bluuebunny/crossref_metadata_2025 huggingface dataset:
3. Murder and Manslaughter
Authors: Allen Mischa
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions. Each book includes typical questions, diagram answer plans, suggested answers, author commentary and advice on study skills. This chapter presents sample exam questions on murder and manslaughter and suggested answers. The key issues of direct and oblique intent as it applies to murder are considered. The chapter also deals with the changes to the partial defences to murder (loss of control and diminished responsibility) brought about by the statutory provisions in the Coroners and Justice Act 2009, and the differences between the types of involuntary manslaughter (by an unlawful act, by gross negligence, and by recklessness).
1. Exam Skills for Success in EU Law
Authors: Foster Nigel
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and illustrative diagrams and flowcharts. This introductory chapter sets out the book’s purpose, which is to provide a number of example questions on European Union (EU) law, which should be fairly typical of those met on degree level courses on EU law. The questions are then followed by a few sentences or paragraphs of comment on the type of question, the main aspects or elements to be considered in the question, various examiner’s tips on particular issues to be aware of, to include or indeed to avoid, and advice on structuring the answer. The suggested answers are designed to demonstrate how the particular questions should be answered to get a good mark, i.e., an upper second or better.
7. The Free Movement of Persons
Authors: Foster Nigel
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and illustrative diagrams and flowcharts. This chapter presents sample exam questions along with examiner’s tips, answer plans, and suggested answers about the free movement of persons in the EU. The area of law straddles three main subdivisions, comprising the free movement of workers, involving most of the secondary legislation and case law; secondly the freedom of establishment and freedom to provide services; and additionally now, Union citizenship. The chapter includes all types of questions, such as combination essay-type questions, combination problem-type questions, problem questions concerned only with the free movement of workers, an essay-type question concentrating on the free movement of professionals and questions which involve citizenship and wider free movement issues.
8. Competition and Merger Law
Authors: Foster Nigel
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary, and illustrative diagrams and flowcharts. This chapter presents sample exam questions along with examiner’s tips, answer plans, and suggested answers about EU competition and merger law. The questions on competition law range from a general overview question, a question which surveys the basic concepts and requirements of Arts 101 and 102 TFEU and the Mergers Regulation, to questions concentrating on specific aspects of competition law including the procedure of competition law investigations and enforcement. The 2007 Lisbon Treaty made little substantive change to the competition law provisions, which can be found in Arts 101–106 of the amended TFEU. More significant is the Competition Regulation 1/2003 and the Merger Regulation, 139/2004, which is under revision for future reform or replacement.
Concentrate Questions and Answers Land Law
Authors: Malcolm Rosalind
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans, suggested answers and author commentary. This book offers advice on what to expect in exams and how best to prepare. This book also includes separate chapters on skills for success in both exams and in coursework assessments.
4. Constitution of Trusts
Authors: Malcolm Rosalind
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans, suggested answers and author commentary. This book offers advice on what to expect in exams and how best to prepare. This chapter covers questions on the constitution of trusts.
13. Breach of Trust
Authors: Malcolm Rosalind
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans, suggested answers and author commentary. This book offers advice on what to expect in exams and how best to prepare. This chapter covers questions on breach of trusts.
14. Equitable Remedies
Authors: Malcolm Rosalind
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans, suggested answers and author commentary. This book offers advice on what to expect in exams and how best to prepare. This chapter covers questions on equitable remedies.
Concentrate Questions and Answers Company Law
Authors: Moore Imogen
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions and coursework. Each book includes: typical questions; suggested answers with commentary; illustrative diagrams; guidance on how to develop your answer; key debates; suggestions for further reading; and advice on exams and coursework. Concentrate Q&A Company Law offers expert advice on what to expect from your company law exam and coursework, how best to prepare, and guidance on what examiners are really looking for. Written by an experienced examiner, it provides: reminders of points to consider; indications of key debates for each topic; exam-length suggested answers; clear commentary with each answer; diagram answer plans; cautionary points; tips to make your answer stand out from the crowd; and annotated further reading suggestions at the end of every chapter. The book should help you to: identify typical company law exam questions; structure and write a first-class answer; avoid common mistakes; show the examiner what you know; develop and demonstrate your understanding; identify connections between topics; and find relevant and helpful further reading. As well as separate chapters on exam skills and preparing coursework, it covers: companies and corporate personality; the corporate constitution; shares and shareholders; directors’ duties; company management and governance; minority shareholder remedies; corporate liability (contracts, torts, and crimes); share capital; loan capital; and corporate insolvency. The book is suitable for undergraduate students taking a module in company law on the LLB and GDL, and undergraduate students studying aspects of company law on other degree courses.
7. Minority Shareholder Remedies
Authors: Moore Imogen
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions and coursework. Each book includes typical questions, suggested answers with commentary, illustrative diagrams, guidance on how to develop your answer, suggestions for further reading, and advice on exams and coursework. This chapter examines the law on minority shareholder remedies, which provide some limited protection or avenues of redress for a shareholder with grievances concerning the actions of the company, directors, or majority shareholders. The chapter explores, in particular: the rule in Foss v Harbottle; derivative claims; personal claims and the issue of reflective loss; the ‘unfair prejudice’ remedy in Companies Act 2006, s. 994; and petitions to wind up the company on the ‘just and equitable’, ground under Insolvency Act 1986, s. 122(1)(g).
1. Exam Skills for Success in Human Rights and Civil Liberties Law
Authors: Foster Steve
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, diagram answer plans, caution advice, suggested answers, illustrative diagrams and flowcharts, and advice on gaining extra marks. Concentrate Q&A Human Rights & Civil Liberties offers expert advice on what to expect from your human rights and civil liberties exam, how best to prepare, and guidance on what examiners are really looking for. Written by experienced examiners, it provides: clear commentary with each question and answer; bullet point and diagram answer plans; tips to make your answer really stand out from the crowd; and further reading suggestions at the end of every chapter. The book should help you to: identify typical law exam questions; structure a first-class answer; avoid common mistakes; show the examiner what you know; make your answer stand out from the crowd.

This chapter briefly sets out the book's purpose, which is to assist students preparing for an examination in human rights and civil liberties, and also offers some suggestions regarding coursework and taking exams.
4. The Human Rights Act 1998
Authors: Foster Steve
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, diagram answer plans, caution advice, suggested answers, illustrative diagrams and flowcharts, and advice on gaining extra marks. Concentrate Q&A Human Rights & Civil Liberties offers expert advice on what to expect from your human rights and civil liberties exam, how best to prepare, and guidance on what examiners are really looking for. Written by experienced examiners, it provides: clear commentary with each question and answer; bullet point and diagram answer plans; tips to make your answer really stand out from the crowd; and further reading suggestions at the end of every chapter. The book should help you to: identify typical law exam questions; structure a first-class answer; avoid common mistakes; show the examiner what you know; make your answer stand out from the crowd.

This chapter covers the Human Rights Act 1998, including its central provisions, its impact on the protection of human rights in the UK, and its potential repeal.
5. The Right to Life
Authors: Foster Steve
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, diagram answer plans, caution advice, suggested answers, illustrative diagrams and flowcharts, and advice on gaining extra marks. Concentrate Q&A Human Rights & Civil Liberties offers expert advice on what to expect from your human rights and civil liberties exam, how best to prepare, and guidance on what examiners are really looking for. Written by experienced examiners, it provides: clear commentary with each question and answer; bullet point and diagram answer plans; tips to make your answer really stand out from the crowd; and further reading suggestions at the end of every chapter. The book should help you to: identify typical law exam questions; structure a first-class answer; avoid common mistakes; show the examiner what you know; make your answer stand out from the crowd. This chapter covers the right to life, including its importance, the duty of the state to preserve it, and the situations where life can be taken.
10. Freedom of Expression
Authors: Foster Steve
Published: September 2018

The Concentrate Questions and Answers series offer the best preparation for tackling exam questions. Each book includes typical questions, diagram answer plans, caution advice, suggested answers, illustrative diagrams and flowcharts, and advice on gaining extra marks. Concentrate Q&A Human Rights & Civil Liberties offers expert advice on what to expect from your human rights and civil liberties exam, how best to prepare, and guidance on what examiners are really looking for. Written by experienced examiners, it provides: clear commentary with each question and answer; bullet point and diagram answer plans; tips to make your answer really stand out from the crowd; and further reading suggestions at the end of every chapter. The book should help you to: identify typical law exam questions; structure a first-class answer; avoid common mistakes; show the examiner what you know; make your answer stand out from the crowd.

This chapter covers freedom of speech and expression, including the scope of free speech and expression, its protection in domestic law and under the ECHR, and its application to areas such as public order, national security contempt of court, press freedom, and defamation law.
1. Exam skills for success in evidence
Authors: Spencer Maureen , Spencer John
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and illustrative diagrams and flow charts. This book is a supplementary aid to coursework preparation and particularly to revision for examinations and coursework. It does not present model answers to be slavishly imitated but, rather, examples to help the student understand the topic and see how it might be approached. The examinee’s objective is to accumulate in the time allowed as many marks as possible, a goal that needs to be broken down into three stages: namely, planning, execution and review. These days law examinations can take different forms, including seen questions, open book exams and so on. To take account of this, the book includes essay answers that are closer to more fully researched pieces than to the answers in a traditional unseen examination.
3. Witnesses: Competence and compellability; Special Measures Directions
Authors: Spencer Maureen , Spencer John
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and illustrative diagrams and flow charts. This chapter covers witnesses, who are a principal source of evidence, and the rules relating to their attendance. All witnesses with relevant information are assumed to be competent to give evidence and usually compellable to give evidence, as the court may summon them to attend. Interests of the witness are secondary to the need of the court to have all necessary information. Some witnesses who are competent may claim a privilege not to give evidence, including defendants on their own behalf. Other exceptions comprise spouses or civil partners testifying for the prosecution. This is based on the concept that compulsion may lead to marital discord. The chapter also includes a review of Special Measures Directions for vulnerable witnesses.
8. Opinion evidence
Authors: Spencer Maureen , Spencer John
Published: September 2018

The Concentrate Questions and Answers series offers the best preparation for tackling exam questions. Each book includes typical questions, bullet-pointed answer plans and suggested answers, author commentary and diagrams and flow charts. This chapter explores an area of evidence law dominated by expert witness evidence and the extent to which flawed testimony leads to miscarriages of justice. Expert evidence is now commonplace in criminal and civil trials, and the courts and Parliament have developed procedures to ensure that it is of high quality. These are an eclectic mix of common law and statute and their development reflects the importance of scientific expertise. It is necessary to be familiar with the differences between expert and non-expert opinion evidence and on when and in what circumstances both types are admissible and questions that can be asked of the expert whilst giving evidence. The approach depends on whether the question relates to civil or criminal trials
11. Administrative law: Ombudsmen, tribunals, and delegated legislation
Authors: Clements Richard
Published: September 2018

The Q&A series offers the best preparation for tackling exam questions. Each chapter includes typical questions; diagram problem and essay answer plans, suggested answers, notes of caution, tips on obtaining extra marks, the key debates on each topic and suggestions on further reading This chapter is about administrative law. The citizen may use judicial review in the courts to ensure that public bodies obey the law, but there are alternatives to the courts, such as the Parliamentary Commissioner for Administration and the tribunal system. The questions here deal with issues such as the Parliamentary Commissioner for Administration (Ombudsman); the tribunal system; and delegated legislation such as statutory instruments.
China’s Mobility Barriers and Employment Allocations
Authors: Ngai L Rachel , Pissarides Christopher A , Wang Jin
Published: September 2018

China’s hukou system imposes two main barriers to population movements. Agricultural workers get land to cultivate but are unable to trade it in a frictionless market. Social transfers (education, health, etc.) are conditional on holding a local hukou. We show that the land policy leads to over-employment in agriculture and it is the more important barrier to industrialization. Effective land tenure guarantees and a competitive rental market would correct this inefficiency. The local restrictions on social transfers also act as disincentives to migration with bigger impact on urban migrations than to job moves to rural enterprises.
Feasibility of a Smartphone-Based Tobacco Treatment for HIV-Infected Smokers
Authors: Shuter Jonathan , Kim Ryung S , An Lawrence C , Abroms Lorien C
Published: September 2018

Background

Cigarette smoking is common among persons living with HIV (PLWH) in the United States. It is the leading cause of mortality in this group, and efforts to promote cessation have been largely unsuccessful.

Methods

From 2015 to 2017, we performed a randomized controlled trial of Positively Smoke Free–Mobile (PSF-M) versus standard care. PSF-M is a mobile Web site that offers a 42-day text message-based quit-smoking program with smartphone features including quit-day selection/calendar, educational/motivational videos, and HELP button for cravings.

Results

One hundred individuals enrolled, 48 were randomized to PSF-M (mean age = 45 years, 54% male, 81% black, 31% Latino) and 52 to the standard care condition. All participants were offered a 3-month supply of nicotine patches. Participants randomized to the mobile intervention visited the PSF-M home page a mean of 83 times, viewed 5.6/8 videos, logged in on 13 of 42 possible days, and received 131 texts. Among them, 77% tapped HELP for cravings, and craving response options were used by the following proportions: phone-a-friend, 58%; play-a-game, 29%; play-a-song, 4%. Older age and nonblack race were both associated with higher levels of engagement with the site. Of participants, 61% rated PSF-M very or extremely helpful, and 98% would recommend PSF-M to PLWH family or friends. Abstinence at 3 months, quit attempts, and daily cigarette intake all favored PSF-M over standard care but did not achieve statistical significance in our pilot sample.

Conclusions

Smartphone-based tobacco treatment for PLWH was feasible and achieved moderate–high rates of engagement and satisfaction in a middle-aged, ethnic or racial minority group in the poorest urban community in the United States.

Implications

Cigarette smoking has emerged as the leading killer of PLWH. Behavioral interventions have achieved only limited success in promoting cessation in this population. In this study, we explore the feasibility and preliminary efficacy of a multimodal, Web-based, quit-smoking intervention delivered to PLWH smokers via their smartphones.
Simultaneous Transcriptome Analysis of Host and Pathogen Highlights the Interaction Between Brassica oleracea and Sclerotinia sclerotiorum
Authors: Ding Yijuan , Mei Jiaqin , Chai Yaru , Yu Yang , Shao Chaoguo , Wu Qinan , Disi Joseph Onwusemu , Li Yuhua , Wan Huafang , Qian Wei
Published: September 2018

White mold disease caused by Sclerotinia sclerotiorum is a devastating disease of Brassica crops. Here, we simultaneously assessed the transcriptome changes from lesions produced by S. sclerotiorum on disease-resistant (R) and -susceptible (S) B. oleracea pools bulked from a resistance-segregating F2 population. Virulence genes of S. sclerotiorum, including polygalacturonans, chitin synthase, secretory proteins, and oxalic acid biosynthesis, were significantly repressed in lesions of R B. oleracea at 12 h postinoculation (hpi) but exhibited similar expression patterns in R and S B. oleracea at 24 hpi. Resistant B. oleracea induced expression of receptors potentially to perceive Sclerotinia signals during 0 to 12 hpi and deployed complex strategies to suppress the pathogen establishment, including the quick accumulation of reactive oxygen species via activating Ca2+ signaling and suppressing pathogen oxalic acid generation in S. sclerotiorum. In addition, cell wall degradation was inhibited in the resistant B. oleracea potentially to prevent the expansion of Sclerotinia hyphae. The transcriptome changes in S. sclerotiorum and host revealed that resistant B. oleracea produces strong responses against S. sclerotiorum during early infection.
Interaction of Brassicaceae Seed Meal Soil Amendment and Apple Rootstock Genotype on Microbiome Structure and Replant Disease Suppression
Authors: Wang Likun , Mazzola Mark
Published: September 2018

Preplant soil application of a Brassica juncea–Sinapis alba seed meal formulation (SM) at a rate of 6.6 t ha−1 alters composition of the orchard soil microbiome in a manner that yields sustainable long-term suppression of soilborne pathogens in apple production systems. However, the cost of SM amendment has hindered the adoption of this tactic to manage apple replant disease in commercial orchards. Greenhouse trials were conducted to assess the effect of reduced SM application rates in concert with apple rootstock genotype on structure of the rhizosphere microbiome and associated disease control outcomes. At all application rates assessed, SM treatment increased tree growth and reduced disease development relative to the control. In general, total tree biomass and leader shoot length were similar in soils treated with SM at 4.4 or 6.6 t ha−1 regardless of rootstock genotype. Equivalent increase in tree biomass when cultivated in soil treated at the lowest and highest SM amendment rate was attained when used in conjunction with G.41 or G.210 apple rootstocks. Suppression of Pythium spp. or Pratylenchus penetrans root densities was similar at all SM application rates. When cultivated in nontreated replant orchard soil, Geneva rootstocks (G.41 and G.210) exhibited lower levels of Pythium spp. and P. penetrans root colonization relative to Malling rootstocks (M.9 and MM.106). For a given rootstock, structure of the rhizosphere microbiome was similar in soils treated with SM at 4.4 and 6.6 t ha−1. G.41 and G.210 rootstocks but not M.9 or MM.106 cultivated in soil treated with SM at 2.2 t ha−1 possessed a rhizosphere bacterial community structure that differed significantly from the control. Findings indicate that effective control of apple replant disease may be attained at lower SM amendment rates than employed previously, with lower effective rates possible when integrated with tolerant rootstock genotypes such as G.41 or G.210.
Advances in Upper Extremity Scleroderma Wound Care
Authors: Cohen Joshua M. , Sibley Rachel A. , Chiu Ernest S. , Sharma Sheel
Published: September 2018

GENERAL PURPOSE:

To provide information about the pathophysiology, diagnosis, and treatment options for systemic sclerosis.

TARGET AUDIENCE:

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After participating in this educational activity, the participant should be better able to:

1. Describe the pathophysiology, signs, symptoms, and diagnosis of systemic sclerosis.

2. Outline the evidence-based medical and surgical management of systemic sclerosis.

OBJECTIVE:

To perform a targeted review of systemic sclerosis, including epidemiology, pathophysiology, diagnosis, signs and symptoms, and medical and surgical management of upper extremity manifestations.

DATA SOURCES AND STUDY SELECTION:

An electronic literature review was conducted using PubMed for all publication dates through October 2017. Searches were performed using combinations of terms including “systemic sclerosis,” “scleroderma,” “management,” “upper extremity,” “hypercalcinosis,” “Raynaud’s phenomenon,” “sympathectomy,” and “digital ulcers.” Only full-length articles written in English that discussed the management of upper extremity scleroderma were used.

DATA EXTRACTION AND SYNTHESIS:

The epidemiology, pathophysiology, diagnosis, upper extremity manifestations, and medical and surgical management of systemic sclerosis were reviewed. The case described in this article reports the utility of microsurgical interventions in the treatment of medically refractory upper extremity systemic sclerosis.

CONCLUSIONS:

Systemic sclerosis is a rare rheumatologic disease that greatly impacts quality of life. Medical management is the mainstay of treatment, propelling an improvement in the dismal 10-year cumulative survival rate from 54% in the 1970s to 66% in the 1990s. However, the pathophysiology of this disease is still poorly understood, and when medical management fails and the disease inevitably progresses, surgical approaches are critical.
CE: The Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in Treating Hemorrhagic Shock from Severe Trauma
Authors: Cheema Fareed , Garcia Carrie , Rivera Aksim G. , Chao Edward
Published: September 2018

Hemorrhage is the leading cause of preventable death in trauma patients. In recent years, technological innovations and research efforts aimed at preventing death from hemorrhagic shock have resulted in the emergence of resuscitative endovascular balloon occlusion of the aorta (REBOA). REBOA offers a less invasive option for emergent hemorrhage control in noncompressible areas of the body without the added risks and morbidities of an ED thoracotomy. This article outlines the procedure and device used, describes the procedure's evolution, and discusses various considerations, pitfalls, and nursing implications.
Cross-cultural Adaptation and Validation of the Simplified-Chinese Version of Neck Bournemouth Questionnaire for Patients in Mainland China
Authors: Zhang Zi-Cheng , Jia Zheng-Yu , Cheng Ya-Jun , Wang Fei , Yang Yi-Lin , Li Ming , Zhou Xiao-Yi , Wei Xian-Zhao
Published: September 2018

Study Design.

A prospective study.

Objective.

The aim of this study was to develop and assess the internal reliability and structure validity of a simplified Chinese version of the Neck Bournemouth Questionnaire (SC-NBQ) for evaluation of patients with nonspecific neck pain (NP) in mainland China.

Summary of Background Data.

The NBQ has been cross-culturally translated into several languages with good internal consistency and construct validity to evaluate low back pain and NP. However, the NBQ has been not translated or validated for Chinese-speaking patients.

Methods.

The SC-NBQ was developed by standard cross-translation procedures, and completed by 106 patients with nonspecific NP, along with other self-reported questionnaires, including the Neck Disability Index (NDI), Hospital Anxiety and Depression Scale (HADS), Functional Rating Index (FRI), and 36-Item Short Form Health Survey (SF-36). The internal consistency, test-retest reliability, and construct validity of the SC-NBQ were determined.

Results.

The NBQ was successfully translated into Chinese. All patients completed the SC-NBQ twice, and the other instruments. Score distribution demonstrated that there was no floor or ceiling effects of the SC-NBQ. Cronbach α coefficient (α = 0.89) and intraclass correlation coefficient (ICC = 0.97) showed good internal consistency and test-retest reliability. A good construct validity was shown by strong correlation with HADS (r = 0.75), NDI (r = 0.82), FRI (r = 0.90) and SF-36 physical functioning (r = 0.75), and bodily pain (r = 0.75) subscales.

Conclusion.

The SC-NBQ demonstrated good internal consistency, test-retest reliability, and construct validity, and may be used for the evaluation of NP in Chinese-speaking patients.

Level of Evidence: 2
“Rule of Spence” and Dickman's Classification of Transverse Atlantal Ligament Injury Revisited
Authors: Liu Peng , Zhu Jun , Wang Zhong , Jin Yufei , Wang Yingbo , Fan Weili , Liu Mingyong , Zhao Jianhua
Published: September 2018

Detailed clinical information of 13 adult patients with acute atlantal fractures underwent nonoperative treatment was retrospectively studied. “Rule of Spence” was found inaccurate in predicting either integrity of transverse atlantal ligament (TAL) or atlantoaxial stability, whereas Dickman's classification of TAL injury was more superior to “rule of Spence” on both prediction.

Study Design.

A retrospective study.

Objective.

To evaluate the prediction accuracy of “Rule of Spence” and Dickman's classification of the transverse atlantal ligament (TAL) injury on clinical outcomes (mainly focused on atlantoaxial stability) of atlas fractures treated nonoperatively.

Summary of Background Data.

TAL is regarded as primary stabilizer of the atlantoaxial complex. Atlas fractures are categorized as unstable and stable according to TAL injury or not. “Rule of Spence” and Dickman's classification have been widely used to evaluate the integrity of TAL indirectly or directly. However, there is controversy about how to interpret and apply these image measures appropriately in treatment decision making, and comparing the two measures in same cohort has been lack.

Methods.

From January 2013 to December 2015, 13 adult patients with atlas fractures, treated nonoperatively at acute posttraumatic phase and followed up for at least 2 years, were enrolled in the study. Lateral mass offset (LMO) and TAL injury were measured by radiography. Atlantoaxial stability, pain in occipital region, limitation of cervical motion, neurological dysfunction, and quality of daily life were evaluated as clinical outcomes.

Results.

LMO less than 6.9 mm was inaccurate either to exclud TAL injury (4/8, 50% failed) or to predict clinical outcomes (2/8, 25% failed), whereas LMO greater than 6.9 mm was accurate to determine TAL injury (5/5, 100% succeeded) but not to predict atlantoaxial stability (4/5, 80% failed). Two cases with Dickman's classification type I injury (100%) failed to restore C1-2 stability and six of seven type II (85.7%) succeeded. Three patients were indicated for fusion surgery due to instability, and one due to traumatic arthritis. Overall clinical outcomes were satisfactory as pain and quality of life were considered.

Conclusion.

Dickman‘s classification of TAL injury is of higher superiority to “Rule of Spence” in term of the accuracy of predicting atlantoaxial stability of nonoperatively treated atlas fractures.

Level of Evidence: 4
Evaluating the Managing Medicines for People With Dementia Website Version 2
Authors: Burns Pippa , Mullan Judy , Gillespie Robyn , Harrison Lindsey , Win Khin Than , Baker Amanda , Traynor Victoria , Kostovski Catherine , Thomas-Lee Rhett Jay , Gleeson Holly , Horne Frances , Velev Zoran
Published: September 2018

The Managing Medicines for People With Dementia version 2 website was developed in three languages, English, Italian, and Macedonian, to assist informal caregivers in the task of managing medications. Medication management is a complex task with potentially high stakes health outcomes, including hospitalization and death. A mixed-methods evaluation was carried out. A survey was available to site users and Web log data were collected over a 3-month period. Subsequently, the quality and suitability of the information and readability and usability of the Web site were evaluated. Focus groups and interviews were conducted with end users from all three language groups. Data collected from the evaluation surveys during the pilot test showed that users were generally satisfied with site usability (77%). The results of the readability testing indicate that future versions could be improved. Feedback from the focus groups and interviews was generally positive. The use of multiple methodologies provided comprehensive testing that is likely to have identified the majority of usability issues. Ways in which the site can be maintained with up-to-date information and be promoted to the target population, informal carers, need to be explored.
A Previously Unrecognized Ca2+‐inhibited Nonselective Cation Channel in Red Blood Cells
Authors: Petkova‐Kirova Polina , Hertz Laura , Makhro Asya , Danielczok Jens , Huisjes Rick , Llaudet‐Planas Esther , Mañú‐Pereira Maria del Mar , Vives Corrons Joan‐Luis , van Wijk Richard , Bogdanova Anna , Kaestner Lars
Published: September 2018

Supplemental Digital Content is available in the text
Controversies in the Treatment of Classical Hodgkin Lymphoma
Authors: Eichenauer Dennis A. , André Marc , Johnson Peter , Fossa Alexander , Casasnovas Olivier , Engert Andreas
Published: September 2018

Hodgkin lymphoma (HL) is a B‐cell‐derived malignancy that mostly affects young adults. Pathologically, HL is divided into classical HL (cHL) and the rare entity of nodular lymphocyte‐predominant HL. Classical HL is characterized by few malignant cells termed Hodgkin and Reed–Sternberg cells embedded in an inflammatory background. The treatment of cHL has consistently improved over the last decades so that current standard approaches result in long‐term remission rates in excess of 80%. However, potentially lethal therapy‐related late complications affect an increasing number of survivors. For this reason, issues regarding the optimal treatment of cHL patients are still fiercely debated. Questions under discussion include how treatment can be guided by interim positron emission tomography, the best initial treatment for advanced‐stage disease and the use of targeted drugs such as the antibody–drug conjugate brentuximab vedotin and the anti‐PD‐1 antibodies nivolumab and pembrolizumab. The identification of patients who should undergo allogeneic stem cell transplantation is another unsolved issue. The present article highlights the most relevant clinical trials and addresses controversial open questions in the treatment of cHL.
Pharmaco-fMRI in Patients With Traumatic Brain Injury: A Randomized Controlled Trial With the Monoaminergic Stabilizer (–)-OSU6162
Authors: Berginström Nils , Nordström Peter , Ekman Urban , Eriksson Johan , Nyberg Lars , Nordström Anna
Published: September 2018

Objective:

To examine the effects of monoaminergic stabilizer (–)-OSU6162 on brain activity, as measured by blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI), in patients in the chronic phase of traumatic brain injury suffering from fatigue.

Setting:

Neurorehabilitation clinic.

Participants:

Patients with traumatic brain injury received either placebo (n = 24) or active treatment (n = 28). Healthy controls (n = 27) went through fMRI examination at one point and were used in sensitivity analysis on normalization of BOLD response.

Design:

Randomized, double-blinded, placebo-controlled design.

Main Measures:

Effects on BOLD signal changes from before to after treatment during performance of a fatiguing attention task.

Results:

The fMRI results revealed treatment effects within the right occipitotemporal cortex and the right orbitofrontal cortex. In these regions, the BOLD response was normalized relative to healthy controls at the postintervention fMRI session. No effects were seen in regions in which we previously observed activity differences between patients and healthy controls while performing this fMRI task, such as the striatum.

Conclusion:

(–)-OSU6162 treatment had influences on functional brain activity, although the normalized regional BOLD response was observed in regions that were not a priori hypothesized to be sensitive to this particular treatment, and was not accompanied by any effects on in-scanner test performance or on fatigue.
MICROPERIMETRY AS A SCREENING TEST FOR HYDROXYCHLOROQUINE RETINOPATHY
Authors: Iftikhar Mustafa , Kaur Ramandeep , Nefalar April , Usmani Bushra , Kherani Saleema , Rashid Isra , Schönbach Etienne , Petri Michelle , Scholl Hendrik P.N. , Shah Syed M.
Published: September 2018

Purpose:

To assess the sensitivity and specificity of microperimetry as a screening test to detecting hydroxychloroquine retinopathy.

Methods:

Retrospective cohort study. Patients with history of hydroxychloroquine use for more than 5 years and with concomitant microperimetry and multifocal electroretinogram testing were retrospectively reviewed. Microperimetry was considered positive if there were three or more contiguous scotoma points in the parafoveal region. Multifocal electroretinogram was used as gold standard and was considered positive if there was an increased R1/R2 ring ratio (>2.5) or reduced R1 absolute amplitude (<9.0). Sensitivity, specificity, positive predictive value, and negative predictive value of microperimetry were calculated.

Results:

A total of 197 patients were reviewed. Hydroxychloroquine retinopathy was present in 22 (11%) patients. Their mean (SD) age was 54 (14) years, and 96% were women. Their mean (SD) daily dose was 5.7 (1.3) mg/kg, cumulative dose was 2041 (1,548) g, and duration of use was 15 (10) years. Sensitivity, specificity, positive predictive value, and negative predictive value of microperimetry were 73%, 93%, 53%, and 96%, respectively.

Conclusion:

Microperimetry has inferior sensitivity but good specificity in detecting hydroxychloroquine retinopathy (compared with multifocal electroretinogram). As such, it may be a useful ancillary test to exclude retinopathy, especially in high-risk patients or those with conflicting results on different modalities.
MYD88 L265P MUTATION DETECTION IN THE AQUEOUS HUMOR OF PATIENTS WITH VITREORETINAL LYMPHOMA
Authors: Miserocchi Elisabetta , Ferreri Andrés J. M. , Giuffrè Chiara , Cangi Maria G. , Francaviglia Ilaria , Calimeri Teresa , Ponzoni Maurilio , Pecciarini Lorenza , Bandello Francesco M. , Modorati Giulio M.
Published: September 2018

Purpose:

To detect the presence of MYD88 L265P mutation in the aqueous humor of patients with cytologically proven vitreoretinal lymphoma.

Methods:

Eight consecutive patients with bilateral vitreoretinal lymphoma (16 eyes) were prospectively evaluated. Genomic DNA was extracted from aqueous samples after paracentesis and vitreous humor samples after diagnostic vitrectomy. MYD88 codon 265 mutation was investigated by both amplification-refractory mutation system polymerase chain reaction approach and pyrosequencing assay in the aqueous humor of all patients and in the vitreous of 6 patients. A control group of 8 age-matched patients with established diagnosis of noninfectious uveitis was also tested for the presence of MYD88 L265P mutation in the aqueous humor.

Results:

Eight patients (three men, five women) with mean age of 69.5 years (range 50–85 years) were considered. All the patients tested for MYD88 L265P in the vitreous (six) were positive, and this result was consistent with cytological examination in all samples but one. The MYD88 L265P mutation was found in the aqueous of 6 patients (75%), and in 3 of them, the mutation was present in both eyes. Results of MYD88 L265P mutation in aqueous and vitreous sample were consistent in 7 of the 8 eyes with available samples. The aqueous humor of the noninfectious uveitis control group was negative for the detection of MYD88 L265P mutation.

Conclusion:

MYD88 mutation was detected in the aqueous humor of 75% of patients with cytologically proven vitreoretinal lymphoma. This technique may be considered as an additional diagnostic tool in the detection of the disease.
Oral Immunotherapy for Allergic Conjunctivitis Using Transgenic Rice Expressing Hypoallergenic Antigens
Authors: Fukuda Ken , Ishida Waka , Wakasa Yuhya , Takagi Hidenori , Takaiwa Fumio , Fukushima Atsuki
Published: September 2018

Pollinosis, or allergic conjunctivitis and rhinitis induced by pollen, is one of the most common diseases worldwide. In Japan, Japanese cedar (Cryptomeria japonica) pollinosis is a predominant allergic condition that affects more than one-third of all Japanese individuals. Pharmacological treatments of allergic conjunctivitis include administration of antiallergic eye drops containing an antihistamine or mast cell stabilizer. However, these topical treatments provide transient relief from symptoms. The only available curative treatment for allergic diseases is allergen-specific immunotherapy. Sublingual immunotherapy for pollinosis has been found to be effective for suppression of ocular and nasal symptoms, but patient compliance is low. Oral administration of staple foods engineered to express allergens is a possible means of delivering antigens for immunotherapy, and its convenience would be expected to improve compliance. With the aim of developing more convenient, effective, and safe immunotherapies for allergic diseases, we have generated rice-based edible vaccines expressing antigens derived from dust mites or pollen from Japanese cedar, birch, or ragweed. In this study, we summarize the results of our immunotherapy studies using transgenic rice. Oral immunotherapy with transgenic rice seeds containing hypoallergenic modified forms of Japanese cedar pollen antigens was effective for both preventing allergic conjunctivitis and suppressing established disease in mice. Oral administration of transgenic rice seeds is thus a promising approach to immunotherapy for conjunctivitis and rhinitis induced by Japanese cedar pollen.
Positive allosteric modulators of nonbenzodiazepine γ-aminobutyric acidA receptor subtypes for the treatment of chronic pain
Authors: Johnstone Timothy B.C. , Xie Jennifer Y. , Qu Chaoling , Wasiak David J. , Hogenkamp Derk J. , Porreca Frank , Gee Kelvin W.
Published: September 2018

Chronic neuropathic pain may be caused, in part, by loss of inhibition in spinal pain processing pathways due to attenuation of local GABAergic tone. Nociception and nocifensive behaviors are reduced after enhancement of tonically activated extrasynaptic GABAAR-mediated currents by agonist ligands for δ subunit–containing GABAARs. However, typical ligands that target δ subunit–containing GABAARs are limited due to sedative effects at higher doses. We used the spinal nerve ligation (SNL) and gp120 models of experimental neuropathic pain to evaluate compound 2-261, a nonbenzodiazepine site positive allosteric modulator of α4β3δ GABAARs optimized to be nonsedative by selective activation of β2/3-subunit–containing GABAARs over receptor subtypes incorporating β1 subunits. Similar levels of 2-261 were detected in the brain and plasma after intraperitoneal administration. Although systemic 2-261 did not alter sensory thresholds in sham-operated animals, it significantly reversed SNL-induced thermal and tactile hypersensitivity in a GABAAR-dependent fashion. Intrathecal 2-261 produced conditioned place preference and elevated dopamine levels in the nucleus accumbens of nerve-injured, but not sham-operated, rats. In addition, systemic pretreatment with 2-261 blocked conditioned place preference from spinal clonidine in SNL rats. Moreover, 2-261 reversed thermal hyperalgesia and partially reversed tactile allodynia in the gp120 model of HIV-related neuropathic pain. The effects of 2-261 likely required interaction with the α4β3δ GABAAR because 2-301, a close structural analog of 2-261 with limited extrasynaptic receptor efficacy, was not active. Thus, 2-261 may produce pain relief with diminished side effects through selective modulation of β2/3-subunit–containing extrasynaptic GABAARs.
Children and adolescents with sickle cell disease have worse cold and mechanical hypersensitivity during acute painful events
Authors: Brandow Amanda M. , Hansen Karla , Nugent Melodee , Pan Amy , Panepinto Julie A. , Stucky Cheryl L.
Published: September 2018

Sickle cell disease (SCD) pain associates with cold temperature and touch. Patients and murine models with SCD have baseline thermal and mechanical pain. In SCD mice, the baseline hypersensitivity is exacerbated by experimental vaso-occlusive crises. We hypothesized that patients with SCD will similarly experience increased hypersensitivity to thermal and mechanical stimuli during acute painful events compared with baseline health. We conducted a prospective study of 24 patients with SCD aged 7 to 19 years. Patients underwent quantitative sensory testing to thermal (cold/heat) and mechanical stimuli on the thenar eminence of the nondominant hand (glabrous skin) and the lateral dorsum of the foot (hairy skin) during baseline health and within 48 hours of hospitalization for acute pain. Primary outcomes were changes in: (1) cold pain threshold (°C), (2) heat pain threshold (°C), and (3) mechanical pain threshold (g). Median age was 10.5 (interquartile range [IQR] 9-14.8) years, 67% were females, and 92% were on hydroxyurea. Patients with SCD had increased cold pain sensitivity in the hand during hospitalization compared with baseline (25.2°C [IQR 18.4-27.5°C] vs 21.3°C [IQR 4.9-26.2°C]; P = 0.011) and increased mechanical pain sensitivity in the foot during hospitalization (0.32 g [IQR 0.09-1.1 g] vs 1.7 g [IQR 0.4-8.3 g]; P = 0.003). There were no differences in heat pain sensitivity. The increased cold (P = 0.02) and mechanical (P = 0.0016) pain sensitivity during hospitalization persisted after adjusting for age, sex, hydroxyurea use, opioid consumption, and numeric pain score. Thus, cold and mechanical pain is significantly worse during an acute SCD painful event as compared to baseline health in patients with SCD.