bluuebunny/crossref_metadata_2025 huggingface dataset:
Conspicuous leisure: The social visibility of cultural experiences
Authors: Bronner Fred , de Hoog Robert
Published: November 2019

Recent research shows that people not only visit a cultural event because of the quality of what is offered, but also to show something of their personality to relevant reference groups. This “signaling-by-cultural-experiences” can be considered as another variant of conspicuous consumption. The term was coined more than 100 years ago, but some recent developments in consumer behavior, such as a shift from material to immaterial purchases and increased visibility of consumption behavior through social media made conspicuous consumption a relevant issue once again. This appears to be particularly relevant for cultural events, as experiences in this area are ephemeral and can only be transmitted using means which allow the transmission of visual and auditive signals. To achieve the intended result of signaling, the cultural event that has been visited must be made visible and known to those others, otherwise you cannot signal anything. Social visibility is, in other words, a precondition for conspicuous consumption, in particular for visitors to cultural events. This social visibility is the central topic in the present contribution. Paying visits to three cultural forms is the subject of the research: visits to Museums, Classical music concerts, and Cultural festivals. The main conclusion from this study is that the social visibility of cultural visits can clearly be improved. This applies much more to Museums and Classical concerts than to Cultural festivals. As face-to-face communication about cultural visits is currently being done more frequently than communication through social media, the study suggests offering more facilities for communication using social media during cultural visits. However, facilitating social media communication requires overcoming existing barriers. Practical implications are sketched out and respondents’ suggestions for improving the facilities for posting their experiences on social media are presented. The suggestions, as made by the respondents, can provide inspiration for Museums and Classical concert venues.
Sarcoidosis and calcium homeostasis disturbances—Do we know where we stand?
Authors: Gwadera Łukasz , Białas Adam Jerzy , Iwański Mikołaj Aleksander , Górski Paweł , Piotrowski Wojciech Jerzy
Published: November 2019

The majority of cases involving hypercalcemia in the setting of sarcoidosis are explained by the overproduction of calcitriol by activated macrophages. Vitamin D takes part in the regulation of granuloma formation. However, using vitamin D metabolites to assess the activity of the disease is still problematic, and its usefulness is disputable. In some cases, though, a calcium metabolism disorder could be a valuable tool (i.e. as a marker of extrathoracic sarcoidosis). Although sarcoidosis does not cause a decrease in bone mineral density, increased incidence of vertebral deformities is noted. Despite increasing knowledge about calcium homeostasis disorders in patients with sarcoidosis, there is still a need for clear guidelines regarding calcium and vitamin D supplementation in these patients.
Optimal nature-walking gait for humanoid robot using Jaya optimization algorithm
Authors: Huan Tran Thien , Anh Ho Pham Huy , Van Kien Cao
Published: November 2019

This article proposes a new method used to optimize the design process of nature-walking gait generator that permits biped robot to stably and naturally walk with preset foot-lift magnitude. The new Jaya optimization algorithm is innovatively applied to optimize the biped gait four key parameters initiatively applied to ensure the uncertain nonlinear humanoid robot walks robustly and steadily. The efficiency of the proposed Jaya-based identification approach is compared with the central force optimization and improved differential evolution (modified differential evolution) algorithms. The simulation and experimental results tested on the original small-sized biped robot HUBOT-4 convincingly demonstrate that the novel proposed algorithm offers an efficient and stable gait for humanoid robots with precise height of foot-lift value.
Implementation of an experiential learning strategy to reduce the risk of ventilator-associated pneumonia in critically ill adult patients
Authors: Michelángelo Hernán , Angriman Federico , Pizarro Rodolfo , Bauque Susana , Kecskes Claudia , Staneloni Inés , García David , Espínola Fidencia , Mazer Gustavo , Ferrari Cristina
Published: November 2019

Objective

We evaluated the impact of an experiential learning strategy on both the adherence to the use of bundles and the incidence of ventilator-associated pneumonia in critically ill adult patients.

Methods

Longitudinal, quasi-experimental interrupted time-series study in a tertiary teaching hospital in Buenos Aires, Argentina. Successive measurements were made before and after the intervention was implemented between January 2016 and December 2018. Our main exposure was experiential learning, which was based on a combination of play activities, simulation models, knowledge and attitude competencies, role-playing and feedback. The adherence to the bundle for the care of mechanically ventilated critically-ill adult patients and the occurrence of ventilator-associated pneumonia were the main outcomes of interest. We used generalized linear models including time as a linear spline to estimate the effect of the experiential learning strategy both on the adherence to the bundle of care and the occurrence of ventilator-associated pneumonia during long-term follow-up.

Results

The overall proportion of adequate bundle use before and after the implementation of the intervention was 60.8% (95% CI: 56.9–64.7) and 85.6% (95% CI: 81.2–90.1), respectively. The incidence rate of ventilator-associated pneumonia before and after the intervention was 6.11 (95% CI: 5.82–6.40) and 3.55 (95% CI: 2.96–4.14) every 1000 days of mechanical ventilation, respectively. The estimated baseline monthly change in the adherence to the mechanical ventilation bundle was 0.4% (95%CI: −0.3–1.2%, p = 0.31) and 1.1% (95% CI: 0.2–2.2%, p < 0.01) before and after the implementation of the intervention, respectively. These results were consistent across our statistical quality control analysis.

Conclusions

The implementation of experiential learning strategies improves the adherence to bundles in the care of mechanically ventilated critically ill adult patients. Such strategies also decrease the incidence rate of ventilator-associated pneumonia. Both effects appear to remain constant during long-term follow-up.
Current concepts in elbow fracture dislocation
Authors: Watts Adam C , Singh Jagwant , Elvey Michael , Hamoodi Zaid
Published: November 2019

Background

Elbow fracture dislocations are complex injuries that can provide a challenge for experienced surgeons. Current classifications fail to provide a comprehensive system that encompasses all of the elements and patterns seen in elbow fracture dislocations.

Methods

The commonly used elbow fracture dislocation classifications are reviewed and the three-column concept of elbow fracture dislocation is described. This concept is applied to the currently recognised injury patterns and the literature on management algorithms.

Results

Current elbow fracture dislocation classification systems only describe one element of the injury, or only include one pattern of elbow fracture dislocation. A new comprehensive classification system based on the three-column concept of elbow fracture dislocation is presented with a suggested algorithm for managing each injury pattern.

Discussion

The three-column concept may improve understanding of injury patterns and treatment and leads to a comprehensive classification of elbow fracture dislocations with algorithms to guide treatment.
The effectiveness and safety of full-dose versus half-dose corticosteroid plus renin-angiotensin system blockers for IgA nephropathy
Authors: Wang Li , Ren Daijin , Huang Tianlun , Liu Xin , Xu Gaosi
Published: November 2019

Background:

Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) showed good responses to corticosteroids (CS) but experienced severe adverse effects. The authors conducted a cohort study to evaluate the effectiveness and safety of half-dose CS plus renin-angiotensin system blockers (RASB) (CS + RASB) versus full-dose CS in IgAN patients.

Methods:

A total of 162 kidney biopsy-confirmed IgAN patients with protein excretion levels ⩾0.75 g/d and an estimated glomerular filtration rate (eGFR) >30 ml/min/1.73 m2 were included. A total of 89 patients received half-dose CS + RASB (half CS + RASB), and 73 patients received full-dose CS (full CS). The primary outcomes were the complete remission rates and incidence of adverse events (AEs). The secondary outcomes included 24 h urinary protein (UP) levels and a combined event.

Results:

Over the 18 months follow-up, the complete remission rates were 59% (53/89 patients) and 57% (42/73 patients) in the half CS + RASB and full CS groups ( p = 0.88), respectively. A total of five patients suffered from serious AEs (SAEs) in the full CS group during the observation period, and no SAEs were observed in the half CS + RASB group ( p = 0.012). The incidences of total AEs ( p = 0.003) and infections ( p = 0.01) were lower in the half CS + RASB group than in the full CS group.

Conclusions:

Although half CS + RASB versus full CS did not differ in terms of reducing proteinuria, therapy with half CS + RASB resulted in fewer AEs in the IgAN patients.
“What Don’t We Do?”: The Experiences of School Counseling Directors in Relation to Leadership and Job Satisfaction
Authors: Walsh Robyn , Gibson Donna M.
Published: November 2019

Limited research has explored the experiences of school counseling directors, defined in this study as school counselors who are the designated department leaders and school counseling supervisors at middle or high schools. In this phenomenological study, we sought to better understand the experiences of those directors, specifically in relation to leadership and job satisfaction. Four themes emerged from the data collected from the 10 participants. We discuss these themes and offer implications for training, support, and role clarification for school counseling directors.
Class and Caste in the 2019 Indian Election–Why Have So Many Poor Started Voting for Modi?
Authors: Jaffrelot Christophe
Published: November 2019

In the 2009 and 2014 elections, the poorer the voters were, the less BJP-oriented they were too. The situation changed in 2019, when the prime minister appeared to be equally popular among all the strata of society, including the poor. Modi’s massive appeal to the poor is counterintuitive given the weakening of pro-poor policies like the National Rural Employment Guarantee Act and the elitist character of BJP. If class has lost some of its relevance for explaining the results of the 2019 elections, caste is showing some resilience, not as aggregates in the garb of OBCs or SCs, but as jatis at the state level. In spite of the BJP’s claim that the party’s ideology was alien to any consideration which may divide the nation, its strategists have meticulously studied caste equations at the local level in order to select the right candidates. This caste-based strategy partly explains the above-mentioned class element as the small OBC and Dalit jatis that the BJP has wooed are often among the poorest—and upper caste poor vote more for BJP than their co-ethnic rich anyway.
Does nature make us happier? A spatial error model of greenspace types and mental wellbeing
Authors: Houlden Victoria , Porto de Albuquerque João , Weich Scott , Jarvis Stephen
Published: November 2019

Exposure to nature is thought to benefit mental health and wellbeing. However, many studies consider greenspace as a single entity, which overlooks the potential significance of the various forms of greenspace, and natural greenspaces in particular. This study was designed to investigate the association between different types of greenspace and mental wellbeing. Drawing wellbeing and socioeconomic data from the Annual Population Survey (2012–2015), and shapefiles from the Greenspace Information for Greater London group, the amount of greenspace accessible within a 300 m walk of individual’s postcodes was calculated, and categorised according to type. Spatial Error Models were used to account for spatial patterns in the data. Natural greenspace was significantly associated with improved life satisfaction ( B =  0.028, p <  0.001) and happiness ( B =  0.023, p =  0.019) scores. The spatial autoregressive parameter ([Formula: see text]) was small but significant ( p <  0.001), implying slight second-order spatial variation in the model. These results imply that natural areas may be more important for hedonic mental wellbeing than other greenspaces. Future research is needed on exploring causal relationships between exposure to greenspace and mental wellbeing outcomes.
Preoperative visual acuity of cataract patients at a tertiary hospital in sub-Saharan Africa: a 10-year review
Authors: Ugalahi Mary O. , Uchendu Obioma C. , Ugalahi Linda O.
Published: November 2019

Purpose:

To determine the preoperative visual acuity of cataract patients over a 10-year period in a tertiary facility as a means of auditing the cataract surgical services.

Methods:

A retrospective study of patients with age-related cataracts who had cataract surgery performed between January 2007 and December 2016 at the University College Hospital, Ibadan. Systematic random sampling and probability proportionate to size were used to recruit a representative sample. Information on sociodemographic characteristics, preoperative visual acuity, ocular and systemic comorbidities were retrieved and analysed.

Results:

Of the 499 patients studied, males were 268 (53.7%) and their mean age was 67.69 (±9.51) years. The predominant visual acuity was hand motion 184 (36.9%) and yearly mean preoperative visual acuity was in the range of 0.0037–0.04 decimal.

Conclusion:

The mean preoperative visual acuity of patients in this facility did not change over the 10-year study period. Mean value of preoperative visual acuity remained within the range of blindness and did not improve over the decade. This could either be a reflection of visual impairment at which our patients seek care or an indication of the range of visual acuities at which surgeons are willing to offer cataract surgery in our environment. This trend has negative implications on the burden of cataract blindness as it reflects poor coverage of surgery for other levels of visual impairment due to cataract.
Learning from beautiful monsters: phylogenetic and morphogenetic implications of left-right asymmetry in ammonoid shells
Authors: Jattiot Romain , Fara Emmanuel , Brayard Arnaud , Urdy Séverine , Goudemand Nicolas
Published: November 2019

Background

Many pathologies that modify the shell geometry and ornamentation of ammonoids are known from the fossil record. Since they may reflect the developmental response of the organism to a perturbation (usually a sublethal injury), their study is essential for exploring the developmental mechanisms of these extinct animals. Ammonoid pathologies are also useful to assess the value of some morphological characters used in taxonomy, as well as to improve phylogenetic reconstructions and evolutionary scenarios.

Results

We report on the discovery of an enigmatic pathological middle Toarcian (Lower Jurassic) ammonoid specimen from southern France, characterized by a pronounced left-right asymmetry in both ornamentation and suture lines. For each side independently, the taxonomic interpretations of ornamentation and suture lines are congruent, suggesting aHildoceras semipolitumspecies assignment for the left side and aBrodieia primariaspecies assignment for the right side. The former exhibits a lateral groove whereas the second displays sinuous ribs. This specimen, together with the few analogous cases reported in the literature, lead us to erect a new forma-type pathology herein called “forma janusa” for specimens displaying a left-right asymmetry in the absence of any clear evidence of injury or parasitism, whereby the two sides match with the regular morphology of two distinct, known species.

Conclusions

Since “forma janusa” specimens reflect the underlying developmental plasticity of the ammonoid taxa, we hypothesize that such specimens may also indicate unsuspected phylogenetic closeness between the two displayed taxa and may even reveal a direct ancestor-descendant relationship. This hypothesis is not, as yet, contradicted by the stratigraphical data at hand: in all studied cases the two distinct taxa correspond to contemporaneous or sub-contemporaneous taxa. More generally, the newly described specimen suggests that a hitherto unidentified developmental link may exist between sinuous ribs and lateral grooves. Overall, we recommend an integrative approach for revisiting aberrant individuals that illustrate the intricate links among shell morphogenesis, developmental plasticity and phylogeny.
Insight into genetic regulation of miRNA in mouse brain
Authors: Kordas Gordon , Rudra Pratyaydipta , Hendricks Audrey , Saba Laura , Kechris Katerina
Published: November 2019

Background

micro RNA (miRNA) are important regulators of gene expression and may influence phenotypes and disease traits. The connection between genetics and miRNA expression can be determined through expression quantitative loci (eQTL) analysis, which has been extensively used in a variety of tissues, and in both human and model organisms. miRNA play an important role in brain-related diseases, but eQTL studies of miRNA in brain tissue are limited. We aim to catalog miRNA eQTL in brain tissue using miRNA expression measured on a recombinant inbred mouse panel. Because samples were collected without any intervention or treatment (naïve), the panel allows characterization of genetic influences on miRNAs’ expression levels.

We used brain RNA expression levels of 881 miRNA and 1416 genomic locations to identify miRNA eQTL. To address multiple testing, we employed permutationp-values and subsequent zero permutation p-value correction. We also investigated the underlying biology of miRNA regulation using additional analyses, including hotspot analysis to search for regions controlling multiple miRNAs, and Bayesian network analysis to identify scenarios where a miRNA mediates the association between genotype and mRNA expression. We used addiction related phenotypes to illustrate the utility of our results.

Results

Thirty-eight miRNA eQTL were identified after appropriate multiple testing corrections. Ten of these miRNAs had target genes enriched for brain-related pathways and mapped to four miRNA eQTL hotspots. Bayesian network analysis revealed four biological networks relating genetic variation, miRNA expression and gene expression.

Conclusions

Our extensive evaluation of miRNA eQTL provides valuable insight into the role of miRNA regulation in brain tissue. Our miRNA eQTL analysis and extended statistical exploration identifies miRNA candidates in brain for future study.
Transcriptomic and evolutionary analysis of the mechanisms by which P. argentatum, a rubber producing perennial, responds to drought
Authors: Nelson Andrew D. L. , Ponciano Grisel , McMahan Colleen , Ilut Daniel C. , Pugh N. Ace , Elshikha Diaa Eldin , Hunsaker Douglas J. , Pauli Duke
Published: November 2019

Background

Guayule (Parthenium argentatum Gray) is a drought tolerant, rubber producing perennial shrub native to northern Mexico and the US Southwest. Hevea brasiliensis, currently the world’s only source of natural rubber, is grown as a monoculture, leaving it vulnerable to both biotic and abiotic stressors. Isolation of rubber from guayule occurs by mechanical harvesting of the entire plant. It has been reported that environmental conditions leading up to harvest have a profound impact on rubber yield. The link between rubber biosynthesis and drought, a common environmental condition in guayule’s native habitat, is currently unclear.

Results

We took a transcriptomic and comparative genomic approach to determine how drought impacts rubber biosynthesis in guayule. We compared transcriptional profiles of stem tissue, the location of guayule rubber biosynthesis, collected from field-grown plants subjected to water-deficit (drought) and well-watered (control) conditions. Plants subjected to the imposed drought conditions displayed an increase in production of transcripts associated with defense responses and water homeostasis, and a decrease in transcripts associated with rubber biosynthesis. An evolutionary and comparative analysis of stress-response transcripts suggests that more anciently duplicated transcripts shared among the Asteraceae, rather than recently derived duplicates, are contributing to the drought response observed in guayule. In addition, we identified several deeply conserved long non-coding RNAs (lncRNAs) containing microRNA binding motifs. One lncRNA in particular, with origins at the base of Asteraceae, may be regulating the vegetative to reproductive transition observed in water-stressed guayule by acting as a miRNA sponge for miR166.

Conclusions

These data represent the first genomic analyses of how guayule responds to drought like conditions in agricultural production settings. We identified an inverse relationship between stress-responsive transcripts and those associated with precursor pathways to rubber biosynthesis suggesting a physiological trade-off between maintaining homeostasis and plant productivity. We also identify a number of regulators of abiotic responses, including transcription factors and lncRNAs, that are strong candidates for future projects aimed at modulating rubber biosynthesis under water-limiting conditions common to guayules’ native production environment.
Age group differences in association between IADL decline and depressive symptoms in community-dwelling elderly
Authors: Kiyoshige Eri , Kabayama Mai , Gondo Yasuyuki , Masui Yukie , Inagaki Hiroki , Ogawa Madoka , Nakagawa Takeshi , Yasumoto Saori , Akasaka Hiroshi , Sugimoto Ken , Ikebe Kazunori , Arai Yasumichi , Ishizaki Tatsuro , Rakugi Hiromi , Kamide Kei
Published: November 2019

Background

Instrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently. IADL decline was reported to be associated with aging and depression. The present study aimed to investigate whether the association between IADL decline and depressive symptoms differs with aging, using two age groups of community-dwelling Japanese elderly in their 70s and 80s.

Methods

We conducted longitudinal analysis among participants in their 70s and 80s at the baseline from Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. IADL was assessed by The Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. As a main predictor, depressive symptoms were measured by the five-item version of the Geriatrics Depression Scale (GDS-5). As possible confounders, we considered cognitive function, body mass index, solitary living, education, economic status, medical history of stroke and heart disease, hypertension, dyslipidemia, diabetes, and sex. We obtained odds ratios (ORs) of IADL decline for having depressive symptoms in each age group (70s/80s) and tested interactions between depressive symptoms and age groups in relation to IADL decline in 3 years by logistic regression. Additionally, to confirm age group differences, we conducted multiple group analysis.

Results

There were 559 participants in their 70s and 519 in their 80s. Compared to participants without depressive symptoms, those with depressive symptoms had higher OR of IADL decline in 70s (OR [95% CI] = 2.33 [1.13, 4.78]), but not in 80s (OR [95% CI] = 0.85 [0.46, 1.53]). There were significant interactions between depressive symptoms and age groups in relation to IADL decline (p-value = 0.03). Multiple group analyses showed differences between the age groups by Akaike information criterion (AIC), and ORs (95%CI) decline for depressive symptoms was 2.33 (1.14, 4.77) in 70s and 0.85 (0.47, 1.54) in 80s.

Conclusion

The association of depressive symptoms and IADL decline during the 3 years was significantly different between the 70s and 80s age groups, and significant association was found only in people in their 70s. Detecting depressive symptoms may be a key for preventing IADL decline in people in their 70s and not for those in their 80s.
Optimizing renal replacement therapy for patients who need extracorporeal membrane oxygenation: cross-talk between two organ support machines
Authors: Kashani Kianoush , Ostermann Marlies
Published: November 2019

Following a substantial increase in the utilization of extracorporeal membrane oxygenation (ECMO) during the last decade, its associated benefits and complications, including acute kidney injury have become more apparent. Acute kidney injury requiring dialysis during the ECMO treatment is very common and is associated with adverse outcomes. Cross talk between ECMO and dialysis equipment has been debated in the literature in order to enhance the quality of dialysis and avoid its potential adverse events.

Na et al. recently published the results of a prospective experiment by using three different methods for integration of the continuous renal replacement therapy device into the ECMO circuit. In this experiment, the investigators showed that by using three different connection strategies between continuous renal replacement therapy device and ECMO and the utilization of three separate structures of pressure control lines, the dialyzer lifespan could be optimized.

In this commentary, following a brief review of the ECMO and dialysis devices history and cross talk, we discuss the findings by Na et al. and provide additional insights for future investigations.
Vitamin D deficiency as a risk factor for dementia and Alzheimer’s disease: an updated meta-analysis
Authors: Chai Bingyan , Gao Fulin , Wu Ruipeng , Dong Tong , Gu Cheng , Lin Qiaoran , Zhang Yi
Published: November 2019

Background

We aimed to comprehensively explore the associations between serum 25(OH)D deficiency and risk of dementia and Alzheimer’s disease(AD).

Methods

We systematically searched Pubmed, the Cochrane Library, Embase and the reference lists of pertinent review articles for relevant articles published from database inception up until January 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with random effects models using the Stata 12.0 statistical software package.

Results

Twelve prospective cohort studies and four cross-sectional studies were included in this meta-analysis. The pooled HRs of dementia and AD, respectively, were 1.32 (95%CI: 1.16, 1.52) and 1.34 (95%CI: 1.13, 1.60) for vitamin D deficiency (< 20 ng/ml). In the subgroup analyses, the pooled HRs of dementia and AD, respectively, were 1.48 (95%CI: 1.19, 1.85) and 1.51 (95%CI: 1.04, 2.18) for moderate vitamin D deficiency (10–20 ng/ml) and 1.20 (95%CI: 0.99, 1.44) and 1.36 (95%CI: 1.01, 1.84) for severe vitamin D deficiency (< 10 ng/ml).

Conclusion

There are significant associations between vitamin D deficiency and both dementia and AD. There are stronger associations between severe vitamin D deficiency (< 10 ng/ml) and both dementia and AD compared to moderate vitamin D deficiency (10–20 ng/ml).
Influence of reduction quality on functional outcome and quality of life in treatment of tibial plafond fractures: a retrospective cohort study
Authors: Privalov Maxim , Euler Finn , Keil Holger , Swartman Benedict , Beisemann Nils , Franke Jochen , Grützner Paul Alfred , Vetter Sven Y.
Published: November 2019

Background

The aim of the study was to evaluate the impact of reduction quality, using intraoperative 3D imaging, on quality of life and functional outcome in the operative treatment of tibial plafond fractures.

Methods

A group of patients with tibial plafond fractures was re-examined. The operative treatment was performed between September 2001 and October 2011. The follow-up examination was at least 2 years after the final surgical procedure. Final reduction result was assessed intraoperatively using a mobile 3D C-arm. A categorization with regard to descriptive parameters as well as type and size of joint surface irregularities was performed. Follow-up results were evaluated using: Olerud and Molander (O & M) score, Short-Form-36 (SF-36) score, movement deficit, Kellgren and Lawrence grade of osteoarthritis, and pain intensity.

Results

34 patients with operatively treated tibial plafond fracture could be re-examined. Reduction quality had the greatest influence on functional result measured by the O & M score (p = 0.001) and the PCS domain of the SF-36 score (p = 0.018).

Significant differences with regard to O & M score (p = 0.000), SF-36 score (p = 0.001 to p = 0.02; without MCS domain), movement deficit (p = 0.001), grade of osteoarthritis (p = 0.005) and pain (p = 0.001) could be verified under consideration of the reduction quality. The group with the anatomically more accurate reduction also showed a better result for clinical follow-up and quality of life. Furthermore, it is not the type of joint surface irregularity that is always decisive, but rather the size.

Conclusions

Despite other relevant factors, it appears that reduction quality –which can be analyzed with intraoperative 3D imaging– plays the most important role in postoperative quality of life and functional outcome. Corrections should therefore be performed on joint surface irregularities with a size above 2 mm.
Are midwives in the Netherlands satisfied with their jobs? A systematic examination of satisfaction levels among hospital and primary-care midwives in the Netherlands
Authors: Cronie Doug , Perdok Hilde , Verhoeven Corine , Jans Suze , Hermus Marieke , de Vries Raymond , Rijnders Marlies
Published: November 2019

Background

Job satisfaction is generally considered to be an important element of work quality and workplace relations. Little is known about levels of job satisfaction among hospital and primary-care midwives in the Netherlands. Proposed changes to the maternity care system in the Netherlands should consider how the working conditions of midwives affect their job satisfaction.

Aim

We aimed to measure and compare job satisfaction among hospital and primary-care midwives in the Netherlands.

Methods

Online survey of all practising midwives in the Netherlands using a validated measure of job satisfaction (the Leiden Quality of Work Questionnaire) to analyze the attitudes of hospital and primary-care midwives about their work. Descriptive and inferential statistics were used to assess differences between the two groups.

Results

Approximately one in six of all practising midwives in the Netherlands responded to our survey (hospital midwives n = 103, primary-care midwives n = 405). All midwives in our survey were satisfied with their work (n = 508). However, significant differences emerged between hospital and primary-care midwives in terms of what was most important to them in relation to their job satisfaction. For hospital midwives, the most significant domains were: working hours per week, workplace agreements, and total years of experience. For primary-care midwives, social support at work, work demands, job autonomy, and the influence of work on their private life were most significant.

Conclusion

Although midwives were generally satisfied, differences emerged in the key predictors of job satisfaction between hospital and primary-care midwives. These differences could be of importance when planning workforce needs and should be taken into consideration by policymakers in the Netherlands and elsewhere when planning new models of care.
Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study
Authors: Assefa Abiyu Ayalew , Astawesegn Feleke Hailemichael , Eshetu Bethlehem
Published: November 2019

Background

In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low.

Methods

An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05.

Results

Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization.

Conclusions

The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.
Circ-HuR suppresses HuR expression and gastric cancer progression by inhibiting CNBP transactivation
Authors: Yang Feng , Hu Anpei , Li Dan , Wang Jianqun , Guo Yanhua , Liu Yang , Li Hongjun , Chen Yajun , Wang Xiaojing , Huang Kai , Zheng Liduan , Tong Qiangsong
Published: November 2019

Background

Circular RNAs (circRNAs), a subclass of non-coding RNAs, play essential roles in tumorigenesis and aggressiveness. Our previous study has identified that circAGO2 drives gastric cancer progression through activating human antigen R (HuR), a protein stabilizing AU-rich element-containing mRNAs. However, the functions and underlying mechanisms of circRNAs derived from HuR in gastric cancer progression remain elusive.

Methods

CircRNAs derived from HuR were detected by real-time quantitative RT-PCR and validated by Sanger sequencing. Biotin-labeled RNA pull-down, mass spectrometry, RNA immunoprecipitation, RNA electrophoretic mobility shift, and in vitro binding assays were applied to identify proteins interacting with circRNA. Gene expression regulation was observed by chromatin immunoprecipitation, dual-luciferase assay, real-time quantitative RT-PCR, and western blot assays. Gain- and loss-of-function studies were performed to observe the impacts of circRNA and its protein partner on the growth, invasion, and metastasis of gastric cancer cells in vitro and in vivo.

Results

Circ-HuR (hsa_circ_0049027) was predominantly detected in the nucleus, and was down-regulated in gastric cancer tissues and cell lines. Ectopic expression of circ-HuR suppressed the growth, invasion, and metastasis of gastric cancer cells in vitro and in vivo. Mechanistically, circ-HuR interacted with CCHC-type zinc finger nucleic acid binding protein (CNBP), and subsequently restrained its binding to HuR promoter, resulting in down-regulation of HuR and repression of tumor progression.

Conclusions

Circ-HuR serves as a tumor suppressor to inhibit CNBP-facilitated HuR expression and gastric cancer progression, indicating a potential therapeutic target for gastric cancer.
Postoperative adjuvant radiation improves local control in surgically treated FIGO stage I-II small cell carcinoma of the cervix
Authors: Shen Ting , Jiang Yan-hui , Zou Yao-yao , Qiu Fang-fang , Qiu Xing-sheng , You Kai-yun
Published: November 2019

Objective

To determine the prognostic effect of adjuvant radiation and clinicopathological variables in surgically treated patients with small cell carcinoma of the cervix (SCCC).

Methods

Clinical data of SCCC patients with International Federation of Gynaecology and Obstetrics (FIGO) stage I-II underwent radical surgery from May 2000 to August 2014 at Sun Yat-sen Memorial Hospital were retrospectively reviewed. Forty-three patients with SCCC were included to this study. Chi-square test or Fisher’s exact test, Student’s t test or Mann–Whitney U test, Kaplan–Meier method and multivariate analysis of Cox proportional hazards regression were used for statistical analysis. P < 0.05 was considered to be statistically significant.

Results

Among 43 patients (median age, 49 years old) recruited, 25(58.1%) had stage I, 18(41.9%) had stage II disease. The 5-year overall survival (OS) rate was 39.54%, and the 5-year disease free survival (DFS) was 27.91%. Distant metastasis was the main cause of treatment failure (71.9%). Patients with adjuvant chemoradiation displayed lower rate of local recurrence than those with adjuvant chemotherapy (10.7% vs 60.0%, P < 0.0001). Multivariable analysis identified lymph node metastasis as a significant prognostic factor for both DFS and OS (P = 0.001, 0.004 respectively). Age was also an independent predictor of OS (P = 0.004). Adjuvant radiation appeared to significantly improve DFS (HR = 0.383, 95% CI, 0.185–0.791), but not OS.

Conclusions

Adjuvant radiotherapy could improve the local control and prolong DFS in surgically treated SCCC. However, a large prospective clinical trial is needed to confirm this.
Total hip arthroplasty with modular stem for Crowe I and II developmental dysplasia of the hip
Authors: Kong Xiangpeng , Sun Yunming , Yang Minzhi , Zhou Yonggang , Chen Jiying , Chai Wei , Wang Yan
Published: November 2019

Background

The variation of femoral anteversion is not completely consistent with the grade of developmental dysplasia of the hip (DDH), which poses challenges to hip replacement with the non-modular tapered stem. Currently, whether the modular stem should be used in Crowe I and II DDH is still controversial. The aim of this study is to compare the clinical efficacy of the modular stem and the non-modular tapered stem in Crowe I and II DDH patients.

Methods

We retrospective analyzed the clinical data of 196 patients with unilateral Crowe I and II DDH from January 2015 to January 2017. One hundred patients were operated by an experienced surgeon with the modular stems; the remaining 96 patient was operated by another equivalent surgeon with the non-modular tapered stems. The preoperative basic information, operating time, intraoperative and postoperative complications, postoperative leg length discrepancy (LLD) and offset, Harris hip score (HHS), and forgotten joint score (FJS) in postoperative 2 years were collected and analyzed.

Results

Postoperative LLD (P = 0.010) and FJS (P = 0.001) had significant difference between two groups. Concurrent acceptable LLD and offset were achieved in 87% of patients with the modular stem and in 68% of patients with the non-modular stem (P = 0.001). There was no significant difference in the operating time (P = 0.086), intraoperative complication (P = 0.096), postoperative dislocation rate (P = 0.056), postoperative offset difference (P = 0.108), and Harris score (P = 0.877) between two groups.

Conclusions

Compared with the non-modular tapered stem, the modular stem was more likely to provide accurate reconstruction and forgotten artificial hip for Crowe I and II DDH patients. We recommend the modular stem as routine choice for these patients.
Hexavalent vaccines in preterm infants: an update by Italian Society of Pediatric Allergy and Immunology jointly with the Italian Society of Neonatology
Authors: Chiappini E. , Petrolini C. , Caffarelli C. , Calvani M. , Cardinale F. , Duse M. , Licari A. , Manti S. , Martelli A. , Minasi D. , Miraglia Del Giudice M. , Pajno GB. , Pietrasanta C. , Pugni L. , Tosca MA. , Mosca F. , Marseglia GL.
Published: November 2019

Hexavalent vaccines, protecting against six diseases (diphtheria, tetanus, pertussis [DTaP], poliovirus, hepatitis B virus [HBV], and Haemophilus influenzae type b [Hib], are routinely the standard of care in Europe. The use of combined vaccines allows the reduction of number of injections and side effects, the reduction of costs, and the increase in adherence of the family to the vaccination schedule both in terms of the number of doses and timing. The safety profile, efficacy and effectiveness of hexavalent vaccines have been extensively documented in infants and children born at term, and data are accumulating in preterm infants. Hexavalent vaccines are particularly important for preterm infants, who are at increased risk for severe forms of vaccine preventable diseases. However, immunization delay has been commonly reported in this age group. All the three hexavalent vaccines currently marketed in Italy can be used in preterm infants, and recent data confirm that hexavalent vaccines have a similar or lower incidence of adverse events in preterm compared to full-term infants; this is likely due to a weaker immune system response and reduced ability to induce an inflammatory response in preterm infants. Apnoea episodes are the adverse events that can occur in the most severe preterm infants and / or with history of respiratory distress. The risk of apnoea after vaccination seems to be related to a lower gestational age and a lower birth weight, supporting the hypothesis that it represents an unspecific response of the preterm infant to different procedures. High seroprotection rates have been reported in preterm infants vaccinated with hexavalent vaccine. However, a lower gestational age seems to be associated with lower antibody titres against some vaccine antigens (e.g. HBV, Hib, poliovirus serotype 1, and pertussis), regardless of the type of hexavalent vaccine used. Waiting for large effectiveness studies, hexavalent vaccines should be administered in preterm infants according to the same schedule recommended for infants born at term, considering their chronological age and providing an adequate monitoring for cardio-respiratory events in the 48–72 h after vaccination, especially for infants at risk of recurrence of apnoea.
Myeloid-derived suppressor cell function and epigenetic expression evolves over time after surgical sepsis
Authors: Hollen McKenzie K. , Stortz Julie A. , Darden Dijoia , Dirain Marvin L. , Nacionales Dina C. , Hawkins Russell B. , Cox Michael C. , Lopez Maria-Cecilia , Rincon Jaimar C. , Ungaro Ricardo , Wang Zhongkai , Wu Quran , Brumback Babette , Gauthier Marie-Pierre L. , Kladde Michael , Leeuwenburgh Christiaan , Segal Mark , Bihorac Azra , Brakenridge Scott , Moore Frederick A. , Baker Henry V. , Mohr Alicia M. , Moldawer Lyle L. , Efron Philip A.
Published: November 2019

Background

Sepsis is an increasingly significant challenge throughout the world as one of the major causes of patient morbidity and mortality. Central to the host immunologic response to sepsis is the increase in circulating myeloid-derived suppressor cells (MDSCs), which have been demonstrated to be present and independently associated with poor long-term clinical outcomes. MDSCs are plastic cells and potentially modifiable, particularly through epigenetic interventions. The objective of this study was to determine how the suppressive phenotype of MDSCs evolves after sepsis in surgical ICU patients, as well as to identify epigenetic differences in MDSCs that may explain these changes.

Methods

Circulating MDSCs from 267 survivors of surgical sepsis were phenotyped at various intervals over 6 weeks, and highly enriched MDSCs from 23 of these samples were co-cultured with CD3/CD28-stimulated autologous T cells. microRNA expression from enriched MDSCs was also identified.

Results

We observed that MDSC numbers remain significantly elevated in hospitalized sepsis survivors for at least 6 weeks after their infection. However, only MDSCs obtained at and beyond 14 days post-sepsis significantly suppressed T lymphocyte proliferation and IL-2 production. These same MDSCs displayed unique epigenetic (miRNA) expression patterns compared to earlier time points.

Conclusions

We conclude that in sepsis survivors, immature myeloid cell numbers are increased but the immune suppressive function specific to MDSCs develops over time, and this is associated with a specific epigenome. These findings may explain the chronic and persistent immune suppression seen in these subjects.
Resazurin assay for assessment of antimicrobial properties of electrospun nanofiber filtration membranes
Authors: Travnickova Eva , Mikula Premysl , Oprsal Jakub , Bohacova Marie , Kubac Lubomir , Kimmer Dusan , Soukupova Jana , Bittner Michal
Published: November 2019

We developed a simple and fast microplate assay for evaluation of the antimicrobial activity of electrospun nanofiber filtration membranes or similar porous materials for water treatment technologies. Resazurin (alamarBlue®) was used as an indicator of the amount of viable experimental microorganisms Gram-negative Escherichia coli, Gram-positive Enterococcus faecalis, and natural wastewater treatment plant effluent bacteria. A bacterial inoculum of concentration 1–3 × 105 CFU mL−1 was pipetted onto the surface of assessed both functionalized and respective control membranes and incubated in 12-well plates for 4 h at 37 °C. Kinetics of resazurin metabolization, i.e. its reduction to fluorescent resorufin, was evaluated fluorimetrically (λex520/λem590 nm). A number of viable bacteria on the membranes expressed as CFU mL−1 was calculated from the kinetic curves by using calibration curves that were constructed for both experimental bacterial species. Antimicrobial activities of the membranes were evaluated by either resazurin assay or modified ISO 20743 plate count assay. Results of both assays showed the significant antimicrobial activity of membranes functionalized with silver nanoparticles for both bacterial species and wastewater treatment plant effluent bacteria as well (log CFU reduction compared to control membrane > 4), while membranes containing specific quaternary ammonium salts were inefficient (log CFU reduction < 1). The suitability of resazurin microplate assay for testing nanofiber filtration membranes and analogous matrices has proven to be a faster and less demanding alternative to the traditionally used approach providing comparable results.