bluuebunny/crossref_metadata_2025 huggingface dataset:
Career Paths in Engineering Firms
Authors: Cardador M. Teresa , Hill Patrick L.
Published: December 2016

Much attention has been paid to explaining the gender disparity in engineering. While significant research examines barriers to professional entry and retention among female engineers, there is a surprising lack of research on the nature of women’s career paths within the profession. In a sample of 274 industry engineers from multiple engineering subfields and firms, we examined the relationship between gender and career path and tested the implications of career path choice for five outcomes consequential to engineers’ experience of their profession and work. We also tested for gender differences in the effects of career path on these outcomes. Our findings show gendered career paths in engineering firms and suggest that some career paths may put women (but not men) at greater risk of professional attrition. Theoretical and practical implications are discussed.
Comparison of Ankle Fusion Rates With and Without Anterior Plate Augmentation
Authors: Mitchell Phillip M. , Douleh Diana G. , Thomson A. Brian
Published: December 2016

Background:

The optimal fixation construct for tibiotalar arthrodesis continues to be debated. While biomechanical data and clinical series support anterior plate augmentation, comparative studies assessing its use are sparse. The purpose of this study was to compare the rates of successful tibiotalar arthrodesis with and without anterior plate augmentation of a compression screw construct.

Methods:

We studied 64 patients (65 ankles) undergoing tibiotalar arthrodesis done by a single surgeon over a 10-year period (2006-2016) with anterior plate augmentation beginning in 2010. Twenty-six ankles had a construct using compression screws only and 39 ankles had anterior plate augmentation of a compression screw construct. We reviewed clinical notes, operative reports, and postoperative radiographs to evaluate for union, incidence of revision, and postoperative complications.

Results:

The nonunion rate in the compression screw (CS) cohort was 15.4% and 7.7% in the anterior plate augmentation (AP) cohort ( P = .33). The revision rate was 7.7% in the CS group and 2.6% in the AP cohort ( P = .34). The use of autograft harvested through a separate incision was 19.2% and 17.9% in the CS and AP cohorts, respectively. There were 2 deep postoperative infections in the AP group and none in the patients with CS only ( P = .24). There were no superficial wound complications in either group.

Conclusion:

Anterior plate augmentation was a viable fixation strategy in tibiotalar arthrodesis. In a trend toward an improved rate of fusion and decreased revision rate in the anterior plate augmentation cohort.

Level of Evidence:

Level III, retrospective comparative series.
3D Model Analysis of Ankle Flexion on Anatomic Reduction of a Syndesmotic Injury
Authors: Schon Jason M. , Mikula Jacob D. , Backus Jonathon D. , Venderley Melanie B. , Dornan Grant J. , LaPrade Robert F. , Clanton Thomas O.
Published: December 2016

Background:

The effect of ankle positioning during suture-button fixation for syndesmosis repair on range of motion (ROM) and anatomic reduction has yet to be investigated. The purpose of this cadaveric study was to compare the effects of 3 different ankle positions during suture-button repair on volumetric reduction of the syndesmosis, fibular displacement, and ROM of the ankle using 3-dimensional computed tomography (CT) analysis. The null hypothesis was that ankle position during fixation would not affect syndesmotic volume restoration, fibular displacement, or ROM.

Methods:

Twelve matched pair (n = 24) human cadaveric specimens were used for this study. Prior to syndesmotic sectioning, ROM assessment and CT scans were performed. Following sectioning of the syndesmosis, specimens were repaired in plantarflexion, dorsiflexion, or neutral, and simulated postrepair ROM evaluations and CT scans were repeated. Least squares mean differences between repair groups and the preinjury state were compared by analysis of variance and Tukey’s method.

Results:

There were no significant differences between repair groups for volumetric reduction ( P = .917), fibular displacement (anterior-posterior, P = .805; medial-lateral, P = .949), or dorsiflexion capacity ( P = .249). Among all specimens, compared with the preinjury state, there was a significant mean ± SD volume reduction of 337 ± 400 mm3 and medial displacement of 1.9 ± 1.5 mm.

Conclusion:

This study failed to reject the null hypothesis and demonstrated that ankle flexion at the time of syndesmotic fixation with a suture-button construct had no significant in vitro effect on volume changes, fibular displacement, or dorsiflexion capacity. However, in comparison to the preinjured state, suture-button repair resulted in significant overcompression with respect to syndesmosis volume and medial displacement of the fibula.

Clinical Relevance:

Ankle position at the time of syndesmotic fixation did not affect overall ankle ROM when using a suture-button construct; however, overcompression was observed in all positions. The clinical impact of syndesmotic overcompression remains largely unknown.
von Willebrand Disease: A Concise Review and Update for the Practicing Physician
Authors: Swami Arjun , Kaur Varinder
Published: December 2016

von Willebrand disease (vWD) is the most common inherited disorder of hemostasis and comprises a spectrum of heterogeneous subtypes. Significant advances have been made in understanding von Willebrand factor ( vWF) gene mutations, resultant physiologic deficits in the vWF peptide, and their correlation to clinical presentation. Diagnostic tests for this disorder are complex, and interpretation requires a thorough understanding of the underlying pathophysiology by the practicing physician. The objective of this review is to summarize our current understanding of pathophysiology, laboratory investigations, and evolving treatment paradigm of vWD with the availability of recombinant von Willebrand factor.
Examining Implicit and Explicit Evaluations of Sexual Aggression and Sexually Aggressive Behavior in Men Recruited Online
Authors: Hermann Chantal A. , Nunes Kevin L. , Maimone Sacha
Published: December 2016

The purpose of the current study was to explore the relationship between implicit and explicit evaluations of sexual aggression and indicators of sexually aggressive behavior in samples of students and community men recruited online. Participants were male undergraduate students recruited online from a Canadian University ( N = 150) and men recruited from the community via an online panel ( N = 378). Participants completed measures of implicit and explicit evaluations of sexual aggression, cognitive distortions regarding rape, self-reported past sexually aggressive behavior, and self-reported proclivity to commit sexually aggressive behavior. We found that more positive explicit evaluations and more cognitive distortions were moderately to strongly associated with sexual aggression; however, this was not the case for implicit evaluations of rape. Our results suggest that explicit evaluations of sexual aggression and cognitive distortions may be relevant for understanding sexual aggression against adults, and that more research is needed exploring whether or not implicit evaluations are associated with sexually aggressive behavior.
Characterization of fretting wear experiments on spline couplings by principal component analysis
Authors: Qureshi Waqar , Cura Francesca , Mura Andrea
Published: December 2016

Fretting wear is a quasi-static process in which repeated relative surface movement of components results in wear and fatigue. Fretting wear is quite significant in the case of spline couplings which are frequently used in the aircraft industry to transfer torque and power. Fretting wear depends on materials, pressure distribution, torque, rotational speeds, lubrication, surface finish, misalignment between spline shafts, etc. The presence of so many factors makes it difficult to conduct experiments for better models of fretting wear and it is the case whenever a mathematical model is sought from experimental data which is prone to noisy measurements, outliers and redundant variables. This work develops a principal component analysis based method, using a criterion which is insensitive to outliers, to realize a better design and interpret experiments on fretting wear. The proposed method can be extended to other cases too.
Use of an online personal health record’s Track Health function to promote positive lifestyle behaviors in Veterans with prediabetes
Authors: Sharit Joseph , Idrees Thaer , Andrade Allen D , Anam Ramanakumar , Karanam Chandana , Valencia Willy , Florez Hermes , Ruiz Jorge G
Published: December 2016

This pilot 3-month clinical trial investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration’s personal health record for eliciting a more positive physical activity and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Comparisons between baseline and 3 months post-intervention indicated significant improvements in weight, physical activity, abdominal circumference, and blood pressure. Use of a personal health record that users can identify with and find usable and useful coupled with instruction targeting critical functionalities could potentially promote healthy behavioral lifestyle changes.
Simply more than swiping left: A critical analysis of toxic masculine performances on Tinder Nightmares
Authors: Hess Aaron , Flores Carlos
Published: December 2016

Launching in September 2012, Tinder has become a popular phenomenon in the world of online dating and hookup culture. Simultaneously, it carries notorious reputation for being home to hypersexual and toxic masculine expressions. This analysis examines Tinder Nightmares, an Instagram page featuring failed attempts at hooking up, as a site that promotes counter-disciplining the deliberate toxic masculine performances on Tinder. Through a Foucauldian lens, we argue that this page delimits the toxic masculine performances through the outward display of crude performances, the showcasing of witty responses from Tinder users, and the extension of counter-discipline through digital circulation practices on the page. Given that Tinder is a location-aware app, the discipline offered through Tinder Nightmares surfaces in interpersonal, physical, and networked spaces, as Tinder users become multiply implicated public subjects of shame across media platforms.
Activities in dementia care: A comparative assessment of activity types
Authors: Lokon Elizabeth , Sauer Philip E , Li Yue
Published: December 2016

This exploratory study compares the impact of five activity types on the well-being of institutionalized people with dementia: the intergenerational art program Opening Minds through Art, art and music therapies, creative activities, non-creative activities, and no activities at all. We validated the Scripps Modified Greater Cincinnati Chapter Well-Being Observational Tool, and used that instrument to systematically observe N = 67 people with dementia as they participated in different activity types. People with dementia showed the highest well-being scores during Opening Minds through Art compared to all other activities. No significant well-being differences were found between creative activities led by licensed art/music therapist versus regular activity staff. Furthermore, no significant well-being differences were found between creative and non-creative activities that were both led by regular activity staff. Overall, people with dementia benefit from participating in activities, regardless of the type (creative or non-creative), or who conducts them (licensed therapists or activity staff). However, in order for people with dementia to reach significantly high levels of overall well-being, we recommend that activities are specifically designed for people with dementia and incorporate a 1:1 ratio between people with dementia and well-trained volunteers/staff members.
Research on the end-plate for vertical axis tidal current turbine
Authors: Xie Yu , Kang Haigui , Chen Bing , Guo Wei
Published: December 2016

Tidal current energy is one of the competitive alternative energy resources. Vertical axis turbine is the technology to extract energy from tidal current with some unique advantages. As the energy efficiency of vertical axis turbine is still relatively low, a blade tip device named end-plate is studied to improve the turbine’s performance. The end-plate was intended to block the fluid from flowing across the tip and the shape of the end-plate was designed according to the influence area of the tip flow. The comparison of the turbine with and without end-plates was made by numerical and experimental methods. Good agreement was achieved, and the result showed that adding end-plates on the tip of the blade could increase the turbine’s output power. On the basis of the former study, two kinds of end-plate enhancement were presented as inward-half end-plates and outward-half end-plates. The numerical research showed that both inward-half end-plates and outward-half end-plates had better output than the original end-plates. The numerical results also indicated that the blade with outward-half end-plates had the minimum amplitude of the torque over one rotational cycle among the three kinds of end-plates, while the blade with inward-half end-plates had the maximum amplitude of the torque. To obtain better power output and prolong the service life of turbine, the outward-half end-plate is recommended.
Protection Order Use Among Latina Survivors of Intimate Partner Violence
Authors: Messing Jill Theresa , Vega Sujey , Durfee Alesha
Published: December 2016

This mixed-methods study examines the impact of immigration status on the ability of Latina survivors of intimate partner violence (IPV) to file for and obtain a domestic violence protection order. Undocumented Latinas living in shelters are less likely to know what a protection order is or how to obtain one. At the same time, undocumented Latinas are more likely to believe that their partner would follow an order and that police would arrest their partner for a violation. Latina survivors of IPV live at the nexus of multiple systems of oppression; therefore, understanding their experiences using an intersectional framework is critically important.
Ten-Year Minimum Follow-Up of 4-Corner Fusion for SLAC and SNAC Wrist
Authors: Traverso Purnell , Wong Anselm , Wollstein Ronit , Carlson Lois , Ashmead Duffield , Watson H. Kirk
Published: December 2016

Background: Scapholunate advanced collapse (SLAC) of the wrist is the most common degenerative condition of the wrist. Four-corner fusion (4CF) is performed as salvage surgery, though there is limited information on its long-term results. We hypothesized that 4CF is a durable surgery with good clinical long-term function. Methods: A retrospective chart review of patients undergoing 4CF as well as an interview and recent radiographs were obtained. Patients with a follow-up period of less than 10 years were excluded. Long-term evaluation included standard wrist radiographs, wrist range of motion, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Radiographs were evaluated and described by the Kellgren-Lawrence classification. Results: Four hundred eighty-nine wrists underwent a 4CF for SLAC wrist from 1982 to 2003. Twelve patients (15 wrists) were available for follow-up. Average age at surgery was 49.1 years (range, 25-67 years). Average follow-up postsurgery was 18 years (11-27). Scapholunate advanced collapse was the etiology in 13 wrists and scaphoid nonunion advanced collapse in 2 wrists. Average extension/flexion arc was 68.6° (0°-96°), and radial/ulnar deviation arc was 32.9° (0°-5°). QuickDASH scores averaged 7.8 (range, 0-32.5), with only 1 score above 16. Seventy-three percent of radiographs showed minimal to moderate joint destruction, and 27% showed severe joint destruction. Conclusions: Scaphoid excision and 4CF remains a reliable procedure for patients with advanced wrist arthritis. Functional results were good at long-term follow-up despite radiographic changes in the radiolunate joint in 73% of patients. Patient satisfaction was high, and functional impairment was low.
Effectiveness of Corticosteroid Injections for Treatment of de Quervain’s Tenosynovitis
Authors: Oh Jinhee K. , Messing Susan , Hyrien Ollivier , Hammert Warren C.
Published: December 2016

Background: Although surgery can provide definitive treatment for de Quervain’s tenosynovitis, nonoperative treatment could be preferable if symptoms are predictably relieved. We sought to determine the effectiveness of corticosteroid injections as treatment for de Quervain’s tenosynovitis and to evaluate patient characteristics as predictors of treatment outcome. Methods: A retrospective study was conducted using our institutional database International Classification of Disease, version 9 (ICD-9) code list for de Quervain’s tenosynovitis. Treatment success was defined as relief of symptoms after 1 or 2 injections. Relief was defined as resolution or improvement to the extent that the patient did not seek further intervention. Failure was defined as a subsequent surgical release or a third injection. Logistic regression analyses were performed to look for univariate associations between patient demographics/comorbidities and risk of treatment failure. Results: The treatment outcome of 222 limbs from 199 patients was studied. Of the 222 limbs, 73.4% (95% confidence interval [CI], 66.9%-79.1%) experienced treatment success within 2 injections, and 51.8% (95% CI, 45.0%-58.6%) experienced success after 1 injection. Body mass index (BMI) >30 and female sex were found to be significantly associated with treatment failure, with a 2.4-fold increase (95% CI, 1.02%-5.72%) in odds and 3.23 times greater (95% CI, 1.08%-9.67%) odds of failure, respectively. Although not reaching statistical significance, African American race, hypothyroidism, and carpal tunnel syndrome suggested increased odds of failure. Conclusions: This study indicates that corticosteroid injections are a useful treatment for de Quervain’s tenosynovitis, leading to treatment success 73.4% of the time within 2 injections. This study also suggests that female sex and BMI >30 are associated with increased treatment failure.
Combined Perihamate Peripisiform and Peritrapezium Open Axial Carpal Dislocation: Description of a New Pattern of Crush Injury
Authors: Jiménez Isidro , Dury Martine
Published: December 2016

Background: Axial carpal dislocations and fracture-dislocations remain difficult to understand and to treat. The outcome is directly related to the injury pattern and long-term results are not good in most cases. Methods: 39-year-old male admitted to our emergency department after his left hand was caught between 2 rollers for 10 minutes. He was diagnosed of an open axial carpal dislocation type B (perihamate peripisiform) and type E (peritrapezium) of Garcia-Elias. An extensive debridement, reduction of the carpometacarpal dislocations and stabilization with Kirschner wires was performed requiring a full thickness skin graft 14 days after the trauma. Results: At 4-year follow-up, he had 70° of wrist extension, and 78° of wrist flexion, grip strength of 65% compared to the healthy side and x-ray showed mild signs of osteoarthritis. He was satisfied and returned to the same job. Conclusions: Axial carpal dislocations continue to be difficult injuries to address but also to classify. Since the prognosis depends on the injury pattern and other associated lesions, we believe that adding a type G which include the association of different patterns to the classification of Garcia-Elias could be useful not in changing the treatment but probably indicating a worse prognosis.
Thermomechanical coupled analysis of split mechanical seal under different rotation speeds
Authors: Hu Qiong , Sun Jianjun , Ma Chenbo
Published: December 2016

Numerical analysis is employed to investigate the influence of parting surface and combined thermal factor (rotation) on deformation of split mechanical seal. Parting surface takes little effect on the temperature distribution, verified by comparison experiment. Shaft rotation speed does not much affect the radial temperature gradient of the seal end faces but can raise the temperature when being increased. The simulated model turns to a drum, with the parting surfaces, close to the primary sealing interface presenting a convergent taper, becoming open-shaped. Increasing rotation dramatically intensifies the seal end face deformation of both split stationary and rotating seal rings and slightly increases the convergent taper size of the primary sealing interface. However, it takes little effect on the parting surface deformation. Compared with integral mechanical seal, parting surfaces distinctly reduce the primary sealing interface cone as well as the seal end face deformation of both split seal rings.
A practical guideline for T1 reconstruction from various flip angles in MRI
Authors: Sandmann Constantin , Hodneland Erlend , Modersitzki Jan
Published: December 2016

A fast and robust method for T1 estimation in MRI is the so-called variable flip angle technique. We introduce a novel family of T1 reconstruction methods from data acquired with various flip angles and propose a family member which combines the robustness of a nonlinear- with the computational advantages of a linear reconstruction. The constructed family contains the most common approaches for T1 estimation, namely a linear and a nonlinear approach. A general sensitivity analysis for arbitrary members of the family is established. Advantages of the optimized reconstruction are demonstrated on phantom- as well as real data, showing improvements of up to 24% as compared with the linear method. As a further means to stabilize T1 estimation, spatial stabilization methods are compared. We demonstrate on phantom and on real data that improved results can be obtained if not only T1 but also a second unknown M0 in the reconstruction is stabilized.
Modified Lambrinudi Arthrodesis for the Acute Treatment of Neurogenic Clubfoot: A Case Report
Authors: So Eric , Hlad Lee M.
Published: December 2016

Neurogenic contracture often results in spastic, nonreducible equinovarus deformity. Rigid contracture leads to pain, instability, and bracing difficulties. This case report details the utilization of the modified Lambrinudi triple arthrodesis intended to create a plantigrade, functional limb that is amenable to an extremity brace in a case of an acquired neurologic clubfoot.

Levels of Evidence: Therapeutic, Level IV: Case Report
How to Deal With Anterior Knee Pain in the Active Young Patient
Authors: Sanchis-Alfonso Vicente , Dye Scott F.
Published: December 2016

Context:

Anterior knee pain (AKP) represents the most common reason to consult with a clinician who specializes in the knee. Despite the high incidence of the disorder, however, its etiology is still controversial. Many unnecessary surgeries that may damage the patient are done for this clinical entity.

Evidence Acquisition:

A PubMed search from 1995 through June 2016.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

The etiology of AKP is multifactorial, and patients with AKP may therefore be divided into several subpopulations. The whole picture must be addressed for each patient to identify all potentially modifiable factors and to achieve better outcomes. Both pelvifemoral dysfunction and psychological factors that may affect the development and symptoms of AKP must be considered to identify therapeutic targets within the context of treatment. Patients presenting with AKP frequently respond well to load restriction that protects their knee and reduces pain during rehabilitation. Surgery should only be considered in very select cases. In a patient who has undergone previous patellar realignment surgery and experienced increased pain, iatrogenic medial patellar instability should be considered.

Conclusions:

The etiology of AKP is multifactorial, and several subpopulations of AKP patients exist and their treatment must be personalized. Normally, the focus is on the knee of a patient with AKP, and only that joint is examined. However, that focus can lead to overlooking other important etiological factors that may be present.
Perceptions and Practices of Physical Activity Among Colombian Overweight/Obese Schoolchildren
Authors: Olaya-Contreras Patricia , Ocampo Diana-Carolina , Ladekjær Larsen Eva
Published: December 2016

The purpose of this study was to explore the contexts that shape obese children’s engagement in physical activity (PA) focusing on children’s perceptions. The qualitative design consisted of non-participant observations, and unstructured and semi-structured focus group and individual interviews. Data were analyzed by use of conventional content analysis. Participants were overweight/obese children from a public school in Colombia. The findings show that the main context where PA took place was during physical education (PE) classes at school and in the children’s neighborhoods. The participants perceived the PE classes to be too competitive and demotivating. PA taking place outside school was associated with fun, but occurred only on an infrequent basis and was challenged by living in insecure neighborhoods. Adapting a health promotion approach that emphasizes participation and social environments might motivate obese children to become physically active at school as well as during leisure time.
Increasing Doctoral Students’ Self-Efficacy to Teach Health Promotion Theory
Authors: Wilkerson J. Michael , Gallardo Kathryn R. , Butame Seyram A. , Hoelscher Deanna M. , Reininger Belinda , Shegog Ross
Published: December 2016

Health education specialists in academia and in the workplace must be effective teachers. However, doctoral programs often fail to equip students with effective teaching skills. In this study, we evaluate a first-year doctoral course that provided students the opportunity to learn how to teach health promotion theory, apply behavioral science theories and models to the development of health interventions, hone group facilitation skills, and develop their scientific writing abilities. Eight doctoral students completed a teaching self-efficacy assessment during the first and last class periods of a fall 2014 semester at a graduate school of public health in the United States. Throughout the semester, students reflected on their teaching. We applied a Wilcoxon signed-rank test to measure changes in pre- and postteaching self-efficacy scores and subjected student reflexive writings to a content analysis. The median increase in pre ( Mdn = 63, range = 24-72) and post ( Mdn = 76, range = 71-90) teaching self-efficacy scores were statistically significant for all participants ( z = 2.523, p = .012). The students’ reflexive writings explained how this increase occurred. Students gained an awareness of skills needed to teach effectively. Students found the course challenging because it uncovered teaching role ambiguities as they became cognizant of their lack of facilitation and presentation skills. The increased awareness of their deficiencies initially decreased their teaching self-efficacy. However, continued engagement in the course allowed them to resolve deficiencies, resolve some role ambiguity, and experience a net increase in teaching self-efficacy.
Ph-like acute lymphoblastic leukemia: a high-risk subtype in adults
Authors: Jain Nitin , Roberts Kathryn G. , Jabbour Elias , Patel Keyur , Eterovic Agda Karina , Chen Ken , Zweidler-McKay Patrick , Lu Xinyan , Fawcett Gloria , Wang Sa A. , Konoplev Sergej , Harvey Richard C. , Chen I-Ming , Payne-Turner Debbie , Valentine Marcus , Thomas Deborah , Garcia-Manero Guillermo , Ravandi Farhad , Cortes Jorge , Kornblau Steven , O’Brien Susan , Pierce Sherry , Jorgensen Jeffrey , Shaw Kenna R. Mills , Willman Cheryl L. , Mullighan Charles G. , Kantarjian Hagop , Konopleva Marina
Published: December 2016

Key Points

Approximately 20% to 25% of adults with B-ALL have Ph-like ALL with increased frequency of Ph-like ALL in adults with Hispanic ethnicity. Adult patients with CRLF2+ ALL have poor long-term outcomes; novel strategies are needed to improve the outcomes.
Definition, discrimination, diagnosis and treatment of central breathing disturbances during sleep
Authors: Randerath Winfried , Verbraecken Johan , Andreas Stefan , Arzt Michael , Bloch Konrad E. , Brack Thomas , Buyse Bertien , De Backer Wilfried , Eckert Danny Joel , Grote Ludger , Hagmeyer Lars , Hedner Jan , Jennum Poul , La Rovere Maria Teresa , Miltz Carla , McNicholas Walter T. , Montserrat Josep , Naughton Matthew , Pepin Jean-Louis , Pevernagie Dirk , Sanner Bernd , Testelmans Dries , Tonia Thomy , Vrijsen Bart , Wijkstra Peter , Levy Patrick
Published: December 2016

The complexity of central breathing disturbances during sleep has become increasingly obvious. They present as central sleep apnoeas (CSAs) and hypopnoeas, periodic breathing with apnoeas, or irregular breathing in patients with cardiovascular, other internal or neurological disorders, and can emerge under positive airway pressure treatment or opioid use, or at high altitude. As yet, there is insufficient knowledge on the clinical features, pathophysiological background and consecutive algorithms for stepped-care treatment. Most recently, it has been discussed intensively if CSA in heart failure is a “marker” of disease severity or a “mediator” of disease progression, and if and which type of positive airway pressure therapy is indicated. In addition, disturbances of respiratory drive or the translation of central impulses may result in hypoventilation, associated with cerebral or neuromuscular diseases, or severe diseases of lung or thorax. These statements report the results of an European Respiratory Society Task Force addressing actual diagnostic and therapeutic standards. The statements are based on a systematic review of the literature and a systematic two-step decision process. Although the Task Force does not make recommendations, it describes its current practice of treatment of CSA in heart failure and hypoventilation.
Comparison of different statistical approaches for urinary peptide biomarker detection in the context of coronary artery disease
Authors: Stanley Eleanor , Delatola Eleni Ioanna , Nkuipou-Kenfack Esther , Spooner William , Kolch Walter , Schanstra Joost P. , Mischak Harald , Koeck Thomas
Published: December 2016

Background

When combined with a clinical outcome variable, the size, complexity and nature of mass-spectrometry proteomics data impose great statistical challenges in the discovery of potential disease-associated biomarkers. The purpose of this study was thus to evaluate the effectiveness of different statistical methods applied for urinary proteomic biomarker discovery and different methods of classifier modelling in respect of the diagnosis of coronary artery disease in 197 study subjects and the prognostication of acute coronary syndromes in 368 study subjects.

Results

Computing the discovery sub-cohorts comprising$$ {\scriptscriptstyle \raisebox{1ex}{$2$}\!\left/ \!\raisebox{-1ex}{$3$}\right.} $$23of the study subjects based on the Wilcoxon rank sum test, t-score, cat-score, binary discriminant analysis and random forests provided largely different numbers (ranging from 2 to 398) of potential peptide biomarkers. Moreover, these biomarker patterns showed very little overlap limited to fragments of type I and III collagens as the common denominator. However, these differences in biomarker patterns did mostly not translate into significant differently performing diagnostic or prognostic classifiers modelled by support vector machine, diagonal discriminant analysis, linear discriminant analysis, binary discriminant analysis and random forest. This was even true when different biomarker patterns were combined into master-patterns.

Conclusion

In conclusion, our study revealed a very considerable dependence of peptide biomarker discovery on statistical computing of urinary peptide profiles while the observed diagnostic and/or prognostic reliability of classifiers was widely independent of the modelling approach. This may however be due to the limited statistical power in classifier testing. Nonetheless, our study showed that urinary proteome analysis has the potential to provide valuable biomarkers for coronary artery disease mirroring especially alterations in the extracellular matrix. It further showed that for a comprehensive discovery of biomarkers and thus of pathological information, the results of different statistical methods may best be combined into a master pattern that then can be used for classifier modelling.
Integrating mean and variance heterogeneities to identify differentially expressed genes
Authors: Ouyang Weiwei , An Qiang , Zhao Jinying , Qin Huaizhen
Published: December 2016

Background

In functional genomics studies, tests on mean heterogeneity have been widely employed to identify differentially expressed genes with distinct mean expression levels under different experimental conditions. Variance heterogeneity (aka, the difference between condition-specific variances) of gene expression levels is simply neglected or calibrated for as an impediment. The mean heterogeneity in the expression level of a gene reflects one aspect of its distribution alteration; and variance heterogeneity induced by condition change may reflect another aspect. Change in condition may alter both mean and some higher-order characteristics of the distributions of expression levels of susceptible genes.

Results

In this report, we put forth a conception of mean-variance differentially expressed (MVDE) genes, whose expression means and variances are sensitive to the change in experimental condition. We mathematically proved the null independence of existent mean heterogeneity tests and variance heterogeneity tests. Based on the independence, we proposed an integrative mean-variance test (IMVT) to combine gene-wise mean heterogeneity and variance heterogeneity induced by condition change. The IMVT outperformed its competitors under comprehensive simulations of normality and Laplace settings. For moderate samples, the IMVT well controlled type I error rates, and so did existent mean heterogeneity test (i.e., the Welch t test (WT), the moderated Welch t test (MWT)) and the procedure of separate tests on mean and variance heterogeneities (SMVT), but the likelihood ratio test (LRT) severely inflated type I error rates. In presence of variance heterogeneity, the IMVT appeared noticeably more powerful than all the valid mean heterogeneity tests. Application to the gene profiles of peripheral circulating B raised solid evidence of informative variance heterogeneity. After adjusting for background data structure, the IMVT replicated previous discoveries and identified novel experiment-wide significant MVDE genes.

Conclusions

Our results indicate tremendous potential gain of integrating informative variance heterogeneity after adjusting for global confounders and background data structure. The proposed informative integration test better summarizes the impacts of condition change on expression distributions of susceptible genes than do the existent competitors. Therefore, particular attention should be paid to explicitly exploit the variance heterogeneity induced by condition change in functional genomics analysis.
Inclusion Body Myositis
Authors: Greenberg Steven A.
Published: December 2016

Purpose of Review: Inclusion body myositis (IBM) is an enigmatic progressive disease of skeletal muscle. This review provides a summary of the clinical and pathophysiologic aspects of IBM.

Recent Findings: The development of diagnostic blood testing for IBM followed from the discovery of a B-cell pathway in IBM muscle and circulating autoantibodies against NT5C1A, further establishing IBM’s status as an autoimmune disease. The key role of cytotoxic T cells in IBM is further supported by the identification of a link between IBM and T-cell large granular lymphocytic leukemia. The testing of research diagnostic criteria in patients is improving its accuracy. Increases in estimated prevalences may be due to a combination of true increases and improved recognition of disease.

Summary: IBM has high unmet medical need. Advances in the mechanistic understanding of IBM as an autoimmune disease will drive effective therapeutic approaches. The identification of a B-cell pathway has resulted in the first identification of an IBM autoantigen and emphasized its status as an autoimmune disease. The recognition that large granular lymphocyte CD8+ T-cell expansions are present in both blood and muscle provides additional biomarkers for IBM and suggests a mechanistic relationship to the neoplastic disease T-cell large granular lymphocytic leukemia.
The Limb-Girdle Muscular Dystrophies and the Dystrophinopathies
Authors: Iyadurai Stanley Jones P. , Kissel John T.
Published: December 2016

Purpose of Review: The classic approach to identifying and accurately diagnosing limb-girdle muscular dystrophies (LGMDs) relied heavily on phenotypic characterization and ancillary studies including muscle biopsy. Because of rapid advances in genetic sequencing methodologies, several additional LGMDs have been molecularly characterized, and the diagnostic approach to these disorders has been simplified. This article summarizes the epidemiology, clinical features, and genetic defects underlying the LGMDs.

Recent Findings: In recent years, the advent of next-generation sequencing has heralded an era of molecular diagnosis in conjunction with physical characterization. Inadvertently, this process has also led to the “next-generation aftermath,” whereby variants of unknown significance are identified in most patients. Similar to the published diagnostic and treatment guidelines for Duchenne muscular dystrophy, diagnostic and treatment guidelines have recently been published for LGMDs. In addition, the first medication (based on the exon-skipping strategy) for treatment of patients with a subset of Duchenne muscular dystrophy has been recently approved by the US Food and Drug Administration (FDA).

Summary: The LGMDs are a heterogeneous group of hereditary, progressive, and degenerative neuromuscular disorders that present with primary symptoms of shoulder girdle and pelvic girdle weakness. Although a combination of clinical and molecular genetic evaluations may be sufficient for accurate diagnosis of LGMDs in many cases, the contribution of imaging and histopathologic correlations still remains a critical, if not a necessary, component of evaluation in some cases.
Toxic and Endocrine Myopathies
Authors: Katzberg Hans D. , Kassardjian Charles D.
Published: December 2016

Purpose of Review: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies.

Recent Findings: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy. Mechanisms underlying toxic myopathies include myosin loss; damage to cellular structures, including myofibrils and organelles such as lysosomes and mitochondria; inflammation; and necrosis. Presentations range anywhere from acute, painful, and necrotic myopathies, as can occur in statin myopathy, to more insidious presentations such as steroid myopathy.

Summary: Endocrinopathies known to cause myopathy include thyroid and parathyroid diseases, disorders of the adrenal axis such as Cushing syndrome, and acromegaly. Patients in the intensive care unit are at risk for developing critical illness myopathy, also known as myosin-loss myopathy, which should be considered if intensive care unit acquired weakness develops. The most common toxic agents associated with myopathy include statins and other lipid-lowering medications, corticosteroids, colchicine, amiodarone, hydroxychloroquine, and chloroquine.
The Dystrophic and Nondystrophic Myotonias
Authors: Sansone Valeria A.
Published: December 2016

Purpose of Review: This article describes clinical and electrical myotonia and provides an update on the classification, diagnosis, and management of myotonic disorders.

Recent Findings: In the myotonic dystrophies, antisense oligonucleotides provide a general strategy to correct RNA gain of function and modulate the expression of CTG expanded repeats; they are currently being tested in a phase 1-2 randomized controlled trial in patients with adult-onset myotonic dystrophy type 1. New genetic mutations are continuously being identified in the nondystrophic myotonias involving sodium and chloride channels. This contributes to the difficulty in describing genotype-phenotype correlations as the same mutations can give rise to different phenotypes, and the same phenotypes can arise from different mutations. Pharmacologic therapy is moving toward mutation-targeted treatments.

Summary: This article describes the clinical and diagnostic characteristics and management of the myotonic dystrophies and the nondystrophic myotonias. Clinical features of the congenital, juvenile, and classic adult forms of myotonic dystrophy type 1 are reviewed, and for the adult form, reference is made to the main diagnostic and follow-up tests for which general consensus exists. The different clinical presentations of myotonic dystrophy type 2 and its main differential diagnostic options are also discussed. The clinical spectrum of the sodium and chloride channelopathies is described, and clinical diagnostic clues to differentiate between these two groups are provided. Therapeutic options for patients with nondystrophic myotonias are also presented with reference to literature review and the author’s personal experience.
Big Affect: The Ephemeral Archive of Second-Wave Feminist Video Collectives in Canada
Authors: Bociurkiw Marusya
Published: December 2016

From 1972 to the early 1990s, Canadian feminist media collectives created dozens of social-issue documentaries and television series, producing an ephemeral archive of a vibrant era of political and social change. This article discusses the loss and/or deterioration of the material object of research, and it attempts, instead, to account for affect. In the absence of a complete audiovisual record, the passionate sites of embodied feeling experienced, remembered, and misremembered by the subjects of this history (including the author) become a way to reinscribe this history. Via interviews with collective members, screenings of archival works, and autoethnographic and archival research, the author examines the sites of feeling that accompanied the collective production of media works, as well as changes in public policy and the rise of neoliberal regulation that have impacted feminist organizing in Canada. The author argues that the lack of primary and secondary records of these collectives represents a significant gap in historical memory on several levels, signaling the forgetting of a moment when technology, public broadcasting, and feminist activism merged. As both participant and researcher, the author narrativizes this history in a way that moves beyond the absence or deterioration of a visual artifact, contending instead with ghosts, feelings, traces of memory and videotape, losses and gains, as well as with the productive dialogue and tension that occurs between historical forms of media activism and current digital platforms for feminist activism.
Arnait Video Productions: Inuit Women's Collective Filmmaking, Coalitional Politics, and a Globalized Arctic
Authors: MacKenzie Scott , Stenport Anna Westerståhl
Published: December 2016

Arnait Video Productions is one of the most aesthetically diverse feminist collectives in the world. Founded in 1991 in Igloolik, Nunavut, Canada, by Madeline Piujuq Ivalu and Marie-Hélène Cousineau as the first women's Inuit filmmaking collective, Arnait engages in collective media production from Inuit women's perspectives with an explicit focus on gender. Arnait's video art, animation, fiction features, television programs, and documentaries address issues faced by women struggling for the recognition of indigenous and minoritarian cultures. The success of Arnait builds on the strategies deployed by the well-known Nunavut-based video and film collective Isuma and also radically departs from it by including women in key production roles. In doing so, Arnait foregrounds women's stories and perspectives from an Inuit point of view and thereby counteracts preexisting yet unexamined “masculine models” of representation. The collective's goals include employing women-only or women-dominant production crews, while embracing traditional forms of Inuit narration and culture.
Cluster Flow: A user-friendly bioinformatics workflow tool
Authors: Ewels Philip , Krueger Felix , Käller Max , Andrews Simon
Published: December 2016

Pipeline tools are becoming increasingly important within the field of bioinformatics. Using a pipeline manager to manage and run workflows comprised of multiple tools reduces workload and makes analysis results more reproducible. Existing tools require significant work to install and get running, typically needing pipeline scripts to be written from scratch before running any analysis. We present Cluster Flow, a simple and flexible bioinformatics pipeline tool designed to be quick and easy to install. Cluster Flow comes with 40 modules for common NGS processing steps, ready to work out of the box. Pipelines are assembled using these modules with a simple syntax that can be easily modified as required. Core helper functions automate many common NGS procedures, making running pipelines simple. Cluster Flow is available with an GNU GPLv3 license on GitHub. Documentation, examples and an online demo are available at http://clusterflow.io.
Estimating limits for natural human embryo mortality
Authors: Jarvis Gavin E.
Published: December 2016

Natural human embryonic mortality is generally considered to be high. Values of 70% and higher are widely cited. However, it is difficult to determine accurately owing to an absence of direct data quantifying embryo loss between fertilisation and implantation. The best available data for quantifying pregnancy loss come from three published prospective studies (Wilcox, Zinaman and Wang) with daily cycle by cycle monitoring of human chorionic gonadotrophin (hCG) in women attempting to conceive. Declining conception rates cycle by cycle in these studies indicate that a proportion of the study participants were sub-fertile. Hence, estimates of fecundability and pre-implantation embryo mortality obtained from the whole study cohort will inevitably be biased. This new re-analysis of aggregate data from these studies confirms the impression that discrete fertile and sub-fertile sub-cohorts were present. The proportion of sub-fertile women in the three studies was estimated as 28.1% (Wilcox), 22.8% (Zinaman) and 6.0% (Wang). The probability of conceiving an hCG pregnancy (indicating embryo implantation) was, respectively, 43.2%, 38.1% and 46.2% among normally fertile women, and 7.6%, 2.5% and 4.7% among sub-fertile women. Pre-implantation loss is impossible to calculate directly from available data although plausible limits can be estimated. Based on this new analysis and a model for evaluating reproductive success and failure it is proposed that a plausible range for normal human embryo and fetal mortality from fertilisation to birth is 40-60%.