bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensation seeking and nonsuicidal self-injurious behavior among adolescent psychiatric patients
Authors: Kentopp Shane D , Conner Bradley T , Fetterling Theodore J , Delgadillo Arianna A , Rebecca Rachel A
Published: February 2021

The Benefits and Barriers model of NSSI postulates that engagement in NSSI is positively reinforced by potent benefits, however there are a host of barriers to engagement, any one of which is salient enough to prevent engagement. It is possible that individual differences in sensation seeking, a trait that describes optimal level of positive reinforcement, may alter the balance between the benefits and barriers of engagement in NSSI. There are significant associations between engagement in NSSI and sensation seeking in college undergraduates, a population with disproportionately high rates of NSSI. However, it is unclear whether these traits play a similar role in adolescents. We expected that higher levels of sensation seeking would positively relate to any NSSI history, lifetime frequency of NSSI, and earlier age at onset of NSSI among a sample of 200 adolescents in a psychiatric hospital. Consistent with previous research, results indicated that females were more likely to engage in NSSI than males. Additionally, increased sensation seeking was associated with greater likelihood of ever engaging in NSSI and a greater number of different NSSI methods tried. Though we expected sensation seeking would be significantly related to lifetime NSSI frequency and earlier onset of NSSI, it was not. Findings suggest that individual differences may alter relations between the benefits and barriers of NSSI and that measuring sensation seeking in adolescents, especially females, and especially those experiencing psychological distress, may identify those at highest risk for engaging in NSSI and may allow for targeted intervention with these individuals.
Inclusion of L2 (Basque) learners in Dialogic Literary Gatherings in a linguistically diverse context
Authors: Santiago-Garabieta Maite , García-Carrión Rocío , Zubiri-Esnaola Harkaitz , López de Aguileta Garazi
Published: February 2021

The increasing linguistic diversity of the students in schools poses a major challenge for inclusive educational systems in which everyone can learn the language of instruction effectively and, likewise, can have access to contents, being language the necessary tool to the latter end. Research suggests that there is a robust connection between interaction and language acquisition. Therefore, there is a need to identify the forms of interaction that are most effective for that purpose. In this sense, a greater emphasis on dialogic teaching and learning that increases quality interactions among students may facilitate the learning process. The present study analyses the implementation of a dialogue-based educational action called Dialogic Literary Gatherings (DLG) to promote teaching and learning Basque, a minority language, in a linguistically diverse context. Our research is an exploratory case study: 9 lessons were video-recorded and 2 interviews were conducted with a group of students and their teacher respectively. Results suggest that the DLG creates affordances for encouraging participation in collaborative interactions in the second language, promoting the inclusion of L2 learners, and fostering literature competence as well as a taste for the universal literature. We discuss the implications of these findings for second language learning.
Resituating the political in cultural intermediary work: Charity sector public relations and communication
Authors: Cronin Anne M , Edwards Lee
Published: February 2021

Drawing on a case study of public relations in the UK charity sector, this article argues that cultural intermediary research urgently requires a more sustained focus on politics and the political understood as power relations, party politics and political projects such as marketization and neoliberalism. While wide-ranging research has analysed how cultural intermediaries mediate the relationship between culture and economy, this has been at the expense of an in-depth analysis of the political. Using our case study as a prompt, we highlight the diversity of ways that the political impacts cultural intermediary work and that cultural intermediary work may impact the political. We reveal the tensions that underpin practice as a result of the interactions between culture, the economy and politics, and show that the tighter the engagement of cultural intermediation with the political sphere, the more tensions must be negotiated and the more compromised practitioners may feel.
Age-associated decline of monocyte insulin sensitivity in diabetic and healthy individuals
Authors: Nakamura Suguru , Mori Kentaro , Okuma Hideyuki , Sekine Tetsuo , Miyazaki Asako , Tsuchiya Kyoichiro
Published: February 2021

Objective:

It is unclear whether monocyte/macrophage insulin signaling in humans is affected by type 2 diabetes (T2DM), systemic insulin sensitivity, and other unknown factors.

Research design and methods:

Fifty-three adult volunteers (control group) not taking any medication and without cardiovascular risk factors, and 59 patients with T2DM (T2DM group) were included. Monocytes were isolated and cultured from all participants.

Results:

In cultured monocytes, insulin-stimulated AKT and FOXO3 phosphorylation was significantly suppressed in T2DM compared with that in the control group. Insulin-stimulated phosphorylation of AKT was significantly correlated with body mass index and serum insulin level only in the control group. In both groups, significant negative correlation between age and insulin-stimulated phosphorylation of AKT and FOXO3 was commonly observed. In the control group, lipopolysaccharide (LPS)-stimulated induction of TNFA, and NOS2 was significantly and negatively correlated with insulin-stimulated AKT phosphorylation. Age was also significantly correlated with LPS-stimulated induction of TNFA.

Discussion:

Aging plays an important role in the development of monocyte insulin resistance, not only in patients with T2DM but also in healthy participants. Monocyte insulin sensitivity is negatively correlated with inflammatory responses and may be helpful for subclinical risk assessment of CVDs and/or insulin resistance in participants without risk factors.
When Race and Class Collide: Classism and Social-Emotional Experiences of First-Generation College Students
Authors: Garriott Patton O. , Ko Shao-Jung “Stella” , Grant Sandra Bertram , Jessen Mackenzie , Allan Blake A.
Published: February 2021

Scholarship devoted to first-generation college students has increased rapidly over the past decade, with studies demonstrating first-generation students are systematically disadvantaged compared to their continuing-generation peers. Recently, scholars have critiqued the treatment of first-generation students as a monolith and encouraged complicating their experiences using intersectionality as an analytic tool. This study examined the association between institutional classism and students’ social-emotional experiences in higher education, and how these relations vary based on sociorace, first-generation college student status, and subjective social status. In a sample ( N = 742) of college students from two four-year public institutions, results showed that the strength of the association between institutional classism and social-emotional experiences varied at different intersections of first-generation status, sociorace, and subjective social status. These findings demonstrate the importance of contextualizing first-generation students’ experiences and have implications for efforts to retain first-generation students in higher education.
Manufacturing a carbon/epoxy NACA 23018 airfoil skin using a circular braiding machine: experimental and numerical study
Authors: Hajrasouliha Jalil , Sheikhzadeh Mohammad
Published: February 2021

In the interest of reducing the weight and also cost of blade skins, various automatic preform manufacturing processes were developed including tape laying, filament winding and braiding. Among them, the circular braiding process was found to be an efficient method in producing seamless preforms on mandrels with various geometries. In this regard, an attempt was made to produce a carbon fiber reinforced composite with the shape of NACA 23018 airfoil using a circular braiding machine. Thus, suitable wooden mandrels were manufactured using NACA 23018 airfoil coordinates, which were obtained by assuming the perimeter of 20 cm. Furthermore, both biaxially and triaxially braided preforms were produced and subsequently impregnated with epoxy resin through an appropriate fabrication method. To assess their performance, four-point bending test was carried out on samples. Ultimately, the elastic response of braided composite airfoils was predicted using a meso-scale finite element modeling and was validated with experimental results.
Role of Testosterone Levels on the Combinatorial Effect of Boswellia serrata Extract and Enzalutamide on Androgen Dependent LNCaP Cells and in Patient Derived Cells
Authors: Pillai Prathesha , Pooleri Ginil Kumar , Nair Shantikumar V.
Published: February 2021

Co-therapy with herbal extracts along with current clinical drugs is being increasingly recognized as a useful complementary treatment for cancer. The anti-cancer property of the phyto-derivative acetyl-11 keto β boswellic acid (AKBA) has been studied in many cancers, including prostate cancer. However, the whole extract of the gum resin Boswellia serrata (BS) and anti-androgen enzalutamide has not been explored in prostate cancer to date. We hypothesized that the BS extract containing 30% (AKBA) with enzalutamide acted synergistically in the early phase of cancer, especially in LNCaP cells, by inhibiting androgen receptor (AR) and by reducing cell proliferation, and further, that the extract would be superior to the action of the active ingredient AKBA when used alone or in combination with enzalutamide. To test our hypothesis, we treated LNCaP cells with BS extract or AKBA and enzalutamide both individually and in combination to analyze cell viability under different levels of dihydrotestosterone (DHT). The inhibition of androgen receptor (AR) followed by the expression of prostate-specific antigen (PSA) and the efflux mechanism of the cells were analyzed to determine the effect of the combination on the cellular mechanism. Cells derived from prostate cancer patients were also tested with the combination. Only 6 µM enzalutamide along with BS in the range of 4.1 µg/ml to 16.4 µg/ml gave the best synergistic results with nearly 50% cell killing even though standard enzalutamide doses were as high as 48 µM. Cell killing was most effective at intermediate DHT concentrations of approximately 1 nM, which corresponds to normal physiological serum levels of DHT. The Pgp expression level and the androgen receptor expression levels were reduced under the combination treatment; the former helping to minimize drug efflux and the latter by reducing the sensitivity to hormonal changes. Furthermore, the combination reduced the PSA level secreted by the cells. In contrast, AKBA could not achieve the needed synergism for adequate cell killing at equivalent concentrations. The combination of enzalutamide and BS extract containing 30% AKBA because of their synergistic interaction is an attractive therapeutic option for treating early stage (hormone-dependent) prostate cancer and is superior to the use of AKBA alone.
Dollars and Sense: Cost-Effectiveness of Epilepsy Surgery
Authors: Terman Samuel W.
Published: February 2021

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Factors and Interventions that Foster Success of Latinx Students in Public Community Colleges: A Theory-Driven Systematic Review and Content Analysis of Psychological Research
Authors: Domínguez-Rebollar Rosaura , Acevedo-Polakovich Ignacio D.
Published: February 2021

Over 40% of U.S. Latinx students complete higher education in community colleges. These students’ retention, persistence, graduation, and transfer rates are notably lower than those of Latinx students in other higher education settings. To understand these differences, we systematically reviewed and content analyzed the peer-reviewed psychological research literature, finding 23 psychological correlates, organized into nine themes across five socioecological system levels. We discuss implications and expand on the importance of considering the interactions among systems.
Student motivations for studying criminology: A narrative inquiry
Authors: Trebilcock Julie , Griffiths Clare
Published: February 2021

The number of students studying criminology at university has significantly increased. Yet, criminology students have been all but ignored in research, despite being key stakeholders and ambassadors in the criminological enterprise. Drawing on the analysis of 12 in-depth interviews, we explore why students are motivated to study criminology and how these motivations are linked to their past experiences and future aspirations. Using a narrative inquiry, three types of stories emerged through our analysis: stories about (1) building on existing interests, (2) understanding the ‘self’, and (3) securing ‘justice’ and ‘helping’ others. The stories students tell about their exposure to ‘crime’ help motivate their decision to study criminology, while their engagement with the discipline, enables them to make sense of these previous experiences and of themselves.
Assessment of 3D-printed span change structures applied to small unmanned aerial vehicles
Authors: Henry Todd C , Hrynuk John T , Phillips Francis R
Published: February 2021

An assessment of 3D-printed span-change structures is presented for determining suitability of the technology to small unmanned aerial vehicles. Materials and manufacturing technologies were used with an emphasis on near term applicability with design trades between the aerodynamic performance and structural response. Aerodynamic performance was assessed on three wind tunnel models varying span (432, 600, and 762 mm), wind speed (Reynolds numbers 18,000, 36,000, and 71,000), additive manufacturing print build plane and camber, quantifying structural response as the resulting shape during aerodynamic loading. Each model displayed increasing compliance as span increased with wing-tip displacement on the order of 50, 100, and 200 mm with various degrees of sweep and twist. Models generated excess lift at Re = 71,000 indicating potential flight demonstration of the technology with a lift to drag improvement of up to 97% at maximum wing extension.
Walking on Visual Illusions
Authors: Dickson Greig , Burtan Daria , James Shelley , Phillips David , Stevanov Jasmina , Heard Priscilla , Leonards Ute
Published: February 2021

In nature, sensory and physical characteristics of the environment tend to match; for example, a surface that looks bumpy is bumpy. In human-built environments, they often don’t. Here, we report observations from people exploring if mismatch between visual and physical characteristics affected their perceived walking experience. Participants walked across four flat floors, each comprising of a visual illusion: two patterns perceived as alternating 3D “furrows and ridges,” the Primrose Field illusion, and a variant of the Cafe Wall illusion as a control pattern without perceived 3D effects. Participants found all patterns intriguing to look at; some describing them as “playful” or “gentle.” More than half found some of the patterns uncomfortable to walk on, aversive, affecting walking stability, and occasionally even evoking fear of falling. These experiences raise crucial research questions for the vision sciences into the impact of architectural design on well-being and walkability.
An intra-abdominal desmoid tumor
Authors: Petró Mátyás , Silye Annamária , Székely András , Kovács Ilona , Yi-Che Chang C , Papp Tamás
Published: February 2021

Desmoid tumor is a very rare neoplasm which develops from fibroblasts. These tumors do not have the ability to metastasize, but they can cause significant morbidity and mortality by local invasion and they are prone to local recurrence. We present a case of an aggressive fibromatosis in a 28-year-old male patient with no previous medical history. The tumor was in the retroperitoneum and eventually caused perforation of the coecum. During the operation, no metastasis was found; however, local lymphadenopathy was seen. After the surgical resection, no adjuvant therapy (radio or chemotherapy) was given to the patient and on follow-up (after three years), no recurrence was observed.
Utility of manual fractional anisotropy measurements in the management of patients with Parkinson disease: a feasibility study with a 1.5-T magnetic resonance imaging system
Authors: de Oliveira Romulo V , Pereira João S
Published: February 2021

Background

Diffusion tensor imaging has emerged as a promising tool for quantitative analysis of neuronal damage in Parkinson disease, with potential value for diagnostic and prognostic evaluation.

Purpose

The aim of this study was to examine Parkinson disease-associated alterations in specific brain regions revealed by diffusion tensor imaging and how such alterations correlate with clinical variables.

Material and Methods

Diffusion tensor imaging was performed on 42 Parkinson disease patients and 20 healthy controls with a 1.5-T scanner. Manual fractional anisotropy measurements were performed for the ventral, intermediate, and dorsal portions of the substantia nigra, as well as for the cerebral peduncles, putamen, thalamus, and supplementary motor area. The correlation analysis between these measurements and the clinical variables was performed using χ2 variance and multiple linear regression.

Results

Compared to healthy controls, Parkinson disease patients had significantly reduced fractional anisotropy values in the substantia nigra ( P < .05). Some fractional anisotropy measurements in the substantia nigra correlated inversely with duration of Parkinson disease and Parkinson disease severity scores. Reduced fractional anisotropy values in the substantia nigra were also correlated inversely with age variable. fractional anisotropy values obtained for the right and left putamen varied significantly between males and females in both groups.

Conclusion

Manual fractional anisotropy measurements in the substantia nigra were confirmed to be feasible with a 1.5-T scanner. Diffusion tensor imaging data can be used as a reliable biomarker of Parkinson disease that can be used to support diagnosis, prognosis, and progression/treatment monitoring.
Technology and concussion: A scoping review
Authors: Reneker Jennifer C , Slaughter Janet , Scruggs Anna , Pannell W Cody
Published: February 2021

Background

Technology for concussion identification and management is rapidly expanding across the continuum of care. Although many technologies offer a range of services around concussion, there is an absence of a non-commercial online location for medical providers to access regarding the functionality of the various technologies used in concussion identification and management.

Objective

The purpose of this review is to present research findings on technology for concussion identification and management.

Methods

Searches for eligible studies were conducted using the PubMed, EMBASE, and Scopus databases with specific search criteria. Through a stepwise process, full-text articles were selected for inclusion if they described clinically useful electronic technologies (i.e. electronics able to be used in standard clinical environments including telehealth) by healthcare providers or end users (i.e. parents or athletes).

Results

A total of 29 articles were included in this review and described technology used to measure symptoms (3), neurocognitive performance (7), the visual system (4), and balance or dual task performance (18). Within the results, various technologies demonstrated increased utility for concussion identification, often detecting subtle deficits not possible with current low-tech clinical methods, differentiating those with concussion from those without concussion, with strong reliability and validity.

Conclusion

Innovative technologies included in this review demonstrate enhanced ability to identify and manage symptoms of concussion, neurocognitive deficits, visual deficits, and balance and dual-task deficits.
Can We Stratify Quality and Cost for Older Patients With Proximal and Midshaft Humerus Fractures?
Authors: Konda Sanjit R. , Johnson Joseph R. , Dedhia Nicket , Kelly Erin A. , Egol Kenneth A.
Published: February 2021

Introduction:

This study sought to investigate whether a validated trauma triage tool can stratify hospital quality measures and inpatient cost for middle-aged and geriatric trauma patients with isolated proximal and midshaft humerus fractures.

Materials and Methods:

Patients aged 55 and older who sustained a proximal or midshaft humerus fracture and required inpatient treatment were included. Patient demographic, comorbidity, and injury severity information was used to calculate each patient’s Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA). Based on scores, patients were stratified to create minimal, low, moderate, and high risk groups. Outcomes included length of stay, complications, operative management, ICU/SDU-level care, discharge disposition, unplanned readmission, and index admission costs.

Results:

Seventy-four patients with 74 humerus fractures met final inclusion criteria. Fifty-eight (78.4%) patients presented with proximal humerus and 16 (21.6%) with midshaft humerus fractures. Mean length of stay was 5.5 ± 3.4 days with a significant difference among risk groups (P = 0.029). Lower risk patients were more likely to undergo surgical management (P = 0.015) while higher risk patients required more ICU/SDU-level care (P < 0.001). Twenty-six (70.3%) minimal risk patients were discharged home compared to zero high risk patients (P = 0.001). Higher risk patients experienced higher total inpatient costs across operative and nonoperative treatment groups.

Conclusion:

The STTGMA tool is able to reliably predict hospital quality measures and cost outcomes that may allow hospitals and providers to improve value-based care and clinical decision-making for patients presenting with proximal and midshaft humerus fractures.

Level of Evidence:

Prognostic Level III.
Falls as One of the Atypical Presentations of COVID-19 in Older Population
Authors: Gawronska Karolina , Lorkowski Jacek
Published: February 2021

Introduction:

Studies revealed COVID-19 atypical symptoms such as falls, delirium, confusion, dizziness, unusual fatigue in older patients. Falls in the older population and their consequences are one of the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence and impaired social functioning. The aim of this study is to present the possible correlation between COVID-19 and diseases of the musculoskeletal system, in particular the occurrence of fall-related injuries.

Significance:

This article highlights the importance of falls as one of the atypical symptoms of COVID-19 infection in older adults, which is not directly associated with infection and could be misinterpreted.

Methods:

The conducted meta-analysis is based on a review of the scientific literature available in English, French, Dutch, Polish in the PubMed/MEDLINE, Cochrane Library, Embase, Scopus, PEDro, GBL databases from December 1, 2019 to July 30, 2020, covering Clinical Trial, Randomized Controlled Trial, Meta-Analysis, Systematic Reviews and Case Reports. The following keywords were taken into account: fall, (hip/pertrochanteric/proximal femur) fracture, aged and COVID-19. Twenty-seven references were accepted for final analysis.

Results:

It was found that symptoms such as falls observed in the older adults can be associated with COVID-19 infection. Falls and slips are also the most common mechanism for hip fracture during the pandemic outbreak.

Conclusions:

According to authors of this study, atypical presentations of COVID-19 should be considered when screening and testing the people at increased risk due to their age. However, further prospective studies are urgently needed to investigate the possible correlation between COVID-19 and falls in older adults.
Implementation of Pre–Employment Transition Services: A Content Analysis of Workforce Innovation and Opportunity Act State Plans
Authors: Taylor Joshua P. , Whittenburg Holly N. , Rooney-Kron Magen , Gokita Tonya , Lau Stephanie J. , Thoma Colleen A. , Scott LaRon A.
Published: February 2021

Many youth with disabilities experience persistently low rates of competitive integrated employment (CIE) and participation in higher education. In 2014, the Workforce Innovation and Opportunity Act (WIOA) established a policy focus on CIE as the goal of vocational services for youth and individuals with disabilities. In addition, WIOA created provision for Pre–Employment Transition Services (Pre-ETS) to ensure that state vocational rehabilitation (VR) agencies focused sufficient resources toward transition-age youth. This study examined a sample of WIOA state implementation plans in depth using content analysis to identify how state VR agencies prioritized the provision of Pre-ETS services to youth with disabilities. Analysis of state plans resulted in three emergent themes: (a) instructional priorities, (b) instructional contexts, and (c) networks of stakeholders. We discuss the implications of these themes for future research, policy, and practice related to the employment of individuals with disabilities.
The Biomechanical Properties of Cement-Augmented Pedicle Screws for Osteoporotic Spines
Authors: Wang Yuetian , Yang Lei , Li Chunde , Sun Haolin
Published: February 2021

Study Design:

This is a broad, narrative review of the literature.

Objective:

In this review, we describe recent biomechanics studies on cement-augmented pedicle screws for osteoporotic spines to determine which factors influence the effect of cement augmentation.

Methods:

A search of Medline was performed, combining the search terms “pedicle screw” and (“augmentation” OR “cement”). Articles published in the past 5 years dealing with biomechanical testing were included.

Results:

Several factors have been identified to impact the effect of cement augmentation in osteoporotic spines. These include the type of augmentation material, the volume of injected cement, the timing of augmentation, the severity of osteoporosis, the design of the pedicle screw, and the specific augmenting technique, among others.

Conclusions:

This review elaborates the biomechanics of cement-augmented pedicle screws, determines which factors influence the augmentation effect, and identifies the risk factors of cement leakage in osteoporotic bone, which might offer some guidance when using this technique in clinical practice. Further, we provide information about newly designed screws and recently developed augmentation materials that provide higher screw stability as well as fewer cement-related complications.
The Asymmetric Effects of Regional House Prices in the UK: New Evidence from Panel Quantile Regression Framework
Authors: Tzeremes Panayiotis
Published: February 2021

This study unfurls the non-linear behaviour of regional house prices in the United Kingdom by employing quarterly observations spanning the period 1992Q1–2017Q4. Our enquiry aims at examining UK house prices within a multivariable framework and, more specifically, by employing panel quantile regression with fixed effect. In brief, the empirical findings obtained from these methodologies indicate that the UK house prices are influenced at lower and upper quantiles, and that precisely they are influenced by variables such as income, private sector housing starts and employment. We highly support that there is a strong heterogeneity among UK regions and that asymmetry may be one of the keys of the ripple effect. Particularly, the income shows a positively significant performance at lower and higher regional house prices. Moreover, the variables private sector housing starts and employment rate are statistically significant for house prices. Leveraging for first-time panel quantile regression for the case of regional house prices in the UK, policymakers will have a profound understanding of regional house prices.

JEL Classifications: C22, R21, R31
Experiences of People Living With HIV in Community Based Exercise: A Qualitative Longitudinal Study
Authors: Solomon Patricia , Carusone Soo Chan , Davis Aileen M. , Aubry Rachel , O’Brien Kelly K.
Published: February 2021

This qualitative longitudinal study examined the experiences of people living with HIV who engaged in a structured community-based exercise (CBE) program under the supervision of a fitness coach. Twenty people living with HIV were invited to participate in 3 semi-structured interviews over time. Participants engaged in exercise 3 times per week for 6 months with one weekly session supervised by a coach. Interviews were audio-recorded, transcribed verbatim and underwent longitudinal thematic analyses. Eleven participants were included representing a total of 30 interviews. Participants valued their experiences with the CBE program, particularly the motivation provided by the coach. Concerns about the environment, stigma and episodic health challenges affected their overall experience. To foster independence and promote self-management, health providers should consider these findings when encouraging CBE with people living with HIV. It is important to understand their goals and offer a variety of exercise options to meet their needs.
Clinical Anatomy of the Anterior Meniscofemoral Ligament of Humphrey: An Original MRI Study, Meta-analysis, and Systematic Review
Authors: Pękala Przemysław A. , Rosa Mateusz A. , Łazarz Dominik P. , Pękala Jakub R. , Baginski Adam , Gobbi Alberto , Mann Mitchell R. , Tomaszewski Krzysztof A. , LaPrade Robert F.
Published: February 2021

Background:

The anterior meniscofemoral ligament (aMFL) of Humphrey is an anatomically variable fibrous band of connective tissue that attaches between the lateral aspect of the medial femoral condyle and posterior horn of the lateral meniscus, running posterior to the anterior cruciate ligament and anterior to the posterior cruciate ligament (PCL). The presence of an intact aMFL may contribute to stabilization of the lateral compartment of the knee joint.

Purpose:

The original magnetic resonance imaging (MRI) arm of this study aimed to assess the aMFL incidence among Polish patients. The goal of the systematic review and meta-analysis was to review the literature discussing the clinical anatomy of the aMFL and provide data on its prevalence. It was hypothesized that significant heterogeneity exists within the published literature.

Study Design:

Cross-sectional study and systematic review; Level of evidence, 3.

Methods:

A retrospective investigation was performed on the MRI scans of 100 knees (52 right, 48 left) of Polish patients. Scans were randomly selected from a database of MRI examinations performed in 2019. For the meta-analysis, major online databases were queried for data on the aMFL, and 2 authors independently assessed and extracted data from all included studies. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool.

Results:

In the MRI arm of this study, the aMFL was found in 62 of the 100 lower limbs. The meta-analysis included 41 studies with a total of 4220 limbs. The aMFL was present in 55.5% (95% CI, 45.5%-65.3%) of cases. Arthroscopic studies yielded the highest prevalence (82.3% [95% CI, 36.6%-100.0%]); of MRI studies, the highest prevalence was at 3.0-T strength (51.0% [95% CI, 13.3%-88.2%]).

Conclusion:

Significant variability in the prevalence of the aMFL was found in the literature. More emphasis should be placed on the clinical relevance of injuries to the aMFL because of its significant role in the function of the knee. It is important to be aware that, because of the anatomy of the aMFL, the ligament can also function to support a torn PCL.
Chronic and Recurrent Rectus Femoris Central Tendon Ruptures in Athletes: Clinical Picture, MRI Findings, and Results of Surgical Treatment
Authors: Lempainen Lasse , Kosola Jussi , Valle Xavier , Puigdellivol Jordi , Ranne Juha , Orava Sakari , Pruna Ricard
Published: February 2021

Background:

Severe rectus femoris central tendon rupture is an uncommon sports-related injury. Most rectus femoris central tendon injuries can be treated by nonoperative means, but some tend to reinjure, resulting in chronic symptoms. Physicians treating athletes with rectus femoris injuries should be aware of this clinical condition and know that surgical treatment could be beneficial to the athlete if the rectus femoris central tendon rupture becomes chronic.

Purpose:

To describe the clinical picture, magnetic resonance imaging (MRI) findings, and surgical treatment results of rectus femoris central tendon injuries.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 12 patients who underwent successful repair of recurrent rectus femoris central tendon rupture. Presurgical MRI scans were obtained and compared with the surgical findings. The time of return to play was recorded, and the outcome of surgical treatment was evaluated with validated Subjective Patient Outcome for Return to Sports (SPORTS) criteria: good = full return to preinjury level of sports without any symptoms; moderate = return to preinjury level of sports with some residual symptoms (mild discomfort during sports); and poor = did not return to preinjury level of sports.

Results:

Overall, 10 patients had a good outcome (83%), and 2 had a moderate outcome (17%). All athletes included in the study were able to return to sport at their preinjury levels 2.5 to 4 months postoperatively. Presurgical MRI scans correlated well with the surgical findings.

Conclusion:

The surgical treatment of rectus femoris central tendon rupture seems to be a good option in chronic and recurrent cases. After surgery and successful rehabilitation, the athlete is expected to continue sports at the preinjury level.
Diversity of Cardiac and Gastrointestinal Presentations of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19: A Case Series
Authors: Shikhare Anuja R. , Iqbal Rimsha M. , Tariq Rabail , Turner Daniel R. , Gebara Bassam M. , Freij Bishara J.
Published: February 2021

COVID-19 is generally a benign or asymptomatic infection in children, but can occasionally be severe or fatal. Delayed presentation of COVID-19 with hyperinflammation and multi-organ involvement was recently recognized, designated the Multisystem Inflammatory Syndrome in Children (MIS-C). Six children with MIS-C with molecular and serologic evidence of SARS-CoV-2 infection were admitted to our hospital between May 5, 2020 and June 25, 2020. All had fever and weakness; 4/6 presented with gastrointestinal symptoms. Two children had features of complete Kawasaki disease, 3 had incomplete Kawasaki disease, while 1 had terminal ileitis with delayed onset of circulatory shock. Treatment consisted of intravenous immunoglobulin and aspirin for Kawasaki-like disease. Remdesivir, corticosteroids, and infliximab were used when indicated. Median hospitalization was 7 days. Immediate treatment resulted in rapid clinical improvement. In children presenting with hyperinflammatory syndromes without cardiac manifestations, testing for SARS-CoV-2 RNA and antibodies, with close cardiac monitoring should be pursued due to the manifold presentations of SARS-CoV-2 infection in children.
Early Outcomes and Complications Following Initiation of a Total Ankle Arthroplasty Program
Authors: Lundeen Gregory , Neary Kaitlin C. , Kaiser Cody , Jackson Lyle
Published: February 2021

Background:

Surgeons who lack experience with total ankle arthroplasty (TAA) may remain hesitant to introduce this procedure owing to previously published results of high complication rates during initial cases. The purpose of the present study was to report the development of a TAA program through intermediate outcomes and complications for an initial consecutive series of TAA patients of a single community-based foot and ankle fellowship–trained orthopedic surgeon with little TAA experience using a co-surgeon with similar training and TAA exposure.

Methods:

The initial 20 patients following third-generation TAA with a single surgeon were reviewed. Clinical outcomes were measured and radiographs were evaluated to determine postoperative implant and ankle position. Complications were also measured including intraoperative, early (<3 months), and intermediate postoperative complications.

Results:

With a minimum follow-up of 2 years and average follow-up of 51 months (range 24-70 months), the mean American Orthopaedic Ankle & Foot Society Ankle-Hindfoot score was 87.7 (59-100) and VAS was 1.0 (0-5.5). All patients were improved following TAA. Radiographic evaluation demonstrated no evidence of component malalignment or ankle joint incongruity. There were no intraoperative complications nor any wound complications. Three patients returned to the operating room for placement of medial malleolar screw placement, and 1 had asymptomatic tibial component subsidence.

Conclusions:

Orthopedic surgeons with a proper background and updated training may be able to perform TAA with good outcomes. A TAA program was developed to define minimum training criteria to perform this procedure in our community. Our complication rate is consistent with those reported in the literature for experienced TAA centers, which contrasts previous literature suggesting increased complication rates and worse outcomes when surgeons perform initial TAAs. Utilization of an orthopedic co-surgeon was felt to be instrumental in the success of the program.

Level of Evidence:

Level IV, retrospective case series.
Tofacitinib for the Treatment of Refractory Palmoplantar Psoriasis: A Case Series
Authors: Muzumdar Sonal , Leonardi Craig , Strober Bruce
Published: February 2021

Background:

Palmoplantar psoriasis can severely impact patient quality of life. Despite the influx of many new medications, it remains one of the most challenging psoriasis phenotypes to treat.

Case Description:

Herein, we present a case series of 7 patients with hyperkeratotic palmoplantar psoriasis refractory to systemic therapy who were successfully treated with tofacitinib, a Janus kinase (JAK) 1/3 inhibitor.

Conclusions:

Tofacitinib may be an effective therapy for the management of recalcitrant palmoplantar psoriasis. The efficacy of tofacitinib for the treatment of palmoplantar psoriasis might clarify the dependence on this subtype of psoriasis on specific cytokines that signal through JAK 1/3.
Rational selection of a biomarker panel targeting unmet clinical needs in kidney injury
Authors: van Duijl T. T. , Soonawala D. , de Fijter J. W. , Ruhaak L. R. , Cobbaert C. M.
Published: February 2021

The pipeline of biomarker translation from bench to bedside is challenging and limited biomarkers have been adopted to routine clinical care. Ideally, biomarker research and development should be driven by unmet clinical needs in health care. To guide researchers, clinical chemists and clinicians in their biomarker research, the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has developed a structured questionnaire in which the clinical gaps in current clinical pathways are identified and desirable performance specifications are predefined. In kidney injury, the high prevalence of the syndrome acute kidney injury (AKI) in the hospital setting has a significant impact on morbidity, patient survival and health care costs, but the use of biomarkers indicating early kidney injury in daily patient care remains limited. Routinely, medical labs measure serum creatinine, which is a functional biomarker, insensitive for detecting early kidney damage and cannot distinguish between renal and prerenal AKI. The perceived unmet clinical needs in kidney injury were identified through the EFLM questionnaire. Nephrologists within our tertiary care hospital emphasized that biomarkers are needed for (1) early diagnosis of in-hospital AKI after a medical insult and in critically ill patients, (2) risk stratification for kidney injury prior to a scheduled (elective) intervention, (3) kidney injury monitoring in patients scheduled to receive nephrotoxic medication and after kidney transplantation and (4) differentiation between prerenal AKI and structural kidney damage. The biomarker search and selection strategy resulted in a rational selection of an eleven-protein urinary panel for kidney injury that target these clinical needs. To assess the clinical utility of the proposed biomarker panel in kidney injury, a multiplexed LC–MS test is now in development for the intended translational research.
A scoping review of studies using observational data to optimise dynamic treatment regimens
Authors: Mahar Robert K. , McGuinness Myra B. , Chakraborty Bibhas , Carlin John B. , IJzerman Maarten J. , Simpson Julie A.
Published: February 2021

Background

Dynamic treatment regimens (DTRs) formalise the multi-stage and dynamic decision problems that clinicians often face when treating chronic or progressive medical conditions. Compared to randomised controlled trials, using observational data to optimise DTRs may allow a wider range of treatments to be evaluated at a lower cost. This review aimed to provide an overview of how DTRs are optimised with observational data in practice.

Methods

Using the PubMed database, a scoping review of studies in which DTRs were optimised using observational data was performed in October 2020. Data extracted from eligible articles included target medical condition, source and type of data, statistical methods, and translational relevance of the included studies.

Results

From 209 PubMed abstracts, 37 full-text articles were identified, and a further 26 were screened from the reference lists, totalling 63 articles for inclusion in a narrative data synthesis. Observational DTR models are a recent development and their application has been concentrated in a few medical areas, primarily HIV/AIDS (27, 43%), followed by cancer (8, 13%), and diabetes (6, 10%). There was substantial variation in the scope, intent, complexity, and quality between the included studies. Statistical methods that were used included inverse-probability weighting (26, 41%), the parametric G-formula (16, 25%), Q-learning (10, 16%), G-estimation (4, 6%), targeted maximum likelihood/minimum loss-based estimation (4, 6%), regret regression (3, 5%), and other less common approaches (10, 16%). Notably, studies that were primarily intended to address real-world clinical questions (18, 29%) tended to use inverse-probability weighting and the parametric G-formula, relatively well-established methods, along with a large amount of data. Studies focused on methodological developments (45, 71%) tended to be more complicated and included a demonstrative real-world application only.

Conclusions

As chronic and progressive conditions become more common, the need will grow for personalised treatments and methods to estimate the effects of DTRs. Observational DTR studies will be necessary, but so far their use to inform clinical practice has been limited. Focusing on simple DTRs, collecting large and rich clinical datasets, and fostering tight partnerships between content experts and data analysts may result in more clinically relevant observational DTR studies.
Expression and prognostic impact of FZDs in pancreatic adenocarcinoma
Authors: Li Yang , Liu Zirong , Zhang Yamin
Published: February 2021

Background

Despite the high number of researches on pancreatic adenocarcinoma (PAAD) over past decades, little progress had been made due to lack of effective treatment regimens. We aimed to investigate the expression level, mutation, and clinical significance of the Frizzled (FZD) family in PAAD so as to establish a sufficient scientific evidence for clinical decisions and risk management.

Methods

PAAD samples were extracted from The Cancer Genome Atlas (TCGA). Oncomine, Gene expression profiling interactive analysis (GEPIA), human protein atlas (HPA), Kaplan–Meier Plotter, cBioPortal, LinkedOmics, DAVID database, and R software (× 64 3.6.2) were used to comprehensively analyze the roles of FZDs. p value below to 0.05 was considered as significant difference.

Results

In total, 179 PAAD tissues and 171 paracancerous tissues were included. The expression levels of FZD1, 2, 6, 7, and 8 were higher in PAAD tissues than those in normal pancreatic tissue. The higher the expression levels of FZD2 and FZD7, the higher the clinical stage. The overall survival (OS) time was significantly different between low FZD3, 4, 5, 6, and 9 expression group and high expression group. Multivariable analysis showed that FZD3 and FZD6 were independent prognostic factors. The recurrence free survival (RFS) time was significantly different between low FZD4 and FZD8 expression group and high expression group. The RFS difference between low FZD6 expression group and high expression group had not reached statistical significance (p = 0.067), which might be due to the small sample size. However, multivariable analysis showed that FZD6 was the only independent factor for RFS. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that FZDs played a critical role in the Wnt signaling pathway, which was further confirmation that FZDs were transmembrane receptors of Wnt signaling pathway.

Conclusions

Our results strongly indicated a crucial role of the FZD family in PAAD. FZD3 and FZD6 could be potential prognostic and predictive markers, and FZD6 might also function as a potential therapeutic target in PAAD by blocking Wnt/β-catenin pathway.
A PET imaging study of the brain changes of glucose metabolism in patients with temporal lobe epilepsy and depressive disorder
Authors: Wen Jin-Feng , Guo Xin-Wen , Cao Xiang-Yi , Liao Ji-Wu , Ma Ping , Hu Xiang-Shu , Pan Ji-Yang
Published: February 2021

Background

This study aims to compare the difference of the brain changes of glucose metabolism between temporal lobe epilepsy patients (TLE) with major depressive disorder and temporal TLE without major depressive disorder.

Methods

A total of 24 TLE patients, who met the inclusion criteria of our hospital, were enrolled in this study. They were divided into a TLE with depression group (n = 11) and a TLE without depression group (n = 13), according to the results of the HAMD-24 Scale. Two groups patients were examined using 18F-FDG PET brain imaging.

Results

The low metabolic regions of the TLE with depression group were mainly found in the left frontal lobe, temporal lobe and fusiform gyrus, while the high metabolic regions of the TLE with depression group were mainly located in the right frontal lobe, visual joint cortex and superior posterior cingulate cortex. Both of the TLE groups had high metabolic compensation in the non-epileptic area during the interictal period.

Conclusions

There is an uptake difference of 18F-FDG between TLE patients with depression and TLE patients without depression in multiple encephalic regions.