bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual Function during Acute Hypoglycaemia
Authors: Tabandeh H. , Ranganath L. , Marks V.
Published: April 2018

Hypoglycaemia symptoms are of particular interest in view of the importance of hypoglycaemia unawareness. Visual symptoms arising during acute hypoglycaemia may be the result of metabolic disturbances in the visual pathways within the central nervous system or impairment of the refractive apparatus of the eye and binocular function. This study investigated the effect of hypoglycaemia upon visual acuity, binocular interaction and contrast sensitivity. Various aspects of visual function were examined in ten normal subjects before, during and after acute insulin-induced hypoglycaemia. A simultaneous study of hypoglycaemic symptoms enabled us to relate the objective findings to the symptoms as reported by the subjects. Snellen visual acuity, fusion and stereopsis were not affected by hypoglycaemia. Five subjects noted visual disturbance. Eight developed significant impairment of contrast sensitivity, which closely matched the lowered blood glucose concentration.

These observations suggest that hypoglycaemic visual symptoms are due to neuroglycopenia of central visual pathways rather than changes within the refractive apparatus or abnormality of binocular function. Although these symptoms are not a constant feature of the hypoglycaemic state, subtle impairment of visual function occurs in most cases. Contrast sensitivity testing can be useful for assessment of fine changes in visual function.
Proper Outcome Measurements regarding Glaucoma: The Inadequacy of using Intraocular Pressure Alone
Authors: Spaeth G.L.
Published: April 2018

Physicians typically assess glaucoma treatment in terms of the effect on intraocular pressure (IOP). However, it is inappropriate to use IOP as the sole outcome measure for the management of glaucoma for several reasons: a) it is a precursor of disease, but not the disease itself. b) Most often, it is not the only factor responsible for glaucomatous damage. c) It suggests, wrongly, that IOP should be maximally lowered in all glaucoma patients. d) We are beginning to be able to assess more accurately other signs, not just precursors, of glaucomatous damage itself, most importantly, optic disc damage and visual field loss. Even though these signs are far more valuable than IOP in assessing the outcome of treatment, they, too, nevertheless, are ultimately subordinate to the effect of treatment on the patient's quality of life.
The Early Results of Excimer Laser Photorefractive Keratectomy for Compound Myopic Astigmatism
Authors: Horgan S.E. , Pearson R.V.
Published: April 2018

An excimer laser (VISX Twenty/Twenty Excimer Refractive System) was used to treat 51 eyes for myopia and astigmatism. Uncorrected pretreatment visual acuity was between 6/18 and 6/60 (log unit +0.45 to +1.0) in 59% and worse than 6/60 in 29%. The mean pretreatment spherical refractive error was –4.05 dioptre (range 1.25 to 13.25), and the mean pretreatment cylindrical error was –0.97 dioptre (range 0.25 to 4.00).

Results

Uncorrected visual acuity measured 6/6 or better (log unit 0.0 or less) in 80% at three months, and averaged 6/6 for all eyes at six months post-treatment, with 75% eyes obtaining 6/6 or better. The mean post-treatment spherical error decayed according to pretreatment values, with a mean sphere of –0.20 dioptre for eyes initially less than –2.00 dioptre, –0.40 dioptre (for those between –2.25 and –3.00), –0.71 dioptre (for those between –4.25 and –5.00), and –1.15 dioptre for eyes initially above –6.25 dioptre. Vectored cylindrical correction exhibited response proportional to initial refraction, with a mean post-treatment cylinder of –1.83 dioptre for eyes formerly averaging –3.08 dioptre, –0.55 dioptre (eyes initially averaging –1.63 dioptre), and –0.51 dioptre (eyes initially averaging –0.67 dioptre). Vector analysis of post-treatment astigmatism showed 58% eyes exhibiting 51 or more degrees of axis shift, although 34% eyes remained within 20 degrees of their pretreatment axis.

Conclusions

An effective reduction in spherocylindrical error was achieved with all eyes, although axis misalignment was a common event.
Pupillary Dilation and Axial Length Measurement for Preoperative Assessment of Intraocular Lens Power
Authors: Sadiq S.A. , Mcelvanney A.M.
Published: April 2018

Cataract extraction is now routinely followed by insertion of an intraocular lens (IOL) which requires preoperative biometry to determine the most accurate implant power required. Biometry is generally performed just prior to surgery and may even require the patient to make a special hospital visit when day case surgery is contemplated. A prospective study was undertaken to determine the accuracy of axial length (AL) measurement through a dilated pupil. The AL of one eye of 64 patients admitted for cataract surgery was measured before and after dilation with a drop of tropicamide 1%. Our results show that there was no significant difference in the ALs before and after dilation (p=0.10), and neither was there a difference in the average range of measurements (p=0.70), with 78% of eyes having a difference of < ±0.3 mm between pre and post dilation ALs. We conclude that AL measurement performed on a dilated pupil can give an accurate result, and suggest that performing biometry on a dilated pupil following ocular assessment may be an efficient and time saving exercise.
Analysis of the Rhodopsin and Peripherin/Rds Gene in Two Families with Pattern Dystrophy of the Retinal Pigment Epithelium
Authors: Daniele S. , Restagno G. , Daniele C. , Nardacchione A. , Danese P. , Carbonara A.
Published: April 2018

Mutations of the peripherin/retinal degeneration slow (RDS) gene have been reported in autosomal dominant retinitis pigmentosa and variable forms of pattern dystrophy of the retinal pigment epithelium. We screened the rhodopsin and the peripherin/RDS gene in the members of two families who presented the clinical features of pattern dystrophy of the retinal pigment epithelium transmitted as an autosomal dominant trait. No migration patterns were detected in single strand conformation polymorphism or hydrolink gels. Both the rhodopsin and the peripherin/RDS gene were normal in one family. In the second, the proband had a normal rhodopsin gene and, although he passed a different haplotype to each of his affected daughters, there was no linkage with the peripherin/RDS gene. The origin of the retinal disturbance in our two pedigrees must therefore be sought, if indeed DNA is involved, elsewhere in the genome. Our findings provide additional evidence that pattern dystrophies of the retinal pigment epithelium may be pathogenically related in spite of different etiological origins. The genetic polymorphism can probably account for the wide range of phenotypes.
The Lactoferrin Tear Test in the Diagnosis of Sjögren's Syndrome
Authors: Da Dalt S. , Moncada A. , Priori R. , Valesini G. , Pivetti-Pezzi P.
Published: April 2018

Purpose.

To assess the sensitivity and specificity of the lactoferrin tear test (LTT) in the diagnosis of keratoconjunctivitis sicca due to Sjögren's syndrome (SS), comparing it with the other lacrimal tests and with immunological tests.

Methods.

25 patients suffering from SS (24 women and 1 man, median age 51.5 years, s.d. 16.3); control group: 20 patients with various kinds of conjunctivitis without dry eye. Tests in both groups: Schirmer I (ST), BUT, ferning test, lactoferrin immunoassay, fluorescein and Rose Bengal staining. Immunological tests: serum titers of anti-nuclear (ANA), anti-DNA, anti-ENA (SS-A, SS-B, RNP, FR) antibodies. In the patients with SS, labial salivary gland biopsy was also performed.

Results.

LTT had a specificity of 95% and a sensitivity of 72%, compared to 85% and 64% for the Schirmer I test. The ferning test has the highest sensitivity (92%), and none of the cases positive to BUT was negative to the ferning test. The combination of LTT and ferning test gave a value of 78% compared to 70% with ST. The correlations between positive LTT and positive ANA, SS-A and labial biopsy were respectively 83%, 67% and 80%, as against 67%, 50% and 65% for the Schirmer I test.

Conclusions.

In our study, LTT showed very high specificity, good sensitivity particularly when combined with qualitative tear tests, and a good correlation with the immunological and bioptic tests for SS. Since it is easy to perform, in our opinion LTT can be included in the diagnostic routine for keratoconunctivitis sicca in SS.
Congenital Glaucoma Associated with An Arginase Deficit: A Case Report
Authors: Saccà S.C. , Campagna P. , Ciurlo G.
Published: April 2018

Purpose.

Argininemia is a rare congenital disease caused by deficiency. We present here a case in which argininemia and buphthalmos are associated.

Case report.

This female patient, who died at eighteen, had intraocular pressure correlated with her blood levels of arginine. Hyperammoniemia causes a change in pH that could explain an increase in aqueous humor (from the ciliary body). Ammonium ions could also damage the matrix of the trabecular meshwork.

Conclusions.

The association of argininemia and buphthalmos have never been described. This might be because of the different expressions of the disease, or because nobody has ever looked for ocular hypertension in these patients unless they had subjective symptoms.
Automatic Speech Recognition in Vitreo-Retinal Surgery. A Project for a Prototypal Computer-Based Voice-Controlled Vitrectomy Machine
Authors: Rossi L. , Sacerdoti Dn. , Billi B. , Lesnoni G. , Orciuolo M. , Rossi T. , Sacerdoti Dv. , Bertollini L.
Published: April 2018

In the past half decade automatic speech recognition techniques, software and hardware technology have matured enough to support sophisticated medical applications. The project described aimed at introducing a computer-based, voice-controlled prototype system in a simulated vitreo-retinal surgery scenario. The aim was to provide the surgeon with a tool that could significantly improve the quality and ease of work and shorten the duration of intervention. The speech recognition system allows voice entry of simple commands to simulate surgical instrument control, including the infusion pump, vitreous cutter and diathermy. The project relies on a Markov-based, speaker-dependent, commercial isolated-word recognizer, and consists of a specific recognition vocabulary and application software, created and developed by the authors.

Results have been encouraging. The system performed well under the test conditions, proving robust, simple to use and accurate (over 97% average word recognition rate). On the basis of their experience, the authors believe that automatic speech recognition technology, though suffering from some limitations such as the need for training, speaker dependence and a relatively small vocabulary, and requiring extensive testing under operating conditions, merits further development and opens new perspectives for a possible new generation of surgical instruments.
Levels of Some Cytokines in Subretinal Fluid in Proliferative Vitreoretinopathy and Rhegmatogenous Retinal Detachment
Authors: Kenarova B. , Voinov L. , Apostolov C. , Vladimirova R. , Misheva A.
Published: April 2018

Purpose.

To determine the cytokine-mediated pathways of inflammation in the clinical course of proliferative vitreoretinopathy (PVR).

Methods.

Cytokines IL-2, IL-6, INF-γ were measured by enzyme-linked immunosorbent assays. Aspirates of subretinal fluid were obtained from 14 eyes with PVR and six with uncomplicated rhegmatogenous retinal detachments. Aspirates obtained via pars plana from ten cadaver vitreouses of normal eyes were used as controls.

Results.

Subretinal fluids from eyes with PVR, uncomplicated rhegmatogenous retinal detachment and cadaver vitreous contained low concentrations of IL-2, with inconsequential differences between groups. IL-6 and IFN-γ were twice as high in the subretinal fluid from eyes with rhetmatogenous retinal detachment as in cadaver vitreous. INF-γ was elevated up to six times in eyes with PVR compared to controls. Fibronectin was found in a larger proportion of eyes with PVR than with uncomplicated rhegmatogenous retinal detachment and cadaver vitreous from healthy persons.

Conclusions.

These are only preliminary investigations and are too few for statistical analysis. The results suggest that cytokine-mediated pathways of inflammation are involved in the pathogenesis of rhegmatogenous retinal detachment and in cellular interactions leading to the development of PVR.
The Role of Patient's Age in Regression of Holmium: Yag Thermokeratoplasty-Induced Correction of Hyperopia
Authors: Gezer A.
Published: April 2018

Purpose.

Hyperopic correction can be induced with holmium: YAG laser thermokeratoplasty, which changes corneal curvature by shrinking stromal collagen. The thermal effectiveness of pulsed Ho:YAG laser depends on the water content of the corneal stroma, which should be related to age. This study investigated the presumed effect of age on the stability of the results of Ho:YAG laser thermokeratoplasty.

Methods.

Ho:YAG laser thermokeratoplasty was done in 63 eyes of 45 patients for low to moderate hyperopic correction (up to 5 diopters). Patients were treated with one or two rings of 8 spots each, with an optical zone of 6 or 7 mm diameters respectively.

Results.

Regression of the therapeutic effect was evaluated on the basis of the difference between the attempted to achieved correction ratio on the first postoperative day and at the last visit. The regression ratio was 18% in the patients older than 20 years. Patients younger than 20 years showed a ratio of 48%. Achieved correction was +2.40 D in older patients and +2.05 in younger patients. These values are respectively 43% and 35% of the attempted corrections.

Conclusions.

It appears that age-dependent corneal factors do influence the effectiveness of thermal energy on stromal collagen.
The Significance of Serum Anti-Borrelia Antibodies in the Diagnostic Work-Up of Uveitis
Authors: Mikkilä H. , Seppälä I. , Leirisalo-Repo M. , Karma A.
Published: April 2018

Purpose.

To assess the utility of testing uveitis patients for anti-Borrelia antibodies in an area endemic for Lyme borreliosis.

Methods.

We examined 161 uveitis patients for serum antibodies to Borrelia burgdorferi by Lyme ELISA. Antibodies were determined in patients with uveitis of unknown etiology and non-selectively from patients with an established diagnosis.

Results.

Concentrations of antibodies to B. burgdorferi were elevated in 26 uveitis patients (16.1%), with elevated IgG in 11 of them (6.8%). In four of these patients Lyme borreliosis was a highly suggestive cause of uveitis because of a history of tick bites, systemic symptoms, response to antibiotic therapy, and/or a positive polymerase chain reaction result. Other causes of uveitis were ruled out. All these patients had vitritis.

Conclusions.

Non-selective testing of uveitis patients for Lyme antibodies is not reasonable even in endemic areas. We recommend using the Borrelia antibody test only in cases of uveitis of unknown cause, especially in patients with vitritis or other symptoms of Lyme borreliosis.
Variations in the Blood Flow of the Human Optic Nerve Head
Authors: Osuský R. , Schoetzau A. , Flammer J.
Published: April 2018

Blood flow in various tissues of the body shows spontaneous variations. The purpose of this study was to analyze variations over time in the blood flow of the optic nerve head. Blood flow was measured by the laser Doppler flowmeter (LDF) in 12 healthy volunteers, and analyzed by spectral Fourier analysis. The LDF technique allows continuous measurement of flow, volume, and velocity in the microcirculation of the optic nerve head. We found variations expressed in cycles per minute (c/min) at frequencies characteristic of vasomotion (<10 c/min) of breathing, and of cardiac pulsation. Oscillations at frequency <10 c/min predominated in volume in all subjects and in flow in all but one. Variations in velocity of 60-90 c/min were identified in 10 of the 12 volunters. Oscillations in the range of breathing frequency made the smallest contribution to changes in blood flow. Fluctuations in the frequency range of 5 c/min and lower were observed most frequently, and the majority of subjects showed fluctuations of several frequencies. Our results provide evidence that blood flow in the human optic nerve head presents some characteristics already known from the general physiology of the microcirculation.
Transscleral Suture Fixation and Anterior Chamber Intraocular Lenses Implanted after Removal of Posteriorly Dislocated Crystalline Lenses
Authors: Omulecki W. , Nawrocki J. , Sempinska-Szewczyk J. , Synder A.
Published: April 2018

The surgical technique is described for simultaneous removal of posteriorly dislocated crystalline lenses and implantation of anterior chamber (AC) or scleral fixation posterior chamber (PC) intraocular lenses (IOL) using pars plana vitrectomy. Twenty-two patients underwent this complex operation. Observation time ranged from 2 to 10 months (mean 5 months). Best-corrected post-operative visual acuity was 1.0 in half the patients in the AC group (n=12), and in 80% of the PC group (n=10). It was less than 0.5 in 25% of cases in the AC group whereas all PC patients had visual acuity 0.5 or better. In nine cases with pre-operative ocular hypertension, post-operative intraocular pressure became normal, although topical glaucoma therapy was necessary in three patients in the AC group and in one from the PC group. No severe complications were found. Removal of posteriorly dislocated crystalline lens using pars plana vitrectomy and limbal incision is a safe procedure. Simultaneous AC or transscleral PC lens implantation is a good alternative to contact lenses. Visual rehabilitation was good in both groups of patients, although post-operative visual acuity was better after PC transscleral fixation than after AC surgery.
Slime Production by Coagulase-Negative Staphylococci Isolated in Chronic Blepharitis
Authors: Oto S. , Aydin P. , Çiftçioğlu N. , Dursun D.
Published: April 2018

Background

The purpose of the study was to determine the impact of slime-producing strains of coagulase-negative staphylococci (CNS) on non-ulcerative blepharitis. Formerly considered harmless organisms, CNS are now recognised as opportunistic pathogens. Although these microorganisms are a component of normal conjunctival flora, they often produce the typical signs and symptoms of chronic staphylococcal blepharoconjunctivitis. Certain strains produce a polysaccharide extracellular material called “slime”. Slime production is considered to be associated with the virulence of the organism.

Methods

Swabs were taken from the lids of 38 eyes of 19 patients with chronic non-ulcerative blepharitis and cultured for CNS. A group of 42 normal control eyes were similarly sampled. The strains of CNS isolated from 26 eyes (68.4%) of the patients with blepharitis and 25 eyes (59.5%) of the normal subjects were studied for slime layer production.

Results

No significant difference was found between normal subjects and patients in the incidence of slime producing CNS strains from the conjunctiva. The antibiotic sensitivity profiles of the slime-producing strains were no different from the slime-negative isolates in the blepharitis (p=0.85) and normal group (p=0.25).

Conclusions

Our data suggest that slime production by CNS does not play a significant role in the pathogenesis of staphylococcal blepharitis.
Non-Freeze Epikeratophakia in Children
Authors: Aznabayev M.T. , Bikbov M.M. , Aznabayev R.A.
Published: April 2018

We describe the use of unfrozen tissue lenses in 42 cases of epikeratophakia in children aged 2-14 years. Fourteen operations were performed in an aphakic eye, 28 in combination with congenital or traumatic cataract extraction. The tissue lenses, made from unfrozen donor cornea according to an original design, healed in 91.5% of cases. The tissue lens was removed when epithelial growth was inadequate on its surface. A five-year follow-up showed that correction within 3.0 D of emmetropia was achieved in 73.7% of the eyes. Preoperatively, mean keratometry readings were 43.5±0.2 D, increasing postoperatively to 53.6±0.8 D. Mean spherical equivalent at the spectacle plane increased by 9.6±0.9 D. Our investigations show the efficacy and safety of non-freeze epikeratophakia in the correction of pediatric aphakia.
The Penetration of Ofloxacin into Human Aqueous Humor Given by Various Routes
Authors: Hanioglu-Kargi S. , Basci N. , Soysal H. , Bozkurt A. , Gürsel E. , Kayaalp O.
Published: April 2018

This study was designed to measure the concentration of ofloxacin in aqueous humor after topical, oral and intravenous administration in 50 patients undergoing cataract extraction. In Group 1, ofloxacin 0.3% eyedrops were topically instilled ten times and the aqueous humor concentration was 2.73 ± 0.88 μg/ml. In Group 2, ofloxacin 0.3% eyedrops were topically instilled six times and the aqueous humor concentration was 0.84 ± 0.61 μg/ml. Aqueous humor concentration 12 hours after 200 mg oral dose in Group 3, was 0.38 ± 0.12 μg/ml. In Group 4, patients were given ofloxacin as a single intravenous 200 mg dose and the aqueous humor concentration 2 hours after the end of infusion was 0.45 ± 0.11 μg/ml. Concentrations were determined by high performance liquid chromatography (HPLC) with fluorescence detection.

There was a significant difference between Group 1 and the other groups, but not between Group 2 and Groups 3, 4.

It was concluded that ofloxacin penetrates the corneal and the blood-aqueous barriers and can achieve good aqueous levels when given topically and systematically. Ofloxacin can be applied topically for external bacterial infections such as conjunctivitis and keratitis. Systematically administered ofloxacin reached higher levels than the MIC for some bacteria which cause endophthalmitis.
In Vitro Effect of Ascorbic Acid on the Proliferation of Bovine Scleral and Tenon's Capsule Fibroblasts
Authors: Denk P.O. , Knorr M.
Published: April 2018

The success of glaucoma filtration surgery depends mainly on an incomplete wound healing process in the area of the fistula. Since Kornblueth and Tenenbaum's investigations in 1956 it has been known that aqueous humour has intrinsic antiproliferative properties. It is assumed that ascorbic acid is involved in the regulation of the wound healing process after filtration surgery. To evaluate the antiproliferative effect of ascorbic acid in vitro, we used cultured fibroblasts of bovine Tenon's capsule and bovine sclera. Incubation of these cells with ascorbic acid at concentrations ranging from 0.5 to 3 mM/L led to dose-dependent inhibition of cell proliferation. The half-maximal inhibitory concentration was 1.0 mM/L for both cell types. Physiological concentrations of ascorbic acid may be valuable in the pharmacological prevention of failure of glaucoma filtration surgery. However, extensive clinical investigations are needed to clarify whether topical intraoperative or postoperative as well as oral administration of ascorbic acid inhibits fibroblast proliferation after glaucoma filtration surgery.
Central Serous Chorioretinopathy in Two Families
Authors: Park D.W. , Schatz H. , Gaffney M.M. , Mcdonald H.R. , Johnson R.N. , Schaeffer D.
Published: April 2018

Purpose and Methods.

The reported occurrence of central serous chorioretinopathy (CSCR) in families is rare. We report two families (five patients) who have been diagnosed with CSCR. The diagnosis of CSCR was made on clinical and fluorescein angiographic findings.

Results

Three members of the first family and two members of the second family had CSCR. Affected individuals were all males.

Conclusions

CSCR has been associated with psychological and emotional stress and the occurrence of CSCR in families may be due to similar inherited psychological and physiological characteristics and responses that predispose these families to the development of CSCR.
Effect of Sex in Branch Retinal Vein Occlusion
Authors: Simsek S. , Demirok A. , Çinal A. , Yasar T.
Published: April 2018

Purpose

To evaluate the effect of sex in relation to crossing numbers, arterial overcrossings and occlusion sites in patients with branch retinal vein occlusion (BRVO).

Methods

Fifty-one eyes with BRVO (study group) and 48 eyes with retinal problems other than BRVO (control group) were investigated. All venous occlusions were examined in detail with regard to their anatomical positions, sites and arteriovenous crossings on the retinal surrounding area two disc diameters nasally, four disc diameters temporally, three disc diameters superiorly and three interiorly from the optic disc, in the arteriovenous phase of fundus fluorescein angiography and fundus color photography.

Results

The study group comprised 29 women (56.86%) and 22 men (43.14%). All occlusions were unilateral and located at the crossing areas. BRVO had arterial overcrossing in 28 eyes (96.6%) in females and 22 eyes (95.5%) in males (p>0.005). The average numbers of crossings were 7.79 ± 1.57 in females and 7.82 ± 1.05 in males in the study group (p>0.05), and respectively 7.30 ± 1.19 and 6.95 ± 1.13 (p>0.05) in the control group. The average arterial overcrossing ratios were 75% in females and 71% in males in the study group (p>0.05), and 74% and 65% in the control group (p<0.05).

Conclusions

Our data suggest that females have a higher risk than males because of their arterial overcrossing ratio and BRVO prefer arterial overcrossing. However the insignificant difference between the female and male patients leads us to assume that the effect of sex on BRVO cannot be explained only by local anatomical factors since their effect is only slight.
Seroprevalences and Correlates of Hepatitis B and C Among Cameroonian Pregnant Women
Authors: Fouelifack Florent Ymele , Fouedjio Jeanne Hortence , Fouogue Jovanny Tsuala , Fouelifa Loic Dongmo
Published: April 2018

Background and rationale:

Viral hepatitis B (VHB) and viral hepatitis C (VHC) are major public health issues in resource-poor countries where vertical transmission remains high.

Aim:

To assess prevalences and correlates of VHB and VHC among women attending antenatal clinic.

Methods:

A cross-sectional study at the Yaounde Central Hospital from January 1 to June 30, 2016. We included 360 pregnant women who were screened for hepatitis B virus surface antigen (HbsAg) and VHCAb by rapid diagnostic test (DiaSpot Diagnostics, USA) followed by confirmation of positive results by a reference laboratory. Odds ratios (95% confidence interval [CI]) were used to measure associations between variables. Statistical significance was set for P-value <.05.

Results:

Mean age was 27.9 ± 5.6 years. The prevalences of HbsAg and VHCAb were 9.4% (n = 34) and 1.7% (n = 6), respectively. Multiplicity of sex partners was significantly associated with HbsAg positivity (adjusted odds ratio [aOR]: 11.6; 95% CI: 5.1-26.7; P < .001) while none of the studied factors was associated with VHCAb.

Conclusion:

The high prevalence of hepatitis B among pregnant women supports systematic screening and free vaccination of pregnant women and women of childbearing age.
The evaluation of social innovation: A review and integration of the current empirical knowledge base
Authors: Milley Peter , Szijarto Barbara , Svensson Kate , Cousins J. Bradley
Published: April 2018

Social innovation has gained prominence as a way to address social problems and needs. Evaluators and social innovators are conceptualizing and implementing evaluation approaches for social innovation contexts; however, no systematic effort has yet been made to explore and assess the overlap between evaluation and social innovation based on the empirical knowledge base. We address this gap, drawing on 28 empirical studies of evaluation in social innovation contexts to describe what evaluation practices look like, what drives those practices, and how they affect social innovations. Findings indicate most had developmental purposes, emphasized collaborative approaches, and used multiple methods. Prominent drivers were a complexity perspective, a learning-oriented focus, and the need for responsiveness. Reported influences on social innovations included advancing strategies, improving delivery, balancing aggregate and local information needs, and reducing risk. Conflict resolution, the quality of relationships, and availability of time and capacity mediated these influences. More peer-reviewed empirical studies and a broader range of study designs are needed, including research on how evaluations influence social innovation processes over time, phases, space and scale.
Managing relationships in qualitative impact evaluation of international development: QuIP choreography as a case study
Authors: Copestake James , Allan Claire , Bekkum Wilm van , Belay Moges , Goshu Tefera , Mvula Peter , Remnant Fiona , Thomas Erin , Zerahun Zenawi
Published: April 2018

Who does what and when during an impact evaluation has an important influence on the credibility and usefulness of the evidence generated. We explore such choreography from technical, political and ethical perspectives by reflecting on a case study that entailed collaborative design of a qualitative impact evaluation protocol (‘the QuIP’) and its pilot use in Ethiopia and Malawi. Double blind interviewing was employed to reduce project-specific confirmation bias, followed by staged ‘unblindfolding’ as a form of triangulation. We argue that these steps can enhance credibility of evidence, and that ethical concerns associated with them can be addressed by being open with stakeholders about the process. The case study illustrates scope for better use of qualitative impact evaluation methods in complex international development contexts.
Building a new tool to evaluate networks and multi-stakeholder governance systems
Authors: Haarich Silke N.
Published: April 2018

Networks are increasingly used in public policy to tackle ever more complex societal challenges. Multi-stakeholder governance systems have been set up to strengthen regional innovation systems, to fight the consequences of climate change and to tackle social change. However, multiple challenges mean that evaluating these networks and governance systems is complex and requires specific evaluation approaches. Learning from the strengths and weaknesses of existing approaches, this article presents a new tool (GOCAPASS) which enables evaluators to assess governance systems and networks involving multiple stakeholders. It has already been tested in regional innovation policy and governance of EU macro-regional strategies. Practical testing demonstrated its usefulness as a tool for evaluation and policy learning, though some weaknesses still need to be resolved.
Experimental and numerical studies on design for deconstruction concrete connections: An overview
Authors: Ding Tao , Xiao Jianzhuang , Zhang Qingtian , Akbarnezhad Ali
Published: April 2018

This article presents an extensive overview of state of the art in design and testing of design for deconstruction concrete connections for concrete elements by reviewing and discussing the results of both experimental and numerical studies in this domain. In particular, characteristics and demonstrated behavior of precast dry beam-to-column concrete connections and beam-to-beam concrete connections that possess certain degree of demountability are critically reviewed. Furthermore, the mechanical behavior and structural performance of various design for deconstruction connections are compared and discussed. The comprehensive review presented in this study highlights considerable potential for minimizing the life cycle impact of buildings, especially with regard to energy and material resources, through application of design for deconstruction systems. The results presented in available literature provide a good degree of assurance with regard to safety and feasibility of implementation of design for deconstruction systems in practice. However, it is also revealed that full-scale tests conducted to evaluate the structural feasibility and construction effectiveness of design for deconstruction concrete connections are limited. Directions for future research are provided by discussing the identified challenges and limitations of design for deconstruction systems for concrete structures.
‘How do they want to know?’ Doctors’ perspectives on making and communicating a diagnosis of dementia
Authors: Bailey Cate , Dooley Jemima , McCabe Rose
Published: April 2018

Recent drives to facilitate earlier identification of dementia have led to increased memory clinic referrals and diagnoses. This study explored the perspectives of memory clinic doctors on making and delivering diagnoses. Four focus groups were conducted with 13 psychiatrists and two geriatricians in the UK. Transcripts were coded line by line using NVIVO. Thematic analysis identified 39 categories, 18 sub-themes and eight overarching themes. Inter-rater reliability on 31% of the data was 0.89. Increased public awareness of dementia was viewed positively in facilitating access to diagnosis and treatment. Doctors viewed diagnosis as a process and expressed concerns about limited pre-diagnostic counselling and post-diagnostic support. In diagnostic delivery doctors sought to develop a narrative drawing on the patient’s report of symptoms and adjust explanations to patient preferences and awareness. However, tailoring the delivery to the individual patient was challenging when meeting for the first time. These consultations often involved three participants (doctor, patient and relative), who were felt to have differing needs and expectations. Doctors emphasized that delicacy was required in deciding in what could be discussed in front of both parties, however also stressed the importance of explicitly naming ‘dementia’. Efforts were made to balance honesty and hope when discussing prognosis and medication. The work was sometimes emotionally distressing, with limited supervision. Existing communication training was felt to be inadequate for consultations involving triads or people with cognitive impairment. Delivering a dementia diagnosis is a nuanced and challenging task. Negotiating honest descriptions of a life-limiting condition whilst instilling hope is further complicated when cognitive impairment affects comprehension. Misunderstandings at the time of feedback may limit patient opportunities for informed future planning afforded by early diagnosis. Doctors in memory clinics would benefit from evidence based training and supervision to prepare them for these emotionally challenging and complex consultations.
How Local Media Coverage of Voter Fraud Influences Partisan Perceptions in the United States
Authors: Udani Adriano , Kimball David C. , Fogarty Brian
Published: April 2018

Extant findings show that voter fraud is extremely rare and difficult to prove in the United States. Voter's knowledge about voter fraud allegations likely comes through the media, who tend to sensationalize the issue. In this study, we argue that the more voters are exposed to media coverage of voter fraud allegations, the more likely that they will perceive that voter fraud is a frequent problem. We merge the 2012 Survey of Performance of American Elections with state-level media coverage of voter fraud leading up to the 2012 election. Our results show that media coverage of voter fraud is associated with public beliefs about voter fraud. In states where fraud was more frequently featured in local media outlets, public concerns about voter fraud were heightened. In particular, we find that press attention to voter fraud has a larger influence on Republicans than Democrats and Independents. We further find that media coverage of voter fraud does not further polarize partisan perceptions of voter fraud. Rather, political interest moderates state media coverage on voter fraud beliefs only among Republicans. Last, our results provide no support that demographic changes, approval of election administration, or information concerning actual reported voting irregularities have any discernable effects on partisan perceptions.
TGFβ1 Promotes Breast Cancer Local Invasion and Liver Metastasis by Increasing the CD44high/CD24− Subpopulation
Authors: Zhang Chenjing , Gao Huiqin , Li Chao , Tu Jiangfeng , Chen Zhihao , Su Weiwei , Geng Xiaoge , Chen Xiaojun , Wang Jingya , Pan Wensheng
Published: April 2018

Objective:

Previous studies have shown that the transforming growth factor β1 pathway plays an important role in breast cancer metastasis to the liver. However, the mechanism of this metastasis has not been fully clarified. Cancer stem cells are essential for the initiation and propagation of tumor metastasis. The objective of our current study was to define the role of cancer stem cells in transforming growth factor β1-mediated breast cancer hepatic metastases.

Method:

Hematoxylin and eosin staining was used to assess the formation of breast cancer liver metastases and local invasion. Cancer stem cells surface markers (CD44, CD24, and Epithelial cell adhesion molecule [EpCAM]), luminal/mesenchymal markers (keratin8 and alpha smooth muscle actin), and proliferation markers (Ki-67 and cyclinD1) were detected by immunohistochemistry assays. Flow cytometry was used to evaluate the effect of transforming growth factor β1 on the CD44+/CD24− cancer stem cell population. Quantitative real-time polymerase chain reaction was employed to assess the gene expression of the stem cell self-renewal markers nanog, pou5f1 (coding for Oct4), and sox2.

Results:

Transforming growth factor β1 increased the formation of liver metastases by the MDA-MB231 (MDA) breast cancer cell line but did not affect the liver metastasis of CD44+/CD24+ noncancer stem cells. Transforming growth factor β1 treatment did not significantly affect tumor proliferation in vitro or in vivo. Transforming growth factor β1 promoted mammary tumor local invasion. Furthermore, the CD44high/CD24− cancer stem cell population was also significantly increased by transforming growth factor β1 treatment. Besides, the gene expression of the stem cell self-renewal markers (nanog, pou5f1, and sox2) and another stem cell surface marker (EpCAM) was increased by transforming growth factor β1 treatment. Finally, clusters of CD44-positive breast cancer cells were observed in the livers of mice from the control and transforming growth factor β1 pretreatment groups.

Conclusion:

Our results indicate that transforming growth factor β1 increases the local invasive capacity and liver metastasis of breast cancer cells by inducing the CD44high/CD24− cancer stem cell population.
Adult Play
Authors: Brown Ashley M. L. , Stenros Jaakko
Published: April 2018

Welcome to the Adult Play Special Issue. In this introduction, we (the editors) explain the origin of the collection and our unique take on what adult play means as a term. Rather than be specifically about sexual play, the term adult is taken here to reference the age of players. The article included how adults play, what they play with, and when they play. This of course includes, but is not limited to, play of a sexual nature. We hope you enjoy reading this issue as much as we enjoyed editing it.
Physician Consultations, Prostate Cancer Knowledge, and PSA Screening of African American Men in the Era of Shared Decision-Making
Authors: Woods-Burnham Leanne , Stiel Laura , Wilson Colwick , Montgomery Susanne , Durán Alfonso M. , Ruckle Herbert R. , Thompson Rupert A. , De León Marino , Casiano Carlos A.
Published: April 2018

African American (AA)/Black men are more likely to develop aggressive prostate cancer (PCa), yet less likely to be screened despite guidelines espousing shared decision-making regarding PCa screening and prostate-specific antigen (PSA) testing. Given the documented racial disparities in PCa incidence and mortality, engaging interactions with physicians are especially important for AA/Black men. Thus, this study evaluated occurrence of physician–patient conversations among AA/Black men, and whether such conversations were associated with PCa knowledge. We also quantified the serum PSA values of participants who had, and had not, discussed testing with their physicians. Self-identified AA/Black men living in California and New York, ages 21–85, donated blood and completed a comprehensive sociodemographic and health survey ( n = 414). Less than half (45.2%) of participants had discussed PCa screening with their physicians. Multivariate analyses were used to assess whether physician–patient conversations predicted PCa knowledge after adjusting for key sociodemographic/economic and health-care variables. Increased PCa knowledge was correlated with younger age, higher income and education, and having discussed the pros and cons of PCa testing with a physician. Serum PSA values were measured by ELISA. Higher-than-normal PSA values were found in 38.5% of men who had discussed PCa screening with a physician and 29.1% who had not discussed PCa screening. Our results suggest that physician–AA/Black patient conversations regarding PCa risk need improvement. Encouraging more effective communication between physicians and AA/Black men concerning PCa screening and PSA testing has the potential to reduce PCa health disparities.
Prostate Cancer Screening Perception, Beliefs, and Practices Among Men in Bamenda, Cameroon
Authors: Kaninjing Ernest , Lopez Ivette , Nguyen Jennifer , Odedina Folakemi , Young Mary Ellen
Published: April 2018

Prostate Cancer (CaP) is the most commonly diagnosed cancer among Cameroonian men. Due to inadequate infrastructure, record keeping, and resources, little is known about its true burden on the population. There are rural/urban disparities with regards to awareness, screening, treatment, and survivorship. Furthermore, use of traditional medicine and homeopathic remedies is widespread, and some men delay seeking conventional medical treatment until advanced stages of CaP. This study examined the perceptions, beliefs, and practices of men in Cameroon regarding late stage CaP diagnoses; identified factors that influence screening decision; and ascertained how men decided between traditional or conventional medicine for CaP diagnosis and treatment.

Semistructured focus groups were used to collect data from men in Bamenda, Cameroon. Qualitative data analysis was used to analyze transcripts for emerging themes and constructs using a socio-ecological framework.

Twenty-five men participated in the study, with an average age of 59. Most of the participants had never received a prostate screening recommendation. Socioeconomic status, local beliefs, knowledge levels, awareness of CaP and screening methods, and stigma were prominent themes.

A significant number of Cameroonian men receive late stage CaP diagnosis due to lack of awareness, attitudes, cultural beliefs, self-medication, and economic limitation. To effectively address these contributing factors to late stage CaP diagnosis, a contextually based health education program is warranted and should be tailored to fill knowledge gaps about the disease, dispel misconceptions, and focus on reducing barriers to utilization of health services.
Cytotoxicity and Genotoxicity of Cypermethrin in Hepatocarcinoma Cells: A Dose- and Time-Dependent Study
Authors: AlKahtane Abdullah A. , Alarifi Saud , Al-Qahtani Ahmed A. , Ali Daoud , Alomar Suliman Y. , Aleissia Mohammed S. , Alkahtani Saad
Published: April 2018

Most of the agricultural workers are potentially exposed to pesticides through different routes. Inhalation exposures may result in numerous diseases that can adversely affect an individual’s health and capacity to perform at work. The aim of this study was to determine the cytotoxic potential of cypermethrin pesticide on cultured human hepatocarcinoma (HepG2) cells. The HepG2 cells were exposed to cypermethrin (0, 5, 15, 40 ng/mL) for 24 and 48 hours. We observed that cypermethrin caused cell death of HepG2 cells using 3-(4, 5-dimethylthiozolyl-2)-2,5-diphenyl tetrazolium bromide (MTT) and lactate dehydrogenase tests. Furthermore, cypermethrin reduced HepG2 cells viability in a time and dose dependent basis, that was probably mediated through the induction of reactive oxygen species (ROS) and apoptosis. An increase in ROS generation with a concomitant increase in expression of the proapoptotic protein Bcl-2 and cytochrome c and decrease in the antiapoptosis protein Bax suggested that a mitochondria-mediated pathway was involved in cypermethrin-induced apoptosis. These findings provide insights into the underlying mechanisms involved in cytotoxicity of cypermethrin in HepG2 cells.
Prognostic value of PIVKA-II in hepatocellular carcinoma patients receiving curative ablation: A systematic review and meta-analysis
Authors: Zhang Dongjing , Liu Zhihong , Yin Xueru , Qi Xiaolong , Lu Bingyun , Liu Yuanyuan , Hou Jinlin
Published: April 2018

Background:

Several studies have been conducted to evaluate the prognostic value of prothrombin induced by vitamin K absence-II (PIVKA-II) overexpression in hepatocellular carcinoma patients treated with curative ablation. However, the results remain controversial. The purpose of this meta-analysis was to explore the correlation between PIVKA-II expression and survival outcomes in these patients.

Methods:

We performed a systematic literature search in PubMed, EMBASE, Medline, Cochrane Library, and Web of Science to identify the relevant articles investigating the prognostic value of PIVKA-II in patients with hepatocellular carcinoma. Combined hazard ratios (HR) and their 95% confidence intervals (CI) for overall survival and recurrence-free survival were calculated as the analysis endpoints.

Results:

A total of 15 cohorts encompassing 5647 patients were included. The results indicated that elevated PIVKA-II was significantly associated with poorer overall survival (HR 1.59; 95% CI 1.40, 1.82; P < 0.001) and recurrence-free survival (HR 1.76; 95% CI 1.42, 2.17; P < 0.001). Similar results were observed in the subgroup analysis based on sample size, analytical method, treatment modality, and cut-off value.

Conclusions:

This meta-analysis suggests that elevated PIVKA-II is a predictor of unfavorable overall survival and recurrence-free survival in hepatocellular carcinoma patients receiving curative ablation. More rigorous studies are warranted to confirm the clinical utility of PIVKA-II in determining hepatocellular carcinoma prognosis.
The Clinical Value of the Tumor Markers Ca 19/9 and Carcinoembryonic Antigen (Cea) in Colorectal Carcinomas: A Critical Comparison
Authors: von Kleist Sabine
Published: April 2018

The monoclonal antibody serum test CA 19.9 after having been described as being colon tumor specific, was advertised as being more sensitive than CEA in the detection of both early and advanced colorectal carcinomas. Furthermore, the combined estimation of the two markers, CEA and CA 19.9 was said to improve the detection rate significantly. However, our own comparative studies as well as those of several other groups recently published have shown CA 19.9 measurements to be less valuable, because being less sensitive than those of CEA. This is especially true for the early stages of intestinal carcinomas.

The parallel determinations of CA 19.9 and CEA improved the positivity rate insignificantly, because in only 3.5% of all cases C 19.9 was elevated in CEA negative cancer sera. However, CA 19.9 was found to have a much lower rate of (false) positive results than CEA in benign intestinal diseases.