bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Thermodynamic Degradation Approach to Quantify Human Stress Response
Authors: Boregowda Satish , Handy Rod , Sleeth Darrah , Riches Naomi
Published: September 2017

The present study provides a thermodynamic degradation approach to model human stress response. Finger skin temperature was used as an indicator of stress response to a stressor (or stressful event) followed by a recovery. The entropy change (ΔS) is calculated using heat transfer (δQ) from the peripheral skin and finger skin temperature (Tf). It was hypothesized that the human stress response, as evidenced by finger skin temperature change, is a quasi-static process. The entropy approach is demonstrated using data from a medical school experimental study. The finger skin temperature was measured under three conditions (relaxation, stressor task, and recovery) during the physiological test profile. The entropy change (ΔS) is postulated as entropy damage (ΔSD), which is a metric for measuring the aging or system degradation. The aging-ratio, Aaging-ratio, that is, the ratio of entropy change due to stressor to that of recovery, is presented for both male and female subjects. The statistical t-tests demonstrate statistical significance in human stress response to stressor and recovery states within and between male and female subjects. This novel approach could be valuable to medical researchers, particularly in the field of occupational health to evaluate human exposure to stressful environments.
The Optimal Cut‐Off Value of Blood Stasis Syndrome Score in BSS Diagnosis in Korea
Authors: Kang Byoung-Kab , Park Tae-Yong , Jung Jeeyoun , Ko Mimi , Lee Myeong Soo , Lee Ju Ah
Published: September 2017

Objective. In the traditional oriental medicine, it is sometimes difficult to diagnose Blood Stasis Syndrome (BSS) in patients, because the diagnosis of BSS is based on the subjective signs and symptoms of patients. This study is aimed at developing the prediction tool of BSS using cut‐off value for BSS score. The identification of a cut‐off value for BSS score to diagnose BSS would be helpful. Methods. A total of 887 patients admitted to six traditional Korean medical hospitals in 2013 and three hospitals in 2014. All patients have an identical pattern as a result of diagnostic decision of two experts. The cut‐off value for BSS score for BSS diagnosis was determined by the receiver‐operating characteristic curve. Results. The area under the curve of this curve was 0.897. The optimal cut‐off point for detection of BSS was 49.0. The sensitivity and specificity of this cut‐off value were 80.8% and 83.2% in modelling data (2013 dataset) and 84.6% and 83.1% in validation data (2014 dataset), respectively. Conclusion. Our study suggests that a BSS score cut‐off value of 49.0 can be used to detect BSS in the traditional Korean medical hospitals. This cut‐off value for diagnosis of BSS will make up the lack of objectivity.
Generation of a Potential Prognostic Matrix for Papillary Thyroid Cancer that Assesses Age, Tumor Size, Transforming Growth Factor-β, and BRAFV600E Mutation
Authors: Wang Ping , Lun Yu , Fu Yudong , Wang Fei , Zhao Shihua , Wang Yangyang , Hou Xu
Published: September 2017

Background: Papillary thyroid cancer (PTC) is the most common differentiated thyroid cancer and is responsible for 80-90% of thyroid cancer cases. Despite typically excellent prognoses, these subclinical low-risk cancers are often treated aggressively by surgical thyroidectomy. Consequently, the objective of this study was to generate a prognostic matrix to be used prior to PTC intervention. Methods: In this study, 80 PTC patients were assessed. Following adjustment for sex, logistic regression analysis showed that BRAFV600E mutation, transforming growth factor beta (TGF-β) expression, age, and tumor size are risk factors that can affect tumor clinical stage (p < 0.05). Based on the results of this analysis, we generated a matrix that incorporated 4 variables: patient age, tumor size, BRAFV600E mutation, and TGF-β expression. Results: We observed that the corresponding area under curve was as high as 0.91. The sensitivity and specificity of the model were 94.74 and 83.61%, respectively. These values are significantly higher than those generated from single indexes. Conclusion: As a result of this analysis, it is hoped that the resultant matrix can be utilized during clinical diagnosis and treatment prior to thyroid nodule surgery.
A Novel Missense GLA Mutation (p.G35V) Detected in Hemodialysis Screening Leads to Severe Systemic Manifestations of Fabry Disease in Men and Women
Authors: Veloso Valeria Soares Pigozzi , Ataides Thiago Lacerda , Canziani Maria Eugênia Fernandes , Veloso Mariana Pigozzi , da Silva Nilzio Antônio , Barreto Daniela Veit , Pereira Edna Regina Silva , de Moura Luiz Antonio Ribeiro , Barreto Fellype Carvalho
Published: September 2017

Background/Aims: Fabry disease (FD), an X-linked lysosomal storage disorder, leads to accumulation of globotriaosylceramide. Screening in dialysis patients may identify genetic variants of unknown clinical significance. We aimed to characterize the pathogenicity of a novel GLA gene mutation identified during hemodialysis screening and the histologic findings of early Fabry nephropathy. Methods: One out of 108 male hemodialysis patients screened for FD presented low α-galactosidase A activity. A novel missense mutation (p.G35V) in the GLA gene was detected. Family screening identified 11 additional cases (8 women). Clinical investigation was conducted in 10 patients (index case and 9 relatives). Pathogenicity of the new mutation was investigated by clinical and laboratory tests, cardiac and cranial magnetic resonance imaging, and kidney biopsy. Results: Cardiac manifestations were detected in most patient from both genders, such as left ventricular hypertrophy and short PR interval. White matter lesion was present in 3 women. Pulvinar lesion of the thalamus and ischemic stroke were detected in male patients. Abnormal glomerular filtration rate (GFR) and/or albuminuria were present in 5 patients (3 women). Renal biopsies (n = 7) revealed globotriaosylceramide deposits in different cell types and foot processes effacement in all patients, including women with normal albuminuria. Despite a normal GFR, tubulointerstitial fibrosis ranging from 5 to 20% was present in young women and men with normal or high albuminuria, respectively. Conclusion: The novel missense mutation p.G35V leads to severe systemic manifestations of FD in men and women. Kidney histological changes, including tubulointerstitial fibrosis, may predate albuminuria and GFR changes in adult women. Novel non-invasive markers are required for early detection of Fabry nephropathy.
Expression of Phosphate Transporters during Dental Mineralization
Authors: Merametdjian L. , Beck-Cormier S. , Bon N. , Couasnay G. , Sourice S. , Guicheux J. , Gaucher C. , Beck L.
Published: September 2017

The importance of phosphate (Pi) as an essential component of hydroxyapatite crystals suggests a key role for membrane proteins controlling Pi uptake during mineralization in the tooth. To clarify the involvement of the currently known Pi transporters (Slc17a1, Slc34a1, Slc34a2, Slc34a3, Slc20a1, Slc20a2, and Xpr1) during tooth development and mineralization, we determined their spatiotemporal expression in murine tooth germs from embryonic day 14.5 to postnatal day 15 and in human dental samples from Nolla stages 6 to 9. Using real-time polymerase chain reaction, in situ hybridization, immunohistochemistry, and X-gal staining, we showed that the expression of Slc17a1, Slc34a1, and Slc34a3 in tooth germs from C57BL/6 mice were very low. In contrast, Slc34a2, Slc20a1, Slc20a2, and Xpr1 were highly expressed, mostly during the postnatal stages. The expression of Slc20a2 was 2- to 10-fold higher than the other transporters. Comparable results were obtained in human tooth germs. In mice, Slc34a2 and Slc20a1 were predominantly expressed in ameloblasts but not odontoblasts, while Slc20a2 was detected neither in ameloblasts nor in odontoblasts. Rather, Slc20a2 was highly expressed in the stratum intermedium and the subodontoblastic cell layer. Although Slc20a2 knockout mice did not show enamel defects, mutant mice showed a disrupted dentin mineralization, displaying unmerged calcospherites at the mineralization front. This latter phenotypical finding raises the possibility that Slc20a2 may play an indirect role in regulating the extracellular Pi availability for mineralizing cells rather than a direct role in mediating Pi transport through mineralizing plasma cell membranes. By documenting the spatiotemporal expression of Pi transporters in the tooth, our data support the possibility that the currently known Pi transporters may be dispensable for the initiation of dental mineralization and may rather be involved later during the tooth mineralization scheme.
Self-assembling Peptide P11-4 and Fluoride for Regenerating Enamel
Authors: Alkilzy M. , Tarabaih A. , Santamaria R.M. , Splieth C.H.
Published: September 2017

Regenerative medicine-based approaches for caries treatment focus on biomimetic remineralization of initial carious lesions as a minimal invasive therapy. In vitro, self-assembling peptide P11-4 enhances remineralization of early carious lesions. To investigate the safety and clinical efficacy of P11-4 for treatment of initial caries, a randomized controlled single-blind study was conducted on children aged >5 y with visible active early caries on erupting permanent molars. Subjects were randomized to either the test group (P11-4 + fluoride varnish) or control group (fluoride varnish alone). Caries were assessed at baseline and at 3 and 6 mo posttreatment per laser fluorescence, a visual analog scale, the International Caries Detection and Assessment System, and Nyvad caries activity criteria. Intention-to-treat analyses were performed, and safety and clinical feasibility of the treatment approaches were assessed. Compared with the control group, the test group showed clinically and statistically significant improvement in all outcomes at 3 and 6 mo. The laser fluorescence readings (odds ratio = 3.5, P = 0.015) and visual analog scale scores (odds ratio = 7.9, P < .0001) were significantly lower for the test group, and they showed regression in the International Caries Detection and Assessment System caries index (odds ratio = 5.1, P = 0.018) and conversion from active to inactive lesions according to Nyvad criteria (odds ratio = 12.2, P < 0.0001). No adverse events occurred. The biomimetic mineralization facilitated by P11-4 in combination with fluoride application is a simple, safe, and effective noninvasive treatment for early carious lesions that is superior to the presently used gold standard of fluoride alone. By regenerating enamel tissue and preventing lesion progression, this novel approach could change clinical dental practice from a restorative to a therapeutic approach. This could avoid additional loss of healthy hard tissue during invasive restorative treatments, potentially enabling longer tooth life and thereby lowering long-term health costs ( ClinicalTrials.gov NCT02724592).
Reading and Phonological Awareness in Africa
Authors: Alcock Katherine J. , Ngorosho Damaris S. , Jukes Matthew C. H.
Published: September 2017

Literacy levels in Africa are low, and school instruction outcomes are not promising. Africa also has a disproportionate number of unschooled children. Phonological awareness (PA), especially phoneme awareness, is critically associated with literacy, but there is little evidence about whether PA is gained through literacy, schooling, or both, because most children studied are in education and can read at least letters. Our previous study of PA and reading in children in and out of school in Tanzania found that PA was associated with reading ability, not schooling or age, and many unschooled children learned to read. We retested 85 children from the baseline study, on measures of PA and literacy, approximately 2 years later. We found that more unschooled children had now learned to read but PA had generally not improved for these children. Unschooled children were still poorer at PA than schooled children. At 2 years, schooling now independently predicted PA and literacy. PA also predicted literacy and vice versa. Explicit phoneme awareness was again poor, even in accurate readers. More unschooled children have now learned to read, possibly because local literacy is in their first language; however, schooling improves reading and PA.
Exploring Rehabilitation Counseling Supervisors’ Role in Promoting Counselor Development of Ethical Fluency
Authors: Landon Trenton J. , Schultz Jared C.
Published: September 2017

Clinical supervision plays an integral role in the professional development of counselors, particularly for developing their awareness of ethical service delivery and decision making. This grounded theory study queried eight rehabilitation counseling supervisors, four from a state rehabilitation agency and four from a nonprofit community rehabilitation organization. The purpose of the study was to determine supervisor perspectives regarding their role in the development of ethical decision making in their supervisees. The emergent construct from the data is termed ethical fluency. Ethical fluency is a cognitive ability representing the interaction between acculturation knowledge, fluid reasoning, and the speed and accuracy with which ethical dilemmas are recognized and processed. Supervisors in this study reported playing a key role in developing ethical fluency in counselors, and the supervisory working alliance was an integral platform from which to approach discussions on ethics. Recommendations for improved practice and future research are provided.
Reciprocal relations between syntax and tense/agreement morphology in children’s interpretation of input: A look at children with specific language impairment
Authors: Leonard Laurence B.
Published: September 2017

There is growing evidence that the grammatical errors reflected in the speech of young children are often related to the nature of the input in the ambient language. Although theoretical frameworks differ in the degree to which input plays a role, there is acknowledgment that children require more input than previously assumed to resolve apparent grammatical ambiguities in the sentences they hear. In languages such as English, tense and agreement morphology seems especially at the mercy of correct interpretation of the input. This review discusses possible input-related reasons for the relatively late mastery of tense and agreement (and related) morphology in English-speaking children, and the especially protracted period of tense and agreement inconsistency in the speech of children with specific language impairment. It is noted that there is a reciprocal relation here. On the one hand, the children’s failure to grasp particular syntactic structures can lead to the extraction and inappropriate use of verbs lacking tense and agreement. On the other hand, the tense and agreement (and related) morphemes in these structures can serve as important cues for interpreting the syntactic structure.
Complement or adjunct? The syntactic principle English-speaking children learn when producing determiner–noun combinations in their early speech
Authors: Ninio Anat
Published: September 2017

In children acquiring various languages, the early mastery of determiners strongly predicts syntactic development. What makes determiners important is not yet clear as there is a linguistic controversy regarding their syntactic behaviour. Some consider determiners to be similar to adjectives and to modify common nouns, while others consider the common nouns their complements. This article aims to find out which of the two basic syntactic operations, complementation or adjunct attribution, children learn when they master determiner–noun combinations in their early speech. Pearson correlations of determiner–nominal combinations with verb–noun combinations and attributive adjective–noun combinations were computed in early two-word-long sentences of a large sample of young English-speaking children. Determiner–nominal combinations were very highly correlated with verb–noun sentences, whereas the correlation with adjective–noun combinations was much lower. It appears that determiner–noun combinations are a type of complementation. When children learn them early, they apparently learn the syntactic principle underlying such combinations which then can be transferred to other syntactic constructions.
Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)
Authors: Persson Carina U , Kjellberg Sigvar , Lernfelt Bodil , Westerlind Ellen , Cruce Malin , Hansson Per-Olof
Published: September 2017

Objective:

This study aimed to investigate incidence of falls and different baseline variables and their association with falling during hospitalization in a stroke unit among patients with acute stroke.

Design:

Prospective observational study.

Setting:

A stroke unit at a university hospital.

Subjects:

A consecutive sample of stroke patients, out of which 504 were included, while 101 declined participation.

Methods:

The patients were assessed a mean of 1.7 days after admission and 3.8 days after stroke onset.

Main measures:

The primary end-point was any fall, from admission to the stroke unit to discharge. Factors associated with falling were analysed using univariable and multivariable Cox hazard regression analyses. Independent variables were related to function, activity and participation, as well as personal and environmental factors.

Results:

In total, 65 patients (13%) fell at least once. Factors statistically significantly associated with falling in the multivariable analysis were male sex (hazard ratio (HR): 1.88, 95% confidence interval (CI): 1.13–3.14, P = 0.015), use of a walking aid (HR: 2.11, 95% CI: 1.24–3.60, P = 0.006) and postural control as assessed with the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS). No association was found with age, cognition or stroke severity, the HR for low SwePASS scores (⩽24) was 9.33 (95% CI: 2.19–39.78, P = 0.003) and for medium SwePASS scores (25–30) was 6.34 (95% CI: 1.46–27.51, P = 0.014), compared with high SwePASS scores (⩾31).

Conclusion:

Postural control, male sex and use of a walking aid are associated with falling during hospitalization after acute stroke.
Roman high and low avoidance rats differ in their response to chronic olanzapine treatment at the level of body weight regulation, glucose homeostasis, and cortico-mesolimbic gene expression
Authors: Evers Simon S , Boersma Gretha J , Tamashiro Kellie LK , Scheurink Anton JW , van Dijk Gertjan
Published: September 2017

Olanzapine, an antipsychotic agent mainly used for treating schizophrenia, is frequently associated with body weight gain and diabetes mellitus. Nonetheless, studies have shown that not every individual is equally susceptible to olanzapine’s weight-gaining effect. Therefore, Roman high and low avoidance rat strains were examined on their responsiveness to olanzapine treatment. The Roman high avoidance rat shares many behavioral and physiological characteristics with human schizophrenia, such as increased central dopaminergic sensitivity, whereas the Roman low avoidance rat has been shown to be prone to diet-induced obesity and insulin resistance. The data revealed that only the Roman high avoidance rats are susceptible to olanzapine-induced weight gain and attenuated glucose tolerance. Here it is suggested that the specific olanzapine-induced weight gain in Roman high avoidance rats could be related to augmented dopaminergic sensitivity at baseline through increased expression of prefrontal cortex dopamine receptor D1 mRNA and nucleus accumbens dopamine receptor D2 mRNA expression. Regression analyses revealed that olanzapine-induced weight gain in the Roman high avoidance rat is above all related to increased prolactin levels, whereas changes in glucose homeostasis is best explained by differences in central dopaminergic receptor expressions between strains and treatment. Our data indicates that individual differences in dopaminergic receptor expression in the cortico-mesolimbic system are related to susceptibility to olanzapine-induced weight gain.
Definition of process parameters for manufacturing of thermoplastic composite sandwiches – Part B
Authors: Grünewald Jonas , Parlevliet Patricia , Altstädt Volker
Published: September 2017

Thermoplastic composite (TPC) sandwich structures offer great potential to meet the demands of lightweight structures for aeronautical applications. In this study, compression moulding of sandwich components, consisting of carbon fibre-reinforced polyetheretherketone (CF/PEEK) skins and polyetherimide (PEI) cores, is studied with the aim of verifying a previously proposed model. This model predicts the influence of processing conditions on the properties of the sandwich structure, particularly the skin to core bond. Sandwich specimens are manufactured according to the parameters resulting from the model, in particular to verify skin and core pre-heat temperatures. The resulting bond quality is characterized by flatwise plane tensile testing and compared to the predicted values. This comparison shows a reasonable good agreement between predicted and experimentally obtained tensile strengths, which mainly depend on the skin pre-heat temperature. In addition, the specimens mostly fail as predicted by the model. While the model predicts that pre-heating the core leads to an improvement of the bond strength, the experiments show that core pre-heating leads often to core collapsing, which was not considered in the model. Therefore, it is proposed to complement the modelling approach with an analysis of the heat flow into core.
Merger of Public Sector Banks in India Under the Rule of Reason
Authors: Ladha Rani S.
Published: September 2017

This article models the idea of rule of reason of the antitrust literature and applies the model to analyse the possible consolidation of the Indian banking industry through merger and acquisition activities. It offers a strategic perspective for public sector banks whereby the banks either meet societal goals or become savvy international players through mergers. India being an emerging economy, the banking industry faces two critical initiatives: (i) proactive servicing of the rural areas and priority sectors and (ii) a serious presence in the international markets to compete with larger global banks. The model developed in this article suggests ways to evaluate and examine mergers in the banking sector in India to support both these initiatives. It proposes that the government could use the threat of merger to induce reluctant public sector banks to meet the critical domestic agenda and performance metrics. Those that meet the societal goals may continue to have the benefit of the status quo. Those that do not are required to merge to form an entity that can internationally compete in raising equity and deposits and providing loans and services.

JEL Classification: G34, G38, K21
Psychological Words in Music and Propagandistic Communication in Two Koreas over the DMZ
Authors: Lim Young Joon , Lemanski Jennifer L.
Published: September 2017

This study analyses linguistic meanings of songs and their effectiveness of psychological influence from a propagandistic perspective with the case of South Korean loudspeaker propaganda targeting North Korean soldiers over the border. The two Koreas resumed to use loudspeakers to inflict psychological pain on each side in 2015, and the South chooses K-pop songs to execute the twenty-first century propaganda. More importantly, a linguistic and psychological analysis of the impact of K-pop songs on North Korean soldiers takes a greater part in this study, in addition to a demonstration of musical influence on emotions, induced by rhythm, beats and lyrics.
Men’s Mental Health Services: The Case for a Masculinities Model
Authors: Seidler Zac E. , Rice Simon M. , River Jo , Oliffe John L. , Dhillon Haryana M.
Published: September 2017

It is well understood that men are reticent in seeking help for mental health concerns. In the wake of government-funded campaigns across many Western nations that have sought to address this, noticeably absent have been the active development, promotion, dissemination, and rigorous evaluation of male-centered treatment styles. We argue that next-generation approaches must actively counteract unhelpful stereotypes, instead promoting diverse and healthy masculinities. The current article makes the case for the development of a masculinities model of mental health care, offering recommendations to advance clinical practice and research toward this goal. We propose that updated help-seeking campaigns and clinician training, gender-sensitive service provision, and comprehensive cost analyses will provide the groundwork for such a model to better target the diversity in men and reduce any reluctance to engage with mental health treatment.
Oncoplastic Surgery
Authors: Chatterjee Abhishek , Dayicioglu Deniz , Khakpour Nazanin , Czerniecki Brian J.
Published: September 2017

Oncoplastic surgery is an evolving field in breast surgery combining the strengths of breast surgical oncology with plastic surgery. It provides the surgeon the ability to excise large areas of the breast in the oncologic resection without compromising, and possibly improving, its aesthetic appearance. The purpose of this review is to provide a guide that could help a breast surgeon excise breast cancer in most areas of the breast using 5 oncoplastic techniques. These techniques would be used depending primarily on the location of the cancer in the breast and also on the size of the tumor.
Role and Future Directions of External Beam Radiotherapy for Primary Liver Cancer
Authors: Keane Florence K. , Hong Theodore S.
Published: September 2017

The incidence of primary liver cancers continues to increase in the United States and worldwide. The majority of patients with primary liver cancer are not candidates for curative therapies such as surgical resection or orthotopic liver transplantation due to tumor size, vascular invasion, or underlying comorbidities. Therefore, while primary liver cancer is the sixth-most common cancer diagnosis worldwide, it represents the second leading cause of cancer-related deaths. Radiotherapy traditionally played a limited role in the treatment of primary liver cancer due to concerns over hepatic tolerance and the inability to deliver a tumoricidal dose of radiotherapy while still sparing normal hepatic parenchyma. However, the development of modern radiotherapy techniques has made liver-directed radiotherapy a safe and effective treatment option for both hepatocellular carcinoma and intrahepatic cholangiocarcinoma. An increasing body of literature has demonstrated the excellent local control and survival rates associated with liver-directed radiotherapy. These data include multiple radiotherapy techniques and modalities, including stereotactic body radiotherapy (SBRT), intensity modulated radiotherapy (IMRT), and charged particle therapy, including proton therapy. In this review, we discuss the development of liver-directed radiotherapy and evidence in support of its use, particularly in patients who are not candidates for resection or orthotopic liver transplantation. We also discuss future directions for its role in the management of primary liver cancers.
Role of Systemic Therapy and Future Directions for Hepatocellular Carcinoma
Authors: Eatrides Jennifer , Wang Emilie , Kothari Nishi , Kim Richard
Published: September 2017

Hepatocellular carcinoma (HCC) is an aggressive tumor that often arises in the setting of liver cirrhosis. Although early-stage disease is often amenable for surgical resection, transplant, or locoregional therapies, many patients are diagnosed at an advanced stage or have poor liver reserve. Systemic therapy is the mainstay of treatment for these patients. At present, the only approved therapy for the treatment of advanced disease is the tyrosine multikinase inhibitor sorafenib. Candidacy for treatment is based on liver reserve. Novel agents for the treatment of this disease are urgently needed. In this article, we review systemic therapy trials and upcoming data for the treatment of HCC.
Surgical Treatment of Hepatocellular Carcinoma
Authors: Zamora-Valdes Daniel , Taner Timucin , Nagorney David M.
Published: September 2017

Hepatocellular carcinoma (HCC) is a major cause of cancer-related death worldwide. In select patients, surgical treatment in the form of either resection or transplantation offers a curative option. The aims of this review are to (1) review the current American Association for the Study of Liver Diseases/European Association for the Study of the Liver guidelines on the surgical management of HCC and (2) review the proposed changes to these guidelines and analyze the strength of evidence underlying these proposals. Three authors identified the most relevant publications in the literature on liver resection and transplantation for HCC and analyzed the strength of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification. In the United States, the liver allocation system provides priority for liver transplantation to patients with HCC within the Milan criteria. Current evidence suggests that liver transplantation may also be indicated in certain patient groups beyond Milan criteria, such as pediatric patients with large tumor burden or adult patients who are successfully downstaged. Patients with no underlying liver disease may also benefit from liver transplantation if the HCC is unresectable. In patients with no or minimal (compensated) liver disease and solitary HCC ≥2 cm, liver resection is warranted. If liver transplantation is not available or contraindicated, liver resection can be offered to patients with multinodular HCC, provided that the underlying liver disease is not decompensated. Many patients may benefit from surgical strategies adapted to local resources and policies (hepatitis B prevalence, organ availability, etc). Although current low-quality evidence shows better overall survival with aggressive surgical strategies, this approach is limited to select patients. Larger and well-designed prospective studies are needed to better define the benefits and limits of such approach.
American Insight Into Strabismus Surgery Before 1838
Authors: Leffler Christopher T , Schwartz Stephen G , Le John Q
Published: September 2017

English surgeon John Taylor attempted to perform strabismus surgery in the 18th century. The field languished until, in Germany, treatment of strabismus by cutting an extraocular muscle was proposed by Louis Stromeyer in 1838 and performed by Johann Friedrich Dieffenbach in 1839. According to traditional teaching, there has never been any proof that anyone in the United States thought of the idea of strabismus surgery before Stromeyer’s report. In 1841, American surgeon William Gibson wrote that he had cut extraocular muscles to treat strabismus several times beginning in 1818 but never published his cases. Gibson’s former trainee Alexander E Hosack of New York confirmed Gibson’s memory. Interestingly, Hosack’s family had a connection with the family of New York oculist John Scudder Jr (1807-1843), whose reported cure of strabismus by cutting some of the fibers of an extraocular muscle was described in newspapers throughout the United States in 1837. Thus, Scudder’s report preceded that of Stromeyer. Scudder’s claim cannot be verified, but his description could have influenced Stromeyer, and demonstrates that the idea of strabismus surgery did exist in America before 1838.
Statistical partial wavefield imaging using Lamb wave signals
Authors: Harley Joel B , Chia Chen Ciang
Published: September 2017

This article presents a baseline-free, model-driven, statistical damage detection and imaging framework for guided waves measured from partial (i.e. non-dense) wavefield scans. Wavefield analysis is an effective non-contact technique for non-destructive evaluation. Yet, there are several limitations to practically implement wavefield methods. These limitations include slow data acquisition and a lack of statistical reliability. Our approach addresses both of these challenges. We use sparse wavenumber analysis, sparse wavenumber synthesis, and data-fitting optimization to accurately model damage-free wavefield data. We then combine this model with matched field processing to image damage from a small number of partial wavefield measurements. We further derive a hypothesis test based on extreme value theory to statistically detect damage. We test our framework with Lamb wave measurements from a steel plate. With 70 experimental wavefield measurements, we achieve an empirical probability of damage detection of more than 98%, an empirical probability of false alarm of less than 0.17%, and an accurate image of the damage.
State-Mandated Nutrition, Physical Activity, and Screen Time Policies in Child Care Centers
Authors: Chang-Martinez Catherina , Ahmed Nasar U. , Natale Ruby A. , Messiah Sarah E.
Published: September 2017

Background. The child care center (CCC) environment presents opportunities for healthy weight promotion in preschoolers. Our study examined the current state of CCC adherence to nutrition, physical activity, and screen time legislative regulations and the differences in their adherence by center socioeconomic position (SEP: low, middle, high) in Miami-Dade County. Method. In 34 CCC, we used the Environment and Policy Assessment and Observation tool to evaluate nutrition, physical activity, and screen time practices during 1-school day. Results. Twenty-five of the centers (73.5%) were participants of the Child and Adult Care Food Program. Almost 80% of the centers adhered to serving low-fat/fat-free milk to children older than 2 years. Only 34.5% served vegetables and 75.9% served whole fruits during meals/snacks. Ninety-four percent of the centers had quiet and active play incorporated into their daily routines. All centers adhered to the 2-hour screen time limit for children older than 2 years. Low- and middle-SEP centers fared better in the serving of fruits, vegetables, and low-fat/fat-free milk. The centers averaged 1 hour in outdoor play regardless of SEP. High-SEP centers had no TV or screen time during day of observation. Conclusion. CCC practices highlight opportunities for improvement in nutrition, physical activity, and screen time practices in the prevention of overweight in early childhood.
Long-term Outcomes of a Telementoring Program for Distant Teaching of Endovascular Aneurysm Repair
Authors: Porretta Alessandra Pia , Alerci Mario , Wyttenbach Rolf , Antonucci Francesco , Cattaneo Mattia , Bogen Marcel , Toderi Marco , Guerra Adriano , Sartori Fabio , Di Valentino Marcello , Tutta Paolo , Limoni Costanzo , Gallino Augusto , von Segesser Ludwig K.
Published: September 2017

Purpose: To prospectively evaluate the long-term outcomes after a telementoring program for distant teaching of endovascular aneurysm repair (EVAR) and the degree of EVAR procedure assimilation into routine practice. Methods: A telementoring protocol using stepwise introduction of EVAR was implemented between a university care center and a remote vascular health care site; from March 1999 to October 2003, 49 EVAR patients (mean age 72 years; 48 men) were treated during telementoring at the remote center. After the telementoring period, 86 patients (mean age 71 years; 77 men) underwent EVAR procedures carried out at the secondary care center from November 2003 to July 2011. The long-term outcomes were compared between the EVAR procedures performed during telementoring with the procedures performed independently thereafter. Results: No significant difference was appreciated between telementored and not telementored procedures either in 30-day mortality (4.1% vs 2.3%, p=0.621) or in the initial technical success (93.9% vs 97.7%, p=0.353). The telementored group showed no significant difference in overall aneurysm-related mortality (6.1% vs 2.3%, p=0.353) or in the overall complication rates (p=0.985). The reintervention rate was significantly lower among the unmentored procedures (11.6% vs 32.7%, p=0.004). In particular, significantly fewer patients underwent late endovascular procedures (1.2% vs 12.2%, p=0.009) and late percutaneous interventions (7.0% vs 20.4%, p=0.027) after telementoring ceased. Conclusion: The telementoring program followed here allowed excellent EVAR skill assimilation into the routine practice of a remote health care site. Telementoring is a feasible strategy to support skill introduction in remote medical facilities.
Positive change and sense of coherence in Japanese mothers of children with congenital appearance malformation
Authors: Omiya Tomoko , Yamazaki Yoshihiko
Published: September 2017

The purpose of this study was to clarify the factors related to perceived positive change and sense of coherence in mothers ( n = 293) of children with cleft lip and palate. The strongest negative correlation with sense of coherence was stigmatizing words from others; there were positive correlations with social capital and perceived positive change. Multiple regression showed that to be aware of positive changes, mothers share their feelings with mothers in the same position, are rooted in a safe community and do not feel isolated in parenting. People who have experienced adversity may have the opportunity to enhance sense of coherence by obtaining perceived positive change.
A randomized, placebo-controlled study of the cardiovascular safety of the once-weekly DPP-4 inhibitor omarigliptin in patients with type 2 diabetes mellitus
Authors: Gantz Ira , Chen Menghui , Suryawanshi Shailaja , Ntabadde Catherine , Shah Sukrut , O’Neill Edward A. , Engel Samuel S. , Kaufman Keith D. , Lai Eseng
Published: September 2017

Background

Omarigliptin is a once-weekly (q.w.) oral DPP-4 inhibitor that is approved for the treatment of patients with type 2 diabetes mellitus (T2DM) in Japan. To support approval of omarigliptin in the United States, the clinical development program included a cardiovascular (CV) safety study. Subsequently, a business decision was made not to submit a marketing application for omarigliptin in the United States, and the CV safety study was terminated. Herein we report an analysis of data from that early-terminated study.

Methods

In this randomized, double-blind study, 4202 patients with T2DM and established CV disease were assigned to either omarigliptin 25 mg q.w. or matching placebo in addition to their existing diabetes therapy. A Cox proportional hazards model was used to summarize the primary endpoint of time to first major adverse CV event (MACE, the composite of CV death, nonfatal myocardial infarction, and nonfatal stroke) and the analysis of first event of hospitalization for heart failure (hHF).

Results

The median follow-up was approximately 96 weeks (range 1.1–178.6 weeks). The primary MACE outcome occurred in 114/2092 patients in the omarigliptin group (5.45%; 2.96/100 patient-years) and 114/2100 patients in the placebo group (5.43%; 2.97/100 patient-years), with a hazard ratio (HR) of 1.00 (95% confidence interval [CI] 0.77, 1.29). The hHF outcome occurred in 20/2092 patients in the omarigliptin group (0.96%; 0.51/100 patient-years) and 33/2100 patients in the placebo group (1.57%; 0.85/100 patient-years), with an HR of 0.60 (95% CI 0.35, 1.05). After 142 weeks, the least-squares mean difference (omarigliptin vs. placebo) in glycated hemoglobin levels was −0.3% (95% CI −0.46, −0.14). The numbers of patients with adverse events, serious adverse events or discontinued from study medication due to adverse events were similar in the omarigliptin and placebo groups.

Conclusions

In this CV safety study of patients with T2DM and established CV disease, omarigliptin did not increase the risk of MACE or hHF and was generally well tolerated.

Trial registration ClinicalTrials.gov: NCT01703208. Registered 05 October 2012
Sophoridine induces apoptosis and S phase arrest via ROS-dependent JNK and ERK activation in human pancreatic cancer cells
Authors: Xu Zihang , Zhang Fei , Bai Chao , Yao Chao , Zhong Hairong , Zou Chunpu , Chen Xiao
Published: September 2017

Background

Pancreatic cancer is generally acknowledged as the most common primary malignant tumor, and it is known to be resistant to conventional chemotherapy. Novel, selective antitumor agents are pressingly needed.

Methods

CCK-8 and colony formation assay were used to investigate the cell growth. Flow cytometry analysis was used to evaluate the cell cycle and cell apoptosis. The peroxide-sensitive fluorescent probe DCFH-DA was used to measure the intracellular ROS levels. Western blot assay was used to detect the levels of cell cycle and apoptosis related proteins. Xenografts in nude mice were used to evaluate the effect of Sophoridine on pancreatic cancer cell in vivo.

Results

Sophoridine killed cancer cells but had low cytotoxicity to normal cells. Pancreatic cancer cells were particularly sensitive. Sophoridine inhibited the proliferation of pancreatic cancer cells and induced cell cycle arrest at S phase and mitochondrial-related apoptosis. Moreover, Sophoridine induced a sustained activation of the phosphorylation of ERK and JNK. In addition, Sophoridine provoked the generation of reactive oxygen species (ROS) in pancreatic cancer cells. Finally, in vivo, Sophoridine suppressed tumor growth in mouse xenograft models.

Conclusion

These findings suggest Sophoridine is promising to be a novel, potent and selective antitumor drug candidate for pancreatic cancer.
Treatment of depression in schizophrenia: Systematic review and meta-analysis
Authors: Gregory Angharad , Mallikarjun Pavan , Upthegrove Rachel
Published: September 2017

Background

Depression in schizophrenia predicts poor outcomes, including suicide, yet the effectiveness of antidepressants for its treatment remains uncertain.

Aims

To synthesise the evidence of the effectiveness of antidepressants for the treatment of depression in schizophrenia.

Method

Multiple databases Were searched and inclusion Criteria included participants aged over 18 years with schizophrenia or related psychosis with a depressive episode. Papers were quality assessed used the Cochrane risk bias tool. Meta-analyses were performed for risk difference and standardised mean difference of all antidepressants, antidepressant class and individual antidepressant where sufficient studies allowed.

Results

A total of 26 moderate- to low-quality trials met inclusion criteria. In meta-analysis a significant risk difference was found in favour of antidepressant treatment, with a number needed to treat of 5 (95% CI 4–9). Studies using tools specifically designed to assess depression in schizophrenia showed a larger effect size. However, after sensitivity analysis standardised mean difference of all antidepressants did not show a statistically significant improvement in depression score at end-point, neither did any individual antidepressant class.

Conclusions

Antidepressants may be effective for the treatment of depression in schizophrenia, however, the evidence is mixed and conclusions must be qualified by the small number of low- or moderate-quality studies. Further sufficiently powered, high-quality studies are needed.
Characterization of Pulmonary Metastases in Children With Hepatoblastoma Treated on Children’s Oncology Group Protocol AHEP0731 (The Treatment of Children With All Stages of Hepatoblastoma): A Report From the Children’s Oncology Group
Authors: O’Neill Allison F. , Towbin Alexander J. , Krailo Mark D. , Xia Caihong , Gao Yun , McCarville M. Beth , Meyers Rebecka L. , McGahren Eugene D. , Tiao Greg M. , Dunn Stephen P. , Langham Max R. , Weldon Christopher B. , Finegold Milton J. , Ranganathan Sarangarajan , Furman Wayne L. , Malogolowkin Marcio , Rodriguez-Galindo Carlos , Katzenstein Howard M.
Published: September 2017

Purpose

To determine whether the pattern of lung nodules in children with metastatic hepatoblastoma (HB) correlates with outcome.

Methods

Thirty-two patients with metastatic HB were enrolled on Children’s Oncology Group Protocol AHEP0731 and treated with vincristine and irinotecan (VI). Responders to VI received two additional cycles of VI intermixed with six cycles of cisplatin/fluorouracil/vincristine/doxorubicin (C5VD), and nonresponders received six cycles of C5VD alone. Patients were imaged after every two cycles and at the conclusion of therapy. All computed tomography scans and pathology reports were centrally reviewed, and information was collected regarding lung nodule number, size, laterality, timing of resolution, and pulmonary surgery.

Results

Among the 29 evaluable patients, only 31% met Response Evaluation Criteria in Solid Tumors (RECIST) for measurable metastatic disease. The presence of measurable disease by RECIST, the sum of nodule diameters greater than or equal to the cumulative cohort median size, bilateral disease, and ≥ 10 nodules were each associated with an increased risk for an event-free survival event ( P = .48, P = .08, P = .065, P = .03, respectively), with nodule number meeting statistical significance. Ten patients underwent pulmonary resection/metastasectomy at various time points, the benefit of which could not be determined because of small patient numbers.

Conclusion

Children with metastatic HB have a poor prognosis. Overall tumor burden may be an important prognostic factor for these patients. Lesions that fail to meet RECIST size criteria (ie, those < 10 mm) at diagnosis may contain viable tumor, whereas residual lesions at the end of therapy may constitute eradicated tumor/scar tissue. Patients may benefit from risk stratification on the basis of the burden of lung metastatic disease at diagnosis.
Historical Poetics between Russia and the West: Toward a Nonlinear Model of Literary History and Social Ontology
Authors: Kliger Ilya
Published: September 2017

This essay explores the manner in which the persistence of literary forms in history has been addressed by the Russian tradition of Historical Poetics (Alexander Veselovsky, Viktor Zhirmunsky, Mikhail Bakhtin, Russian Formalism) and within a certain strain of Western Marxism (Georg Lukács, Walter Benjamin, Fredric Jameson). The discussion is in part descriptive and in part programmatic: a reconstruction that does not pretend to do full justice to any one of these thinkers independently but strives to outline a field, the various inflections of which produce complementary perspectives and points of emphasis. The focus is on the central problematic of the paradigm: an attempt to construct a universal history of literary forms in their relation to the social conditions — and modes — of their production on the basis of a certain understanding of the past's vitality and mobility in the present.
A support worker's guide to models of living and nursing
Authors: Stonehouse David
Published: September 2017

As a follow-up to the author's recent thoughts on ‘understanding the nursing process’ ( Stonehouse, 2017 ), this article examines the two complementary models of Roper, Logan and Tierney (1980) : their model of living and model of nursing. The different components which make up the two models will be explored and related to clinical practice.

It is important for support workers to understand both models and how they are being used within their clinical environment. Through support workers examining different models will assist in achieving section 6 of The Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England ( Skills for Care and Skills for Health, 2013 ), which urges employees to ‘strive to improve the quality of healthcare, care and support through continuing professional development’.