bluuebunny/crossref_metadata_2025 huggingface dataset:
“I Knew I Could Make a Difference”: Motivations and Barriers to Engagement in Fighting the West African Ebola Outbreak Among U.S.-Based Health Professionals
Authors: Greenberg Alexandra , Michlig Georgia J. , Larson Elizabeth , Varallyay Ilona , Chang Karen , Enobun Blessing , Schenk Ellen , Whong Benjamin , Surkan Pamela J. , Kennedy Caitlin E. , Harvey Steven A.
Published: April 2018

The 2014 West African Ebola outbreak was unprecedented in scale and required significant international assistance. Many U.S.-based health professionals traveled to West Africa to participate in the response, whereas others considered participation, but ultimately decided against it. This study explores motivators, facilitators, and barriers to international health care worker mobilization. We conducted 24 semistructured in-depth interviews and one focus group discussion with clinical and nonclinical responders and nonresponders. Responders reported feeling duty-bound to help, confidence in their training, and prior experience in humanitarian response. Media coverage was perceived to create environments of stigma and misinformation. Supportive workplaces and clear leave of absence policies facilitated engagement, whereas unsupportive workplaces posed barriers. Although nonresponders were included in the study, the dynamics of nonresponse were less clear and warrant further exploration. Understanding how to support health professionals in responding to outbreak situations may improve mobilization in future public health crises.
Gender Differences in Efficacy and Safety of Direct Oral Anticoagulants in Atrial Fibrillation: Systematic Review and Network Meta-analysis
Authors: Raccah Bruria Hirsh , Perlman Amichai , Zwas Donna R. , Hochberg-Klein Sarit , Masarwa Reem , Muszkat Mordechai , Matok Ilan
Published: April 2018

Background: Studies indicate that women with atrial fibrillation (AF) are less likely to receive anticoagulants despite their higher risk of stroke compared with men. Objective: To evaluate whether the efficacy and safety of direct oral anticoagulants (DOACs) differ in women with AF as compared with men. Our secondary aim was to examine gender differences regarding the safety and efficacy of specific DOACs. Data Sources: MEDLINE, EMBASE, Cochrane, and ClinicalTrials.gov were searched through March 2017. Study Selection and Data Extraction: Randomized clinical trials that reported on major bleeding and stroke with DOACs in women and men with AF were included. Meta-analysis and network meta-analysis was performed. Data Synthesis: Five trials met the inclusion criteria. Among 66 389 patients, 37.8% were women. Women treated with DOACs were at higher risk of stroke and systemic embolism compared with men (RR = 1.19; 95% CI = 1.04-1.35; I2 = 10%) but there was a significantly lower risk of major bleeding in women compared with men (RR = 0.86; 95% CI = 0.78-0.94; I2 = 0%). Network meta-analyses suggested differences between various DOACs in men and women. Limitations: Patient-level data enabling control for differences in baseline risk and head-to-head comparisons between DOACs were not available. Relevance to Patient Care and Clinical Practice: Undertreatment with DOACs among women cannot be justified. Conclusion: Women treated with DOACs had a lower rate of major bleeding and higher rate of stroke and systemic emboli compared with men. Further investigation of DOACs, including differences between the DOACs in specific populations is warranted.
Direct-Acting Antivirals to Prevent Vertical Transmission of Viral Hepatitis C: When Is the Optimal Time to Treat?
Authors: Cervino Leigh , Hynicka Lauren M.
Published: April 2018

Objective: To describe the most current evidence for the use of direct-acting antivirals (DAAs) to treat hepatitis C along the pregnancy-pediatric continuum in the United States. Data Sources: The MEDLINE/PubMed databases were searched (January 1995 to February 2018) for articles in English using the terms: hepatitis C, vertical transmission, pregnancy, pediatrics, ribavirin, interferon, direct acting antivirals, daclatasvir, dasabuvir, elbasvir, glecaprevir, grazoprevir, ledipasvir, ombitasvir, paritaprevir, pibrentasvir, simeprevir, sofosbuvir, and velpatasvir. Study Selection and Data Extraction: All relevant studies, meta-analyses, systematic reviews, guidelines, and review articles were evaluated for inclusion. References from pertinent articles were assessed for additional content that was not found during the initial search. Data Synthesis: The primary route of transmission for hepatitis C virus (HCV) in pediatric patients is vertical transmission (VT), with the rate estimated to be 5.8%. Screening for HCV during pregnancy is not routinely part of clinical care, and the data for the use of DAAs in pregnancy is limited. A significant number of infected infants will clear the HCV infection spontaneously, and ledipasvir/sofosbuvir and sofosbuvir have recently been Food and Drug Administration approved for use in pediatric patients older than 12 years. Conclusions: Data to determine the best treatment point along the pregnancy-pediatric continuum are limited; however, given the lack of human data for use of DAAs during pregnancy, low rate of VT, high rate of spontaneous pediatric clearance, and recent approval of DAAs for pediatric patients, treatment of chronically infected children seems to be the optimal strategy currently.
Patterns of Narcotic Prescribing by Orthopedic Surgeons for Medicare Patients
Authors: Boylan Matthew R. , Suchman Kelly I. , Slover James D. , Bosco Joseph A.
Published: April 2018

In recent years, narcotics have been subject to increased regulation and monitoring because of their side effects and potential for misuse. Currently, variation in prescribing patterns of narcotics among orthopedic surgeons is unknown. The Medicare Part D claims database was used to identify orthopedic surgeons who prescribed at least one schedule II or III narcotic during 2014. The median duration of a narcotic prescription was 8.2 days. The median prescription duration was shortest for hand surgeons (5.6 days) and longest for spine surgeons (12.6 days). Orthopedic surgeons in New York (10.1 days) provided the most narcotics per prescription, with physicians in Vermont (6.2 days) providing the least. Substantial variation exists in narcotic prescribing patterns for orthopedic surgeons at the individual, subspecialty, and statewide levels. With public health focus on reducing narcotics abuse, physician stewardship of these medications will become increasingly relevant.
“It’s Largely a Rigged System”: Voter Confidence and the Winner Effect in 2016
Authors: Sinclair Betsy , Smith Steven S. , Tucker Patrick D.
Published: April 2018

The 2016 presidential election provided a unique opportunity to revisit two competing hypotheses for how voters establish their perceptions of electoral integrity. First, mass public opinion is believed to derive from elite messages. In the 2016 presidential campaign, candidate Donald Trump maintained that the election system was “rigged,” while election administration experts and officials received considerable media coverage in their efforts to counter Trump’s claims. Second, literature on voter confidence has established a “winner effect”—voters who cast ballots for winners are more likely than voters on the losing side to believe their vote was counted correctly. Thus, voters were exposed to two theoretically opposite effects. In this paper, we find that the “winner” effect mitigates the effects from strong pre-election cues from elites. We also show the effect of pre-election attention to the rigging issue, find a symmetry of the election outcome effect for winners and losers, and reconsider our explanations of the winner effect. Finally, we go beyond the existing studies of the winner effect to consider the kind of citizens who are most susceptible to that effect.
The People’s Two Bodies: An Alternative Perspective on Populism and Elitism
Authors: Fumurescu Alin
Published: April 2018

Inspired by the late medieval doctrine of the King’s Two Bodies, the idea of the People’s Two Bodies has been so far used lightly by scholars, mostly to point out a supposed contradiction in our shared assumptions about “the people.” The essay argues that the People’s Two Bodies paradigm is more than a mere linguistic artifice, proving useful for dealing with the pitfalls of elitism and populism while taking advantage of both approaches. It shows that the dual understanding of “the people,” both as a multitude and as a corporate whole, enjoys actually a long pedigree in the history of political thought. As such, the paradigm of the People’s Two Bodies helps address some of the major theoretical and practical challenges that liberal democracies are facing today.
Resection of Medial Talocalcaneal Coalition With Interposition of a Pediculated Flap of Tibialis Posterior Tendon Sheath
Authors: Hubert Jan , Hawellek Thelonius , Beil Frank Timo , Saul Dominik , Kling Jens Henning , Viebahn Christoph , Jungesblut Oliver , Stücker Ralf , Rupprecht Martin
Published: April 2018

Background:

The purpose of the study was to present a novel operative technique in the management of medial talocalcaneal coalition (TC) and to report our clinical and radiologic results after interposition of a pediculated flap (PF) of the tibialis posterior tendon sheath.

Methods:

Twelve feet of 10 patients with a medial TC were treated with the interposition of PF of the tibialis posterior tendon sheath following resection. Pre- and postoperative clinical examinations were performed to evaluate the range of motion and the function of the tibialis posterior muscle of the affected foot. Pain was registered by visual analog scale (VAS) and the function of the foot by the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. The mean follow-up duration was 57.2 months (SD ±37.2 range 12-128) after surgery. Magnetic resonance imaging (MRI) was carried out to assess the outcome.

Results:

All patients reported a significant reduction of pain ( P = .002) at the final follow-up. The activity level had improved since the operation, and the subtalar joint motion was increased, but no weakness of the tibialis posterior muscle could be observed. The AOFAS hindfoot score was significantly improved ( P = .002). MRI did not reveal any migration of the tibialis posterior tendon sheath, and the interposed PF was confirmed at the resection zone. Furthermore, no TC relapse or ruptures of the functional anatomical structures could be observed.

Conclusion:

The resection combined with the interposition of a PF of the tendon sheath seems to avoid relapse of TC and improves symptoms and the function of the foot.

Level of Evidence:

Level IV, case series.
Exercise-Induced Neuroplasticity: A Mechanistic Model and Prospects for Promoting Plasticity
Authors: El-Sayes Jenin , Harasym Diana , Turco Claudia V. , Locke Mitchell B. , Nelson Aimee J.
Published: April 2018

Aerobic exercise improves cognitive and motor function by inducing neural changes detected using molecular, cellular, and systems level neuroscience techniques. This review unifies the knowledge gained across various neuroscience techniques to provide a comprehensive profile of the neural mechanisms that mediate exercise-induced neuroplasticity. Using a model of exercise-induced neuroplasticity, this review emphasizes the sequence of neural events that accompany exercise, and ultimately promote changes in human performance. This is achieved by differentiating between neuroplasticity induced by acute versus chronic aerobic exercise. Furthermore, this review emphasizes experimental considerations that influence the opportunity to observe exercise-induced neuroplasticity in humans. These include modifiable factors associated with the exercise intervention and nonmodifiable factors such as biological sex, ovarian hormones, genetic variations, and fitness level. To maximize the beneficial effects of exercise in health, disease, and following injury, future research should continue to explore the mechanisms that mediate exercise-induced neuroplasticity. This review identifies some fundamental gaps in knowledge that may serve to guide future research in this area.
Family-Focused Practice for Families Affected by Maternal Mental Illness and Substance Misuse in Home Visiting: A Qualitative Systematic Review
Authors: Leonard Rachel A. , Linden Mark , Grant Anne
Published: April 2018

Maternal mental illness is a major public health issue and can adversely affect the whole family. Increasingly, research and policy are recognizing the benefits of a family-focused approach to practice, an approach that emphasizes the family as the unit of care. This review was conducted with the aim of systematically analyzing the qualitative literature surrounding health visitors’ family-focused practice with mothers who have mental illness and/or substance misuse. Through the synthesis, we developed three main findings: (a) parents’ needs regarding health visitors’ family-focused practice, (b) the ambiguity of mental illness in health visiting, and (c) the challenges of family-focused practice in health visiting. Above all, health visitors, families, and mothers with mental illness experience many challenges in family-focused practice, even though it is both desirable and beneficial. This calls for a deeper understanding of how family-focused practice can be effectively practiced in health visiting.
Prothrombin: Another Clotting Factor After FV That Is Involved Both in Bleeding and Thrombosis
Authors: Girolami Antonio , Cosi Elisabetta , Ferrari Silvia , Girolami Bruno
Published: April 2018

Clotting factor defects are usually associated with bleeding. About 2 decades ago, 2 polymorphisms, one of FII (G20210A) and another of FV (Arg506Gln), have been shown to be associated with prothrombotic state and venous thrombosis. As a consequence, FII and FV could be considered both as prohemorrhagic factors and prothrombotic conditions. Recently, it has been shown that missense mutations in the prothrombin gene of amino acid Arg596 of exon 14 to Leu596, Gln596, or Trp596 caused the appearance of a thrombophilic state and venous thrombosis. These mutated FII are not associated with bleeding, but only with venous thrombosis. Furthermore, they are all heterozygotes for the mutations. No missense mutation associated with thrombosis has been discovered so far for FV. As a consequence, the prothrombotic activity of FII is the result of a polymorphism and of a missense mutation, whereas that of FV derives only from a polymorphism. The observation that a clotting factor defect may be associated with both bleeding or venous thrombosis depending on the site of the mutation has caused an extensive reevaluation of the blood clotting mechanism.
A Distinction Without a Difference? Examining the Causal Pathways Behind Ideologically Motivated Mass Public Shootings
Authors: Capellan Joel Alfredo , Anisin Alexei
Published: April 2018

This study utilizes crisp-set qualitative comparative analysis to assess 306 mass shootings. We compare non-extremist and extremist mass shooters according to characteristics that capture mental health histories of offenders, their grievances, and strains. We discover that offenders who sympathized with extremism were driven by grievance against a social group and were suffering from either mental health issues or from general strain. Extremist sympathizers differ from non-extremists in the nature of their grievances and the strains they experience. These results imply there may exist different causal mechanistic activity underpinning extremist and non-extremist violence, specifically with regards to mass shootings.
Toward a Research Agenda for the Study of Situation Perceptions: A Variance Componential Framework
Authors: Rauthmann John , Sherman Ryne
Published: April 2018

Situation perception represents the fulcrum of a “psychology of situations” because situation ratings are ubiquitous. However, no systematic research program exists so far, particularly because two competing traditions have not been integrated: Objectivist views stress situations’ consensually shared meanings (social reality), and subjectivist views idiosyncratic meanings (personal reality). A componential framework can disentangle social from personal reality in situation perceptions: When multiple perceivers (P) rate multiple situations (S) on multiple situation characteristics (C), variance in those ratings can be decomposed according to S × C, P × S, and P × C breakdowns. Six grand questions of situation perception research are spawned from these decompositions: complexity, similarity, assimilation, consensus, uniqueness, and accuracy. Analyses of real data are provided to exemplify our ideas, along with customizable R codes for all methods. A componential framework allows novel and unique insights into different questions surrounding situation perceptions and provides a coherent research agenda.
Critical Incidents in the Scale-Up of State Multitiered Systems of Supports
Authors: Charlton Cade T. , Sabey Christian V. , Dawson Melanie Rees , Pyle Daniel , Lund Emily M. , Ross Scott W.
Published: April 2018

State and national educational leaders encourage the use of an integrated multitiered system of supports (MTSS) to improve services to students with academic and social behavior problems. Implementing and sustaining MTSS is facilitated by support from leaders in state education agencies (SEAs). The purpose of this study was to identify the specific events, resources, and supports that help or hinder the work of scaling up an integrated MTSS approach from the perspective of MTSS leaders in SEAs. Researchers interviewed leaders in 27 U.S. states using the critical incident technique, a qualitative methodology to identify critical incidents associated with changes in practice. Eight helping incident, seven hindering incident, and nine “wish list” categories were identified. Helping categories included multidisciplinary leadership, access to professional development, consistent language and/or practices, consultation with external partners, and a focus on student outcomes in evaluation and planning. Seven hindering categories included competing philosophies, high personnel turnover, varying levels of readiness, and inadequate data systems. Participants also identified two unique categories associated with the items they wished had happened or could happen in the future including access to personnel with high-level MTSS training and access to more effective interventions.
Bullous Pemphigoid: A 10-Year Study of Discordant Results on Direct Immunofluorescence
Authors: Fudge Jessica G. , Crawford Richard I.
Published: April 2018

Background:

Bullous pemphigoid (BP) is the most common subepidermal autoimmune disorder characterized by tense bullae. It is associated with circulating autoantibodies against BP antigen-1 and BP antigen-2. Diagnosis is based upon clinical, histopathologic, and immunopathologic examination. Direct immunofluorescence (DIF) of perilesional skin highlights C3 with or without IgG in a linear pattern along the basement membrane.

Objectives:

We hypothesized that repeat biopsies may be required for a definitive DIF diagnosis of BP, as initial DIF evaluation may result in a false-negative result.

Methods:

A retrospective chart review was conducted on 1143 specimens collected for evaluation for BP. Cases from 2 Vancouver Coastal Health Authority laboratories from 2006 to 2016 were reviewed. Results were interpreted as positive, negative, or indeterminate based on pathologic description and specimen quality.

Results:

After meeting the inclusion criteria, 739 specimens were further evaluated. There were 289 cases of BP in the 10-year period. Five patients (1.73%; 95% confidence interval [CI], 1.50-1.96) required a second biopsy to support a BP diagnosis, and within this group, 1.04% of the 289 (95% CI, 0.811-1.27) were true successive negative-to-positive DIF results.

Conclusions:

DIF is the most reliable test used to diagnose BP; however, a small percentage of patients will initially have a negative result. False-negative or indeterminate results may be due to specimen sampling from lesional skin or due to a subthreshold quantity of immune complexes in the skin. Repeat biopsy is warranted despite an initial negative DIF if BP is clinically suspected.
Firefighter-Paramedic With Posttraumatic Stress Disorder, Horrific Images, and Depression: A Clinical Case Study
Authors: Gramlich Michael A. , Neer Sandra M.
Published: April 2018

Despite the existence of evidence-based treatments for posttraumatic stress disorder (PTSD), no identifiable study reported delivery of exposure therapy for a first responder with PTSD, as well as horrific images that generalized beyond the index trauma to loved ones. Horrific images have been defined as strongly aversive intrusive thoughts such as images of dismembered bodies or disgusting scenes. This clinical case describes the assessment and treatment of Ryan, a 41-year-old, firefighter-paramedic who completed a multifaceted intervention that included imaginal exposure therapy, behavioral activation, and cognitive therapy for depression. PTSD symptoms as measured by the PTSD Checklist for DSM-5 (PCL-5) displayed a clinically significant decrease from 25 at pretreatment to 3 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for PTSD. In addition, Ryan endorsed a clinically significant reduction in horrific images from 21 per week at pretreatment to 0 at 2-month-follow-up. Depressive symptoms as measured by the Beck Depression Inventory–Second Edition (BDI-II) demonstrated a clinically significant decrease from 18 at pretreatment to 1 at 2-month-follow-up, indicating Ryan no longer met diagnostic criteria for depression. This clinical case study provides evidence for the feasibility and effectiveness of delivering a multifaceted intervention for a first responder with multiple psychiatric disorders.
TAM Infiltration Differences in “Tumor-First” and “ZHENG-First” Models and the Underlying Inflammatory Molecular Mechanism in Pancreatic Cancer
Authors: Wang Feng-Jiao , Wang Peng , Chen Lian-Yu , Geng Ya-Wen , Chen Hao , Meng Zhi-Qiang , Liu Lu-Ming , Chen Zhen
Published: April 2018

Background: Syndrome ( ZHENG in Chinese) in traditional Chinese medicine (TCM) refers to the intrinsic characteristics of a pathological process at a certain stage; these characteristics are influenced by internal and external environments and reveal the nature of a disease. Proper syndrome differentiation is the basic principle that guides clinical treatment. Objective: To have a good understanding of tumor progression and the different mechanisms related to ZHENG that have occurred before and after tumor development and to explore the valid evaluation criteria of different pancreatic cancer syndromes to improve the guiding role of TCM syndrome differentiation in pancreatic cancer treatment. Methods: In this study, we established mouse subcutaneous pancreatic cancer models, namely, Con (control), Pi-Xu (Spleen-Deficiency), Shi-Re (Dampness-Heat), and Xue-Yu (Blood-Stasis). Then, for the first time, we compared the different effects of “ ZHENG-first” (referring to a different disease status that occurred before tumor occurrence) and “Tumor-first” (referring to the change in the tumor microenvironment and the resulting changes in the state of the body) conditions on tumor progression and evaluated the associated molecular mechanisms. Results: We found that tumor growth in the “ ZHENG-first” and “Tumor-first” conditions was different. In the “Tumor-first” model, the tumor growth in the Pi-Xu group was faster than that in the other groups. However, in the “ ZHENG-first” model, the tumor growth trend was most obvious in the Shi-Re group. There was a difference in tumor-associated macrophage infiltration between the 2 models. The expression levels of the inflammatory cytokines IL-6, IL-10, and P-STAT3 were also differentially altered. Conclusion: The emergence of ZHENG conditions before or after tumor occurrence had different impacts on pancreatic cancer development, and these impacts may be related to differences in tumor-associated macrophage infiltration and the involved inflammatory cytokines IL-6, IL-10, and P-STAT3. The study results uncovered the molecular basis of syndrome differentiation in pancreatic cancer progression, which might provide more specific guidance for TCM treatment of pancreatic cancer.
Cognitively-Based Compassion Training (CBCT®) in Breast Cancer Survivors: A Randomized Clinical Trial Study
Authors: Gonzalez-Hernandez Edgar , Romero Rocio , Campos Daniel , Burychka Diana , Diego-Pedro Rebeca , Baños Rosa , Negi Lobsang Tenzin , Cebolla Ausiàs
Published: April 2018

Context. Breast cancer (BC) requires a significant psychological adaptation once treatment is finished. There is growing evidence of how compassion training enhances psychological and physical well-being, however, there are very few studies analyzing the efficacy of compassion-based Interventions on BC survivors. Objective. To study the efficacy of the Cognitively-Based Compassion Training (CBCT) protocol in a BC survivor sample on quality of life, psychological well-being, fear of cancer recurrence, self-compassion, and compassion domains and mindfulness facets. Furthermore, enrollment, adherence, and satisfaction with the intervention were also analyzed. Methods. A randomized clinical trial was designed. Participants (n = 56) were randomly assigned to CBCT (n = 28) or a treatment-as-usual control group (TAU; n = 28). Pre-post intervention and 6-month follow-up measures took place to evaluate health-related quality of life, psychological well-being; psychological stress, coping strategies, and triggering cognitions; self-compassion and compassion; and mindfulness in both intervention and wait-list groups. Results. Accrual of eligible participants was high (77%), and the drop-out rate was 16%. Attendance to CBCT sessions was high and practice off sessions exceeded expectations). CBCT was effective in diminishing stress caused by FCR, fostering self-kindness and common humanity, and increasing overall self-compassion scores, mindful observation, and acting with awareness skillsets. Conclusion. CBCT could be considered a promising and potentially useful intervention to diminish stress caused by FCR and enhance self-kindness, common humanity, overall self-compassion, mindful observation, and acting with awareness skillsets. Nevertheless, future randomized trials are needed and a process of deeper cultural adaptation required.
A Conceptual Framework for Critical Appraisal in Systematic Mixed Studies Reviews
Authors: Hong Quan Nha , Pluye Pierre
Published: April 2018

The past decade has been rich with methodological advancements in systematic reviews, several of which were inspired by the literature on mixed methods research. Systematic mixed studies reviews—that is, reviews combining qualitative and quantitative evidence—are increasingly popular as they can provide a better understanding of complex phenomena and interventions. However, they raise new challenges, especially regarding how to perform critical appraisal of the included studies that vary regarding the methodologies used. To address this challenge, conceptually clarifying critical appraisal is necessary. To this end, this article provides a framework for critical appraisal in systematic mixed studies reviews. This framework is an essential first step toward providing clear guidance on how to perform critical appraisal.
Common Misconceptions in the Nutritional Management of Athletes
Authors: Stoll Scott
Published: April 2018

Athletes today face a multitude of competing voices with health claims and products to enhance performance. This has led to both confusion and misconceptions about healthy dietary practices for athletes. Research has demonstrated that athletes do not understand the recommended nutritional requirements necessary for health. Further, improper study methods and research design can create and propagate misconceptions about how athletes view their own health and personal sacrifices. These misconceptions not only influence attitudes and recommendations by healthcare providers and coaches but can also affect legislation. Healthcare providers, coaches and trainers have the opportunity to positively influence healthy nutritional lifestyles in athletes. Research has demonstrated that the balance of expert power and referent power have been shown to emphasize personal empowerment and long term change.
Research on stress intensity factor of crack at intersection of crossbores
Authors: Si Zhang , Sizhu Zhou
Published: April 2018

Circular crossbore as a common geometric construction exists widely in the engineering components. Its fatigue life is heavily decreased by the crack failure around the intersecting line. So, the typical analysis model of crossbores with mode I crack is built, and the influence of four main parameters, such as thickness–diameter ratio Y, crossbores diameter ratio Q, crack length a, and axis ratio of elliptical crack face b/ a, on fracture parameter KI is presented. The results show that the distribution of KI is mainly influenced by Q and b/ a, and the influence of b/ a is more obvious. The value of KI is mainly influenced by Y, Q, and a, while the influence of b/ a is not evident. For elliptical crack face, the KImax (maximum value of KI) located at the short axis leads to higher crack growth rate. KImax is a crucial factor of fracture criterion, and the significance of factors on it is also analyzed here. A variance analysis of four factors is performed and their order is Y >  Q >  a >  b/ a. In addition, a calculation function of KImax is built based on 294 sets’ data and the error is analyzed by mean absolute percentage error with maximum error being less than 7.2%.
A link between expression level of long-non-coding RNA ZFAS1 in breast tissue of healthy women and obesity
Authors: Mansoori Yaser , Tabei Mohammad Bagher , Askari Alireza , Izadi Pantea , Daraei Abdolreza , Naghizadeh Mohammad Mehdi , Zendehbad Zahra , Bastami Milad , Nariman-Saleh-Fam Ziba , Mansoori Hosein , Tavakkoly-Bazzaz Javad
Published: April 2018

Background:

Epidemiological and experimental literature indicates that the risk of breast cancer incidence is strongly linked to hormone-dependent factors, including reproductive history and obesity. However, the molecular mechanisms underlying the association between these factors and breast cancer risk are poorly understood. The aim of this study, therefore, was to determine whether obesity and reproductive history are associated with expression levels of two breast cancer-related long non-coding RNAs (lncRNAs), namely ZFAS1 and SRA1 in cancer-free breast tissues of women.

Methods:

In the current research, 145 healthy women were recruited, and the quantitative expression levels of the two lncRNAs were determined through qPCR assay after gathering the mammoplasty breast tissue samples.

Results:

It was found that women with body mass index (BMI)≥30 kg/m2 and BMI 25–29 kg/m2 show a low expression of ZFAS1 compared to the BMI<25 kg/m2 ( P=0.031 and P=0.027, respectively). Then, the correlation analysis disclosed a negative correlation of ZFAS1 low expression with increasing BMI (r=−0.194, P=0.019). Interestingly, this analysis demonstrated a negative correlation between low expression of the ZFAS1 and high BMI in women with menarche age below 14 (r=−221; P=0.028). Lastly, it was also revealed that there was a negative association of the low expression level of ZFAS1 with increasing BMI in women through regression models (B=−0.048, P=0.019).

Conclusions:

These findings suggest interesting clues about the links between high BMI and the expression levels of ZFAS1 in non-diseased breasts that may help us better understand the underlying mechanisms through which obesity contributes to breast carcinogenesis. However, such results need more validations in future research.
Recent evolutions in flexor tendon repairs and rehabilitation
Authors: Tang Jin Bo
Published: April 2018

This article reviews some recent advancements in repair and rehabilitation of the flexor tendons. These include placing sparse or no peripheral suture when the core suture is strong and sufficiently tensioned, allowing the repair site to be slightly bulky, aggressively releasing the pulleys (including the entire A2 pulley or both the A3 and A4 pulleys when necessary), placing a shorter splint with less restricted wrist positioning, and allowing out-of-splint active motion. The reported outcomes have been favourable with few or no repair ruptures and no function-disturbing tendon bowstringing. These changes favour easier surgeries. The recent reports have cause to re-evaluate long-held guidelines of a non-bulky repair site and the necessity of a standard peripheral suture. Emerging understanding posits that minor clinically noticeable tendon bowstringing does not affect hand function, and that free wrist positioning and out-of-splint motion are safe when strong surgical repairs are used and the pulleys are properly released.
Particulated Autograft Cartilage Implantation for the Treatment of Osteochondral Lesions of the Talus: A Novel Technique
Authors: Delman Connor , Wuellner John , Kreulen Chris , Lundeen Gregg , Giza Eric
Published: April 2018

Osteochondral lesions of the talus often occur following ankle sprains and fractures. Operative intervention is typically required because of the diminished intrinsic repair capability of talar articular cartilage. Several techniques have evolved that emphasize replacing the defect with cartilage that closely mimics the biological properties of hyaline articular cartilage. The goals of operative treatment are resolution of symptoms, physiologic healing, and restoration of function while eliminating the need for further intervention. This article describes a novel, single-step technique for the treatment of osteochondral lesions of the talus with the use of particulated autograft cartilage implantation.

Levels of Evidence: Level V
From Liberal to Polarized Liberal? Contemporary U.S. News in Hallin and Mancini’s Typology of News Systems
Authors: Nechushtai Efrat
Published: April 2018

The 2016 presidential election demonstrated the extent to which U.S. news has changed since its “high modernist” moment. Evidence of these shifts—fragmented and poorly monetized news markets, politicization of news content and funding, uneven professionalization, and even increasing openness to state involvement—have been documented in the literature for some years, but often framed as exceptions. This paper revisits Hallin and Mancini’s typology of news systems to suggest that as variants of Polarized Pluralist elements are entrenched in the American news system, it is drifting away from the Liberal model into a hybrid category of “Polarized Liberal.” Research and meta-journalism from the last decade are reviewed to characterize this hybrid model, which is applicable beyond the United States and might well become the focal point of convergence in the near future. Potential reasons for this transition are discussed, evoking sociopolitical and technological dynamics.
Preparing Principal Candidates to Be Instructional Leaders Through Virtual Coaching Preservice Teachers
Authors: Jones Karen D. , Ringler Marjorie C.
Published: April 2018

The purpose of this collaborative action research study was to determine whether practicing instructional coaching with teacher candidates (TCs) improved coaching skills of principal candidates (PCs). Findings indicated that PCs improved their coaching skills. Findings illustrated ways to improve principal preparation in an instructional supervision course and by collaborating with a teacher education program to provide field experiences to practice coaching. This study also determined that there was not a significant difference in practicing coaching with TCs through video lessons or face to face observations.
Streamlining cardiopulmonary exercise testing for use as a screening and tracking tool in primary care
Authors: Kim Chul‐Ho , Van Iterson Erik H. , Hansen James E. , MacCarter Dean J. , Johnson Bruce D.
Published: April 2018

Cardiopulmonary exercise testing (CPET) using a spectrum of different approaches demonstrates usefulness for objectively assessing patient disease severity in clinical and research settings. Still, an absence of trained specialists and/or improper data interpretation techniques can pose major limitations to the effective use of CPET for the clinical classification of patients. This study aimed to test an automated disease likelihood scoring algorithm system based on cardiopulmonary responses during a simplified step‐test protocol. For patients with heart failure (HF), pulmonary hypertension (PAH), obstructive lung disease (OLD), or restrictive lung disease (RLD), we compared patient scores stratified into one of four “silos” generated from our novel algorithm system against patient evaluations provided by expert clinicians. Patients with HF (n = 12), PAH (n = 9), OLD (n = 16), or RLD (n = 10) performed baseline pulmonary function testing followed by submaximal step‐testing. Breath‐by‐breath measures of ventilation and gas exchange, in addition to oxygen saturation and heart rate were collected continuously throughout testing. The algorithm demonstrated close alignment with patient assessments provided by clinical specialists: HF (r = 0.89, P < 0.01); PAH (r = 0.88, P < 0.01); OLD (r = 0.70, P < 0.01); and RLD (r = 0.88, P < 0.01). Furthermore, the algorithm was capable of differentiating major disease from other disease pathologies. Thus, in a clinically relevant manner, these data suggest this simplified automated disease algorithm scoring system used during step‐testing to identify the likelihood that patients have HF, PAH, OLD, or RLD closely correlates with patient assessments conducted by trained clinicians.
Temporal trends in secondary prevention in myocardial infarction patients discharged with left ventricular systolic dysfunction in Poland
Authors: Gasior Mariusz , Gierlotka Marek , Pyka Łukasz , Zdrojewski Tomasz , Wojtyniak Bogdan , Chlebus Krzysztof , Rozentryt Piotr , Niedziela Jacek , Jankowski Piotr , Nessler Jadwiga , Opolski Grzegorz , Hoffman Piotr , Jankowska Ewa , Polonski Lech , Ponikowski Piotr
Published: April 2018

Background

The proportion of patients discharged after myocardial infarction with left ventricular systolic dysfunction remains high and the prognosis is unfavourable. The aim of this study was to analyse the temporal trends in the treatment and outcomes of a nationwide cohort of patients.

Methods and results

Data from the Polish Registry of Acute Coronary Syndromes and Acute Myocardial Infarction in Poland Registry were combined to achieve complete information on inhospital course, treatment and outcomes. An all-comer population of patients discharged with left ventricular ejection fraction of 40% or less formed the sample population ( n = 28,080). The patients were analysed for the incidence of significant temporal trends and their possible consequences. The implementation of guideline-based treatment at discharge was high. In the post-discharge course a trend towards a higher frequency of percutaneous coronary intervention and a lower prevalence of planned coronary artery bypass grafting procedures was observed. The number of implantable cardioverter defibrillator/cardiac resynchronisation therapy defibrillator implantations was increasing. Cardiac rehabilitation was performed in 19–23% cases. The post-discharge outpatient care was based on general practitioner visits, with only 47.9–48.1% of patients attending an ambulatory cardiology specialist visit. In 12 months of observation the frequency of heart failure rehospitalisations was 17.5–19.1%, while the prevalence of rehospitalisations due to myocardial infarction decreased (8.3% in 2009 to 6.7% in 2013, P < 0.001). A trend towards lower all-cause mortality was observed. Assessment of composite outcomes (death, myocardial infarction, stroke or heart failure rehospitalisation) adjusted for sex and age at 12 months revealed a significant decreasing trend.

Conclusion

The overall prognosis in this population is improving slowly. This may be due to the increasing prevalence of guideline-based forms of secondary prevention. Efforts aimed at maintaining these trends are essential, as overall compliance with these guideline remains suboptimal.
Giant peritoneal loose body in a patient with end-stage renal disease
Authors: Cojocari Nadejda , David Leonard
Published: April 2018

A 72-year-old male with end-stage renal disease underwent a computed tomography scan to assess renal function. An oval-shaped mass, 50 mm × 60 mm in size, was discovered incidentally in his recto-vesical pouch. Because it was suspected to be a teratoma, which could be an impediment for future renal transplantation, surgery was performed. It revealed a giant peritoneal loose body, a rare entity, that has not been reported before in patients with renal chronic insufficiency.
Surgical Outcomes and Limitations of Decompression Surgery for Degenerative Spondylolisthesis
Authors: Sugiura Tsuyoshi , Okuda Shinya , Matsumoto Tomiya , Maeno Takafumi , Yamashita Tomoya , Haku Takamitsu , Iwasaki Motoki
Published: April 2018

Study Design:

A retrospective study.

Objectives:

To investigate surgical outcomes and limitations of decompression surgery for degenerative spondylolisthesis.

Methods:

One hundred patients with degenerative spondylolisthesis who underwent decompression surgery alone were included in this study. The average follow-up period was 3.7 years. Radiography and magnetic resonance imaging were used for radiological assessment. Patients with a recovery rate of >50% throughout the study period were classified as the control group (Group C), while those with a recovery rate of <50% throughout the study period were classified as the poor group (Group P). Patients that had improved symptoms, and yet later showed neurological deterioration due to foraminal stenosis at the same level were classified as the exiting nerve root radiculopathy group (Group E), while those who showed deterioration due to slip progression at the same level were classified as the traversing nerve root radiculopathy group (Group T).

Results:

Patient distribution in each group was 73, 12, 7, and 8 in Groups C, P, E, and T, respectively. As for preoperative radiological features, slippage and an upper migrated disc in Group P, disc wedging and an upper migrated disc in Group E, and lamina inclination and posterior opening in Group T were evident. The cutoff value of preoperative slippage with a poor outcome was 13%.

Conclusions:

Surgical outcomes of decompression surgery for degenerative spondylolisthesis were successful in 73% cases. Preoperative radiological features for poor outcomes were slippage of more than 13%, an upper migrated disc, disc wedging, and lamina inclination.
Pharmacy-Based Travel Health Services: State Approaches to Prescriptive Authority
Authors: Adams Alex J. , Dering-Anderson Allison
Published: April 2018

Pharmacists have provided travel health services in some capacity for more than 25 years. The ability of pharmacists to autonomously prescribe travel medications is growing. Three states (California, Idaho, and New Mexico) allow pharmacists to autonomously prescribe medications for international travel using the Centers for Disease Control and Prevention Yellow Book as a guide. Idaho also allows pharmacists to autonomously prescribe select medications appropriate to domestic travel (motion sickness prevention and Lyme disease prophylaxis), and Florida allows for the prescribing of drugs for motion sickness. Core elements from each state law including education, patient assessment, provider notification, and documentation are reviewed.
Abdominal Adiposity Measured by Sonography as a Tool for Determining Disease Risk
Authors: Stigall A. Nicole , Evans Kevin D. , Tatarski Rachel , Pargeon Rachel L. , Spees Colleen
Published: April 2018

A preexperimental cohort study was conducted with 67 overweight cancer survivors. This cohort of participants was screened for baseline body composition and anthropometrics based on a variety of techniques, including body mass index (BMI), dual X-ray absorptiometry–percentage body fat (DXA-android %BF), diagnostic medical sonography (DMS), and waist circumference (WC). The combination of subcutaneous fat layer at the xyphoid and umbilicus compared with BMI, WC, and DXA-android %BF. These variables demonstrated moderately positive association and were statistically significant. A total maximum mean score of DMS measures of subcutaneous and visceral fat was also compared with BMI, WC, and DXA-android %BF. The aforementioned comparison had a moderately positive association and was statistically significant. The sonographic measure of mesentery fat was compared with WC and demonstrated a strongly positive strength of association and was statistically significant. Sonography may be an inexpensive, noninvasive, portable, and valid body composition measure for overweight patients.
Pediatric Intussusception: The Cinnamon Bun Sign
Authors: Poole Erica , Penny Steven M.
Published: April 2018

Acute abdominal pain in the pediatric patient is a common clinical symptom often resulting in uncertainty and thus often subsequently leads to a sonographic examination of the abdomen. Sonography is often the modality of choice for pediatric abdominal imaging, and consequently, sonographers should have a fundamental appreciation for the causes of acute abdominal pain in the pediatric population. Intussusception, which is the telescoping of a proximal segment of bowel into a distal segment, is one potential cause of acute abdominal pain for these patients. This review clarifies the etiology and classification of intussusception and provides an overview of the clinical manifestations, sonographic identification, and treatment of this potentially severe disorder. Also, this review provides a novel imaging sign, called the “cinnamon bun” sign, that sonographers can employ while examining patients for possible intussusception. The cinnamon bun sign is a descriptive term that may be used to illustrate a transverse sonographic plane through an intussusception.
Amino acid transporter SLC7A11/xCT at the crossroads of regulating redox homeostasis and nutrient dependency of cancer
Authors: Koppula Pranavi , Zhang Yilei , Zhuang Li , Gan Boyi
Published: April 2018

Cancer cells often upregulate nutrient transporters to fulfill their increased biosynthetic and bioenergetic needs, and to maintain redox homeostasis. One nutrient transporter frequently overexpressed in human cancers is the cystine/glutamate antiporter solute carrier family 7 member 11 (SLC7A11; also known as xCT). SLC7A11 promotes cystine uptake and glutathione biosynthesis, resulting in protection from oxidative stress and ferroptotic cell death. Recent studies have unexpectedly revealed that SLC7A11 also plays critical roles in glutamine metabolism and regulates the glucose and glutamine dependency of cancer cells. This review discusses the roles of SLC7A11 in regulating the antioxidant response and nutrient dependency of cancer cells, explores our current understanding of SLC7A11 regulation in cancer metabolism, and highlights key open questions for future studies in this emerging research area. A deeper understanding of SLC7A11 in cancer metabolism may identify new therapeutic opportunities to target this important amino acid transporter for cancer treatment.