bluuebunny/crossref_metadata_2025 huggingface dataset:
American Ethos and the Revolutionary Option
Authors: Neuhaus Richard J.
Published: September 2018

I confess at the outset that I speak of America and the revolutionary option as one who wishes to be informed by, and faithful to, the biblical tradition. I use "confess" here not as an admission of weakness, but as one who would be a "confessor," clearly positioning himself in terms of the myriad beginning points one might choose for serious personal statement. I am increasingly unhappy with an. intensified and highly politicized atmosphere in which one is pressed to distinguish his position by relating it to the prevailing, and usually false, alternatives of political debate. Christians and Jews who take their religious tradition seriously must demonstrate more emphatically the connection between their political posture and the referents in that tradition. For me this means discovering political commitment and style that square with the gospel of the oncoming Kingdom of God, which is what I think the tradition is all about.
The Solzhenitsyn Affair: A Minority View
Authors: Blackstock Paul W.
Published: September 2018

Eight years ago an obscure algebra teacher, Aleksander Solzhenitsyn, was introduced to the Soviet public by the publication of his gripping story of life in a Stalinist labor camp, One Day in the Life of Ivan Denisovich in Novy Mir (New World), a distinguished liberal literary journal then edited by the poet, Aleksander Tvardovsky. The release of this sensational work was personally approved by both the Party Central Committee and former Premier Nikita S. Khrushchev. It followed Khrushchev's famous "Secret Speech" which denounced the evils of the Stalinist regime and blamed them on "the cult of personality."
Acheson, Present at the Creation, Now Reports
Authors: Brandon Donald
Published: September 2018

Dean Acheson, President Truman's Secretary of State from 1949-1953, is generally considered to have been one of the ablest men to have held that position in the twentieth century. His memoirs recall the qualities of mind and the at times testy temperament which, together with the role he played in great events, made him also a very controversial Secretary. He did not suffer fools gladly, and was at times impatient and tactless with lesser mortals who failed to grasp what he considered to be elementary truths of world affairs. Although he has mellowed somewhat, he still believes that he was correct on all the great decisions in which he had his way, and the memoirs do not include a single significant case in which he acknowledges having been wrong.
Some Comments on Relevance
Authors: Murchland Bernard
Published: September 2018

Towards the end of his tenure as president of Sarah Lawrence College Harold Taylor attacked “the present system of lectures textbooks survey courses standard requirements of subject matter examinations md grades” for failing “to touch the inner consciousness of the student or to dtil with his motivations his emotions his aims ind his needs.” It was a typical call for relevance in education.

What I want to do is examine some of the puzzles and hidden assumptions that attach to the relevance-in-education controversy, We need not raise such misty questions is What is the relevance of relevance? (although this is sometimes done) But it does seem imperative to begin with the basic question: Relevant to what? Taylor's answer to that question would appear clear enough.
Structure and Dynamics of Three‐Dimensional Magnetotail Reconnection
Authors: Walker Raymond J. , Lapenta Giovanni , Liang Haoming , Berchem Jean , El‐Alaoui Mostafa , Goldstein Melvyn L.
Published: September 2018

We have used a global magnetohydrodynamic simulation and embedded particle‐in‐cell (PIC) simulation to analyze magnetotail reconnection in and near the electron diffusion region (EDR). Results from the magnetohydrodynamic simulation were used to set the initial and boundary conditions for the large‐scale implicit PIC simulation. We examined proxies for the EDR (the nongyrotropy of the electron distribution function, slippage, and the nonideal terms in Ohm's law and the work done [J·E′] in the electron frame). The reconnection was well organized by the Bx = 0 surface. All of the proxies gave false positive values but together, along with the magnetic field Bz component and calculations of magnetic field lines, we were able to locate the EDR. Three of the proxies (the slippage, the nonideal terms in Ohm's law, and agyrotropy) give consistent results in the EDR. The EDR is structured and time dependent. Multiple EDRs aligned roughly parallel to the X axis extended from X ~ −31RE to X ~ −38RE with structure in the Y direction. There are regions with both J·E′ < 0 and J·E′ > 0. Wave‐like behavior with a scale of ~0.5RE or 2–3di develops in the reconnected plasma sheet. The structure is closely related to strong electron flows in the YZ plane and to the density gradient at the outer edge of the plasma sheet. These results are consistent with expectations for the lower hybrid drift instability coupled with a shear‐type instability such as the Kelvin‐Helmholtz instability. Similar results were found in a Harris sheet PIC simulation.
Flash Heating and Local Fluid Pressurization Lead to Rapid Weakening in Water‐Saturated Fault Gouges
Authors: Yao Lu , Ma Shengli , Chen Jianye , Shimamoto Toshihiko , He Honglin
Published: September 2018

Coseismic fault displacement is quite large at shallow depths in some earthquakes, and it implies that fault gouges and sediments have extremely low dynamic friction during seismic slip. However, the dynamic weakening mechanisms of gouges under wet conditions are still not well constrained. Here we present direct evidence for the occurrence of flash heating and local fluid pressurization in water‐saturated gouges, by performing low‐ to high‐velocity (V = 10 μm/s to 1 m/s) friction experiments in a pressure vessel, under conditions specially designed to suppress weakening effects of bulk thermal and compaction‐induced pressurization. The tested gouges exhibit transition from velocity strengthening to drastic velocity weakening as slip rates increase. Strong dynamic weakening starts to occur at V ≥ 0.04 m/s at the initiation of sliding (<~0.1 m), which is much more efficient than previously reported in terms of the weakening velocity and distance. Furthermore, the onset of weakening is always accompanied by an instantaneous dilatancy (10–25 μm), which is much larger than that observed in dry tests and in contrast with gradual changes displayed in the wet tests without dynamic weakening. Numerical modeling integrated with microstructural observation reveals that bulk thermal pressurization cannot explain the experimental results, while flash weakening triggered by vaporization of water layers on/around asperity contacts and the resultant local fluid pressurization may be responsible for the observed rapid weakening concomitant with instantaneous dilatancy. Given high efficiency of such weakening process, fluid‐infiltrated faults could be weakened more rapidly than previously recognized during seismic slip.
Simulating Biogenic Secondary Organic Aerosol During Summertime in China
Authors: Qin Momei , Wang Xuesong , Hu Yongtao , Ding Xiang , Song Yu , Li Mengmeng , Vasilakos Petros , Nenes Athanasios , Russell Armistead G.
Published: September 2018

Biogenic secondary organic aerosol (BSOA) contributes significantly to summertime organic particulate matter. In this study, a simulation of BSOA for summer 2012 over China is performed using the Community Multiscale Air Quality model with an explicit representation of BSOA formation via reactive uptake of isoprene‐derived intermediates, species‐specific parameters for monoterpene‐derived BSOA production, and a multigenerational oxidation scheme. Simulated BSOA tracks the measurements well (normalized mean bias of 1% and r2 of 0.59). Elevated BSOA occurs in the Sichuan Basin and southeastern China (except the coastal areas) where concentrations are mostly within the range of 5–7.5 μg/m3. Nitrate oxidation dominates fresh BSOA originating from monoterpenes. Simulated monoterpene‐formed BSOA increases by a factor of 3–11 with multigenerational oxidation. Isoprene‐formed BSOA shows high concentrations in southwestern China, formed primarily by two methyltetrols (2‐MT) and organosulfates (62%–83%). High concentrations in this region are driven by the abundance of IEPOX and high particle surface area of sulfate‐laden aerosols. NOx emissions influence the formation pathways of isoprene‐formed BSOA, as a high ratio of two‐methylglyceric acid (2‐MG)/2‐MT is found in the North China Plain and part of the Yangtze River Delta Region. The simulated isoprene‐formed BSOA is more strongly correlated with sulfate than with particle water mass concentration or particle acidity, in part because sulfate increases the surface area increasing uptake for heterogeneous reactions. Decreases in isoprene‐formed BSOA were simulated with a pH increase of 2, implying that particle acidity mediates the BSOA formation.
Dimethylamine adducts of allylic triorganoboranes as effective reagents for Petasis-type homoallylation of primary amines with formaldehyde
Authors: Kuznetsov Nikolai Yu. , Tikhov Rabdan M. , Strelkova Tatiana V. , Bubnov Yuri N.
Published: September 2018

A mild method of Petasis-type homoallylation of NH3and amines with CH2O aq. and Me2NH adducts of allylic triorganoboranes has elaborated.
Graphene-induced tuning of the d-spacing of graphene oxide composite nanofiltration membranes for frictionless capillary action-induced enhancement of water permeability
Authors: Hung Wei-Song , Lin Tzu-Jen , Chiao Yu-Hsuan , Sengupta Arijit , Hsiao Yi-Chen , Wickramasinghe S. Ranil , Hu Chien-Chieh , Lee Kueir-Rarn , Lai Juin-Yih
Published: September 2018

While dispersing graphene in water is a formidable challenge, π–π stacking between graphene oxide (GO) and graphene is known to enable the dispersion of graphene in water.
Buffering chronic kidney disease with sodium bicarbonate
Authors: Williams Emily N. , Mathis Keisa W.
Published: September 2018

The roles of the kidney are well defined, if there is a progressive loss in renal function, the kidney is no longer able to perform the listed tasks and chronic kidney disease (CKD) persists. In both clinical and experimental studies, NaHCO3 supplementation has been shown to improve glomerular filtration rate (GFR) as well as halt the progression toward end-stage renal disease (ESRD). In an article recently published in Clinical Science (vol 132 (11) 1179-1197), Ray et al. presented an intriguing and timely study, which investigates the mechanisms involved in the protection that follows oral NaHCO3 ingestion. Here we comment on their research findings.
The use of hydrogels for cell-based treatment of chronic kidney disease
Authors: McFetridge Meg L. , Del Borgo Mark P. , Aguilar Marie-Isabel , Ricardo Sharon D.
Published: September 2018

Chronic kidney disease (CKD) is a major and growing public health concern with increasing incidence and prevalence worldwide. The therapeutic potential of stem cell therapy, including mesenchymal stem cells (MSCs) and endothelial progenitor cells (EPCs) holds great promise for treatment of CKD. However, there are significant bottlenecks in the clinical translation due to the reduced number of transplanted cells and the duration of their presence at the site of tissue damage. Bioengineered hydrogels may provide a route of cell delivery to enhance treatment efficacy and optimise the targeting effectiveness while minimising any loss of cell function. In this review, we highlight the advances in stem cell therapy targeting kidney disease and discuss the emerging role of hydrogel delivery systems to fully realise the potential of adult stem cells as a regenerative therapy for CKD in humans. MSCs and EPCs mediate kidney repair through distinct paracrine effects. As a delivery system, hydrogels can prolong these paracrine effects by improving retention at the site of injury and protecting the transplanted cells from the harsh inflammatory microenvironment. We also discuss the features of a hydrogel, which may be tuned to optimise the therapeutic potential of encapsulated stem cells, including cell-adhesive epitopes, material stiffness, nanotopography, modes of gelation and degradation and the inclusion of bioactive molecules. This review concludes with a discussion of the challenges to be met for the widespread clinical use of hydrogel delivery system of stem cell therapy for CKD.
Adenylyl cyclase 6 in acid-base balance – adding complexity
Authors: Voelkl Jakob , Lang Florian
Published: September 2018

Systemic acid-base balance is tightly controlled within a narrow range of pH. Disturbances in systemic acid-base homeostasis are associated with diverse detrimental effects. The kidney is a key regulator of acid-base balance, capable of excreting HCO3− or H+, and chronic kidney disease invariably leads to acidosis. However, the regulatory pathways underlying the fine-tuned acid-base sensing and regulatory mechanisms are still incompletely understood. In the article published recently in Clinical Science (vol 132 (16) 1779-1796), Poulson and colleagues investigated the role of adenylyl cyclase 6 (AC6) in acid-base homeostasis. They uncovered a complex role of AC6, specifically affecting acid-base balance during HCO3− load, which causes pronounced alkalosis in AC6-deficient mice. However, the phenotype of AC6-deficient mice appears much more complex, involving systemic effects associated with increased energy expenditure. These observations remind us that there is much to be learned about the intricate signaling pathways involved in renal control of acid-base balance and the complex ramifications of acid-base regulation.
Robust quaternary fountain codes in AWGN interference
Authors: Spencer James , Hayajneh Khaled F. , Yousefi Shahram
Published: September 2018

Luby transform (LT) codes have received less attention in larger non‐binary fields. Robust soliton distribution (RSD) was designed to provide universal optimality over the binary erasure channel in terms of minimising the overhead. In this study, the authors introduce a fundamental degree distribution (FDD), which when used with non‐binary LT codes, outperforms their binary counterparts using the RSD in terms of error rate and realised code rate. For instance, over an additive white Gaussian noise (AWGN) channel at of 12 dB and a rateless criteria (zero error probability), a non‐systematic 4‐ary LT code using the FDD can achieve a code rate of 0.75, compared to its binary counterpart which only achieves a code rate of 0.7.
Reduced‐order dynamic model for droop‐controlled inverter/converter‐based low‐voltage hybrid AC/DC microgrids – part 1: AC sub‐microgrid
Authors: Rasoolzadeh Arsalan , Salmasi Farzad Rajaei
Published: September 2018

This study focuses on reduced‐order dynamical modelling of droop‐controlled inverter‐based low‐voltage AC sub‐microgrid in a hybrid AC/DC microgrid. The authors aim to develop a comprehensive reduced‐order model for the low‐voltage AC side in this part. The reduced‐order models are preferred in real‐time calculations. In hybrid microgrids, electrical power is exchanged between the AC and DC sub‐microgrids by a bidirectional AC/DC converter. The distributed energy resources are connected to the main AC bus through power inverters. Voltage and frequency commands are generated by droop controllers for each inverter. For the main AC bus, equations describing voltage magnitude and frequency are derived. Steady‐state values of the phase angles and injected power of the inverters are calculated. The overall non‐linear dynamical and algebraic equations are derived for the low‐voltage AC side, and then linearised around the operating point. To validate the developed model, a hybrid microgrid is implemented in PSCAD. Then, the proposed model for the case study is implemented in Matlab/Simulink and the results are compared with PSCAD outputs. The comparative results show the validity of the developed comprehensive reduced‐order model which can be used in fault detection approaches.
Wachstumsschmerzen im Kindes- und Jugendalter – Wenn wachsen wehtut
Authors: Herz Mona
Published: September 2018

Beinschmerzen im Kinder- und Jugendalter müssen nicht immer „schlimm“ sein. Denn auch durch Wachstum können Schmerzen entstehen. Die sogenannten Wachstumsschmerzen sind bisher wenig erforscht. Was man jedoch sicher weiß: Sie können zwar belasten, sind aber harmlos.
SHV – das Sprachrohr der Therapeuten – Der große Unbekannte
Authors: Oldenburg Elke
Published: September 2018

Von „Therapeuten am Limit“ dürfte fast jeder schon gehört haben. Den „Spitzenverband der Heilmittelverbände“ kennen hingegen nicht alle, obwohl er seit Jahren dieselben Ziele verfolgt. Zeit dafür, hinter die Kulissen des Dachverbandes zu schauen, der sich auf höchster politischer Ebene starkmacht für die Interessen der Heilmittelerbringer.
Mit klarer Führung gegen Mobbing – Kante zeigen!
Authors: Freitag-Herse Barbara
Published: September 2018

Das gezielte Ausgrenzen einzelner Menschen aus einer sozialen Gruppe hat in den letzten Jahren deutlich zugenommen. Mobbing passiert in Kindergärten und Vereinen, in Schulen und Hausgemeinschaften, und macht auch vor dem Arbeitsplatz nicht Halt. Wenn in Ihrer Praxis ein Mitarbeiter davon betroffen sein sollte, sind Sie als Führungskraft gefragt, dem Einhalt zu bieten – je früher, desto besser.
Optimismus hilft!
Authors: Mehrholz Jan
Published: September 2018

Der Patient ist 6 Jahre alt und leidet unter spastischer Zerebralparese. Er hat einen gesunden Zwillingsbruder. Beide sind zu früh geboren. Die Eltern sind
beruflich sehr erfolgreich, sehr eingespannt in Leitungspositionen und beinahe voll berufstätig.
Die Magnetresonanztomografie – das Arbeitspferd der Bildgebung des Bewegungsapparates
Authors: Achim Burget
Published: September 2018

Ein fundiertes Wissen zu den einzelnen Sequenzen einer MRT-Aufnahme unterstützt Therapeuten darin, das MRT-Bild adäquat zu analysieren. Fett und Wasser zum Beispiel erscheinen je nach Sequenz entweder dunkel oder hell. Doch für alle MRT-Aufnahmen gilt: Sie sollten immer in Zusammenhang mit klinischen Symptomen interpretiert werden.
Möglichkeiten zur gezielten Stressregulation neben Hands-on-Interventionen
Authors: Graf Carmen , Gordon Christopher-Marc , Düll Stefan
Published: September 2018

Zwei Drittel der unter einem hohen Stresspegel stehenden Bundesbürger leiden unter Rückenschmerzen und Muskelverspannungen. Diese Studie stellt den Zusammenhang zwischen körperlichen und seelischen Symptomen deutlich dar.

Neben den bekannten manuellen und aktiven Therapieformen eignet sich zur Behandlung die evidenzbasierte Interdisciplinary Fascia Therapy (IFT), da sie Techniken aus myofaszialer Körpertherapie mit Stressbewältigungs- und Selbsthilfemethoden kombiniert. Sie zeigt jedoch nicht nur bei Patienten mit chronischen Schmerzen positive Wirkungen, sondern erzielt auch im Hochleistungssport beachtliche Erfolge.
Einfluss der Emotionen des Klinikers auf das Clinical Reasoning: Abgleich des analytischen Prozesses
Authors: Schiller Stefan
Published: September 2018

Langridge N, Roberts L, Pope C. Man Ther 2016; 21: 277–281. doi: 10.1016/j.math.2015.06.007
Evidence GDF15 Plays a Role in Familial and Recurrent Hyperemesis Gravidarum
Authors: Fejzo Marlena , Arzy Daria , Tian Rayna , MacGibbon Kimber , Mullin Patrick
Published: September 2018

Introduction Hyperemesis gravidarum (HG), a pregnancy complication characterized by severe nausea and vomiting in pregnancy, occurs in up to 2% of pregnancies. It is associated with both maternal and fetal morbidity. HG is highly heritable and recurs in approximately 80% of women. In a recent genome-wide association study, it was shown that placentation, appetite, and the cachexia gene GDF15 are linked to HG. The purpose of this study was to explore whether GDF15 alleles linked to overexpression of GDF15 protein segregate with the condition in families, and whether the GDF15 risk allele is associated with recurrence of HG.

Methods We analyzed GDF15 overexpression alleles for segregation with disease using exome-sequencing data from 5 HG families. We compared the allele frequency of the GDF15 risk allele, rs16982345, in patients who had recurrence of HG with its frequency in those who did not have recurrence.

Results Single nucleotide polymorphisms (SNPs) linked to higher levels of GDF15 segregated with disease in HG families. The GDF15 risk allele, rs16982345, was associated with an 8-fold higher risk of recurrence of HG.

Conclusion The findings of this study support the hypothesis that GDF15 is involved in the pathogenesis of both familial and recurrent cases of HG. The findings may be applicable when counseling women with a familial history of HG or recurrent HG. The GDF15-GFRAL brainstem-activated pathway was recently identified and therapies to treat conditions of abnormal appetite are under development. Based on our findings, patients carrying GDF15 variants associated with GDF15 overexpression should be included in future studies of GDF15-GFRAL-based therapeutics. If safe, this approach could reduce maternal and fetal morbidity.
Ist eine Operation der Brust bei Komplettremission nach neoadjuvanter Chemotherapie des Mammakarzinoms notwendig?
Authors: Richter Hannah , Hennigs André , Schaefgen Benedikt , Hahn Markus , Blohmer Jens , Kümmel Sherko , Kühn Thorsten , Thill Marc , Friedrichs Kay , Sohn Christof , Golatta Michael , Heil Jörg
Published: September 2018

Die Wahrscheinlichkeit einer pathologischen Komplettremission (pCR) bei Brustkrebs nach neoadjuvanter Chemotherapie (NACT) nimmt zu; vor allem in den Subgruppen der tripel-negativen und HER-2-positiven Tumoren. Daher stellt sich die Frage, ob bei einer Komplettremission nach NACT eine operative Therapie der Brust notwendig ist und ob es ein Vorteil für das onkologische Behandlungsergebnis ist, wenn kein Tumor mehr nachgewiesen werden kann. Ein Verzicht auf die Operation und gegebenenfalls auch auf die Radiotherapie ist jedoch nur auf der Basis einer verlässlichen pCR-Diagnose ohne Operation denkbar. Bildgebende Verfahren erreichen derzeit nicht die nötige Sensitivität und Spezifität, um die Diagnose einer pathologischen Komplettremission sicher zu stellen. Daher sind weitere Studien nötig, um herauszufinden, welche Methode die bestmögliche Evaluation des Tumoransprechens auf NACT erlaubt. Erste vielversprechende Ergebnisse zeigen sich in Studien zu bildgebungsgesteuerten, minimalinvasiven Biopsien nach NACT. Diese evaluieren die Möglichkeit einer pCR-Diagnose vor der Operation und könnten die Grundlage für weitere Studien zu einem möglichen Verzicht auf eine Operation in diesem ausgewählten Kollektiv sein.
Psychische Belastungen und Patientinnenressourcen während einer primär systemischen Therapie bei Brustkrebs. Ergebnisse einer prospektiven Studie
Authors: Tschuschke Volker , Karadaglis Georgios , Evangelou Kalliopi , von Schweinitz Clara , Schwickerath Jürgen
Published: September 2018

Einleitung Diese prospektive Studie berichtet über die Auswirkungen psychologischer Faktoren bei Patientinnen mit primärer Mammakarzinomerkrankung, die sich einer neoadjuvanten Chemotherapie unterzogen haben. Die spezielle Situation dieser Frauen ist nicht nur gekennzeichnet durch den Schock der Krebsdiagnose, sondern auch durch die Tatsache, dass der bösartige Tumor nicht sofort, sondern erst nach Abschluss der Chemotherapie entfernt wird. Eine solche Situation belastet und benötigt persönliche Stärken, über die nicht jede Frau verfügt.

Methoden In einer prospektiven Studie wurden 53 Patientinnen vor dem Staging und der systemischen Therapie mithilfe verschiedener psychologischer und psychoonkologischer Fragebögen und Interviews auf ihre psychische Belastung und ihre Bewältigungsressourcen hin untersucht (t 1). Unmittelbar nach Abschluss der Chemotherapie und noch vor dem operativen Eingriff erfolgte eine weitere Testung mit denselben Messinstrumenten (t 2). Zusätzlich wurden die Patientinnen zu t 1 und t 2 bezüglich ihrer Bewältigungsstrategien interviewt. Die Interviews wurden mit dem Ulmer Coping-Manual (UCM) von bezüglich der medizinischen Informationen blinden Ratern objektiv geratet.

Ergebnisse Patientinnen mit einer schlechten psychosozialen Anpassung an die Situation konnten zum Zeitpunkt t 1 identifiziert werden. Sie wiesen Defizite im sozialen Bewältigungsverhalten auf. Weiterhin wiesen sie höhere Werte in resignativem Bewältigungsverhalten und niedrigere Werte in der Suche nach sozialer Unterstützung auf, was insgesamt das Risiko für das Auftreten eines Rezidivs bzw. einer anderen Krebserkrankung im Betrachtungszeitraum von 3,7 bis 5,5 Jahren nach der chemotherapeutischen Behandlung erhöhte. Im Gegensatz dazu konnten wir über unsere Studie Patientinnen identifizieren, die über eine Stärkung ihrer Copingfaktoren die primär systemische Therapie signifikant besser bewältigten.

Schlussfolgerung Ein sorgfältiges psychologisches Screening unmittelbar nach der Diagnose und noch vor der onkologischen Behandlung ist dringend empfohlen. Über diese Maßnahmen könnten jene Patientinnen identifiziert werden, die aufgrund ihrer psychisch hohen Vulnerabilität eine zusätzliche psychoonkologische Unterstützung erhalten sollten.
Mid- and Long-Term Outcomes of Total Arterial Myocardial Revascularization in Patients Aged 70 Years and Older: A Single-Center Experience
Authors: Jussli-Melchers Jill , Panholzer Bernd , Friedrich Christine , Broch Ole , Huenges Katharina , Cremer Joachim , Haneya Assad
Published: September 2018

Background Patients receiving arterial grafts have superior late survival after coronary artery bypass graft (CABG) surgery. The aim of our study was to evaluate the mid- and long-term results of total arterial (TA) revascularization in the elderly.

Methods Between January 2005 and December 2012, a retrospective study on age-, gender-, and EuroSCORE-matched patients aged 70 years and older was performed. Altogether, 356 patients who received isolated CABG were assigned to either TA group or control (CON) group.

Results No significant differences were noted in regard to preoperative risk factors. The number of distal anastomoses was significantly higher in the CON group (3.6 ± 0.6 vs. 2.9 ± 0.8; p < 0.001). Postoperatively, no significant differences were noted in regard to morbidity or mortality. There were no significant differences in mortality rate at 1 year (5.6 vs. 5.2%; p = 0.98), or 5 years (9.0 vs. 12.1%; p = 0.39) between both groups. However, the TA group was associated with significantly higher rate of event-free survival (p = 0.017).

Conclusion This study suggests that TA revascularization is an effective procedure. Lower rates of late cardiac events encourage the use of this concept for the elderly.
Genetics of schizoaffective disorder
Authors: Craddock N.
Published: September 2018

“Schizoaffective” refers to a mix of clinical features associated with prototypical schizophrenia and prototypical bipolar disorder. Such cases are common but definitions have varied substantially. Nosological possibilities considered include (a) a form of schizophrenia, (b) a form of mood disorder, (c) a distinct disorder, (d) some mixture of (a)-(c). In current usage “schizoaffective disorder” tends to be used only when cases cannot be fitted to definitions of schizophrenia or bipolar disorder and such cases have been under-represented in cases collections to date. Methodological and practicalissues continue to cause difficulty for accumulating robust knowledge about schizoaffectivedisorder. Here we consider genetic understanding of schizoaffective disorder, particularly recent findings. These show that bipolar disorder andschizophrenia are not completely separate disease entities and confirm that schizoaffectivedisorder is genetically related to both. Some genetic variants influencerisk broadly across the mood-psychosis spectrum (e.g. Variation at CACNA1C). Some studies have implicated common variation at specific genes and gene families as conferring relatively specific phenotypic risk for a schizoaffective-type clinical pattern (e.g. GABAA receptorgenes). Such findings are of great interest and offer promise ofgreat advances in understanding over the next 20 years. It is important that there is a willingnessof researchers to study schizoaffective cases and to use approaches to phenotypic assessmentand classification that go beyond the traditional approaches enshrined within DSM and ICD.
Gestörte epigenetische Regulation als Angriffspunkt für neue Substanzen zur Behandlung von Demenzen und Psychosen
Authors: Falkai P. , Fischer A.
Published: September 2018

Die Pathogenese neuropsychiatrischer Erkrankungen geht meist mit einer veränderten Genexpression in Hirnzellen einher. Es ist allerdings weitgehend unverstanden, welche Mechanismen zu dieser veränderten Transkriptom-Plastizität beitragen und ob solche Veränderungen ursächlich für den Krankheitsverlauf sind. Eine Reihe von Daten weisen darauf hin, dass deregulierte epigenetische Prozesse wie Histonacetylierung oder DNA-Methylierung in eine Reihe von neurodegenerativen und kognitiven Erkrankungen involviert ist. Histondeactylase (HDAC) Inhibitoren gelten daher als aussichtsreiche therapeutische Strategie für so unterschiedliche neuronale Erkrankungen wie Chorea Huntington, Morbus Alzheimer oder Schizophrenie. Dieser Artikel stellt die wichtigsten Ergebnisse dieses neuen Forschungsgebiets zusammen.
Formality of logic and Frege’sBegriffsschrift
Authors: Mezzadri Daniele
Published: September 2018

This paper challenges a standard interpretation according to which Frege’s conception of logic (early and late) is at odds with the contemporary one, because on the latter’s view logic is formal, while on Frege’s view it is not, given that logic’s subject matter is reality’s most general features. I argue that Frege – inBegriffsschrift– retained the idea that logic is formal; Frege sees logic as providing the ‘logical cement’ that ties up together the contentful concepts of specific sciences,notthe most general truths. Finally, I discuss how Frege conceives of the application of Begriffsschrift, and of its status as a ‘lingua characteristica’.
Are You on the Right Platform? A Conjoint Analysis of Social Media Preferences in Aesthetic Surgery Patients
Authors: Nayyar Apoorve , Jadi Jihane , Garimella Roja , Elkins-Williams Stephen Tyler , Gallagher Kristalyn K , Kalliainen Loree K , Hultman Charles Scott , Wu Cindy
Published: September 2018

Background

Social media has become an indispensable tool for patients to learn about aesthetic surgery. Currently, procedure-specific patient preferences for social media platforms and content are unknown.

Objectives

The authors sought to evaluate social media preferences of patients seeking aesthetic surgery.

Methods

We utilized a choice-based conjoint analysis survey to analyze the preferences of patients seeking 3 common aesthetic procedures: breast augmentation (BA), facial rejuvenation (FR), and combined breast/abdominal surgery (BAB). Participants were asked to choose among social media platforms (Facebook, Twitter, Instagram, Snapchat, Pinterest, Tumblr, YouTube), information extent (basic, moderate, comprehensive), delivery mechanism (prerecorded video, live video, photographs, text description), messenger (surgeon, nurse/clinic staff, patient), and option for interactivity (yes/no). The survey was administered using an Internet crowdsourcing service (Amazon Mechanical Turk).

Results

A total of 647 participants were recruited: 201 in BA, 255 in FR, and 191 in BAB. Among attributes surveyed, participants in all 3 groups (BA, FR, BAB) valued social media platform as the most important (30.9%, 33.1%, 31.4%), followed by information extent (23.1%, 22.9%, 21.6%), delivery mechanism (18.9%, 17.4%, 18%), messenger (16%, 17%, 17.2%), and interactivity (11.1%, 9.8%, 11.8%). Within these attributes, Facebook ranked as the preferred platform, with comprehensive information extent, live video as the delivery mechanism, and surgeon as the messenger as most preferred.

Conclusions

The choice of social media platform is the most important factor for patients, and they indicated a preference for comprehensive information delivered by the surgeon via live video on Facebook. Our study elucidates social media usage in common aesthetic populations, which can help improve aesthetic patient outreach.
Aesthetic Treatment Positively Impacts Social Perception: Analysis of Subjects From the HARMONY Study
Authors: Dayan Steven , Rivkin Alexander , Sykes Jonathan M , Teller Craig F , Weinkle Susan H , Shumate Garrett T , Gallagher Conor J
Published: September 2018

Background

The impact of facial aesthetic treatments not only enhances physical appearance but also psychological well-being. Accordingly, patient-reported outcomes are increasingly utilized as an important measure of treatment success. Observer-reported outcomes are a relevant yet often overlooked measure of treatment benefit.

Objectives

The authors aimed to evaluate the impact of panfacial aesthetic treatment on the perception of an individual in a variety of social contexts.

Methods

A total 2000 men and women (aged 18-65 years) participated in an online study designed to capture the blinded observer’s social perception of pretreatment and posttreatment patients who received panfacial aesthetic treatment in the HARMONY study. Perceptions relevant to character traits, age, attractiveness, and social status were evaluated. Observers were divided into 2 groups. Single image respondents (n = 1500) viewed 6 single, randomized patient images (3 pretreatment, 3 posttreatment), and paired image respondents (n = 500) viewed 6 pretreatment and posttreatment image pairs.

Results

Single image respondents reported significantly (P < 0.05) higher levels of agreement that posttreatment subjects appeared to possess more positive character traits (eg, healthy and approachable), were more socially adept, younger, more attractive, more successful at attracting others, and possessed a higher social status. Paired image respondents also reported a higher level of agreement for posttreatment images being aligned with positive character traits, representative of a younger and more attractive individual, and one with a higher social status.

Conclusions

The results suggest that the positive impact of minimally invasive panfacial treatment extends beyond enhancing physical appearance and highlights the importance of social perception and observer-reported outcomes in aesthetic medicine.
FA01.06: ON THE RELATIONSHIP BETWEEN HISTOLOGY, ESOPHAGEAL-GASTRIC INTESTINAL METAPLASIA, GREATER CURVATURE LYMPHATIC METASTASES AND SURVIVAL IN SIEWERT II ADENOCARCINOMA
Authors: Lugaresi Marialuisa , Mattioli Benedetta , Tassi Valentina , Daddi Niccolò , Ruffato Alberto , Raulli Gian , Malvi Deborah , D’Errico Antonietta , Mattioli Sandro
Published: September 2018

Background

In Siewert type II adenocarcinoma we investigated the relationship between adenocarcinoma subtypes and survival, histologic/biologic patterns related to the presence/absence of gastric greater curvature metastases.

Methods

154 patients who underwent primary transthoracic esophageal resection, total gastrectomy, thoracic-abdominal lymphadenectomy according to a research prospective protocol were considered. Cases were categorized in intestinal and diffuse subtypes, in Barrett's-like, cardiopyloric-like, and gastric-like adenocarcinoma according to the presence/absence of intestinal metaplasia in esophagus and stomach. Cancer specific survival and gastric greater curvature metastases were studied in those categories.

Results

Pathological stage (7th TNM ed) was IA-IIA in 11%; IIB in 15.6%; IIIA-IV in 73.4%. Cases were: 59% intestinal-type, 41% diffuse-type; Barrett's-type 1.3%, cardiopyloric-type 65%, gastric-type 33.7%. Greater gastric curvature lymph node metastases were detected in 22%, in stage IIIa-IV only, intestinal type 47%; diffuse type 53%. The number of metastatic lymph nodes at station 4 was higher in cardiopyloric-like than in gastric-like type (P < .0001).Five years cancer-specific survival of 154 cases was 40.5%, 59.4.% for intestinal type, 0% for diffuse type; 5-year cancer-specific survival in the absence/presence of greater gastric curvature metastases was respectively 48.7% and 14.9%, for intestinal type it was 67.4% and 27.9%. Histological subtype was an independent prognostic factor.

Conclusion

The radical difference of 5 year survival between intestinal and diffuse types of Siewert type II adenocarcinoma after primary surgery, the relevant frequency and biologic patterns of station 4 nodal metastases do require further investigation in light of current indications for neoadjuvant therapy and total gastrectomy.

Disclosure

All authors have declared no conflicts of interest.
FA02.05: PROGRESSION RATE OF BARRETT’S ESOPHAGUS FROM NATIONAL REGISTRY OF EXPERT CENTERS IS MUCH GREATER THAN ANTICIPATED FROM POPULATION STUDIES
Authors: O'Byrne Lisa , Verhage Roy , O'Brien Marie , O'Toole Dermot , Muldoon Cian , Buckley Martin , Murphy Tom , Reynolds Rob , Patchett Stephen , Kay Elaine , Azam Haleema , Ravi Narayanasamy , Reynolds John
Published: September 2018

Background

Barrett's Esophagus (BE) is well established as the main pathological precursor for esophageal adenocarcinoma (EAC). Progression to high grade dysplasia (HGD) or EAC varies widely between population based studies and specialized BE registries from high volume centers. No such data existed from the Republic of Ireland until 2011 when a multicenter registry was established involving three centers to more accurately determine the risk of progression to EAC in the Irish population.

Methods

A detailed clinical, endoscopic and pathological database includes 3397 patients from January 2008 to July 2017, with BE defined by the presence of specialized intestinal metaplasia (SIM). A prospective web based database was used to gather information from three designated esophageal centers with initial and follow up data abstracted by a data manager and overseen by a project manager.

Results

325 were excluded following a diagnosis of HGD or EAC at index biopsy, or being a tertiary referral, leaving 3072 with a median age of 61 and a 2.1:1 male to female ratio and a median follow up of 3 years, and 5024 person years. 127 (4%) cases progressed to HGD/EAC, 65 after one year of follow up. 55 (2%) developed EAC were identified, 30 of those within one year. The overall incidence HGD/EAC was 2.53% per year, 1.3% if the first year is excluded. The risk of progression to EAC alone was 1.09% per year, 0.5% excluding the first year. Low grade dysplasia (LGD) on index biopsy was associated with a progression rate of 11.7% per year, 4.2% with the first year excluded.

Conclusion

With strict data entry and pathologic quality assurance, progression rates for non-dysplastic BE was several fold higher than population studies, highlighting caution in abstracting from population data. True LGD, as evidenced in a recent report by Kestens et al.1 represent high risk disease, with most of the risk evident within the first year. Reference: 1. Kestens C, Offerhaus G, van Baal J, Siersema PD. Patients wtih Barrett's esophagus and persistent low-grade dysplasia have an increased risk for high- grade dysplasia and cancer. Clin Gastroenterol Hepatol. 2016;14:956–962

Disclosure

All authors have declared no conflicts of interest.
FA03.04: ACTIVE SURVEILLANCE VS SURGERY IN CLINICALLY COMPLETE RESPONDERS AFTER NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL CANCER: A PROPENSITY-MATCHED STUDY
Authors: Van Der Wilk Berend , Neijenhuis Lisanne , Noordman B , Nieuwenhuijzen Grard A P , Sosef M N , Van Berge Henegouwen Mark I , Lagarde Sjoerd M , Wijnhoven Bas P L , Van Der Gaast Ate , Van Lanschot Jan B J
Published: September 2018

Background

Nearly one third of esophageal cancer patients show a pathologically complete response in their resection specimens after neoadjuvant chemoradiotherapy (nCRT) according to CROSS regimen. This raises questions whether all patients benefit from surgery or if active surveillance can be applied to patients with a clinically complete response (cCR) after nCRT. This retrospective-multicenter propensity matched study compared outcomes of patients with a cCR after nCRT undergoing active surveillance or standard surgery.

Methods

Patients that refused surgery after nCRT between 2012–2017 from 4 hospitals were included. For the standard surgery group, patients from the preSANO trial were enrolled. A cCR was defined as endoscopies with multiple (bite-on-bite) biopsies, EUS-FNA and PET-CT showing no residual disease 6 and 12 weeks after completion of nCRT. Optimal propensity-score matching generated a matched cohort (1:2) matched for age, comorbidities, cT, cN, histology of the tumor and biopsy type. For comparison of severity of complications according to Clavien-Dindo (CD) classification, a separate optimal propensity-score matching cohort was generated (1:2) for all patients in the active surveillance group that underwent surgery. Primary outcome was overall survival, secondary outcomes were rate of radically resected tumors, distant dissemination rate and rate of postoperative complications according to the CD-classification.

Results

75 patients were identified of whom 50 patients underwent standard surgery and 25 patients underwent active surveillance. 13 of 25 patients in the active surveillance group underwent surgery for locoregional recurrent disease. Median follow-up was 23.7 months for the standard surgery group and 18.8 months for the active surveillance group. There was no statistically significant difference between the groups in overall survival (HR = 0.48, 95%C.I. 0.10–2.2, P = 0.96). In both groups, all tumors were radically resected. There were no statistically significant differences in distant dissemination rate between the active surveillance and standard surgery group (16.0% versus 22.0%, P = 0.76) or in severity of complications (CD ≥ 3;46.2% versus 23.1%, P = 0.16).

Conclusion

There was no statistically significant difference in overall survival, distant dissemination rate and severity of complications between patients undergoing standard surgery or active surveillance after nCRT. However, since sample sizes were small, especially for the severity of complications, these results should be interpreted with caution.

Disclosure

All authors have declared no conflicts of interest.
FA04.01: TEN-YEAR FOLLOW-UP OF A MULTICENTRE, DOUBLE-BLIND RANDOMISED CONTROLLED TRIAL OF LAPAROSCOPIC NISSEN VS ANTERIOR 90° PARTIAL FUNDOPLICATION
Authors: Hopkins Roy , Irvine Tanya , Jamieson Glyn , Devitt Peter , Watson David
Published: September 2018

Background

Nissen fundoplications have been reported to have various side effects, which have led to modifications, including partial fundoplications such as anterior 90° wrap. Five-year follow up of randomised trials suggest less side effects following anterior 90° partial compared to Nissen fundoplication, although Nissen fundoplication achieved better reflux control. There is, however, limited longer-term outcome data for Nissen versus 90° anterior partial fundoplication. This study determined outcomes of previous randomised control trials at 10 + years follow-up.

Methods

From 1999 to 2003, 191 patients were enrolled in two randomised trials comparing anterior 90° partial versus Nissen fundoplication, with outcomes available for 155 (78%) at 10 years. Patients completed annual questionnaires assessing dysphagia, heartburn, medications, satisfaction and other symptoms. Visual analogue scales (0–10), a validated dysphagia score (0–45), Visick score (1–5) and yes/no responses were used. The two trials were combined to evaluate long-term outcomes.

Results

Following anterior 90° fundoplication patients reported less dysphagia to liquids (0.8 vs 1.8, P = 0.032) and solids (2.0 vs 3.3, P = 0.015). Dysphagia assessed using the 0–45 scale was also less following anterior 90° fundoplication (7.6 vs 12.7, P = 0.023). There was no significant difference in heartburn scores (2.8 vs 1.9 P = 0.053), although more patients were consuming PPIs following anterior 90° fundoplication at 10 years (43.8% vs 20.0% P = 0.004). Overall satisfaction scores were similar for both groups (7.9 vs 7.5, P = 0.215), and the majority considered their original decision for surgery to be correct (78.1% vs. 84.6%, P = 0.387). Reoperation rates were similar (anterior 90° - 13.7% vs Nissen 10.8%, P = 0.796).

Conclusion

At 10 years follow up, both procedures achieved similar overall success rates as measured by global satisfaction measures, but with more dysphagia following Nissen fundoplication, versus a higher rate of PPI consumption after anterior 90° fundoplication. Heartburn symptom differences failed to reach statistical significance.

Disclosure

All authors have declared no conflicts of interest.
FA05.01: NON-ONCOLOGICAL PULMONARY MORTALITY IS ASSOCIATED WITH OESOPHAGECTOMY FOR CANCER
Authors: Antonowicz Stefan , Markar Sheraz , Wiggins Tom , Mackenzie Hugh , Askari Alan , Faiz Omar , Hanna George
Published: September 2018

Background

Improvements in oesophageal cancer care have meant ever more patients are being declared cured. Whether oesophagectomy itself causes long-term non-cancer mortality is not known. This study was conducted to assess the timing and frequency of non-cancer causes of death after oesophagectomy in the UK with a population-based survey.

Methods

Hospital Episode Statistics provides contemporaneous admission data for all inpatient National Health Service encounters since 2000. A linked database was constructed of all HES encounters with oesophagectomy treatment codes, with Office for National Statistics mortality data, which included cause and date of death. Minimum follow-up was to 5 years. Independent variables potentially predictive of cause of death were entered into logistic regression analyses.

Results

There were 7204 oesophagectomy patients for which linked mortality data was available. A total of 302 died within 90 days, and a further 5874 died of primary cancer recurrence. Of the remaining 908 non-index-cancer deaths, 238 (26.2%) died of respiratory causes, 210 (23.1%) died of other cancers, 158 (17.4%) died of cardiac diagnoses and 64 (7%) died of cerebrovascular diagnoses. Survival patterns for those dying of cardiac and primary cancer recurrence were similar, with 80% occurring within 2 years of surgery. Non-cancer respiratory mortality was a later occurrence, with 80% occurring by 6 years. A pre-operative pulmonary diagnosis was associated with pulmonary mortality (OR 2.66 95% C.I. 1.49–4.77, P < 0.001), and a pre-operative ischaemic heart disease diagnosis were associated with post-operative cardiac death (OR 2.28 95% C.I. 1.13–4.59, P = 0.021). Long-term respiratory mortality was associated with inpatient respiratory complications in the index encounter (OR 2.60 95% C.I. 1.36 to 4.98, P = 0.004). Comparison to mortality rates after colectomy for cancer revealed 2-fold increased risk of non-cancer pulmonary death after oesophagectomy.

Conclusion

Oesophagectomy may increase the risk of non-cancer respiratory death in oesophageal cancer survivorship, with implications for peri-operative pathways and follow-up programs. Further work is needed to test whether this is a consequence of reconstruction, peri-operative complications, or progression of pre-morbid diagnoses.

Disclosure

All authors have declared no conflicts of interest.