bluuebunny/crossref_metadata_2025 huggingface dataset:
An evaluation of discharge documentation for people with dementia discharged home from hospital – A cross-sectional pilot study
Authors: Kable Ashley , Pond Dimity , Hullick Carolyn , Chenoweth Lynnette , Duggan Anne , Attia John , Oldmeadow Christopher
Published: December 2017

This study evaluated discharge documentation for people with dementia who were discharged home, against expected discharge criteria and determined relationships between compliance scores and outcomes. This cross-sectional study audited discharge documentation and conducted a post discharge survey of carers. There were 73 eligible discharges and clinically significant documentation deficits for people with dementia included: risk assessments of confusion (48%), falls and pressure injury (56%); provision of medication dose-decision aids (53%), provision of contact information for patient support groups (6%) and advance care planning (9%). There was no significant relationship between compliance scores and outcomes. Carer strain was reported to be high for many carers. People with dementia and their carers are more vulnerable and at higher risk of poor outcomes after discharge. There are opportunities for improved provision of medications and risk assessment for people with dementia, provision of information for patient support groups and advanced care planning.
A systematic review of electronic assistive technology within supporting living environments for people with dementia
Authors: Daly Lynn Jean , Rondón-Sulbarán Janeet , Quinn Eamon , Ryan Assumpta , McCormack Brendan , Martin Suzanne
Published: December 2017

Health and social care provision needs to change in order to meet the needs of an increase in the number of people living with dementia. Environmental design, technology and assistive devices have the potential to complement care, help address some of the challenges presented by this growing need and impact on the lived experience of this vulnerable population. This systematic review was undertaken to identify the research on the use of electronic assistive technology within long-term residential care settings. A total of 3229 papers published from the inception of each of the databases up until May 2016 were retrieved from searches in four major databases. Sixty-one were identified to be included in the review. The inclusion criteria were: original peer reviewed journals; an electronic assistive technology intervention; with residents or tenants living with dementia or their family or paid caregivers; in supported living environments or residential care. The data extracted from the included studies focused on the methodology, technology, outcomes and the role of people living with dementia within the research. Overall, an extensive variety of technical interventions were found, with a broad range of methodological heterogeneity to explore their effect. Additionally, wide-spanning outcomes to support the potential of technology solutions and the challenges presented by such intervention were found.
Critical reflections on methodological challenge in arts and dementia evaluation and research
Authors: Gray Karen , Evans Simon Chester , Griffiths Amanda , Schneider Justine
Published: December 2017

Methodological rigour, or its absence, is often a focus of concern for the emerging field of evaluation and research around arts and dementia. However, this paper suggests that critical attention should also be paid to the way in which individual perceptions, hidden assumptions and underlying social and political structures influence methodological work in the field. Such attention will be particularly important for addressing methodological challenges relating to contextual variability, ethics, value judgement and signification identified through a literature review on this topic. Understanding how, where and when evaluators and researchers experience such challenges may help to identify fruitful approaches for future evaluation.
Narratives of health and illness: Arts-based research capturing the lived experience of dementia
Authors: Moss Hilary , O’Neill Desmond
Published: December 2017

Introduction

This paper presents three artists’ residencies in a geriatric medicine unit in a teaching hospital. The aim of the residencies was creation of new work of high artistic quality reflecting the lived experience of the person with dementia and greater understanding of service user experience of living with dementia. This paper also explores arts-based research methodologies in a medical setting.

Method

Arts-based research and narrative enquiry were the method used in this study. Artists had extensive access to service users with dementia, family carers and clinical team. Projects were created through collaboration between clinical staff, arts and health director, artist, patients and family carers. Each performance was accompanied by a public seminar discussing dementia. Evaluations were undertaken following each residency. The process of creating artistic responses to dementia is outlined, presented and discussed.

Results

The artworks were well received with repeat performances and exhibitions requested. Evaluations of each residency indicated increased understanding of dementia. The narratives within the artworks aided learning about dementia. The results are a new chamber music composition, a series of visual artworks created collaboratively between visual artist and patients and family carers and a dance film inspired by a dancer’s residency, all created through narrative enquiry. Discussion and conclusion: These projects support the role of arts-based research as creative process and qualitative research method which contributes to illuminating and exploring the lived experience of dementia. The arts act as a reflective tool for learning and understanding a complex health condition, as well as creating opportunities for increased understanding and public awareness of dementia. Issues arising in arts-based research in medical settings are highlighted, including ethical issues, the importance of service user narrative and multidisciplinary collaboration in arts and health practice and research.
Development and pilot testing of the “focus on the person” form: Supporting care transitions for people with dementia
Authors: Burton Elissa , Slatyer Susan , Bronson Mary , Nichols Pam , Quested Eleanor , Hill Andrew , Maher Sean , Aoun Samar , Hill Keith D , Kuno Yukiko , Toye Chris
Published: December 2017

When people with dementia are hospitalised, their capacity to communicate with the staff may be limited, compounding risks of distress and other adverse outcomes. Opportunities for carers to share relevant information to inform appropriate person-centred care are also limited. This four-phase mixed methods study aimed to develop an evidence-based family carer–staff communication form, the Focus on the Person form, to address this concern. In Phase I, a literature review plus consultation with clinicians and carers informed form development. In Phase II, the professionally formatted form was piloted by 31 family carers, who were then interviewed about their experiences. These data, combined with data from 30 hospital staff members who participated in Phase III focus groups, led to final, Phase IV, refinements of the form. The form now provides an opportunity for families to inform the person-centred care of people with dementia in hospital, potentially improving outcomes for this vulnerable group.
Utilizing evidence-based assessment instruments to detect well-being and distress in English- and Spanish-speaking caregivers of individuals affected by dementia
Authors: Burke Shanna L , Burgess Aaron , Cadet Tamara
Published: December 2017

Objective

The purpose of this study was to examine the most effective and available English and Spanish language caregiver assessments for providers and caregivers.

Methods

Assessments were included if they screened for caregiving-related concerns, including stress, depression, and caregiving burden and could be administered directly to caregivers in person or online.

Results

Eighteen assessments are designed to assess caregiver burden, distress, depression, and grief. Six did not have psychometric data to support efficacy but are widely used in clinical and research settings. Six were validated in Spanish, and one other is available in Spanish but not validated.

Conclusion

As many as 80% of care recipients are cared for in the home by family members who act as informal caregivers. Caregivers of persons with dementia may experience depression symptoms, high caregiver burden, and feelings of being constrained. Due to the lack of psychometric evidence available, the validity of some assessments is questionable.
Achieving positive outcomes in complex cases: The Admiral Nurse Dementia Helpline (Innovative Practice)
Authors: Drayton Susan , Dening Karen H
Published: December 2017

Carer distress is an all too common factor in caring for someone with dementia, whether living with the person with dementia, or trying to maintain their independence when they are living alone. Providing support for families on many day-to-day issues with immediacy as and when they arise can be very difficult to achieve for services on the ground as carer need can be difficult to anticipate as well as the changing status of the person with dementia. This paper discusses the innovative role of managing complexity on a dementia telephone helpline manned by Admiral Nurses, specialist dementia nurses, in expertly supporting a family over a weekend where there were health concerns of a family member with dementia and a high level of carer distress.
Optimisation of dementia care in care homes: Dementia care framework (innovative practice)
Authors: Royston Claire , Mitchell Gary , Sheeran Colin , Strain Joanne , Goldsmith Sue
Published: December 2017

There are an increasing number of people living with dementia in care home settings. Recent reports suggest that people who deliver care to residents living with dementia in care homes require specialist support to provide optimum care. To address this need Four Seasons Health Care, the largest provider of care homes within the UK today, sought to design a dementia care framework that enhanced the quality of life for people living with dementia in their care homes. The framework was designed using a robust evidence base, engagement with people living with dementia, their care partners, policy-writers, multidisciplinary professionals and people within the organisation. This paper describes the methodology behind the dementia care framework and outcomes data from the first phase (of 20 care homes that included the care of 451 people living with dementia). The main outcome was a significant improvement in the quality of the lives of residents across biological, psychological, social and spiritual needs.
Building creative communities of care: Arts, dementia, and hope in the United States
Authors: Basting Anne
Published: December 2017

This essay explores the history of the cultural community development model in the United States and its potential benefits for transforming the lived experience of dementia. Using her work with the 2011 Penelope Project as a case study, the author identifies core elements of a “Creative Community of Care:” open systems; all activities are accessible; the arts are immersed into the environment of care; projects build on existing assets and rituals; projects evolve over long periods of time; and projects have high cultural value/capital.
Perceptions of reciprocity in friendship by community dwelling people with mild to moderate dementia
Authors: Perion Jennifer , Steiner Victoria
Published: December 2017

Positive social interaction is important for people with dementia, providing emotional and psychological benefits. Friendships may retain more reciprocal balance than caregiver relationships, which often become one-sided. This qualitative study investigates the meaning that friendship has for people with dementia, and how reciprocity relates to positive social identity. Individuals experiencing dementia were recruited from programs sponsored by a Midwest chapter of The Alzheimer’s Association. In a face-to-face, one-time interview, participants were asked to share their perceptions about reciprocal friendship. Participants included 10 individuals who were primarily White, averaged 76 years old, with at least some college education. The data were analyzed using a phenomenological approach that revealed five themes of reciprocal friendship: recognizing the importance of longevity in friendship, helping one another is a normal part of friendship, feeling “alive” through the give and take in friendship, knowing somebody is there for them, and seeking security through friendship.
Medication and care in Alzheimer’s patients in the acute care setting: A qualitative analysis
Authors: Jensen Anders Møller , Pedersen Birthe D , Olsen Rolf Bang , Hounsgaard Lise
Published: December 2017

The acute hospital admission of patients with dementia is associated with poor outcome and higher costs. Much of our knowledge on how hospital stays are experienced by patients and staff is generated from short and fragmented data collections, in which the significance of knowledge about day-to-day care might be overlooked, and might partly explain why the poor outcome for this group of patients is not fully understood. This study used participant observation to follow patients with Alzheimer’s disease admitted to orthopaedic wards after fall incidents. To gather longitudinal data, patients were followed during day and evening shifts, from admission to discharge. The data were interpreted from a phenomenological-hermeneutic perspective, inspired by Ricoeur's interpretation theory. The data showed that, despite having little specific knowledge about dementia care, staff were able to gather information about the patient’s needs and wishes relevant to administrating medicine in a person-centred way. However, much of this valuable information was lost between shifts or became hidden among the overwhelming amount of information in electronic patient records. As a consequence, much of the knowledge about individual patients’ needs and wishes had to be collected all over again at every shift. The study concludes that careful handover of information on person-centred dementia care can play an important role in making hospital stays more dementia-friendly.
Weaving social reality around the grandparent/great-grandparent with dementia to maintain relational presence: A verbal and non-verbal dementia interactions model
Authors: Miron Anca M , Thompson Ashley E , Ebert Alexandria R , McFadden Susan H
Published: December 2017

We proposed a dementia interactions model based on analyses of five focus groups with grandchildren of grandparents with dementia. Interactions with their grandparent with dementia motivate grandchildren to maintain connection with a grandparent who is relationally present. To do so, they weave a social reality around the grandparent. To help the grandparent remain connected, grandchildren engage in scripts and routines and employ three intertwined psychological processes: perspective taking, vigilance, and knowledge about the grandparent's preferences, personality, state of mind, and context. Grandchildren use four relationship anchors to help the grandparent remain relationally present: family members, meaningful sensory objects and activities, physical space/context, and themselves. Implications for improving social interactions with close others with dementia are discussed.
Experiences of loss and relationship quality in couples living with dementia
Authors: Colquhoun Anna , Moses Jennifer , Offord Rosslyn
Published: December 2017

Couples living with dementia face multiple losses in their relationship, and may experience changes in their overall sense of relationship quality. These topics have predominantly been researched from the caring partner’s perspective therefore, this study aimed to explore how couples adapt to relational losses to maintain quality in their relationship from the perspective of both partners. Using a constructivist grounded theory approach 10 spousal dyads, where one partner has a diagnosis of dementia, engaged in a joint interview. The results revealed three master themes: consolidating us, contextual positioning, and living well together, as well as an overarching theme of ‘turning to and away’. The findings are discussed in relation to theories of loss and family adaptation, and implications for clinical practice and future research are proposed.
Assessing apathy in long-term care residents with dementia: Who should be the rater?
Authors: Jao Ying-Ling , Williams Kristine , Mogle Jacqueline , Behrens Liza , McDermott Caroline
Published: December 2017

Background

Apathy is prominent in persons with dementia and apathy assessment is challenging. It remains unclear who should conduct apathy assessments in long-term care settings for residents with moderate to advanced dementia. The Apathy Evaluation Scale (AES) is a widely used instrument and its use for long-term care residents with dementia needs to be further established. This study explored the relationship among apathy assessments conducted by family and clinical caregivers using the original AES (AES-18) and the nursing home version (AES-10).

Methods

This study used a cross-sectional, descriptive design and enrolled 15 quartets of participants recruited from long-term care settings. Each quartet consisted of one resident with dementia, one family member, one certified nursing assistant, and one licensed practical nurse or activity staff. Family, certified nursing assistants, and licensed practical nurses/activity staff rated the resident’s apathy level on the AES independently. Bivariate Pearson correlation coefficients were used for analysis.

Results

The results revealed that ratings conducted by certified nursing assistants and licensed practical nurses/activity staff were moderately correlated for the AES-18 and the result approached statistical significance (r = 0.47, p = .08). None of the other AES ratings among family, certified nursing assistants, and licensed practical nurses/activity staff were significantly correlated.

Discussion

Family and clinical caregivers were incongruent on their AES ratings of apathy. It remains undetermined which rater provides the most valid AES rating for residents with dementia. Findings from this study further highlight challenges in rating apathy in this population. Future research is needed to determine best practices for accurate apathy assessment for residents with dementia in long-term care.
Soviet, post-Soviet and neo-liberal: Governing Russian schools through quality assurance and evaluation
Authors: Gurova Galina
Published: December 2017

This paper problematizes the dichotomy between neo-liberalism and socialism and the tendency to view the post-socialist condition as a process of convergence with ‘Western’ and ‘global’. It does so by analysing the development and implementation of a quality assurance and evaluation (QAE) policy in school education in the context of the Russian Federation. Since the dissolution of the Soviet Union, Russian national QAE policy has changed greatly and currently resembles the agendas of transnational organizations in education. At the same time, the national policy and the political discourse on quality continue to draw on Soviet as well as post-Soviet legacies. Juxtaposing the case of Russian QAE policy with theoretical models of post-bureaucratic governance in education, the paper also questions clear-cut distinctions between ‘old’ and ‘new’ governance regimes. The analysis in the paper is guided by two questions: 1) What has changed and what has remained unchanged in Russian education policy with the transition from the Soviet period to current state? and 2) How do different legacies and influences contribute to the QAE policy implemented at the local level? The brief inquiry into the history of Russian QAE policy focuses on three periods: post-war Soviet Russia, the transition period of the 1980–1990s and modern Russia. Recognizing the specific characteristics of each of the reviewed periods, the paper highlights complexities, contradictions and continuities within and between previous and present regimes of education governance in Russia. The analysis of the QAE policy implemented at the local level demonstrates the blending of diverse legacies, and the prevalence of Soviet-era practices in school governance.
A Case Report of Living Donor Liver Transplantation for Fulminant Hepatitis Related to Hepatitis E Virus Infection
Authors: Shimata Keita , Sugawara Yasuhiko , Yamamoto Hidekazu , Okamoto Hiroaki , Uchida Koushi , Kawabata Seiichi , Isono Kaori , Hayashida Shintaro , Inomata Yukihiro
Published: December 2017

Hepatitis E virus (HEV) infection which may become fulminant, especially in elderly people is more common than previously recognized in develop countries. Here we report successful living-donor liver transplantation (LDLT) in a case of acute liver failure due to HEV. A 63-year-old Japanese man with no previous history of liver disease was admitted for severe acute hepatitis. Detection of anti-HEV immunoglobulin A established a diagnosis of this virus-related liver failure. The patient suffered from hepatic encephalopathy 10 days after symptom onset and underwent LDLT. The patient had an uneventful course. The HEV RNA showed spontaneous negative conversion 10 weeks after LDLT. LDLT led to a successful outcome in a patient with acute liver failure due to HEV infection and regular testing for HEV RNA should be performed until HEV RNA is undetectable.
Assessing Transcendental Experiences vs Mental Illnesses
Authors: Lucas Shawn
Published: December 2017

In our experience, being able to differentiate between mental illness and transcendent experiences has led patients to remain engaged in treatment. This is important since those who have experienced religious preoccupation are the least likely to seek out mental health care. We have developed a “Transcendent Assessment Tool” to assist clinicians and clients in discerning whether an experience is a delusion or part of a transcendent experience.
Return to Babel
Authors: Gross Anna Lisa
Published: December 2017

End of life and beginning of life are surprisingly similar. What can we learn about the value and nature of our lives from dementia and aging?
The Role of the Pastoral Practitioner in Health Outcomes and Wellbeing During Acute Illness: Exploring the Patient Experience of a Pastoral Visit
Authors: Brown Janie , Gardner Jennifer
Published: December 2017

The role of the pastoral practitioner is embedded in many health care services and organizations. Despite this, there is little evidence to describe the impact of this role on patient outcomes, in particular how visits by a pastoral practitioner influence patient healing and recovery. This paper describes a small study that explored the patient experience of pastoral practitioner visits in an acute care facility.
The partisan contours of conspiracy theory beliefs
Authors: Smallpage Steven M. , Enders Adam M. , Uscinski Joseph E.
Published: December 2017

The “conspiracy theories are for losers” argument suggests that out-of-power groups use conspiracy theories to sensitize minds, close ranks, and encourage collective action. Two necessary conditions of this argument are that (1) group members subscribe mostly to conspiracy theories that malign out-groups or bolster their in-group, and (2) group members must recognize whether conspiracy theories emanate from their own group, an opposing group, or are outside of partisan conflict. Using representative survey data from the 2012 Cooperative Congressional Election Study, we show that conspiracy accusations follow the contours of partisan conflict: partisans accuse opposing groups, rather than co-partisans or non-partisans, of conspiring. Using MTurk data, we show that partisans can differentiate between the conspiracy theories coming from members of each party. We suggest that many conspiracy beliefs behave like most partisan attitudes; they follow the contours of partisan conflict and act as calling cards that send clear signals to co-partisans.
Uterus unicornis and pregnancy in two feline littermates
Authors: Brookshire Wilson C , Shivley Jacob , Woodruff Kimberly , Cooley Jim
Published: December 2017

Case series summary

A queen, tom and four 1-year-old female offspring presented for routine neuter. Two of the littermates (cats 1 and 2) were diagnosed with a uterine abnormality during surgery. The left uterine horn of both cats appeared as a thin, solid, cord-like structure, whereas the right uterine horn of both cats appeared to have intermittent bulges consistent with pregnancy. The two other littermates, queen and tom were reproductively normal. The uteruses of the affected cats were nearly identical with a gross and histopathologic diagnosis of uterus unicornis with concurrent pregnancy. Ovaries were present, bilaterally. An oviduct was present only on the single normally developed and pregnant uterine horn in both cats. At a postoperative follow-up evaluation, abdominal ultrasound was performed on the two cats with uterine abnormalities. Cat 1 was ultrasonographically within normal limits. Cat 2 was diagnosed with ipsilateral renal agenesis on the same side as the absent uterine horn.

Relevance and novel information

The complexity of uterus unicornis and renal aplasia is demonstrated by this unique presentation of five related cats for ovariohysterectomy. This report raises questions regarding the genetic, environmental, hormonal or other underlying causes of this anatomic abnormality in cats that may spur additional research. This is the first publication describing uterus unicornis in gravid feline littermates, with one of the cats having ipsilateral renal agenesis. This is also the first publication to describe oviduct agenesis on the affected uterine horn in feline uterus unicornis.
Multilocus genotyping of Giardia duodenalis isolates from breeding cattery cats in Japan
Authors: Ito Yoichi , Iijima Yuko , Itoh Naoyuki , Kimura Yuya
Published: December 2017

Objectives

The present study reports the multilocus genotyping of Giardia duodenalis isolates from cats maintained in breeding catteries in Japan and discusses their potential for zoonotic transmission.

Methods

A total of 41 faecal samples positive for Giardia-specific antigen were procured from cats maintained in five breeding catteries and subjected to PCR to amplify four gene loci, namely small subunit ribosomal RNA ( SSU rRNA), glutamate dehydrogenase ( gdh), beta-giardin ( bg) and triose phosphate isomerase ( tpi ). The PCR-amplified DNA fragments were sequenced to determine the G duodenalis genotypes (synonym for assemblages).

Results

The most commonly occurring single assemblage was assemblage F (68.3%; n = 28/41), followed by assemblage A (12.2%; n = 5/41) and assemblage C (2.4%; n = 1/41). The mixed assemblages were identified as follows: assemblages F and A (9.8%; n = 4/41), assemblages F and C (4.9%; n = 2/41) and assemblages C and D (2.4%; n = 1/41). Additional sub-genotyping of assemblage A isolates based on three of the sequenced loci ( gdh, bg and tpi ) revealed that all eight isolates were identified as sub-assemblage AI and/or AII.

Conclusions and relevance

The present study is the first to report the detection of dog-adapted assemblages C and D in feline isolates from Japan. In addition, zoonotic sub-assemblage AI and human-adapted sub-assemblage AII were also identified. Thus, we concluded that the risk of transmission of G duodenalis from breeding cattery cats to humans is considerable and cannot be ignored.
Naturally Available Extracts Inhibiting Cancer Progression: A Systematic Review
Authors: Abraham Marin , Augustine Dominic , Rao Roopa S. , Sowmya S. V. , Haragannavar Vanishri C. , Nambiar Shwetha , Prasad Kavitha , Awan Kamran Habib , Patil Shankargouda
Published: December 2017

Aim.

This systematic review is aimed at evaluating the literature on the efficacy of naturally available extracts that inhibit cancer.

Methods.

A literature search was performed to strengthening the reporting of observational studies in epidemiology analysis. Approximately 3000 research articles were initially selected. Of these articles, 200 were included, and 2800 were excluded. On further scrutiny, 150 of the 200 studies were reviews, seminars, and presentations, and 50 were original study articles. Among these articles, 20 studies were selected for the systematic review.

Results.

The predominant molecular pathways followed by natural extracts were nuclear factor kappa B ligand, suppression of the protein kinase B-Akt/P13K pathway (an intracellular signaling pathway important in regulating cell cycle), vascular endothelial growth factor downregulation, and tumor protein-P53 tumor suppressor upregulation.

Conclusions.

It is evident that natural extracts have the ability to inhibit cancer progression. Continued research in this field could facilitate the use of natural extracts with currently available anticancer agents.
Does the Addition of Either a Lateral or Posterior Interbody Device to Posterior Instrumented Lumbar Fusion Decrease Cost Over a 6-Year Period?
Authors: Schadler Paul , Derman Peter , Lee Lily , Do Huong , Girardi Federico P. , Cammisa Frank P. , Sama Andrew A. , Shue Jennifer , Koutsoumbelis Stelios , Hughes Alexander P.
Published: December 2017

Study Design:

Retrospective case-control study.

Objectives:

Few studies have compared the costs of single-level (1) posterior instrumented fusion alone (PSF), (2) posterior interbody fusion with PSF (PLIF), and (3) lateral interbody fusion with PSF (circumferential LLIF). The purpose of this study was to compare costs associated with these procedures.

Methods:

Charts were reviewed and patients followed-up with a telephone questionnaire. Medicare reimbursement data was used for cost estimation from the payer’s perspective. Multivariate survival analysis was performed to assess time to elevated resource use (greater than 90% of study patients or $68 672).

Results:

A total of 337 patients (PSF, 45; PLIF, 222; circumferential LLIF, 70) were included (63% follow-up at 6 years). PSF and circumferential LLIF patients were 3 times more likely to reach the cutoff value compared with PLIF patients ( P = .017).

Conclusions:

Circumferential LLIF and PSF patients were more likely to have higher resource use than PLIF patients and thus incur greater costs at 6-year follow-up.
Results of Posterior Vertebral Column Resection: Surgical Modification of Suk Technique
Authors: Aydinli Ufuk , Kara Kursat , Mutlu Muren , Yaray Osman
Published: December 2017

Study Design:

Consecutive, retrospective review.

Objectives:

To evaluate and report a modified posterior vertebral column technique.

Methods:

We present a retrospective analysis of 20 patients. Patients having severe 3-dimensional deformity with flexibility less than 20% and managed by posterior vertebral body resection (PVCR) between 2011 and 2014 were included in this study. There were 12 female and 8 male patients, with a mean age of 18 year (range = 3-63 years).

Results:

The average follow-up was 3.5 years (2-5 years). The preoperative coronal plane deformity was 84° (70° to 120°) and corrected to 42° (28° to 68°), showing 60% scoliosis correction. Average preoperative local kyphotic angle was 92° (82° to 110°). Correction rate for kyphosis was 62%. All patients after surgery showed their baseline neurological status, and no complications were encountered. The mean estimated blood loss was 1072 mL (350-2000 mL). Thirty-nine percent (33% to 50%) of total blood loss occurred after vertebral body resection, and 61% (50% to 67%) blood loss occurred after the removal of posterior elements. The ratio of estimated blood loss to estimated body blood volume was 26% (range = 19% to 52%).

Conclusion:

We found that 60% of total bleeding occurs during and after posterior bone resection. Spinal cord is open to possible iatrogenic direct spinal cord injury with surgical instruments for a much shorter period of time compared with the original technique.
Consider All Stakeholders in Quality Assurance of Preprofessional Education
Authors: Gambescia Stephen F. , Early Jody O.
Published: December 2017

This commentary explains (via a schematic and some detail) that quality assurance in the teaching and learning process is not a hierarchical relationship among stakeholders but rather an ongoing review, discussion, and set of quality improvement and capacity building actions among stakeholders. These stakeholders include employers, professional membership associations, accrediting bodies, the public, individual certifying entities, and providers of higher education. Each group has its value-added contribution and sphere of influence in the education quality assurance process, especially during times of change. Each group has its understandable needs, capacity for contributions, and limitations when changes are being made. The nature and extent of the influence of each group will change, but the key is to consider all stakeholders and their interests to improve the practice of the individual health professional.
Are there opportunities for a closer collaboration on clinical stroke research in Europe?
Authors: Berge Eivind , Ford Gary A. , Stapf Christian , Al-Shahi Salman Rustam , Fischer Urs , Coveney Sarah , Weimar Christian , Arnold Marcel , Arsovska Anita , Lemmens Robin , Nederkoorn Paul J. , Kelly Peter J.
Published: December 2017

Introduction

One of the aims of the European Stroke Organisation (ESO) is to facilitate academic, multinational clinical stroke research. However, despite examples of successful regional and national stroke research networks and collaborative groups, there is no organisational structure at a European level that can facilitate multinational clinical stroke research.

Materials and methods

In a project including a survey and a workshop and involving stroke researchers in the ESO, we sought to identify the challenges faced by existing clinical stroke research networks, to define the purpose and roles of any future European stroke research collaboration, and to propose an organisational structure.

Results

The survey and workshop gave strong support for an alliance model with independent network members, with the purpose of facilitating clinical stroke research through improved coordination and communication, provision of support, education, and advocacy and communication with other stakeholders. The focus of a proposed European clinical stroke research alliance should be multinational randomised-controlled trials in acute care, prevention and rehabilitation, but the alliance could also support other forms of multi-national clinical stroke research.

Conclusion

There is an interest for increased collaboration on multinational clinical stroke research in Europe, in the form of an alliance of independent research networks and collaborative groups. The ESO Trials Network Committee will continue consultation with existing stroke research networks and collaborative groups, and other key stakeholders, to assess the feasibility and support for development of an ESO Trials Alliance.
Interim results of brentuximab vedotin in combination with nivolumab in patients with relapsed or refractory Hodgkin lymphoma
Authors: Herrera Alex F. , Moskowitz Alison J. , Bartlett Nancy L. , Vose Julie M. , Ramchandren Radhakrishnan , Feldman Tatyana A. , LaCasce Ann S. , Ansell Stephen M. , Moskowitz Craig H. , Fenton Keenan , Ogden Carol Anne , Taft David , Zhang Qu , Kato Kazunobu , Campbell Mary , Advani Ranjana H.
Published: December 2017

Key Points

BV and Nivo were well-tolerated in patients with R/R HL, with less than 10% of patients treated with systemic steroids for immune-related AEs. The complete response rate was 61% (82% objective response rate), and patients were able to undergo stem cell transplant without adverse impact.
Erythropoietin promoted the proliferation of hepatocellular carcinoma through hypoxia induced translocation of its specific receptor
Authors: Miao Shuo , Wang Su-Mei , Cheng Xue , Li Yao-Feng , Zhang Qing-Song , Li Gang , He Song-Qing , Chen Xiao-Ping , Wu Ping
Published: December 2017

Background

Erythropoietin (EPO) is a hypoxia-inducible stimulator of erythropoiesis. Besides its traditional application in anemia therapy, it offers an effective treatment in the cancer patients, especially those who receive chemotherapy. Several reports indicated that it could promote the tumor cell proliferation through its specific receptor (EPOR). Unfortunately, the role of EPO/EPOR in hepatocellular carcinoma (HCC) progressing is still uncertain.

Methods

Protein in tumor tissue from HCC patients or H22 tumor-bearing mice was detected with immunohistochemistry. Cells were cultured under 1% oxygen to establish hypoxia. RT-PCR and western blotting were used to measure mRNA and protein of EPO/EPOR, respectively. MTT, flow cytometry and PCNA staining were used to detect cell proliferation. Immunofluorescence staining was applied to study the expression and location of cellular EPOR. The EPOR binding studies were performed with 125I-EPO radiolabeling assay.

Results

EPO and EPOR protein were up-regulated in HCC tissue of patients and H22-bearing mice. These were positively correlated with hypoxia-inducible factor -1 α and ki-67. Hypoxia up-regulated the expression of EPO and EPOR in HepG2 cells. It also induced the proliferation and increased the percentage of divided cells after 24, 48 and 72 h treatment. These were inhibited in cells pre-treated with 0.5 μg/mL soluble-EPOR. Immunofluorescence staining presented that EPOR was obviously translocated from nucleus to cytoplasm and membrane under hypoxia. EPOR binding activity was also increased after exposure to hypoxia. Recombinant human erythropoietin obviously elevated cell proliferation rate and the percentage of divided under hypoxia but not normoxia, which were also inhibited by soluble-EPOR.

Conclusions

Our result indicated for the first time that EPO promoted the proliferation of HCC cells through hypoxia induced translocation of it specific receptor.

Trial registration TJC20141113, retrospectively registered
Generic and attribute-specific deep representations for maritime vessels
Authors: Solmaz Berkan , Gundogdu Erhan , Yucesoy Veysel , Koc Aykut
Published: December 2017

Fine-grained visual categorization has recently received great attention as the volumes of labeled datasets for classification of specific objects, such as cars, bird species, and air-crafts, have been increasing. The availability of large datasets led to significant performance improvements in several vision-based classification tasks. Visual classification of maritime vessels is another important task, assisting naval security and surveillance applications. We introduced, MARVEL, a large-scale image dataset for maritime vessels, consisting of 2 million user-uploaded images and their various attributes, including vessel identity, type, category, year built, length, and tonnage, collected from a community website. The images were categorized into vessel type classes and also into superclasses defined by combining semantically similar classes, following a semi-automatic clustering scheme. For the analysis of the presented dataset, extensive experiments have been performed, involving several potentially useful applications: vessel type classification, identity verification, retrieval, and identity recognition with and without prior vessel type knowledge. Furthermore, we attempted interesting problems of visual marine surveillance such as predicting and classifying maritime vessel attributes such as length, summer deadweight, draught, and gross tonnage by solely interpreting the visual content in the wild, where no additional cues such as scale, orientation, or location are provided. By utilizing generic and attribute-specific deep representations for maritime vessels, we obtained promising results for the aforementioned applications.
Evaluating which plan quality metrics are appropriate for use in lung SBRT
Authors: Yaparpalvi Ravindra , Garg Madhur K , Shen Jin , Bodner William R , Mynampati Dinesh K , Gafar Aleiya , Kuo Hsiang-Chi , Basavatia Amar K , Ohri Nitin , Hong Linda X , Kalnicki Shalom , Tome Wolfgang A
Published: December 2017

Objective:

Several dose metrics in the categories—homogeneity, coverage, conformity and gradient have been proposed in literature for evaluating treatment plan quality. In this study, we applied these metrics to characterize and identify the plan quality metrics that would merit plan quality assessment in lung stereotactic body radiation therapy (SBRT) dose distributions.

Methods:

Treatment plans of 90 lung SBRT patients, comprising 91 targets, treated in our institution were retrospectively reviewed. Dose calculations were performed using anisotropic analytical algorithm (AAA) with heterogeneity correction. A literature review on published plan quality metrics in the categories—coverage, homogeneity, conformity and gradient was performed. For each patient, using dose-volume histogram data, plan quality metric values were quantified and analysed.

Results:

For the study, the radiation therapy oncology group (RTOG) defined plan quality metrics were: coverage (0.90 ± 0.08); homogeneity (1.27 ± 0.07); conformity (1.03 ± 0.07) and gradient (4.40 ± 0.80). Geometric conformity strongly correlated with conformity index (p < 0.0001). Gradient measures strongly correlated with target volume (p < 0.0001). The RTOG lung SBRT protocol advocated conformity guidelines for prescribed dose in all categories were met in ≥94% of cases. The proportion of total lung volume receiving doses of 20 Gy and 5 Gy (V20 and V5) were mean 4.8% (±3.2) and 16.4% (±9.2), respectively.

Conclusion:

Based on our study analyses, we recommend the following metrics as appropriate surrogates for establishing SBRT lung plan quality guidelines—coverage % (ICRU 62), conformity (CN or CIPaddick) and gradient (R50%). Furthermore, we strongly recommend that RTOG lung SBRT protocols adopt either CN or CIPadddick in place of prescription isodose to target volume ratio for conformity index evaluation.

Advances in knowledge:

Our study metrics are valuable tools for establishing lung SBRT plan quality guidelines.
Analysis of intra and extramyocellular lipids in the multifidus muscle in patients with chronic low back pain using MR spectroscopy
Authors: Takashima Hiroyuki , Takebayashi Tsuneo , Ogon Izaya , Yoshimoto Mitsunori , Morita Tomonori , Imamura Rui , Nakanishi Mitsuhiro , Nagahama Hiroshi , Terashima Yoshinori , Yamashita Toshihiko
Published: December 2017

Objective:

To analyse the intra- (IMCL) and extramyocellular lipids (EMCL) concentration in the multifidus muscle (Mm) using MR spectroscopy (MRS) in patients with low back pain (LBP), and to evaluate the correlation between those lipid concentrations and age, obesity, atrophy of the Mm and LBP intensity.

Methods:

60 LBP patients underwent routine diagnostic MRI of the lumbar spine before undergoing imaging for the study. Body mass index, as an indicator of obesity and visual analogue scale, as an indicator of LBP were also measured. Proton MRS was acquired with a single-voxel point-resolved spectroscopy sequence. Furthermore, the MRS volume of interest for measuring the IMCL and EMCL concentration at L4/5 for the right Mm was determined, and we measured the cross-sectional area of Mm as an indicator of muscle atrophy.

Results:

Age showed correlation with EMCL concentration (r = 0.314, p = 0.008). The body mass index showed correlation with EMCL concentration (r = 0.358, p = 0.005). The cross-sectional area of Mm showed correlation with EMCL concentration (r = −0.543, p < 0.001). Moreover, the LBP visual analogue scale showed correlation with IMCL concentration (r = 0.367, p = 0.004).

Conclusion:

There were correlations between age, obesity, muscle atrophy, and EMCL concentration in Mm. IMCL concentration in Mm showed a correlation with LBP intensity. This may suggest that IMCL concentration could become an effective objective indicator of chronic LBP intensity.

Advances in knowledge:

We investigated the characteristics of fat content in Mm with LBP patients. This study was demonstrated the association of the IMCL and EMCL concentration in Mm with various patient parameters.
Initial study of three different pathogenic microorganisms by gas chromatography-mass spectrometry
Authors: Karami Najmeh , Mirzajani Fateme , Rezadoost Hassan , Karimi Abdollah , Fallah Fatemeh , Ghassempour Alireza , Aliahmadi Atusa
Published: December 2017

Background: Diagnoses  of  respiratory  tract  infections  usually happen  in  the  late  phase  of  the  disease  and  usually  result  in  reduction  of  the  pathogen  load after broad-spectrum  antibiotic  therapy,  but  not  in eradication of the pathogen.  The  development  of a  non-invasive,  fast,  and  accurate  method  to  detect  pathogens  has  always  been  of  interest  to  researchers  and  clinicians  alike.  Previous studies have shown that bacteria produce organic gases.  The  current  study  aimed  to  identify  the  volatile  organic  compounds  (VOCs)  produced  by three  respiratory  tract  pathogens,  including  Staphylococcus  aureus,  Escherichia  coli  and  Candida  albicans.

Methods: The  VOCs  produced  were identified by gas chromatography–mass spectrometry (GC-MS), with  prior  collection  of  microbial  volatile  compounds  using  solid  phase  microextraction  (SPME)  fiber.  The volatile compounds were collected by obtaining bacterial headspace samples.

Results: Results  showed  that  these  three  organisms  have  various  VOCs,  which  were  analyzed  under  different  conditions.  By ignoring common VOCs, some species-specific VOCs could be detected.  The most important VOC of E. coli was Indole, also some important VOCs produced by S. aureus  were 2,3-Pentandione,  cis-Dihydro-α-terpinyl  acetate,  1-Decyne,  1,3-Heptadiene-3-yne,  2,5-dimethyl  Pyrazine,  Ethyl  butanoate  and  Cyclohexene,4-ethenyl  furthermore,  most  of  identified  compounds  by  C.  albicans are  alcohols.

Conclusions: The  detection  of  VOCs  produced  by  infectious  agents  maybe  the  key  to  make   a  rapid  and  precise  diagnosis  of  infection,  but  more  comprehensive  studies  must  be  conducted  in this  regard.
Simulation and visualization of multiple KEGG pathways using BioNSi
Authors: Yeheskel Adva , Reiter Adam , Pasmanik-Chor Metsada , Rubinstein Amir
Published: December 2017

Motivation: Many biologists are discouraged from using network simulation tools because these require manual, often tedious network construction. This situation calls for building new tools or extending existing ones with the ability to import biological pathways previously deposited in databases and analyze them, in order to produce novel biological insights at the pathway level.

Results: We have extended a network simulation tool (BioNSi), which now allows merging of multiple pathways from the KEGG pathway database into a single, coherent network, and visualizing its properties. Furthermore, the enhanced tool enables loading experimental expression data into the network and simulating its dynamics under various biological conditions or perturbations. As a proof of concept, we tested two sets of published experimental data, one related to inflammatory bowel disease condition and the other to breast cancer treatment. We predict some of the major observations obtained following these laboratory experiments, and provide new insights that may shed additional light on these results.

Tool requirements: Cytoscape 3.x, JAVA 8

Availability: The tool is freely available at http://bionsi.wix.com/bionsi, where a complete user guide and a step-by-step manual can also be found.