bluuebunny/crossref_metadata_2025 huggingface dataset:
New frontiers in tree-ring research
Authors: Pearl Jessie K , Keck John R , Tintor William , Siekacz Liliana , Herrick Hannah M , Meko Matthew D , Pearson Charlotte L
Published: February 2020

From its inception as a scientific discipline, tree-ring research has been used as a trans-disciplinary tool for dating and environmental reconstruction. Tree-ring chronologies in some regions extend back many thousands of years, opening up new potential for the study of climate, people, and ecology at annual and sub-annual resolution. As such, they are a frequently used resource for a diverse range of studies spanning the Holocene. They are also the focus of a constantly evolving array of analytical techniques and multidisciplinary approaches to research questions. This literature review discusses case studies at the cutting-edge of interdisciplinary tree-ring research, notes recent breakthroughs and limitations, and identifies key frontiers for the future of tree-ring research.
Upregulation of Nrf2-related cytoprotective genes expression by acetaminophen-induced acute hepatotoxicity in mice and the protective role of betaine
Authors: Khodayar MJ , Kalantari H , Khorsandi L , Rashno M , Zeidooni L
Published: February 2020

Overdose of acetaminophen (APAP) is the main reason for acute liver failure. Oxidative stress is associated with hepatotoxicity caused by APAP. Betaine is a methyl donor and S-adenosylmethionine precursor. The present study investigated the effect of betaine and the role of nuclear factor-erythroid-2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) genes in hepatotoxicity induced by APAP in mice. In this study, male Naval Medical Research Institute (NMRI) mice were treated with 500 mg/kg of betaine for 5 days followed with a single dose of APAP 300 mg/kg on the fifth day. Biochemical, histological, immunohistochemical, Western blot, and real-time polymerase chain reaction (PCR) analyses were then conducted. The results of the present study showed that betaine pretreatment improved hepatotoxicity through the reduction of serum ALT and AST levels and ameliorating histopathological finding. Betaine pretreatment also increased glutathione level and decreased malondialdehyde level. Importantly, the results of immunohistochemical, Western blot and real-time PCR showed that the APAP increased the expression of the genes and proteins of Nrf2 and HO-1. While betaine decreased Nrf2 and HO-1 expression in comparison with the APAP group. The findings of this study demonstrated that the increased expression of Nrf2 and HO-1 genes and proteins by APAP is a compensatory mechanism to combat acute liver toxicity. While the protective effect of betaine against acute liver injury induced by APAP is independent on the Nrf2 and HO-1 genes but occurs via modifying cysteine supply as a precursor of glutathione in the transsulfuration pathway in the liver.
SIRT4 prevents excitotoxicity via modulating glutamate metabolism in glioma cells
Authors: Yalçın G Dönmez , Colak M
Published: February 2020

Excitotoxicity is the presence of excessive glutamate, which is normally taken up by glutamate transporters on astrocytes. Glutamate transporter 1 (GLT-1) is the major transporter on glia cells clearing more than 90% of the glutamate. Sirtuin 4 (SIRT4) is a mitochondrial sirtuin which is expressed in the brain. Previously, it was shown that loss of SIRT4 leads to a more severe reaction to kainic acid, an excitotoxic agent, and also decreased GLT-1 expression in the brain. In this study, we aimed to investigate whether overexpression of SIRT4 is protective against excitotoxicity in glia cells. We overexpressed SIRT4 in A172 glioma cell line and treated with kainic acid in order to induce excitotoxicity. We observed that SIRT4 overexpression increased the cell viability after kainic acid treatment. In addition, reduced glutamate was detected in glutamate assay with overexpression of SIRT4 after kainic acid treatment since SIRT4 decreased cell death by preventing excitotoxicity. Our results show that overexpression of SIRT4 increased the protein levels of GLT-1 and glutamate dehydrogenase (GDH) after kainic acid (KA) treatment so that excess glutamate can be absorbed. However, overexpression of SIRT4 decreased glutamine synthetase (GS) levels. These results demonstrate that, by inhibiting GS, SIRT4 prevents glutamine formation, which will be converted to glutamate in neurons. SIRT4 prevents excitotoxicity via upregulating glutamate metabolism. Finally, our results may show that SIRT4 might prevent excitotoxicity and related cell death via reducing GS expression and upregulating GLT-1 and GDH levels. Therefore, it is important to develop therapeutics against excitotoxicity through SIRT4-related pathways in the cell.
Gas gangrene in mammals: a review
Authors: Junior Carlos A. Oliveira , Silva Rodrigo O. S. , Lobato Francisco C. F. , Navarro Mauricio A. , Uzal Francisco A.
Published: February 2020

Gas gangrene is a necrotizing infection of subcutaneous tissue and muscle that affects mainly ruminants and horses, but also other domestic and wild mammals. Clostridium chauvoei, C. septicum, C. novyi type A, C. perfringens type A, and C. sordellii are the etiologic agents of this disease, acting singly or in combination. Although a presumptive diagnosis of gas gangrene can be established based on clinical history, clinical signs, and gross and microscopic changes, identification of the clostridia involved is required for confirmatory diagnosis. Gross and microscopic lesions are, however, highly suggestive of the disease. Although the disease has a worldwide distribution and can cause significant economic losses, the literature is limited mostly to case reports. Thus, we have reviewed the current knowledge of gas gangrene in mammals.
The College Orientation Workshop as an Experiential, Positive Youth Development Program
Authors: Whipple Sara S. , Frein Scott T. , Kline Keith A.
Published: February 2020

Background: The 4-week-long College Orientation Workshop (COW) is an experiential education program that combines physical and mental challenges with classroom instruction to promote self-confidence, self-control, wellness, and life success in promising male youth facing challenges to reaching their full potential. Purpose: This was an exploratory study to assess whether young men who completed the program manifested psychological and/or physical changes. Methodology/Approach: Sixteen young men were assessed at the beginning and end of the program. Physical measures included fitness test scores (pull-ups, sit-ups, push-ups, 1.5 mile run time), resting blood pressure, and pulse rate. Psychological variables included positive and negative affect, life satisfaction, self-esteem, self-efficacy, perceived control, self-control, impulsivity, social support, and subjective socioeconomic status. Findings/Conclusions: From pre- to post-COW, there were significant increases in self-esteem, positive affect, and sit-ups completed as well as significant decreases in run times, systolic and diastolic blood pressure, and heart rate. Several nonsignificant trends were also detected. Associations of psychological variables with fitness/health measures suggest that changes in the latter may be partly due to changes in the former. Implications: The COW Program may be an effective experiential education program. Follow-up studies with program participants are currently underway to determine longer term outcomes.
The Effects of a Multicomponent Self-Monitoring Intervention on the Rates of Pre-Service Teacher Behavior-Specific Praise in a Masked Single-Case Experimental Design
Authors: Sallese Mary Rose , Vannest Kimberly J.
Published: February 2020

The effects of self-monitoring (SM) on teacher behavior are well documented, but previous research does not attempt to control for reactivity as a threat to internal validity. This study examined the effects of a multicomponent SM intervention on the use of a classroom management practice with participant masking to address this absence in the literature. Participating teachers selected between two practices (behavior-specific praise and opportunities to respond). A multiple baseline design across four pre-service teacher interns occurred in general education classroom settings. Participant masking to the purpose of the study precluded exposure to SM, performance feedback, and goal setting. Analyses included an independent visual analysis by three masked raters, an independent quality review for What Works Clearinghouse standards, a nonparametric statistical analysis based on data characteristics, and correspondence reporting between visual and statistical analyses. Overall results indicated an increase in the rate of classroom management practice use by the participants and good social validity across the three constructs. Student outcome data for on-task behavior were inconclusive. Limitations and implications for research and practice are discussed.
Concurrent thoracic pathology identified with radiology in hyperthyroid cats referred for radioiodine therapy
Authors: Kormpou Foteini , Gil-Morales Claudia , Warren-Smith Chris , Hibbert Angie
Published: February 2020

Objectives

Radioiodine (RAI) treatment for hyperthyroidism is becoming increasingly available in the UK. Pretreatment assessment is commonly performed, as patient handling is limited once RAI has been administered. The aims of this study were to determine the prevalence of thoracic pathology using thoracic radiography in hyperthyroid cats referred for RAI treatment and to determine the value of this technique pretreatment.

Methods

The hospital databases were searched for hyperthyroid cats referred for RAI treatment at the Feline Centre, Langford Vets, between January 2012 and July 2016. Radiographs were reviewed by Diplomates of the European College of Veterinary Diagnostic Imaging at the time of treatment and each set of radiographs was subsequently reviewed by one radiologist for the study. Cardiorespiratory signs were recorded, if present, and any change in treatment plan or suitability for RAI treatment was documented.

Results

Two hundred and fifty-two cats were included in the study. Thoracic pathology was identified in 77% (n = 194/252) of the cats, of which 59% (n = 115/194) had pulmonary abnormalities with bronchial and bronchointerstitial patterns most frequently; 57% (n = 111/194) had skeletal abnormalities and 43% (n = 84/194) had cardiac abnormalities, with mild-to-moderate cardiomegaly most prevalent. Other abnormalities included sternal lymphadenomegaly (7%; n = 13/194), mediastinal pathology (3%; n = 5/194), oesophageal pathology (2%; n = 4/194) and pleural space disease (0.5%; n = 1/194).Twelve cases (6%) had a change in their treatment plan as a result of thoracic radiographic abnormalities, of which five subsequently underwent RAI treatment.

Conclusions and relevance

A low prevalence of significant thoracic pathology was identified on radiographs in hyperthyroid cats referred for RAI treatment. Incidental thoracic abnormalities were found much more commonly; hence, results of thoracic radiology need to be combined with the clinical picture, to decide whether further investigations or alterations to the treatment plan are required pre-RAI.
Contraceptive implants used by cat breeders in France: a study of 140 purebred cats
Authors: Furthner Etienne , Roos Juliette , Niewiadomska Zuzanna , Maenhoudt Cindy , Fontbonne Alain
Published: February 2020

Objectives

Deslorelin 4.7 mg and melatonin 18 mg subcutaneous implants were studied in purebred male and female cats, via questionnaires sent to French cat breeders, to assess breed, age, duration of the contraceptive effect, fertility after use, changes in behaviour and side effects.

Methods

Reproductive data were collected in 57 tom cats and 41 queens implanted with deslorelin 4.7 mg, and 42 queens implanted with melatonin 18 mg, for a total of 140 purebred cats, from 38 different catteries, representing 18 breeds.

Results

Using deslorelin (Suprelorin 4.7 mg; Virbac), sexual behaviour in males was inhibited for a mean ± SD of 13.4 ± 3.2 (range 8–21) months in 37/57 cats. Of these, 24/37 mated successfully and produced litters at a mean of 15.5 ± 3.6 (range 9–20) months. Inhibition lasted 11 ± 1.1 (range 9–12; n = 6), 13.2 ± 2.4 (range 12–18; n = 6) and 15 ± 3.5 (range 9–18; n = 6) months in Norwegian Forest Cat, Singapura and Ragdoll males, respectively. In 26/41 females implanted with deslorelin 4.7 mg, oestrus was inhibited for a mean of 16.0 ± 5.7 (8–38) months; 12/26 went on to produce a litter. Of the side effects specific to females: two presented persistent oestrus, leading to the removal of the implant; two developed lactation; one had fibroadenomatosis; and one was sterilised owing to cystic endometrial hyperplasia. Using melatonin (Melovine 18 mg; Ceva), 33/42 females had oestrus inhibited for a mean of 86 ± 50 (range 21–277) days after implantation with a peak return to oestrus in March, and 12/33 had a subsequent litter. No side effects were reported.

Conclusions and relevance

This study is the first to collect a large amount of field data, in 140 purebred male and female cats where a deslorelin 4.7 mg or a melatonin 18 mg implant was used. These field results may allow for more accurate clinical advice and open up new avenues of research.
Alemtuzumab-related eosinophilic central nervous system vasculitis
Authors: Leach Oliver A , Hilton David A , Adams William , Love Seth , Straukiene Agne
Published: February 2020

A 36-year-old woman with relapsing remitting multiple sclerosis (MS) presented with right-sided spasms, focal seizures and neuropsychiatric symptoms 10 months after her first course of alemtuzumab. Magnetic resonance imaging (MRI) brain imaging revealed multiple foci of T2 hyperintensity. Subsequent blood and cerebrospinal fluid (CSF) testing for progressive multifocal leukoencephalopathy (PML), vasculitis and infective causes was negative. A brain biopsy was performed, revealing a prominent perivascular inflammatory infiltrate with multiple immune cells including eosinophils, suggesting eosinophilic vasculitis. The patient was treated successfully with cyclophosphamide. The potential sequelae of alemtuzumab treatment are discussed; this treatable complication should be considered when tests for JC virus are negative.
Cooperative learning in physical education encountering Dewey’s educational theory
Authors: Casey Ashley , Quennerstedt Mikael
Published: February 2020

Cooperative learning can be considered as an umbrella term for a number of classroom practices. In this paper we consider the educative nature of cooperative learning in physical education, and we have challenged ourselves to examine how cooperative learning can enhance the education of young people. We do this by revisiting cooperative learning’s Deweyan foundations and hold that such a move would be a constructive way forward for cooperative learning in physical education. We argue that there is a risk, in not going back to its educational roots, that cooperative learning might just become another way to teach, for example, games or sports, and that it currently puts too much emphasis on destination rather than journey. We suggest that using Dewey’s idea of education and experience would add: a situational element, a directional element, a temporal element, a communal element and an educative element. In this way, the use of cooperative learning in physical education can move away from exclusively developing students’ skills, towards an open-ended process of becoming where a diversity of students transform and are being transformed by one another.
Sorry to say goodbye: the dilemmas of letting go in longitudinal research
Authors: Batty Elaine
Published: February 2020

The emotional dilemmas and challenges facing researchers within the research process are beginning to be documented within the literature, and academic interest in them is in ascendency. This paper adds to this growing discourse by taking a reflective journey through 19 years of research practice. It presents an honest and revealing manuscript highlighting in particular, the researcher’s emotional dilemmas experienced when disengaging from participants at the end of longitudinal research studies. It uses case studies to highlight some of the challenges in maintaining the participant–researcher boundaries and the emotional dilemmas this creates when trying to say goodbye. It argues that blurring the boundaries of participant–researcher relationships and establishing a trusting relationship can present emotional difficulties for researchers during and long after the closure of a research study.
Characterizing mechanical change in metals using amplitude-modulated diffuse ultrasound
Authors: Xie Fan , Zhang Yuxiang , Larose Eric , Duclos Aroune , Chen Su , Li Xiaoyun , Fei Chunlong
Published: February 2020

In this article, we present an ultrasonic method based on diffuse ultrasound with successive excitation amplitudes. This method provides amplitude-dependent parameters of diffuse ultrasound using coda wave interferometry, and these parameters can be used to characterize mechanical change in metallic materials. The localized mechanical change caused by an instantaneous 400°C thermal shock in a meter-scale aluminum alloy slab was characterized by measuring the diffuse-wave velocity change and decorrelation coefficient as functions of the excitation amplitude. The potential mechanisms and spatial distribution that cause the observed amplitude-dependent diffuse waveform modification are discussed. Combining the method presented here with complementary approaches will enhance the ability to nondestructively detect early-stage damage in the laboratory or in the field.
Second-Generation Women Entrepreneurs in Chinese Family-Owned Businesses: Motivations, Challenges, and Opportunities
Authors: Li Jessica , Sun Judy Yi , Wang Lianjuan , Ke Jie
Published: February 2020

The Problem

Family-owned businesses provide a large portion of the job opportunities in the Chinese economy. Many successful family-owned businesses in China were established during the initial years of economic reform in the late 1970s and 1980s. Today, as the founders of these companies approach retirement, leadership transition is becoming a pressing issue. Among the various factors involved in family business succession are gender-specific obstacles faced by women who seek to achieve leadership positions. Women entrepreneurs in China are gradually increasing in number, but those who desire to take the helm of family-owned companies face important social and structural challenges in China’s male-dominated business culture.

The Solution

In this study, we used a qualitative interview approach to learn about the experiences of second-generation women entrepreneurs in Chinese family-owned businesses and to better understand their motivations along with the challenges and opportunities that they face. The findings revealed that the motivations of these women entrepreneurs were centered more on internal “pull” factors (e.g., self-actualization) rather than external “push” factors (e.g., economic pressures). The major challenges that were reported included tense relationships with parents, gender-role conflicts, and alignment issues in relation to their family businesses’ established culture. Understanding these factors can help in identifying opportunities for effective human resource development and promoting women’s entrepreneurship in the Chinese context.

The Stakeholders

Second-generation women entrepreneurs, family businesses in China, women leaders, and human resource development professionals.
Exploring the Risky Terrain of Entrepreneurship With Support From Developmental Relationships: Narratives From Indian Women Entrepreneurs
Authors: Chaudhuri Sanghamitra , Ghosh Rajashi , Abichandani Yogita
Published: February 2020

The Problem

There has been a burgeoning interest in studies on women entrepreneurs in the past decade, but in most studies conducted thus far, the scope has remained narrow with the focus mostly on strategic perspective and not so much on the individual-level understanding of the entrepreneurs. Furthermore, the limited number of studies that have looked into novice women entrepreneurs are restricted to western hemisphere, and to our knowledge, no study has looked into narratives on how women entrepreneurs in India benefit from various developmental relationships over the course of their entrepreneurial journey.

The Solution

Using narrative inquiry, we explore the stories of six urban women entrepreneurs in India illustrating how and why they started their careers in entrepreneurship, the challenges they experienced along the way, and how the varied developmental relationships they nurtured over time supported them to cope with those challenges.

The Stakeholders

The article aimed at venture capitalists that extend support to women entrepreneurs and to women who are considering to pursue entrepreneurship. The findings can guide them to anticipate the challenges and opportunities commonly experienced by women entrepreneurs and appreciate the value of developmental relationships that help to sustain motivation to be entrepreneurs.
Getting Involved: Lizbeth Mateo
Authors: Vallejo Jody Agius
Published: February 2020

Jody Agius Vallejo sits down with immigrant rights activist and attorney, Lizbeth Mateo.
Memories of Azoteas
Authors: Páramo Andrea Santiago
Published: February 2020

Roma catalyzed public discussions about deep-rooted racism against indigenous people, government repression of student movements, and above all, household workers’ lack of rights.
Feeding the Cultural Omnivores
Authors: Kolb Kenneth H.
Published: February 2020

In Masters of Craft: Old Jobs in the New Urban Economy, Richard Ocejo offers an in-depth analysis of the resurgence of once working class and low status occupations.
How to Cohabitate
Authors: Reid Matt
Published: February 2020

Sharon Sassler and Amanda Jayne Miller set out to expand our understanding of how cohabitating relationships evolve in their compelling new book, Cohabitation Nation: Gender, Class, and the Remaking of Relationships.
Energy Intake Deficiency Promotes Bone Resorption and Energy Metabolism Suppression in Japanese Male Endurance Runners: A Pilot Study
Authors: Taguchi Motoko , Moto Kuniko , Lee Sihyung , Torii Suguru , Hongu Nobuko
Published: February 2020

It has been reported that male athletes face increased risk for low energy availability and resulting health consequences similar to female athletes. The present study aimed to reveal the energy status of Japanese male runners and to examine the association between energy deficiency and physiological characteristics such as energy metabolism, bone health, and hormonal status. Six male collegiate long-distance runners during a training season participated in this study. Energy intake (EI) was assessed using 3-day dietary records with food pictures. Exercise energy expenditure (EEE) was determined by the HR-VO2 method. Body composition and bone status were measured by dual-energy X-ray absorptiometry. Energy availability (EA) was calculated by subtraction of EEE from EI and normalized by fat-free mass (FFM). Energy balance (EB) was calculated EI minus estimated total energy expenditure (TEE). Resting energy expenditure (REE) was measured by indirect calorimetry using the Douglas bag technique, and blood sampling was conducted to assess hormonal status. The mean EA of the subjects was 18.9 ± 6.8 kcal/kg FFM/day, and severe negative EB (range: −1444 ~ −722 kcal/d) was observed. REE of four runners was suppressed, and moreover, bone resorption was promoted in all subjects. The data in our study suggested that energy deficiency could promote bone resorption and energy metabolism suppression in Japanese male endurance runners. Additional short- and long-term studies are needed to clarify the health risks caused by energy deficiency in male athletes and explore strategies to prevent health problems related to energy deficiency in long-distance runners.
Dimensions of Masculine Norms, Depression, and Mental Health Service Utilization: Results From a Prospective Cohort Study Among Emerging Adult Men in the United States
Authors: Sileo Katelyn M. , Kershaw Trace S.
Published: February 2020

The purpose of this study was to examine the role of multidimensional masculine norms (“status,” “toughness,” “anti-femininity”) on depression and mental health service utilization among emerging adult men in the Northeast United States. This study examines substance use and hostility as secondary outcomes and depression status as an effect moderator on the relationship between masculine norms and mental health service utilization. This study used data from a prospective cohort study that followed 18- to 25-year-old heterosexual men over 6 months. At baseline and 6 months, approximately 29% and 25% of the sample met the criteria for depression. The results of multivariate linear and logistic regression models found that greater endorsement of masculine status was associated with less depressive symptoms at baseline and 6 months, masculine toughness was associated with more substance use at baseline, and masculine anti-femininity was associated with greater hostility at baseline and 6 months. The multivariate Poisson model found that greater endorsement of status was associated with greater mental health service utilization in the prior year, especially for men not meeting the criteria for depression. In contrast, greater endorsement of anti-femininity and toughness norms was associated with less mental health service utilization; for men endorsing toughness norms, this effect was greater for those who were depressed. This study sheds light on the harmful and protective effects of masculine norms on depression, related mental health outcomes, and mental health service utilization, with implications for gender-tailored approaches to engage and retain young men in mental health services.
Improved integrated metric for quantitative assessment of resilience
Authors: Cheng Congcong , Bai Guanghan , Zhang Yun-An , Tao Junyong
Published: February 2020

Resilience provides a new approach that system administrators can use in the design and analysis of engineering systems to enhance the ability of such systems to withstand uncertain threats. In this article, an improved integrated metric is proposed for the quantitative assessment of resilience. The proposed metric is constructed in the form of a summation of two capacities: absorptive and restorative capacities. A weight coefficient is assigned to each capacity to enhance the flexibility according to various system requirements of stakeholders. In addition, based on the absolute time scale, a new time factor is proposed and incorporated into the resilience metric to quantify the effect of time on system performance. To test the performance of the proposed metric, three experimental studies are conducted wherein the proposed metric is compared with two other metrics reported in the literature. The results indicate that the proposed metric extends the flexibility of the previous metrics to systems where the time scale is addressed, and that the numerical values of resilience lie in a proper range and can be compared conveniently across different engineering systems. Furthermore, an example of an information exchange network is adopted to demonstrate the applicability of the proposed metric.
Computational deconvolution of transcriptomic data for the study of tumor-infiltrating immune cells
Authors: Bolis Marco , Vallerga Arianna , Fratelli Maddalena
Published: February 2020

Cancer is a complex disease characterized by a wide array of mutually interacting components constituting the tumor microenvironment (connective tissue, vascular system, immune cells), many of which are targeted therapeutically. In particular, immune checkpoint inhibitors have recently become an established part of the treatment of cancer. Despite great promise, only a portion of the patients display durable response. Current research efforts are concentrated on the determination of tumor-specific biomarkers predictive of response, such as tumor mutational burden, microsatellite instability, and neo-antigen presentation. However, it is clear that several additional characteristics pertaining to the tumor microenvironment play a critical role in the effectiveness of immunotherapy. Here we comment on the computational methods that are used for the analysis of the tumor microenvironment components from transcriptomic data, discuss the critical needs, and foresee potential evolutions in the field.
Predictive biomarkers in clinical practice: State of the art and perspectives in solid tumors
Authors: Ulivi Paola
Published: February 2020

The discovery of molecular alterations that play key functions in pathways of tumor growth and survival have changed the treatment approach of several solid tumors. A number of biomarkers are now approved in clinical practice for the selection of patients to be treated with the specific targeted drug, and others are currently under study. None of these biomarkers are perfect and they have a number of biases. Novel treatment approaches, such as immunotherapy, require the development of more complex biomarker combinations as the mechanism of action of these drugs involves multiple parameters. In this short communication the principal approved biomarkers in solid tumors are discussed, with attention to the novel promising biomarkers that will be developed in the future.
Acute kidney injury is associated with increased healthcare utilization, complications, and mortality after primary total knee arthroplasty
Authors: Singh Jasvinder A. , Cleveland John D.
Published: February 2020

Background:

The objective of this study was to assess healthcare utilization and complications associated with acute kidney injury (AKI) in patients undergoing primary total knee arthroplasty (TKA).

Methods:

We used the 1998–2014 US National Inpatient Sample to assess whether AKI is associated with healthcare utilization or in-hospital postoperative complications post-TKA using multivariable-adjusted logistic regression analyses. We calculated odds ratios (ORs) and a 95% confidence intervals (CIs). Sensitivity analyses additionally adjusted for hospital characteristics (location/teaching status, bed size, and region).

Results:

Of the 8,127,282 people who underwent primary TKA from 1998 to 2014, 104,366 (1.3%) had a diagnosis of AKI. People with AKI had longer unadjusted mean hospital stay, 6.1 versus 3.5 days, higher mean hospital charges, US$71,385 versus US$42,067, and higher rates of all in-hospital postoperative complications, including mortality. Adjusted for age, sex, race, underlying diagnosis, medical comorbidity, income, and insurance payer, AKI was associated with a significantly higher OR (95% CI) of total hospital charges above the median, 2.76 (2.68, 2.85); length of hospital stay > 3 days, 2.21 (2.14, 2.28); and discharge to a rehabilitation facility, 4.68 (4.54, 4.83). AKI was associated with significantly higher OR (95% CI) of in-hospital complications, including infection, 2.60 (1.97, 3.43); transfusion, 2.94 (2.85, 3.03); revision, 2.13 (1.72, 2.64); and mortality, 19.75 (17.39, 22.42). Sensitivity analyses replicated the main study findings, without any attenuation of ORs.

Conclusions:

AKI is associated with a significantly higher risk of increased healthcare utilization, complications, and mortality after primary TKA. Future studies should assess significant factors associated and interventions that can prevent AKI.
A Pilot Study of Flat and Circadian Insulin Infusion Rates in Continuous Subcutaneous Insulin Infusion (CSII) in Adults with Type 1 Diabetes (FIRST1D)
Authors: Rilstone Siân , Reddy Monika , Oliver Nick
Published: February 2020

Background:

Initiation of continuous subcutaneous insulin therapy (CSII) in type 1 diabetes requires conversion of a basal insulin dose into a continuous infusion regimen. There are limited data to guide the optimal insulin profile to rapidly achieve target glucose and minimize healthcare professional input. The aim of this pilot study was to compare circadian and flat insulin infusion rates in CSII naïve adults with type 1 diabetes.

Methods:

Adults with type 1 diabetes commencing CSII were recruited. Participants were randomized to circadian or flat basal profile calculated from the total daily dose. Basal rate testing was undertaken on days 7, 14 and 28 and basal rates were adjusted. The primary outcome was the between-group difference in absolute change in insulin basal rate over 24 hours following three rounds of basal testing. Secondary outcomes included the number of basal rate changes and the time blocks.

Results:

Seventeen participants (mean age 33.3 (SD 8.6) years) were recruited. There was no significant difference in absolute change in insulin basal rates between groups ( P = .85). The circadian group experienced significant variation in the number of changes made with the most changes in the morning and evening ( P = .005). The circadian group received a greater reduction in total insulin (−14.1 (interquartile range (IQR) −22.5-12.95) units) than the flat group (−7.48 (IQR −11.90-1.23) units) ( P = .021).

Conclusion:

The initial insulin profile does not impact on the magnitude of basal rate changes during optimization. The circadian profile requires changes at specific time points. Further development of the circadian profile may be the optimal strategy.
The relationship between obstructive sleep apnoea and quality of life in women with polycystic ovary syndrome: a cross-sectional study
Authors: Kahal Hassan , Tahrani Abd A. , Kyrou Ioannis , Dimitriadis Georgios K. , Kimani Peter K. , Barber Thomas M. , Nicholls Matthew , Ali Asad , Weickert Martin O. , Randeva Harpal S.
Published: February 2020

Background:

Obstructive sleep apnoea (OSA) and polycystic ovary syndrome (PCOS) are associated with significant comorbidities and commonly coexist. The primary aim of this study was to examine the relationship between OSA and quality of life (QoL) in women with PCOS.

Methods:

We conducted an observational cross-sectional study. PCOS was diagnosed according to the Rotterdam criteria. Women with increased risk of OSA, based on the Berlin questionnaire or the Epworth Sleepiness Scale (ESS), had home-based polysomnography performed (ALICE PDx). Participants were divided into two groups: (a) PCOS only: women with normal ESS and low-risk Berlin questionnaire (no sleep studies performed), or women with normal sleep studies [oxygen desaturation index (ODI) < 5 events/hour]; and (b) PCOS+OSA: women with PCOS and OSA ODI ⩾ 5. QoL was assessed using the World Health Organization QoL questionnaire (WHOQOL-BREF) and the PCOS health-related quality of life questionnaire (PCOSQ).

Results:

A total of 39 women were included; age (mean ± SD) was 32.2 ± 8.9 years, weight 92.5 ± 23.7 kg and body mass index (BMI) 34.1 ± 7.9 kg/m2; 38.5% ( n = 15) had OSA. Compared with women with PCOS only, women with PCOS+OSA had higher BMI, HbA1c, C-reactive protein and low-density lipoprotein. ODI was independently associated with impaired QoL. Excessive daytime sleepiness (EDS) was independently associated with anxiety, depression and impaired QoL.

Conclusions:

OSA is highly prevalent and is associated with impaired QoL and worse metabolic profile in women with PCOS. Interventional studies are needed to examine the impact of OSA in women with PCOS.

ClinicalTrials.gov Identifier:

NCT03065322
Use of the Living Kidney Donor Profile Index in the Canadian Kidney Transplant Recipient Population: A Validation Study
Authors: Shantier Mohamed , Li Yanhong , Ashwin Monika , Famure Olsegun , Singh Sunita K.
Published: February 2020

Background:

The Living Kidney Donor Profile Index (LKDPI) was derived in a cohort of kidney transplant recipients (KTR) from the United States to predict the risk of total graft failure. There are important differences in patient demographics, listing practices, access to transplantation, delivery of care, and posttransplant mortality in Canada as compared with the United States, and the generalizability of the LKDPI in the Canadian context is unknown.

Objective:

The purpose of this study was to externally validate the LKDPI in a large contemporary cohort of Canadian KTR.

Design:

Retrospective cohort validation study.

Setting:

Toronto General Hospital, University Health Network, Toronto, Ontario, Canada

Patients:

A total of 645 adult (≥18 years old) living donor KTR between January 1, 2006 and December 31, 2016 with follow-up until December 31, 2017 were included in the study.

Measurements:

The predictive performance of the LKDPI was evaluated. The outcome of interest was total graft failure, defined as the need for chronic dialysis, retransplantation, or death with graft function.

Methods:

The Cox proportional hazards model was used to examine the relation between the LKDPI and total graft failure. The Cox proportional hazards model was also used for external validation and performance assessment of the model. Discrimination and calibration were used to assess model performance. Discrimination was assessed using Harrell’s C statistic and calibration was assessed graphically, comparing observed versus predicted probabilities of total graft failure.

Results:

A total of 645 living donor KTR were included in the study. The median LKDPI score was 13 (interquartile range [IQR] = 1.1, 29.9). Higher LKDPI scores were associated with an increased risk of total graft failure (hazard ratio = 1.01; 95% confidence interval [CI] = 1.0-1.02; P = .02). Discrimination was poor (C statistic = 0.55; 95% CI = 0.48-0.61). Calibration was as good at 1-year posttransplant but suboptimal at 3- and 5-years posttransplant.

Limitations:

Limitations include a relatively small sample size, predicted probabilities for assessment of calibration only available for scores of 0 to 100, and some missing data handled by imputation.

Conclusions:

In this external validation study, the predictive ability of the LKDPI was modest in a cohort of Canadian KTR. Validation of prediction models is an important step to assess performance in external populations. Potential recalibration of the LKDPI may be useful prior to clinical use in external cohorts.
Mass Transit Shutdowns as a Tactical Innovation in Bogotá, Colombia
Authors: Leal Diego F.
Published: February 2020

In a context of debilitated formal political institutions, a period of high levels of collective contention, and a protest culture in which road blockades are commonly used, this article argues that the implementation of a novel easy-to-block bus-based mass transit system, Transmilenio (TM), changed the repertoire of contention in Bogotá. To support this argument, panel data that register all protest events that took place in Bogotá between 2001 and 2010 are used in the context of a research design akin to a natural experiment. Results suggest that TM infrastructure did act as a magnet, pulling traditional street protest tactics that used to take place on regular streets and redirecting them toward TM lanes. In addition, following rationalist approaches regarding the emergence of tactical innovations, the article provides preliminary population-based attitudinal evidence suggesting that activists’ perceived effectiveness of TM shutdowns might be one likely mechanism connecting TM infrastructure to activists’ decision to mobilize in Bogotá.
A molecular survey, whole genome sequencing and phylogenetic analysis of astroviruses from roe deer
Authors: Jamnikar-Ciglenecki Urska , Civnik Vita , Kirbis Andrej , Kuhar Urska
Published: February 2020

Background

Although astroviruses (AstV) have been detected in a variety of host species, there are only limited records of their occurrence in deer. One of the most important game species in Europe, due to its meat and antlers, is roe deer. Infected game animals can pose a threat to the health of other animals and of humans, so more attention needs to be focused on understanding the diversity of viruses in wildlife. The complete genome and organization of the roe deer AstV genome have not so far been described.

Results

In our study, 111 game animals were screened for the presence of AstV. While no AstVs were detected in red deer, wild boar, chamois and mouflon, AstV RNA was present in three samples of roe deer. They were further subjected to whole genome sequencing with next generation sequencing. In this study, two AstV genomes were assembled; one in sample D5–14 and one in sample D12–14, while, in sample D45–14, no AstV sequences were identified. The complete coding sequences of the AstV SLO/D5–14 strain genome and of the almost complete genome of the AstV SLO/D12–14 strain were determined. They showed a typical Mamastrovirus organization. Phylogenetic analyses and amino acid pairwise distance analysis revealed that Slovenian roe deer AstV strains are closely related to each other and, also, related to other deer, bovine, water buffalo, yak, Sichuan takin, dromedary, porcine and porcupine AstV strains - thus forming a highly supported group of currently unassigned sequences.

Conclusions

Our findings suggest the existence of a new Mamastrovirus genogroup might be constituted while this aforementioned group is distantly related to Mamastrovirus genogroups I and II. In this study, additional data supporting a novel taxonomic classification are presented.
Syndesmotic malreduction may decrease fixation stability: a biomechanical study
Authors: Bai Lu , Zhang Wentao , Guan Siyao , Liu Jianxin , Chen Peng
Published: February 2020

Background

This study aims to investigate the malreduction of syndesmosis and its effects on stability.

Methods

The biomechanical tests, including the three-dimensional (3D) displacement of the syndesmotic incisura, fibular rotation angle, and torque resistance, were performed on six cadaver legs. These specimens were first tested intact (intact group), then cut all the syndesmotic ligaments and fixed in anatomical position (anatomical model group) and test again. After that, syndesmosis was fixed in 1 cm malreduction (anterior and posterior displacement group) to do the same test.

Results

In internal or external load, there were significant differences in torque resistance and fibular rotation angle (internal t = 2.412, P = 0.036; external t = 2.412, P = 0.039) between the intact and post-malreduction groups. In internal rotation load, there were significant differences in sagittal displacement between the intact and post-malreduction groups (P = 0.011), and between the anatomical and post-malreduction groups (P = 0.020). In external rotation load, significant differences existed between the intact and ant-malreduction group (P = 0.034) in sagittal (anterior-posterior) displacement. Significant differences also existed between the intact and post-malreduction groups (P = 0.013), and between the anatomical and post-malreduction groups (P = 0.038) in coronal (medial-lateral) displacement.

Conclusions

Malreduction in different conditions does affect the stability of the syndesmotic fixation. The result of the study may reveal the biomechanical mechanism of poor clinical outcome in syndesmosis malreduction patients and pathological displacement patterns of the ankle under syndesmotic malreduction conditions.

Level of evidence

III
Sick leave, disability, and mortality in acute hepatic porphyria: a nationwide cohort study
Authors: Baravelli Carl Michael , Aarsand Aasne Karine , Sandberg Sverre , Tollånes Mette Christophersen
Published: February 2020

Background

Acute hepatic porphyria (AHP) consists of three rare metabolic disorders. We investigated the risk of long-term sick leave, disability pension, and premature death in individuals with AHP compared to the general population.

Methods

In a nationwide cohort study from 1992 to 2017, records of 333 persons (total person-years = 6728) with a confirmed AHP diagnosis were linked to several national compulsory registries (reference population = 5,819,937). We conducted survival analyses to assess additional risk.

Results

Persons with AHP had higher risks of accessing long-term sick leave (adjusted hazard ratio (aHR): 1.5, 95% confidence interval (CI): 1.3, 1.7) and disability pension (aHR: 1.9, CI: 1.5, 2.4). The risk was highest in persons who had been hospitalised for acute attacks, while no additional risk was observed in asymptomatic AHP gene mutation carriers. The median age when accessing disability pension was 45 years, 21 years younger than the general population. AHP was associated with increased risk of mortality due to hepatocellular carcinoma (adjusted mortality rate ratio (aMRR): 84.4, CI: 37.8, 188.2), but no overall increased risk of premature death was observed.

Conclusions

Persons with symptomatic AHP were at increased risk of accessing long-term sick leave and disability pension but not of premature death.
Lack of knowledge and misperceptions about thalassaemia among college students in Bangladesh: a cross-sectional baseline study
Authors: Hossain Mohammad Sorowar , Hasan Md. Mahbub , Raheem Enayetur , Islam Muhammad Sougatul , Al Mosabbir Abdullah , Petrou Mary , Telfer Paul , Siddiqee Mahbubul H.
Published: February 2020

Background

Thalassaemia is a potentially life-threatening yet preventable inherited hemoglobin disorder. Understanding local socio-cultural context and level of public awareness about thalassaemia is pivotal for selecting effective prevention strategies. This study attempted to assess knowledge and perceptions about thalassaemia among college students in Bangladesh.

Methods

A supervised cross-sectional survey was conducted on 1578 college students using a self-administered structured questionnaire. The survey took place from 15 February 2018 to 17 March 2018 in the Jamalpur district in Bangladesh. Besides the attitude-related questions, the study asked a total of 12 knowledge-related questions, which were scored on a scale of 0–12 points.

Results

Over two-thirds (67%) of the college students had never heard of thalassaemia. The urban-rural dichotomy was observed among those familiar with the term; (46.4% from urban vs. 25.8% from rural colleges). A similar pattern was observed for knowledge score; 5.07 ± 1.87 for students from the urban colleges compared to 3.69 ± 2.23 for rural colleges. Students from the science background had the highest knowledge score (5.03 ± 1.85), while those from arts and humanities background scored lowest (3.66 ± 2.3). Nearly 40% of the students were not sure or did not want to be a friend of a thalassaemia patient. Whereas 39% either declined or remained hesitant about helping thalassaemia patients by donating blood. However, most of the respondents (88%) showed a positive attitude towards ‘premarital’ screening to prevent thalassaemia.

Conclusions

This study has identified critical knowledge gaps and societal misperceptions about thalassaemia. A better understanding of these aspects will be pivotal for disseminating thalassaemia related information. As the first study of this kind in Bangladesh, findings from this study has generated baseline data that would contribute to developing effective intervention strategies in Bangladesh and other countries with a comparable socio-cultural setting.