bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term mortality and morbidity of patients with systemic lupus erythematosus: a single-center cohort study in China
Authors: Wang Z , Li M , Wang Y , Xu D , Wang Q , Zhang S , Zhao J , Su J , Wu Q , Shi Q , Leng X , Zhang W , Tian X , Zhao Y , Zeng X
Published: January 2018

Objective

This study aims to exhibit the prognosis, both mortality and morbidity, of patients with systemic lupus erythematosus (SLE) in a single-center cohort in China.

Methods

A cohort of Chinese SLE patients were recruited from April 2009 to February 2010, and followed up regularly in clinic at Peking Union Medical College Hospital (PUMCH). Data for baseline, follow-up, and survival were collected, including demography, manifestations, activity, the Systemic Lupus International Collaborating/American College of Rheumatology (SLICC/ACR) Damage Index (SDI), and medications. The Kaplan–Meier method was adopted for survival analysis. Predicting and risk factors for both mortality and morbidity were evaluated by the Cox proportional hazard model. Associated factors were analyzed by the logistic regression model.

Results

A total of 260 patients were included at entry. The one-, three-, and five-year survival rates were 98.4%, 95.5%, and 93.8%. The proportion of patients with organ damage increased from 13.4% at baseline to 28.4% at year 6. Regression analysis showed that organ damage led to higher mortality, and organ-involved flare was associated with more future damage. Time from onset to diagnosis > 1 year, nephropathy and severe organ involvement were potential prognostic factors. Furthermore, onset age > 50 and previous organ damage were predictors for further damage.

Conclusion

Organ damage, severe organ involvement, and prolonged remission could be targets for the management of Chinese SLE patients to further reduce mortality. Early diagnosis, paying more attention to severe organ involvement, and preventing organ-involved flares and new organ damage would be crucially important in the future for Chinese SLE patients.
Which sports do you like? Testing intra-domain omnivorousness in Canadian following of professional sport
Authors: Gemar Adam
Published: January 2018

The theory of the cultural omnivore has been applied to many cultural domains. However, given the pervasiveness of professional sport in contemporary societies, less is known about omnivorous behaviour when it comes to consuming this cultural form. This study sets out to find if indeed there is an omnivorous consumption profile for professional sport. Using a latent class and regression analysis of survey data on five major professional sports leagues from Canada, this paper seeks to determine if this professional sport omnivore exists, how prevalent it might be, and if it maps onto wider socio-economic differentiations. The latent class analysis does show that there is an omnivorous consumption profile. However, it is the second smallest professional sport profile and does not map onto wider socio-economic differentiations, even as other patterns of professional sports’ consumption do display such distinctions.
Natural bodybuilding: An account of its emergence and development as competition sport
Authors: Liokaftos Dimitrios
Published: January 2018

Natural, i.e. drug-free, bodybuilding has been rapidly developing in different parts of the world as a distinct body culture with its own practices, discourses, organisations, key figures and focal points. A central aspect of this has been natural bodybuilding’s emergence and development as a competition sport. The present article traces its tentative articulation in the late 1970s, its formation as part of a broader natural movement in bodybuilding in the 1990s, and its consolidation and global expansion from the 2000s to the present day. In sketching this trajectory, natural bodybuilding is situated in the context of the bodybuilding industry and its historical transformations, as well as of the broader phenomenon of performance- and image-enhancing drugs and the reactions the latter has provoked in sport and wider society. The aim of the article is to offer an initial overview of a previously uncharted competition sport and in the process contribute to an exploration of bodybuilding as a varied and evolving phenomenon.
The intellectual development of Yuji Ijiri
Authors: Hsieh Pei-Gin
Published: January 2018

This study investigates the contextual background and development of Yuji Ijiri’s thought. Ijiri was inducted into the Accounting Hall of Fame in 1989 for his work on the dynamic structure of accounting measurements and retired from Carnegie Mellon University in 2011. He passed away on 18 January 2017. His dynamic structure provides both historical cost information and information relevant to managers, based on areas including cost accounting, matrices, and physics. He was influenced by his elders, and his work emphasized the importance of scientific and systematic calculation and represented a big step forward in accounting research on measurements.
H∞ tracking control for an inverted pendulum
Authors: Ashok Kumar M , Kanthalakshmi S
Published: January 2018

The objective of this paper is to design an [Formula: see text] controller for an inverted pendulum system, synthesized using the [Formula: see text] loop shaping technique. In the [Formula: see text] loop shaping technique, a linear plant model is augmented with certain weight functions, such as the sensitivity weight function and complementary sensitivity weight function, so that the closed loop transfer function of the plant will have the desired performance. In this work, the [Formula: see text] controller is synthesized and the analysis on robustness and performance of the system is done by taking the singular value response and robustness indicator plots.
Relational Climate and Health Care Costs: Evidence From Diabetes Care
Authors: Soley-Bori Marina , Stefos Theodore , Burgess James F. , Benzer Justin K.
Published: January 2018

Quality of care worries and rising costs have resulted in a widespread interest in enhancing the efficiency of health care delivery. One area of increasing interest is in promoting teamwork as a way of coordinating efforts to reduce costs and improve quality, and identifying the characteristics of the work environment that support teamwork. Relational climate is a measure of the work environment that captures shared employee perceptions of teamwork, conflict resolution, and diversity acceptance. Previous research has found a positive association between relational climate and quality of care, yet its relationship with costs remains unexplored. We examined the influence of primary care relational climate on health care costs incurred by diabetic patients at the U.S. Department of Veterans Affairs between 2008 and 2012. We found that better relational climate is significantly related to lower costs. Clinics with the strongest relational climate saved $334 in outpatient costs per patient compared with facilities with the weakest score in 2010. The total outpatient cost saving if all clinics achieved the top 5% relational climate score was $20 million. Relational climate may contribute to lower costs by enhancing diabetic treatment work processes, especially in outpatient settings.
Prevalence Estimates of ADHD in a Sample of Inpatients With Alcohol Dependence
Authors: Luderer Mathias , Sick Christian , Kaplan-Wickel Nurcihan , Reinhard Iris , Richter Agnes , Kiefer Falk , Weber Tillmann
Published: January 2018

Objective: ADHD is common in patients with alcohol dependence, but prevalence results are inconsistent. We investigated ADHD prevalence in a complex design to avoid over- or underdiagnosing. Method: Patients with alcohol dependence starting long-term residential treatment were included. A structured interview (Diagnostic Interview for ADHD in Adults [DIVA]) was conducted on all patients. DIVA results indicating childhood or adulthood ADHD were assessed in successive diagnostic interviews by two expert clinicians. Results: 415 of 488 patients had completed the entire diagnostic assessment. ADHD prevalence was 20.5%. DIVA results correlated moderately with experts’ diagnoses. In patients with ADHD, a higher comorbid illicit substance use was prevalent and alcohol dependence started earlier and was more severe. Conclusion: This study provides the largest sample on ADHD prevalence in alcohol dependent inpatients. Despite great efforts to avoid overestimation, we found every fifth patient to have ADHD. ADHD diagnosis should not be based solely on a structured interview but should be clinically confirmed.
HumanMethylation450K Array–Identified Biomarkers Predict Tumour Recurrence/Progression at Initial Diagnosis of High-risk Non-muscle Invasive Bladder Cancer
Authors: Kitchen Mark O , Bryan Richard T , Emes Richard D , Luscombe Christopher J , Cheng KK , Zeegers Maurice P , James Nicholas D , Gommersall Lyndon M , Fryer Anthony A
Published: January 2018

Background:

High-risk non-muscle invasive bladder cancer (HR-NMIBC) is a clinically unpredictable disease. Despite clinical risk estimation tools, many patients are undertreated with intra-vesical therapies alone, whereas others may be over-treated with early radical surgery. Molecular biomarkers, particularly DNA methylation, have been reported as predictive of tumour/patient outcomes in numerous solid organ and haematologic malignancies; however, there are few reports in HR-NMIBC and none using genome-wide array assessment. We therefore sought to identify novel DNA methylation markers of HR-NMIBC clinical outcomes that might predict tumour behaviour at initial diagnosis and help guide patient management.

Patients and methods:

A total of 21 primary initial diagnosis HR-NMIBC tumours were analysed by Illumina HumanMethylation450 BeadChip arrays and subsequently bisulphite Pyrosequencing. In all, 7 had not recurred at 1 year after resection and 14 had recurred and/or progressed despite intra-vesical BCG. A further independent cohort of 32 HR-NMIBC tumours (17 no recurrence and 15 recurrence and/or progression despite BCG) were also assessed by bisulphite Pyrosequencing.

Results:

Array analyses identified 206 CpG loci that segregated non-recurrent HR-NMIBC tumours from clinically more aggressive recurrence/progression tumours. Hypermethylation of CpG cg11850659 and hypomethylation of CpG cg01149192 in combination predicted HR-NMIBC recurrence and/or progression within 1 year of diagnosis with 83% sensitivity, 79% specificity, and 83% positive and 79% negative predictive values.

Conclusions:

This is the first genome-wide DNA methylation analysis of a unique HR-NMIBC tumour cohort encompassing known 1-year clinical outcomes. Our analyses identified potential novel epigenetic markers that could help guide individual patient management in this clinically unpredictable disease.
Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil
Authors: Renkonen Suvi , Mäkitie Antti A , Bäck Leif
Published: January 2018

Objectives:

Benign enlargement of the lingual tonsils due to various causes may cause symptoms that warrant treatment. Conventional lingual tonsillectomy remains a challenging procedure, and there is no established standard procedure. We aimed to review the patients receiving different methods of lingual tonsil surgery for various indications at our institute.

Methods:

Retrospective clinical data on all patients with an ablative operation of the tongue base during the 8-year period between 2007 and 2014 at the Helsinki University Hospital, Helsinki, Finland, were reviewed. The larger cohort comprised 35 patients, of whom 26 were men (74%). Ten patients had undergone solely lingual tonsil radio frequency ablation (LTRFA). The minimum follow-up time for all patients was 2 years.

Results:

Of the 10 patients, 5 patients with LTRFA had been operated on because of symptomatic lingual tonsil hypertrophy and 5 because of periodic fever associated with possible lingual tonsil involvement. In 2 of the 5 patients with periodic fever, the fever cycles ended after the operation. Of the 5 patients, 3 patients with symptomatic lingual tonsil hypertrophy have been non-symptomatic after 1 to 3 treatment sessions. The last 2 patients continue to have persistent symptoms. There were no major complications.

Conclusions:

Development of new approaches for the management of various lingual tonsil conditions is warranted. Lingual tonsil volume reduction by LTRFA seems to be a treatment alternative with low morbidity but with limited curative effect only.
Daylight, Shape, and Cross-Cultural Influences Through the Routes of Discoveries: The Case of Baroque Temples
Authors: Cabeza-Lainez Joseph M , Almodovar-Melendo Jose M
Published: January 2018

Baroque temples were developed in the context of cross-cultural influences through new territories where the climatic conditions were often opposed to those prevailing in Europe. The nature of weather differences could not be predicted with the knowledge of the era and consequently, a set of gradual and successive transformations in the typologies “imported” from Europe was produced. These adaptations were lengthy, intuitive, and not always recognizable by the Metropolitan culture. Although daylight requirements played an important role in this process and its quality in baroque temples is celebrated by architectural historians, very few daylighting simulations and on-site measurements have been developed. Therefore, a twofold result is produced: Daylighting’s beneficial effects can neither be transmitted nor reproduced in other new buildings. Consequently, we discuss in this article the results of a daylighting simulation program capable of analyzing complex baroque temples around the world and to show the implications of its environmental attitude.
In defense of digital commoning
Authors: Kostakis Vasilis
Published: January 2018

This article is a reply to ‘The illusion of the digital commons’, an idea introduced by Ossewaarde and Reijers. Their criticism challenges those of us arguing that digital commons are emancipatory, exhibiting post-capitalist dynamics. From the perspective of the digital commoner as well as that of the scholar who studies commoning practices, my thesis is that digital commoning is not grounded in a-political principles as the authors claim. But rather it introduces a political platform upon which various progressive movements are converging.
Mendelian randomization in multiple sclerosis: A causal role for vitamin D and obesity?
Authors: Harroud Adil , Richards J Brent
Published: January 2018

The etiology of multiple sclerosis (MS) involves a complex interplay of genetic and environmental factors. Epidemiologic studies have furthered our understanding of these risk factors but remain limited by residual confounding and potential for reverse causation, particularly in MS where time of disease onset is not known. Mendelian randomization (MR) uses genetic variants to study the causal effect of modifiable exposures on an outcome. This method avoids some of the limitations of classical epidemiology and can strengthen causal inference. Here, we introduce the basic concepts of MR and review its contributions to the field of MS. Indeed, several studies using MR have now provided support for a causal role for low vitamin D level and obesity in the development of MS.
Epigenetic modifications in brain and immune cells of multiple sclerosis patients
Authors: Castro Kamilah , Casaccia Patrizia
Published: January 2018

Multiple sclerosis (MS) is a debilitating neurological disease whose onset and progression are influenced by the interplay of genetic and environmental factors. Epigenetic modifications, which include post-translational modification of the histones and DNA, are considered mediators of gene–environment interactions and a growing body of evidence suggests that they play an important role in MS pathology and could be potential therapeutic targets. Since epigenetic events regulate transcription of different genes in a cell type–specific fashion, we caution on the distinct functional consequences that targeting the same epigenetic modifications might have in distinct cell types. In this review, we primarily focus on the role of histone acetylation and DNA methylation on oligodendrocyte and T-cell function and its potential implications for MS. We find that decreased histone acetylation and increased DNA methylation in oligodendrocyte lineage (OL) cells enhance myelin repair, which is beneficial for MS, while the same epigenetic processes in T cells augment their pro-inflammatory phenotype, which can exacerbate disease severity. In conclusion, epigenetic-based therapies for MS may have great value but only when cellular specificity is taken into consideration.
The role of testosterone in MS risk and course
Authors: Chitnis Tanuja
Published: January 2018

There is significant animal model data demonstrating a benefit of testosterone on both inflammatory and neuroprotective mechanisms relevant to multiple sclerosis (MS). Several studies have demonstrated lowered testosterone levels in up to 40% of men with MS. Lower testosterone levels were correlated with worsened scores of physical and cognitive disability. There is increasing data suggesting a role of testosterone in MS risk. A pilot study has demonstrated significant benefits of testosterone replacement therapy on cognitive, radiological, and immunological outcome measures in men with MS. Larger studies in other conditions have demonstrated concerns in terms of cardiovascular risk, which indicate the need for careful monitoring upon administration to MS patients. Further studies are needed to develop safer testosterone preparations, which preserve its multiple beneficial effects, as well as multicenter clinical trials to evaluate safety, dosing, and efficacy in larger populations of men with MS. Additionally, studies are needed to further explore the role of androgens as a risk factor for MS, particularly at key life transitions.
The political geography of government formation: Why regional parties join coalitions
Authors: Falcó-Gimeno Albert
Published: January 2018

Political parties differ in the geographic distribution of their support. This article argues that a regionalized distribution of a party’s votes facilitates its participation in government, because it produces a tendency to prioritize demands for locally targeted goods that are more conducive to the negotiation of reciprocal logrolling agreements with potential partners. Using a measure based on the Gini coefficient, I empirically evaluate the extent to which the geographic concentration of votes plays a role in the formation of governments, taking Spanish local elections from 1987 to 2011 as a test bed. With around 500 formation opportunities and 20,000 potential governments, multinomial choice models are estimated (conditional and mixed logits) and a very sizable effect is documented: A one-standard deviation increase in the electoral geographic concentration of the members of a potential government almost doubles the likelihood of its formation. These findings are relevant for students of government formation, regional parties, and political geography.
Behaviour of carbon fibre–reinforced polymer-confined hollow circular concrete columns with inner polyvinyl chloride tube
Authors: Goaiz Hussam A , Yu Tao , Hadi Muhammad NS
Published: January 2018

Existing studies have shown that the use of an inner tube can significantly enhance the effectiveness of confinement in fibre-reinforced polymer-confined hollow columns. The inner tube used in the existing studies, however, generally had a large stiffness and also served as longitudinal reinforcement. The use of a stiff inner tube is inefficient in resisting bending for hollow columns with a relatively small void and may be unnecessary for constraining the inner surface of concrete. Against this background, this article presents the first experimental study on fibre-reinforced polymer-confined hollow columns with an inner polyvinyl chloride tube. The experimental program included a total of 18 specimens which were tested under axial compression. The test variables included the section configuration (i.e. solid specimens, hollow specimens and hollow specimens with a polyvinyl chloride tube) and the thickness of fibre-reinforced polymer. The test results showed that due to the beneficial effect of the polyvinyl chloride tube which provided constraints/confinement from inside, fibre-reinforced polymer-confined hollow columns with an inner polyvinyl chloride tube generally possessed good strength and ductility compared to their counterparts without a polyvinyl chloride tube.
Road lighting research for drivers and pedestrians: The basis of luminance and illuminance recommendations
Authors: Fotios S , Gibbons R
Published: January 2018

This article discusses quantitative recommendations for road lighting as given in guidelines and standards, primarily, the amount of light. The discussion is framed according to the type of road user, the driver and the pedestrian, these being the user groups associated with major and minor roads, respectively. Presented first is a brief history of road lighting standards, from early to current versions, and, where known, the basis of these standards. Recommendations for the amount of light do not appear to be well-founded in robust empirical evidence, or at least do not tend to reveal the nature of any evidence. This suggests a need to reconsider recommended light levels, a need reinforced by recent developments in the science and technology of lighting and of lighting research. To enable improved recommendations, there is a need for further evidence of the effects of changes in lighting: This article therefore discusses the findings of investigations, which might be considered when developing new standards.
Perceived well-being and light-reactive hormones: An exploratory study
Authors: Tonello G , Hernández de Borsetti N , Borsetti H , Tereschuk L , López Zigarán S
Published: January 2018

Light can impact psychobiological processes in a healthy or harmful way, challenging designers to better understand the resources they are manipulating. The present exploratory study compared two forms of office lighting which differed in correlated colour temperatures and light level. A holistic approach, comprising visual, emotional and biological dimensions, was used to assess the lighting conditions that could favour productivity and well-being by means of the identification of congruent relationships between objective and subjective measurements in response to light stimuli. The former included analyses of melatonin and cortisol, and the latter were psychological instruments for measuring transitory mood, somnolence, and visual comfort. Controlled experiments were run in a laboratory with a repeated measures design, which yielded fifty-six evaluations. Although no extreme ranges of correlated colour temperatures were used in this study, the spectral blue component present in the correlated colour temperature of approximately 4000 K, and also provided by the light-emitting diodes system at a higher light level, could have contributed to render most of the strong effects on the inter and intra correlations among the psychobiological responses. The mediator role of the psychological profile of the individuals was demonstrated by the significant predictive value of the perceived stress measures.
Dancing between Nordic and neoliberal: Lifelong learning in South Korea
Authors: Choi Jinhee , Kim Junghwan
Published: January 2018

This article aims to examine the government-centered lifelong learning model of South Korea using two representative lenses of lifelong learning: Nordic and neoliberal models. By investigating the socio-economic and political backgrounds of lifelong learning in South Korea, we address how South Korea has developed an original lifelong learning model that differs from both the Nordic and the neoliberal models. Our examination implies that South Korea’s lifelong learning model in its provisions, networks, and inclusion policy requires discernment for promoting better social equity and democratic participation, especially for underrepresented citizens.
A Multicenter Experience With a New Fenestrated-Branched Device for Endovascular Repair of Thoracoabdominal Aortic Aneurysms
Authors: Youssef Marwan , Deglise Sebastien , Szopinski Piotr , Jost-Philipp Schäfer , Jomha Amer , Vahl Christian F. , Koshty Ahmed
Published: January 2018

Purpose: To investigate the outcomes of patients who were treated for thoracoabdominal aortic aneurysms (TAAAs) using custom-made fenestrated-branched stent-grafts. Methods: A consecutive series of 108 patients (mean age 73.5 years; 73 men) with TAAA were treated with E-xtra Design Engineering customized fenestrated-branched stent-grafts between November 2011 and January 2017. Data on baseline characteristics, procedures, and clinical follow-up were collected from 6 regional European surgical centers for retrospective analysis of endoleaks, reinterventions, and target vessel patency. The median aneurysm diameter was 6.75 cm (range 5.5–13). The distribution of the TAAA according to the modified Crawford classification of extent was 25 (24%) type I, 19 (17%) type II, 20 (18%) type III, 29 (27%) type IV, and 15 (14%) type V. Results: Technical success was achieved in 95% (103/108) of cases. Major early perioperative complications occurred in 40 (37%) patients. The 30-day mortality was 9.2% (10/108), and perioperative spinal cord ischemia was observed in 6 (5.5%) patients [2 (1.8%) permanent]. During the mean follow-up of 17.6 months (range 3–52), 28 (26%) patients required late reintervention. Two patients died due to aneurysm- or procedure-related causes. The estimated survival rates at 1, 2, and 4 years were 87%, 84%, and 51%, respectively. The estimated target vessel patency rates at the same time points were 95%, 91%, and 90%, respectively. The freedom from reintervention estimates were 84% and 73% at 1 and 4 years, respectively. Conclusion: Endovascular repair of TAAA using Jotec customized fenestrated-branched stent-grafts appears to be safe and effective in the early to midterm. The considerable rate of secondary interventions indicates that further improvements, graft surveillance, and follow-up are required.
Methodological Cyborg as Black Feminist Technology: Constructing the Social Self Using Computational Digital Autoethnography and Social Media
Authors: Brown Nicole Marie
Published: January 2018

This article reimagines the quantified self within the context of Black feminist technologies. Bringing computation and autoethnographic methods together using a methodology I call computational digital autoethnography, I harvest my social media data to create a corpus for analysis. I apply topic modeling to these data to uncover themes that are connected with broader societal issues affecting African American women. Applying a computational autoethnographic approach to a researcher’s own digitized data allows for yet another dimension of mixed-methods research. This radical intervention has the potential to transform the social sciences by bringing together two seemingly divergent methodological approaches in service to Black feminist ways of knowing.
NREM Sleep and Antiepileptic Medications Modulate Epileptiform Activity by Altering Cortical Synchrony
Authors: Nayak Chetan S. , Mariyappa N. , Majumdar Kaushik K. , Ravi G. S. , Prasad Pradeep D. , Nagappa Madhu , Kandavel Thennarasu , Taly Arun B. , Sinha Sanjib
Published: January 2018

Introduction. The activating role of non–rapid eye movement (NREM) sleep on epileptic cortex and conversely, the seizure remission brought about by antiepileptic medications, has been attributed to their effects on neuronal synchrony. This study aims to understand the role of neural synchrony of NREM sleep in promoting interictal epileptiform discharges (IEDs) in patients with epilepsy (PWE) by assessing the peri-IED phase synchrony during awake and sleep states. It also studies the role played by antiepileptic drugs (AEDs) on EEG desynchronization in the above cohort. Methods. A total of 120 PWE divided into 3 groups (each n = 40; juvenile myoclonic epilepsy [JME], temporal lobe epilepsy [TLE]. and extratemporal lobe epilepsy [Ex-TLE]) were subjected to overnight polysomnography. Each patient group was subdivided into drug-naive and on treatment (Each n = 20). EEG phase synchronization analysis was performed to compare peri-IED phase synchronization indices (SI) during awake and sleep stages and between drug naïve and on treatment groups in 4 frequency bands, namely delta, theta, alpha, and beta. The mean ± SD of peri-IED SI among various subgroups was compared employing a multilevel mixed effects modeling approach. Results. Patients with JME had increased peri-IED cortical synchrony in N3 sleep stage, whereas patients with partial epilepsy had increased IED cortical synchrony in N1 sleep stage. On the other hand, peri-IED synchrony was lower during wake and REM sleep. We also found that peri-IED synchronization in patients with JME was higher in drug-naive patients compared with those on sodium valproate monotherapy in theta, alpha, and beta bands. Conclusion. The findings of this study suggest that sleep stages can alter cortical synchrony in patients with JME and focal epilepsy, with NREM IEDs being more synchronized and wake/REM IEDs being less synchronized. Furthermore, it also suggests that AEDs alleviate seizures in PWE by inhibiting cortical synchrony.
Collective memory and social media: Fostering a new historical consciousness in the digital age?
Authors: Birkner Thomas , Donk André
Published: January 2018

The impact of social media has grown significantly during the past decade in several fields of our society. This article advocates the research subfield of social media memory studies based on empirical data from a case study on the role of social media in a local conflict about re-naming a public square in an average German town. The square had been named after Paul von Hindenburg, who played a crucial role in the implementation of Adolf Hitler as German Reichskanzler and was therefore regarded as an inadequate public patron. Conservatives fought against the new name, also on Facebook. Our findings indicate that the platform played a decisive role as counter-public sphere against hegemonic mainstream media and politics in fostering a new historical consciousness. The case might be seen as a precedent of right-wing movements and their use of social media in the Brexit campaign or the US elections.
Same-day dual radial artery puncture examination in patients requiring percutaneous coronary intervention and the incidence of radial artery occlusion
Authors: Brancheau Daniel , Jain Sachin Kumar Amruthlal , Alexander Patrick B.
Published: January 2018

Background:

We sought to investigate the rate of radial artery occlusion (RAO) after same-day dual radial artery puncture. The trans-radial arterial approach (TRA) for diagnostic and interventional procedures has risen significantly in the United States. Although becoming more commonly performed, TRA is not without risk, and a potential complication is RAO. The rate of RAO after same-day dual artery puncture is unknown.

Methods:

A retrospective analysis of 27 patients who underwent same-day dual radial artery puncture for percutaneous coronary intervention (PCI) at our institution (Providence Heart Institute in Southfield, MI, USA) from November 2011 to December 2013 were included after initially presenting for cardiac catheterization at a non-PCI-capable facility. The study patients were asked to follow up for evaluation of the radial artery, including obtaining a duplex ultrasound evaluation.

Results:

The mean age of the patients was 65 years old with 66% of the patients being male. Of the 27 study participants, there were no symptoms reported that were related to RAO. Overall, one (3.7%) patient had an absent radial pulse. The modified Allen’s test was normal in all of the patients with a mean return of palmar flush time of 4 seconds. Duplex ultrasound revealed subtotal RAO in four (14.8%) patients and no patients experienced total occlusion following the intervention.

Conclusion:

Dual radial artery puncture appears to be a well-tolerated and viable strategy in patients that are transferred to a PCI-capable hospital for coronary interventions.
The impact of comorbidities, sex and age on the occurrence of acute kidney injury among patients undergoing nephron-sparing surgery
Authors: Hellou Elias , Bahouth Zaher , Sabo Edmond , Abassi Zaid , Nativ Ofer
Published: January 2018

Background:

The aim of this study was to report the impact of patients’ baseline characteristics on the incidence of acute kidney injury (AKI) after nephron-sparing surgery (NSS) for localized kidney cancer.

Patients and methods:

Data from our kidney cancer database were retrospectively extracted to include 402 patients who underwent NSS between March 2000 and June 2016, and had sufficient data. Definition of AKI was based on the postoperative serum creatinine levels and estimated glomerular filtration rate (eGFR) magnitude, which were measured during the 72 h after surgery.

Results:

Based on RIFLE and AKIN criteria, the overall rate of postoperative AKI was 35%. The average decrease in eGFR among patients who developed AKI was 20% as compared with the non-AKI subgroup (2%). In univariate analysis, variables that were associated with AKI included right-sided tumors ( p = 0.014), male sex ( p = 0.01), hypertension ( p = 0.003), baseline eGFR ( p = 0.009) and history of nephrolithiasis ( p = 0.039). However, multivariate analysis revealed that the only independent predictors of postoperative AKI were hypertension ( p = 0.009) and cigarette smoking ( p = 0.024).

Conclusion:

AKI is a common complication of NSS affecting about one-third of the patients. The most important risk factors are hypertension and smoking.
Development of a personalized therapeutic strategy for ERBB-gene-mutated cancers
Authors: Milewska Malgorzata , Cremona Mattia , Morgan Clare , O’Shea John , Carr Aoife , Vellanki Sri HariKrishna , Hopkins Ann M. , Toomey Sinead , Madden Stephen F. , Hennessy Bryan T. , Eustace Alex J.
Published: January 2018

Background:

The application of genomic technologies to patient tumor samples identified groups of signaling pathways which acquire activating mutations. Some cancers are dependent on these mutations and the aberrant proteins resulting from these mutations can be targeted by novel drugs which can eradicate the cancer.

Methods:

We used www.cbioportal.org to determine the frequency of ERBB mutations in solid tumors. We then determined the sensitivity of a panel of cell lines to clinically available PI3K inhibitors. Using proliferation and apoptosis assays as well as functional interrogation with reverse phase protein arrays we demonstrated the impact of targeting ERBB-mutant cancers with the combination of a PI3K inhibitor and the pan-HER family inhibitor afatinib.

Results:

In over 14,000 patients we found that 12% of their tumors have an ERBB family gene mutation (EGFR, ERBB2, ERBB3 and ERBB4). In cancers not commonly associated with HER family protein overexpression, such as ovarian, endometrial, melanoma and head and neck cancers ( n = 2116), we found that ERBB family mutations are enriched, occurring at rates from 14% to 34% and commonly co-occur with PIK3CA mutations. Importantly, we demonstrate that ERBB family mutant cancers are sensitive to treatment with PI3K inhibitors. Finally we show that the combination of afatinib and copanlisib represents a novel therapeutic strategy for patients whose cancers harbor both ERBB family and PIK3CA mutation.

Conclusions:

We demonstrate that ERBB family mutations are common in cancers not associated with overexpression or amplification of HER family proteins. These ERBB family mutant cancers are sensitive to treatment with PI3K inhibitors, and when combined with pan-HER inhibitors have synergistic antiproliferative effects.
Online Physical Therapy Protocol Quality, Variability, and Availability in Achilles Tendon Repair
Authors: Lightsey Harry M. , Noback Peter C. , Caldwell Jon-Michael E. , Trofa David P. , Greisberg Justin K. , Vosseller J. Turner
Published: January 2018

Background: Substantial progress has been made in characterizing the benefit of early functional rehabilitation following Achilles tendon repair (ATR). However, standardized ATR rehabilitation guidelines have yet to be produced. Furthermore, as patients increasingly use the Internet to independently retrieve health care content, access to standardized, clinically effective rehabilitation protocols is necessary. Methods: Online ATR physical therapy protocols from US academic orthopaedic programs were reviewed. A comprehensive scoring rubric was designed after reviewing all identified protocols and was used to assess each protocol for both the presence of various rehabilitation components as well as when those components were introduced. Results: Twenty-two of 155 US academic orthopaedic programs published postoperative Achilles rehabilitation protocols online, with a total of 27 individual protocols available for review. Twenty-one protocols (78%) recommended immediate postoperative splinting. Only one protocol recommended short-leg casting. Twenty-six protocols (96%) advised immediate nonweightbearing with progression to weightbearing as tolerated at an average of 3.0 weeks (range, 1-8 weeks) and to full weightbearing at an average of 7.3 weeks (range, 2-12 weeks). Active plantarflexion and dorsiflexion to neutral were included by most protocols (93%) at an average of 3.9 (range, 0-9) weeks and 3.4 (range, 0-8) weeks, respectively. There was considerable variability in the inclusion and timing of strengthening, stretching, proprioception, and basic cardiovascular exercises. Fourteen protocols (52%) recommended return to training after meeting certain athletic activity criteria. Conclusion: The purpose of this investigation was to evaluate the quality, variability, and patient accessibility of publicly available rehabilitation protocols for ATR provided by US orthoapedic teaching programs. To this end, we found that a minority of US academic orthopaedic programs publish ATR rehabilitation protocols online. While a trend away from traditional ankle casting is apparent, many programs have not adopted the accelerated weightbearing and controlled mobilization techniques that have been shown to produce better functional outcomes and greater patient satisfaction. There is also a substantial degree of variability in both the composition and timing of rehabilitation components across physical therapy protocols.

Levels of Evidence: Level III: Retrospective comparative study
Utility of Third-Week Postoperative Radiographs in the Management of Ankle Fractures
Authors: Şahin Ercan , Kalem Mahmut
Published: January 2018

Objectives. To evaluate the costs and efficacy of radiographs taken in the third week after fixation of bimalleolar and trimalleolar fractures. Patients and method. A retrospective evaluation was made of patients who underwent surgical fixation because of bimalleolar and trimalleolar fractures between January 1, 2008, and October 1, 2013. Patient demographics (age, gender, body mass index), fracture type, follow-up periods, and fixation methods were recorded, and the radiographs taken on postoperative day 1, at 3 weeks, 6 weeks, and the final follow-up were examined by 2 orthopedists. Measurements were taken of the medial clear space (MCS ≤ 4 mm), the tibiofibular clear space (TFCS < 5 mm), and the talocrural angle (TCA = 83° ± 4°) on the mortise radiograph and of the overlap between the tibial tubercle and fibula (TFO > 10 mm) on the anteroposterior radiograph; residual step (mm) was measured on the lateral radiograph. Results. A total of 263 patients were examined, and of these, 112 were included for evaluation. In the measurements of postoperative day 1, third week, and sixth week and the final radiographs, no statistically significant difference was determined in the MCS, TFCS, TCA, TFO, and residual step values. Because the cost of a series of 3-way ankle radiographs in Turkey is US$3.81 per patient, the cost of the control series for the 112 patients in this study was US$ 427.3. Conclusions. In patients treated surgically for bimalleolar and trimalleolar fractures, the radiographs taken in the third week rarely resulted in a change of patient management. Therefore, it simply constitutes an additional cost for the patient or the hospital.

Levels of Evidence: Level III: Retrospective Cohort study
Thrombophilia-Associated Factors in Patients with Spontaneous Osteonecrosis of the Knee
Authors: Marom Niv , Koch Jonathan EJ. , Beer Yiftah , Ellis Martin , Ganot Gil , Nyska Meir , Maoz Guy , Hetsroni Iftach
Published: January 2018

Objective

To test whether patients with spontaneous osteonecrosis of the knee (SONK) are characterized by abnormal levels of thrombophilia-associated factors.

Design

Twenty-five patients with SONK were recruited. Inclusion criteria were (1) age >40 years, (2) acute onset knee pain not precipitated by trauma, and (3) MRI findings consistent with SONK. Exclusion criteria were (1) history of cancer and chemotherapy and (2) factors associated with secondary osteonecrosis. Blood tests included 13 thrombophilia-associated factors that were either heritable mutations or acquired factors. Descriptive statistics included medians, ranges, means, and standard deviations. Mann-Whitney test was used to compare thrombophilia-associated factor levels between the sexes. Spearman’s rank test was used to test correlations between smoking status and each thrombophilia-associated factor. Level of significance was set at 0.05.

Results

Median patient age was 62 years (range, 44-77 years). There were 16 (64%) men. Thirteen (52%) patients had thrombophilia-associated factor abnormalities of which 9 were elevated fibrinogen but this was less than 1 standard deviation above norm threshold. Other findings were 3 patients with marginally decreased antithrombin below norm threshold, low protein S Ag in only 1 patient, and factor V Leiden mutation heterozygosity in 2 patients, which was not higher than normal population prevalence. Thrombophilia-associated factors neither differed between sexes ( P = nonsignificant) nor correlated with smoking status ( P = nonsignificant).

Conclusion

Thrombophilia-associated factor abnormalities in patients with SONK were minimal. Therefore, clinical workup and treatment strategy in this disease should focus on addressing alternative etiologies leading to abnormal subchondral bone metabolism with focal osteopenia.
Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study
Authors: Gorostegi-Anduaga Ilargi , Corres Pablo , MartinezAguirre-Betolaza Aitor , Pérez-Asenjo Javier , Aispuru G Rodrigo , Fryer Simon M , Maldonado-Martín Sara
Published: January 2018

Background

Both exercise training and diet are recommended to prevent and control hypertension and overweight/obesity.

Purpose

The purpose of this study was to determine the effectiveness of different 16-week aerobic exercise programmes with hypocaloric diet on blood pressure, body composition, cardiorespiratory fitness and pharmacological treatment.

Methods

Overweight/obese, sedentary participants ( n = 175, aged 54.0 ± 8.2 years) with hypertension were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups (2 days/week: high-volume with 45 minutes of moderate-intensity continuous training (MICT), high-volume and high-intensity interval training (HIIT), alternating high and moderate intensities, and low-volume HIIT (20 minutes)). All variables were assessed pre- and post-intervention. All participants received the same hypocaloric diet.

Results

Following the intervention, there was a significant reduction in blood pressure and body mass in all groups with no between-group differences for blood pressure. However, body mass was significantly less reduced in the attention control group compared with all exercise groups (attention control –6.6%, high-volume MICT –8.3%, high-volume HIIT –9.7%, low-volume HIIT –6.9%). HIIT groups had significantly higher cardiorespiratory fitness than high-volume MICT, but there were no significant between-HIIT differences (attention control 16.4%, high-volume MICT 23.6%, high-volume HIIT 36.7%, low-volume HIIT 30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants.

Conclusions

The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of blood pressure, cardiorespiratory fitness and body composition in overweight/obese and sedentary individuals with hypertension. High-volume HIIT seems to be better for reducing body mass compared with low-volume HIIT. The exercise-induced improvement in cardiorespiratory fitness is intensity dependent with low-volume HIIT as a time-efficient method in this population. ClinicalTrials.gov Registration: NCT02283047.
Orthogonal strategy based computer-mediated negotiation: Principles and example
Authors: Susetyo Cahyono , Timmermans Harry , de Vries Bauke
Published: January 2018

Previous efforts to improve stakeholders’ involvement in planning and decision-making processes mostly put planners and decision makers as the ones who decide which solution is the best for the decision problems. In bottom-up planning and decision-making processes that supposedly involve stakeholders as much as possible, the most common practice is that when stakeholders have different preferences about the decision issues, supra decision makers such as planners and experts gather stakeholders’ preferences, and then, using their expertise and experience, decide what is the best choice for stakeholders. We approach the involvement of stakeholders in planning and decision-making not by relying on planners’ expertise but from a negotiation perspective. Previous works related to stakeholders’ negotiation mostly require stakeholders to engage in a face-to-face negotiation that seldom involves a computer system to improve the process. In this paper, we develop a negotiation system to support multi-issue and multi-stakeholder decision-making problems. In our approach, stakeholders do not directly interact with each other. Their proposals are submitted to a system that produces counter-proposals to reduce the differences among stakeholders’ proposals. Therefore, stakeholders do not exchange their preferences directly, but rather preference elicitations are mediated by the system. This approach is called computer-mediated negotiation. The system itself is based on the principle of an orthogonal strategy. Our computer-mediated negotiation protocol consists of two main phases. The first phase is the preference elicitation phase, which measures stakeholders’ utility functions. The second phase is the e-negotiation phase, in which stakeholders make their proposals and the computer system provides suggestions to improve them. To simulate real-world negotiations where stakeholders make proposals and counter-proposals in a series of negotiation rounds, we implemented the indifference curve approach to enable stakeholders to make incremental changes of their proposals during negotiation. The results from our experiment suggest that our method can produce an optimum solution for a multi-issue and multi-stakeholder decision problem by moving stakeholders’ proposals closer to one another.