bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective Analysis of the Risk Factors for Grade IV Neutropenia in Oesophageal Cancer Patients Treated with a Docetaxel, Cisplatin, and 5-Fluorouracil Regimen
Authors: Naito Masahito , Yamamoto Tomoya , Shimamoto Chikao , Miwa Yoshihiro
Published: April 2017

Background: Previous Japanese trials of the docetaxel, cisplatin, and 5-fluorouracil regimen for oesophageal cancer have demonstrated that a large proportion of patients also develop grade IV neutropenia. Our aim was to examine the risk factors for neutropenia in patients treated with this regimen. Methods: We retrospectively analysed the risk factors for developing grade IV neutropenia in 66 patients with oesophageal cancer using a multivariate analysis. Results: After administering the docetaxel, cisplatin, and 5-fluorouracil regimen, 49 patients (74.2%) developed grade IV neutropenia. Grade IV neutropenia was significantly associated with platelet count (p < 0.01), alanine transaminase level (p = 0.05), and proton-pump inhibitor administration (p < 0.05). Receiver operating characteristic curve analysis confirmed a platelet count of 290 × 103/μL as the optimal diagnostic cut-off value for grade IV neutropenia. The receiver operating characteristic area for grade IV neutropenia was increased by including patients that were administered a proton-pump inhibitor and alanine transaminase level (updated model; sensitivity and specificity, 75.5 and 88.2%, respectively). Conclusions: Our findings suggest that a platelet count is the most significant predictor of grade IV neutropenia.
Hearing Loss and Risk of Mild Cognitive Impairment and Dementia: Findings from the Singapore Longitudinal Ageing Study
Authors: Heywood Rebecca , Gao Qi , Nyunt Ma Shwe Zin , Feng Lei , Chong Mei Sian , Lim Wee Shiong , Yap Philip , Lee Tih-Shih , Yap Keng Bee , Wee Shiou Liang , Ng Tze Pin
Published: April 2017

Aim: To investigate the associations between hearing loss and prevalent and incident mild cognitive impairment (MCI), dementia and MCI or dementia (all cases). Methods: Cross-sectional and longitudinal analyses of baseline and follow-up data were performed in a population-based cohort. The baseline sample of 2,599 adults aged ≥55 included 1,515 cognitively normal subjects who were followed up to 8 years. Hearing loss at baseline was determined by the whispered voice test, and MCI and dementia by Mini-Mental State Examination screening, Clinical Dementia Rating scale, neurocognitive tests, MRI, and panel consensus diagnosis. Results: Hearing impairment was associated with increased prevalence of dementia (odds ratio = 3.63, 95% confidence interval [CI] 1.16-11.4, p = 0.027) but not MCI alone or all cases of MCI or dementia, adjusted for sex, age, ethnicity, education, central obesity, hypertension, diabetes, dyslipidemia, smoking, alcohol, leisure time activity, cardiac diseases, and depressive symptoms. Among participants who were cognitively normal at baseline, those with hearing impairment were more likely to develop MCI or dementia (hazard ratio [HR] = 2.30, 95% CI 1.08-4.92, p = 0.032). Hearing loss was associated with elevated but statistically nonsignificant estimates of adjusted HR (1.85, 95% CI 0.78-4.40) for incident MCI alone. Conclusions: Hearing loss is independently associated with prevalent dementia and incident MCI or dementia.
Topical Histamine Stimulates Repigmentation of Nonsegmental Vitiligo by a Receptor-Dependent Mechanism
Authors: Liu Jun , Xu Yan , Lin Tzu-Kai , Lv Chengzhi , Elias Peter M. , Man Mao-Qiang
Published: April 2017

Background: Though vitiligo is a common depigmentary disorder, it still represents a substantial therapeutic challenge. Therapeutic options are limited in part due to its uncertain etiology. Objective: Because recent studies suggest that histamine stimulates melanogenesis in vitro, we determined here whether topical histamine stimulates repigmentation in patients with stable, nonsegmental vitiligo. Methods: A total of 23 otherwise normal volunteers with vitiligo, including 14 males and 9 females aged 6-59 years (mean age 29.2 ± 2.8), were enrolled in this study. 1% histamine in distilled water was applied to the lesions twice daily for 5 weeks, while comparable lesions, treated with distilled water alone, served as the controls. The melanin index was measured on the uninvolved and lesional skin sites before and after 5 weeks of treatments using the melanin/erythema probe connected to a Courage-Khazaka MPA5 (Cologne, Germany). Changes in epidermal permeability barrier were also assessed at the same time point. To determine whether histamine-induced repigmentation is receptor-dependent, both ears of C57BL/6J mice were treated topically with 5% cimetidine, a histamine type 2 receptor (H2r) antagonist, twice daily for 10 days. One hour after each cimetidine application, the right ear was treated topically with 10% histamine, while vehicle alone was applied to the left ear. Changes in melanin index were measured 24 h after the last application of histamine and vehicle as described in the human study. Results: In patients with vitiligo treated with vehicle alone for 5 weeks, the melanin index remained unchanged, while topical histamine treatment increased the melanin index by 38% (p < 0.001 vs. both vehicle and pretreatment), which was paralleled by a >60% reduction in lesion surface area. Moreover, topical histamine accelerated permeability barrier recovery. No adverse events were observed following histamine applications. In mice, topical histamine significantly increased the melanin index, while topical co-applications of the H2r antagonist (cimetidine) prevented the expected histamine-induced increase in melanin index. Conclusions: These studies indicate that topical histamine or an H2r agonist could be useful for treating nonsegmental vitiligo, but further clinical studies in large populations will be required to validate the efficacy and safety of this approach.
Extended Small-Dose Platelet Transfusions in Multitransfused Hemato-Oncological Patients: A Single-Center Experience
Authors: Gurevich-Shapiro Anna , Tzadok Sharon , Rosenberg Alina , Inbal Aida , Bar-Natan Michal , Wolach Ofir , Raanani Pia
Published: April 2017

Background: Refractoriness to platelet transfusion, prevalent among 15-20% of hemato-oncological patients, is associated with multitransfusions and inferior outcomes. We evaluated the effectiveness of extended slow-dose transfusion (ESDT) in increasing platelet increments in multitransfused patients. Methods: Patients treated after the implementation of ESDT were compared with historical controls treated with standard single-donor platelet (SDP) transfusions. Cohorts of early and late recipients were assembled for comparison, i.e. the 8th or 9th and 11th platelet unit per patient, respectively. Patients in the ESDT group received transfusions equal to half an SDP unit, administered over 4 h. Effectiveness was defined as a higher corrected count increment (CCI) at 1, 12, and 24 h after transfusion. Results: In the early-recipients cohort, 24-h-posttransfusion increments were available for 29 ESDT patients and 6 standard patients, and did not differ significantly between the groups (p = 0.078). The 24-h-posttransfusion increment was available for 20 ESDT patients and 7 standard patients in the late-recipients cohort. The CCI was significantly higher in the ESDT group (p = 0.042). ABO compatibility improved the CCI (p = 0.01). Conclusions: ESDT demonstrated slightly higher increments at 24 h after transfusion in late recipients, suggesting this could be a cost-effective approach for the treatment of thrombocytopenic multitransfused hemato-oncological patients.
Polydimethyl Siloxane as an Internal Tamponade for Vitreoretinal Surgery
Authors: Hussain Rumana N. , Myneni Jayavani , Stappler Theodor , Wong David
Published: April 2017

Purpose: To report the efficacy and safety of polydimethyl siloxane (Siluron Xtra®) as an internal tamponade. Design: Audit and adverse event screening of procedures (March 2014-2015). Methods: Patients who had undergone vitreoretinal procedures with Siluron Xtra® tamponade were retrospectively analysed with respect to anatomical outcome, visual outcomes, and perioperative complications, in particular intraocular pressure. Inclusion Criteria: all patients who had undergone Siluron Xtra® tamponade. Exclusion Criteria: No cases were excluded; however, there were no paediatric or pregnant patients within this cohort. All vitreoretinal cases were included, including retinal detachments, but also trauma, endophthalmitis, and intraocular foreign bodies. Results: Twenty-eight patients had polydimethyl siloxane as an intraocular tamponade; 24 retinal detachments (83% complicated by proliferative vitreoretinopathy ≥grade C), 12 had previous failed surgery, and 4 had procedures for intraocular lymphoma, endophthalmitis, or trauma. Follow-up was 14-20 months, and mean duration of tamponade was 6.8 months (3-12 months). Anatomical success was 79% after polydimethyl siloxane injection, 58% 3 months following removal (14/24), 5 remain with long-term tamponade, and 5 with redetachment under tamponade required further intervention. Five required topical anti-glaucomatous agents, and 1 following trauma required glaucoma surgery. Cataract developed in 3/6 phakic patients, and visible emulsification occurred in a single patient. Conclusion: Polydimethyl siloxane seems to be an acceptable alternative tamponade agent for the management of complex retinal detachments with comparable anatomical success and comparable rates of raised intraocular pressure to other low-viscosity silicone oil agents, but more importantly, with a lower rate of emulsified oil-related complications, which is important particularly for cases requiring long-term tamponade.
Thiazide-Associated Hyponatremia, Report of the Hyponatremia Registry: An Observational Multicenter International Study
Authors: Burst Volker , Grundmann Franziska , Kubacki Torsten , Greenberg Arthur , Becker Ingrid , Rudolf Despina , Verbalis Joseph
Published: April 2017

Background: Hyponatremia is a frequent and potentially life-threatening adverse side effect of thiazide diuretics. This sub-analysis of the Hyponatremia Registry database focuses on current management practices of thiazide-associated hyponatremia (TAH) and compares differences between TAH and syndrome of inappropriate antidiuretic hormone secretion (SIADH). Methods: We analyzed 477 patients from 225 US and EU sites with euvolemic hyponatremia ([Na+] ≤130 mEq/L) who were receiving a thiazide diuretic. Of these, 118 met criteria for true thiazide-induced hyponatremia (TIH). Results: Thiazide was withdrawn immediately after hyponatremia was diagnosed only in 57% of TAH; in these patients, the median rate of [Na+] change (Δdaily[Na+]) was significantly higher than those with continued thiazide treatment (3.8 [interquartile range: 4.0] vs. 1.7 [3.8] mEq/L/day). The most frequently employed therapies were isotonic saline (29.6%), fluid restriction (19.9%), the combination of these two (8.2%), and hypertonic saline (5.2%). Hypertonic saline produced the greatest Δdaily[Na+] (8.0[6.4] mEq/L/day) followed by a combination of fluid restriction and normal saline (4.5 [3.8] mEq/L/day) and normal saline alone (3.6 [3.5] mEq/L/day). Fluid restriction was markedly less effective (2.7 [2.7] mEq/L/day). Overly rapid correction of hyponatremia occurred in 3.1% overall, but in up to 21.4% given hypertonic saline. Although there are highly significant differences in the biochemical profiles between TIH and SIADH, no predictive diagnostic test could be derived. Conclusions: Despite its high incidence and potential risks, the management of TAH is often poor. Immediate withdrawal of the thiazide is crucial for treatment success. Hypertonic saline is most effective in correcting hyponatremia but associated with a high rate of overly rapid correction. We could not establish a diagnostic laboratory-based test to differentiate TIH from SIADH.
Treatment Deintensification Is Uncommon in Adults With Type 2 Diabetes Mellitus
Authors: McAlister Finlay A. , Youngson Erik , Eurich Dean T.
Published: April 2017

Background—

Whether treatment deintensification in Americans with diabetes mellitus varies by glycemic control, health status, and calendar year (before/after February 2008 when safety concerns about intensive glucose control were reported in the ACCORD trial [Action to Control Cardiovascular Risk in Diabetes]) is unclear.

Methods and Results—

We defined deintensification as discontinuation or dosage decrease of at least 1 glycemic medication without addition of, or uptitration of, another agent in the 120 days after the index glycosylated hemoglobin (HbA1C) measurement. Of 99 694 individuals (mean age 54 years) in this retrospective cohort study being actively treated for new diabetes mellitus (50% 1 drug, 33% 2 drugs, and 17% ≥3 drugs), 12 921 (13.0%) had HbA1C <6% after 1 year, 19 670 (19.7%) had HbA1C 6.0% to 6.4%, 35 012 (35.1%) had HbA1C 6.5% to 7.5%, and 32 091 (32.2%) had HbA1C >7.5%. Glycemic therapy was deintensified in 18.3% of patients (21.2% of frail patients, 19.4% of those with multiple comorbidities, and 17.7% of otherwise healthy patients) with no gradient across glycemia levels (20.6% of those with HbA1C<6%, 17.3% of those with HbA1C 6.0%–6.4%, 17.7% of those with HbA1C 6.5%–7.5%, and 18.6% of those with HbA1C>7.5%). Similar proportions were seen even after exclusion of 26 985 patients being treated with metformin monotherapy: 23.3%, 20.4%, 20.3%, and 20% across the HbA1C strata. Therapy was deintensified in 22.5% of patients with index HbA1C <6.0% before February 2008 compared with 19.5% after (
P
<0.001).

Conclusions—

Among frail patients or those with multiple comorbidities, over three quarters with low HbA1C did not have their glycemic therapy deintensified, even after safety concerns were raised in the ACCORD trial.
Physiological and Pathological Roles in Human Adrenal of the Glomeruli-Defining Matrix Protein NPNT (Nephronectin)
Authors: Teo Ada Ee Der , Garg Sumedha , Johnson Timothy Isaac , Zhao Wanfeng , Zhou Junhua , Gomez-Sanchez Celso Enrique , Gurnell Mark , Brown Morris Jonathan
Published: April 2017

Primary aldosteronism is a common cause of hypertension, which becomes refractory if undiagnosed, but potentially curable when caused by an aldosterone-producing adenoma (APA). The discovery of somatic mutations and differences in clinical presentations led to recognition of small but common zona glomerulosa (ZG)–like adenomas, distinct from classical large zona fasciculata–like adenomas. The inverse correlation between APA size and aldosterone synthase expression prompted us to undertake a systematic study of genotype–phenotype relationships. After a microarray comparing tumor subtypes, in which
NPNT
(
nephronectin
) was the most highly (>12-fold) upregulated gene in ZG-like APAs, we aimed to determine its role in physiological and pathological aldosterone production. NPNT was identified by immunohistochemistry as a secreted matrix protein expressed exclusively around aldosterone-producing glomeruli in normal adrenal ZG and in aldosterone-dense ZG-like APAs; the highest expression was in ZG-like APAs with gain-of-function
CTNNB1
mutations, whose removal cured hypertension in our patients. NPNT was absent from normal zona fasciculata, zona fasciculata–like APAs, and ZG adjacent to an APA. NPNT production was regulated by canonical Wnt pathway, and
NPNT
overexpression or silencing increased or reduced aldosterone, respectively. NPNT was proadhesive in primary adrenal and APA cells but antiadhesive and antiapoptotic in immortalized adrenocortical cells. The discovery of
NPNT
in the adrenal helped recognition of a common subtype of APAs and a pathway by which Wnt regulates aldosterone production. We propose that this arises through NPNT’s binding to cell-surface integrins, stimulating cell–cell contact within glomeruli, which define ZG. Therefore, NPNT or its cognate integrin could present a novel therapeutic target.
The Case of a Rudderfish Highlights the Role of Natural History Museums as Sentinels of Bio-invasions
Authors: BRUTTO SABRINA LO
Published: April 2017

In September 2013 fishermen captured a rudderfish—Kyphosus vaigiensis—off Favignana Island, one of the islands of the Egadi Islands Marine Protected Area (MPA) in western Sicily (Mannino et al., 2015). This species is rarely sampled in the Mediterranean Sea.
First record of blackfin pearlfish Austrolebias nigripinnis (Regan, 1912 (Cyprinodontiformes, Cynolebiidae) from Brazil
Authors: VOLCAN MATHEUS VIEIRA , GONÇALVES ÂNDRIO CARDOZO , LANÉS LUIS ESTEBAN KRAUSE
Published: April 2017

Austrolebias Costa is a genus of annual fish inhabiting temporary wetlands in the Chaco-Pampasic region of southern Brazil, Uruguay, Paraguay, Bolivia and Argentina (Costa, 2006, Nielsen & Pillet, 2015, Alonso et al., 2016). Currently, about 45 species of Austrolebias are known (Costa, 2006, Volcan et al., 2014, Nielsen & Pillet, 2015), and of these, 24 occur in Rio Grande do Sul, the southernmost state of Brazil, distributed across the Rio Uruguay basin and the Patos-Mirim lagoon system and adjacent coastal areas (Volcan et al., 2015).
An Analytical Model of Iceberg Drift
Authors: Wagner Till J. W. , Dell Rebecca W. , Eisenman Ian
Published: April 2017

The fate of icebergs in the polar oceans plays an important role in Earth’s climate system, yet a detailed understanding of iceberg dynamics has remained elusive. Here, the central physical processes that determine iceberg motion are investigated. This is done through the development and analysis of an idealized model of iceberg drift. The model is forced with high-resolution surface velocity and temperature data from an observational state estimate. It retains much of the most salient physics, while remaining sufficiently simple to allow insight into the details of how icebergs drift. An analytical solution of the model is derived, which highlights how iceberg drift patterns depend on iceberg size, ocean current velocity, and wind velocity. A long-standing rule of thumb for Arctic icebergs estimates their drift velocity to be 2% of the wind velocity relative to the ocean current. Here, this relationship is derived from first principles, and it is shown that the relationship holds in the limit of small icebergs or strong winds, which applies for typical Arctic icebergs. For the opposite limit of large icebergs (length > 12 km) or weak winds, which applies for typical Antarctic tabular icebergs, it is shown that this relationship is not applicable and icebergs move with the ocean current, unaffected by the wind. The latter regime is confirmed through comparisons with observed iceberg trajectories near the Antarctic Peninsula.
Unconscious Fantasy and The Priming Phenomenon
Authors: Erreich Anne
Published: April 2017

This paper is the third in a series of investigations into (1) the nature and development of unconscious fantasy, (2) its place in a contemporary model of mind that, parenthetically, suggests a possible solution to the problem of theoretical pluralism, and (3) its mode of operation in the mind. The aim of these investigations is to update the notion of unconscious fantasy, an indispensable construct in psychoanalytic theories that assume out-of-awareness mentation, and to situate that construct within contemporary views of mental functioning in disciplines such as philosophy of mind, cognitive science, and developmental psychology. At the same time, data accessible only through psychoanalytic work challenge these fields with findings that indicate the need for further investigation. This paper argues that experimental evidence on the phenomenon of “priming” lends support to one of the seminal claims in our field, one frequently attacked as an outmoded shibboleth: that is, that the past matters, whether encoded in declarative or in procedural memory. In common parlance, we are “primed” to respond to some situations in predetermined ways; the past primes us to experience the present in often unique and personal ways. There is evidence too that the priming mechanism and the encoding of subjective experience in declarative and procedural memory operate from very early in life.
The myth of the secular–Islamist divide in Muslim politics: Evidence from Tunisia
Authors: Gorman Brandon
Published: April 2017

Many scholars argue that politics in majority-Muslim societies are marked by deep polarization: dominated by struggles between secularists and Islamists who hold fundamentally divergent ideological positions. Yet, this finding is likely a result of scholarly focus on Islamist organizations and political parties rather than their constituencies. Using Tunisia as a case study, this article investigates attitudinal polarization between secularists and Islamists at the individual level using a mixed-method design combining statistical analyses of survey data with content analyses of in-depth interviews. Statistical results indicate that Islamists are no different from non-Islamists in attitudes about excommunication ( takfir), popular sovereignty, women’s rights, or minority rights, though they are more skeptical of democracy and express less religious tolerance. Interview results show that many political procedures advocated by Islamists resemble the secular procedures they seek to replace and, though secularists tend to have negative views of Islamists, many express support for Islamist ideological positions. Taken together, these findings provide little evidence of attitudinal polarization along the so-called secular–Islamist divide.
Saved from hegemonic masculinity? Charismatic Christianity and men’s responsibilization in South Africa
Authors: Burchardt Marian
Published: April 2017

In this article, the author explores the role of religion in social constructions of heterosexual masculinity in South Africa in the context of civil society driven programs to fight sexual and gender-based violence and the spread of HIV. Critically engaging with the concept of hegemonic masculinity and the sociological literature on gender relations in conservative Christian communities, the author examines how Charismatic Christian and Pentecostal communities in the townships of Cape Town negotiate their model of masculinity and gender authority in the context of the prevailing hegemonies of ‘traditional’ and ‘liberal’ masculinity. Based on ethnographic observations and qualitative interviews with Pentecostal men, the author specifies the concrete mechanisms whereby Pentecostalism both contributes to transform but also to reproduce rather than undermine hegemonic masculinity. He finds that Pentecostalism responsibilizes men not because men adopt its sexual ideology but because they adopt its model of personhood.
Multicultural Teaching in Flemish Secondary Schools: The Role of Ethnic School Composition, Track, and Teachers’ Ethnic Prejudice
Authors: Vervaet Roselien , Van Houtte Mieke , Stevens Peter A. J.
Published: April 2017

In this study, we investigate the association between a school’s ethnic composition, the track in which teachers teach, and their level of involvement with multicultural teaching (MCT) in the Flemish context, taking into account the ethnic prejudice of teachers. Multilevel analyses of data from 590 Flemish teachers in 40 Belgian secondary schools suggest that teachers in schools with more ethnic minority pupils, teachers in vocational education, and ethnically unprejudiced teachers implement more MCT. These findings highlight the need for more research into the relationship between school features, the sociopsychological characteristics of teachers, and their involvement with MCT.
The Relationship Between the “Invisibility” of African American Women in the American Civil Rights Movement of the 1950s and 1960s and Their Portrayal in Modern Film
Authors: Lott Martha
Published: April 2017

This research argues that the representation of African American women in modern civil rights film is a result of the “invisibility” that they faced during the civil rights movement in America during the 1950s and 1960s. To make its argument, this article contends that the media’s scant but negative coverage of women activists along with male leaders, such as Malcolm X’s attitude toward African American women during the period of the movement, is the reason why ultimately African American women activists received lack of recognition for their involvement in the movement. This work also argues that the lack of recognition for these women is evident in modern civil rights film and they negatively portray African American women’s role during the movement. This is shown by examining two films— Selma and The Help. This work also debates whether using film as a historical source is correct. This work touches upon the ongoing stereotypical role of “Mammy” in films such as The Help and argues that overall, by studying various arguments, and as historian Peniel Joseph believes, that many prestigious movies take dramatic license with historical events, arguing that films are not scholarly books and people should not learn about historical events through films.
Black Power in Philadelphia: Selective Patronage and the Effectiveness of Direct Action Protest
Authors: Gammage Justin
Published: April 2017

Black Power during the 1960s is a shift in direct action protest with its aim at procuring power (economic, political, educational, etc.). The manifestation of Black Power in Philadelphia in the late 1960s provides us an elaborate model of direct action protest that included central components of the African American community. Moreover, the selective patronage movement successfully maintained organization and momentum without the prototypical one leader model that was prominent in the civil rights movement that preceded it. Much like the Black Lives Matter movement, the selective patronage movement in Philadelphia drew on the national outcry for racial justice but largely built the core of its strength on local networks. This article explores the history of the selective patronage movement in Philadelphia during the early 1960s. Next, it assesses the strengths and weakness of the movement. Lastly, it provides recommendations for future movements aimed at economic development.
Probabilistic first ply failure prediction of composite laminates using a multi-scale M-SaF and Bayesian inference approach
Authors: Mustafa Ghulam , Suleman Afzal , Crawford Curran
Published: April 2017

This paper presents a probabilistic first ply failure analysis of composite laminates using a high-fidelity multi-scale approach called M-SaF (Micromechanics-based approach for Static Failure). To this end, square and hexagonal representative unit cells of composites are developed to calculate constituent stresses with the help of a bridging matrix between macro and micro stresses referred to as the stress amplification factor matrix. Separate failure criteria are applied to each of the constituents (fiber, matrix, and interface) in order to calculate the damage state. The successful implementation of M-SaF requires strength properties of the constituents which are the most difficult and expensive to characterize experimentally, limiting the use of M-SaF in the early design stages of a structure. This obstacle is overcome by integrating a Bayesian inference approach with M-SaF. An academic sample problem of a cantilever beam is used to first demonstrate the calibration procedure. Bayesian inference calibrates the M-SaF first ply failure model parameters as posterior distributions from the prior probability density functions drawn from lamina test data. The posterior statistics were then used to calculate probabilistic first ply failure for a range of different laminates.
Making automobiles in Yugoslavia: Fiat technology in the Crvena Zastava Factory, 1954–1962
Authors: Miljković Marko
Published: April 2017

The license agreement between the Italian Fiat and the Yugoslav Crvena Zastava, signed in 1954, was the first commercial arrangement and enterprise between a Western corporation and a socialist country in the post-war era. The Yugoslav side expected the establishment of the modern automobile industry to have a spin-off effect, helping to modernise the entire industrial sector. However, this ambitious plan failed to materialise, leaving the country with Western-type automobiles, which often fell below even East European quality standards. As it was linked to almost the entire industrial sector, the underperformance of the Yugoslav automobile industry can be understood as both a reason for and indication of a dangerously overstretched political and economic system. In particular, the ‘ethnic key’ policy and so-called workers’ self-management were bottlenecks in reaching successful outcomes, only further fuelling Yugoslav contradictions instead of helping to modernise the Yugoslav economy.
‘What it means to be truly human’: The postsecular hack of mindfulness
Authors: Arat Alp
Published: April 2017

The present ubiquity of meditation represents the latest ripple in the easternisation of the West. The mindfulness movement in particular has emerged as a popular expression of this contemplative turn. The vast majority of scholarly work on this subject rests on the assumption that mindfulness represents the culmination of the traditional trajectory of secularisation. Drawing on a discourse-analytic study of how contemporary mindfulness is constructed and made meaningful however, this article argues that these developments point towards a new modality of the secular. While the surface language of mindfulness operates in complete discursive isolation from the religious, its ontological foundation is nevertheless found to rest on a claim towards a transcendent whole. In the final analysis, this post secular hack of mindfulness signals a sacralisation of the secular with significant implications for the sociology of religion.
Research on the character and degumming process of different parts of ramie fiber
Authors: Cui Yi , Jia Manlan , Liu Liu , Zhang Ruiyun , Cheng Longdi , Yu Jianyong
Published: April 2017

The aim of this paper is to study the differences of the aggregation structure, physical properties and chemical composition of different parts of ramie fiber, as well as segmented degumming processes applying to those different parts. The ramie was divided into three parts, namely the root, the middle and the head and then the traditional two-step alkali method was adopted for degumming. It has been observed that the linear density and breaking strength reduced gradually from the root to head and the friction coefficient of the head was the largest. X-ray diffraction measurement found that the crystallinity of the middle fiber was the highest. Fourier transform infrared spectroscopy revealed that the component content of different parts was not the same and there was much more gum content on the head, which was also confirmed by scanning electron microscopy. To shorten the degumming process and reduce the energy consumption that the two-step segmented degumming caused, the one-step optimization process was explored. The results illustrated that by using one-step optimization segmented degumming, the residual gum content of the head, the middle and the root were 2.55%, 2.17% and 2.12%, respectively. By using two-step degumming, the residual gum contents were 2.16%, 1.97% and 2.07%, respectively. Contrasting one-step degumming and two-step degumming, it could be concluded that the head and the middle parts were suitable for two-step degumming while the root part was suitable for one-step degumming.
Asymmetric Business Cycle Effects and Tourism Demand Cycles
Authors: Croes Robertico , Ridderstaat Jorge , Rivera Manuel
Published: April 2017

This study examines the relationship between business and tourism demand cycles in Aruba and Barbados during 1970–2015. The study uses a 2SLS method and is grounded in the output gap approach. The results indicate that business cycles explain nearly 49% of tourism demand flows to Aruba and nearly 91% to Barbados. Thus, the study sheds light on the nature of the relationship between business and tourism demand cycles, which could help managers and policy makers refine their strategies to further tourism development. Procyclical and asymmetric movements characterized the long-term co-movements between the business cycles and tourism demand variables. However, individual variables were stationary, hence transitory in nature, and therefore mainly driven by demand motivations. The asymmetric fluctuations were defined by positive and negative gaps, with the former displaying stronger duration effects compared to the latter. The relationship between the two variables seems country specific in nature.
Does Social Support Buffer the Association Between Stress Eating and Weight Gain During the Transition to College? Differences by Gender
Authors: Darling Katherine E. , Fahrenkamp Amy J. , Wilson Shana M. , Karazsia Bryan T. , Sato Amy F.
Published: April 2017

This study sought to examine whether social support moderates the relationship between stress eating and body mass index (BMI) change over the freshman year in males and females. This longitudinal study included 70 college students (72.9% female; M age = 18.23) who completed self-reported measures of stress eating and perceived social support, with objective height and weight measurements collected. Among males, social support moderated the relationship between stress eating and BMI change. Among males, social support may serve as a buffer against the impact of stress eating on weight gain during the freshman year of college.
Federal Strategies to Induce Resistant States to Participate in the ACA Health Exchanges
Authors: Noh Shihyun
Published: April 2017

Initial state implementation of the Affordable Care Act health exchanges was marked by political polarization. More than half of the states initially chose not to create their own health exchanges, leading the federal government to adopt a new strategy: dividing the implementation of health exchanges into a series of smaller tasks. States could choose which of four core functions of the exchanges they would implement, with the federal government handling the remaining functions. This strategy induced some resistant states to administer some core functions. Why did some states take part in the exchanges while others did not? Ordered logistic regression analyses provide evidence that both state political context and other factors affected this decision. The analyses also suggest that state officials considered state workforce capacity and financial inducements from the federal government and that they were influenced by divided government.
Can Intracapsular Tonsillectomy Be an Alternative to Classical Tonsillectomy? A Meta‐analysis
Authors: Kim Jong Seung , Kwon Sam Hyun , Lee Eun Jung , Yoon Yong Joo
Published: April 2017

Objective

Tonsillectomy is the most common operation performed in the otolaryngologic fields. Efforts have been made to reduce postoperative complications, and one of these is intracapsular tonsillectomy and adenoidectomy (ICTA), which leaves the tonsillar tissue with tonsillar capsule. This study aimed to evaluate intracapsular tonsillectomy compared with classical extracapsular tonsillectomy in terms of efficacy of the technique for managing obstructive sleep apnea (OSA) and reducing postoperative complications.

Data Sources

We performed a literature search using PubMed, EMBASE, and the Cochrane Library through December 2016.

Review Methods

Summarized risk ratio (RR), risk differences (RDs), and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated by summarizing the risk estimates of each study using random‐effects models that considered both within‐ and between‐study variations.

Results

Our search included 15 randomized controlled studies. The RRs for postoperative bleeding and residual tonsils were, respectively, 0.44 (P =. 01) and 6.02 (P =. 0002). There were significant differences in postoperative pain (P =. 0022), need for analgesics (P <. 0001), days to normal diet (P =. 006), and days to normal activity (P <. 00001) between intracapsular tonsillectomy and extracapsular tonsillectomy.

Conclusions

Intracapsular tonsillectomy can effectively reduce postoperative pain and bleeding, which shortens the time required to return to normal life. There was no difference between microdebrider and coblator in intracapsular tonsillectomy regarding postoperative pain and bleeding. It can increase the risk of remnant tonsils; however, it does not increase the risk of recurrent infection.
The Use of Noninvasive Positive Pressure Ventilation following Pediatric Tonsillectomy
Authors: Buzi Adva , Coblens Orly M. , MacGillivray Michael , Elden Lisa
Published: April 2017

Objective

To determine the risks of bleeding and other complications in pediatric patients who require noninvasive positive pressure ventilation (PPV) in the immediate posttonsillectomy period.

Study Design

Case series with chart review.

Setting

Single tertiary pediatric hospital.

Subjects and Methods

Sixty‐nine patients who had undergone tonsillectomy from July 2007 through December 2013 and required postoperative PPV were reviewed. Data collected included age, sex, medical history, preoperative polysomnogram parameters, length of use and type of noninvasive ventilatory support, and postoperative complications. Bleeding rate was calculated.

Results

Sixty‐nine children met inclusion criteria for the study. Most had comorbid conditions. The mean age of these patients was 6.4 years. The postoperative bleeding rate of children who required operative intervention for control was 5.97%. Patients did not experience other complications.

Conclusion

This is the largest study in the literature investigating bleeding in pediatric patients undergoing tonsillectomy who required postoperative noninvasive PPV. Some hesitation may exist in using this form of ventilation when open pharyngeal wounds are exposed to pressure, but this study suggests that it can be used as a suitable alternative to invasive ventilation.
USMLE and Otolaryngology: Predicting Board Performance
Authors: Puscas Liana , Chang C. W. David , Lee Hui‐Jie , Diaz Rodney , Miller Robert
Published: April 2017

Objective

To ascertain what relationship exists between the United States Medical Licensing Examination (USMLE) and the American Board of Otolaryngology Written Qualifying Examination (WQE).

Study Design

Retrospective, longitudinal study.

Setting

De‐identified database.

Subjects

Residents entering otolaryngology–head and neck surgery (OHNS) residency between 2007 and 2009 and taking the WQE for the first time between 2012 and 2014.

Methods

Regression models were used to determine if the USMLE score predicts passage of the WQE on the first attempt, which step score was a better predictor, and whether an increase in the Step 2 score increased the chances of WQE passage.

Results

There were 611 Step 1 and 402 Step 2 scores. Mean (SD) Step 1 score was 238 (14.4), and the mean (SD) Step 2 score was 243 (16.8). The overall WQE first‐time passage rate was 95.3%. Step 1 score was a better predictor than Step 2 for successful passage of the WQE on the first attempt (P =. 0026). An increase in the Step 2 score compared with the Step 1 score did not predict an improved first‐time passage rate on the WQE.

Conclusions

There is an association between USMLE scores and successful first‐time passage of the WQE, with Step 1 being a stronger predictor than Step 2. Residents with USMLE scores lower than the average successful OHNS applicant still have a high chance of passing the WQE. USMLE scores alone are of limited usefulness in identifying those applicants at risk of failing the WQE on the first attempt.
Clinician views of patient decisional conflict when deciding between dialysis and conservative management: Qualitative findings from the PAlliative Care in chronic Kidney diSease (PACKS) study
Authors: Noble Helen , Brazil Kevin , Burns Aine , Hallahan Sarah , Normand Charles , Roderick Paul , Thompson Colin , Maxwell Peter , Yaqoob Magdi
Published: April 2017

Background:

Only a paucity of studies have addressed clinician perspectives on patient decisional conflict, in making complex decisions between dialysis and conservative management (renal supportive and palliative care).

Aim:

To explore clinician views on decisional conflict in patients with end-stage kidney disease.

Design:

Interpretive, qualitative study.

Setting and participants:

As part of the wider National Institute for Health Research, PAlliative Care in chronic Kidney diSease study, semi-structured interviews were conducted with clinicians (nephrologists n = 12; 7 female and clinical nurse specialists n = 15; 15 female) across 10 renal centres in the United Kingdom. Interviews took place between April 2015 and October 2016 and a thematic analysis of the interview data was undertaken.

Results:

Three major themes with associated subthemes were identified. The first, ‘Frequent changing of mind regarding treatment options’, revealed how patients frequently altered their treatment decisions, some refusing to make a decision until deterioration occurred. The second theme, ‘Obligatory beneficence’, included clinicians helping patients to make informed decisions where outcomes were uncertain. In weighing up risks and benefits, and the impact on patients, clinicians sometimes withheld information they thought might cause concern. Finally, ‘Intricacy of the decision’ uncovered clinicians’ views on the momentous and brave decision to be made. They also acknowledged the risks associated with this complex decision in giving prognostic information which might be inaccurate.

Limitations:

Relies on interpretative description which uncovers constructed truths and does not include interviews with patients.

Conclusion:

Findings identify decisional conflict in patient decision-making and a tension between the prerequisite for shared decision-making and current clinical practice. Clinicians also face conflict when discussing treatment options due to uncertainty in equipoise between treatments and how much information should be shared. The findings are likely to resonate across countries outside the United Kingdom.
Low-dose systemic scopolamine disrupts context conditioning in rats
Authors: Luyten Laura , Nuyts Shauni , Beckers Tom
Published: April 2017

Cholinergic neurotransmission plays a key role in learning and memory. Prior research with rats indicated that a low dose of pre-training scopolamine (0.1 mg/kg), a cholinergic receptor antagonist, did not affect cued fear conditioning, but did block renewal when injected before extinguishing a conditioned tone, opening up opportunities to pharmacologically improve exposure therapy for anxiety patients. Before translating these findings to the clinic, it is important to carefully examine how scopolamine affects contextual fear memories. Here, we investigated the effects of scopolamine on encoding of contextual anxiety and its generalization in male Wistar rats. We found a profound disruption of context conditioning, suggesting that, even at a low dose, systemic scopolamine may influence contextual encoding in the hippocampus, particularly when the context is the best predictor for the presence of shocks.
Laparoscopic management of cholecystoenteric fistula: A single-center experience
Authors: Li Xiang-yang , Zhao Xin , Zheng Peng , Kao Xiao-Ming , Xiang Xiao-Song , Ji Wu
Published: April 2017

Aim

To report our experience regarding management of cholecystoenteric fistula (CEF) and identify the most effective diagnostic methods and surgical treatment.

Methods

In total, 10,588 patients underwent laparoscopic cholecystectomy for cholecystolithiasis from January 2000 to December 2014 at the Research Institute of General Surgery, Jinling Hospital (Nanjing, China). Twenty-nine patients were diagnosed with CEF preoperatively or intraoperatively. Data were retrospectively collected on demographics, preoperative diagnostics, intraoperative findings, laparoscopic procedures, complications, and follow-up.

Results

Twenty-nine patients (female/male ratio, 2.2; mean age, 68.7 years) with CEF were evaluated. Twenty-three (79.3%) patients had a cholecystoduodenal fistula (CDF), four (13.8%) had a cholecystocolonic fistula (CCF), one (3.4%) had a cholecystogastric fistula, and one (3.4%) had a CDF combined with a CCF. Only nine (31.0%) patients obtained a preoperative diagnosis. All patients initially underwent laparoscopic treatment, but five (17.2%) underwent conversion to open surgery; three of these five developed postoperative morbidity or mortality, and the other two had an uneventful postoperative course. Among patients managed successfully by laparoscopy, the hospital stay ranged from 3 to 6 days (mean, 4 days). All patients were asymptomatic at a mean follow-up of 13 months (range, 3–21 months).

Conclusion

Ultrasound and computed tomography can provide valuable diagnostic clues for CEF. Laparoscopic management of CEF in experienced hands is safe, feasible, and associated with rapid postoperative recovery.
Global scientific production in the field of knee arthroplasty: A cross-sectional survey of research activities
Authors: Wang Lu , Li Lingxia , Cheng Cai , Tian Hua , Li Yang , Zhao Minwei
Published: April 2017

Objective

To determine the quantity and quality of articles in the field of knee arthroplasty worldwide and elucidate the characteristics of global scientific production.

Methods

Web of Science was used to identify articles in the field of knee arthroplasty from 2011 to 2015. The total number of papers, number of papers per capita, total number of citations, and mean number of citations were collected.

Results

In total, 11,590 papers were identified. The number of publications significantly increased from 2011 to 2015. Most originated from North America, East Asia, and West Europe. Most (88.51%) were from high-income countries, 11.48% were from middle-income countries, and only 0.01% were from lower-income countries. The United States had the most articles and total citations. Sweden had the highest mean citations, followed by Denmark and Canada. However, when adjusted by population size, Denmark had the most articles per million population, followed by Switzerland and the Netherlands.

Conclusions

The number of knee arthroplasty publications has rapidly increased in recent years. The United States is the most prolific, but some European countries are more productive relative to their population.