bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial metal ion levels predict risk of elevation in metal on metal total hip arthroplasty
Authors: Martin J. Ryan , Odum Susan M , Springer Bryan D , Griffin William L
Published: July 2019

Introduction:

Screening protocols for asymptomatic patients with metal on metal (MoM) total hip arthroplasty (THA) are evolving. Most surgeons began screening patients around 2010 by obtaining cobalt (Co) and chromium (Cr) metal ion levels. There is currently no data available to guide repeat screening in this familiar clinical scenario. Therefore, the following study evaluated how metal ion levels change after an initial metal ion level in patients with MoM THAs.

Materials and methods:

171 consecutive patients (265 hips) underwent primary MoM THA. All patients had at least one Co and Cr ion level draw. 84 patients (136 hips) had 2 ion level draws. Ion levels were divided into elevated levels (⩾4.5 ppb) and normal levels (<4.5 ppb). The probability of an ion level returning elevated after an initial normal level was identified. Additionally, a threshold value was determined that reliably identified every patient that did not subsequently rise above 4.5 ppb.

Results:

12 metal ion levels were ⩾4.5 ppb on the first lab draw. On the second draw, all 12 remained ⩾4.5 ppb. Of the 121 hips with initial metal ion levels <4.5 ppb, 5 metal ion levels became ⩾4.5 ppb. Utilising an initial screening cutoff of 3.0 ppb, no patient was identified with a second lab value ⩾4.5 ppb.

Discussion:

Initial metal ion levels reliably predicted those that would remain elevated or remain normal with a subsequent metal ion level. An initial metal ion level above 3.0 ppb may represent a cutoff at which further workup is necessary.
Accepting the Challenge—Moderate-Intensity Exercise with Individuals with Dementia: A Case Series
Authors: Dawson Nicole , Judge Katherine
Published: July 2019

Background and purpose:

The global impact of dementia demands a response from researchers and clinicians to not only assist with prevention and a cure, but also to assist in the management of symptoms related to this progressive disease. The purpose of this case series is to highlight the participation of 3 individuals with varying levels of dementia in a moderate-intensity functional exercise program.

Intervention:

The intervention, developed using principles from exercise science and a Strength-Based Approach, consisted of 24 sessions of moderate-intensity exercises delivered in participant’s home.

Outcomes:

Each participant completed a pre- and post-assessment including gait speed, strength, balance, depressive symptoms, cognition, and perceived difficulty with activities of daily living. Despite various clinical presentations, each participant successfully completed all 24 sessions with noted improvements in at least two measures.

Discussion:

These findings highlight the flexibility of using the Strength-Based Approach to enhance participation in a standardized exercise program.
Parent couples’ participation in speech-language therapy for school-age children with autism spectrum disorder in the United States
Authors: Flippin Michelle , Hahs-Vaughn Debbie L
Published: July 2019

This study examined parent couples’ participation in and satisfaction with speech-language therapy for school-age children with autism spectrum disorder in the United States. Responses from 40 father–mother couples ( n = 80 parents) were examined across therapy components (i.e. parent–therapist communication, assessment, planning, and intervention). Descriptive frequencies, chi-square tests, intraclass correlations, and dyadic multilevel modeling were used to examine participation across fathers and mothers and within parent couples. Compared to mothers, fathers communicated less with therapists and participated less in assessment and planning. Fathers also had lower satisfaction than mothers with parent–therapist communication and planning. Although few parents participated in school-based therapy sessions, 40% of fathers and 50% of mothers participated in homework. However, few parents received homework support from therapists. Results are discussed in terms of clinical implications for interventionists to more effectively engage both fathers and mothers in family-centered speech-language therapy for school-aged children with autism spectrum disorder.
The next media regime: The pursuit of ‘audience engagement’ in journalism
Authors: Nelson Jacob L
Published: July 2019

As news organizations struggle to overcome losses in revenue and relevance, academics and professionals have pinned their hopes for salvation on increasing ‘audience engagement’. Yet few agree on what audience engagement means, why it will make journalism more successful, or what ‘success’ in journalism should even look like. This article uses Williams and Delli Carpini’s ‘media regimes’ as a theoretical framework to argue that studying the current open-arms approach to the news audience – and the ambiguity surrounding it – is vital to understanding journalism’s transition from one rapidly disappearing model to one that is yet to fully emerge. In doing so, it offers a definition of audience engagement that synthesizes prior literature and contributes an important distinction between reception-oriented and production-oriented engagement. It concludes with a call for more research into audience engagement efforts to better understand what journalism is and what it might become.
Beyond the boundaries of science: Resistance to misinformation by scientist citizens
Authors: Russell Adrienne , Tegelberg Matthew
Published: July 2019

In November 2016, small groups of coders, climate scientists, scholars, journalists, and activists came together under the umbrella organization Environmental Data & Governance Initiative (EDGI) to defend against the Trump administration’s attacks on environmental protections. A distinguishing feature of EDGI, and the focus of this study, is the methods it has developed to combat propaganda and misinformation around science. This article analyzes the push-and-pull dynamic between the values and practices of EDGI and journalism, as they interacted in the expanded political information news field. Drawing on EDGI publications and interviews with its members, this article details EDGI’s efforts to connect with journalists and the public. It explores EDGI news coverage, focusing on the manner and frequency in which EDGI values and perspectives were, and were not, conveyed in the coverage. We trace the development of what we argue are new forms of public intervention and offer an expanded understanding of the misinformation ecosystem.
Preparation and characterization of novel VAc/VeoVa10/DBM/VTES quadripolymer latex emulsified with green surfactants
Authors: Chen Lijun , Shao Tantan , Gong Yilu , Wang Xiuming
Published: July 2019

The novel vinyl acetate (VAc)/vinyl neo-decanoate (VeoVa10)/dibutyl maleate/triethoxy vinyl silane quadripolymer latex was prepared via the semi-continuous seeded emulsion polymerization emulsified with disodium laureth sulfosuccinate (AEMES) as anionic surfactant and beta-cyclodextrin (β-CD) mixture as emulsifier and initiated with potassium persulfate (KPS), respectively. The chemical compositions of copolymer was determined by Fourier transform infrared spectromer (FTIR). The glass transition temperature ( Tg) of the copolymer was measured by differential scanning calorimetry. The water resistance of the film was assessed by the water contact angle measurement. The conditions of preparing the novel latex were optimized and obtained as follows. The amount of AEMES and β-CD mixtures were 6 wt% and the mass ratio of AEMES to β-CD were 1:1. The dosage of KPS was 0.6 wt% and the mass ratio of VAc to VeoVa10 was 3:1. The amount of dibutyl maleate and triethoxy vinyl silane was 4% and 3%, respectively. In this case, the conversion percentage of the mixed monomers was 99.0% and the polymerization stability was good.
SCN8A: When Neurons Are So Excited, They Just Can’t Hide It
Authors: Gertler Tracy S. , Carvill Gemma L.
Published: July 2019

[Box: see text]
HIV Testing Among Middle-Aged and Older Men Who Have Sex With Men (MSM): A Blind Spot?
Authors: Sousa Alvaro Francisco Lopes , Queiroz Artur Acelino Francisco Luz Nunes , Fronteira Inês , Lapão Luís , Mendes Isabel Amélia Costa , Brignol Sandra
Published: July 2019

Middle-aged and older men who have sex with men (MSM) are one of the most underestimated populations with regard to HIV/AIDS infection, despite the worldwide trend of increasing prevalence in recent years. This population also has low rates of testing, although rare studies are done exclusively with middle-aged and older MSM assessing the factors associated with this prevalence. Thus, based on data from an exclusive online survey with middle-aged and older MSM who use geolocation-based dating applications, the purpose of the study was to analyze factors associated with not taking the HIV test among middle-aged (50 years old) and older MSM in Brazil. Using a modification of time-location sampling adapted to virtual reality, 412 volunteers were approached in Grindr®, Hornet®, SCRUFF®, and Daddyhunt®. The multivariate logistic regression model was adopted to produce adjusted odds ratios (ORa), considering a significance level at .05. There were factors associated with not taking the test: being in a relationship (ORa: 0.24; 95% CI [0.10, 0.53]); knowing partner through the applications (ORa: 1.84; 95% CI [1.07, 3.15]); not knowing the serological status (ORa: 5.07; 95% CI [1.88, 13.67]); ejaculating outside of anal cavity (ORa: 1.79; 95% CI [1.04, 3.05]); practicing sex without penetration (ORa: 2.30; 95% CI [1.17, 4.50]); not taking the test as a form of prevention (ORa: 2.83; 95% CI [1.05, 7.68]); and rarely using Viagra in sexual intercourse (ORa: 1.91; 95% CI [1.20, 3.65]). There is a blind spot in the prevalence of HIV testing in older MSM because this population is not being covered by services, which compromises the overall response to HIV, the goals set for universal health coverage.
Letting Go: Representation, Presentation, and Disney’s Art of Animation
Authors: Telotte JP
Published: July 2019

This article considers two linked developments in Disney animation at a major point of change for the studio. One is the effort to craft a new ‘logistics of perception’ or way of seeing and appreciating Disney’s work in this period. Prompting that effort is the other, a shift from the studio’s early emphasis on realistic representation, or an ‘illusion of life’, to what might be termed a presentational approach that repackaged Disney animation and re-framed its experience. These developments, observed in episodes of the Disneyland TV series of the 1950s–1960s dedicated to ‘the art of animation’, anticipate the emergence of new styles in Disney animation and of a new approach to animation that would eventually be reflected in the development of audio-animatronics and theme parks.
Expressive Motion in the Early Films of Mary Ellen Bute
Authors: Moen Kristian
Published: July 2019

Between 1935 and 1938, Mary Ellen Bute began her career as a filmmaker with a series of mostly animated films, including Rhythm in Light (1935), Synchromy No. 2 (1936), Parabola (1938) and Escape (1938). This article examines how these films offered an innovative, subtle and purposeful investigation of the potentials of animation to create artistic and expressive motion. Paying close attention to Bute’s own writing, the article explores how these films related to Bute’s expansive vision of cinema as a new form of kinetic art that was both composed and free-flowing. Drawing upon painting, music, sculpture and chronophotography, Bute’s work was highly intermedial, investing these arts and media with the dynamic potentials of filmic and animated motion. Tracing how Bute composed motion, displayed motion and used motion expressively, this article aims to develop our understanding of a pivotal 20th-century filmmaker, while at the same time investigating the distinctive ideas of the aesthetics, forms and effects of animated motion that were articulated in her filmmaking practice and theoretical writing.
Activos para la salud en cuidadores familiares de enfermos de Alzheimer: desarrollo de un mapa de activos para la salud
Authors: Agulló-Cantos José Manuel , García-Alandete Joaquín , Paredes-Carbonell Joan J.
Published: July 2019

El Alzheimer es la enfermedad más prevalente en mayores de 65 años, siendo una enfermedad neurodegenerativa progresiva. El cuidado de estas personas enfermas se sustenta, en la mayoría de los casos, desde el núcleo familiar, siendo éste quien sufre las consecuencias del cuidado. Tradicionalmente, el estudio y análisis de las personas cuidadoras se ha realizado desde perspectivas de déficit o negativas. El presente estudio introduce el modelo salutogénico y de activos para la salud, e intenta comprender el valor positivo del cuidado y la superación de las circunstancias adversas, a través de aquellas habilidades o recursos del cuidador o de su entorno que le ayudan a afrontar de forma positiva esta enfermedad.

En el estudio participaron cuidadores familiares ( n=45) de tres Centros de Estancias Diurnas para enfermos de Alzheimer diferentes, donde fueron entrevistados en grupos (de 5 a 13 participantes por entrevista) y grabados en audio, para su posterior trascripción y análisis de contenido temático.

Los resultados muestran que los cuidadores familiares a pesar de vivir bajo una fuente de estrés, también puedn obtener consecuencias positivas de la experiencia del cuidado, siendo capaces de identificar activos para la salud, tanto internos como externos, que les ayudan a mejorar y/o mantener su salud como cuidador.
Atypical mycobacterium infection of sternoclavicular joint: A unique case
Authors: Cheema K , Raad M , Sehjal R , Virani S , Relwani J
Published: July 2019

We report a rare case of atypical Mycobacterium intracellulare infection encountered in a left sternoclavicular joint of an immunocompetent patient. The 34-year-old female patient presented with a one-year history of left sternoclavicular joint pain and swelling. The patient had multiple radiological investigations, which were suspicious for an infective cause. The patient had a biopsy of the joint, which returned showing acid-fast bacilli. The patient consequently received a prolonged course of medical treatment for M. intracellulare.
Evaluating the Impact of a Futures-Oriented Organization
Authors: Vataja Katri , Dufva Mikko , Parkkonen Pinja
Published: July 2019

Foresight and futures work aim at imagining, rethinking, and setting conditions for systemic changes in the society. The societal change as a starting point of evaluation poses challenges to the traditional evaluation approaches. To analyze whether something has an impact on systemic changes, we need methods that consider the dynamics of the operating environment, the multi-actor perspective, and the long-time span of societal changes. In this article, we explore the design and methodological questions related to evaluating the impact of actors, which have set goals for societal impact of their futures work. Our case is based on the wide-scale evaluations of the Finnish Innovation Fund Sitra. In this article, we describe the process and thinking behind the evaluation of the futures work at Sitra and illustrate it with a case study of an evaluation of one of Sitra’s impact goals. Based on our experience from this and other impact evaluations, we provide good practices and recommendations on how to evaluate futures work and foresight in a way that helps steer an organization’s actions.
Long‐term study of oral treprostinil to treat pulmonary arterial hypertension: dosing, tolerability, and pharmacokinetics
Authors: White R. James , Parikh Keyur , Allen Roblee , Feldman Jeremy , Jerjez‐Sanchez Carlos , Pan Lei , Keogh Anne , Vizza C. Dario , Shapiro Shelley , Gordon Kathryn , Broderick Meredith , Bartolome Sonja
Published: July 2019

Oral treprostinil may be an option for low‐ and intermediate‐risk patients with pulmonary arterial hypertension, a rare lung vascular disease. This open‐label extension study collected data on participants who completed previously reported, placebo‐controlled oral treprostinil studies. Eligible participants had completed the prospective parent studies and took increasing doses of oral treprostinil twice daily; some later transitioned to three times daily dosing. Investigators measured 6‐minute walk distance at Month 12 as the sole efficacy measure but collected adverse events throughout the study. A single center measured pharmacokinetics in 13 subjects who changed dosing from twice daily to three times daily. Eight hundred and ninety‐four participants enrolled and 71% completed one year of therapy, with a median total daily dose of 7 mg and a median 6‐minute walk distance increase of 22 m (interquartile range, −14 to 67 m). Subjects achieving higher doses had larger increases in 6‐minute walk distance; 42% of participants completed three years of therapy. Adverse events were typical for prostacyclin class therapy, but prostacyclin‐type adverse events may have been better tolerated with three times daily dosing in 105 participants. In 13 participants transitioned to three times daily dosing with pharmacokinetic measurements before and after, trough drug levels were higher with three times daily dosing. Oral treprostinil is associated with modest but durable, dose‐responsive effects on exercise tolerance for those who remained on therapy at one year in this prospective, uncontrolled study. Three times daily dosing was associated with higher trough levels and better tolerability. The recently completed Freedom‐EV study will provide further insights into the utility of oral treprostinil (https://clinicaltrials.gov/show/NCT01560624).
The process of developing a content analysis study to evaluate the quality of breastfeeding information on the Internet-based media
Authors: Monteiro Juliana Cristina dos Santos , Richter Solina
Published: July 2019

The Internet offers a powerful network of information on breastfeeding that is used by doctors, patients, and scientists. The objective of this study is to describe the process of development of a data extraction tool to evaluate the content and quality of breastfeeding information on the Internet. Using a descriptive study method, we examined Internet pages to determine which variables needed to be measured in order to develop the data extraction tool. A purposive sampling of websites was selected to pilot test this tool. The developed data extraction tool has a descriptive structure to characterize websites and text pages. Using the developed tool, we can assess whether the information on text pages is supportive of breastfeeding and whether other strategies that protect breastfeeding are followed. The developed data extraction tool is a useful instrument that can assist researchers in evaluating the quality of information posted on the Internet related to breastfeeding.
Paternalistic Leadership and Employee Organizational Attitudes: The Role of Positive/Negative Affectivity
Authors: Ünler Ela , Kılıç Bülent
Published: July 2019

The aim of the present study is to examine the relationship between paternalistic leadership (PL) and organizational attitudes, namely, job satisfaction and organizational commitment. The effect of positive/negative affectivity (PA/NA) as a mediator was analyzed in this relationship. The questionnaires were distributed to a total of 550 MBA students who are employed in companies located in Istanbul with a 61.45% return rate. Multiple regression analyses were performed to test the hypotheses. The results of regression analysis indicated that PL was positively associated with both affective commitment and job satisfaction. PA/NA functioned as a mediator between PL and organizational attitudes. This study advances the understanding of PL with affective states and organizational attitudes. The current literature focuses on PL for different cultures and its relationship with different variables. Research in PL and affectivity is relatively limited. This study contributes to the literature by enhancing the understanding of PL with affective traits.
Core Burnout and Power in Portuguese Nursing Staff: An Explanatory Model Based on Structural Empowerment
Authors: Orgambídez Alejandro , Almeida Helena
Published: July 2019

In the nursing context, structural empowerment has proved to be an organizational tool leading to the prevention of stress and burnout. Structural empowerment is defined as the perception of the presence or absence of empowering conditions in the workplace. However, few studies have explored the particular relationships between power in organizations, structural empowerment, and burnout. The aim of this study was to examine the mediator role of structural empowerment (access to opportunities, information, support, and resources) in the relationship between formal and informal power, and core burnout among Portuguese nurses. We administered a questionnaire among a convenience sample of 304 nurses employed in public hospitals. Model fit and mediation analysis were conducted using path analysis and bootstrapping methods. Formal power, informal power, access to opportunities, and access to resources were significant and negative predictors of core burnout. Opportunities, resources, and informal power had a direct influence on core burnout. Formal power and informal power showed an indirect influence, mediated by opportunities and resources, on core burnout. These findings suggest that by providing nurses with high levels of formal and informal power, as well as access to resources and opportunities, their risk of core burnout can be lowered.
Oral Health Status and Treatment Needs of Government Employees in New Delhi
Authors: Kharbanda O. P. , Priya Harsh , Mishra Deepika , Gupta Shalini , Ivaturi Anupama , Ravi Priyanka , Bhatia Anu , Prasad Ashish , Ali Azhar , Haldane Desmia
Published: July 2019

Oral diseases, including dental caries, periodontitis, and edentulism (toothlessness), affect about 3.5 billion people worldwide. A cross-sectional study was conducted to assess the oral health status and treatment needs of government employees employed at an organization in New Delhi. Oral health information was recorded using the standard World Health Organization’s (WHO) Oral Health Assessment Tool. A total of 476 employees at various levels of administration were screened at their worksite. Dental caries and periodontal disease were present in more than half of the participants. Around 56% had decayed teeth, 20% had missing teeth, and 16% had filled teeth. Bleeding from gums was seen in 71% and periodontitis in 59% of participants. Preventive treatment and oral health promotion was required in at least 41% of the screened individuals. Annual workplace oral examinations may help in decreasing the oral disease burden and create awareness on the oral health among employees.
Outcomes of Discectomy in Young Adults With Large Central Lumbar Disc Herniations Presenting With Predominant Leg Pain
Authors: Kulkarni Arvind G. , Tapashetti Sandeep
Published: July 2019

Study Design:

Retrospective cohort study.

Objectives:

Discectomy alone or discectomy with fusion have been 2 polarized options in the management of large lumbar disc herniations presenting with leg-dominant pain in young patients. The objective of the study was to evaluate the outcomes of discectomy in young patients with large central lumbar disc herniation (CLDH) presenting with predominant leg pain.

Material and Methods:

Young patients (<45 years) presenting with predominant leg pain and MRI confirmed diagnosis of CLDH between April 2007-January 2017 were included in the study. All patients underwent tubular microdiscectomy. Outcomes of surgery were evaluated using visual analogue score (VAS) for leg and back pain, Oswestry Disability Index (ODI), and Macnab’s criteria.

Results:

Ninety patients fulfilled the inclusion criteria. The mean age of patients was 34.9 years (range 19-45 years). Mean follow-up was 5.09 years (range 2-10 years). The incidence of CLDH in young adults was 30% and incidence among all “operated” lumbar disc herniations was 15.9%. The mean VAS for leg pain improved from 7.48 ± 0.9 to 2.22 ± 0.84 ( P < .05) and the mean ODI changed from 60.53 ± 7.84 to 18.33 ± 6.20 ( P < .05). Fifty-nine patients (65.6%) reported excellent, 25 patients (27.8%) reported good, 3 patients each (3.3%) as fair and poor outcomes respectively.

Conclusion:

Discectomy alone for CLDH with predominant leg pain is associated with high success rate and low need for a secondary surgical procedure. Patient selection in terms of leg-dominant pain may be the main attribute for lower incidence of recurrence, postoperative back-pain, and instability needing a secondary procedure. Minimally invasive discectomy may provide an added advantage of preserving normal spinal anatomy, thus minimizing the need for primary spinal fusion in these patients.
Preoperative Performance of PROMIS in Patients With Patellofemoral Malalignment and Chondral Disease
Authors: Carender Christopher N. , Bollier Matthew J. , Wolf Brian R. , Duchman Kyle R. , An Qiang , Westermann Robert W.
Published: July 2019

Background:

Use of the Patient-Reported Outcomes Measurement Information System (PROMIS) instrument has not yet been validated in patients undergoing operative treatment for patellofemoral malalignment and chondral disease.

Purpose:

To evaluate the PROMIS Physical Function Computer Adaptive Testing (PF CAT) instrument in a population of patients with patellofemoral malalignment and chondral disease relative to established patient-reported outcome (PRO) instruments.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Eligible patients were prospectively enrolled at the time of indication for surgery and completed 5 PRO instruments preoperatively: 36-Item Short Form Health Survey (SF-36); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); Marx activity rating scale (Marx); EuroQol 5-dimension, 5-level instrument (EQ-5D-5L); and PROMIS PF CAT. Convergent and discriminant validity was assessed by measuring correlations between PROMIS PF CAT and other PRO instruments, including the Knee injury and Osteoarthritis Outcome Score (KOOS). Strength of correlation was measured by use of Spearman correlation coefficients.

Results:

In total, 37 patients (40 knees) were enrolled in the study. All knees underwent Fulkerson osteotomy and concomitant cartilage procedure (29 chondroplasty, 6 allograft, 5 microfracture). Mean patient age was 33.4 years, and 73% of knees were in female patients. Correlations ( r) between PROMIS PF CAT and knee PRO instruments were as follows: SF-36 PF ( r = 0.80; P < .01); KOOS Pain ( r = 0.74; P < .01); KOOS Symptoms ( r = 0.47; P < .01); KOOS Quality of Life ( r = 0.68; P < .01); KOOS Sports and Recreation ( r = 0.72; P < .01); KOOS Activities of Daily Living (ADL) ( r = 0.80; P < .01); WOMAC Function ( r = 0.80; P < .01); WOMAC Pain ( r = 0.72; P < .01); WOMAC Stiffness ( r = 0.38; P = .02); Marx ( r = 0.22; P = .31); and EQ-5D-5L ( r = 0.72; P < .01). Neither floor nor ceiling effects were observed in PROMIS PF CAT or KOOS ADL. Mean (±SD) question burden with PROMIS PF CAT was 5.6 ± 0.6 questions.

Conclusion:

In patients with patellofemoral malalignment and chondral disease, PROMIS PF CAT is an efficient and reliable PRO instrument to preoperatively assess patients across a spectrum of knee function without floor or ceiling effects.
Everyday practices in the production of uneven water pricing regimes in Lilongwe, Malawi
Authors: Pihljak Lejla H , Rusca Maria , Alda-Vidal Cecilia , Schwartz Klaas
Published: July 2019

Recent scholarship has called for widening investigations of cities through the analysis of everyday practices that shape urban life. Critical water studies have contributed to this emerging debate by using an everyday lens to document the diversity of practices of accessing and distributing water. Thus far, little attention has been given to the everyday practices of setting water prices and how these shape access. We contribute to this gap by investigating the practices of setting prices in two distinct service modalities within Lilongwe’s water supply network. Our study reveals the hybrid and dynamic arrangements that shape pricing regimes, formed through the formal and informal negotiations on subsidies, incentives, tariff increases and distribution of profits. In these negotiations, the decision makers opportunistically mobilise their different and at times conflicting mandates (business and social) and guiding principles (equity versus cost-recovery). We conclude that pricing regimes are the outcome of intertwined structural processes and everyday practices that exacerbate uneven water flows in the city.
Sex × Gender and Sexual Orientation in Relation to Stress Hormones and Allostatic Load
Authors: Juster Robert-Paul
Published: July 2019

In this selective review, emerging literature linking biological sex, sociocultural gender, and sexual orientation to stress hormone functioning and multisystemic physiological dysregulations are summarized. Beyond sex as a binary biological variable, continuums of sex hormones, gender roles, gender identity, and sexual orientation each uniquely help delineate pathways and mechanisms linked to stress-related disease trajectories. This implicates glucocorticoid functioning and allostatic load, the “wear and tear” of chronic stress in synergy with unhealthy behaviors. Clinical considerations are also discussed for the field of gender medicine.
The correlation of routine hematological indices with pterygium
Authors: Kurtul Bengi Ece , Kabatas Emrah Utku , Ozates Serdar
Published: July 2019

Purpose:

Increased systemic/local inflammation and oxidative stress play a key role in the pathophysiology of pterygium, but there is limited information regarding routine hematological indices’ levels in patients with pterygium. In this study, we aimed to evaluate the levels of complete blood count parameters in patients with pterygium.

Material and Method:

In all, 61 patients with pterygium (pterygium group; mean age = 51.4 ± 13.8 years) and 55 healthy individuals (control group; mean age = 50.2 ± 13.1 years) were included in the study. Participants were given routine ophthalmic examinations; complete blood count parameters were assayed.

Results:

Compared to the control group, red cell distribution width level was significantly higher in patients with pterygium ( p = 0.009), but the difference between the groups in terms of the other complete blood count parameters was not statistically significant. However, high-density lipoprotein cholesterol level was significantly lower in the pterygium group than control group ( p = 0.015). In the pterygium group, low-density lipoprotein cholesterol levels were lower, but this difference was not statistically significant ( p = 0.079).

Conclusion:

Red cell distribution width levels were significantly increased in patients with pterygium. Our data support the idea that inflammation cytokines and oxidative stress may play an important role in the pathogenesis of this disorder.
Anti-inflammatory effect of naringin and sericin combination on human peripheral blood mononuclear cells (hPBMCs) from patient with psoriasis
Authors: Deenonpoe Raksawan , Prayong Pokpong , Thippamom Nattakarn , Meephansan Jitlada , Na-Bangchang Kesara
Published: July 2019

Background

Several immunological pathways, particularly skin inflammation via various pro-inflammatory cytokines have been reported to be involved in the pathogenesis and clinical manifestations of psoriasis. The aim of the study was to investigate the potential role of naringin from Citrus maxima (Burm.) Merr and sericin from Bombyx mori combination in the treatment of psoriasis. Inhibitory effects on the expression of mRNA and the production of pro-inflammatory cytokines (TNF-α, IL-6, IL-23, and IL-12p40) were investigated.

Methods

Human peripheral blood mononuclear cells (hPBMCs) were isolated from 10 healthy subjects and 10 patients with psoriasis. The hPBMCs from each group were exposed to naringin or sericin alone, and the combination of naringin and sericin. The expression levels of mRNA and the production of all cytokines were determined using quantitative RT-PCR and ELISA, respectively.

Results

Naringin/sericin combination significantly decreased the expression of mRNA and the production of all pro-inflammatory cytokines in hPBMCs from patients with psoriasis. The potency of inhibitory activity was markedly higher than naringin or sericin alone.

Conclusion

The activity of naringin/sericin combination on down-regulation of these pro-inflammatory cytokines suggested its potential clinical use in psoriasis as well as other inflammation-associated diseases. The combination might be used as a complementary therapy with conventional treatment in psoriasis to improve clinical efficacy and tolerability.
Using Kirkpatrick’s model to measure the effect of a new teaching and learning methods workshop for health care staff
Authors: Heydari Mohammad Reza , Taghva Fatemeh , Amini Mitra , Delavari Somayeh
Published: July 2019

Objectives

This study is designed to evaluate the effect of a workshop about new teaching and learning methods on the response, knowledge, and behavior of healthcare staff working a large city healthcare center.

Results

Kirkpatrick’s program evaluation model showed that the workshop on new teaching and learning methods significantly improved the healthcare staff’s satisfaction about the teaching environment of workshops, their knowledge about new teaching and learning methods and their behavior in performing workshops for teaching people. It is recommended that this teaching and learning methods workshop should be considered in educational programs for healthcare staff.

Trial registration Trial registration number: IRCT20180619040150N1 approved by Iranian Registry of Clinical Trials at 2018-07-27
Medicines reconciliation at the community mental health team–general practice interface: quality improvement study
Authors: Johnson Chris F. , Liddell Karen , Guerri Claudio , Findlay Paul , Thom Alex
Published: July 2019

Aims and method

To increase the proportion of patients with no psychotropic drug discrepancies at the community mental health team (CMHT)–general practice interface. Three CMHTs participated. Over a 14 month period, quality improvement methodologies were used: individual patient-level feedback to patient's prescribers, run charts and meetings with CMHTs.

Results

One CMHT improved medicines reconciliation accuracy and demonstrated significant reductions in prescribing discrepancies. One in three (119/356) patients had ≥1 discrepancy involving 20% (166/847) of all prescribed psychotropics. Discrepancies were graded as: ‘fatal’ (0%), ‘serious’ (17%) and ‘negligible/minor harm’ (83%) but were associated with extra avoidable prescribing costs. For medicines routinely supplied by secondary care, 68% were not recorded in general practice electronic prescribing systems.

Clinical implications

Improvements in medicines reconciliation accuracy were achieved for one CMHT. This may have been partly owing to a multidisciplinary team approach to sharing and addressing prescribing discrepancies. Improving prescribing accuracy may help to reduce avoidable drug-related harms to patients.
Glucocorticoid Replacement Affects Serum Adiponectin Levels and HDL-C in Patients With Secondary Adrenal Insufficiency
Authors: Hayashi Reiko , Tamada Daisuke , Murata Masahiko , Kitamura Tetsuhiro , Mukai Kosuke , Maeda Norikazu , Otsuki Michio , Shimomura Iichiro
Published: July 2019

Context

Low serum adiponectin and high-density lipoprotein–cholesterol (HDL-C) levels are risk factors for cardiovascular disease. Patients with primary adrenal insufficiency are at higher risk of cardiovascular complications compared with healthy subjects. However, there is no information on the relationship between adiponectin and glucocorticoid replacement therapy in patients with secondary adrenal insufficiency (SAI).

Objective

To determine the effects of intrinsic adrenal function and glucocorticoid replacement therapy on serum adiponectin levels and lipid profile in patients with SAI.

Design

Part 1: a cross-sectional study. Part 2: a randomized, double-blind, crossover study.

Setting

Osaka University Hospital, Osaka, Japan.

Patients

Part 1: 58 patients diagnosed with nonfunctioning pituitary adenoma who underwent insulin tolerance test (ITT) for assessment of adrenal function. Part 2: 12 SAI patients randomly received hydrocortisone replacement therapy at a dose of 10, 20, or 30 mg/d for 4 weeks per term for three terms.

Outcome Measurements

Part 1: we analyzed the relationship between serum cortisol levels during ITT and serum adiponectin levels and the lipid profile. Part 2: serum adiponectin levels and lipid profile were measured every 4 weeks.

Results

Serum levels of adiponectin and HDL-C correlated significantly with peak cortisol levels after ITT. Serum adiponectin and HDL-C levels were significantly lower in patients with SAI than non-SAI. Serum levels of adiponectin and HDL-C increased in a hydrocortisone dose-dependent manner.

Conclusions

Glucocorticoid replacement therapy increased serum levels of adiponectin, an adipose-derived anti-atherogenic factor, and HDL-C in patients with SAI.
Longitudinal Phenotypes of Type 1 Diabetes in Youth Based on Weight and Glycemia and Their Association With Complications
Authors: Kahkoska Anna R , Nguyen Crystal T , Adair Linda A , Aiello Allison E , Burger Kyle S , Buse John B , Dabelea Dana , Dolan Lawrence M , Malik Faisal S , Mottl Amy K , Pihoker Catherine , Reboussin Beth A , Sauder Katherine A , Kosorok Michael R , Mayer-Davis Elizabeth J
Published: July 2019

Context

Subclinical and clinical complications emerge early in type 1 diabetes (T1D) and may be associated with obesity and hyperglycemia.

Objective

Test how longitudinal “weight-glycemia” phenotypes increase susceptibility to different patterns of early/subclinical complications among youth with T1D.

Design

SEARCH for Diabetes in Youth observational study.

Setting

Population-based cohort.

Participants

Youth with T1D (n = 570) diagnosed 2002 to 2006 or 2008.

Main Outcome Measures

Participants were clustered based on longitudinal body mass index z score and HbA1c from a baseline visit and 5+ year follow-up visit (mean diabetes duration: 1.4 ± 0.4 years and 8.2 ± 1.9 years, respectively). Logistic regression modeling tested cluster associations with seven early/subclinical diabetes complications at follow-up, adjusting for sex, race/ethnicity, age, and duration.

Results

Four longitudinal weight-glycemia clusters were identified: The Referent Cluster (n = 195, 34.3%), the Hyperglycemia Only Cluster (n = 53, 9.3%), the Elevated Weight Only Cluster (n = 206, 36.1%), and the Elevated Weight With Increasing Hyperglycemia (EWH) Cluster (n = 115, 20.2%). Compared with the Referent Cluster, the Hyperglycemia Only Cluster had elevated odds of dyslipidemia [adjusted odds ratio (aOR) 2.22, 95% CI: 1.15 to 4.29], retinopathy (aOR 9.98, 95% CI: 2.49 to 40.0), and diabetic kidney disease (DKD) (aOR 4.16, 95% CI: 1.37 to 12.62). The EWH Cluster had elevated odds of hypertension (aOR 2.18, 95% CI: 1.19 to 4.00), dyslipidemia (aOR 2.36, 95% CI: 1.41 to 3.95), arterial stiffness (aOR 2.46, 95% CI: 1.09 to 5.53), retinopathy (aOR 5.11, 95% CI: 1.34 to 19.46), and DKD (aOR 3.43, 95% CI: 1.29 to 9.11).

Conclusions

Weight-glycemia phenotypes show different patterns of complications, particularly markers of subclinical macrovascular disease, even in the first decade of T1D.
What Remains of Mountains and Waters: Fragments, Mutilation, and Creation in Early Qing Literature and Culture
Authors: Zhao Yingzhi
Published: July 2019

This article examines the discourse and representation of canshan shengshui (devastated landscape) in early Qing literature and culture through a focused interpretation of the works of Ming loyalists Zhang Dai (1597–1684) and Wang Fuzhi (1619–92). Connecting aesthetics with ethics, these authors symbolically translate the devastated landscape (aesthetically objectified) into ethical sites, namely, the mutilated body and the shattered psyche. They push beyond the orthodox discourse of canshan shengshui, which seeks to supplement the natural landscape with artistic representation and thereby re-create nature. Zhang and Wang stand as outliers of this tradition as they explore the nuances of creation through destruction—their symbiosis, the dark forces behind creation, and destruction beyond redemption. Their insights liberate the aesthetics of the devastated landscape from the immediate political context, evoke social and intellectual trends predating the dynasty's demise, and infuse new and lasting life into the writings of the loyalists.
Nostalgic Fragments in the Thick of Things: Yuan Kewen (1890–1931) and the Act of Remembering
Authors: Wu Shengqing
Published: July 2019

This article delves into the nexus of nostalgia, memory, and visuality by examining the images, objects, and events surrounding Yuan Kewen's remembrances of his father, Yuan Shikai, and their family estate in Huanshang. It also considers Zhang Boju's remembrance of his interactions with Yuan Kewen as another layer of historical memory. Phenomenological analysis of the act of remembering, especially in the work of Edward Casey, will be shown to yield rich insights when applied to China's early twentieth-century Republican culture. Surviving fragments—poems, anecdotes, photographs, and paintings—replete with sensuous and affective images of the past become the loci of memory in which these historical figures lived. Lamentation and reminiscence are also conducted through performance of historical dramas whose gestures of mourning and remembrance allowed Yuan to cultivate feelings of perpetual nostalgia through personal artistic expressions. The act of remembering became symptomatic for Yuan, Zhang, and to a large extent the entire generation of literati who experienced drastic social-political changes in the twentieth century.
Srrm234, but not canonical SR and hnRNP proteins, drive inclusion of Dscam exon 9 variable exons
Authors: Ustaoglu Pinar , Haussmann Irmgard U. , Liao Hongzhi , Torres-Mendez Antonio , Arnold Roland , Irimia Manuel , Soller Matthias
Published: July 2019

Alternative splicing of pre-mRNA is a major mechanism to diversify protein functionality in metazoans from a limited number of genes. The Drosophila melanogaster Down syndrome cell adhesion molecule (Dscam) gene, which is important for neuronal wiring and phagocytosis of bacteria, can generate up to 38,016 isoforms by mutually exclusive alternative splicing in four clusters of variable exons. However, it is not understood how a specific exon is chosen from the many variables and how variable exons are prevented from being spliced together. A main role in the regulation of Dscam alternative splicing has been attributed to RNA binding proteins (RBPs), but how they impact on exon selection is not well understood. Serine-arginine rich (SR) proteins and hnRNP proteins are the two main types of RBPs with major roles in exon definition and splice site selection. Here, we analyzed the role of SR and hnRNP proteins in Dscam exon 9 alternative splicing in mutant Drosophila melanogaster embryos because of their essential function for development. Strikingly, loss or overexpression of canonical SR and hnRNP proteins even when multiple proteins are depleted together, does not affect Dscam alternative exon selection very dramatically. Conversely, noncanonical SR protein Serine–arginine repetitive matrix 2/3/4 (Srrm234) is a main determinant of exon inclusion in the Dscam exon 9 cluster. Since long-range base-pairings are absent in the exon 9 cluster, our data argue for a small complement of regulatory factors as main determinants of exon inclusion in the Dscam exon 9 cluster.
A testing cascade to identify repurposed insecticides for next-generation vector control tools: screening a panel of chemistries with novel modes of action against a malaria vector
Authors: Lees Rosemary , Praulins Giorgio , Davies Rachel , Brown Faye , Parsons George , White Anthony , Ranson Hilary , Small Graham , Malone David
Published: July 2019

Background: With insecticide resistance in malaria vectors spreading in geographical range and intensity, there is a need for compounds with novel modes of action to maintain the successes achieved to date by long-lasting insecticidal nets and indoor residual sprays, used as part of an insecticide resistance management strategy. Screening existing registered pesticides, predominantly those developed for use in agriculture, may provide a more rapid and less logistically challenging route to identifying active ingredients of value to public health than screening and chemical synthesis programmes for novel compounds.

Methods: Insecticides and acaricides from all IRAC classes, including those with unclassified modes of action, were assessed for inclusion in a laboratory bioassay testing cascade against adult female Anopheles gambiae mosquitoes. A longlist of representative candidate compounds was selected, excluding those with safety concerns, unsuitable physiochemical properties, and likely hurdles to registration for public health use.  An initial screen using topical application eliminated compounds with insufficient intrinsic activity, and a tarsal contact assay identified those with activity at an appropriate concentration. Compounds of interest were ranked by relative potency using dose response assays and discriminating dose calculations.

Results: Inclusion of an adjuvant enhanced the tarsal efficacy of several compounds, facilitating the promotion of chemistries with great potential, given suitable formulation, which would not progress based on activity of compound alone. Comparison of data between stages in the testing cascade suggest that a more streamlined approach, topical application to test for intrinsic activity and determining the discriminating dose to compare relative potency of compounds, may be sufficient to identify compounds with potential value for use in long lasting insecticidal nets and indoor residual spray products.

Conclusions: Identified were 11 compounds of interest as vector control agents (in descending order of potency): clothianidin, spinetoram, metaflumizone, dinotefuran, indoxacarb, abamectin, sulfoxaflor, oxazosulfyl, triflumezopyrim, fenpyroximate, and tolfenpyrad.
СРАВНИТЕЛЬНЫЙ АНАЛИЗ ОБРАЗОВАНИЯ КРИСТАЛЛОВ В ВЫСЫХАЮЩЕЙ КАПЛЕ В НОРМЕ И ПРИ ПАТОЛОГИИ
Authors: Suleymanova Nazif Lenurovna , Ageeva Elizaveta Sergeevna , Korablyova Tatiana Rafailovna
Published: July 2019

Исследованы фации высыхающей капли плазмы крови здоровых и больных доноров. Обнаруженные в результате патологические структуры в фациях свидетельствуют об определенных патологических процессах, происходящих в организме пациентов. Сравнительный анализ особенностей образования кристаллов проведен с растворами физиологических концентраций NaCl, глюкозы и белка. Метод может быть перспективным в использовании кристаллографии для быстрой диагностики и прогнозирования ряда патологических состояний.
ВЛИЯНИЕ ВЫРАЖЕННОСТИ ТРЕВОЖНО-ДЕПРЕССИВНЫХ РАССТРОЙСТВ НА КАЧЕСТВО ЖИЗНИ БОЛЬНЫХ АРТЕРИАЛЬНОЙ ГИПЕРТОНИЕЙ
Authors: Yaskevich Roman Anatolyevich , Kochergina Ksenia Nikolaevna , Kasparov Eduard Vilyamovich
Published: July 2019

Изучены особенности влияния тревожно-депрессивных расстройств на качество жизни (КЖ) у 145 больных с артериальной гипертонией (АГ). Использовалась госпитальная шкала тревоги и депрессии (HADS). Для исследования КЖ использовалась методика, разработанная Гладковым А.Г с соавт. (1982). Выявлена высокая частота встречаемости тревожно-депрессивной симптоматики среди больных с АГ. Среди лиц с клинически выраженной тревогой и депрессией встречалось наибольшее количество пациентов со значительным снижением КЖ.