bluuebunny/crossref_metadata_2025 huggingface dataset:
Staff Nurse Decisional Involvement in the United States and Turkey
Authors: Ugur Esra , Scherb Cindy A. , Specht Janet P. , Sen Sevim , Lazzara Lydia K.
Published: December 2016

The purpose of this descriptive comparative study is to compare the levels of decisional involvement of staff nurses between one Midwestern health care system in the United States with a nongovernmental University hospital in Turkey. The Decisional Involvement Scale was used for data collection. U.S. ( n = 163) and Turkey ( n = 50) staff nurses were included in the study. Both samples preferred more decisional involvement than they currently experienced. However, Turkish nurses experienced and preferred lower levels of decisional involvement than the U.S. sample. Shared governance structures may be a strategy used to enhance staff nurse decisional involvement.
Therapeutic approaches to pediatric pseudotumor cerebri: New insights from literature data
Authors: Vitaliti Giovanna , Pavone Piero , Matin Nassim , Tabatabaie Omidreza , Cocuzza Salvatore , Vecchio Michele , Maiolino Luigi , Di Mauro Paola , Conti Angelo , Lubrano Riccardo , Serra Agostino , Falsaperla Raffaele
Published: December 2016

The pseudotumor cerebri syndrome (PTCS), also known as idiopathic intracranial hypertension (IIH), is characterized by signs and symptoms of increased intracranial pressure such as headache and cranial nerve palsies, in the absence of any space-occupying mass. This condition commonly affects overweight women of childbearing age, even if it is also frequent in men and children. Children with PTCS may present with atypical signs and symptoms, with a different prognosis compared to adults. However, the treatment is the same for both children and adults, even if there are no strict treatment guidelines in regards. All treatment strategies in children are based on retrospective studies and none has been evaluated in prospective or randomized controlled trial studies. This review focuses on literature data on PTCS treatment in children.
Optimisation of power generation cycles using saturated liquid expansion to maximise heat recovery
Authors: Read MG , Smith IK , Stosic N
Published: December 2016

The use of two-phase screw expanders in power generation cycles can achieve an increase in the utilisation of available energy from a low-temperature heat source when compared with more conventional single-phase turbines. The efficiency of screw expander machines is sensitive to expansion volume ratio, which, for given inlet and discharge pressures, increases as the expander inlet vapour dryness fraction decreases. For single-stage screw machines with low inlet dryness, this can lead to underexpansion of the working fluid and low isentropic efficiency. The cycle efficiency can potentially be improved by using a two-stage expander, consisting of a machine for low-pressure expansion and a smaller high-pressure machine connected in series. By expanding the working fluid over two stages, the built-in volume ratios of the two machines can be selected to provide a better match with the overall expansion process, thereby increasing the efficiency. The mass flow rate though both stages must be matched, and the compromise between increasing efficiency and maximising power output must also be considered. This study is based on the use of a rigorous thermodynamic screw machine model to compare the performance of single- and two-stage expanders. The model allows optimisation of the required intermediate pressure in the two-stage expander, along with the built-in volume ratio of both screw machine stages. The results allow specification of a two-stage machine, using either two screw machines or a combination of high-pressure screw and low-pressure turbine, in order to achieve maximum efficiency for a particular power output. For the low-temperature heat recovery application considered in this paper, the trilateral flash cycle using a two-stage expander and the Smith cycle using a high-pressure screw and low-pressure turbine are both predicted to achieve a similar overall conversion efficiency to that of a conventional saturated vapour organic Rankine cycle.
“They Shouldn’t Be Coming to the ED, Should They?”: A Descriptive Service Evaluation of Why Patients With Palliative Care Needs Present to the Emergency Department
Authors: Green Emilie , Ward Sarah , Brierley Will , Riley Ben , Sattar Henna , Harris Tim
Published: December 2016

Background:

Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED.

Methods:

This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records.

Results:

A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted.

Conclusions:

Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient’s presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.
Education for the Next Frontier in Patient Safety: A Longitudinal Resident Curriculum on Diagnostic Error
Authors: Ruedinger Emily , Olson Maren , Yee Justin , Borman-Shoap Emily , Olson Andrew P. J.
Published: December 2016

Diagnostic error is a common, serious problem that has received increased attention recently for its impact on both patients and providers. Presently, most graduate medical education programs do not formally address this topic. The authors developed and evaluated a longitudinal, multimodule resident curriculum about diagnostic error and medical decision making. Key components of the curriculum include demystifying the medical decision-making process, building skills in critical thinking, and providing strategies for diagnostic error mitigation. Special attention was paid to avoiding the second victim effect and to fostering a culture that supports constructive, productive feedback when an error does occur. The curriculum was rated by residents as helpful (96%), and residents were more likely to be aware of strategies to reduce cognitive error (27% pre vs 75% post, P < .0001) following its implementation. This article describes the development, implementation, and effectiveness of this curriculum and explores generalizability of the curriculum to other programs.
A viscoelastic Timoshenko shaft finite element for dynamic analysis of rotors
Authors: Ganguly Smitadhi , Nandi A , Neogy S
Published: December 2016

A new shaft element is proposed for viscoelastic rotors in a spinning frame considering the shear deformation in addition to bending deformation. The Maxwell–Wiechert model is considered here to replicate linear viscoelastic behavior. This model considers additional internal damping displacement variables between elastic and viscous elements and the stress depends not only on the elastic strain and elastic strain rate, but also on additional strains and their rates corresponding to the damping variables. The present work assumes that these additional strains can be derived from continuous fictitious displacement variables, which in turn are interpolated from their nodal values using the Timoshenko beam shape functions. Therefore, in addition to the standard degrees of freedom for a three-dimensional shaft, extra degrees of freedom are defined at the nodes. The finite element matrices are assembled in state space. The time domain equations are then used for stability analysis and computation of response to a unit step load and an unbalance.
Sericin ameliorated dysmorphic mitochondria in high-cholesterol diet/streptozotocin rat by antioxidative property
Authors: Ampawong Sumate , Isarangkul Duangnate , Aramwit Pornanong
Published: December 2016

Sericin has been implicated in lower cholesterolemic effect due to its properties with several mechanisms. Mitochondria are one of the most important targets to be affected in high blood cholesterol and glucose conditions. The protective role of sericin on mitochondria remains doubtful. To examine this role, electron microscopic, histopathologic, immunohistochemical, and biochemical studies were performed in a high-cholesterol diet/streptozotocin rat model. The results demonstrated that sericin reduced blood cholesterol without hypoglycemic effect. Sericin alleviated dysmorphic mitochondria in heart and liver but not in kidney and also decreased peculiar endoplasmic reticulum in the exocrine pancreas. In addition, sericin decreased hepatic steatosis and preserved zymogen granule referable to the decline of reactive oxygen species production in hepatic mitochondrial extraction and down-regulation of malondialdehyde expression in the liver and exocrine pancreas however irrelevant to lipase activity. This study suggests that sericin has antioxidative property to reduce blood cholesterol by means of diminishing fat deposit in hepatocyte and improves mitochondria and endoplasmic reticulum integrities.

[Box: see text]
Consciousness and Amnesia
Authors: Martek Igor , Lozanovska Mirjana
Published: December 2016

After the decimation of the urban fabric resulting from the 1963 earthquake, Skopje, the capital of Macedonia, became a center of town planning and architectural activity. The aftermath response was unprecedented, with eighty-five countries offering aid and thirty-five nations raising Skopje to a priority status within the United Nations (UN). The acclaimed Japanese architect, Kenzo Tange, was awarded first prize in the subsequent UN competition for the reconstruction master plan and was asked to work with the second prize winners, Zagreb firm Miscevic and Wenzler. The design and rebuilding produced one of the greatest collaborative and visionary realizations of a complete city concept undertaken in history. Yet, the significance of Skopje’s reconstruction has slipped from architectural consciousness. “Actor network theory” (ANT) offers insights into the social dynamics of large-scale projects and provides a lens by which to investigate five features of the reconstruction of Skopje: (1) the social process, including problematization, interessement, enrollment, and mobilization; (2) the key participants; (3) the project scale; (4) artifacts; and (5) project duration. ANT proves to be a useful tool for understanding both the heroic achievement and the subsequent neglect of Skopje reconstructed.
Sociocultural Characteristic, Lifestyle, and Metabolic Risk Factors Among a Sample of Kuwaiti Male University Students
Authors: Al-Sejari Maha
Published: December 2016

In the past six decades, the Kuwaiti population has been exposed to rapid transformation in the quality of diet intake, daily activities, and career types. This major socioeconomic shift was accompanied by the introduction of both communicable and noncommunicable chronic diseases afflicting people of all ages. This article aims to detect a relationship between sociocultural characteristics—such as physical activity, dietary habits, and smoking—and the prevalence of metabolic syndrome (MetS). A descriptive, cross-sectional survey was conducted among 262 male university students in Kuwait; participants were selected by using a convenient nonrandom opportunistic sample. Associated social and health factors were obtained using a closed-ended questionnaire. BMI and blood tests that include clusters of MetS risk components were drawn from participants in primary health care clinics. More than half of the participants were overweight and obese; 74.4% of the participants reported they did not visit a nutritionist; 69.8% said that they are currently not on a diet; 53.4% of the students were nonsmokers; 42.7% reported moderate to very low daily physical activity. The prevalence of MetS components increased among students with older age, employed, and married ( p < .001), higher BMI, higher income, smoking, fewer number of family members living, and belonging to the Shia religious sect ( p < .05). The high frequency of MetS among younger students needs to be considered by Kuwaiti community members and the government to highlight the risk factors of MetS on individuals’ well-being, quality of life, and life expectation.
Facilitating the interpretation of pedobarography: the relative midfoot index as marker for pathologic gait in ankle osteoarthritic and contralateral feet
Authors: Arno Frigg , Roman Frigg , Martin Wiewiorski , Jennifer Goldoni , Monika Horisberger
Published: December 2016

Background

Pedobarography offers dynamic information about the foot, but the interpretation of its large data is challenging. In a prior study it was shown that attention can be restricted to pedobarographic midfoot load data. We aim to verify this observation in ankle osteoarthritic and contralateral feet.

Methods

We assessed both feet of 120 patients with end‐stage ankle osteoarthritis (OA) and 35 healthy volunteers with AOFAS‐score and dynamic pedobarography in barefoot condition. We introduce a new parameter, the Relative Midfoot Index (RMI), representing the depth of the midfoot weighted by the maximal force (MF) in the hindfoot and forefoot. Main outcome measures were the RMI, MF and contact times in the hindfoot, midfoot and forefoot. Ankle OA, contralateral and healthy feet were compared with ANOVA.

Results

The RMI was significantly smaller in OA feet (0.65 ± 0.19) and contralateral feet (0.69 ± 0.15) than in healthy feet (0.84 ± 0.08, p < 0.0001). There was no significant difference between OA and contralateral feet. The RMI showed a correlation of 0.48 with the AOFAS score. Contralateral and OA feet were significantly different from healthy feet (p < 0.001) in all parameters except the hindfoot MF. An RMI <0.8 showed a positive predictive value of 80% and sensitivity of 78% for being unhealthy.

Conclusion

The RMI assists the interpretation of pedobarographic parameters and provides a user‐friendly indicator for unhealthy foot conditions with a cut‐off value of 0.8. The contralateral feet of ankle OA patients differed significantly from healthy feet and are therefore not suitable as control group.

Level of Evidence: 3 case control study
The relationship between foot posture index, ankle equinus, body mass index and intermetatarsal neuroma
Authors: Naraghi Reza , Bremner Alexandra , Slack‐Smith Linda , Bryant Alan
Published: December 2016

Background

The main purpose of this study was to investigate the presence of an association between intermetatarsal neuroma and foot type, as measured by the Foot Posture Index. The study also examined whether there was a relationship between foot type and the interspace affected with intermetatarsal neuroma, and whether ankle equinus or body mass index had an effect.

Methods

In total, 100 participants were recruited from The University of Western Australia's Podiatry Clinic, 68 of whom were diagnosed with inter‐metatarsal neuroma from 2009 to 2015. There were 32 control participants recruited from 2014 to 2015. The age of subjects was recorded, as were weight and height, which were used to calculate body mass index. The foot posture index and ankle dorsiflexion were measured using standard technique. Independent t‐tests and Kruskal‐Wallis tests were used to compare differences in foot posture index, body mass index and ankle dorsiflexion between the inter‐metatarsal neuroma and control groups. Multivariable logistic regression was also used to model relationships for outcome.

Results

The 68 intermetatarsal neuroma subjects had a mean age of 52 years (range 20 to 74 years) and comprised of 56 females and 12 males. The 32 control subjects had a mean age of 49 years (range 24 to 67 years) with 26 females and six males. There were no significant differences between the control and the intermetatarsal neuroma groups with respect to the mean foot posture index scores of the left and right foot (p = 0.21 and 0.87, respectively). Additionally no significant differences were detected between the affected intermetatarsal neuroma interspace and foot posture index (p = 0.27 and 0.47, respectively). There was no significant difference in mean body mass index between the intermetatarsal neuroma (26.9 ± 5.7) and control groups (26.5 ± 4.1) (p = 0.72). There was, however, a significant difference in mean ankle dorsiflexion between the intermetatarsal neuroma and control groups (p < 0.001 for both feet). Logistic regression models, adjusted for age, sex, foot posture index and body mass index estimated that the odds of having an intermetatarsal neuroma in the right foot increased by 61% (OR 1.61; 95% CI 1.32–1.96) with each one degree reduction of ankle dorsiflexion, and in the left foot by 43% (OR 1.43; 95% CI 1.22–1.69).

Conclusion

No relationships were found between foot posture index and body mass index with intermetatarsal neuroma, or between foot posture index and the interspaces affected. However, a strong association was demonstrated between the presence of intermetatarsal neuroma and a restriction of ankle dorsiflexion.
Decreasing loco-regional recurrence for oral cavity cancer with total Mohs margins technique
Authors: Bergeron Mathieu , Gauthier Pierre , Audet Nathalie
Published: December 2016

Background

The conventional technique for cancer resection margin analysis studies only 0.1% of the surgical margins. Complete frozen section margins - also known as Mohs margins – allows for analysis of 100% of the surgical margins.

Methods

The objective of our study is to compare oral cavity cancer loco-regional recurrence rates when treated by total frozen sections technique (Total Mohs margins) versus conventional margins. We conducted a multicenter retrospective cohort chart review. Loco-regional oral cancer recurrence rates were compared between patients treated with total Mohs margins (2007–2013) and patients treated with conventional margins techniques (2002–2007).

Results

After applying inclusion criteria, a total of 60 patients treated by total Mohs margins and 57 patients with conventional margins were identified. Patients had similar baseline cancer stages, pathological types, past head and neck cancers and comorbidities (all p > 0.05). One-year recurrence rate was lower (10.0% vs 21.1%, p = 0.019) in favor of Mohs total margins and stayed significantly lower at 5 years of follow-up. When adjusted for T grade with N0 disease, Mohs technique was still beneficial in loco-regional recurrence for Tis-T4N0 up to 2 years (10.5% vs 25.7%, z-score 1.849, p = 0.032). The Number Needed to Treat at 2 years of follow-up for this subgroup of patients (Tis-T4N0) is 6.6. Margins had to be retaken more often intra-operatively in Mohs technique (68.3% vs 12.3%, p < 0.0001), mainly for positive deep margins (48.6% of all margins, p = 0.028). Duration of surgery was not increased with Mohs vs conventional technique (380 min vs 475 min respectively, p = 0.025).

Conclusions

Mohs total margins may result in a significant reduction in cancer recurrence rate at 5 years compare to conventional surgery. Moreover, duration of surgery was not increased when using Mohs technique when judiciously performed.
Metagenome phylogenetic profiling of microbial community evolution in a tetrachloroethene-contaminated aquifer responding to enhanced reductive dechlorination protocols
Authors: Reiss Rebecca A. , Guerra Peter , Makhnin Oleg
Published: December 2016

Chlorinated solvent contamination of potable water supplies is a serious problem worldwide. Biostimulation protocols can successfully remediate chlorinated solvent contamination through enhanced reductive dechlorination pathways, however the process is poorly understood and sometimes stalls creating a more serious problem. Whole metagenome techniques have the potential to reveal details of microbial community changes induced by biostimulation. Here we compare the metagenome of a tetrachloroethene contaminated Environmental Protection Agency Superfund Site before and after the application of biostimulation protocols. Environmental DNA was extracted from uncultured microbes that were harvested by on-site filtration of groundwater one month prior to and five months after the injection of emulsified vegetable oil, nutrients, and hydrogen gas bioamendments. Pair-end libraries were prepared for high-throughput DNA sequencing and 90 basepairs from both ends of randomly fragmented 400 basepair DNA fragments were sequenced. Over 31 millions reads were annotated with Metagenome Rapid Annotation using Subsystem Technology representing 32 prokaryotic phyla, 869 genera, and 3,181 species. A 3.6 log2 fold increase in biomass as measured by DNA yield per mL water was measured, but there was a 9% decrease in the number of genera detected post-remediation. We apply Bayesian statistical methods to assign false discovery rates to fold-change abundance data and use Zipf’s power law to filter genera with low read counts. Plotting the log-rank against the log-fold-change facilitates the visualization of the changes in the community in response to the enhanced reductive dechlorination protocol. Members of the Archaea domain increased 4.7 log2 fold, dominated by methanogens. Prior to remediation, classes Alphaproteobacteria and Betaproteobacteria dominated the community but exhibit significant decreases five months after biostimulation. Geobacter and Sulfurospirillum replace “Sideroxydans” and Burkholderia as the most abundant genera. As a result of biostimulation, Deltaproteobacteria and Epsilonproteobacteria capable of dehalogenation, iron and sulfate reduction, and sulfur oxidation increase. Matches to thermophilic, haloalkane respiring archaea is evidence for additional species involved in biodegradation of chlorinated solvents. Additionally, potentially pathogenic bacteria increase, indicating that there may be unintended consequences of bioremediation.
High-resolution model building with multistage full-waveform inversion for narrow-azimuth acquisition data
Authors: Mao Jian , Sheng James , Hart Matt , Kim Taejong
Published: December 2016

Full-waveform inversion (FWI) is an attractive tool for high-resolution velocity-model building without a high-frequency assumption compared to conventional reflection tomography. However, there are two main challenges to the application of FWI on narrow-azimuth acquisition (NAZ) data: cycle skipping and acquisition footprints. Here, a multistage FWI is proposed to build a high-resolution model for NAZ data. It is well known that FWI may suffer from a cycle-skipping problem when the starting model is not close enough to the true solution. To mitigate this problem, we introduce dynamic-warping preconditioned full-waveform inversion (DWFWI) as the first stage of the velocity inversion. DWFWI iteratively preconditions the observed early arrivals through dynamic warping to avoid cycle skipping in the model, which allows large-scale background updates. The second stage of our workflow is the conventional FWI with image-guided smoothing (IGFWI). On top of DWFWI, more reflection events are included and inverted through the conventional L2-norm FWI, which can add more detailed updates to the velocity model with much higher resolution. Due to poor crossline sampling, there are strong acquisition footprints on FWI updates in the crossline direction. Image-guided smoothing is used to reduce the acquisition footprints in the FWI gradient as well as to preserve the detailed update around the faults. It is then followed by an additional tomography to update the deep portion. This approach was applied on the Hoop Fault Complex data in the southwestern Barents Sea. The results show that a more geologically realistic and higher-resolution model of the Hoop Fault Complex was obtained, and the migration image and gathers were significantly improved.
We should replace conventional mental health law with
capacity-based law
Authors: Szmukler George , Kelly Brendan D.
Published: December 2016

As general medicine moves away from ‘paternalism’ and places an increasing
emphasis on patient choice and autonomy, George Szmukler and Brendan D.
Kelly debate whether conventional mental health legislation should be
replaced with a model that focuses on the person's decision-making
capabilities.
Non-medical use of olanzapine by people on methadone treatment
Authors: James Philip David , Fida Ali Shaik , Konovalov Pavel , Smyth Bobby P.
Published: December 2016

Aims and method

We examined non-medical use (NMU) of olanzapine among adults on methadone treatment. Information was collected on patient demographics and NMU of olanzapine. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was administered to assess risk among current users of olanzapine.

Results

Ninety-two clients participated and 30% reported lifetime history of NMU of olanzapine. Nine people reported doses of 30 mg or higher on a typical day of use, with three typically using 100 mg. The most common reasons for use were to relieve anxiety and to aid sleep, but a quarter used it to ‘get stoned’. Eleven participants (12%) reported NMU of olanzapine in the preceding month. Eight completed the ASSIST with four scoring in the high-risk zone.

Clinical implications

Self-medication is the dominant motivator for NMU of olanzapine, but hedonic motivations also occur. A small minority show features of dependency. All doctors should be aware of the potential NMU of olanzapine, especially among patients with history of addiction.
What and who? Mindfulness in the mental health setting
Authors: Russell Tamara A. , Siegmund Gerson
Published: December 2016

A strong and growing evidence base exists for the use of mindfulness-based interventions to prevent relapse in major depression and for the self-management of chronic physical health conditions (e.g. pain), but the evidence in other domains of mental health work is still emerging. Much work is being conducted outside the evidence base and standardised protocols, and by individuals with varied levels of experience and training. The (mis)perception of mindfulness as a ‘simple technique’ belies the complexity and skill needed to deliver a mindfulness training that has real therapeutic and transformative power. We propose a framework to help clinicians think through the suitability of mindfulness for their particular client group with the intention of providing guidance for thoughtful decision-making.
“Stubborn Masculine Women”
Authors: Tsampiras Carla
Published: December 2016

In 1832, Lea, a twenty-six-year-old slave from the Graaff-Reinet district of Britain's Cape Colony, complained to the assistant protector of slaves that her female owner, Saartjie van der Merwe, had beaten her. Lea claimed that the beating had resulted in her having a miscarriage during the eight days that she walked to town to lay the complaint. Lea was not alone in complaining about violence experienced at the hands of women owners—in Graaff-Reinet it was common. The legislation that enabled Lea to complain attempted to entrench gendered norms and ideas relating to gender roles and violence. Women in Graaff-Reinet, however, had experiences of violence that did not fit comfortably with ideas about the relationships between violence and gender held by colonial officials. This essay explores aspects of this discomfort and calls for further exploration of what such discomfort might mean for normative ideas of patriarchy, masculinities, and femininities.
Boko Haram, Refugee Mimesis, and the Archive of Contemporary Gender-Based Violence
Authors: Lawrance Benjamin N.
Published: December 2016

Lawrance explores asylum-seeking as an emergent archival form to highlight how the strategies shaping asylum claiming conceal a potentially rich archive of gender-based violence. Asylum seekers today face ever greater obstacles entering western migration fortresses. Protection from the 1951 Refugee Convention seems, at minimal, constricted. Refugees engage new frameworks of persecution to access protection, but they face heavy scrutiny for credibility. The Nigerian claims examined here illustrate how gender-based violence asylum claimants mimetically emphasize Boko Haram as a vehicle for resistance to endemic bureaucratic suspicion, doubt, and disbelief. By reshaping personal testimonies of gender-based violence to foreground persecution by Boko Haram, a discrete group of Nigerian asylum seekers actuate a mimetic strategy engaging powerful—and problematic—tropes about Africa and Africans. Creative strategies anchor complex asylum narratives and render them exotically familiar to adjudicators.
Stromal Hedgehog signaling maintains smooth muscle and hampers micro-invasive prostate cancer
Authors: Yang Zhaohui , Peng Yu-Ching , Gopalan Anuradha , Gao Dong , Chen Yu , Joyner Alexandra L.
Published: December 2016

It is widely appreciated that reactive stroma or carcinoma-associated fibroblasts can influence epithelial tumor progression. In prostate cancer (PCa), the second most common male malignancy worldwide, the amount of reactive stroma is variable and has predictive value for tumor recurrence. By analyzing human PCa protein and RNA expression databases, we found smooth muscle cells (SMCs) are decreased in advanced tumors, whereas fibroblasts are maintained. In three mouse models of PCa, we found the composition of the stroma is distinct. SMCs are greatly depleted in advanced PB-MYC tumors and locally reduced in ERG/PTEN prostates, whereas in TRAMP tumors the SMC layers are increased. In addition, interductal fibroblast-like cells expand in PB-MYC and ERG/PTEN tumors, whereas in TRAMP PCa they expand little and stromal cells invade into intraductal adenomas. Fate mapping of SMCs showed that in PB-MYC tumors the cells are depleted, whereas they expand in TRAMP tumors and interestingly contribute to the stromal cells in intraductal adenomas. Hedgehog (HH) ligands secreted by epithelial cells are known to regulate prostate mesenchyme expansion differentially during development and regeneration. Any possible role of HH signaling in stromal cells during PCa progression is poorly understood. We found that HH signaling is high in SMCs and fibroblasts near tumor cells in all models, and epithelial Shh expression is decreased while Ihh and Dhh are increased. In human primary PCa IHH is expressed the highest, and elevated HH signaling correlates with high stromal gene expression. Moreover, increasing HH signaling in the stroma of PB-MYC PCa resulted in more intact SMC layers and decreased tumor progression (micro-invasive carcinoma). Thus, we propose HH signaling restrains tumor progression by maintaining the smooth muscle and preventing invasion by tumor cells. Our studies highlight the importance of understanding how HH signaling and stromal composition impact on PCa to optimize drug treatments.
Cold-acclimation improves chill tolerance in the migratory locust through preservation of ion balance and membrane potential
Authors: Andersen Mads Kuhlmann , Folkersen Rasmus , MacMillan Heath A. , Overgaard Johannes
Published: December 2016

Most insects have the ability to alter their cold tolerance in response to temporal temperature fluctuations, and recent studies have shown that insect cold tolerance is closely tied to the ability to maintain transmembrane ion-gradients that are important for the maintenance of cell membrane potential (Vm). Accordingly, several studies have suggested a link between preservation of Vm and cellular survival after cold stress, but none have measured Vm in this context. We tested this hypothesis by acclimating locusts (Locusta migratoria) to high (31°C) and low temperature (11°C) for four days before exposing them to cold stress (0°C) for up to 48 hours and subsequently measuring ion balance, cell survival, muscle Vm, and whole animal performance. Cold stress caused gradual muscle cell death which coincided with a loss of ion balance and depolarisation of muscle Vm. The loss of ion-balance and cell polarisation were, however, dampened markedly in cold-acclimated locusts such that the development of chill injury was reduced. To further examine the association between cellular injury and Vm we exposed in vitro muscle preparations to cold buffers with low, intermediate, or high [K+]. These experiments revealed that cellular injury during cold exposure occurs when Vm becomes severely depolarised. Interestingly we found that cellular sensitivity to hypothermic hyperkalaemia was lower in cold-acclimated locusts that were better able to defend Vm whilst exposed to high extracellular [K+]. Together these results demonstrate a mechanism of cold-acclimation in locusts that improves survival after cold stress: Increased cold tolerance is accomplished by preservation of Vm through maintenance of ion homeostasis and decreased K+-sensitivity.
Vitamin C distribution in acerola fruit by near infrared hyperspectral imaging
Authors: Malegori Cristina , Grassi Silvia , Marques Emanuel , de Freitas Sergio , Casiraghi Ernestina
Published: December 2016

The study aims at developing a methodology for qualitative mapping of nutraceutical compounds in fruit by near
infrared hyperspectral imaging (NIR-HSI), focusing on vitamin C mapping in acerola (Malpighia emarginata D.C.), a Brazilian
super-fruit characterised by its high content of ascorbic acid. Despite the fact that the spectral approach has often been
applied to agricultural crops, research on acerola is very limited. So far, it is known that ascorbic acid decreases in
acerola during ripening, but there is no information about its distribution in the fruit from green to red ripe maturity stages.
Towards this aim, hyperspectral images of ten sliced acerola, picked at three maturity stages, were acquired using a
SisuChema NIR-HSI system. On the pre-processed images, combined in a comprehensive matrix, principal component
analysis was computed to select relevant components for classical least square (CLS) regression. CLS allowed
distribution maps of ascorbic acid to be obtained (non-negativity, LOF = 1.9%), using, as reference spectra, acerola juices
enriched with 0% and 5% of vitamin C powder. The pixels correlated with 5%-enriched juice showed a reduction from
29% to 6.5% according to colour changes, confirming a vitamin C decrease along the ripening stages. These results
demonstrated the reliability of NIR-HSI for the evaluation of vitamin C distribution inside the different acerola areas. The
presented approach presents the basis for qualitative mapping of nutraceutical compounds in fruits.
Mitochondrial apoptosis and BH3 mimetics
Authors: Dai Haiming , Meng X. Wei , Kaufmann Scott H.
Published: December 2016

The BCL2-selective BH3 mimetic venetoclax was recently approved for the treatment of relapsed, chromosome 17p-deleted chronic lymphocytic leukemia (CLL) and is undergoing extensive testing, alone and in combination, in lymphomas, acute leukemias, and solid tumors. Here we summarize recent advances in understanding of the biology of BCL2 family members that shed light on the action of BH3 mimetics, review preclinical and clinical studies leading to the regulatory approval of venetoclax, and discuss future investigation of this new class of antineoplastic agent.
MRI appearances of atypical cartilaginous tumour/grade I chondrosarcoma after treatment by curettage, phenolisation and allografting
Authors: Verdegaal S. H. M. , van Rijswijk C. S. , Brouwers H. F. C. , Dijkstra P. D. S. , van de Sande M. A. J. , Hogendoorn P. C. W. , Taminiau A. H. M.
Published: December 2016

Aims

The purpose of this retrospective study was to differentiate between the MRI features of normal post-operative change and those of residual or recurrent disease after intralesional treatment of an atypical cartilage tumour (ACT)/grade I chondrosarcoma.

Patients and Methods

We reviewed the case notes, radiology and histology of 75 patients, who had been treated for an ACT/grade I chondrosarcoma by curettage, phenolisation and bone allografting between 1994 and 2005. The first post-operative Gd-enhanced MRI scan was carried out within one year of surgery. Patients had a minimum of two scans and a mean follow-up of 72 months (13 to 169). Further surgery was undertaken in cases of suspected recurrence.

Results

In 14 patients (18.6%) a second procedure was undertaken after a mean period of 59 months (8 to 114). Radio frequency ablation (RFA) was used in lesions of < 10 mm and curettage, phenolisation and bone grafting for those ≥ 10 mm. Only six of these (8% of total) had a histologically-proven recurrence. No increase in tumour grade was seen at time of recurrence.

Conclusion

Based on this study, we have been able to classify the post-operative MRI appearances into four groups. These groups differ in follow-up, and have a different risk of recurrence of the lesion. Follow-up and treatment vary for the patients in each group. We present a flow diagram for the appropriate and safe follow-up for this specific group of patients. Cite this article: Bone Joint J 2016;98-B:1674–81.
When is the ideal time to operate on a patient with a fracture of the hip?
Authors: Lewis P. M. , Waddell J. P.
Published: December 2016

Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to ‘fast track’ patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting.

This paper has been written following an extensive review of the available literature. An attempt is made to clarify what is meant by early surgery (expeditious versus emergency), and we conclude with a personal view for the practical management of these patients of variable age, fitness and type of surgery performed within services that are often under considerable pressure of finance and available operating theatres and qualified staff.

Cite this article: Bone Joint J 2016;98-B:1573–81.
What is the morbidity of a non-invasive growing prosthesis?
Authors: Gilg M. M. , Gaston C. L. , Parry M. C. , Jeys L. , Abudu A. , Tillman R. M. , Carter S. R. , Grimer R. J.
Published: December 2016

Aims

Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is ‘non-invasive’ and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis.

Patients and Methods

Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma. The minimum follow-up was 24 months for those who survived. Their mean age was 10.4 years (6 to 14). The incidence of complications and further surgery was documented.

Results

The mean follow-up was 64 months (20 to 145). The overall survivorship of the patients was 84% at three years and 70% at five years. Revision-free survival was 81.7% at three years and 61.6% at five years with competing risk analysis. Deep infection occurred in 19.6% of implants at a mean of 12.5 months (0 to 55). Other complications were a failure of the lengthening mechanism in five prostheses (9.8%) and breakage of the implant in two (3.9%). Overall, there were 53 additional operations (0 to 5 per patient). A total of seven patients (14%) underwent amputation, three for local recurrence and four for infection. Their mean limb length discrepancy was 4.3 mm (0 to 25) and mean Musculoskeletal Tumor Society Score functional score was 26.5 (18 to 30) at the final follow-up.

Conclusions

When compared with previously published early results, this mid-term series has shown continued good functional outcomes and compensation for leg-length discrepancy. Infection is still the most common complication: post-operative wound healing problems, central line infection and proximal tibial location are the main risk factors. Cite this article: Bone Joint J 2016;98-B:1697–1703.
Multisite Evaluation of a Data Quality Tool for Patient-Level Clinical
Datasets
Authors: Huser Vojtech , DeFalco Frank J. , Schuemie Martijn , Ryan Patrick B. , Shang Ning , Velez Mark , Park Rae Woong , Boyce Richard D. , Duke Jon , Khare Ritu , Utidjian Levon , Bailey Charles
Published: December 2016

Introduction: Data quality and fitness for analysis are crucial if outputs of
analyses of electronic health record data or administrative claims data should be
trusted by the public and the research community.Methods: We describe a data quality
analysis tool (called Achilles Heel) developed by the Observational Health Data Sciences
and Informatics Collaborative (OHDSI) and compare outputs from this tool as it was
applied to 24 large healthcare datasets across seven different organizations.Results: We
highlight 12 data quality rules that identified issues in at least 10 of the 24 datasets
and provide a full set of 71 rules identified in at least one dataset. Achilles Heel is
a freely available software that provides a useful starter set of data quality rules
with the ability to add additional rules. We also present results of a structured
email-based interview of all participating sites that collected qualitative comments
about the value of Achilles Heel for data quality evaluation.Discussion: Our analysis
represents the first comparison of outputs from a data quality tool that implements a
fixed (but extensible) set of data quality rules. Thanks to a common data model, we were
able to compare quickly multiple datasets originating from several countries in America,
Europe and Asia.
Breaking Down Barriers to Community Inclusion Through Service-Learning: A Qualitative Exploration
Authors: Jones Jennifer L. , Gallus Kami L. , Cothern Amanda S.
Published: December 2016

Lack of meaningful interaction between persons with and without disabilities contributes to prejudice and perpetuates barriers to community inclusion. The current study explored a university-community agency partnership designed to break down barriers to community inclusion by promoting interaction between college students and adults with developmental disabilities. The purpose of this phenomenological study was to discover and describe the experience of undergraduate university students involved in a service-learning project that included visiting the community homes of adults with intellectual and developmental disabilities receiving state services. Final course term papers of 156 undergraduate students were analyzed using a team-based approach. Nine salient themes emerged from the term papers and are discussed. Findings from this study have implications for university faculty and community agencies interested in promoting cultural competence and removing barriers to community inclusion.
EFEITO DA ADIÇÃO DO FERMENTO NATURAL SOBRE A CONTAGEM DE BACTÉRIAS LÁTICAS EM QUEIJO MINAS ARTESANAL DO SERRO
Authors: Paiva Vigínia Nardy , Cunha Ana Luísa Ferreira Simões , Da Cruz Roberta Ribeiro , Sobral Denise , De Souza Rogério Marcos , Pinto Maximiliano Soares
Published: December 2016

Os queijos Minas artesanais possuem grande importância econômica, social, ambiental e política para o estado de Minas Gerais, sendo o responsável pelo sustento direto e indireto de mais de 35 mil famílias. O fermento natural é utilizado pela grande maioria de produtores na forma de soro fermento ou porções de queijos fabricados anteriormente. Todavia o seu uso é indiscriminado o que contribui para a descaracterização do queijo. Até o presente momento não existem estudos envolvendo a utilização do fermento natural na fabricação de queijos Minas artesanais. O objetivo deste estudo foi avaliar o efeito da adição de fermento natural sobre as contagens de bactérias láticas do queijo Minas artesanal do Serro ao longo de 60 dias de maturação. Foram analisados queijos fabricados com e sem fermento natural de três diferentes produtores nos tempos: 8, 20, 40 e 60 dias de maturação, em três repetições. Os resultados mostraram que não houve diferença na contagem de bactérias láticas nos queijos fabricados com e sem fermento natural após oito dias de fabricação. Embora não tenha sido encontrada diferença nas contagens de bactérias láticas dos queijos, certamente há diferença qualitativa na microbiota presente dos queijos provenientes dos dois tratamentos, uma vez que a concentração de sal do fermento natural seleciona certos grupos de bactérias láticas. Estudos de caracterização da microbiota devem ser feitos para que o uso do fermento natural tenha base científica.
The Multiplicity Problem for Periodic Orbits of Magnetic Flows on the 2-Sphere
Authors: Abbondandolo Alberto , Asselle Luca , Benedetti Gabriele , Mazzucchelli Marco , Taimanov Iskander A.
Published: December 2016

We consider magnetic Tonelli Hamiltonian systems on the cotangent bundle of the 2-sphere, where the magnetic form is not necessarily exact. It is known that, on very low and on high energy levels, these systems may have only finitely many periodic orbits. Our main result asserts that almost all energy levels in a precisely characterized intermediate range

(

e
0

,

e
1

)

${(e_{0},e_{1})}$

possess infinitely many periodic orbits. Such a range of energies is non-empty, for instance, in the physically relevant case where the Tonelli Lagrangian is a kinetic energy and the magnetic form is oscillating (in which case,

e
0

=
0

${e_{0}=0}$

is the minimal energy of the system).
„Wenn auf der Erde die Liebe herrschte, wären alle Gesetze entbehrlich.“
Authors: Wischermann Else Maria , Lorenzen Heinz-Jürgen , Hatscher Bernd
Published: December 2016

Das Unmögliche erreichen: wie bekommt man unterschiedliche Bibliotheken, Pflichtexemplarrecht, Innovation, Gleichbehandlung der Bürger bei der Medien- und Informationsversorgung und digitale Herausforderungen unter einen Hut? Drei Bibliotheksvertreter Schleswig-Holsteins, die sehr unterschiedliche Bibliothekstypen vertreten, beschreiben, welche Prämissen zugrunde lagen und welche Hoffnungen sie mit dem Bibliotheksgesetz verbinden.