bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Evaluation of AK 100 ULTRA for Predilution HF with on-line Prepared Bicarbonate Substitution Fluid. Comparison with HD and Acetate Postdilution HF
Authors: Umido D. , Beretta P. , Vigano M.R. , Mariani P. , Borström M. , Redaelli B.
Published: October 2018

Convective transport across dialysis membranes has been known for a long time to be a good alternative to diffusion. Predilution hemofiltration (HF) offers a better clearance of small molecules and overcomes the blood viscosity problems related to conventional postdilution HF treatment. Three patients have performed a total of 293 predilution HF treatment with AK 100 ULTRA. The bicarbonate substitution fluid has been prepared on-line by the machine. The treatments have been well tolerated and no adverse patients reactions related to the quality of the substitution fluid or the predilution HF treatment have been observed. There is a drop in creatinine for all patients indicating an improved creatinine clearance. Bicarbonate predilution HF has been shown to be a safe and efficient treatment modality, it offers the possibility to improve the cardiovascular stability of patients having problems with other treatment modalities an it offers an improved intertreatment well-being for the patients.
Comparison between Urea Removal in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis using a Mathematical Kinetic Model
Authors: Kanamori T. , Sakai K.
Published: October 2018

Urea removal by continuous ambulatory peritoneal dialysis (CAPD) was compared with that by hemodialysis (HD) using a mathematical kinetic model. The time-averaged urea-nitrogen concentration (TAC) in the blood of a patient on maintenance HD was calculated by the model. Clearance with HD giving a TAC value equal to the constant urea-nitrogen concentration in the blood of a patient on CAPD was obtained, leading to the relation of equivalent clearances between HD and CAPD on the assumption that the urea-generation rate of the patient on CAPD was equal to that of the patient on HD.
Ethical Free Riding: When Honest People Find Dishonest Partners
Authors: Gross Jörg , Leib Margarita , Offerman Theo , Shalvi Shaul
Published: October 2018

Corruption is often the product of coordinated rule violations. Here, we investigated how such corrupt collaboration emerges and spreads when people can choose their partners versus when they cannot. Participants were assigned a partner and could increase their payoff by coordinated lying. After several interactions, they were either free to choose whether to stay with or switch their partner or forced to stay with or switch their partner. Results reveal that both dishonest and honest people exploit the freedom to choose a partner. Dishonest people seek a partner who will also lie—a “partner in crime.” Honest people, by contrast, engage in ethical free riding: They refrain from lying but also from leaving dishonest partners, taking advantage of their partners’ lies. We conclude that to curb collaborative corruption, relying on people’s honesty is insufficient. Encouraging honest individuals not to engage in ethical free riding is essential.
Effects of hybridization and fiber orientation on flexural properties of hybrid short glass fiber– and short carbon fiber–reinforced vinyl ester composites
Authors: Irfan Muhammad Shafiq , Saeed Farhan , Gill Yasir Qayyum , Qaiser Asif Ali
Published: October 2018

Short fiber–reinforced hybrid polymer (SFRHP) composites were prepared using short glass fibers (SGFs) and short carbon fibers (SCFs) as the reinforcements and vinyl ester resin as the matrix. The flexural properties of all-SGF, all-SCF, and SGF-SCF hybrid composites with controlled fiber orientation were found out experimentally and also predicted using rule of hybrid mixtures. Hand layup technique was used for the preparation of the composites. Composites with different patterns of fiber alignment were prepared and their properties were compared with randomly oriented short fiber composites. The results showed that the flexural performance of samples with longitudinal orientation of the fibers was significantly better than randomly oriented samples for all composites. Synergistic effect of hybridization (positive hybridization) with respect to flexural properties of SFRHP composites was obtained by controlling the orientation of the fibers. It was shown that the hybridization of fibers in the short fiber composites can provide economic savings.
A Spatiotemporal Analysis of Schistosomiasis in Hunan Province, China
Authors: Wang Enru , Zhao Zhengyuan , Miao Changhong , Wu Zhongcai
Published: October 2018

Based on annual parasitological data recently collected at county and village levels, this article presents a multiscale spatiotemporal analysis of transmission risk of schistosomiasis japonica in Hunan Province during 2001 to 2015 in a geographic information system environment. The study shows that the incidence and prevalence rate of human Schistosoma japonicum infection in Hunan Province decreased after 2001. A spatial autocorrelation analysis reveals the existence of spatial clusters of human Schistosoma japonicum infection and a growing tendency of spatial clustering over time. The identification of high-risk areas (hot spots) helps find areas of priority for future implementation of control strategies. The research demonstrates the importance of spatial scale in public health studies.
Preparing Social Work Students for Interprofessional Team Practice in Health-Care Settings
Authors: Delavega Elena , Neely-Barnes Susan L. , Elswick Susan Elizabeth , Taylor Laura C. , Pettet Fawn Lindsey , Landry Margaret A.
Published: October 2018

Purpose:

This study presents the results of a workforce development initiative focused on preparing master’s-level social work students to work in interprofessional settings and integrated care. The study examines both trainees’ changes in interprofessional skills and attitudes as well as if there were differences in trainee experiences across race and gender.

Method:

Ninety-nine trainees participated in a training program and completed pre- and posttest measures on attitudes toward interdisciplinary teams and team skills. The team used multivariate analysis of variance (MANOVA) to examine the change in means and interaction effects.

Results:

Findings suggest that the training helps trainees acquire interdisciplinary team skills. However, results on attitudes toward interdisciplinary teams varied based on race and gender of the trainees.

Discussion:

Results suggest that there continue to be disparities in the training experiences of social work trainees around race and gender. Future research needs to continue to focus on this issue.
Effects of Physical Activity Intervention for Chinese People With Severe Mental Illness
Authors: Young Daniel , Ng Petrus Yat-Nam , Cheng Daphne , Hong Leung Chun
Published: October 2018

Purpose:

This research project aims to evaluate the effectiveness of a physical activity (PA) intervention model for people with severe mental illness in a Chinese society.

Methods:

A quasi-experimental design was adopted in this study. In addition to treatment-as-usual (TAU), the treatment group ( n = 52) participated in a supervised jogging activity twice a week for a total of eight sessions, followed by four sessions of psychoeducation on nutrition and personal appearance. The control group ( n = 42) received TAU. Standardized assessment tools were used for the outcomes assessment at pre- and posttreatment.

Results:

2 × 2 repeated measures analysis of covariance demonstrated that the treatment group was significantly more effective than the control group in reducing depressive symptoms and increasing self-esteem and social support.

Conclusions:

This study supports the effectiveness of a PA intervention model in a Chinese society, suggesting the importance of incorporating regular physical exercises into community-based mental health services.
A Pilot Study of a Teen Dating Violence Prevention Program With Karen Refugees
Authors: Ravi Kristen E. , Black Beverly M. , Mitschke Diane B. , Pearson Katelyn
Published: October 2018

While teen dating violence (TDV) prevention programs generally report changes in participants’ attitudes and mixed findings about changes in behavior, little is known about the impact of TDV programs on ethnic minority youth. This study examined the effectiveness of Safe Dates, an evidence-based TDV prevention program, in educating 21 resettled Karen refugee youth from Burma. Findings indicated changes in attitudes toward violence occurred from pretest to follow-up. Years living in the United States was significantly related to pretest and posttest attitudes. More research about TDV is needed among Karen youth with attention given to the role of acculturation on TDV attitudes.
Failing the third toilet test: Reflections on fieldwork, gender and Indian loos
Authors: Frøystad Kathinka
Published: October 2018

This article reexamines the long-standing corridor topic of toilet facilities in anthropological fieldwork, arguing that their condition has stronger methodological implications than previously acknowledged. Drawing on personal experiences from three successive fieldworks in one of India’s poorest states – Uttar Pradesh – it reflects on the importance of gender, age, and prior experience with unfamiliar sanitary facilities in shaping our adjustment to the conditions we meet in the field. It narrates the three ‘toilet tests’ to which the author has been exposed over a series of field visits: the transition to water, squatting, and ultimately the lack of privacy. Failing the latter, she had to shelve a promising fieldwork lead. Scaling up, the article suggests that, if field sites with ‘difficult’ toilet conditions attract fewer and differently positioned anthropologists, the result is likely to be a bias in coverage and theory-building that merits more reflection.
Talent Development in Emerging Economies Through Learning and Development Capacity Building
Authors: Muyia Machuma Helen , Wekullo Caroline S. , Nafukho Fredrick M.
Published: October 2018

The Problem

It has been argued correctly that of all the resources that nations are endowed with including physical resources such as land, gas, oil, mineral resources, and financial resources, the most durable resource is people. It is also a truism that regions endowed with large populations such as Brazil, China, and India are now emerging nations with very strong and growing economies. As the world of work changes globally, the demand for talent development is becoming one of the greatest opportunities for profit and nonprofit organizations in emerging economies such as Kenya. Africa with its young and educated population and its competition for talent poses both opportunities and challenges as the continent tries to address this critical component. Nowhere is this opportunity for talent development (TD) more urgent than in Kenya.

The Solution

Given the rising of Africa’s youth population and the need to develop talent in this region of the world, there is no easy or ready-made solution to guide human resource development (HRD) researchers and practitioners and policy makers in developing and optimally utilizing Africa’s best resource—its people. However, this article seeks to demonstrate how strategic planning and provision of quality education are the best form of intervention for TD in Africa. The fact that individuals have talent is not sufficient, hence the importance of developing talent through learning. Thus, learning requires well-designed quality education and training programs that can lead to people being open to new ideas and a disposition to question what people already know. This is even more seminal especially in the fast-changing technology-controlled workplace.

The Stakeholders

Human resource officers, learning and development officers, Directors of Human Resource Management, HRD researchers, HRD practitioners.
New Toolkits to Improve Patient and Family Engagement
Authors: Davis Kristina K. , Syeda Aisha
Published: October 2018

Patient and Family Engagement in Primary Care and Safe Transitions to New Appointments are both recent toolkits developed for the Agency for Healthcare Research and Quality (AHRQ). Both available on AHRQ’s Patient Safety Tools and Resources webpage, these tools were designed to be used by clinicians, staff, patients, and family members in outpatient settings. While designed broadly for any staff, the techniques and skills necessary to use the toolkits fully align well with the role of health educators building on core skills already employed. This document details key components of the tools, their similarities and differences, how the tools help health promotion and how health educators may use the tools in practice.
Identification of miR-708-5p in peripheral blood monocytes: Potential marker for postmenopausal osteoporosis in Mexican-Mestizo population
Authors: De-La-Cruz-Montoya Aldo H. , Ramírez-Salazar Eric G. , Martínez-Aguilar Mayeli M. , González-de-la-Rosa Pablo M. , Quiterio Manuel , Abreu-Goodger Cei , Salmerón Jorge , Velázquez-Cruz Rafael
Published: October 2018

Osteoporosis is the most frequent disorder of bone metabolism, owing to an alteration between osteoclast and osteoblast activity, which results from the interaction of genetic, environmental, and epigenetic factors. microRNAs, small non-coding RNAs of around 22 nucleotides with important regulatory roles in gene regulation, that target mRNAs for post-transcriptional destabilization have been suggested as biomarkers in several disorders. In this work, we used small RNA sequencing to identify microRNAs from peripheral blood monocytes that were differentially expressed between non-osteoporotic and osteoporotic Mexican postmenopausal women, to elucidate the potential role of microRNAs as non-invasive marker candidates in osteoporosis. We identified six candidate microRNAs: four were up-regulated (miR-708-5p, miR-34b-5p, miR-3161, miR-328-5p), while two were down-regulated (miR-4422 and miR-939-3p) in osteoporotic women. Differential expression was validated by quantitative RT-PCR and only the upregulation of miR-708-5p was found to be statistically significant. Bioinformatic analysis of target genes for miR-708-5p showed 15 signaling pathways related to bone metabolism. Since monocytes are osteoclast precursors, 10 potential target genes present in these pathways and related to osteoclastogenesis were identified ( AKT1, AKT2, CCND1, PARP1, SMAD3, CXCL5, FKBP5, MAP2K3, MMP2, and IKBKG). Five of them were found to be down-regulated according to microarray expression data. This is the first time that miR-708-5p has been identified in peripheral blood monocytes and associated with postmenopausal osteoporosis. Our results suggest that miR-708-5p reduces the expression of AKT1, AKT2, PARP1 FKBP5, and MP2K3 in peripheral blood monocytes contributing to an osteoporotic phenotype and could be a candidate marker for postmenopausal osteoporosis in Mexican population.
Utility maximization for multi-vehicle multimedia dissemination in vehicular ad hoc networks
Authors: Pan Bin , Wu Hao
Published: October 2018

In vehicular ad hoc networks, maximizing the satisfaction level of multimedia services is a significant issue of concern to users. Relying on the vehicle-to-infrastructure communications, how to schedule the disseminations of multiple vehicles for ensuring high efficiency and guarantee users’ quality of service is difficult and challenging, due to the limited channel resource and vehicle sojourn time. In this article, the scheduling problem of multi-vehicle multimedia dissemination in vehicular ad hoc networks is investigated. A utility model is developed to map the throughput (i.e. the amount of received data) to the user satisfaction level. The scheduling problem is formulated as a utility maximization problem of all the users, which is NP-hard. Then it is transformed into a finite-state decision problem and we obtained an optimal solution by the searching algorithm, which is impractical and can serve as the upper bound. To solve the problem in practice, an online admission control and scheduling algorithm is devised, which guarantees the inflexible data requirements of those admitted vehicles and maximize the total utility. Finally, we implement and conduct extensive simulations on the basis of real video trace to evaluate the performance. Simulation results show that our proposed algorithm has better performance than the state-of-the-art and the conventional algorithms. Thus, it can effectively make scheduling decisions to obtain higher total utility and admission probability.
Safety evaluation for roadside crashes by vehicle–object collision simulation
Authors: Long Kejun , Gao Zhibo , Yuan Quan , Xiang Wang , Hao Wei
Published: October 2018

In order to evaluate roadside crash severity and help making decision on roadside safety improvement alternatives, this article proposes a roadside crash severity evaluation method based on vehicle kinematics metric during the crash: Acceleration Severity Index. Based on the field investigation on 1917 km of representative roads, roadside crash test standards and parameters were determined. A total of 59 crash scenarios, involving 5 typical roadside obstacles, 2 types of guardrails, 15 embankment slopes, and 3 types of vehicles (car, bus, and truck), were designed for simulated crash testing with VPG3.2 and LS-DYNA971 software. The x-, y-, and z-direction acceleration (or deceleration) curves of a test vehicle’s center of mass during each crash test were collected for the calculation of the Acceleration Severity Index values. The Fisher optimal partition algorithm was used to cluster the Acceleration Severity Index values to identify an appropriate number of roadside crash severity levels and the corresponding threshold values that demarcate these levels. The results showed that the roadside crash severity classification produced by Acceleration Severity Index–based method is consistent with handbook Guideline for Implementation of Highway Safety Enhancement Project. Therefore, when crash data are missing, crash test could be a feasible surrogate method for roadside crash severity evaluation.
Non-dehalogenation Mechanisms for Excretion of Radioiodine after Administration of Labeled Antibodies
Authors: De Nardo G.L. , De Nardo S.J. , Miyao N.P. , Mills S.L. , Peng J.S. , O'Grady L.F. , Epstein A.L. , Young W.C.
Published: October 2018

In patients or mice with cancer the pharmacokinetic behavior of radioiodinated and radiometal chelated antibodies has been observed to be different. Rapid clearance from the tissues and excretion into the urine can occur after injection of radioiodinated antibodies. These observations have been interpreted to reflect in vivo dehalogenation of the antibody. This publication describes a variety of other mechanisms that can underlie these phenomena. These mechanisms include receptor uptake and catabolism of antibody and instability of the labeled antibody due to the labeling conditions. Specifically, the relative masses of chloramine-T and antibody in the iodination reaction mixture, the level of iodination of the antibody, and the amount of antibody administered to the recipient are all factors which can influence the clearance of radioiodinated antibody from the recipient. The final determinant for the different behavior of radioiodinated and In-111 metal chelated antibody relate to the different biologic pathways of indium when compared to iodine
Analysis of the Human Immune Repertoire using Human Monoclonal Antibodies
Authors: Cote R.J.
Published: October 2018

The investigations of the human immune response to cancer and other diseases have been hampered by the difficulty in determining the specificity of low-titered antibodies in serum, and the inability to define the specificity of individual lymphocytes. In order to study these issues, we developed the hybridoma technology so that human monoclonal antibodies (hMAb) could be reliably and reproducibly obtained.

Using a variety of fusion partners of both mouse and human origin, a large number of human immunoglobulin-secreting hybrids have been generated. We have found that 5 to 10% of the hybridomas produced secrete hMAb reactive with antigens (Ag) expressed by human cells. Specificity analysis and cellular localization studies of the Ag have been performed for a large number of these hMAb, and several general points have emerged from our study: (A) A significant proportion of the evaluable B-cell repertoire is directed to the production of antibodies reactive with Ags expressed by human cells. (B) The great majority of these Ags have an intracellular location, and are broadly distributed, being expressed by both normal and malignant cells. (C) Intracellular and cell surface differentiation Ags and other Ags with restricted distribution have been defined by hMAb, including a series of cell surface and intracellular Ags not detected on normal cells. (D) The relationship of these findings to cancer is unclear as hMAb showing distinctive distributions have been generated from the lymphocytes of normal individuals as well as tumor-bearing patients. (E) hMAb with distributions distinct from any known mouse monoclonal antibodies (mMAb) have been obtained. These reagents may hold great promise for antibody-directed in vivo diagnosis and therapy of cancer and other diseases due to their unique specificity and decreased immunogenicity compared with mMAb.
Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review
Authors: Marin Tania S , Kourbelis Constance , Foote Jonathon , Newman Peter , Brown Alex , Daniel Mark , Coffee Neil T , Nicholls Stephen J , Ganesan Anand , Versace Vincent L , Beks Hannah , Haedtke Christine A , Clark Robyn A
Published: October 2018

Background

Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease.

Methods

Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology.

Results

Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years).

Conclusion

This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied.
Comprehensive Management Considerations of Select Noncardiac Organ Systems in the Cardiac Intensive Care Unit
Authors: Huff Christin , Mastropietro Christopher W. , Riley Christine , Byrnes Jonathan , Kwiatkowski David M. , Ellis Misty , Schuette Jennifer , Justice Lindsey
Published: October 2018

As the acuity and complexity of pediatric patients with congenital cardiac disease have increased, there are many noncardiac issues that may be present in these patients. These noncardiac problems may affect clinical outcomes in the cardiac intensive care unit and must be recognized and managed. The Pediatric Cardiac Intensive Care Society sought to provide an expert review of some of the most common challenges of the respiratory, gastrointestinal, hematological, renal, and endocrine systems in pediatric cardiac patients. This review provides a brief overview of literature available and common practices.
Maternal Distress and Infant Social Withdrawal (ADBB) Following Infant Cardiac Surgery for Congenital Heart Disease
Authors: Re Jennifer M. , Dean Suzanne , Mullaert Jimmy , Guedeney Antoine , Menahem Samuel
Published: October 2018

Background:

Mothers and infants are exposed to multiple stresses when cardiac surgery is required for the infant. This study reviewed infant responsiveness using a standardized objective observational measure of social withdrawal and explored its association with measures of maternal distress.

Methods:

Mother–infant pairs involving infants surviving early cardiac surgery were assessed when the infant was aged two months. Infant social withdrawal was measured using the Alarm Distress Baby Scale. Maternal distress was assessed using self-report measures for maternal depression (Edinburgh Postnatal Depression Scale), anxiety (Spielberger State-Trait Anxiety Scale), and parenting stress (Parenting Stress Index–Short Form). Potential associations between infant social withdrawal and maternal distress were evaluated.

Results:

High levels of maternal distress and infant social withdrawal were identified relative to community norms with a positive association. Such an association was not found between infant social withdrawal and the cardiac abnormality and surgery performed.

Conclusion:

The vulnerability of infants requiring cardiac surgery may be better understood when factors beyond their medical condition are considered. The findings suggested an association between maternal distress and infant social withdrawal, which may be consistent with mothers’ distress placing infants subjected to cardiac surgery at substantially increased risk of social withdrawal. However, it is unclear to what extent infant withdrawal may trigger maternal distress and what the interactive effects are. Further research is warranted. Trialing a mother–infant support program may be helpful in alleviating distress and improving the well-being and outcomes for these families.
Surgery for TGA/VSD/LVOTO—Many Treatment Options for a Heterogeneous and Rare Malformation
Authors: Hörer Jürgen
Published: October 2018

Surgical techniques for correction of transposition of the great arteries with ventricular septal defect and left ventricular outflow tract obstruction have been introduced into clinical practice nearly five decades ago. However, the optimal surgical strategy is still controversial. The reasons for the diverse approaches to this malformation are discussed in this commentary.
Anatomy of the Functionally Univentricular Heart
Authors: Anderson Robert H. , Franklin Rodney C. G. , Spicer Diane E.
Published: October 2018

The world of pediatric cardiac surgery and cardiac surgery as a whole lost one of the great pioneers with the passing, at the beginning of 2018, of Francis Fontan. Hence to add to the recognition of his achievements, the European Congenital Heart Surgeons Association (ECHSA) has established a lecture to be given in his memory at their annual meetings. It was a significant honor and privilege to be invited to present the initial lecture. In this report, we describe the essence of the presentation. Many patients are now palliated by construction of the Fontan circulation. Very few of those put forward for this operative procedure have anatomically univentricular hearts. It remains frequent, nonetheless, to find accounts of many patients allegedly having “single” ventricles. We discuss the background to this illogical approach to description of hearts having one big and one small ventricle, showing that those with normal hearts have a single left ventricle, albeit co-existing with a single right ventricle. We show that analysis of the ventricular mass in tripartite fashion produces much needed clarity in the appropriate description of the ventricular mass in those increasingly submitted for construction of the Fontan circulation. We emphasize that although it was patients with univentricular atrioventricular connections who were the first to benefit from the procedure, the majority of patients now have biventricular atrioventricular connections, although the hypoplastic ventricle possesses all three of its normal components. We show that description of the ventricular arrangement as being functionally, or physiologically, univentricular provides logic in what had previously been an illogical environment.
Inclusive Education: Perception of Visually Impaired Students, Students Without Disability, and Teachers in Ghana
Authors: Asamoah Edward , Ofori-Dua Kwadwo , Cudjoe Ebenezer , Abdullah Alhassan , Nyarko Joy Ato
Published: October 2018

The purpose of this study is to investigate the perception of visually impaired students, their peers without disabilities, and teachers about inclusive education, focusing on a second cycle educational institution in the Eastern region of Ghana implementing inclusive education for the visually impaired. In this study, we collected data from 23 visually impaired students, 27 students without disabilities, and 19 teachers in the inclusive school. Data were collected through semistructured in-depth interviews. This study followed a phenomenological approach, reporting findings from participants’ own words. The study findings revealed that visually impaired students and some teachers supported inclusion while a number of students without disabilities disliked the practice. Some teachers indicated that the idea of inclusive education is a good way to ensure equal educational opportunities. The study concludes that Ghanaian teachers in inclusive schools should be equipped with training to teach students with disabilities.
Sagittal Plane Trunk Tilt Is Associated With Upper Extremity Joint Moments and Ball Velocity in Collegiate Baseball Pitchers
Authors: Solomito Matthew J. , Garibay Erin J. , Nissen Carl W.
Published: October 2018

Background:

The trunk is a major contributor to the kinetic chain during baseball pitching by helping to transfer energy from the lower limbs to produce the desired ball speed. However, most of the research detailing the trunk’s contribution to the pitch is focused on rotational timing and coronal plane lean, with little attention focused on sagittal plane positioning of the trunk.

Purpose:

To determine the association between sagittal plane trunk motion and elbow varus moment and ball velocity in collegiate baseball pitchers.

Study Design:

Descriptive laboratory study.

Methods:

A total of 99 collegiate pitchers were recruited for this study and underwent a comprehensive biomechanical assessment of their pitching motion using 3-dimensional motion techniques. A random-intercepts, mixed-effects regression model was used to determine whether statistically significant associations were noted between sagittal plane trunk motion and the ball velocity and elbow varus moment.

Results:

There were a number of significant associations between sagittal plane trunk tilt and the elbow varus moment and ball velocity. Increased forward trunk tilt at the time of ball release was associated with an increase in elbow varus moment and a small increase in ball velocity; for every 10° of increased forward trunk tilt greater than 28° at ball release, the elbow varus moment increased by 2.9 N·m ( P = .007), and the ball velocity increased by 0.7 m/s ( P = .002).

Conclusion:

Sagittal plane positioning of the trunk plays a role in pitching mechanics, as it can affect both pitching performance and elbow moments. The results also indicated that there is a potential optimal trunk position and range of motion during the acceleration of the pitch that could limit the stress placed on the elbow joint. Implementing proper trunk mechanics from an early age could lead to a reduction in joint moments.

Clinical Relevance:

The results provide evidence for coaches and trainers to emphasize the importance of proper trunk positioning through the inclusion of core strengthening and motor control in their practice and coaching sessions in an effort to reduce the moments placed on the elbow during the pitch.
Complement-mediated thrombotic microangiopathy as a link between endothelial damage and steroid-refractory GVHD
Authors: Wall Sarah A. , Zhao Qiuhong , Yearsley Martha , Blower Luke , Agyeman Akwasi , Ranganathan Parvathi , Yang Shangbin , Wu Haiwa , Bostic Matthew , Jaglowski Samantha , Brammer Jonathan E. , William Basem , Choe Hannah , Mims Alice S. , Penza Sam , Efebera Yvonne , Devine Steven , Cataland Spero , Davies Stella M. , Vasu Sumithira
Published: October 2018

Transplant-associated thrombotic microangiopathy (TA-TMA), a complication of hematopoietic cell transplant (HCT), is associated with significant morbidity and mortality. The pathophysiology and overlap of TA-TMA with other posttransplant complications such as graft-versus-host disease (GVHD) is poorly understood. We retrospectively identified cases of TA-TMA among patients with grade 3/4 gastrointestinal (GI) GVHD, reviewed intestinal biopsy specimens, and performed correlative testing of biomarkers associated with TA-TMA. TA-TMA was more common in patients with steroid-refractory GVHD compared with steroid-responsive GVHD (79.3% vs 42.1%; P = .001). Among patients surviving 100 days post-HCT, 1-year survival from day 100 was significantly better for patients who had not developed TA-TMA in the first 100 days (69.5% vs 36.7%; P < .001). Only 1 of 7 proposed TA-TMA histology criteria (mucosal hemorrhage) differed significantly based on GVHD steroid response. In multivariable modeling, steroid-refractory GVHD was a risk factor for development of TA-TMA (hazard ratio, 3.09; 95% confidence interval, 1.68-5.67; P < .001). There were no differences in complement activation at GVHD onset; however, 2 to 6 weeks later, patients with TA-TMA had higher levels of BBPlus and C5b-9, markers of alternative and terminal pathway activation (BBPlus: median, 600 vs 209.3 ng/mL; P = .0045) (C5b-9: median, 425.9 vs 258.4 ng/mL; P = .029). TA-TMA is associated with poor overall survival (OS) following HCT and may be detected early by histologic findings and may be differentiated from GVHD by measurement of alternative and terminal complement pathway activation. It is unknown whether treatment of TA-TMA will improve survival in steroid-refractory GVHD.
Cytogenetic intraclonal heterogeneity of plasma cell dyscrasia in AL amyloidosis as compared with multiple myeloma
Authors: Bochtler Tilmann , Merz Maximilian , Hielscher Thomas , Granzow Martin , Hoffmann Korbinian , Krämer Alwin , Raab Marc-Steffen , Hillengass Jens , Seckinger Anja , Kimmich Christoph , Dittrich Tobias , Müller-Tidow Carsten , Hose Dirk , Goldschmidt Hartmut , Hegenbart Ute , Jauch Anna , Schönland Stefan O.
Published: October 2018

Analysis of intraclonal heterogeneity has yielded insights into the clonal evolution of hematologic malignancies. We compared the clonal and subclonal compositions of the underlying plasma cell dyscrasia in 544 systemic light chain amyloidosis (PC-AL) patients with 519 patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), or symptomatic MM; ie, PC–non-AL patients). Using interphase fluorescence in situ hybridization, subclones were stringently defined as clone size below two thirds of the largest clone and an absolute difference of ≥30%. Subclones were found less frequently in the PC-AL group, at 199 (36.6%) of 544 as compared with 267 (51.4%) of 519 in the PC–non-AL group (P < .001), and were not associated with the stage of plasma cell dyscrasia in either entity. In both groups, translocation t(11;14), other immunoglobulin heavy chain translocations, and hyperdiploidy were typically found as main clones, whereas gain of 1q21 and deletions of 8p21, 13q14, and 17p13 were frequently found as subclones. There were no shifts in the subclone/main clone ratio depending on the MGUS, SMM, or MM stage of plasma cell dyscrasia. In multivariate analysis, t(11;14) was associated with lower rates of subclone formation and hyperdiploidy with higher rates. PC-AL itself lost statistical significance, demonstrating that the lower subclone frequency in AL is a reflection of its exceptionally high t(11;14) frequency. In summary, the subclone patterns in PC-AL and PC–non-AL are closely related, implying that subclone formation depends on the main cytogenetic categories and is independent of disease entity and stage.
Development of a Precise, Clinically Relevant, Digital Classification Schema for Cancer
Authors: Pecora Andrew L. , Norden Andrew D. , Hervey John , Schultz Eric V. , Gallucci Thomas L. , Rushforth Elizabeth , Goldberg Stuart L.
Published: October 2018

Purpose

Health care transactions depend on the efficiency of digital codes. The International Classification of Diseases and Related Health Problems (ICD) coding system, which is the most commonly used digital system, fails to capture the complexity of oncologic diseases. Because important prognostic information such as cancer stage and genomic markers are missing, the potential for ICD codes to define and compare patient cohorts is severely limited. A more precise, clinically relevant, digital classification schema that incorporates prognostic elements would address these needs.

Methods

Working with cancer disease–specific experts, a new digital classification scheme, known as the Cota Nodal Address (CNA) system, was developed. The CNA has six components that define the disease of interest and incorporate all standard-of-care prognostic and predictive markers related to the particular cancer, including patient features.

Results

Properly sorted into homogeneous groupings of patients with similar prognostic characteristics, the CNA system facilitated big data analytic approaches, such as evaluations of population health, identification of variation in treatment decisions, and the enablement of value-based payment models. The schema has been applied to patients with breast cancer at a large tertiary cancer care hospital and a regional community cancer care network and has facilitated the creation and application of value-based payment models.

Conclusion

The development and potential uses of a prognosis-based classification system are reviewed herein. Compared with ICD coding, the greater precision of the schema permits improved analyses of variance in treatment, outcomes, and costs in cancer care management.
Vangl2-dependent regulation of membrane protrusions and directed migration requires a fibronectin extracellular matrix
Authors: Love Anna M. , Prince Dianna J. , Jessen Jason R.
Published: October 2018

During zebrafish gastrulation the planar cell polarity (PCP) protein Vang-like 2 (Vangl2) regulates polarization of cells engaged in directed migration. However, it is unclear whether Vangl2 influences membrane-protrusive activities in migrating gastrula cells and if these processes require the fibronectin extracellular matrix. We report that Vangl2 modulates formation and polarization of actin-rich filopodia-like and large lamellipodia-like protrusions in ectodermal cells. By contrast, disrupted Glypican4/PCP signaling affects protrusion polarity but not protrusion number or directed migration. Analysis of fluorescent fusion protein expression suggests widespread Vangl2 symmetry in migrating cells but enrichment at membrane domains with developing large protrusions compared to non-protrusive domains. We show the fibronectin extracellular matrix is essential for cell surface Vangl2 expression, membrane-protrusive activity, and directed migration. Manipulation of fibronectin protein levels rescues protrusion and directed migration phenotypes in vangl2 mutant embryos, but is not sufficient to restore PCP and convergence and extension movements. Together, our findings identify distinct roles for Vangl2 and Glypican4/PCP signaling during membrane protrusion formation and demonstrate cell-matrix interactions underlie Vangl2-dependent regulation of protrusive activities in migrating gastrula cells.
The Hippo pathway effector Taz is required for cell morphogenesis and fertilization in zebrafish
Authors: Dingare Chaitanya , Niedzwetzki Alina , Klemmt Petra A. , Godbersen Svenja , Fuentes Ricardo , Mullins Mary C. , Lecaudey Virginie
Published: October 2018

Hippo signaling is a critical pathway integrating extrinsic and intrinsic mechanical cues to regulate organ size. Despite its essential role in organogenesis, little is known about its role in cell fate specification and differentiation. Here we unravel a novel and unexpected role of the Hippo pathway effector Taz (wwtr1) in controlling the size, shape and fate of a unique cell in the zebrafish ovary. We show that wwtr1 mutant females are infertile. In teleosts, fertilization occurs through the micropyle, a funnel-like opening in the chorion, formed by a unique, enlarged follicle cell, the micropylar cell (MC). We describe here for the first time the mechanism underlying the differentiation of the MC. Our genetic analyses show that Taz is essential for MC fate acquisition and subsequent micropyle formation in zebrafish. We identify Taz as the first bona fide MC marker and show that Taz is specifically and strongly enriched in the MC precursor. Altogether, we performed the first genetic and molecular characterization of the MC and propose that Taz is a key regulator of the MC fate.
Recent advances in bronchoscopy
Authors: Dumoulin Elaine
Published: October 2018

Bronchoscopy is a very common tool for diagnosis and therapeutic purposes in dealing with diseases of the lungs and the airways. Thankfully, a multitude of new technologies have made it more accessible for the use of physicians. This article is a review of the indication of bronchoscopy as it is being used today for a variety of chest pathologies.
Demographic data and fi gures derived from Estonian Iron Age graves
Authors: Allmäe Raili
Published: October 2018

Three Iron Age cremation graves from south-eastern Estonia and four graves including cremations as well inhumations from western Estonia were analysed by osteological and palaeodemographic methods in order to estimate the age and sex composition of burial sites, and to propose some possible demographic figures and models for living communities.

The crude birth/death rate estimated on the basis of juvenility indices varied between 55.1‰ and 60.0‰ (58.5‰ on average) at Rõsna village in south-eastern Estonia in the Middle Iron Age. The birth/death rates based on juvenility indices for south eastern graves varied to a greater degree. The estimated crude birth/death rate was somewhat lower (38.9‰) at Maidla in the Late Iron Age and extremely high (92.1‰) at Maidla in the Middle Iron Age, which indicates an unsustainable community. High crude birth/death rates are also characteristic of Poanse tarand graves from the Pre-Roman Iron Age – 92.3‰ for the 1st grave and 69.6‰for the 2nd grave. Expectedly, newborn life expectancies are extremely low in both communities – 10.8 years at Poanse I and 14.4 years at Poanse II. Most likely, both Maidla I and Poanse I were unsustainable communities.

According to the main model where the given period of grave usage is 150 years, the burial grounds were most likely exploited by communities of 3–14 people. In most cases, this corresponds to one family or household. In comparison with other graves, Maidla II stone grave in western Estonia and Rõsna-Saare I barrow cemetery in south-eastern Estonia could have been used by a somewhat larger community, which may mean an extended family, a larger household or usage by two nuclear families.
Sportsanthropometric and performance parameters of elite rock ‘n’ roll dancers
Authors: Fritzsche Anna , Fritzsche Jürgen
Published: October 2018

Rock ‘n’ roll dancing is one of the technical compositional sports. The current state of scientific knowledge on it can be described as minimal. To change this state, the first sports science survey regarding squad training was conducted under the guidance of the authors at the Austrian national rock ‘n’ roll team. The study group consisted of 26 A, B and C level athletes in the sport of rock ‘n’ roll acrobatics. The mean BMI of the male athletes with the mean age of 23.0 years was 23.3 kg/m2. The female subjects’ mean age was 19.5 years and their mean BMI 19.8 kg/m2. The bounce values of the men were as follows: squat jump (SQJ) 37.1 cm and counter- movement jump (CMJ) 41.9 cm. Men’s mean result in long jump was 256.0 cm. The women had a lower mean bounce of 25.8 cm and 27.2 cm in SQJ and CMJ respectively. Their mean length of the long jump was 204.6 cm.

The anthropometric data showed that the male subjects’ mean body height was 1.81 m and weight 76.2 kg. The BIA measurement yielded a value of 15.8% body fat. The women’s mean height was 1.64 m and percentage of passive body substance 23.5%; their mean weight was 53.4 kg. The waist/hip ratio was 0.9 in both men and women. The Broca index was 1.2% in women and 6% in men. The AKS-index reached 1.02 in men and 0.91 in women.

Data were collected to determine the one-repetition maximum (1RM) of the upper and lower extremities: lat pulldowns (m: 76.9 kg; w: 39.4 kg), rowing (m: 58.1 kg; w: 31.9 kg), bench press (m: 75.0 kg; w: 33.8 kg) and knee flexion (90°) (m: 82.1 kg; w: 44.7 kg). The result of the sit and reach test was 7.8 cm for male subjects and 16.2 cm for female athletes.
In memoriam: Mart Viikmaa
Authors: Heapost Leiu
Published: October 2018

In memoriam: Mart Viikmaa
In Which Type of Healthcare Do Patients Show Greater Loyalty? (Public Sector Management vs. Public-Private Partnership)
Authors: Calero Remedios , Gallarza Martina G.
Published: October 2018

Introduction: The present study analyses the patients behavior in a setting with different management types: public sector management and public-private partnership. More specifically, the objective is to establish in which healthcare type (hospitalization, ambulatory surgery, emergencies, outpatients consultation) do the patients show a loyal behavior when they are in different management scenarios. Material and methods: A descriptive analysis based on secondary data collected from an internal database of the Conselleria de Sanidad of the Valencian Community in Spain, a scenario with two different healthcare management types (public sector management and public-private partnership) was conducted. Results: Higher patient  ows in two healthcare types (emergency and outpatient consultation); disparate growth of the patients’ net basis; partnership favors maintaining the relationship with the patient thus preventing dropout; specialization of the public-private partnership in an assistance type: ambulatory surgery. Conclusion: The obtained results identify the healthcare types with higher patients’ loyalty, as well as the extent to which the management type affects this loyalty behaviour.