bluuebunny/crossref_metadata_2025 huggingface dataset:
081 Description of a stroke unit mimic admissions
Authors: Cashion Catelyn , Gawarikar Yash , Patel Ronak
Published: May 2018

Introduction

There is evidence to support both clinically and economically that stroke units improve stroke outcomes, but this is offset by high stroke mimics rates, which account for up to quarter of stroke unit admissions. There is no Australian data looking at stroke mimic rates and the time of day when they are admitted.

Methods

We conducted a retrospective cross-sectional study at Calvary Public Hospital, Bruce from May 2014 to May 2017 looking at stroke unit admission rates and mimic types. We collected data on the times of stroke unit admission, business hours Monday to Friday 0800–1630 hours and after-hours Monday to Friday 1630–0800 hours, weekends 0800–0800 hours. Stroke mimics length of stay (LOS) was compared with TIA mild strokes (NIHSS <5) LOS.

Results

Out of 1017 stoke unit admissions, 257 (25.3%) were stroke mimics. The most common mimic diagnoses were migraine and headaches (18.3%), peripheral vestibulopathy (14.0%), and functional neurology (13.2%). Data on admission times were available for 240 of 257 (93.4%) mimics of which more than 2/3 s of mimics were admitted after-hours; Bayes factor 0.912 demonstrating this is unlikely to be a significant difference. 3.5% of stroke mimics were thrombolysed with 2/3 s occurring after-hours. The average LOS was 2.3 days for mimics, compared to 4.0 days for TIA and minor strokes (p=0.00017).

Conclusion

Our study shows similar stroke mimic rates as previously described in literature with a higher proportion of these patients were admitted after-hours. However, there is little evidence that this difference is significant. The LOS for stroke mimics was less than TIAs and minor strokes. Our study highlights the need for better recognition of stroke mimics in order to prevent unnecessary utilisation of a valuable resource such as the stroke unit.
085 Clinical outcomes were better for relapsing-remitting multiple sclerosis (RRMS) patients who remained on natalizumab compared to those who switched to oral or injectable therapies after 2 years in the tysabri® observational program (TOP)
Authors: Butzkueven Helmut , Kappos Ludwig , Spelman Tim , Trojano Maria , Wiendl Heinz , Dong Qunming , Licata Stephanie , Ho Pei-Ran , Campbell Nolan
Published: May 2018

Introduction

Natalizumab is a high-efficacy RRMS therapy. Data on post-natalizumab disease activity may be important for physician consideration. We compared outcomes in patients who switched to an oral or injectable therapy or remained on natalizumab and analysed post-natalizumab relapse predictors using data from TOP, an ongoing 10 year observational study of natalizumab-treated RRMS patients.

Methods

Data from November 2016 were analysed for patients who stayed on natalizumab (≥3 years natalizumab and only natalizumab during follow-up; n=2466; mean time on natalizumab: 5.5 years) or switched to oral (n=660) or injectable (n=95) therapies for ≥1 year after ≥2 years on natalizumab (mean post-natalizumab follow-up 2.5 vs 2.4 years). Annualised relapse rates (ARRs) and Expanded Disability Status Scale (EDSS) worsening risks were evaluated. Disease activity predictors were compared using adjusted Cox models.

Results

Relapse risk was higher for oral switchers (hazard ratio [HR]=2.18; p<0.001) or injectable switchers (HR=3.02; p<0.001) than for patients who stayed on natalizumab >2 years. EDSS worsening risk was similar for oral (HR=1.19; p=0.266) and higher for injectable (HR=2.52; p<0.001) switchers compared with stayed-on-natalizumab patients. ARRs decreased after 2 years by 20.2% for stayed-on-natalizumab patients but increased from on-natalizumab rates by 17.8% in oral switchers (p<0.001) and 108.1% in injectable switchers (p<0.001). In oral switchers, lower relapse risk was predicted by shorter washout time (>12 weeks vs ≤4 weeks; HR=2.03; p<0.001), fewer pre-natalizumab relapses (HR=1.24/relapse in the prior year; p<0.001), lower baseline EDSS (>3.5 vs≤3.5; HR=1.44; p=0.007), and longer natalizumab duration (>3 years vs ≤3 years; HR=0.76; p=0.040).

Conclusion

Staying on natalizumab >2 years yields better clinical outcomes than switching to oral or injectable therapies. For those discontinuing natalizumab, switching to an oral versus an injectable yields better outcomes. Disease activity risk in oral switchers is predicted by washout time, pre-natalizumab relapses and EDSS, and time on natalizumab.

Study support

Biogen.
088 Cryoglobulinemic neuropathy associated with lymphoplasmacytic lymphoma
Authors: Dang Yew Li , Foster Emma , Finlay Moira , Evans Andrew
Published: May 2018

Introduction

A 64 year old woman presented with livedo reticularis and peripheral neuropathy secondary to Type 1 (IgM paraproteinemia) cryoglobulinemia, associated with lymphoplasmacytic lymphoma. Type 1 cryoglobulinemia is rare and remains poorly studied. However, given the common association of Type 1 cryoglobulinemia with lymphoproliferative diseases, it is important to consider Type 1 cryoglobulinemia as a differential diagnosis in presentations of a rash and peripheral neuropathy, and search for underlying malignancy.

Case

Our patient presented with a leukocytoclastic vasculitic rash over bilateral lower limbs, which improved with topical betamethasone and oral prednisolone. Two months later, she had rapidly progressive right upper limb and bilateral lower limb weakness, absent reflexes in these limbs, and right arm reduced sensation. Nerve conduction studies revealed generalised axonal sensorimotor peripheral neuropathy in all four limbs, most prominent in the right upper limb. She then developed a livedo reticularis rash over her right forearm and punch biopsy revealed luminal pseudo-thrombi in small vessels consistent with Type 1 cryoglobulinemia. Her cryoglobulin (1558 mg/L, N 0–50 mg/L) and IgM paraprotein levels (4 g/L, N 0.4–2.3) were elevated. Vasculitic and other infective screens were unremarkable. Computer tomography imaging of chest, abdomen and pelvis found widespread lymphadenopathy. Subsequent lymph node core biopsy and bone marrow aspirate revealed lymphoplasmacytic lymphoma—the likely underlying cause of the Type 1 (IgM paraproteinemia) cryoglobulinemia.

Conclusion

Peripheral neuropathy is commonly associated with Type 2 and 3 cryoglobulinemia, especially in the presence of hepatitis C infection. However, reports of vasculitic peripheral neuropathy due to Type 1 cryoglobulinemia are limited. Early recognition is essential to allow the identification and treatment of the underlying haematological malignancy, commonly associated with Type 1 cryoglobulinemia. Treatment of the underlying cause indirectly treats the cryoglobulinemia, and avoids or reduces the associated; sometimes severe; cutaneous, neurological, and renal manifestations of this condition.
089 Prognostic significance of magnetic resonance imaging in patients with severe non-penetrating traumatic brain injury requiring decompressive craniectomy
Authors: Ho Kwok-Ming , Honeybul Stephen , Ambati Ravi
Published: May 2018

Introduction

Diffuse axonal injury (DAI) detected on magnetic resonance imaging (MRI) may be useful to predict outcome after traumatic brain injury (TBI).

Methods

This study compared the ability of the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic model with DAI on MRI, to predict 18 months neurological outcome in 56 patients who had required a decompressive craniectomy after TBI.

Of the 56 patients included in the study (19 scans occurred within 14 days; median time for all patients 24 days, interquartile range 14–42), 18 (32%) had evidence of DAI on the MRI scans. The presence of DAI on the MRI diffusion-weighted (DW), T2*-weighted-gradient echo and susceptibility-weighted (SWI) sequences was associated with an increased risk of unfavourable outcome at 18 months compared to those without DAI (44% vs. 17%, difference=27%, 95% confidence interval 2.4%–46.7%; p=0.032), particularly when brainstem was involved. However, neither the grading (I to IV) nor the number of brain regions with DAI was as good as the IMPACT model in discriminating between patients with unfavourable and favourable outcome (area under the receiver-operating-characteristic curve: 0.625 and 0.621 vs 0.918, respectively; p<0.001 for both comparisons). After adjusting for the IMPACT prognostic risks, DAI in different brain regions and the grading of DAI were also not independently associated with unfavourable outcome.

Conclusion

The prognostic significance of DAI on MRI may, in part, be captured by the IMPACT prognostic model. More research is needed before MRI should be routinely used to prognosticate outcomes of patients with TBI requiring decompressive craniectomy.
090 The expanding clinical phenotype of late onset pompe disease: a multi-system disorder
Authors: Reardon Katrina , McKelvie Penny
Published: May 2018

Introduction

The diagnosis of late onset Pompe disease (LOPD) can be difficult and delayed due to heterogeneous presentation. LOPD was typically a triad of weakness affecting the limb girdle, respiratory and axial muscles. Recent reports highlight more widespread, less well recognised, multi system manifestations of LOPD.

Cases

Three clinical cases of LOPD are described with atypical presenting manifestations for many years, who after diagnosis and investigation all qualified for enzyme replacement therapy. A review of the literature on the manifestations of LOPD is presented. These three clinical cases highlight important clues and pitfalls in making a diagnosis of LOPD when there are subtle presenting symptoms for many years on history, examination or investigations. The literature review has broadened our clinical perspective with reports of multi-system manifestations of LOPD. The manifestations of LOPD may be seen by clinicians in a wide variety of fields including neurology, stroke, rheumatology, gastroenterology, cardiovascular, respiratory, genitourinary and metabolic bone medicine. LOPD will present to a wide variety of specialists with symptoms, who may not be aware of this potential diagnosis. These reports will change our concept of what is LOPD and encourage investigation for this disorder. The dried blood spot testing for diagnosis of LOPD is beneficial, cost effective and non-invasive.

Conclusion

LOPD is an under diagnosed and often misdiagnosed neuromuscular disorder which is now recognised as having other associated multi-system features which can be identified on history, examination or laboratory findings. These patients may present to a wide variety of health professionals with symptoms and greater awareness in needed. Early diagnosis of patients with LOPD disease will allow better management, prevent complications and may improve outcomes now that enzyme replacement therapy is available for certain individuals.
What makes clinical labour different? The case of human guinea pigging
Authors: Różyńska Joanna
Published: May 2018

Each year thousands of individuals enrol in clinical trials as healthy volunteers to earn money. Some of them pursue research participation as a full-time or at least a part-time job. They call themselves professional or semiprofessional guinea pigs. The practice of paying healthy volunteers raises numerous ethical concerns. Different payment models have been discussed in literature. Dickert and Grady argue for a wage-payment model. This model gives research subjects a standardised hourly wage, and it is based on an assumption that research participation is morally indistinguishable from other forms of unskilled labour. In this paper, I will challenge this assumption. I will argue that human guinea pigging has particular characteristics which taken together make it significantly different from other forms of labour. (1) Participation in research is skill-independent. Healthy volunteers are valuable not because they are skilful persons, but because they are human bodies. (2) The role of research volunteers is mainly passive. They are not asked to produce goods or deliver services. They are paid for enduring unpleasant, painful and risky interventions performed by investigators. (3) Research volunteering involves inherent risks and uncertainties, and subjects have little or no control over their minimisation and materialisation. I conclude that participation in clinical research is a specific kind of activity. It is more like renting out one’s body to strangers, than working. Thus, research participation should not be treated on par with other forms of employment.
Asymmetric cationic gemini surfactants: an improved synthetic procedure and the micellar and surface properties of a homologous series in the presence of simple salts
Authors: Greencorn David J. , Sandre Victoria M. , Piggott Emily K. , Hillier Michael R. , Mitchell A. James , Reid Taryn M. , McAlduff Michael J. , Singh Kulbir , Marangoni D. Gerrard
Published: May 2018

The micellar and morphological properties of symmetric, cationic gemini surfactants have been well studied in the literature as a function of nature and type of the spacer group and the length and type of hydrophobic chain. In this paper, we have examined the effects of tail asymmetry on the properties of a series of cationic surfactants, the N-alkyl-1-N′-alkyl-2-N,N,N′,N′-tetramethyldiammonium dibromide. A novel synthetic method is used to prepare a series of these surfactants and the consequences of asymmetry on micellar properties are presented. This new method has been shown to be more efficient, with higher yields of the asymmetric surfactants than the yields of the accepted literature method. The critical micelle concentration values and the micelle sizes of the asymmetric gemini surfactants, 12-4-12, 12-4-10, 12-4-8, and 12-4-6 gemini surfactants, were obtained from conductivity and dynamic light scattering. With increasing chain asymmetry, the size of the micelle increased due to the formation of loose micelles. The addition of NaCl and Na2SO4 to the surfactant solutions increased the aggregate size, and this effect was more pronounced with increasing salt concentrations. These results are interpreted in terms of the effect these ions have on the “compactness” of the micelle structure.
Heterogeneity in attitudes underlying preferences for genomic technology producing hybrid poplars on public land
Authors: Maruta Admasu Asfaw , Boxall Peter , Mohapatra Sandeep
Published: May 2018

We investigate the public preference heterogeneity of planting genetically improved poplar trees for biofuel production on public land in western Canada. Using a sample of the public from British Columbia, Alberta, Saskatchewan, and Manitoba, respondents were asked to vote in a series of hypothetical referenda comparing the new, proposed forest policies with the current policy (base scenario). Proposed policies varied based on poplar breeding method (traditional, genomics, or genetic modification) and whether poplars may be used for biofuel production. A respondents’ segmentation framework with cluster analysis and probit model was applied to data of respondents to uncover the heterogeneity of public’s perception. The results of this study reveal that positive and negative perceptions about planting genetically improved poplar trees in the region create a division of respondents into Environmentalists, Knowledgeable, Challengers, and Supporters. Respondents from British Columbia and Manitoba are identified as Environmentalists and Challengers, respectively, of the new policy of planting genetically improved poplar trees on public land. Conversely, respondents from Saskatchewan and Alberta are identified as Supporters and Knowledgeable, respectively, of the new policy.
Exhaustive-exercise-induced oxidative stress alteration of erythrocyte oxygen release capacity
Authors: Xiong Yanlian , Xiong Yanlei , Wang Yueming , Zhao Yajin , Li Yaojin , Ren Yang , Wang Ruofeng , Zhao Mingzi , Hao Yitong , Liu Haibei , Wang Xiang
Published: May 2018

The aim of the present study was to explore the effect of exhaustive running exercise in the oxygen release capacity of rat erythrocytes. Rats were divided into sedentary control, moderate running exercise, and exhaustive running exercise groups. The thermodynamic and kinetic properties of the erythrocyte oxygen release process of the different groups were tested. We also determined the degree of band-3 oxidation and phosphorylation, anion transport activity, and carbonic anhydrase isoform II activity. Biochemical studies suggested that exhaustive running significantly increased oxidative injury parameters in thiobarbituric acid reactive substances and methaemoglobin levels. Furthermore, exhaustive running significantly decreased anion transport activity and carbonic anhydrase isoform II activity. Thermodynamic analysis indicated that erythrocytes oxygen release ability also significantly increased due to elevated 2,3-DPG level after exhaustive running. Kinetic analysis indicated that exhaustive running resulted in significantly decreased T50value. We presented evidence that exhaustive running remarkably impacted thermodynamic and kinetic properties of RBC oxygen release. In addition, changes in 2,3-DPG levels and band-3 oxidation and phosphorylation could be the driving force for exhaustive-running-induced alterations in erythrocyte oxygen release thermodynamic and kinetic properties.
EFFECT OF FRICTION STIR PROCESSING ON CORROSION BEHAVIOR OF CAST AZ91C MAGNESIUM ALLOY
Authors: HASSANI BEHZAD , VALLANT RUDOLF , KARIMZADEH FATHALLAH , ENAYATI MOHAMMAD HOSSEIN , SABOONI SOHEIL , PRADEEP KASYAP
Published: May 2018

The corrosion behavior of as-cast AZ91C magnesium alloy was studied by performing friction stir processing (FSP) and FSP followed by solution annealing and then aging. Phase analysis, microstructural characterization, potentiodynamic polarization test and immersion tests were carried out to relate the corrosion behavior to the samples microstructure. The microstructural observations revealed the breakage and dissolution of coarse dendritic microstructure as well as the coarse secondary [Formula: see text]-Mg[Formula: see text]Al[Formula: see text] phase which resulted in a homogenized and fine grained microstructure (15[Formula: see text][Formula: see text]m). T6 heat treatment resulted in an excessive growth and dispersion of the secondary phases in the microstructure of FSP zone. The potentiodynamic polarization and immersion tests proved a significant effect of both FSP and FSP followed by T6 on increasing the corrosion resistance of the cast AZ91C magnesium alloy. Improve in corrosion resistance after FSP was attributed to grain refinement and elimination of segregations and casting defects which makes more adhesive passive layer. Increase in volume fraction of precipitations after T6 heat treatment is determined to be the main factor which stabilizes the passive layer at different polarization values and is considered to be responsible for increasing the corrosion resistance.
Substrate-Induced Formation of Ribosomal Decoding Center for Accurate and Rapid Genetic Code Translation
Authors: Pavlov Michael Y. , Ehrenberg Måns
Published: May 2018

Accurate translation of genetic information is crucial for synthesis of functional proteins in all organisms. We use recent experimental data to discuss how induced fit affects accuracy of initial codon selection on the ribosome by aminoacyl transfer RNA in ternary complex ( T3) with elongation factor Tu (EF-Tu) and guanosine-5′-triphosphate (GTP). We define actual accuracy ([Formula: see text]) of a particular protein synthesis system as its current accuracy and the effective selectivity ([Formula: see text]) as [Formula: see text] in the limit of zero ribosomal binding affinity for T3. Intrinsic selectivity ([Formula: see text]), defined as the upper thermodynamic limit of [Formula: see text], is determined by the free energy difference between near-cognate and cognate T3 in the pre-GTP hydrolysis state on the ribosome. [Formula: see text] is much larger than [Formula: see text], suggesting the possibility of a considerable increase in [Formula: see text] and [Formula: see text] at negligible kinetic cost. Induced fit increases [Formula: see text] and [Formula: see text] without affecting [Formula: see text], and aminoglycoside antibiotics reduce [Formula: see text] and [Formula: see text] at unaltered [Formula: see text].
Hydrogel-Tissue Chemistry: Principles and Applications
Authors: Gradinaru Viviana , Treweek Jennifer , Overton Kristin , Deisseroth Karl
Published: May 2018

Over the past five years, a rapidly developing experimental approach has enabled high-resolution and high-content information retrieval from intact multicellular animal (metazoan) systems. New chemical and physical forms are created in the hydrogel-tissue chemistry process, and the retention and retrieval of crucial phenotypic information regarding constituent cells and molecules (and their joint interrelationships) are thereby enabled. For example, rich data sets defining both single-cell-resolution gene expression and single-cell-resolution activity during behavior can now be collected while still preserving information on three-dimensional positioning and/or brain-wide wiring of those very same neurons—even within vertebrate brains. This new approach and its variants, as applied to neuroscience, are beginning to illuminate the fundamental cellular and chemical representations of sensation, cognition, and action. More generally, reimagining metazoans as metareactants—or positionally defined three-dimensional graphs of constituent chemicals made available for ongoing functionalization, transformation, and readout—is stimulating innovation across biology and medicine.
The Biophysics of 3D Cell Migration
Authors: Wu Pei-Hsun , Gilkes Daniele M. , Wirtz Denis
Published: May 2018

Three-dimensional (3D) cell culture systems have gained increasing interest not only for 3D migration studies but also for their use in drug screening, tissue engineering, and ex vivo modeling of metastatic behavior in the field of cancer biology and morphogenesis in the field of developmental biology. The goal of studying cells in a 3D context is to attempt to more faithfully recapitulate the physiological microenvironment of tissues, including mechanical and structural parameters that we envision will reveal more predictive data for development programs and disease states. In this review, we discuss the pros and cons of several well-characterized 3D cell culture systems for performing 3D migration studies. We discuss the intracellular and extracellular signaling mechanisms that govern cell migration. We also describe the mathematical models and relevant assumptions that can be used to describe 3D cell movement.
Tema XI. Bases Hemodinámicas y de Cosumo de O2 Cerebral en el Paciente Neuroquirúrgico
Authors: De la Fuente B. José
Published: May 2018

Sin resunen
Interpretación de los estudios de susceptibilidad antimicrobiana.
Authors: Palavecino Rosales Elizabeth
Published: May 2018

Sin resumen
Garantía de calidad en el laboratorio de Microbiología.
Authors: Guzmán Durán Ana María
Published: May 2018

Sin resumen
Síndrome de apneas obstructivas del sueño.
Authors: Leiva Rodríguez Isabel
Published: May 2018

Sin resumen
Casos radiológicos
Authors: Cruz O. Francisco , Rodríguez B. Walter
Published: May 2018

Sin resumen
Carta de los agentes de salud
Authors: Escuela de Medicina Boletín
Published: May 2018

Sin resumen
Diagnosis of Vertigo and Dizziness Syndromes in a Neurological Outpatient Clinic
Authors: Pan Qi , Zhang Yixin , Long Ting , He Wei , Zhang Shanshan , Fan Yulan , Zhou Jiying
Published: May 2018

Background: Dizziness and vertigo are frequent complaints of outpatients in the neurological department. Our objective was to explore the epidemiological category and clinical features of patients with dizziness or vertigo in the neurological outpatient department of a tertiary hospital. Methods: We consecutively recruited all patients with dizziness and/or vertigo visiting the neurological outpatient clinic of the First Affiliated Hospital of Chongqing Medical University from January 2016 to June 2017. All patients were interviewed by 4 neurologists and they completed self-administered questionnaires. General physical and standardized neuro-otology bedside examinations were performed in all participants. Instrumental examinations and other related examinations were prescribed as needed. Results: A total of 392 patients, 272 female and 120 male, were enrolled and the ratio of males to females was 1: 2.27. The mean age was 52.39 ± 13.87 years (range 11–90). Elderly patients (≥60 years) accounted for about one-third of the patients. Peripheral vestibular disorders accounted for 54.6% of patients, central vestibular disorders (including vestibular migraine [VM]) accounted for 22.4% of patients, psychogenic vertigo in 64 (16.3%), other reasons in 9 (2.3%) and unknown in 17 (4.3%). Benign paroxysmal positional vertigo (BPPV; 30.8%), psychiatric dizziness (20.5%), and VM (14.4%) were the 3 major vestibular diseases in patients under 60 years of age; however, BPPV (27.9%), central vertigo (21.7%), and Meniere’s disease (11.7%) were more common in patients over 60 years of age. Conclusions: This study provided a classification and clinical features of vestibular disorders in a neurological outpatient department of a tertiary hospital in China. The spectrum of vertigo or dizziness is different between different age groups and clinicians should pay attention to this difference in clinical reasoning.
Five new species of the genus Ernolatia Walker, 1862 (Lepidoptera: Bombycidae) from islands of Malesia
Authors: ZOLOTUHIN VADIM V. , DOLGUNOV VLADISLAV A.
Published: May 2018

Five new species of the genus Ernolatia Walker, 1862 are described from the islands of Malesia. They are E. adrasteia sp. nov. (type locality: Philippinen, Negros occ., Mt. Kanlaon, 600-800 m, W-Route via Mambucal), E. invicema sp. nov. (type locality: S. Sulawesi, Puncak, Palopo, 2°55’S, 120°05’E), E. callirhoe sp. nov. (type locality: S. Sulawesi, Mt. Sampuraga, 2°10’S, 120°45’E), E. fumidiflora sp. nov. (type locality: Indonesia, N. Tengg. Timur, Flores, 9 km S Ruteng Golo Luseng) and E. doris sp. nov. (type locality: Indonesia, Sumba (W), Prov. Nusa Tenggara Barat, Gunung (Mt) Areas). The holotypes of all taxa are deposited in the coll. of entomological Museum Witt (which will be attributed to the Zoologische Staatssammlung, Munich). Their habitus, as well as available genitalia, are illustrated.
Intraoperative Cryoanalgesia for Reducing Post-Tonsillectomy Pain: A Systemic Review
Authors: Raggio Blake S. , Barton Blair M. , Grant Maria C. , McCoul Edward D.
Published: May 2018

Objective:

Summarize the effectiveness of intraoperative cryoanalgesia in the management of postoperative pain among patients undergoing palatine tonsillectomy.

Methods:

A systematic review of PubMED, MEDLINE, EMBASE, Google Scholar, and Cochrane trial registries was performed through January 2017 using the PRISMA standards. We included English-language randomized controlled trials evaluating patients of all age groups with benign pathology who underwent tonsillectomy with cryoanalgesia versus without.

Results:

Three limited quality randomized controlled trials involving 153 participants (age range, 1-60 years) were included. Cryoanalgesia was performed with a cryotherapy probe (−56°C) in 1 trial and ice-water cooling (4°C to 10°C) in 2. In the 3 trials reviewed, patients who received cryoanalgesia reported 21.38%, 28.33%, and 31.53% less average relative postoperative pain than controls on the visual analog scale. Review of secondary outcomes suggested no significant difference in time to resume normal diet (2 studies) or postoperative bleeding (2 studies) between the 2 groups. Cryoanalgesia allowed patients to return to work 4 days earlier than controls in 1 study. Two studies reported a trend toward less postoperative analgesia use among the treatment group; however, no statistical conclusions could be drawn.

Conclusion:

The available evidence suggests that patients undergoing tonsillectomy with cryoanalgesia experience less average postoperative pain without additional complications.
Competing Through Categorization: Product- and Audience-Centric Strategies in an Evolving Categorical Structure
Authors: Kodeih Farah , Bouchikhi Hamid , Gauthier Valérie
Published: May 2018

We investigate how and why competing organizations position their similar products in categories of varying status. We studied the paired longitudinal case of the highly publicized contest between ESSEC and HEC, two French business schools, as they sought to position their core Grande Ecole program in the evolving international business education categorical structure. We conceptualize categorization as a competitive, relational process involving multiple actors and producing various meanings and perceptions. Our study (a) highlights the role of anticipated category status spillovers versus anticipated relative status within a category in producers’ entry decisions; (b) contrasts product- and audience-centric categorization strategies; and (c) shows the role of intermediaries in adjudicating categorization contests.
Unequal Consumers: Consumerist healthcare technologies and their creation of new inequalities
Authors: Visser Laura M. , Benschop Yvonne W.M. , Bleijenbergh Inge L. , van Riel Allard C.R.
Published: May 2018

This article examines how consumerist technology creates new inequalities among patients in healthcare. More specifically, we analyse a communication technology that presents a case of consumerization of patients. Using critical diversity literature, we theorize how consumerism embedded in technology assumes a ‘universal individual’, creating a tension for healthcare professionals between acknowledging differences among patients while aiming for equal treatment of all patients. Based on our empirical analysis of so-called personal online health communities, we explore, at the micro level, how healthcare professionals deal with this tension. We identify four different practices: lacking awareness of differences, downplaying differences, discomfort around acknowledging differences and actively accommodating differences. We theorize how they ultimately all create new inequalities.
Understanding entrepreneurial success: A phenomenographic approach
Authors: Angel Pablo , Jenkins Anna , Stephens Anna
Published: May 2018

Entrepreneurship research has predominately focused on firm-level conceptions of success and the personal factors that help predict them but has stopped short of investigating what it means to entrepreneurs. When entrepreneurial success has been studied at the individual level, the approach has been to identify common success criteria and examine the importance of these to the entrepreneur. However, criteria-based approaches overlook the possibility that entrepreneurs may ascribe different meanings to common success criteria, and this can influence how entrepreneurs develop their firms. In this article, we adopt a phenomenographic approach to explore what success means to entrepreneurs. Our analysis reveals four qualitatively distinct understandings of entrepreneurial success and shows that entrepreneurs interpret common success criteria differently depending on their underlying understanding of success. These findings extend the literature on entrepreneurial success by illustrating that entrepreneurs not only vary in the importance they place on different success criteria but also vary in how they understand these different success criteria.
Fragility of strong media effects in authoritarian environment (Evidence from Russia)
Authors: Savin Nikita , Kashirskikh Oleg , Mavletova Aigul
Published: May 2018

The article is devoted to the issue to what extent mass media produces strong attitudes in an authoritarian political environment. A growing body of research scrutinizes how contemporary autocracies use media to promote legitimizing messages and undermine opposition. This study contributes to the literature by showing whether public opinion formed under authoritarianism is strong in the face of counterframing. While Russian state-owned TV-channels extensively promoted the idea that Donald Trump’s victory will be positive for Russian-American relations, we run an experimental study with various treatments. We revealed two major findings: (1) participants are strongly exposed to counterframing and (2) those who watch news on state-owned TV-channels are more susceptible to the counterframing effect.
Lexical accent perception in highly-proficient L2 Japanese learners: The roles of language-specific experience and domain-general resources
Authors: Goss Seth J , Tamaoka Katsuo
Published: May 2018

This article reports empirical findings on the roles of domain-general resources and language-specific experience in the second language (L2) acquisition of Japanese lexical pitch accent. Sixty-one advanced-proficiency L2 Japanese learners from two first languages (L1s), Mandarin Chinese and Korean, identified and categorized Japanese nouns embedded in short sentences in two aurally-presented tasks. Mixed effects models showed that although the tonal-language Chinese group outperformed non-tonal Korean speakers, L2 lexical knowledge, but not overall proficiency or learning experience, predicted performance on both perception tasks regardless of L1, suggesting that long-term knowledge of L2 phonological structure facilitates perception of lexical-level prosody. Domain-general resources, however, played no predictive role in advanced learners’ accent perception. A decision-tree analysis then revealed further divergence in perception accuracy by accent pattern, L1, and task type. Taken together, the results establish a close connection between language learning experience and L2 speech perception at the advanced level, and highlight the complexity inherent in the learning of non-native prosodic categories.
Life-cycle cost as basis to optimize waste collection in space and time: A methodology for obtaining a detailed cost breakdown structure
Authors: Sousa Vitor , Dias-Ferreira Celia , Vaz João M , Meireles Inês
Published: May 2018

Extensive research has been carried out on waste collection costs mainly to differentiate costs of distinct waste streams and spatial optimization of waste collection services (e.g. routes, number, and location of waste facilities). However, waste collection managers also face the challenge of optimizing assets in time, for instance deciding when to replace and how to maintain, or which technological solution to adopt. These issues require a more detailed knowledge about the waste collection services’ cost breakdown structure. The present research adjusts the methodology for buildings’ life-cycle cost (LCC) analysis, detailed in the ISO 15686-5:2008, to the waste collection assets. The proposed methodology is then applied to the waste collection assets owned and operated by a real municipality in Portugal (Cascais Ambiente – EMAC). The goal is to highlight the potential of the LCC tool in providing a baseline for time optimization of the waste collection service and assets, namely assisting on decisions regarding equipment operation and replacement.
A High School Replication of Targeted Professional Development for Classroom Management
Authors: Freeman Jennifer , Kowitt Jennifer , Simonsen Brandi , Wei Yan , Dooley Kate , Gordon Lola , Maddock Eleanor
Published: May 2018

In areas of emerging research, such as supporting teachers’ classroom management, replication of research is critical to ensuring that recommendations for the field are based on sound science and appropriate for the contexts to which they are being applied. This article describes a replication of research on efficient professional development supports for teachers’ classroom managements in a new context: high school classrooms. Data did not support a functional relation between teachers’ use of specific praise and the targeted professional development and self-management in the high school setting. Results of this study highlight the critical importance of replication in education research. Based on our findings and our experience conducting this study, we suggest several possible adaptations may be necessary for successful replication at the high school level.
Genetic Enhancements and Relational Autonomy: Christian Ethics and the Child’s Autonomy in Vulnerability
Authors: Massmann Alexander
Published: May 2018

Technical advances in genome editing methods raise the question how autonomy should figure in theological ethical debates about genetic enhancements. Thinking primarily of the parents’ reproductive autonomy, several secular and theological thinkers argue parents should be allowed to ‘enhance’ an embryo genetically. Jürgen Habermas’s critique of enhancements in the name of the child’s autonomy, meanwhile, has been met with a critique of autonomy in theology. This article argues that theological views about God’s relationship to the creature provide strong theological grounds for a new appropriation of autonomy. A liberal maximisation of individual choice is to be viewed critically, but more recent discourses on relational autonomy see certain forms of vulnerability contribute to a communal understanding of autonomy. This view dovetails with Habermas’s argument, according to which enhancements create too strong a temptation towards overly directive parenting—less in modifying an embryo than in the ensuing relationship to the child.
Freud’s psychoanalysis, contemporary cognitive/social psychology, and the case against introspection
Authors: Lo Dico Giuseppe
Published: May 2018

Although Freud and contemporary cognitive/social psychologists differ with regards to various traditions, vocabularies, methods, and areas of application, they agree in their criticism of the use of introspection as a means of inquiring about the mind. They share not only a strong outlook against introspection but both go so far as to make some outright arguments against introspection. Very briefly, it seems that both of these approaches conceive of introspection and the data stemming from it as hindrances to the construction of a science of mind. After presenting the theoretical assumptions and methodological underpinnings of contemporary cognitive/social psychology and Freud’s psychoanalysis, this article will compare them so as to highlight their differences and commonalities. The paper will conclude by arguing that both approaches appear to reject introspection as a method of inquiry because each understands psychology to be a natural science that is free from subjectivity.
Titanium dioxide nanoparticles induce in vitro autophagy
Authors: Dai X , Liu R , Li N , Yi J
Published: May 2018

Aim:

Concerns about the possible toxicity to environment and human health of titanium dioxide nanoparticles (TiO2 NPs) are increasing. The aim of this study was to investigate the relationship between toxicology and autophage in vitro.

Methods:

RAW 264.7 cells were exposed to five concentrations (50, 100, 200, 300, and 400 μg/mL) and two particle size of TiO2 NPs (30 and 100 nm) for 24 h.

Results:

The results showed that TiO2 NPs decreased cell viability, phagocytic rate, and phagocytic index in a concentration-dependent manner, thereby inducing autophagy. TiO2 NPs-induced autophagy was indicated by monodansyl cadaverine staining and transmission electron microscopy. TiO2 NPs-induced messenger RNA expression of autophagy-related proteins LC3 and Beclin-1 was also significantly increased compared with those of the unexposed control cells. LC3 and Beclin-1 protein expression levels were markedly increased with the increase of TiO2 NPs concentrations.

Conclusion:

These results suggest the possibility that TiO2 NPs-induced toxicology probably plays a key role in autophagy in RAW 264.7 cells, and further exhaustive research on the harmful effects of these NPs in relevant organisms is needed for their safe application.
Group Medical Visits as Participatory Care in Community Health Centers
Authors: Thompson-Lastad Ariana
Published: May 2018

In this article, I examine group medical visits, a clinic-based intervention that aims to improve patient health by combining clinical care, health education and peer support. Research shows that health care inequalities are reproduced through the interplay of interpersonal, institutional, and structural factors. I examine changing social relations made possible by group visits, including peer support and an expanded role for patient knowledge. The qualitative data presented here are part of a mixed-methods study of how group medical visits and integrative medicine are combined and implemented for low-income people with chronic conditions. I find that patients take active roles in each other’s care, supporting, challenging, and advocating in ways that shift patient-provider relationships. Such shifts demand reflection about what kinds of knowledge matter for health. Health care encounters can reproduce inequality for marginalized patients; this study suggests group visits can restructure patient-provider encounters to interrupt healthcare inequalities.
Implementation and Intervention Practices to Facilitate Communication Skills for a Child With Complex Communication Needs
Authors: Chazin Kate T. , Barton Erin E. , Ledford Jennifer R. , Pokorski Elizabeth A.
Published: May 2018

For children with complex communication needs (CCN), augmentative and alternative communication (AAC) devices offer a means to communicate and participate in daily activities. Effective implementation and intervention practices are needed for supporting teaching teams working with children with CCN to improve child use of AAC. The purpose of this article is to describe two studies examining these issues. Study 1 examined the effects of a behavior skills training (BST) approach to professional development to support a classroom teaching team in the implementation of a behavior support plan for a child with CCN; Study 2 evaluated the effects of a single behavior (adult modeling) on AAC use. Results indicated teachers increased their fidelity with training and coaching, but not with training alone. Further, unprompted use of the AAC device occurred more frequently when an adult modeled use of the device.
Experimental study on wheel-spoke crossed cable structures
Authors: Hu Zongyu , Wang Jun , Zhao Jida , Chen Yiyi
Published: May 2018

Wheel-spoke crossed cable structure is a new type of cable-strut structure. In this article, the tension forming and static performance of wheel-spoke crossed cable structure are experimentally investigated by testing four scale models under full-span and half-span downward uniform load, and the effect of structural parameters including variable prestress level, height difference between inner ring and outer ring, and layer height of inner ring is studied by finite element method as well. The test results indicate that radial cables tensioning scheme is effective for wheel-spoke crossed cable structure to reach initial prestress state, and wheel-spoke crossed cable structure possesses excellent load-carrying capacity and structural stiffness since internal forces and vertical displacements of models vary almost linearly under such load cases. Moreover, the static test results are in good agreement with the finite element analysis results, confirming that the model design, measurement methods, and loading schemes are reasonable. Therefore, the results of this study can provide valuable reference for the design and application of wheel-spoke crossed cable structure.
Deconstructing datafication’s brave new world
Authors: Couldry Nick , Yu Jun
Published: May 2018

As World Economic Forum’s definition of personal data as ‘the new “oil” – a valuable resource of the 21st century’ shows, large-scale data processing is increasingly considered the defining feature of contemporary economy and society. Commercial and governmental discourse on data frequently argues its benefits, and so legitimates its continuous and large-scale extraction and processing as the starting point for developments in specific industries, and potentially as the basis for societies as a whole. Against the background of the General Data Protection Regulation, this article unravels how general discourse on data covers over the social practices enabling collection of data, through the analysis of high-profile business reports and case studies of health and education sectors. We show how conceptualisation of data as having a natural basis in the everyday world protects data collection from ethical questioning while endorsing the use and free flow of data within corporate control, at the expense of its potentially negative impacts on personal autonomy and human freedom.
Peer scaffolding techniques and approaches in preschool children’s multiliteracy practices with iPads
Authors: Kirova Anna , Jamison Nicole M
Published: May 2018

This article presents findings from a 4-month qualitative intrinsic case study that examined 25 preschool children’s early multiliteracy experiences and technology uses within the context of their homes and classroom. First, to find out about the different forms of technology and literacy practices the children participated in within their homes and classroom, we surveyed 13 parents and the two classroom teachers. Next, we conducted regular in-class observations, interviewed seven children about their digital experiences, and analyzed digital artifacts created on the iPads. Vygotsky’s sociocultural theory of learning grounded our interpretation of the classroom events and artifacts regarding multiliteracy practices. We gave special attention to the role of adult and peer scaffolding. This article briefly outlines the process of teacher scaffolding and discusses in detail the instances of peer scaffolding that emerged. Of importance were two video series that demonstrated a more capable peer using various strategies and approaches to scaffold her peers in creating digital literacy texts. Based on the data, we argue that more capable peers can be important sources for scaffolding young children’s multiliteracy experiences in preschool classroom contexts. The findings from this study offer teachers and educational researchers insights into how young children may be engaged in and scaffolded by both teachers and peers in their multiliteracy practices prior to formal schooling.
Modeling adverse event counts in phase I clinical trials of a cytotoxic agent
Authors: Muenz Daniel G , Braun Thomas M , Taylor Jeremy MG
Published: May 2018

Background/Aims

The goal of phase I clinical trials for cytotoxic agents is to find the maximum dose with an acceptable risk of severe toxicity. The most common designs for these dose-finding trials use a binary outcome indicating whether a patient had a dose-limiting toxicity. However, a patient may experience multiple toxicities, with each toxicity assigned an ordinal severity score. The binary response is then obtained by dichotomizing a patient’s richer set of data. We contribute to the growing literature on new models to exploit this richer toxicity data, with the goal of improving the efficiency in estimating the maximum tolerated dose.

Methods

We develop three new, related models that make use of the total number of dose-limiting and low-level toxicities a patient experiences. We use these models to estimate the probability of having at least one dose-limiting toxicity as a function of dose. In a simulation study, we evaluate how often our models select the true maximum tolerated dose, and we compare our models with the continual reassessment method, which uses binary data.

Results

Across a variety of simulation settings, we find that our models compare well against the continual reassessment method in terms of selecting the true optimal dose. In particular, one of our models which uses dose-limiting and low-level toxicity counts beats or ties the other models, including the continual reassessment method, in all scenarios except the one in which the true optimal dose is the highest dose available. We also find that our models, when not selecting the true optimal dose, tend to err by picking lower, safer doses, while the continual reassessment method errs more toward toxic doses.

Conclusion

Using dose-limiting and low-level toxicity counts, which are easily obtained from data already routinely collected, is a promising way to improve the efficiency in finding the true maximum tolerated dose in phase I trials.