bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial Factors Mediating the Effect of the CHoBI7 Intervention on Handwashing With Soap: A Randomized Controlled Trial
Authors: George Christine Marie , Biswas Shwapon , Jung Danielle , Perin Jamie , Parvin Tahmina , Monira Shirajum , Saif-Ur-Rahman K. M. , Rashid Mahamud-ur , Bhuyian Sazzadul Islam , Thomas Elizabeth D. , Dreibelbis Robert , Begum Farzana , Zohura Fatema , Zhang Xiaotong , Sack David A. , Alam Munirul , Sack R. Bradley , Leontsini Elli , Winch Peter J.
Published: January 2017

Inadequate hand hygiene is estimated to result in nearly 300,000 deaths annually, with the majority of deaths being among children younger than 5 years. In an effort to promote handwashing with soap and water treatment behaviors among highly susceptible household members of cholera patients, we recently developed the Cholera-Hospital-Based Intervention-for-7-Days (CHoBI7); chobi means picture in Bengali. This 1-week handwashing with soap and water treatment intervention is delivered by a promoter in the hospital and the home to cholera patients and their household members. In our randomized controlled trial of this intervention, we observed a significant reduction in symptomatic cholera infections during the 1-week intervention period compared to the control arm and sustained high uptake of observed handwashing with soap behaviors up to 12 months postintervention. The aim of the present study was to assess the underlying mechanism of change that led to the high handwashing with soap behavior observed among participants who received the CHoBI7 intervention. Handwashing with soap was measured using 5-hour structured observation, and psychosocial factors were assessed using a structured questionnaire among 170 intervention and 174 control household members enrolled in the CHoBI7 trial. To investigate potential mediators of the CHoBI7 intervention effect, mediation models were performed. Response efficacy was found to mediate the intervention’s effect on habit formation for handwashing with soap at the 1-week follow-up, and disgust, convenience, and cholera awareness were mediators of habit maintenance at the 6- to 12-month follow-up. These results support the use of theory-driven approaches for the development and implementation of handwashing with soap interventions.
Herpes Zoster with Cutaneous Dissemination in a Patient 21 Years after Splenectomy for Idiopathic Thrombocytopenic Purpura
Authors: Moquete Rachel A. , Hartman Barry , Granstein Richard D.
Published: January 2017

Background:

Varicella-zoster virus is a member of the herpes virus family that causes varicella during a primary infection and herpes zoster (HZ) when reactivated. Patients who are immunocompromised often have atypical presentations of HZ and experience complications such as multidermal involvement and dissemination.

Objective:

We report a case of disseminated HZ in an immunocompetent patient with a history of splenectomy for idiopathic thrombocytopenic purpura (ITP). Our 46-year-old female patient presented with a painful vesiculopapular dermatomal rash with approximately 80 other lesions diffusely spread over her body. She was in good health but had a splenectomy for ITP 21 years earlier and a history of recurrent herpes labialis. The latter led to the tentative diagnosis of a widespread herpes simplex infection. However, laboratory results confirmed a diagnosis of disseminated herpes zoster. A workup of the patient's immune status did not reveal any abnormalities other than the patient's previously noted splenectomy.

Conclusions:

This case adds to the two reports of patients developing cutaneous disseminated HZ several years after splenectomy. Our case serves as a reminder that patients with a history of splenectomy appear to be at increased risk for cutaneous dissemination of HZ.

Renseignements de base:

Le virus varicelle-zona est un virus de la famille des Herpesviridae qui cause la varicelle durant une primo-infection, et l'herpès zoster (zona) (HZ) en cas de réactivation. Les patients qui sont immunocompromis ont souvent des présentations atypiques de HZ et affichent des complications telles que la participation et la dissémination multicutanées.

Objectif:

Nous exposons un cas de zona disséminé chez un patient immunocompétent ayant subi une splénectomie pour traiter un purpura thrombocytopénique idiopathique (PTI). Notre patiente âgée de 46 ans présentait une éruption vésiculo-papuleuse douloureuse localisée dans une zone dermatome avec environ 80 autres lésions diffuses réparties sur son corps. Elle était en bonne santé mais avait subi une splénectomie pour traiter un PTI 21 ans plus tôt et présentait des antécédents d'épisodes récurrents d'herpès labial. Ce dernier a abouti 'a un diagnostic provisoire d'une infection généralisée par le virus herpès simplex. Cependant, les résultats des analyses de laboratoire ont confirmé un diagnostic d'herpès zoster (zona) disséminé. Une investigation de l'état immunitaire de la patiente n'a pas révélé d'anomalies autres que la splénectomie que la patiente a subie antérieurement.

Conclusions:

Ce cas vient s'ajouter aux deux cas de patients signalés qui ont développé un HZ disséminé plusieurs années après avoir subi une splénectomie. Notre cas sert à rappeler que les patients présentant des antécédents de splénectomie semblent être exposés à un risque accru de dissémination cutanée sous forme de HZ.
Network Options for Wide-Area Telesurgery
Authors: Smithwick Mark
Published: January 2017

Telesurgery requires a network with the following characteristics: reliability; acceptable end-to-end delay; the ability to transfer data from sources with widely different data rates; low data error rates. A wide range of network options is currently available and even more will be available shortly. It is concluded that for telesurgery ISDN is the best option at present. In the near future, as they become available commercially, ATM networks are likely to be preferable.
Teleworking in Connection with Technical Aids for Disabled Persons
Authors: Alimandi L , Andrich R , Porqueddu B
Published: January 2017

An experimental teleworking arrangement was established between Milan and Rome in order to evaluate the use of multimedia technology and remote working for improving the service provided by an information and advice centre for the disabled. This activity requires a highly interdisciplinary approach and both clinical and technical expertise. The hypothesis was that offering the lone expert in Rome the possibility of teleconsulting with colleagues in Milan (where the whole range of expertise was available) would provide a comprehensive service for disabled clients asking for advice on technical aids in Rome. The results of an experiment demonstrated the feasibility of such teleworking and allowed a teleconsulting method to be defined that fits the specific needs of the technical-aid information service and improves quality.
Development of a Telemedicine and Distance Learning Network in Rural Eastern North Carolina
Authors: Kesler Charles , Balch David
Published: January 2017

A telemedicine service was established between the East Carolina University (ECU) School of Medicine in Greenville and the Central Prison in Raleigh, about 160 km away. Based on the first two years' experience of providing a prison telemedicine service, a medical education network was set up, linking the School of Medicine to health institutions in Ahoskie, approximately 160 km away, and Jacksonville, approximately 145 km away. At about the same time, a telemedicine network was installed linking the ECU to two rural hospitals, the Roanoke-Chowan Hospital in Ahoskie, and the Martin General Hospital in Williamston, both approximately 75 km away. Although it was a demonstration project, the prison telemedicine service was thought to be cost-effective. The cost of transporting a patient from prison for medical care was estimated to be $700. In comparison, a telemedicine consultation cost about $70, excluding the equipment and network costs. During the first 33 months of operation there were over 400 telemedicine consultations carried out in eastern North Carolina. The majority were dermatology consultations, with neurology and gastroenterology being next most frequent.
American populism, Glenn Beck and affective media production
Authors: Jutel Olivier
Published: January 2017

This article examines the centrality of affective media production to contemporary American populism with a case study of the right-wing broadcaster Glenn Beck. The rise of far-right media and Donald Trump in social media spaces demonstrates the convergence of the economic and political logic of affect. In soliciting the affective and collaborative labour of users, affective media necessarily deploys discourses of social transformation, autonomy and critical knowingness. Beck’s show exemplifies this logic with Beck functioning as a leader of the Tea Party movement who perform ‘free labour’ for Fox News and Beck’s own media empire, while experiencing this as a form of revolutionary education. Where this audience movement speaks to the political ontology of affective media is in the return of a fetishistic ‘symbolic efficiency’. In foreshadowing Trump, Beck articulates an antagonistic division of the social with a populist community of jouissance and individuation both threatened and constituted by the rapacious enemy.
Treatment with Autologous Bone Marrow Mononuclear Cells in Patients with Critical Lower Limb Ischaemia. A Pilot Study
Authors: Wester T. , Jørgensen J. J. , Stranden E. , Sandbæk G. , Tjønnfjord G. , Bay D. , Kollerøs D. , Kroese A. J. , Brinchmann J. E.
Published: January 2017

Background and Aims:

Treatment with autologous, bone marrow mononuclear stem cells has shown effects in patients with chronic limb ischaemia in one randomized clinical study. The aim of the study was to test the potential effect of stem cell treatment in a strict defined group of patients with stable critical limb ischaemia (CLI). Design: A prospective, combined-centre pilot study.

Material:

Eight patients with CLI of the lower extremities, and without any other treatment options.

Methods:

Bone marrow cells were harvested from the patient's iliac crest and, after separation, injected into the calf muscles of the affected leg. Outcome was evaluated by digital subtraction angiography (DSA), visual analogue scale (VAS) and several non-invasive circulatory physiological tests.

Results:

There were no complications from the procedures. Two patients were amputated two months after cell injection. Five patients reported pain relief after four months. Five patients could be evaluated at eight months. According to VAS and physiological tests, they were all either stable or showed improvement.

Conclusion:

This method seems to be a safe option for treating patients with CLI. Inclusion of patients took a long time, mainly because many patients with CLI are offered endovascular treatment in our institution. While symptomatic improvement was found in individual patients, larger trials are required to investigate efficacy. This will probably require multi-centre participation.
Health-Related Quality of Life in Severely and Morbidly Obese Patients Waiting for Bariatric Surgery in Finland
Authors: Victorzon M. , Tolonen P. , Sintonen H.
Published: January 2017

Background:

Important outcome measurements in bariatric surgery include the improvement or resolvement of medical comorbid conditions caused by obesity, and the possible changes in quality of life. The health-related quality of life (HRQoL) among Finnish obese subjects awaiting bariatric surgery has not previously been compared to age- and gender-standardized general population.

Methods:

The HRQoL in 75 obese subjects waiting for bariatric surgery was assessed by the generic 15D instrument. The resulting 15D profile and single index score were compared to those of a sample of age- and gender-standardized general population (n = 4955).

Results:

The patients were significantly worse off than the age- and gender-standardized general population on 11 of the 15 dimensions. The mean total 15D score among patients scheduled for bariatric surgery was 0.844 compared to 0.934 in the control group (P < 0.001).

Conclusion:

The Finnish patients awaiting bariatric surgery suffer from a very poor HRQoL compared with age- and gender-standardized general population.
Preliminary Study Comparing the Effects of Locally and Systemically Applied L-Carnitine on the Healing of Full-Thickness Skin Defects
Authors: Karsidag T. , Asensio J. A. , Kabukcuoglu F. , Tuzun S.
Published: January 2017

Background and Aims:

L-carnitine as an endogenous cofactor has a role in the regulation of energy flow between different oxidative sources. The purpose of this study is to investigate that the clinical and histopathologic effects of L-carnitine locally and systemically on secondary healing in wounds of full thickness defects. We also measured the effects of L-carnitine on wound tensile strength as mechanical.

Material and Methods:

Sixty adult male Sprague—Dawley rats were divided into three groups randomly; group 1 (control group, n = 20), group 2 (local experimental group, n = 20), group 3 (systemic experimental group, n = 20). Group 1 was not given any pharmacologic agents. L-carnitine was administered locally in the group 2, and systemically in group 3 for a total of 14 days. The healing days of all groups were recorded. On the 7th, 10th,14th and 21st postoperative days, biopsy specimens, including tissue samples both from healing wound sites and surrounding healthy skin were evaluated for neovascularization, inflammation, the amount of collagen deposit, fibroblast migration and re-epithelization. Tensile strength was measured in the samples which completed healing on the 30th day. The results were evaluated by nonparametric Kruskall-Wallis test followed by Mann Whitney-U test.

Results:

The mean clinical healing days were 18.25 days, 16.5 days, 15 days for the control group, local experimental and systemic group, respectively. The differences between groups were statistically significant (p < 0.005). Mean tensile strength values were 762.10 centinewton (cN), 801.69 cN and 786.13 cN for the control group, local experimental group and systemic experimental group, respectively. There were no statistically significant differences between groups (p > 0.05). There was no statistically significant difference in the histopathologic examination on the 7th, 10th, 14th and 21st days in the neovascularization, inflammation and fibroblast migration. Collagen deposit was most prevalent in the systemic experimental group and was least in the control group. Complete wound closure rate was observed on the 7th day in the systemic administration group, on the 10th day in local administration group and on the 14th day in the control group. Re-epithelization thickness in the systemic carnitine group was more than the other groups.

Conclusions:

L-carnitine administered locally or systemically has positive effects on wound healing rate and tensile strength in rats.
Incidence and Risk Factors of Surgical Wound Infection in Children: A Prospective Study
Authors: Varik K. , Kirsimägi Ü. , Värimäe E.-A. , Eller M. , Lõivukene R. , Kübarsepp V.
Published: January 2017

Background and Aims:

To establish the incidence and risk factors of surgical site infection (SSI) in children operated in the Department of Paediatric Surgery of the Clinic of Surgery of Tartu University Hospital.

Material and Methods:

The data of wound healing were obtained for 589 children operated between 15 March 2003 and 31 March 2005. The operations were divided into general surgical (451), orthopaedic (70) and urological (68). The surgical wounds were classified as clean (442), clean-contaminated (96), contaminated (36) and dirty-infected (15). Univariate and multivariate analyses were performed to identify risk factors.

Results:

There were 7 SSI cases, overall rate being 1.2%. Superficial wound infection occurred in 5 cases and deep wound infection occurred in 2 cases. There was no organ/space infection. SSI was significantly more frequent in the case of contaminated and dirty-infected compared with clean or clean—contaminated operations, 7.8% and 0.6%, respectively (p = 0.0008). Wound infection endangered more children who had operation related complications compared with non-complicated cases, 11.1% and 0.4%, respectively (p < 0.0001).
Informational pathologies and interest bubbles: Exploring the structural mobilization of knowledge, ignorance, and slack
Authors: Wiewiura Joachim S , Hendricks Vincent F
Published: January 2017

This article contends that certain configurations of information networks facilitate specific cognitive states that are instrumental for decision and action on social media. Group-related knowledge and belief states—in particular common knowledge and pluralistic ignorance—may enable strong public signals. Indeed, some network configurations and attitude states foster informational pathologies that may fuel interest bubbles affecting agenda-setting and the generation of narratives in public spheres.
Professional impact and job satisfaction among Chinese journalists
Authors: Liu Yi , Xiaoming Hao , Wen Nainan
Published: January 2017

Through a survey of 343 journalists from 5 metropolitan newspapers, this study explores the link between job satisfaction of journalists and their perceived work impact within the social context of China. The study shows that (a) Chinese journalists may not be happy about the current press system in China; however, this does not necessarily make them feel dissatisfied with their job; (b) In a controlled press system, journalists who find the system more acceptable tend to see the personal benefits offered by their job and to feel contented with their work environment; and (c) Journalists who find the existing press system acceptable are more likely to experience their personal impact on the news production process and perceive the significant influence of their newspaper. Such perceptions lead to greater satisfaction with their job.
Embodied connections: Engaging the body in group work
Authors: Kimmell Alissa , Gockel Annemarie
Published: January 2017

Group work is a key modality in social work practice. In this study, we sought to explore how the growing trend toward body-oriented psychotherapy is being integrated into group work, and to identify the potential significance of this trend for social work practice with groups. We conducted in-depth interviews with 20 practitioners engaged in developing this emerging form of practice across the United States, and used thematic analysis to identify how integrating body-oriented psychotherapy may impact the nature and practice of group work from their perspectives. The overarching theme identified was that using body-oriented psychotherapy serves to Deepen the Group Process and Enhance the Therapeutic Potential of Group. This overarching theme was supported by four subthemes that describe how participants used body-oriented psychotherapy to enrich their group work. These subthemes include Coming into the Present Moment, Accessing the Body’s Unconscious Knowing, Regulating Affect and Facilitating Working Through, and Enhancing Interpersonal Connection. We discuss how these findings fit with existing research on group work and body-oriented psychotherapy, and describe how they reflect recent neurobiological models of therapeutic change. We also identify potential benefits and limitations to using body-oriented psychotherapy in group work, and outline key considerations for responding to this emerging trend in the profession at large.
‘To give an outsider an idea of what it could be like’: A case study of the creative representation of hearing voices
Authors: Flavin Michael , James Bethany
Published: January 2017

This paper reports on a case study which aims to recreate the hearing voices symptom in schizophrenia. The case study was submitted for a co-curricular module at King’s College London by a first-year undergraduate Music student, Bethany James, and was created using the web application, Mahara. The core of the case study consists of a soundscape of both everyday and unusual sounds, in conjunction with an original musical composition. The paper describes the case study and discusses it using chaos narrative as an analytical lens. The paper argues that the case study (‘A Beautiful Mind – Artefact’) effectively evokes the hearing voices symptom, conveying a lucid sense of the experience to non-sufferers and thus potentially creating use value for clinicians and care workers.
Thoughts on history, tuning and the scholarship of teaching and learning in the United States
Authors: Pace David
Published: January 2017

The Tuning Movement and the scholarship of teaching and learning have each had a significant impact on teaching history in higher education in the United States. But the isolation of these initiatives from each other has lessened their potential impact. Interactions between the two might bring together the intellectual exploration of scholarship of teaching and learning and the activist engagement with practical challenges present in the U.S. Tuning Movement. The work of groups, such as the History Learning Project, could facilitate such interactions.
Elevated levels of adipokines predict outcome after acute myocardial infarction: A long-term follow-up of the Glucose Tolerance in Patients with Acute Myocardial Infarction cohort
Authors: Ritsinger Viveca , Brismar Kerstin , Malmberg Klas , Mellbin Linda , Näsman Per , Rydén Lars , Söderberg Stefan , Tenerz Åke , Norhammar Anna
Published: January 2017

Objective:

Adiponectin and leptin are associated with insulin resistance and cardiovascular disease. Information on the prognostic value after an acute myocardial infarction is still conflicting.

Methods:

Patients (n = 180) without known diabetes and with admission glucose of <11 mmol/L admitted for an acute myocardial infarction in 1998–2000 were followed for mortality and cardiovascular events (first of cardiovascular mortality/acute myocardial infarction/stroke/heart failure) until the end of 2011 (median: 11.6 years). Plasma adiponectin and leptin were related to outcome in Cox proportional-hazard regression analyses.

Results:

Median age was 64 years and 69% were male. Total mortality was 34% (n = 61) and 44% (n = 80) experienced a cardiovascular event. Adiponectin at discharge predicted cardiovascular events (hazard ratio; 95% confidence interval; 1.45; 1.02–2.07, p = 0.038), total mortality (2.53; 1.64–3.91, p < 0.001) and cancer mortality (3.64; 1.51–8.74, p = 0.004). After adjustment for age, sex, body mass index, previous myocardial infarction and heart failure, adiponectin predicted total mortality (1.79; 1.07–3.00, p = 0.027) but not cardiovascular events. High levels of leptin were associated with cardiovascular events during the first 7 years, after which the association was attenuated. Leptin did not predict total mortality.

Conclusion:

In patients with acute myocardial infarction but without previously known diabetes, high levels of adiponectin at discharge predicted total mortality. The present results support the hypothesis that high rather than low levels of adiponectin predict mortality after acute myocardial infarction.
The metabolites in peripheral blood mononuclear cells showed greater differences between patients with impaired fasting glucose or type 2 diabetes and healthy controls than those in plasma
Authors: Kim Minjoo , Kim Minkyung , Han Ji Yun , Lee Sang-Hyun , Jee Sun Ha , Lee Jong Ho
Published: January 2017

To determine differences between peripheral blood mononuclear cells and the plasma metabolites in patients with impaired fasting glucose or type 2 diabetes and healthy controls. In all, 65 nononobese patients (aged 30–70 years) with impaired fasting glucose or type 2 diabetes and 65 nonobese sex-matched healthy controls were included, and fasting peripheral blood mononuclear cell and plasma metabolomes were profiled. The diabetic or impaired fasting glucose patients showed higher circulating and peripheral blood mononuclear cell lipoprotein phospholipase A2 activities, high-sensitivity C-reactive protein and tumour necrosis factor-α than controls. Compared with controls, impaired fasting glucose or diabetic subjects showed increases in 11 peripheral blood mononuclear cell metabolites: six amino acids (valine, leucine, methionine, phenylalanine, tyrosine and tryptophan), l-pyroglutamic acid, two fatty acid amides containing palmitic amide and oleamide and two lysophosphatidylcholines. In impaired fasting glucose or diabetic patients, peripheral blood mononuclear cell lipoprotein phospholipase A2 positively associated with peripheral blood mononuclear cell lysophosphatidylcholines and circulating inflammatory markers, including tumour necrosis factor-α, high-sensitivity C-reactive protein and lipoprotein phospholipase A2 activities. In plasma metabolites between patients and healthy controls, we observed significant increases in only three amino acids (proline, valine and leucine) and decreases in only five lysophosphatidylcholines. This study demonstrates significant differences in the peripheral blood mononuclear cell metabolome in patients with impaired fasting glucose or diabetes compared with healthy controls. These differences were greater than those observed in the plasma metabolome. These data suggest peripheral blood mononuclear cells as a useful tool to better understand the inflammatory pathophysiology of diabetes.
Endothelial dysfunction in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia
Authors: Zhang Junxia , Xiang Lin , Zhang Bilin , Cheng Yangyang
Published: January 2017

Objective:

To reveal the effect of hyperuricaemia on endothelial function in normoglycaemic first-degree relatives of type 2 diabetes mellitus.

Methods:

In all, 40 first-degree relatives of type 2 diabetes mellitus with hyperuricaemia, 40 first-degree relatives of type 2 diabetes mellitus with normouricaemia and 35 healthy subjects without diabetic family history were recruited in this study. Anthropometric parameters as well as blood pressure, blood lipids, fasting blood glucose, fasting insulin, C-reactive protein, tumour necrosis factor-α and interleukin-6 were measured. Insulin resistance was assessed with homoeostasis model assessment index-insulin resistance index. To assess endothelial function, high-resolution ultrasonography was used for measuring flow- and nitroglycerine-mediated brachial artery vasodilation.

Results:

When compared with control, flow-mediated dilation was lower in first-degree relatives with or without hyperuricaemia (both p < 0.001). When compared with first-degree relative subjects with normouricaemia, there were lower flow-mediated dilation ( p < 0.001) and higher levels of uric acid ( p < 0.001), fasting blood glucose ( p < 0.001), C-reactive protein ( p = 0.001), tumour necrosis factor-α ( p < 0.001) and interleukin-6 ( p < 0.001) in first-degree relative subjects with hyperuricaemia. Flow-mediated dilation was found to be negatively related to uric acid ( r = −0.597, p < 0.001). Stepwise multiple regressions demonstrated that uric acid was a significant determinant of flow-mediated dilation independent of other variables in first-degree relatives of type 2 diabetes mellitus (β = −0.677, p < 0.001; confidence interval: −0.010 to −0.006).

Conclusion:

Further endothelial dysfunction is found in normoglycaemic first-degree relatives of type 2 diabetes mellitus complicated with hyperuricaemia.
Lifestyle and Health Status Differ over Time in Long-Term Heart Transplant Recipients
Authors: Flattery Maureen P. , Salyer Jeanne , Maltby Megan C. , Joyner Pamela L. , Elswick R. K.
Published: January 2017

Objective

To describe differences in lifestyle and health status across 5 posttransplant periods.

Methods

The sample consisted of 126 heart transplant recipients (87% men) grouped by time after transplantation: group 1, 12 to 24 months (n = 13); group 2, 25 to 48 months (n = 19); group 3, 49 to 72 months (n = 24); group 4, 72 to 96 months (n = 27); and group 5, ≥ 97 months (n = 43). Data were obtained using demographic and health status evaluation forms and the Lifestyle Profile-II, which measures physical activity, nutrition, health responsibility, interpersonal relationships, stress management, and spiritual growth.

Results

Most often reported lifestyle attributes were spiritual growth and interpersonal relationships. Least often reported was physical activity. Pairwise comparisons revealed that groups 3 (χ2= 16.4; SD = 4.8; P = .03) and 4 (χ2 = 16.6; SD = 5.8; P = .04) had lower physical activity than group 2 (χ2 = 21.3; SD = 5.2). Health status evaluation revealed that there were no group differences in systolic ( P = .46) or diastolic ( P = .77) blood pressure. Although creatinine was elevated, there were no group differences ( P = .86). High-density lipoprotein was higher than 42 mg/dL in all groups, but there were differences across groups in low-density lipoprotein ( P = .003). Groups 1 (χ2 = 139.2; SD = 38.5) and 2 (χ2 = 141.0; SD = 47.8) were different than group 5 (χ2 = 112.9; SD = 36.1; P = .05). There were group differences in cholesterol ( P = .002), with lower levels in groups 4 (χ2 = 190.5; SD = 38.6) and 5 (χ2 = 186.3; SD = 37.7) as compared to group 2 (χ2 = 230.8; SD = 66.5).

Conclusions

Identifying posttransplant periods in which healthy behaviors and health status may be vulnerable to decline is important for providing ongoing education and psychological support to transplant recipients who manage a complex regimen.
Acanthosis Nigricans following Single Lung Transplantation: A Case Report
Authors: Pandya Chirag , Blazey Holli , Budev Marie M. , Mehta Atul C. , Minai Omar A.
Published: January 2017

Acanthosis nigricans was observed 3 months after single lung transplantation in a 51-year-old African American woman with idiopathic pulmonary fibrosis. The patient had no endocrinological abnormalities and was not taking any medications known to cause acanthosis nigricans; extensive investigation did not reveal an underlying malignant process. Because acanthosis nigricans may occur as a paraneoplastic phenomenon, it is important to rule out an underlying malignancy. This is especially important in solid-organ transplant recipients receiving chronic immunosuppressive therapy.
Ethical Issues Surrounding High-Risk Kidney Recipients: Implications for the Living Donor
Authors: O'Hara Jerome F. , Bramstedt Katrina , Flechner Stewart , Goldfarb David
Published: January 2017

Evaulating patients for living kidney donor transplantation involving a recipient with significant medical issues can create an ethical debate about whether to proceed with surgery. Donors must be informed of the surgical risk to proceed with donating a kidney and their decision must be a voluntary one. A detailed informed consent should be obtained from high-risk living kidney donor transplant recipients as well as donors and family members after the high perioperative risk potential has been explained to them. In addition, family members need to be informed of and acknowledge that a living kidney donor transplant recipient with pretransplant extrarenal morbidity has a higher risk of a serious adverse outcome event such as graft failure or recipient death. We review 2 cases involving living kidney donor transplant recipients with significant comorbidity and discuss ethical considerations, donor risk, and the need for an extended informed consent.
Sickle Cell Anemia and Comorbid Leg Ulcer Treated With Curative Peripheral Blood Stem Cell Transplantation
Authors: Connor Joseph L. , Minniti Caterina P. , Tisdale John F. , Hsieh Matthew M.
Published: January 2017

Allogeneic bone marrow transplantation or peripheral blood stem cell transplantation (PBSCT) are the only curative therapies for patients with sickle cell disease (SCD). Once the patients have successfully undergone transplantation and engrafted, the hallmark of hemolytic anemia resolves, and normal hemoglobin levels are achieved. Some transplant protocols exclude patients with open wounds, including leg ulcers, because of infection risks associated with transplantation and long-term immunosuppression required to prevent graft-versus-host disease. Recalcitrant and recurrent leg ulcers are a serious complication of SCD and a determinant of morbidity. Here, we report the case of a 37-year-old man with sickle cell anemia and a chronic leg ulcer, who underwent PBSCT, engrafted successfully, and then had complete healing of his ulcer 16 months posttransplant.
A Prospective Community-Based Study of Falls among Older People in Australia: Frequency, Circumstances, and Consequences
Authors: Mackenzie Lynette , Byles Julie , Higginbotham Nick
Published: January 2017

Falls among the population of older people are a major international public health concern. Few prospective studies have been conducted in Australia with a healthy, rural and urban community sample that measure a broad range of health-related potential risk factors for falls. This study aims to identify the nature and circumstances of falls experienced by people aged 70 years and older, and explores any health and environmental variables associated with falls over a 6-month period. A total of 264 participants kept calendars and recorded information about falls. Health status measures were taken prior to the study period. Falls occurred mainly during mobility and housework activities causing a wide range of minor but notable injuries, and were associated with psychosocial factors as well as medical risk factors. The need for occupational therapists to develop specific programs for healthy older people living in the community is identified, as well as the need for cross-national falls research.
An efficient secure Internet of things data storage auditing protocol with adjustable parameter in cloud computing
Authors: Liu Meng , Wang Xuan , Yang Chi , Jiang Zoe Lin , Li Ye
Published: January 2017

Nowadays, an increasing number of cloud users including both individuals and enterprises store their Internet of things data in cloud for benefits like cost saving. However, the cloud storage service is often regarded to be untrusted due to their loss of direct control over the data. Hence, it is necessary to verify the integrity of their data on cloud storage servers via a third party. In real cloud systems, it is very important to improve the performance of the auditing protocol. Hence, the well-designed and cost-effective auditing protocol is expected to meet with the performance requirement while the data size is very large in real cloud systems. In this article, we also propose an auditing protocol based on pairing-based cryptography, which can reduce the computation cost compared to the state-of-the-art third-party auditing protocol. Moreover, we also study how to determine the number of sectors to achieve the optimal performance of our auditing protocol in a case of the same challenged data. And an equation for computing the optimal number of sectors is proposed to further improve the performance of our auditing protocol. Both the mathematical analysis method and experiment results show that our solution is more efficient.
Understanding Sarcopenia Development
Authors: Hardee Justin P. , Carson James A.
Published: January 2017

For decades the biomedical community has documented the accelerated loss of muscle mass that occurs with advancing aging, termed sarcopenia. The timely review article (“Attenuation of Adverse Effects of Aging on Skeletal Muscle by Regular Exercise and Nutritional Support”) by Arthur Leon presents our current state of knowledge on the biological processes responsible for age-induced loss of muscle mass and function. This loss of skeletal muscle has critical health implications as it can negatively affect morbidity and mortality. A significant theme throughout the review is that a lifelong commitment to regular physical activity and good dietary habits is extremely important to combat age related reductions in muscle mass and function. However, multi-targeted therapeutic approaches, in conjunction with nutrition and exercise, may be beneficial to prevent or treat sarcopenia. Additionally, while significant progress has been made in our understanding of the molecular and biochemical contributors to sarcopenia, further research using well-controlled clinical trials are needed to determine the long-term benefit of exercise and nutrition on aging skeletal muscle.
Usefulness of Multidetector 3D-CT Angiography in the Evaluation of Infantile Perimedullary Spinal Arteriovenous Fistula
Authors: Iizuka Y. , Shimoji K. , Kyogoku S. , Maehara T. , Yamashiro Y.
Published: January 2017

We report an infantile huge perimedullary spinal arteriovenous fistula (SAVF) associated with Hereditary-Hemorrhagic-Telangiectasia (HHT), which was treated by glue embolization in one session. Three-dimensional Multidetector Computed Tomography Angiography (3D-MCTA) was useful in pre- and post-endovascular intervention.
Internal Carotid Artery Pseudoaneurysm after Tonsillectomy Treated by Endovascular Approach
Authors: Raffin C.N. , Montovani J.C. , Neto J.M.P. , Campos C.M.S. , Piske R.L.
Published: January 2017

Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm.

We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.
Correlation between Haemorrhagic Complications and CT Findings before and after Intra-arterial Reperfusion Therapy for Acute Middle Cerebral Artery Occlusion
Authors: Nakano S. , Wakisaka S. , Kawano H. , Yoneyama T.
Published: January 2017

The purpose of this study was to investigate whether haemorrhagic complications can be predicted by evaluating CT findings before and after intra-arterial reperfusion therapy for acute middle cerebral artery (MCA) occlusion. Pretherapeutic early CT signs within three hours after onset and post-therapeutic contrast extravasation were evaluated in 61 patients treated within six hours after onset. Early CT signs were evaluated in the deep (obscuration of the margin of the lentiform nucleus and loss of the insular ribbon) and superficial MCA territories (cortical effacement). Haemorrhagic transformations were seen in 39.3% of patients, 54.2% of them had both pre-therapeutic early CT signs and post-therapeutic contrast extravasation. Obscuration of the entire lentiform nucleus and the presence of contrast extravasation were reliable predictors for haemorrhagic transformations, and cortical effacement had also a tendency to be associated with haemorrhage. Absence of early CT signs did not always result in the absence of haemorrhagic transformations and 37.5% of haemorrhage occurred in the presumed normal area without early CT signs. On the other hand, absence of post-therapeutic contrast extravasation was a reliable negative predictor for intraparenchymal haematoma.
Clinical Results of Stenting for Cervical Internal Carotid Stenoses
Authors: Tsuura M. , Terada T. , Matsumoto H. , Masuo O. , Itakura T. , Hyoutani G. , Nakamura Y. , Nishiguchi T. , Moriwaki H. , Hayashi S.
Published: January 2017

Total 89 patients with cervical ICA stenosis were treated by stenting. In 74 cases of stenting, we used our blocking balloon systems to prevent distal embolism. The morbidity and the mortality rate was 4.5% and 0%, respectively. Two(3%) of 74 cases showed distal embolism when blocking balloon catheter systems(BBCS) were used, while distal embolism occurred in four (27%) of 15 cases of stenting without BBCS. On diffusion-weighted MRI (DWI), hyperintense areas were detected in seven (47%) of 15 lesions when we used BBCS only during postdilatation. On the other hand, use of BBCS during predilatation as well as postdilatation reduced hyperintense areas on DWI, which were detected in three (25%) of 12 patients. Our blocking balloon catheter system is a useful device to reduce the risk of distal embolism, especially when we use it during not only postdilatation but predilatation.
Complications and Their Management during NBCA Embolization of Craniospinal Lesions
Authors: Niimi Y. , Berenstein A. , Setton A.
Published: January 2017

Technical complications during embolization of craniospinal lesions using NBCA may be classified as nonspecific catheterization-related or specific embolization-related. Catheterization-related complications include vessel injuries such as spasm, dissection or perforation, catheter injuries and thrombus formation. Embolization-related complications include occlusion of normal territories, migration of the embolic material to the venous side, and catheter gluing to the vessel wall. Causes, prevention and management of each complication are discussed with presentation of demonstrative cases.
Education and Propagation of Intravascular Surgery in Okinawa
Authors: Harakuni T. , Hyodo A. , Shingaki T. , Kugai M. , Kinjyo T. , Kinjyo T. , Tsuchida H. , Sugimoto K. , Yoshii Y.
Published: January 2017

Okinawa is an island located on the southwest edge of the Japanese Islands in which about 1,300,000 people live, and is an area where self-conclusion type medical treatment is desired. In this area, intravascular surgery was only performed for several cases per year until 1998. From May 1999, intravascular surgery started being performed in earnest, and 140 or more cases of intravascular surgery per year were performed in 2002. In the meantime, various measures for the propagation and development of intravascular surgery that we undertook led to the increase in the number of cases. As a result, the choice of medical treatment has increased by propagating these medical treatments, and it seems that this has contributed to the welfare of the people of Okinawa.
Stability of Microcatheter for Cerebral Aneurysm Embolization after Steam Shaping
Authors: Abe T. , Hirohata M. , Tanaka N. , Uchiyama Y. , Morimitsu H. , Fujimura N. , Takeuchi Y. , Kojima K. , Hayabuchi N.
Published: January 2017

To compare the performance of stability after steam shaping on 4 types of microcatheters, which are commonly used for cerebral aneurysm embolization, an experimental simulation was performed. Distal portion of the microcatheters were shaped into the 90 degree with length of 5 mm with the steam under the instruction of each catheter.

In the temperature kept water bath, the change of the angle of the catheter tips were recorded and measured. Several stresses were added to the tips with coaxially passing through the guiding catheter, using guidewire and Guglielmi detachable coil (GDC).

The degree of straightening was prominent on braided microcatheters and on the short length of shaping. The degree of recover of the primary shaping was prominent on non-braided catheter. The most influence factor of straightening of shaped catheter tip was the stress from the manipulation of guidewire.

The influence from the inserting GDC was less than the guidewire manipulation. It was shown that the decreased angle after large stress was recovered under the situation of without or with small stress. Our study shows that the non-braided microcatheter was suitable when stability of microcatheter tip after steam shaping was requested for aneurysm coiling.
Clinical Results of Percutaneous Transluminal Angioplasty and Stenting for Intracranial Vertebrobasilar Atherosclerotic Stenoses and Occlusions
Authors: Tsuura M. , Terada T. , Masuo O. , Tsumoto T. , Yamaga H. , Itakura T. , Matsumoto H. , Hyoutani G. , Hayashi S.
Published: January 2017

Eighteen patients with intracranial vertebrobasilar stenosis and occlusion were treated by PTA or stenting. In 11 of 18 cases, only PTA was performed and in seven of 18 cases, we used stents. The mean stenosis before and after PTA/stenting was 82.8% and 22.3%, respectively. In 11 cases of PTA only, the stenotic rate decreased from 81.8% to 29.6%, while 85.0% of the stenotic rate remarkably reduced to 6.0% in seven cases of stenting.

The 30 days morbidity and 30 days mortality rate were 5.5% and 5.5%, respectively. There was only one haemorrhagic complication (cerebellar haemorrhage) in cases of stenting, and no ischemic events during or after the procedures. Restenosis (more than 50% stenosis) occurred in four of 18 cases (22.2%) during mean follow-up period of 12 months. Two patients with VA occlusion before treatment, developed restenosis and reocclusion. Complete total occlusion seems to be a high-risk lesion and strict follow-up is required.

In this study, PTA/stenting for intracranial vertebrobasilar artery stenosis or occlusion is an effective treatment, but strict indications may be required because procedure-related 30 days morbidity rate was 5.5% in addition to unclear natural history.
Efficacy and Limitations of the Neuroform Stent System for Intracranial Aneurysms
Authors: Handa A. , Abdo G. , Yilmaz H. , Lovblad K.O. , Lylyk P. , Rüfenacht D.A.
Published: January 2017

We performed aneurysm embolization in seven patients using a self-expandable Neuroform stent (Boston Scientific/Target, Fremont, CA) and coils to cover the aneurysm neck and fill the aneurysm sac. Seven patients with an average age of 45 were treated in the period from October 2002 to July 2003.

The aneurysm lesions involved the basilar trunk in one case, the basilar-superior cerebellar artery in one case, the internal carotid artery in four cases, and the middle cerebral artery in one case. The ruptured lesions involved the internal carotid artery in one case and the middle cerebral artery in one case. We used a Neuroform stent measuring 4.5 × 20 mm in four cases, 4.5 × 15 mm in two cases, 3.5 × 20 mm in one case, and 3.5 × 15 mm in one case. We performed aneurysm coil embolization after Neuroform stenting in all cases without development of neurological deficits caused by the interventional procedure.

In performing these procedures, we investigated the efficacy and limitations of the Neuroform stent system for intracranial aneurysms. The advantages of Neuroform self-expanding stents include better flexibility and adaptability to different vessel sizes, but this stent system presents various technical difficulties during delivery.
Initial Experience with Intracranial Stent-Graft Use
Authors: Duncan I. C. , Fourie P. A.
Published: January 2017

We describe our initial experience with the placement of two premounted balloon expandable intracranial Jostent stent-grafts within the intracavernous internal carotid artery for the treatment of a symptomatic large intracavernous aneurysm in one case and a post-traumatic caroticocavernous fistula in the second. Among the initial technical complications we encountered were stent-graft migration and rapidly progressive intragraft thrombosis, with delayed sealing of the stent-graft coverings and exclusion of the pathologies relating to the use of abciximab in both cases. Despite these initial problems both cases had excellent short-term clinical outcomes with angiographic exclusion of both lesions by day three and good clinical and angiographic outcomes at one and two months respectively.
Percutaneous Retrieval of Intravascular Broken Catheter Fragments. A Novel Technique Using a Balloon
Authors: Gupta A. K. , Purkayastha S. , Krishnamoorthy T.
Published: January 2017

We describe a novel technique to retrieve broken catheter fragments from the vascular tree at difficult locations using a balloon. A coronary balloon can be taken over a microwire into the catheter fragment to hold it after inflation of the balloon and then the whole assembly can be gradually taken out. We used this novel technique successfully in three patients where the snare failed to retrieve the broken catheter fragment from vascular tree.