bluuebunny/crossref_metadata_2025 huggingface dataset:
Advanced stage breast cancer is associated with catheter-tip thrombus formation following implantable central venous port placement
Authors: Makary Mina S , Lionberg Alexander , Khayat Mamdouh , Lustberg Maryam B , AlTaani Jamal , Pan Xueliang J , Layman Richard R , Raman Subha V , Layman Rachel M , Dowell Joshua D
Published: May 2018

Purpose

Catheter-tip associated thrombosis is not uncommon in patients with implantable central venous ports; however, the prevalence and clinical impact of this complication on patient management is unclear. This study aims to identify risk factors for thrombus formation in a large population receiving serial echocardiograms (echo) following port placement.

Methods

A total of 396 female breast cancer patients underwent internal jugular vein chest port placement between 2007 and 2013 and received echo studies every third month. Catheter tip position was measured from chest radiography and catheter associated thrombus was identified by echo.

Results

Sixteen out of 396 patients (4%) had catheter-tip thrombus. No patients were symptomatic or prophylactically anticoagulated. Patients with thrombus were significantly younger than those without (46.4 years versus 53.4 years, respectively, p = 0.02) and had higher stage breast cancer with 75% versus 44.7% having stage III or IV cancer ( p = 0.017). Thrombus was identified after a median of 91 days. No significant difference was identified in anatomic ( p = 0.1) or measured ( p = 0.15) tip position, port laterality ( p = 0.86), or number of port lumens ( p = 0.65).

Conclusions

In this large cohort, younger patients and those with more advanced stage breast cancer were more associated with catheter-tip-related thrombus after port placement.
Early reduced behavioral activity induced by large strokes affects the efficiency of enriched environment in rats
Authors: Wahl Anna-Sophia , Erlebach Eva , Brattoli Biagio , Büchler Uta , Kaiser Julia , Ineichen Benjamin V , Mosberger Alice C , Schneeberger Shirin , Imobersteg Stefan , Wieckhorst Martin , Stirn Martina , Schroeter Aileen , Ommer Bjoern , Schwab Martin E
Published: May 2018

The majority of stroke patients develop post-stroke fatigue, a symptom which impairs motivation and diminishes the success of rehabilitative interventions. We show that large cortical strokes acutely reduce activity levels in rats for 1–2 weeks as a physiological response paralleled by signs of systemic inflammation. Rats were exposed early (1–2 weeks) or late (3–4 weeks after stroke) to an individually monitored enriched environment to stimulate self-controlled high-intensity sensorimotor training. A group of animals received Anti-Nogo antibodies for the first two weeks after stroke, a neuronal growth promoting immunotherapy already in clinical trials. Early exposure to the enriched environment resulted in poor outcome: Training intensity was correlated to enhanced systemic inflammation and functional impairment. In contrast, animals starting intense sensorimotor training two weeks after stroke preceded by the immunotherapy revealed better recovery with functional outcome positively correlated to the training intensity and the extent of re-innervation of the stroke denervated cervical hemi-cord. Our results suggest stroke-induced fatigue as a biological purposeful reaction of the organism during neuronal remodeling, enabling new circuit formation which will then be stabilized or pruned in the subsequent rehabilitative training phase. However, intense training too early may lead to wrong connections and is thus less effective.
Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults: a meta-analysis
Authors: Kim Sung-Eun , Hong Eun Pyo , Kim Heung Cheol , Lee Si Un , Jeon Jin Pyeong
Published: May 2018

Background

The optimal optic nerve sheath diameter (ONSD) cut-off for identifying increased intracranial pressure (IICP) remains unclear in adult patients.

Purpose

To validate the diagnostic accuracy of ultrasonographic (US) ONSD > 5.0 mm as a cut-off for detecting IICP by computed tomographic (CT) through a meta-analysis.

Material and Methods

A systemic literature review was performed of online databases from January 1990 to September 2017. A bivariate random-effects model was used to estimate pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95% confidence intervals (CIs). A summary receiver operating characteristic (SROC) graph was used to provide summary points for sensitivity and specificity. Meta-regression tests were performed to estimate the influence of the study characteristics on DOR. Publication bias was assessed using Deeks' funnel plot asymmetry test.

Results

Six studies with 352 patients were included in the meta-analysis. US ONSD > 5.0 mm revealed pooled sensitivity of 99% (95% CI = 96–100) and specificity of 73% (95% CI = 65–80) for IICP detection. DOR was 178. The area under the SROC curve was 0.981, indicating a good level of accuracy. Meta-regression studies showed no significant associations between DOR and study characteristics such as probe mode (relative DOR [RDOR] = 0.60; P = 0.78), study quality (RDOR = 0.52; P = 0.67), IICP prevalence (RDOR = 0.04; P = 0.17), or pathology at admission (RDOR = 1.30; P = 0.87).

Conclusion

US ONSD > 5.0 mm can be used to rapidly detect IICP in adults in emergency departments and intensive care units. Further meta-analysis based on individual patient-level databases is needed to confirm these results.
Automated daily quality control analysis for mammography in a multi-unit imaging center
Authors: Sundell Veli-Matti , Mäkelä Teemu , Meaney Alexander , Kaasalainen Touko , Savolainen Sauli
Published: May 2018

Background

The high requirements for mammography image quality necessitate a systematic quality assurance process. Digital imaging allows automation of the image quality analysis, which can potentially improve repeatability and objectivity compared to a visual evaluation made by the users.

Purpose

To develop an automatic image quality analysis software for daily mammography quality control in a multi-unit imaging center.

Material and Methods

An automated image quality analysis software using the discrete wavelet transform and multiresolution analysis was developed for the American College of Radiology accreditation phantom. The software was validated by analyzing 60 randomly selected phantom images from six mammography systems and 20 phantom images with different dose levels from one mammography system. The results were compared to a visual analysis made by four reviewers. Additionally, long-term image quality trends of a full-field digital mammography system and a computed radiography mammography system were investigated.

Results

The automated software produced feature detection levels comparable to visual analysis. The agreement was good in the case of fibers, while the software detected somewhat more microcalcifications and characteristic masses. Long-term follow-up via a quality assurance web portal demonstrated the feasibility of using the software for monitoring the performance of mammography systems in a multi-unit imaging center.

Conclusion

Automated image quality analysis enables monitoring the performance of digital mammography systems in an efficient, centralized manner.
Attribution and contestation: Relations between elites and other social groups
Authors: Salverda Tijo , Skovgaard-Smith Irene
Published: May 2018

In this article, we explore the often ambiguous relations between elites and other social groups, both subordinate and of relatively equal standing. The article draws on two distinctive ethnographic cases: the white Franco-Mauritian elite, and the expert elite of management consultants in a Western European context. Our analysis of the two cases provides insights into how the power and status of elites are both contested and attributed by the people they interact with and relate to in concrete, yet substantially different contexts and situations. The aim is to show how the position and power of different kinds of elites are relationally negotiated and achieved. As we argue, a better understanding of the role of other social groups in the attribution, maintenance and contestation of status is relevant for understanding both more traditional economic elites and expert elites without tight networks.
Double-blind placebo-controlled randomized clinical trial of ginger (Zingiber officinale Rosc.) addition in migraine acute treatment
Authors: Martins Laís Bhering , Rodrigues Ana Maria dos Santos , Rodrigues Débora Fernandes , dos Santos Luana Caroline , Teixeira Antônio Lúcio , Ferreira Adaliene Versiani Matos
Published: May 2018

Background

Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce.

Objective

This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment.

Methods

A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study. Only adults with episodic migraine (one to six migraine attacks per month) with or without aura were included. Sixty participants were randomized into two groups in which they received 400 mg of ginger extract (5% active ingredient) or placebo (cellulose), in addition to an intravenous drug (100 mg of ketoprofen) to treat the migraine attack. Patients filled a headache diary before, 0.5 h, 1 h, 1.5 h and 2 h after the medication. Pain severity, functional status, migraine symptoms and treatment satisfaction were also recorded.

Results

Patients treated with ginger showed significantly better clinical response after 1 h ( p = 0.04), 1.5 h ( p = 0.01) and 2 h ( p = 0.04). Furthermore, ginger treatment promoted reduction in pain and improvement on functional status at all times assessed.

Conclusions

The addition of ginger to non-steroidal anti-inflammatory drugs may contribute to the treatment of migraine attack. This trial is registered at ClinicalTrials.gov (NCT02568644)
Hamstring and Ankle Flexibility Deficits Are Weak Risk Factors for Hamstring Injury in Professional Soccer Players: A Prospective Cohort Study of 438 Players Including 78 Injuries
Authors: van Dyk Nicol , Farooq Abdulaziz , Bahr Roald , Witvrouw Erik
Published: May 2018

Background:

Hamstring injuries remain a significant injury burden in sports such as soccer that involve high-speed running. It has repeatedly been identified as the most common noncontact injury in elite male soccer, representing 12% of all injuries. As the incidence of hamstring injuries remains high, investigations are aimed at better understanding how to prevent hamstring injuries. Stretching to improve flexibility is commonly used in elite-level sports, but risk factor studies have reported contradicting results, leading to unclear conclusions regarding flexibility as a risk factor for hamstring injuries.

Purpose:

To investigate the association of lower limb flexibility with the risk of hamstring injuries in professional soccer players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

All teams (n = 18) eligible to compete in the premier soccer league in Qatar (Qatar Stars League [QSL]) underwent a comprehensive musculoskeletal assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included passive knee extension and ankle dorsiflexion range of motion. A clustered multivariate Cox regression analysis was used to identify associations with the risk of hamstring injuries. Receiver operating characteristic (ROC) curves were calculated to determine sensitivity and specificity.

Results:

A total of 438 unique players (72.4% of all QSL players) competed for 601 player-seasons (148 players competed both seasons) and sustained 78 hamstring injuries. Passive knee extension range of motion (hazard ratio [HR], 0.97 [95% CI, 0.95-0.99]; P = .008) and ankle dorsiflexion range of motion (HR, 0.93 [95% CI, 0.88-0.99]; P = .02) were independently associated with the injury risk. The absolute differences between the injured and uninjured players were 1.8° and 1.4 cm, respectively, with small effect sizes ( d < 0.2). The ROC curve analyses showed an area under the curve of 0.52 for passive knee extension and 0.61 for ankle dorsiflexion, indicating failed to poor combined sensitivity and specificity of the 2 strength variables identified in the multivariate Cox regression analysis.

Conclusion:

This study identified deficits in passive hamstring and ankle dorsiflexion range of motion as weak risk factors for a hamstring injury. These findings have little clinical value in predicting the risk of future hamstring injuries, and test results must therefore be interpreted cautiously in athletic screening.
Urban Farming as a Transformative Planning Practice: The Contested New Territories in Hong Kong
Authors: Huang Shu-Mei
Published: May 2018

This article presents an alternative approach to understanding urban farming. Through the lens of feminist theories of regenerative politics, it demonstrates that urban farming can be rearticulated as/for/from within a transformative planning practice. Drawing on planning practices in the less studied terrain of Hong Kong—the New Territories bordering mainland China—this article illustrates how urban farming can be seen as an enabling, cross-scale practice that nurtures the micro-politics of democracy in everyday life to reconnect and regenerate theories, practices, and boundaries.
The Teaching of Urban Design: A Morphological Approach
Authors: Gu Kai
Published: May 2018

Geographical urban morphology as a field of research provides a systematic basis for theorizing and managing urban landscape change. After a review of urban morphology as a field of knowledge, particularly within Europe, and as a basis for planning and urban design, an example of its application in an urban design studio is discussed, focusing on the urban waterfront redevelopment in Auckland, New Zealand. The characterization of urban landscape forms is supported by cartographic- and field-based investigation. Urban design guidelines and development plans prepared by students contribute to improving the character of the built environment.
Congruity and Divergence in Perceptions of Adolescent Romantic Experience Between Chinese Parents and Adolescents
Authors: Liu Ting , Fuller Jeffrey , Hutton Alison , Grant Julian
Published: May 2018

This qualitative research article explored the convergences and divergences of perceptions of adolescent romantic experience between a group of adolescents and parents in China. One-to-one, in-depth interviews were conducted with 38 adolescents (aged 15-18 years; 26 girls, 12 boys) and 27 parents (aged 40-52 years; 16 mothers, 11 fathers) from the urban areas of a northern Chinese city. Data analysis was conducted using thematic analysis and interpreted using a socio-ecological approach. Four major themes were identified: opportunities and risks, acceptable versus unacceptable sexual intimacy, generational difference, and girls’ vulnerability and “self-respect.” In these themes, congruity and divergence of perceptions were found between the groups of adolescents and parents. These perceptions were largely influenced by traditional cultural beliefs of education, sexuality, gender, and family as well as the current socio-cultural context of modernization and globalization in China. The findings provide implications regarding how to support both adolescents and parents in managing adolescent romantic experience for adolescent health-promoting romantic and sexual behaviors.
Comment former le client à son rôle de coproducteur ? Etude de l’influence de la formation et de ses caractéristiques sur les bénéfices de la coproduction
Authors: Nicod Lionel , Llosa Sylvie
Published: May 2018

Cette recherche étudie l’impact de la formation du client à son rôle lors d’une rencontre de service. Elle examine l’influence de celle-ci sur les bénéfices de la coproduction en adoptant un regard croisé : celui de l’entreprise, à travers la productivité du personnel en contact, et celui du client, via sa satisfaction. La recherche se décompose en deux phases. Elle montre d’abord que globalement la formation accroît la productivité du personnel sans nuire à la satisfaction. Une fois l’intérêt de former le client avéré, elle s’intéresse à deux caractéristiques de la formation : son contenu (cognitif seul ou cognitif et affectif) et le moyen par lequel elle est délivrée (en personne ou numérique). La formation du client augmente la productivité particulièrement quand son contenu est à la fois cognitif et affectif alors que son moyen ne l’influence pas. Inversement, concernant la satisfaction, la formation donnée par du personnel a un impact plus important qu’une formation numérique tandis que son contenu ne l’affecte pas. Ces résultats donnent des pistes d’actions aux entreprises pour améliorer leurs bénéfices et ceux du client.
Anticoagulation Monitoring Under ECMO Support: A Comparative Study Between the Activated Coagulation Time and the Anti-Xa Activity Assay
Authors: Delmas Clément , Jacquemin Aemilia , Vardon-Bounes Fanny , Georges Bernard , Guerrero Felipe , Hernandez Nicolas , Marcheix Bertrand , Seguin Thierry , Minville Vincent , Conil Jean-Marie , Silva Stein
Published: May 2018

Purpose:

Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)—a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population.

Methods:

All patients treated by venoarterial or venovenous ECMO in our intensive care unit between January 2014 and December 2015 were prospectively included. A concomitant measurement of the anti-Xa activity and ACT was performed on the same sample collected twice a day (morning–evening) for unfractionated heparin adaptation with an ACT target range of 180 to 220 seconds.

Results:

One hundred and nine patients (men 69.7%, median age 54 years) treated with ECMO (70.6% venoarterial) were included. Spearman analysis found no correlation between anti-Xa and ACT (ρ < 0.4) from day 1 and worsened over time. Kappa analysis showed no agreement between the respective target ranges of ACT and anti-Xa.

Conclusions:

We demonstrate that concomitant measurement of ACT and anti-Xa activity is irrelevant in ECMO patients. Since ACT is poorly correlated with heparin dosage, anti-Xa activity appears to be a more suitable assay for anticoagulation monitoring.
Mediating Justice: Women’s Perceptions of Fairness in the Civil Protection Order Process
Authors: Hefner M. Kristen , Baboolal Aneesa A. , Fleury-Steiner Ruth E. , Miller Susan L.
Published: May 2018

Mediation use has grown rapidly in the past few decades as an efficacious method of civil dispute resolution. However, early research suggests that civil mediation may cause further harm to victims of intimate partner abuse because, based on the inherent power dynamics of abusive relationships, they are not able to effectively advocate on their own behalf. In addition, organizational efficiency concerns have led to the development of consent processes for civil protection orders (POs). However, research has yet to examine the extent to which victims of intimate partner violence who take part in these consent processes perceive the process and associated outcomes as fair. Using qualitative data ( N = 19 interviews) collected from women who sought civil POs through Family Court in Delaware, this research finds that the consent process and women’s interactions with mediators reproduce power inequalities that are inherent in cases of intimate partner abuse, which shape their perceptions of fairness in the PO process and outcomes. Victims being silenced and disempowered throughout the consent process results in cumulative effects—similar tactics used by batterers—which continue to leave victims vulnerable. In addition, the power asymmetry victims experience in abusive relationships is replicated by the legal institution and court structure in terms of not having access to attorneys, not receiving guidance and advocacy, and, at times, experiencing insensitive treatment. Thus, this study provides insight into the inequalities present within the PO consent process that can create further harm to victims.
The Influence of Friends and Psychosocial Factors on Physical Activity and Screen Time in Normal and Overweight Adolescents: A Mixed-Methods Analysis
Authors: Garcia Jeanette M. , Sirard John R. , Whaley Diane E. , Rice David J. , Baker Kayla , Weltman Arthur
Published: May 2018

Background:

Understanding factors that influence physical activity (PA) and sedentary behavior is crucial to develop interventions to improve adolescents’ health-related behaviors.

Purpose:

To compare the influence of friends and psychosocial factors on moderate-to-vigorous physical activity (MVPA) and screen time (ST) between normal weight (NW) and overweight (OW) adolescents.

Methods:

In all, 21 OW and 21 NW adolescents wore accelerometers and completed questionnaires assessing MVPA, ST, and psychosocial variables. The MVPA and ST were assessed in nominated friends. Adolescents participated in focus groups assessing influence on activity behaviors.

Results:

There were no differences in MVPA; however, NW adolescents reported less ST than OW adolescents (8.9 vs 13.1 h/wk, P = .04). For OW adolescents, friends’ ST ( P = .002) and psychosocial factors ( P = .05) were associated with ST, while only PA self-efficacy was associated with MVPA. For NW adolescents, only friends’ MVPA ( P = .04) was associated with self-reported PA. Exploratory analyses revealed differences among weight status and gender. Focus group discussions revealed that friends influenced both OW and NW adolescents’ MVPA; however, this appeared to be more apparent for NW males, while psychosocial factors played a role in both OW and NW females. The OW adolescents reported that friends were more of an influence on their ST levels, while NW adolescents indicated that their ST was not affected by their friends’ behaviors.

Conclusions:

Interventions to increase MVPA and/or decrease ST may need to be tailored for NW and OW adolescents.
Pharmacist Impact on Treatment Intensification and Hemoglobin A1C in Patients With Type 2 Diabetes Mellitus at an Academic Health Center
Authors: Cowart Kevin , Sando Karen
Published: May 2018

Background:

Achievement of treatment goals for patients with type 2 diabetes mellitus (T2DM) is suboptimal. This is in part driven by a lack of treatment intensification when warranted, termed “clinical inertia.”

Objectives:

To investigate time to treatment intensification and changes in A1C among pharmacist–physician managed (PPM) patients compared to usual medical care (UMC) in patients with T2DM.

Methods:

Retrospective matched cohort study at 2 academic family medicine clinics. Patients in each cohort were matched 1:1 based on age (±5 years), primary care provider, gender, and race.

Results:

A total of 50 patients met inclusion criteria. Mean time to treatment intensification was longer in the UMC cohort as compared with the PPM cohort (325 (66) days vs 200 (62) days [ P = .50]). A higher percentage of patients in the PPM cohort achieved ≥0.5% reduction in A1C in comparison to the UMC cohort (60% vs 44%, respectively [ P = .41]). Patients in the PPM cohort experienced a greater mean decrease in A1C from baseline when compared to patients in the UMC cohort (−1% (1.8%) vs −0.4% (2.2%) [ P = .24]).

Conclusion:

Patients exposed to a pharmacist in this retrospective matched cohort study experienced shorter time to treatment intensification and a greater reduction in A1C than those managed solely by a medical provider, although results were not statistically significant. Additional research is needed to evaluate the role of the pharmacist in improving clinical inertia in the management of T2DM.
Energy absorption design study of subway vehicles based on a scaled equivalent model test
Authors: Xu Ping , Lu Sisi , Yan Kaibo , Yao Shuguang
Published: May 2018

To obtain the characteristics of collision energy absorption and improve the passive safety of subway vehicles, the energy absorption design of subway vehicles was studied based on a one-seventh-scale model crash test. A full-size three-dimensional model of a subway vehicle was established using the multibody dynamics software MADYMO. The simulation results of the dynamics model were scaled down according to the similarity coefficients. By comparing the simulation results with the scaled model test results, the maximum error of deformation was 2.10 and 4.35% for the head car and the maximum deforming middle car, respectively, and the energy absorption error was found to be 8.75 and 5.70% for the head car and the maximum deforming middle car, respectively. The results indicate that the collision dynamics model of subway vehicles is relatively accurate. Next, based on this dynamics model, a full factorial experiment was designed to study the effects of the marshalling, mass and crushing tube’s plastic deformation platform force on the energy absorption of subway vehicles. The calculation results were fitted by multiple linear regression functions. Finally, the authors obtained the crash energy absorption formulas for the subway head car with an accuracy of 98.42% and for the maximum deforming middle car with an accuracy of 95.31%. These formulas can be applied to the preliminary design of subway vehicles and offer guiding significance for the parameter design of subway vehicles’ energy-absorbing devices.
Neurologic manifestations of antiphospholipid syndrome
Authors: Ricarte I F , Dutra L A , Abrantes F F , Toso F F , Barsottini O G P , Silva G S , de Souza A W S , Andrade D
Published: May 2018

Neurological involvement in antiphospholipid antibody syndrome (APS) is common, and its occurrence increases morbidity and mortality. Patients may present variable neurological involvement, such as cerebrovascular disease, cognitive dysfunction, headache, seizures, movement disorders, multiple sclerosis-like syndrome, transverse myelitis and ocular symptoms. Most neurological manifestations are associated with thrombosis of the microcirculation or of large vessels; nonetheless, there is compelling evidence suggesting that, in some cases, symptoms are secondary to an immune-mediated pathogenesis, with direct binding of aPL on neurons and glia. Herein we describe clinical characteristics and management of neurological APS manifestations.
Gingival Mesenchymal Stem Cells Outperform Haploidentical Dental Pulp-derived Mesenchymal Stem Cells in Proliferation Rate, Migration Ability, and Angiogenic Potential
Authors: Angelopoulos Ioannis , Brizuela Claudia , Khoury Maroun
Published: May 2018

High donor variation makes comparison studies between different dental sources dubious. Dental tissues offer a rare opportunity for comparing the biological characteristics of haploidentical mesenchymal stem cells (MSCs) isolated from the same donor. The objective was to identify the optimal dental source of MSCs through a biological and functional comparison of haploidentical MSCs from gingival (GMSCs) and dental pulp stem cells (DPSCs) focusing mainly on their angiogenic potential. The comparison study included (1) surface markers expression, (2) mesodermal differentiation capacity (chondrogenic, adipogenic, and osteogenic), (3) proliferation, (4) migration potential, (5) ability to form colony units, and (6) angiogenic potential in vitro and in vivo. Comparative analysis showed no difference in the immunophenotypic profile nor for the trilineage differentiation potential. Proliferation of GMSCs was higher than DPSCs at day 6 (2.6-fold higher, P < 0.05). GMSCs showed superior migratory capacity compared to DPSCs at 4, 8, and 12 h (2.1-, 1.5-, and 1.2-fold higher, respectively, P < 0.05). Furthermore, GMSCs formed a higher number of colony units for both cell concentrations (1.7- and 1.4-fold higher for 150 and 250 starting cells, respectively, P < 0.05). GMSCs showed an improved angiogenic capacity compared to DPSCs (total tube lengths 1.17-fold higher and 1.5-fold total loops, P < 0.05). This was correlated with an enhanced release of vascular growth factor under hypoxic conditions. Finally, in the plug transplantation assay evaluating the angiogenesis in vivo, the DPSC and GMSC hemoglobin content was 3.9- and 4-fold higher, respectively, when compared to the control (Matrigel alone). GMSCs were superior to their haploidentical DPSCs in proliferation, migration, and angiogenic potentials. This study positions GMSCs in the forefront of dental cell sources for applications in regenerative medicine.
Prospective Randomized Trial of Electrolysis for Chronic Plantar Heel Pain
Authors: Fernández-Rodríguez Tomás , Fernández-Rolle Álvaro , Truyols-Domínguez Sebastián , Benítez-Martínez Jose C. , Casaña-Granell Jose
Published: May 2018

Background:

Chronic plantar heel pain (CPHP) is a common condition with high prevalence rates and a projected cost of treatment of US$192 to US$376 million. There are several therapeutic approaches and there is increased interest in treatments aimed at the regeneration of tissues with poor healing potential. Our purpose was to investigate the effectiveness of ultrasound-guided percutaneous needle electrolysis in chronic plantar heel pain.

Methods:

A total of 73 patients with a clinical and ultrasonographic diagnosis of plantar heel pain unrelated to systemic inflammatory disease who had not received any other treatment in the previous 6 months on the affected foot were randomly allocated to receive either ultrasound-guided percutaneous needle electrolysis of the fascia (experimental group, n = 39) or placebo puncture (control group, n = 34). The primary outcome was pain scored with an 11-point numeric pain rating scale (0 = no pain, 10 = maximum pain). Secondary outcomes were function and disability measured by the 21-item activities of daily living subscale of the Foot and Ankle Ability Measure questionnaire, and fascia thickness measured by ultrasound. Outcomes were measured at 1, 12, and 24 weeks.

Results:

The mixed-model analysis of covariance observed significant group x time interactions from all variables: pain in numeric pain rating scale ( P < .001), FAAM Activities of Daily Living Subscale scale ( P < .002), and ultrasonographic measures of the plantar heel ( P < .002). Patients in the experimental group had better results posttreatment at 12 and 24 weeks compared with the control group.

Conclusion:

With chronic plantar heel pain, ultrasound-guided percutaneous needle electrolysis improved pain and function. This treatment may also decrease fascia thickness.

Level of Evidence:

Level I, randomized controlled trial.
Comparison of LDL-C Reduction Using Different Evolocumab Doses and Intervals
Authors: Wasserman Scott M. , Sabatine Marc S. , Koren Michael J. , Giugliano Robert P. , Legg Jason C. , Emery Maurice G. , Doshi Sameer , Liu Thomas , Somaratne Ransi , Gibbs John P.
Published: May 2018

Background:

The proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor evolocumab reduces low-density lipoprotein cholesterol (LDL-C) and the risk of cardiovascular events.

Objectives:

To compare LDL-C reduction using evolocumab 140 mg once every 2 weeks (Q2W) or 420 mg monthly (QM) versus lower doses (70 mg Q2W or 280 mg QM) or placebo.

Methods:

Patients received evolocumab 70 or 140 mg Q2W, 280 or 420 mg QM, or placebo Q2W or QM in two 12-week phase 2 studies: one with and one without statins. Changes from baseline in LDL-C were compared across Q2W doses and across QM doses.

Results:

The analysis included 741 patients. Mean (95% confidence interval [CI]) reduction in LDL-C across Q2W visits through week 12 was 63.0% (60.3% to 65.7%) for evolocumab 140 mg Q2W, compared to 41.3% (38.6% to 44.0%) for 70 mg Q2W and 1.9% (4.6% reduction to 0.8% increase) for placebo Q2W (each P < .001 vs 140 mg Q2W), and 62.7% (60.1% to 65.3%) for 420 mg QM, compared to 55.5% (52.9% to 58.0%) for 280 mg QM and 2.5% (5.1% reduction to 0.1% increase) for placebo QM (each P < .001 vs 420 mg QM). Similar results were observed at the mean of weeks 10 and 12. In a subgroup (n = 151) with weekly assessments from weeks 8 to 12, mean (95% CI) peak effect on LDL-C reduction was 72.8% (67.7% to 77.9%) for 140 mg Q2W and 69.0% (63.6% to 74.3%) for 420 mg QM. Trough effect at week 12 underestimated LDL-C reduction. Median peak–trough variability was 20.5%, 21.1%, 31.9%, and 35.1% for evolocumab 140 mg Q2W, 420 mg QM, 70 mg Q2W, and 280 mg QM, respectively.

Conclusion:

Evolocumab 140 mg Q2W and 420 mg QM yielded similar LDL-C reduction. These doses sustained maximal LDL-C reduction, resulting in greater stability in LDL-C reduction over the dosing interval compared to lower doses. These results support evolocumab doses of either 140 mg Q2W or 420 mg QM.
Higher Preoperative Plasma Thrombin Potential in Patients Undergoing Surgery for Aortic Stenosis Compared to Surgery for Stable Coronary Artery Disease
Authors: Dimberg Axel , Alström Ulrica , Ståhle Elisabeth , Christersson Christina
Published: May 2018

Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68). Patients with AS displayed higher plasma thrombin potential, both thrombin peak with median 252 nmol/L (interquartile range 187-319) and endogenous thrombin potential (ETP) with median 1552 nmol/L/min (interquartile range 1340-1838), when compared to patients with CAD where thrombin peak was median 174 nmol/L (interquartile range 147-229) and ETP median 1247 nmol/L/min (interquartile range 1034-1448; both P < .001). Differences persisted after adjustment for age, gender, comorbidity, and antithrombotic treatment. Differences observed in thromboelastometry between the groups did not persist after adjustment for baseline characteristics. Bleeding amount showed no relationship with plasma thrombin potential but weakly to thromboelastometry ( R2 = .064, P = .001). Patients with AS exhibited preoperatively increased plasma thrombin potential compared to patients with CAD. Plasma thrombin potential was not predictive for postoperative bleeding in patients scheduled for elective surgery.
Challenges of dispensing costly tablets with short shelf-life
Authors: de Lemos Mário L , Mathers Brittney , Badry Nadine , Hamata Linda , Lo Kelly
Published: May 2018

Afatinib, trametinib and regorafenib are three costly oral oncology drugs with a short shelf-life after the original container has been opened. Their short shelf-lives are due to degradation on exposure to moisture. Therefore, manufacturers recommend them to be dispensed in the original packaging with the desiccant. However, the prescribed quantities do not always match the quantities in the original packaging, usually because of dose modifications for toxicities. This leads to potentially significant drug wastage and financial losses. We describe some potential approaches to this issue.
Brief Prompting to Improve Classroom Behavior: A First-Pass Intervention Option
Authors: Moore Tara C. , Alpers Andrew J. , Rhyne Rachael , Coleman Mari Beth , Gordon Jason R. , Daniels Stephanie , Skinner Christopher H. , Park Yujeong
Published: May 2018

Two studies were conducted to examine the effects of a brief prompting intervention (verbal and visual reminder of classroom rules) to improve classroom behavior for an elementary student during small-group reading instruction in a special education classroom (Study 1) and for three high school students with mild disabilities in an inclusive general education classroom (Study 2). Using within-participant reversal designs, the teachers provided brief reminders of behavioral expectations just before class. Teachers were instructed to respond to the students’ appropriate and inappropriate behaviors in a typical manner to ensure no programmed changes in the contingencies for student behavior. Results indicated improvements in classroom behavior for all four students, and teachers and students indicated positive perceptions about the intervention and its effects. Implications for future research and practice are discussed.
Current concepts in revision hip arthroscopy
Authors: Locks Renato , Bolia Ioanna , Utsunomiya Hajime , Briggs Karen , Philippon Marc J
Published: May 2018

Hip arthroscopy is an evolving procedure and its indications have expanded. The number of patients undergoing this procedure has increased significantly as well as the number of surgeons being trained. This has resulted in a notable increase in post-operative complication rates creating the need to develop advanced hip arthroscopic techniques. Revision hip arthroscopy is often complex and many factors should be considered to achieve a satisfactory clinical outcome. Careful pre-operative planning and agreement of expectations between the physician and patient regarding the procedure are important. This review describes several advanced treatment options that are used mainly in revision or complex primary hip arthroscopy cases. Labral reconstruction or augmentation technique is used in cases of severely deficient acetabular labral tissue to restore the fluid seal mechanism. In cases of symptomatic (often post-operative) adhesion formation, a spacer between the labrum and the joint capsule is useful for pain relief and prevention of future adhesions. Large defects of the capsule due to previous unrepaired capsulotomy or any other cause can be addressed with the capsular reconstruction technique. Ligamentum teres reconstruction using an anterior tibialis allograft is indicated in patients with hip instability and persistent pain after previous debridement or with complete tears of this structure. The senior author’s treatment of choice in cases of previous over-resection of CAM impingement is the remplissage technique to restore the bony defect of the femoral head-neck junction and preserve the joint seal.
Cross-modal plasticity among sensory networks in neuromyelitis optica spectrum disorders
Authors: Rocca Maria Assunta , Savoldi Filippo , Valsasina Paola , Radaelli Marta , Preziosa Paolo , Comi Giancarlo , Falini Andrea , Filippi Massimo
Published: May 2018

Objective:

To explore resting-state (RS) functional connectivity (FC) of the main sensory/motor networks of patients with neuromyelitis optica spectrum disorders (NMOSDs), clinically isolated optic neuritis (ON), and myelitis.

Methods:

Clinical evaluation and RS fMRI were obtained from 28 NMOSD, 11 recurrent ON, and 12 recurrent myelitis patients and 30 healthy controls. Between-group RS FC comparisons and correlations with motor performance were assessed (SPM12) on the main sensory/motor RS networks (RSNs) identified by independent component analysis. Functional network connectivity analysis estimated inter-network connectivity.

Results:

Intra- and inter-network RS FCs were reduced in RSNs associated to somatosensory modalities affected by pathology: regions of the primary visual network in ON patients, of the sensorimotor networks in myelitis patients, and of the sensorimotor and secondary visual networks in NMOSD patients. The opposite trend was observed in regions of RSNs spared by pathology: the auditory and part of visual networks in NMOSD, the secondary visual and sensorimotor networks in ON, and the primary visual network in myelitis patients. Better motor performance correlated with higher RS FC of spared RSNs.

Conclusion:

Sensory and motor RSN abnormalities occur in NMOSD. Loss of function within disease–target networks may elicit cross-modal plasticity across sensory networks potentially preserving clinical function.
Personality and its relation to the use of alcohol and cigarettes during pregnancy: A multinational study
Authors: Lupattelli Angela , Ronningen Elke , Krogsrud Stine Kleppe , Nordeng Hedvig , Ystrom Eivind
Published: May 2018

This study explored the impact of women’s personality on drinking and smoking habits before and during pregnancy, using a multinational perspective. Data on maternal personality traits, background information, and alcohol and cigarette smoking before and during pregnancy were collected from 9187 women from more than 18 countries. High conscientiousness and agreeableness resulted as protective factors against alcohol consumption during pregnancy; trait-specific associations were apparent on individual region level. Highly extrovert women were more likely to consume medium/high amount of alcohol (10%–17% increased odds). High neuroticism conferred a 16 percent increased odds for continued smoking during pregnancy. Personality and nationality are important factors for adequate pre- and postnatal health care.
Parents’ mobile relational maintenance in resource-constrained contexts: Barriers and facilitating access conditions
Authors: Velasquez Alcides
Published: May 2018

Mobile phones have become central to family members’ daily communication. This study investigates the material and skills access barriers that parents of adolescents in resource-constrained contexts face for mobile relational maintenance. Following an exploratory sequential mixed-methods design, interviews with parents in Bogotá, Colombia, explored how they managed to keep in touch with their children despite facing access barriers and how these barriers still affected their parent–child mobile interactions. A survey was conducted in the quantitative phase to confirm the relationship patterns suggested by qualitative findings. Financial, cognitive, and environmental resources constituted access barriers. Despite gaining material access through alternative social and environmental resources, the barriers they faced still influenced the nature and frequency of their parent–child mobile interactions. Findings also showed that cognitive barriers, observed as parents’ low levels of perceived capability to learn how to use mobile phones, affected parents’ text messaging through their acquisition of skills.
The conversational rollercoaster: Conversation analysis and the public science of talk
Authors: Albert Saul , Albury Charlotte , Alexander Marc , Harris Matthew Tobias , Hofstetter Emily , Holmes Edward J. B. , Stokoe Elizabeth
Published: May 2018

How does talk work, and can we engage the public in a dialogue about the scientific study of talk? This article presents a history, critical evaluation and empirical illustration of the public science of talk. We chart the public ethos of conversation analysis that treats talk as an inherently public phenomenon and its transcribed recordings as public data. We examine the inherent contradictions that conversation analysis is simultaneously obscure yet highly cited; it studies an object that people understand intuitively, yet routinely produces counter-intuitive findings about talk. We describe a novel methodology for engaging the public in a science exhibition event and show how our ‘conversational rollercoaster’ used live recording, transcription and public-led analysis to address the challenge of demonstrating how talk can become an informative object of scientific research. We conclude by encouraging researchers not only to engage in a public dialogue but also to find ways to actively engage people in taking a scientific approach to talk as a pervasive, structural feature of their everyday lives.
Who’s responsible for food waste? Consumers, retailers and the food waste discourse coalition in the United Kingdom
Authors: Welch Daniel , Swaffield Joanne , Evans David
Published: May 2018

Drawing on empirical research, including interviews with 38 key informants, this article examines how the challenge of food waste reduction has come to be framed, interpreted and responded to in the United Kingdom, focusing on household food waste and the interface between supermarkets and households. We identify a ‘discourse coalition’ arising from collective actors central to the issue that has achieved discursive hegemony over the framing of food waste as a problem. We analyse this discourse coalition – its core storylines, actors and practices – and the conditions that have enabled its emergence. Critical accounts of sustainable consumption commonly note the ‘responsibilisation of the consumer’: or the reduction of systemic issues to the individualised, behavioural choices of the ‘sovereign consumer’. We find, by contrast, that the ‘responsibilised consumer’ is by no means the discourse coalition’s dominant framing of the problem of household food waste. Instead, its dominant framing is that of distributed responsibility: responsibility distributed throughout the production–consumption system. The article also contributes towards understanding why retailers have embraced household food waste reduction as an object of intervention without framing the issue as one of, primarily, consumer responsibility.
Consumer reform in Ireland and the UK
Authors: Kelly Cliona
Published: May 2018

The departure of the UK from the European Union is likely to pose significant challenges for the Irish economy and legal system. This article explores the impact of various possible outcomes of Brexit negotiations on the ‘special relationship’ that currently exists between Irish and UK consumer law. If post-Brexit the Westminster Parliament is free to repeal or replace existing consumer rules of European origin, and courts are not bound to interpret remaining rules in a manner consistent with decisions of the Court of Justice of the European Union, there is likely to be significant regulatory divergence between the two jurisdictions. In Ireland, the increasing impact of the European Union might affect not merely the substance of consumer rights, but also the architecture of statutes and categorisation of consumer rights, the language and conceptual tools used, and how rights are interpreted by the courts. This article also examines how regulatory divergence can be observed even prior to Brexit: the enactment of the Consumer Rights Act 2015 represents a significant change in the regulation of consumer contracts in the UK, and the inability of Ireland to progress a similar consolidation and reform of the law is the first of many divergences which we are likely to see in the coming years.
A Strategic Planning Tool for Increasing African American Blood Donation
Authors: Singleton Ashley , Spratling Regena
Published: May 2018

Historically, African Americans (AAs) have been underrepresented as blood donors. Having a lack of racially diverse blood donors contributes to transfusion complications, particularly in patients with sickle cell disease, who are both disproportionately AA and the recipients of frequent transfusions. Increasing AA blood donation is a complex public health issue. This review article serves to fill a gap in translating research regarding known hindrances and facilitators of AA blood donation to improve real-world donation practice and ultimately, patient outcomes. We incorporate findings from a literature review to develop a tool that blood centers, provider organizations, and patient advocacy groups can use to aid strategic planning efforts aimed at increasing AA blood donation.