bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine Learning With K-Means Dimensional Reduction for Predicting Survival Outcomes in Patients With Breast Cancer
Authors: Zhao Melissa , Tang Yushi , Kim Hyunkyung , Hasegawa Kohei
Published: November 2018

Objective:

Despite existing prognostic markers, breast cancer prognosis remains a difficult subject due to the complex relationships between many contributing factors and survival. This study seeks to integrate multiple clinicopathological and genomic factors with dimensional reduction across machine learning algorithms to compare survival predictions.

Methods:

This is a secondary analysis of the data from a prospective cohort study of female patients with breast cancer enrolled in the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). We constructed a series of predictive models: ensemble models (Gradient Boosting and Random Forest), support vector machine (SVM), and artificial neural networks (ANN) for 5-year survival based on clinicopathological and gene expression data after K-means clustering with K-nearest-neighbor (KNN) classification. Model performance was evaluated by receiver operating characteristic (ROC) curve, accuracy, and calibration slope (CS). Model stability was assessed over 10 random runs in terms of ROC, accuracy, CS, and variable importance.

Results:

The analytic cohort is composed of 1874 patients with breast cancer. Overall, the median age was 62 years; the 5-year survival rate was 75%. ROC and accuracy were not significantly different between models (ROC and accuracy around 0.67 and 0.72 across models, respectively). However, ensemble methods resulted in better fit (CS) with stable measures of variable importance across 10 random training/validation splits. K-means clustering of gene expression profiles on training data points along with KNN classification of validation data points was a robust method of dimensional reduction. Furthermore, the gene expression cluster with the highest mortality risk was an influential factor in model prediction.

Conclusions:

Using machine learning methods to construct predictive models for 5-year survival in patients with breast cancer, we demonstrated discrimination ability across models with new insight into the stability and utility of dimensional reduction on genomic features in breast cancer survival prediction.
The masque of Blackness: Or, performing assimilation in the white academe
Authors: Dar Sadhvi
Published: November 2018

‘Diversity’ is a dangerous misnomer in the white academe because the idea fails to recognize the politics of Whiteness that structure a spectrum of assimilation academics of colour are positioned by. Taking the title and plotline from the Jacobean masque written by Ben Jonson in 1605, this revisionist play sets out to consider the politics of assimilation academics of colour perform in their daily lives. Drawing on Black liberation and anti-racist literature, the play draws attention to how Black and Brown bodies that are asked to perform and use voice daringly or silence instrumentally to leverage degrees of assimilation into white structures. The play first, questions the ontology of foreignness by reflecting on the colonized history of the Black body becoming assimilated into Whiteness, and second, it provides a counter-narrative to those who experience perpetual exclusion and racism at work while other academics of colour seem to become accepted and even celebrated by white hierarchies.
Seychellois courts and the protection of the right to equal protection of the law
Authors: Mujuzi Jamil Ddamulira
Published: November 2018

Unlike the constitutions of other African countries such as Uganda, South Africa, Kenya, Mauritius, Zimbabwe and Namibia which expressly provide for grounds on which a person may not be discriminated against, the Constitution of Seychelles, although prohibits discrimination, does not provide for grounds on which a person may not be discriminate against. Article 27 of the Constitution of Seychelles provides for the right to equal protection of the law. In this article, the author analyses the jurisprudence of the Supreme Court and the Court of Appeal of Seychelles to illustrate how these courts have dealt with the following issues: defining ‘equal protection of the law’ and ‘discrimination’ and giving the grounds on which a person may not be discriminated against, alleging discrimination, locus standi to challenge discriminatory laws or programmes and permissible discrimination. The author recommends, inter alia, that the Constitution may have to be amended to enumerate the grounds on which a person may not be discriminated against.
‘No expectations’: Straight men's sexual and moral identity-making in non-monogamous dating
Authors: De Graeve Katrien
Published: November 2018

This article juxtaposes the discursive strategies of two groups of heterosexual men in the context of non-monogamous internet-mediated dating in Belgium, notably men who are open about their extra-dyadic sexual practices and ‘cheating’ men. The analysis shows that regardless of the men's use of openness or discretion to construct narratives of sexual identity, morality and care, their accounts seem to be deeply intertwined with monogamist and gendered ideas on sex, care and commitment, which serves to define a largely uncaring and consumeristic dating culture. The article argues that attentiveness to power inequalities should be the main focus of ‘ethical’ non-monogamy.
Learning how: Body techniques, skill acquisition and the consumption of experience
Authors: Murphy Stephen , Patterson Maurice , O’Malley Lisa
Published: November 2018

Although the skilful body has been ever-present in research accounts of consumption experiences, no sustained attention has been given to the acquisition of skills necessary for successful engagement with those experiences. In the present study, we report an empirical investigation of the acquisition and diffusion of embodied competencies among high-speed motorcyclists. In doing so, we mobilize the concept of reflexive body techniques in order to unpack the social, physical and mindful aspects of skilled embodiment. We demonstrate that skill acquisition is a necessary precursor to successful immersion into certain kinds of consumption experiences offered by the marketplace. Further, we underline the role of skill acquisition in subject formation.
Ezetimibe — maximising cholesterol reduction through dual inhibition
Authors: Shepherd James
Published: November 2018

Statins cannot always bring plasma lipoprotein levels to target because they only attack one element of the cholesterol homoeostatic pathway. By inhibiting cholesterol absorption as well, using ezetimibe, additional benefits may be obtained. Ezetimibe co-administered with low-dose statin may give an additional 10% reduction in triglyceride, 14% reduction in low-density lipoprotein (LDL) cholesterol, and a 5% rise in high-density lipoprotein (HDL) cholesterol compared to statin alone.

In one study, significantly better National Cholesterol Education Program goal achievement was seen with co-administration of ezetimibe and a statin compared to statin treatment alone. Ezetimibe plus a statin is generally well tolerated.
Role of nicotinic acid in raising high-density lipoprotein cholesterol (HDL-C) to reduce cardiovascular risk: an Asian/Pacific consensus
Authors: Barter Philip
Published: November 2018

ardiovascular disease is a leading cause of morbidity and mortality in Asia, and the burden of disease is expected to rise further in the 21st century. As in Western populations, dyslipidaemia is an important cardiovascular risk factor in Asian people. International guidelines focus on reduction of low-density lipoprotein cholesterol (LDL-C) for prevention and treatment of coronary heart disease (CHD). However, increasing body mass index and prevalence of type 2 diabetes and metabolic syndrome in Asia have highlighted the importance of low levels of high-density lipoprotein cholesterol (HDL-C) as a coronary risk factor. Therapeutic lifestyle changes and pharmacological intervention aimed at raising HDL-C, should benefit such patients. Weight loss and physical However, to achieve target HDL-C levels exercise are important interventions for raising HDL-C. pharmacological intervention is usually necessary. Current treatment options include statins, fibrates and nicotinic acid, either as monotherapy or in combination. Statins are generally regarded as the foundation of lipid-modifying therapy. Mainly via reduction of LDL-C. Both fibrates and nicotinic acidare effective in raising HDL-C levels, and reducing triglyceride-rich lipoproteins. The efficacy and safety profile of nicotinic acid demonstrated in Western populations indicates the clinical benefits of this therapy either alone or in combination with a statin. Based on the available evidence, the Pan-Asian Consensus Panel recommends that HDL-C levels should be raised to at least 1.0 mmol/L (40 mg/dL) in Asian patients with CHD or with a high level of risk for premature vascular disease, including patients at high risk with type 2 diabetes or the metabolic syndrome.
Capital and capabilities in education: Re-examining Australia’s 2015 PISA performance and context assessment framework
Authors: Pham Lien
Published: November 2018

This paper offers a conceptual framework that combines Sen’s concept of capability and Bourdieu’s forms of capital to understand the generative mechanisms of educational advantage or disadvantage. The paper illustrates some ways that the Sen–Bourdieu framework can be applied to understand the Programme for International Student Assessment 2015 results and measures of educational contexts for Australia. The Programme for International Student Assessment 2015 results indicated that students’ socioeconomic background and student-level and school-level factors affect their educational performance. Guided by the proposed framework, the paper explains some of these effects and the contexts in which they occur. It suggests educational disadvantages are attributable to economic capital and other forms of capital within broader structural, representational and relational contexts of schooling practices. The implications for improving equity in education are to recognise forms of capital that enable or limit students’ educational capabilities, identify contexts and schooling practices in which such enablers or limitations occur, and improve opportunities as well as processes in schools in ways that secure students’ differences and uniqueness.
Prognostic Value of Mismatch Repair Genes for Patients With Colorectal Cancer: Meta-Analysis
Authors: Hou Jiang-tao , Zhao Li-na , Zhang Ding-jun , Lv Dong-yong , He Wei-ling , Chen Bin , Li Hui-biao , Li Pei-ru , Chen Li-zhen , Chen Xin-lin
Published: November 2018

DNA mismatch repair was proposed to play a pivotal role in the development and prognosis of colorectal cancer. However, the prognostic value of mismatch repair on colorectal cancer is still unknown. The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched. The articles about mismatch repair (including hMLH1, hMSH2, hMSH3, hMSH6, hPMSH1, and hPMSH2) deficiency for the prognosis of patients with colorectal cancer were included in the study. The hazard ratio and its 95% confidence interval were used to measure the impact of mismatch repair deficiency on survival time. Twenty-one articles were included. The combined hazard ratio for mismatch repair deficiency on overall survival was 0.59 (95% confidence interval: 0.50-0.69) and that on disease-free survival was 0.57 (95% confidence interval: 0.43-0.75). In subgroup analysis, there were a significant association between overall survival and mismatch repair deficiency in Asian studies (hazard ratio: 0.67; 95% confidence interval: 0.50-0.91) and Western studies (hazard ratio: 0.56; 95% confidence interval: 0.46-0.67). For disease-free survival, the hazard ratios in Asian studies and Western studies were 0.55 (95% confidence interval: 0.38-0.81) and 0.62 (95% confidence interval: 0.50-0.78), respectively. Our meta-analysis indicated that mismatch repair could be used to evaluate the prognosis of patients with colorectal cancer.
School leadership practice across international policy contexts: Organizational roles and distributed leadership in Denmark and the United States
Authors: Modeste Marsha E , Hornskov Søren Buhl , Bjerg Helle , Kelley Carolyn J
Published: November 2018

This comparative analysis applies a distributed leadership framework to data from teachers and leaders taking the Comprehensive Assessment of Leadership for Learning (CALL). Because the policies educators in Denmark and the United States respond to in their daily practice are related through the transnational policy borrowing process, we are better able to understand how these policies impact educators in their respective countries by comparing their leadership practice through a shared lens: the CALL framework. In this exploratory analysis, we take a comparative perspective by asking: How does distributed leadership practice compare in the US and the Danish contexts of schooling? And: How do views on leadership practice vary according to professional roles in specific national and local (school) contexts? Our conceptual framework has three components: neoinstitutional theory, translation theory, and distributed leadership. We use multilevel confirmatory factor analysis and t-tests with SY2015–2016 CALL data to compare and contrast the pattern of leadership practices teachers and school leaders take-up in Danish and US schools. We found that the leadership practices aligned to a school-wide focus on learning are closely associated with the work of monitoring teaching and learning and building nested learning communities, particularly in the US context of schooling.
Extended dynamometry: reference values
Authors: Belcher Henry J. C. R. , Smith Hayley
Published: November 2018

Grip strength is used as a measure of capacity in disability and personal injury claims. Although seemingly an objective measure, it is widely recognized that it is fallible to the effects of sub-maximal effort. We have developed an extended test protocol that uses the five positions of a Jamar dynamometer. The protocol mitigates the effect of inconsistency while retaining the ability to detect sub-maximal effort. Dynamometry was undertaken in 242 volunteers (male:female, 124:118) with a median age of 39 years (range 18–89, interquartile range 29–52). Normative values for consistency, curve deviation and variation from the expected curve pattern are provided. None of these measures were significantly affected by laterality, hand dominance, sex or age despite the effects of these variables on grip strength. The study defines the methodology and reference values to allow assessment of both the capacity of a patient and the reliability of the test for use in medicolegal practice.

Level of evidence: II
Whatever happened to the Shwartzman phenomenon?
Authors: Chahin Abdullah B , Opal Jason M , Opal Steven M
Published: November 2018

Ninety years ago, Gregory Shwartzman first reported an unusual discovery following the intradermal injection of sterile culture filtrates from principally Gram-negative strains from bacteria into normal rabbits. If this priming dose was followed in 24 h by a second intravenous challenge (the provocative dose) from same culture filtrate, dermal necrosis at the first injection site would regularly occur. This peculiar, but highly reproducible, event fascinated the microbiologists, hematologists, and immunologists of the time, who set out to determine the mechanisms that underlie the pathogenesis of this reaction. The speed of this reaction seemed to rule out an adaptive, humoral, immune response as its cause. Histopathologic material from within the necrotic center revealed fibrinoid, thrombo-hemorrhagic necrosis within small arterioles and capillaries in the micro-circulation. These pathologic features bore a striking resemblance to a more generalized coagulopathic phenomenon following two repeated endotoxin injections described 4 yr earlier by Sanarelli. This reaction came to be known as the generalized Shwartzman phenomenon, while the dermal reaction was named the localized or dermal Shwartzman reaction. A third category was later added, called the single organ or mono-visceral form of the Shwartzman phenomenon. The occasional occurrence of typical pathological features of the generalized Shwartzman reaction limited to a single organ is notable in many well-known clinical events (e.g., hyper-acute kidney transplant rejection, fulminant hepatic necrosis, or adrenal apoplexy in Waterhouse-Fredrickson syndrome). We will briefly review the history and the significant insights gained from understanding this phenomenon regarding the circuitry and control mechanisms responsible for disseminated intravascular coagulation, the vasculopathy and the immunopathy of sepsis.
Does a hospital culture influence adherence to infection prevention and control and rates of healthcare associated infection? A literature review
Authors: van Buijtene Adriana , Foster Dona
Published: November 2018

Background:

Over 4 million patients acquire a healthcare-associated infection (HCAI) in Europe every year, indicating possible shortcomings in hospitals converting evidence-based infection prevention and control (IPC) strategies into universal adherence. We present a literature review exploring whether insufficient adherence could be culturally based.

Aim:

To find empirical evidence if and how specific traits of organisational culture improve adherence to IPC strategies utilising HCAI rates as the marker of system failures or successes.

Methods:

PubMed, CINAHL, PsycINFO and the British Nursing index database were searched from January 2007 to June 2018. Hand-searching, Google Scholar and the snowball effect completed the investigation. The quality of the studies was assessed with the guidance of CASP and Cochrane tools.

Results:

Twenty papers were eligible for data extraction and thematic analysis. Studies predominantly report positive findings for the association, but none were determined high quality due to multiple methodological concerns. Analysing both quantitative and qualitative research revealed eight major themes: hospital cultures with better HCAI rates foster safety culture; have a generative leadership style; embrace innovation; ensure interventions fit local context; accept long-term orientation; engage and empower health professionals; promote collaboration and communication; and see the benefits of a non-punitive climate.

Interpretation:

The literature linking organisational culture and HCAI rates is suggestive, but not conclusive, indicating caution about their inferences. Leaving cultural growth to chance or allowing for weak or toxic cultures impedes on our IPC strategies and equivalently our HCAI rates.
Evaluation of Skin Colonisation And Placement of vascular access device Exit sites (ESCAPE Study)
Authors: Moureau Nancy L , Marsh Nicole , Zhang Li , Bauer Michelle J , Larsen Emily , Mihala Gabor , Corley Amanda , Lye India , Cooke Marie , Rickard Claire M
Published: November 2018

Background:

Skin microorganisms may contribute to the development of vascular access device (VAD) infections. Baseline skin microorganism type and quantity vary between body sites, yet there is little evidence to inform choice of VAD site selection.

Objective:

To compare microorganisms present at different body sites used for VAD insertions and understand the effect of transparent dressings on skin microflora.

Methods:

The ESCAPE observational study consisted of three phases: (1) skin swabs of four sites (mid-neck, base neck, chest, upper arm) from 48 hospital patients; (2) skin swabs of five body sites (mid-neck, base neck, chest, upper arm, lower arm) from 10 healthy volunteers; and (3) paired skin swabs (n = 72) under and outside of transparent dressings from 36 hospital patients (16 mid/base neck, 10 chest, upper arm). Specimens were cultured for 72 h, species identified and colony-forming units (CFU) counted. Ordinal logistic regression compared CFU categories between variables of interest.

Results:

The chest and upper arm were significantly associated with fewer microorganisms compared to neck or forearm (odds ratio [OR] = 0.40, 95% confidence interval [CI] = 0.25–0.65, P < 0.05). CFU levels under transparent dressings were not significantly different from outside (OR = 0.57, 95% CI = 0.22–1.45). Staphylococci were predominant at all sites. Other significant ( P < 0.05) predictors of higher CFU count included prolonged hospitalisation and medical/surgical patient status.

Discussion:

Skin microorganism load was significantly lower at the upper arm or chest, compared to the mid- or base neck. This may impact VAD site selection and subsequent infection risk.
Inhibitors targeting CDK4/6, PARP and PI3K in breast cancer: a review
Authors: Nur Husna Siti Muhamad , Tan Hern-Tze Tina , Mohamud Rohimah , Dyhl-Polk Anne , Wong Kah Keng
Published: November 2018

Breast cancer is the global leading cause of cancer-related death in women and it represents a major health burden worldwide. One of the promising breast cancer therapeutic avenues is through small molecule inhibitors (SMIs) which have undergone rapid progress with successful clinical trials. Recently, three emerging and vital groups of proteins are targeted by SMIs for breast cancer treatment, namely cyclin-dependent kinase 4 and 6 (CDK4/6), poly (adenosine diphosphate-ribose) polymerase (PARP) and phosphoinositide 3-kinase (PI3K). Several of these inhibitors have been approved for the treatment of breast cancer patients or progressed into late-stage clinical trials. Thus, modeling from these successful clinical trials, as well as their limitations, is pivotal for future development and trials of other inhibitors or therapeutic regimens targeting breast cancer patients. In this review, we discuss eight recently approved or novel SMIs against CDK4/6 (palbociclib, ribociclib and abemaciclib), PARP (olaparib, veliparib and talazoparib), and PI3K (buparlisib and alpelisib). The mechanisms of action, series of clinical trials and limitations are described for each inhibitor.
Dynamic contrast-enhanced magnetic resonance imaging may act as a biomarker for vascular damage in normal appearing brain tissue after radiotherapy in patients with glioblastoma
Authors: Fahlström Markus , Fransson Samuel , Blomquist Erik , Nyholm Tufve , Larsson Elna-Marie
Published: November 2018

Background

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a promising perfusion method and may be useful in evaluating radiation-induced changes in normal-appearing brain tissue.

Purpose

To assess whether radiotherapy induces changes in vascular permeability (Ktrans) and the fractional volume of the extravascular extracellular space (Ve) derived from DCE-MRI in normal-appearing brain tissue and possible relationships to radiation dose given.

Material and Methods

Seventeen patients with glioblastoma treated with radiotherapy and chemotherapy were included; five were excluded because of inconsistencies in the radiotherapy protocol or early drop-out. DCE-MRI, contrast-enhanced three-dimensional (3D) T1-weighted (T1W) images and T2-weighted fluid attenuated inversion recovery (T2-FLAIR) images were acquired before and on average 3.3, 30.6, 101.6, and 185.7 days after radiotherapy. Pre-radiotherapy CE T1W and T2-FLAIR images were segmented into white and gray matter, excluding all non-healthy tissue. Ktrans and Ve were calculated using the extended Kety model with the Parker population-based arterial input function. Six radiation dose regions were created for each tissue type, based on each patient’s computed tomography-based dose plan. Mean Ktrans and Ve were calculated over each dose region and tissue type.

Results

Global Ktrans and Ve demonstrated mostly non-significant changes with mean values higher for post-radiotherapy examinations in both gray and white matter compared to pre-radiotherapy. No relationship to radiation dose was found.

Conclusion

Additional studies are needed to validate if Ktrans and Ve derived from DCE-MRI may act as potential biomarkers for acute and early-delayed radiation-induced vascular damages. No dose-response relationship was found.
Expanding the Utility of Race-Based Accountability: An Application of RBA to Longitudinal Data Analyses
Authors: Ruiz Andrea L. , Acevedo Gabriel A. , Marquez Raquel R. , Marquez Marcos
Published: November 2018

Despite the strong empirical evidence linking childhood abuse to negative mental health outcomes later in life, a number of questions remain regarding race variations in this association. Moreover, less is known about the salience of protective factors that can offset or ameliorate the negative effects of abuse on adult mental health, and whether these factors work differently by race. Using three waves of panel data from a nationally representative survey of American adults, the present study examined the long-term effects of childhood abuse on adult mental health over a span of 20 years. In addition, we assessed social support as a protective factor, and examined its differential effects on mental health outcomes for Whites and non-Whites. Results indicate that despite frequent childhood abuse, social support is associated with less depression for Whites—its positive effects being most pronounced for those with the most severe abuse experiences. However, social support is associated with worst depression for non-Whites—its negative effects being most pronounced for those with severe abuse experiences. These findings demonstrate that the factors commonly considered as protective and beneficial for adult victims of abuse work differently across racial groups and in fact, may be detrimental for non-Whites.
Book Review: M. V. Nadkarni, N. Sivanna and Lavanya Suresh, Decentralised Democracy in India: Gandhi’s Vision and Reality
Authors: Venkatesu E.
Published: November 2018

M. V. Nadkarni, N. Sivanna and Lavanya Suresh, Decentralised Democracy in India: Gandhi’s Vision and Reality. New Delhi: Routledge. 2018. 420 pages. ₹1,295.
High School Epidemiology: Helping Students Practice Science Through Guided Inquiry and Authentic Learning Strategies
Authors: D’Agostino Emily M.
Published: November 2018

A call has been made over the last decade for the expansion of epidemiology coursework into high schools in the United States. Epidemiology instruction has been shown to increase student scientific and health literacy, promote critical thinking skills, enhance students’ perception of public health as both practical and relevant, and empower students as independent, lifelong learners. Epidemiology is also a flexible science with relevance to students from diverse backgrounds, skill levels, and interests. While there has been tremendous growth in undergraduate public health education, we have yet to witness the mainstream adoption of epidemiology into high school coursework. In this article, I propose the formal integration of epidemiology into high school curricula to help students practice science as it relates to public health. I posit that epidemiology is a flexible science discipline with real-world significance to students from diverse backgrounds, skill levels, and interests. Also, teaching epidemiology through guided inquiry and authentic learning strategies can intrinsically motivate and empower students to address health-related problems in their local communities. Moreover, epidemiology instruction at the high school level can meet student learning needs, teacher instructional objectives, administrative mandates, and community interests. In essence, epidemiology instruction at the high school level can hone fundamental skills in preparation for health and science careers and promote important public health awareness and interest among adolescents.
Training Staff of Afterschool Programs on Healthy Eating and Physical Activity: Opportunity to Reduce Childhood Obesity
Authors: Nerud Kimberly , Steiner Matthew
Published: November 2018

Escalating obesity rates among children across the nation has prompted interest in investigating the role of afterschool programs in the promotion of healthy eating and physical activity among participating children. This approach facilitates intervention programs that will be supported in daily routines of staff. Children need positive role models; the work could be a challenging process and will require staff willingness and assistance.
End-of-Life Communication Among Chinese Elderly in a Malaysian Nursing Home
Authors: Jiao Ng Xi , Hussin Nur Atikah Mohamed
Published: November 2018

Religion and culture play important roles in influencing end-of-life communication among the elderly. However, little is known about end-of-life communication among elderly nursing home residents. A qualitative study involving a sample of 13 elderly residents of a non- government nursing home in the north of Peninsular Malaysia was conducted to investigate residents’ attitudes and ideas about their end-of-life preferences. Thematic analysis was performed to identify major themes emerging from the interviews. This study found that elderly residents actively avoided end-of-life communication, but that their cultural and religious beliefs remained of paramount importance. It is hoped that these findings will provide a platform upon which to improve current nursing home care in Malaysia.
The endogenous antimicrobial cathelicidin LL37 induces platelet activation and augments thrombus formation
Authors: Salamah Maryam F. , Ravishankar Divyashree , Kodji Xenia , Moraes Leonardo A. , Williams Harry F. , Vallance Thomas M. , Albadawi Dina A. , Vaiyapuri Rajendran , Watson Kim , Gibbins Jonathan M. , Brain Susan D. , Perretti Mauro , Vaiyapuri Sakthivel
Published: November 2018

Platelet-associated complications including thrombosis, thrombocytopenia, and hemorrhage are commonly observed during various inflammatory diseases such as sepsis, inflammatory bowel disease, and psoriasis. Despite the reported evidence on numerous mechanisms/molecules that may contribute to the dysfunction of platelets, the primary mechanisms that underpin platelet-associated complications during inflammatory diseases are not fully established. Here, we report the discovery of formyl peptide receptor 2, FPR2/ALX, in platelets and its primary role in the development of platelet-associated complications via ligation with its ligand, LL37. LL37 acts as a powerful endogenous antimicrobial peptide, but it also regulates innate immune responses. We demonstrate the impact of LL37 in the modulation of platelet reactivity, hemostasis, and thrombosis. LL37 activates a range of platelet functions, enhances thrombus formation, and shortens the tail bleeding time in mice. By utilizing a pharmacological inhibitor and Fpr2/3 (an ortholog of human FPR2/ALX)–deficient mice, the functional dependence of LL37 on FPR2/ALX was determined. Because the level of LL37 is increased in numerous inflammatory diseases, these results point toward a critical role for LL37 and FPR2/ALX in the development of platelet-related complications in such diseases. Hence, a better understanding of the clinical relevance of LL37 and FPR2/ALX in diverse pathophysiological settings will pave the way for the development of improved therapeutic strategies for a range of thromboinflammatory diseases.
Predictors of quality of life of older persons in rural Uganda: A cross sectional study
Authors: Maniragaba Fred , Kwagala Betty , Bizimungu Emmanuel , Ojiambo Wandera Stephen , Ntozi James
Published: November 2018

Background: Little is known about the quality of life of older persons (OPs) in Uganda in particular, and Africa in general. This study examined factors associated with quality of life of older persons in rural Uganda.

Method: We performed a cross-sectional survey of 912 older persons from the four regions of Uganda. Data were analyzed at univariate, bivariate and multivariate level where ordinal logistic regression was applied.

Results: Older persons in northern (OR=0.39; CI=0.224-0.711) and western (OR=0.33; CI=0.185-0.594) regions had poor quality of life relative to those in central region. Those who were HIV positive had poor quality of life (OR=0.45; CI=0.220-0.928) compared to those who were HIV negative. In contrast, living in permanent houses predicted good quality of life (OR=2.04; CI=1.391-3.002). Older persons whose household assets were controlled by their spouses were associated with good quality of life (OR=2.06;CI=1.032-4.107) relative to those whose assets were controlled by their children.

Conclusion: Interventions mitigating the HIV and AIDS related Quality of life should target older persons. The government of Uganda should consider improving housing conditions for older persons in rural areas.
Emerging Hand Foot Mouth Disease in Bangladeshi Children- First Report of Rapid Appraisal on Pocket Outbreak: Clinico-epidemiological Perspective Implicating Public Health Emergency
Authors: Hossain Khan Md. Azraf , Anwar Kazi Selim , Muraduzzaman A. K. M. , Hossain Mollah Md. Abid , Akhter-ul-Alam S. M. , Munisul Islam Kazi , Hoque Sheikh Ariful , Nazrul Islam Md. , Ali Md. Ahasan
Published: November 2018

Background:Hand, foot and mouth disease (HFMD) is a common contagious disease among children under 5 years, particularly in the Asia-Pacific-region. We report a localized outbreak of childhood HFMD for the first time from Bangladesh, diagnosed only based on clinical features due to gross lack in laboratory-diagnostic facilities.

Methods:Following the World Health Organization’s case-definition, we conducted a rapid-appraisal of HFMD among all of the 143 children attending Pabna Medical College and General Hospital with fever, mouth ulcers and extremity rash. Data were collected between September and November 2017 using a preset syndromic approach and stringent differential diagnostic-protocols.

Results:The mean age of children was 2.9±2.3 years. Age did not differ with sex (P=0.98), first sibling being more belonging to middle-income families (62%). Younger children (<5 years) were more likely to suffer with moderate-to-high (38.5°C) fever (P<0.04), painful oral ulcers (P<0.03) and painful/itchy rash (P<0.01). Sex did not differ with other symptoms, but boys had less painful oral ulcers than girls (P<0.04). Fever (63%) and chicken-pox-like-rash (62%) was observed more in mid-October to mid-November than September to mid-October (P<0.01 and P<0.03, respectively). No differences in symptoms (fever, oral ulcers and extremity rash) were observed with precipitation, nor with ambient temperature. Children <5 years (85%) had quicker recovery (within 5 days) than those ≥5 years (69%), (P<0.04), with marginal differences in sex (P<0.05).

Conclusions:Our findings highlight the potential usefulness in diagnosing HFMD based on clinical parameters, although stringent differential diagnosis remains indispensable. It is particularly applicable for resource-constrained countries who lack appropriate virology/essential laboratory equipment. Since no specific treatment or effective vaccination is available for this disease, supportive therapy and preventive measures remain the primary methods to circumvent transmission augmented by climate-related factors. Standardized virology laboratory warrants appropriate diagnosis and globally representative multivalent vaccine is deemed essential towards preventing HFMD.
Where Is Your Pain? A Cross-cultural Comparison of the Concept of Pain in Americans and South Koreans
Authors: Kim Hyo-eun , Poth Nina , Reuter Kevin , Sytsma Justin
Published: November 2018

Philosophical orthodoxy holds that pains are mental states, taking this to reflect the ordinary conception of pain. Despite this, evidence is mounting that English speakers do not tend to conceptualize pains in this way; rather, they tend to treat pains as being bodily states. We hypothesize that this is driven by two primary factors -- the phenomenology of feeling pains and the surface grammar of pain reports. There is reason to expect that neither of these factors is culturally specific, however, and thus reason to expect that the empirical findings for English speakers will generalize to other cultures and other languages. In this article we begin to test this hypothesis, reporting the results of two cross-cultural studies comparing judgments about the location of referred pains (cases where the felt location of the pain diverges from the bodily damage) between two groups -- Americans and South Koreans -- that we might otherwise expect to differ in how they understand pains. In line with our predictions, we find that both groups tend to conceive of pains as bodily states.
Pushmi-pullyu Representations and Mindreading in Chimpanzees
Authors: Danón Laura
Published: November 2018

Lurz and Krachun (2011) propose a new experimental protocol designed to discriminate genuine mindreading animals from mere behavior-readers and to give evidence in favor of the claim that chimpanzees are capable of attributing internal goals to others. They suggest that chimpanzees' variety of "internal goal attribution" consists in attributing to others basic intentional representations, baptized by Millikan as "pushmi-pullyu representations" (PPs). Now, Millikan (1996, 2004a, 2004b) distinguishes what I propose to call 'pure' PPs from more complex varieties of PPs, which allow their owners to respond more flexibly to their environments. But, what would happen if we tried to differentiate, analogously, between more or less sophisticated mind-readers in virtue of the sorts of PPs that they could attribute to others? What would attributing complex PPs consist in and how would such capacity increase the predictive powers of chimpanzee mind-readers? This paper offers an answer to these questions. Based on Millikan's work, I differentiate two varieties of complex PPs. Then, I examine what a basic mind-reader, only capable of attributing 'pure' PPs, would be able to do. After that, I distinguish two more sophisticated varieties of mindreading, each consisting in the attribution of one of the complex PPs previously presented, and I show how the ability to attribute complex PPs to others comes with more potent and flexible capacities to anticipate their behavior. Finally, I offer some reasons to think that attributing complex PPs is still simpler than full-blown mindreading and I briefly evaluate the prospects of extending this proposal to infant social cognition.
English. Stylistics. The Power of Stylistics
Authors: Лушникова Галина , Lushnikova Galina , Осадчая Татьяна , Osadchaya Tat'yana
Published: November 2018

The manual is intended for undergraduate students studying the subject "Style of the English language" in preparation for the profiles of "foreign Philology", "Teaching of philological disciplines", "Primary education and English." It consists of 8 chapters, which include a theoretical part devoted to the key problems of style, and questions for self-control and practical tasks, designed for both classroom and for independent work of students. Performing tasks contributes to the formation of professional competence of the future philologist, teacher and researcher.
The manual will be useful for students of language universities and philological faculties, studying English.
Rare health conditions 18: measles, mumps, rubella and Potter syndrome
Authors: Barber Chris
Published: November 2018

The purpose of this series is to briefly highlight a range of rare health conditions. Rare health conditions are those that affect no more and usually less than 1 person in every 2000 and many HCAs and nurses will encounter some of these conditions, given the high number of these conditions. This eighteenth article will briefly explore four of these conditions.
The role of the maternity support worker as part of the maternity care team
Authors: Lindsay Pat
Published: November 2018

The care needs of childbearing women have changed in the past 20 years and the maternity care team has expanded to include other professionals and increasing numbers of unregistered maternity support workers (MSWs). MSWs are now an indispensable part of the maternity care team. However, their role has often been overlooked and undervalued in the past. This article considers the context of maternity care, the role of the MSW, their potential career opportunities and their contribution to high–quality maternity care. The focus is principally England, as other parts of the UK may have slightly different arrangements.
Raising awareness of autistic spectrum disorders for healthcare assistants
Authors: Hayes Catherine , Alcorn Lisa , Graham Yitka
Published: November 2018

This article provides an insight for healthcare assistants (HCAs) who may have limited knowledge of the implications of autistic spectrum disorder (ASD) for their everyday practice working with patients and their families and carers. The role of HCAs in this context is invaluable in providing compassion, support and much–needed reassurance in the different contexts within which healthcare is delivered.

This article provides a basic overview of what the common presentations of ASD are and this is framed in an understanding of why a key consideration for patients living with the condition and their families and carers is where care is provided. Via raising awareness of how adaptations to HCA practice might best be made to facilitate high–quality care, the paper simultaneously raises the need for holistic management of a very vulnerable patient caseload.

The article ends by facilitating HCAs in reflecting on their level of existing knowledge of autism and how they might better apply this in practice with patients living with the everyday challenges of ASD.
Considering autistic spectrum disorders in the context of clinical nurse prescribing
Authors: Hayes Catherine , Alcorn Lisa , Graham Yitka
Published: November 2018

This article provides an insight for clinical nurse prescribers who may have limited knowledge of the implications of autistic spectrum disorder (ASD) on their practice. It will provide an insight into the common characteristics of the condition, alongside an overview of contextual and situational issues of direct relevance to sensory overload and underload. Through this, awareness is raised of how specific adaptations to practice might be made to support and empower those people living with the condition, and their families and carers. The need for individualised, holistic care is emphasised alongside information of specific relevance to the practicalities of nurse prescribing in practice. The article also outlines the issues of polypharmacy and pharmacotherapy of relevance to patients with ASD and the precursors to these, which can be readily identified in practice.
The case for resilience in veterinary nursing care
Authors: Kerrigan Lynne
Published: November 2018

The purpose of this article is to provide a review of the concept of resilience and how it relates to the field of veterinary nursing. Resilience is defined as the ability of an individual to adjust to adversity, maintain equilibrium, retain a sense of control over their environment and continue to move on in a positive manner ( Jackson et al, 2007 ). Because of the challenges faced daily by veterinary nurses, including taking care of critically ill or dying patients, staff shortages, and emotional exhaustion, it is important to address the concept of resilience, at both an individual and organisational level, in order to maintain a healthy workforce.
Brexit…what's being done?
Authors: Stokes Laura
Published: November 2018

Over 2 years after the UK held the Brexit referendum, there is still much confusion over how the change will impact both the veterinary industry and pet travel. Potential changes to many areas of veterinary medicine — including disease surveillance, education, research and factors affecting workforce — all need to be considered, along with the opportunity for amendments and improvements to the Pet Travel Scheme (PETS) to combat UK biosecurity.
Calciphylaxis Involving Both the Upper and Lower Extremities
Authors: Ozer Tulay , Borazan Ali , Hosnuter Mubin , Kargi Eksal , Savranlar Ahmet , Yılmaz Ahmet
Published: November 2018

Calciphylaxis is an uncommon complication of end stage renal disease (ESRD) and secondary hyperparathyroidism. It characterized by cutaneous necrosis with mural calcifications and thrombosis in the small vessels of dermis. It is important to diagnose and treat, because of mortality rate from calciphylaxis is very high. We present the case of a patient with ESRD and type II diabetes mellitus developing calciphylaxis of the both upper and lower extremities had normal corrected calcium-phosphate product level. After amputation, necrosis was showed rapid progression resulting in death in one month.
Iron Deposition in the Brain Following the Ischemia in a Rat Model of Ischemic Tolerance
Authors: Danielisová Viera , Némethová Miroslava , Burda Jozef
Published: November 2018

Preconditioning of the brain by short-term ischemia increases brain tolerance to the subsequent severer ischemia. In this study, we investigated iron deposition in the cerebral cortex and the ischemic tolerance in a rat model of cerebral ischemia. Forebrain ischemia was induced by four-vessel occlusion for 5 min as ischemic preconditioning. Two days after preconditioning or after the sham-operation, the second ischemia was induced for 20 min. Changes in the cerebral cortex were examined after 1 to 8 weeks of recirculation following 20 min ischemia with or without preconditioning using the iron histochemistry. Granular deposits of the iron were found in the cytoplasm of the pyramidal cells in the layers III and V of the frontal cortex after 1 week of recirculation. When the rats were exposed to 5 min ischemia 2 days before 20 min lasting ischemia, the deposition of iron in the cytoplasm of the pyramidal cells in layers III and V of the frontal cortex was significantly lower during all periods of reperfusion. Preconditioning 5 min ischemia followed by 2 days of reperfusion before 20 min ischemia also prevented degeneration of the pyramidal neurons in layers III and V of the frontal cortex.
Mechanical Properties of Selfexpandable Stents
Authors: Hanuš Josef , Záhora Jiří
Published: November 2018

The stents or stentgrafts (covered stents) are the medical instruments used in invasive radiology for miniinvasive treatment of stenosis and aneurisms especially in the blood circulation system. We measured and compared the mechanical parameters of different selfexpandable Nitinol stents, which differed in the geometry (radius and length), in the type of construction (number of branches and rising of winding) and in the diameter of the used wire. The results of measurements confirmed the theoretical assumptions that just the diameter of the Nitinol wire significantly influences the rigidity and the level of compressibility of the stent as well. The compromise must be found between the required rigidity of the stent and the minimal size of the delivery system. The exact description of the relation between the mechanical properties and geometry and construction of the stents enables us to design the stent to fit the patient's needs. The results of measurement are also necessary for the design and identification of the parameters of the models of the stents.