bluuebunny/crossref_metadata_2025 huggingface dataset:
Angiopoietin-1 Mimetic Peptide Promotes Neuroprotection after Stroke in Type 1 Diabetic Rats
Authors: Venkat Poornima , Yan Tao , Chopp Michael , Zacharek Alex , Ning Ruizhuo , Van Slyke Paul , Dumont Daniel , Landschoot-Ward Julie , Liang Linlin , Chen Jieli
Published: August 2018

Angiopoietin-1 (Ang1) mediates vascular maturation and immune response. Diabetes decreases Ang1 expression and disrupts Ang1/Tie2 signaling activity. Vasculotide is an Ang1 mimetic peptide, and has anti-inflammatory effects. In this study, we test the hypothesis that vasculotide treatment induces neuroprotection and decreases inflammation after stroke in type 1 diabetic (T1DM) rats. T1DM rats were subjected to embolic middle cerebral artery occlusion (MCAo) and treated with: 1) phosphate buffered saline (PBS); 2) vasculotide (3µg/kg, i.p. injection) administered half an hour prior to MCAo and at 8 and 24 hours after MCAo. Rats were sacrificed at 48 h after MCAo. Neurological function, infarct volume, hemorrhage, blood brain barrier (BBB) permeability and neuroinflammation were measured. Vasculotide treatment of T1DM-MCAo rats significantly improves functional outcome, decreases infarct volume and BBB permeability, but does not decrease brain hemorrhagic transformation compared with PBS-treated T1DM-MCAo rats. In the ischemic brain, Vasculotide treatment significantly decreases apoptosis, number of cleaved-caspase-3 positive cells, the expression of monocyte chemotactic protein-1 (MCP-1) and tumor necrosis factor (TNF-α). Western blot analysis shows that vasculotide significantly decreases expression of receptor for advanced glycation end products (RAGE), MCP-1 and TNF-α in the ischemic brain compared with T1DM-MCAo rats. Vasculotide treatment in cultured primary cortical neurons (PCN) significantly decreases TLR4 expression compared with control. Decreased neuroinflammation and reduced BBB leakage may contribute, at least in part, to vasculotide-induced neuroprotective effects after stroke in T1DM rats.
Managing Central Government Finances: Asymmetric Seasonality in Receipts and Expenditures
Authors: Srivastava D. K. , Trehan Ragini
Published: August 2018

This article examines asymmetry in the pattern of seasonality in revenues and expenditures of central government, highlighting the scope of improving efficiency in the management of government finances. Asymmetry is conceptualized as consisting of three inter-related aspects: (a) monthly pattern of unevenness measured against a norm of equally distributed monthly shares of revenues and expenditures, (b) non-synchronization between the pattern of unevenness for expenditures as compared to that for revenues and (c) fiscal year start–end (April and March) extreme variations. We have defined and applied an index of seasonal unevenness to individual revenue and expenditure aggregates. A prominent feature of asymmetry in revenue receipts emanates from the bunching of corporate and income tax revenues in the months of September, December and March. Non-tax revenues peak prominently in August and March. Mismatches in expenditures and revenues due to different patterns of unevenness necessitate financing by borrowing, which involve fiscal costs. In addition, non-synchronization of expenditures that invite injecting demand into the system and revenues that involve withdrawal of resources have macro implications that affect aggregate demand. This also has a monetary cost affecting availability of liquidity. In making comparisons, we have examined monthly revenue and expenditure data over the period from 2000–2001 to 2015–2016, which was divided into four periods with respect to political economy regimes relating to NDA1, UPA1, UPA2 and NDA2. We also take note of undue adjustments in expenditures and revenues for ostensibly meeting fiscal and revenue deficit targets by postponing expenditures to the next fiscal year and obtaining advance payments of taxes.
Criminal Activities and Firms’ Market Power: Evidence from Nigerian Banking Industry
Authors: Ajide Folorunsho M. , Bankefa Olasupo I. , Ajisafe Rufus A.
Published: August 2018

In this article, we examined the effect of criminal activities on firms’ market power in Nigerian banking industry. Data sourced from Central Bank of Nigeria, National Bureau of Statistics, Nigerian Police force, annual report and accounts of commercial banks in Nigeria were analysed using autoregressive distributed lag-bound test methodology. The study revealed that crime, innovation, market size and capital requirements had negative relationship with firms’ market power in the long run. Criminal activity had no significant effect on firms’ power, while other variables had significant effects on market power. However, in the short run, crime had positive effect on firm’s power, while other variables had negative effect. Meanwhile, all the variables with the exception of innovation had significant effect on firm’s power. The previous period crime rate had significant and positive effect on current period of firm’s market power. This means a firm that employs sophisticated security devices would increase in market share by wooing more customers through deposit safety guaranteed. Consequently, such a firm enjoyed market power in the industry. While, in the long run, the market power disappeared, because most firms would have increased their security level. Henceforth, an attempt to provide for more sophisticated security devices would bring down normal profit in the long run. Therefore, such actions have no value to woo more customers. The study, therefore, concluded that while firms could consider criminal activities as a relevant variable in the short-run decision-making, such a variable becomes irrelevant in the long-run decision-making.
Impact of Capital Structure on Shareholder Value in Indian Pharmaceutical Industry: An Empirical Approach Through Created Shareholder Value
Authors: Venugopal Merugu , Bhanu Prakash Sharma G.  , Ravindar Reddy M.
Published: August 2018

Enhancing shareholder value is one of the primary goals along with the profitability in the competitive world. Top-level management is striving for creating the higher shareholder value by making efficient decisions. Shareholder value as the key objective of the firm and measures such as economic value added, market value added, shareholder value added and created shareholder value (CSV) have gained popularity in measuring the shareholder wealth creation. Among various financing decisions, capital structure decision plays a vital role, that is, mix of debt and equity. Considering the optimal capital structure with the right balance between equity and debt is always a challenge for the financial managers, and also to run the business successfully by gaining higher profits and enhancing shareholder value. An attempt has been made to analyse the capital structure impact on shareholder value by considering CSV as a shareholder value measure in 77 Indian pharmaceutical firms listed in BSE over a period of 9 years from 2007 to 2015. Using the balanced panel data and regression models, we found that determinants such as debt–equity ratio, long-term debt ratio and short-term debt ratios have positive correlation with CSV and negatively related to total debt ratio in the absence of tax.
Using Propensity Score Weighting to Reduce Selection Bias in Large-Scale Data Sets
Authors: Bishop Crystal D. , Leite Walter L. , Snyder Patricia A.
Published: August 2018

Data sets from large-scale longitudinal surveys involving young children and families have become available for secondary analysis by researchers in a variety of fields. Researchers in early intervention have conducted secondary analyses of such data sets to explore relationships between nonmalleable and malleable factors and child outcomes, and to address issues of measurement. Survey data have been used to a lesser extent to examine plausible causal relationships between variables, perhaps due to the increased likelihood of selection bias that results with nonexperimental data. In this article, we use National Early Intervention Longitudinal Study data to demonstrate the use of inverse probability of treatment weighting, a quasi-experimental methodology based on propensity scores that can be used to reduce selection bias and examine plausible causal relationships. We discuss the advantages and disadvantages of this approach, and implications for its use in early intervention research.
Extrapelvic Metastases in Endometrial Stromal Sarcomas: A Clinicopathological Review With Immunohistochemical and Molecular Characterization
Authors: Baniak Nick , Adams Scott , Lee Cheng-Han , Chibbar Rajni , Kanthan Rani
Published: August 2018

Endometrial stromal sarcoma is a rare uterine tumor associated with favorable outcomes despite its ability to recur and metastasize to distant sites. Most recurrences are local, being limited to the abdomen/pelvis, but distant metastases can occur. Metastatic endometrial stromal sarcoma can occur many months to years after the original diagnosis or may present prior to the primary, potentially creating a diagnostic challenge. We report a bi-institutional review of 10 cases of endometrial stromal sarcoma with extrapelvic metastases without a prior history of endometriosis. The histologic, immunophenotypic, and molecular characteristics of these tumors are analyzed in the context of a relevant literature review.
An estimator algorithm for the rotation time of magnetization vector in nuclear magnetic resonance for imaging (NMRI)
Authors: Barbaraci Gabriele , D'Ippolito Filippo
Published: August 2018

The purpose of this paper is to propose a useful method to investigate the rotation time of the magnetization vector in the nuclear magnetic resonance for imaging (NMRI) system. The ninety degrees rotation of the magnetization vector is the first step in order to establish the free induction decay that radiates electromagnetic energy inside the NMRI chamber. The estimator involved in this research is called Luenberger's observer which is a state estimator of a dynamical system. The Bloch's equation is a dynamical system characterized by a radio frequency (RF) impulse located inside the dynamic matrix, which means the system is not linear. The observer algorithm involved in this paper estimates each vector's component of the Bloch's dynamic model characterized by the magnetizations along the x, y and z direction which are axles located inside the NMRI chamber where the z axis has the same direction of the uniform magnetic field. The result is compared with one shown in the literature which results coincident with estimation. The estimator has been calculated in a closed form except in some cases where the symbolic expression makes the mathematical characterized by a high computational burden. The expression of the solutions is calculated by using the Heaviside expansion once the poles of the dynamical systems characterizing the Bloch's differential equations system are known. A set of simulations is carried out by using different configurations of the observer that have been calculated formerly without considering the RF pulse and subsequently with its introduction showing how the Bloch's dynamical system is affected by the skew symmetric matrix which is typical of a gyroscopic dynamical system. This likelihood produces a time estimation of the rotation vector which is slightly higher than the estimated value offered in the literature.
Structural stability enhancement by nonlinear geometry design and piezoelectric layers
Authors: Keshmiri Alireza , Wu Nan
Published: August 2018

Vibration and stability analysis of nonlinearly tapered cone beams coupled with a piezoelectric layer under compressive axial load is conducted using a new semi-theoretical model based on the Adomian decomposition method and a modified mathematical procedure. The method is applied to tapered structures with perfectly surface-bonded piezoelectric layers and general boundary conditions to analytically derive the natural frequencies and mode shape functions for flutter and buckling analysis. Furthermore, from the optimum structural design perspective, the effects of follower force, geometrical tapering ratio, boundary condition, and applied voltage on piezoelectric layers on the structural stability are thoroughly studied and presented. Simulation results show that the stability of the beam can be noticeably enhanced by the external voltage because of a pair of tensile loads locally induced by the piezoelectric effect. Moreover, for certain boundary conditions and applied voltages, the nonlinear tapered design has much greater buckling and flutter capacities than does the uniform beam. Consequently, the ideal structural design for effective stability enhancement can be reached efficiently.
Avoidant Coping as a Moderator of the Association Between Childhood Abuse Types and HIV/Sexual Risk Behaviors
Authors: Weiss Nicole H. , Peasant Courtney , Sullivan Tami P.
Published: August 2018

Women who experience intimate partner violence (IPV) report high rates of HIV/sexual risk behaviors. Childhood abuse has been linked to HIV/sexual risk behaviors among IPV-victimized women; however, limited research has examined factors that may influence this association. The current study tested the moderating role of avoidant coping in the relation between childhood abuse types (physical, emotional, and sexual) and HIV/sexual risk behaviors. Participants were 212 community women currently experiencing IPV (mean age = 36.63 years, 67.0% African American). Higher levels of avoidant coping were related to more severe childhood abuse types. Severity of childhood abuse types was associated with greater HIV/sexual risk behaviors. Avoidant coping moderated the relation between childhood sexual abuse severity and HIV/sexual risk behaviors, such that this association was significant for IPV-victimized women with high (but not low) levels of avoidant coping. Findings suggest the utility of targeting avoidant coping in interventions aimed at preventing or reducing HIV/sexual risk behaviors among IPV-victimized women with a history of childhood sexual abuse.
Factors Related To Depression and Post-Traumatic Stress Disorder in Shelter-Based Abused Women
Authors: Jonker Irene E. , Lako Danielle A. M. , Beijersbergen Mariëlle D. , Sijbrandij Marit , van Hemert Albert M. , Wolf Judith R. L. M.
Published: August 2018

In this study, linear mixed-effects regression analyses were used to examine whether sociodemographic variables, abuse-related variables, and well-being variables were associated with symptoms of depression and post-traumatic stress disorder (PTSD) in abused women residing in shelters. Results pointed out that symptoms of depression severity were positively associated with migration background and the experience of physical abuse and negatively associated with self-esteem and social support. PTSD symptoms were positively associated with the experience of sexual abuse and negatively associated with self-esteem. Within women’s shelters, staff could be sensitive to improving the social integration of women, especially those with a non-Dutch background, and strengthening the women’s social networks and their self-esteem.
Anti-Ri-associated paraneoplastic neurological syndrome: Initial symptom of breast cancer with HER2 overexpression and treatment by dual HER2 blockade
Authors: Olmez Omer Fatih , Kinikoglu Oguzcan , Yilmaz Nesrin Helvacı , Bilici Ahmet , Cubukcu Erdem , Seker Mehmet , Cakir Tansel , Yildiz Ozcan , Hamdard Jamshid
Published: August 2018

Paraneoplastic neurological syndrome is associated with anti-Ri antibodies, which are typically present with opsoclonus–myoclonus–ataxia. Human epidermal growth factor receptor 2 (HER2) overexpression is present in 15%–25% of breast cancer and is associated with poor prognosis. There are a few reports of paraneoplastic neurological syndrome associated with HER2-positive breast cancer in the literature, of which most are anti-Yo-associated paraneoplastic neurological syndrome. We present herein the case of a female patient with HER2-positive breast cancer who had atypical anti-Ri antibody associated with opsoclonus–myoclonus paraneoplastic neurological syndrome. Following the diagnosis of paraneoplastic syndrome, chemotherapy with dual HER2 blockade and immunomodulating treatment including intravenous immunoglobulin and oral prednisolone were administered. Although the patient was negative for serum anti-Ri antibodies, there was partial clinical improvement and her neurological deficit persisted. To our knowledge, this is the first case report of female patient with HER2-positive breast cancer who had atypical anti-Ri antibody associated with opsoclonus–myoclonus paraneoplastic neurological syndrome and treated with dual HER2 blockade.
Negotiating the Uniform: Youth Attitudes towards Military Service in Israel
Authors: Girsh Yaron
Published: August 2018

Military service is one of the key milestones in Jewish Israelis’ transition to adulthood. Given the dominant role of the military in Israeli society, an understanding of young adults’ attitude towards the importance of the military and the nature of their service is needed. Based on 44 group interviews with 132 Jewish Israeli high school students, the study follows the differential attitude of youths towards compulsory military service, along socioeconomic lines. It concludes that (a) despite changes in Israeli society, young people still consider soldiers as the ultimate models of heroism, and view military service as a necessary component of normative citizenship and (b) they negotiate the nature and content of their military service based on its expected contribution to future mobility opportunities. The findings indicate that within the shared cultural script of the military’s importance, alternative paths play out without directly challenging the dominant consensus within Israeli society.
Could a Common Mechanism of Protein Degradation Impairment Underlie Many Neurodegenerative Diseases?
Authors: Smith David M
Published: August 2018

At the cellular level, many neurodegenerative diseases (NDs), often considered proteinopathies, are characterized by the accumulation of misfolded and damaged proteins into large insoluble aggregates. Prominent species that accumulate early and play fundamental roles in disease pathogenesis are amyloid β (Aβ) and tau in Alzheimer disease, α-synuclein (α-syn) in Parkinson disease, and polyQ-expanded huntingtin (Htt) in Huntington disease. Although significant efforts have focused on how the cell deals with these protein aggregates, why is it that these misfolded proteins are not degraded normally in the first place? A vast body of literature supports the notion that the cell’s protein degradation system for individual proteins—the ubiquitin proteasome system (UPS)—does not function sufficiently in many NDs. The proteasome itself has received significant focus for years due to its obvious failure to degrade misfolded proteins in ND, but no general mechanism has been uncovered. We have recently found that specific pathologically relevant oligomers can potently and directly inhibit the proteasome. What is most interesting is that the misfolded protein’s primary amino acid sequence was irrelevant to its ability to inhibit. Instead, the culprit is the 3-dimensional shape of the misfolded oligomers. It turns out that many misfolded proteins in ND can take on this proteasome-impairing shape suggesting that there could be a common mechanism for UPS impairment in many NDs. The proteasome is already an important target for treating cancer, could it also be targeted to broadly treat ND?
Acoustic metastructure for effective low-frequency acoustic energy harvesting
Authors: Yuan Ming , Cao Ziping , Luo Jun , Ohayon Roger
Published: August 2018

In this study, a multifunctional acoustic metastructure is proposed to achieve both effective low-frequency sound isolation and acoustic energy harvesting. A metallic substrate with proof mass is adopted to generate the local resonant phenomenon for the purpose of overcoming the drawbacks of the previous rubber film-based acoustic metastructure; the latter usually requires an elaborate tension process. Numerical simulations show that the proposed structure exhibits excellent noise isolation performance in the low-frequency band. Meanwhile, the incident sound energy can be converted into electrical energy with the help of an added piezoelectric patch. Numerical simulation results indicate that the harvested energy can reach the mW level. The parameters’ influence on the metastructure’s vibro-acoustic and energy harvesting performance are discussed in detail. An optimized configuration is selected and used for experimental study. It is demonstrated that 0.21 mW electrical power at 155 Hz can be harvested by the proposed metastructure under 114 dB sound pressure excitation.
Networked publics as agents of accountability: Online interactions between citizens, the media and immigration officials during the European refugee crisis
Authors: Ojala Markus , Pantti Mervi , Laaksonen Salla-Maaria
Published: August 2018

This study examines how citizens made use of online platforms to direct diverging critiques and demands at the Finnish Immigration Service during what has come to be known as the refugee crisis in Europe. Focusing on peak periods of debate, identified using big data, we closely observe how public scrutiny of the immigration service occurred in the interactions between online users, the news media and the agency itself. Our analysis indicates that networked publics can be regarded as influential drivers of accountability for government agencies, which often feel obligated to justify their actions to these publics. However, the operation of networked publics as accountability agents remains heavily dependent on the broader public debate, which is still largely shaped by news media organisations, political elites and the officials themselves.
Interpersonal Insecurity and Risk-Taking Propensity Across Domains and Around the Globe
Authors: Lu Jingyi , Zhang Yi , Liu Jiayi
Published: August 2018

During social interactions, individuals frequently experience interpersonal insecurity, including feelings of not being loved, protected, trusted, or cared for; these feelings cause numerous behavioral consequences. The present research explores the relationship between interpersonal insecurity and risk-taking propensity in multiple risk domains and around the globe based on risk-sensitivity theory and research on group identity. In Study 1, participants ( N = 209) reported their interpersonal insecurity and risk-taking propensity across seven risk domains. The results show that risk-taking propensity generally increases with interpersonal insecurity. However, this relationship was negative in the cooperation domain and null in the financial domain. In Study 2 ( N = 128,162), data from the World Values Survey from 77 countries reveal a positive correlation between risk-taking propensity and interpersonal insecurity with in-group members but a negative relationship between risk-taking propensity and interpersonal insecurity with out-group members.
Childhood Maltreatment and Violent Outcomes: A Systematic Review and Meta-Analysis of Prospective Studies
Authors: Fitton Lucy , Yu Rongqin , Fazel Seena
Published: August 2018

The risk of violence following childhood maltreatment is uncertain. This meta-analytic review identified prospective studies that have examined this association. We systematically searched three electronic databases (PsycINFO, EMBASE, and MEDLINE) and completed a targeted search on Google Scholar. These were supplemented with scanning reference lists and correspondence with authors. We considered non-English-language and unpublished studies. Studies were included if childhood maltreatment was measured before age 18 years and occurred before violent outcomes. We identified 18 eligible studies with data on 39,271 participants. We conducted meta-analysis to calculate odds ratios ( ORs) using random-effects models. Heterogeneity was explored through subgroup analyses and meta-regression. The overall OR of violent outcomes in childhood maltreatment was 1.8 (95% confidence interval [1.4, 2.3]) with substantial heterogeneity ( I2 = 92%). Meta-regression suggested that risk of violence following childhood maltreatment was more elevated in samples with higher percentage of females, in higher quality investigations, in studies with case-linkage methods compared to that followed-up participants over time using a prospective cohort design, when general population or matched controls were used rather than selected population controls, and when violent outcomes were ascertained in older individuals. In conclusion, the risk of later violence perpetration was modestly increased in individuals with a history of childhood maltreatment. Preventative strategies and interventions for childhood maltreatment may have an important role in violence reduction. Methodological issues and recommendations for future research are discussed.
High-Resolution Scanning Fiber Angioscopy as an Adjuvant to Fluoroscopy During Endovascular Interventions
Authors: McVeigh Patrick Z. , Moloney Tony , Wilson Brian C. , Wheatcroft Mark
Published: August 2018

Purpose: To demonstrate the feasibility and potential utility of high-resolution angioscopy during common endovascular interventions. Methods: A 3.7-F scanning fiber angioscope was used in 6 Yorkshire pigs to image branch vessel selection, subintimal dissection, wire snaring, and stent placement. The angioscope was introduced in a coaxial fashion within a standard 6-F guide catheter. A clear field of view was provided using continuous heparinized saline flush through the outer guide catheter. The flush flow rate was manually adjusted to provide clear imaging depending on the diameter of the vessel and local blood flow conditions. Results: The scanning fiber angioscope was compatible with off-the-shelf catheters and devices commonly used in peripheral and aortic interventions. Video-rate, high-resolution images were obtained during all the interventions tested and provided information that was complementary to simultaneously acquired fluoroscopy. The scanning fiber angioscope was able to detect subintimal dissection and branch vessel stent coverage with higher resolution than fluoroscopy alone. Conclusion: Endoluminal imaging with the scanning fiber angioscope is feasible with current endovascular devices and provides additional relevant information that cannot be assessed fluoroscopically. The scanning fiber angioscope represents a novel optical platform on which new endovascular techniques may be developed that will minimize radiation and contrast doses for patients.
Stent Protrusion >20 mm Into the Aorta: A New Predictor for Restenosis After Kissing Stent Reconstruction of the Aortoiliac Bifurcation
Authors: Vértes Miklós , Juhász Ildikó Zsófia , Nguyen Tin Dat , Veres Dániel Sándor , Hüttl Artúr , Nemes Balázs , Hüttl Kálmán , Dósa Edit
Published: August 2018

Purpose: To determine the long-term patency of aortoiliac kissing stents and to identify predisposing factors for the development of in-stent restenosis (ISR). Methods: A retrospective analysis was conducted of 105 patients (median age 60.9 years; 64 women) with symptomatic aortoiliac occlusive disease who had kissing stents implanted between 2001 and 2015. The indication for kissing stents was severe claudication in 91 (86.7%) patients and critical limb ischemia in 14 (13.3%). Lesions were TASC A in 52 (49.5%), B in 29 (27.6%), C in 4 (3.8%), and D in 20 (19%) patients. Twenty-five (23.8%) patients had heavily calcified lesions. In all, 210 stents were deployed [180 (85.7%) self-expanding and 30 (14.3%) balloon-expandable]. Follow-up included clinical evaluation, ankle-brachial index measurement, and duplex ultrasonography. Results: The median follow-up was 45 months. The primary patency rates were 93%, 86%, and 77% at 12, 24, and 60 months, respectively. Significant ISR developed in 23 (21.9%) patients (12 unilateral and 11 bilateral). Univariate Cox regression analysis revealed older age [hazard ratio (HR) 0.5, 95% confidence interval (CI) 0.31 to 0.81, p=0.004] and larger aortic diameter (HR 0.42, 95% CI 0.25 to 0.7, p<0.001) to be variables favoring long-term patency, while a longer aortic stent segment (HR 1.56, 95% CI 1.16 to 2.09, p=0.003) and a larger discrepancy between the summed stent diameters and the aortic diameter (HR 1.64, 95% CI 1.01 to 2.65, p=0.043) were associated with ISR development. Multivariate analysis showed a longer aortic stent segment to be the only significant determinant of ISR (HR 1.44, 95% CI 1.02 to 2.01, p=0.035). Conclusion: The kissing stent technique can be performed with good long-term patency. Patients whose iliac stents protrude too far into the aorta need closer follow-up.
Understanding the Impact of Chicana Feminism on College Success: A Literature Review
Authors: Carrillo Victoria G. , Dean Shannon R.
Published: August 2018

Chicanas and Latinas are still severely underrepresented in higher education. Much of the previous literature focuses on the barriers to their success. This article highlights studies related to Chicana Feminism and the ways this perspective can positively impact college attainment and success. The authors conclude by discussing implications of biculturalism and further recommendations developing biculturalism among Chicanas and Latinas.
An Analysis of Informed Consent Form Readability of Oncology Research Protocols
Authors: Munley Benjamin , Buser Amy T. , Gaudreau Stephanie , Breault Joseph L. , Bazzano Lydia A.
Published: August 2018

Twenty-two percent of adults in the United States have only basic health literacy skills. We used a multiple linear regression model to identify associations between readability of informed consent documents with study sponsor, study phase, and approval year using a sample of 143 oncology studies at Ochsner Medical Center. The M ± SD Flesh-Kincaid Reading Grade Level (RGL) was 10.33 ± 0.85 and Flesh Reading Ease (FRE) was 52.89 ± 5.49. National Cancer Institute studies had a significantly lower mean RGL and FRE as compared with other sponsors (RGL 9.85 ± 0.66 vs. 10.72 ± 0.79; p value < .0001). Mean RGL did not differ by study phase. Future research should include assessment and improvement of the readability of informed consent documents.
Crossover Mixed Analysis in a Convergent Mixed Methods Design Used to Investigate Clinical Dialogues About Cancer Treatment in the Japanese Context
Authors: Hatta Taichi , Narita Keiichi , Yanagihara Kazuhiro , Ishiguro Hiroshi , Murayama Toshinori , Yokode Masayuki
Published: August 2018

The convergent mixed methods design is a common mixed methods research strategy; however, a challenge arises when data are collected concurrently but not analyzed completely independently due to overlapping research aims or certain styles of reasoning. The aims of this study were to (1) implement a crossover-tracks analysis in a convergent design wherein qualitative and quantitative strands were intertwined and informed each other and (2) examine a working hypothesis about the relationship between temporal change in clinical dialogues to examine the strength of patients’ motivation to participate in a clinical consultation. Using hypothetico-deductive method, the dynamic analytical approach shifted between inductive and deductive approaches. The qualitative and quantitative results were merged, and a joint-display depicted the relation for the final interpretation.
The Effect of Proximal Hamate Osteotomy on Carpal Kinematics for Reconstruction of Proximal Pole Scaphoid Nonunion With Avascular Necrosis
Authors: Kakar Sanjeev , Greene Ryan M. , Hewett Timothy , Thoreson Andrew R. , Hooke Alexander W. , Elhassan Bassem T.
Published: August 2018

Background: The purpose of this study is to determine the effects of proximal hamate transfer for proximal pole scaphoid reconstruction upon carpal kinematics. Methods: Eight fresh-frozen cadaveric wrists underwent evaluation of their radiocarpal and midcarpal motion after proximal hamate osteotomy. A wrist simulator was used to apply cyclical tension to the flexor carpi ulnaris (FCU), flexor carpi radialis (FCR), extensor carpi ulnaris (ECU), and extensor carpi radialis longus and brevis stitched together (ECR). Kinematic motion was captured using Moiré Phase Tracking 3-dimensional motion-tracking sensors (MPT, Metria Innovation, Inc, Milwaukee, Wisconsin) to evaluate the lunocapitate and scapholunate angles for each condition. Results: During wrist flexion-extension and radial-ulnar deviation, there were no statistically significant differences about the lunocapitate or scapholunate axis between the intact and post-hamate osteotomy conditions. Conclusions: The harvest of the proximal hamate for proximal pole scaphoid reconstruction does not appear to adversely affect wrist kinematics.
Stent-assisted coiling of posterior inferior cerebellar artery aneurysm complicated by arterial avulsion
Authors: Cora EA , Finitsis S , Woulfe J , Essbaiheen F , AlQahtani H , Drake B , Lesiuk H , Iancu D
Published: August 2018

Background

Rapid development of new devices and techniques in endovascular neurosurgery allows treatment of complex intracranial vascular lesions. These treatments, however, are not without risk. We report a case of unusual vascular laceration during stent-assisted coiling of a posterior inferior cerebellar artery (PICA) aneurysm.

Case presentation

A 75-year-old female with a recurrent, previously coiled PICA aneurysm developed avulsion of the parent vessel followed by fatal bleeding while an attempt was made to place a microcatheter across the aneurysmal neck for stent-assisted coiling.

Conclusions

Pathological examination was performed to understand the mechanism of the rupture. The most likely mechanism was straightening of the significant vascular tortuosity, excessive tension on the vessel origin and avulsion upon advancement of the microcatheter over the microguidewire.
Key word signing: Parents’ experiences of an unaided form of augmentative and alternative communication (Lámh)
Authors: Glacken Michele , Healy Denise , Gilrane Ursula , Gowan Siobhan Healy-Mc , Dolan Seamus , Walsh-Gallagher Dympna , Jennings Carmel
Published: August 2018

Parents’ experiences of using Lámh, a key word signing approach used in Ireland, were captured through in-depth face-to-face interviews with parents of children with a range of intellectual disabilities. It emerged that Lámh provides child users with one of the rudiments of inclusion, that is, a means of engaging with others. A number of factors can potentially influence the engagement achieved, namely ongoing family commitment to the sustainment of Lámh, available communication partners, accessibility, appropriate Lámh training, speech and language therapy support and the existence of a Lámh signing environment external to the home. The child’s family, education and community need to commit to Lámh in order to support a child user become an active member of their community.
Autoinflammatory and autoimmune contributions to complex regional pain syndrome
Authors: David Clark J , Tawfik Vivianne L , Tajerian Maral , Kingery Wade S
Published: August 2018

Complex regional pain syndrome (CRPS) is a highly enigmatic syndrome typically developing after injury or surgery to a limb. Severe pain and disability are common among those with chronic forms of this condition. Accumulating evidence suggests that CRPS may involve both autoinflammatory and autoimmune components. In this review article, evidence for dysfunction of both the innate and adaptive immune systems in CRPS is presented. Findings from human studies in which cytokines and other inflammatory mediators were measured in the skin of affected limbs are discussed. Additional results from studies of mediator levels in animal models are evaluated in this context. Similarly, the evidence from human, animal, and translational studies of the production of autoantibodies and the potential targets of those antibodies is reviewed. Compelling evidence of autoinflammation in skin and muscle of the affected limb has been collected from CRPS patients and laboratory animals. Cytokines including IL-1β, IL-6, TNFα, and others are reliably identified during the acute phases of the syndrome. More recently, autoimmune contributions have been suggested by the discovery of self-directed pain-promoting IgG and IgM antibodies in CRPS patients and model animals. Both the autoimmune and the autoinflammatory components of CRPS appear to be regulated by neuropeptide-containing peripheral nerve fibers and the sympathetic nervous system. While CRPS displays a complex neuroimmunological pathogenesis, therapeutic interventions could be designed targeting autoinflammation, autoimmunity, or the neural support for these phenomena.
Transforming the English model of community safety: From crime and disorder to the safeguarding of vulnerable people
Authors: Menichelli Francesca
Published: August 2018

The literature on the English model of community safety describes it as being centrally directed, situational in nature, focused on anti-social behaviour and incivilities and not concerned with measures of social crime prevention. Based on an analysis of the community safety plans issued by English and Welsh local authorities between 2010 and 2014, this article argues that such a characterization is no longer accurate. Partnerships in England and Wales are now free from central oversight, and increasingly focused on safeguarding. In light of the work they do in support of vulnerable populations, and their role within the changing governance of England, more attention should be paid to them.
Salivary Immunoglobulin A, E, and G4 Levels Specific to Dermatophagoides pteronyssinus in Allergic Rhinitis Patients Treated With Subcutaneous Immunotherapy
Authors: Liu Yan , Xing Zhimin , Wang Junge , Geng Congli
Published: August 2018

Background

Allergen-specific immunotherapy (AIT) is an effective treatment for allergic rhinitis (AR). During the course of AIT, many biomarkers in body fluids change. It is necessary to find effective indicators of AIT.

Objective

To examine levels of salivary immunoglobulin A, E, and G4 (IgA, IgE, and IgG4, respectively) specific to Dermatophagoides pteronyssinus (Dp-IgA, Dp-IgE, and Dp-IgG4, respectively) and their changes in AR patients undergoing subcutaneous immunotherapy (SCIT).

Methods

This study included 82 patients with AR sensitized only to Dp and 14 healthy controls. Among patients with AR, 30 patients were not treated with specific immunotherapy (group A), while the remainder (n = 52) received house dust mite SCIT in the up-dosing phase (n = 27; group B) or the maintenance treatment phase (n = 25; group C). Dp-IgA, Dp-IgE, and Dp-IgG4 levels in the saliva were measured using the enzyme-linked immunosorbent assay. Clinical symptoms, concomitant medication, and the Rhinoconjunctivitis Quality of Life Questionnaire score were recorded and correlated with immunoglobulin levels.

Results

Salivary Dp-IgG4 and Dp-IgA levels were significantly lower in AR patients than in healthy controls ( P < .001 for both), while Dp-IgE levels were significantly higher ( P < .001). SCIT resulted in sustained increases in Dp-IgG4 and Dp-IgA in the maintenance phase compared to the up-dosing phase ( P < .001 for both), whereas Dp-IgE only increased in the up-dosing phase ( P = .004, P < .0125). There was no correlation between the different salivary immunoglobulins and clinical scores during SCIT.

Conclusions

This study shows that allergen-specific IgE levels are increased in the saliva of sensitized patients, suggesting that measuring salivary IgE testing should be further considered for the diagnosis of AR. Moreover, allergen-specific IgA and IgG4 in the saliva, which may play protective roles against allergy, may serve as objective indicators for evaluating treatment response to SCIT. However, none of the immunoglobulin reflects subjective symptoms.
Ferromagnetic sand: A possible MRI hazard
Authors: Barkovich Emil Jernstedt , Jernstedt Barkovich Matthew , Hess Christopher
Published: August 2018

While the ferromagnetic properties of metallic objects, implantable medical devices, and cosmetics are well known, sand is not generally considered a consequential substance. Beaches in specific geographic regions, including the San Francisco Bay Area, have a propensity for ferromagnetic sand because of their geologic history. We describe a case in which ferromagnetic sand in a patient’s hair coated the magnetic resonance imaging (MRI) scanner bore and caused significant imaging artifact, fortunately with no harm to the patient. We recommend that MRI facilities in areas where ferromagnetic sand is found consider educating technologists and screening patients for recent black sand exposure prior to scanning.
Process improvement for reducing side discrepancies in radiology reports
Authors: Digumarthy Subba Rao , Vining Rachel , Tabari Azadeh , Nandimandalam Sireesha , Otrakji Alexi , Shepard JoAnne O , Kalra Mannudeep K
Published: August 2018

Background

Laterality errors in radiology reports can lead to serious errors in management.

Purpose

To reduce errors related to side discrepancies in radiology reports from thoracic imaging by 50% over a six-month period with education and voice recognition software tools.

Material and Methods

All radiology reports at the Thoracic Imaging Division from the fourth quarter of 2016 were reviewed manually for presence of side discrepancies (baseline data). Side discrepancies were defined as a lack of consistency in side labeling of any abnormality in the “Findings” to “Impression” sections of the reports. Process map and Ishikawa fishbone diagram (Microsoft Visio) were created. All thoracic radiologists were educated on side-related errors in radiology reports for plan–design–study–act cycle 1 (PDSA #1). Two weeks later, voice recognition software was configured to capitalize sides (RIGHT and LEFT) in the reports during dictated (PDSA# 2). Radiology reports were analyzed to determine side-discrepancy errors following each PDSA cycle (post-interventional data). Statistical run charts were created using QI Macros statistical software.

Results

Baseline data revealed 33 side-discrepancy errors in 47,876 reports with an average of 2.5 errors per week (range = 1–8 errors). Following PDSA #1, there were seven errors pertaining to side discrepancies over a two-week period. Errors declined following implementation of PDSA #2 to meet the target of 0.85 side-discrepancy error per week over seven weeks.

Conclusion

Automated processes (such as capitalization of sides) help reduce left/right errors substantially without affecting reporting turnaround time.
Maternal Psychosocial Risk Profiles in Pregnancy: Associations With Postpartum Maternal Health and Child Outcomes
Authors: Racine Nicole , Madigan Sheri , Plamondon André , Hetherington Erin , McDonald Sheila , Tough Suzanne
Published: August 2018

Previous research on prenatal stress and social support has primarily involved variable-centered approaches, with limited knowledge on whether profiles exist, how early childhood adversity experiences predict these profiles, and whether these profiles are differentially associated with maternal and child outcomes postnatally. Using a pregnancy cohort ( N = 1,994), we identify three distinct profiles of maternal stress and maternal social support: low stress–high support (69.4%), moderate stress–moderate support (25.7%), and high stress–low support (4.9%). Mothers in the high stress–low support group experienced more physical/emotional abuse in childhood, whereas mothers in the moderate stress–moderate support group experienced more family dysfunction. The moderate and the high stress groups had poorer reproductive and physical health, and mothers reported their children had poorer developmental outcomes compared with the low stress–high support mothers. Identifying levels of stress and social support in pregnancy and implementing interventions for mothers at risk is crucial in the pursuit to mitigate family-wide deleterious outcomes.
A prospective surveillance study for multidrug-resistant bacteria colonization in hospitalized patients at a Thai University Hospital
Authors: Rattanaumpawan Pinyo , Choorat Chatiros , Takonkitsakul Kanchanaporn , Tangkoskul Teerawit , Seenama Chakrapong , Thamlikitkul Visanu
Published: August 2018

Background

Colonization with multidrug-resistant (MDR) bacteria is a major risk factor for developing subsequent MDR infections.

Methods

We performed a prospective surveillance study in hospitalized patients at Siriraj Hospital. Nasal cavity, throat, inguinal area and rectal swabs were obtained within the first 48-h after admission, on day-5 after hospitalization and then every 7 days until discharge. Target bacteria included extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL), carbapenem-resistant-P.aeruginosa (CR-PA), carbapenem-resistant-A.baumannii (CR-AB) and methicillin-resistant S.aureus (MRSA).

Results

From January 2013–December 2014, 487 patients were enrolled. The baseline prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA at any site was 52.2%, 6.8%, 4.7% and 7.2%, respectively. After 3-week of hospitalization, the prevalence of colonization by ESBL, CR-PA, CR-AB and MRSA increased to 71.7%, 47.2%, 18.9% and 18.9%, respectively. Multivariable analysis revealed that diabetes mellitus and recent cephalosporin exposure were the independent risk factors for baseline colonization by ESBL. The independent risk factors for CR-AB and/or CR-PA colonization were cerebrovascular diseases, previous hospitalization, transfer from another hospital/a LTCF and previous nasogastric tube use, whereas those for MRSA colonization were previous fluoroquinolone exposure and previous nasogastric tube use.

Conclusions

The baseline prevalence of colonization by ESBL was relatively high, whereas the baseline prevalence of colonization by CR-PA, CR-AB and MRSA was comparable to previous studies. There was an increasing trend in MDR bacteria colonization after hospitalization.