the population wear incorrectly sized footwear, which is associated with foot pain and foot disorders. Greater emphasis should be placed on both footwear fitting education and the provision of an appropriately large selection of shoes that can accommodate the variation in foot morphology among the population, particularly in relation to foot width.
Molecular characterization of extended spectrum β -lactamases enterobacteriaceae causing lower urinary tract infection among pediatric population
Authors: Eltai Nahla O. , Al Thani Asmaa A. , Al-Ansari Khalid , Deshmukh Anand S. , Wehedy Eman , Al-Hadidi Sara H. , Yassine Hadi M.
Published: July 2018

Background

The β-lactam antibiotics have traditionally been the main treatment of Enterobacteriaceae infections, nonetheless, the emergence of species producing β- Lactamases has rendered this class of antibiotics largely ineffective. There are no published data on etiology of urinary tract infections (UTI) and antimicrobial resistance profile of uropathogens among children in Qatar. The aim of this study is to determine the phenotypic and genotypic profiles of antimicrobial resistant Enterobacteriaceae among children with UTI in Qatar.

Methods

Bacteria were isolated from 727 urine positive cultures, collected from children with UTI between February and June 2017 at the Pediatric Emergency Center, Doha, Qatar. Isolated bacteria were tested for antibiotic susceptibility against sixteen clinically relevant antibiotics using phoenix and Double Disc Synergy Test (DDST) for confirmation of extended-spectrum beta-lactamase (ESBL) production. Existence of genes encoding ESBL production were identified using polymerase chain reaction (PCR). Statistical analysis was done using non-parametric Kappa statistics, Pearson chi-square test and Jacquard’s coefficient.

Results

201 (31.7%) of samples were confirmed as Extended Spectrum β -Lactamases (ESBL) Producing Enterobacteriaceae. The most dominant pathogen was E. coli 166 (83%) followed by K. pneumoniae 22 (11%). Resistance was mostly encoded by bla CTX-M (59%) genes, primarily bla CTX-MG1 (89.2%) followed by bla CTX-MG9 (7.7%). 37% of isolated bacteria were harboring multiple bla genes (2 genes or more). E. coli isolates were categorized into 11 clusters, while K. pneoumoniae were grouped into five clonal clusters according to the presence and absence of seven genes namely bla TEM, bla SHV, bla CTX-MG1, bla CTX-MG2, bla CTX-MG8 bla CTX-MG9,bla CTX-MG25.

Conclusions

Our data indicates an escalated problem of ESBL in pediatrics with UTI, which mandates implementation of regulatory programs to reduce the spread of ESBL producing Enterobacteriaceae in the community. The use of cephalosporins, aminoglycosides (gentamicin) and trimethoprim/sulfamethoxazole is compromised in Qatar among pediatric population with UTI, leaving carbapenems and amikacin as the therapeutic option for severe infections caused by ESBL producers.
Intra-hospital differences in antibiotic use correlate with antimicrobial resistance rate in Escherichia coli and Klebsiella pneumoniae: a retrospective observational study
Authors: Cusini Alexia , Herren David , Bütikofer Lukas , Plüss-Suard Catherine , Kronenberg Andreas , Marschall Jonas
Published: July 2018

Background

Monitoring antimicrobial use and resistance in hospitals are important tools of antimicrobial stewardship programs. We aimed to determine the association between the use of frequently prescribed antibiotics and the corresponding resistance rates in Escherichia coli and Klebsiella pneumoniae among the clinical departments of a tertiary care hospital.

Methods

We performed a retrospective observational study to analyse the use of nine frequently prescribed antibiotics and the corresponding antimicrobial resistance rates in hospital acquired E. coli and K. pneumoniae isolates from 18 departments of our institution over 9 years (2008–2016). The main cross-sectional analysis assessed the hypothetical influence of antibiotic consumption on resistance by mixed logistic regression models.

Results

We found an association between antibiotic use and resistance rates in E. coli for amoxicillin-clavulanic acid (OR per each step of 5 defined daily dose/100 bed-days 1.07, 95% CI 1.02–1.12; p = 0.004), piperacillin-tazobactam (OR 2.11, 95% CI 1.45–3.07; p < 0.001), quinolones (OR 1.52, 95% CI 1.25–1.86; p < 0.001) and trimethoprim-sulfamethoxazole (OR 1.59, 95% CI 1.19–2.13; p = 0.002). Additionally, we found a significant association when all nine antibiotics were combined in one analysis. The association between consumption and resistance rates was stronger for nosocomial than for community strains. In K. pneumoniae, we found an association for amoxicillin-clavulanic acid (OR 1.07, 95% CI 1.01–1.14; p = 0.025) and for trimethoprim-sulfamethoxazole (OR 2.02, 95% CI 1.44–2.84; p < 0.001). The combined analysis did not show an association between consumption and resistance (OR 1.06, 95% CI 0.99–1.14; p = 0.07).

Conclusions

We documented an association between antibiotic use and resistance rate for amoxicillin-clavulanic acid, piperacillin-tazobactam, quinolones and trimethoprim-sulfamethoxazole in E. coli and for amoxicillin-clavulanic acid and trimethoprim-sulfamethoxazole in K. pneumoniae across different hospital departments. Our data will support stewardship interventions to optimize antibiotic prescribing at a department level.
Cytokines, breast cancer stem cells (BCSCs) and chemoresistance
Authors: Chen Weilong , Qin Yuanyuan , Liu Suling
Published: July 2018

Chemotherapy resistance of breast cancer poses a great challenge to the survival of patients. During breast cancer treatment, the development of intrinsic and acquired drug resistance tends to further induce adverse prognosis, such as metastasis. In recent years, the progress of research on cytokine‐modulated tumor microenvironment and breast cancer stem cells (BCSCs) has shed light on defining the mechanisms of drug resistance gradually. In this review, we have discussed cytokine regulation on breast cancer chemoresistance. Cytokines can affect tumor cell behavior or reprogram tumor niche through specific signaling pathways, thereby regulating the progress of drug resistance. In addition, we summarized the mutually regulatory networks between cytokines and BCSCs in mediating chemoresistance. Cytokines in the tumor microenvironment can regulate the self‐renewal and survival of BCSCs in a variety of ways, sequentially promoting chemotherapeutic resistance. Therefore, the combinational treatment of BCSC targeting and cytokine blockade may have a positive effect on the clinical treatment of breast cancer.
Mass spectrometry identification of the liquor contained in the plum vase excavated from Jurou Li’s Grave of the Jin Dynasty (1115–1234 CE) in Xi’an, Shannxi, China
Authors: Zhu Zhanyun , Yu Chunlei , Miao Yifei , Lu Zhiyong , Yang Junchang
Published: July 2018

In order to accurately identify the ancient liquid contained in the plum vase excavated from Jurou Li’s Grave of the Jin Dynasty (1115–1234 CE) in Xi’an, mass spectrometry was applied to determine the amino acid sequences of the residual proteins extracted from the liquid sample. The sequences were searched against a standard protein sequence database. The proteins extracted was identified as glycosyltransferase from Sorghum bicolor, calcium-dependent protein kinase 2 from Wickerhamomyces ciferrii, and cytochrome b-c1 complex subunit Rieske from Nadsonia fulvescens. These findings indicate that the extremely degraded liquid in the plum vase was made from the cereal of sorghum by alcoholic fermentation of Wickerhamomyces ciferrii and Nadsonia fulvescens, providing direct evidence for liquor in the Jin Dynasty.
First‐generation EGFR tyrosine kinase inhibitor therapy in 106 patients with compound EGFR‐mutated lung cancer: a single institution's clinical practice experience
Authors: Yu Xiangyang , Zhang Xuewen , Zhang Zichen , Lin Yongbin , Wen Yingsheng , Chen Yongqiang , Wang Weidong , Zhang Lanjun
Published: July 2018

Background

The antitumour efficacy of tyrosine kinase inhibitors (TKIs) in lung cancer patients with compound epidermal growth factor receptor (EGFR) mutations has not been resolved. Our study summarizes a single institutional experience of first‐generation TKI therapy for lung cancers with compound EGFR mutations.

Methods

A total of 106 consecutive patients with tumours bearing compound EGFR mutations were identified between January 2012 and May 2016; all patients received first‐generation TKI therapy. Deletions in exon 19 and the L858R point mutation in exon 21 were considered common mutations; T790M was considered separately because of its association with TKIs resistances. Any other mutation was defined as a rare mutation. Patients were divided as follows: double common mutations (group A); common plus T790M mutations (group B); common plus rare mutations (group C); double rare mutations (group D); and rare plus T790M mutations (group E). A separate group of 115 consecutive patients with a single common mutation was created for comparative analysis (group F).

Results

The frequency of patients with compound EGFR was 2.9% (114/3925) and their response rate to first‐generation TKIs was 50.9%, which was not significantly different from group F (67.0%, P = 0.088). The progression‐free survival (PFS) of the 106 patients receiving TKI therapy was worse than that of group F (median, 9.1 vs. 13.0 months, respectively; P < 0.001). The PFS of the compound mutation group was shorter than that of the single common mutation group (median, 10.1 months in group A, P = 0.240; 9.1 months in group B, P < 0.001; 9.6 months in group C, P = 0.010; 6.5 months in group D, P = 0.048; 5.4 months in group E, P = 0.017). Patients with a co‐occurring mutation in exon 20 (excluding T790M) exhibited significantly worse PFS than the patients with other compound mutations or with a single common mutation (median, 6.5 vs. 9.1 vs. 13.0 months, respectively, P = 0.002).

Conclusions

There was significant heterogeneity among the compound EGFR mutations and their response to first‐generation TKIs. Individualized treatment in clinical practice should be considered for each case.
Competing RNA pairings in complex alternative splicing of a 3′ variable region
Authors: Pan Huawei , Shi Yang , Chen Shuo , Yang Yun , Yue Yuan , Zhan Leilei , Dai Lanzhi , Dong Haiyang , Hong Weiling , Shi Feng , Jin Yongfeng
Published: July 2018

Alternative pre-mRNA splicing remarkably expands protein diversity in eukaryotes. Drosophila PGRP-LC can generate three major 3′ splice isoforms that exhibit distinct innate immune recognition and defenses against various microbial infections. However, the regulatory mechanisms underlying the uniquely biased splicing pattern at the 3′ variable region remain unclear. Here we show that competing RNA pairings control the unique splicing of the 3′ variable region of Drosophila PGRP-LC pre-mRNA. We reveal three roles by which these RNA pairings jointly regulate the 3′ variant selection through activating the proximal 3′ splice site and concurrently masking the intron-proximal 5′ splice site, in combination with physical competition of RNA pairing. We also reveal that competing RNA pairings regulate alternative splicing of the highly complex 3′ variable regions of Drosophila CG42235 and Pip. Our findings will facilitate a better understanding of the regulatory mechanisms of highly complex alternative splicing as well as highly variable 3′ processing.
Dynamic temperature-sensitive A-to-I RNA editing in the brain of a heterothermic mammal during hibernation
Authors: Riemondy Kent A. , Gillen Austin E. , White Emily A. , Bogren Lori K. , Hesselberth Jay R. , Martin Sandra L.
Published: July 2018

RNA editing diversifies genomically encoded information to expand the complexity of the transcriptome. In ectothermic organisms, including Drosophila and Cephalopoda, where body temperature mirrors ambient temperature, decreases in environmental temperature lead to increases in A-to-I RNA editing and cause amino acid recoding events that are thought to be adaptive responses to temperature fluctuations. In contrast, endothermic mammals, including humans and mice, typically maintain a constant body temperature despite environmental changes. Here, A-to-I editing primarily targets repeat elements, rarely results in the recoding of amino acids, and plays a critical role in innate immune tolerance. Hibernating ground squirrels provide a unique opportunity to examine RNA editing in a heterothermic mammal whose body temperature varies over 30°C and can be maintained at 5°C for many days during torpor. We profiled the transcriptome in three brain regions at six physiological states to quantify RNA editing and determine whether cold-induced RNA editing modifies the transcriptome as a potential mechanism for neuroprotection at low temperature during hibernation. We identified 5165 A-to-I editing sites in 1205 genes with dynamically increased editing after prolonged cold exposure. The majority (99.6%) of the cold-increased editing sites are outside of previously annotated coding regions, 82.7% lie in SINE-derived repeats, and 12 sites are predicted to recode amino acids. Additionally, A-to-I editing frequencies increase with increasing cold-exposure, demonstrating that ADAR remains active during torpor. Our findings suggest that dynamic A-to-I editing at low body temperature may provide a neuroprotective mechanism to limit aberrant dsRNA accumulation during torpor in the mammalian hibernator.
Speech Aggression As a Communicative Phenomenon: Aspect of Linguistics And Axiology
Authors: Гончарова Любовь , Goncharova Lyubov
Published: July 2018

The article examines the reasons for the changes in communication in the modern society, as well as the areas where speech aggression is particularly pronounced. Speech aggression is seen as a communicative

phenomenon in the aspect of linguistics and axiology - in terms of norms, ethical, moral and cultural values. There is a paradox that in the modern world, speech aggression often becomes a stimulus for establishing and

continuing a communicative contact..
UMA ANÁLISE CRÍTICA DA TEORIA DA IGNORÂNCIA DELIBERADA À LUZ DO PRINCÍPIO DA IMPUTAÇÃO SUBJETIVA
Authors: Rosa Gerson Faustino , De Carvalho Gisele Mendes
Published: July 2018

O presente trabalho tem como meta a análise crítica e a exploração de um grande problema jurídico-penal da atualidade, qual seja, a importação da teoria da ignorância deliberada para viabilizar a inculpação de condutas que não se enquadrem nos critérios de imputação previstos em nosso ordenamento jurídico, violando o princípio da imputação subjetiva. Para tanto, analisou-se a origem histórica da teoria da ignorância deliberada, apresentando julgados dos Direitos inglês, norte-americano, espanhol e brasileiro. Demonstrou-se, ademais disso, a sua utilização inicial no sistema anglo-saxão e, posteriormente, a sua importação para o sistema continental. Adiante, discorreu-se acerca das proposta de definição e delimitação doutrinária e jurisprudencial da presente teoria, seguidas de uma análise crítica frente a sua incompatibilidade com o princípio político-criminal de garantia da imputação subjetiva.
Crash, bang, wallop: The school nurse's role in the management of dental trauma
Authors: Warrilow Laura , Gohil Tanika , McDonald Sheridan
Published: July 2018

Initial management of dental trauma has a huge impact on the long-term prognosis of any teeth involved, therefore school nurses play an import role in implementing appropriate first aid. Good management can mean less initial and long-term treatment is required, less time off school and less psychological impact on the child. The International Association of Dental Traumatology (IADT) have created guidelines for trauma management, however, these are targeted to dentists, who are rarely involved in the crucial immediate management stage of dental trauma. This article aims to translate elements of these guidelines to make them more accessible and to support school nurses who are more often involved in the frontline management of dental injuries.
Promoting sun safety: A guide for school nurses
Authors: Croghan Emma
Published: July 2018

Skin cancer is the fifth most prevalent cancer in both men and women. Emma Croghan provides an overview of the risks of UV exposure and how to reduce these risks in children and young people.
Liver disease in children—the role of the school nurse
Authors: Hogg Lindsay
Published: July 2018

Liver disease can have a substantial impact on children's school life. Lindsay Hogg provides an overview of the symptoms, and explains how school nurses can help support children and young people with liver disease.
Supporting students with Tourette's syndrome
Authors: Thornton Stephanie
Published: July 2018

Signs of Tourette's syndrome usually start in early childhood and can be co-morbid with a number of mental health conditions. Stephanie Thornton explains why it is important for families to access expert help as early as possible and looks at strategies to help support students with Tourette's.
Where does smoking fit into your school's PSHE curriculum?
Authors: Macdonald Ian
Published: July 2018

Ian Mcdonald looks at the incidence of smoking among young people and gives advice on delivering education about smoking and how it can be linked to other areas of the PSHE curriculum.
Tackling sexual harassment in schools: New guidance
Authors: Cole Anna
Published: July 2018

New government advice on tackling sexual violence and sexual harassment between students has been published. Anna Cole advises schools on the next steps
HPV: Immunising boys and parental acceptance
Authors: Cotton Richard
Published: July 2018

The research round-up series provides an overview of a selection of relevant public health research and comments on the findings and methods. This month, Richard Cotton looks at four articles focusing on HPV immunisation.
Immediate dentures part 1: assessment and treatment planning
Authors: Jogezai Ursala , Laverty Dominic , Walmsley A Damien
Published: July 2018

Abstract: This two part review article aims to provide a comprehensive summary on immediate dentures. In the first part, after a brief introduction, the advantages and disadvantages of immediate dentures are compared. There is a detailed discussion on assessment and treatment planning which includes history-taking, examination of the soft and hard tissues, current prostheses, occlusion, as well as discussion on investigations required and formulating a diagnosis. The first part ends with a summary of types of immediate dentures and denture designs.

CPD/Clinical Relevance: Immediate dentures are commonly used to provide patients with tooth replacement immediately following extractions in order to maintain aesthetics and function. Therefore, they are an integral part of a dentist's armamentarium.
Management of infra-occluded primary molars
Authors: Attwall Roshanak , Parker Kate , Gill Daljit S
Published: July 2018

Abstract: This article reviews the aetiology, diagnosis and management of infra-occluded primary molars. The different treatment options are detailed as well as the differences in the management of patients depending on their age, the severity of the infra-occlusion and whether the permanent successor is present or absent.

CPD/Clinical Relevance: The ability to identify and diagnose infra-occluded primary molars is crucially important for their subsequent management. Knowledge of the different treatment options and their relevance in different clinical situations is important for all dental healthcare professionals.
Oral lymphoma: a case series
Authors: Allsobrook Olive FL , Bakri Issam , Farthing Paula M , Morley Nick J , Hegarty Anne M
Published: July 2018

Abstract: Oral presentation of lymphoma is rare but highlights the need for dentists in primary care to consider it for inclusion when determining differential diagnoses for patients who present with oral lesions. Oral lymphoma manifests in both intra- and extra-osseous sites within the oral cavity with a variety of clinical appearances which may mimic benign or innocuous processes. There may be non-specific signs which may be misleading to the clinician or present mimicking other oral malignancies, such as a non-healing ulcer, rapidly growing swelling with sudden onset or dental pathological processes. This case series highlights the varied presentations of oral lymphoma and the role of general dental practitioners in the early diagnosis, timely referral and management of these patients.

CPD/Clinical Relevance: This article highlights the need for primary care clinicians to consider oral lymphoma in patients who present in the general dental setting with oral lesions.
Oral rehabilitation of a patient suffering mal-union of a fractured mandible
Authors: Bryce Graeme , Sterlitz Stephen , Smith Stephen
Published: July 2018

Abstract: Mandibular mal-union following fracture is a rare occurrence that can normally be surgically corrected. This article reviews the aetiology of mal-union and details the restorative rehabilitation of a patient suffering a failing dentition and mal-union of the mandible, using dental implants.

CPD/Clinical Relevance: This article discusses the restorative challenges with managing a patient with mandibular mal-union and details a successful treatment pathway using dental implants.
3D printed tooth model – a patient education tool and surgical aid in endodontics
Authors: Arora Ankit , Mody Bharat , Patel Niraj
Published: July 2018

Abstract: The use of 3D printed models created using cone beam computed tomography (CBCT) is a new addition to the field of dentistry. 3D printed models are easier for the patients to understand and serve as an effective treatment planning tool for the clinician. This case describes 3D printing as a technique which not only aids in visualization of the complex anatomy but serves as a great motivational and educational tool. A tooth with dens invaginatus and chronic apical periodontitis requiring surgical intervention was printed and used for patient motivation and three-dimensional visualization, which improved the accuracy of diagnosis, treatment planning, predictability of procedures and final outcome.

CPD/Clinical Relevance: 3D printed models can be utilized as a patient education tool for motivating patients who are not convinced by the surgical treatment modality.
Malignant oral melanoma: how to spot it and how it is managed
Authors: Khan Zahid , Albuquerque Rui , Richards Andrea
Published: July 2018

Abstract: Primary oral melanoma (POM) is a rare malignancy affecting primarily the hard palate and maxillary gingivae. Oral melanoma has a poor prognosis due to the frequent delay in diagnosis, the tendency of the tissues to be invaded locally and the potential to metastasize. This article aims to summarize the key clinical features of different types of oral pigmentation that are likely to be encountered by a general dental practitioner (GDP) and to highlight those that should prompt an urgent referral for investigation.

CPD/Clinical Relevance: The aim of this article is to increase awareness of the varying and sometimes atypical features of oral melanoma.
Why Does The Use of Social Network Site (SNS) Make Happy? : A Qualitative Analysis
Authors: Dogan Ugur , Uysal Humeyra , Sidekli Sabri
Published: July 2018

The aim of this study investigate to the reasons why the usage of Social Network Sites (SNS) makes users happy. To this end, the study was conducted with as a qualitative research method. The phenomenological design, which is a qualitative research method, was utilized for determining why SNS usage cause happiness and having a better to understand of how SNS users describe SNSs and what they feel about it. The study group was composed of 137 university students (60 males and 77 females) attending the Faculty of Education, Faculty of Science, Faculty of Literature, and Faculty of Economics and Administrative Sciences at a university in the southwestern of Turkey. A structured, open-ended interview was used as the data collection instrument. The contributors were asked the question “Why does SNS usage cause happiness?” and their answers were retrieved. The answers were encoded and entered to the NVivo software to conduct analyses. Based on the most frequent answers of the participants, three different experts were consulted and seven themes were created accordingly. These seven themes include Need for Stroke, Self-Concealment, Ease of Interaction, Ease of Accessing and Disseminating Information, Ease of Shopping, Leisure Activity, and Fear of Missing Out. Subcategories were also created for these seven themes. It was concluded that the theme of FoMO is nourished by all other themes.
The Exeter V40 cemented femoral component at a minimum 10-year follow-up
Authors: Westerman R. W. , Whitehouse S. L. , Hubble M. J. W. , Timperley A. J. , Howell J. R. , Wilson M. J.
Published: July 2018

Aims

The aim of this study was to report the initial results of the Exeter V40 stem, which became available in 2000.

Patients and Methods

A total of 540 total hip arthroplasties (THAs) were performed in our unit using this stem between December 2000 and May 2002. Our routine protocol is to review patients postoperatively and at one, five, and ten years following surgery.

Results

A total of 145 patients (26.9%) died before ten years and of the remaining 395 stems, 374 (94.7%) remain in situ. A total of 21 well-fixed stems (5.3%) were revised. Ten were exchanged using a cement-in-cement technique to facilitate acetabular revision. Three were revised for infection, one for instability, one for fracture of the stem, and six following a periprosthetic fracture. An additional 16 acetabular components (4.1%) were revised; five for aseptic loosening and 11 for instability. There were no revisions for aseptic loosening of the stem, and no evidence of aseptic loosening in any hip. The fate of every stem is known and all patients remain under review. Survivorship, with revision of the stem for aseptic loosening as the endpoint, was 100%. At 13.5 years, the Kaplan–Meier survival rate for all-cause revision of the stem was 96.8% (95% confidence interval (CI) 94.8 to 98.8) and all-cause revision (including acetabular revision, infection, and instability) was 91.2% (95% CI 88.3 to 94.1).

Conclusion

No stem was revised for aseptic loosening in this series. The contemporary Exeter V40 stem continues to perform well, and survival has remained comparable with that of the Exeter Universal stem. Cite this article: Bone Joint J 2018;100-B:1002–9.
A randomized controlled trial of cementedversuscementless arthroplasty in patients with a displaced femoral neck fracture
Authors: Barenius B. , Inngul C. , Alagic Z. , Enocson A.
Published: July 2018

Aims

The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem.

Patients and Methods

A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58).

Results

Early differences in functional outcome, assessed using the Harris Hip Score, the Short Musculoskeletal Functional Assessment score and EuroQol-5D, with better results in cemented group, deteriorated over time and there were no statistically significant differences at 48 months. Two (3%) patients in the cemented group and five (6.8%) in the cementless group underwent further surgery for a periprosthetic fracture. This difference was statistically significant (p = 0.4). No patient underwent further surgery for instability or infection between one and four years postoperatively. The mortality and the radiological outcomes were similar in both groups.

Conclusion

Patients with a displaced femoral neck fracture treated with an arthroplasty using a cemented or cementless stem had good function and few complications up to four years postoperatively. However, due to the poor short-term functional outcomes in the cementless group, the findings do not support their routine use in the treatment of these elderly patients. Cite this article: Bone Joint J 2018;100-B:1087–93.
Total disc replacement versus anterior cervical discectomy and fusion
Authors: Findlay C. , Ayis S. , Demetriades A. K.
Published: July 2018

Aims

The aim of this study was to determine how the short- and medium- to long-term outcome measures after total disc replacement (TDR) compare with those of anterior cervical discectomy and fusion (ACDF), using a systematic review and meta-analysis.

Patients and Methods

Databases including Medline, Embase, and Scopus were searched. Inclusion criteria involved prospective randomized control trials (RCTs) reporting the surgical treatment of patients with symptomatic degenerative cervical disc disease. Two independent investigators extracted the data. The strength of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. The primary outcome measures were overall and neurological success, and these were included in the meta-analysis. Standardized patient-reported outcomes, including the incidence of further surgery and adjacent segment disease, were summarized and discussed.

Results

A total of 22 papers published from 14 RCTs were included, representing 3160 patients with follow-up of up to ten years. Meta-analysis indicated that TDR is superior to ACDF at two years and between four and seven years. In the short-term, patients who underwent TDR had better patient-reported outcomes than those who underwent ACDF, but at two years this was typically not significant. Results between four and seven years showed significant differences in Neck Disability Index (NDI), 36-Item Short-Form Health Survey (SF-36) physical component scores, dysphagia, and satisfaction, all favouring TDR. Most trials found significantly less adjacent segment disease after TDR at both two years (short-term) and between four and seven years (medium- to long-term).

Conclusion

TDR is as effective as ACDF and superior for some outcomes. Disc replacement reduces the risk of adjacent segment disease. Continued uncertainty remains about degeneration of the prosthesis. Long-term surveillance of patients who undergo TDR may allow its routine use. Cite this article: Bone Joint J 2018;100-B:991–1001.
LA COMPETENCIA MATEMÁTICA EN EDUCACIÓN INFANTIL: ESTUDIO COMPARATIVO DE TRES METODOLOGÍAS DE ENSEÑANZA
Authors: Rodríguez Mantilla Jesús Miguel , Martínez Zarzuelo Angélica
Published: July 2018

INTRODUCCIÓN. En Educación Infantil resulta de especial importancia el modo en que se trabaja la adquisición de conocimientos y el desarrollo de competencias, pudiendo ser determinante la metodología utilizada en el aula. El objetivo de este estudio es evaluar y comparar el nivel de competencia matemática en el ámbito numérico, en alumnos de 3º de Educación Infantil en función de tres metodologías (Centros de Interés, Juegos y Narraciones y Aprendizaje Cooperativo). MÉTODO. Se ha aplicado la Prueba Evolutivo-Curricular de Matemáticas (PRECUMAT) a una muestra de 181 niños de 9 centros educativos de la Comunidad Autónoma de Madrid. Se han realizado, por un lado, análisis descriptivos y diferenciales sobre la adquisición de conocimientos y el desarrollo de la competencia matemática en el ámbito numérico, en función de la metodología utilizada en el aula y, por otro, un análisis clúster para la identificación de perfiles de alumnos en base a su nivel de competencia matemática en el ámbito de estudio. RESULTADOS. Los resultados muestran que los alumnos de la metodología Cooperativa presentan niveles significativamente más altos en Numeración verbal, Numeración visual, Sentido numérico, Cálculo mental y Resolución de problemas (p < 0,01). Se han identificado tres perfiles de alumnos en función de su nivel de competencia matemática, resultando ser el conglomerado formado por los alumnos que han seguido una metodología basada en el Aprendizaje Cooperativo los que poseen un nivel más alto de desarrollo de la competencia. DISCUSIÓN. Los resultados del estudio permiten afirmar que el uso de metodologías basadas en el aprendizaje cooperativo en la etapa de Educación Infantil favorece la adquisición y el desarrollo de competencias matemáticas en el ámbito numérico.
LA CLASE INVERTIDA EN LA FORMACIÓN INICIAL DEL PROFESORADO: ACERCANDO LA REALIDAD DEL AULA DE MATEMÁTICAS
Authors: Cid Cid Ana Isabel , Guede Cid Rocío , Tolmos Rodríguez-Piñero Piedad
Published: July 2018

INTRODUCCIÓN. La formación inicial del profesorado es un elemento básico para garantizar un sistema educativo de calidad. Los programas de formación, en cualquiera de sus etapas, deben asegurar las competencias del futuro profesor en materia de conocimientos, tanto teóricos como prácticos, y estar actualizados en metodologías educativas innovadoras y en tecnología. MÉTODO. En este trabajo se presenta una experiencia en la que se acerca a los alumnos del Máster en Formación del Profesorado de Educación Secundaria la realidad del aula en la que ejercerán su profesión en un futuro: los alumnos de la especialidad de Matemáticas del máster se transforman en docentes realizando los vídeos necesarios para aplicar la metodología del Aula Invertida (Flipped Learning) en un centro educativo real. RESULTADOS. Los estudiantes del máster aprendieron de un modo significativo a implementar una metodología innovadora, la Clase Invertida, formándose además en la grabación y edición de vídeos educativos. La actividad se complementó con la retroalimentación que se generó desde el centro educativo, enriqueciendo de este modo la experiencia. Para analizar el impacto de la actividad se realizó una encuesta a los estudiantes del máster y una entrevista semiestructurada a una muestra de ellos. DISCUSIÓN. Llevar la práctica real a los profesores en formación es un elemento esencial para su capacitación como docentes. Los estudiantes valoran como muy positivas este tipo de iniciativas, que los formadores de profesores conciben como necesarias para poder enseñar a aplicar los conocimientos teóricos que se imparten en el entorno universitario.
Do candidates from non-profit organisations who adopt party political values improve their chances of electoral success?
Authors: Potluka Oto , Perez Marybel
Published: July 2018

This article explores the relationship between the adoption of core party political values and an individual’s electoral prospects. Our survey of 355 local candidates in Prague, Budapest and Bratislava shows that many aspiring politicians, including non-profit leaders, make a strategic calculation to adopt core party values in order to improve their prospects of success in running for election in local government. Their willingness to enter a political party may increase the likelihood of their being selected as a candidate. However, it did not improve their chances of being elected. The results suggest that voter behaviour is influenced by other factors and in particular the national standing of political parties. The finding that local political issues are secondary to national politics in city elections casts doubt on the scope for effective local collective action and has implications for our understanding of local leadership and for policies that seek to promote devolution.
Venous Thromboembolism: Role of the Clinical Laboratory in Diagnosis and Management
Authors: Parakh Rugvedita S , Sabath Daniel E
Published: July 2018

Background

Venous thromboembolism (VTE) is the third most common cause of cardiovascular illness and is projected to double in incidence by 2050. It is a spectrum of disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE). In February 2016, the American College of Chest Physicians provided updated management guidelines for DVT and PE to address some of the unresolved questions from the previous version and to provide recommendations related to newer anticoagulants.

Content

Here we review current concepts for screening, diagnosis, thromboprophylaxis, and management of DVT and PE. We also describe the management of VTE in acute, long-term, and extended phases of treatment. Thrombophilia testing is rarely necessary and should be used judiciously; the laboratory can serve an important role in preventing unnecessary testing. The direct oral anticoagulants are as effective as conventional treatment and are preferred agents except in the case of cancer. The initial management of PE should be based on risk stratification including the use of D-dimer testing. Thrombolysis is used in cases of hemodynamically unstable PE and not for low-risk patients who can be treated on an outpatient basis.

This review is intended to provide readers with updated guidelines for screening, testing, prophylaxis, and management from various organizations.
Leituras do Pensamento Educacional de António Nóvoa. Análise Comparada de Revistas Científicas de Educação e Ensino em Portugal (1987-2017)
Authors: Ferreira António Gomes , Mota Luís , Vilhena Carla
Published: July 2018

O contributo de António Nóvoa para a análise social da educação e das ciências da educação em geral atravessa todo o período de expansão do sistema educativo português e início da sua retração. Que leituras da obra de António Nóvoa são convocadas no âmbito das publicações científicas de educação e ensino? Para concretizar o nosso questionamento mobilizámos um conjunto de periódicos científicos de educação e ensino, nomeadamente, a Revista de Educação do Departamento de Educação da Faculdade de Ciências da Universidade de Lisboa, a Revista ESC – Educação, Sociedade & Culturas, a Revista Lusófona de Educação, a Revista Portuguesa de Educação e a Revista Portuguesa de Pedagogia. A análise de conteúdo permitiu identificar um conjunto de quatro dimensões – Curricula, inovação e práticas; Formação de professores e desenvolvimento profissional; Política educativa e organização escolar; e História da educação e educação comparada – que se atualizam num conjunto de categorias e subcategorias.
The thickness of the epicardial fat is the "visit card" of metabolic syndrome
Authors: Drapkina Oxana M , Shepel Ruslan N , Deeva Tatiana A
Published: July 2018

AIMS. On the basis of echocardiography to evaluate the thickness of epicardial fat (TEF) in patients with metabolic syndrome (MS) and to establish a connection with the main indicators of laboratory and instrumental methods of research.

MATERIALS AND METHODS. The study included 76 patients, 43 patients with MS and 33 without MS. The average age of patients in the MS group at the time of inclusion in the study was 62.7±10.3 years in the control group (without MS) – 60±14.7 years. All patients underwent a comprehensive examination that included the collection of complaints, study of history, physical examination, anthropometric measurements, laboratory (including the study of the levels of caspase – 8, leptin in blood plasma enzyme-linked immunosorbent assay using kits «Platinum ELISA») and instrumental examination (echocardiography, ultrasound examination of organs of small pelvis). TEF was determined using transthoracic echocardiography on the machine Acuson Sequoia 512.

RESULTS. According transthoracic echocardiography was significantly higher in the group of patients with MS and was 4.67±1.7 mm, as compared to 2.66±1.15 mm in the control group (p<0.001). Identified moderate and strong correlation between TEF and weight of the patients, waist circumference, ratio of waist circumference to hip circumference, body mass index, glucose levels in the blood plasma, the presence of diabetes mellitus type 2, ultrasonic signs of steatosis of the liver and pancreas, increased aminotransferases, the level of caspase-8 concentration in plasma leptin. Patients the MS group with increased TEF increases the risk of developing hypertension, ischemic heart disease, left ventricular hypertrophy, diastolic dysfunction of the left ventricle type 2, level of caspase-8 and concentration in plasma leptin.

CONCLUSION. Based on the obtained data, the measurement of TEF is justified in patients with MS in everyday clinical practice. The correlations between the TEF and the clinical and metabolic parameters of the CVD and MS make it possible to consider the TEF as a new marker of the risk of developing MS and cardiovascular diseases.
Effects of inclusion of dietary fibers in the composition of the diet in obesity
Authors: Kurmangulov Albert А , Dorodneva Elena F , Troshina Irina A , Petrova Yulianna A , Golubeva Tatyana I
Published: July 2018

BACKGROUND. In recent years, clinical work, discovered a correlation between the violations of quantitative and/or qualitative composition of the intestinal microbiota and the development of various dysmetabolic disorders, including obesity.
AIMS. To evaluate the effect of the additional inclusion in the diet program of foods with a high content of dietary fibers and microbiotics on anthropometric indicators of obesity.
MATERIALS AND METHODS. The dynamic 6-month observation study included 50 people with 2–3 degrees of obesity (BMI≥35 kg/m2) according to WHO criteria, divided depending on the method of exposure (the traditional scheme of rational diet/or additionally enriched diet with fiber) into two comparable groups. Among the methods of the study were allocated anthropometry, the actual nutritional analysis and chromatographic study of short-chain fatty acids in the feces.
RESULTS. Analysis of anthropometric data (body weight, BMI, waist circumference) using the Wilcoxon test showed a more pronounced dynamics of basic anthropometric data in the group with additional enrichment diet dietary fiber (p<0.01). The data of chromatographic studies showed more significant changes in the total concentration of short chain fatty acids (p<0.01) and in their profile (p<0.05) in the group with additional enrichment diet dietary fiber. Clinically normalization of symbiotic digestion in the intestine in the group with additional enrichment diet dietary fiber was confirmed by reducing the frequency of presented complaints, for flatulence and flatulence from 38.3% to 13.7% (p<0.05), abdominal discomfort from 63.4% to 25.5% (p<0.05), constipation from 44.5% to 13.8% (p<0.05), rumbling in the abdomen on palpation from 50.4% to 18.8% (p<0.05).
CONCLUSIONS. Complex effect of dietary fiber within the food products of functional purpose on the processes and symbiotic digestion in the gastrointestinal tract leads to improved clinical and metabolic (normalization of functional activity of the intestinal microbiota) and anthropometric parameters (lower values of body weight, waist circumference), which predetermines the possibility of using dietary fiber in programmes for the treatment and prevention of obesity.
Therapy of obesity by sibutramin: polymorphisms of TPH2 and GNB3 genes and decrease of body weight
Authors: Galieva Marina O , Troshina Ekaterina A , Mazurina Nataliya V , Volynkina Anna P , Artiushin Andrey , Pavlova Anastasia S
Published: July 2018

AIMS. To study of the polymorphisms of the TPN2 and GNB3 genes in obese patients and their effect on weight loss in patients on sibutramine therapy.
MATERIALS AND METHODS. The research study included 118 patients with exogenous-constitutional obesity who received Reduxin (sibutramine + CMC) at the dose of 10 mg. Term follow-up was 3 months. A genetic study was performed to assess ТРН2 and GNB3 gene polymorphisms. The response to the therapy was evaluated after 3 months by the dynamics of body weight.
RESULTS. In the study the G703T polymorphism of the GNB3 gene showed that during 3 months of observation, carriers of the TT genotype had a greater decrease in body weight in comparison with carriers of the allele C – -8 kg (-12; -5) vs. -5 kg (-8; -3), p = 0.018. In carriers of different variants of the genotype of the TPH2 gene (polymorphism C825T), there was no difference in body weight dynamics with sibutramine therapy. There was no correlation between the foresaid polymorphisms of the TPH2 and GNB3 genes with the indices of blood pressure and heart rate.
CONCLUSIONS. 1. The result of sibutramin therapy may depend on genetic factors: in carriers of the TT-genotype C825T of the GNB3 gene the body weight loss was higher than among the carriers of the C allele. 2. Changes in blood pressure and heart rate did not show any statistically significant relationship with polymorphisms of the TPH2 and GNB3 genes.
Hypophosphatemic rickets: pathogenesis, diagnosis and treatment
Authors: Kulikova Kristina S , Tiulpakov Anatoly N
Published: July 2018

Hypophosphatemic rickets (HR) - a group of diseases characterized by the development of ricketic changes in bone tissue due to increased excretion of phosphorus from the body. This form of rickets is the most common among variants of genetically determined forms of disturbances in mineral metabolism. HR is an actual medical and social problem, requiring constant updating of knowledge of both endocrinologists and doctors of other profile. This is due to the fact that the clinical picture of HR has a significant heterogeneity and can manifest as severe deformations of the skeleton, delay in physical development, severe muscle hypotension, frequent fractures, tooth abscesses, which in some cases leads to disability of the patient and, accordingly, reduces the quality of life. Timely diagnosis and adequate therapy of HR is extremely important for preventing the development of severe complications. Currently, more than 10 candidate genes are known, the defects in which lead to the development of congenital forms of GFR. Genetic diagnostics of the HR is of great importance for determining the form of the HR, and for carrying out genetic counseling of families when planning pregnancy.
Multiple hormonal resistance and metabolic disorders in pseudogypoparatiosis
Authors: Dzeranova Larisa K , Makazan Nadezhda V , Pigarova Ekaterina A , Tiuliakova Anna N , Artemova Ekaterina V , Soldatova Tatiana V , Tulupov Denis O , Vorontsov Alexandr V , Mel`nichenko Galina A
Published: July 2018

Pseudohypoparathyroidism is a rare group of clinically and genetically heterogeneous diseases caused by the inactivation of the PTH-signaling pathway. The main component of the disease is resistance to PTH, causing a disturbance of calcium-phosphorus metabolism. With pseudohypoparathyroidism, there may also be a development of insensitivity to thyrotropic and gonadotropic hormones of the pituitary gland and the formation of characteristic clinical features in the form of subcutaneous calcifications, brachidactyly, obesity, stuntedness, mental retardation. This article describes the clinical case of pseudohypoparathyroidism in a 35-year-old woman with classic phenotypic hypoparathyroidism with hereditary Albright osteodystrophy and a proven mutation in the GNAS gene, and discusses the spectrum of metabolic disorders of the disease.