bluuebunny/crossref_metadata_2025 huggingface dataset:
Etoposide and etoposide phosphate hypersensitivity in children: Incidence, risk factors, and prevention strategies
Authors: Stockton Winifred M , Nguyen Theresa , Zhang Lishi , Dowling Thomas C
Published: July 2019

Introduction

Etoposide is critical in treating pediatric cancers, although hypersensitivity can be severe and treatment-limiting. Reported rates of hypersensitivity range from 2% to 51%. Hypersensitivity data for etoposide phosphate, a newer product, are lacking. The primary objective of this study was to assess etoposide and etoposide phosphate hypersensitivity incidence. Secondary objectives included evaluation of potential risk factors for hypersensitivity and strategies to prevent recurrence.

Methods

This retrospective cohort study evaluated pediatric patients who received initial etoposide phosphate or etoposide dose between August 2012 and July 2017. The primary outcome was documentation of hypersensitivity within four months of initial dose. Potential risk factors evaluated included age, allergies, dose, infusion rate, infusion concentration, and premedication.

Results

Of 246 patients, hypersensitivity reactions occurred in five of 54 patients (9.3%) who received etoposide phosphate and 52 of 192 patients (27.1%) who received etoposide ( p = 0.0061). For etoposide, the mean initial infusion rate was 64.6 ± 40.9 mg/m2/h for patients with hypersensitivity and 49.5 ± 33.4 mg/m2/h without hypersensitivity ( p = 0.0886). Etoposide phosphate rate was not associated with hypersensitivity. Recurrent hypersensitivity occurred in one of nine patients (11.1%) who received etoposide desensitization and one of 38 patients (2.6%) who changed formulation to etoposide phosphate.

Conclusions

Etoposide was associated with more hypersensitivity than etoposide phosphate in pediatric patients. Etoposide hypersensitivity was associated with higher infusion rates, but not etoposide phosphate. Differences in hypersensitivity incidence and infusion rate influence indicate a formulation-effect. Etoposide hypersensitivity recurrence may be prevented by changing to etoposide phosphate formulation. During etoposide phosphate shortages, etoposide desensitization may prevent recurrent hypersensitivity.
Biomarkers of intestinal barrier function in multiple sclerosis are associated with disease activity
Authors: Camara-Lemarroy Carlos R , Silva Claudia , Greenfield Jamie , Liu Wei-Qiao , Metz Luanne M , Yong V Wee
Published: July 2019

Background:

Recent evidence suggests a role for the gut–brain axis in the pathophysiology of multiple sclerosis (MS).

Materials and methods:

We studied biomarkers of intestinal permeability in 126 people with MS (57 relapsing-remitting multiple sclerosis (RRMS) and 69 progressive MS) and in a group of healthy controls for comparison. Serum/plasma concentrations of zonulin (a regulator of enterocyte tight junctions), tight junction proteins (ZO-1 and occludin), intestinal fatty acid binding protein (IFABP)/ileal bile acid binding protein (IBABP), D-lactate, and lipopolysaccharide (LPS) binding protein were measured.

Results:

Zonulin concentrations were significantly higher when a concurrent magnetic resonance imaging (MRI) confirmed the presence of blood–brain barrier (BBB) disruption (Gad+ RRMS) and were correlated with tight junction proteins. IBABP and D-lactate were elevated in people with RRMS compared to controls, but did not discriminate between Gad+ and Gad– subgroups. Baseline zonulin concentrations were associated with 1-year disease progression in progressive MS.

Conclusions:

People with MS have altered biomarkers of intestinal barrier integrity. Zonulin concentrations are associated with 1-year disease progression in progressive MS and closely mirror BBB breakdown in RRMS. Zonulin may mediate breakdown of both the intestinal barrier and the BBB in gut dysbiosis through the regulation of tight junctions. This could explain how the gut–brain axis modulates neuroinflammation in MS.
A pilot study of the effects of running training on visuospatial memory in MS: A stronger functional embedding of the hippocampus in the default-mode network?
Authors: Huiskamp Marijn , Moumdjian Lousin , van Asch Paul , Popescu Veronica , Schoonheim Menno Michiel , Steenwijk Martijn D , Vanzeir Ellen , van Wijmeersch Bart , Geurts Jeroen JG , Feys Peter , Hulst Hanneke E
Published: July 2019

Background/objective:

Endurance exercise can improve memory function in persons with multiple sclerosis (pwMS), but the effects on hippocampal functioning are currently unknown. We investigated the effects of a running intervention on memory and hippocampal functional connectivity in pwMS.

Methods/results:

Memory and resting-state functional magnetic resonance imaging (fMRI) data were collected in a running intervention ( n = 15) and waitlist group ( n = 14). Visuospatial memory improvement was correlated to increased connectivity between the hippocampus and the default-mode network (DMN) in the intervention group only.

Conclusion:

As a result of endurance exercise, improvements in visuospatial memory may be mediated by a stronger functional embedding of the hippocampus in the DMN.
Improved performance of the 2017 McDonald criteria for diagnosis of multiple sclerosis in children in a real-life cohort
Authors: Hacohen Yael , Brownlee Wallace , Mankad Kshitij , Chong Wui K ‘Kling’ , Thompson Alan , Lim Ming , Wassmer Evangeline , Hemingway Cheryl , Barkhof Frederik , Ciccarelli Olga
Published: July 2019

Objective:

To compare the performance of the 2017 McDonald criteria with that of the 2010 criteria for the diagnosis of multiple sclerosis (MS) in children in the clinical setting.

Methods:

In this retrospective, multi-centre study, we identified children who presented with symptoms suggestive of a clinically isolated syndrome (CIS) and were followed up for at least 2 years or until their second attack.

Results:

Of 156 children with CIS followed up for a median of 4.17 years, 94 (60.3%) were diagnosed with MS. In all, 83 (88.3%) of these fulfilled the 2010 dissemination in space (DIS) criteria at onset. Three additional children fulfilled the 2017 DIS criteria because of the inclusion of symptomatic lesions. Of the 59 children with MS who underwent post-gadolinium magnetic resonance imaging (MRI), 44 (74.6%) fulfilled the 2010 dissemination in time (DIT) criteria at baseline. When the presence of oligoclonal bands (OCBs) was used to substitute DIT, an additional 35 children (79/94, 84.0%) were diagnosed with MS according to the 2017 criteria. The 2017 criteria had higher accuracy (87.2% vs 66.7%), higher sensitivity (84.0% vs 46.8%), but reduced specificity (91.9% vs 96.8%) when compared to the 2010 criteria.

Conclusion:

The improved performance of the 2017 criteria when compared to the 2010 criteria was predominantly due to the inclusion of intrathecal OCBs.
Function and progression of non-suicidal self-injury and relationship with suicide attempts: A qualitative investigation with an adolescent clinical sample
Authors: Taliaferro Lindsay A , Almeida Joanna , Aguinaldo Laika D , McManama O’Brien Kimberly H
Published: July 2019

Aim:

To investigate the function and progression of non-suicidal self-injury (NSSI) and its relationship with suicide attempts.

Method:

Qualitative in-depth interviews were conducted with 15 adolescents psychiatrically hospitalized following a suicide attempt who reported NSSI. Applied thematic analysis was used to identify and examine themes from the interview data.

Results:

Thematic analysis revealed that the primary function of NSSI was relief from emotional pain, though the function often changed over time. NSSI was often not directly related to patients’ suicide attempts, yet risk of suicidal behavior seemed to increase once NSSI lost its effectiveness, and suicide became the only option.

Conclusion:

Clinicians need to understand and monitor the functions of NSSI, and its relationship with suicidality, to prevent suicide attempts among adolescents.
Implementing Narrative Exposure Therapy for unaccompanied asylum-seeking minors with post-traumatic stress disorder: A pilot feasibility report
Authors: Said Glorianne , King Dorothy
Published: July 2019

There are high rates of post-traumatic stress disorder (PTSD) in unaccompanied asylum-seeking minors (UAM) and there is a requirement for feasible, acceptable and evidence-based treatments. Narrative Exposure Therapy (NET) is a short-term treatment for PTSD following multiple traumatic events. This article aims to examine the applicability of NET for UAM in routine clinical practice and to provide preliminary feasibility, acceptability and effectiveness data. The participants were four UAM receiving NET within a dedicated child and adolescent mental health service for refugee children. Semi-structured interviews were conducted to understand the acceptability of this approach and standardised measures of PTSD were used to provide preliminary data regarding the effectiveness of NET for these clients. The clients attended NET consistently with few missed appointments. At post-treatment, two clients’ symptom scores were below the clinical cut-off for PTSD and all three clients who completed NET met reliable improvement criteria. The clients reported improvements in functional outcomes and mentioned that they would encourage other young people with similar difficulties to engage in NET. This study was limited by the small sample size and naturalistic time limitations in clinicians’ contracts. This article highlights that it is possible to implement NET within routine clinical practice and observed improvements in PTSD symptoms and functional outcomes for UAM.
Digitizing freelance media labor: A class of workers negotiates entrepreneurialism and activism
Authors: Salamon Errol
Published: July 2019

Due to economic instability and technological change in digital media industries, media organizations and educators have encouraged freelance media workers to see themselves as individual businesses rather than a class of workers that should collectively protect their rights and fair pay. This article examines how freelance media workers negotiate individualism and collectivism, producing a contradictory freelance class ideology. It is grounded in an exploratory critical political economy of communication and sociology of work approach. It is based on interviews with 21 freelance journalists and professional writers, considering how they discursively construct their work practices and coping strategies vis-à-vis their uses of digital technology and the structural factors that shape media industries. Through discourse, these workers produce a contradictory “e-lance” class ideology as both entrepreneurs who temporarily sell goods and services and activists who temporarily resist demands from clients that they give up their rights and pay.
Time to read: Exploring the timespaces of subscription-based audiobooks
Authors: Tattersall Wallin Elisa , Nolin Jan
Published: July 2019

With remediation of the printed book into audiobook subscription services, reading by listening is becoming a popular alternative to reading by seeing. This article explores when people read by listening and whether there may be a shift regarding the places and times people read by listening rather than by seeing. Based on a considerable dataset from a Swedish subscription service for digital books, this article reveals that audiobook reading takes place at somewhat different times than expected and that subscribers read significant amounts each day. The findings indicate that the remediation into reading by listening using digital audiobooks may close the gender gap common in reading, as the reading practices of men and women are very similar, with men even reading slightly more than women. The reading practices of young adults are also similar to the larger population. Furthermore, the concepts stationary reading, mobile reading and stationary/mobile reading are introduced.
Governing ‘disadvantage’ through readiness: A Foucauldian policy genealogy of funded nursery places for two-year-olds
Authors: Lee Siew Fung
Published: July 2019

This article critically examines how the policy of funded nursery places for ‘disadvantaged’ two-year-olds in England opens up economic and political spaces in readiness for increased governance. The government introduced funded nursery places in September 2013, which aimed to promote disadvantaged children’s educational outcomes, narrow the attainment gap and encourage parental employment. Using a Foucauldian policy genealogy, the article sets out the ways in which funded nursery places constitute and deploy techniques for governing ‘disadvantage’ – specifically, how ‘disadvantage’ is constructed as a ‘problem of the population’, which, in turn, is productive of particular subjectivities and practices. The article traces how funded nursery places construct a particular ‘disadvantage’ through ‘experts of truth’, evidence-based policy, regimes of quality and neurobiology in preparation for the next phase of nursery at the age of three. These processes establish ‘disadvantaged’ two-year-olds as governable objects and therefore subject to the increased formalization of early experiences. The close links between ‘disadvantage’ and ‘readiness’ discursively provide conditions of possibility for technical and instrumental practice that is driven by a global hegemonic rationale in human capital. Although the analysis is focused in the English context, these developments have wider global implications in relation to school readiness and early education reforms across countries that are reaching into ever younger spaces.
Ethnography, ethics and ownership of data
Authors: Russell Lisa , Barley Ruth
Published: July 2019

Establishing trust and obtaining informed consent with participants is reliant upon on a process whereby unequally positioned agents constantly re-negotiate (mis)trust and consent during ethnographic encounters. All research has been increasingly subject to an intensification in ethical regulation, within a context whereby Eurocentric norms and ethical guidelines arguably diminish individual accountability under the guise of quasi-contractual relationships. This phenomenon has particular implications for ethnography and its management of ethics, given its intimate, longitudinal and receptive nature. Two expert ethnographers working with children and young people draw upon their work to reveal how issues of informed consent and data ownership can shift and be a source of tension and unequal power dynamics. The ethnographer requires autonomy while managing ethics soundly in situ to work within the messiness and unpredictability of participants’ everyday lives.
Justice and discretion in the law of unjust enrichment
Authors: Hedley Steve
Published: July 2019

The academic theory of unjust enrichment, hypersensitive to charges that it represents ‘palm-tree justice’, aspires to a high degree of rigour and conceptual unity. The judiciary, while highly receptive to that theory, are nonetheless subject to the demand to do substantial justice in individual cases. This article reviews that tension in contemporary theory and case law. Firstly, it reviews the failure, to date, of theories seeking to justify modern unjust enrichment theory. Next, it notes the increasing rigidity of that theory. Then it reviews recent case law, where judges have evidently allowed other considerations to guide the application of theory. Finally, the article suggests that we have reached the stage where any apparently unfair claim in unjust enrichment will be refused whether or not that unfairness can find a niche in current theory, thus effectively making the liability subject to a judicial discretion.
Association Between Comprehensive School Physical Activity Program Implementation and Principal Support
Authors: Lee Joey A. , Welk Gregory J.
Published: July 2019

The use of Comprehensive School Physical Activity Program (CSPAP) has been recommended to help students achieve 60-minutes of physical activity each day. Implementing a CSPAP requires planning, coordination, and ongoing oversight, but an understudied factor is how principal support influences CSPAP implementation. The purpose of this study was to evaluate the impact of principal support on CSPAP implementation. Method. Schools in the Iowa FitnessGram Initiative ( n = 84), a participatory network of schools committed to supporting physical education and wellness efforts, were invited to participate in the study. Physical education teachers from 42 schools completed a survey assessing CSPAP implementation and principal support for school wellness. Descriptive statistics and correlation analyses were used to report associations between the variables. A regression analysis was conducted to evaluate the impact of principal support on CSPAP implementation. Results. Almost half of the schools were reported to be fully implementing just one CSPAP component and no school was reported to be fully implementing all five. The CSPAP component with the highest reported level of implementation was quality physical education, while the lowest level of implementation was reported for family and community engagement and staff involvement. The regression analysis identified that principal support was a significant predictor of CSPAP implementation, b = 0.55, t(37) = 3.10, p < .004. Conclusions. Principal support is associated with implementation of CSPAP initiatives. Strategies that focus on how to attain principal support for CSPAP initiatives are needed and could have a significant impact on student physical activity and health.
From Cervical Cap to Mobile App: Examining the Potential Reproductive Health Impacts of New Technologies
Authors: Dorland Julie M. , Fowler Leah R. , Morain Stephanie R.
Published: July 2019

Web- and application-based prescription services have been heralded as “Uber for birth control,” offering patients the convenience of obtaining hormonal contraceptives at the touch of a smartphone screen. This innovation stands poised to disrupt a system that currently fails to meet the contraceptive needs of many women, particularly adolescents and those who are rural or low-income. The creation of online contraceptive prescribers provides a new and promising avenue for increased access to hormonal birth control. However, the reach and coverage of these services, as well as their implications for public health goals, including unintended pregnancy and various health screenings, remains unclear. In this article, we describe the current landscape of online contraceptive services and identify the potential impacts on unplanned pregnancy and other health outcomes. We find these services may reduce geographic and logistical barriers for rural and low-income populations. However, their impact on access for adolescents is likely to be minimal, as more than half the services do not prescribe to minors. Furthermore, increasing use of telemedicine may reduce rates of screening for public health concerns, including interpartner violence, sexually transmitted infections, and cervical cancer. We offer specific recommendations for future research to evaluate the impact of these services on unplanned pregnancy and other public health outcomes.
Effect of Different EndoAnchor Configurations on Aortic Endograft Displacement Resistance: An Experimental Study
Authors: Goudeketting Seline R. , Vermeulen Jenske J. M. , van Noort Kim , te Riet o. g. Scholten Gerben , Kuipers Henny , Slump Cornelis H. , de Vries Jean-Paul P. M.
Published: July 2019

Purpose: This study investigated the effect of different EndoAnchor configurations on aortic endograft displacement resistance in an in vitro model. Materials and Methods: An in vitro model was developed and validated to perform displacement force measurements on different EndoAnchor configurations within an endograft and silicone tube. Five EndoAnchor configurations were created: (1) 6 circumferentially deployed EndoAnchors, (2) 5 EndoAnchors within 120° of the circumference and 1 additional, contralateral EndoAnchor, (3) 4 circumferentially deployed EndoAnchors, (4) 2 rows of 4 circumferentially deployed EndoAnchors, and (5) a configuration of 2 columns of 3 EndoAnchors. An experienced vascular surgeon deployed EndoAnchors under C-arm guidance at the proximal sealing zone of the endograft. A constant force with increments of 1 newton (N) was applied to the distal end of the endograft. The force necessary to displace a part of the endograft by 3 mm was defined as the endograft displacement force (EDF). Two video cameras recorded the measurements. Videos were examined to determine the exact moment 3-mm migration had occurred at part of the endograft. Five measurements were performed after each deployed EndoAnchor for each configuration. Measurements are given as the median and interquartile range (IQR) Q1, Q3. Results: Baseline displacement force measurement of the endograft without EndoAnchors resulted in a median EDF of 5.1 N (IQR 4.8, 5.2). The circumferential distribution of 6 EndoAnchors resulted in a median EDF of 53.7 N (IQR 49.0, 59.0), whereas configurations 2 through 5 demonstrated substantially lower EDFs of 29.0 N (IQR 28.5, 30.1), 24.6 N (IQR 21.9, 27.2), 36.7 N, and 9.6 N (IQR 9.4, 10.0), respectively. Decreasing the distance between the EndoAnchors over the circumference of the endograft increased the displacement resistance. Conclusion: This in vitro study demonstrates the influence EndoAnchor configurations have on the displacement resistance of an aortic endograft. Parts of the endograft where no EndoAnchor has been deployed remain sensitive to migration. In the current model, the only configuration that rivaled a hand-sewn anastomosis was the one with 6 EndoAnchors. A circumferential distribution of EndoAnchors with small distances between EndoAnchors should be pursued, if possible. This study provides a quantification of different EndoAnchor configurations that clinicians may have to adopt in clinical practice, which can help them make a measured decision on where to deploy EndoAnchors to ensure good endograft fixation.
Effect of KNL1 on the proliferation and apoptosis of colorectal cancer cells
Authors: Bai Tianliang , Zhao Yalei , Liu Yabin , Cai Bindan , Dong Ning , Li Binghui
Published: July 2019

Objective:

To identify the expression of kinetochore scaffold 1 ( KNL1) in colorectal tumor tissues and to clarify the role of this gene in the proliferation capability of colorectal cancer cells.

Methods:

A total of 108 paired colorectal tumor and normal tissue samples were collected from patients with colorectal cancer and subjected to quantitative polymerase chain reaction and immunohistochemistry analyses. Expression levels of KNL1 mRNA and protein were compared between tumor and normal tissues, and KNL1 levels were evaluated in relation to the patients’ tumor differentiation, sex, lymph node metastasis, TNM stage, infiltration depth, age, and tumor location. Survival curves were also constructed and compared between patients with tumor samples with and without KLN1 protein expression. KNL1 was under-expressed in colorectal cancer cells in vitro using lentiviral transfection with short hairpin RNA, and its function was evaluated by proliferation, colony-formation, and apoptosis assays. Expression levels of BUB1 protein were also compared between tumor and normal tissues, and the correlation between KNL1 expression and BUB1 expression in colorectal cancer tissues was examined.

Results:

KNL1 mRNA and protein were both highly expressed in colorectal tumor tissues compared with paired normal tissues. KNL1 downregulation significantly inhibited colorectal cancer cell proliferation and colony formation, and promoted apoptosis. KNL1 protein expression was significantly associated with tumor differentiation, but not with sex, lymph node metastasis, TNM stage, infiltration depth, age, or tumor location. KNL1 protein expression was also significantly associated with poorer survival. Moreover, there was a significant correlation between KNL1 and BUB1 in colorectal cancer tissues.

Conclusions:

KNL1 plays an effective role in decreasing apoptosis and promoting the proliferation of colorectal cancer cells, suggesting that its inhibition may represent a promising therapeutic approach in patients with colorectal cancer.
Leukoaraiosis Is Associated With a Decline in Language Abilities in Chronic Aphasia
Authors: Basilakos Alexandra , Stark Brielle C. , Johnson Lisa , Rorden Chris , Yourganov Grigori , Bonilha Leonardo , Fridriksson Julius
Published: July 2019

Background. A fraction of stroke survivors with chronic aphasia experience declines in language abilities over time, but the reason for this remains unclear. Objective. To evaluate the effect of leukoaraiosis on baseline aphasia severity and long-term changes in aphasia severity. This study directly compares the predictive capacity of leukoaraiosis severity to that of lesion damage, a factor known to account for a substantial proportion of variance in the degree of language impairment and recovery. Methods. Using a longitudinal database of behavioral and neuroimaging data from 35 individuals in the chronic stage of recovery after a single-event left-hemisphere stroke (9 females, mean stroke age = 55.8 ± 9.1 years, mean months poststroke at initial evaluation = 36.3 ± 40.8), we examined 2 lines of inquiry: (1) to what extent does leukoaraiosis severity at initial evaluation predict aphasia severity and (2) to what extent does leukoaraiosis severity at initial evaluation predict longitudinal change in aphasia severity. Participants underwent high-resolution magnetic resonance imaging for the purpose of lesion volume analysis and leukoaraiosis severity rating. Biographical information was also considered. Results. Lesion volume and time poststroke at initial assessment best predicted initial aphasia severity (adjusted R2 = 0.37). Leukoaraiosis severity and initial aphasia severity significantly predicted decline in language abilities at follow-up, accounting for approximately one-third of the variance (adjusted R2 = 0.33). More severe leukoaraiosis was associated with a 4.3 odds increase of decline. Conclusions. Leukoaraiosis is a significant risk factor for declining language abilities in aphasia and should be considered for better identification of individuals at risk for long-term decline, which can guide clinical decision making.
Back to the future? The role of temporal focus for mapping time onto space
Authors: Bylund Emanuel , Gygax Pascal , Samuel Steven , Athanasopoulos Panos
Published: July 2019

Do we conceptualise the future as being behind us or in front of us? Although this question has traditionally been investigated through the lens of spatiotemporal metaphors, new impetus was recently provided by the Temporal-Focus Hypothesis. This hypothesis holds that the mapping of temporal concepts onto the front–back axis is determined by an individual’s temporal focus, which varies as a function of culture, age, and short-term attention shifts. Here, we instead show that participants map the future on to a frontal position, regardless of cultural background and short-term shifts. However, one factor that does influence temporal mappings is age, such that older participants are more likely to map the future as behind than younger participants. These findings suggest that ageing may be a major determinant of space–time mappings, and that additional data need to be collected before concluding that culture or short-term attention do influence space–time mappings.
The impact of consonant–vowel transpositions on masked priming effects in Italian and English
Authors: Colombo Lucia , Spinelli Giacomo , Lupker Stephen J
Published: July 2019

There are now a number of reports in the literature that transposed letter (TL) priming effects emerge when two consonants are transposed (e.g., caniso-CASINO) but not when two vowels are transposed (e.g., cinaso-CASINO). In the present article, four masked priming lexical decision experiments, two in Italian and two in English, are reported in which TL priming effects involving the transposition of two adjacent consonants (e.g., atnenna-ANTENNA) were contrasted with those involving the transposition of a vowel and an adjacent consonant (e.g., anetnna-ANTENNA), a contrast not directly examined in the previous literature. In none of the experiments was there any indication that the priming effects were different sizes for the two types of transpositions, including Experiment 4 in which a sandwich priming paradigm was used. These results support the assumption of most orthographic coding models that the consonant–vowel status of the letters is not relevant to the nature of the orthographic code. The question of how to reconcile these results with other TL manipulations investigating vowel versus consonant transpositions is discussed.
The Artification of Trapeze Acts: A New Paradigm for Circus Arts
Authors: Sizorn Magali
Published: July 2019

This article uses the concept of artification to analyze how circuses have been transformed. Through a socio-historical study of trapeze artists’ work since 1850, I will show that the opening of two schools for circus performers in Paris in 1974 (the Carré Monfort school and the Fratellini school), as well as the concomitant development of new aesthetics constituted decisive factors in the shift to artistry and contributed to a redefinition of trapeze acts and the circus as arts. While my fieldwork was conducted mainly in France, the purpose of this contribution is also to initiate wider discussion about the effects of artification in a globalized context. The transformations, begun in the 1970s, succeeded in creating new markets, but also new spaces for training, production and circulation dedicated to the circus arts, within which actors, skills and values now circulate.
Official memories and legal constraints: A classification of memory instruments in France and Belgium
Authors: Grandjean Geoffrey
Published: July 2019

Public authorities do not have a monopoly over memory constraint in the sense that they are not alone in promoting collective memories. However, the article suggests a classification of the memory instruments in France and Belgium according to the degree of legal constraint (sanctioning, prescriptive and latent). This classification offers a new understanding of the exercise of the legal constraints which are a way for the public authorities to offer specific accounts of certain past events.
Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?
Authors: Nardone Olga Maria , Cannatelli Rosanna , Zardo Davide , Ghosh Subrata , Marietta Iacucci
Published: July 2019

The targets of therapy in inflammatory bowel disease have transformed in the last few years. The standard definition of mucosal healing assessed using white light standard definition endoscopy is being challenged because even when endoscopy suggests mucosal healing, the presence of histological activity can often still be observed. Of note, microscopic signs of inflammation correlate with clinical outcomes such as risk of relapse, hospitalization and colorectal cancer. Therefore, histological healing has increasingly become an important target to achieve. Advanced endoscopic technologies have been developed and many are starting to be adopted in daily clinical practice. They can provide a more detailed view of the mucosal and vascular architecture almost at the histology level, including crypt, vessel architecture and cellular infiltration. So, these can provide a more accurate definition of mucosal and histological healing. In this review we focus on new advanced endoscopic techniques, and how these have the potential to reduce the gap between histological and mucosal healing.
Intravenous immunoglobulin to prevent myasthenic crisis after thymectomy and other procedures can be omitted in patients with well-controlled myasthenia gravis
Authors: Gamez Josep , Salvadó María , Carmona Francesc , de Nadal Miriam , Romero Laura , Ruiz Daniel , Jáuregui Alberto , Martínez Olga , Pérez Javier , Suñé Pilar , Deu María
Published: July 2019

Background:

Myasthenic crisis (MC) is a potentially life-threatening complication of myasthenia gravis. Its precipitating factors include surgical procedures, particularly thymectomy. The role of preoperative intravenous immunoglobulin (IVIg) in preventing MC in patients scheduled for thymectomy and other surgery with general anaesthesia is unknown. Our objective was to test the hypothesis that preoperative IVIg is effective in preventing myasthenic crisis in patients with myasthenia gravis scheduled for surgery under general anaesthesia, including thymectomy.

Methods:

A prospective, randomized, double-blind, single-centre study was conducted over a 4-year period. The treatment group received IVIg, 0.4 g/kg/day preoperatively for 5 consecutive days, and the placebo group received saline solution under the same conditions. The two groups were age-matched, with similar functional status, and Myasthenia Gravis Foundation of America class. All patients had well-controlled myasthenia gravis with minimal manifestations before surgery. The primary outcome measured was MC. Intubation times, time in the recovery room, number of postoperative complications, and days of hospitalization were the secondary outcomes measured.

Results:

A total of 47 patients were randomized, 25 to the IVIg group and 22 to placebo. There were 19 men and 28 women, with a mean age of 58.6 years, mean body mass index of 27.8 kg/m2, and mean acetylcholine receptor antibodies of 12.9 nmol/l. The mean forced vital capacity was 84.4%. The mean quantitative myasthenia gravis sum score was 6.3. Ten patients (five in each arm) had a history of MC. Thymectomy was performed in 16 patients. Only one patient in the placebo group presented with MC requiring non-invasive ventilation (but no reintubation) for 6 days. Neither differences between groups in the univariate analysis nor risk factors for MC in the multivariate analysis were found.

Conclusions:

Preoperative IVIg to prevent MC does not appear to be justified in well-controlled myasthenia gravis patients. This study provides class I evidence that preparation with IVIg to prevent MC is not necessary in well-controlled myasthenia gravis patients scheduled for surgery with general anaesthesia.
A real-world analysis of second-line treatment options in pancreatic cancer: liposomal-irinotecan plus 5-fluorouracil and folinic acid
Authors: Kieler Markus , Unseld Matthias , Bianconi Daniela , Scheithauer Werner , Prager Gerald W.
Published: July 2019

Background:

Nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil/leucovorin (5-FU/LV) is a novel treatment option for gemcitabine-pretreated metastatic pancreatic adenocarcinoma (PAC) patients, but real-world evidence is rare. Our aim was to determine the effectiveness and tolerability of this regimen in advanced PAC patients and to compare it with oxaliplatin plus fluoropyrimidines in the second-line setting after failure of gemcitabine.

Methods:

This is a retrospective single-center analysis of all patients who have been treated with nal-IRI plus 5-FU/LV. To compare its effectiveness with other second-line treatment options, all patients who had received oxaliplatin plus fluoropyrimidines after gemcitabine-based chemotherapy were also eligible for analysis.

Results:

Fifty-two patients were treated with nal-IRI plus 5-FU/LV between April 2016 and August 2018. The median progression-free survival (PFS) was 3.84 months and the median overall survival (OS) was 6.79 months. Median OS from the beginning of the treatment for advanced disease was 19.9 months. Median PFS in patients that received nal-IRI plus 5-FU/LV as second-line treatment after gemcitabine-based chemotherapy was 4.49 months whereas median PFS in a matched cohort of patients treated with oxaliplatin plus fluoropyrimidines was 3.44 months ( p = 0.007). Between these two groups the median OS of patients with CA 19-9 levels above the statistical median (⩾772.8 kU/l) differed significantly (9.33 versus 6.18 months, p = 0.038).

Conclusion:

Our data confirms the effectiveness of nal-IRI plus 5-FU/LV treatment as a well-tolerated regimen in the treatment of advanced PAC and extends available data on its use as a second-line treatment option when compared with oxaliplatin plus fluoropyrimidines.
Synthesis and Cytotoxicities of Novel Podophyllotoxin Xyloside Derivatives
Authors: Zi Cheng-Ting , Yang Liu , Zhang Bang-Lei , Li Yan , Ding Zhong-Tao , Jiang Zi-Hua , Hu Jiang-Miao , Zhou Jun
Published: July 2019

Novel podophyllotoxin xyloside derivatives 8 to 11 were synthesized and evaluated for their cytotoxicities against a panel of 5 human cancer cell lines (HL-60, SMMC-7721, A-549, MCF-7, SW480) using [3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide] assays. These derivatives showed good to moderate activities, with compound 9 having an IC50 value of 4.42 μM against the A-549 cell line. Overall, compound 9 might be a promising candidate for further development.
Increasing Tips in Less Than Two Hours: Impact of a Training Intervention on the Amount of Tips Received by Restaurant Employees
Authors: Fernandez Sébastien , Dufour Florian , Costa Vânia , de Boer Charlotte , Terrier Lohyd , Golay Philippe
Published: July 2019

Previous studies have shown that restaurant employees who use tip-enhancing behaviors such as smiling, introducing oneself by one’s name or writing “thank you” on the bill receive more tips. The aim of this study is to evaluate the impact of a training intervention about tip-enhancing behaviors on the amount of tips received by restaurant employees. The sample of this study comprised 143 employees working in 62 restaurants. Sixty-nine participants took part in the training intervention and 74 were in the control condition. After the training intervention, the amount of tips received by the employees was tracked over 5 days. Results showed that participants who followed the training intervention used more tip-enhancing behaviors than the participants in the control group, that a higher use of tip-enhancing behaviors was related to higher amount of tips and that the effect of the training intervention on the amount of tips was fully mediated by an increase in the use of tip-enhancing behaviors.
Overclaiming Knowledge Predicts Anti-establishment Voting
Authors: van Prooijen Jan-Willem , Krouwel André P. M.
Published: July 2019

People often vote against the political establishment, as underscored by “Brexit” and the Trump election. The current contribution proposes that overclaiming one’s own knowledge predicts anti-establishment voting. We tested this idea in the context of a Dutch referendum on a European Union treaty with a clear pro- versus anti-establishment voting option. In a first wave (6 weeks before the referendum), Dutch citizens indicated their self-perceived understanding of the treaty, after which we tested their actual knowledge. We also measured participants’ general tendency to overclaim knowledge by assessing their familiarity with nonexisting stimuli. In a second wave shortly after the referendum, we asked participants what they had voted. Results revealed that increased self-perceived understanding yet decreased actual knowledge of the treaty, and general knowledge overclaiming, predicted an anti-establishment vote. Furthermore, these effects were most pronounced among right-wing extremists. We conclude that knowledge overclaiming predicts anti-establishment voting, particularly at the radical right.
New literacies in participatory cultures: The assumption of trust
Authors: Marsh Valerie L , Hoff Martha J
Published: July 2019

New literacies research and theory touts the advantages of participatory cultures where youth collaborate, connect, and share knowledge. However, these practices assume a certain level of trust. With a lens that combines sociological theories of trust and a new literacies theory of participatory culture, this paper draws on two studies of youth literacies practices. The participants represent urban and suburban as well as online and offline contexts. Findings bring to bear the centrality of trust to decisions and choices when participating in these communities, pushing research to consider trust and mistrust more thoroughly when theorizing benefits of participatory cultures.
Management of patients eligible for proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors: economic impact and reform proposals
Authors: Jommi Claudio , Cavazza Marianna
Published: July 2019

Background:

PCSK9 inhibitors are indicated for primary hypercholesterolemia (heterozygous familial and non-familial) and for homozygous familial hypercholesterolemia (only evolocumab). They are subject to a drug registry for patient eligibility and follow-up. Patient access to PCSK9 inhibitors is still very limited and varies across regions.

Aim:

This paper aimed to investigate the cost of the PCSK9-treated patient pathway and main barriers to patient access to medicines and to suggest some changes to this pathway.

Methods:

The research was conducted through a literature review and an expert panel, which was surveyed through a Delphi approach. The panel included seven clinicians and five pharmacists.

Results:

If patients are exempt from co-payment, the Italian National Health Service spends €169.70 and €276.93 per year to manage the PCSK9-treated patient pathway, depending on registry coverage (six or three treatment months, respectively). Non-exempt patients pay €176,43 and €271.53 (for six and three months of coverage, respectively) per year. The referral process and the length of the pre-PCSK9 treatment period were considered the main barriers to access. The panelists suggested that the pre-PCSK9 treatment period be shortened to three months; they recommended six months of registry coverage, thereby decreasing the costs compared to three months’ coverage; and they advised that outpatient specialists also be authorized to manage the follow-up. These actions may reduce pathway costs and enhance awareness of the disease.

Discussion:

The study shows that the pathway of patients eligible for PCSK9 inhibitors can be improved. The surveyed experts integrated pathway-specific recommendations with broader advice to increase awareness on hypercholesterolemia in both citizens and general practitioners.
Surgical treatment of chondroblastoma using extended intralesional curettage with phenol as a local adjuvant
Authors: Zekry Karem M , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Araki Yoshihiro , Alkhooly Ali Zein AA , Abd-Elfattah Ahmed Saleh , Fouly Ezzat H , Elsaid Ahmed Nady Saleh , Tsuchiya Hiroyuki
Published: July 2019

Purpose:

The aim of this study is to report the clinical and radiological outcomes following surgical treatment of chondroblastoma by means of an extended intralesional curettage using high-speed burr, with phenol as a local adjuvant which is followed by the implantation of synthetic bone graft, aiming to lower the recurrence rate of this tumor.

Patients and Methods:

This retrospective study included 20 patients with chondroblastoma lesions during the period between 2000 and 2015.

Results:

Fifteen males and five females were followed up for a mean of 63.35 (26–144) months with average age at the time of presentation was 20.8 (range: 12–32) years. Nineteen patients (95%) were complaining of pain at the time of presentation, and the lesion was discovered accidently in one patient. The mean operative time was 138.5 min (75–250). At the most recent follow-up, all patients had regained full physical function without pain at the operation site.

Conclusion:

The aggressive treatment of chondroblastoma by an extended intralesional curettage using high-speed burr with phenol as a local adjuvant seems effective in lowering the incidence of local recurrence and secondary more aggressive surgeries. Implantation of the bone defects that result from curettage with the synthetic bone substitutes is a good alternative due to rapid restoration of the mechanical strength with good remodeling.
Knee Extension Does Not Reliably Reduce Acute Type II Tibial Spine Fractures: MRI Evaluation of Displacement During Extension Versus Resting Flexion
Authors: Cannamela Peter C. , Quinlan Noah J. , Maak Travis G. , Adeyemi Temitope F. , Aoki Stephen K.
Published: July 2019

Background:

Type II tibial spine avulsion (TSA) fractures have traditionally been managed by first attempting to achieve closed reduction with extension and immobilization, with surgical indications reserved for those who fail to reduce within 3 mm. However, the frequency with which appropriate reduction can be achieved is largely unknown.

Purpose:

To evaluate changes in displacement of type II TSA fractures by comparing magnetic resonance imaging (MRI) scans obtained with the knee in flexion and in extension.

Study Design:

Case series; Level of evidence, 4.

Methods:

Ten patients with type II TSA fractures were identified. Fracture displacement was measured using 3 images for each patient: (1) initial lateral view radiography, (2) sagittal-plane MRI of the knee in resting flexion, and (3) sagittal-plane MRI of the knee in passive extension. Maximum displacement of the bony fragment was measured in the 2 MRI studies for all patients, and the corresponding change in displacement was calculated. Displacement in flexion was compared with displacement in extension using a paired-sample t test. Statistical significance was set at P < .05.

Results:

The displacement distance of the bony fragment was reduced by a mean of 0.97 mm on MRI when the knee was in extension compared with flexion in patients with type II TSA fractures ( P = .02). Mean displacement with extension was 6.14 mm, with no fractures reduced below 4 mm. The largest reduction observed was 2.80 mm. The displacement distance increased in 2 knees with extension. The intermeniscal ligament (IML) was entrapped in 4 of 10 patients; however, the amount of reduction achieved did not differ based on the presence of IML entrapment ( P = .85).

Conclusion:

While the amount of tibial spine displacement warranting surgical treatment can be debated, the study findings suggest that knee extension is not reliable in obtaining adequate closed reduction for type II TSA fractures. Management decisions may need to be based on the initial displacement distance of the fracture, with a lower threshold for operative treatment than previously recognized.