Assessing Correlations Between Radiographic Classification and Patient-Reported Outcome Measures for Symptomatic Thumb Carpometacarpal Osteoarthritis

Purpose: Clinicians routinely use the Eaton-Glickel radiographic classification to stage severity of thumb carpometacarpal osteoarthritis (CMC OA). Our purpose was to evaluate correlations between baseline radiographic stages and prospectively collected patient-reported outcome measures (PROMs) for CMC OA. Methods: This is a retrospective review of prospectively collected data from a larger observational study of patients aged 35–85 years with newly symptomatic thumb CMC OA. Patients with bilateral presentation complete PROMs for each side. We identified patients with adequate radiographs available for review and who had completed baseline PROMs. PROMs were collected electronically and included the Brief Michigan Hand Questionnaire and visual analog/numerical rating scales regarding pain as well as Patient-Reported Outcomes Measurement Information System Pain Interference v1.1 and Global Health modules. We recorded participants’ demographics, medical and surgical history, prior treatments, and PROM scores at initial presentation. A medical student was first taught by a fellowship-trained hand surgeon on Eaton-Glickel radiographic staging. They each then independently staged the first 40 series of radiographs. After establishing adequate reliability, the student staged the remaining available radiographic series. We used Cohen’s Kappa analyses to determine intrarater reliability and interrater reliability. We used Spearman's rho to assess correlations between PROM scores and radiographic stages. Results: Adequate radiographs and baseline PROMs were retrievable for 85 patients (64 unilateral, 21 bilateral) for a total of 106 series of radiographs. The student's intrarater reliability was moderate, whereas the surgeon’s was substantial. Their interrater reliabilities were moderate (all P < .05). We found no significant correlations between any PROMs and radiographic staging. Conclusions: Our study adds to growing evidence that radiographic severity for thumb CMC OA does not correlate with validated PROMs. It is becoming clearer that objective measures of CMC OA severity do not fully capture the way patients experience this condition. Type of study/level of evidence: Therapeutic IV

Development and Assessment of the Curtis Thumb Carpometacarpal Osteoarthritis Radiographic Classification

Purpose: Given the availability of modern digital imaging and measurement technologies, we hypothesized we could improve precision and reliability for radiographic classification of thumb carpometacarpal osteoarthritis (CMC OA). Methods: We developed our Curtis CMC classification with literature reviews and input from several hand surgeons at our center. We designed the scheme to allow embedding of the Eaton-Glickel system to facilitate cross-use and comparisons. We applied specific digital imaging measurements to radiographic criteria as well as discrete cutoffs between stages. We conducted a retrospective review of consecutive patients aged 35–85 in our CMC registry. Eligible patients presented with symptomatic thumb CMC OA with no prior nonsurgical care within the past year and no history of CMC surgery. We identified those with adequate digital radiographs within 1 year of baseline presentation that were available for review. A board-certified orthopedic hand surgeon and an instructed medical student independently classified 40 series of radiographs using the Curtis and Eaton-Glickel classifications. One week later, they independently repeated the classifications to determine intra-/interrater reliabilities. Results: For the Eaton-Glickel classification intrarater reliability assessments, there was moderate agreement for the medical student and substantial agreement for the hand surgeon. For the Curtis classification intrarater assessments there was substantial agreement for student and surgeon. Regarding interrater reliability between the student and surgeon, the Eaton-Glickel classification had moderate agreement for the initial and 1-week evaluations. The Curtis classification had almost perfect interrater agreement for the initial determinations and substantial agreement for the 1-week measures. Conclusions: The Curtis CMC classification has potential to improve rater reliability for grading OA radiographic severity. Its use of precise digital imaging technology measurements could aid research and care paradigms. Future studies are needed for independent verification of our findings and to evaluate these measures in relation to clinical outcomes. Type of study/level of evidence: Diagnostic II

Ultrastructure of male reproductive system of Eurydema ventrale

The male reproductive system of Eurydema ventrale Kolenati 1846 is studied morphologically and histologically by using light, scanning and transmission electron microscopes. The reproductive system of the male E.ventrale consists of a pair of testis, a pair of vas deferens, a pair of seminal vesicles, accessory glands, a bulbus ejaculatorius, a pair of ectodermal sacs, and a ductus ejaculatorius. The testicular follicles have three different development zones (growth zone, maturation zone, and differentiation zone). The testes are connected to the seminal vesicles by the vas deferens that is a specialized in sperm storage. Sperm have an elongated head and a tail (flagellum) with an axonema and two mitochondrial derivatives. Vas deferens and seminal vesicles are fine, long, and cylindrical. The seminal vesicle is connected with bulbus ejaculatorius, which is balloon shaped and surrounded with accessory glands. The bulbus ejaculatorius is continuous with ductus ejaculatorius which is connected to the aedeagus. Microsc. Res. Tech. 78:643-653, 2015. (c) 2015 Wiley Periodicals, Inc

Hematological, serum biochemical, and immunological responses in common carp (Cyprinus carpio) exposed to phosalone

This study was conducted to investigate the effects of sublethal phosalone concentrations on the hematological, serum biochemical, and immunological responses of carp (Cyprinus carpio). The fish were semi-statically exposed to low (0.15 mg/L), medium (0.3 mg/L), and high (0.6 mg/L) phosalone concentrations for 14 days. Results showed that the hematological variables red blood cell count (RBC, ×106/mm3), white blood cell count (×103/mm3), hematocrit (Hct, %), hemoglobin (Hb) concentration (g/dL), corpuscular volume mean (MCV, ?m3), corpuscular Hb mean (MCH, pg), and mean corpuscular Hb concentration (MCHC, %) were significantly affected by phosalone concentrations. In addition, white blood cell types (neutrophil, lymphocyte, and monocyte) were also affected. Furthermore, serum proteins, metabolites, lipids, enzymes, and electrolytes were significantly altered by different phosalone concentrations. Nitroblue tetrazolium (NBT), lysozyme, and myeloperoxidase activities significantly altered treatment with phosalone concentrations. As a result, phosalone resulted in significant physiological and behavioral changes in C. carpio. These changes may potentially impair C. carpio’s survival capability in natural habitats or aquaculture. © 2014, Springer-Verlag London.British Association for Psychopharmacology, BAP, (2010/80); Çanakkale Onsekiz Mart University Scientific Foundatio

Vitamin E and Sodium Selenite Against Mercuric Chloride-Induced Lung Toxicity in the Rats

The aim of the present study was to elucidate the possible protective role of vitamin E and / or sodium selenite on mercuric chloride-induced oxidative stress and histopathological changes in the lung tissue of the rats. Adult male albino Wistar rats were exposed to mercuric chloride (1.0 mg/kg day) for four weeks. Treatment with mercuric chloride led to oxidative stress by enhancing MDA level and also decreasing superoxide dismutase (SOD), catalase (CAT) glutathione peroxidase (GPx) and glutathione S transferaz (GST) activities. However, mercuric chloride exposure resulted in histopathological changes in the lung tissue in the rats. MDA level and SOD, CAT GPx and GST activities and histopathological changes modulated in concomitantly supplementation of vitamin E (100 mg/kg day) and /or sodium selenite (0.25 mg/kg day) to mercuric chloride-treated groups

Cancer Stem Cells: An Innovative Therapeutic Approach

Cancer stem cells (CSCs) are gaining prominence in oncology. The characterization of the molecular phenotype of CSCs or \u201ccancer cell-like stem cells\u201d can clarify several intriguing and obscure aspects of cancer pathophysiology (e.g., cancer cell dormancy, chemoresistance and metastasis) and could represent a fundamental advance in terms of early diagnosis and selective therapy for cancer. Moreover, understanding the underlying pathogenetic mechanisms of CSCs can expand the therapeutic applications of normal adult stem cells by reducing the risk of disordered uncontrolled and potentially tumorigenic stem cell differentiation. An explosion of emerging therapeutic and diagnostic options for cancer treatment that selectively target CSCs has occurred in recent years. These include the targeting of cell surface proteins, various activated signaling pathways, different molecules of the stem cell niche and various drug resistance mechanisms. Importantly, approaching cancer research by investigating the pathogenesis of these intriguing cancer cells is increasing the knowledge of the pathophysiology of the disease, emphasizing certain concepts and molecular mechanisms that have been partially neglected and facilitating the understanding of a global vision of complex cancer cell biology

The Effectiveness of CSR’s Approaches: Before Practice or Theory? Insights from Italian Corporate Territorial Responsibility Projects

The work proposes an overview of the process and the models relative to the diffusion of CSR and sustainability based on a public-private involvement. The multilevel and multidimensional approach to CSR and sustainable growth can be interpreted as a specific model of territorial social responsibility which is based on the rise of paths of local governance and social innovation whose protagonists are members of a localized network. Starting from these premises and drawing from the reflections developed in previous works this paper intends to add new perspectives on the current debate by presenting a comparative analysis based on Italian case-studies related to CSR and sustainability-driven best practices which are being developed in two Italian areas (notably the Marches and Emilia Romagna Regions). The selected projects started even before the discussion on multilevel and territorial governance begun at the national and international level and they are highly innovative and dynamic since over the years their objectives have become progressively enriched and adapted. Using a qualitative-based approach the empirical analysis focuses on both the weaknesses and strengths, as well as on the similarities and differences of these bottom-up approaches of territorial responsibility and sustainability. Findings underline the effectiveness of approaches and tools which are not disconnected from specific local (anthropological, cultural and socio-economic) dynamics. Territorial pathways of CSR and sustainability seem more suited to lead and preserve sustainability over time. Accordingly , in the analysis of sustainable development processes, a priority should be attributed to the territorial dimension since it contains all combined factors (human and environmental resources, entrepreneurial and social creativity) which generate processes of social innovation. At the same time, these innovative pathways that are capable of generating social innovation underline the urgency of new theoretical constructs which take into account a maturity model of CSR/sustainability based on different stages and actors involved in CSR and sustainability-oriented projects. The chapter is organized into three main sections: the first presents the theoretical framework, the second describes the empirical analysis, while discussion and conclusions summarize the main theoretical propositions and empirical implications of the present research and offer insights useful for further investigation

Authenticity: Is Corporate Social Responsibility the Key to Overcoming Crisis?

The paper aims to develop within the theoretical and normative perspective the concept of the “golden rule” of authentic CSR-driven strategy as a necessary path to overcoming the financial crisis. To this end, firstly a critical review is provided of the recent Encyclical Letter (Pope Francis, Laudato Sì, 2015) focusing on the care of our “common home” that emphasizes the complexity of the crisis and suggests the path to overcoming the crisis through a renewed environmental, economic and social ecology. Secondly, the work provides the business context with a series of examples related to companies which in “hard times” voluntarily persist in investing in CSR (Corporate Social Responsibility) activities conceived as an effective and leading way to building the future and replying to the current and future crises. The work intends to feed the scientific debate on the opportunity to focus attention on the origins of entrepreneurial and managerial behaviors that have lead to the crisis and the need for a profound rethinking of the business conduct. Moreover, it provides examples to the corporate world by observing the validity of the strategic and operational behaviors that are based on a durable and tough CSR orientation as well as on an authentic socio-responsibility driven decision-making process