bluuebunny/crossref_metadata_2025 huggingface dataset:
Clean Colorectum at Diagnostic Colonoscopy: Subsequent Detection of Extracolonic Malignancies by Plasma Protein Biomarkers?
Authors: Wilhelmsen Michael , Christensen Ib J , Jørgensen Lars N , Madsen Mogens R , Vilandt Jesper , Hillig Thore , Klærke Michael , Nielsen Knud T , Laurberg Søren , Gawel Susan , Yang Xiaoping , Davis Gerard , Heijboer Anne Meike , Martens Frans , Nielsen Hans J
Published: May 2018

Introduction:

Most of the subjects undergoing diagnostic colonoscopy do not have neoplastic bowel lesions. Potentially, some of the symptoms may therefore be caused by extracolonic malignancy, and subjects with persisting symptoms may need subsequent examinations. Blood-based, cancer-associated biomarkers may aid in directing the examinations for other specific malignant diseases.

Methods:

EDTA plasma samples available from a previous prospective study of subjects undergoing diagnostic colonoscopy were used for analysis of 18 protein biomarkers. The study population of 3732 subjects included 400 patients with colorectal cancer (CRC) and 177 patients with extracolonic malignancies. Univariable analysis of the association of specific biomarkers and extracolonic cancers included those with 10 or more cases. Subsequently, reduced models of 4 or 6 biomarkers, respectively, were established by choosing those with the highest likelihood; age and sex were included as well.

Results:

Univariable analyses showed that CyFra21-1 had an area under curve (AUC) of 0.87 for lung cancers (n = 33), CA19-9 had an AUC of 0.85 for pancreatic cancer (n = 22), CA125 had an AUC of 0.95 for ovary cancer (n = 16), B2M had an AUC of 0.81 for non-Hodgkin lymphoma (n = 12), and total prostate-specific antigen had an AUC of 0.99 for prostate cancer (n = 10). The multivariable analysis of 4 or 6 biomarkers plus age and sex as explanatory variables showed AUCs of 0.82 to 0.85 both for extracolonic cancers and CRC. The 4 biomarkers included in the model for detection of extracolonic cancers were CA125, hsCRP, CA19-9, and CyFra21-1; the 2 additional for the 6 biomarkers model were CEA and Galectin-3. Similarly, the 4 biomarkers included in the model for detection of CRC were CEA, CyFra21-1, Ferritin, and HE4; the two additional for the 6 biomarkers model were hsCRP and Pepsinogen 2.

Conclusions:

Results of this study indicate that it may be possible to detect subjects that have an increased risk of extracolonic cancer following a colonoscopy without findings of neoplastic lesions. Combinations of various protein biomarkers may direct subsequent examination after colonoscopy with clean colorectum. The results, although preliminary, may form the basis for additional research directed both for primary examinations of subjects with symptoms of malignancy and subsequent examinations after colonoscopy.
Climate adaptation in the Anthropocene: Constructing and contesting urban risk regimes
Authors: Wissman-Weber Nichole K , Levy David L
Published: May 2018

The Anthropocene heralds a new era of heightened and unknown risks, particularly regarding the impacts of climate change. This article explores the initial phase of organizing for climate adaptation in Boston, Massachusetts, examining how multiple actors, including business, government, and community organization, are interacting as they attempt to comprehend, assess, and act on this issue. To understand this process of organizing, we develop the concept of ‘risk regime’ as a contingently stabilized system with governance, economic, and discursive dimensions. We draw from theories of risk, organizational resilience, and urban regimes and value regimes to develop the ‘risk regime’ framework, which provides a nuanced view of contestation, collaboration, and accommodation among actors with differential interests, knowledge, and influence on the process. We suggest how the character, evolution, and stabilization of the regime is influenced by competing imaginaries regarding, for example, the nature and manageability of risk, the need for radical change, and the role of markets versus regulations in addressing tensions between economic and sustainability goals. We demonstrate that the regime for adaptation has grown out of the organizational and discursive infrastructure for addressing climate mitigation, or carbon control, but that the unique character of adaptation presents different, and perhaps more difficult challenges.
Melodramatic animation in crime news and news information learning
Authors: Cheng Benjamin Ka Lun , Lo Wai Han
Published: May 2018

This study used the dual-coding hypothesis to examine how melodramatic animation in crime news reports affects news learning among older children in Hong Kong. In total, 74 older children (mean age = 15.3) were exposed to news videos that either did or did not include melodramatic animation. The results showed that melodramatic animation helped the participants learn the news. The social implications of the results are discussed.
Feeling ‘like a minority . . . a pathology’: interpreting race from research with African and Caribbean women on violence and abuse
Authors: Kanyeredzi Ava
Published: May 2018

Qualitative researchers are often advised to use their emotional responses to data, and participants’ experiences are understood through those of researchers’, how this process unfolds is less clear. This article is about the role of feelings for the qualitative researcher at different stages of the process and offers strategies for working through, ‘using’ and ‘feeling together with’ participants’ reflections on lived experiences. I interviewed nine African and Caribbean heritage British women about their experiences of violence and abuse where one described feeling ‘like a minority . . . a pathology’. This article describes my responses to experiences of racialised and gendered intrusion in interviews, later reflection and analytic work. The article brings recognition to a stigmatised and hidden process within qualitative interviews and data interpretation. This serves to amplify the impact of injustice and adverse experiences for participants, and researchers, and to a wider audience, and to validate its existence and emotional burden as a legitimate and crucial stage of qualitative data analysis.
The post-secular tourist: Re-thinking pilgrimage tourism
Authors: Nilsson Mats , Tesfahuney Mekonnen
Published: May 2018

The coming of post-secular society has opened up interesting transdisciplinary research and perspectives. Research and academic debates on the post-secular have yet to make inroads into the discipline of tourism studies, which is ironic since there is an intrinsic religiosity to tourism. We table that tourism lies at the core of the post-secular turn and should be studied as such. Likewise, academic debate on post-secularism has not accorded tourism its proper due. This study has two objectives. First, to fill the research gap in studies of tourism and post-secularism and, second, to show that post-secular tourism is one of the key spaces where the post-secular is articulated. This article is based on interviews of pilgrims in the Galicia region (Spain) conducted in 2011, 2012 and 2014. Four major attributes of post-secular tourism were identified: (self-)reflexivity, quest for ontological security, heterodoxy and topos-disloyalty. Our findings indicate that the post-secular tourist transcends conventional dichotomies between religious pilgrimage and tourism, journeying as affirmation of denominational faith and pure leisure. Post-secular tourism is about ontogenesis, that is, it is performative rather than injunctive. It is in this sense that one can speak of post-secular tourism as something open, unfolding and in constant becoming.
Adaptive wavelet transform: Definition, parameter optimization algorithms, and application for concrete delamination detection from impact echo responses
Authors: Qu Hongya , Li Tiantian , Chen Genda
Published: May 2018

In this study, an amplitude-adaptive wavelet transform is proposed and defined as an average of overlapped short-time wavelet transforms with optimized time-varying resolution in a time–frequency domain of interest. A flowchart of two optimization algorithms for time and frequency resolution updating is proposed and developed to determine the wavelet parameters for a desirable time–frequency representation of dynamic responses. Numerical example with two closely spaced, frequency-modulated sinusoids and two closely spaced delta functions indicates that the time and frequency resolution of the proposed method are approximately 7.7 times as uniform as those of the continuous wavelet transform. The end effect of short-time response segments is significantly less than 10% in amplitude except at the beginning and ending of the overall response. When the proposed method is applied to the impact echo responses experimentally recorded from a 60″ × 36″ × 7.25″ concrete slab, this improvement in time and frequency resolution leads to seven more successful detections of deep or shallow delamination of 40 sets of analyzed test data, with the error in estimation of deep delamination depth less than 3%. The selection process of time-varying central frequencies, scaling factors, and window lengths proves robust.
Percutaneous Retrieval of IVC Filters With Struts Penetrating the Vertebral Body
Authors: Mohan Prasoon P. , Richardson Andrew J. , Salsamendi Jason T.
Published: May 2018

Introduction:

Inferior vena cava (IVC) filter penetration of the caval wall is a well-documented complication. Less frequently, the struts of an IVC filter can penetrate a vertebral body that can lead to symptoms of abdominal pain. Vertebral penetration poses a management challenge, and characteristics for successful endovascular retrieval of such filters has not been reported.

Case Description:

We present 2 cases of IVC filters with vertebral body penetration that were successfully retrieved through an endovascular approach. On preprocedure computed tomography, both patients had a small zone of osteolysis surrounding the penetrated struts into the vertebral body. The procedures were done via right internal jugular access using an Ensnare device. In one of the cases, the hangman technique was used to release the filter apex from the vessel wall. Both filters were able to be retrieved without using excessive force, follow-up venacavograms showed no sign of extravasation, and no postprocedure complications developed.

Discussion:

Preprocedure CT imaging is essential prior to IVC filter removal if vertebral penetration is suspected. The zone of osteolysis seen around the struts in both cases are likely the result of constant cardiorespiratory motion of the filter. Based on the fact that in both cases the filter legs were able to be disengaged from the vertebral body without the use of excessive force, we hypothesize that if a zone of osteolysis surrounding the struts can be confirmed on preprocedural CT, the filter removal can be safely attempted by the standard percutaneous endovascular approach.
The Value of Location for Urban Hotels
Authors: Valentin Maxence , O’Neill John W.
Published: May 2018

This study finds that hotel location significantly contributes to the property market value. With a sample of more than 600 hotel sales transactions within the Chicago Metropolitan Statistical Area (MSA), the theory that properties located closer to the city center, that is, the Loop, carry market value premiums is tested and supported by the data. Despite being the predominant spatial value driver for hotels, the effect of proximity to the city center is found to be heterogeneous. An additional mile away from the Loop decreases property value by 13% on average when the hotel is located within the 10 miles from the Loop. However, value decreases at a much lower pace when hotels are located outside this 10-mile buffer. Other spatial variables, such as access to transportation systems and neighborhood dimensions, show that accessibility and environment play a lesser but decisive role in hotel market value. Practitioners and researchers may benefit from these findings mostly when comparing and analyzing hotel market values in a context similar to the urban structure of Chicago.
Prevalence of frailty syndrome and its associated factors among community-dwelling elderly in East Coast of Peninsular Malaysia
Authors: Mohd Hamidin Fairus Asma , Adznam Siti Nur’Asyura , Ibrahim Zuriati , Chan Yoke Mun , Abdul Aziz Nur Hafizah
Published: May 2018

Objective:

Frailty is a clinical syndrome with increased risk of poor health outcomes and particularly prevalent in older adults and community population. The study’s aim was therefore to determine the prevalence of frailty and its association with sociodemographic and socioeconomic characteristics, health-related status, and anthropometric measurements among community-dwelling older adults.

Methods:

A total of 279 older adults aged 60 years and above were randomly selected. Respondents were classified as non-frail (<2 criteria) or frail (≥3 criteria) based on the ‘phenotype of frailty’. A binary logistic regression was used to determine predictors of frailty.

Results:

The prevalence of frailty was 18.3%. The frail older adults were positively associated with advanced age, being unmarried, hospitalisation in the previous year, poor self-rated health, and lower body mass index.

Discussion:

These results give an overview on underlying effects and guiding actions for prevention programmes functioning to reverse and minimise the adverse effects of frailty syndrome.
Prevalence and use of clinical pathways in 23 countries – an international survey by the European Pathway Association
Authors: Vanhaecht Kris , Bollmann Marcus , Bower Kathy , Gallagher Clare , Gardini Andrea , Guezo Jen , jansen Uwe , Massoud Rashad , Moody Karen , Sermeus Walter , Van Zelm Ruben , Whittle Claire , Yazbeck Anne-Marie , Zander Karen , Panella Massimiliano
Published: May 2018

Objectives

To give an overview on the use and prevalence of clinical pathways.

Design

Cross-sectional descriptive study.

Study participants

European Pathway Association (E-P-A) contact persons in 23 countries.

Results

Clinical pathways, also known as critical pathways or integrated care pathways, have been used in health care for 20 years. Although clinical pathways are well established, little information exists on their use and dissemination around the world. The E-P-A has performed their first international survey on the use and dissemination of clinical pathways in 23 countries. At present, pathways are used with a minority of patients, mainly in acute hospital trusts. Our survey showed that clinical pathways were predominantly viewed as a multidisciplinary tool to improve the quality and efficiency of evidence-based care. Pathways were also used as a communication tool between professionals to manage and standardize outcome-oriented care.

Conclusions

There is a future for the use of clinical pathways, but there is a need for international benchmarking and knowledge sharing with regard to their development, implementation and evaluation.
Critical Pathway for Hip and Knee Arthroplasty: Faster Home due to Multidisciplinary Cooperation
Authors: Pilot Peter , Engelen Martin , Dreessen Fer , Van Os Johannes J , Kuipers Harm
Published: May 2018

Clinical pathways (CP) for hip and knee replacements appear to be successful in reducing costs and length of stay in acute care hospitals, with no compromise in patient outcomes. These programmes are proven to score highly on quality indicators as well as providing high patient and healthcare professional satisfaction. We describe the principles, advantages and outcomes of the CP used in our hospital.
Incident Reporting: A Curate's Egg?
Authors: Armitage Gerry , Chapman E Jane
Published: May 2018

Background

Medical errors and adverse events are a source of concern to patients, practitioners and patient safety agencies across the world. The value of incident reporting as a means of improving patient safety has been questioned in the patient safety literature.

Aim

This paper provides a critical appraisal of incident reporting in the British National Health Service (NHS) as its prominence continues to grow at international, national and local levels. A number of implications are considered through reference to the available literature. Both national and local reporting systems will be discussed, before revisiting two key issues: the safety-information capacity of report data compared with medical record review, and the continued low reporting rate of medical staff.

Conclusions

While there are powerful drivers behind incident reporting, all of which have potentially beneficent rationales, a growing number of health-care professionals are beginning to question the usefulness of both reporting processes and outcomes. The authors suggest that an analysis of evidence of action taken to improve patient safety following the reporting of an incident would reveal low levels of activity and that, for many practitioners, the risk management activity is perceived as merely the act of reporting itself. Due to the continuing investment of organizational energy and finance into incident reporting, both at local and national level, it is prudent to reflect upon any uncertainties, so that further developments can be approached with confidence as part of the patient safety imperative.
Intranasal Diamorphine for Paediatric Analgesia in the Accident and Emergency Department: Lessons Learned from the Development, audit and re–audit of an Integrated Care Pathway
Authors: Gahir K K , Ransom P A
Published: May 2018

The objective of this study was to introduce intranasal diamorphine for paediatric analgesia in the Accident and Emergency (A&E) Department and to monitor its use. It was carried out at the A&E Department of a District General Hospital. An integrated care pathway was developed, drawing on both the evidence base for intranasal diamorphine use and extant guidelines for emergency analgesia in the paediatric age group. Implementation, audit and modification of the care pathway were undertaken, followed by re-audit to complete the audit cycle. The integrated care pathway proved easy to use, but audit showed that documentation of parameters of care was inadequate. A clinical proforma was added to the care pathway to ensure adequate data capture, and re-audit showed significant improvement in documentation. In conclusion, this integrated care pathway for the use of intranasal diamorphine for paediatric analgesia may be of general applicability in A&E Departments.
Cultural co-orientation revisited: The case of the South China Morning Post
Authors: Wiebrecht Felix
Published: May 2018

The freedom of press is one aspect that leaders from the West often criticise about China. As former British colony, Hong Kong has been able to preserve its special status with constitutional rights and liberties that also include the freedom of press. However, in recent years, sentiments of increased influence from Beijing have led to fears that it would curb the freedoms enjoyed by residents of the Special Administrative Region. However, instead of clear unambiguous interferences, Beijing has opted for an indirect approach that is predominantly characterised by the salience of economic considerations in reporting news binding the media outlets closer to the position of Beijing. This article shows that the South China Morning Post has undergone an editorial shift that moves it closer to the position of the Chinese government.
Ketogenic Diet in Refractory Childhood Epilepsy
Authors: Weijenberg Amerins , van Rijn Margreet , Callenbach Petra M. C. , de Koning Tom J. , Brouwer Oebele F.
Published: May 2018

Background:

Ketogenic diet in children with epilepsy has a considerable impact on daily life and is usually adopted for at least 3 months. Our aim was to evaluate whether the introduction of an all-liquid ketogenic diet in an outpatient setting is feasible, and if an earlier assessment of its efficacy can be achieved.

Methods:

The authors conducted a prospective, observational study in a consecutive group of children with refractory epilepsy aged 2 to 14 years indicated for ketogenic diet. Ketogenic diet was started as an all-liquid formulation of the classical ketogenic diet, KetoCal 4:1 LQ, taken orally or by tube. After 6 weeks, the liquid diet was converted into solid meals. The primary outcome parameter was time-to-response (>50% seizure reduction). Secondary outcome parameters were time to achieve stable ketosis, the number of children showing a positive response, and the retention rate at 26 weeks.

Results:

Sixteen children were included. Four of them responded well with respect to seizure frequency, the median time-to-response was 14 days (range 7-28 days). The mean time to achieve stable ketosis was 7 days. The retention rate at 26 weeks was 50%. Of the 8 children who started this protocol orally fed, 6 completed it without requiring a nasogastric tube.

Conclusions:

Introduction of ketogenic diet with a liquid formulation can be accomplished in orally fed children without major complications. It allowed for fast and stable ketosis.
Book Review: Pius Malekandathil, Joy L.K. Pachuau, Tanika Sarkar, ed., Christianity in Indian History: Issues of Culture, Power and Knowledge
Authors: Tandon Shivangini
Published: May 2018

Pius Malekandathil, Joy L.K. Pachuau, Tanika Sarkar, ed., Christianity in Indian History: Issues of Culture, Power and Knowledge (New Delhi: Primus Books), 2016, 283 pp., ₹1,750.
State formation and political integration: Subordinate rulers under the Guptas in central India
Authors: Kumar Ashish
Published: May 2018

The Gupta Empire (fourth–fifth centuries ad) succeeded in subjugating a series of local forest chiefs and tribal territories. The Allahabad prashasti not only enumerates the conquests of the Gupta king Samudragupta, but also lays out the hierarchy of the kings equal in status and such as were subordinate to him, in his eyes. The political integration of dispersed political elements under the Guptas was linked with the changing contours of the Gupta authority in central India, on the one hand, and the process of transition from pre-state to state-society, on the other. This process is studied here mainly on the basis of epigraphic evidence.
Mapping the canal system of Fīroz Shāh including an abortive Sarasvati ‘restoration’
Authors: Habib Irfan , Habib Faiz
Published: May 2018

The aim is to collect all information from contemporary and near-contemporary sources about the canals of Fīroz Shāh (reigned 1351–88), so as to map them as accurately as possible. The area involved includes Indian Punjab, Himachal Pradesh, Haryana and western UP. The paper also gives the account of a massive Sarasvati-restoration project, which like its paler modern-day successor (undertaken by the Haryana government), was a total failure.
Response to the intellectual challenge of the West: The evolution of Syed Ahmad Khan’s thought
Authors: Akhtar Shamim
Published: May 2018

Syed Ahmad Khan (1817–98) remains an important figure of the Indian Renaissance. The present essay examines how he came under the influence of Western ideas, and how these influences radicalised his views in respect of religion and science. The essay strives to set Syed Ahmad Khan’s modernisation project in a broad chronological order, stressing the ideological changes he underwent. His political activities especially after 1885, which involved a bruising conflict with the Congress in 1885–86, and later his intervention in the Hindi–Urdu controversy do not lie within the scope of this paper.
Book review: Aslam Pervez, The Life and Poetry of Bahadur Shah Zafar, translated from Urdu by Ather Farouqui
Authors: Aziz Sana
Published: May 2018

Aslam Pervez, The Life and Poetry of Bahadur Shah Zafar, translated from Urdu by Ather Farouqui (Delhi: Hay House India), 2017, 240 pp., ₹599.
Structural and chemical study of weishanite, (Au,Ag,Hg), from the Keystone mine, Colorado, USA.
Authors: Bindi Luca , Keutsch Frank N. , Lepore Giovanni O.
Published: May 2018

Structural data for weishanite, an alloy of Au, Ag and Hg, were collected for the first time from a crystal from the Keystone Mine, Colorado, USA. The structure was solved in the space group P63/mmc with the unit cell a = 2.9348(8) and c = 4.8215(18) Å] and refined to R = 0.0299 for 40 observed reflections [4σ(F) level] and four parameters and to R = 0.0356 for all 47 independent reflections. The weishanite structure can be considered a derivative of the zinc structure, with Au, Ag and Hg disordered in the same structural position. On this basis, we suggest that the formula is normalized to 1 atom with Z = 2, leading, for the sample investigated, to Au0.41Ag0.31Hg0.28 (electron microprobe data). Accordingly, weishanite can be considered the Au-rich isotype of schachnerite. A comparison with other Au/Ag-Hg alloys is presented together with a critical discussion about the nomenclature rules to be applied to alloys and simple metals.
Exceptionally high whole-rock δ18O values in intra-caldera rhyolites from Northeast Iceland
Authors: Berg Sylvia E. , Troll Valentin R. , Harris Chris , Deegan Frances M. , Riishuus Morten S. , Burchardt Steffi , Krumbholz Michael
Published: May 2018

The Icelandic crust is characterized by low δ18O values that originate from pervasive high-temperature hydrothermal alteration by18O-depleted meteoric waters. Igneous rocks in Iceland with δ18O values significantly higher than unaltered oceanic crust (~5.7‰) are therefore rare. Here we report on rhyolitic intra-caldera samples from a cluster of Neogene central volcanoes in Borgarfjörður Eystri, Northeast Iceland, that show whole-rock δ18O values between +2.9 and +17.6‰ (n= 6), placing them among the highest δ18O values thus far recorded for Iceland. Extra-caldera rhyolite samples from the region, in turn, show δ18O whole-rock values between +3.7 and +7.8‰ (n= 6), consistent with the range of previously reported Icelandic rhyolites. Feldspar in the intra-caldera samples (n= 4) show δ18O values between +4.9 and +18.7‰, whereas pyroxene (n= 4) shows overall low δ18O values of +4.0 to +4.2‰, consistent with regional rhyolite values. In combination with the evidence from mineralogy and rock H2O contents, the high whole-rock δ18O values of the intra-caldera rhyolites appear to be the result of pervasive isotopic exchange during subsolidus hydrothermal alteration with18O-enriched water. This alteration conceivably occurred in a near-surface hot spring environment at the distal end of an intra-caldera hydrothermal system, and was probably fed by waters that had already undergone significant isotope exchange with the country rock. Alternatively,18O-enriched alteration fluids may have been produced during evaporation and boiling of standing water in former caldera lakes, which then interacted with the intra-caldera rock suites. Irrespective of the exact exchange processes involved, a previously unrecognized and highly localized δ18O-enriched rock composition exists on Iceland and thus probably within the Icelandic crust too.
Acmonidesite, a new ammonium sulfate chloride from La Fossa crater, Vulcano, Aeolian Islands, Italy
Authors: Demartin Francesco , Castellano Carlo , Campostrini Italo
Published: May 2018

The new mineral acmonidesite, (NH4,K,Pb2+,Na)9Fe42+(SO4)5Cl8, was found in an active fumarole (fumarole FA, temperature ~250°C) at La Fossa crater, Vulcano, Aeolian Islands, Sicily, Italy. It occurs on a pyroclastic breccia as brown prismatic crystals up to 0.10 mm long, in association with salammoniac, alunite and adranosite. The mineral is orthorhombic, space group C2221 (no. 20) with a = 9.841(1), b = 19.448(3) c = 17.847(3) Å, V = 3415.7(9) Å3 and Z = 4. The six strongest reflections in the powder X-ray diffraction pattern are: [dobs in Å(I)(hkl)] 8.766(100)(110), 1.805(88)(390), 5.178(45)(131), 4.250(42)(221), 2.926(42)(330) and 2.684(32)(261). The empirical formula (based on 28 anions per formula unit [pfu]) is (NH4)5.77K1.42Pb0.62Na1.24Fe3.96Mn0.08S5.04O20.16Cl7.97Br0.08. The idealised formula is (NH4,K,Pb2+,Na)9Fe42+(SO4)5Cl8. The calculated density is 2.551 g cm–3. Using single-crystal diffraction data, the structure was refined to a final R(F) = 0.0363 for 4614 independent observed reflections [I > 2σ(I)]. The structure contains two independent, distorted octahedral iron sites, Fe1 and Fe2, with the iron atoms in the 2+ oxidation state, as confirmed by the interatomic distances and bond-valence calculations (2.06 and 1.94 vu, respectively). Fe1 is surrounded by two chlorine atoms and four oxygens of the sulfate ions, with the following average distances (Å): Fe1–O 2.125 and Fe1–Cl 2.472; and Fe2 is surrounded by three chlorine atoms and three oxygens of the sulfate ions, with the following average distances (Å): Fe2–O 2.110 and Fe2–Cl 2.531. Three independent sulfate anions are also present and are connected with the iron polyhedra to form a three-dimensional structure containing voids occupied by four independent ammonium ions (two of them partially replaced by K+), one Na+/Pb2+ site and one Cl– ion.
Lineage tracing of murine adult hematopoietic stem cells reveals active contribution to steady-state hematopoiesis
Authors: Chapple Richard H. , Tseng Yu-Jung , Hu Tianyuan , Kitano Ayumi , Takeichi Makiko , Hoegenauer Kevin A. , Nakada Daisuke
Published: May 2018

Key Points

HSCs contribute robustly to steady-state hematopoiesis. Platelets receive extensive influx from HSCs compared with other myeloid or lymphoid cells.
Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies
Authors: Ferkol Thomas W. , Farber Harold J. , La Grutta Stefania , Leone Frank T. , Marshall Henry M. , Neptune Enid , Pisinger Charlotta , Vanker Aneesa , Wisotzky Myra , Zabert Gustavo E. , Schraufnagel Dean E.
Published: May 2018

Children and adolescents are highly susceptible to nicotine addiction, which affects their brain development, even in those who smoke infrequently. Young people who become addicted to nicotine are at greater risk of becoming lifelong tobacco consumers. The use of nicotine-delivering electronic cigarettes has risen dramatically among youths worldwide. In addition to physical dependence, adolescents are susceptible to social and environmental influences to use electronic cigarettes. The product design, flavours, marketing, and perception of safety and acceptability have increased the appeal of electronic cigarettes to young people, thus leading to new generations addicted to nicotine. Moreover, there is growing evidence that electronic cigarettes in children and adolescents serve as a gateway to cigarette smoking. There can be no argument for harm reduction in children. To protect this vulnerable population from electronic cigarettes and other nicotine delivery devices, we recommend that electronic cigarettes be regulated as tobacco products and included in smoke-free policies. Sale of electronic cigarettes should be barred to youths worldwide. Flavouring should be prohibited in electronic cigarettes, and advertising accessible by youths and young adults be banned. Finally, we recommend greater research on the health effects of electronic cigarettes and surveillance of use across different countries.
Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update
Authors: Wolff Antonio C. , Hammond M. Elizabeth Hale , Allison Kimberly H. , Harvey Brittany E. , Mangu Pamela B. , Bartlett John M.S. , Bilous Michael , Ellis Ian O. , Fitzgibbons Patrick , Hanna Wedad , Jenkins Robert B. , Press Michael F. , Spears Patricia A. , Vance Gail H. , Viale Giuseppe , McShane Lisa M. , Dowsett Mitchell
Published: May 2018

Purpose

To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists human epidermal growth factor receptor 2 (HER2) testing in breast cancer guideline.

Methods

Based on the signals approach, an Expert Panel reviewed published literature and research survey results on the observed frequency of less common in situ hybridization (ISH) patterns to update the recommendations.

Recommendations

Two recommendations addressed via correspondence in 2015 are included. First, immunohistochemistry (IHC) 2+ is defined as invasive breast cancer with weak to moderate complete membrane staining observed in > 10% of tumor cells. Second, if the initial HER2 test result in a core needle biopsy specimen of a primary breast cancer is negative, a new HER2 test may (not “must”) be ordered on the excision specimen based on specific clinical criteria. The HER2 testing algorithm for breast cancer is updated to address the recommended work-up for less common clinical scenarios (approximately 5% of cases) observed when using a dual-probe ISH assay. These scenarios are described as ISH group 2 ( HER2/chromosome enumeration probe 17 [CEP17] ratio ≥ 2.0; average HER2 copy number < 4.0 signals per cell), ISH group 3 ( HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 6.0 signals per cell), and ISH group 4 ( HER2/CEP17 ratio < 2.0; average HER2 copy number ≥ 4.0 and < 6.0 signals per cell). The diagnostic approach includes more rigorous interpretation criteria for ISH and requires concomitant IHC review for dual-probe ISH groups 2 to 4 to arrive at the most accurate HER2 status designation (positive or negative) based on combined interpretation of the ISH and IHC assays. The Expert Panel recommends that laboratories using single-probe ISH assays include concomitant IHC review as part of the interpretation of all single-probe ISH assay results. Find additional information at www.asco.org/breast-cancer-guidelines .
Phentolamine Reverses Epinephrine-Enhanced Skin Antinociception of Dibucaine in Rats
Authors: Chou An-Kuo , Chiu Chong-Chi , Chen Yu-Wen , Wang Jhi-Joung , Hung Ching-Hsia
Published: May 2018

BACKGROUND:

The objective of the experiment was to assess the antinociceptive effect of dibucaine, bupivacaine, and epinephrine. To assess the mechanism of action of the interaction between dibucaine and epinephrine, phentolamine, a nonselective α-adrenergic antagonist, was added to the mixture.

METHODS:

We assessed sensory blockade with these drugs by injecting 0.6 mL of drug-in-saline in the dorsal thoracolumbar area of rats; pinprick of the “wheal” formed by the injectate was the area targeted for stimulation to elicit a cutaneous trunci muscle reflex. The sensory block of dibucaine was compared with that of bupivacaine or epinephrine. Drug–drug interactions were analyzed by isobologram. Phentolamine was added to investigate the antinociceptive effect of dibucaine coinjected with epinephrine.

RESULTS:

We demonstrated that dibucaine, epinephrine, and bupivacaine produced dose-dependent skin antinociception. On the median effective dose (ED50) basis, the potency was higher for epinephrine (mean, 0.011 [95% confidence interval {CI}, 0.007–0.015] μmol) than for dibucaine (mean, 0.493 [95% CI, 0.435–0.560] μmol) (P < .01), while there were no significant differences between dibucaine and bupivacaine (mean, 0.450 [95% CI, 0.400–0.505] μmol). On the equipotent basis (75% effective dose, median effective dose, and 25% effective dose), sensory block duration provoked by epinephrine was greater (P < .01) than that provoked by dibucaine or bupivacaine. Coadministration of dibucaine with epinephrine produced a synergistic nociceptive block, whereas phentolamine blocked that synergistic block.

CONCLUSIONS:

The preclinical data indicated that there is no statistically significant difference between the potency and duration of dibucaine and bupivacaine in this model. Epinephrine synergistically enhances the effects of dibucaine, while phentolamine partially blocked those effects. α-Adrenergic receptors play an important role in controlling synergistic analgesic effect of dibucaine combined with epinephrine.
The transcription factor SOX30 is a key regulator of mouse spermiogenesis
Authors: Zhang Daoqin , Xie Dan , Lin Xiwen , Ma Longfei , Chen Jian , Zhang Daoqi , Wang Yang , Duo Shuguang , Feng Yanmin , Zheng Chunwei , Jiang Binjie , Ning Yan , Han Chunsheng
Published: May 2018

The postmeiotic development of male germ cells, also known as spermiogenesis, features the coordinated expression of a large number of spermatid-specific genes. However, only a limited number of key transcription factors have been identified and the underlying regulatory mechanisms remain largely unknown. Here, we report that SOX30, the most-divergent member of the Sry-related high-motility group box (SOX) family of transcription factors, is essential for mouse spermiogenesis. The SOX30 protein was predominantly expressed in spermatids, while its transcription was regulated by retinoic acid and by MYBL1 before and during meiosis. Sox30 knockout mice arrested spermiogenesis at step 3 round spermatids, which underwent apoptosis and abnormal chromocenter formation. We also determined that SOX30 regulated the expression of hundreds of spermatid-specific protein-coding and long non-coding RNA genes. SOX30 bound to the proximal promoter of its own gene and activated its transcription. These results reveal SOX30 as a novel key regulator of spermiogenesis that regulates its own transcription to enforce and activate this meiotic regulatory pathway.
Collaborative repressive action of the antagonistic ETS transcription factors Pointed and Yan fine-tunes gene expression to confer robustness inDrosophila
Authors: Webber Jemma L. , Zhang Jie , Massey Alex , Sanchez-Luege Nicelio , Rebay Ilaria
Published: May 2018

The acquisition of cellular identity during development depends on precise spatiotemporal regulation of gene expression, with combinatorial interactions between transcription factors, accessory proteins and the basal transcription machinery together translating complex signaling inputs into appropriate gene expression outputs. The Drosophila ETS family transcription factors Yan and Pointed, whose opposing repressive and activating inputs orchestrate numerous cell fate transitions downstream of receptor tyrosine kinase signaling, provide one of the premier systems for studying this process. Current models describe the differentiative transition as a switch from Yan-mediated repression to Pointed-mediated activation of common target genes. We describe here a new layer of regulation whereby Yan and Pointed co-occupy regulatory elements to coordinately repress gene expression, with Pointed unexpectedly required for the genome-wide occupancy of both Yan and the corepressor Groucho. Using even-skipped as a test-case, synergistic genetic interactions between Pointed, Groucho, Yan and components of the RNA polymerase II pausing machinery suggest Pointed integrates multiple scales of repressive regulation to confer robustness. We speculate that this mechanism may be used broadly to fine-tune the expression of many developmentally critical genes.
Mitochondrial maintenance under oxidative stress depends on mitochondrially localised α-OGG1
Authors: Lia Debora , Reyes Aurelio , de Melo Campos Julliane Tamara Araújo , Piolot Tristan , Baijer Jan , Radicella J. Pablo , Campalans Anna
Published: May 2018

Accumulation of 8-oxoguanine (8-oxoG) in mitochondrial DNA and mitochondrial dysfunction have been observed in cells deficient for the DNA glycosylase OGG1 when exposed to oxidative stress. In human cells, up to eight mRNAs for OGG1 can be generated by alternative splicing and it is still unclear which of them codes for the protein that ensures the repair of 8-oxoG in mitochondria. Here, we show that the α-OGG1 isoform, considered up to now to be exclusively nuclear, has a functional mitochondrial-targeting sequence and is imported into mitochondria. We analyse the sub-mitochondrial localisation of α-OGG1 with unprecedented resolution and show that this DNA glycosylase is associated with DNA in mitochondrial nucleoids. We show that the presence of α-OGG1 inside mitochondria and its enzymatic activity are required to preserve the mitochondrial network in cells exposed to oxidative stress. Altogether, these results unveil a new role of α-OGG1 in the mitochondria and indicate that the same isoform ensures the repair of 8-oxoG in both nuclear and mitochondrial genomes. The activity of α-OGG1 in mitochondria is sufficient for the recovery of organelle function after oxidative stress.
1 Versus 2-cm Excision Margins for pT2-pT4 Primary Cutaneous Melanoma (MelMarT): A Feasibility Study
Authors: Moncrieff Marc D. , Gyorki David , Saw Robyn , Spillane Andrew J. , Peach Howard , Oudit Deemesh , Geh Jenny , Dziewulski Peter , Wilson Ewan , Matteucci Paolo , Pritchard-Jones Rowan , Olofsson Bagge Roger , Wright Frances C. , Crampton Nic , Cassell Oliver , Jallali Navid , Berger Adam , Kelly John , Hamilton Stephen , Durrani Amer , Lo Serigne , Paton Elizabeth , Henderson Michael A.
Published: May 2018

Background

There is a lack of consensus regarding optimal surgical excision margins for primary cutaneous melanoma > 1 mm in Breslow thickness (BT). A narrower surgical margin is expected to be associated with lower morbidity, improved quality of life (QoL), and reduced cost. We report the results of a pilot international study (MelMarT) comparing a 1 versus 2-cm surgical margin for patients with primary melanoma > 1 mm in BT.

Methods

This phase III, multicentre trial [NCT02385214] administered by the Australia & New Zealand Medical Trials Group (ANZMTG 03.12) randomised patients with a primary cutaneous melanoma > 1 mm in BT to a 1 versus 2-cm wide excision margin to be performed with sentinel lymph node biopsy. Surgical closure technique was at the discretion of the treating surgeon. Patients’ QoL was measured (FACT-M questionnaire) at baseline, 3, 6, and 12 months after randomisation.

Results

Between January 2015 and June 2016, 400 patients were randomised from 17 centres in 5 countries. A total of 377 patients were available for analysis. Primary melanomas were located on the trunk (56.9%), extremities (35.6%), and head and neck (7.4%). More patients in the 2-cm margin group required reconstruction (34.9 vs. 13.6%; p < 0.0001). There was an increased wound necrosis rate in the 2-cm arm (0.5 vs. 3.6%; p = 0.036). After 12 months’ follow-up, no differences were noted in QoL between groups.

Discussion

This pilot study demonstrates the feasibility of a large international RCT to provide a definitive answer to the optimal excision margin for patients with intermediate- to high-risk primary cutaneous melanoma.
Metabolic profiles derived from residual blood spot samples: A longitudinal analysis
Authors: Murphy Malia S.Q. , Hawken Steven , Cheng Wei , Wilson Lindsay A. , Lamoureux Monica , Henderson Matthew , Potter Beth , Little Julian , Chakraborty Pranesh , Wilson Kumanan
Published: May 2018

Background: Secondary use of newborn screening dried blood spot samples include use for biomedical or epidemiological research. However, the effects of storage conditions on archival samples requires further examination. The objective of this study was to determine the utility of residual newborn samples for deriving reliable metabolic gestational age estimates.

Methods: Residual newborn dried blood spot samples that had been stored for 2-, 4-, 6-, or 12-months in temperature controlled (21°C) conditions were re-analyzed for the full panel of newborn screening analytes offered by a provincial newborn screening lab in Ottawa, Canada. Data from re-analyzed samples were compared to corresponding baseline newborn screening values for absolute agreement, and Pearson and intraclass correlation. Performance of a gestational age estimation algorithm originally developed from baseline newborn screening values was then validated on data derived from stored samples.

Results: A total of 307 samples were used for this study. 17-hydroxyprogesterone and newborn hemoglobin profiles measured by immunoassay and high-performance liquid chromatography, respectively, were among the most stable markers across all time points of analysis. Acylcarnitines exhibited the greatest degree of variation in stability upon repeat measurement. The largest shifts in newborn analyte profiles and the poorest performance of metabolic gestational age algorithms were observed when samples were analyzed 12-months after sample collection.

Conclusions: Duration of sample storage, independent of temperature and humidity, affects newborn screening profiles and gestational age estimates derived from metabolic gestational dating algorithms. When considering use of dried blood spot samples either for clinical or research purposes, care should be taken when interpreting data stemming from secondary use.
The future of non-invasive cerebral oximetry in neurosurgical procedures: A systematic review
Authors: Kim WooJin , Taw Benedict , Yokosako Suguru , Koyanagi Masaomi , Fukuda Hitoshi , Sinclair David , Sirhan Denis , Teitelbaum Jeanne , Lui Matthew W.M. , Kasuya Hidetoshi , Angle Mark , Lo Benjamin W.Y.
Published: May 2018

Background:Cerebral hypoxia is one of the most important causes of secondary brain injury during neurosurgical procedures and in neurointensive care. In patients with brain injury, cerebrovascular reactivity may be impaired and a decrease in mean arterial pressure or cerebral perfusion pressure may lead to inadequate cerebral blood flow and secondary ischemia. There are several techniques available to measure brain oxygenation. In particular, near infrared spectroscopy (NIRS) is a non-invasive neuromonitoring technique and there has been a rapid expansion of clinical evidence that NIRS reduces perioperative neurologic complications.  

Methods:This systematic review synthesizes prospective and retrospective cohort studies that investigate the benefit of using NIRS in prevention of perioperative neurologic complications. The methodological quality of these studies is appraised.

Results:Seven studies were included in this systematic review. The methodological quality of each study was assessed. They had representative patient populations, clear selection criteria and clear descriptions of study designs. Reproducible study protocols with ethics board approval were present. Clinical results were described in sufficient detail and were applicable to patient undergoing neurosurgical procedures and in neurointensive care. Limitations included small sample sizes and lack of reference standard.

Conclusions:This systematic review synthesizes the most current evidence of non-invasive, inexpensive, and continuous measurement of cerebral oxygenation by NIRS. Results gained from these studies are clinically useful and shed light on how this neuromonitoring technique is beneficial in preventing perioperative neurological complications.
Medicamentos biosimilares en Colombia: una revisión desde el consumo informado
Authors: Bernal-Camargo Diana Rocío , Gaitán-Bohórquez Julio César , León-Robayo Édgar Iván
Published: May 2018

Introducción: este artículo presenta un análisis sobre medicamentos biosimilares en Colombia con miras a establecer si existe un consumo informado respecto de estos fármacos, teniendo en cuenta la calidad y cantidad de información que circula en relación con su disponibilidad y acceso económico (precios). Desarrollo: el tipo de estudio es cualitativo con un diseño documental a partir de la revisión en bases de datos como Pubmed, Scopus, Scielo, Vlex y Redalyc, bases de información de registros sanitarios de agencias reguladoras de medicamentos (FDA, EMA e Invima) y el Sistema de Información de Vademecum Med Informática. Uno de los biosimilares autorizados en FDA y cuatro de la EMA se encuentran registrados en el Invima; sin embargo, son más los biosimilares no autorizados ni en fda ni en ema que se encuentran registrados en el Invima, los cuales aún no aparecen con esta clasi cación de biosimilares ni en la agencia reguladora colombiana ni en ningún otro medio o cial o comercial. De los medicamentos biológicos de referencia de estos biosimilares, 12 tienen control de precios y 7 han sido autorizados al menos una vez vía judicial a los usuarios del sistema. Conclusiones: si bien, la reglamentación ha sido de gran avance en relación con el acceso a biosimilares y, en consecuencia, a sus biológicos pioneros, el sistema aún tiene barreras jurídicas, de información, disponibilidad y acceso que dificultan la protección y efectividad del derecho a la salud de la población en términos de un consumo informado de estos.