bluuebunny/crossref_metadata_2025 huggingface dataset:
Pioglitazone Attenuates Injury-Induced Neointima Formation in Mouse Femoral Artery Partially through the Activation of AMP-Activated Protein Kinase
Authors: Osman Islam , Fairaq Arwa , Segar Lakshman
Published: May 2017

Background/Aims: Pioglitazone (PIO), an antidiabetic drug, has been shown to attenuate vascular smooth muscle cell (VSMC) proliferation, which is a major event in atherosclerosis and restenosis after angioplasty. Till date, the likely contributory role of AMP-activated protein kinase (AMPK) toward PIO inhibition of VSMC proliferation has not been examined in vivo. This study is aimed at determining whether pharmacological inhibition of AMPK would prevent the inhibitory effect of PIO on neointima formation in a mouse model of arterial injury. Methods: Male CJ57BL/6J mice were subjected to femoral artery injury using guidewire. PIO (20 mg/kg/day) was administered orally 1 day before surgery and for 3 weeks until sacrifice in the absence or presence of compound C (an AMPK inhibitor). Injured femoral arteries were used for morphometric analysis of neointima formation. Aortic tissue lysates were used for immunoblot analysis of phosphorylated AMPK. Results: PIO treatment resulted in a significant decrease in intima-to-media ratio by ∼50.3% (p < 0.05, compared with vehicle control; n = 6), which was accompanied by enhanced phosphorylation of AMPK by ∼85% in the vessel wall. Compound C treatment led to a marked reduction in PIO-mediated inhibition of neointima formation. Conclusion: PIO attenuates injury-induced neointima formation, in part, through the activation of AMPK.
An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma
Authors: Ribeiro Sara Filipa Teixeira , Queirós Tatiana , Amorim José M. , Ferreira Ana M. , Sales-Sanz Marco
Published: May 2017

Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications.
The Overall Survival of Patients with Hepatocellular Carcinoma Correlates with the Newly Defined Time to Progression after Transarterial Chemoembolization
Authors: Arizumi Tadaaki , Ueshima Kazuomi , Iwanishi Mina , Minami Tomohiro , Chishina Hirokazu , Kono Masashi , Takita Masahiro , Yada Norihisa , Hagiwara Satoru , Minami Yasunori , Ida Hiroshi , Komeda Yoriaki , Takenaka Mamoru , Sakurai Toshiharu , Watanabe Tomohiro , Nishida Naoshi , Kudo Masatoshi
Published: May 2017

Aim/Background: The ultimate aim of any treatment for hepatocellular carcinoma (HCC) is to improve overall survival (OS); however, the clinical significance of time to progression (TTP) after transarterial chemoembolization (TACE) is unclear. This retrospective study examined the association between OS and the newly defined time to TACE progression (TTTP) to assess whether TTTP can be an alternative to OS in HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage B. Methods: Between January 2006 and December 2013, 592 patients with HCC (BCLC B1, n = 118; BCLC B2, n = 170) underwent TACE. TTTP was then redefined as time to progression from the first image taken after TACE. The relationship between TTTP and OS was then examined based on survival time. Results: Survival analysis revealed significant differences in the OS of patients with BCLC B1 and those with BCLC B2 (median OS: 42.3 months, 95% confidence interval [CI] 34.4-50.7; and 29.3 months, 95% CI 26.1-37.6, respectively, p = 0.0348). The median TTTP values were 9.5 months (95% CI 7.0-10.9) and 5.3 months (95% CI 4.6-6.7), respectively (p = 0.0078). There was a moderate positive correlation between OS and TTTP for both B1 (R2 = 0.6563, p = 0.0045) and B2 (R2 = 0.6433, p = 0.0052) substages. There was also a positive correlation between OS and TTTP for the combined B1 and B2 substages (R2 = 0.6590, p = 0.0024). Conclusions: There was a moderate correlation between the TTTP and OS of patients with HCC after TACE therapy, where the patients with short TTTP represented short OS, indicating that TTTP is an alternative parameter for survival analysis of HCC patients with BCLC stage B tumors who undergo TACE.
Overlapping DRESS and Stevens-Johnson Syndrome: Case Report and Review of the Literature
Authors: Casagranda Aneline , Suppa Mariano , Dehavay Florence , del Marmol Véronique
Published: May 2017

Drug-induced severe cutaneous adverse reactions (SCARs) include acute generalized exanthematous pustulosis, drug reaction with eosinophilia and systemic symptoms (DRESS), and epidermal necrolysis (Stevens-Johnson syndrome [SJS], toxic epidermal necrolysis). The identification of the causal drug is crucial in order to avoid further exposure, but making the right differential diagnosis of the type of SCAR is equally important since treatment, follow-up, and prognosis of different SCARs are not the same. These syndromes are distinct entities with different clinical, biological, and histological patterns, but sometimes the early distinction between 2 SCARs can be extremely challenging, and overlapping conditions could therefore be taken into consideration, although true overlapping SCARs are very rare when using strict diagnostic criteria (described by the RegiSCAR group). Only a better understanding of the physiopathology of the SCARs could possibly explain these ambiguities and overlaps. We report a case of SCAR in an 86-year-old patient probably induced by allopurinol and simultaneously fulfilling the diagnostic criteria for DRESS and SJS, thus considered as an overlapping case of SCARs.
New species of Bacuma Cameron (Hymenoptera: Braconidae: Braconinae) from Kenya and West Darfur with a key to species
Authors: QUICKE DONALD L. J. , GUY TRAVIS J. , NOORT SIMON VAN , BROAD GAVIN R. , BUTCHER BUNTIKA A.
Published: May 2017

Three new species of the Afrotropical braconine wasp genus Bacuma are described, and biological observations (nectar feeding) by one of them are noted. The new species are: B. kayserae Quicke & Butcher sp. nov. from Kenya, B. madiensis Quicke & Butcher sp. nov. from Uganda and B. darfurensis Quicke & Butcher sp. nov. from Sudan. A group of four large nominal species with red metasomas and finely sculptured tergites (B. granulatus, B. maculipennis, B. rufa and B. whitei) may represent a single widespread species or a pair of species separated by mesoscutum colour, or four separate but morphologically very similar species. However, given the small number of specimens available for study and the poor condition of some of these, including the types, they are not formally synonymised here. A partial key to the species of Bacuma is presented, which recognizes those species that are clearly distinct, including three new species. Interactive Lucid dichotomous and matrix keys are available on www.waspweb.org.
The Perception of Daily Temperatures as Evidence of Global Warming
Authors: Broomell Stephen B. , Winkles Jon-Francis , Kane Patrick Bodilly
Published: May 2017

Unlike the scientific definition of global warming (GW), public discussion often links the existence of GW to daily temperatures rather than long-term averages. Previous research found that daily weather is perceived as personal experiences with GW. Additionally, prior beliefs about GW can affect interpretations of such experiences as evidence for the existence of GW. However, previous studies demonstrating that beliefs affect interpretations of experiences were based on correlational designs—limiting causal inferences—and relied only on self-reports of remembered personal experiences instead of direct interpretations of weather. The authors present the first randomized experiment investigating how people interpret daily temperatures in terms of the evidence that it provides about GW, clarifying the psychological causes for different interpretations of the same experiences across individuals. They test the influence of knowledge about (and beliefs in) GW on the interpretation of daily temperatures across two framing conditions labeled weather (interpreting a temperature as abnormal weather) and climate (interpreting a temperature as evidence of GW). The authors use signal detection theory to measure the decision-maker’s (a) ability to discriminate between temperatures, called sensitivity, and (b) threshold for describing a temperature as abnormal, called the decision threshold. The results replicate previous research finding a motivational distortion in interpreting temperatures as evidence of GW and further find belief-consistent distortions in decision thresholds while observing no measurable change in sensitivity. In other words, people know when temperatures are abnormally hot, but classify ambiguous events (i.e., less extreme abnormalities) differently based on their beliefs in GW.
TNFα depleting therapy improves fertility and animal welfare in TNFα-driven transgenic models of polyarthritis when administered in their routine breeding
Authors: Naylor Amy J. , Desanti Guillaume , Saghir Atif N. , Hardy Rowan S.
Published: May 2017

Transgenic tumour necrosis factor alpha (TNFα)-driven models of polyarthritis such as the TNFΔARE mouse have proven to be invaluable in delineating aspects of inflammatory disease pathophysiology in humans. Unfortunately, the onset of joint destruction and inflammation in these models represents a significant detriment to breeding management. We examined whether TNFα depleting therapy ‘infliximab’ might represent a significant refinement in routine breeding. Clinical scores of joint inflammation were assessed in TNFΔARE males receiving either infliximab (10 mg/kg) or saline by twice-weekly intraperitoneal injection. Joint histology and bone morphology were assessed by histological analysis and micro-computed tomography (CT), respectively. Analysis of breeding was examined retrospectively in TNFΔARE males prior to, and following, regular introduction of infliximab. Clinical scores of inflammation were significantly reduced in TNFΔARE males receiving infliximab (control 6.6 arbitrary units [AU] ± 0.88 versus infliximab 4.4 AU ± 1.4; P < 0.05), while measures of pannus invasion and bone erosion by histology and micro-CT were markedly reduced. In the breeding groups, TNFΔARE males receiving infliximab injections sired more litters over their breeding lifespan (control 1.69 ± 0.22 versus infliximab 3.00 ± 0.19; P < 0.005). Furthermore, prior to infliximab, TNFΔARE males had a 26% risk of failing to sire any litters. This was reduced to 7% after the introduction of infliximab. This study is the first to report that regular administration of infliximab is effective at suppressing disease activity and improving animal welfare in TNFΔARE animals. In addition, we have shown that infliximab is highly efficacious in improving breeding behaviour and increasing the number of litters sired by TNFΔARE males.
Effective education for families of children with visual impairments and blindness in physical activity environments: A workshop model with a focus on Orientation and Mobility skills
Authors: Columna Luis , Lepore-Stevens Maria , L.W.K.D. Kavanagh Erin
Published: May 2017

Children with visual impairments (VI) and their families experience multiple barriers when trying to access physical activity opportunities. These barriers reduce family participation in sports and physical activities and lessen access to the well-known benefits. Basic mobility skills and orientation skills can be a challenge with low vision or no vision, and the professional field of Orientation and Mobility (O&M) can be useful in addressing barriers to physical activity. The purpose of this article is to describe two O&M workshops that were provided within the context of a larger physical activity program for parents of children with VI delivered for participants’ practical ideas and direct experience. This article will discuss detailed program and workshop components, rationales, design, and effective modifications for developing a similar program for children with VI and their families. Previous studies have indicated parent need for this type of hands-on experience and comments from participating parents and their children identifies the effectiveness of this approach.
Tolerability and benefit of a tetramethoxyluteolin-containing skin lotion
Authors: Theoharides Theoharis C , Stewart Julia M , Tsilioni Irene
Published: May 2017

As many as 40% of people have sensitive skin and at least half of them suffer from pruritus associated with allergies, atopic dermatitis (AD), chronic urticaria (CU), cutaneous mastocytosis (CM), and psoriasis. Unfortunately, the available topical formulations contain antihistamines that are often not as effective as those containing corticosteroids. Certain natural flavonoids have anti-inflammatory actions. We recently reported that the natural flavonoid tetramethoxyluteolin has potent antiallergic and anti-inflammatory actions in vitro and in vivo. This flavonoid was formulated in a skin lotion along with olive fruit extract and was first tested for tolerability in 25 patients with mastocytosis or mast cell activation syndrome and very sensitive skin who reported back through a questionnaire. The skin lotion was then used by eight patients, four with AD and four with psoriasis, who had not received any topical treatment for at least 2 months, twice daily for 2 weeks. The use of this tetramethoxyluteolin formulation resulted in significant improvement of the skin lesions and could be useful adjuvant treatment for allergic and inflammatory skin conditions.
Clinical and immunological characteristics of 150 systemic lupus erythematosus patients in Jamaica: a comparative analysis
Authors: Maloney K C , Ferguson T S , Stewart H D , Myers A A , De Ceulaer K
Published: May 2017

Background

Epidemiological studies in systemic lupus erythematosus have been reported in the literature in many countries and ethnic groups. Although systemic lupus erythematosus in Jamaica has been described in the past, there has not been a detailed evaluation of systemic lupus erythematosus patients in urban Jamaica, a largely Afro-Caribbean population. The goal of this study was to describe the clinical features, particularly disease activity, damage index and immunological features, of 150 systemic lupus erythematosus subjects.

Methods

150 adult patients (≥18 years) followed in rheumatology clinic at a tertiary rheumatology hospital centre (one of two of the major public referral centres in Jamaica) and the private rheumatology offices in urban Jamaica who fulfilled Systemic Lupus International Collaborating Clinics (SLICC) criteria were included. Data were collected by detailed clinical interview and examination and laboratory investigations. Hence demographics, SLICC criteria, immunological profile, systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) and SLICC/American College of Rheumatology (ACR) damage index (SDI) were documented.

Results

Of the 150 patients, 145 (96.7%) were female and five (3.3%) were male. The mean age at systemic lupus erythematosus onset was 33.2 ± 10.9. Mean disease duration was 11.3 ± 8.6 years. The most prevalent clinical SLICC criteria were musculoskeletal, with 141 (94%) of subjects experiencing arthralgia/arthritis, followed by mucocutaneous manifestations of alopecia 103 (68.7%) and malar rash 46 (30.7%), discoid rash 45 (30%) and photosensitivity 40 (26.7%). Lupus nephritis (biopsy proven) occurred in 42 (28%) subjects and 25 (16.7%) met SLICC diagnostic criteria with only positive antinuclear antibodies/dsDNA antibodies and lupus nephritis on renal biopsy. The most common laboratory SLICC criteria were positive antinuclear antibodies 136 (90.7%) followed by anti-dsDNA antibodies 95 (63.3%) and low complement (C3) levels 38 (25.3%). Twenty-seven (18%) met SLICC diagnostic criteria with only positive antinuclear antibodies/anti-dsDNA antibodies and lupus nephritis on renal biopsy. Mean SLEDAI score was 6.9 ± 5.1 with a range of 0–32. Organ damage occurred in 129 (86%) patients; mean SDI was 2.4 ± 1.8, with a range of 0–9.

Conclusion

These results are similar to the clinical manifestations reported in other Afro-Caribbean populations; however, distinct differences exist with respect to organ involvement and damage, particularly with respect to renal involvement, which appears to be reduced in our participants.
Hierarchical models for sharing information across populations in phase I dose-escalation studies
Authors: Cunanan Kristen M , Koopmeiners Joseph S
Published: May 2017

The primary goal of a phase I clinical trial in oncology is to evaluate the safety of a novel treatment and identify the maximum tolerated dose, defined as the maximum dose with a toxicity rate below some pre-specified threshold. Researchers are often interested in evaluating the performance of a novel treatment in multiple patient populations, which may require multiple phase I trials if the treatment is to be used with background standard-of-care that varies by population. An alternate approach is to run parallel trials but combine the data through a hierarchical model that allows for a different maximum tolerated dose in each population but shares information across populations to achieve a more accurate estimate of the maximum tolerated dose. In this manuscript, we discuss hierarchical extensions of three commonly used models for the dose–toxicity relationship in phase I oncology trials. We then propose three dose-finding guidelines for phase I oncology trials using hierarchical modeling. The proposed guidelines allow us to fully realize the benefits of hierarchical modeling while achieving a similar toxicity profile to standard phase I designs. Finally, we evaluate the operating characteristics of a phase I clinical trial using the proposed hierarchical models and dose-finding guidelines by simulation. Our simulation results suggest that incorporating hierarchical modeling in phase I dose-escalation studies will increase the probability of correctly identifying the maximum tolerated dose and the number of patients treated at the maximum tolerated dose, while decreasing the rate of dose-limiting toxicities and number of patients treated above the maximum tolerated dose, in most cases.
Cover stories: An emerging aesthetic of prestige science
Authors: Wang Guoyan , Gregory Jane , Cheng Xi , Yao Yuting
Published: May 2017

Our statistical analysis of research publications in the prestigious scientific journals Nature, Science and Cell reveals that papers represented by an image on the journal’s cover gain many more citations in the academic literature than those papers in the same journals that are not represented on the cover. Meanwhile, the number of images used by high-prestige journals is much higher than that used by journals in general, which indicates both the emergence of a new aesthetic of prestige scientific publication, and also that this aesthetic is relevant to journals’ impact. Furthermore, there are significant differences in the use of images in different countries and in different disciplines.
Doctor in the sky: Medico-legal issues during in-flight emergencies
Authors: Wong Marcus
Published: May 2017

More people are travelling by air and in-flight medical emergencies are becoming more common. Some in-flight emergencies require assistance from passenger doctors who act as good Samaritans in the sky. Their liability and the associated medico-legal issues of providing assistance in mid-flight emergencies are unknown. Although provisions exist in theory about good Samaritans on the ground, it is unclear to what extent these doctrines are applicable to good Samaritans in the sky. This article examines the obligations, liability and legal protection of doctors when acting as good Samaritans in mid-flight emergencies, regardless of their nationalities. It examines the jurisdiction, existing legislations, case law in the United Kingdom and compares with their equivalence in the United States and to some extent, with the legal provisions in France. In addition to in-flight emergencies, this article reviews airlines’ liability for injuries sustained by passengers during flight. It is concluded that doctors’ liability is unclear and uncertain, their legal protection is inadequate and inconsistent; airlines’ liability is restricted by the courts. Reforms proposed include legislative enactment and extension of commercial airliners’ insurance to accord the deficient legal protection.
New visiting policy: A step toward nursing ethics
Authors: Khaleghparast Shiva , Joolaee Soodabeh , Maleki Majid , Peyrovi Hamid , Ghanbari Behrooz , Bahrani Naser
Published: May 2017

Background:

Patients’ rights arise from their expectations of the healthcare system, which are rooted in their needs. Visitation is seen as a necessary need for patients and families in intensive care units.

Objectives:

The authors attempted to design, implement, and evaluate a new visiting policy in the intensive care units.

Research design:

This study was an action research, including two qualitative and quantitative approaches.

Participants and research context:

The viewpoints of 51 participants (patients, families, doctors, nurses, and guards) on how to change the limited visiting policy were explained through semi-structured interviews and focus groups. The new visiting policy (contractual visitation) was designed, implemented, and evaluated with the involvement of participants.

Ethical considerations:

The hospital ethics committee approval was gained and the informed consent was obtained from all the participants.

Findings:

The content of interviews was analyzed and classified into four categories: advantages and disadvantages of visiting policies, and barriers and facilitators of changing the limited visiting policy. After implementation of the new policy (contractual visitation), a significant difference observed in satisfaction status before and after the changes (p value < 0.001).

Discussion:

Nowadays, many countries’ clinical guidelines recommend flexible visiting policy, which is consistent with the results of this study.

Conclusion:

Changing the limited visiting policy was a necessary need for patients and families that established with the involvement of them and staff.
Outcomes After Percutaneous Reduction and Fixation of Low-Energy Lisfranc Injuries
Authors: Vosbikian Michael , O’Neil Joseph T. , Piper Christine , Huang Ronald , Raikin Steven M.
Published: May 2017

Background:

Lisfranc injuries are often missed initially or not anatomically reduced, leading to midfoot collapse, arthrosis, and pain. Operative management of these injuries is also fraught with complications, particularly with respect to the soft tissues. Wound dehiscence and infection are not uncommon. The goal of this study was to analyze the outcomes of a minimally invasive technique in reduction and percutaneous fixation of low-energy minimally displaced Lisfranc injuries and determine if it is a safe alternative to more traditional, open approaches.

Methods:

A retrospective review was performed for all patients who underwent minimally invasive Lisfranc treatment at a single institution over a 6-year period. Thirty-eight patients were identified in this series. All patients were skeletally mature and had a minimum follow-up of 3 years. Patients were assessed clinically and radiographically, in addition to undertaking patient-centric outcome scoring using the Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and sports subscales at a mean follow-up of 66 months (range, 36-100). Patients were also asked to subjectively rate their percentage return to preinjury functional level at the time of final follow-up. There were 20 males and 18 females. Seventeen patients were injured participating in sports-related activities, 19 during falls, and 2 as a result of motor vehicle accidents. The average age at the time of surgery was 34.2 (range, 16-69) years. At final follow-up, 31 patients were available for assessment (81.6%).

Results:

The mean FAAM-ADL score was 94.2 (range, 40.5-100), and sports score was 90.4 (range, 0-100). Percentage recovery compared to their preinjury functional level averaged 91.4% (range, 40%-100%). There were no complications in this series. Twenty-two patients underwent screw removal electively at an average of 6.9 months following the index procedure. No patients had undergone any additional operative procedures, or had any objective evidence of midfoot collapse or arthritis at the time of final follow-up.

Conclusion:

Minimally invasive methods of treating low-energy Lisfranc injuries with less soft tissue stripping and disruption, as described in this series, were a valuable tool to optimize outcomes while minimizing the potential morbidity of more traditional, open techniques.

Level of Evidence:

Level IV, retrospective case series.
Sluggish Cognitive Tempo, Internalizing Symptoms, and Executive Function in Adults With ADHD
Authors: Leikauf John E. , Solanto Mary V.
Published: May 2017

Objective: We sought to characterize relationships between sluggish cognitive tempo (SCT) and both internalizing symptoms and executive functioning in adults with ADHD. Method: A total of 102 adults with ADHD completed clinical interviews and clinical rating scales. Hierarchical regression analyses were conducted to ascertain the independent predictive power of SCT symptoms for deficits in executive function (EF) after considering severity of ADHD inattentive and hyperactive-impulsive symptoms and internalizing symptoms. Results: SCT correlated with ADHD inattentive symptoms and dimensional measures of depression and anxiety but not with clinical diagnosis of depression or anxiety. SCT predicted EF deficits over and above the effects of internalizing and ADHD symptoms. This relationship between SCT and EF was limited to the subset of participants ( n = 48) receiving stimulant treatment. Conclusion: SCT in adults with ADHD is associated with internalizing symptoms, ADHD inattentive symptoms, and, independently, with EF deficits. Further research is needed to ascertain why this relationship occurred primarily in adults concurrently receiving stimulants.
Hidradenitis Suppurativa, Intimate Partner Violence, and Sexual Assault
Authors: Sisic Mia , Tan Jerry , Lafreniere Kathryn D.
Published: May 2017

Background:

Sexual assault and intimate partner violence have never been examined in individuals with hidradenitis suppurativa. The research is important, because prior studies show higher incidences of intimate partner violence and sexual assault in individuals with disabilities, and hidradenitis suppurativa meets criteria for a disability.

Objectives:

The objective of the study is to examine whether individuals with hidradenitis suppurativa are at significantly higher risk of intimate partner violence and sexual assault compared with individuals who have acne, a recognised disability.

Methods:

Participants who met criteria for hidradenitis suppurativa and acne were recruited from a mid-sized university and a dermatology clinic. Participants spoke English and were over the age of sexual consent. Group (hidradenitis suppurativa and acne) differences on intimate partner violence and sexual assault were analysed. Victimisation within the past 12 months was measured using the Checklist for Controlling Behaviours, a measure of intimate partner violence, as well as the Sexual Experiences Survey–Short Form Victim, a measure of sexual assault.

Results:

In total, 243 participants (n = 128 for hidradenitis suppurativa; n = 115 for acne) were surveyed. Individuals with hidradenitis suppurativa were significantly more likely to report being victimised by intimate partner violence.

Conclusions:

Intimate partner violence was more frequently observed in individuals with hidradenitis suppurativa. Health care providers should be aware of this issue when interacting with patients with hidradenitis suppurativa.
Affirmation, validation, and empowerment: Influences of a composition competition on students’ self-concepts as musicians
Authors: Albert Daniel J.
Published: May 2017

The purpose of this study was to determine if participation in a composition competition influenced four K–12 students’ self-concepts as musicians. Research questions explored motivations for these four students to enter into a composition competition, influences of the competition on students’ self-concepts as musicians (if at all), and effects of the competition besides those of self-concept as a musician (if at all). Data sources for this multiple case design study included semi-structured interviews, journals, and wiki interactions. Findings determined that acceptance to the competition, performance of students’ works, and the reception that students received validated and strengthened their self-concepts as musicians. Suggestions for teaching practice include providing constructive feedback from competition adjudicators, creating face-to-face and online experiences for student composers to network, and offering non-adjudicated composition festival experiences for students.
Characterization of annual disease progression of multiple sclerosis patients: A population-based study
Authors: Freilich Jonatan , Manouchehrinia Ali , Trusheim Mark , Baird Lynn G , Desbiens Sophie , Berndt Ernst , Hillert Jan
Published: May 2017

Background:

Previous research characterizing factors influencing multiple sclerosis (MS) disease progression has typically been based on time to disease milestones (Kaplan–Meier, Cox hazard regression, etc.). A limitation of these methods is the handling of the often large groups of patients not reaching the milestone.

Objective:

To characterize clinical factors influencing MS disease progression as annual transitions from each Expanded Disability Status Scale (EDSS).

Method:

The annual progression of 11,964 patients from the Swedish MS Registry was analysed with 10 multinomial logistic regressions, that is, one for transition from each full EDSS with explanatory variables age, sex, age at onset, time in current EDSS, highest prior EDSS, MS course and treatment.

Results:

All factors (except sex) investigated had statistically significant impacts on transitions from at least one EDSS. However, significance and size of the effect are dependent on the EDSS state of the patient. Greater age, longer time in a state, highest prior EDSS, having progressive MS and treatment had significant impacts, whereas age at onset had minor impact.

Conclusion:

Our study confirms that established factors associated with MS disease worsening in time to disease milestones also have impacts on annual progression. This approach adds granularity to what EDSS these factors have an influence.
Culture-specific ideologies undermine collective action support: Examining the legitimizing effects of postcolonial belief systems
Authors: Osborne Danny , Yogeeswaran Kumar , Sibley Chris G.
Published: May 2017

Ideologies can legitimate inequality and undermine collective action. Yet research overlooks the effects culture-specific ideologies—ideologies that develop within a specific sociohistorical context—have on collective action support. We address this oversight by arguing that two culture-specific ideologies that deny the contemporary relevance of past injustices (historical negation) and reject Indigenous culture from the nation’s identity (symbolic exclusion) undermine support for collective action on behalf of the disadvantaged (namely, Māori—New Zealand’s Indigenous population). As predicted, historical negation and symbolic exclusion had independent negative cross-lagged effects on collective action support amongst Māori ( N = 561) and New Zealand European ( N = 4,104) participants. The cross-lagged effects of collective action support on historical negation and symbolic exclusion, however, were nonsignificant. Thus, the relationships these culture-specific ideologies have with collective action support are unidirectional. Our results highlight the need to incorporate culture-specific ideologies into models of collective action.
A study on students’ acceptance of mobile phone use to seek health information in South Africa
Authors: Cilliers Liezel , Viljoen Kim Lee-Anne , Chinyamurindi Willie Tafadzwa
Published: May 2017

Background:

In South Africa, inequitable access to healthcare information has made many young people with limited resources more vulnerable to health risks. Mobile phones present a unique opportunity to address this problem due to the high penetration of mobile phones in South Africa and the popularity of these devices among young adults.

Objective:

This research sought to examine the adoption of mobile phones to access health information among students at a traditional university in the Eastern Cape, South Africa.

Method:

A cross-sectional survey approach was used to collect information from a convenience sample of 202 university students (58 males; 104 females), the majority (71.3%) of whom were aged between 18 and 27 years and of Black African ethnicity (75.2%). The unified theory of acceptance and use of technology (UTAUT) framework formed the theoretical foundation for the questionnaire. A research model was developed to test the hypotheses that behavioural intention to use a mobile phone to access health information would be influenced by: perceived usefulness (PU), perceived effort, social influence (SI), attitude towards technology (AT) and mobile phone experience.

Results:

Factor analyses indicated that the research model explained 36% of the variance in behavioural intention to use mobile devices to search for health-related queries, with PU being the largest predictor, followed by mobile experience, SI, and AT. Perceived effort did not make a statistically significant contribution.

Conclusion:

Using mobile phones to disseminate health information to students is a useful, convenient, and cost-effective health-promotion strategy. This research has contributed to the body of knowledge concerning the applicability of the UTAUT framework to study the adoption of technology and provided useful information to guide future research and implementation of mHealth initiatives.
Pediatric Trainees Managing a Difficult Airway: Comparison of Laryngeal Mask Airway, Direct, and Video‐Assisted Laryngoscopy
Authors: Ambrosio Art , Marvin Kastley , Perez Colleen , Byrnes Chelsie , Gaconnet Cory , Cornelissen Chris , Brigger Matthew
Published: May 2017

Objective

Difficult airway management is a key skill required by all pediatric physicians, yet training on multiple modalities is lacking. The objective of this study was to compare the rate of, and time to, successful advanced infant airway placement with direct laryngoscopy, video‐assisted laryngoscopy, and laryngeal mask airway (LMA) in a difficult airway simulator. This study is the first to compare the success with 3 methods for difficult airway management among pediatric trainees.

Study Design

Randomized crossover pilot study.

Setting

Tertiary academic medical center.

Methods

Twenty‐two pediatric residents, interns, and medical students were tested. Participants were provided 1 training session by faculty using a normal infant manikin. Subjects then performed all 3 of the aforementioned advanced airway modalities in a randomized order on a difficult airway model of a Robin sequence. Success was defined as confirmed endotracheal intubation or correct LMA placement by the testing instructor in ≤120 seconds.

Results

Direct laryngoscopy demonstrated a significantly higher placement success rate (77.3%) than video‐assisted laryngoscopy (36.4%, P =. 0117) and LMA (31.8%, P =. 0039). Video‐assisted laryngoscopy required a significantly longer amount of time during successful intubations (84.8 seconds; 95% CI, 59.4‐110.1) versus direct laryngoscopy (44.9 seconds; 95% CI, 33.8‐55.9) and LMA placement (36.6 seconds; 95% CI, 24.7‐48.4).

Conclusions

Pediatric trainees demonstrated significantly higher success using direct laryngoscopy in a difficult airway simulator model. However, given the potential lifesaving implications of advanced airway adjuncts, including video‐assisted laryngoscopy and LMA placement, more extensive training on adjunctive airway management techniques may be useful for trainees.
A review of Lise Fontaine, Tom Bartlett and Gerard O’Grady (eds.), Systemic functional linguistics exploring choice. Cambridge: Cambridge University Press, 2013. 533pp
Authors: Zhao Changling , He Wei
Published: May 2017

Systemic Functional Linguistics Exploring Choice provides a fresh inter-disciplinary perspective on the key notion of choice in Systemic Functional Linguistics (SFL). Although one of the basic assumptions of SFL is that language is a system of choices, the very nature and the place of choice have not been explicitly and critically debated within current SFL literature. With a critique of this as the point of departure, the editor Lise Fontaine points out in the introduction that the purpose of the volume is to open the debate on choice and offer a critical examination of its place in systemic functional theory. The volume comprises 22 chapters bringing together a range of linguistic viewpoints, informed by sociology, evolutionary theory, computational approaches, psychology and neuroscience to produce a comprehensive account of choice. It is divided into five sections, and each section addresses one of the five questions brought up by the editor.
High quality permanent draft genome sequence of Chryseobacterium bovis DSM 19482T, isolated from raw cow milk
Authors: Laviad-Shitrit Sivan , Göker Markus , Huntemann Marcel , Clum Alicia , Pillay Manoj , Palaniappan Krishnaveni , Varghese Neha , Mikhailova Natalia , Stamatis Dimitrios , Reddy T. B. K. , Daum Chris , Shapiro Nicole , Markowitz Victor , Ivanova Natalia , Woyke Tanja , Klenk Hans-Peter , Kyrpides Nikos C. , Halpern Malka
Published: May 2017

Chryseobacterium bovis DSM 19482T (Hantsis-Zacharov et al., Int J Syst Evol Microbiol 58:1024-1028, 2008) is a Gram-negative, rod shaped, non-motile, facultative anaerobe, chemoorganotroph bacterium. C. bovis is a member of the Flavobacteriaceae, a family within the phylum Bacteroidetes. It was isolated when psychrotolerant bacterial communities in raw milk and their proteolytic and lipolytic traits were studied. Here we describe the features of this organism, together with the draft genome sequence and annotation. The DNA G + C content is 38.19%. The chromosome length is 3,346,045 bp. It encodes 3236 proteins and 105 RNA genes. The C. bovis genome is part of the Genomic Encyclopedia of Type Strains, Phase I: the one thousand microbial genomes study.
Breast Reconstruction With Postmastectomy Radiation: Choices and Tradeoffs
Authors: Poppe Matthew M. , Agarwal Jayant P.
Published: May 2017

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 45-year-old premenopausal woman presented with multifocal cancer in the right breast, with lesions at 1:00 and 4:00, the largest measuring approximately 3 cm on exam, and multiple palpable right axillary lymph nodes. A core biopsy confirmed invasive ductal carcinoma, grade 2 of 3, that was estrogen receptor positive, progesterone receptor positive, and HER2 negative. Fine needle aspiration of a right axillary node confirmed metastatic carcinoma. A positron emission tomography (PET)/ computed tomography done before starting chemotherapy demonstrated an absence of metastatic disease with expected avidity in two separate breast masses and multiple conglomerated 1-2 cm level I and II axillary lymph nodes. She received neoadjuvant chemotherapy with doxorubicin plus cyclophosphamide, followed by paclitaxel, and had a complete clinical response with resolution of the breast and axillary masses on exam. A repeat PET/computed tomography demonstrated reduced size of the breast and axillary disease, and no significant residual PET avidity. Her breast surgeon recommended a right mastectomy with axillary node dissection. As part of her multidisciplinary treatment plan, she consulted with two plastic surgeons to discuss reconstruction options. Plastic Surgeon A advised placement of an implant at the time of mastectomy while Surgeon B contrasted the pros and cons of an autologous transverse rectus abdominis muscle flap reconstruction with an implant based reconstruction. Surgeon B believed that autologous reconstruction would yield the best long-term cosmetic outcome. Before making her surgery decision, the patient consulted with a radiation oncologist to discuss the effect radiation may have on her reconstruction outcome.
The Dismembered Body in Myth and Literature: Isis and Osiris and the Levite of Ephraim
Authors: Ziolkowski Theodore
Published: May 2017

This essay analyzes two variations on the theme of dismemberment. In Egyptian myth, when Osiris is killed and dismembered by his brother, Isis reassembles his body and consecrates the places where she finds the pieces as sites of veneration. This version, clearly anticipating the veneration of saintly relics in Christianity, was secularized in the tale of Lemminkäinen in the Finnlandic epic Kalevala. In the biblical tale of the Levite of Ephraim, in contrast, the dismembered parts of the protagonist's violated spouse are sent to the tribes of Israel to unite them against a common enemy. The tale was taken up in the eighteenth century by Voltaire, Rousseau, and Bodmer as an occasion to reflect on the differences between a state of nature and civilization and on the morality of vengeance. In Kleist's Hermannsschlacht it was secularized into a purely political exhortation.
Beyond Afro-Orientalism: Langston Hughes, Koreans, and the Poetics of Overlapping Dispossessions
Authors: Huh Jang Wook
Published: May 2017

After Langston Hughes was shadowed by Japanese police in the port city of Chongjin, Korea, on his trip from the Soviet Union to Japan and China in 1933, he drew a parallel between the racialization of Koreans under Japanese colonial rule and that of American Negroes under Jim Crow rule. This essay examines Hughes's writings on Korea in conjunction with Korean translations of Hughes. Hughes employs the poetics of what I call “overlapping dispossessions” to analogize Korean colonial subjugation with African American racial oppression. In what I call a form of “cross-racial ventriloquism,” Korean translators subtly insert subversive slogans into Hughes's radical poem “Our Land” in order to encourage anticolonial sentiment against Japanese censorship. By focusing on both Hughes's disaggregate representations of Asians and Korean circulations of black culture, this essay reconsiders the discourse of Afro-Orientalism that represents Asia as an undifferentiated, static entity and thus marginalizes Asian cultural production.
Phenotypic plasticity in morphological features of Thelaxes suberi (Del Guercio, 1911) (Hemiptera: Aphidoidea) feed on Quercus (L.) species
Authors: Görür Gazi , Demirtaş Emin
Published: May 2017

Phenotypic plasticity is a common and important phenomenon in aphids, particularly in host plant utilization. It has been shown that Thelaxes suberi species fed on three closely related Quercus species showed high amount of phenotypic plasticity in morphological characters. Thelaxes suberi population has the largest morphological features on Quercus infectoria and the smallest morphological features on the Quercus coccifera. It was thought that these differences related with the total protein content and level of amino acid in acorns of the host plant where Thelaxes individuals were collected during this study. Findings of the study indicated how high is phenotypic plasticity capacity of aphid species and interactions with host plant properties. Another important implication of the result is that as aphid has a close relationship with host plant and even small amount of changes in the same Quercus species caused that amount of plasticity in Thelaxes species. Recent ecological changes including climatic fluctuations directly influences host plants morphological/nutritional composition and might also impacts the diversity and distribution of aphid species. Findings were also discussed for possible changes in host plant range of the T. suberi as a result of the current phenotypic plasticity and possible interactions between different types of phenotypic plasticities.
"This house believes that emergency surgery should be a specialty in its own right"
Authors: James David , Puttick Michael , Bond-Smith Giles , Mortensen Professor Neil
Published: May 2017

Highlights from the Oxford Surgery Symposium debate.
Art and surgery
Authors: Court Stephen
Published: May 2017

The links between the worlds of art and surgery are powerful and pervasive. We talk to two surgeons who also practise art and sculpture in what spare time they have.
Rational decision-making
Authors: Walker Antony
Published: May 2017

Honest opinions from surgeons operating at the coalface of our health service.
Mentor, Examiner, Administrator: What kind of assessor are you?
Authors: Bussey Maria , Gareth Griffiths
Published: May 2017

How written feedback reveals your approach to training.
Policy Spotlight
Authors: Davies John
Published: May 2017

This regular feature aims to provide key political news in relation to dentistry and an update on the Faculty’s policy activities. You can find out more in the Government Relations and Media sections of the FDS website.
From air raids to e-Den: 70 Years of the Faculty of Dental Surgery
Authors: Stephens Chris
Published: May 2017

Since its inception in 1947, the Faculty of Dental Surgery (FDS) has furthered the field of dental surgery through research programmes and continued professional development, alongside specialty training and international and intercollegiate collaboration. Here the first 70 years of the FDS, which have seen its membership increase 10-fold and the recent launch of a pioneering interactive educational programme, are discussed.
How Trump’s ‘really good plan’ could be the ruin of dentistry in the USA
Authors: Simmons Gerald
Published: May 2017

The future’s not bright – it’s orange.
The post-truth tooth fairy, or the high tower of teeth
Authors:   Spinnbarkeit
Published: May 2017

When even pillow talk is fake news…