bluuebunny/crossref_metadata_2025 huggingface dataset:
The Tortoise and the Hare: Interactions between Reinforcement Learning and Working Memory
Authors: Collins Anne G. E.
Published: January 2018

Learning to make rewarding choices in response to stimuli depends on a slow but steady process, reinforcement learning, and a fast and flexible, but capacity-limited process, working memory. Using both systems in parallel, with their contributions weighted based on performance, should allow us to leverage the best of each system: rapid early learning, supplemented by long-term robust acquisition. However, this assumes that using one process does not interfere with the other. We use computational modeling to investigate the interactions between the two processes in a behavioral experiment and show that working memory interferes with reinforcement learning. Previous research showed that neural representations of reward prediction errors, a key marker of reinforcement learning, were blunted when working memory was used for learning. We thus predicted that arbitrating in favor of working memory to learn faster in simple problems would weaken the reinforcement learning process. We tested this by measuring performance in a delayed testing phase where the use of working memory was impossible, and thus participant choices depended on reinforcement learning. Counterintuitively, but confirming our predictions, we observed that associations learned most easily were retained worse than associations learned slower: Using working memory to learn quickly came at the cost of long-term retention. Computational modeling confirmed that this could only be accounted for by working memory interference in reinforcement learning computations. These results further our understanding of how multiple systems contribute in parallel to human learning and may have important applications for education and computational psychiatry.
Pinus daflaensis (Pinaceae), a replacement name for P. arunachalensis Khan & Bera
Authors: KHAN MAHASIN ALI , Bera Subir
Published: January 2018

The fossil species Pinus arunachalensis Khan & Bera (04 July, 2017: 4) was described on the basis of winged seed remains from the middle to late Miocene Siwalik sediments of the Dafla Formation exposed around West Kameng district in Arunachal Pradesh, eastern Himalaya. So far, the report provided the first ever fossil record of Pinus winged seeds from the Indian Cenozoic. However, the name P. arunachalensis Khan & Bera is an illegitimate later homonym of P. arunachalensis Srivastava (06 May, 2017: 86) (Art. 53.1 of the ICN, McNeill et al., 2012) (see also IFPNI, Doweld 2016). The latter name was used by a new extant species of Pinus Linnaeus (1753: 1000) from Arunachal Pradesh.
Near-Infrared Spectroscopy Screening to Allow Detection of Pathogenic Mitochondrial DNA Variants in Individuals with Unexplained Abnormal Fatigue: A Preliminary Study
Authors: Celie Bert M. , Mariman An , Boone Jan , Delesie Liesbeth , Tobback Els , Seneca Sara , De Paepe Boel , Vogelaers Dirk , Van Coster Rudy N. , Bourgois Jan G.
Published: January 2018

Unexplained abnormal fatigue is characterized by chronic fatigue persisting for at least six months and not sufficiently explained by any recognized medical condition. In this pilot study, twelve individuals with abnormal fatigue remaining unexplained after thorough screening were investigated using a near-infrared (NIR) spectroscopy handgrip test. Four of them were found to have an abnormal oxygen extraction pattern similar to participants with documented mitochondrial myopathy. In three of the four individuals, diverse mitochondrial abnormalities were documented by spectrophotometric, immunocytological, fluorescent, and morphological analyses performed in skeletal muscle and in cultured skin fibroblasts. Three of the four participants with decreased muscular oxygen extraction were each shown to harbor a different homoplasmic pathogenic mitochondrial DNA point mutation (m.961T > C, m.1555A > G, m.14484T > C). In the fourth participant, the presence of multiple large mitochondrial DNA deletions was suspected in muscle tissue. In contrast, none of the eight abnormally fatigued participants with normal NIR spectroscopy results harbored either a pathogenic mitochondrial DNA point mutation or large deletions ( P < 0.001). This pilot study shows that NIR spectroscopy may serve as a noninvasive screening tool to delineate a subgroup (of participants) with mitochondrial dysfunction among the large group of individuals with unexplained abnormal fatigue.
Robust Empirical Best Small Area Finite Population Mean Estimation Using a Mixture Model
Authors: Gershunskaya Julie , Lahiri Partha
Published: January 2018

We propose a new robust empirical best estimation approach to estimate small area finite population means that are relatively insensitive to a model misspecification or to the presence of outliers. This important robustness property is achieved by replacing the standard normality assumption of the sampling errors in a nested-error regression (NER) model by a scale mixture of two normal distributions with different variances. We present a formal statistical test to identify if a small area is an outlier and provide an efficient new computing algorithm to implement our procedure. We examine the finite sample robustness properties of our proposed method using a Monte Carlo simulation and compare the proposed method with alternative existing methods in a study using data from the Current Employment Statistics (CES) survey conducted by the US Bureau of Labor Statistics (BLS).
On the Actual Risk of Bystander Intervention
Authors: Liebst Lasse Suonperä , Heinskou Marie Bruvik , Ejbye-Ernst Peter
Published: January 2018

Objectives:

Bystander studies have rarely considered the victimization risk associated with intervention into violent, dangerous emergencies. To address this gap, we aim to identify factors that influence bystanders’ risk of being physically victimized.

Method:

We observed bystander behavior from video surveillance footage of naturally occurring violence in nighttime economy settings, and data were analyzed with a logistic regression model.

Results:

Data show that approximately one of the six interventions results in some type of victimization, typically with a relatively low degree of severity. The bystander’s social group membership, the setting of the emergency, and the bystander’s intervention type are estimated as risk factors for victimization.

Conclusions:

Previous research suggests that a bystander’s social group membership with victims promotes intervention behavior. Our results expand the role of social group membership as being a factor that also influences whether the intervening bystander is victimized.
Muslim Men, Racialised Masculinities and Personal Life
Authors: Britton Joanne
Published: January 2018

This article contributes to the study of Muslim men and masculinities by drawing attention to the usefulness of exploring the under-researched relational, emotional and intimate dimensions of Muslim men’s lives. It argues that exploring personal life facilitates critical examination of Muslim men’s affective ties by casting light on their emotional and intimate lives, beyond a narrow focus on negative emotionality. It highlights the private sphere as a domain of social life that has been neglected in understanding Muslim men’s lived experience. The article presents findings from research exploring the impact on Muslim men of a child sexual exploitation crisis in Rotherham. Drawing on interviews with men to foreground their accounts, it shows how focusing on personal life enhances understanding of changing gender and generational relations in Muslim families and shifting masculine roles and identities. It highlights the impact of experiences of racialisation on men’s personal lives within the private domain.
“A Trespass against the Whole Species”: Universal Crime and Sovereign Founding in John Locke’s Second Treatise of Government
Authors: Graf Sinja
Published: January 2018

This essay theorizes how the enforcement of universal norms contributes to the solidification of sovereign rule. It does so by analyzing John Locke’s argument for the founding of the commonwealth as it emerges from his notion of universal crime in the Second Treatise of Government. Previous studies of punishment in the state of nature have not accounted for Locke’s notion of universal crime which pivots on the role of mankind as the subject of natural law. I argue that the dilemmas specific to enforcing the natural law against “trespasses against the whole species” drive the founding of sovereign government. Reconstructing Locke’s argument on private property in light of universal criminality, the essay shows how the introduction of money in the state of nature destabilizes the normative relationship between the self and humanity. Accordingly, the failures of enforcing the natural law require the partitioning of mankind into separate peoples under distinct sovereign governments. This analysis theorizes the creation of sovereign rule as part of the political productivity of Locke’s notion of universal crime and reflects on an explicitly political, rather than normative, theory of “humanity.”
Effect of Chromoendoscopy Filters on Visualization of KTP Laser–Associated Tissue Changes: A Cadaveric Animal Model
Authors: Johnson Christopher M. , Pate Mariah B. , Postma Gregory N.
Published: January 2018

Standard KTP laser (potassium titanyl phosphate) wavelength‐specific protective eyewear often impairs visualization of tissue changes during laser treatment. This sometimes necessitates eyewear removal to evaluate tissue effects, which wastes time and poses safety concerns. The objective was to determine if “virtual” or “electronic” chromoendoscopy filters, as found on some endoscopy platforms, could alleviate the restricted visualization inherent to protective eyewear. A KTP laser was applied to porcine laryngeal tissue and recorded via video laryngoscopy with 1 optical (Olympus Narrow Band Imaging) and 8 digital (Pentax Medical I‐scan) chromoendoscopy filters. Videos were viewed by 11 otolaryngologists wearing protective eyewear. Using a discrete visual analog scale, they rated each filter on its ability to improve visualization,. No filter impaired visualization; 5 of 9 improved visualization. Based on statistical significance, the number of positive responses, and the lack of negative responses, narrow band imaging and the I‐scan tone enhancement filter for leukoplakia performed best. These filters could shorten procedure time and improve safety; therefore, further clinical evaluation is warranted.
Identifying Metrics before and after Readmission following Head and Neck Surgery and Factors Affecting Readmission Rate
Authors: Puram Sidharth V. , Bhattacharyya Neil
Published: January 2018

Objectives

Determine nationally representative readmission rates after head and neck cancer (HNCA) surgery and factors associated with readmission.

Study Design

Cross‐sectional analysis of admissions database.

Methods

The 2013 Nationwide Readmissions Database was analyzed for HNCA surgery admissions and subsequent readmission within 30 days. The readmission rate, length of stay (LOS), disposition, mortality rate, and total charges were determined. Diagnoses and procedures upon readmission were quantified. Factors that were associated with readmission were determined.

Results

In total, 132,755 HNCA surgery inpatient admissions (mean age, 57.3 years; 52.2% male) were analyzed. Nationally representative metrics for HNCA surgery were mean LOS (4.4 ± 0.1 days), disposition (home without services, 80.5%; home health care, 10.9%; and skilled facility, 6.6%), mortality rate (1.0% ± 0.1%), and total charges ($53,106 ± $1167). The readmission rate was 7.7% ± 0.2% (mean readmission postoperative days, 17.1 ± 0.1), with readmission LOS (5.6 ± 0.1 days), mortality rate (3.7% ± 0.3%), and total charges ($49,425 ± $1548). The most common diagnoses at readmission included surgical complications (15.5%), mental health and substance abuse (13.1%), hypertension (12.8%), septicemia/infection (12.1%), gastrointestinal disease (11.3%), nutritional/metabolic disorders (10.1%), electrolyte abnormalities (8.5%), and esophageal disorders (8.1%). In multivariate analyses, male sex, increasing All Patients Refined Diagnosis Related Group (APR‐DRG) severity score, and initial LOS were associated with readmission (odds ratio [95% confidence interval], 1.11 [1.04‐1.20], 1.94 [1.77‐2.12], and 1.34 [1.22‐1.48], respectively), whereas age and discharge location were not (P =. 361 and. 482).

Conclusion

HNCA surgery readmission is associated with significant increases in services/skilled care on discharge, mortality, and additional total health care cost. This national analysis identifies common readmission diagnoses to target to prevent readmissions.
The Association of External Transfer Status with Adverse Outcomes in Otolaryngology
Authors: Suresh Krish , Gouveia Christopher J. , Kern Robert C. , Cramer John D.
Published: January 2018

Objective

To compare rates of morbidity and mortality in patients treated by otolaryngologists who undergo interhospital transfers vs those who do not and to quantify conditions requiring interhospital transfers in this population.

Study Design

Cohort study.

Setting

American College of Surgeons National Surgical Quality Improvement Program.

Subjects and Methods

We identified patients requiring surgery by otolaryngologists in the National Surgical Quality Improvement Program database from 2006 to 2013. We compared patients who were transferred from an outside institution to those admitted from home. Multivariate regression was used to adjust for patient characteristics, comorbidities, and case mix. The primary outcome was overall morbidity and mortality within 30 days of surgery.

Results

We identified 60,498 patients; 488 (0.8%) were transferred from another institution. Operations that were more common in the transferred group were incision and drainage (24.0% vs 1.2%), facial trauma repair (9.0% vs 3.1%), and oropharyngeal hemorrhage control (3.9% vs 0.4%). External transfer patients had significantly longer hospital stays (44.1% vs 4.4% >7 days, P <. 05). On unadjusted analysis, transferred patients had a significantly higher rate of morbidity and mortality (odds ratio [OR], 11.3; 95% confidence interval [CI], 9.4‐13.5). On multivariate analysis, transferred patients had a significantly greater rate of morbidity and mortality (OR, 3.1; 95% CI, 2.4‐4.0).

Conclusion

Transfer from another institution is associated with worse outcomes independent of case mix, demographics, and preoperative comorbidities in acute otolaryngology conditions requiring surgery. Practitioners should be aware of this when caring for transfer patients, and transfer status should be considered when measuring hospital quality.
Evaluating high-resolution remote sensing data for reconstructing the recent evolution of supra glacial debris
Authors: Azzoni Roberto S , Fugazza Davide , Zerboni Andrea , Senese Antonella , D’Agata Carlo , Maragno Davide , Carzaniga Alessandro , Cernuschi Massimo , Diolaiuti Guglielmina A
Published: January 2018

Over the last decades, the expansion of supraglacial debris on worldwide mountain glaciers has been reported. Nevertheless, works dealing with the detection and mapping of supraglacial debris and detailed analyses aimed at identifying the temporal and spatial trends affecting glacier debris cover are still limited. In this study, we used different remote sensing sources to detect and map the supraglacial debris cover, to analyze its evolution, and to assess the potential of different remote-sensed image data. We performed our analyses on the glaciers of Ortles-Cevedale Group (Stelvio Park, Italy), one of the most representative glacierized sectors of the European Alps. High-resolution airborne orthophotos (pixel size 0.5 m × 0.5 m) acquired during the summer season in the years 2003, 2007, and 2012 permitted to map in detail, with an error lower than ±5%, the supraglacial debris cover through a maximum likelihood classification. Our findings suggest that over the period 2003–2012, supraglacial debris cover increased from 16.7% to 30.1% of the total glacier area. On Forni Glacier we extended these quantification thanks to the availability of UAV (Unmanned Aerial Vehicle) orthophotos from 2014 and 2015 (pixel size 0.15 m × 0.15 m): this detailed analysis permitted to confirm debris is increasing on the glacier melting surface (+20.4%) and confirms the requirement of high-resolution data in debris mapping on Alpine glaciers. Finally, we also checked the suitability of medium-resolution Landsat ETM+ data and Sentinel 2 data to map debris in a typical Alpine glaciation scenario where small ice bodies (<0.5 km2) are the majority. The results we obtained suggest that medium-resolution data are not suitable for a detailed description and evaluation of supraglacial debris cover in the Alpine scenario, nevertheless Sentinel 2 proved to be appropriate for a preliminary mapping of the main debris features.
Emotions, Motivation, Cognitive–Metacognitive Strategies, and Behavior as Predictors of Learning Performance in Blended Learning
Authors: Ramirez-Arellano Aldo , Bory-Reyes Juan , Hernández-Simón Luis Manuel
Published: January 2018

Several studies have focused on identifying the significant behavioral predictors of learning performances in web-based courses by examining the log data variables of learning management systems, including time spent on lectures, the number of assignments submitted, and so forth. However, such studies fail to quantify the impact of emotional, motivational, behavioral, and cognitive–metacognitive factors simultaneously. This research was an attempt to understand the relations between students’ motivation, cognitive–metacognitive strategies, behavior, and learning performance in the context of blended courses in higher education. Then, relevant predictors are used to obtain a model to classify the students’ performance and to identify those who are at risk of failing the course. The authors conducted an empirical study in a higher educational course with 137 Mexican students. Nineteen variables related to emotions, motivation, cognitive–metacognitive strategies, and behavior. Only six were found to be significant. These variables explain approximately 67% of the variance between each student’s overall grade. The model, based on those variables, correctly classifies 96% of the students.
Modularising outpatient care delivery: A mixed methods case study at a Finnish University Hospital
Authors: Silander Katariina , Torkki Paulus , Peltokorpi Antti , Lepäntalo Aino , Tarkkanen Maija , Bono Petri , Klintrup Katariina , Kaila Minna
Published: January 2018

Background

Modularisation is a potential means to develop health care delivery by combining standardisation and customisation. However, little is known about the effects of modularisation on hospital care. The objective was to analyse how modularisation may change and support health care delivery in specialised hospital care.

Methods

A mixed methods case study methodology was applied using both qualitative and quantitative data, including interviews, field notes, documents, service usage data, bed count and personnel resource data. Data from a reference hospital’s unit were used to understand the context and development of care delivery in general.

Results

The following outcome themes were identified from the interviews: balance between demand and supply; support in shift from inpatient to outpatient care; shorter treatment times and improved management of service production. Modularisation supported the shift from inpatient towards outpatient care. Changes in resource efficiency measures were both positive and negative; the number of patients per personnel decreased, while the number of visits per personnel and the bed utilisation rate increased.

Conclusions

Modularisation may support health care providers in classifying patients and delivering services according to patients’ needs. However, as the findings are based on a single university hospital case study, more research is needed.
The different audiences of science communication: A segmentation analysis of the Swiss population’s perceptions of science and their information and media use patterns
Authors: Schäfer Mike S. , Füchslin Tobias , Metag Julia , Kristiansen Silje , Rauchfleisch Adrian
Published: January 2018

Few studies have assessed whether populations can be divided into segments with different perceptions of science. We provide such an analysis and assess whether these segments exhibit specific patterns of media and information use. Based on representative survey data from Switzerland, we use latent class analysis to reconstruct four segments: the “Sciencephiles,” with strong interest for science, extensive knowledge, and a pronounced belief in its potential, who use a variety of sources intensively; the “Critically Interested,” also with strong interest and support for science but with less trust in it, who use similar sources but are more cautious toward them; the “Passive Supporters” with moderate levels of interest, trust, and knowledge and tempered perceptions of science, who use fewer sources; and the “Disengaged,” who are not interested in science, do not know much about it, harbor critical views toward it, and encounter it—if at all—mostly through television.
Level of Entrepreneurship and Scanning Source Usage in Very Small Businesses
Authors: Schafer D. Sue
Published: January 2018

This study examined the relationship between entrepreneurship level and scanning source usage in an emerging industry composed of very small businesses. The sample included 450 randomly selected private physical therapy businesses. Data were gathered using a structured questionnaire. Results suggest that very small businesses differentiate their scanning behaviors according to their level of entrepreneurship. Specifically, the “high” entrepreneurial group used human sources to gain information to a significantly greater degree than did either the “low” or “middle” groups. Written sources were used to the same degree by all groups.
A Profile of Entrepreneurship Research Centers: Orientations, Interests, Activities, and Resources
Authors: Sandberg William R. , Gatewood Elizabeth J.
Published: January 2018

One indication of progress in the field of entrepreneurship is its growing number of research centers. Their potential to hasten and guide the field's development warrants scholars’ attention to their role in entrepreneurship research. We report the results of a survey of entrepreneurship research centers conducted in 1988. Twenty-nine centers provided usable responses to our questionnaire. We report and analyze their ages, affiliations, and principal research constituencies; several dimensions of their research orientations; their research budgets and the types of support they provide; and how their findings are disseminated. Our analyses detect a pattern of associations among larger budgets, applications-based research orientations, and the presence of state or local governments as a principal constituent of a center. Finally we analyze research centers’ topical interests, comparing them to those of researchers.
Endowed Positions: Entrepreneurship and Related Fields
Authors: Katz Jerome A.
Published: January 2018

Just as nations take a small measure of their success in their counts of Olympic medals, academics and the media see counts of professorships and chairs as indicative of the strength of a field. For the field of entrepreneurship, Vesper and Kierulff provided an overview of endowed positions in the 1985 edition of Entrepreneurship Education (Vesper, 1985). However the field's growth since that time has been explosive. Recent guestimates of roughly 100 chairs have made media headlines and have stood without verification or rebuttal. This paper establishes a list of endowed academic positions related to the diverse interests of the field of entrepreneurship, taken broadly. The focus of this first effort has been positions in the United States; future versions will attempt to better cover positions throughout the world.
The Partially Clothed Emperor: Evidence-Based Practices
Authors: Taxman Faye S.
Published: January 2018

The evidence-based practices literature has defined a core set of practices and treatments that are effective, at least in empirical studies. Implementing these evidence-based practices and treatments requires a different set of empirical studies to understand the operational issues that affects client-driven outcomes. In this article, we review the following three areas: (a) use of a standardized risk and need assessment tool, (b) use of cognitive-behavioral programs to address criminogenic needs, and (c) use of swift and certain responses to shape behavior. The review focuses on the unanswered questions regarding implementation and organizational change strategies to increase receptivity for the evidence-based practices, lay the foundation for improving effectiveness of “evidence-based practices and treatments,” and provide a work environment that supports evidence-based practices and treatments. This article outlines a research agenda to build implementation knowledge that can further the use of evidence-based practices and treatments.
Addressing Faulty Prescribing Practices of Psychotropic Medication Among Court-Involved Children and Adolescents
Authors: Calleja Nancy G. , Dadah Ann M.
Published: January 2018

Recent data have illustrated the increasing use of psychotropic medication among children and the disproportionality of use among court-involved children and adolescents and have raised serious concerns among mental health professionals. As a result of advocacy efforts by practitioners and researchers promoting awareness of the issue, child welfare professionals and legislators have begun taking steps to address the issue at both the public system and state levels. This article examines the results of recent advocacy efforts to address this issue to date, explores the complexity of factors that continue to influence the problem, and offers specific strategies for counselors and other mental health professionals to employ in resolving the problem.
Complications Related to Percutaneous Thrombectomy of Hemodialysis Grafts
Authors: Vesely T.M.
Published: January 2018

Purpose

To retrospectively review the complications reported during percutaneous thrombectomy procedures performed on polytetrafluoroethylene hemodialysis grafts.

Materials and Methods

A retrospective review revealed that 935 percutaneous thrombectomy procedures were performed at our institution between January 1993 and June 2001. The type and number of procedures include: Arrow PTD (527), pulse-spray with urokinase (240), Amplatz Thrombectomy Device (96), AngioJet (17), Oasis (15), Hydrolyser (10), Endovac (7), Lyse and Wait (7), Thrombex (6), Cragg brush (6), Castaneda brush (4). Complications were reported to have occurred in 31 patients. The radiology reports and medical records of these patients were reviewed.

Results

The overall complication rate was 3.3%. The type and number of complications included: rupture of a vein during angioplasty (13), severe cardiopulmonary distress (4), arterial emboli (4), rigors related to urokinase (3), minor bleeding (2), hypoxia with chest pain (2), other assorted complications (3). There was one death resulting from a fall from the angiography table immediately following the procedure. There were 12 minor complications, requiring minimal treatment, and 19 major complications that altered the course of the procedure or treatment of the patient.

Conclusion

The most common complication was angioplasty-induced rupture of the vein or graft. The most severe complications occurred immediately following dislodgement of the arterial plug and were likely due to acute pulmonary embolization.
Internal Jugular Vein Thrombosis after Positioning CVC in Dialysis Patients: The Most Common Ultrasound Patterns
Authors: Manca O. , Murgia A.M. , Loi L. , Pili G.F. , Murgia M.G. , Barracca A.
Published: January 2018

Frequently patients are started on hemodialysis after the placement of a central venous catheter (temporary or tunneled) in the internal jugular vein (IJV). Currenty this procedure is facilitated by ultrasound probes that improve the rate of success of catheter placement in vessels and diminishes the possible complications, minimizing the gap between nephrologists with wide surgical expertise and those with limited surgical experience. Stenosis and thrombosis of the subclavia vein are well documented complications derived from the placement of the venous catheter. Internal jugular vein thrombosis is not seen very often due to scarce clinical evidence. In our paper we have been able to systematically document various extrinsic thrombotic complications outside the central venous catheter, by use of ultrasound (periluminar or related to the vessel).
The suitability of the femoral vein for permanent vascular access
Authors: Pecorari M.
Published: January 2018

In our dialysis unit, we commonly position permanent catheters (the Tesio twin catheter) in femoral veins with “high” exit sites, in the abdominal area. We prefer this method because of its intrinsic safety in patients immediately requiring hemodialysis (HD), because there is no need for ultrasound guidance and a low incidence of complications during and after positioning. In addition, we consider that this method is suitable for older patients without good native vessels for an arteriovenous fistula (AVF). Sixty-nine femoral catheters were positioned in 61 patients (mean age 70.8 yrs): 307 observational months/patients (mean duration 4.45 months) demonstrated the following results: a) no incidents during catheter positioning; b) four iliac-femoral thromboses (in three cases complete recanalization with heparin treatment); c) two catheters were removed due to an infection of the tunnel; d) no generalized, life-threatening sepsis.

Therefore, we recommend this solution as a “bridge-access” between the immediate need for HD and the successive best strategy for the treatment of end-stage renal disease (ESRD).
A Successful Struggle to Prolong Arteriovenous Fistula Patency: A Case Report
Authors: Gil C.C. , Azevedo F.V. , Ferreira M.A.
Published: January 2018

An adequate vascular access (VA) significantly determines the morbidity and mortality of chronic renal failure (CRF) patients on maintenance hemodialysis (HD). VA patency depends on the early identification of complications and its management by the nephrologists and vascular surgeon. Venous stenosis accounts for the majority of thromboses, but its early detection followed by either percutaneous angioplasty (PTA) and/or surgical correction will improve fistula patency. We present the clinical case report of a 90-year-old patient with recurrent central venous stenosis after PTA that was corrected with bypass surgery. Two years after surgery the original fistula is still used showing no signs of access dysfunction.
Impact of pre-operative venography on the planning and outcome of vascular access for hemodialysis patients
Authors: Elsharawy M.A. , Moghazy K.M.
Published: January 2018

Objective

Pre-operative venous mapping has increased dramatically in most dialysis units since the Dialysis Outcome Quality Initiative (DOQI) guidelines recommended a native arteriovenous venous fistula (AVF) rather than a graft for hemodialysis (HD) access procedures. However, there are conflicting consequences as a result of this policy. Some studies have showed that routine mapping has resulted in a marked increase in maturation rate while others have observed the reverse. This study aimed to evaluate the impact of pre-operative venography on the planning and outcome of AVF for our HD patients.

Patients and methods

A prospective study was performed on all patients with end-stage renal disease (ESRD) who had HD access procedures and pre-operative venography between October 2003 and November 2005. Upper limb venography was done for all patients except those that required primary access and had visible veins. All patients had HD immediately after the venography. Access procedure selection was based on the result of the venography. The complications of venography, the surgical procedure and the outcome were recorded.

Results

One hundred and twenty-nine patients with ESRD who had pre-operative venography were included in this study. They were mostly middle age (mean age ± SD = 41 ± 15.5 yrs) with a high rate of diabetes mellitus (53%). No single complication was reported. A graft was placed in six patients (5%) only. Unsuccessful surgical exploration was 0%. Early failure was in 10 patients (8%).

Conclusion

Pre-operative venography resulted in an increase in the number of AVFs. It can improve the results of HD access procedures by selecting the most suitable veins.
Increasing prevalence of emotional symptoms in higher socioeconomic strata: Trend study among Danish schoolchildren 1991–2014
Authors: Due Pernille , Damsgaard Mogens T. , Madsen Katrine R. , Nielsen Line , Rayce Signe B. , Holstein Bjørn E.
Published: January 2018

Aims: The aims of this study were: (a) to examine trends in daily emotional symptoms among 11- to 15-year-olds from 1991 to 2014 in Denmark, and (b) to examine trends in social inequality in daily emotional symptoms, that is, whether the differences in prevalence between adolescents with parents of varying occupational social class changed over time. Methods: We combined seven comparable cross-sectional Health Behaviour in School-aged Children surveys ( N=31,169). Daily emotional symptoms were measured by the HBSC Symptom Check List and occupational social class (OSC) by students’ reports about parents’ occupation. We calculated absolute (per cent) differences in emotional symptoms between high and low OSC and relative differences by odds ratio for emotional symptoms by parents’ OSC. Results: Eight per cent reported at least one daily emotional symptoms, with an increasing trend from 1991 to 2014 ( p<0.001). The prevalence in high, middle and low OSC was 6.2%, 7.4% and 10.6% ( p<0.0001). From 1991 to 2014, there was an increase in the prevalence of daily emotional symptoms in high ( p<0.0001) and middle ( p<0.0001) but not low OSC ( p=0.4404). This resulted in a diminishing absolute social inequality in emotional symptoms. The statistical interaction between OSC and survey year was significant ( p=0.0023) and suggests a diminishing relative social inequality in emotional symptoms from 1991 to 2014. Conclusions: There was an increasing prevalence of daily emotional symptoms from 1991 to 2014 and a diminishing social inequality in prevalence of daily emotional symptoms in terms of both absolute and relative social inequality.
Effect fusion using model-based clustering
Authors: Malsiner-Walli Gertraud , Pauger Daniela , Wagner Helga
Published: January 2018

Abstract:

In social and economic studies many of the collected variables are measured on a nominal scale, often with a large number of categories. The definition of categories can be ambiguous and different classification schemes using either a finer or a coarser grid are possible. Categorization has an impact when such a variable is included as covariate in a regression model: a too fine grid will result in imprecise estimates of the corresponding effects, whereas with a too coarse grid important effects will be missed, resulting in biased effect estimates and poor predictive performance.

To achieve an automatic grouping of the levels of a categorical covariate with essentially the same effect, we adopt a Bayesian approach and specify the prior on the level effects as a location mixture of spiky Normal components. Model-based clustering of the effects during MCMC sampling allows to simultaneously detect categories which have essentially the same effect size and identify variables with no effect at all. Fusion of level effects is induced by a prior on the mixture weights which encourages empty components. The properties of this approach are investigated in simulation studies. Finally, the method is applied to analyse effects of high-dimensional categorical predictors on income in Austria.
Extending Rights to Marginalized Minorities: Same-Sex Relationship Recognition in Mexico and the United States
Authors: Beer Caroline , Cruz-Aceves Victor D.
Published: January 2018

What explains the extension of greater rights to traditionally marginalized minorities? This article compares the extension of legal equality to lebian, gay, bisexual and transgender (LGBT) people in Mexico and the United States with a focus on the legal recognition of same-sex relationships. A national-level comparison of gay rights in Mexico and the United States presents a theoretical puzzle: most theories predict that the United States would have more egalitarian policies than Mexico, but in fact, Mexico has provided greater legal equality for LGBT people for a longer time than the United States. A subnational analysis of equal relationship rights in the United States and Mexico provides evidence to support social movement and partisan theories of minority rights. We find that religion plays a different role in Mexico than in the United States. The different findings at the national and subnational levels suggest the importance of subnational comparative analysis in heterogeneous federal systems.
Preliminary Evaluation of Prostate Cancer Metastatic Risk Biomarkers
Authors: Paris P.L. , Weinberg V. , Simko J. , Andaya A. , Albo G. , Rubin M.A. , Carroll P.R. , Collins C.
Published: January 2018

Prostate cancer patients at high risk of metastasis need to be identified as early as possible since metastasis is invariably fatal. Treatment could be tailored to risk. Recent array comparative genomic hybridization (aCGH) studies of primary and metastatic prostate tumors identified 39 BAC clones capable of detecting genomic signatures of metastasis. We termed these loci the genomic evaluators of metastatic CaP (GEMCaP). Risk assessments were made on a set of men who were managed with radical prostatectomy. We compared the utility of GEMCaP loci and the Kattan nomogram, a common risk assessment tool, in relation to biochemical outcome. This preliminary evaluation experiment suggests we can use aCGH to detect genomic signatures of metastasis in primary tumors with an accuracy of 78%. The classification accuracy for the Kattan nomogram was 75%. Therefore, validation of GEMCaP is warranted in a larger, appropriately designed cohort.
Serum Calcitonin-Negative Medullary Thyroid Carcinoma: Role of CgA and CEA as Complementary Markers
Authors: Giovanella L. , Crippa S. , Ceriani L.
Published: January 2018

The biochemical activity of medullary thyroid carcinoma (MTC) includes production of calcitonin (CT), chromogranin A (CgA) and carcinoembryonic antigen (CEA). Routine CT measurement has been proposed as part of the initial evaluation of thyroid nodules and its use could ultimately decrease the morbidity and mortality of MTC. We report on a 43-year-old female patient with a large MTC expressing CT, CgA and CEA on immunostains but with negative preoperative CT and CgA results. Serum CEA was slightly increased and its rapid disappearance predicted radical cure by surgery as confirmed by 2-year follow-up. Our report illustrates that a diagnosis of MTC cannot always be excluded by negative preoperative CT. Fine-needle aspiration with cytomorphological analysis and complementary immunocytochemistry remains an essential diagnostic tool. Finally, serum aliquots must be stored before thyroid surgery in order to measure circulating forms of complementary markers found by tissue immunostaining (CEA and CgA)
Immunohistochemical Expression of Fatty acid Synthase, Ki-67 and p53 in Squamous Cell Carcinomas of the Larynx
Authors: De Vincentiis M. , Di Cello P. , Censi F. , Leopizzi M. , Natalizi S. , Sardella B. , Gallo A. , Soldo P. , Alò P. L. , Zotti G.C. , Rocca C. Della , Pietrasanta D. , Castelli M. , Izzo L.
Published: January 2018

Fatty acid synthase (FAS) is a recently discovered molecule involved in the energy supply to normal cells. FAS is overexpressed in neoplastic tissues because of their increased energy needs. We explored the immunohistochemical expression of FAS, Ki-67 and p53 in squamous cell carcinomas (SCC) of the larynx and their association with clinicopathological features and outcome. Specimens from 43 patients with SCC were evaluated. Statistical analysis revealed an association between poorly differentiated laryngeal carcinomas and FAS expression (p<0.005) and between FAS and Ki-67 overexpression (p<0.001). Finally, FAS expression was associated with overall survival (p<0.001). We suggest that FAS is a powerful prognostic indicator whose strength can be enhanced when it is evaluated together with clinicopathological data and Ki-67 expression.
Current therapeutic approaches to diffuse grade II and III gliomas
Authors: Picca Alberto , Berzero Giulia , Sanson Marc
Published: January 2018

The 2016 WHO classification of Tumors of the Central Nervous System brought major conceptual and practical changes in the classification of diffuse gliomas, by combining molecular features and histology into ‘integrated’ diagnoses. In diffuse gliomas, molecular profiling has thus become essential for nosological purposes, as well as to plan adequate treatment strategies and identify patients susceptible of target therapy. WHO grade II (low grade) and grade III (anaplastic) diffuse gliomas form a heterogeneous group of neoplasms, also known as ‘lower-grade gliomas’, characterized by a wide range of malignant potential. Molecular profile accounts for this biological diversity, and provides an accurate prognostic stratification of tumors in this group. Treatment strategies in lower-grade gliomas are ultimately based on molecular profile and WHO grade, as well as on patient characteristics such as age and Karnofsky performance status. The purpose of this review is to summarize recent advances in the classification of grade II and III gliomas, synthesize current treatment schemes according to molecular profile and describe ongoing research and future perspectives for the use of target therapies.
Examining Relationships Between Sexual Risk–Safety Behaviors and Physical Self-Concept by Gender: A Cluster Analytical Approach
Authors: Potard Catherine , Lancelot Céline , Courtois Robert
Published: January 2018

Sexual behavior is a normative part of the transition to adulthood, with an intensification of the exploration of the links between self-esteem, sexuality, and physical self-perception. This study examined the relationships between sexual risk–safety behaviors and overall physical self-concept, as well as its subdimensions such as sports ability, body fat, or physical appearance. In total, 652 sexually active undergraduate students completed self-report questionnaires about their physical self-concept and sexual behaviors. A clustering analysis described three patterns of sexual risk–safety behaviors for women and men: “birth control in a relationship,” “condom users,” and “risk-takers.” The male sexual risk-takers reported lower physical self-concept scores related to physical competence and masculinity subdomains (sports, endurance) than the two other groups. The female sexual risk-takers expressed significantly higher physical dissatisfaction in social and femininity subdomains (appearance, strength) than the others. A lack of perceived physical coordination was strongly associated with sexual risk-taking for both men and women. These findings indicate that specific subdomains of physical self-concept may be linked to safer or risky sexual behaviors in a sample of young adults.
Self-Management of Multiple Chronic Conditions by Community-Dwelling Older Adults: A Concept Analysis
Authors: Garnett Anna , Ploeg Jenny , Markle-Reid Maureen , Strachan Patricia H.
Published: January 2018

The proportion of the aging population living with multiple chronic conditions (MCC) is increasing. Self-management is valuable in helping individuals manage MCC. The purpose of this study was to conduct a concept analysis of self-management in community-dwelling older adults with MCC using Walker and Avant’s method. The review included 30 articles published between 2000 and 2017. The following attributes were identified: (a) using financial resources for chronic disease management, (b) acquiring health- and disease-related education, (c) making use of ongoing social supports, (d) responding positively to health changes, (e) ongoing engagement with the health system, and (f) actively participating in sustained disease management. Self-management is a complex process; the presence of these attributes increases the likelihood that an older adult will be successful in managing the symptoms of MCC.
Accuracy of Humeral Articular Surface Restoration in a Novel Anatomic Shoulder Arthroplasty Technique and Design: A Cadaveric Study
Authors: Goldberg Steven S , Akyuz Ephraim , Murthi Anand M , Blaine Theodore
Published: January 2018

Introduction

Accurate restoration of the humeral joint line during shoulder arthroplasty is critical to maximizing outcomes. However, clinical studies show that both resurfacing and stemmed arthroplasty systems routinely do not restore the articular surface accurately, even by experienced surgeons. The purpose of this study was to evaluate surgeons’ ability to recreate the 3-dimensional geometry of the proximal humerus using a newly developed arthroplasty system.

Methods

The difference in articular surface location before and after arthroplasty was measured using a new nonspherical arthroplasty system which uses a calibrated multiplanar osteotomy technique matching bone removal thickness to implant thickness. Eight human cadaver specimens were measured at 9 separate point locations over the articular surface from a fixed reference point on the lateral humerus. We repeated the measurements after bone preparation with the implant trial. Articular surface points >3.0 mm from their original location were considered outliers, based on literature.

Results

Average absolute deviation of each point on the articular surface measured 0.9 ± 0.7 mm (range: 0.0–2.7 mm) from preoperative to postoperative articular surface location. All (72/72) points measured were below the 3.0 mm outlier threshold from their original location.

Conclusion

Surgeons using the new system, ie, using a nonspherical head design and a calibrated multiplanar osteotomy surgical technique, were able to restore the joint line accurately with minimal (<1.0 mm) change from preop, with no outliers. Arthroplasty systems matching bone removal directly to implant thickness potentially may improve the reproducibility of arthroplasy and improve shoulder kinematics compared to traditional systems.