bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative outcomes of endoscopic ultrasound–guided cystogastrostomy for peripancreatic fluid collections: a systematic review and meta-analysis
Authors: Renelus Benjamin D. , Jamorabo Daniel S. , Gurm Hashroop K. , Dave Niel , Briggs William M. , Arya Mukul
Published: May 2019

Background:

Endoscopic ultrasound–guided cystogastrostomy has become the first-line treatment for symptomatic peripancreatic fluid collections. The aim of this study is to analyze the efficacy and safety of cystogastrostomy via a meta-analysis of the literature.

Methods:

We performed a systematic search of PubMed and Medline databases for studies published from January 2005 to May 2018. We included randomized controlled trials along with retrospective and prospective observational studies reporting endoscopic ultrasound–guided cystogastrostomy stent placement for peripancreatic fluid collections. The primary outcome for our meta-analysis was complete peripancreatic fluid collection resolution on imaging. Our secondary outcomes included comparative efficacy and safety of the procedure for pseudocysts and walled-off pancreatic necrosis using metal and plastic stents.

Results:

Seventeen articles involving 1708 patients met our inclusion criteria for meta-analysis. Based upon the random effects model, the pooled technical success rate of cystogastrostomy was 88% (95% confidence interval = 83–92 with I2 = 85%). There was no difference in the technical success rate between pancreatic pseudocysts and walled-off pancreatic necrosis (91% and 86%, respectively p = nonsignificant). The adverse event rates for metal and plastic stents were equivalent (14% and 18%, respectively, p = nonsignificant).

Conclusion:

Endoscopic ultrasound–guided cystogastrostomy stents are effective in the treatment of pancreatic pseudocysts and walled-off pancreatic necrosis. We found no difference in technical success or adverse event rates of drainage based on peripancreatic fluid collection type or stent used.
ACPA-negative RA consists of subgroups: patients with high likelihood of achieving sustained DMARD-free remission can be identified by serological markers at disease presentation
Authors: Boeters Debbie M. , Burgers Leonie E. , Sasso Eric H. , Huizinga Tom W. J. , van der Helm – van Mil Annette H. M.
Published: May 2019

Background

Disease-modifying antirheumatic drug (DMARD)-free remission, the sustained absence of synovitis after DMARD cessation, is increasingly achievable, especially in autoantibody-negative rheumatoid arthritis (RA). However, underlying mechanisms are unknown and patient subgroups that achieve this outcome are insufficiently characterized. We evaluated whether serological biomarkers at disease onset, as measured within the multi-biomarker disease activity (MBDA) score, are differently expressed in RA patients who achieve sustained DMARD-free remission.

Methods

Two hundred ninety-nine RA patients were evaluated for achievement of sustained DMARD-free remission during a median follow-up of 4.3 years. Twelve biomarkers, as included in the MBDA score, were determined from the serum obtained at disease onset. Patients were categorized as having a low (< 30), moderate (30–44) or high (> 44) score. Analyses were stratified for anti-citrullinated protein antibodies (ACPA) based under the assumption that ACPA-positive and ACPA-negative RA are different disease entities.

Results

Twenty percent achieved sustained DMARD-free remission. Overall, high MBDA scores were associated with achieving DMARD-free remission (high vs. low HR 3.8, 95% CI 1.2–12.2). Among ACPA-negative RA patients, moderate or high scores associated strongly with DMARD-free remission (moderate vs. low HR 9.4, 95% CI 1.2–72.9; high vs. low HR 9.7, 95% CI 1.3–71.1). This association was independent of age and other clinical factors (high vs. low HR 8.2, 95% CI 1.1–61.8). For ACPA-negative RA patients, the biomarkers C-reactive protein, serum amyloid A and matrix metalloproteinase-3 were individually associated with sustained DMARD-free remission. Among ACPA-positive RA patients, scores were not associated with DMARD-free remission.

Conclusions

ACPA-negative RA patients who achieved sustained DMARD-free remission after treatment withdrawal were characterized by moderate to high MBDA scores at diagnosis. This is the first evidence that ACPA-negative RA can be subdivided in clinically relevant subsets at disease onset using a protein profile.
Pitfalls and implementation of data conditioning, attribute analysis, and self-organizing maps to 2D data: Application to the Exmouth Plateau, North Carnarvon Basin, Australia
Authors: Ha Thang N. , Marfurt Kurt J. , Wallet Bradley C. , Hutchinson Bryce
Published: May 2019

Recent developments in attribute analysis and machine learning have significantly enhanced interpretation workflows of 3D seismic surveys. Nevertheless, even in 2018, many sedimentary basins are only covered by grids of 2D seismic lines. These 2D surveys are suitable for regional feature mapping and often identify targets in areas not covered by 3D surveys. With continuing pressure to cut costs in the hydrocarbon industry, it is crucial to extract as much information as possible from these 2D surveys. Unfortunately, much if not most modern interpretation software packages are designed to work exclusively with 3D data. To determine if we can apply 3D volumetric interpretation workflows to grids of 2D seismic lines, we have applied data conditioning, attribute analysis, and a machine-learning technique called self-organizing maps to the 2D data acquired over the Exmouth Plateau, North Carnarvon Basin, Australia. We find that these workflows allow us to significantly improve image quality, interpret regional geologic features, identify local anomalies, and perform seismic facies analysis. However, these workflows are not without pitfalls. We need to be careful in choosing the order of filters in the data conditioning workflow and be aware of reflector misties at line intersections. Vector data, such as reflector convergence, need to be extracted and then mapped component-by-component before combining the results. We are also unable to perform attribute extraction along a surface or geobody extraction for 2D data in our commercial interpretation software package. To address this issue, we devise a point-by-point attribute extraction workaround to overcome the incompatibility between 3D interpretation workflow and 2D data.
Assessment Supporting the Use of Outcropping Rock Evolutionary Intensity Measures for Prediction of Liquefaction Consequences
Authors: Bullock Zach , Dashti Shideh , Liel Abbie B. , Porter Keith A. , Karimi Zana
Published: May 2019

This study evaluates a variety of intensity measures (IMs) for predicting the liquefaction-induced residual settlement and tilt of shallow-founded structures. We use data from both numerical and physical (centrifuge) models of soil-foundation-structure systems. The relative quality of these IMs is quantified in terms of efficiency, sufficiency, and predictability. We consider both scalar and vector-valued IMs and evaluate the relative performance of IMs recorded at different locations (outcropping rock, within rock, far-field, and foundation) from nonlinear and equivalent-linear simulations. Cumulative absolute velocity (CAV) at outcropping rock is the optimum IM for predicting foundation settlement, while either outcropping rock CAV, peak ground velocity, or peak incremental ground velocity is optimum for predicting permanent foundation tilt. Vector IMs offer improvements to efficiency and sufficiency but may be impractical to predict.
Treatment of Primary Aldosteronism With mTORC1 Inhibitors
Authors: Trinh Beckey , Hepprich Matthias , Betz Matthias J , Burkard Thilo , Cavelti-Weder Claudia , Seelig Eleonora , Meienberg Fabian , Kratschmar Denise V , Beuschlein Felix , Reincke Martin , Odermatt Alex , Hall Michael N , Donath Marc Y , Swierczynska Marta M
Published: May 2019

Context

Mammalian target of rapamycin complex 1 (mTORC1) activity is often increased in the adrenal cortex of patients with primary aldosteronism (PA), and mTORC1 inhibition decreases aldosterone production in adrenocortical cells, suggesting the mTORC1 pathway as a target for treatment of PA.

Objective

To investigate the effect of mTORC1 inhibition on adrenal steroid hormones and hemodynamic parameters in mice and in patients with PA.

Design

(i) Plasma aldosterone, corticosterone, and angiotensin II (Ang II) were measured in mice treated for 24 hours with vehicle or rapamycin. (ii) Plasma aldosterone levels after a saline infusion test, plasma renin, and 24-hour urine steroid hormone metabolome and hemodynamic parameters were measured during an open-label study in 12 patients with PA, before and after 2 weeks of treatment with everolimus and after a 2-week washout.

Main Outcome Measures

(i) Change in plasma aldosterone levels. (ii) Change in other steroid hormones, renin, Ang II, and hemodynamic parameters.

Results

Treatment of mice with rapamycin significantly decreased plasma aldosterone levels (P = 0.007). Overall, treatment of PA patients with everolimus significantly decreased blood pressure (P < 0.05) and increased renin levels (P = 0.001) but did not decrease aldosterone levels significantly. However, prominent reduction of aldosterone levels upon everolimus treatment was observed in four patients.

Conclusion

In mice, mTORC1 inhibition was associated with reduced plasma aldosterone levels. In patients with PA, mTORC1 inhibition was associated with improved blood pressure and renin suppression. In addition, mTORC1 inhibition appeared to reduce plasma aldosterone in a subset of patients.
MR guided high intensity focused ultrasound (MRgHIFU) for treating recurrent gynaecological tumours: a pilot feasibility study
Authors: Giles Sharon L , Imseeh Georgios , Rivens Ian , ter Haar Gail R , Taylor Alexandra , deSouza Nandita M
Published: May 2019

Objective:

To assess the feasibility of targeting recurrent gynaecological tumours with MR guided high intensity focused ultrasound (MRgHIFU).

Methods:

20 patients with recurrent gynaecological tumours were prospectively scanned on a Philips/Profound 3 T Achieva MR/ Sonalleve HIFU system. Gross tumour volume (GTV) and planning target volume (PTV) were delineated on T 2W and diffusion-weighted imaging (DWI). Achievable treatment volumes that (i) assumed bowel and/or urogenital tract preparation could be used to reduce risk of damage to organs-at-risk (TVoptimal), or (ii) assumed no preparations were possible (TVno-prep) were compared with PTV on virtual treatment plans. Patients were considered treatable if TVoptimal ≥ 50 % PTV.

Results:

11/20 patients (55%) were treatable if preparation strategies were used: nine had central pelvic recurrences, two had tumours in metastatic locations. Treatable volume ranged from 3.4 to 90.3 ml, representing 70 ± 17 % of PTVs. Without preparation, 6/20 (30%) patients were treatable (four central recurrences, two metastatic lesions). Limiting factors were disease beyond reach of the HIFU transducer, and bone obstructing tumour access. DWI assisted tumour outlining, but differences from T 2W imaging in GTV size (16.9 ± 23.0%) and PTV location (3.8 ± 2.8 mm in phase-encode direction) limited its use for treatment planning.

Conclusions:

Despite variation in size and location within the pelvis, ≥ 50 % of tumour volumes were considered targetable in 55 % patients while avoiding adjacent critical structures. A prospective treatment study will assess safety and symptom relief in a second patient cohort.

Advances in knowledge:

Target size, location and access make MRgHIFU a viable treatment modality for treating symptomatic recurrent gynaecological tumours within the pelvis.
Ultrasound-guided radiofrequency ablation (RFA) of benign symptomatic thyroid nodules – initial UK experience
Authors: Jawad Susan , Morley Simon , Otero Sofia , Beale Timothy , Bandula Steven
Published: May 2019

Objective:

To report on the use of RFA for the treatment of symptomatic benign and autonomously functioning thyroid nodules (AFTNs) in the first reported UK cohort.

Methods:

Patients treated over a 19-month period were retrospectively reviewed. Nodules were assessed pre-treatment and at 1 and 6 months post-treatment. Nodule volume was calculated and cosmetic assessment and thyroid-related quality of life (QoL) scores were recorded at each time point. Thyroid function tests (TFTs) were recorded at all three time points for patients with ATFNs.

Results:

46 patients with 50 nodules were treated with no complications. The mean volume reduction 1-month post-treatment was 53 +- 14.9 % ( p < 0.0001). Six month data was available for 31 nodules and showed a mean 67 +- 17.6% vol reduction ( p < 0.0001). Five of the six patients with ATFNs were euthyroid at 1-month post-procedure. 6-month data was available on three of these patients, and all remained euthyroid. The thyroid-related QoL and cosmetic scores also improved. Data from 23 patients was available pre-treatment and at 6 months post-treatment and there was a significant ( p < 0.0001) reduction in QoL score. Pre-treatment, 82 % of nodules were readily visible at rest, decreasing to 12.5 % 6 months after treatment ( p < 0.0001).

Conclusions:

Results align with published data suggesting that RFA is effective at reducing nodule volume and at treating ATFNs and leads to improvement in thyroid-related QoL and cosmetic scores.

Advances in knowledge:

This early UK experience demonstrates that day-case radiofrequency ablation can provide safe and effective treatment of benign symptomatic thyroid nodules.
Usefulness of white blood cell count to mean platelet volume ratio in the prediction of SYNTAX score in patients with non-ST elevation myocardial infarction
Authors: Sivri Serkan , Sökmen Erdoğan , Celik Mustafa , Ozbek Sinan Cemgil , Yildirim Alp , Boduroglu Yalcin
Published: May 2019

Objective: White blood cell (WBC) count to mean platelet volume (MPV) ratio (WMR) is associated with major adverse cardiovascular events in patients with non-ST elevation myocardial infarction (NSTEMI). We aimed to compare WMR between NSTEMI patients and matched-controls and to evaluate its predictive value on SYNTAX score.

Methods: Total 175 patients with NSTEMI and 160 age and co-morbidity matched subjects were recruited in our study. WMR was compared between the patient and control groups. The patient group was further subdivided into 3 tertiles according to SYNTAX scores as follows: low SYNTAX score tertile (score ≤22, 141 patients); intermediate SYNTAX score tertile (score between 23 and 32, 20 patients); and, high SYNTAX score tertile (score ≥33, 14 patients). WMR was further assessed among the tertiles.

Results: WMR was significantly greater in the patient group compared to the control group (p<0,001). WMR among low, intermediate and high score tertiles were calculated to be 890±26, 1090±042 and 1500±65, respectively (p <0,001). In receiver operating characteristics (ROC) analysis, WMR >960 predicted a SYNTAX score ≥23 with 80.6% sensitivity and 67.6% specificity (AUC: 0.756; 95% CI: 0.685 - 0.818; p <0.0001) and a WMR >1360 predicted a SYNTAX score ≥33 with 71.4% sensitivity and 93% specificity (AUC: 0.840; 95% CI: 0.777 - 0.892; p <0.0001).

Conclusions: WMR value was significantly elevated in NSTEMI patients, compared to controls. Higher WMR was associated with greater SYNTAX score in patients with NSTEMI. WMR may be used to predict severity of the CAD and to implement risk stratification in patients with NSTEMI.

doi: https://doi.org/10.12669/pjms.35.3.1017

How to cite this:Sivri S, Sokmen E, Celik M, Ozbek SC, Yildirim A, Boduroglu Y. Usefulness of white blood cell count to mean platelet volume ratio in the prediction of SYNTAX score in patients with non-ST elevation myocardial infarction. Pak J Med Sci. 2019;35(3):824-829.  doi: https://doi.org/10.12669/pjms.35.3.1017

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Etiology and outcomes of convulsive status epilepticus in children
Authors: Uzair Muhammad , Ibrahim Asif , Zafar Faisal , Sultan Tipu
Published: May 2019

Objective: The study aimed to ascertain different causes and outcomes of convulsive status epilepticus in children.

Methods: From January 2018 to June 2018, seventy three patients who presented with status epilepticus were studied. Data were recorded with the help of a pre-formed performa. Etiological factors and outcomes in terms of recovery, morbidity and mortality were studied.

Results: Out of 73 children, forty one (56%) were males and 32(44%) were females with median age of 1.09±0.27 years. Etiologies were acute symptomatic 25(34%), febrile 19(26%), progressive encephalopathy 10(14%), remote symptomatic 10(14%) and idiopathic 7(9%) with p-value 0.005. Status epilepticus was controlled within one hour in 42(57%), within 1-6 hours in 21(29%) and more than 6 hours in 10(14%) patients with p-value 0.027. During hospitals stay, twenty one (29%) patients recovered completely, seizure recurred in 12(16%), Twelve (16%) became mentally retarded, Twelve (16%) developed mental retardation along with seizures and 16(22%) died. Eight (10.9%) deaths were attributed to acute symptomatic etiology with p-value less than 0.001.

Conclusion: This study concluded that acute symptomatic etiology was more common cause of status epilepticus as compared to other etiologies and it is associated with poorer outcomes as compared to other etiologies.

doi: https://doi.org/10.12669/pjms.35.3.120

How to cite this:Uzair M, Ibrahim A, Zafar F, Sultan T. Etiology and outcomes of convulsive status epilepticus in children. Pak J Med Sci. 2019;35(3):620-623. doi: https://doi.org/10.12669/pjms.35.3.120

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Oxidant-Antioxidant balance in patients with coronary slow flow
Authors: Baysal Sadettin Selçuk , Koç Şahbender
Published: May 2019

Objective: Recent studies have focused on the probable role of oxidative stress in cardiovascular diseases. We aimed to assess the oxidant/antioxidant biomarkers in coronary slow flow (CSF).

Methods: The study included 51 subjects with CSF and age and sex matched 32 controls. Detailed anamnesis of the patients in the study was taken and routine physical examinations were performed. Routine biochemical blood tests were analyzed. Total oxidative status (TOS), oxidative stress index (OSI) and lipid hydroxyperoxide (LOOH) levels as oxidant biomarkers; paraoxonase (PON1), ceruloplasmin (CP), free sulphydryl (SH) groups, and total antioxidant capacity (TAS) levels as antioxidant biomarkers were studied.

Results: Baseline demographic characteristics of the study population did not differ significantly between groups. TOS, OSI and LOOH concentrations were higher in study group than in control group. However, there was no significant difference detected in levels of TAS, PON1, SH and CP. Multivariate logistic regression analysis revealed that TOS, hsCRP and smoking were indepedent risk factors of CSF.

Conclusions: Although there was not any significant difference in antioxidant biomarkers (TAS, PON1, SH and CP) in CSF patients, we detected increased TOS, OSI and LOOH levels which have oxidant properties. These data supported the possible involvement of oxidative stress in pathogenesis of CSF as previous studies reported.

doi: https://doi.org/10.12669/pjms.35.3.162

How to cite this:Baysal SS, Koc S. Oxidant-Antioxidant balance in patients with coronary slow flow. Pak J Med Sci. 2019;35(3):786-792.  doi: https://doi.org/10.12669/pjms.35.3.162

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effectiveness and Quality of Life with Montelukast in Asthma – A double-blind randomized control trial
Authors: Ullah Baig Mirza Saif , Khan Rashid Ahmed , Khan Kamran , Rizvi Nadeem
Published: May 2019

Objective: To determine the role of montelukast – a leukotriene receptor antagonist (LTRA) – in improving the quality of life (QOL) and asthma control of adult patients with mild to moderate persistent asthma.

Methods: Randomized, double-blind, placebo-controlled, non-crossover trial was conducted from March 2017 till November 2018 in three hospitals of Karachi and Hyderabad. Adults of age 15 years or more with mild to moderate persistent asthma. Treatment group was administered tablet montelukast 10mg once daily; the other group was given a similar looking placebo; as an adjuvant to the current medication. QOL was assessed with Asthma Quality of Life Questionnaire – Standard (AQLQ-S) before and after the treatment. Asthma control was monitored via Asthma Control Test (ACT).

Results: After 4 weeks, the mean ± SD of overall QOL on AQLQ-S improved from 3.74±0.88 to 5.06±0.89 for montelukast group and from 3.58±0.92 to 4.71±0.97 for placebo group (p=0.02). The improvement in sub-domains of symptoms, activity, and emotional functions was not significant; however, the sub-domain “environmental stimuli” significantly improved with 5.06±0.89 for montelukast group and 4.71±0.97 for placebo group (p=0.02). The mean ± SD of ACT, after four weeks, for montelukast group was 18.19±2.91 and for placebo group 17.28±3.36. Only on ACT, Montelukast did not show any statistically insignificant results.

Conclusion: The role of montelukast in improving QOL of adult patients with mild to moderate persistent asthma is quite beneficial. It improves patient quality of life. It has the ease of once daily oral administration and also eradicates side effects associated with long-term adherence to steroids.

doi: https://doi.org/10.12669/pjms.35.3.42

How to cite this:Baig S, Khan RA, Khan K, Rizvi N. Effectiveness and Quality of Life with Montelukast in Asthma – A double-blind randomized control trial. Pak J Med Sci. 2019;35(3):731-736. doi: https://doi.org/10.12669/pjms.35.3.42

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Pattern of changes in latissimus dorsi, gluteus maximus, internal oblique and transverse abdominus muscle thickness among individuals with sacroiliac joint dysfunction
Authors: Bashir Muhammad Salman , Noor Rabiya , Hadian Mohammad Reza , Olyaei Gholamreza
Published: May 2019

Background and Objective: Altered Pattern of the Global Muscle system is presented in literature among individuals with sacroiliac Joint Dysfunctions. However, the pattern of changes in the Latissimus dorsi (LD) and gluteal maximus (GM) among sacroiliac joint dysfunctions (SIJD) is not reported. This study aimed to investigate the changes in the resting muscle thickness of the Latissimusdorsi and gluteal maximus in SIJD.

Method: A total of 88 subjects (44 individuals with SIJD and 44 healthy individuals as matched control) was included in this study. The resting thickness of the Latissimusdorsi and gluteal maximus was measured using real time musculoskeletal ultrasonography and data was compared between the ipsilateral side and contra lateral side among subjects with SIJD as well as healthy subjects. Independent sample t test was used to analyze the data by using SPSS version-25.

Results: The results showed that contralateral LD were reduced significantly among subjects with SIJD when compared with the other side and with control. It also showed that ipsilateral IO, TrA and GM were reduced significantly among subjects with SIJD when compared with the controls and with contralateral side.

Conclusion: The reduced resting muscle thickness showed an altered motor pattern of Deep Muscles of local system and Gross muscles of global system among patients with sacroiliac joint dysfunction.

doi: https://doi.org/10.12669/pjms.35.3.62

How to cite this:Bashir MS, Noor R, Hadian MR, Olyaei G. Pattern of changes in latissimus dorsi, gluteus maximus, internal oblique and transverse abdominus muscle thickness among individuals with sacroiliac joint dysfunction. Pak J Med Sci. 2019;35(3):818-823.  doi: https://doi.org/10.12669/pjms.35.3.62

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Political science
Authors: Пляйс Яков , Plyays YAkov , Брега Александр , Brega A. , Петросянц Даниэл , Petrosyants Daniel , Расторгуев Сергей , Rastorguev S. , Ерохина Оксана , Yerokhina Oksana , Кулинченко Александр , Kulinchyenko Alyeksandr , Шатилов Александр , SHatilov Alyeksandr , Пырма Роман , Pyrma Roman , Кафтан Виталий , Kaftan Vitaliy , Седых Николай , Syedykh Nikolay , Сучилина Анна , Suchilina Anna , Белоконев Сергей , Belokonev Sergey , Володенков Сергей , Volodenkov S. , Помигуев Илья , Pomiguev Il'ya , Селезнев Павел , Seleznev Pavel , Матвеев Олег , Matveev Oleg , Митрофанова Анастасия , Mitrofanova Anastasiya , Зубов Вадим , Zubov Vadim , Ястремский Анатолий , Yastremskiy Anatoliy
Published: May 2019

The textbook was created by a team of authors of the Department of political science of the Financial University under the Government of the Russian Federation and is designed to study the main topics in the field of "political Science". The textbook reflects not only the previously established provisions of political science, but also new approaches to the basic topics of political science.
Meets the requirements of the Federal state educational standard of higher education of the last generation.
For University students studying in the areas of higher education (bachelor) and studying Humanities, social Sciences, mathematical and natural Sciences, technical Sciences.
The textbook can be used by teachers to develop training courses and special courses on basic topics of political science.
Does Loss Aversion Preclude Price Variation?
Authors: Chen Ningyuan , Nasiry Javad
Published: May 2019

Problem definition: In modern retailing, frequent discounts are seemingly at odds with the idea that price variation antagonizes loss-averse consumers and hence, diminishes their demand for products and services. Our research question then is whether (or not) loss aversion rules out price variation—and in particular, cyclic pricing. Academic/practical relevance: Pricing and revenue management subject to behavioral considerations are key research areas in operations management. Our approach contributes to this research by highlighting the importance of incorporating heterogeneity in consumers’ behavioral responses in pricing models. Methodology: We model a monopolist selling a product over time to loss-averse consumers who differ in their sensitivity to gains/losses. Although the market is thus segmented, the firm cannot price discriminate among consumers based on that sensitivity. We then characterize the structural properties of the firm’s optimal pricing policy. Results: We show that charging a long-run constant price may be suboptimal and then derive conditions under which the optimal policy is cyclic. These findings establish that loss aversion does not preclude price variation and thereby, underscore the importance of incorporating consumer heterogeneity into pricing policies. Managerial implications: For operations management scholars, our model highlights the importance of heterogeneity in consumers’ behavioral responses to firms’ policies and shows that structurally different insights are obtained from pricing models if this heterogeneity is appropriately accounted for. This approach offers new avenues in pricing and revenue management research. For managers, our model suggests that they could vary prices, under certain conditions, without worrying that price variation will antagonize consumers. Our model offers insights on what these conditions are, which managers may incorporate in devising the pricing policies.
The pupils who banned phones before bedtime
Authors: Lee-Potter Emma
Published: May 2019

After a research project looking at mobile phone use and its impact on sleep, year 6 pupils at Weaverham Primary Academy have pledged to ditch their phones an hour before bedtime. Emma Lee-Potter explains
Premenstrual dysphoric disorder: A new psychological entity
Authors: Cope Graham F.
Published: May 2019

Graham Cope details this recently classified condition which is still poorly understood by clinicians
Research roundup: May 2019
Authors: Austin Yasmin , Odd Dawn , Seal Joanne
Published: May 2019

In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.
Health visiting and safeguarding children: A perfect storm?
Authors: Peckover Sue , Appleton Jane V
Published: May 2019

Health visitors play an important role in safeguarding and protecting children. In this article we review current research evidence and professional literature about this aspect of health visiting and highlight some of the practice challenges in undertaking this work. Three critical issues are discussed: the invisibility and unquestioned nature of much health visiting safeguarding work; that health visitors with their clinical expertise and accepted home visiting role are well placed to undertake this type of work; and the challenges of ensuring effective safeguarding within the context of economic austerity. The article highlights the important contribution of contemporary health visiting to safeguarding children and child protection. It is important that this role is made explicit to those commissioning health visiting services for children in the early years.
GCSEs: A healthy approach
Authors: Stafford Clare
Published: May 2019

Exam season is looming and many pupils will be feeling the pressure. Clare Stafford looks at ideas for offering emotional support in the run-up to and during the exam period
LGBT within high-quality RSE
Authors: Emmerson Lucy
Published: May 2019

What can schools do to make LGBT-inclusive approaches central to high-quality, statutory relationships and sex education for all pupils. Lucy Emmerson offers some guidance
Sensor-based equine gait analysis: more than meets the eye?
Authors: Pfau Thilo
Published: May 2019

Quantitative gait analysis in the lame horse has gained in popularity, likely related to the potential to remove bias from the clinical decision-making process. Its implementation into clinical practice is, however, not without challenges. This review visits some of the challenges related to the use of thresholds and guideline values in the context of clinical decision making, as well as when applied to scientific studies based on relevant published studies: issues such as ‘normal day-to-day variation’, conformational asymmetry and the often limited number of parameters that are being quantified. Emphasis is put on outlining the basic underlying principles relating to head nod and hip hike, which are explained in the context of Newtonian mechanics associating reduced vertical acceleration of the upper body to reduced force production with the limb that is in contact with the ground during that time period. Further to quantifying what can be seen ‘by eye’, the review also visits phenomena such as asymmetries in weight bearing or pushoff and compensatory mechanisms, with emphasis on measurement of withers movement and thoughts about multilimb lameness. The review concludes with thoughts about additional parameters such as limb movement and movement of the thoraco-lumbo-sacral area, which may provide additional insights into lameness and poor performance but are at current less frequently included into clinical gait analysis in the horse.
Ultrasonography of the stifle
Authors: Cauvin Eddy R J , Smith Roger K W
Published: May 2019

Stifle injuries are increasingly recognised as a major cause of hind limb lameness and commonly affect the soft tissues of the joint in adult horses, making ultrasonography a vital part of diagnostic imaging of this joint. This article aims to provide an introduction to stifle ultrasonography. To ensure comprehensive evaluation of the stifle, a systematic approach is necessary. The ultrasonographic examination is divided into five approaches: initially weight-bearing scans should be obtained of the cranial aspect (for the femoropatellar joint), medial aspect (for the medial femorotibial joint), and lateral aspect (for the lateral femorotibial joint), followed by flexed views from cranial (for the cranial aspect of the femorotibial joints) and, finally, in limited cases because pathology is rarer and the technique more demanding, weight-bearing views of the caudal aspect (for the caudal parts of both femorotibial joints). For the femoropatellar joint, ultrasound can be used to identify bruising (haematoma), injuries to the patellar ligaments, trochlear ridges (including osteochondrosis), and patella and tibial crest fractures. For the femorotibial joints, injuries to the menisci are the most common, but ultrasound can also identify rarer collateral and cruciate ligament injuries. and abnormalities of the weight-bearing surfaces of the femoral condyles, such as cartilage damage and subchondral bone cysts.
Iogurte probiótico com polpa de frutas vermelhas: caracterização físico química e microbiológica, aceitabilidade sensorial e viabilidade dos probióticos
Authors: Gallina Darlila Aparecida , Ormenese Rita Cássia S. Celeste , Garcia Aline Oliveira
Published: May 2019

Este trabalho teve como objetivo elaborar um iogurte probiótico com polpa de frutas vermelhas (n =3) e avaliar a qualidade microbiológica, a composição físico-química, a viabilidade dos probióticos, a aceitação sensorial e intenção de compra, bem como verificar a viabilidade da cultura probiótica e características físico-químicas (pH, acidez titulável e sinérese) ao longo de 30 dias de estocagem refrigerada. O iogurte apresentou qualidade higiênico sanitária apropriada e composição (média) de: pH de 4,76; acidez titulável de 0,81 g ácido láctico %; extrato seco total de 17,67 %; gordura total de 0,22 %; proteína total de 3,51 %; cinzas de 1,05 % e carboidratos totais de 12,90 %. O probiótico Howaru Bifido HN 019 manteve-se viável, em torno de 8 log UFC/mL durante os 30 dias de estocagem, em nível considerado terapêutico. O produto obteve mais de 75 % de aceitação para os atributos avaliados, destacando-se a aparência, o sabor e a consistência que obtiveram avaliações médias entre “gostei muito” e “gostei”, sendo que 53,3 % dos consumidores demonstraram atitude positiva quanto à intenção de compra.
Características físico-químicas de queijo Minas artesanal do Serro fabricados com pingo e com rala
Authors: Oliveira Sâmya Petrina Pessoa , Martins José Manoel , Nogueira Cristina Henriques , Vale Rosana Campos do , Rodrigues Maria Paula Jensen , Galleti Aline Nogueira
Published: May 2019

A produção do queijo Minas artesanal do Serro é realizada com a utilização do leite cru, coalho e fermento lático natural, conhecido por pingo. Alguns produtores da região fazem uso da rala, parte ralada do próprio queijo artesanal que é adicionado ao leite em substituição ao pingo. O objetivo deste trabalho foi avaliar a influência do tipo de fermento (pingo ou rala) nas características físico-químicas do queijo Minas artesanal do Serro maturado nas fazendas. Queijos artesanais de seis produtores cadastrados no Instituto Mineiro de Agropecuária (IMA) foram maturados nas propriedades de origem durante 31 dias. Os queijos foram analisados nos Laboratórios do Departamento de Ciência e Tecnologia de Alimentos do IF Sudeste MG, Campus Rio Pomba, nos tempos 3, 10, 17, 24 e 31 dias de maturação. Houve diferença (p < 0,05) para tratamento e tempo para os parâmetros de extensão de maturação, profundidade de maturação e pH. Não houve diferença (p > 0,05) entre os tratamentos de queijos fabricados com “pingo” e com rala, para os seguintes parâmetros físico-químicos: acidez, umidade, proteína, gordura e gordura no extrato seco. Estudos mais aprofundados sobre as condições de maturação dos queijos Minas artesanais deverão ser mais bem explorados para que este produto possa atender não somente aos padrões microbianos, mas principalmente às características sensoriais, que tanto tem atraído à atenção do consumidor.
Cryptogenic Multifocal Ulcerative Sclerosing Enteritis: A Curious Case of Intestinal Obstruction in the Setting of Human Immunodeficiency Virus
Authors: Hathorn Kelly , Qazi Taha , Caton Michael Travis , Allegretti Jessica R.
Published: May 2019

Cryptogenic multifocal ulcerative sclerosing enteritis (CMUSE) is a rare clinical entity characterized by chronic, relapsing episodes of ileus and obstruction resulting from superficial ulcerating lesions of the small intestine with a clinical course that responds favorably to corticosteroids. We report a case of CMUSE arising in a patient with a history of human immunodeficiency virus infection. This case highlights the unique pathology of CMUSE as well as the potential pathogenesis of this atypical clinical entity.
Portobiliary Fistula in a Liver Transplant Recipient Treated With an Endoscopically Deployed Fully Covered Self-Expandable Biliary Metal Stent
Authors: Murray Fritz , Buetikofer Simon , Dutkowski Philipp , Gubler Christoph
Published: May 2019

Biliary complications following liver transplantations, with leaks and bile duct strictures being the most common ones, are greatly feared. Portobiliary fistulas are rare, but may cause potentially life-threatening complications. The presented case shows the first successful treatment of a portobiliary fistula by an endoscopically deployed fully covered self-expandable metal stent after liver transplantation. In accordance to the already established use in refractory bile leaks, we believe that fully covered self-expandable metal stent is a safe and efficient treatment option for portobiliary fistula.
A Curious Case of Coil-Angitis
Authors: Beard Jasna I. , Murphy Sharif , Philips George
Published: May 2019

A 43-year-old man with a history of pedestrian-truck collision 18 months prior presented with right-sided abdominal pain and chills. His trauma consisted of orthopedic injuries and a grade 4 liver laceration. Surgical liver repair was complicated by a biloma requiring common bile duct stenting. Postendoscopy hemobilia led to extensive coiling of a hepatic artery pseudoaneurysm. Remaining hospitalization was relatively uneventful, and he was lost to follow-up. Repeat presentation was marked by leukocytosis and obstructive transaminitis. Computed tomography raised concern for a dilated 14-mm common bile duct with migrated coil mass near the pancreatic head. The patient underwent urgent endoscopic retrograde cholangiopancreatography with cholangioscopy and successful removal of a coil mass measuring approximately 4 × 3 cm without injury to the common bile duct or vascular structures. His pain was relieved, and he was discharged with a common bile duct stent and outpatient follow-up.
Resuturing of Stomach in Endoscopic Sleeve Gastroplasty 8 Months After Original Procedure
Authors: Galvão Neto Manoel dos Passos , Silva Marco , Grecco Eduardo , de Souza Thiago Ferreira , Baldim Luana Leite , Teixeira André , Gomes Sara , Macedo Guilherme , de Quadros Luiz Gustavo
Published: May 2019

Endoluminal treatments such as endoscopic gastroplasty have been gaining ground in obesity treatment. A 52-year-old woman gained weight 5 months after endoscopic gastroplasty. Thus, it was decided to resuture the greater curvature of the stomach 8 months after the initial procedure by reducing the gastric pouch even further. The patient lost 16% of her total body weight with this procedure. Endoscopic gastroplasty, which can be reperformed in patients who regain weight, reach a plateau, or do not achieve the initial planned weight loss, is an effective and safe first-line obesity treatment.
Monogenic auto-inflammatory diseases in children and adults: what a rheumatologist should know
Authors: Salugina S. O. , Fedorov E. S. , Agafonova E. M.
Published: May 2019

The article presents information on the current state of the problem of autoinflammatory diseases (AID) in rheumatology, reflects the clinical and demographic, laboratory and molecular genetic characteristics of the main monogenic AID (mAID), the most common in real clinical practice. Approaches to the diagnosis and differential diagnosis of these conditions are presented. The variants of classification and diagnostic criteria of the most studied mAID are discussed. The principles of treatment with an emphasis on the use of targeted therapy with interleukin 1 (IL1) inhibitors are shown. The clinical examples demonstrate the variants of late diagnosis of the mAID in adult patients with the disease onset in childhood. Different variants of multi-organ damage are considered. Effectiveness of therapy with IL1β inhibitor kanakinumab is demonstrated. Even in such cases it provided the possibility of significant symptoms regression and restoration of a satisfactory quality of life.
Allelic polymorphisms of thymidylate synthase gene and their haplotypes as predictors of the therapeutic response to methotrexate in patients with rheumatoid arthritis
Authors: Devald I. V. , Khodus E. A. , Khromova E. B. , Nesmeyanova O. B. , Burmistrova A. L.
Published: May 2019

Methotrexate (MT) is recognized as the main component of the treat to target strategy in patients with rheumatoid arthritis (RA). Unfortunately, MT therapy is not equally effective in all patients with RA, some of them are resistant to such treatment, and have steady progression of destructive changes of the joints, reducing quality of life and leading to disability.

Objective: examination of genetic predictors of therapeutic efficacy and resistance to MT among single-nucleotide polymorphisms (SNP) of folate cycle genes, in particular polymorphisms of the thymidylate synthase gene TSER 2R/3R and TS 6bp del/ins and their haplotypes.

Subjects and methods. The study included 85 patients with RA, who were prescribed MT at a dose of 10 to 17.5 mg/week as a the «first line» disease-modifying antirheumatic drug. The therapeutic response was evaluated with DAS28 after 6 months of continuous treatment. According to the results of this assessment groups of «respondents» and «non-respondents» to MT were identified. Genetic typing of SNP TSER 2R/3R and TS 6bp del/ins was performed by real-time polymerase chain reaction.

Results and discussion. In RA patients with different efficacy of MT, statistically significant differences in the frequency of alleles and genotypes of polymorphic variants of the gene thymidylate synthase were revealed. Thus, in patients resistant to MT homozygous genotype TS 6bp ins/ins frequency was significantly increased (OR 4,3; 95% CI of 1.58 to 11.7; p=0.003), whereas response to the treatment was associated with occurrence of TS 6bp allele del (HR OF 0.48; 95% CI of 0.23 to 1.0; p=0.049), of TSER 2R/3R (OR 0,32; 95% CI 0,12–0,88; p=0.042) and TS 6bp del/ins (OR 0.23; 95% CI 0.08–0.65; p=0.008) genotypes. We have not established statistically significant differences in the frequency of occurrence of haplotypes of the thymidylate synthase gene in RA patients with different therapeutic efficacy of MT, but we found a tendency to increase of the haplotype TS 3R-6bp del (OR 0.39; 95% CI 0.24–1.09; p=0.081) frequency in the «respondents» to the treatment.

Conclusion. Our results may indicate the relationship of the thymidylate synthase gene single nucleotide polymorphisms with therapeutic response to MT in patients with RA.
La avanzada material del viejo idealismo
Authors: Binetti María José
Published: May 2019

El presente artículo se proponer trazar la línea de continuidad especulativa que une al idealismo absoluto con lo que algunos autores denominan el último programa materialista del viejo idealismo alemán. El giro ontológico o especulativo del pensamiento contemporáneo se ha proclamado heredero de la vieja tradición idealista, especialmente en consideración de dos ideas centrales, a saber: la negatividad reflexiva del absoluto y su inmanencia medial en el fundamento de todas las cosas. Sobre estas dos ideas se articula el nuevo materialismo dialéctico, cuyos lineamientos generales intentaremos seguir, en particular a través de Slavoj Žižek y Catherine Malabou.
Fabrication and Characterization of Diatomite Functionalized Cellulose Acetate Nanofibers
Authors: Akduman Çiğdem
Published: May 2019

Cellulose acetate (CA) nanofiber membranes incorporated with diatomite (DE) were prepared by electrospinning to produce electrospun nanofiber membranes with high specific surface area and high porosity with fine pores. When the DE percentage increased from 0 to 30%, the water contact angle (WCA) of the membranes increased from 86.21° to 118.44°, indicating that neat CA nanofibers were more hydrophilic than CA/DE nanofibers and had a better wetting tendency. CA, CA-10DE, and CA-20DE nanofiber membranes showed a mean flow pore size (MFP) of 2.941, 2.681, and 2.408 μm, respectively, with narrow pore size distributions. However, the CA-30DE nanofiber membrane showed a smaller MFP size of 0.5014 μm. CA nanofibers were produced in the range of 206.31 to 281.13 nm. The dye removal ability of these membranes was tested using an aqueous solution of C.I. Reactive Red 141.
Analysis of Engine Oils from Farm Tractors in the Aspect of their Change
Authors: Gołębiowski Wojciech , Zając Grzegorz , Wolak Artur
Published: May 2019

The paper presents results of research on selected physico-chemical parameters of engine oils from farm tractors based on the date of their change assumed by the user. 17 samples of used engine oil from farm tractors of various producers and with a varied exploitation course were analysed. Oils for research were collected during oil change, registering the service life of oil each time. They were obtained from service points that repair farm tractors in the region of Lublin Province. The studies were to verify whether a decision concerning oil change taken by tractor users after specific time of operation of an engine was good. Number of exceedings of the threshold values of parameters of engine oil which are responsible for correct lubrication were the basis for evaluation
Chemical Threats in Thermally Processed Traditional Food and Possibilities of Their Reduction
Authors: Grochowicz Józef
Published: May 2019

The objective of the paper is to review the present state of knowledge on health threats that occur as a result of some thermal processing of food products. Depending on the type and properties of raw materials and conditions of processes, carcinogenic, mutagen and genotoxic substances may be formed out of them, which may be treated as a process contamination. They are produced in processing plants, where their content is obligatorily controlled and organic, as well as in the conditions of food production in gastronomic units and households. The paper emphasises the second area of food processing, in particular, house-holds and popularised grilling processes, where there are no other possibilities of control of the threat level and awareness of people who prepare food and consumers is insufficient. The paper presents the most often occurring hazardous compounds, the most important regulations and admissible limits of consumption, as well as principles of thermal processing in a safe manner, and possibilities of limiting the levels of those substances in products