bluuebunny/crossref_metadata_2025 huggingface dataset:
A new ligament-compatible patient-specific 3D-printed implant and instrumentation for total ankle arthroplasty: from biomechanical studies to clinical cases
Authors: Faldini C. , Mazzotti A. , Belvedere C. , Durastanti G. , Panciera A. , Geraci G. , Leardini A.
Published: September 2020

Background

Computer navigation and patient-specific instrumentation for total ankle arthroplasty have still to demonstrate their theoretical ability to improve implant positioning and functional outcomes. The purpose of this paper is to present a new and complete total ankle arthroplasty customization process for severe posttraumatic ankle joint arthritis, consisting of patient-specific 3D-printed implant and instrumentation, starting from a ligament-compatible design.

Case presentation

The new customization process was proposed in a 57-year-old male patient and involved image analysis, joint modeling, prosthesis design, patient-specific implant and instrumentation development, relevant prototyping, manufacturing, and implantation. Images obtained from a CT scan were processed for a 3D model of the ankle, and the BOX ankle prosthesis (MatOrtho, UK) geometries were customized to best fit the model. Virtual in silico, i.e., at the computer, implantation was performed to optimize positioning of these components. Corresponding patient-specific cutting guides for bone preparation were designed. The obtained models were printed in ABS by additive manufacturing for a final check. Once the planning procedure was approved, the models were sent to final state-of-the-art additive manufacturing (the metal components using cobalt-chromium-molybdenum powders, and the guides using polyamide). The custom-made prosthesis was then implanted using the cutting guides. The design, manufacturing, and implantation procedures were completed successfully and consistently, and final dimensions and location for the implant corresponded with the preoperative plan. Immediate post-op X-rays showed good implant positioning and alignment. After 4 months, clinical scores and functional abilities were excellent. Gait analysis showed satisfactory joint moment at the ankle complex and muscle activation timing within normality.

Conclusions

The complete customization process for total ankle arthroplasty provided accurate and reliable implant positioning, with satisfactory short-term clinical outcomes. However, further studies are needed to confirm the potential benefits of this complete customization process.

Level of evidence

5. Case report.
Reconciling evolution: evidence from a biology and theology course
Authors: Tolman Ethan R. , Ferguson Daniel G. , Mann Mark , Cordero April Maskiewicz , Jensen Jamie L.
Published: September 2020

Background

Many individuals reject evolutionary theory due to a perceived conflict with their religious beliefs. To bridge this gap, educators have attempted different approaches including approaching evolution rejection as a consequence of deficit thinking and teaching students the nature of science (including the scientific process and peer review process as well as questions that science can and cannot answer).Teaching the nature of science has shown promising gains in the acceptance of evolution, although acceptance rates remain low. We propose a further approach: the use of a reconciliatory model designed to help students accept evolution within the framework of their religious beliefs. We tested this approach in both biology and theology classrooms at a Nazarene-affiliated university. Both professors approached the subject in a reconciliatory fashion.

Results

This study found that by utilizing a reconciliatory approach, the students in both classrooms saw significant gains in evolution acceptance, with gains being greatest in the biology classroom. In addition, we saw no decrease in student religiosity.

Conclusions

Implications of this are discussed. The results of this study confirm the effectiveness of a reconciliatory model, which opens several avenues for further research.
Community-derived recommendations for healthcare systems and medical students to support people who are houseless in Portland, Oregon: a mixed-methods study
Authors: King Caroline , Fisher Cameron , Johnson Jacob , Chun Arum , Bangsberg David , Carder Paula
Published: September 2020

Background

People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community.

Methods

Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process.

Results

We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions.

Conclusions

Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.
Revision surgery for instrumentation failure after total en bloc spondylectomy: a retrospective case series
Authors: Shinmura Kazuya , Kato Satoshi , Demura Satoru , Yokogawa Noriaki , Yonezawa Noritaka , Shimizu Takaki , Oku Norihiro , Kitagawa Ryo , Handa Makoto , Annen Ryohei , Murakami Hideki , Tsuchiya Hiroyuki
Published: September 2020

Background

There have been several reports of instrumentation failure after three-column resections such as total en bloc spondylectomy (TES) for spinal tumors; however, clinical outcomes of revision surgery for instrumentation failure after TES are seldom reported. Therefore, this study assessed the clinical outcomes of revision surgery for instrumentation failure after TES.

Methods

This study employed a retrospective case series in a single center and included 61 patients with spinal tumors who underwent TES between 2010 and 2015 and were followed up for > 2 years. Instrumentation failure rate, back pain, neurological deterioration, ambulatory status, operation time, blood loss, complications, bone fusion after revision surgery, and re-instrumentation failure were assessed. Data were collected on back pain, neurological deterioration, ambulatory status, and management for patients with instrumentation failure, and we documented radiological bone fusion and re-instrumentation failure in cases followed up for > 2 years after revision surgery.

Results

Of the 61 patients, 26 (42.6%) experienced instrumentation failure at an average of 32 (range, 11–92) months after TES. Of these, 23 underwent revision surgery. The average operation time and intraoperative blood loss were 204 min and 97 ml, respectively. Including the six patients who were unable to walk after instrumentation failure, all patients were able to walk after revision surgery. Perioperative complications of reoperation were surgical site infection (n = 2) and delayed wound healing (n = 1). At the final follow-up, bone fusion was observed in all patients. No re-instrumentation failure was recorded.

Conclusion

Bone fusion was achieved by revision surgery using the posterior approach alone.
Skin rash following Administration of Apalutamide in Japanese patients with Advanced Prostate Cancer: an integrated analysis of the phase 3 SPARTAN and TITAN studies and a phase 1 open-label study
Authors: Uemura Hiroji , Koroki Yosuke , Iwaki Yuki , Imanaka Keiichiro , Kambara Takeshi , Lopez-Gitlitz Angela , Smith Andressa , Uemura Hirotsugu
Published: September 2020

Background

A higher incidence of apalutamide-related skin rash has been observed in Japanese patients with prostate cancer (PC).

Methods

This integrated analysis of data of Japanese patients from 2 global Phase 3 studies, SPARTAN (NCT01946204; patients with non-metastatic castration-resistant PC [nmCRPC]) and TITAN (NCT02489318; patients with metastatic castration-sensitive PC [mCSPC]), and the Phase 1 study 56021927PCR1008 (NCT02162836; patients with metastatic CRPC [mCRPC]), assessed clinical risk factors of apalutamide-related skin rash as well as the potential correlation with plasma exposure to apalutamide. Kaplan-Meier method was used for time-to-event analyses. Clinical risk factors for skin rash were assessed using odds ratio.

Results

Data from 68 patients (SPARTAN: n = 34, TITAN: n = 28, 56021927PCR1008: n = 6) receiving apalutamide 240 mg orally once-daily were analyzed. Rash (13 [19.1%]) and maculo-papular rash (11 [16.2%]) were the most frequently reported skin rash. All Grade and Grade 3 skin rash occurred in 35 (51.5%) and 10 (14.7%) patients, respectively. Most (85.7%) skin rash occurred within 4 months of apalutamide initiation and resolved in a median time of 1 month following the use of antihistamines, topical or systemic corticosteroids, with/without apalutamide dose interruptions/reductions. Median time-to-remission of first incidence of rash and maximum grade incidence of rash were 1.0 month (IQR: 0.36–1.81) and 1.0 month (IQR: 0.30–2.43), respectively. No significant clinical risk factors for the incidence of skin rash were observed. Areas under the curve (0–24 h) (AUC0–24, ss) at steady-state of plasma apalutamide concentration were numerically slightly higher in patients with skin rash than those without.

Conclusions

No clinical risk factors for rash could be detected. There is a potential correlation between incidence of skin rash and plasma exposure to apalutamide. In general, apalutamide-related skin rash is easily managed, with appropriate treatment with or without dose adjustment.

Trial registration

Retrospective pooled analysis of NCT01946204, NCT02489318, and NCT02162836.
Modified nucleic acids: replication, evolution, and next-generation therapeutics
Authors: Duffy Karen , Arangundy-Franklin Sebastian , Holliger Philipp
Published: September 2020

Modified nucleic acids, also called xeno nucleic acids (XNAs), offer a variety of advantages for biotechnological applications and address some of the limitations of first-generation nucleic acid therapeutics. Indeed, several therapeutics based on modified nucleic acids have recently been approved and many more are under clinical evaluation. XNAs can provide increased biostability and furthermore are now increasingly amenable to in vitro evolution, accelerating lead discovery. Here, we review the most recent discoveries in this dynamic field with a focus on progress in the enzymatic replication and functional exploration of XNAs.
Characterization of a novel HDAC/RXR/HtrA1 signaling axis as a novel target to overcome cisplatin resistance in human non-small cell lung cancer
Authors: Wang Wenjing , Zhao Mengyue , Cui Lijuan , Ren Yong , Zhang Jingyuan , Chen Junli , Jia Lina , Zhang Jiayu , Yang Jingyu , Chen Guoliang , Ashby Charles R. , Wu Chunfu , Chen Zhe-Sheng , Wang Lihui
Published: September 2020

Background

Cisplatin is a first-line drug for the treatment of human non-small cell lung cancer (NSCLC); however, the majority of patients will develop drug resistance after treatment. In order to overcome cisplatin resistance, it is important to understand the mechanisms underlying the resistance.

Methods

A gene microarray was used to screen for genes related to cisplatin resistance in NSCLC cell lines. Subsequently, the correlation between the HDAC, RXR and HtrA1 genes, in NSCLC, were verified using gene manipulation. Immunohistochemical staining was used to detect HDAC, RXR and HtrA1 expression in NSCLC specimens. Proliferation, migration and invasion assays were performed in vitro and in vivo to determine the role of the HDAC/RXR/HtrA1 signaling axis in cisplatin resistance, and luciferase reporter analysis and ChIP assays were performed to ascertain the mechanisms by which HDAC and RXR regulate the expression of HtrA1. Furthermore, in vitro and in vivo experiments were conducted in NSCLC cisplatin-resistant NSCLC to elucidate the effect of the low molecular weight compound, DW22, which targets the NSCLC cisplatin resistance HDAC/RXR/HtrA1 signaling pathway.

Results

HtrA1 was identified as a cisplatin resistance-related gene in NSCLC cells. The regulation of HtrA1 by HDAC and RXR significantly decreased the efficacy of cisplatin in NSCLC cells resistant to cisplatin. Immunohistochemistry results showed a negative relationship between HDAC1 and HtrA1, and a positive relationship between RXRα and HtrA1 in NSCLC patients’ tissues. Notably, the expression of HDAC1 and HtrA1 can be considered as biomarkers for the efficacy of platinum-based drugs and prognosis in NSCLC patients. Mechanistically, the heterodimers of the nuclear receptor RXR, in combination with the enzyme, HDAC, regulate the transcription of HtrA1 in NSCLC cells. The rescue of HtrA1 expression by dual targeting of HDAC and RXR with the compound, DW22, significantly inhibited the proliferation, migration and invasion of NSCLC cells resistant to cisplatin, and induced NSCLC cell apoptosis.

Conclusion

Our results indicate that HtrA1, a cisplatin resistance-related gene, is synergistically regulated by HDAC and RXR in NSCLC. Targeting the HDAC/RXR/HtrA1 signaling axis can rescue HtrA1 expression and reverse cisplatin resistance in NSCLC.
Development of supraspinatus imaging guidance for primary care physicians with a focus on patient selection
Authors: Dalai Anurag , Langford Leanne , Beavis Cole , Obaid Haron
Published: September 2020

Background

Primary care physicians frequently encounter patients with supraspinatus pathology and face a difficult task of managing this subset of patients using limited imaging resources. The purpose of this study was to develop a guidance that could help primary care physicians choose appropriate imaging tests judiciously for patients with suspected supraspinatus pathology.

Methods

The imaging reports of one hundred patients who underwent ultrasound and MRI for suspected supraspinatus tendinopathy were retrospectively assessed. The supraspinatus tendon was recorded as intact, partial tear (articular or bursal), or full-thickness tear (focal or complete width). The agreement between imaging modalities was then evaluated using factors such as pathology type and age.

Results

There was agreement between modalities in 48/100 patients (Kappa statistic = 0.30). The consistency varied with type of pathology: intact tendons by ultrasound had 55.8% agreement with MRI, partial sided bursal tears 50%, partial sided articular tears 25%, and full-thickness focal tears 33.3%. Full-thickness complete-width tears had a much better agreement with MRI at 90.9%. Age was also significant, with increased disagreement between ultrasound and MRI in patients over 50 years old.

Conclusions

Our data showed that ultrasound findings correlated well with MRI in patients under 50 years of age and also in patients with full-thickness supraspinatus tears. We recommend that primary care physicians may consider using ultrasound as the initial test in younger patients and in patients with suspected full supraspinatus tears, based on clinical exam, with MRI as an option for further evaluation to quantify supraspinatus muscle atrophy. These patient selection recommendations will help promote mindful utilization of scarce resources.
Progressive amnestic cognitive impairment in a middle-aged patient with developmental language disorder: a case report
Authors: Takaya Masahiko , Ishii Kazunari , Kiguchi Kaori , Saigoh Kazumasa , Shirakawa Osamu
Published: September 2020

Background

Developmental disorder and dementia in older adults have been considered unrelated clinical entities because their timing of diagnosis differs greatly; however, recent studies have suggested an association between them. This case describes a middle-aged patient with language disorder exhibiting progressive amnestic cognitive impairment.

Case Presentation

A 44-year-old Japanese man with long-term language dysfunction presented for his first-ever medical evaluation at age 36 years. Although his conversational ability had been impaired since childhood, he was able to graduate from secondary school and gain unskilled employment. At age 36 years, however, his workplace environment became more stressful, which led to behavioral problems that necessitated medical consultation. He consulted two psychiatrists in vain. At age 44 years, the third attending psychiatrist examined him in detail. The major component of his language disorder was amnestic cognitive impairment in the language domain as shown by logical memory subtests of the Wechsler Memory Scale–Revised. Magnetic resonance imaging showed normal findings for his age and no small vessel disease. Global cerebral hypoperfusion versus cerebellar blood flow was shown on (123I) iodoamphetamine single-photon emission computed tomography, and amyloid-β deposition was negative on positron emission tomography with 11C-Pittsburgh compound B. Pathologic tau accumulation was negative on 18F-THK5351 positron emission tomography imaging. Laboratory tests show no infections, no vitamin deficiencies, and no other diseases that may cause dementia. Clinical features, results of neurocognitive tests and neuroimaging studies showed no well-known neurodegenerative diseases. Collectively, he was diagnosed with language disorder based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria. Over a 2-year follow-up period, amnestic cognitive impairment in visual and language domains progressed in parallel with global cerebral hypoperfusion.

Conclusion

This case suggests a possible link between language disorder as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and progressive amnestic cognitive impairment in middle age, which may ultimately lead to dementia, derived from a neurodegenerative disease.
Are antenatal interventions effective in improving multiple health behaviours among pregnant women? A systematic review protocol
Authors: Hollis Jenna L. , Doherty Emma , Dray Julia , Tremain Danika , Hunter Mandy , Takats Karen , Williams Christopher M. , Murray Henry , Pennell Craig E. , Tully Belinda , Wiggers John , Daly Justine B. , Kingsland Melanie
Published: September 2020

Background

Maternal behaviours in pregnancy associated with adverse pregnancy, birth and health outcomes include tobacco smoking, poor nutrition, alcohol consumption and low physical activity, collectively referred to as the SNAP risk factors. Due to the high prevalence, co-occurrence and possible interactive health effects of such health behaviours in pregnancy, antenatal interventions that support pregnant women to improve multiple SNAP behaviours have a greater potential impact on the health outcomes of women and their children than interventions addressing single behaviours. The objective of this review is to determine the effectiveness of interventions delivered as part of antenatal care that aim to improve multiple SNAP behaviours among pregnant women.

Methods

Seven electronic databases will be searched for potentially eligible studies. Eligible studies will include those where pregnant women are attending antenatal care. Studies that examine the effect of an intervention that addresses multiple SNAP behaviours (≥ 2 behaviours) during pregnancy and are delivered or instigated through antenatal care in a healthcare service will be included. Systematic reviews of randomised controlled trials (RCTs), RCTs, cluster RCTs, stepped-wedge RCTs and non-randomised control trials will be eligible. Studies that include a no-intervention control, wait-list control group, standard/usual care, or another active single behavioural intervention (e.g. addressing one behaviour only) will be considered. Two independent reviewers will conduct study screening, data extraction and risk of bias assessment. Discrepancies will be resolved by consensus or a third reviewer if required. A random effects model will be used to synthesise the results. Alternative synthesis methods will be investigated in instances where a meta-analysis is not appropriate, such as summarising effect estimates, combining P values, vote counting based on direction of effect, or synthesis in narrative form.

Discussion

The review will synthesise the evidence on the effect of interventions that address multiple SNAP behaviours in antenatal care and will help researchers, policy-makers and health services to develop and deliver best practice integrated models of antenatal care that have the potential to impact on both the short- and long-term health outcomes for women and their children.

Systematic review registration

PROSPERO CRD42018095315
Relationship between volume and outcome for gastroschisis: a systematic review protocol
Authors: Morche Johannes , Mathes Tim , Jacobs Anja , Wessel Lucas , Neugebauer Edmund A. M. , Pieper Dawid
Published: September 2020

Background

Gastroschisis is a congenital anomaly that needs surgical management for repositioning intestines into the abdominal cavity and for abdominal closure. Higher hospital or surgeon volume has previously been found to be associated with better clinical outcomes for different especially high-risk, low volume procedures. Therefore, we aim to examine the relationship between hospital or surgeon volume and outcomes for gastroschisis.

Methods

We will perform a systematic literature search from inception onwards in Medline, Embase, CENTRAL, CINAHL, and Biosis Previews without applying any limitations. In addition, we will search trial registries and relevant conference proceedings. We will include (cluster-) randomized controlled trials (RCTs) and prospective or retrospective cohort studies analyzing the relationship between hospital or surgeon volume and clinical outcomes. The primary outcomes will be survival and mortality. Secondary outcomes will be different measures of morbidity (e.g., severe gastrointestinal complications, gastrointestinal dysfunctions, and sepsis), quality of life, and length of stay. We will systematically assess risk of bias of included studies using RoB 2 for individually or cluster-randomized trials and ROBINS-I for cohort studies, and extract data on the study design, patient characteristics, case-mix adjustments, statistical methods, hospital and surgeon volume, and outcomes into standardized tables. Title and abstract screening, full text screening, critical appraisal, and data extraction of results will be conducted by two reviewers independently. Other data will be extracted by one reviewer and checked for accuracy by a second one. Any disagreements will be resolved by discussion. We will not pool results statistically as we expect included studies to be clinically and methodologically very diverse. We will conduct a systematic synthesis without meta-analysis and use GRADE for assessing the certainty of the evidence.

Discussion

Given the lack of a comprehensive summary of findings on the relationship between hospital or surgeon volume and outcomes for gastroschisis, this systematic review will put things right. Results can be used to inform decision makers or clinicians and to adapt medical care.

Systematic review registration

Open Science Framework (DOI: 10.17605/OSF.IO/EX34M; 10.17605/OSF.IO/HGPZ2)
The association between analgesic drug use in pregnancy and neurodevelopmental disorders: protocol for an umbrella review
Authors: Kwok Janell , Hall Hildigunnur Anna , Murray Aja Louise , Auyeung Bonnie
Published: September 2020

Background

Maternal prenatal health has been shown to be an important influence on children’s developmental outcomes, which has led to an increased emphasis on providing more information to support clinical decisions in pregnancy. Several systematic reviews suggest that analgesic drug use during pregnancy may have neurodisruptive properties. However, no firm conclusions have yet been drawn on the associations between prenatal analgesic drug use and children’s long-term development of neurodevelopmental disorders such as autism spectrum disorder (ASD) or attention deficit hyperactivity disorder (ADHD). Therefore, an umbrella review is proposed for the purpose of examining the associations between maternal analgesic drug use during pregnancy and diagnoses of neurodevelopmental disorders.

Methods

Included systematic reviews will consist of studies examining the effect of maternal prenatal analgesic drug use, specifically ibuprofen, acetaminophen, aspirin, naproxen, diclofenac, and ketoprofen, on children’s neurodevelopmental disorder status. Examined drugs were restricted to those readily accessible and frequently used by pregnant women, and with characteristics that allow them to cross the placenta and directly affect fetal development. Outcomes will be restricted to formal clinical diagnoses of ASD and/or ADHD. Two reviewers will independently identify eligible reviews from six databases (e.g., PubMed, EMBASE, PsychINFO) from inception dates of databases to the date of data extraction, and conduct manual searches of reference lists, consultation with field experts, and scan of pre-print archives. Extracted data will also include short qualitative summaries by both reviewers. As part of quality assessment, a standardized measurement tool to assess systematic reviews (AMSTAR 2) will be used. A narrative synthesis is proposed to integrate findings from different, potentially methodologically heterogeneous, studies.

Discussion

This umbrella review of associations between maternal prenatal use of analgesic drugs and children’s neurodevelopmental disorders could allow for firmer conclusions to be drawn through the synthesis of all relevant published research. The synthesis of findings using high-quality evidence could provide more accurate healthcare information on the long-term effects of analgesic drugs on neurodevelopment, to better guide future clinical decisions during pregnancy. This review will also allow gaps and methodological differences in the literature to be identified, informing recommendations for future research.

Systematic review registration

PROSPERO CRD42020179216.
SD2PA: a fully safe driving and privacy-preserving authentication scheme for VANETs
Authors: Alfadhli Saad Ali , Lu Songfeng , Fatani Abdulaziz , Al-Fedhly Haider , Ince Mahmut
Published: September 2020

The basic idea behind the vehicular ad-hoc network (VANET) is the exchange of traffic information between vehicles and the surrounding environment to offer a better driving experience. Privacy and security are the main concerns for meeting the safety aims of the VANET system. In this paper, we analyse recent VANET schemes that utilise a group authentication technique and found important vulnerabilities in terms of driving safety. These systems also suffer from vulnerabilities in terms of management efficiency and computational complexity. To defeat these problems, we propose a lightweight scheme, SD2PA, based on a general hash function for VANET. The proposed scheme overcomes the non-safe driving problem that resulted from the critical driving area. Moreover, the vehicle authentication is only done once by the VANET system administrator during the vehicle’s moving, so the authentication redundancy for the entire system is reduced and system management efficiency is enhanced. The SD2PA scheme also provides anonymity to protect the vehicle’s privacy, unless an important action needs to be taken against a malicious vehicle. A deep computational cost and communicational overhead analysis indicates that SD2PA is better than related schemes, as well as efficiently meeting VANET’s security and privacy needs.
The study of the causal relationship between innovativeness and entrepreneurial intention among undergraduate students
Authors: Wathanakom Narubodee , Khlaisang Jintavee , Songkram Noawanit
Published: September 2020

In recent years, entrepreneurs have become key drivers of business growth worldwide, since that time, entrepreneurial education has subsequently been garnering an increased level of interest. Entrepreneurship is considered to be a combination of both art and science, used to create value when targeting customers; however, there appears to be a myth when it comes to the recipe required for success. It was discovered by The Office of Small and Medium Enterprise Promotion that less than 10% of Thai small and medium entrepreneurial businesses were successful, while the global rate of success is close to 5 times higher than that of Thailand. Therefore, a better understanding of key success factors is necessary going forward. Typically, an entrepreneur’s journey starts with entrepreneurial intention, opportunity recognition, business initiative creation, and resource assembly, if they are to start their venture successfully. Entrepreneurial intention is a prerequisite to entrepreneurial behavior, based on the theory of planned behavior. Subsequently, scholars are interested in the key factors which drive entrepreneurial intention. While innovativeness has been proven to be one of the critical factors within certain groups of the population, there is little empirical data on the causal relationship between innovativeness and entrepreneurial intention amongst undergraduate students. As such, this study has two main objectives: (1) to explore factors influencing innovativeness, attitudes towards entrepreneurship and the entrepreneurial intentions of undergraduate students, and (2) to understand the causal relationship between innovativeness and entrepreneurial intentions among undergraduate students. The population of the study is comprised of undergraduate students from public universities and 330 effective responses were received in the survey. Based on the findings from confirmatory analysis and multiple regression, the empirical data is consistent with the theoretical measurement model for both innovativeness and entrepreneurial intention and (2) innovativeness can effectively predict entrepreneurial intention among undergraduate students.
Psychometric properties of instruments assessing exercise in patients with eating disorders: a systematic review
Authors: Harris Astrid , Hay Phillipa , Touyz Stephen
Published: September 2020

Background

Research has identified factors specific to exercise in eating disorder patients such as affect regulation and compulsivity. Existing measures of exercise behaviour which were not originally designed for eating disorder patients may not adequately assess these factors. The aim of this systematic review is to identify and assess the psychometric properties of all self-report measures of exercise designed to be used with eating disorder patients.

Method

A systematic review was conducted following the PRISMA guidelines. MedLine, Scopus and PsycINFO were systematically searched. A total of 12 studies examining two measures, the Exercise and Eating Disorders and the Compulsive Exercise Test, met inclusion criteria.

Results

Validation studies showed promising results for both tests and established internal consistency, concurrent and convergent validity, and construct validity. The factor structure of the Compulsive Exercise Test was not confirmed in the majority of the studies included in this review, while there are only two studies conducting factor analysis on the Exercise and Eating Disorders.

Conclusion

The two measures identified by this systematic review represent the current research on measures of compulsive exercise for eating disorder patients. Further research is needed to confirm a factor structure and validate both the Compulsive Exercise Test and the Exercise and Eating Disorders in more diverse clinical samples.
Correlates of avifaunal diversity along the elevational gradient of Mardi Himal in Annapurna Conservation Area, Central Nepal
Authors: Pandey Naresh , Khanal Laxman , Chalise Mukesh Kumar
Published: September 2020

Background

Patterns of biological diversity and richness can vary along the elevational gradients among mountain systems making it difficult to conclude the general pattern. The drivers of such pattern are also poorly known in the southern flank of the Himalaya due to limited studies. Therefore, we assessed the species richness, seasonal patterns and drivers of avian diversity along an elevational gradient on Mardi Himal trekking trail, a newly open tourist route in Annapurna Conservation Area of the central Himalaya.

Methods

Two surveys (winter and summer seasons of 2019) were conducted from the bank of Seti-Gandaki River confluence (1030 m above sea level, asl) up to the Low Camp (3050 m asl) of the Mardi Himal. The point count method was employed in every 100 m rise in the elevation. Diversity indices were calculated and bird abundance data on species, sites, seasons and environmental variables were analyzed. Generalized linear model, polynomial regression and ordinary least square regression were performed to examine the importance of environmental factors in shaping the avian richness pattern.

Results

A total of 673 individuals of birds belonging to 112 species, of which 72 in winter and 80 in summer, were recorded. We observed a hump-shaped pattern of the overall species richness along the elevational gradient. The richness pattern remained consistent even when explored by season, for winter and summer separately. Diversity indices were found higher during the summer. Elevation and mean monthly temperature in both seasons showed non-linear relation with avian species richness. Precipitation exhibited positive association in summer whereas the same in winter was negatively correlated with avian species richness. Distance to the nearest water source and the nearest human settlement were negatively correlated with the richness of birds. Small-ranged and insectivorous birds were under the strong influence of gradients on climatic variables like temperature and precipitation.

Conclusions

We conclude that the combined effects of multiple factors such as area, gradients of climate (i.e. temperature and precipitation), resource availability and disturbance play an important role in bird diversity and richness pattern along an elevational gradient of a montane environment in Mardi Himal.
Variation in abundance and habitat relationship of three understory insectivorous birds in a disturbed landscape of Neotropical dry forest of Colombia
Authors: Loaiza Camilo , Montenegro Olga L. , King David , Spínola Manuel , Palacio Lilibeth Arinda , Rudas Agustín
Published: September 2020

Background

Evaluating relationships between avian populations and their habitat is important for understanding the biology of these species and for management decisions that improve the effectiveness of restoration practices. We investigated how habitat variation along a disturbance gradient affected the abundance of three insectivorous bird species, White-bellied Antbird (Myrmeciza longipes), Barred Antshrike (Thamnophilus doliatus), and Pale-breasted Spinetail (Synallaxis albescens) in a Neotropical dry forest remnant in central Colombia.

Methods

The study area, which is located in Magdalena Valley, is under ecological restoration after the construction of the “El Quimbo” hydroelectric dam, with a gradient of habitat conditions, from relatively advanced secondary growth to recently disturbed areas. We conducted bird surveys and quantified the habitat conditions from June 2018 to June 2019. We compared the relative abundance of the birds among the three zones with increasing disturbance and modeled the relationship between the bird abundance with the micro- and landscape-habitat conditions, with Poisson generalized linear model regression.

Results

The relative abundance of the three bird species varied according to the habitat features and disturbance level. The abundance of White-bellied Antbirds was higher in forests and thickets than shrubland fragments; Barred Antshrike was more abundant in shrubland and thickets than in forest fragments, and Pale-breasted Spinetail had the highest abundance in shrubland and the lowest in forest fragments. The abundance of both White-bellied Antbird and Pale-breasted Spinetail did not differ among zones with different levels of disturbance, while the abundance of Barred Antshrike decreased in zones with more disturbance.

Conclusions

There were significant differences in the habitat relationships of the three understory insectivorous species along the disturbance gradient, although these species were within the same trophic group. These bird species preferred different stages of habitat succession and responded to different habitat and landscape features. Increasing forest fragment areas and decreasing the amount of edge would be useful restoration priorities for these and other similar avian species in this study area.
Implant primary stability depending on protocol and insertion mode — an ex vivo study
Authors: Staedt Henning , Kämmerer Peer W. , Goetze Elisabeth , Thiem Daniel G. E. , Al-Nawas Bilal , Heimes Diana
Published: September 2020

Background

Dental implant primary stability is thought to be a fundamental prerequisite for the long-term survival and success. The aim of this study was to analyze the influence of protocol and insertion mode on dental implant stability ex vivo. One hundred and twenty implants were inserted either manually or machine-driven into porcine mandibles by a standard or over-dimensioned protocol. Dental implant stability was measured via resonance frequency analysis (RFA), insertion torque (IT), and torque out (TO).

Results

Statistically significant higher IT and TO values were seen after standard protocol insertion (p < 0.05), whereas manual and machine-driven insertion mode showed equivalent values.

Conclusions

The over-dimensioned protocol exceeded the primary stability values recommended for immediate implant insertion; therefore, it could be recommended as well.
Developing a theory-based multimedia intervention for schools to improve young people’s asthma: my asthma in school (MAIS)
Authors: Mosler Gioia , Harris Katherine , Grigg Jonathan , Steed Liz
Published: September 2020

Background

Asthma control in adolescents is low with half of the young people in a London study identified as having suboptimal control when measured using the Asthma Control Test. Control of asthma symptoms can be improved by addressing barriers to good self-management, such as poor understanding of asthma and adherence to medication. The aim of this study was therefore to develop the My Asthma in School (MAIS) intervention for the improvement of asthma control and self-management in adolescents and to test its initial feasibility. The intervention intended to combine a strong focus on theory with a design specifically aimed to engage adolescents.

Methods

The intervention development was based on previous qualitative and quantitative findings, and on guidelines from the Medical Research Council for the development of complex interventions. The COM-B (Capability, Opportunity, Motivation–Behaviour) model was applied to inform the design of intervention elements. Behavioural targets were identified from existing barriers to good asthma self-management and were then used to guide the development of engaging intervention elements, which were described using the Behavioural Change Technique (BCT) Taxonomy version 1. Adolescents were involved throughout this process. The MAIS intervention was tested in a feasibility phase in London secondary schools with adolescents aged between 11 and 13.

Results

The complex school-based MAIS intervention comprised a first school visit from a theatre group, who conducted a workshop with all year 7–8 students and addressed peer understanding and attitudes to asthma. The second visit included four self-management workshops for adolescents with asthma, including games, short-films and role play activities. Forty different types of techniques to change behaviour were applied, totalling 163 instances of BCT use across intervention elements, addressing all areas of capability, opportunity and motivation. In this initial feasibility study, 1814 adolescents with and without asthma from nine schools received the theatre intervention visit; 23 adolescents with asthma from one of the schools attended the workshop visit. The intervention was found acceptable and engaging, and 91.4% of participants agreed that the workshops changed how they think or feel about asthma.

Conclusion

This study demonstrates development and initial feasibility of a complex theory-based intervention, and how it can combine engaging media and interactive elements, to achieve a multi-directional approach to behavioural change. However more work is needed to assess the feasibility of trial processes, including recruitment and delivery format of the workshops.
Subacromial impingement syndrome: a survey of Italian physiotherapists and orthopaedics on diagnostic strategies and management modalities
Authors: Brindisino Fabrizio , Ristori Diego , Lorusso Mariangela , Miele Simone , Pellicciari Leonardo , Rossettini Giacomo , Bonetti Francesca , Heick John Duane , Testa Marco
Published: September 2020

Background and aim

The subacromial impingement syndrome (SIS) represents a common cause of disability in approximately 74% of patients with Shoulder Pain (SP). Even if contemporary research suggests that this mechanism is not (always) the dominant driver in SP, SIS is still a source of debate among scholars and clinicians. From a clinical point of view, evidence has suggested that clinicians can use both medical and physiotherapy approaches as effective methods to treat SIS.

This survey aims to investigate models of management of patients with SIS in a sample of Italian physiotherapist specialists (Orthopaedic Manipulative Physical Therapists, −OMPTs-) and orthopaedic surgeons.

Materials and methods

An online survey with 29-item questionnaire was administered to assess the knowledge of OMPTs and orthopaedic surgeons about: a) strategies of clinical examination; b) the role of imaging in the diagnostic process; c) the physiotherapy management; and d) the pharmacological and surgical management in patients with SIS.

Results

Six-hundred and twenty-nine respondents completed the survey (511 OMPTs (79.97%) and 128 orthopaedic surgeons (20.03%)). Ninety-two percent (n = 470) of the OMPTs and 80.5% (n = 103) of orthopaedic surgeons stated that in patients with SIS, a combination of diagnostic tests produced better accuracy (p = < 0.001). Twenty point seven % of OMPTs (n = 106) and 4.7% of orthopaedic surgeon (n = 6) stated that the Lift off was the most specific test (p = < 0.001). Four-hundred-and-twenty-four OMPTs (83%) and 40 orthopaedic surgeons (31.3%) answered that the gold standard for diagnosis of a patient with SIS are history and clinical examination (p < 0.001).

Conclusion

OMPTs and orthopaedic surgeons approach patients with SIS differently during both the assessment and the treatment. OMPTs appear to be appropriate in planning and managing clinical examination and therapeutic strategies to use with patients with SIS.
Mutagenic, Genotoxic and Immunomodulatory effects of Hydroxychloroquine and Chloroquine: a review to evaluate its potential to use as a prophylactic drug against COVID-19
Authors: Giri Allan , Das Ankita , Sarkar Ajoy K. , Giri Ashok K.
Published: September 2020

Hydroxychloroquine (HCQ) and Chloroquine (CQ) are two anti-malarial drugs that are now being extensively used by front-line healthcare workers and other common people as a prophylactic drug against the Corona Virus Disease − 19 (COVID-19) in India and as well as in many parts of the world. While only a few in vitro studies have pointed to some efficacy of these drugs as a prophylactic against COVID-19, to date, there are no clinical studies that have established any clinical efficacy of these drugs as a prophylactic. These drugs are commonly used for the treatment of Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) because of its immunomodulatory effects. Previously, we have evaluated the genetic toxicology of different drugs and chemicals including antimalarial drug CQ both in vitro and in vivo. Thus, we recognize the need to critically review the mutagenic, genotoxic, and immunomodulatory effects of these drugs, to find out whether it is safe to use as a prophylactic drug against COVID-19. Existing literature suggests that CQ can induce mutagenic and genotoxic effects in multiple test systems and both the drugs have immunomodulatory effects. There was no data available to evaluate the mutagenicity and genotoxicity for HCQ. However, during metabolism about 60% of both the drugs remain unchanged and about 40% of the drugs are metabolized into two metabolites, desethylchloroquine and bisdesethylchloroquine by the action of the cytochrome P450 (CYP) enzymes in the liver. Both HCQ and CQ are immunomodulatory drugs and have the potential to suppress normal immune system activation. In this review, we have elucidated the mechanism of immunomodulation by both HCQ and CQ and highlighted the mutagenic and genotoxic effects from the available literature. This article is written with the sole objective that the reader will be able to recognize the adverse effects of these drugs when consumed by healthy individuals as a prophylactic. Current literature indicates that healthy individuals should refrain from the use of these drugs until further investigation.
The impact of the COVID-19 pandemic on firms: a survey in Guangdong Province, China
Authors: Zou Peng , Huo Di , Li Meng
Published: September 2020

Background

The COVID-19 pandemic has affected all sectors of the world economy and society. To understand the impact of the pandemic on firms in China and suggest public policies to deal with the negative effects, we investigated firms in Guangdong Province.

Methods

The survey sample included 524 firms in 15 cities in Guangdong Province. We chose these firms from the list published by the government, considering the industrial characteristics of Guangdong province and firm size. The questionnaire was developed based on previous studies carried out by UNDP. It comprised four categories with a total of 17 questions. The executives of firms were contacted by telephone or WeChat, and were invited to answer self-administered questionnaires through an online survey platform. The data was analyzed by SPSS.

Results

The following key findings were revealed through the survey: (1) 48.7% of firms maintained stability, and 35.1% experienced a halt in operation or faced closure; (2) Nearly 70–90% already exploit online commerce or are willing to do so, and also remote office work, and digital operations. (3) 46% believe that they will certainly incur losses for 2020, and 83.5% expect the city’s GDP to decrease.

Conclusions

Firms in Guangdong Province have faced great challenges in the epidemic. Their production and operation activities have been limited, and they are facing significant risks. It is necessary to implement policies that would profoundly lower production costs for firms, help them survive this difficult period, and gradually return to normal business.