bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed implications of private supplementary tutoring for students’ learning
Authors: Mahmud Rafsan
Published: January 2019

Purpose

Private supplementary tutoring, common in many countries, has mixed (both positive and negative) dimensions that impact student learning. Private supplementary tutoring runs parallel to mainstream schooling and provides lessons before or after school hours in exchange for additional fees. The purpose of this paper is to focus on how private supplementary tutoring benefits students’ learning in secondary education. It also identifies the drawbacks of tutoring, and shows variations in and between urban and rural locations.

Design/methodology/approach

The paper employed a mixed methods approach using a survey and individual interview collected from two different research settings: urban and rural. Grades 8 and 10 were purposefully chosen for data collection. A sample of 802 participants, including 401 students and their 401 parents (either mothers or fathers), participated in the survey, in addition to 48 interviewees comprising students, parents and teachers.

Findings

At times, pupils’ educational perspectives are influenced by the conflicting (positive/negative) standpoints of tutoring issues. The paper finds mixed impacts of private tutoring with a focus on disparities of implications between urban and rural locations. It identifies positive aspects such as learning attainment, exam preparation, relationship growth and lesson practice, as well as negative perspectives, such as an examination-centered aim and hamper of mainstream school learning.

Originality/value

The study contributes to the awareness of private supplementary tutoring that benefits students’ learning while also bringing disadvantages. It shows implications of fee-charging tutoring which may relate to students’ family socio-economic situations. The paper addresses private tutoring in general (including English and all other subjects) in most cases, and, more specifically, private tutoring in English as a subject in some cases.
International students in Kazakhstan
Authors: Mukhamejanova Dinara
Published: January 2019

Purpose

Kazakhstan has taken considerable steps to improve the incoming mobility of international students; however, despite these measures, the number of international students studying in Kazakhstan is still very low. Research indicates that in order to attract and retain international students it is necessary to build a thorough understanding of their experiences in the host country. The purpose of this paper is to gain a better understanding of international students’ experiences in Kazakhstan by exploring how they exercise their human agency while adapting to the academic and socio-cultural life in Kazakhstan.

Design/methodology/approach

The author used a purposeful criterion sampling to select six international students from Afghanistan, Great Britain, Russia, South Korea, Ukraine and the USA studying at Kazakhstani universities to participate in this research. The primary data collection was semi-structured in-depth interviews. Supportive methods included a demographic questionnaire and a researcher journal.

Findings

The study revealed that the international students actively employed their human agency to negotiate their studying and to adapt to their life in Kazakhstan. They did not simply adjust to the host environment, but also learned from it and attempted to transform it according to their circumstances and goals.

Research limitations/implications

The implication is that Kazakhstani universities and any other higher education institutions that seek to increase the number of their international students should consider not only how to attract these students, but also how to adapt their institution’s practices and regulations to create an inclusive learning environment for their diverse student population. It is also very important for higher education institutions to provide international students with the necessary conditions to exercise their human agency because as it was revealed by this study, international students’ human agency is a very powerful mechanism helping them live and learn comfortably in their host country.

Originality/value

Taking into consideration the reviewed previous research, this was the first attempt to use Albert Bandura’s social cognitive theory for the purpose of building an understanding about how international students exercise their agency while adapting to the academic and socio-cultural life in the host country. The social cognitive theory allows investigating international students as active and self-sufficient agents of their own adaptation process who can and do change themselves, and have the potential to navigate and alter their host environment to achieve their own goals. This study encourages researchers and practitioners to think about international students outside the dimension of internationalization as a means of improving country’s economic capital.
The role of personalization on continuance intention in food service mobile apps
Authors: Kang Jee-Won , Namkung Young
Published: January 2019

Purpose

This paper aims to examine consumers’ behaviors toward personalized services offered by branded mobile apps in the food service industry by applying privacy calculus theory and technology acceptance model (TAM). Further, this research identified the moderating role of technology anxiety.

Design/methodology/approach

An online survey was carried out to investigate the role of personalization on continuance intention toward branded mobile apps. In total, 348 valid responses were analyzed to test hypotheses using structural equation modeling.

Findings

The results show that personalization had significantly affected perceived benefit, perceived risk and perceived ease of use. Perceived benefit had positive effects on perceived value of disclosure, but perceived risk did not affect perceived value of disclosure. Perceived value of disclosure and perceived ease of use were linked to trust. Trust, in turn, positively affected intentions to use mobile apps. With regard to the moderating effect of technology anxiety, it had a significant moderating impact on the relationship between personalization and perceived risk. However, it did not moderate the relationship between personalization and perceived benefit.

Practical implications

The findings of this study could provide useful theoretical and practical implications related to the successful implementation of mobile marketing.

Originality/value

This study proposes the integrated model of privacy calculus theory and the TAM for deeper understanding of the customers’ responses toward personalization of branded mobile apps.
Migrant women’s health and housing insecurity: an intersectional analysis
Authors: Hanley Jill , Ives Nicole , Lenet Jaime , Hordyk Shawn-Renee , Walsh Christine , Ben Soltane Sonia , Este David
Published: January 2019

Purpose

This paper presents an analysis of how health intersects with the experience of housing insecurity and homelessness, specifically for migrant women. The authors argue that it is important to understand the specificities of the interplay of these different factors to continue the advancement of our understanding and practice as advocates for health and housing security.

Design/methodology/approach

An exploratory, qualitative, methodological approach was adopted, using a broad definition of housing insecurity: from absolute homelessness (e.g. residing rough) to invisible homelessness (e.g. couch surfing) to those at risk of homelessness. In total, 26 newcomer (foreign-born women who came to live in Canada during the previous ten years, regardless of their immigration status) women were recruited in Montreal, Canada. Participants were recruited directly through advertisements in public places and in collaboration with community organizations (women’s centers, homeless shelters, crisis centers, domestic violence shelters, immigrant settlement agencies and ethnic associations) and they self-identified as having experienced housing insecurity. Efforts were made to include a diversity of immigrant statuses as well as diversity in ethnicity, race, country of origin, family composition, sexual orientation, age and range of physical and mental ability. Women were engaged in semi-structured, open-ended interviews lasting approximately 1 h. Interviews were conducted in English or French in a location and time of participants’ choosing.

Findings

The findings are presented around three themes: how health problems instigate and maintain migrant women’s housing insecurity and homelessness; ways in which women’s immigration trajectories and legal status may influence their health experiences; and particular coping strategies that migrant women employ in efforts to maintain or manage their health. The authors conclude with implications of these findings for both policy and practice in relation to migrant women who experience or are at risk of housing insecurity and homelessness.

Originality/value

Intersections of women experiencing migration and housing insecurity in Canadian contexts have rarely been examined. This paper addresses a gap in the literature in terms of topic and context, but also in terms of sharing the voices of migrant women with direct experience with housing insecurity.
Telephone health survey estimates: Effects of nonresponse and sample limitations
Authors: Fowler Floyd J. , Brenner Philip S. , Buskirk Trent D. , Roman Anthony
Published: January 2019

Objective

The objective of this study was to assess nonresponse error in telephone health survey data based on an address‐based sample.

Data Sources

Telephone and in‐person interviews in Greater Boston.

Study Design/Data Collection

Interviewers attempted telephone interviews at addresses that were matched to telephone numbers using questions drawn from federal health surveys. In‐person household interviews were carried out with telephone nonrespondents and at addresses without matching telephone numbers.

Principal Findings

After adjusting for demographic differences, only eight of 15 estimates based on the telephone interviews lay within two standard errors of the estimates when data from all three groups were included.

Conclusions

For health surveys of address‐based samples, many estimates based on telephone respondents differ from the total population in ways that cannot be corrected with simple demographic adjustments.
Clinical practice guideline on atraumatic (pencil‐point) vs conventional needles for lumbar puncture: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine
Authors: Rehn Marius , Chew Michelle S. , Olkkola Klaus T. , Sverrison Kristinn Ö. , Yli‐Hankala Arvi , Møller Morten Hylander
Published: January 2019

The Scandinavian Society of Anaesthesiology and Intensive Care Medicine Clinical Practice Committee endorses the BMJ Rapid Recommendation clinical practice guideline on atraumatic (pencil‐point) vs conventional needles for lumbar puncture. This includes the strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age or indication.
Vision‐related quality of life according to location of visual field loss in patients with glaucoma
Authors: Chun Yeoun Sook , Sung Kyung Rim , Park Chan Kee , Kim Hwang Ki , Yoo Chungkwon , Kim Yong Yeon , Park Ki Ho , Kim Chan Yun , Choi Kyu‐Ryong , Lee Kyoo Won , Han Seungbong , Kim Chang‐sik ,   the LIGHT (Life Quality of Glaucoma Patients Who Underwent Treatment) study of the Korean Glaucoma Society
Published: January 2019

Purpose

To assess influence of the location of visual field (VF) loss on vision‐related quality of life (VRQOL) in patients with glaucoma.

Methods

We included 826 patients with primary open‐angle glaucoma (POAG) enrolled in the prospectively designed Life Quality of Glaucoma Patients Who Underwent Treatment (LIGHT) study organized by the Korean Glaucoma Society. We divided the integrated binocular visual field (IVF) into four regions and evaluated the associations between Rasch‐analysed 25‐item National Eye Institute Visual Function Questionnaire (NEI VFQ‐25) and location of the IVF using univariate and hierarchical multivariable linear regression.

Results

Mean deviation (MD) of the IVF at superior centre showed the lowest value among the four regions. Multivariable linear regression analysis revealed significant correlation of the composite score and all subscales of the NEI VFQ‐25 except ocular pain and near activities at each of four IVF regions. Mean deviation at superior centre showed significant correlation with composite score (R2 = 0.181), near activities (R2 = 0.175), and social functioning (R2 = 0.166); MD at superior periphery showed highest correlation with role difficulties (R2 = 0.137); MD at inferior centre showed highest correlation with driving (R2 = 0.145); and MD at inferior periphery showed significant correlation with distance activities (R2 = 0.214) and dependency (R2 = 0.119).

Conclusion

Four different regions of the IVF had a similarly important impact on subscales of the NEI VFQ‐25 in glaucoma patients. Preservation of the superior field should be considered as much as that of the inferior field for maintaining a good VRQOL in patients with glaucoma.
No conscientious objection without normative justification: A reply
Authors: Blackshaw Bruce P.
Published: January 2019

Benjamin Zolf, in his recent paper ‘No conscientious objection without normative justification: Against conscientious objection in medicine’, attempts to establish that in order to rule out arbitrary conscientious objections, a reasonability constraint is necessary. This, he contends, requires normative justification, and the subjective beliefs that ground conscientious objections cannot easily be judged by normative criteria. Zolf shows that the alternative of using extrinsic criteria, such as requiring that unjustified harm must not be caused, are likewise grounded on normative criteria. He concludes that conscientious objection is therefore untenable. Here, I present an alternative account, based on the value we are willing to place on conscientious objection as an expression of freedom of conscience and religion. Using an extrinsic criterion such as harm, we can make a judgement of what degree of harm should be tolerated as the cost of permitting conscientious objection. A normative criterion for judging individual claims is therefore not required.
Testing the Heckscher–Ohlin–Vanek theory with a natural experiment
Authors: Zimring Assaf
Published: January 2019

I use the historical episode of near‐elimination of commuting from the West Bank into Israel to test three key predictions of the Heckscher–Ohlin–Vanek model of trade and find strong support for them. On the production side, I use variation between districts and find that wage changes were not correlated with the size of the shock to the labour force (factor price insensitivity) and that districts that received larger influx of returning commuters shifted production more towards labour‐intensive industries (Rybczynski effect). On the consumption side, data are consistent with identical homothetic preferences, which, combined with the production results, supports the Heckscher–Ohlin–Vanek theorem on the factor content of trade.
Identification and characterization of a naïve CD8+ T cell repertoire for benzylpenicillin
Authors: Bechara Rami , Maillere Bernard , Joseph Delphine , Weaver Richard J. , Pallardy Marc
Published: January 2019

Background

Beta‐lactams allergy is the most commonly reported drug allergy and constitutes an important health problem. We previously showed the pre‐existence of a naïve CD4+ T cell repertoire for benzylpenicillin (BP) coupled to human serum albumin (HSA) but little is known about the naïve CD8+ T cell repertoire specific for BP.

Objective

The purpose of this work was to identify naïve CD8+ T cells specific for BP and to explore mechanisms dictating their activation.

Methods

Co‐cultures were established with naïve CD8+ T cells and autologous dendritic cells (DCs) loaded with HSA‐BP or free BP. T cells were restimulated once a week with autologous DCs loaded with HSA‐BP or BP. The specific CD8+ T cell response was measured using an IFN‐γ ELISpot assay.

Results

When using free BP, we were able to detect a naïve CD8+ T cell repertoire for BP in the 6 out of 7 tested healthy donors. However, our results showed that HSA‐BP was recognized by naïve CD8+ T cells in only one donor out of five tested healthy donors. Using free BP, we evidenced its binding to cellular proteins in DCs that was concentration dependent and was correlated with BP‐specific CD8+ T cell activation. Moreover, the BP‐specific CD8+ cell response was MHC class I‐dependent and required intracellular processing and proteasome activity.

Conclusion and clinical relevance

This work showed the existence of a naïve CD8+ T cell repertoire for BP when DCs were treated with free BP suggesting that patients could be immunized by haptenated peptides from cellular proteins generated in antigen‐presenting cells.
Immunogenicity assay development and validation for biological therapy as exemplified by ustekinumab
Authors: Mojtahed Poor S , Ulshöfer T , Gabriel L A , Henke M , Köhm M , Behrens F , Geisslinger G , Parnham M J , Burkhardt H , Schiffmann S
Published: January 2019

Introduction of biotherapeutics has been a major milestone in the treatment of different chronic diseases. Nevertheless, the immune system can recognize the administered biological as non-self and respond with generation of anti-drug antibodies (ADA), including neutralizing ADA (nADA). Immunogenic responses may result in altered drug dynamics and kinetics leading to changes in safety and efficacy. However, there are several challenges with standard techniques for immunogenicity testing. Ustekinumab (UST), used in different inflammatory diseases, is a therapeutic antibody directed against the shared p40 subunit of interleukin (IL)-12 and IL-23, interfering in the pathogenically crucial T helper type 1 (Th1)/Th17 pathway. We established and validated different approaches for detection and quantitation of UST, UST-specific ADA and nADA. Addressing the obstacle of complex formation of UST with nADA, we developed an acidification assay to approach the total amount of nADA. Validated methods were based on surface plasmon resonance spectroscopy (SPR), enzyme-linked immunosorbent assay (ELISA) and a cell-based approach to characterize neutralizing capacity of nADA. Parameters assessed were determination and quantitation limits, linearity, range, precision, accuracy and selectivity. Quantitation of ADA and UST was feasible at lower concentrations using ELISA, whereas SPR showed a wider linear range for determination of ADA and UST. Accuracy, precision and linearity for quantitation were comparable using ELISA, SPR and the cell-based approach. All validated parameters fulfill the requirements of regulatory agencies. A combination of the testing approaches could address the increasing demand of precision medicine as it can be suitable for capturing the whole spectrum of immunogenicity and is transferable to other biologicals.
Clinical outcomes and cortical reserve in adrenal histoplasmosis—A retrospective follow‐up study of 40 patients
Authors: Singh Mahaveer , Chandy David D. , Bharani Tamnay , Marak Rungmei S. K. , Yadav Subhash , Dabadghao Preeti , Gupta Sushil , Sahoo Saroj K. , Pandey Rakesh , Bhatia Eesh
Published: January 2019

Objective

Detailed studies of Addison's disease resulting from disseminated adrenal histoplasmosis (AH) are not available. We describe the presentation and prognosis of AH and cortisol status before and after antifungal therapy.

Design

Single‐centre retrospective hospital‐based study of 40 consecutive adults with AH [39 males; age (mean ± SD) 53 ± 11 years] was conducted between 2006 and 2018. The median duration of follow‐up was 2.5 years (range 0.2‐12 years).

Patients and methods

AH was diagnosed by bilateral adrenal enlargement on CT scan and presence of Histoplasma by histology and/or culture of biopsied adrenal tissue. All patients received oral itraconazole and, if required, amphotericin B as per guidelines. ACTH‐stimulated serum cortisol (normal > 500 nmol/L) was measured in 38 patients at diagnosis and re‐tested after one year of antifungal therapy in 21 patients.

Results

Seventy‐three per cent of patients had primary adrenal insufficiency (PAI) and one‐third had an adrenal crisis at presentation. HIV antibody was negative in all patients. Of the 29 patients who completed antifungal therapy, 25 (86%) were in remission at last follow‐up. Overall, 8 (20%) patients died: three had a sudden death, four had severe histoplasmosis and one died due to adrenal crisis. No patient with PAI became eucortisolemic on re‐testing after one year of antifungal therapy. Of the eight patients with normal cortisol at diagnosis, two developed adrenal insufficiency on follow‐up.

Conclusion

All patients with AH tested negative for HIV antibody. While patients achieved a high rate of clinical remission after antifungal therapy, overall mortality was significant. Cortisol insufficiency did not normalize despite treatment.
Obesity and hospital outcomes following traumatic injury: Associations in 9 years of patient data from a single metropolitan area
Authors: Rock Kathryn , Hayward Richard D. , Edhayan Elango
Published: January 2019

Traumatic injury is a leading cause of death and disability worldwide. Obesity may put trauma patients at risk for complications leading to negative clinical outcomes. Data on all hospital admissions due to traumatic injury in the Detroit metropolitan area between 2006 and 2014 were obtained from the Michigan State Inpatient Database. Generalized linear modelling was used to compare patients with and without obesity on three outcomes: mortality, length of hospital stay and total charges for care. Adjusting for demographics, patients with obesity had 26% longer hospitalization. Adjusting for demographics and length of stay, charges were 8% higher. Obesity was unrelated to mortality. Obesity had greater impact on length of stay among younger adults; its relationship with charges emerged only among older adults. Obesity has significant clinical implications for trauma care. Demands for trauma care resources, and the charges associated with providing care, are likely to increase as obesity rates rise.
QingBai decoction regulates intestinal permeability of dextran sulphate sodium‐induced colitis through the modulation of notch and NF‐κB signalling
Authors: Lin Jun‐Chao , Wu Jie‐Qiong , Wang Fang , Tang Feng‐Ying , Sun Jia , Xu Bing , Jiang Mingzuo , Chu Yi , Chen Di , Li Xiaowei , Su Song , Zhang Yujie , Wu Nan , Yang Shaoqi , Wu Kaichun , Liang Jie
Published: January 2019

Objective

Chinese Herb QingBai decoction (QBD) has been approved affective in the treatment of IBD patients in clinic. However, the underlying mechanism remains unknown. We aim to investigate the effect of QBD on the mouse model of ulcerative colitis and its possible mechanism.

Methods

C57/bL mice were given 5% DSS to induce colitis and were divided as QBD and mesalazine group. Weight, faeces and mental status were recorded each day and the histopathological changes (goblet cells etc) of the colon were observed after sacrificed. Fluorescein isothiocyanate‐dextran 4000 was measured to reflect the intestinal mucosal permeability. In addition, cell junction‐related proteins and possible signal pathways were investigated.

Results

QingBai decoction could significantly alleviate the inflammation and the protection effect of colitis is comparable as those in mesalazine enema group. It was found that the permeability reduced significantly with QBD treatment vs the control group, while no significant difference between the mesalazine and QBD groups. QBD treatment could upregulate the expression of tight junction complex（ZO‐1, claudin‐1 and occludin）and muc‐2 expression. It significantly reduced the production and secretion of serials proinflammatory cytokines (IL‐1β, IL‐6, Kc and TNF‐α) compared with the control group. Meanwhile, NF‐κB and Notch pathways were regulated.

Conclusion

QingBai decoction can effectively alleviate intestinal inflammation and mucosal barrier function in colitis mice, and the mechanism may be related to the inhibition of inflammatory cascade as well as enhanced mucus layer barrier and mechanical barrier function by NF‐κB and Notch signalling.
Access to Routinely Collected Clinical Data for Research: A Process Implemented at an Academic Medical Center
Authors: Guerrero Susan C. , Sridhar Sujatha , Edmonds Cynthia , Solis Christina F. , Zhang Jiajie , McPherson David D. , Bernstam Elmer V.
Published: January 2019

Electronic health records are valuable for clinical and translational research. Institutions must protect patient privacy and comply with applicable regulations while allowing appropriate access to clinical data for research. The processes that investigators must follow to access clinical data can be substantially different at different institutions. In this paper, we describe the process developed at our institution that has been active for 5 years and was used to satisfy over 200 requests for access to identified clinical data, usually within 1 day for internal requests and 3 days for visiting researchers.
RANKL is associated with persistent primary teeth and delayed permanent tooth emergence
Authors: Arid Juliana , Xavier Thaís Aparecida , da Silva Raquel Assed Bezerra , De Rossi Andiara , da Silva Lea Assed Bezerra , de Queiroz Alexandra Mussolino , Galo Rodrigo , Antunes Lívia Azeredo Alves , Silva Marcelo José Barbosa , Antunes Leonardo Santos , Abbasoglu Zerrin , Nelson Filho Paulo , Küchler Erika Calvano , Fukada Sandra Yasuyo
Published: January 2019

Background

Tooth eruption is a process that is not fully understood.

Aim

To evaluate whether genetic polymorphisms for RANK/RANKL/OPG are associated with delayed tooth emergence. To evaluate whether the relative expression of this genes is associated with persistent primary teeth.

Design

To evaluate whether genetic polymorphisms for RANK/RANKL/OPG could be involved in delayed tooth emergence, saliva samples from 160 children, aged 6‐13 years old, were analysed. To test if there is correlation between gene expression of RANK/RANKL/OPG in children with delayed tooth emergence and persistent primary teeth, periapical tissue from 15 children with persistent primary teeth and from 15 control subjects were collected for qPCR analysis.

Results

Fifty‐six children with delayed tooth emergence (35%) had at least one permanent tooth with delayed emergence. The T allele in RANKL (rs9594738) increased the risk of delayed tooth emergence (P = 0.02; OR = 1.71, 95%CI 1.09‐2.75). The relative gene expression for RANKL and the ratio RANKL/OPG in children with delayed tooth emergence and persistent primary teeth were lower compared to controls (P = 0.02 and P = 0.005, respectively).

Conclusions

Data suggest that the polymorphism rs9594738 in RANKL is associated with delayed permanent tooth emergence. Moreover, reduced relative gene expression of RANKL in periapical tissue is associated with persistent primary teeth.
High triglyceride to high‐density lipoprotein cholesterol ratio and arterial stiffness in postmenopausal Korean women
Authors: Chung Tae‐Ha , Shim Jae‐Yong , Kwon Yu‐Jin , Lee Yong‐Jae
Published: January 2019

The ratio of triglyceride to high‐density lipoprotein cholesterol (TG/HDL) is positively linked to insulin resistance, and it has emerged as an independent predictor of cardiovascular disease. Menopause is characterized by various detrimental metabolic and vascular changes that may lead to high TG with low HDL cholesterol and arterial stiffness. Several epidemiological studies have reported that high TG/HDL ratio has a positive association with arterial stiffness in both adult and adolescent populations; it is not known whether TG/HDL ratio is related to brachial‐ankle PWV (baPWV) in postmenopausal women. Thus, the authors aimed to investigate the association between TG/HDL ratio and arterial stiffness as measured by baPWV in 434 postmenopausal women. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for high baPWV were calculated after adjusting for confounding variables across TG/HDL ratio quartiles using multiple logistic regression analysis. The mean values of meaningful cardiometabolic variables increased with TG/HDL ratio quartiles. The adjusted baPWV (SEs) significantly increased with TG/HDL quartiles: Q1 = 1412 (22.1), Q2 = 1469 (21.4), Q3 = 1482 (21.0), and Q4 = 1505 (21.6) cm/s after adjusting for age, body mass index (BMI), and systolic blood pressure. The OR (95% CI) of the highest TG/HDL ratio quartile as compared to the lowest TG/HDL ratio quartile for high PWV was 2.77 (1.16‐6.63) after adjusting for age, BMI, smoking status, regular exercise, mean arterial pressure, fasting plasma glucose, total cholesterol level, hypertension, log‐transformed C‐reactive protein, and the use of antihypertensive and lipid‐lowering drugs. The TG/HDL ratio was positively and independently associated with arterial stiffness in postmenopausal Korean women.
‘Absent’ pulmonary valve with intact ventricular septum mimicking tricuspid valve atresia: Prenatal diagnosis and postnatal course
Authors: Monacci Francesca , Bondi Tommaso , Canessa Clementina , Chiappa Enrico
Published: January 2019

Absent pulmonary valve syndrome is a rare congenital heart disease characterized by absent or rudimentary pulmonary valve leaflets and hypoplastic pulmonary annulus. The most common variant, associated with tetralogy of Fallot, implies dilatation of pulmonary branches and usually absent ductus arteriosus. Rarely, absent pulmonary valve occurs with intact ventricular septum: pulmonary branches are normally sized or mildly dilated and ductus arteriosus is usually patent. The rarest type is associated with intact ventricular septum and tricuspid atresia. A close connection has been raised between pulmonary regurgitation and development of tricuspid valve. We describe a case of prenatal diagnosed absent pulmonary valve with intact ventricular septum and patent ductus arteriosus in which severe pulmonary regurgitation caused reversible functional atresia of tricuspid valve. Postnatally, satisfactory biventricular circulation was obtained with inotropic support for a few days while ductus arteriosus closed spontaneously. At a 3‐year follow up the child is asymptomatic without therapy.
Unusual facio‐upper arm band of a fetus mimicking amniotic band syndrome
Authors: Inan Cihan , Sayin N. Cenk , Gurkan Hakan , Erzincan Selen G. , Uzun Isil , Sutcu Havva , Atli Engin , Varol Fusun
Published: January 2019

Amniotic band syndrome can lead to a wide spectrum of congenital abnormalities including orofacial and visceral defects. It is associated with malformations in truncal, craniofacial regions and the limbs, whereas it sometimes may imitate some genetic disorders. Here, we present an atypical case mimicking amniotic band syndrome with a facio‐upper arm band that was having multiple fetal structural abnormalities including scoliosis, bilateral cleft lip and palate, upper limb abnormality, unilateral anophthalmia with contralateral microphthalmia, left hypertrophic kidney and severe ventriculomegaly.
Memory studies and the eighteenth century
Authors: Davis Leith
Published: January 2019

InMemory in Culture, Astrid Erll contends that if we want to understand the various crises of the present, we need to consider the “mental, discursive, and habitual paradigms that were formed in long historical processes – via cultural memory.” In the current climate of debates about the national past, it is timely to take stock of the field of memory studies, as such studies can help us understand, as Ann Rigney suggests, “how stories about the past emerge as common points of reference and, in the process, help to define collective identities.” This article will provide some background to the field of memory studies and discuss two important new directions in the field: a concern with the mediation of memory and an interest in postcolonial, transnational, and “traveling” memory. The specific objective is to consider the relevance of memory studies for scholars of 18th‐century literature and, conversely, the relevance of 18th‐century literature for the field of memory studies. The broader aim is to encourage further work that will focus attention on the constructedness of even the most long‐standing and pervasive national memories.
Quantitative assessment of microperfusion by indocyanine green angiography in kidney transplantation resembles chronic morphological changes in kidney specimens
Authors: Rother Ulrich , Amann Kerstin , Adler Werner , Nawroth Nina , Karampinis Ioannis , Keese Michael , Manap Serhat , Regus Susanne , Meyer Alexander , Porubsky Stefan , Hilgers Karl , Krämer Bernhard K. , Lang Werner , Nowak Kai , Gerken Andreas L. H.
Published: January 2019

Objective

ICG fluorescence angiography enables a quantitative real‐time perfusion assessment in kidney transplantation. The results of intraoperative microperfusion of the kidney allograft were compared to the renal chronicity score in pre‐transplantation kidney biopsy specimens. The intrarenal resistance index was calculated by duplex sonography as a method of reference.

Methods

Seventy‐seven patients with end‐stage renal disease undergoing kidney transplantation were prospectively included in two centers. Correlation analysis of chronic changes in kidney biopsy specimens and the IN ofICGfluorescence signal were investigated.

Results

The results yielded a significantly negative correlation for the renal chronicity (r = −0.294,P = 0.017) as well as the intestinal fibrosis and tubular atrophy score (r = −0.328,P = 0.007). There was a significant inverse relationship between the IN and the meanRIvalues of the upper pole of the kidney allograft.

Conclusions

In summary, fluorescence angiography reflects preexisting morphological changes of the renal cortex.ICGangiography may serve as an alternative method for the assessment of microperfusion of the kidney allograft.
Long‐term outcome and mode of recurrence following noninducibility during noninvasive programmed stimulation after ventricular tachycardia ablation
Authors: Shirai Yasuhiro , Liang Jackson J. , Santangeli Pasquale , Arkles Jeffrey S. , Schaller Robert D. , Supple Gregory E. , Lin David , Nazarian Saman , Deo Rajat , Dixit Sanjay , Epstein Andrew E. , Callans David J. , Marchlinski Francis E. , Frankel David S.
Published: January 2019

Background

Noninducibility of ventricular tachycardia (VT) at noninvasive programmed stimulation performed shortly following ablation (negative NIPS) predicts low risk of the medium‐term recurrence. This study aimed to evaluate long‐term rate and mode of recurrence following negative NIPS.

Methods

We extended follow‐up on patients in whom no VT could be induced at NIPS following ablation between 2008 and 2010. Recurrent VTs were categorized as “Original clinical” if they matched VT that had occurred spontaneously prior to the index ablation; “Original nonclinical” if they matched VT that was induced during the index ablation but had not occurred spontaneously; or “New.” Among those undergoing repeat ablation, the area ablated to treat the recurrent VT was categorized as “Targeted initial scar” if it was targeted during the index procedure; “Untargeted initial scar” if it was present but not targeted during the index procedure; or “New scar” if it was not present during the index procedure.

Results

Of 60 patients with negative NIPS, 18 (30%) had recurrent VT and nine underwent repeat ablation over (4.1 ± 3.2) years follow‐up. Of 23 recurrent VTs, 18 (78%) were “New.” During repeat ablations, six (46%) of the 13 recurrent VTs were ablated in “untargeted initial scar” and four (31%) in “new scar.”

Conclusions

When spontaneous or inducible VTs are eliminated with ablation and no longer inducible during NIPS, these VTs are unlikely to recur during long‐term follow‐up. More commonly, new VTs occur, which are either associated with areas of scar not present or not targeted during the initial ablation.
Failure to detect life‐threatening arrhythmias in ICDs using single‐chamber detection criteria
Authors: Stroobandt Roland X. , Duytschaever Mattias F. , Strisciuglio Teresa , Van Heuverswyn Frederic E. , Timmers Liesbeth , De Pooter Jan , Knecht Sébastien , Vandekerckhove Yves R. , Kucher Andreas , Tavernier Rene H.
Published: January 2019

Background

There are anecdotal reports of sudden death despite a functional implantable cardioverter defibrillator (ICD). We sought to describe scenarios leading to fatal or near‐fatal outcome due to inappropriately inhibited ICD therapy in devices programmed with single‐chamber detection criteria.

Methods

Programmed settings, episode lists, and intracardiac electrograms from 24 patients with a life‐threatening event (n = 12) or fatal outcome (n = 12) related to failed ventricular arrhythmia detection were used to clarify the underlying scenario.

Results

Fifty episodes of failed ventricular arrhythmia detection were identified and categorized into six scenarios: (1) spontaneous ventricular tachycardia (VT) or ventricular fibrillation (VF) with a rate below the detection limits, (2) misclassification of polymorphic VT (PVT) or VF as supraventricular tachycardia (SVT), (3) misclassification of VT/VF as cluster of nonsustained VT episodes, (4) misclassification of monomorphic VT (MVT) as SVT, (5) inappropriate shock abortion, and (6) false termination detection. These scenarios occurred respectively 6, 9, 3, 9, 8, and 15 times. In 9/9 (100%) patients with PVT/VF classified as SVT, rate stability was active for rates ranging from 222 to 250 beats/min. MVT detected as SVT was due to the sudden onset criterion in 7/9 (78%) patients and twice a consequence of the rate stability criterion active for rates ranging from 200 to 250 beats/min.

Conclusion

We describe six scenarios leading to failure of ventricular arrhythmia detection in a single‐chamber detection setting withholding life‐saving therapy. These scenarios are more likely to occur with high‐rate programming and long detection times, especially if combined with rate stability and sudden onset.
Social anxiety disorder and avoidant personality disorder from an interpersonal perspective
Authors: Frandsen Frederik Weischer , Simonsen Sebastian , Poulsen Stig , Sørensen Per , Lau Marianne Engelbrecht
Published: January 2019

Objectives

The general objective of this article is to study the unclear and overlapping relationship between social anxiety disorder (SAD) and avoidant personality disorder (AvPD) from an interpersonal perspective. The first specific objective is to compare the disorders with regard to interpersonal problems and general symptom distress. The second specific objective is to examine interpersonal subgroups and pathoplasticity.

Design

In a cross‐sectional design, patients from an outpatient psychotherapy clinic diagnosed with social anxiety disorder (SAD, n = 299), avoidant personality disorder (AvPD, n = 180), or the comorbid condition of both disorders (AvPD + SAD, n = 29) were assessed before treatment.

Methods

Patients filled out the Inventory of Interpersonal Problems (IIP‐64) and the Symptom Checklist‐Revised (SCL‐R‐90) before treatment.

Results and Conclusions

From an interpersonal perspective, the relationship between the diagnostic groups is well described by the severity continuum hypothesis, with similar interpersonal problems related to Nonassertiveness and lower levels of general interpersonal stress in the SAD group compared to the two AvPD groups. However, other differences in severity do not fit the severity continuum hypothesis, as there are no differences in severity on the global severity index, and, moreover, the SAD group has the most severe problems on the SCL‐90 phobic anxiety scale. Interpersonal pathoplasticity is not found in the diagnostic groups or in the full sample. However, three interpersonal subgroups are identified in the full sample, designated as Nonassertive, Friendly‐submissive, and Cold‐submissive. Implications for treatment are discussed.

Practitioner points

SAD is characterized by a lower level of interpersonal distress compared to AvPD, but the two disorders are similar in having Nonassertiveness as their general interpersonal problem.

Contrary to expectation, SAD and AvPD did not differ in general level of symptom severity, and patients with SAD reported more problems with phobic anxiety than AvPD patients did.

When understanding SAD and AvPD as different conceptualizations of the same disorder and analysing all patients together, three distinct interpersonal subgroups emerge, which can be identified as Nonassertive, Friendly‐submissive, and Cold‐submissive.
Multiple melanocytic nevi restricted to mycosis fungoides patches in pediatric and young‐adult patients. The potential role of local immunosuppression
Authors: Martinez‐Escala Maria Estela , Amin Sapna Modi , Sable Kimberly Anne , Gerami Pedram , Guitart Joan
Published: January 2019

We described the development of multiple melanocytic nevi within long‐standing MF patches in four young patients. Mycosis fungoides (MF) patches are characterized by a regulatory‐like cytokine profile leading to local immune suppression. The proliferation of nevomelanocytes is regulated by cellular senescence mechanisms mediated by immune system. The immunosuppressive effect of MF infiltrate in conjunction with the systemic effect of treatments may play a specific role in the nevomelanogenesis of the patients herein described.
Digital mapping of soil ecosystem services in Scotland using neural networks and relationship modelling—Part 1: Mapping of soil classes
Authors: Aitkenhead Matt J. , Coull Malcolm C.
Published: January 2019

A digital mapping approach was applied to soils in Scotland, producing maps at 100‐m resolution and different levels of classification. This used neural networks to predict fuzzy soil class weightings based upon site descriptors from existing soil survey data. The intention of this work was to produce a set of soil maps for Scotland, which provide greater spatial resolution mapping than currently available, and provide fuzzy data to be used in mapping of ecosystem services using a novel approach explained in a second paper. When selecting the class with the highest weighting for test data points, Producer's Accuracy of 70.7% was achieved in mapping the broadest classification (five classes), while Producer's Accuracy levels of 59.9% and 43.7% were achieved for 11 and 30 classes, respectively. Evaluation of confusion matrices generated from the neural network model tests showed that, particularly for the classification systems with 11 and 30 classes, misclassification errors were more common between similar soil classes than between classes that were very different from one another. This implies that straightforward estimation of classification accuracy that measures “correct” and “incorrect” gives misleading results, and that the fuzzy classification maps are more useful than the crisp classification accuracy values. These fuzzy classification maps are therefore potentially useful for evaluating ecosystem services relating to soil type. We conclude that the mapping approach used here provides a classification accuracy comparable to other approaches and that the outputs can be used for mapping soil properties, processes, functions and ecosystem services.
A double‐blinded, randomized, methylprednisolone‐controlled study on the efficacy of oclacitinib in the management of pruritus in cats with nonflea nonfood‐induced hypersensitivity dermatitis
Authors: Noli Chiara , Matricoti Irina , Schievano Carlo
Published: January 2019

Background

Oclacitinib is a Janus‐kinase inhibitor that decreases interleukin‐31‐induced pruritus in cats. At 0.4–0.6 mg/kg/day orally, it decreased pruritus and skin lesions in <50% of allergic cats.

Hypothesis/Objectives

To evaluate efficacy and safety of oclacitinib in feline nonflea nonfood‐induced hypersensitivity dermatitis (NFNFIHD).

Animals

Forty cats with NFNFIHD.

Methods and materials

Cats were randomly assigned to receive oclacitinib (group A, 20 cats, 0.7–1.2 mg/kg) or methylprednisolone (group B, 20 cats, 0.5–1 mg/kg) orally twice daily for 28 days. On day (D)1 and D28, lesions were evaluated using the Scoring Feline Allergic Dermatitis (SCORFAD) scale and owners assessed pruritus using a Visual Analog Scale (VAS) and quality of life (QoL) questionnaire. Results were analysed by General Linear Mixed Model (P < 0.05). Haematochemical analyses were performed on D1 and D28.

Results

In both groups all parameters improved significantly, with no difference at either time point. Group A had a 61% mean SCORFAD and 54% pruritus VAS improvement, compared with 69% and 67% in group B; 70% of cats in group A and 75% in group B achieved a ≥ 50% reduction of pruritus VAS scores; with 60% and 80% of SCORFAD. There were five non‐responders in group A and three in group B. The QoL score improved in both groups (25 and 21%). Four of 14 cats had mild increases in kidney function tests (oclacitinib group) and three of 12 cats had elevated alanine transferase (methylprednisolone group).

Conclusions and clinical importance

Oclacitinib appears to be effective for treating pruritus and lesions in cats with NFNFIHD, albeit methylprednisolone seemed to perform better.
The Elekta Fraxion™ system is not suitable for maxillary fixation in canine conformal radiation therapy techniques
Authors: Yu Sonya , Morrow Deanna , Moutrie Vaughan , Lurie David
Published: January 2019

In this prospective, exploratory study, we evaluated the positioning accuracy in a group of 15 dogs undergoing fractionated stereotactic radiotherapy for tumors affecting the head, using a modified human maxillary fixation device (Elekta Fraxion™ system). Positioning was assessed using on‐board volumetric imaging, with a six‐degrees‐of‐freedom image registration technique. Prior to treatment delivery, CBCT images were obtained and patient alignment was corrected, in both translational and rotational planes, using a six‐degrees‐of‐freedom robotic patient positioning system (HexaPOD Evo RT System). The maximum angular inter‐fraction motions observed were 6.1° (yaw), 10.9° (pitch), and 4.5° (roll). The mean systematic translational errors were 4.7, 2.6, and 2.3 mm, mean random translational errors were 3.0, 2.2, and 2.5 mm, and mean overall translational errors were 2.4, 0.7, and 2.3 mm in the cranial‐caudal, lateral, and dorsal‐ventral directions, respectively. The mean systematic rotational errors were 1.17°, 0.77°, and 1.43°, the mean rotational random errors were 1.65°, 1.46°, and 1.34° and the mean overall rotational errors were 0.56°, 0.22°, and 0.29° in the yaw, pitch, and roll directions, respectively. The mean error of the three‐dimensional vector was 6.9 mm with a standard deviation of 3.8 mm. Ninety‐five percent of the three‐dimensional vectors were <14.8 mm. This study demonstrates that this maxillary fixation device relies on six‐degrees‐of‐freedom registration and an ability to apply corrections using a six‐degrees‐of‐freedom couch for accurate patient positioning and tumor targeting. Its use in conformal radiation therapy in dogs is not recommended.