bluuebunny/crossref_metadata_2025 huggingface dataset:
Partial-volume correction increases estimated dopamine D2-like receptor binding potential and reduces adult age differences
Authors: Smith Christopher T , Crawford Jennifer L , Dang Linh C , Seaman Kendra L , San Juan M Danica , Vijay Aishwarya , Katz Daniel T , Matuskey David , Cowan Ronald L , Morris Evan D , Zald David H , Samanez-Larkin Gregory R
Published: November 2017

The relatively modest spatial resolution of positron emission tomography (PET) increases the likelihood of partial volume effects such that binding potential (BPND) may be underestimated. Given structural grey matter losses across adulthood, partial volume effects may be even more problematic in older age leading to overestimation of adult age differences. Here we examined the effects of partial volume correction (PVC) in two studies from different sites using different high-affinity D2-like radioligands (18 F-Fallypride, 11C-FLB457) and different PET camera resolutions (∼5 mm, 2.5 mm). Results across both data sets revealed that PVC increased estimated BPND and reduced, though did not eliminate, age effects on BPND. As expected, the effects of PVC were smaller in higher compared to lower resolution data. Analyses using uncorrected data that controlled for grey matter volume in each region of interest approximated PVC corrected data for some but not all regions. Overall, the findings suggest that PVC increases estimated BPND in general and reduces adult age differences especially when using lower resolution cameras. The findings suggest that the past 30 years of research on dopamine receptor availability, for which very few studies use PVC, may overestimate effects of aging on dopamine receptor availability.
Community Involvement in Health Systems Strengthening to Improve Global Health Outcomes: A Review of Guidelines and Potential Roles
Authors: Sacks Emma , Swanson Robert C. , Schensul Jean J. , Gleave Anna , Shelley Katharine D. , Were Miriam K. , Chowdhury A. Mushtaque , LeBan Karen , Perry Henry B.
Published: October 2017

Definitions of health systems strengthening (HSS) have been limited in their inclusion of communities, despite evidence that community involvement improves program effectiveness for many health interventions. We review 15 frameworks for HSS, highlighting how communities are represented and find few delineated roles for community members or organizations. This review raises the need for a cohesive definition of community involvement in HSS and well-described activities that communities can play in the process. We discuss how communities can engage with HSS in four different areas—planning and priority-setting; program implementation; monitoring, evaluation, and quality improvement; and advocacy—and how these activities could be better incorporated into key HSS frameworks. We argue for more carefully designed interactions between health systems policies and structures, planned health systems improvements, and local communities. These interactions should consider local community inputs, strengths, cultural and social assets, as well as limitations in and opportunities for increasing capacity for better health outcomes.
Technological Factors and Student-to-Student Connected Classroom Climate in Cloud Classrooms
Authors: MacLeod Jason , Yang Harrison Hao , Zhu Sha , Shi Yinghui
Published: October 2017

In an effort to address student engagement challenges, much research has explored student-to-student connected classroom climate (CCC). Research positively associates CCC to the benefits of student integration, learning, and retention in face-to-face environments. However, few studies have examined CCC in computer-mediated environments. This study provides empirical evidence of the relationships between key technological factors and CCC in cloud classrooms. A survey was administered to 641 college students, and the results indicate that four of the five technological factors examined were positively associated with CCC: advanced computer self-efficacy, program/software computer experience, Internet/entertainment computer experience, and computer importance. Basic computer self-efficacy was not related to CCC. These findings identify mechanisms that can improve CCC in cloud classrooms. Researchers and practitioners should use this knowledge to develop, implement, and assess the cloud classroom. In addition, this study contributes knowledge that can direct student training of digital literacies for improving the learning processes of cloud classrooms in higher education.
Writing Quality Manuscripts for the Clothing and Textiles Research Journal
Authors: Pedersen Elaine L.
Published: October 2017

The purpose of this article is to discuss the components of a quality Clothing and Textiles Research Journal ( CTRJ) manuscript from the perspectives of different categories of scholarship including qualitative or quantitative data analyses. The expectations for the content and quality of the typical manuscript sections are discussed. These sections commonly include the introduction, review of literature, method, results, and conclusion, although terminology may vary according to varied disciplinary norms. The conceptual or theoretical framework segment is also discussed. Overall, conceptual terms should be used consistently, key concepts/variables should be defined, the manuscript should be clearly and logically organized, and the writing should be clear, careful, and logical. Ethics and intellectual property rights are discussed as is the CTRJ review process.
Multimorbidity Profiles in German Centenarians: A Latent Class Analysis of Health Insurance Data
Authors: Gellert Paul , von Berenberg Petra , Zahn Thomas , Neuwirth Julia , Kuhlmey Adelheid , Dräger Dagmar
Published: October 2017

Objectives: Multimorbidity in centenarians is common; although investigations of the prevalence of morbidity in centenarians are accumulating, research on profiles of co-occurrence of morbidities is still sparse. Our aim was to explore profiles of comorbidities in centenarians. Method: Health insurance data from 1,121 centenarians comprising inpatient and outpatient diagnoses from the past 5 years (2009-2013) were analyzed using latent class analysis with adjustments for sex, age, hospitalization, and long-term care. Results: Four distinct comorbidity profiles emerged from the data: 36% of centenarians were categorized as “age-associated”; 18% had a variety of comorbidities but were not diabetic were labeled “multimorbid without diabetes”; 9% were labeled “multimorbid with diabetes”; and 36% “low morbidity.” Conclusion: Patterns of comorbidities describe the complexity of geriatric multimorbidity more appropriately than an approach focused on a single disease. The profiles described by this specific research may inform clinicians and health care planners for the oldest old.
Effect of immunosuppressive therapies on survival of systemic lupus erythematosus: a propensity score analysis of a longitudinal cohort
Authors: Mok C C , Tse S M , Chan K L , Ho L Y
Published: October 2017

Objectives

The aim of this study was to study the relationship between immunosuppressive drug treatment and survival in patients with systemic lupus erythematosus (SLE).

Methods

Patients who fulfilled four or more American College of Rheumatology criteria for SLE were followed longitudinally. Clinical characteristics, use of immunosuppressive agents and mortality were reviewed. Cox regression was used to study the relationship between immunosuppressive treatment and survival, adjusted for age, sex, vascular risk factors, organ damage, the anti-phospholipid antibodies and a propensity score for the indication of individual immunosuppressive agent derived from separate regression models.

Results

A total of 803 SLE patients were studied (92% women; age of SLE onset 33.2±14 years; follow-up time 10.8±7.7 years). The frequencies of ever use of immunosuppressive agents were: high-dose prednisolone (≥0.6 mg/kg/day for ≥4 weeks) (85%), azathioprine (63%), cyclophosphamide (25%), mycophenolate mofetil (27%), the calcineurin inhibitors (23%) and hydroxychloroquine (69%). Ninety-seven patients (12%) died and 56 (7%) patients were lost to follow-up. The causes of death were infection (44%), cerebrovascular events (12%), cardiovascular events (10%) and malignancy (8.2%). Cox regression revealed that the ever use of high-dose prednisolone, mycophenolate mofetil, calcineurin inhibitors or cyclophosphamide was not significantly associated with improved survival. However, the ever use of hydroxychloroquine (hazard ratio 0.59 (0.37–0.93); P=0.02) and azathioprine (hazard ratio 0.46 (0.28–0.75); P=0.002) was significantly associated with reduced mortality (41% and 54%, respectively) after adjustment for the propensity score and other confounding factors. A similar beneficial effect of hydroxychloroquine and azathioprine on survival was also observed in patients with lupus nephritis.

Conclusions

In this longitudinal cohort of Chinese SLE patients, the ever use of hydroxychloroquine and azathioprine was significantly associated with a probability of better survival. Treatment with high-dose prednisolone, cyclophosphamide, mycophenolate mofetil or the calcineurin inhibitors was not associated with long-term survival benefit.
Cutaneous vasculitis in systemic lupus erythematosus patients: potential key players and implications
Authors: Gheita T A , Abaza N M , Sayed S , El-Azkalany G S , Fishawy H S , Eissa A H
Published: October 2017

Objectives

The aim of the present work was to study the clinical characteristics of cutaneous vasculitis (CV) in systemic lupus erythematosus (SLE) patients and find possible potential key players in its development and implicated associations with the disease manifestations.

Patients and methods

Fifty adult female SLE patients underwent full history taking, thorough clinical examination and laboratory investigations. The SLE Disease Activity Index (SLEDAI) and accumulated damage using the Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI) were assessed.

Results

The mean age of the patients was 29.1 ± 6.1 years and was significantly lower in those with CV ( p = 0.018). The disease duration was 4.9 ± 3.7 years. CV was present in 30% of the patients. Musculoskeletal manifestations and hypocomplementemia were present in all patients with CV. The SLEDAI and SLICC/ACR DI tended to be higher in those with CV. Complement (C3 and C4) was significantly consumed in CV patients ( p < 0.0001). Antiphospholipids were comparable between those with and without CV. Lupus nephritis, cardiovascular manifestations and Sjögren syndrome were significantly linked to the development of CV ( p = 0.025, p = 0.023 and p < 0.0001, respectively). Both C3 and C4 showed a high sensitivity (93.3% and 86.7%) to detect CV in SLE at cut-off values below 81.4 mg/dl and 16.8 mg/dl, respectively.

Conclusion

CV is closely related to hypocomplementemia but not to antiphospholipids and is associated with lupus nephritis, musculoskeletal manifestations and Sjögren syndrome.
Social Reactions to Sexual Assault Disclosure: A Qualitative Study of Informal Support Dyads
Authors: Lorenz Katherine , Ullman Sarah E. , Kirkner Anne , Mandala Rupashree , Vasquez Amanda L. , Sigurvinsdottir Rannveig
Published: October 2017

This interview study examined 45 informal support dyads where sexual assault was disclosed. Analysis showed social reactions and appraisals of reactions varied by relationship type (family, friend, significant other). Themes identified were role reversal or “parentification” of supporters, reactions of anger and aggression toward perpetrators, supporters using their own trauma experiences to respond to survivors, and reactions of betrayal. Results revealed the potential for identifying relational patterns and dynamics occurring in social reactions through dyadic analysis not otherwise captured by a survivor-only perspective. This approach helps understand and address distinct relationship contexts to improve supporters’ reactions to sexual assault disclosure.
Effects of postharvest oligochitosan treatment on fungal diseases and defence responses in Dongxue peach fruit
Authors: Chen Chen , Hu Wenzhong , Zhang Ruidong , Jiang Aili
Published: October 2017

In this study, the effects of oligochitosan treatment on controlling postharvest diseases in Dongxue peach ( Prunus Persica L. Batsch, cv Dongxuemi) were examined and the possible underlying mechanisms were discussed. Results showed that the disease incidence and lesion area in peach fruit inoculated with Monilinia fructicola and Penicillium expansum were all remarkably reduced by oligochitosan treatment. Oligochitosan treatment inhibited spore germination and mycelial growth of the two fungi in vitro. Oligochitosan treatment also induced upregulation of the salicylic acid signalling pathway-related genes (NPR1, PR1 and phenylalanine ammonia lyase) and enhanced the levels of total phenolics, flavonoids and lignin in peach. Meanwhile, enzymatic activities of superoxide dismutase, catalase, polyphenoloxidase, ascorbate peroxidase and phenylalanine ammonia lyase also increased. These findings suggest that the effects of oligochitosan on the disease control of peach fruit may be associated with its direct antimicrobial effects as well as increasing antioxidant, phenylpropanoid metabolism and accumulating antifungal compounds by activating the salicylic acid-dependent pathway.
The Principal and Nurse Perspective on Gaps in Asthma Care and Barriers to Physical Activity in New York City Schools: A Qualitative Study
Authors: Cain Agnieszka , Reznik Marina
Published: October 2017

Background. School officials and nurses play an important role in facilitating asthma management in schools. Little is known about their perspectives on in-school asthma management and barriers to physical activity (PA) at school. Aims. The goal of this study is to explore school officials’ and nurses’ perspectives on asthma care and barriers to PA in children with asthma attending New York City schools. Method. We conducted qualitative, semistructured interviews with 10 principals, 3 assistant principals, and 9 nurses in 10 Bronx, New York elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and coded for common themes. The thematic and content review was subsequently used to analyze interview data. Emerging themes were discussed and agreed on by both investigators. Results. Three main categories arose from the analysis: (1) procedures and policies around asthma management in school, (2) barriers to effective medication administration in school, and (3) barriers to PA in children with asthma. Discussion. Participants identified gaps to in-school asthma management and barriers to PA participation: ineffective ways of identifying students with asthma; lack of written procedures for asthma management; difficulty in meeting the administrative requirements to administer asthma medication; lack of knowledge and training on asthma management for the parents, students, and school staff; parental limitation of children’s PA; and schools not meeting the state physical education requirement. Conclusions. Our findings suggest the need for policy reform on asthma management and PA in urban schools and should be considered in the design of future interventions.
Antiwear and extreme pressure performance of castor oil with nano-additives
Authors: Gupta Rajeev Nayan , Harsha AP
Published: October 2017

The aim of the present study is to examine the antiwear, antifriction, and extreme pressure performance of castor oil with nano-additives by using a four-ball tester. CeO2 (≈90 nm) and polytetrafluroethylene (≈150 nm) nanoparticles were used as an additive in castor oil with four different concentrations in the range of 0.1–1.0% w/v. The suspension stability of the nanoparticles was improved by using sodium dodecyl sulfate as a dispersant. Different analytical tools were used to characterize the nanoparticles parameter (i.e. shape and size) as well as the worn surfaces. The additive concentration was optimized on the basis of tribological performance. The test results of antiwear and extreme pressure property have been reported on the basis of wear scar diameter and weld load, respectively. For the antiwear test, it was observed that the maximum reduction in the wear scar diameter was 37.4 and 35.3% at an optimum concentration of CeO2 and polytetrafluroethylene additive, respectively. Also, antifriction and load carrying properties of castor oil were significantly improved with the addition of nanoparticles as an additive in a small amount. The mechanism for such improvement in the tribological behavior has also been discussed.
Product placement on YouTube: An explorative study on YouTube creators’ experiences with advertisers
Authors: Gerhards Claudia
Published: October 2017

During its process of diffusion, YouTube has become increasingly attractive for advertisers, not only in terms of classical commercials (like pre-roll ads) but also in terms of product placement opportunities. This article aims to explore the processes between YouTube creators and advertisers concerning product placement enquiries. For this purpose, YouTube creators from Germany ( n = 57) answered an online survey about their experiences with advertisers. The creators covered a wide range of YouTube channel genres (beauty, fashion, comedy, gaming, cooking) and differed in number of subscribers. Some creators who took part in the survey had less than 20,000 subscribers, others had between 20,000 and 500,000 subscribers and still others had more than 500,000 subscribers. How often do YouTube creators use product placement? Is paid-for placement an important source of finance for them? How professional are the relations and processes between YouTube creators and advertisers? Before presenting and discussing the results of the empirical survey of the current use of product placement, a brief history of how YouTube has become a marketing space for advertisers is provided.
Handling of spatially truncated source fields based on pressure time derivatives in hybrid computational aeroacoustics
Authors: Schröder Thorben , von Estorff Otto
Published: October 2017

In hybrid computational aeroacoustics, the acoustic computation domain is oftentimes larger than the domain of the flow simulation. Consequently, discontinuities of the source field occur on the acoustic mesh, which can diminish the quality of the results. A common way to handle truncated source fields is spatial windowing. The present work focuses on aeroacoustic approaches that use time derivatives of the incompressible base flow pressure as acoustic source terms and their distinctive character with respect to source domain truncation. Especially for those approaches, a novel alternative to spatial windowing is proposed, which uses a simplified pressure field continuation beyond the source domain. Numerical results display that spatial windowing and simplified pressure field continuation can both treat truncated source fields effectively. The windowing approach is computationally cheaper but exhibits issues for small flow computation domains. The simplified pressure field continuation can overcome these and other issues yielding very good results while adding little computational cost.
Continuous dynamic monitoring of a prestressed concrete bridge based on strain, inclination and crack measurements over a 14-year span
Authors: Hu Wei-Hua , Said Samir , Rohrmann Rolf G , Cunha Álvaro , Teng Jun
Published: October 2017

The Westend Bridge is located on the A100 Highway in Berlin. An integrated continuous dynamic monitoring system, composed of 20 velocity sensors, 5 temperature sensors, 3 strain gauges, 2 inclination sensors and 1 crack sensor was implemented by the Federal Institute for Materials Research and Testing (BAM) in 2000. The system runs continuously with occasional intermittence and leads to a huge amount of data over a 14-year span. In this article, variations of the strain, crack and inclination measurements during the last 14 years are presented. It is noted that the observed crack and inclination of the bridge are strongly influenced by seasonal temperature variation. It further induces change in the relationship between the strains measured in both concrete and prestressed tendon. Application of k-means cluster analysis technique in both the crack and strain measurements can partition them into different seasonal phases by identifying ‘turning points’ that indicate annual periodical bridge change. In the period of these two ‘turning points’, a strong linear relation of the strains in two materials is observed. In the rest of the year, a nonlinear relationship between the strains recorded in both the concrete and the prestressed tendon is noted. The possible reason is the additional thermal load due to the change in temperature difference between the bridge’s surface and soffit. Finally, a health index in a framework of regression model and process control theory is proposed by investigating the linear relationship between the strains in concrete and prestressed tendon. The tendency of the health index in the 14 years may suggest the long-term bridge change during that time frame.
A crack growth–based individual aircraft monitoring method utilising a damage metric
Authors: White Paul , Mongru David , Molent Lorrie
Published: October 2017

The need and benefits of individual aircraft fatigue monitoring are now well established. There are broadly two fatigue damage methods employed for this purpose, namely, crack growth and stress (or strain)-life. The crack growth methods tend to provide a relative comparison between an aircraft’s usage and a baseline usage, while the strain-life methods provide a measure of the amount of fatigue life consumed against that (generally) demonstrated through a fatigue test. In this article, a new crack growth–based tracking method is described that also includes a measure of the certified fatigue life consumed. The damage model is compared against the results of an extensive coupon fatigue test programme for aluminium alloy 7050-T7451.
Ready for Change? Emotions and Resistance in the Face of Social Justice Leadership
Authors: Murray-Johnson Kayon , Guerra Patricia L.
Published: October 2017

Inspired by true events, this case presents how the Northwestern Elementary leadership team confronts the challenges of deficit thinking on their campus. An action research study uncovers a glaring lack of cultural responsiveness in practice, concerning Black and Hispanic students. Motivated by these findings, Anne, a White principal and Myra, a Hispanic assistant principal, begin the first of several workshops on culturally responsive classrooms. However, they quickly discover surprising guests—their own challenging emotions, evoked by dialogue Anne initiates with staff—and disturbing emotional reactions from several staff members. How can they lead for social justice with these feelings?
Endovascular treatment of middle cerebral artery aneurysms: A single center experience with a focus on thromboembolic complications
Authors: Link Thomas W , Boddu Srikanth R , Hammad Hoda T , Knopman Jared , Lin Ning , Gobin Pierre , Patsalides Athos
Published: October 2017

Background

Endovascular treatment of middle cerebral artery (MCA) aneurysms has traditionally been considered difficult due to complex branching patterns, frequent involvement of parent vessels within the aneurysm neck, and a high incidence of thromboembolic complications.

Methods

The cases of 93 MCA aneurysms treated with endovascular intervention at our institution between 2003 and 2015 were retrospectively reviewed. Demographic, clinical, and radiographic variables were recorded and analyzed.

Results

Immediate complete or near-complete occlusion was achieved in 81 (90%) cases. At the longest follow up of 6 months or greater, 83.3% of the aneurysms were stable-to-improved in the Raymond occlusion classification, 8.3% were found to have minor recanalization not requiring retreatment, and 8.3% required retreatment due to significant recanalization. Thromboembolic events occurred in 18 (19.3%) of cases, but only 1 resulted in permanent vessel occlusion and only 1 resulted in permanent neurologic impairment. Thrombus was resolved with intra-arterial thrombolysis or mechanical thrombectomy in 17 of the 18 cases. There were only two cases resulting in morbidity (2.15%). There was no statistically significant correlation between aneurysm location, size, morphology, or use of adjuvant device with radiographic outcome or thromboembolic event.

Conclusions

While the rate of thromboembolic events in our series was 19%, the overall morbidity was only 2%. This highlights the fact that even complex MCA aneurysms can safely and effectively be treated by endovascular means with or without the use of balloon or stent assistance, as long as the interventionalist is astutely aware of the possibility of thrombus formation and acts accordingly with thrombolytic therapy when necessary.
Causes and Effects of Forest Fires in Tropical Rainforests: A Bibliometric Approach
Authors: Juárez-Orozco S. M. , Siebe C. , Fernández y Fernández D.
Published: October 2017

Despite their humid environment, tropical rainforests are threatened by fires that negatively impact their ecological and economic value. However, fires in these ecosystems have been investigated to a far lesser degree compared with temperate or seasonally dry forests. We performed a bibliometric analysis to identify knowledge gaps in rainforest fire studies from 1981 to 2015. Through an analysis of the temporal and spatial research trends, we aimed to evaluate the main drivers that motivate investigations in this field of study. In total, we recorded 366 publications in indexed journals. Approximately 60% of these studies were conducted in four countries. The number of publications tended to increase after El Niño years. A word co-occurrence network revealed a strong relationship between land use change and fires and the role of fire in agricultural and ecosystem traits. We conclude that socioeconomic drivers, deforestation, and global climate change should be considered to gain a better understanding of the occurrence of forest fires. Further studies should include the cause, intensity, and recurrence of fires, since they determine the effects of fire on the soil and biota (fire severity). The spatiotemporal patterns of forest fires require further study to develop strategies for good agricultural production and to predict successional routes after fires. These identified gaps in the research on forest fires could guide decision-making toward the prevention of further fire expansion or at least to reduce its negative effects in tropical rain forests.
Cold-perfusion decellularization of whole-organ porcine pancreas supports human fetal pancreatic cell attachment and expression of endocrine and exocrine markers
Authors: Elebring Erik , Kuna Vijay K , Kvarnström Niclas , Sumitran-Holgersson Suchitra
Published: October 2017

Despite progress in the field of decellularization and recellularization, the outcome for pancreas has not been adequate. This might be due to the challenging dual nature of pancreas with both endocrine and exocrine tissues. We aimed to develop a novel and efficient cold-perfusion method for decellularization of porcine pancreas and recellularize acellular scaffolds with human fetal pancreatic stem cells. Decellularization of whole porcine pancreas at 4°C with sodium deoxycholate, Triton X-100 and DNase efficiently removed cellular material, while preserving the extracellular matrix structure. Furthermore, recellularization of acellular pieces with human fetal pancreatic stem cells for 14 days showed attached and proliferating cells. Both endocrine (C-peptide and PDX1) and exocrine (glucagon and α-amylase) markers were expressed in recellularized tissues. Thus, cold-perfusion can successfully decellularize porcine pancreas, which when recellularized with human fetal pancreatic stem cells shows relevant endocrine and exocrine phenotypes. Decellularized pancreas is a promising biomaterial and might translate to clinical relevance for treatment of diabetes.
Platelets from donors with consistently low HLA-B8, -B12, or -B35 expression do not undergo antibody-mediated internalization
Authors: Saris Anno , Tomson Bert , Brand Anneke , Mulder Arend , Claas Frans H. , Lorinser Jos , Scharenberg John , van Ham S. Marieke , ten Brinke Anja , Zwaginga Jaap Jan , van der Meer Pieter F.
Published: November 2017

Key Points

HLA-B8, -B12, or -B35 expression on platelets varies significantly between donors and in certain donors is consistently low or undetectable. Antibody-mediated internalization of platelets correlates with antigen expression and is absent in platelets with low HLA expression.
Geophysics Bright Spots
Authors: Krohn Christine
Published: November 2017

Welcome to the new Bright Spots. This column, which was originally started by Steve Hill, spotlights a few upcoming Geophysics papers nominated by the editors. This is my first column, and I appreciate Valentina Socco for giving me this incentive to continue to read Geophysics during my retirement. I hope to encourage greater perusal of these outstanding and diverse groups of papers, beginning with this collection from the November-December 2017 issue.
Memorial
Authors: Abdullayev Nazim
Published: November 2017

The death of Yusif Shikhaliyev on 12 September 2017 at the peak of his activity is a huge loss to the Azerbaijani geophysical community. For many years, Shikhaliyev was an active participant in local geophysics community life, an ambassador for Azerbaijani geophysics abroad, and a friend to SEG.
Invited commentary on … Confusing procedures with process in cognitive bias modification research
Authors: Cristea Ioana A. , Kok Robin N. , Cuijpers Pim
Published: November 2017

The notion that cognitive bias modification should be appraised exclusively on the basis of trials where its postulated mechanisms were successfully changed starkly contradicts the standards of evidence-based psychotherapy. In the laboratory or as a treatment, cognitive bias modification cannot continue to eschew the rigorous scrutiny applied to other interventions.
Bosutinib Versus Imatinib for Newly Diagnosed Chronic Myeloid Leukemia: Results From the Randomized BFORE Trial
Authors: Cortes Jorge E. , Gambacorti-Passerini Carlo , Deininger Michael W. , Mauro Michael J. , Chuah Charles , Kim Dong-Wook , Dyagil Irina , Glushko Nataliia , Milojkovic Dragana , le Coutre Philipp , Garcia-Gutierrez Valentin , Reilly Laurence , Jeynes-Ellis Allison , Leip Eric , Bardy-Bouxin Nathalie , Hochhaus Andreas , Brümmendorf Tim H.
Published: November 2017

Purpose

Bosutinib is a potent dual SRC/ABL kinase inhibitor approved for adults with Philadelphia chromosome–positive chronic myeloid leukemia (CML) resistant and /or intolerant to prior therapy. We assessed the efficacy and safety of bosutinib versus imatinib for first-line treatment of chronic-phase CML.

Methods

In this ongoing, multinational, phase III study, 536 patients with newly diagnosed chronic-phase CML were randomly assigned 1:1 to receive 400 mg of bosutinib once daily (n = 268) or imatinib (n = 268). Per protocol, efficacy was assessed in patients who were Philadelphia chromosome–positive with typical (e13a2/e14a2) transcripts (bosutinib, n = 246; imatinib, n = 241). Patients with Philadelphia chromosome–negative–/ BCR-ABL1–positive status and those with unknown Philadelphia chromosome status and/or atypical BCR-ABL1 transcript type were excluded from this population.

Results

The major molecular response (MMR) rate at 12 months (primary end point) was significantly higher with bosutinib versus imatinib (47.2% v 36.9%, respectively; P = .02), as was complete cytogenetic response (CCyR) rate by 12 months (77.2% v 66.4%, respectively; P = .0075). Cumulative incidence was favorable with bosutinib (MMR: hazard ratio, 1.34; P = .0173; CCyR: hazard ratio, 1.38; P < .001), with earlier response times. Four patients (1.6%) receiving bosutinib and six patients (2.5%) receiving imatinib experienced disease progression to accelerated/blast phase. Among treated patients, 22.0% of patients receiving bosutinib and 26.8% of patients receiving imatinib discontinued treatment, most commonly for drug-related toxicity (12.7% and 8.7%, respectively). Grade ≥ 3 diarrhea (7.8% v 0.8%) and increased ALT (19.0% v 1.5%) and AST (9.7% v 1.9%) levels were more common with bosutinib. Cardiac and vascular toxicities were uncommon.

Conclusion

Patients who received bosutinib had significantly higher rates of MMR and CCyR and achieved responses faster than those who received imatinib. Consistent with the known safety profile, GI events and transaminase elevations were more common with bosutinib. Results indicate bosutinib may be an effective first-line treatment for chronic-phase CML.
Rare fungal infectious agents: a lurking enemy
Authors: Skiada Anna , Pavleas Ioannis , Drogari-Apiranthitou Maria
Published: October 2017

In the expanding population of immunocompromised patients and those treated in intensive care units, rare fungal infectious agents have emerged as important pathogens, causing invasive infections associated with high morbidity and mortality. These infections may present either asde novoor as breakthrough invasive infections in high-risk patients with hematologic malignancies receiving prophylactic or empirical antifungal therapy or in patients with central venous catheters. Diagnosis and treatment are challenging. Physicians should have a high index of suspicion because early diagnosis is of paramount importance. Conventional diagnostic methods such as cultures and histopathology are still essential, but rapid and more specific molecular techniques for both detection and identification of the infecting pathogens are being developed and hopefully will lead to early targeted treatment. The management of invasive fungal infections is multimodal. Reversal of risk factors, if feasible, should be attempted. Surgical debridement is recommended in localized mold infections. The efficacy of various antifungal drugs is not uniform. Amphotericin B is active against most yeasts, exceptTrichosporon, as well as againstMucorales,Fusarium, and some species ofPaecilomycesand dimorphic fungi. The use of voriconazole is suggested for the treatment of trichosporonosis and scedosporiosis. Combination treatment, though recommended as salvage therapy in some infections, is controversial in most cases. Despite the use of available antifungals, mortality remains high. The optimization of molecular-based techniques, with expansion of reference libraries and the possibility for direct detection of resistance mechanisms, is awaited with great interest in the near future. Further research is necessary, however, in order to find the best ways to confront and destroy these lurking enemies.
Recent advances in understanding/managing type 2 diabetes mellitus
Authors: Aschner Pablo
Published: October 2017

The treatment of type 2 diabetes mellitus has evolved in the present century toward safer and maybe more effective drugs, which in some cases can also reduce the risk of cardiovascular and renal outcomes. Nevertheless, we still need better strategies to reduce excess body weight in order to achieve diabetes remission, which is now a feasible target, as has been demonstrated with bariatric surgery. This review focuses on the significant advances in the management of blood glucose in type 2 diabetes mellitus, including the current understanding of the mechanisms of drug action but keeping in mind that the treatment of the disease is multifactorial.
Recent therapeutic advances in chronic lymphocytic leukemia
Authors: Bose Prithviraj , Gandhi Varsha
Published: October 2017

The last several years have witnessed a paradigm shift in the management of patients with chronic lymphocytic leukemia (CLL). The course of this very heterogeneous disease, traditionally treated with chemotherapeutic agents usually in combination with rituximab, typically has been characterized by remissions and relapses, and survival times vary greatly, depending on intrinsic biological attributes of the leukemia. The developments of the last few years have been transformative, ushering in an era of novel, molecularly targeted therapies, made possible by extensive efforts to elucidate the biology of the disease that predated the new targeted drugs. Thus, successful therapeutic targeting of the B-cell receptor signaling pathway and of the Bcl-2 anti-apoptotic protein with small molecules has now made chemotherapy-free approaches possible, hopefully mitigating the risk of development of therapy-related myeloid neoplasms and making eventual cure of CLL with the use of optimal drug combinations a realistic goal. Most importantly, these therapies have demonstrated unprecedented efficacy in patients with deletion 17p/TP53 mutation, a subset that historically has been very difficult to treat. However, as we gain more experience with the newer agents, unique safety concerns and resistance mechanisms have emerged, as has the issue of cost, as these expensive drugs are currently administered indefinitely. Accordingly, novel laboratory-based strategies and clinical trial designs are being explored to address these issues. The availability of whole exome/genome sequencing has given us profound insights into the mutational landscape of CLL. In this article, we highlight some of the most impactful advances since this topic was last reviewed in this journal.
Cancer complaints: The profile of patients from the emergency department of a Brazilian oncology teaching hospital
Authors: Batalini Felipe , Gomes Millena , I Fábio , Kuwae Flávio , Macanhan Giselle , Pereira Julio L.B.
Published: October 2017

Background: With the increase in prevalence of cancer in our society, we aim to clarify through primary data use what drives emergency department (ED) utilization among patients with cancer.

Methods: This is a cross-sectional study. A direct survey was applied to cancer patients over 277 visits in 2015. Variables including chief complaint for current and last visit, frequency of visits, primary tumor site, and demographics were collected.

Results: Pain was the most common complaint, responsible for 40% of visits, followed by constitutional symptoms (17%), and gastrointestinal complaints (11%). Abdominal pain was the single most noted pain type, with 18.4%, and had the highest rate of recurrence. It was followed by back pain, dyspnea, asthenia and fever, accounting for 8.5%, 8.5%, 8.1% and 7%, respectively. Cervical cancer represented 14.8% of patients, followed by breast (11.6%) and lung (7.6%) cancers. The majority of patients visited the emergency department less than once a month.

Conclusion: The drivers of emergency department utilization among patients with cancer found through primary use data mostly confirm findings from larger studies with secondary use data. Our research underscores the burden of pain to patients with cancer, as it is the most common complaint leading to ED visits, and generally requires multiple visits. Abdominal pain was more likely to recur than other complaints. Patients could benefit from focused outpatient pain management, and from more research and education targeting cancer-related pain.
Development of a deep neural network derived from contours defined by consensus-based guidelines for automatic target segmentation in hepatocellular carcinoma radiotherapy: A study protocol
Authors: Zhao Jiandong , Wang Jiazhou , Cheng Mingxia
Published: November 2017

Hepatocellular carcinoma (HCC) is a leading cause of cancer death in China and around the world. Tumoricidal doses of modern radiation therapy (RT) can now be safely delivered with excellent local control and minimal toxicity. Delivering adequate doses of radiation to the primary tumor, while preserving adjacent healthy organs, depends on accurate target identification.

In recent years, different novel machine learning techniques, including artificial intelligence technology, have been exploited in RT with impressive results in automatic image segmentation. If the machine learning algorithms are trained on delineated contours, according to consensus contouring guidelines, it promises greatly reduced interobserver and intraobserver variability in target delineation, thus substantially improving the quality and efficiency of HCC radiotherapy.

This study protocol proposes to develop a fully-automated target structure contouring system, which is based on deep neural networks trained on contours delineated according to consensus contouring guidelines in HCC radiotherapy. In addition, the study will evaluate the contouring system’s feasibility and performance during application in normal clinical operations. The study is ongoing (data analysis).
Trends in Hospitalization for Opioid Overdose among Rural Compared to Urban Residents of the United States, 2007‐2014
Authors: Mosher Hilary , Zhou Yunshou , Thurman Andrew L. , Sarrazin Mary Vaughan , Ohl Michael E.
Published: November 2017

Hospitalizations and deaths due to opioid overdose have increased over the last decades. We used data from the National Inpatient Sample and the American Community Survey to describe trends in hospitalization rates for opioid overdose among rural residents compared with urban residents in the United States from 2007 to 2014. Hospitalization rates for heroin overdose increased in all years and were higher in urban residents compared with rural residents (5.5 per 100,000 in large urban populations vs 2.1 per 100,000 in rural populations in 2014). In contrast, hospitalization rates for prescription opioid overdose were 20% to 30% higher in rural populations compared with large urban populations between 2007 and 2012, before declining in rural populations in 2013 and 2014. The proportion of rural patients admitted for overdose who are cared for in urban hospitals increased from 23.1% in 2007 to 41.2% in 2014. These trends are clinically relevant as rural patients and urban patients may have different discharge needs.
Helping Seniors Plan for Posthospital Discharge Needs Before a Hospitalization Occurs: Results from the Randomized Control Trial of PlanYourLifespan.org
Authors: Lindquist Lee A. , Ramirez‐Zohfeld Vanessa , Sunkara Priya D. , Forcucci Chris , Campbell Dianne S. , Mitzen Phyllis , Ciolino Jody D. , Kricke Gayle , Seltzer Anne , Ramirez Ana V. , Cameron Kenzie A.
Published: November 2017

BACKGROUND

Hospitalized seniors are frequently too sick to make informed decisions about their postdischarge care. Subsequently, loved ones often make support choices (eg, skilled nursing facility placement, caregivers) at discharge. We sought to advance the timeline for postacute care decisions to before a hospitalization occurs.

OBJECTIVE

Investigate the effect of PlanYourLifespan.org (PYL) on knowledge of posthospital discharge options.

DESIGN

Multisite randomized controlled trial.

SETTING/PATIENTS

Nonhospitalized adults, aged ≥65 years, living in urban, suburban, and rural areas of Texas, Illinois, and Indiana.

INTERVENTION

PYL is a national, publicly available tool that provides education on posthospital therapy choices and local home‐based resources.

MEASUREMENTS

Participants completed an in‐person baseline survey, followed by exposure to intervention or attention control (AC) websites, then 1‐month and 3‐month telephone surveys. The primary knowledge outcome was measured with 6 items (possible 0‐6 points) pertaining to hospital discharge needs.

RESULTS

Among 385 participants randomized, mean age was 71.9 years (standard deviation 5.6) and 79.5% of participants were female. At 1 month, the intervention group had a 0.6 point change (standard deviation = 1.6) versus the AC group who had a ‐0.1 point change in knowledge score. Linear mixed modeling results suggest sex, health literacy level, level of education, income, and history of high blood pressure/kidney disease were significant predictors of knowledge over time. Controlling for these variables, treatment effect remained significant (P < 0.0001).

CONCLUSION

Seniors who used PYL demonstrated an increased understanding of posthospitalization and home services compared to the control group.

TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT0 2256072.
What's the Purpose of Rounds? A Qualitative Study Examining the Perceptions of Faculty and Students
Authors: Hulland Oliver , Farnan Jeanne , Rabinowitz Raphael , Kearns Lisa , Long Michele , Monash Bradley , Bhansali Priti , Fromme H. Barrett
Published: November 2017

BACKGROUND

Rounds are a critical activity on any inpatient service, but there is little literature describing the purpose of rounds from the perspective of faculty and trainees in teaching hospitals.

OBJECTIVE

To evaluate and compare the perceptions of pediatric and internal medicine attendings and medical students regarding the purpose of inpatient attending rounds.

METHODS

The authors conducted 10 semistructured focus groups with attendings and medical students in the spring of 2014 at 4 teaching hospitals. The protocol was approved by the institutional review boards at all institutions. The authors employed a grounded theory approach to data collection and analysis, and data were analyzed by using the constant‐comparative method. Two transcripts were read and coded independently by 2 authors to generate themes.

RESULTS

Forty‐eight attendings and 31 medical students participated in the focus groups. We categorized 218 comments into 4 themes comprised of 16 codes representing what attendings and medical students believed to be the purpose of rounds. These themes included communication, medical education, patient care, and assessment.

CONCLUSIONS

Our results highlight that rounds serve 4 purposes, including communication, medical education, patient care, and assessment. Importantly, both attendings and students agree on what they perceive to be the many purposes of rounds. Despite this, a disconnect appears to exist between what people believe are the purposes of rounds and what is happening during rounds.
Obtaining a real consent
Authors: Griffith Richard
Published: November 2017

Obtaining a real consent is fundamental to the propriety of treatment given by district nurses. Real consent respects patient autonomy and is underpinned by three key elements.

In this article, on the principles of patient consent, Richard Griffith outlines the elements of a real consent and the importance of obtaining consent to district nurse practice.
A new species of Alastor Lepeletier de Saint-Fargeau, 1841 (Hymenoptera: Vespidae: Eumeninae) from Pakistan
Authors: Selis Marco
Published: November 2017

A new species of the genus Alastor Lepeletier de Saint-Fargeau, 1841, namely A. laticlypeus sp. nov., is described. This is the first record of Alastor from Pakistan. The new species shows characters intermediate between the subgenera Alastor s. str., Megalastor Blüthgen, 1951 and Parastalor Blüthgen, 1939, placing in doubt the validity of the subgeneric division of the genus.
Pengaruh temperatur sintering terhadap struktur dan sifat magnetik La3+ - barium nanoferit sebagai penyerap gelombang mikro
Authors: Hasanah Siti Uswatun , Widanarto Wahyu , Sunardi Sunardi
Published: November 2017

Seri La3+-barium nanoferit telah dibuat melalui metode solid-state reaction termodifikasi tanpa sintering dan dengan sintering pada temperatur 600, 800 dan 1000 °C. Pengaruh temperatur sintering terhadap komposisi, struktur, ukuran kristal, sifat magnetik dan kemampuan menyerap gelombang mikro dari La3+-barium nanoferit dikarakterisasi masing-masing menggunakan XRD, VSM dan VNA. Hasil karakterisasi menunjukkan bahwa La3+-barium nanoferit yang di-sintering pada 600 ºC mempunyai kemampuan menyerap gelombang mikro yang paling baik, dengan rata-rata nilai reflection loss sebesar -16,2165 dB pada frekuensi 10,86 GHz. Ferit terdiri dari tiga fasa kristal yaitu BaLa2Fe2O7, BaFe11.9O19, dan Fe21.33O32 dengan nilai Hc yang rendah 231,65 Tesla. Hal ini menunjukkan bahwa temperatur sintering sangat berpengaruh terhadap La3+-barium ferit sebagai penyerap gelombang mikro.