bluuebunny/crossref_metadata_2025 huggingface dataset:
High-throughput profiling of the circulating proteome suggests sexually dimorphic corticosteroid signaling following ischemic stroke
Authors: O’Connell Grant C. , Walsh Kyle B. , Burrage Emily , Adeoye Opeolu , Chantler Paul D. , Barr Taura L.
Published: July 2018

Increasing evidence suggests that there are innate differences between sexes with respect to stroke pathophysiology; however, the molecular mechanisms underlying these differences remain unclear. In this investigation, we employed a shotgun approach to broadly profile sex-associated differences in the plasma proteomes of a small group of male ( n = 6) and female ( n = 4) ischemic stroke patients. Peripheral blood was sampled during the acute phase of care, and liquid chromatography electrospray ionization mass spectrometry was used to quantify plasma proteins. We observed widespread differences in plasma composition, as 77 out of 294 detected proteins were significantly differentially expressed between sexes. Corticosteroid-binding globulin (CBG), a negative acute-phase reactant that inversely regulates levels of bioactive free cortisol, was the most dramatically differentially regulated, exhibiting 16-fold higher abundance in plasma from women relative to men. Furthermore, functional annotation analysis revealed that the remaining differentially expressed proteins were significantly enriched for those involved in response to corticosteroid signaling. Plasma CBG levels were further examined in an additional group of male ( n = 19) and female ( n = 28) ischemic stroke patients, as well as a group of male ( n = 13) and female ( n = 18) neurologically normal controls. CBG levels were significantly reduced in male stroke patients relative to male controls; however, no differences were observed between female stroke patients and female controls, suggesting that women may exhibit an attenuated cortisol response to stroke. Collectively, our findings reinforce the idea that there are sex-associated differences in stroke pathophysiology and suggest that cortisol signaling should be investigated further as a potential molecular mediator.
A Novel Inhibitor Targets Both Wnt Signaling and ATM/p53 in Colorectal Cancer
Authors: Cheng Jiongjia , Dwyer Mary , Okolotowicz Karl J. , Mercola Mark , Cashman John R.
Published: July 2018

For 2017, the estimated lifetime risk of developing colorectal cancer was 1 in 22. Even though preventative colonoscopy screening and standard-of-care surgery, radiation, and chemotherapy have decreased the death rate from colorectal cancer, new therapies are needed for metastatic colorectal cancer. Here, we developed a novel small molecule, compound 2, that inhibited proliferation and viability of human colorectal cancer cells (HCT-116, DLD-1, SW480, and 10.1). Compound 2 inhibited cell migration, invasion, and epithelial–mesenchymal transition processes and potently increased cell apoptosis in human colorectal cancer cells. Compound 2 also modulated mitotic stress signaling, leading to both inhibition of Wnt responsiveness and stabilization and activation of p53 to cause cell-cycle arrest. In mouse xenografts, treatment with compound 2 (20 mg/kg/day, i.p.) induced cell death and inhibited tumor growth more than four-fold compared with vehicle at day 34. Neither acute cytotoxicity nor toxicity in animals (up to 1,000 mg/kg, i.p.) were observed for compound 2. To our knowledge, compound 2 is the first reported potent small molecule that inhibits Wnt/β-catenin signaling, activates p53 signaling regardless of p53 mutation status, and binds microtubules without detectable toxicity. Thus, compound 2 offers a novel mechanism of action and a new strategy to treat colorectal cancer.

Significance: These findings identify a potent small molecule that may be therapeutically useful for colon cancer that works by inhibiting Wnt/β-catenin signaling, activating p53, and binding microtubules without detectable toxicity. Cancer Res; 78(17); 5072–83. ©2018 AACR.
“The East Asian Frontier of the Socialist World: North Korea in the 1950s”
Authors: Agov Avram
Published: July 2018

The decade of the 1950s was a formative period for the Democratic People’s Republic of Korea (dprk), one that shaped its integration into the international socialist system. This article examines the interaction between North Korea’s internal (institutional) and external (international) integration into the socialist system that, at this time, the Soviet Union and its East European bloc allies dominated. It argues that North Korea was more integrated into the socialist world than its nationalist ideology implied. The 1950s marked the culmination of the dprk’s connectivity to the international socialist world. The narrative begins in the second half of the 1940s with the building of North Korea’s socialist system. It then focuses on East European bloc aid to North Korea during and after the Korean War, as well as the dprk’s reactions to this fraternal assistance. By the second half of the 1950s, North Korea came to associate integration with dependency, generating nationalist impulses in dprk policy and laying the foundation for the juche (self-reliance) paradigm. North Korea’s nationalist ideology was part of a broader post-colonial nation building drive, but socialist interdependency also played a role in the dprk’s divergence, after the early 1960s, from the Soviet bloc and the People’s Republic of China.
Sudden Bilateral Hearing Loss, Tinnitus, and Vertigo as Presenting Symptoms of Chronic Myeloid Leukemia
Authors: Cass Nathan D. , Gubbels Samuel P. , Portnuff Cory D. F.
Published: July 2018

Objectives:

The objective was to describe a unique case of sudden bilateral hearing loss, tinnitus, and vertigo presenting as the first symptoms of chronic myeloid leukemia (CML).

Methods:

A patient case is discussed along with a review of associated literature.

Results:

A patient presented with sudden onset hearing loss, tinnitus, and vertigo, and was diagnosed with CML with an initial white blood cell (WBC) count of 555 000 per microliter. The proposed etiology of otologic symptoms is hyperleukocytosis. Serial audiograms showed minimal improvement in hearing despite reduction of WBC.

Conclusion:

In cases of bilateral, sudden onset sensorineural hearing loss, evaluation for systemic causes of otologic symptoms, including CML, should be considered.
Grill-Cleaning Wire Brush Bristle Ingestion: Case Series and Review of the Literature
Authors: Mortensen Melissa , Samara Ghassan , Regenbogen Elliot
Published: July 2018

Objectives:

The authors report a small case series of an unusual ingested foreign body, wire brush bristles, whose small size can present a challenge for endoscopic removal. The authors describe transnasal endoscopic removal and provide a literature review.

Methods:

From 2011 to 2017, 8 patients presented to an academic tertiary medical center with ingestion of wire brush bristles. The patients’ medical records were reviewed and are described in this report, along with a literature review.

Results:

In 4 patients, the bristles were in the lingual tonsils. In 1 patient, a bristle was within the pharyngoepiglottic fold and lingual tonsils. Three patients underwent office removal with a fiber-optic laryngoscope under local anesthesia. Two patients underwent direct laryngoscopy with bristle removal. In 1 patient the wire bristle transected the esophagus, requiring an open procedure. One patient presented with a complicated deep-space neck infection.

Conclusions:

Wire brush bristles easily become displaced and subsequently become lodged in the upper aerodigestive tract. Localization of a bristle can be difficult on examination and laryngoscopy. Radiography can be performed, but computed tomographic examination with contrast is superior for precise localization for preparation for an operative approach. Depending on the precise location of the bristle, endoscopic removal using a fiber-optic channeled scope may be a safe and effective solution.

Level of Evidence:

Case Series, IV
Programming Flexible Congestion Mitigation and Air Quality Program Funds: Best Practices for State DOTs
Authors: Rowangould Gregory , Nadafianshahamabadi Razieh , Poorfakhraei Amir
Published: July 2018

State departments of transportation (DOTs) face unique challenges in programming funds for the federal Congestion Mitigation and Air Quality Improvement (CMAQ) program. This is particularly true as more DOTs receive larger shares of so-called “flexible” CMAQ funding. Unlike other CMAQ funds, flexible funds can be spent outside of non-attainment and maintenance areas, which often means in more rural areas where there is no metropolitan planning organization (MPO) to program the funding. Flexible funds may also be spent on a wider range of project types. DOTs in these situations have many options for programming CMAQ funds but there has been little guidance on best practices for doing this. Prior studies have focused exclusively on best practice for MPOs. This study provides a comprehensive survey of current CMAQ programming practices among DOTs and MPOs and then highlights practices best suited to the particular needs of DOTs.
Fuel Consumption Optimization Model for the Multi-Period Inventory Routing Problem
Authors: Cheng Chun , Qi Mingyao , Rousseau Louis-Martin
Published: July 2018

In the traditional multi-period inventory routing problem (MIRP), traveling distance is considered as the only measurement of vehicles’ variable transportation cost; however, it is in fact the fuel consumption cost, not the distance, which is the greater concern. This paper evaluates vehicles’ variable transportation cost by fuel consumption, which is influenced by distance, load, and fuel price. It presents an integer program to formally characterize the fuel consumption considered MIRP (FCMIRP), which can help enterprises obtain a more accurate tradeoff between transportation and inventory costs. It also benefits the environment, because reducing fuel consumption will curb carbon dioxide (CO2) emissions. Valid inequalities are added to strengthen the model and use a branch-and-cut algorithm. Computational tests indicate that the FCMIRP can decrease fuel consumption and total cost over the traditional model. Factors that influence the results of FCMIRP are also discussed.
Bayesian Network for Freeway Traffic State Prediction
Authors: Park Ho-Chul , Kim Dong-Kyu , Kho Seung-Young
Published: July 2018

Traffic state prediction is an important issue in traffic operations. One of the main purposes of traffic operations is to prevent a flow breakdown. Therefore, it is necessary to predict the traffic state in such a way as to reflect the stochastic process of traffic flow. To predict accurately the traffic state, machine learning-based models have been widely adopted, but they have difficulty in obtaining insights for traffic state prediction due to black-box procedures of the models. A Bayesian network (BN) is a methodology that is suitable for dealing with problems that involve uncertainty, and it can also improve the understanding of such problems. In this study, we develop a traffic state prediction model using a BN to reflect the dynamic and stochastic characteristics of traffic flow. To improve the BN, which has been used with a simple structure in transportation problems, we propose a modeling procedure using a mixture of Gaussians (MoGs). In the performance evaluation, the BN has better performance than a logistic regression, and it has the same level of performance as an artificial neural network based on machine learning. Also, by performing sensitivity analyses, we provide the understanding of traffic state prediction and the guidelines for improving the model. The BN developed in this study can be considered as a traffic state prediction model with good prediction accuracy and interpretability.
Coordinated Daily Activity Pattern Type in an Applied Activity-Based Travel Model System: Specifics of Modeling Large Households and Modality Preferences
Authors: Vyas Gaurav , Vovsha Peter , Givon Danny , Birotker Yehoshua
Published: July 2018

This paper describes a modified approach to modeling an individual daily activity-travel pattern (DAP) coordinated at the household level. The model was primarily introduced to handle large households that are typical for the city of Jerusalem. However, the developed method proved useful in adding more behavioral aspects to the model. The study introduced daily modality and added the emphasis on modeling it for all household members simultaneously. It is of special practical value for Jerusalem since such population sectors as ultra-Orthodox Jewish and Arabs are characterized by a large share of persons who have an entire day of travel implemented in a non-motorized fashion. In addition to daily modality, this paper presents a simple but useful approach to understand at-home time-use. A binary choice model was formulated for the main reason of being inactive (working-at-home or other).

The paper also discusses possible extensions of the current approach as well as alternative approaches to frame DAP type choice in the context of a complete activity-based travel model (ABM). In particular, this model can be easily extended in order to better address the joint nature of the choices using the Gibbs sampler. The paper discusses how DAP type choice can be framed in many ways and with different levels of detail subject to the ultimate model system design.
Monte Carlo Simulation-Based Benefit-Cost Analysis Combined with Analytical Hierarchy Process to Support ITS Investment with Consideration of Connected Vehicle Technology
Authors: Khazraeian Samaneh , Hadi Mohammed
Published: July 2018

Decisions to invest in alternative intelligent transportation system (ITS) technologies are expected to increase in complexity, particularly with the introduction of connected vehicles (CV) and automated vehicles (AV) in the coming years. Traditional alternative analyses based on deterministic return on investment analysis are unable to capture the risks and uncertainties associated with the investment problem. In addition, these methods cannot account for agency preferences and constraints that cannot be converted to dollar values. This study utilizes a combination of a stochastic return on investment and a multi-criteria decision analysis method referred to as the Analytical Hierarchy Process (AHP) to select between ITS deployment alternatives considering emerging technologies. The approach is applied in a case study of the selection between using CV data and point detector data to support the freeway traffic data collection and monitoring service. The four objectives specified in the AHP analysis are providing the required functions, providing the required performance, minimizing the risks and constraints, and maximizing the return on investment. A stochastic return-on-investment analysis using a Monte Carlo simulation was used to calculate the return on investment values for input to the AHP method.
Methods for the Design of Safety Service Patrol Beats: The Florida Road Ranger Case Study
Authors: Sun Xiaotong , Shahabi Mehrdad , Carrick Grady , Yin Yafeng , Srinivasan Sivaramakrishnan , Shirmohammadi Nima
Published: July 2018

This paper introduces a framework for the design and deployment of safety service patrols (SSP) on freeways. Three mathematical programming models are proposed, with the targets of minimizing fleet size and total average response time and maximizing social benefits to accommodate various design objectives. Fast heuristic algorithms based on neighborhood searching techniques are presented for solving the optimization problems. In addition, a computer tool with a graphical user interface has been developed that takes roadway segments information as the input and provides real-world recommendations for deployment. The tool was tested using nearly 800 unique Florida roadway segments, totaling over 2,000 centerline freeway miles. The results were consistent with more than 100 current beats of Florida Road Ranger service patrols, and will be used for budget forecasting for the state.
Is There a Limit to Adoption of Dynamic Ridesharing Systems? Evidence from Analysis of Uber Demand Data from New York City
Authors: Gerte Raymond , Konduri Karthik C. , Eluru Naveen
Published: July 2018

Recent technological advances have paved the way for new mobility alternatives within established transportation networks, including on-demand ride hailing/sharing (e.g., Uber, Lyft) and citywide bike sharing. Common across these innovative modes is a lack of direct ownership by the user; in each of these mobility offerings, a resource not owned by the end users’ is shared for fulfilling travel needs. This concept has flourished and is being hailed as a potential option for autonomous vehicle operation moving forward. However, substantial investigation into how new shared modes affect travel behaviors and integrate into existing transportation networks is lacking. This paper explores whether the growth in the adoption and usage of these modes is unbounded, or if there is a limit to their uptake. Recent trends and shifts in Uber demand usage from New York City were investigated to explore the hypothesis. Using publicly available data about Uber trips, temporal trends in the weekly demand for Uber were explored in the borough of Manhattan. A panel-based random effects model accounting for both heteroscedasticity and autocorrelation effects was estimated wherein weekly demand was expressed as a function of a variety of demographic, land use, and environmental factors. It was observed that demand appeared to initially increase after the introduction of Uber, but seemed to have stagnated and waned over time in heavily residential portions of the island, contradicting the observed macroscopic unbounded growth. The implications extend beyond already existing fully shared systems and also affect the planning of future mobility offerings.
Video Learning in Community Planning
Authors: Grodach Carl
Published: July 2018

This article explores the use of video as an experiential learning tool in planning education. We report on the design of a video learning assignment for undergraduate community planning students and the results of a pre- and postsurvey used to gauge the student learning experience. Results show that video-making can be an effective tool to inspire students to make connections between complex urban theory and planning content and their everyday surroundings. This approach may be a useful support for future planners whose roles will involve community engagement and developing scenarios for community change.
Effects of freezing on ability to detect Mycobacterium avium subsp. paratuberculosis from bovine tissues following culture
Authors: Corbett Caroline S. , De Buck Jeroen , Barkema Herman W.
Published: July 2018

Mycobacterium avium subsp. paratuberculosis (MAP) is the bacterium that causes Johne’s disease in cattle. Although infected cattle can be identified by examining fecal, blood, or milk samples, the gold standard is identification of MAP in tissue samples postmortem. Although tissue samples are commonly frozen, the ability to detect MAP in frozen–thawed tissue samples has apparently not been reported. We therefore determined the ability to detect MAP in tissue samples following freezing. Tissue samples were collected from calves that were either inoculated (IN) 3 mo prior, or contact-exposed (CE) for 3 mo. Following autopsy, tissues were immediately processed for culture, followed by DNA extraction and detection by qPCR. Samples were categorized as positive or negative based on the cycle threshold (Ct) value. The remaining unprocessed tissue samples were frozen at −80°C. After 18 mo, 50 tissue samples designated MAP-positive were thawed and processed for detection of MAP. Four (8%) samples were qPCR-negative, and Ct values of the remaining 46 samples were higher after freezing. Given the small numerical change in Ct values for MAP-positive samples after 18 mo of frozen storage, freezing and thawing may have had some deleterious effects on MAP detection in tissues. Although the decrease in ability to detect MAP-positive samples was minor for IN calves, there may be a greater effect for CE calves that should be considered when freezing tissue samples.
Extra-enteric Blastocystis infection in a duck
Authors: Ilchyshyn Nicholas P. , Monti Paola
Published: July 2018

Cell structures morphologically consistent with Blastocystis were aspirated from a subcutaneous facial swelling in a 13-mo-old pet duck. On PCR analysis and sequencing, the organism was confirmed as Blastocystis sp. subtype 7. Blastocystis is a single-celled protist that is found in the intestinal tract of many species, including mammals, birds, reptiles, amphibians, and insects. A complete understanding of the lifecycle and pathogenesis of the parasite remains elusive. Blastocystis has been implicated in human and animal disease; however, its role is controversial given that it is commonly found among healthy gut microbiota. Infection with Blastocystis outside the intestinal tract has been reported only rarely in humans. Our case of subcutaneous Blastocystis infection in a duck is a novel presentation of a ubiquitous, generally asymptomatic, parasite or commensal of the intestinal tract.
Characterization of the histologic appearance of normal gill tissue using special staining techniques
Authors: Smith Stephen A. , Newman Shelley J. , Coleman Matthew P. , Alex Charles
Published: July 2018

Anatomic pathologists are familiar with stains used in light microscopy to identify cells, storage products, tissue deposits, and pathogens. Assessment of the surrounding tissue with special stains may reveal aspects of interest for the tissue or the species. We illustrate the expected staining characteristics of normal rainbow trout gill tissue with routine hematoxylin and eosin and 18 other histochemical stains.
Lead contamination in backyard chicken layer flocks in California
Authors: Sobhakumari Arya , Hargrave Sabine A. , Hill Ashley E. , Poppenga Robert H.
Published: July 2018

Backyard layer chickens may be exposed to a variety of metals in the environment, including lead. The potential public health concerns associated with lead exposure prompted us to systematically screen liver samples from backyard layers submitted to the diagnostic laboratory to estimate the prevalence of lead exposure. Over a period of 1 y, we tested 1,476 chicken livers, of which 45 were found to have lead concentrations of 0.9–41 µg/g. The lead-positive cases were investigated by follow-up questions to the bird owners on the environment, general management of the flock, and egg consumption of family members. Lead concentrations in 14 pooled egg samples were determined, and a conservative estimate of daily exposure of family members to lead was made based on egg consumption. In some cases, estimated daily lead intake exceeded the recommended limits for lead consumption in children. Analysis of feed, water, and environmental samples did not identify a source of exposure in most cases. Only 34% of owners of lead-positive birds submitted eggs or environmental samples, indicating a lack of interest or financial concerns. In most cases, neither the case history nor postmortem findings were indicative of lead intoxication; without systematically testing all birds, some cases could have been missed. Our study highlights the need for backyard chicken owners, veterinarians, and public health personnel to be aware of the risk of lead exposure and undertake preventive and surveillance measures.
Living With Type 2 Diabetes in San Jose Tecoh, Yucatan, Mexico: A Phenomenological Study
Authors: Vicente Antonio , Candila Julia , Thomas Jenifer J. , Gomez Aguilar Patricia , Oliva Aviles Cristian
Published: July 2018

Introduction: Understanding the psychosocial aspects that accompany and influence type 2 diabetes mellitus (T2DM) has become increasingly important for culturally appropriate health care in Mexico. The purpose of this study was to understand the lived experience of individuals’ with T2DM in Merida, Yucatan. Method: A phenomenological method guided data collection and analysis. Patients in San Jose Tecoh, diagnosed with T2DM for at least 5 years, were interviewed. Results: Eight (six female, two male) patients described their lived experience. Individuals discussed knowledge of the disease (e.g., care, beliefs about origin, consequences, type, symptoms) and changes arising from diagnosis (e.g., emotional, dietary, physiological, lifestyle and self-care, economic). Discussion: The Mayan–Yucatecan cultural perceptions of factors that influence physical health are unique to this region. Nurses can facilitate improvement in T2DM health outcomes through providing information and encouraging self-care. Our results emphasize the importance of considering T2DM in terms of differences between and within culture.
Adapting the DIPLOMACY Board Game Concept for 21st Century International Relations Teaching
Authors: Mattlin Mikael
Published: July 2018

Background. This article reports on pedagogical experiences of designing and teaching an active learning international relations (IR) course utilizing the classical board game DIPLOMACY, with added game elements and modified game rules to make the game better suited for educational purposes.

Aim. Game adaptations include team play, a dedicated peace mediator team, altered win rules and a post-game debriefing discussion on different cultures of anarchy. These elements were designed to overcome a shortcoming that the game approximates a worldview akin to offensive realism, which is not practical in contemporary international relations, and also normatively objectionable to many IR scholars.

Method. Teacher experiences designing and modifying the course, coupled with student feedback on the course concept from three consecutive years.

Results. Student feedback has been exceedingly positive, with a 4.61 average grade (n = 210 grades) on a five-point Likert-type scale, where 1 signifies poor and 5 excellent.

Conclusions. Through game modifications, students turned a game infamous for its backstabbing and breaking of promises into a game that resolves in a mediated and negotiated outcome. The findings suggest that DIPLOMACY can be useful beyond teaching the realist worldview, and adapted to create a more accurate microworld approximation of international relations.
“Patients Are Not Following the [Adherence] Club Rules Anymore”: A Realist Case Study of the Antiretroviral Treatment Adherence Club, South Africa
Authors: Mukumbang Ferdinand C. , Marchal Bruno , Van Belle Sara , van Wyk Brian
Published: July 2018

There is growing evidence that differentiated care models employed to manage treatment-experienced patients on antiretroviral therapy could improve adherence to medication and retention in care. We conducted a realist evaluation to determine how, why, for whom, and under what health system context the adherence club intervention works (or not) in real-life implementation. In the first phase, we developed an initial program theory of the adherence club intervention. In this study, we report on an explanatory theory-testing case study to test the initial theory. We conducted a retrospective cohort analysis and an explanatory qualitative study to gain insights into the important mechanisms activated by the adherence club intervention and the relevant context conditions that trigger the different mechanisms to achieve the observed outcomes. This study identified potential mitigating circumstances under which the adherence club program could be implemented, which could inform the rollout and implementation of the adherence club intervention.
Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia
Authors: Bielsten Therése , Lasrado Reena , Keady John , Kullberg Agneta , Hellström Ingrid
Published: July 2018

The aim of this study is to identify relevant content for a self-management guide by using the outcomes of previous research in combination with knowledge and experiences from couples where one partner has a diagnosis of dementia. The study was carried out in three phases: (a) literature search of previous research related to well-being and couplehood in dementia; (b) interviews with couples with dementia based on the findings of the literature search; and (c) further authentication of the findings within expert groups of people with dementia and carers. For analysis of data, we used a hybrid approach of thematic analysis with combined deductive and inductive approaches. The findings of this study indicated that the four main themes “Home and Neighborhood,” “Meaningful Activities and Relationships,” “Approach and Empowerment,” and “Couplehood” with related subthemes could be appropriate targets for a self-management guide for couples where one partner has a diagnosis of dementia.
Formal Authority, Persuasive Power, and Effectiveness in State Legislatures
Authors: Edwards Barry
Published: July 2018

What makes some lawmakers more effective than others is a central question in American politics. Recent research has emphasized the role of informal, persuasive leadership, but this research has focused almost exclusively on Congress, so it is unclear whether this approach to lawmaking is generally effective. Analysis of state legislatures is hampered by the lack of a theoretically sound and practically feasible measure of legislative effectiveness. I offer a solution to the primary problem with traditional hit rates. I apply this approach to North Carolina legislators and show my effectiveness estimates correspond with expert evaluations. I then examine recent terms of the Michigan, Georgia, and North Carolina legislatures to evaluate the relative importance of formal and informal powers at the state level. I hypothesize and find that informal, persuasive leadership is not effective in state legislatures where lawmaking is better explained by formal, hierarchical authority.
Popular, Informal, and Vernacular Music Classrooms: A Review of the Literature
Authors: Mercado Emily M.
Published: July 2018

The purpose of this literature review is to examine research in popular, informal, nontraditional, out-of-school, and vernacular music education from 2012 to the present in order to concentrate on recent literature and make suggestions to inform current practice. Researchers have indicated that these classrooms can provide creative and collaborative opportunities and can help students connect with out-of-school music experiences. In addition, these classrooms seem to align with culturally relevant and student-centered pedagogies and an inclusive curriculum. In contrast, researchers have discussed a perceived dissonance concerning the validity and use of vernacular music in the classroom (i.e., the musical genres considered acceptable in the classroom and how they support or hinder the learning outcomes).
Markers of metabolic endotoxemia as related to metabolic syndrome in an elderly male population at high cardiovascular risk: a cross-sectional study
Authors: Awoyemi Ayodeji , Trøseid Marius , Arnesen Harald , Solheim Svein , Seljeflot Ingebjørg
Published: July 2018

Background

Metabolic syndrome (MetS) is a cluster of conditions that conjoined represents a 1.5–2.5 fold increased risk of developing cardiovascular disease (CVD). Recent studies have reported that gut dysbiosis and leakage of bacterial components, may contribute to the metabolic disturbances and systemic inflammation observed in subjects with MetS. Chronic exposure to lipopolysaccharide (LPS) has been shown to induce features of MetS in experimental studies. LPS interacts with the innate immune system, facilitated through LPS-binding protein (LBP) and the co-receptor CD14, both regarded as markers of gut leakage.

Purpose

We investigated whether circulating levels of LBP and sCD14 are associated with the presence of MetS and its components, and further any association with systemic inflammation.

Methods

We examined 482 men, aged between 65 and 75 years, all at high CVD risk. MetS criteria’s according to the US National Cholesterol Education Program Adult Treatment Panel III were met in 182 subjects (38%).

Results

Levels of LBP and sCD14 did not differ between individuals with and without MetS. However, a trend towards increased risk of MetS through quartiles of LBP was observed (p = 0.05). Individuals in the highest quartile (Q4), had an increased risk of MetS (OR = 1.76, 95% CI (1.04–3.00), compared to the lowest quartile (Q1) (p = 0.04). With regard to the separate constituents of MetS, patients who met the waist circumference criterion had significant higher concentration of LBP compared to those who did not (p = 0.04). We also found a weak, but significant correlation between LBP and waist circumference (r = 0.10, p = 0.03). Moderate, yet significant correlations were observed between both LBP and sCD14 and several markers of systemic inflammation (r = 0.1–0.23; p < 0.001–0.04).

Conclusion

The trend for increased prevalence of MetS observed with increasing quartiles of LBP seems to be mainly driven by central obesity in our male cohort. The associations between LBP, sCD14 and systemic inflammation, indicate a potential role of the innate immune system in MetS.

Trial registrationCLINICALTRIALS.GOV, NCT00764010. Registered 01 October 2008—retrospectively registered,https://clinicaltrials.gov/ct2/show/NCT00764010?term=NCT00764010&rank=1
The Carbapenems Issue
Authors: Sotello David , Chakkour Wadih , Fuhrmann Kristen
Published: July 2018

The development of antibiotics remains one of the great advances in medicine. Antibiotics have saved countless lives. Unfortunately, the widespread use of antimicrobials has led to the development of antimicrobial resistance. Antibiotic resistance is an important concern for public health; it is associated with poor outcomes. Carbapenems, members of the β-lactam class of antibiotics, have the broadest spectrum of antimicrobial activity. Carbapenem resistance is one of the toughest challenges in infectious diseases; it is associated with high mortality and is seen more often now due to the proliferation of multi-drug resistant bacteria. Multiple genes that cause carbapenem resistance have been identified. Resistance transmission is usually nosocomial, but community-acquired infections with resistance have been reported. Early recognition of high risk patients for multi-drug resistant infections is fundamental for adequate management. The rational use of antibiotics is required to prevent the spread of antimicrobial resistance; this requires multidisciplinary efforts among clinicians, Infection Control departments, and Antimicrobial Stewardship programs.
Indwelling pleural catheters for recurrent pleural effusions: A useful clinical tool with serious implications
Authors: Copeland Samuel , Schwalk Audra , Suchartlikitwong Salkowan , Yang Shengping , Berdine Gilbert
Published: July 2018

Background: Indwelling pleural catheters (IPC) have been used increasingly in patients with recurrent pleural effusions. However, data about mortality after IPC use are limited. Objectives: We sought to determine the natural history following IPC placement in Lubbock, Texas, in terms of life expectancy and pleurodesis rates in patients with both malignant and benign effusions. Methods: A retrospective review of patients who had IPC insertion from March 2014 through December 2016 at University Medical Center in Lubbock, Texas, was performed. Patients 18 years and older who had IPC placement for recurrent pleural effusions were included. The duration of IPC placement, the type of pleural effusion, the volume of fluid, pleurodesis, complications, and mortality after IPC placement were retrieved from electronic medical records. Results: There were 45 patients included in the study; 20 patients (44%) were male, and 25 patients (56%) were female. The mean age was 63.5 years old. There were 33 patients with malignant pleural effusion and 12 patients with benign pleural effusion. No patients with malignant effusion were known to be alive at the time of mortality calculation, whereas two patients with benign effusion were known to be alive. Median survival was 468 days in the benign effusion group and 115 days in the malignant effusion group. The 30-day mortality was not significantly different between the two groups (malignant 34.5% vs. benign 25.0%). However, 1-year mortality was significantly higher in the malignant effusion group (89.7%) than in the benign effusion group (41.7%) (p < 0.005). Conclusion: The use of indwelling pleural catheters in Lubbock, Texas, has comparable results to published studies. These catheters should be considered as a bridge to a long-term treatment rather than a definitive therapy.
Comparing the asthma control in overweight/obese and normal weight pediatric patients: A retrospective study in West Texas
Authors: Huang Jason , Lever Jarrett , Kola Bhargavi
Published: July 2018

Asthma is one of the most common chronic diseases in children. Excess weight is thought to contribute adversely to this disease and has been associated with both an increased incidence and severity of asthma in multiple studies. However, this information does not seem to be conclusive, since there are also studies showing either no relationship or a relationship only in certain subpopulations of children. The aim of this study was to see if we could identify any pattern in the relationship of weight and asthma severity and control in our pediatric population at a university affiliated clinic in rural West Texas. We were unable to find statistically significant differences either in the overall population or in the boys or girls subpopulations. We estimate based on our results that future studies would need at least 800 children to achieve adequate statistical power. More well designed studies are needed to clarify and confirm the relationship between obesity and asthma control and severity in children.
Gastrointestinal bleeding in pregnant patients with cirrhosis: Pathophysiology, review of outcomes, and management
Authors: Shredi Abdussalam , Elberson Benjamin
Published: July 2018

Pregnancy is a rare event in patients with cirrhosis because the metabolic and hormonalchanges associated with cirrhosis lead to anovulation and amenorrhea. Liver cirrhosis withportal hypertension is considered one of the most common causes of gastrointestinal bleedingin general and comes after peptic ulcer disease. Gastrointestinal bleeding in the setting ofportal hypertension occurs secondary to either esophageal varices or portal hypertensivegastropathy. Its management can be challenging in general, and pregnancy can only make itmore complicated. In this article we will review the management of variceal gastrointestinalbleeding in pregnancy.
Review: Pharmacotherapy for smoking cessation
Authors: Limsuwat Chok , Saito Shigeki , Halvorson Karin
Published: July 2018

Smoking is associated with numerous cancers and atherosclerosis. Smoking cessationhas substantial potential in reducing morbidity and mortality worldwide. The initial steps “5 A’s”(Ask, Advise, Assess, Assist, Arrange) should be applied in all patients. Behavioral counselingand pharmacotherapy are both effective, but the combination of the two is more effective thaneither alone. The first-line pharmacotherapy includes nicotine replacement, bupropion, andvarenicline. Nicotine replacement therapy (NRT) consists of long-active formulations, such asin a patch, and short-acting formulations such as in gum, lozenge, inhaler, and nasal spray. Ascompared to placebo, NRT increases the chances of quitting smoking. Nicotine replacementtherapy does not increase cardiovascular risk and is safe in patients with cardiovasculardisease. Sustained-release bupropion is more effective than nicotine patches and can becombined with nicotine patches. Buprenorphine is generally well tolerated, except that it lowersseizure threshold and is contraindicated in patients with seizure disorders. Varenicline alsosignificantly improves the success rate of smoking cessation. The latest evidence suggeststhat varenicline is not associated with an increased risk of neuropsychiatric or cardiovascularevents. In conclusion, the use of NRT (nicotine patch + nicotine gum/lozenge/inhaler/spray),bupropion (with NRT), or varenicline is strongly recommended for smoking cessation, unlessthey are contraindicated.
Intra-pleural tissue plasminogen activator and deoxyribonuclease: An alternative treatment option for pleural infections in specific populations
Authors: Medrano Rita , Schwalk Audra , Islam Ebtesam
Published: July 2018

Pleural infections can be associated with significant morbidity and mortality. Systemicantibiotics and drainage are the standard treatment, but some patients require surgicalintervention for complete resolution. For unsuitable surgical candidates, the intra-pleuraladministration of tissue plasminogen activator and deoxyribonuclease (tPA/DNase) is apotential treatment option for loculated effusions. We present a case of loculated empyemasuccessfully treated with a 3-day course of once daily intra-pleural administration of tPA/DNase. Considering the frailty of our patient, we choose the once daily tPA/DNase due toconcerns about potential complications, such as increased risk of bleeding. The published trialevidence and administration regimens of intra-pleural tPA/DNase are also discussed.
Recurrent atrial myxoma, right atriotomy, and sinus node dysfunction: A case of interdisciplinary care
Authors: Argueta Erwin , Ratheal Kelly , Prieto Sofia , Paone Ralph , Jenkins Leigh Ann , Oyenuga Olusegun
Published: July 2018

Primary cardiac tumors are rare, and atrial myxomas represent about half of the benigntumors encountered. When found, definitive treatment is surgical resection. Followingresection of these tumors, recurrence is possible, and these patients need regular follow-up.In the case of recurrence, repeat surgical intervention is feasible, but the potential for moredisruption in atrial anatomy has to be considered. This could contribute to cardiac arrhythmias,and anticipation of these events is necessary to optimize patient care. We present the caseof a woman with a recurrent left atrial myxoma who developed sinus node dysfunction afterresection and discuss her clinical management.
Improving health self-efficacy at a community health fair in Lubbock, Texas
Authors: Lindgren Taylor , Burroughs Chelsea , Burroughs Mark , Parker George , Levent Fatma
Published: July 2018

To improve the health self-efficacy of the Lubbock, Texas community, Texas Tech University Health Sciences Center School of Medicine students organized a health fair to promote patient education and improve awareness of health issues, such as diabetes, heart health, hypertension, skin care, hypercholesterolemia, nutrition, stress management, cancer screening and recommendations, physical fitness, and mental health. An evaluation of 57 health fair participants’ self-reported self-efficacy on a scale from 0 to 10 before and after visiting the health fair revealed an average increase in self-efficacy of 0.87 (before: 7.96, after: 8.83, p<0.0001, std=1.78). Although the health fair was successful in marginally improving patient self-efficacy, patient education and overall community health can continue to be improved by expanding educational opportunities for health promotion and illness prevention, furthering overall access to care, and broadening the health fair’s target population.
Consensus or dissensus? Analysing people's perceptions of the necessities of life in Finland
Authors: Mäkinen Lauri
Published: July 2018

The aim of this study is to analyse whether or not people are in consensus on what the necessities of life are in Finland. Consensus is analysed through two criteria: a public oriented view on the necessities and agreement between individuals. The study utilises a Finnish postal survey from 2015 where people were asked about the necessity of 23 items. The results suggest that individual views are shaped by personal circumstances and a fully public-oriented view cannot be established. Further, the respondents did not seem to agree on what are necessities. This implies that the minimum living standard could not be established consensually.
Influence of abiotic elicitors on improvement production of artemisinin in cell culture of Artemisia annua L.
Authors: Zebarjadi Alireza , Dianatkhah Saeideh , Pour Mohammadi Payam , Qaderi Ardeshir
Published: July 2018

A significant sesquiterpene lactone used as a drug is artemisinin. It is definitely an anti-parasitic drug isolated from field-grown Artemisia annua L. a plant from Asteraceae family. It is the best treatment for Plasmodium falciparum malaria. Unfortunately, artemisinin content in A. annua is extremely low (0.01-0.8% dry weight). So, some researchers focused on enhancing artemisinin content either in tissue/cell culture or the whole plant of A. annua sp. The aims of the current study were the effect of plant growth regulators on callus production and improvement of artemisinin content in cell suspension culture of A. annua, an alternative to the whole plant using abiotic elicitors. For callus induction, an experiment was laid out as a factorial experiment with three factors (explant type, different concentrations of BAP and 2,4-D) based on completely randomized design with three replications. The maximum frequency of callus induction (100%) was found in leaf explant on MS medium with a combination of 2, 4-D (3 mg/l) and BAP (1.5 mg/l). Therefore, the best calli were used for cell suspension culture and the effects of GA3 and ABA as abiotic elicitors were evaluated on the improvement of artemisinin production. The results indicated that both ABA and GA3 increased artemisinin content (2.02 fold and 1.67 fold in comparison to control respectively) in cell suspension culture.
The first successful application of preimplantation genetic diagnosis for hearing loss in Iran
Authors: Karimi Yazdi Alireza , Davoudi-Dehaghani Elham , Rabbani Anari Mahtab , Fouladi Paanti , Ebrahimi Elmira , Sabeghi Solmaz , Eftekharian Ali , Fatemi Kiyana Sadat , Emami Hamed , Sharifi Zohreh , Ramezanzadeh Fatemeh , Tajdini Ardavan , Zeinali Sirous , Amanpour Saeid
Published: July 2018

Hearing impairment (HI) caused by mutations in the connexin-26 gene (GJB2) accounts for the majority of cases with inherited, nonsyndromic sensorineural hearing loss. Due to the illegality of the abortion of deaf fetuses in Islamic countries, preimplantation genetic diagnosis (PGD) is a possible solution for afflicted families to have a healthy offspring. This study describes the first use of PGD for GJB2 associated non-syndromic deafness in Iran. GJB2 donor splicing site IVS1+1G>A mutation analysis was performed using Sanger sequencing for a total of 71 Iranian families with at least 1 deaf child diagnosed with non-syndromic deafness. In Vitro Fertilization (IVF) was performed, followed by PGD for a cousin couple with a 50% chance of having an affected child. Bi-allelic pathogenic mutations were found in a total of 12 families (~17 %); of which a couple was a PGD volunteer. The deaf woman in this family was homozygous and her husband was a carrier of the IVS1+1G>A gene mutation. Among 8 biopsied embryos, two healthy embryos were implanted which resulted in a single pregnancy and subsequent birth of a healthy baby boy. This is the first report of a successful application of PGD for hearing loss in Iran. Having a baby with a severe hearing impairment often imposes families with long-term disease burden and heavy therapy costs. Today PGD has provided an opportunity for high-risk individuals to avoid the birth of a deaf child.