bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence of tuberculosis infection in hematopoietic stem cell transplantation recipients: A retrospective cohort study from a center in Turkey
Authors: Akı Şahika Zeynep , Sucak Gülsan Türköz , Tunçcan Özlem Güzel , Köktürk Nurdan , Şenol Esin
Published: April 2018

Background

Immune‐compromised patients with latent TB infection (LTBI) are at risk for TB reactivation and should receive prophylaxis. Whereas the tuberculin skin test (TST) has limitations particularly in immune‐compromised patients.

Aims

This retrospective study was conducted to determine the incidence of TB infection in adult HSCT recipients whose preventive therapy for LTBI was determined according to the guidance of targeted TST.

Patients and Methods

Five hundred and fifty‐eight consecutive HSCT recipients (287 autologous and 271 allogeneic) who survived ≥100 days post‐transplantation were included in this analysis.

Results

Tuberculin skin test results were available in 493 of 558 transplants (88.3%). The incidence of negative TST was 54.5% (269 of 493 patients). One multiple myeloma patient with a history of TB and negative TST result and was not on INH prophylaxis developed reactivation of TB infection. None of the recipients under INH prophylaxis (151 of 558 transplants; 27.1%) and none of the 224 patients with TST ≥5 mm developed TB infection.

Discussion

Despite the limitations of being a retrospective analysis and variable prophylaxis thresholds of TST, there are some remarkable results of this analysis. We had no TB infection in the allogeneic HSCT recipients. The high incidence of negative TST results may be attributed to the underlying immune‐deficiency. TST may not be a reliable guide for predicting TB reactivation risk in hematology patients.

Conclusion

Tuberculin skin test may have a high rate of false‐negative and false‐positive results in HSCT recipients. The general guidelines for targeted TST to guide treatment of LTBI may not apply to all regions and situations. More reliable methods are required to predict and treat LTBI in these specific conditions.
Fungal infections in hematopoietic stem cell transplantation in children at a pediatric children’s hospital in Argentina
Authors: Gomez Sergio M. , Caniza Miguela , Fynn Alicira , Vescina Cecilia , Ruiz Clau‐dia , Iglesias Daniela , Sosa Fernanda , Sung Lillian
Published: April 2018

Our primary objective was to describe the incidence of proven or probable invasive fungal infections (IFIs), a devastating complication of hematopoietic stem cell transplant (HSCT), in HCST in a middle‐income country. Secondary objectives were to describe factors associated with IFIs and outcomes. In this single center retrospective study, pediatric patients who underwent a first allogeneic or autologous HSCT from 1998 to 2016 were included. Of the 251 HSCT recipients: 143 transplants were allogeneic and 108 were autologous. Overall, 23 (9%) experienced an IFI, mostly due to yeasts (83%). IFIs were more common in allogeneic HSCT (18/143, 13%) than in autologous HSCT (5/108, 5%; P = .045). Of the 23 patients with IFIs, 14 (61%) died, but only 1 directly from IFI (pulmonary aspergillosis). Overall survival at 3 years was 0.42 ± 0.11 in patients with IFIs and 0.60 ± 0.37 in those without IFIs (P = .049). In Argentina, IFIs during HSCT are common. Recipients of allogeneic HSCT are at higher risk, and IFI is associated with reduced overall survival. Future work should focus on interventions to reduce and improve IFI outcomes in children undergoing transplants in low‐ and middle‐income countries.
Challenges to Societal Progress - Pull-back in Response to Disparities
Authors: Weber Georg F
Published: April 2018

There are empirical grounds for supporting unrestrained, globalized cooperative human measures as being beneficial to the international standard of living. A high extent of interconnectedness on multiple levels has already been realized in transportation systems, energy distribution channels, and communication networks. However, in periods of societal transition, as can be the case under rapid technology development, tensions may arise if disparities in wealth, power, or infrastructure access widen extensively. When subgroups of the citizenry that do not sufficiently partake in progress feel left behind or disenfranchised, their triggering of pull-back phenomena is very common. The pattern is repetitive: disparities not remedied on a lower scale impair integration on a larger scale. Equitable infrastructure maintenance and development, regionally, nationally, and globally, is a powerful policy tool for preempting pull-backs – especially if it is applied to communities with weak support or high inequality. The characteristics of the modern world demand far-reaching collaborations. Only universal interdependence, built from the roots up, can enable progress and social justice.
An Examination of Understandings of Prospective Teachers About Science and Science History
Authors: Yildiz Cemalettin
Published: April 2018

The purpose of this study was to reveal beliefs of prospective teachers about “science” and “science history”. The qualitative research approach was employed in the study. The study group consisted of 150 prospective teachers. A form developed by the researcher was used for data collection. The form consisted of open-ended questions. The data was analyzed using the content analysis method. As a result of the study, it was found that the prospective teachers explained science and science history mostly with the procedural understanding dimension. It was also found that the prospective teachers attributed the low number of female scientists mostly to socio-cultural factors, and success in science to cognitive factors. Lastly, the prospective teachers had positive beliefs about the contribution of science history to cognitive and affective domains, and believed that enriching courses with science history could be done by adopting a teacher-centered approach which involves the teacher’s explaining lives, works, or inventions of various scientists. It is recommended that conceptual, procedural, and contextual dimensions of science are addressed in courses related to science history, and prospective teachers should be informed about how to use science history in their classes.
Oribatid mites (Acari, Oribatida) from Korup National Park (Cameroon): list of taxa, new findings, descriptions of two new species
Authors: Ermilov Sergey G. , Starý Josef
Published: April 2018

The present study is based on oribatid mite material (Acari, Oribatida) collected from the Cameroonian Korup National Park in 2016. A list of identified taxa, including 51 species from 33 genera and 19 families, is presented; of these, 28 species, 16 genera and 6 families are recorded in Cameroon for the first time. Two new species belonging to the genera Lasiobelba and Haplozetes are described: Lasiobelba camerunica sp. nov. differs from Lasiobelba decui (Vasiliu & Ivan, 1995) by the presence of eight pairs of notogastral setae (c represented by alveoli, h3 and their alveoli absent), spindle-form bothridial setae with distinct thin apex and longer notogastral setae la, lm and lp; Haplozetes paracancellatus sp. nov. differs from Haplozetes cancellatus Beck, 1964 by the presence of long interlamellar setae and foveolate anogenital region.
Two new species of the genus Aculus Keifer, 1959 (Acari: Eriophyidae: Phyllocoptinae) from Iran
Authors: Tajaddod Sadegh , Lotfollahi Parisa , De Lillo Enrico
Published: April 2018

During the survey of eriophyoid mite fauna in Ajabshir region of Iran in summer 2016, two new eriophyid species, Aculus asparagi Lotfollahi & Tajaddod sp. nov. on Asparagus verticillatus L. (Asparagaceae) and Aculus thyrsoidi Lotfollahi & Tajaddod sp. nov. on Eryngium thyrsoideum Boiss. (Apiaceae), were found, described and illustrated. Aculus asparagi sp. nov. is the first eriophyoid mite found on an Asparagus and the first Aculus from Asparagaceae. Aculus thyrsoidi sp. nov. is the first Aculus collected on an Eryngium. Both new species appeared to be vagrants on their host plants and no apparent damage was associated to them. A key of the worldwide Aculus species associated with Apiaceae was provided.
Adapting a Technology-Based Eating Disorder Model for Athletes
Authors: Flatt Rachael E. , Taylor Craig Barr
Published: April 2018

Eating disorders (EDs) are common amongst athletes, yet few receive treatment. Given that athletes have a unique set of risk factors for eating disorders and are faced with additional barriers to treatment, new models outside of face-to-face treatment are necessary to reach the population and provide more affordable, tailored, evidence-based care. One solution is to use digital mental health programs to provide primary or supplemental therapy. Digital programs can provide accessibility and privacy, and recent advancements allow for more personalized online experiences. However, there have been no studies to date that integrate technology-based tools to address the especially high prevalence rates of EDs in athletes. This paper describes how an integrated model that includes online screening linked to guided self-help programs, all adapted specifically for athletes, can be used to provide prevention and intervention of EDs in athletes.
Review of economic evaluations of teleophthalmology as a screening strategy for chronic eye disease in adults
Authors: Sharafeldin Noha , Kawaguchi Atsushi , Sundaram Aishwarya , Campbell Sandy , Rudnisky Chris , Weis Ezekiel , Tennant Matthew T S , Damji Karim F
Published: April 2018

Background/aims

Teleophthalmology is well positioned to play a key role in screening of major chronic eye diseases. Economic evaluation of cost-effectiveness of teleophthalmology, however, is lacking. This study provides a systematic review of economic studies of teleophthalmology screening for diabetic retinopathy (DR), glaucoma and macular degeneration.

Methods

Structured search of electronic databases and full article review yielded 20 cost-related articles. Sixteen articles fulfilled the inclusion criteria and were retained for a narrative review: 12 on DR, 2 on glaucoma and 2 on chronic eye disease.

Results

Teleophthalmology for DR yielded the most cost savings when compared with traditional clinic examination. The study settings varied among urban, rural and remote settings, community, hospital and health mobile units. The most important determinant of cost-effectiveness of teleophthalmology was the prevalence of DR among patients screened, indicating an increase of cost savings with the increase of screening rates. The required patient pool size to be screened varied from 110 to 3500 patients. Other factors potentially influencing cost-effectiveness of teleophthalmology were older patient age, regular screening and full utilisation of the equipment. Teleophthalmology for glaucoma was more cost-effective compared with in-person examination. Similarly, increasing number of glaucoma patients targeted for screening yielded more cost savings.

Conclusions

This economic review provides supportive evidence of cost-effectiveness of teleophthalmology for DR and glaucoma screening potentially increasing screening accessibility especially for rural and remote populations. Special selection of the targeted screening population will optimise the cost-effectiveness of teleophthalmology.
The MomConnect helpdesk: how an interactive mobile messaging programme is used by mothers in South Africa
Authors: Xiong Khou , Kamunyori Joy , Sebidi Jane
Published: April 2018

South Africa’s MomConnect mobile messaging programme, which aims to promote safe motherhood and improve pregnancy outcomes for South African women, includes a helpdesk feature which allows women registered on the system to ask maternal and child health (MCH)-related questions and to provide feedback on health services received at public health clinics. Messages sent to the helpdesk are answered by staff located at the National Department of Health. We examined event data from the MomConnect helpdesk database to identify any patterns in messages received, such as correlation of frequency or types of messages with location. We also explored what these data could tell us about the helpdesk’s effectiveness in improving health service delivery at public health clinics. We found that approximately 8% of registered MomConnect users used the helpdesk, and that usage was generally proportional to the use of antenatal care (ANC) services in provinces (as indicated by number of ANC first visits and number of MomConnect registrations), except in two provinces. Language, category and key topics of helpdesk messages were correlated with provinces. Most users accessed the helpdesk to seek maternal information, and where feedback about health services was provided, there were significantly more compliments than complaints. The MomConnect helpdesk is an important resource providing expectant mothers and mothers of infants with an interactive option for accessing MCH-related information—above that included in the standard MomConnect messages—and advances achievement of the health goals of the MomConnect programme.
Sex differences in macronutrient intake and adherence to dietary recommendations: findings from the UK Biobank
Authors: Bennett Elizabeth , Peters Sanne A E , Woodward Mark
Published: April 2018

Objectives

To characterise sex differences in macronutrient intakes and adherence to dietary recommendations in the UK Biobank population.

Design

Cross-sectional population-based study.

Setting

UK Biobank Resource.

Participants

210 106 (52.5% women) individuals with data on dietary behaviour.

Main outcome measures

Women-to-men mean differences in nutrient intake in grams and as a percentage of energy and women-to-men ORs in non-adherence, adjusting for age, socioeconomic status and ethnicity.

Results

There were sex differences in energy intake and distribution. Men had greater intakes of energy and were less likely to have energy intakes above the estimated average requirement compared with women. Small, but significant, sex differences were found in the intakes of all macronutrients. For all macronutrients, men had greater absolute intakes while women had greater intakes as a percentage of energy. Women were more likely to have intakes that exceeded recommendations for total fat, saturated fat and total sugar. Men were less likely to achieve the minimum recommended intakes for protein, polyunsaturated fat and total carbohydrate. Over 95% of men and women were non-adherent to fibre recommendations. Sex differences in dietary intakes were moderated by age and to some extent by socioeconomic status.

Conclusions

There are significant sex differences in adherence to dietary recommendations, particularly for sugar. However, given the increased focus on food groups and dietary patterns for nutritional policy, these differences alone may not be sufficient for policy and health promotion. Future studies that are able to explore the sex differences in intakes of different food groups that are risk factors for diet-related diseases are warranted to improve the current understanding of the differential impact of diet on health in women and men.
A smartphone application for reporting symptoms in adults with cystic fibrosis: protocol of a randomised controlled trial
Authors: Wood Jamie , Jenkins Sue , Putrino David , Mulrennan Siobhain , Morey Sue , Cecins Nola , Hill Kylie
Published: April 2018

Introduction

In people with cystic fibrosis (CF), exacerbations have been shown to have profound and prolonged negative effects such as reducing physical activity and health-related quality of life, increasing the rate of decline of lung function and healthcare costs, and ultimately increasing the risk of mortality. Delayed initiation of treatment following the signs of an exacerbation has been shown to be associated with failure to recover to baseline. Therefore, the late identification and treatment of an exacerbation due to delayed presentation will potentially worsen short-term and long-term outcomes. We have developed a smartphone application, containing questions which require yes or no responses relating to symptoms suggestive of a respiratory exacerbation. Its use is intended to facilitate the early identification of symptoms suggestive of a respiratory exacerbation, and allow the CF team to initiate treatment sooner, thereby potentially reducing the risk of severe exacerbations which require intravenous antibiotics (IVAB) and often a hospital admission.

Methods

We will undertake a randomised controlled trial. 60 adults with CF will be recruited and randomised to either the intervention or control group. The intervention group will use the smartphone application weekly for 12 months, or earlier than the next weekly reporting time if they feel their symptoms have worsened. The control group will continue to receive usual care, involving regular (approximately 3 monthly) CF outpatient clinic appointments. The primary outcome measure will be courses and days of IVAB.

Ethics and dissemination

Approval was obtained from the Sir Charles Gairdner Group Human Research Ethics Committee for WA Health (2015-030) and Curtin University Human Research Ethics Committee (HR212/2015), and has been registered with the Australian and New Zealand Clinical Trials Registry. Results of this study will be presented at international conferences and published in peer-reviewed journals in accordance with the Consolidated Standards of Reporting Trials statement.

Trial registration number

ACTRN12615000599572.
SPECT V/Q for the diagnosis of pulmonary embolism: protocol for a systematic review and meta-analysis of diagnostic accuracy and clinical outcome
Authors: Le Roux Pierre-Yves , Robin Philippe , Tromeur Cécile , Davis Alexandra , Robert-Ebadi Helia , Carrier Marc , Couturaud Francis , Le Gal Grégoire , Salaun Pierre-Yves
Published: April 2018

Introduction

Single photon emission computed tomography ventilation/perfusion (SPECT V/Q) imaging has many proponents within the nuclear medicine community and has already largely replaced planar V/Q scintigraphy in daily practice for the diagnosis of pulmonary embolism (PE). However, the test is still described in clinical guidelines as an experimental test because of insufficient evidence.

Methods and analysis

We will conduct a systematic review and a meta-analysis of diagnostic accuracy and management outcome studies involving patients evaluated with V/Q SPECT for suspected acute PE. We will search from inception to 19 December 2017 MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for diagnostic accuracy studies, randomised controlled trials and observational cohort studies. Two reviewers will conduct all screening and data collection independently. The methodological quality and risk of bias of eligible studies will be carefully and rigorously assessed using the Quality Assessment of Diagnostic Accuracy Studies-2, the Cochrane Collaboration’s tool and the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. The primary outcomes will be sensitivity, specificity and likelihood ratios of V/Q SPECT for the diagnosis of acute PE. The secondary outcomes will be the rate of venous thromboembolism during a 3-month follow-up period in patients left untreated after a negative diagnostic work-up based on SPECT V/Q.

Ethics and dissemination

This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature.

PROSPERO registration number

CRD42018084095.
Large Q and S waves in lead III on the electrocardiogram distinguish patients with hypertrophic cardiomyopathy from athletes
Authors: Chen Alvin S , Bent Rachel E , Wheeler Matthew , Knowles Joshua W , Haddad Francois , Froelicher Victor , Ashley Euan , Perez Marco V
Published: April 2018

Objective

To identify electrocardiographic findings, especially deep Q and S waves in lead III, that differentiate athletes from patients with hypertrophic cardiomyopathy (HCM).

Methods

Digital ECGs of athletes and patients with HCM followed at the Stanford Center for Inherited Cardiovascular Disease were studied retrospectively. All patients with HCM had an echocardiogram performed. A multivariable logistic regression model was used to calculate ORs for various demographic and ECG characteristics. Linear regression was used to correlate ECG characteristics with echocardiogram findings.

Results

We studied 1124 athletes and 240 patients with HCM. The average Q+S wave amplitude in lead III (IIIQ+S) was significantly higher in patients with HCM compared with athletes (0.71±0.69 mV vs 0.21±0.17 mV, p<0.001). In patients with HCM, IIIQ+S directly correlated with interventricular septal (IVS) thickness on echocardiography (ρ=0.45, p<0.001). In a multivariable analysis adjusted for demographic and ECG characteristics, higher IIIQ+S values remained independently associated with HCM compared with athletes (OR=4.2 per 0.5 mV, p<0.001). In subgroup analyses of young patients, African–American subjects and subjects without left axis deviation (LAD), IIIQ+S remained associated with HCM. The addition of IIIQ+S>1.0 mV as an abnormal finding to the International Criteria for athletic ECG interpretation improved sensitivity from 64.2% to 70.4%, with a minimal decrease in specificity.

Conclusion

Large Q and S waves in lead III distinguished athletes from patients with HCM, independent of axis and well-known ECG markers associated with HCM. The correlation between IVS thickness in patients with HCM and IIIQ+S suggests a partial explanation for this association.
Association between the Great China Famine exposure in early life and risk of arthritis in adulthood
Authors: Wang Zhenghe , Zou Zhiyong , Dong Bin , Ma Jun , Arnold Luke
Published: April 2018

Background

The association between famine exposure in early life and risk of arthritis (combination of osteoarthritis and inflammatory arthritis) in adulthood is unclear. The aim of this study is to explore the association.

Methods

A total of 4124 subjects were selected from the national data of the China Health and Retirement Longitudinal Study in 2011–2012. Doctor-diagnosed arthritis was self-reported in participants’ questionnaire. Birthdates were used to categorise participants into famine-exposed and non-exposed groups. Logistic regression model was used to explore the association of famine exposure in early life with the risk of arthritis in adulthood.

Results

The prevalence of arthritis in both infant-exposed and preschool-exposed groups was significantly higher than those in the non-exposed group (35.0% and 30.6% vs 27.3%; p<0.05). Compared with the non-exposed group, the infant-exposed group showed a significantly elevated risk of arthritis in adulthood after adjusting for confounding factors (OR=1.65; 95% CI 1.29 to 2.11; p<0.001). In the stratified analysis, we found that participants who lived in severely affected areas (OR=1.91; 95% CI 1.41 to 2.59; p<0.001), who are female (OR=2.21; 95% CI 1.57 to 3.11; p<0.001) and those with a body mass index ≥24.0 kg/m2(OR=2.46; 95% CI 1.70 to 3.55; p<0.001) in the infant-exposed group had increased risk of arthritis in adulthood. Similar results were additionally observed when age-balanced control group was used.

Conclusion

Great China Famine exposure in infancy may be associated with an elevated risk of arthritis in adulthood, particularly in women and participants with adiposity. These findings suggest nutrition intervention in infancy and weight control in later life may reduce the risk of arthritis in adulthood.
Viral Pneumonia: Etiologies and Treatment
Authors: Dandachi Dima , Rodriguez-Barradas Maria C
Published: April 2018

Viral pathogens are increasingly recognized as a cause of pneumonia, in immunocompetent patients and more commonly among immunocompromised. Viral pneumonia in adults could present as community-acquired pneumonia (CAP), ranging from mild disease to severe disease requiring hospital admission and mechanical ventilation. Moreover, the role of viruses in hospital-acquired pneumonia and ventilator-associated pneumonia as causative agents or as co-pathogens and the effect of virus detection on clinical outcome are being investigated.

More than 20 viruses have been linked to CAP. Clinical presentation, laboratory findings, biomarkers, and radiographic patterns are not characteristic to specific viral etiology. Currently, laboratory confirmation is most commonly done by detection of viral nucleic acid by reverse transcription-PCR of respiratory secretions.

Apart from the US Food and Drug Administration-approved medications for treatment of influenza pneumonia, the treatment of non-influenza respiratory viruses is limited. Moreover, the evidence supporting the use of available antivirals to treat immunocompromised patients is modest at best. With the widespread use of molecular diagnostics, an aging population, and advancement in cancer therapy, physicians will face a bigger challenge in managing viral respiratory tract infections. Emphasis on infection control measures to prevent the spread of respiratory viruses especially in healthcare settings is extremely important.
Fatal head and neck injuries in military underbody blast casualties
Authors: Stewart Sarah K , Pearce A P , Clasper Jon C
Published: April 2018

Introduction

Death as a consequence of underbody blast (UBB) can most commonly be attributed to central nervous system injury. UBB may be considered a form of tertiary blast injury but is at a higher rate and somewhat more predictable than injury caused by more classical forms of tertiary injury. Recent studies have focused on the transmission of axial load through the cervical spine with clinically relevant injury caused by resultant compression and flexion. This paper seeks to clarify the pattern of head and neck injuries in fatal UBB incidents using a pragmatic anatomical classification.

Methods

This retrospective study investigated fatal UBB incidents in UK triservice members during recent operations in Afghanistan and Iraq. Head and neck injuries were classified by anatomical site into: skull vault fractures, parenchymal brain injuries, base of skull fractures, brain stem injuries and cervical spine fractures. Incidence of all injuries and of each injury type in isolation was compared.

Results

129 fatalities as a consequence of UBB were identified of whom 94 sustained head or neck injuries. 87 casualties had injuries amenable to analysis. Parenchymal brain injuries (75%) occurred most commonly followed by skull vault (55%) and base of skull fractures (32%). Cervical spine fractures occurred in only 18% of casualties. 62% of casualties had multiple sites of injury with only one casualty sustaining an isolated cervical spine fracture.

Conclusion

Improvement of UBB survivability requires the understanding of fatal injury mechanisms. Although previous biomechanical studies have concentrated on the effect of axial load transmission and resultant injury to the cervical spine, our work demonstrates that cervical spine injuries are of limited clinical relevance for UBB survivability and that research should focus on severe brain injury secondary to direct head impact.
Examining the use of ‘natural’ in breastfeeding promotion: ethical and practical concerns
Authors: Martucci Jessica , Barnhill Anne
Published: April 2018

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood.
A single-center experience in the endovascular treatment of carotid siphon aneurysms using the Willis covered stent: a retrospective analysis
Authors: Ma Lin , Xu Ji-Chong , Yan Shuo , Feng Hao , Han Hong-Jie , Tan Hua-Qiao , Fang Chun , Huang Hong-En
Published: April 2018

Objective

To report the clinical results and initial clinical experience of endovascular isolation with the Willis covered stent for carotid siphon aneurysms.

Methods

Between November 2013 and December 2016, a total of 57 patients who presented with carotid siphon aneurysms were treated with the Willis covered stent. Results of the procedures, technical events, and complications were recorded. Clinical and imaging follow-ups were performed at 3 months following the endovascular procedures.

Results

Placement of the Willis covered stent was successful in all patients. Immediate angiography revealed complete exclusion of aneurysms in 48 patients (84%), while endoleak occurred in nine patients (16%). Procedure-related complications occurred in three cases, including displacement of the covered stent in one patient, acute in-stent thrombosis in one patient, and microwire-related intracranial hemorrhage in one patient. Angiographic follow-ups were done in 49 patients, with complete exclusion of aneurysms in 47 patients. Endoleak was present in two patients. No aneurysm recurrence occurred. Forty-four patients showed good parent artery patency, while the other five patients showed mild to moderate asymptomatic in-stent stenosis. During the follow-up period, no ischemic or hemorrhagic event occurred. The modified Rankin Scale scores at follow-up were 0–2 in 56 patients and >2 in one patient.

Conclusions

The treatment of siphon aneurysms with Willis covered stent implantation resulted in satisfactory clinical outcomes. The Willis covered stent seems safe and feasible for the treatment of siphon aneurysms, which still needs to be confirmed by longer follow-up periods and controlled studies with larger samples.
Impact of transcatheter aortic valve implantation on the risk of mortality in patients with severe aortic valve diseases: a health insurance-based analysis
Authors: Barth Alexander , Yücel Seyrani , Ince Hüseyin , Doblhammer Gabriele
Published: April 2018

Background

Transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for aortic valve patients who are inoperable or have a prohibitively high surgical risk for surgical aortic valve replacement (SAVR). Most studies compare the efficacy of TAVI and SAVR, yet the assessment of TAVI for this group of patients requires more study.

Methods

This quasiexperimental study compares TAVI cases (ages of 75–90 years, n=187) ex-post with a control group without implantation (n=728, 4:1 ratio intended). The control group was drawn randomly on the condition that it matches the TAVI cases based on age at aortic valve disease incidence, gender and comorbidity index. The mortality risk is analysed from incident diagnosis. Data were taken from three random samples of health claims data in Germany’s largest public health insurance (Allgemeine Ortskrankenkassen) and cover the years 2004–2013 (n=750 000).

Results

Compared with the medically treated control group with 6+ comorbidities, medically treated patients with fewer comorbidities have half the mortality risk (HR 0.48, 95% CI 0.34 to 0.69, p<0.001). TAVI patients with fewer than six comorbidities show a mortality risk half that (HR 0.23, 95% CI 0.09 to 0.63, p=0.004). TAVI patients with 6+ comorbidities do not benefit from TAVI compared with the control group with 6+ comorbidities (HR 0.99, 95% CI 0.71 to 1.36, p=0.93).

Conclusion

TAVI is an effective therapy for aortic valve disease patients with few comorbidities; it is not effective for patients with a high comorbidity burden. Careful assessment of the individual patient in terms of comorbidities is important for a beneficial outcome.
Strengths and weaknesses of ‘real-world’ studies involving non-vitamin K antagonist oral anticoagulants
Authors: Camm A John , Fox Keith A A
Published: April 2018

Randomised controlled trials (RCTs) provide the reference standard for comparing the efficacy of one therapy or intervention with another. However, RCTs have restrictive inclusion and exclusion criteria; thus, they are not fully representative of an unselected real-world population. Real-world evidence (RWE) studies encompass a wide range of research methodologies and data sources and can be broadly categorised as non-interventional studies, patient registries, claims database studies, patient surveys and electronic health record studies. If appropriately designed, RWE studies include a patient population that is far more representative of unselected patient populations than those of RCTs, but they do not provide a robust basis for comparing treatment strategies. RWE studies can have very large sample sizes, can provide information on treatments in patient groups that are usually excluded from RCTs, are generally less expensive and quicker than RCTs, and can assess a broad range of outcomes. Limitations of RWE studies can include low internal validity, lack of quality control surrounding data collection and susceptibility to multiple sources of bias for comparing outcomes. RWE studies can complement the findings from RCTs by providing valuable information on treatment practices and patient characteristics among unselected patients. This information is necessary to guide treatment decisions and for reimbursement and payment decisions. RWE studies have been extensively applied in the postmarketing approval assessment of non-vitamin K antagonist oral anticoagulants since 2010. However, the benefits, costs, limitations and methodological challenges associated with the different types of RWE must be considered carefully when interpreting the findings.
HIV seroprevalence, self-reported STIs and associated risk factors among men who have sex with men: a cross-sectional study in Rwanda, 2015
Authors: Ntale Roman Saba , Rutayisire Gad , Mujyarugamba Pierre , Shema Eliah , Greatorex Jane , Frost Simon David William , Kaleebu Pontiano
Published: April 2018

Objectives

In many populations, men who have sex with men (MSM) are at a high risk of HIV infection. This study aimed to estimate the burden of HIV, other STIs and risk behaviours among Rwandan MSM.

Methods

In this cross-sectional study, we recruited through peer referral men aged between 18 and 60 years, who reported sex with men at least once in the 12 months prior to the survey. Representativeness was increased using ‘seeds’ from a variety of sources. Signed informed consent was obtained from all participants. Data on demographics, risk behaviours and self-reported STIs were collected through an interviewer-administered questionnaire. We screened all eligible participants for HIV using the Rwanda-approved protocol for rapid HIV detection.

Results

504 MSM were recruited from five major cities in Rwanda. Participants were mostly young (median age 23 years, range 18–55 years) and unmarried (484/504, 96.0%). Thirteen per cent (65/504) of the participants reported past gonorrhoea and/or syphilis infection. Of 504 MSM, 53 (10.5%) reported they were diagnosed and treated for gonorrhoea in the past 12 months and 24 (4.8%) tested positive for HIV. A high proportion (232/504, 46%) reported receiving payment for sex by a man, with almost half of these reporting on more than three occasions (107/232, 46%). Many reported having had an HIV test within the past 12 months (385/504, 76.4%). In multivariate logistic regression models controlling for age, being paid for sex was associated with higher odds of past STI (OR 3.36 (1.82–6.43]; P<0.001) and testing HIV positive (OR 3.13, P<0.05).

Conclusion

Further research is needed to understand the high rate of payment for sex in this population, which appears to be a major risk factor for STI including HIV.
Relationships between plasma insulin‐like growth factor‐1 and insulin concentrations in multiparous dairy cows with cytological endometritis
Authors: Valdmann Merle , Kurykin Jevgeni , Kaart Tanel , Mällo Gret‐Kristel , Waldmann Andres
Published: April 2018

Cytological endometritis (CYTO) is a uterine inflammation characterised by the percentage of polymorphonuclear neutrophils in endometrial cytology. This observational study evaluated the association of blood plasma insulin‐like growth factor‐1 (IGF‐1) and insulin concentrations at −2 weeks prepartum, +1 week and +3 weeks postpartum with the development of CYTO in 119 multiparous Holstein cows. Overall CYTO prevalence was 30.3 per cent. Multivariable logistic regression model revealed the odds of developing CYTO were 3.54 times (P=0.018) greater in cows with week −2 prepartum IGF‐1 concentrations less than 74.6 ng/ml and 4.41 times (P=0.004) higher in cows with week +1 postpartum IGF‐1 concentrations less than 13.2 ng/ml than the odds of this health outcome in cows with IGF‐1 concentrations at least 74.6 and13.2 ng/ml, respectively. Additionally, cows with body condition score (BCS) up to 2.75 at week −2 prepartum and cows experiencing calving‐related disorders and/or ill health had higher risk for CYTO compared with cows with BCS=3.50–3.75 (OR=6.8, P=0.049) and cows without health complications (OR=3.1, P=0.030). Insulin was not a significant predictor for CYTO in the model. Our findings provide further evidence that reduced dairy cow fertility associated with low plasma concentrations of IGF‐1 is in part mediated through the inflammatory status of the uterus.
Learning to Recommend Related Entities With Serendipity for Web Search Users
Authors: Huang Jizhou , Ding Shiqiang , Wang Haifeng , Liu Ting
Published: April 2018

Entity recommendation, providing entity suggestions to assist users in discovering interesting information, has become an indispensable feature of today’s Web search engine. However, the majority of existing entity recommendation methods are not designed to boost the performance in terms of serendipity, which also plays an important role in the appreciation of users for a recommendation system. To keep users engaged, it is important to take into account serendipity when building an entity recommendation system. In this article, we propose a learning to recommend framework that consists of two components: related entity finding and candidate entity ranking. To boost serendipity performance, three different sets of features that correlate with the three aspects of serendipity are employed in the proposed framework. Extensive experiments are conducted on large-scale, real-world datasets collected from a widely used commercial Web search engine. The experiments show that our method significantly outperforms several strong baseline methods. An analysis on the impact of features reveals that the set of interestingness features is the most powerful feature set, and the set of unexpectedness features can significantly contribute to recommendation effectiveness. In addition, online controlled experiments conducted on a commercial Web search engine demonstrate that our method can significantly improve user engagement against multiple baseline methods. This further confirms the effectiveness of the proposed framework.
Constructing a WordNet for Turkish Using Manual and Automatic Annotation
Authors: Ehsani Razieh , Solak Ercan , Yildiz Olcay Taner
Published: April 2018

In this article, we summarize the methodology and the results of our 2-year-long efforts to construct a comprehensive WordNet for Turkish. In our approach, we mine a dictionary for synonym candidate pairs and manually mark the senses in which the candidates are synonymous. We marked every pair twice by different human annotators. We derive the synsets by finding the connected components of the graph whose edges are synonym senses. We also mined Turkish Wikipedia for hypernym relations among the senses. We analyzed the resulting WordNet to highlight the difficulties brought about by the dictionary construction methods of lexicographers. After splitting the unusually large synsets, we used random walk–based clustering that resulted in a Zipfian distribution of synset sizes. We compared our results to BalkaNet and automatic thesaurus construction methods using variation of information metric. Our Turkish WordNet is available online.
Social Crises: Signatures of Complexity in a Fast‐Growing Economy
Authors: Cárdenas Juan Pablo , Vidal Gerardo , Urbina Carolina , Olivares Gastón , Rodrigo Pablo , Fuentes Miguel
Published: April 2018

Social systems are always exposed to critical processes in which their organization, or part of it, is questioned by the society that demands solutions through different critical saliences. The traditional approach to such social crises has mainly focused on their anticipation and management, implying that the focus is on trying to deal with crises once they occur, rather than delving in their essential characteristics that seemingly depend on the adaptive nature of the system and the increase in its internal complexity. To address this issue, we propose a dual approach that utilizes both qualitative (documentary analysis) and quantitative methods (online social network analysis) in order to delve into the relationship between the complexity of the social system, its adaptation, and critical episodes. Our analysis shows how an explosive economic growth affects a social system, increasing its complexity. This complexity produces different demands from the system itself. These demands manifest signatures of complexity such as a heterogeneous and rich social structure, which emerges during moments when the society acts strongly.
Carbohydrate Antigen 19-9, Carcinoembryonic Antigen, and Carbohydrate Antigen 72-4 in Gastric Cancer: Is the Old Band Still Playing?
Authors: Kotzev Andrey Iskrenov , Draganov Peter Vassilev
Published: April 2018

Background: Gastric cancer (GC) is characterized by aggressive behavior and a high mortality rate. The diagnosis of GC is challenging because the GC is often diagnosed in an advanced stage. The use of tumor markers is a putative way to improve the detection and treatment in patients with GC. Summary: In this article, we review the significance of serum carbohydrate antigen (CA) 19-9, carcinoembryonic antigen (CEA), and CA 72-4 in GC. The results from different studies regarding the diagnostic and prognostic role of CA 19-9, CEA, and CA 72-4 in GC are encouraging, but inadequate sensitivity and specificity obstruct their use as standardized and unconditionally reliable markers in GC. New prospective clinical trials are mandatory for clarifying their value in GC. Key Message: CA 19-9, CEA, and CA 72-4 should not be used for screening and early diagnosis in GC, whereas they are beneficial in the detection of late GC. CA 19-9, CEA, and CA 72-4 could be used as prognostic and monitoring tools in GC, and their combined measurement in shorter periods of time is the best method to increase sensitivity and specificity. Practical Implications: Serum CA 19-9, CEA, and CA 72-4 are useful diagnostic and prognostic tumor markers in GC.
Dispensa coletiva e negociação sindical
Authors: Mallet Estêvão
Published: April 2018

O artigo envolve o exame da necessidade ou não de negociação sindical para a realização de dispensa coletiva. Parte da consideração dos fundamentos invocados pelas decisões para justificar a imposição da exigência conclui que, no sistema jurídico brasileiro, ela não se justifica.
O direito judiciário lusitano - os assentos da casa da suplicação
Authors: Carmignani Maria Cristina Da Silva
Published: April 2018

O tema tem como enfoque principal retratar a função de interpretar as leis, de forma autêntica, da Casa da Suplicação em Lisboa, por meio de assentos normativos. Será demonstrado que essa função interpretativa da lei conferida à Casa da Suplicação na verdade implicava em verdadeira atividade legislativa, introduzindo profundas modificações no Direito Privado Português no período de um século entre a Lei da Boa Razão até a promulgação do Código Civil português.
Proteção conferida à zona costeira brasileira na esfera do município
Authors: Loureiro Filho Lair Da Silva
Published: April 2018

Este trabalho trata da competência do Município, na defesa do interesse local na zona costeira urbana brasileira, na disciplina do uso e ocupação do solo, das atividades desenvolvidas na região e da fruição da praia enquanto bem de uso comum do povo. Defende a extinção do instituto do terreno de marinha, construído com base em critérios dotados de pouca cientificidade e estribado nos fundamentos de defesa nacional, instrumento condutor de política nacional de proteção ambiental e de planejamento urbano, argumentos que não mais subsistem em face da atual tecnologia de defesa, da superveniência da política urbana delineada no art. 182 da Constituição Federal, efetivada pela Lei n. 10.257 de 10.7.2001, da previsão da participação do Município no Plano Nacional de Gerenciamento Costeiro, e da utilização dos recursos provenientes do Projeto Orla, especialmente pelos Municípios de pequeno porte, desprovidos de recursos e quadros. O estudo também defende a consolidação na esfera municipal do regramento da zona costeira, compreendendo o terreno de marinha e a orla marítima, salientando-se, ainda, que este tratamento unitário não deve implicar na transferência das receitas hauridas pela União ao Município e tampouco na criação de novos tributos.
Processo administrativo disciplinar. Alegações e relatório orais. Legalidade
Authors: Campos Roberto Augusto De Carvalho , Pancheri Ivanira
Published: April 2018

Cinge-se ao tema da legalidade da apresentação de Alegações Finais e respectivo Relatório Final, de forma oral, em sede de Procedimento Administrativo Disciplinar. Noutros termos, cuida-se de questionamento acerca da higidez procedimental em face de Alegações Finais e Relatório Final verbais. A relevância do debate tem como cerne o Devido Processo Legal. Como hipótese, parte-se da concepção primordial de uma nulificação processual. Discorre-se historicamente sobre os planos de existência, validade e eficácia. E, primordialmente, sobre o hodierno conceito de nulidade absoluta e nulidade relativa. Não se olvide todavia que, ao lado destes grandes nortes, há inteligências dissonantes que serão devidamente analisadas. Sob uma metodologia monotemática, teórica e científica, investiga-se material bibliográfico para solver assunto contemporâneo e de importância à Administração Pública. A partir da premissa de que existe um tipo processual que traduz a avaliação de valores do legislador, prestando para assegurar garantias constitucionais do sistema processual, alcançou-se a ilação acerca da imprescindibilidade de nulificação. Destarte, o deslinde é no sentido de uma declaração de nulidade absoluta do procedimento disciplinar a partir das Alegações Finais inclusive, com refazimento de todos os atos processuais decorrentes.
Nacionalidade – Direito Fundamental, Direito Público Interno e Direito Internacional
Authors: Casella Paulo Borba
Published: April 2018

A nacionalidade é tema fundamental para o direito, como para o indivíduo – enquanto vínculo genuíno com determinada comunidade nacional – mas também para o Direito Constitucional e o Direito Público interno, em relação recíproca de direitos e de obrigações, entre o Estado e o particular; nacionalidade se tornou matéria extensamente regulada, pelo Direito Internacional Público e Privado – de um lado se reconhece que a regulação da nacionalidade é prerrogativa de cada Estado, mas também se reconhece que o indivíduo tem direito a essa condição de ‘nacional’ e não possa dela ser arbitrariamente privado.