bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of Orofacial Clefting in New York City From 1983 to 2010
Authors: Butts Sydney C. , Reynolds Simone , Gitman Lyuba , Patel Prayag , Joseph Michael
Published: April 2018

Objective:

To determine the role of racial background, public health initiatives, and residence on the prevalence of orofacial clefts (OFCs) in New York City (NYC).

Design/Methods:

Retrospective review of OFC cases from the New York State Congenital Malformations Registry.

Patients/Participants:

Patients born with an OFC and all live births to mothers residing in NYC between 1983 and 2010.

Main Outcome Measures:

Orofacial cleft birth prevalence by cleft type, race, and borough of maternal residence for each year and by time period around the implementation of public health interventions including folate supplementation.

Results:

A total of 3557 cases were reviewed. The prevalence remained stable for cleft palate and cleft lip with or without cleft palate (CL ± P) in sequential time periods of the study. Among CL ± P cases, cleft lip prevalence decreased early in the study compared to increases in cleft lip and palate prevalence. For most years, the prevalence of OFCs was lower among African Americans than whites. A total of 12% to 26% of mothers in 4 of the NYC boroughs deliver outside of their borough of residence, choosing to give birth in Manhattan most often. No difference in OFC prevalence was shown in any of the 5 NYC boroughs.

Conclusions:

The period prevalence remained relatively stable during the time periods before and after the implementation of folate supplementation for OFCs in NYC. Prevalence of OFC subtypes was lower for most time periods during this study among African Americans compared to whites. Several factors may explain the choice of birthplace outside of the mother’s borough of residence.
Parental Experience of Sleep-Disordered Breathing in Infants With Cleft Palate: Comparing Parental and Clinical Priorities
Authors: Davies Karen , Lin Yin-Ling , Glenny Anne-Marie , Callery Peter , Bruce Iain A.
Published: April 2018

Objective:

To identify outcomes relating to sleep-disordered breathing (SDB) that are relevant to parents, during the early weeks of caring for infants with cleft palate (CP), and compare these with clinical outcomes identified in a systematic search of research literature.

Design:

A qualitative study using telephone/face-to-face interviews with parents explored their understanding of breathing and respiratory effort in infants with CP.

Setting:

Care provided by 3 specialist cleft centers in the United Kingdom, with study conducted in parents’ homes.

Participants:

Criteria for participation were parents of infants with isolated CP aged 12 to 16 weeks. Thirty-one parents of infants with CP (over 12 weeks) were invited to participate in the interview. Interviews were completed with 27 parents; 4 parents could not be contacted after completing the sleep monitoring.

Results:

Parents’ description of infants’ sleep suggests that breathing is not considered as a separate priority from their principal concerns of feeding and sleeping. They observe indicators of infants’ breathing, but these are not perceived as signs of SDB. Parents’ decision to use lateral or supine sleep positioning reflects their response to advice from specialists, observation of their infants’ comfort, ease of breathing, and personal experience. Outcomes, identified in published research of SDB, coincide with parents’ concerns but are expressed in medical language and fit into distinct domains of “snoring,” “sleep,” “gas exchange,” and “apnea.”

Conclusions:

Parents’ description of sleeping and respiration in infants with CP reflect their everyday experience, offering insight into their understanding, priorities, and language used to describe respiration. Understanding parents’ individual priorities and how these are expressed could be fundamental to selecting meaningful outcomes for future studies of airway interventions.
Congenital Brown's Syndrome: Clinical and Surgical Approach
Authors: Berk A.T. , Erkan D. , Şener C. , Sanaç A.S.
Published: April 2018

Brown's syndrome is a well-recognized clinical disorder of ocular motility consisting mainly of a restriction of active and passive elevation in adduction. We report a series of 17 patients with true Brown's syndrome and discuss the clinical features and results of surgical intervention. Surgery should be considered carefully for the treatment of this syndrome as reoperation may be necessary and spontaneous resolution is seen during long-term follow-up of some patients.
Penetration of [3H] Tiazofurin Into Guinea Pig Eye by a Saturable Mechanism
Authors: Redžić Z.B. , Marković I.D. , Jovanović S.S. , Zloković B.V. , Rakić Lj.M.
Published: April 2018

This study investigated the transport of tiazofurin (2-ß-D-ribofuranosyl thia-zole-4-carboxamide) across the blood-aqueous humor barrier, using the vascular perfusion method in the guinea pig. Volume of distribution (Vd) of [3H] tiazofurin increased almost linearly in time, from 4% of its plasma concentration at 3 min to 10% after 12 min of perfusion. Unidirectional transport constant, Kin was 7.01 ± 1.06 × 10-3 ml/min/g. These results indicate that tiazofurin penetrates the aqueous humor to a considerable extent. Addition of unlabelled tiazofurin to the perfusing medium caused a significant decrease in the uptake of [3H] labelled tiazofurin (Kin = 2.60 ± 0.91 × 10-3 ml/min/g). Therefore, penetration of tiazofurin from blood into aqueous humor seems to be a saturable process with a diffusional component that cannot be disregarded. Such findings could be of considerable importance since this molecule is known to affect tissue metabolism.
Long-Term Visual Outcome of Choroidal Neovascularization in Pathologic Myopia: Natural History and Laser Treatment
Authors: Secrétan M. , Kuhn D. , Soubrane G. , Coscas G.
Published: April 2018

This retrospective study was designed to help clarify the visual prognosis during long-term follow-up (5-10 years) of myopic choroidal neovascularization (CNV) with and without laser treatment in a referral population.

Patients and Methods.

A group of 50 consecutive non-treated eyes and a group of 50 consecutive treated eyes were selected retrospectively. Inclusion criteria were: fluorescein angiographic documentation of CNV not involving the center of the fovea, visual acuity (VA) > 20/200, age less than 60, onset of symptoms ≤ 6 months and at least five years of follow-up. The mean decrease in VA in non-treated and treated eyes during the follow-up was analysed on the basis of subgroups with the same initial VA.

Results

Considering both groups (100 eyes) at presentation, 89% of CNV spared the center of the fovea but were located in the foveolar area (< 200 μm) and only 11% were extrafoveal (> 200 μm). In the natural history group, after five years all CNV involved the center of the fovea and mean VA was 20/160. In the treated group, at the end of the five year follow-up and after one or more laser session, 64% of eyes had a dry scar and mean VA was 20/74. Nevertheless there was a very high rate of recurrences (72%) and at the end of follow-up, 36% of treated eyes had a subfoveal recurrence with a mean decrease in VA to 20/154. The difference between the mean decrease in VA of the treated and non-treated groups was statistically significant at two years. At five years (100 eyes), the difference persisted only for eyes with initial VA better than ≥ 20/40 (P<0.05). At eight years (76 eyes) and ten years (24 eyes), this difference was no longer significant.

Comments

This study confirms that CNV accompanying degenerative myopia has an extremely poor prognosis. Nevertheless analysis of final VA in both groups suggests that eyes with high initial VA gain more from treatment.
The effect of self-assessed fatigue and subjective cognitive impairment on work capacity: The case of multiple sclerosis
Authors: Kobelt Gisela , Langdon Dawn , Jönsson Linus
Published: April 2018

Objectives:

The impact of physical disability in multiple sclerosis on employment is well documented but the effect of neurological symptoms has been less well studied. We investigated the independent effect of self-reported fatigue and cognitive difficulties on work.

Methods:

In a large European cost of illness survey, self-reported fatigue, subjective cognitive impairment (SCI), and productivity at work were assessed with visual analogue scales (VAS 0–10). The analysis controlled for country, age, age at diagnosis, gender, education, and physical disability.

Results:

A total of 13,796 patients were of working age and 6,598 were working. Physical disability had a powerful impact on the probability of working, as did education. The probability of working was reduced by 8.7% and 4.4% for each point increase on the VAS for SCI and fatigue, respectively ( p < 0.0001). Regular work hours decreased linearly with increasing severity of fatigue and cognitive problems, while sick leave during the 3 months preceding the assessment increased. Finally, the severity of both symptoms was associated with the level at which productivity at work was affected ( p < 0.0001).

Conclusion:

Our results confirm the independent contribution of self-reported fatigue and SCI on work capacity and highlight the importance of assessment in clinical practice.
Towards an Inclusive Systemic Evaluation for the SDGs: Gender equality, Environments and Marginalized voices (GEMs)
Authors: Stephens Anne , Lewis Ellen D. , Reddy Shravanti
Published: April 2018

With the advent of the United Nation’s 2030 Sustainable Development Agenda, and its 17 Sustainable Development Goals, there is a call for more methodologies to understand and evaluate combinations of these global challenges, their integrated nature and their complexities. Accordingly, UN Women Independent Evaluation Office along with Australian and American researchers have written and piloted a new evaluation guide: Inclusive Systemic Evaluation for Gender equality, Environments and Marginalized voices (ISE4GEMs): A new approach for the SDG era (2018). Referred to as the ‘ISE4GEMs’, this guide is an original piece of work that brings together transdisciplinary evaluation methods, re-thinks systemic evaluation methodology and introduces the Gender equality, Environments and Marginalized voices (GEMs) framework. This article provides a summary of the key theoretical concepts that have been synthesized from systems thinking, social and ecological sciences to produce process guidance.
No evidence of atypical attentional disengagement in autism: A study across the spectrum
Authors: Wilson C Ellie , Saldaña David
Published: April 2018

The ability to disengage attention and reengage elsewhere has been proposed as a fundamental deficit in the autism spectrum, potentially disrupting development of higher cognitive domains. Eye-movements were recorded while 16 autism spectrum children of mixed ability, and 18 typically developing age-matched controls, completed the Gap–Overlap paradigm. A significant difference in latency to fixate target was found between Gap and Overlap conditions. A significant interaction with group was due to autism spectrum participants’ shorter latencies to fixate target in the Gap condition, but similar group responses in the Overlap condition. Considerable within-group variability emerged. We predicted that attentional disengaging would be related to specific features of the phenotype; however, there was no evidence of an association with receptive language, non-verbal IQ, sensory behaviors, or autistic severity in autism spectrum or typically developing groups. In conclusion, while atypical visual attention mechanisms may be a feature of autism spectrum, this is not explained by impaired visual disengaging but is more likely due to increased susceptibility of visual fixation offset cueing. Despite best efforts, nine additional autism spectrum children could not complete testing, and data from a further six were unusable; more work is needed to develop research methods that enable individuals across the spectrum to participate.
Unpacking (the) secret: Anonymous social media and the impossibility of networked anonymity
Authors: Sharon Tzlil , John Nicholas A
Published: April 2018

This study focuses on the perceptions and practices of anonymous communication with friends enabled by tie-based anonymous apps. Based on qualitative analysis of in-depth interviews with users of the application Secret, the strategies deployed by interviewees in order to de-anonymize other users are emphasized and placed within the broader context of the real-name web. The article shows that Secret was not only based on pre-existing social networks but also drew on the network as a structure of thought. The concept of networked anonymity is introduced to account for the ways that anonymous actors imagine one another as “someone,” rather than as an unknown “anyone.” As such, the survivability of this communicative model is inherently limited by competing forces—the drive to connectivity, on the one hand, and to anonymity, on the other.
Convergence and de-convergence of Chinese journalistic practice in the digital age
Authors: Li Ke
Published: April 2018

The existing literature broadly suggests that newsrooms are adapting to the media convergence world at the cost of traditional quality journalism. However, based on my ethnographic study of the Beijing News, I propose a convergence and de-convergence model of journalistic practice. The model explains how one Chinese newspaper preserves the legacy of critical journalism, on the one hand, while negotiating the challenges of adapting to the converging trends on the other. I argue that a well-established organizational culture and a working routine are crucial in the newspaper’s transformation, which makes it impossible to redesign the newsroom and redefine journalism with technology alone. Moreover, the article calls for a more nuanced understanding of the transformation of legacy media in the digital age, especially considering a non-Western context. I argue that the Chinese newspaper’s response to technological and economic impacts brought by the Internet is in fact mediated by political concerns.
Beyond a deficiencies approach: Towards a more integral representation of the everyday life of children growing up in contexts of poverty
Authors: Sarti Asia , Dedding Christine , Bunders Joske FG
Published: April 2018

The research on child poverty typically takes a deficiencies approach that focuses on material deficiencies, which are considered to have a profoundly negative impact on children’s well-being. Countering this approach, our research is based on a lifeworld orientation and explores children’s everyday life from their own perspective. Using a range of qualitative methods such as photovoice, focus group discussions, interviews, and participant observation, we gathered detailed information on the lives and well-being of children growing up in contexts of poverty. Our research provides insights into the complex and multi-layered issue of childhood poverty and suggests that support must take into account not only the negative aspects of poverty, but also those aspects that children consider positively. This begins with taking note of children’s best use of public and private resources that are already available to them.
Students’ Temporal Distributing of Learning Activities in Psychology Courses: Factors of Influence and Effects on the Metacognitive Learning Outcome
Authors: Barenberg Jonathan , Roeder Ute-Regina , Dutke Stephan
Published: April 2018

Studies demonstrate that students’ study behavior is frequently dysfunctional, because they tend to cram shortly before examinations. This behavior is antithetical to spaced learning and can impair academic achievement. We investigated the extent that the temporal distribution of learning activities (a) varies as a function of the organization of the course, (b) is subject to individual differences and (c) affects the metacognitive learning outcome. Participants of four lecture-like educational psychology courses ( N = 259) were presented with learning materials stored on the university’s online learning platform. New materials were published weekly and access to these materials was automatically registered. The students completed either a test at the end of the semester (in two end-term-test courses) or fulfilled written assignments throughout the semester (in two multiple-assignment courses) . Students in the multiple-assignment courses accessed the materials more continuously than students in the end-term-test courses. Cluster analyses in the end-term-test courses revealed students primarily accessing the materials late in the semester and students accessing the materials continuously throughout the semester. Continuous access was associated with more accurate metacognitive monitoring. The results are discussed in the context of the relation between metacognitive monitoring and the regulation of study behavior.
Prospective risk of osteoporotic fractures in patients with advanced chronic obstructive pulmonary disease
Authors: Gupta Ayushman , Greening Neil J , Evans Rachael A , Samuels Abigail , Toms Nicole , Steiner Michael C
Published: April 2018

Despite the high prevalence of osteoporosis in chronic obstructive pulmonary disease (COPD) patients, the fracture risk prediction tools are not routinely undertaken in the management of COPD. We quantified fracture risk using a validated risk prediction tool (Fracture Risk Assessment (FRAX®)) and determined potential bone-protection treatment needs in patients with advanced COPD. The 10-year probability of major osteoporotic or hip fracture was calculated using the FRAX tool in a cohort of patients attending a hospital complex COPD service. Patients were identified to be at low, intermediate and high risk based on their FRAX scores, in accordance with the National Osteoporosis Guideline Group recommendations, to assess the number of patients requiring bone mineral density (BMD) testing or bone protection therapy. Two hundred forty-seven patients [mean (standard deviation (SD)) age 66 (9.1) years, 26% current smokers, 40% women and median (interquartile range (IQR)) Medical Research Council (MRC) breathlessness scale 4 (0)] had a 10-year probability of 9.5% (6.1) and 3.8% (4.6) for major osteoporotic and hip fractures, respectively. Thirty-six percentage of patients were identified to be at intermediate risk of developing fragility fracture, requiring BMD assessment, while 9% were at high risk, requiring treatment. Thirty-two percentage of high-risk patients were on bisphosphonates. The FRAX score can be used to assess the fracture risk within the COPD cohort and assist with decision-making about BMD measurement and provision of bone protection therapy.
Strong Impact of Interviewers on Respondents’ Political Choice
Authors: Németh Renáta , Luksander Alexandra
Published: April 2018

Despite much literature on interviewer effects, limited attention has been paid to party preference surveys, although the effect is expectedly strong in this field. This article analyzes interviewer effects in a face-to-face political survey. Specifically, we are interested in whether the interviewer’s own party preference has an effect on the respondent’s party choice. We used cross-classified two-level logistic regression models with median odds ratio as effect size. We found four main results: (1) Place of residence significantly affects political preference, but interviewers do so to the same degree; (2) the size of these effects is comparable to those of demographic characteristics of the respondent; (3) interviewers’ political preference has an effect and it does not disappear once controlled for obvious interviewer characteristics; and (4) the impact of political preference is such that respondents tend to have a preference similar to that of their interviewers.
Reduced Lung Cancer Mortality With Lower Atmospheric Pressure
Authors: Merrill Ray M. , Frutos Aaron
Published: April 2018

Background:

Research has shown that higher altitude is associated with lower risk of lung cancer and improved survival among patients. The current study assessed the influence of county-level atmospheric pressure (a measure reflecting both altitude and temperature) on age-adjusted lung cancer mortality rates in the contiguous United States, with 2 forms of spatial regression.

Methods:

Ordinary least squares regression and geographically weighted regression models were used to evaluate the impact of climate and other selected variables on lung cancer mortality, based on 2974 counties.

Results:

Atmospheric pressure was significantly positively associated with lung cancer mortality, after controlling for sunlight, precipitation, PM2.5 (µg/m3), current smoker, and other selected variables. Positive county-level β coefficient estimates ( P < .05) for atmospheric pressure were observed throughout the United States, higher in the eastern half of the country.

Conclusion:

The spatial regression models showed that atmospheric pressure is positively associated with age-adjusted lung cancer mortality rates, after controlling for other selected variables.
Numerical calculation of axial-flow pump’s pressure fluctuation and model test analysis
Authors: Xie Chuanliu , Tang Fangping , Zhang Rentian , Zhou Wei , Zhang Wenpeng , Yang Fan
Published: April 2018

To study the significance of internal pressure pulsation characteristics between prototype and model pump devices, monitoring of computational fluid dynamics and dynamic measurement of a model were carried out under different working conditions and measuring points. The results of computational fluid dynamics calculation and model test are as follows. First, the positions of main frequency and subfrequency are almost the same, whereas the amplitude has a slight deviation. Second, the amplitude of inlet impeller is larger, and the main frequency is three times of rotating frequency. Third, the inlet speaker has mainly low pulsation, which is almost distributed in blade frequency and 1/3 times of rotating frequency. Moreover, the pressure pulsation of symmetrical points in each condition has a good symmetry. As the flow rate decreases, both the mixing and blade frequency amplitudes in the inlet speaker and impeller first decrease and then increase. The minimum mixing amplitude appears in the design condition of 253 L/s, whereas the blade frequencies are 203 and 253 L/s. The numerical calculation results are almost the same as those of prototype and model devices. Therefore, numerical calculations and experimental studies on pressure pulsation can guide the design and stable operation of similar pump stations.
Significance of S-100 Protein Immunostaining in the Immunohistological Analysis of Normal and Neoplastic Lymphoid Tissues - An Appraisal
Authors: Carbone Antonino , Manconi Riccardo , Poletti Alessandro , Volpe Rachele
Published: April 2018

S-100 protein is a heterogeneous fraction of dimeric polypeptides (alpha and beta subunits) that can exist in different combination forms within the various tissues. Concerning the S-100 protein immunodetection within lymphoid tissue, the heterogeneity of the S-100 antigen, the tissue quality (frozen or paraffin-embedded after treatment with different fixatives) and the treatment of the tissue with different immunostaining methods and antibodies of different nature, all make for inconsistent results obtained in the immunohistological studies reported in the literature. Most of the S-100-positive cells of the lymphoreticular system are dendritic cells involved in the immune response (interdigitating reticulum cells, Langerhans cells, and follicular dendritic reticulum cells), other S-100-positive cells belonging to the mononuclear/phagocytic system. S-100 protein immunostaining may be used as a helpful immunohistological diagnostic clue to certain malignancies of the immune system (follicular center cell lymphomas) on the basis of their specifically related dendritic cell microenvironment. In addition to monoclonal antibodies for the immunophenotypic characterization of dendritic cells and macrophages and to enzyme reactions, the combined use of anti-S-100 antibodies specific for each of the S-100 protein subunits, tested with sensitive procedures, would be a very useful tool in the attempt to classify the proliferative disorders of dendritic cells and macrophages.
Liability to Chromosome Damage in Lymphocytes of “Cancer Family” Subjects: A Study of Spontaneous and Induced Chromosomal Fragility
Authors: Larizza Lidia , Doneda Luisa , Stefanini Miria , Francone Giuseppa , Gualandri Valter , Conti Annamaria Fuhrman
Published: April 2018

Spontaneous chromosomal fragility was detected in seven tumor patients and one healthy member from two families with a high recurrence of cancer. Major chromosome lesions, such as terminal deletions and rearranged chromosomes, were found at levels significantly higher than those reported for control individuals. The prevalence of these aberrations in comparison to minor ones (chromosome gaps and chromatid breaks) in this group ofpatients seems to indicate that the fragility observed is the end-point of a process of chromosomal instability, which may have already been brought to expression. Study of other parameters of genetic instability in the most unstable karyotypes showed that the chromosome damage observed was neither paralleled by abnormal SCE frequency nor sustained by defective DNA repair mechanisms or expression of inherited or constitutional fragile sites. As all the subjects investigated here had previously been shown to display intraindividual variations in the C-banded region of chromosome 1, it is possible that spontaneous fragility and acquired C-heterochromatin polymorphism may be markers that, combined with chromosomal instability, create genetic predisposition to cancer.
Ferritin Immunohistochemical Localization in Normal and Neoplastic Colonic Mucosa
Authors: Campo Elias , Palacin Antonio , Benasco Carmen , Condom Enric , Cardesa Antonio
Published: April 2018

High levels of ferritin have been detected in serum and tumoral extracts of gastrointestinal neoplasms. However, its histological localization is not well known. An immunoperoxidase technique (PAP) was used for detecting ferritin in 30 colorectal carcinomas, 20 polyps and 8 cases of non-neoplastic mucosae. Ferritin staining was detected in stromal cells (98%) much more than in epithelial cells (21%). Connective cells were positive in 5 cases of normal mucosae (62%), 19 polyps (95%) and all carcinomas (100%). The number of positive cells gradually rose from normal mucosa to carcinoma with an intermediate score in adenomas. However, no relation could be found between the stromal ferritin score and dysplasia in polyps. Likewise, no relation was found between the stromal ferritin score and the differentiation grade, invasion or metastases in carcinomas. The positive epithelial pattern seen in 12 cases (21%) suggests non-specific staining due to passive diffusion from the stroma. Thus, these immunohistochemical findings suggest that in colonic neoplasms, ferritin could be a tumor marker produced mainly by stromal cell reaction more than by the epithelial cells.
Tumor Antigen Nb/70K and Ca 125 Levels in the Blood of Preoperative Ovarian Cancer Patients and Controls: A Preliminary Report of the use of the Nb12123 and Ca 125 Radioimmunoassays Alone and in Combination
Authors: Knauf S. , Bast R.C.
Published: April 2018

The NB12123 and CA125 radioimmunoassays, murine monoclonal antibody assays for measuring circulating levels of human ovarian tumor associated antigens NB/70K and CA 125, respectively, have been previously described. In the present study, preoperative serum samples were obtained from patients undergoing laparotomy for benign neoplastic ovarian tumors (N = 16), cancer of the cervix (N = 22), cancer of the uterus (N = 20), and cancer of the ovary (N = 47). Controls (N = 50) were obtained from healthy blood bank donors. No correlation was observed between the levels of NB/70K and CA 125 in these samples (r2 = .079, linear regression analysis). In general, increasing levels of both antigens were present with increasing tumor burden and higher histological grade. In addition, both markers were most elevated in the serum of ovarian cancer patients with serous and unclassified adenocarcinomas.

Using 40 AU and 35 unit cut-offs for the NB/70K and CA 125 assay, respectively, overall specificity for healthy controls and patients with benign diseases approaches 100%. The combined sensitivity of the assays for ovarian cancer patient sera in this study indicates that the assays may be helpful in establishing a pre operative diagnosis of ovarian cancer. Complementarity of the NB/70K and CA 125 assays has been demonstrated, indicating that one or both assays may be used to monitor as many as 85% of ovarian cancer patients.
Tumor Markers and Lung Cancer: Guidelines in a Cost-limited Medical Organization
Authors: Falcone F. , Marinelli M. , Minguzzi L. , Paganelli G.M. , Turba E. , Cavalli A. , Rapellino M.
Published: April 2018

The aim of our study was to evaluate the cost of the tumor marker assays most widely used in pneumological practive and the effectiveness of the percentage of DRG-based reimbursements absorbed by these assays.

For this purpose we assessed the cost of lung tumor marker assays in Emilia Romagna compared to the DRG-based reimbursement of inpatients affected by lung diseases in whom the use of tumor markers is indicated.

As an example, we evaluated the cost/effectiveness of the CEA assay in the differential diagnosis of 68 pleural effusions from 46 patients (20 benign diseases, 26 malignant).

Because the CEA assay was not a substitute for cytology when this was not diagnostic, 41.3% of the resources were not efficiently spent. If the marker assay had been performed only in cases with negative cytology, we could have spared 14 of 46 tests.

Moreover, since the expense lies predominantly in the cost of reagents (81.23%), we suggest as a routine procedure to collect and store samples for tumor marker assay in all cases; the test should be performed in a selected population of patients with negative cytology and “suspect” clinical outcome.
Interleukin-4 Blood Concentrations in Early and Metastatic Human Solid Neoplasms
Authors: Lissoni P. , Merlini D. , Pirato D. , Meregalli S.
Published: April 2018

Blood levels of the immunosuppressive cytokines IL-6 and IL-10 are often abnormally high in patients with advanced cancer. However, since IL-6 and IL-10 may be produced by macrophages and TH2 cells, the evidence of abnormally high values of IL-6 and/or IL-10 may reflect hyperactivation either of the macrophage system or of TH2 cell functions. In contrast, IL-4 is almost completely produced by the TH2 lymphocytes. Therefore, evaluation of IL-4 levels could help to differentiate macrophage from TH2 cell hyperactivation. This study was performed to investigate IL-4 serum levels in a group of cancer patients in relation to the stage of disease and to the secretion of other cytokines. The study included 50 patients, 28 of whom showed distant organ metastases. Lung cancer and gastrointestinal cancers were the most frequent neoplasms in our patients. The control group consisted of 60 healthy subjects. IL-4 was measured by the Elisa method. No patient showed high levels of IL-4. No significant differences were seen between controls and cancer patients, nor between metastatic and non-metastatic patients. In addition, no significant differences in IL-4 mean values were found between patients with normal or high levels of IL-6 and IL-10, or between patients with normal or low IL-2 concentrations. This preliminary study seems to exclude cancer-related abnormally high secretion of IL-4. Therefore, the high levels of IL-6 and/or IL-10 often occurring in advanced neoplastic disease would mainly depend on macrophage production.
Anti-malignin Antibody Evaluation: A Possible Challenge for Cancer Management
Authors: Botti C. , Martinetti A. , Nerini-Molteni S. , Ferrari L.
Published: April 2018

The major problem in the management of cancer is the difficulty of an early diagnosis. Clinical signs and symptoms generally appear late in the course of the disease. The availability of a non-invasive test which detects a blood molecule closely associated with the malignant transformation of the cells could be of help in the early detection of cancer. Malignin is a 10 kDa polypeptide located in the cytoplasmic and outer membranes of all malignant cells. Anti-malignin antibodies (AMAs) are IgM immunoglobulins spontaneously produced by the host against the oncoprotein malignin when neoplastic transformation occurs; since AMAs are IgM, they can represent an “early” transformation indicator useful for the early detection of cancer. Elevated AMA serum concentrations, measured by means of TARGET®@ reagent, have been demonstrated inpatients with a wide spectrum of non-terminal active cancers, regardless of the anatomical site and histotype of the tumor. The AMA test showed a sensitivity and specificity of 95% on first determination and >99% on repeated determinations, and has been reported to be a promising diagnostic tool for the early detection of cancer, as well as for monitoring of the response to treatment and possibly for screening of an asymptomatic population.
Impact of Steroid Receptors, pS2 and Cathepsin D on the Outcome of N+ Postmenopausal Breast Cancer Patients Treated with Tamoxifen
Authors: Dittadi R. , Biganzoli E. , Boracchi P. , Salbe C. , Mione R. , Gatti C. , Gion M.
Published: April 2018

In spite of the complexity of the biological basis of the hormonal regulation of breast cancer, clinical studies tend to simplify the information by mainly categorizing continuous variables related to hormonal status and not considering the interactions between variables. The present study was planned to examine the presence of an interaction between cathepsin D (Cath-D) and pS2 in patients treated with adjuvant tamoxifen in a homogeneous subset of node-positive postmenopausal patients and to evaluate the contribution of the interaction to the predictive ability of the model. Steroid receptors (ER and PgR) were measured in cytosol using the dextran-coated charcoal method, while Cath-D and pS2 were determined using commercially available immunoradiometric assays. The prognostic role of each variable and their joint effect were investigated using a Cox regression model. Biological variables were analyzed as continuous and when their prognostic relationship did not seem linear, a restricted cubic spline regression smoothing approach was adopted. The logarithm of hazard showed a linear relationship with the log(ER), while it i) remained almost constant up to about 20 fmol/mg and subsequently decreased for PgR; ii) was almost constant up to about 50 pmol/mg and subsequently decreased for Cath-D; iii) decreased for increasing log(value) up to about 33 ng/mg and subsquently increased for pS2. In the multivariate analysis both PgR and the interaction between pS2 and Cath-D retained a significant prognostic role. For low values of pS2, the prognosis worsened with the increase in Cath-D levels and this relationship reversed for high values of pS2. From the results of the present study we can conclude that i) a significant interaction between Cath-D and pS2 was found in this case series; ii) the prognostic relationships should not be underestimated in clinical decision making; iii) a predictive score obtained considering the contribution of PgR, pS2 and Cath-D could be useful for clinical use.
School principals’ leadership types and student achievement in the Italian context: Empirical results from a three-step latent class analysis
Authors: Agasisti Tommaso , Bowers Alex J , Soncin Mara
Published: April 2018

This study investigates the existence of various leadership types in a sample of lower secondary school principals across Italy ( n = 1073). Information is obtained using a questionnaire about instructional practices and leadership perceptions administered by the National Evaluation Committee for Education (INVALSI). Employing a latent class analysis (LCA) for the specification of the educational production function (EPF), we identify three subgroups of school leaders: educative leaders (49% of the total sample), who support school improvement that utilises teachers’ skills; leaders who teach (35%), who are actively present in the classroom; and transactional leaders (16%), who support the school and balance various viewpoints. We then analyse the data to ascertain if some principals’ individual characteristics and school context factors are statistically correlated with the probability of having certain leadership attitudes. Finally, we provide evidence that schools with ‘leaders who teach’ report lower academic test scores; this third step is novel as few previous studies have attempted to link leadership styles and test scores. However, the difference in test scores across groups disappears when the geographical factor is accounted for, pointing to the importance of contextual factors in that they affect both leadership types and educational outcomes.
Indoor environment quality assessment in classrooms: An integrated approach
Authors: Tahsildoost Mohammad , Zomorodian Zahra S
Published: April 2018

Indoor Environmental Quality is an important issue in educational buildings since it is directly related to students’ well-being and learning activities. Indoor Environmental Quality parameters have been assessed in three representative campus building typologies (old, new, and retrofitted), in Tehran, Iran, by measurements and questionnaire (n = 842) from July 2016 to April 2017. Results have been compared to the students’ overall satisfaction level and recommended standards. According to results, minimum attention to local standards with regard to Indoor Air Quality, acoustic, and lighting, especially in the old and retrofitted buildings, seems the main reason of low environmental quality in the studied cases. Fitting a multiple regression model to the questionnaire data, a mathematical model is developed to predict the overall comfort (Indoor Environmental Quality index). Studied buildings have been ranked based on the Indoor Environmental Quality index from high quality: I (building C) to out of the comfort range: IV (building A). Moreover, results reveal that the acceptable range of each Indoor Environmental Quality parameters, especially with regard to thermal and acoustic comfort, is broader in real condition in comparison with the standards. Finally, the buildings’ annual energy consumption is used to propose a Retrofit Potential Index in order to assess the impact of comfort parameters on energy consumption by integrated analyses.
SoundEar noise warning devices cause a sustained reduction in ambient noise in adult critical care
Authors: Plummer Nicholas Russell , Herbert Anna , Blundell James Edward , Howarth Rachel , Baldwin Jacqueline , Laha Shondipon
Published: April 2018

Introduction

Elevated sound levels in critical care are associated with sleep deprivation and an increased incidence of delirium. We aimed to determine whether a sound-activated visual noise display meter could cause a sustained reduction in sound levels overnight in an adult critical care unit.

Method

Sound levels were recorded overnight for eight days before and after the introduction of a visual noise display meter, with a further eight days recorded four months later after continued use of the visual noise display meter.

Results

Median ambient sound levels were significantly reduced from 57.4 dB by 3.9 dB, with a sustained reduction of 3.6 dB from baseline after four months of the device operating. Peak ambient sound levels had a small but significant reduction from 66.0 dB by 0.7 dB, with a sustained reduction of 0.8 dB after four months.

Discussion

Sound-activated visual noise display meters can be effective in providing a sustained reduction in ambient sound overnight in adult critical care units, which would appear to be driven by behavioural change.
The effect of early relearning on sensory recovery 4 to 9 years after nerve repair: a report of a randomized controlled study
Authors: Vikström Pernilla , Rosén Birgitta , Carlsson Ingela K , Björkman Anders
Published: April 2018

Twenty patients randomized to early sensory relearning (nine patients) or traditional relearning (11 patients) were assessed regarding sensory recovery 4 to 9 years after median or ulnar nerve repair. Outcomes were assessed with the Rosen score, questionnaires, and self-reported single-item questions regarding function and activity. The patients with early sensory relearning had significantly better sensory recovery in the sensory domain of the Rosen score, specifically, discriminative touch or tactile gnosis and dexterity. They had significantly less self-reported problems in gripping, clumsiness, and fine motor skills. No differences were found in questionnaires between the two groups. We conclude that early sensory relearning improves long-term sensory recovery following nerve repair.

Level of evidence: I
Devic syndrome and pregnancy: A case series
Authors: Wuebbolt Danielle , Nguyen Vanessa , D’Souza Rohan , Wyne Ahraaz
Published: April 2018

Background

Devic syndrome or neuromyelitis optica is an autoimmune neurological condition characterized by relapsing symptoms of optic neuritis and transverse myelitis. Women with neuromyelitis optica suffer from adverse pregnancy outcomes and high relapse rates during pregnancy and the postpartum period.

Methods

This case series describes 13 pregnancies in four women with neuromyelitis optica managed at a tertiary hospital in Toronto, Canada.

Results

In most cases, neurologic symptoms either worsened or developed for the first time during pregnancy or the postpartum period, and often responded to a combination of steroids, immunosuppressant medications, plasma exchange and intravenous immunoglobulin. The 13 pregnancies resulted in two miscarriages, three preterm and eight term births. One fetus whose mother was on gabapentin, prednisone and spironolactone, had congenital malformations (aplastic lung and fused fingers).

Conclusions

Despite high frequency of relapses in pregnancy and the postpartum period, with multidisciplinary team management, outcomes for women with neuromyelitis optica are encouraging.
Physiological changes of pregnancy and the Swansea criteria in diagnosing acute fatty liver of pregnancy
Authors: Morton Adam , Laurie Josephine
Published: April 2018

The Swansea criteria are used to assess the likelihood of acute fatty liver of pregnancy. There are significant physiological changes in normal pregnancy in several of the pathology parameters used in the Swansea criteria. This may impact the sensitivity and specificity of the Swansea criteria. Five of the 11 case series reporting laboratory values in acute fatty liver of pregnancy used values divergent from the Swansea criteria. When using the Swansea criteria for diagnosis of acute fatty liver of pregnancy, using pregnancy-specific and/or laboratory-specific reference intervals is recommended. Simpler diagnostic criteria using parameters of hepatocellular damage and hepatic synthetic dysfunction may be an alternative to the Swansea criteria, and further studies investigating the sensitivity and specificity of these parameters would be useful.
Collateral pial circulation relates to the degree of brain edema on CT 24 hours after ischemic stroke
Authors: Galego Orlando , Jesus-Ribeiro Joana , Baptista Mariana , Sargento-Freitas João , Martins Ana Inês , Silva Fernando , Santos Gustavo Cordeiro , Cunha Luís , Nunes César , Machado Egídio
Published: April 2018

Background

Cerebral edema is frequent in patients with acute ischemic stroke (AIS) who undergo reperfusion therapy and is associated with high mortality. The impact of collateral pial circulation (CPC) status on the development of edema has not yet been determined.

Methods

We studied consecutive patients with AIS and documented M1–middle cerebral artery (MCA) and/or distal internal carotid artery (ICA) occlusion who underwent reperfusion treatment. Edema was graded on the 24-hour non-contrast computed tomography (NCCT) scan. CPC was evaluated at the acute phase (≤6 hours) by transcranial color-coded Doppler, angiography and/or CT angiography. We performed an ordinal regression model for the effect of CPC on cerebral edema, adjusting for age, baseline National Institutes of Health Stroke Scale, Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on admission, NCCT, parenchymal hemorrhagic transformation at 24 hours and complete recanalization at six hours.

Results

Among the 108 patients included, 49.1% were male and mean age was 74.2 ± 11.6 years. Multivariable analysis showed a significant association between cerebral edema and CPC status (OR 0.22, 95% CI 0.08–0.59, p = 0.003), initial ASPECTS (OR 0.72, 95% CI 0.57–0.92, p = 0.007) and parenchymal hemorrhagic transformation (OR 23.67, 95% CI 4.56–122.8, p < 0.001).

Conclusions

Poor CPC is independently associated with greater cerebral edema 24 hours after AIS in patients who undergo reperfusion treatment.
Tamm-Horsfall Protein Deposit In The Ureteral Wall: A Case Report
Authors: Arrom Laura Mateu , Arce Yolanda , Errando Carlos , Rosales Antonio , Gutierrez Cristina , Arañó Pedro , Villavicencio Humberto
Published: April 2018

Level of evidence: Not applicable.
An Integrated SEM Neural Network Approach to Study Effectiveness of Brand Extension in Indian FMCG Industry
Authors: Joshi Richa , Yadav Rajan
Published: April 2018

Brand extension as a strategy is used by corporates for increasing profits. It is an approach for new product development. Brand extensions have already been studied in the past few years, however, till now extensions have not been evaluated with the help of structural equation modeling (SEM) and neural networks (NNs) integrated approach. The NNs help to analyze nonlinear influence in data without prior knowledge of such influences. The SEM helps to validate framework proposed in the study and the significant variables gathered through SEM are used as an input for NNs. The major advantage of such kind of hybrid technique is to understand the causal relationships in the variables, followed by the prediction of factors which influence brand extension. The study is based on the recent brand extension done by brand Frooti in the form of Frooti Fizz (an aerated fruit drink). It is a cross-sectional study with the sample size of 281 respondents from Delhi/NCR region. The results of the study are useful for a comprehensive understanding of factors affecting brand extension and also to identify the relative importance of each of them through the use of NN Technique.
Application of Ensemble Models in Credit Scoring Models
Authors: Chopra Anjali , Bhilare Priyanka
Published: April 2018

Loan default is a serious problem in banking industries. Banking systems have strong processes in place for identification of customers with poor credit risk scores; however, most of the credit scoring models need to be constantly updated with newer variables and statistical techniques for improved accuracy. While totally eliminating default is almost impossible, loan risk teams, however, minimize the rate of default, thereby protecting banks from the adverse effects of loan default. Credit scoring models have used logistic regression and linear discriminant analysis for identification of potential defaulters. Newer and contemporary machine learning techniques have the ability to outperform classic old age techniques. This article aims to conduct empirical analysis on publically available bank loan dataset to study banking loan default using decision tree as the base learner and comparing it with ensemble tree learning techniques such as bagging, boosting, and random forests. The results of the empirical analysis suggest that the gradient boosting model outperforms the base decision tree learner, indicating that ensemble model works better than individual models. The study recommends that the risk team should adopt newer contemporary techniques to achieve better accuracy resulting in effective loan recovery strategies.