bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-dimensional Simulation of Quantitative Ultrasound in Cancellous Bone Using the Echographic Response of a Metallic Pin
Authors: Nagatani Yoshiki , Guipieri Séraphin , Nguyen Vu-Hieu , Chappard Christine , Geiger Didier , Naili Salah , Haїat Guillaume
Published: May 2017

Degenerative discopathy is a common pathology that may require spine surgery. A metallic cylindrical pin is inserted into the vertebral body to maintain soft tissues and may be used as a reflector of ultrasonic wave to estimate bone density. The first aim of this paper is to validate a three-dimensional (3-D) model to simulate the ultrasonic propagation in a trabecular bone sample in which a metallic pin has been inserted. We also aim at determining the effect of changes of bone volume fraction (BV/TV) and of positioning errors on the quantitative ultrasound (QUS) parameters in this specific configuration. The approach consists in coupling finite-difference time-domain simulation with X-ray microcomputed tomography. The correlation coefficient between experimental and simulated speed of sound (SOS)—respectively, broadband ultrasonic attenuation (BUA)—was equal to 0.90 (respectively, 0.55). The results show a significant correlation of SOS with BV/TV ( R = 0.82), while BUA values exhibit a nonlinear behavior versus BV/TV. The orientation of the pin should be controlled with an accuracy of around 1° to obtain accurate results. The results indicate that using the ultrasonic wave reflected by a pin has a potential to estimate the bone density. SOS is more reliable than BUA due to its lower sensitivity to the tilt angle.
The Criminology of the Corporation
Authors: Minkes John P. , Minkes A.L.
Published: May 2017

Can criminologists throw any light on corporate accountability? How realistically can organizational responsibility before the law be compared with that of individuals?
The Virtual Organization: Emerging Forms of ICT-Based Work Arrangements
Authors: Atkins Martin , Dawson Patrick
Published: May 2017

What are the main options for organizing people's work to make the best use of information and communications technologies?
Does it Need Emotional Intelligence to Lead Change?
Authors: Higgs Malcolm , Rowland Deborah
Published: May 2017

What are the requirements of effective leadership in a ‘post-transformational’ world?
Editorial: Prophecies and Profits
Authors: Macmillan Keith
Published: May 2017

Milton Friedman has argued that the social responsibility of business is to increase its profits. He has also predicted that Britain's economy will collapse with a consequent loss of freedom and democracy. Can British managers reconcile these views of the most esteemed living political economist? The outlook both for themselves and for the economy may hardly be conducive to developing a new sense of entrepreneurial mission but the Editor of JGM argues that this is precisely what they must do. For once their social responsibilities are clear: they must generate profits and jobs. This adaptation of Milton Friedman's famous dictum is the only way his depressing prophecies for the British economy can be proved false.
Industrial Relations in the Future
Authors: Poole Michael
Published: May 2017

The objective of this paper is to examine, with special reference to management, some likely developments in British industrial relations in the forthcoming decade [1]. During the past fifteen or so years, this aspect of our national life has of course had momentous economic, political and social repercussions for all members of the population and, as a consequence, it has been the focal point for a considerable measure of popular and scholarly disputation. Moreover, in view particularly of fundamental technical changes in manufacturing industry in the future, issues of labour-management relations are almost certain to feature no less prominently in these respects during the period under review.
Competing in the Digital Age
Authors: Hougaard Søren , Duus Henrik Johannsen
Published: May 2017

The driving forces behind digitalization are so powerful that they will inevitably challence almost all supply chains, trade relationships and successful competitive strategies of today.
Politics, values, and reflexivity: The case of adaptation to climate change in Hampton Roads, Virginia
Authors: Haverkamp Jamie AR
Published: May 2017

Climate adaptation planning is said to be a necessary and inevitable facet of future societies, and is rapidly occurring across a range of geopolitical scales. Previous scholarship suggests that a democratic decentralized approach, one that fosters inclusive participation and representation, is central to achieving equitable and sustainable outcomes of adaptation. However, recent studies frequently characterize the adaptation process as dominated by a techoscientific approach, among expert and elite actors, that tends to obscure or neglect the perceptions and desires of more marginalized members of society. This paper employs a values-based approach to better understand motivational factors for a closed and non-inclusive adaptation process. Through a case study of early, yet formidable stages of adaptation planning in the urban, coastal region of Hampton Roads, Virginia, empirical data among the epistemic community were gathered by interviews and participant observation at de facto adaptation planning forums. Research results document an exclusionary process favoring the participation and representation of technocratic elites and the exclusion of elected officials and local citizens. When linking these case study findings to value theory, inferences are made that adaptation planning in Hampton Roads is motivated by dominant institutional actor values of power and security, those that are theorized to be in opposition to values fostering social and environmental justice. In light of these research results, this paper calls for a critically reflexive adaptation practice, thereby challenging values, assumptions, and beliefs of the self, as well as social structures and power relations that shape adaptation planning.
Langerhans cell histiocytosis (eosinophilic granuloma) of the skull mimicking nummular headache. Report of two cases
Authors: Silva Rosas Carlos , Angus-Leppan Heather , Lemp Melchor Bruno , Rozas Juan Pablo , Quijada Alonso Humberto
Published: May 2017

Background

Nummular headache is a rare, recently described topographic headache defined by the circumscribed coin-shaped area of pain. It is classified as a primary headache. There is debate about whether it is due to a peripheral or central disturbance, and its relationship to migraine.

Case reports

We report two patients with presumed nummular headache secondary to Langerhans cell histiocytosis, both with resolution of their headaches after surgical resection.

Conclusion

Imaging in patients with clinical features of nummular headache is recommended, as this and other cases highlight that it may be symptomatic. There are no distinguishing clinical features to separate nummular headache from secondary mimics, and treatment of the underlying cause may be curative.
The Effects of Repeated Insulin Hypoglycaemia on Capillary and Tissue Metabolism in Man
Authors: Lovett Doust John W. , Salna Marta E.
Published: May 2017

(1) The response of 2 male schizophrenic patients in terms of quantified extent of mental state disturbance, 12 measures of capillary vascular physiology and oxidative metabolism and 5 estimates of tissue cell metabolism were employed kinetically to determine the influence of insulin hypoglycaemia in man. Longitudinal observations were continued for 5 months, serial measurements being obtained daily prior to commencement of the insulin course and in the afternoons after interruption of the hypoglycaemic state by glucose.

(2) Clinically, both patients improved initially but only one of them maintained this improvement and returned to his job; the other was finally committed to an Ontario Hospital. This difference was reflected in a mean fall of 10 points in the quantified disturbance rating scale in the former and of only 3 points in the latter patient.

(3) The post-insulin state differed significantly from the pre-insulin baseline state in the patient who improved in that the body weight increased while tissue oedema diminished; the C.F.F. rose; pCO2 was increased; pulse pressure widened; capillary blood pressure fell; arteriolar and capillary blood flow both increased; and capillary oxygen saturation also rose. In the patient who finally failed to improve clinically, similar changes were also found save that although his pO2 increased, arteriolar blood flow fell somewhat and, in general, the physiological gains were less than in the former patient. Improvement in capillary resistance occurred in both patients, but the results could not be analysed statistically.

(4) Microscopic observations showed a gain in capillary tone in both patients following the hypoglycaemic episodes, and an increase in translucency in the inter-vascular and peri-vascular tissue field. Together with the decrease in waterlogging of the tissues, it was felt that these findings supported an improved local cellular metabolism. Again, the changes in the clinically indifferent patient were differentially less well marked than in the patient who did well from his treatment.
The Relationship of HLA to Depression and Manic Depression. I. The Newfoundland Follow-Up
Authors: Stancer H.C. , Mellor C. , Weitkamp L.R. , Jorna T. , Flood C. , Persad E. , Jain S.C. , Guttormsen S.
Published: May 2017

This report constitutes the Newfoundland component of a large scale replication study to assess the relationship of HLA to affective disorders; the Ontario component will be published subsequently. In a collaborative study between the University of Toronto, Memorial University and the University of Rochester, first degree family members of Probands with major affective disorder in Newfoundland were assessed for the lifetime presence of psychiatric disorder; their blood was also typed for Human Leucocyte Antigens (HLA). Because of the high rate of refusal to participate, only 10 Newfoundland families could be assessed completely. While this number of families is too small to evaluate the role of HLA as a marker of susceptibility to affective disorder, the results will be added to those of the larger Ontario component. Some problems of conducting research in communities similar to those found in Newfoundland are briefly discussed in the context of characteristics of the Probands in the study group as compared with those of subjects who refused entry into the study.
Personality Patterns and Duodenal Ulcer Relapse under Antisecretory Treatment*
Authors: Magni Guido , Di Mario Francesco , Conlon Patrick , Naccarato Remo
Published: May 2017

The personality pattern of duodenal ulcer (DU) patients on maintenance treatment who relapsed (N = 22) was compared to a similar group who did not relapse (N = 57) using the Sixteen Personality Factors Questionnaire

Multivariate analysis of data indicated that a subgroup of DU patients with personality marked by dependent and anxiety traits was more prone to relapse of illness.
Adolescent Residential Treatment: A One to Three Year Follow-Up
Authors: Blackman Maurice , Eustace Jonathan , Chowdhury Tofael
Published: May 2017

Considerable difficulties have been encountered in the residential treatment of adolescents with psychiatric disorders. Few of these programs have been successful. This study describes the long term effectiveness of a residential treatment program for disturbed adolescents. This program was particularly successful in returning severely disturbed adolescents to the community. None of the adolescents needed intensive residential treatment during the follow-up period. Three objective measures (Global Assessment Scale, Level of Functioning Scale, Adolescent Functioning Scale) were used at three specific times (admission, discharge and long term follow-up) to determine the level ofpsych osocialfunctioning of each adolescent. A significant improvement was found in the adolescents' level offunctioning. These treatment gains were maintained at the time of long term follow-up (one to three years).
Relapse Prevention in Manic Depressive Illness: Important and Unimportant Factors
Authors: Schou Mogens
Published: May 2017

Many factors play a role in the safe and effective prevention of relapses. These include: selection of patients; organization of treatment; choice of drug; dosage and treatment regimen; clinical and laboratory monitoring; information and instruction given to patients and relatives; and psychotherapeutic and social support. Some of these factors have received much attention in the past, although perhaps not always the most important ones. This paper, a brief refresher course, discusses the priorities and precautions which must be considered when treating patients with manic depressive illnesses.
Haloperidol-Induced Bronchospasm
Authors: Sethna Rustom , Notkin Robert
Published: May 2017

A case of haloperidol-induced bronchospasm is described, and possible etiologies are suggested. Since haloperidol is commonly used in the treatment of psychoses, it is important for clinicians to be aware of this potentially lethal yet treatable side-effect.
Dimensions of Personality Pathology
Authors: Livesley W. John , Jackson Douglas N. , Schroeder Marsha L.
Published: May 2017

The reliability of DSM-III-R diagnoses of personality disorders is poor and their validity has yet to be established. There is little evidence that the features of personality pathology cluster into these diagnostic entities. For these reasons, it is important to explore alternative ways of classifying personality disorders. In this preliminary study, reliable scales were developed to assess 100 personality dimensions which were systematically developed. The factorial structure underlying the dimensions was evaluated in a heterogeneous sample of 110 subjects from the general population. Sixteen components, accounting for 81.4% of the variance, were retained for rotation to oblique structure. The components were labelled social avoidance, narcissism, insecure attachment, compulsive behaviours, interpersonal disesteem, mobility, anxiousness, conduct problems, stimulus seeking, identity disturbance, self-harm, rejection, diffidence, and hypersensitivity. Two components were not interpreted because they only had one or two salient loadings.
In-plane flexural behaviour and failure prediction of carbon fibre-reinforced aluminium laminates
Authors: Xu Ruohang , Huang Yaxin , Lin Yuan , Bai Binsheng , Huang Teng
Published: May 2017

This paper investigated the in-plane bending behaviour of carbon fibre-reinforced aluminium laminates (CARALL). The flexural progressive damage and failure mechanisms were analysed numerically and experimentally. Four types of CARALL specimens with a 3/2 configuration were prepared via hot-pressing using different aluminium alloy materials (2024-T3, 7075-T6 aluminium alloy) and fibre orientations ([0°/90°/0°]3, [45°/0°/−45°]3). The three-point bending tests were conducted under static loading. It was found that the primary damage modes were aluminium layer yielding in the mid-span and delamination between the aluminium and carbon fibre-reinforced polymer (CFRP) layers. A user-defined FORTRAN subroutine VUMAT based on ABAQUS was used to simulate the failure of the CFRP, a cohesive zone model was used to predict the inter-laminar failure, and a von Mises plastic model was used to define the isotropic hardening behaviour of the aluminium layers. The predicted results agreed well with the experimental ones. Two convenient calculation methods based on the elasticity mechanics and material mechanics were derived. And the non-linear behaviour of aluminium was considered in the elasticity mechanics method. The theoretical results matched closely with the experimental findings during the linear elastic deformation process.
Dating Violence Victimization, Nonsuicidal Self-Injury, and the Moderating Effect of Borderline Personality Disorder Features in Adolescent Inpatients
Authors: Hatkevich Claire , Mellick William , Reuter Tyson , Temple Jeff R. , Sharp Carla
Published: May 2017

The aim of the study was to examine whether Borderline Personality Disorder (BPD) features moderate the relation between dating violence victimization (DVV) experiences and nonsuicidal self-injury (NSSI) in adolescent inpatients. A total of 184 adolescent inpatients completed measures on DVV, BPD features, and NSSI at admission to treatment. Bivariate analyses revealed significant relations between DVV, BPD features, and NSSI. Hierarchical multiple regression analyses demonstrated a moderating effect of BPD features such that in the low BPD features group, more severe DVV was associated with greater NSSI frequency; adolescents in the high BPD group endorsed elevated, though stable, levels of NSSI at all levels of DVV. BPD features differentially affect the relationship between DVV and NSSI. Low BPD adolescents exposed to high DVV appear to self-injure more frequently and at rates similar to high BPD adolescents when faced with more severe DVV, while DVV appears neither necessary nor sufficient to be the cause of NSSI in high BPD adolescents. Our results indicate that DVV may be a particularly important focal point for treating adolescents who self-injure and have been victimized by a dating partner. As such, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Dialectical Behavior Therapy (DBT) may serve as valuable clinical interventions.
Control strategy optimization for a dual-clutch transmission downshift with a single slipping clutch during the torque phase
Authors: Liu Jikai , Ma Biao , Li Heyan , Chen Man , Li Guoqiang
Published: May 2017

During the torque phase, appropriate coordination between two clutches is of vital importance to the dual-clutch transmission so that a high-quality shift is achieved without clutch interaction and engine flare, because a poor-quality shift definitely extends the shift time and increases the friction work. Concerning this problem, two different power flow conditions during the torque phase are discussed in detail, after investigation of the dual-clutch transmission downshift process and the design of an H∞ robust controller for the inertia phase. The results obtained indicate that, if two clutches are slipping simultaneously during the torque phase, either power interruption or power circulation occurs. Thus, by optimizing the relationship between the two clutches, a novel control strategy is proposed for the dual-clutch transmission so that the downshift process is accomplished with only one slipping clutch, in order to obtain the highest system efficiency. The system model was established on the MATLAB/Simulink platform and used to study the variations in the torque and the speed output in response to different control strategies. The simulation results show that, with the smooth inertia phase guaranteed by the robust controller, the proposed control strategy not only can avoid power interruption or power circulation during the torque phase but also can shorten the shift time (from 1.1 s to 0.8 s) and reduce the jerk level (from 6.8 m/s3 to 5.7 m/s3) effectively, in comparison with the conventional control strategy. Finally, to validate the effectiveness of the proposed control strategy, bench tests on a dual-clutch transmission were carried out, and the test data obtained show good agreement with the simulation results.
Blast effect zones and damage mechanisms of concrete bridges under above-deck car-bomb attacks
Authors: Hu Zhijian , Fang Jian Q , Sun Lizhi Z
Published: May 2017

Above-deck car-bomb attacks cause significant effects on engineering structures from those of explosive blasts in the free air. In this paper, a post-disaster investigation for an existing bridge under above-deck car-bomb blast loading is presented. The crack distribution and damage deformation of the blast loaded girders are systematically investigated, and the blast effect zone is proposed to describe the blast loading distributions on girders and to characterize the girder structural behavior. The girder failure is dominated by one of the three typical damage mechanisms: shear, flexural-shear, and flexural, depending on the blast effect zone where the girder is located. The study also indicates that the isolation effect of the vehicle can significantly affect the blast loading distribution on structures, even though the isolation effect is localized in a region with a small standoff distance. It is gradually attenuated by the increase of the standoff distance. Numerical analysis is conducted to verify the findings by simulating the truck isolation effect with a steel plate.
Stability and perturbation analysis of a one-degree-of-freedom doubly clamped microresonator with delayed velocity feedback control
Authors: Han Jianxin , Zhang Qichang , Wang Wei , Jin Gang , Li Baizhou
Published: May 2017

In this paper, a study on a doubly clamped microresonator actuated by two symmetrical electrodes is carried out to investigate its dynamic properties with delayed velocity feedback control. A stability chart of the linearized system depicting delay time versus feedback gain is drawn first, which is actually nonperiodic. Moreover, stability switches do exist in this system. Then, the method of multiple scales is used to determine the existence, stability and dynamic properties of small amplitude vibration in the neighborhood of different equilibrium positions. It is shown that the stability condition via perturbation analysis overestimates the system stable region. The delayed stability condition via linearized analysis is more suitable for stability estimation. The following analytical and numerical results are presented to investigate frequency responses and frequency/damping trimming properties with various system and control parameters. Moreover, explicit formulas for optimum direct current (DC) voltage and equivalent natural frequency, corresponding to an approximate linear-like state, are deduced, respectively. Two typical design sketches depicting the initial gap width versus DC voltage are drawn with different beam lengths and thicknesses. Finally, a case study is carried out to verify the correctness of our analytical results about linear-like state prediction and frequency/damping trimming.
The primacy of sports television: Olympic media, social networking services, and multi-screen viewing during the Rio 2016 games
Authors: Hutchins Brett , Sanderson Jimmy
Published: May 2017

The Olympic Games are a global sports mega-event where the aggregation of mass audiences is still observable at a time when multiplying forms of personalized connective media – digital, mobile and social – are making inroads into media consumption habits. Using the 2016 summer Olympics in Rio de Janeiro, Brazil, as a case study, this article examines the intersections between (1) broadcast television coverage of the Games, (2) digital live streaming of Olympic events via desktop computing and mobile apps, and (3) the social networking services, Facebook, Instagram, Twitter, and Snapchat. It is argued that broadcast television anchors the flow of content across screens, with social networking services both extending the televisual logics of media sports coverage and emphasizing their own commercial influence and command of massive user numbers. This arrangement ultimately bolsters the power of television as the primary means through which sports mega-events are experienced.
Legislative language and judicial politics: The effects of changing parliamentary language on UK immigration disputes
Authors: Williams Matthew
Published: May 2017

Why does the British government increasingly lose immigration cases in court? More broadly, what can explain the changing behaviour of appeal court judges? It is because government powers to manage immigration, delegated by Parliament, are increasingly couched in indeterminate language. Indeterminacy in legislation not only allows for executive discretion but also encourages litigation. Parliament has therefore provided the cause of action, and judges are not being ‘activist’. This argument revitalises, with nuance, the legal model of judicial behaviour. New evidence supports the claim, with discourse analysis of all 1233 sections of immigration legislation enacted from 1905 to 2016 showing an increase in indeterminacy. Logit regression modelling of 252 immigration appeal cases between 1970 and 2012 shows that changes to language and the administration of the law can explain the outcome in 73% of cases.
Changes in alcohol and tobacco use during pregnancy
Authors: Ihlen Bente-Marie , Amundsen Arvid , Trønnes Liv , Sande Hans Andreas
Published: May 2017

Objective: to chart the use of alcohol and tobacco during pregnancy. Design: prospective study. Setting: outpatient clinic at a major hospital in Oslo at the time of 17th week ultrasound examination and the maternity ward at the time of delivery. Subjects: representative sample of pregnant women in the Oslo area. Main outcome measures: interview at 17th week of pregnancy, questionnaire at time of birth, biological markers for tobacco and alcohol. Results: Alcohol consumption decreased significantly, mainly among women with low levels of consumption. Use of tobacco showed a relatively stable tendency during pregnancy.
ELR opinion issue 3 2016
Authors: Rodgers¹ Christopher
Published: May 2017

Brexit will have major implications for land use and the natural environment. The way in which we currently use the land resource is conditioned by the common agricultural policy (‘CAP’). Withdrawal from the CAP will offer opportunities to develop new policies to promote biodiversity and address pollution. This opinion examines the issues.
Recruitment of macrophages from the spleen contributes to myocardial fibrosis and hypertension induced by angiotensin II
Authors: Wang Ning-Ping , Erskine James , Zhang Wei-Wei , Zheng Rong-Hua , Zhang Li-Hui , Duron Garret , Gendreau Julian , Zhao Zhi-Qing
Published: May 2017

Introduction:

The purpose of this study was to determine whether macrophages migrated from the spleen are associated with angiotensin II-induced cardiac fibrosis and hypertension.

Methods:

Sprague-Dawley rats were subjected to angiotensin II infusion in vehicle (500 ng/kg/min) for up to four weeks. In splenectomy, the spleen was removed before angiotensin II infusion. In the angiotensin II AT1 receptor blockade, telmisartan was administered by gastric gavage (10 mg/kg/day) during angiotensin II infusion. The heart and aorta were isolated for Western blot analysis and immunohistochemistry.

Results:

Angiotensin II infusion caused a significant reduction in the number of monocytes in the spleen through the AT1 receptor-activated monocyte chemoattractant protein-1. Comparison of angiotensin II infusion, splenectomy and telmisartan comparatively reduced the recruitment of macrophages into the heart. Associated with this change, transforming growth factor β1 expression and myofibroblast proliferation were inhibited, and Smad2/3 and collagen I/III were downregulated. Furthermore, interstitial/perivascular fibrosis was attenuated. These modifications occurred in coincidence with reduced blood pressure. At week 4, invasion of macrophages and myofibroblasts in the thoracic aorta was attenuated and expression of endothelial nitric oxide synthase was upregulated, along with a reduction in aortic fibrosis.

Conclusions:

These results suggest that macrophages when recruited into the heart and aorta from the spleen potentially contribute to angiotensin II-induced cardiac fibrosis and hypertension.
A phenomenological study of time concept and management and productivity in a sub–Saharan African context
Authors: Abugre James B
Published: May 2017

The purpose of this article was to investigate the concept of time and its management in relation to productivity. Consequently, this work employed phenomenological psychology to unearth the experiences of employees on the concept of time management and its impact on productivity using Ghana as a study. Participants involved both local and expatriate workers sharing their experiences on the subject matter in a conversational style. Results indicated that clock time is considered a flexible resource in both social and professional settings. Findings also revealed that time management drives productivity, and its orientation is consequential to the cultural behaviors of local employees in both public and private organizations based on the quality of their corporate cultures. Hence, rigid timelines can turn around public organizations in sub-Saharan Africa and the world as a whole.
Estimating the traction factor and designing the deck gear for the anchor handling tug
Authors: Carral-Couce Luis , Naya Salvador , Álvarez Feal Carlos , Lamas Pardo Miguel , Tarrío-Saavedra Javier
Published: May 2017

In offshore activities, it is necessary for the floating equipment extracting raw materials to reach and maintain a static position along the seabed. Increasingly crucial in these operations is a new type of auxiliary vessel: the anchor handling and supply. While this work is being carried out, the deck gear related to towing and anchor handling – secondary and tugger winches, as well as capstans – play a key role on the anchor handling and supply. To estimate the vessels capacity for taking part in towing and anchor handling tasks, one can turn to the concept of the pull number as the sum total of the traction for this equipment. Linear regression, non-linear and semi-parametric generalised and additive models are adjusted around a broad data base about state-of-the-art vessels. This makes it possible to estimate their value, using as a starting point the vessels main dimensions and power. From this estimate, the traction values for the main and anchor handling winches can be determined. The next step is to propose a way of calculating the traction needed by the secondary, capstan and towing winches assisting the manoeuvre. This study provides procedures and statistical models that can help determine the traction of the towing and anchor handling winches for the anchor handling and supply. These depend on the traction obtained in Bollard Pull testing. The analysis proposed here involves dimensioning the key equipment used on these kinds of vessels so that valuable design information is obtained.
Faecal microbiota transplantation: Where did it start? What have studies taught us? Where is it going?
Authors: Chanyi Ryan M , Craven Laura , Harvey Brandon , Reid Gregor , Silverman Michael J , Burton Jeremy P
Published: May 2017

The composition and activity of microorganisms in the gut, the microbiome, is emerging as an important factor to consider with regard to the treatment of many diseases. Dysbiosis of the normal community has been implicated in inflammatory bowel disease, Crohn’s disease, diabetes and, most notoriously, Clostridium difficile infection. In Canada, the leading treatment strategy for recalcitrant C. difficile infection is to receive faecal material which by nature is filled with microorganisms and their metabolites, from a healthy individual, known as a faecal microbiota transplantation. This influx of bacteria into the gut helps to restore the microbiota to a healthy state, preventing C. difficile from causing further disease. Much of what is known with respect to the microbiota and faecal microbiota transplantation comes from animal studies simulating the human disease. Although these models allow researchers to perform studies that would be difficult in humans, they do not always recapitulate the human microbiome. This makes the translation of these results to humans somewhat questionable. The purpose of this review is to analyse these animal models and discuss the advantages and the disadvantages of them in relation to human translation. By understanding some of the limitation of animal models, we will be better able to design and perform experiments of most relevance to human applications.
Retromalleolar Groove Deepening in Recurrent Peroneal Tendon Dislocation: Technique Tip
Authors: van Dijk Pim A. D. , Vopat Bryan G. , Guss Daniel , Younger Alastair , DiGiovanni Christopher W.
Published: May 2017

Peroneal tendon dislocations are most prevalent in the active and athletic population, so accurate diagnosis and management are essential for optimal return of function. Although many nonoperative and surgical management options have been described, the optimal treatment method continues to be debated. In this technique article, a modified retromalleolar groove–deepening technique is described for addressing all anatomic variations of the posterior distal fibula and retromalleolar groove without unduly disturbing the important anatomic facets meant for retention in this region. This technique is indicated for chronic dislocated peroneal tendons, recurrent dislocating peroneal tendons, and dislocation of the tendons after acute injury with a shallow fibular peroneal groove. Although it remains unclear what effect a cortically abraded fibular gliding surface or forceful cortical impaction on the fibrocartilage gliding surface might have on peroneal tendon integrity and function long term, it would seem preferable to avoid such techniques if reliable alternatives are available.
Unmet Primary Care Needs in Diabetic Patients with Multimorbidity in a Medically Underserved Area
Authors: Jackson Bianca M. , Gutierrez Mary Lou , Relyea George E. , Carlton Erik L. , Ahn SangNam , Binkley Bonnie L. , Bailey James E.
Published: May 2017

Background:

Diabetic patients with multimorbidity in medically underserved minority communities are less engaged in primary care and experience high emergency department (ED) utilization. This study assesses unmet primary care needs among diabetic patients in a medically underserved area (MUA).

Community Context:

A suburb of Memphis—Whitehaven, Tennessee (Shelby County, ZIP codes 38109 and 38116)—majority African American (96.6%) with 30.5% below the poverty level.

Methods:

Community case study using multiple data sources including diabetes registry, individual interviews, focus groups, and a survey of 30 ED patients with diabetes and multimorbidity.

Results:

Diabetes registry data indicated that 95.5% of 5723 diabetic patients had multimorbidity. Over 91.5% were uncontrolled at some point in 2014 to 2015. Only 83% of patients with diabetes and multimorbidity reported having a primary care provider (PCP) and those without a PCP were more likely to report delays in needed care. Patients expressed strong interest in health coaching (88%) and receiving text messages from the doctor’s office (73%). Individual patient interviews (n = 9) and focus groups (n = 11) revealed common primary care and self-care experiences and needs including diabetes education, improved patient–provider communication, health-care access and coverage, and strengthened primary care and community.

Conclusion:

This study demonstrates that almost 1 in 5 ED complex diabetic patients in an MUA do not have a PCP, and that difficulty accessing primary care often results in patients forgoing needed care. Qualitative findings support these conclusions. These results suggest that primary care capacity and infrastructure to support diabetes self-care need strengthening in MUAs.
Public Health 3.0: A New Vision Requiring a Reinvigorated Workforce
Authors: DeSalvo Karen B. , Wang Y. Claire
Published: May 2017

In 2016, the U.S. Department of Health and Human Services Office of the Assistant Secretary for Health launched the Public Health 3.0 initiative to define a framework for the future of public health. Regional Public Health Training Centers are at the forefront of testing new pedagogical approaches that incorporate Public Health 3.0 and social determinants of health principles.
Hydroxycalciomicrolite, Ca1.5Ta2O6(OH), a new member of the microlite group from Volta Grande pegmatite, Nazareno, Minas Gerais, Brazil
Authors: Andrade M. B. , Yang H. , Atencio D. , Downs R. T. , Chukanov N. V. , Lemée-Cailleau M. H. , Persiano A. I. C. , Goeta A. E. , Ellena J.
Published: May 2017

Hydroxycalciomicrolite, Ca1.5Ta2O6(OH) is a new microlite-group mineral found in the Volta Grande pegmatite, Nazareno, Minas Gerais, Brazil. It occurs as isolated octahedral and as a combination of octahedral and rhombic dodecahedral crystals, up to1.5 mm in size. The crystals are yellow and translucent, with a white streak and vitreous to resinous lustre. The mineral is brittle, with a Mohs hardness of 5–6. Cleavage is not observed and fracture is conchoidal. The calculated density is 6.176 g cm–3. Hydroxycalciomicroliteis isotropic, ncalc. = 2.010. The infrared and Raman spectra exhibit bands due to O–H stretching vibrations. The chemical composition determined from electron microprobe analysis (n = 13) is (wt.%): Na2O 0.36(8), CaO 15.64(13), SnO2 0.26(3),Nb2O5 2.82(30), Ta2O5 78.39(22), MnO 0.12(2), F 0.72(12) and H2O 1.30 (from the crystal structure data), O = F –0.30, total 99.31(32), yielding an empirical formula, (Ca1.48Na0.06Mn0.01)∑1.55(Ta1.88Nb0.11Sn0.01)∑2.00O6.00[(OH)0.76F0.20O0.04].Hydroxycalciomicrolite is cubic, with unit-cell parameters a = 10.4205(1) Å, V = 1131.53(2) Å3 and Z = 8. It represents a pyrochlore supergroup, microlite-group mineral exhibiting P4332 symmetry, instead of Fd3m. Thereduction in symmetry is due to long-range ordering of Ca and vacancies on the A sites. This is the first example of such ordering in a natural pyrochlore, although it is known from synthetic compounds. This result is promising because it suggests that other species with P4332or lower-symmetry space group can be discovered and characterized.
Noninvasive detection of F8 int22h-related inversions and sequence variants in maternal plasma of hemophilia carriers
Authors: Hudecova Irena , Jiang Peiyong , Davies Joanna , Lo Y. M. Dennis , Kadir Rezan A. , Chiu Rossa W. K.
Published: May 2017

Key Points

Droplet digital PCR is an affordable and user-friendly method for the detection of F8 and F9 sequence variants in maternal plasma. Targeted MPS accurately determines fetal inheritance of F8 int22h-related inversions, using maternal plasma of pregnant hemophilia carriers.
USP7 inhibition alters homologous recombination repair and targets CLL cells independently of ATM/p53 functional status
Authors: Agathanggelou Angelo , Smith Edward , Davies Nicholas J. , Kwok Marwan , Zlatanou Anastasia , Oldreive Ceri E. , Mao Jingwen , Da Costa David , Yadollahi Sina , Perry Tracey , Kearns Pamela , Skowronska Anna , Yates Elliot , Parry Helen , Hillmen Peter , Reverdy Celine , Delansorne Remi , Paneesha Shankara , Pratt Guy , Moss Paul , Taylor A. Malcolm R. , Stewart Grant S. , Stankovic Tatjana
Published: May 2017

Key Points

USP7 is overexpressed and regulates HRR in CLL cells. USP7 inhibition is selectively cytotoxic to CLL cells independently of ATM and p53 and synergizes with chemotherapy.
Full-waveform inversion using seislet regularization
Authors: Xue Zhiguang , Zhu Hejun , Fomel Sergey
Published: May 2017

Because of inaccurate, incomplete, and inconsistent waveform records, full-waveform inversion (FWI) in the framework of a local optimization approach may not have a unique solution, and thus it remains an ill-posed inverse problem. To improve the robustness of FWI, we have developed a new model regularization approach that enforced the sparsity of solutions in the seislet domain. The construction of seislet basis functions requires structural information that can be estimated iteratively from migration images. We implement FWI with seislet regularization using nonlinear shaping regularization and impose sparseness by applying soft thresholding on the updated model in the seislet domain at each iteration of the data-fitting process. The main extra computational cost of the method relative to standard FWI is the cost of applying forward and inverse seislet transforms at each iteration. This cost is almost negligible compared with the cost of solving wave equations. Numerical tests using the synthetic Marmousi model demonstrate that seislet regularization can greatly improve the robustness of FWI by recovering high-resolution velocity models, particularly in the presence of strong crosstalk artifacts from simultaneous sources or strong random noise in the data.
A randomized trial (MA.17R) of extending adjuvant letrozole for 5 years after completing an initial 5 years of aromatase inhibitor therapy alone or preceded by tamoxifen in postmenopausal women with early-stage breast cancer.
Authors: Goss Paul E. , Ingle James N. , Pritchard Kathleen I. , Robert Nicholas J. , Muss Hyman , Gralow Julie , Gelmon Karen A. , Whelan Timothy Joseph , Strasser-Weippl Kathrin , Rubin Sheldon , Sturtz Keren , Wolff Antonio C. , Winer Eric P. , Hudis Clifford A. , Stopeck Alison , Beck J. Thaddeus , Kaur Judith Salmon , Whelan Kate , Tu Dongsheng , Parulekar Wendy R.
Published: May 2017

LBA1

Background: Five years of aromatase inhibitor (AI) therapy either as up-front treatment or after 2-5 years of tamoxifen has become the standard of care for postmenopausal women with hormone receptor positive early breast cancer. Extending treatment with an AI to 10 years may further reduce the risk of breast cancer recurrence. Methods: We conducted a double-blind, placebo-controlled trial (Canadian Cancer Trials Group MA.17R) to test the efficacy of extending AI treatment for an additional five years using letrozole. The primary endpoint was disease-free survival. Results: A total of 1,918 women with early stage breast cancer were enrolled (median follow-up 75 months, 6.3 years). A total of 165 disease-free survival (DFS) events (67 on letrozole and 98 on placebo) occurred, of which 42 versus 53 were distant recurrences on letrozole and placebo, respectively. There were 200 deaths (100 in each treatment group). The 5 year DFS was respectively 95% for patients receiving letrozole versus 91% for those on placebo (HR 0.66; P = 0.01) from a two-sided log-rank test stratified by nodal status, prior adjuvant chemotherapy, interval between last dose of AI therapy and randomization, and duration of prior tamoxifen at randomization. The 5 year overall survival was respectively 93% for subjects on letrozole and 94% on placebo with a HR of 0.97 (P = 0.83). The annual incidence rate of contralateral breast cancer was 0.21% for subjects on letrozole versus 0.49% on placebo (P = 0.007). Conclusions: Compared to 5 years of AI treatment as initial therapy or preceded by 2-5 years of tamoxifen, extending AI treatment to 10 years significantly improves disease-free survival. Further analyses will provide a comprehensive picture of toxicities and QOL. Clinical trial information: NCT00754845.
A phase III randomized controlled trial of short-course radiotherapy with or without concomitant and adjuvant temozolomide in elderly patients with glioblastoma (CCTG CE.6, EORTC 26062-22061, TROG 08.02, NCT00482677).
Authors: Perry James R. , Laperriere Normand , O'Callaghan Christopher J. , Brandes Alba Ariela , Menten Johan , Phillips Claire , Fay Michael F. , Nishikawa Ryo , Cairncross J. Gregory , Roa Wilson , Osoba David , Sahgal Arjun , Hirte Hal W. , Wick Wolfgang , Laigle-Donadey Florence , Franceschi Enrico , Chinot Olivier L. , Winch Chad , Ding Keyue , Mason Warren P.
Published: May 2017

LBA2

Background: The EORTC (26981-22981)/NCIC CTG (CE.3) RCT in newly diagnosed glioblastoma (GB) showed increased overall survival (OS) with concomitant and adjuvant temozolomide (TMZ) added to radiotherapy (RT). Pts were 18-71 (median 56) years; however, a trend of decreasing benefit from the addition of TMZ with increasing age was noted. Recent RCTs in elderly GB detected non-inferiority of 40 Gy/15 v 60 Gy/30 RT and superior survival was noted for MGMT-methylated pts treated with TMZ alone. However, whether the addition of TMZ to RT improves survival in elderly pts remained unanswered. Methods: We conducted a global randomized phase III clinical trial for patients ≥ 65 yrs with histologically confirmed newly diagnosed GB, ECOG 0-2, randomized 1:1 to receive 40Gy/15 RT v 40Gy/15 RT with 3 weeks of concomitant TMZ plus monthly adjuvant TMZ until progression or 12 cycles. Stratification was by centre, age (65-70, 71-75, or 76+), ECOG 0,1 vs 2, and biopsy vs resection. Results: 562 pts were randomized, 281 on each arm; median age 73 yrs (range 65-90), male 61%, PS 0/1 77%, resection 68%. RT+TMZ significantly improved OS over RT alone (median 9.3m v 7.6m, HR 0.67, 95%CI 0.56-0.80, p < 0.0001) and significantly improved PFS (median 5.3m v 3.9m, HR 0.50, 95%CI 0.41 – 0.60, p < 0.0001). Tissue from 462 pts was provided and adequate for MGMT analysis in 354 to date. In MGMT methylated patients (n = 165) OS for RT+TMZ v RT was 13.5 m and 7.7m respectively (HR: 0.53 (95% C.I. 0.38, 0.73, p = 0.0001). In MGMT unmethylated patients (n = 189) OS for RT + TMZ v RT was 10.0m vs 7.9m respectively (HR 0.75 (95% C.I. 0.56 – 1.01, p = 0.055). QoL analyses showed no differences in functional domains of QLQC30 and BN20 but were worse in the RT/TMZ arm for nausea, vomiting, and constipation. Systemic therapy after PD was reported in 39% on RT+TMZ v 41% on RT. Conclusions: The addition of concomitant and adjuvant TMZ to hypofractionated RT for elderly pts with GB significantly improves OS and PFS in all patients and is well tolerated. Patients with MGMT methylated tumors benefit the most from the addition of TMZ to RT where median OS is nearly doubled. Clinical trial information: NCT00482677.
Phase III randomized controlled study of daratumumab, bortezomib, and dexamethasone (DVd) versus bortezomib and dexamethasone (Vd) in patients (pts) with relapsed or refractory multiple myeloma (RRMM): CASTOR study.
Authors: Palumbo Antonio , Chanan-Khan Asher Alban Akmal , Weisel Katja , Nooka Ajay K. , Masszi Tamas , Beksac Meral , Spicka Ivan , Hungria Vania T.M. , Mateos María-Victoria , Mark Tomer Martin , Qi Ming , Schecter Jordan Mark , Amin Himal , Qin Xiang , Deraedt William , Ahmadi Tahamtan , Spencer Andrew , Sonneveld Pieter
Published: May 2017

LBA4

Background: Daratumumab (D), a human anti-CD38 IgGκ mAb, induces deep and durable responses with a favorable safety profile in RRMM pts. We report a pre-specified interim analysis of the first randomized controlled study of D (CASTOR; NCT02136134). Methods: Pts with ≥1 prior line of therapy were randomized (1:1) to 8 cycles (q3w) of bortezomib (V)/dexamethasone (d) (V: 1.3 mg/m2sc on Days 1, 4, 8, 11; d: 20 mg po on Days 1, 2, 4, 5, 8, 9, 11, 12) ± D (16 mg/kg iv qw in Cycles 1-3, Day 1 of Cycles 4-8, then q4w until progression). Primary endpoint was PFS. Results: 498 pts (DVd, 251; Vd, 247) were randomized. Baseline demographics and disease characteristics were well balanced. Pts received a median of 2 prior lines of therapy (range 1-10). 66% received prior V; 76% received prior IMiD; 48% received prior PI and IMiD; 33% were IMiD-refractory; 32% were refractory to last line of prior therapy. With median follow-up of 7.4 months, D significantly improved median PFS (61% reduction in risk of progression) and TTP for DVd vs Vd (Table). D significantly increased ORR (83% vs 63%, P <0.0001), and doubled rates of ≥VGPR (59% vs 29%, P <0.0001), and ≥CR (19% vs 9%, P= 0.0012) for DVd vs Vd, respectively; median duration of response was NR vs 7.9 months, respectively. Most common (>25%) AEs (DVd/Vd) were thrombocytopenia (59%/44%), peripheral sensory neuropathy (47%/ 38%), diarrhea (32%/22%) and anemia (26%/31%). Most common grade 3/4 AEs (>10%) were thrombocytopenia (45%/33%), anemia (14%/16%), neutropenia (13%/4%). 7%/9% of pts discontinued due to a TEAE. D-associated infusion-related reactions (45% of pts) mostly occurred during the first infusion; most were grade 1/2 (grade 3/4, 9%/0%). Conclusions: D significantly improved PFS, TTP, and ORR in combination with Vd vs Vd alone. DVd doubled both VGPR and sCR/CR rates vs Vd alone. Safety of DVd is consistent with the known safety profile of D and Vd. The addition of D to Vd should be considered a new standard of care for RRMM pts currently receiving Vd alone. Clinical trial information: NCT02136134. [Table: see text]