bluuebunny/crossref_metadata_2025 huggingface dataset:
Delayed ischemic stroke due to stent marker band occlusion after stent-assisted coiling
Authors: Kawabata Shuhei , Imamura Hirotoshi , Suzuki Keita , Tani Shoichi , Adachi Hidemitsu , Sakai Nobuyuki
Published: November 2017

A middle-aged patient with an internal carotid-posterior communicating artery aneurysm and basilar artery tip aneurysm was treated by stent-assisted coiling. One ischemic infarction and two transient ischemic attacks occurred with the same symptoms (inability to walk unassisted and tendency to fall to the left) during the first 2 years post-treatment. The ischemic infarction was found in the right side of the pons, consistent with the vascular territory of the stent-containing vessel. The cause of the delayed ischemic stroke was investigated on DSA and cone beam CT, which revealed that the proximal end of the stent, one marker band, was just covering a small perforating artery of the basilar artery trunk. The present case suggests that marker band occlusion can induce delayed ischemic stroke. To prevent this complication, it is important to evaluate the perforating vessels preoperatively and carefully deploy a stent for the marker band to avoid occlusion of large perforating vessels. Post-treatment evaluation is also important because dual antiplatelet therapy will be required for a longer period if an artery is occluded by a marker band.
Cabergoline-induced fibrosis of prolactinomas: a neurosurgical perspective
Authors: Mohan Niraj , Chia Yi Yan , Goh Giap Hean , Ting Eric , Teo Kejia , Yeo Tseng Tsai
Published: November 2017

Presently, the standard of care for prolactinomas, a type of pituitary adenoma, is dopaminergic agents such as bromocriptine and cabergoline. However, dopaminergic agents may induce fibrosis of cardiac valves leading to valvular insufficiency, necessitating surgical treatment of prolactinoma. Fibrosis of prolactinoma can be induced by prolonged medical treatment with bromocriptine, and this usually occurs after years of treatment. In comparison to bromocriptine, there have been no reports of cabergoline-induced fibrosis of prolactinoma. There is a potential for greater emphasis to be placed on assessing the tumour consistency from preoperative MRI scans, or even preoperative contrast-enhanced 3D Fast Imaging Employing Steady-state Acquisition imaging to allow better planning of the surgery. We report a rare case of fibrosis of prolactinoma after cabergoline treatment resulting in its subsequent difficult surgical removal. This patient had early MRI changes of fibrosis of prolactinoma after a short period of 6 months of cabergoline treatment.
Randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website
Authors: Wallace Paul , Struzzo Pierliugi , Della Vedova Roberto , Scafuri Francesca , Tersar Costanza , Lygidakis Charilaos , McGregor Richard , Scafato Emanuele , Hunter Rachael , Freemantle Nick
Published: November 2017

Background

Brief interventions (BIs) delivered in primary care have been shown to be effective in reducing risky drinking, but implementation is limited. Facilitated access to a digital application offers a novel alternative to face-to-face intervention, but its relative effectiveness is unknown.

Methods

Primary care-based, non-inferiority, randomised controlled trial comparing general practitioner (GP) facilitated access to an interactive alcohol reduction website (FA) with face-to-face BI for risky drinking. Patients screening positive on the short Alcohol Use Disorders Identification Test (AUDIT-C) were invited to participate in the trial. Assessment at baseline, 3 months and 12 months was carried out using AUDIT and EQ-5D-5L questionnaires.

Findings

58 participating GPs approached 9080 patients of whom 4529 (49.9%) logged on, 3841 (84.8%) undertook screening, 822 (21.4%) screened positive and 763 (19·9%) were recruited. 347 (45.5%) were allocated to FA and 416 (54.5%) to BI. At 3 months, subjects in FA group with an AUDIT score of ≥8 reduced from 95 (27.5%) to 85 (26.8%) while those in BI group increased from 123 (20.6%) to 141 (37%). Differences between groups were principally due to responses to AUDIT question 10. Analysis of primary outcome indicated non-inferiority of FA compared with BI, and prespecified subgroup analysis indicated benefits for older patients and those with higher levels of computer literacy and lower baseline severity. Additional analyses undertaken to take account of bias in response to AUDIT question 10 failed to support non-inferiority within the prespecified 10% boundary.

Interpretation

Prespecified protocol-driven analyses of the trial indicate that FA is non-inferior to BI; however, identified bias in the outcome measure and further supportive analyses question the robustness of this finding. It is therefore not possible to draw firm conclusions from this trial, and further research is needed to determine whether the findings can be replicated using more robust outcome measures.

Trial registration number

NCT01638338; Results.
Perceived barriers to leisure time physical activity in adults with type 2 diabetes attending primary healthcare in Oman: a cross-sectional survey
Authors: Alghafri Thamra , Alharthi Saud M , Al Farsi Yahya Mohd , Bannerman Elaine , Craigie Angela Mary , Anderson Annie S
Published: November 2017

Objectives

Physical activity is fundamental in diabetes management for good metabolic control. This study aimed to identify barriers to performing leisure time physical activity and explore differences based on gender, age, marital status, employment, education, income and perceived stages of change in physical activity in adults with type 2 diabetes in Oman.

Design

Cross-sectional study using an Arabic version of the ‘Barriers to Being Active’ 27-item questionnaire.

Setting

Seventeen primary health centres randomly selected in Muscat.

Participants

Individuals>18 years with type 2 diabetes, attending diabetes clinic for >2 years and with no contraindications to performing physical activity.

Primary and secondary outcome measures

Participants were asked to rate how far different factors influenced their physical activity under the following categories: fear of injury, lack of time, social support, energy, willpower, skills, resources, religion and environment. On a scale of 0–9, barriers were considered important if scored ≥5.

Results

A total of 305 questionnaires were collected. Most (96%) reported at least one barrier to performing leisure time physical activity. Lack of willpower (44.4%), lack of resources (30.5%) and lack of social support (29.2%) were the most frequently reported barriers. Using χ2test, lack of willpower was significantly different in individuals with low versus high income (54.2%vs40%, P=0.002) and in those reporting inactive versus active stages of change for physical activity (50.7%vs34.7%, P=0.029), lack of resources was significantly different in those with low versus high income (40%vs24.3%, P=0.004) and married versus unmarried (33.8%vs18.5%, P=0.018). Lack of social support was significant in females versus males (35.4%vs20.8%, P=0.005).

Conclusions

The findings can inform the design on physical activity intervention studies by testing the impact of strategies which incorporate ways to address reported barriers including approaches that enhance self-efficacy and social support.
Clinical and economic evaluation of modulated electrohyperthermia concurrent to dose-dense temozolomide 21/28 days regimen in the treatment of recurrent glioblastoma: a retrospective analysis of a two-centre German cohort trial with systematic comparison and effect-to-treatment analysis
Authors: Roussakow Sergey V
Published: November 2017

Objective

To assess the efficacy and cost-effectiveness of modulated electrohyperthermia (mEHT) concurrent to dose-dense temozolomide (ddTMZ) 21/28 days regimen versus ddTMZ 21/28 days alone in patients with recurrent glioblastoma (GBM).

Design

A cohort of 54 patients with recurrent GBM treated with ddTMZ+mEHT in 2000–2005 was systematically retrospectively compared with five pooled ddTMZ 21/28 days cohorts (114 patients) enrolled in 2008–2013.

Results

The ddTMZ+mEHT cohort had a not significantly improved mean survival time (mST) versus the comparator (p=0.531) after a significantly less mean number of cycles (1.56 vs 3.98, p<0.001). Effect-to-treatment analysis (ETA) suggests that mEHT significantly enhances the efficacy of the ddTMZ 21/28 days regimen (p=0.011), with significantly less toxicity (no grade III–IV toxicity vs 45%–92%, p<0.0001). An estimated maximal attainable median survival time is 10.10 months (9.10–11.10). Cost-effectiveness analysis suggests that, unlike ddTMZ 21/28 days alone, ddTMZ+mEHT is cost-effective versus the applicable cost-effectiveness thresholds €US$25 000–50 000/quality-adjusted life year (QALY). Budget impact analysis suggests a significant saving of €8 577 947/$11 201 761 with 29.1–38.5 QALY gained per 1000 patients per year. Cost-benefit analysis suggests that mEHT is profitable and will generate revenues between €3 124 574 and $6 458 400, with a total economic effect (saving+revenues) of €5 700 034 to $8 237 432 per mEHT device over an 8-year period.

Conclusions

Our ETA suggests that mEHT significantly improves survival of patients receiving the ddTMZ 21/28 days regimen. Economic evaluation suggests that ddTMZ+mEHT is cost-effective, budget-saving and profitable. After confirmation of the results, mEHT could be recommended for the treatment of recurrent GBM as a cost-effective enhancer of ddTMZ regimens, and, probably, of the regular 5/28 days regimen. mEHT is applicable also as a single treatment if chemotherapy is impossible, and as a salvage treatment after the failure of chemotherapy.
Beyond the diagnosis: a qualitative exploration of the experiences of persons with hepatitis B in the Accra Metropolis, Ghana
Authors: Adjei Charles Ampong , Naab Florence , Donkor Ernestina S
Published: November 2017

Objective

This study explored the experiences of people with hepatitis B in the Accra metropolis.

Design

The study employed qualitative exploratory descriptive design with purposive sampling technique. Data were collected through face-to-face interview and transcribed verbatim. The data were analysed using content analysis.

Settings

Participants were recruited from one government and one mission hospital in Ghana.

Participants

Fourteen individuals aged between 26 and 45 years with hepatitis B infection were interviewed.

Results

The findings of the study showed that people with hepatitis B in the Accra metropolis were unclear about the impact of their infection. Furthermore, they experienced psychological and social problems especially when they were initially informed about their hepatitis B status. Sadness, fear, shock, shame and disbelief were some of the experiences reported by participants. Coping strategies adopted include religiosity, denial and lifestyle modification.

Conclusions

It is, therefore, necessary as a country to integrate hepatitis B counselling into the already existing HIV structures in the health delivery system to offer support for individuals diagnosed with hepatitis B. Furthermore, it is important to draw lessons from the process used in the diagnosis of HIV, particularly in ensuring that people provide consent for being tested.
Development of a clinical pharmacy model within an Australian home nursing service using co-creation and participatory action research: theVisitingPharmacist (ViP) study
Authors: Elliott Rohan A , Lee Cik Yin , Beanland Christine , Goeman Dianne P , Petrie Neil , Petrie Barbara , Vise Felicity , Gray June
Published: November 2017

Objective

To develop a collaborative, person-centred model of clinical pharmacy support for community nurses and their medication management clients.

Design

Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and other stakeholders.

Setting

A large, non-profit home nursing service in Melbourne, Australia.

Participants

Older people referred to the home nursing service for medication management, their carers, community nurses, general practitioners (GPs) and pharmacists, a multidisciplinary stakeholder reference group (including consumer representation) and the project team.

Data collection and analysis

Feedback and reflections from minutes, notes and transcripts from: project team meetings, clinical pharmacists’ reflective diaries and interviews, meetings with community nurses, reference group meetings and interviews and focus groups with 27 older people, 18 carers, 53 nurses, 15 GPs and seven community pharmacists.

Results

The model was based on best practice medication management standards and designed to address key medication management issues raised by stakeholders. Pharmacist roles included direct client care and indirect care. Direct care included home visits, medication reconciliation, medication review, medication regimen simplification, preparation of medication lists for clients and nurses, liaison and information sharing with prescribers and pharmacies and patient/carer education. Indirect care included providing medicines information and education for nurses and assisting with review and implementation of organisational medication policies and procedures. The model allowed nurses to refer directly to the pharmacist, enabling timely resolution of medication issues. Direct care was provided to 84 older people over a 15-month implementation period. Ongoing feedback and consultation, in line with participatory action research principles, informed the development and refinement of the model and identification of enablers and challenges.

Conclusions

A collaborative, person-centred clinical pharmacy model that addressed the needs of clients, carers, nurses and other stakeholders was successfully developed. The model is likely to have applicability to home nursing services nationally and internationally.
A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP)
Authors: Alonge Olakunle , Agrawal Priyanka , Meddings David , Hyder Adnan A
Published: November 2017

Introduction

This study presents a systematic approach—assessment of child injury prevention policies (A-CHIPP)—to assess and track policies on effective child injury interventions at the national level. Results from an initial pilot test of the approach in selected countries are presented.

Method

A literature review was conducted to identify conceptual models for injury policy assessment, and domains and indicators were proposed for assessing national injury policies for children aged 1–9 years. The indicators focused on current evidence-supported interventions targeting the leading external causes of child injury mortality globally, and were organised into a self-administered A-CHIPP questionnaire comprising 22 questions. The questionnaire was modified based on reviews by experts in child injury prevention. For an initial test of the approach, 13 countries from all six WHO regions were selected to examine the accuracy, usefulness and ease of understanding of the A-CHIPP questionnaire.

Results

Data on the A-CHIPP questionnaire were received from nine countries. Drowning and road traffic injuries were reported as the leading causes of child injury deaths in seven of these countries. Most of the countries lacked national policies on interventions that address child injuries; supportive factors such as finance and leadership for injury prevention were also lacking. All countries rated the questionnaire highly on its relevance for assessment of injury prevention policies.

Conclusion

The A-CHIPP questionnaire is useful for national assessment of child injury policies, and such an assessment could draw attention of stakeholders to policy gaps and progress in child injury prevention in all countries.
Alcohol and other substance use among medical and law students at a UK university: a cross-sectional questionnaire survey
Authors: Bogowicz Paul , Ferguson Jennifer , Gilvarry Eilish , Kamali Farhad , Kaner Eileen , Newbury-Birch Dorothy
Published: November 2017

Purpose of the study

To examine the use of alcohol and other substances among medical and law students at a UK university.

Study design

Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university.

Results

1242 of 1577 (78.8%) eligible students completed the questionnaire. Over half of first and second year medical students (first year 53.1%, second year 59.7%, final year 35.9%) had an Alcohol Use Disorders Identification Test (AUDIT) score suggestive of an alcohol use disorder (AUDIT≥8), compared with over two-thirds of first and second year law students (first year 67.2%, second year 69.5%, final year 47.3%). Approximately one-quarter of medical students (first year 26.4%, second year 28.4%, final year 23.7%) and over one-third of first and second year law students (first year 39.1%, second year 42.4%, final year 18.9%) reported other substance use within the past year. Over one-third of medical students (first year 34.4%, second year 35.6%, final year 46.3%) and approximately half or more of law students (first year 47.2%, second year 52.7%, final year 59.5%) had a Hospital Anxiety and Depression Scale anxiety score suggestive of a possible anxiety disorder.

Conclusions

Study participants had high levels of substance misuse and anxiety. Some students’ fitness to practice may be impaired as a result of their substance misuse or symptoms of psychological distress. Further efforts are needed to reduce substance misuse and to improve the mental well-being of students.
Clinical indicators of hemorrhagic shock in pregnancy
Authors: Jenkins Peter C , Stokes Samantha M , Fakoyeho Stephen , Bell Teresa M , Zarzaur Ben L
Published: November 2017

Background

Several hemodynamic parameters have been promoted to help establish a rapid diagnosis of hemorrhagic shock, but they have not been well validated in the pregnant population. In this study, we examined the association between three measures of shock and early blood transfusion requirements among pregnant trauma patients.

Methods

This study included 81 pregnant trauma patients admitted to a level 1 trauma center (2010–2015). In separate logistic regression models, we tested the relationship between exposure variables—initial systolic blood pressure (SBP), shock index (SI), and rate over pressure evaluation (ROPE)—and the outcome of transfusion of blood products within 24 hours of admission. To test the predictive ability of each measure, we used receiver operating characteristic (ROC) curves.

Results

A total of 10% of patients received blood products in the patient cohort. No patients had an initial SBP≤90, so the SBP measure was excluded from analysis. We found that patients with SI>1 were significantly more likely to receive blood transfusions compared with patients with SI<1 (OR 10.35; 95% CI 1.80 to 59.62), whereas ROPE>3 was not associated with blood transfusion compared with ROPE≤3 (OR 2.92; 95% CI 0.28 to 30.42). Furthermore, comparison of area under the ROC curve for SI (0.68) and ROPE (0.54) suggested that SI was more predictive than ROPE of blood transfusion.

Conclusion

We found that an elevated SI was more closely associated with early blood product transfusion than SBP and ROPE in injured pregnant patients.

Level of evidence

Prognostic, level III
Emergency general surgery in pregnancy
Authors: Skubic Jeffrey J , Salim Ali
Published: November 2017

It is often that the acute care surgeon will be called on to evaluate the pregnant patient with abdominal pain. Most of the diagnostic and management decisions regarding pregnant patients will follow the usual tenets of surgery; however, there are important differences in the pregnant patient to be aware of to avoid pitfalls which can lead to complications for both mother and fetus. This review hopes to describe the most common emergencies facing the surgeon caring for the pregnant patient and the latest management options.
A Meta-Analysis of Organizational Learning and IT Assimilation
Authors: Roberts Nicholas , Gerow Jennifer E. , Jeyaraj Anand , Roberts Sara
Published: November 2017

Researchers often apply organizational learning concepts and theories to study what factors affect organizational IT assimilation. Although this body of work has substantially improved our understanding of the relationship between organizational learning and IT assimilation, to date there is no rigorous analysis of the empirical research that gives us an accurate assessment of what we truly know in this area. We meta-analyze 33 studies of organizational learning-based IT assimilation. While results show that an organization's level of related knowledge and knowledge diversity are both positively related to IT assimilation, moderator tests show that the consistency in these links varies depending upon the type of IT innovation studied and the way in which assimilation was conceptualized and measured. By narrowing the gap between what we know and what we need to know about the role of organizational learning during IT assimilation, this study contributes to our understanding of whether, when, and how organizations assimilate IT innovations.
Big Data, the Internet of Things, and the Revised Knowledge Pyramid
Authors: Jennex Murray E.
Published: November 2017

The knowledge pyramid has been used for several years to illustrate the hierarchical relationships between data, information, knowledge, and wisdom. An earlier version of this paper presented a revised knowledge-KM pyramid that included processes such as filtering and sense making, reversed the pyramid by positing there was more knowledge than data, and showed knowledge management as an extraction of the pyramid. This paper expands the revised knowledge pyramid to include the Internet of Things and Big Data. The result is a revision of the data aspect of the knowledge pyramid. Previous thought was of data as reflections of reality as recorded by sensors. Big Data and the Internet of Things expand sensors and readings to create two layers of data. The top layer of data is the traditional transaction / operational data and the bottom layer of data is an expanded set of data reflecting massive data sets and sensors that are near mirrors of reality. The result is a knowledge pyramid that appears as an hourglass.
Optimal Pricing Strategies and Customers’ Equilibrium Behavior in an Unobservable M/M/1 Queueing System with Negative Customers and Repair
Authors: Lee Doo Ho
Published: November 2017

This work investigates the optimal pricing strategies of a server and the equilibrium behavior of customers in an unobservable M/M/1 queueing system with negative customers and repair. In this work, we consider two pricing schemes. The first is termed the ex‐post payment scheme, where the server charges a price that is proportional to the time spent by a customer in the system. The second scheme is the ex‐ante payment scheme, where the server charges a flat rate for all services. Based on the reward‐cost structure, the server (or system manager) should make optimal pricing decisions in order to maximize its expected profit per time unit in each payment scheme. This study also investigates equilibrium joining/balking behavior under the server’s optimal pricing strategies in the two pricing schemes. We show, given a customer’s equilibrium, that the two pricing schemes are perfectly identical from an economic point of view. Finally, we illustrate the effect of several system parameters on the optimal joining probabilities, the optimal price, and the equilibrium behavior via numerical examples.
IDO Immune Status after Chemoradiation May Predict Survival in Lung Cancer Patients
Authors: Wang Weili , Huang Lei , Jin Jian-Yue , Jolly Shruti , Zang Yong , Wu Huanmei , Yan Li , Pi Wenhu , Li Lang , Mellor Andrew L. , Kong Feng-Ming (Spring)
Published: November 2017

Host immunity influences the impact of radiotherapy (RT) in cancer, but mechanistic connections remain obscure. In this study, we investigated the relationship of indoleamine 2,3-dioxygenase (IDO) systemic activity on clinical outcomes in RT-treated non–small cell lung cancer (NSCLC). IDO-mediated production of kynurenine and the kynurenine:tryptophan ratio in patient blood serum were determined for stage III NSCLC patients at times before, during, and after RT administration and then correlated to overall survival (OS), progression-free survival, and disease progression rate in patients. We found the impact of RT on these serum IDO markers to be heterogeneous in patients. On average, kynurenine:tryptophan ratios were reduced during RT but restored after RT. Notably, both baseline levels of kynurenine:tryptophan and changes in the levels of kynurenine after RT were significantly associated with OS. When combined, favorable change and favorable baseline corresponded with very long-term OS (median OS was not reached after 57 months of median follow-up). Favorable change combined with unfavorable baseline still corresponded with a lack of distant metastases. Our results suggest that RT alters IDO-mediated immune status in NSCLC patients and that changes in this serum biomarker may be useful to predict outcomes and perhaps personalize RT dosage to improve survival.

Significance: Radiotherapy appears to influence systemic IDO activity and to exert a significant impact on metastatic risk and overall survival, with possible implications for defining a biomarker to optimize radiation dose in patients to improve outcomes. Cancer Res; 78(3); 809–16. ©2017 AACR.
The Unorthodox Theory of Forms in Plato's Philebus
Authors: Wood James
Published: November 2017

This paper argues that we can make best sense of four key passages as well as the Philebus as a whole by rejecting the “orthodox” view that forms exist separately from particulars as determinate entities in their own right and accepting the “unorthodox” view that forms exist within particulars as their limiting and unifying measures and the ousiai of their geneseis.
Newborn hearing screenin in Batatais county: analysis of results
Authors: Bertoldi Patrícia Mendonça , Manfredi Alessandra Kerli Silva , Mitre Edson Ibrahim
Published: November 2017

Purpose: analyse the results of the newborn hearing screening program in the county of Batatais. Methods: the sample of this research consisted of 4017 newborns assessed, in 4422 newborns. The procedure used was the examination of transient evoked otoacoustic emissions. The data were taken from the database of the institution that performs the hearing screening. Results: the findings showed failure in 365 newborns in the test, but, only 22 flaws in the retesting of which 4 were diagnosed with sensorineural hearing loss. The use of ototoxic antibiotics was the only risk factor observed. Conclusion: the hearing screening program in the city of Batatais seemed to be effective even if done on an outpatient basis. We believe that this is due to linkage of newborn screening and exclusive fulfillment in a single institution which is a benchmark in health care in the city. There was failure to TAN in only 0.5% of the assessed newborns.
Metastatic breast cancer: clinicopathological features and survival according to the site of metastasis
Authors: Brum Igor Vilela , Guerra Maximiliano Ribeiro , Cintra Jane Rocha Duarte , Bustamante-Teixeira Maria Teresa
Published: November 2017

Study design: retrospective cohort study. Objectives: investigate clinical and pathological features, as well as the survival of metastatic breast cancer according to the site affected by the metastasis, osseous or extraosseous. Methods: the study population consisted of a cohort of 124 women with metastatic breast cancer assisted in an oncology referral hospital. The association between sociodemographic, tumoral and treatment variables and the site of metastasis was assessed with a chi-square test and the survival functions were estimated by the Kaplan-Meier method. Results: osseous-only metastasis was observed in 26.6% of patients and extra-osseous metastasis in 45.2%, the remainder presented metastasis in both sites. Among patients with osseous-only metastasis, 68.2% had been treated with hormonal therapy, compared with 44.9% of those with extraosseous metastasis (p=0.06); progesterone receptor–positive tumors were found in 63.6% and 43.3% of the patients in each group (osseous-only versus extraosseous), respectively (p=0.09). Overall 5-years survival rate was 38.5% (CI95%: 18.6-58.2) for patients with osseous-only metastasis and 24.8% (CI95%: 15.2-35.7) for patients with extraosseous metastasis. The mean survival time after the diagnosis of metastasis was 19.6 months in cases of bone-only metastasis and 12.1 in extraosseous metastasis. Conclusions: hormone receptor positivity and use of hormone therapy seem to be associated with the occurrence of isolated bone metastasis; patients within this group were suggested to have longer survival times.
Retroperitoneal cellular schwannoma
Authors: Queiroz Rodolfo Mendes , Rocha Pedro Henrique Pereira , Félix Paulo Roberto , Landell Glaucia Aparecida Magnani , Gomes Michela Prestes , Abud Lucas Giansante , Oliveira Rafael Gouvêa Gomes de
Published: November 2017

We present the case of a female patient, 35 years old, who had a complaint of sporadic left flank pain for 5 years. She said she had no comorbidities. The results of the laboratory tests did not show abnormalities. Previous ultrasonography of the urinary tract (without the use of color Doppler) described a possible single cyst postero-inferiorly to the left renal pelvis. In recent ultrasound we observed that topography massive oval formation markedly hypoechoic with discrete intermingled flow. Subsequent abdominal computed tomography and magnetic resonance imaging characterized retroperitoneal mass along the hilum of the left kidney, associated with renal dimensional reduction and ipsilateral hydronephrosis. Histological diagnosis after tumor excision: cell schwannoma (Antoni A histological standard only).
Index of Microcirculatory Resistance at the Time of Primary Percutaneous Coronary Intervention Predicts Early Cardiac Complications: Insights From the OxAMI (Oxford Study in Acute Myocardial Infarction) Cohort
Authors: Fahrni Gregor , Wolfrum Mathias , De Maria Giovanni Luigi , Cuculi Florim , Dawkins Sam , Alkhalil Mohammad , Patel Niket , Forfar John C. , Prendergast Bernard D. , Choudhury Robin P. , Channon Keith M. , Banning Adrian P. , Kharbanda Rajesh K.
Published: November 2017

Background

Early risk stratification after primary percutaneous coronary intervention (
PPCI
) for
ST
‐segment–elevation myocardial infarction is currently challenging. Identification of a low‐risk group may improve triage of patients to alternative clinical pathways and support early hospital discharge. Our aim was to assess whether the index of microcirculatory resistance (
IMR
) at the time of
PPCI
can identify patients at low risk of early major cardiac complications and to compare its performance against guideline‐recommended risk scores.

Methods and Results

IMR
was measured using a pressure–temperature sensor wire. Cardiac complications were defined as the composite of cardiac death, cardiogenic shock, pulmonary edema, malignant arrhythmias, cardiac rupture, and presence of left ventricular thrombus either before hospital discharge or within 30‐day follow‐up. In total, 261 patients undergoing
PPCI
who were eligible for coronary physiology assessment were prospectively enrolled. Twenty‐two major cardiac complications were reported. Receiver operating characteristic curve analysis confirmed the utility of
IMR
in predicting complications and showed significantly better performance than coronary flow reserve, the Primary Angioplasty in Myocardial Infarction II (PAMI‐II), and Zwolle score (
P
≤0.006). Low microvascular resistance (
IMR
≤40) was measured in 159 patients (61%) of the study population and identified all patients who were free of major cardiac complications (sensitivity: 100%; 95%
CI
, 80.5–100%).

Conclusions

IMR
immediately at the end of
PPCI
for
ST
‐segment–elevation myocardial infarction reliably predicts early major cardiac complications and performed significantly better than recommended risk scores. These novel data have implications for early risk stratification after
PPCI
.
Time in Therapeutic Range, as a Determinant of All‐Cause Mortality in Patients With Hypertension
Authors: Doumas Michael , Tsioufis Costas , Fletcher Ross , Amdur Richard , Faselis Charles , Papademetriou Vasilios
Published: November 2017

Background

Accumulating evidence indicates that reducing systolic blood pressure (
BP
) to <140 mm Hg improves health outcomes; however, an optimal level has not yet been determined. Many population studies or post hoc analyses suggest a target systolic
BP
between 120 and 140 mm Hg with increased risk above and below that range. We tested the hypothesis that consistent control of systolic
BP
between 120 and 140 mm Hg—time in therapeutic range—is a strong determinant of all‐cause mortality among
US
veterans.

Methods and Results

A total of 689 051 individuals from 15 Veterans Administration Medical Centers were followed over a 10‐year period. Participants were classified as hypertensive, intermediate hypertensive, and normotensive according to the number of elevated
BP
recordings (>3, 1 or 2, and none, respectively). Time within, above, or below therapeutic range (120–140 mm Hg) was considered in quartiles and related to all‐cause mortality. The study population consisted of 54% hypertensive, 19.9% intermediate, and 26.1% normotensive participants; the corresponding mortality rates for the 3 groups were 11.5%, 8%, and 1.9%, respectively (
P
<0.0001 for all comparisons). Mortality rates for hypertensive participants with
BP
consistently within, above, or below the therapeutic range were 6.5%, 21.9%, and 33.1%, respectively (
P
<0.0001 for all comparisons). Mortality rates in hypertensive participants increased from 6.5% in the most consistently controlled quartile (>75%) to 8.9%, 15.6%, and 23.5% towards the less consistently controlled quartiles (50–75%, 25–50%, and <25%, respectively;
P
<0.0001 for all comparisons).

Conclusions

An inverse and gradual association between time in therapeutic range and all‐cause mortality was observed in this large veteran cohort. Consistency of
BP
control over time is a strong determinant of all‐cause mortality, and consistency of
BP
control should be monitored in everyday clinical practice.
Review of the genus Eburodacrys White, 1853 (Coleoptera: Cerambycidae: Cerambycinae)
Authors: BOTERO JUAN PABLO
Published: November 2017

The genus Eburodacrys White, 1853 is redescribed. Four new species are proposed: Eburodacrys yolandae, from Colombia; E. eduardoi and E. bezarki, from Brazil, and E. santossilvai, from Venezuela. Eburodacrys curialis Gounelle, 1909; and Eburodacrys hesperidis Chemsak & Linsley, 1970 are proposed as synonyms of Eburodacrys nemorivaga Gounelle, 1909; and Eburodacrys amabilis Galileo & Martins, 2009 as synonym of Eburodacrys sulfurifera Gounelle, 1909. The genus is now composed of 89 species. The geographical distribution of 26 species is expanded and the specific locality in Colombia for E. ayri Galileo & Martins, 2006 and in Argentina for E. seabrai Zajciw 1958 are provided. Photographs of Eburodacrys species are included and a key to differentiate them is provided.
Redescription and new records of Jansen’s goatfish, Parupeneus jansenii (Mullidae), from the Western Pacific and Eastern Indian Ocean
Authors: UIBLEIN FRANZ , HOANG TUAN ANH , GLEDHILL DANIEL
Published: November 2017

For Jansen’s goatfish, Parupeneus jansenii (Mullidae), taxonomic knowledge has been rather poor and occurrence information restricted to a few localities only, with verified records from northern Sulawesi and Sunda Street (Indonesia), and Luzon (Philippines). This species is here included in the so-called “heptacanthus” group together with the Indo-Pacific cinnabar goatfish, P. heptacanthus, and five Indian Ocean congenerics, based on an evenly, symmetrically rounded posterior maxilla margin and similarities in meristic characters and preserved colour. In total 29 P. jansenii and 53 P. heptacanthus consisting of types, recently collected material from south-central Vietnam, southern Indonesia, and NE Australia, and geographically related reference material were studied along with single types of the other five heptacanthus-group species and P. angulatus, a morphologically similar Western Indian Ocean species. In total 62 quantitative meristic and morphometric characters including standard length (SL) were analysed after splitting the data into two size classes (small-sized fish, < 110 mm SL, vs. large-sized fish  > 110 mm SL) to account for size-related differences due to allometry. Diagnoses for P. jansenii and P. heptacanthus and a redescription for P. jansenii were prepared. Fresh-fish colour descriptions for both large- and small-sized voucher specimens of P. jansenii are provided and the effects of freshness status on colour patterns is documented. New records for P. jansenii for Vietnam, southern Indonesia and NE Australia (= first verified record for Australia) are reported and depth information (24–100 m depth range) is given for the first time. P. jansenii differs from the co-occurring P. heptacanthus - independently of size - in shallower body and caudal peduncle, smaller maximum head depth, shorter barbels, caudal and pelvic fins, shallower first dorsal fin, shallower first ray of second dorsal fin, and lack of small dark red or reddish-brown spot on or just below the eighth lateral-line scale. The populations of P. jansenii from Vietnam and Australia differ from each other in a single character, the height of the eighth dorsal-fin ray, but both overlap with the intermediate population from Indonesia. This comprehensive alpha-taxonomic approach provides a useful tool for uncovering the diversity of Parupeneus goatfishes.
The role of ToM in creating a reminiscence bump for MEAMs from adolescence
Authors: Kristen-Antonow Susanne
Published: November 2017

To date, studies have yet to consider the role of theory of mind as an important factor in developing music-related autobiographical memories. Further, it remains unclear if one remembers primarily factual knowledge about a song (semantic memory) or if one retrieves the perceptual and emotional aspects of the life situation connected to a song (episodic memory). To close these research gaps, 61 participants with an average age of 20 years listened to 33 songs topping the charts during their early childhood, childhood or youth. Next to a range of control variables (e.g. family size) participants’ state emotions before and after the experiment, as well as their socio-affective and socio-cognitive theory of mind were assessed. The music mainly invoked episodic versus semantic memories. The strongest positive predictor of specific episodic music-related autobiographical memories from later youth was participants’ socio-cognitive theory of mind. Results also revealed that songs released during early and middle childhood were listened to beyond this time period and triggered mainly memories from early youth. The results are discussed in regard to the possible role of socio-cognitive factors in creating a reminiscence bump for music from later youth.
Treatment of Knee Osteochondritis Dissecans With a Cell-Free Biomimetic Osteochondral Scaffold: Clinical and Imaging Findings at Midterm Follow-up
Authors: Perdisa Francesco , Kon Elizaveta , Sessa Andrea , Andriolo Luca , Busacca Maurizio , Marcacci Maurilio , Filardo Giuseppe
Published: November 2017

Background:

Osteochondritis dissecans (OCD) is a developmental condition of subchondral bone that may result in secondary separation and instability of the overlying articular cartilage, which in turn may lead to degeneration of the overall joint and early osteoarthritis. Biphasic scaffolds have been developed to address defects of the entire osteochondral unit by reproducing the different biological and functional requirements and guiding the growth of both bone and cartilage.

Purpose:

To evaluate midterm clinical and imaging results after cell-free osteochondral scaffold implantation for the treatment of knee OCD.

Study Design:

Case series; Level of evidence, 4.

Methods:

Twenty-seven patients (8 women, 19 men; mean age, 25.5 ± 7.7 years) were treated for knee OCD, with International Cartilage Repair Society (ICRS) grade 3 to 4 lesions with a mean size of 3.4 ± 2.2 cm2 (range, 1.5-12 cm2), and prospectively evaluated for up to 5 years using the ICRS classification system and the Tegner score. Eighteen patients underwent magnetic resonance imaging (MRI) at 24 and 60 months of follow-up, and the graft was evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) score for the cartilage layer, while a specific score was used for subchondral bone.

Results:

All patients significantly improved their clinical scores at each follow-up until their final evaluation. The mean International Knee Documentation Committee (IKDC) subjective score improved from 48.4 ± 17.8 to 82.2 ± 12.2 at 2 years ( P < .0005), and it then remained stable for up to 5 years postoperatively (90.1 ± 12.0). The mean Tegner score increased from 2.4 ± 1.7 preoperatively to 4.4 ± 1.6 at 2 years ( P = .001), with a further increase up to 5.0 ± 1.7 at 5 years of follow-up ( P < .0005 vs preoperatively), reaching almost the preinjury level (5.7 ± 2.2). The MOCART score showed stable results between 24 and 60 months, whereas the subchondral bone status significantly improved over time. No correlation was found between MRI findings and clinical outcomes.

Conclusion:

This 1-step cell-free scaffold implantation procedure showed good and stable results for up to 60 months of follow-up for the treatment of knee OCD. MRI showed abnormalities, in particular at the subchondral bone level, but there was an overall improvement of features over time. No correlation was found between imaging and clinical findings.
Narrating Catastrophe, Cultivating Hope: Apocalyptic Practices and Theological Virtue
Authors: Phillips Elizabeth
Published: November 2017

Apocalypticism has been widely denounced as a framework that devalues the world and its history, funding moral dualism. While this is certainly true of many forms of apocalypticism, it is not an accurate understanding of ancient apocalyptic texts. This article establishes a framework of theological virtue ethics drawn particularly from Herbert McCabe, in which human rationality and Christian morality are understood as political, linguistic, narrative, bodily and sacramental. From within this framework, Anathea Portier-Young’s work is considered, relating early Jewish apocalyptic to trauma theory and describing how these texts narrated socio-political catastrophe in order to open up possibilities of resistance and hope. These considerations point us towards a constructive understanding of apocalyptic imagination and praxis within a political, linguistic, narrative, bodily and sacramental framework. Contemporary employments of Afro-pessimism in Black theology, particularly in J. Kameron Carter, then interrogate the proposed apocalyptic imagination, asking whether Christian apocalyptic praxis can cultivate hope in the face of the catastrophe of modern racism.
Pooling of interdigital swab samples for PCR detection of virulent Dichelobacter nodosus
Authors: Greber Deborah , Locher Iwan , Kuhnert Peter , Butty Marc-André , Holdener Kerstin , Frey Joachim , Schüpbach-Regula Gertraud , Steiner Adrian
Published: November 2017

Virulent ovine foot rot is a contagious foot disease. Given the development and validation of a real-time PCR to detect Dichelobacter nodosus isolates that contain the virulence-associated protease genes aprV2 and aprB2, the diagnosis of foot rot has made considerable progress. We evaluated pooling methods to reduce the number of samples during a foot rot control program. Samples of individual feet were compared to a 4-feet sample of the same sheep. All further analyses based on 4-feet samples (pools-of-5 and pools-of-10 4-feet samples) were compared to samples of individual sheep, and a risk-based herd sampling was evaluated and compared to the whole flock. The sensitivity and specificity of the 4-feet samples for detection of aprV2-positive strains was 93.8% (CI: 87.6–97.5%) and 98.3% (CI: 96.5–99.3%), respectively. The sensitivity and specificity of the pools-of-10 was 86.7% (CI: 78.4–92.7%) and 100.0% (CI: 97.4–100%), respectively. Pools-of-5 were not significantly more sensitive than pools-of-10. The pooling of 4 individual foot samples into one 4-feet sample is an adequate method to reduce the number of samples of individual sheep. The sensitivity of pools-of-5 and pools-of-10 is too imprecise for a control program. Risk-based sampling allowed for a substantial reduction of samples to be tested, had a sensitivity of 95.8% (CI: 78.9–99.9%) and specificity of 100.0% (CI: 88.1–100.0%) when determining the foot rot flock status, and represents an adequate methodology to predict within-flock freedom from infection.
Induction of Proteases in Peritoneal Carcinomatosis, the Role of ICAM-1/CD43 Interaction
Authors: Alkhamesi Nawar A. , Roberts Gretta , Ziprin Paul , Peck David H. , Darzi Ara W.
Published: November 2017

Introduction

The development of peritoneal metastases is a significant clinical issue in the treatment of abdominal cancers and is associated with poor prognosis. We have previously shown that ICAM-1-CD43 interaction plays a significant role in tumor adhesion. However, an invasive phenotype is critical to establish tumor progression via cell associated and secreted proteases including matrix metalloproteinases. High metalloproteinases level significantly enhanced metastasis phenotype on tumors, a detrimental effect on surgical outcome. We investigated the role of direct and indirect signaling between the mesothelium and the tumor cells in enhancing tumor invasion and possible therapeutic intervention.

Methods

Mesothelial cells were enzymatically derived from human omental tissue and implanted in 24 wells plates. Colorectal cancer cells were then introduced and allowed a direct and an indirect contact with the mesothelial layer. Anti-ICAM antibodies, anti-CD43 antibodies, and heparin were used to block MMP production. Gelatin zymography was performed on the supernatant to detect MMPs activity.

Results

MMP production was observed in mesothelial and tumor cells. Direct contact between cell types enhanced MMP9 and 2 (p < 0.05). Indirect contact also stimulate MMPs but at a lower degree. ICAM-1 blocking antibodies attenuated MMP production in direct contact to that observed in the indirect. Heparin introduction achieved a similar outcome.

Conclusions

ICAM-1-CD43 interaction plays a vital role in tumor cells-peritoneum adhesion and invasion, which is manifested by the increased production of MMPs leading to tumor invasion and peritoneal loco-regional. Blocking this interaction with heparin can provide a new therapeutic option.
Social media’s breaking news: the logic of automation in Facebook Trending Topics and Twitter Moments
Authors: Duguay Stefanie
Published: November 2017

This article draws on van Dijck and Poell’s framework of social media logic to examine two platform news functionalities: Facebook Trending Topics and Twitter Moments. It uses the walkthrough method to investigate their technical features while also examining how they fit into platforms’ economic interests and regulatory processes. While the framework of social media logic enables the identification of platforms’ influential elements – programmability, popularity, connectivity and datafication – embedded in news functionalities, a fifth element becomes apparent. The logic of automation naturalises these elements into processes of news distribution through claims that platform news functionalities are free from human intervention. By perpetuating the logic of automation, platforms position themselves as neutral conduits of news information. Expanding the framework of social media logic to include automation enables future analysis of platform developers’ evasion of accountability for shaping social and institutional processes, supported through their claims to produce unbiased automated technologies.