bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient vs Home Management Protocol Results for Plantar Fasciitis
Authors: Çil Elif Tuğçe , Şaylı Uğur , Subaşı Feryal 
Published: August 2019

Background: We compared the effectiveness of stretching and strengthening exercises combined with myofascial releasing and mobilization techniques to a stretching and strengthening only home program in plantar fasciitis (PF) management. Method: The study included 53 feet of 47 patients with plantar fasciitis (35 women / 12 men; mean age 48.9±11.2 years). Pain, disability, and activity restrictions were assessed by Foot Function Index (FFI), and first step pain was graded by visual analog scale (VAS). Ankle range of motion (ROM), gastrocnemius-soleus flexibility, proprioception, dynamic balance, and foot sensation were also considered. The patients were randomly divided into outpatient clinic treatment (Outpatient, n = 27 feet) and home rehabilitation groups (Home, n = 26 feet). Patient education was routine for all at the beginning of the management programs. In the Outpatient group, the foot-ankle-hip exercise program, myofascial releasing, and joint and soft tissue mobilization techniques were “hands on” at a clinic (twice a week for 8 weeks), whereas the Home group completed their home rehabilitation program on their own (8 weeks’ duration with follow-ups every week). Results: VAS, FFI, ROM, balance, proprioception, foot sense, and flexibility improved at the eighth week in both groups according to intragroup comparison ( P < .05). When the 2 groups were compared, the results of plantar flexion range, balance, proprioception, foot sensation, flexibility, FFI, and VAS showed significant improvements in the Outpatient vs the Home group ( P < .05). Also, the FFI and VAS scores at the sixth month were superior in the Outpatient group ( P < .05). Conclusion: A combined supervised management protocol had superior clinical results in plantar fasciitis management. Level of Evidence: Level II, comparative study.
Screw Fixation of the Posterior Malleolus Fragment in Ankle Fracture
Authors: Kang Chan , Hwang Deuk-Soo , Lee Jeong-Kil , Won Yougun , Song Jae-Hwang , Lee Gi-Soo 
Published: August 2019

Background: This study aimed to evaluate the outcomes of ankle fractures with posterior malleolus fragments (PMFs) involving <25% of the articular surface treated with or without screw fixation. Methods: Among patients with ankle fractures and PMFs who underwent surgery between March 2014 and February 2017, 62 with type 1 PMFs involving <25% of the articular surface were included. Of these 62 patients, 32 underwent screw fixation for PMFs and lateral and/or medial malleolar fracture fixation (group A) and 30 underwent internal fixation for malleolar fractures without screw fixation for PMFs (group B). Ankle joint alignment and fracture healing were measured using plain radiography and computed tomography (CT). Clinical outcomes were determined using the American Academy of Orthopaedic Surgeons Foot and Ankle Questionnaire, Short Form-36, and American Orthopaedic Foot & Ankle Society Scale. Results: Nonunion was not noted in either group. However, we detected union with a step-off of 2 mm or more in 2 cases from group B. With regard to ankle joint alignment, 1 case in group A and 3 cases in group B showed mild asymmetry of the medial and lateral clear spaces on CT at 12 months. Clinical outcomes at 6 and 12 months after surgery were better in group A than in group B. Conclusion: Screw fixation of PMFs was effective for fracture healing and maintaining ankle alignment. Additionally, it improved short-term clinical outcomes, which we believe was due to stabilization of ankle fractures with PMFs involving <25% of the articular surface. Level of Evidence: Level II, prospective comparative study.
Intraoperative evaluation of acetabular cup position during anterior approach total hip arthroplasty: are we accurately interpreting?
Authors: Delagrammaticas Dimitri E , Ochenjele George , Rosenthal Brett D , Assenmacher Benjamin , Manning David W , Stover Michael D 
Published: August 2019

Introduction: Intraoperative radiographic evaluation during total hip arthroplasty (THA) has shown to improve the accuracy of acetabular component placement, however, differences in interpretation based on radiographic technique has not been established. This study aims to determine if differences exist in the interpretation of acetabular component abduction and anteversion between different radiographic projections. Methods: 55 consecutive direct anterior THAs in 49 patients were prospectively enrolled. Target anteversion and abduction was defined by the Lewinnek zone. Fluoroscopy was used to direct acetabular component placement intraoperatively. After final cup implantation, fluoroscopic posterior-anterior hip and pelvis images were obtained for analysis. After completion of the procedure, an anterior-posterior plain pelvis radiograph was obtained in the operating room. Acetabulum component abduction and anteversion were postoperatively determined using specialised software on each of the 3 image acquisition methods. Results: Average acetabular cup abduction for intraoperative fluoroscopic posterior-anterior hip (FH), intraoperative fluoroscopic posterior-anterior pelvis (FP), and postoperative, standard, anteroposterior pelvis radiographs (PP) was 40.95° ± 2.87°, 38.87° ± 3.82° and 41.73° ± 2.96° respectively. The fluoroscopic hip and fluoroscopic pelvis tended to underestimate acetabular cup abduction compared to the postoperative pelvis ( p < 0.001). Average acetabular cup anteversion for FH, FP, and PP was 19.89° ± 4.87°, 24.38° ± 5.31° and 13.36° ± 3.52° respectively. Both the fluoroscopic hip and fluoroscopic pelvis overestimated anteversion compared to the AP pelvis, with a 6.38° greater mean value measurement for FH ( p < 0.001), and an 11° greater mean value measurement for FP ( p < 0.001). Conclusions: Fluoroscopic technique and differences between radiographic projections may result in discrepancies in component position interpretation. Our results support the use of the fluoroscopic posterior-anterior hip as the choice fluoroscopic imaging technique.
Constructing academic identity in the European higher education space: Experiences of early career educational researchers
Authors: Djerasimovic Sanja , Villani Marialuisa 
Published: August 2019

This exploratory paper presents insights from a qualitative interview-based study of the academic identity-building among a group of early career researchers working in the field of education across the European higher education space. Set against a policy background framed by the initiatives in European higher education and research policy, geared towards a production of a mobile, entrepreneurial researcher in pursuit of ‘valuable’ knowledge, the respondents’ narratives reveal individual complexity, but also emerging patterns of professional identification. We identify the traditional academic values of creating and sharing knowledge validated by an epistemic community, and pursuing autonomy and collegiality in research, as still dominant, however, find these interacting with the demonstration of a strong proactive, entrepreneurial spirit, and a lack of institutional attachment. The narratives indicate the availability of supportive, encouraging communities as being of high significance, and contest the notions of Europeanisation and the utility of geographic mobility in researchers’ identities. The paper discusses different types of academic identification driven by value orientation and social attachment that emerged from the early career researchers’ interviews, alongside pervasive issues around mobility raised in most narratives, and concludes with suggestions for further study.
Microtubules: Evolving roles and critical cellular interactions
Authors: Logan Caitlin M , Menko A Sue 
Published: August 2019

Microtubules are cytoskeletal elements known as drivers of directed cell migration, vesicle and organelle trafficking, and mitosis. In this review, we discuss new research in the lens that has shed light into further roles for stable microtubules in the process of development and morphogenesis. In the lens, as well as other systems, distinct roles for characteristically dynamic microtubules and stabilized populations are coming to light. Understanding the mechanisms of microtubule stabilization and the associated microtubule post-translational modifications is an evolving field of study. Appropriate cellular homeostasis relies on not only one cytoskeletal element, but also rather an interaction between cytoskeletal proteins as well as other cellular regulators. Microtubules are key integrators with actin and intermediate filaments, as well as cell–cell junctional proteins and other cellular regulators including myosin and RhoGTPases to maintain this balance.Impact statementThe role of microtubules in cellular functioning is constantly expanding. In this review, we examine new and exciting fields of discovery for microtubule’s involvement in morphogenesis, highlight our evolving understanding of differential roles for stabilized versus dynamic subpopulations, and further understanding of microtubules as a cellular integrator.
A win ratio approach to the re-analysis of Multiple Risk Factor Intervention Trial
Authors: Kotalik Ales , Eaton Anne , Lian Qinshu , Serrano Carlos , Connett John , Neaton James D 
Published: August 2019

Background: Composite outcomes, which combine multiple types of clinical events into a single outcome, are common in clinical trials. The usual analysis considers the time to first occurrence of any event in the composite. The major criticisms of such an approach are (1) this implicitly treats the outcomes as if they were of equal importance, but they often vary in terms of clinical relevance and severity, (2) study participants often experience more than one type of event, and (3) often less severe events occur before more severe ones, but the usual analysis disregards any information beyond that first event. Methods: A novel approach, referred to as the win ratio, which addresses the aforementioned criticisms of composite outcomes, is illustrated with a re-analysis of data on fatal and non-fatal cardiovascular disease time-to-event outcomes reported for the Multiple Risk Factor Intervention Trial. In this trial, 12,866 participants were randomized to a special intervention group ( n = 6428) or a usual care ( n = 6438) group. Non-fatal outcomes were ranked by risk of cardiovascular disease death up to 20 years after trial. In one approach, participants in the special intervention and usual care groups were first matched on coronary heart disease risk at baseline and time of enrollment. Each matched pair was categorized as a winner or loser depending on which one experienced a cardiovascular disease death first. If neither died of cardiovascular disease causes, they were evaluated on the most severe non-fatal outcome. This process continued for all the non-fatal outcomes. A second win ratio statistic, obtained from Cox partial likelihood, was also estimated. This statistic provides a valid estimate of the win ratio using multiple events if the marginal and conditional survivor functions of each outcome satisfy proportional hazards. Loss ratio statistics (inverse of win ratios) are compared to hazard ratios from the usual first event analysis. A larger 11-event composite was also considered. Results: For the 7-event cardiovascular disease composite, the previously reported first event analysis based on 581 events in the special intervention group and 652 events in the usual care group yielded a hazard ratio (95% confidence interval) of 0.89 (0.79–0.99), compared to 0.86 (0.77–0.97) and 0.91 (0.81–1.02) for the severity ranked estimates. Results for the 11-event composite also confirmed the findings of the first event analysis. Conclusion: The win ratio analysis was able to leverage information collected past the first experienced event and rank events by severity. The results were similar to and confirmed previously reported traditional first event analysis. The win ratio statistic is a useful adjunct to the traditional first event analysis for trials with composite outcomes.
Effect of Injury Prevention Programs on Lower Extremity Performance in Youth Athletes: A Systematic Review
Authors: Hanlon Colleen , Krzak Joseph J. , Prodoehl Janey , Hall Kathy D. 
Published: August 2019

Background: Understanding how existing youth injury prevention programs affect specific modifiable injury risk factors will inform future program development for youth athletes. Objective: To comprehensively evaluate the effects of injury prevention programs on the modifiable intrinsic risk factors associated with lower extremity performance in youth athletes. Data Sources: This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A systematic search of the literature was performed using multiple databases (PubMed, EBSCOhost [including CINAHL, Medline, and SPORTDiscus], and PEDro). Secondary references were appraised for relevant articles. Article types included randomized or cluster randomized controlled trials and randomized cohort designs with youth athletes engaged in organized sports, along with outcomes that included at least 1 physical performance outcome measure. Study Selection: Eight studies met inclusion and exclusion criteria and were reviewed by 2 independent reviewers, with a third consulted in the case of disagreement, which was not needed. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Included studies underwent review of methodological quality using the Physiotherapy Evidence Database scale. Results: Studies included mixed-sex samples of youth athletes who predominantly participated in soccer at different skill levels. The FIFA 11+ series was the most commonly used injury prevention program. Among studies, the mean percentage of improvement identified was 11.3% for force generation, 5.7% for coordination, 5.2% for posture, and 5.2% for balance. The lowest mean percentage improvement was in speed (2.2%). Endurance was not significantly affected by any of the programs. Conclusion: This systematic review shows that injury prevention programs improve several modifiable intrinsic risk factors of lower extremity performance among youth athletes, particularly force generation. However, several intrinsic risk factors were either not significantly affected or specifically addressed by existing programs.
Use of Ayurveda in the Treatment of Type 2 Diabetes Mellitus
Authors: Gordon Allison , Buch Zankhana , Baute Vanessa , Coeytaux Remy 
Published: August 2019

Background Ayurveda is an ancient medicine practice that is emerging in the United States as a complementary and alternative treatment for chronic illness. Type 2 diabetes is a chronic illness that has major long-term implications for individuals suffering from the disease as well as the health-care system as a whole. Modifications in diet, exercise, and lifestyle are all important factors in successful treatment of type 2 diabetes and are incorporated into the ancient Indian medicinal practice of Ayurveda. Review Summary: This review summarizes the available evidence for the use of Ayurvedic therapies in the treatment of type 2 diabetes. For the treatment of type 2 diabetes, Ayurvedic practices primarily emphasizes the use of herbal supplements; however, exercise, weight management, and various supplemental procedures are included in Ayurvedic practices. The goal of Ayurvedic practices on the treatment of type 2 diabetes like in Western medicine focuses on bringing the hemoglobin A1c (HbA1c) value into a therapeutic range. Where Ayurveda differs is that it looks at the functionality of a person in the context of striking a balance between the life forces or doshas that each individual possesses. Finally, this article includes a case study received from AyurVAID clinic in Bangalore, India that details the specific Ayurvedic intervention used in a patient, bringing his HbA1c from a level of 11.2 to 5.7 over the course of 9 months. Conclusion Patients with type 2 diabetes may inquire about current complementary and alternative therapies available for the treatment of their disease. Awareness of such modalities is necessary for effective patient counseling and care. The benefits of offering a wide array of treatment options include possible reduction of HbA1c and of comorbidities with adjunct use of supplements and mind–body practices.
Factors Influencing Patient Satisfaction After Decompression Surgery Without Fusion for Lumbar Spinal Stenosis
Authors: Ogura Yoji , Kobayashi Yoshiomi , Shinozaki Yoshio , Kitagawa Takahiro , Yonezawa Yoshiro , Takahashi Yoshiyuki , Yoshida Kodai , Yasuda Akimasa , Ogawa Jun 
Published: August 2019

Study Design: Retrospective cohort study. Objectives: Decompression without fusion is a standard surgical treatment for lumbar spinal stenosis (LSS) with reasonable surgical outcomes. Nevertheless, some studies have reported low patient satisfaction (PS) following decompression surgery. The cause of the discrepancy between reasonable clinical outcomes and PS is unknown; moreover, the factors associated with PS are expected to be complex, and little is known about them. This study aimed to identify satisfaction rate and to clarify the factors related to PS following decompression surgery in LSS patients. Methods: We retrospectively reviewed 126 patients who underwent lumbar decompression with a minimum follow-up of 1 year. Patients were divided into 2 groups based on the PS question. The Japanese Orthopaedic Association (JOA) scores, and the Numeric Rating Scale (NRS) scores of low back pain (LBP), leg pain, and leg numbness were compared between the 2 groups preoperatively and at the latest visit. To identify the prognostic factors for dissatisfaction, multiple logistic regression analysis was performed. Results: Overall satisfaction rate was 75%. The JOA recovery rate, NRS improvement, and Short Form–8 (SF-8) were significantly higher in the satisfied group. Postoperative NRS scores of LBP, leg pain, and leg numbness were significantly lower in the satisfied group. Multivariate logistic regression analysis showed that smoking and scoliosis were significant risk factors for dissatisfaction. Conclusions: Overall satisfaction rate was 75% in patients with LSS undergoing decompression surgery. This study found that smoking status and scoliosis were associated with patient dissatisfaction following decompression in LSS patients.
On the Need to Revisit the Ethical Structure of Economics in the Light of Advaita Vedānta
Authors: Sivakumar K. S. 
Published: August 2019

The ethical structure of economics, based on the standard of economic maximization of satisfaction, explains all kinds of behaviour in terms of maximization of self-interest. This paper shows that interventions from the philosophy of Advaita Vedānta would enable economics to recognize and accommodate, within its ethical structure, the important role played by altruistic and moral commitments in the decision-making deliberations of individuals. The concept-based paper deduces the primary or basic causes for the limitations in the ethical structure of economics and, in this background, expounds the ethical philosophy of Advaita Vedānta, its important takeaways and implications for the ethical structure of economics. The ethical ideal offered by Advaita Vedānta, unlike that of economics, is based on the standard of self-purification through intention/duty. The ideal is neither committed to the naturalistic fallacy (the identification of the ‘good’ with ‘satisfaction/pleasure’) nor upholds a position of maximization of consequences. By incorporating the perspectives of Advaita Vedānta into the ethical structure of economics, we may evolve an ethical standard that would exhibit, among other factors, the following implications: (a) the ethical standard would enlarge the scope of economics, without dismantling the present ethical structure of economics; (b) economic models built based on such an ethical standard would not only be comprehensive theoretical models and empirically- verifiable practical models, but more importantly, ethically-validated holistic models as well; and (c) the ethical standard and the models build upon it would also enrich other disciplines like management science, commerce, etc., which also share the strategies and models of economics.
The JAK/STAT pathway is activated in systemic sclerosis and is effectively targeted by tofacitinib
Authors: Wang Wenxia , Bhattacharyya Swati , Marangoni Roberta Goncalves , Carns Mary , Dennis-Aren Kathleen , Yeldandi Anjana , Wei Jun , Varga John 
Published: August 2019

Rationale: Fibrosis leads to failure of the skin, lungs, and other organs in systemic sclerosis; accounts for substantial morbidity and mortality; and lacks effective therapy. Myofibroblast activation underlies organ fibrosis, but the key extracellular cues driving persistence of the process remain incompletely characterized. Objectives: The objectives were to evaluate activation of the IL6/JAK/STAT axis associated with fibrosis in skin and lung biopsies from systemic sclerosis patients and effects of the Food and Drug Administration–approved JAK/STAT inhibitor, tofacitinib, on skin and lung fibrosis in animal models. Methods: Bioinformatic analysis showed that IL6/JAK/STAT3 and tofacitinib gene signatures were aberrant in biopsies from systemic sclerosis patients in four independent cohorts. The results were confirmed by JAK and STAT3 phosphorylation in both skin and lung biopsies from patients with systemic sclerosis. Furthermore, treatment of mice with the selective JAK inhibitor tofacitinib not only prevented bleomycin-induced skin and lung fibrosis but also reduced skin fibrosis in TSK1/+ mice. Conclusion: These findings implicate the JAK/STAT pathway in systemic sclerosis skin and lung fibrosis and identify tofacitinib as a potential antifibrotic agent for the treatment of systemic sclerosis and other fibrotic diseases.
Insights into determinants of spleen injury in sickle cell anemia
Authors: El Hoss Sara , Cochet Sylvie , Marin Mickaël , Lapouméroulie Claudine , Dussiot Michael , Bouazza Naïm , Elie Caroline , de Montalembert Mariane , Arnaud Cécile , Guitton Corinne , Pellegrino Béatrice , Odièvre Marie Hélène , Moati Frédérique , Le Van Kim Caroline , Aronovicz Yves Colin , El Nemer Wassim , Brousse Valentine 
Published: August 2019

AbstractSpleen dysfunction is central to morbidity and mortality in children with sickle cell anemia (SCA). The initiation and determinants of spleen injury, including acute splenic sequestration (ASS) have not been established. We investigated splenic function longitudinally in a cohort of 57 infants with SCA enrolled at 3 to 6 months of age and followed up to 24 months of age and explored the respective contribution of decreased red blood cell (RBC) deformability and increased RBC adhesion on splenic injury, including ASS. Spleen function was evaluated by sequential 99mTc heated RBC spleen scintigraphy and high-throughput quantification of RBCs with Howell-Jolly bodies (HJBs). At 6 and 18 months of age, spleen filtration function was decreased in 32% and 50% of infants, respectively, whereas the median %HJB-RBCs rose significantly (from 0.3% to 0.74%). An excellent correlation was established between %HJB-RBCs and spleen scintigraphy results. RBC adhesion to laminin and endothelial cells increased with time. Adhesion to endothelial cells negatively correlated with splenic function. Irreversibly sickled cells (ISCs), used as a surrogate marker of impaired deformability, were detected at enrollment and increased significantly at 18 months. %ISCs correlated positively with %HJB-RBCs and negatively with splenic uptake, indicating a relationship between their presence in the circulation and spleen dysfunction. In the subgroup of 8 infants who subsequently experienced ASS, %ISCs at enrollment were significantly higher compared with the asymptomatic group, suggesting a major role of impaired deformability in ASS. Higher levels of %HJB-RBCs were observed after the occurrence of ASS, demonstrating its negative impact on splenic function.