bluuebunny/crossref_metadata_2025 huggingface dataset:
Lateral vibration analysis of monatomic chains considering atomic longitudinal displacement
Authors: Liu Canchang , Ma Chicheng , Qin Zhichang , Zhou Changcheng
Published: February 2019

The lateral vibration of monatomic chains considering atomic longitudinal displacements is studied by using the string vibration theory. The modes of lateral vibration of monatomic chains are assumed as the modes of string vibration. Based on the string assumption, the equation of string vibration for monatomic chains is established. Coordinates of the vibration atoms can be calculated by utilizing boundary conditions and symmetry conditions of monatomic chains. The natural angular frequencies of transverse vibration of monatomic chains are calculated by the string vibration method. The tension of the quantum limitation is given and the value of limitation can be used to distinguish nanoelectromechanical systems from quantum-electromechanical Systems. Natural angular frequencies and resonant frequencies of the monatomic chain string are associated with the axial tension acting on the string and the length of monatomic chains, and they can be altered by changing the length of the string and the axial tension acting on the string. The nonlinear vibration of single atomic chain can be analyzed using the improved Lindstedt–Poincaré multiscale method. The study found that the stiffness of the carbon monatomic chain can be altered by changing the length of the string and the tension acting on the string.
Effective finite element model in-loop system of laminated cylindrical structure for multiple inputs and multiple outputs active vibration control
Authors: Liu Jinxin , Cui Minqi , Qiao Baijie , Li Zengguang , Yang Zhibo , Chen Xuefeng
Published: February 2019

Active vibration control of large laminated cylindrical structures, for example, the cabin of space, air, surficial or subaqueous vehicles, usually requires multiple inputs and multiple outputs to the system, since there are usually multiple vibration sources and each source contains multiple frequency components. The performance of multiple inputs and multiple outputs control system will be dramatically affected by the complex dynamic behavior of the laminated cylindrical structure, thus an effective model is in great request in analyzing and designing the control system. However, there is seldom distributed parametric model, typically, finite element model, applying to the active vibration control system, because of its computational complexity. In this work, we propose an effective finite element model in-loop system of laminated cylindrical structure for multiple inputs and multiple outputs active vibration control simulation. Firstly, an finite element model of laminated thick cylindrical structure with four-node Mindlin degenerated shell element has been constructed. Then, a model reduction procedure has been proposed to obtain in-loop model of the control system. The numerical global modal analysis and harmonic response analysis of the cylindrical structure have been conducted to verify the correctness of the model. Afterward, a multiple inputs and multiple outputs adaptive algorithm which is able to coup with multiple frequencies and multiple sources vibration has been applied to the finite element model in-loop system. Finally, four numerical case studies have been conducted, in which the vibration sources contain multiple frequency components and artificial colored noises. The result shows that the vibration of the multiple control points can be dramatically suppressed simultaneously, which demonstrates the effectiveness of the algorithm and finite element model in-loop system.
Effect of violation of social missions on public attitude towards a social enterprise crisis: Mediation of causal attribution and moderation of medium and framing of online articles
Authors: Ip Ching Yin , Liang Chaoyun
Published: February 2019

This study examined the mediating effect of perceived causal attribution of crisis on the relationship between perceived violation of social missions and public attitude, in addition to examining the moderating effects of both the medium and framing of online articles on the relationship between perceived violation of social missions and public attitude and that between perceived causal attribution and public attitude. The study conducted a quantitative content analysis of 511 comments obtained from 16 online articles for analysing a social enterprise crisis. The results supported that perceived causal attribution mediated the effect of perceived violation of social missions on public attitude. In addition, episodically framed articles enhanced the effect of perceived violation of social missions on public attitude, whereas Facebook articles enhanced the effect of perceived causal attribution on public attitude. Implications for public relations practitioners and journalists are discussed in this article.
United in fear: Interest group coalition formation as a weapon of the weak?
Authors: Hanegraaff Marcel , Pritoni Andrea
Published: February 2019

Although many interest groups work together perpetually, most academic studies agree that coalition formation does not lead to more influence. In this article, we try to explain these puzzling findings. While former research generally tends to frame the decision of forming an interest group coalition as a strength, in this paper, we argue that coalition building should be considered as a ‘weapon of the weak’. Interest groups fearing that they are insufficiently influential, and whose very existence as an organisation is at risk, are more likely to coalesce. This theoretical framework is tested on a sample of around 3000 interest groups in six European countries – Belgium, Italy, Lithuania, the Netherlands, Slovenia and Sweden – and the European Union. Empirical findings clearly demonstrate that perceived fears – oriented towards both organisational survival and policy influence – have an effect on how likely it is that an interest group will decide to build a coalition.
Club Rugby, the University Student Collegiate Experience, and Perceived Gains
Authors: Martin Eric , Unfried Alana , Beckham George
Published: February 2019

To examine the relationship between club rugby participation, collegiate experiences, and perceived gains, 37 rugby players and 33 nonathlete students completed the Student-Athlete Experiences Inventory–Revised, Student-Athlete Gains Inventory, and Perceived Stress Scale at the start of a Spring semester. Linear regressions were used to determine the relationship between rugby participation, stress, participation in experiences, and perceived gains of students. The two gains modeled were practical and liberal arts gains. Practical arts gains were predicted positively by the experiences of active campus involvement and social interaction, while rugby was a negative predictor, adjusted R 2 = .280, F(3, 65) = 10.90, p < .0001. Liberal arts gains were predicted by social interaction, academic pursuits, and active involvement, adjusted R 2 = .22, F(4, 64) = 6.06, p = .0005. This study confirms how experiences predict different perceived gains. Club rugby players should be encouraged to take advantage of support services on campus to prepare them for their careers.
Adaptive finite-time fuzzy command filtered controller design for uncertain robotic manipulators
Authors: Deng Yanping
Published: February 2019

In this article, an adaptive fuzzy control command filtered control approach, which is capable of achieving finite-time trajectory tracking control of uncertain robotic manipulators, is proposed by using the backstepping control technique. To obtain a finite-time estimation of a virtual control input and its first-order derivative, a second-order finite-time command filter is designed. Based on the backstepping control technique, an adaptive fuzzy controller that guarantees not only that the tracking errors tend to an arbitrary small region in finite time but also that all signals in the closed-loop system keep bounded is established. Finally, the effectiveness of the proposed method is demonstrated by simulation on a two-link robotic manipulator.
Assessing Contradictions: Methodological Challenges when Mapping Symbolic Boundaries
Authors: Sølvberg Lisa MB , Jarness Vegard
Published: February 2019

In this article, we address the methodological question of making sense of contradictions in sociological analysis. Focusing on the scholarly debate about generating and interpreting data on symbolic boundaries – the ways in which social actors evaluate, categorise and judge others – we argue in favour of the continued relevance of the qualitative interview. We discuss how we can move beyond merely mapping attitudinal stances and deal with inconsistencies and contradictions in interviewees’ accounts when classifying others. Rather than seeing contradictions as reflecting a fundamentally unreliable and invalid method of studying people’s feelings, thoughts and attitudes, we argue that they can be viewed as reflecting existing contradictions that people grapple with in everyday life. To illustrate our methodological points, we conduct a small-scale empirical analysis of bodily distinction and symbolic boundaries among a sample of physically active, upper-class men in Norway. Highlighting tensions between interviewees’ honourable and visceral narratives, our analysis explores how such tensions can be teased out by using certain interviewing techniques. We argue that interviewees’ contradictory accounts are connected to the level of abstraction in the phrasing of interview questions. We thus emphasise the importance of methodological reflexivity in studying symbolic boundaries.
Prepared to Lead: Educational Leadership Graduates as Catalysts for Social Justice Praxis
Authors: Guillaume Rene O. , Saiz Magdalena S. , Amador Adam García
Published: February 2019

Situated within PK-12 school settings is the most diverse student population this nation has seen. Concern regarding the preparedness of those at the forefront of education bestows the task to educational leadership programs of developing leaders ready to address social justice issues. This study highlights how graduates from one educational leadership program relied on their academic knowledge and applied critical leadership to operationalize social justice praxis. Utilizing a phenomenological approach, 10 semi-structured interviews revealed three themes. Findings suggest educational leadership programs reflect their mission of social justice values through their curriculum to prepare educational leaders for sustainable change.
Genetic testing for familial hypercholesterolemia: Impact on diagnosis, treatment and cardiovascular risk
Authors: Lee Seohyuk , Akioyamen Leo E , Aljenedil Sumayah , Rivière Jean-Baptiste , Ruel Isabelle , Genest Jacques
Published: February 2019

Aims

Familial hypercholesterolemia (FH) is the most common genetic disorder in medicine, with a prevalence of 1/250. Affected individuals have elevated low-density lipoprotein cholesterol (LDL-C) and an increased lifetime risk of atherosclerotic cardiovascular disease (ASCVD). The diagnosis of FH is based on algorithms that include LDL-C levels, physical manifestations, family history of high LDL-C and premature ASCVD, and, more recently, genetic testing. We sought to determine the impact of genetic testing on the: 1) diagnosis of ‘definite familial hypercholesterolemia’, 2) initiation and adherence of lipid-lowering therapy and 3) risk of ASCVD.

Methods

We performed a systematic review and meta-analysis, pooling odds ratios and 95% confidence intervals for ASCVD from studies comparing risk estimates in individuals harboring FH-causing variants and unaffected individuals.

Results

After screening 3304 unique publications, 56 studies were included in the analysis. 1) Genetic testing provided confirmation of FH in 28–80%, over clinical criteria alone, depending on the diagnostic algorithm and the method of analysis. In two large population-based studies comprising 76,751 individuals, an FH-causing variant was identified in only 1.7–2.5% of subjects with an LDL-C > 4.9 mmol/L (190 mg/dL). 2) A confirmed molecular diagnosis increased lipid-lowering therapy adherence (five studies, n = 4181 definite FH). 3) Loss-of-function variant of the LDLR were at a markedly increased risk of myocardial infarction (odds ratio 6.77, 95% confidence interval 4.75–9.66), and patients with a milder (hypomorphic) pathogenic LDLR change had a 4.4-fold increase in risk (odds ratio 4.4, 95% confidence interval 2.34–8.26), compared with controls.

Conclusion

DNA sequencing confirms the diagnosis of FH but has a poor yield in unselected patients whose sole criterion is an elevated LDL-C. Initiation and adherence to treatment is improved. The risk of ASCVD is 4.4- to 6.8-fold increased in patients with an FH-causing variant compared with controls, depending on the severity of the DNA change.
Isocapnic buffering period: From physiology to clinics
Authors: Carriere Cosimo , Corrà Ugo , Piepoli Massimo , Bonomi Alice , Salvioni Elisabetta , Binno Simone , Magini Alessandra , Sciomer Susanna , Pezzuto Beatrice , Gentile Piero , Schina Mauro , Sinagra Gianfranco , Agostoni Piergiuseppe
Published: February 2019

Background

During cardiopulmonary exercise test, the isocapnic buffering period ranges between anaerobic threshold (AT) and respiratory compensation point (RCP). We investigated whether oxygen uptake (VO2) increase during the isocapnic buffering period (ΔVO2AT-RCP) is related to heart failure severity and prognosis.

Methods

We retrospectively analysed reduced ejection fraction heart failure patients who attained RCP at cardiopulmonary exercise test. The study endpoint was the composite of cardiovascular mortality and urgent heart transplantation/left ventricular assist device implantation. Hazard ratio was assessed to identify the increase of risk associated with ΔVO2AT-RCP (below and above the median of ΔVO2AT-RCP).

Results

AT and RCP were both identified in 782 (39.2%) out of 1995 reduced ejection fraction heart failure cases. Left ventricular ejection fraction and peak VO2 were 33 ± 9% and 16.5 ± 4.5 mL/kg per min (61 ± 16% of predicted value), suggesting moderate heart failure. At five years, endpoint did not vary between patients below and above the median ΔVO2AT-RCP (3.85 mL/min per kg (25–75th interquartile range = 2.69–5.46)). ΔVO2AT-RCP correlated with several parameters associated to heart failure prognosis, such as peak VO2, VE/VCO2 slope, brain natriuretic peptide and left ventricular ejection fraction. The ΔVO2AT-RCP value was associated with prognosis at univariate but not at multivariable analysis, where only VE/VCO2 slope endured.

Conclusion

ΔVO2AT-RCP correlates with several parameters linked to heart failure severity. Isocapnic buffering period stratifies heart failure patients, but not more than other prognostic indices.
Left ventricular hypertrophy in world class elite athletes is associated with signs of improved cardiac autonomic regulation
Authors: Oggionni Gianluigi , Spataro Antonio , Pelliccia Antonio , Malacarne Mara , Pagani Massimo , Lucini Daniela
Published: February 2019

Aim

In this study we sought to assess whether in elite athletes the physiological increase in cardiac mass attending severe long-term training leading to athlete's heart is accompanied by an improvement of autonomic performance, as assessed by post exercise vagal indices and a novel unitary Autonomic Nervous System Index for sports (ANSIs).

Methods

The study involved 500 elite athletes (23.9 ± 6.4 years) participating in a screening organised by the National Italian Olympic Committee. All subjects underwent a complete medical examination, rest and stand autonomic assessment (heart rate variability) as well as bicycle exercise. ANSIs was also derived as radar plot from rest, stand and heart rate recovery individual proxies of autonomic nervous system regulation. All subjects were grouped into those with left ventricular hypertrophy present (LVH(+)), or not (LVH(–)), according to recognised thresholds.

Results

We observed that LVH(+) athletes (24.8%) showed a marked increase of post-exercise vagal indices (p < 0.001) and of ANSIs (p < 0.001), while no difference was observed for heart-rate variability indices. These changes were contingent upon sport intensity categories.

Conclusions

Elite athletes with physiological cardiac hypertrophy (LVH(+)) present a selective profile of indices of autonomic nervous system performance, characterised by increases of markers of vagal recovery and of the novel unitary autonomic index for sports while RR variance and spectral indices seem to be unmodified. Athlete's heart may be characterised by a specific combination of anatomical and neurocardiac remodeling. This approach might furnish potential warning signs differentiating normal training induced physiology from pathological adaptation.
Body image transformation after breast cancer diagnosis and treatment in southern Thai women
Authors: Peerawong Thanarpan , Phenwan Tharin , Mahattanobon Somrit , Tulathamkij Kandawsri , Pattanasattayavong Uraiwan
Published: February 2019

Objective:

To understand the transition of changed body image after the diagnosis and surgery in women with breast cancer.

Methods:

Semi-structured interview and focus group with narrative approach. Thematic analysis was performed using methodological and investigator triangulation methods.

Results:

Participants’ body image transformation was categorized into three phases: (1) the moment of diagnosis and changed self, (2) transition and recovery, and (3) normalization.

Conclusion:

The truth-telling process of breast cancer diagnosis and the freedom to choose their treatment options have a profound impact on body image transformation of women with breast cancer. Family support, social construction, and social support could help women with breast cancer pass through these transitional process faster, while inappropriate truth-telling by their surgeons and not having any choice in their treatment options will delay the transitional process.
Staged coil embolization after thoracic endovascular stent grafting for aneurysmal chronic type B aortic dissection: A case report
Authors: Nakayama Takuya , Hattori Koji , Hashizume Takuya , Asano Miki
Published: February 2019

We herein describe a 38-year-old woman with Marfan syndrome and chronic type A aortic dissection. Computed tomography showed that the sinus of Valsalva and thoracoabdominal aorta had a diameter of 62 and 55 mm, respectively. After 7 months of a Bentall operation and total arch replacement with the elephant trunk technique, we performed thoracic endovascular aortic repair for an aneurysm of the descending aorta, but we preserved the retrograde flow into the false lumen because it supplied vessels perfusing the spinal cord. Computed tomography angiography 14 months after thoracic endovascular aortic repair showed that the thoracic aortic diameter had increased to 68 mm. We then performed partial (proximal only) coil embolization of the false lumen. After 6 months, the thoracic aortic diameter had decreased to 60 mm and the spinal cord remained perfused via the distal false lumen. Staged coil embolization after thoracic endovascular aortic repair for aneurysmal chronic type B aortic dissection is feasible and can be beneficial.
Monomorphic epitheliotropic intestinal T-cell lymphoma may mimic intestinal inflammatory disorders
Authors: Tian Sufang , Xiao Shu-Yuan , Chen Qiongrong , Liu Huan , Ping Jie
Published: February 2019

There is a significant overlap between intestinal lymphoproliferative disorders (LPDs) and inflammatory conditions of the intestine, including inflammatory bowel disease (IBD), in clinical, endoscopic, or histologic appearance, leading to diagnostic challenges. We report two cases of monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) that were initially considered to be ulcerative colitis (UC) and lymphocytic colitis, respectively. Both patients presented with diarrhea and abdominal pain. Colonoscopy revealed hyperemia and scattered shallow ulcerations in the colon, without obvious mass. Microscopically, the first case exhibited features of active chronic colitis. The second case exhibited features mimicking lymphocytic colitis and ileitis. Correct diagnosis of lymphoma was established when the cases were received as consultation, with additional ancillary tests performed. Being familiar with the endoscopic features and unusual histologic patterns of MEITL described here is critical for prompt diagnosis and timely treatment, which may be conductive to a better prognosis.
A Not So Benign Family Pedigree With Hereditary Chorea: A Broader Phenotypic Expression or Additional Picture?
Authors: Milone Roberta , Masson Riccardo , Di Cosmo Caterina , Tonacchera Massimo , Bertini Veronica , Guzzetta Andrea , Battini Roberta
Published: February 2019

NKX2-1 mutations have been usually associated with a non-progressive neurological disease. Recent reports revealed a vast variability regarding its clinical expressivity. Aim of this work was widening the Benign Hereditary Chorea neurological, cognitive and behavioral phenotype through the description of a child and her family pedigree. Molecular analysis focused on NKX2-1 gene revealed a novel frameshift mutation in the three-generation members described. Cognitive scales detected a relevant developmental delay, and the clinical observation and Autism Diagnostic Observation Schedule -2 administration allowed the diagnosis of autism spectrum disorder in the proband. Microarray testing, further executed to exclude a double hit contextually provoking the complex neurodevelopmental disorder, revealed the 22q11.2 Duplication Syndrome. This paper may contribute to enlarge Benign Hereditary Chorea variable expressivity and, together with other studies reported in the literature, underlines the need to reconsider the term “benign,” verifying the opportunity of more a complex diagnosis.
Social Actors “to Go”: An Analytical Toolkit to Explore Agency in Business Discourse and Communication
Authors: Darics Erika , Koller Veronika
Published: February 2019

We argue that language awareness and discourse analytical skills should be part of business communication curricula. To this end, we propose a three-step analytical model drawing on organizational and critical discourse studies, and approaches from systemic-functional linguistics, to explore agency and action in business communication. Focusing on language and discourse helps students to analyze texts more systematically, researchers to gain deeper insights into organizational discourse, and practitioners to reflect on communication processes and produce texts with more impact. We view discourse as central to organizational processes and render a specific approach accessible and easy to integrate into business communication curricula.
Early Childhood Education at Scale: Lessons From Research for Policy and Practice
Authors: Bassok Daphna , Engel Mimi
Published: February 2019

This AERA Open special topic takes stock of the current knowledge about scaled-up early childhood education (ECE) programs. Rapidly rising ECE participation rates in recent decades have coincided with wide variability in the types of programming available for young children. This expansion makes understanding heterogeneity in effects of ECE crucial. Three articles in this special topic explore heterogeneity in ECE program effects with regard to timing, context, domains, programmatic features, counterfactual conditions, and child characteristics. In addition to exploring heterogeneity, understanding possible mechanisms for improving ECE experiences and outcomes for children and their families is crucial. Articles in this special topic explore three potential drivers for improving ECE services and outcomes, including professional development, curriculum and instruction, and parental supports for ECE educators.
Pilot Study Examining Feasibility and Comparing the Effectiveness of Decision Aids for Hip and Knee Osteoarthritis: A Randomized Trial
Authors: Mangla Mahima , Bedair Hany , Dwyer Maureen , Freiberg Andrew , Sepucha Karen
Published: February 2019

Background. There are many patient decision aids (DAs) available, yet there is limited evidence on comparative effectiveness of different tools. Objective. To examine feasibility of a study protocol and gather preliminary data on comparative effectiveness. Methods. Adult patients seeing a surgeon to discuss treatment for hip or knee osteoarthritis were randomized to hip and knee DAs from two vendors. Pre-visit survey included Hip/Knee Decision Quality Instrument, DA usage, health literacy, and quality of life (EQ-5D). Surgical status was ascertained 6 months post-visit. We examined response rates, eligibility, and compared the two DAs on amount of use, knowledge scores, and receipt of preferred treatment. Results. Overall response rate was 58/74 (78%) and did not differ by study arm. More patients in DA-A group reported reviewing all the DAs (64.5% DA-A v. 24.0% DA-B, P = 0.003). Knowledge scores were similar across arms (55.2% DA-A v. 48.8% DA-B, P = 0.4). For DA-B, knowledge scores were higher for those who reviewed all the DAs compared with those who did not (80% knowledge v. 39% knowledge, respectively, P = 0.004), while scores for DA-A did not vary by usage (62% knowledge v. 53% knowledge, respectively, P = 0.3). A similar percentage of each group received their preferred treatment (77% v. 73%, P = 0.8). Patients who were unsure about preferred treatment at baseline were more likely to have surgery in the DA-A arm compared with the DA-B arm (55% v. 20%, P = 0.1). Limitations. Small sample; patients were only surveyed pre-visit. Conclusion. Despite having different content and formats, the two DAs had similar overall effectiveness. Patients were more likely to review all of DA-A; however, patients who reviewed all of DA-B had the highest knowledge scores.
Preoperative Comorbidities and Postoperative Complications Do Not Influence Patient-Reported Satisfaction Following Humeral Head Resurfacing: Mid- to Long-term Follow-up of 106 Patients
Authors: Beck Andrea , Lee Hannah , Fourman Mitchell , Giugale Juan , Zlotnicki Jason , Rodosky Mark , Lin Albert
Published: February 2019

Background

Humeral head resurfacing (HHR) has emerged as an alternative treatment for glenohumeral osteoarthritis. We investigated the outcomes of HHR using validated patient-reported outcome (PRO) measures.

Methods

A retrospective review was performed on 213 patients who underwent HHR. A PRO follow-up was performed by administering a questionnaire including the American Shoulder and Elbow Society (ASES) score, Brophy activity survey, short form of the Disabilities of the Arm, Shoulder and Hand (quickDASH) survey, and general shoulder function. PRO scores were stratified by comorbidities and complications.

Results

Survey responses were received from 106 patients (51%), with a mean follow-up of 5.6 ± 1.8 years (range: 9 months to 6.1 years). Preoperative comorbidities were associated with significantly higher quickDASH scores. Postoperative complications were associated with significantly higher rates of current pain, higher visual analog scale scores, night pain, lower subjective shoulder values, and lower ASES pain and total scores. No differences in patient satisfaction were identified between the cohorts with and without preoperative comorbidities and between the cohorts with and without postoperative complications.

Conclusion

In our cross-sectional analysis of mid- to long-term outcomes following HHR, preoperative comorbidities, or postoperative complications had no impact on patient-perceived postoperative satisfaction or most PROs. HHR is clinically viable in a wide variety of patients. Future work is necessary to compare the efficacy of HHR compared with more traditional total shoulder arthroplasty and stemmed hemiarthroplasty regarding long-term outcomes and appropriate indications.
Disorganization of Retinal Inner Layers in Retinal Vein Occlusions: New Insights From Anti-VEGF Treatment
Authors: Nguyen Minh T. , Martins Aline L.B. , Heiligenstein Mia A. , Blodi Barbara A. , Mititelu Mihai
Published: February 2019

Purpose:

The purpose of this study is to determine the significance of disorganization of the retinal inner layers (DRIL) in patients with retinal vein occlusions (RVOs) and whether this is influenced by the choice of antivascular endothelial growth factor (anti-VEGF) agent used.

Methods:

A retrospective chart study was conducted on patients with RVO and center-involved macular edema (ME) presenting to the University of Wisconsin with a minimum follow-up time of 12 months. Medical records were reviewed for demographics, vision, and imaging at baseline and 2 study visits over the course of 1 year. Two masked graders evaluated spectral-domain optical coherence tomography scans for DRIL and other features within the 1-mm-wide area centered on the foveal depression.

Results:

Twenty-two eyes had DRIL at baseline. DRIL resolved in 10 eyes at the first study visit, and in 2 more eyes at the second study visit. Although we could not establish an association between visual acuity (VA) and DRIL at baseline, we found a more robust correlation between DRIL extent and VA at baseline in eyes with central retinal vein occlusion/hemicentral vein occlusion compared to eyes with branch retinal vein occlusion. There was an association between DRIL improvement at the first study visit and VA improvement at the second study visit ( P = .049). However, this effect was smaller than the effect of initial VA improvement on final VA improvement. No significant difference in DRIL change was observed between the 3 anti-VEGF treatment algorithms: bevacizumab only, aflibercept only, and bevacizumab followed by aflibercept. Additionally, there was no significant correlation between RVO risk factors and change in DRIL over time.

Conclusions:

In our study, DRIL was not associated with VA in RVO-ME, but its resolution was predictive of VA improvement in response to anti-VEGF therapy. The choice of anti-VEGF agent (bevacizumab, aflibercept or a combination of the 2) did not affect the magnitude of DRIL resolution in RVO.
Factors Influencing Health of the Santals: A Study of Selected Villages of Birbhum
Authors: Sarkar Asok Kumar , Singha Sujan
Published: February 2019

The study discusses the influence of social, economic and cultural factors on health-seeking behaviours of the Santals living in six villages of Birbhum district in West Bengal, India. By employing both qualitative and quantitative methods, data were collected for the study. The analysis shows the link between educational, social, economic and cultural factors and health-seeking behaviour. Lack of economic freedom was found as the predominant indicator in restricting access to better health-care facilities. Poor occupational standards, low levels of income and less investment in maintaining health influence the health-seeking behaviour of Santals in the studied area. The study argues that the existing services are inadequate and often inappropriately implemented. The findings have implications for enhancing the role of education and improving the quality and quantity of services.
Primary Hepatic Follicular Lymphoma Presenting as Sub-acute Liver Failure: A Case Report and Review of the Literature
Authors: Williams Mary-Jane OU , Akhondi Hossein , Khan Omar
Published: February 2019

Sub-acute liver failure is a term that describes the relatively sudden loss of liver function, usually >21 days and <26 weeks, with impaired synthetic function and associated encephalopathy in a person with no pre-existing liver disease or cirrhosis. It is commonly caused by viruses and drugs, less so by malignancy. Our patient is a 71-year-old Japanese man who presented with signs of sub-acute liver failure. A subsequent liver biopsy demonstrated involvement by B-cell non-Hodgkin lymphoma. Evaluation of the bone marrow demonstrated significant marrow involvement by B-cell lymphoma. The fluorescence in situ hybridization (FISH) returned positive for t(14; 18). Noted was the patient’s clinical presentation of cholestasis secondary to hepatic lymphoma with no evidence of lymphadenopathy or peripheralized lymphoma. Given the disease distribution, the overall findings are consistent with primary hepatic follicular lymphoma as described in few case reports and small case series in the literature.
Phase 2 study using oral thalidomide-cyclophosphamide-prednisone for idiopathic multicentric Castleman disease
Authors: Zhang Lu , Zhao Ai-lin , Duan Ming-hui , Li Zhi-yuan , Cao Xin-xin , Feng Jun , Zhou Dao-bin , Zhong Ding-rong , Fajgenbaum David C. , Li Jian
Published: February 2019

Idiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder. The anti–interleukin 6 (IL-6) therapy siltuximab is not available everywhere, and is not effective for over one-half of patients. Alternative treatment approaches are urgently needed. In the first iMCD clinical trial directed against a target other than IL-6 signaling, we investigated a thalidomide-cyclophosphamide-prednisone (TCP) regimen in newly diagnosed iMCD patients. This single-center, single-arm, phase 2 study enrolled 25 newly diagnosed iMCD patients between June 2015 and June 2018. The TCP regimen (thalidomide 100 mg daily for 2 years; oral cyclophosphamide 300 mg/m2 weekly for 1 year; prednisone 1 mg/kg twice a week for 1 year) was administered for 2 years or until treatment failure. The primary end point was durable tumor and symptomatic response for at least 24 weeks. Twelve patients (48%) achieved the primary end point with no relapse, 3 patients (12%) demonstrated stable disease, and 10 patients (40%) were evaluated as treatment failure. Even when considering all patients, there were significant (P < .05) improvements in median symptom score, IL-6 level, hemoglobin, erythrocyte sedimentation rate, albumin, and immunoglobulin G. Among responders, the median levels of all evaluated parameters significantly improved, to the normal range, after treatment. The regimen was well tolerated. One patient died of pulmonary infection and 1 patient had a grade 3 adverse event (rash); 2 patients died following disease progression. Estimated 1-year progression-free survival and overall survival were 60% and 88%, respectively. The TCP regimen is an effective and safe treatment of newly diagnosed iMCD patients, particularly when siltuximab is unavailable. This trial was registered at www.clinicaltrials.gov as #NCT03043105.
Prognostic significance of p16 immunohistochemical expression in urothelial carcinoma
Authors: Hashmi Atif Ali , Hussain Zubaida Fida , Irfan Muhammad , Hashmi Shumaila Kanwal , Asif Huda , Faridi Naveen
Published: February 2019

Background

p16 is the protein product of most commonly involved gene in bladder carcinogenesis. Therefore, we performed an immunohistochemical study to evaluate association of p16 overexpression with prognostic parameters in bladder cancer.

Methods

p16 immunohistochemistry was performed on 121 cases of bladder cancer and association with tumor grade, lamina propria invasion, muscularis propria invasion and survival status was noted.

Results

Low expression of p16 was noted in 86% (104 cases), whereas 14% (17 cases) revealed high p16 expression. We found significant association of p16 expression with tumor grade (p = 0.000), muscularis propria invasion (p = 0.001), lamina propria invasion (p = 0.001) and survival status (p = 0.020). Univariate binary logistics showed that low grade tumors were less likely to express high p16 expression as compared to high grade tumors. Similarly, patients with lamina propria and muscularis propria invasion were more likely to exhibit high p16 expression. Significant association of high p16 expression was noted with worse long term survival (p = 0.020), while univariate logistic regression showed that patients with low p16 expression were at low risk (HR = 0.194) to die of disease as compared to patients with high p16 expression.

Conclusion

p16 is an important biomarker in bladder cancer as it can be used for prognostic stratification of patients with bladder cancer. Moreover, we suggest that molecular studies should be performed in our population in order to correlate abnormal p16 expression with underlying gene mutations.
ATML1 activity is restricted to the outermost cells of the embryo through post-transcriptional repressions
Authors: Iida Hiroyuki , Yoshida Ayaka , Takada Shinobu
Published: February 2019

Cell fate determination in plants relies on positional cues. To investigate the position-dependent gene regulation in plants, we focused on shoot epidermal cell specification, which occurs only in the outermost cells. ATML1, which encodes an HD-ZIP class IV transcription factor, is a positive regulator of shoot epidermal cell identity. Despite the presence of a weak ATML1 promoter activity in the inner cells, ATML1 protein was detected mostly in the outermost cells, which suggests that ATML1 accumulation is inhibited in the inner cells. ATML1 nuclear localization was reduced in the epidermis and there was a positive, albeit weak, correlation between the amount of ATML1 in the nuclei and the expression of a direct target of ATML1. Nuclear accumulation of ATML1 was more strongly inhibited in the inner cells than in the outermost cells. Domain deletion analyses revealed that the ZLZ-coding sequence was necessary and partially sufficient for the post-transcriptional repression of ATML1. Our results suggest that post-transcriptional repressions contribute to the restriction of master transcriptional regulator activity in specific cells to enable position-dependent cell differentiation.
Alternative use of miRNA-biogenesis co-factors in plants at low temperatures
Authors: Ré Delfina A. , Lang Patricia L. M. , Yones Cristian , Arce Agustin L. , Stegmayer Georgina , Milone Diego , Manavella Pablo A.
Published: February 2019

Plants use molecular mechanisms to sense temperatures, trigger quick adaptive responses and thereby cope with environmental changes. MicroRNAs (miRNAs) are key regulators of plant development under such conditions. The catalytic action of DICER LIKE 1 (DCL1), in conjunction with HYPONASTIC LEAVES 1 (HYL1) and SERRATE (SE), produces miRNAs from double-stranded RNAs. As plants lack a stable internal temperature to which enzymatic reactions could be optimized during evolution, reactions such as miRNA processing have to be adjusted to fluctuating environmental temperatures. Here, we report that with decreasing ambient temperature, the plant miRNA biogenesis machinery becomes more robust, producing miRNAs even in the absence of the key DCL1 co-factors HYL1 and SE. This reduces the morphological and reproductive defects of se and hyl1 mutants, restoring seed production. Using small RNA-sequencing and bioinformatics analyses, we have identified specific miRNAs that become HYL1/SE independent for their production in response to temperature decrease. We found that the secondary structure of primary miRNAs is key for this temperature recovery. This finding may have evolutionary implications as a potential adaptation-driving mechanism to a changing climate.
Prevalencia del uso de equipos de protección individual y accidentes en usuarios de bicicletas en São Paulo
Authors: Oliveira dos Santos Rennan Luiz , Hoyos Cadavid Ana María , Gomes Bitu Mariana , Morandi Gabriela , Pena Coto Neide , Campanini Geraldini Cleusa Aparecida
Published: February 2019

Introducción: las bicicletas son un medio de transporte popular que trae beneficios para la salud, cuando son utilizadas regularmente. Sin embargo, son frecuentes los accidentes que se presentan en sus usuarios. El objetivo de este trabajo fue evaluar la prevalencia de accidentes y el uso de equipos de protección individual (EPI) en usuarios de bicicletas en São Paulo (Brasil), por medio de formularios. Además, la población estudiada fue orientada sobre la importancia del uso de EPI. Materiales y métodos: ciclistas de diferentes regiones de São Paulo respondieron a las preguntas hechas en un formulario y fueron orientados sobre el correcto uso de los EPI. Resultados: la muestra total fue de 608 personas, evaluadas y entrevistadas (210 mujeres y 398 hombres). El porcentaje mayor de entrevistados tenía entre 20 y 40 años. Los EPI más usados fueron casco, tenis y señalización de pedales. El 48% de los encuestados dijo que había sufrido accidentes usando este medio de transporte. Gran parte de los accidentes ocurrieron en momentos de ocio, durante las mañanas y en días de sol. El 69.5 % de las personas entrevistadas escucharon las indicaciones. Conclusiones: la mayoría de los ciclistas de la ciudad de São Paulo son jóvenes, varones y no utilizan los EPI obligatorios. Los accidentes sufridos, relatados por la población encuestada, no estuvieron relacionados con las condiciones meteorológicas ni con el consumo de alcohol. En este estudio, se observó que solo los ciclistas que ya usaban los EPI estaban interesados en las directrices sobre su importancia y uso correcto.
Intervenciones nutricionales para el tratamiento de la diabetes mellitus gestacional
Authors: Perulero Niño Guadalupe , Orozco González Claudia Nelly , Zúñiga Torres María Guadalupe
Published: February 2019

Introducción: la diabetes mellitus gestacional (DMG) es una alteración del metabolismo de los hidratos de carbono (HC), de severidad variable, que se inicia o se reconoce por primera vez durante la gesta- ción; su frecuencia se ha duplicado en la última década en mujeres con factores de riesgo fácilmente identificables. La terapia de nutrición es una parte integral de la gestión de la dmg. Antiguamente, se utilizaba la restricción de HC; actualmente, se utiliza control de calidad y cantidad de HC, y se está evaluando la eficacia de distintas intervenciones nutricionales. Materiales y métodos: se realizó una búsqueda de artículos originales mediante Pubmed y bases académicas, principalmente ensayos clínicos en los que se demuestra el efecto de la intervención con distintos tipos de dietas en mujeres con DMG. Resultados: se obtuvieron mejores resultados en cuanto a los niveles de glucosa en las dietas altas en HC complejos, grasas saturadas y la utilización de proteína de soja, siendo estas una mejor opción para el control glucémico y evitar repercusiones en el estado nutrición de la madre y del bebé. Conclusión: la terapia nutricional basada en el control de la cantidad, calidad y distribución de hc es el tratamiento inicial para la DMG, pero existe la necesidad de ensayos controlados aleatorios que comparen diferentes intervenciones dietéticas y que evalúen modificaciones en porcentajes de macronutrimentos, valor calórico total, tipo y calidad de nutrimentos que demuestren el papel que cumple la intervención nu- tricional en los resultados de embarazos afectados con DMG.
Medellín: una ciudad de encrucijadas. Pobreza, modelo de ciudad y cambio social en el proyecto Cinturón Verde
Authors: Echeverry Tamayo Juan David
Published: February 2019

Medellín ha cargado, durante años, con un conjunto de problemáticas que le han impedido trazar una visión clara de futuro con la que pueda figurar en el mundo por algo más que el narcotráfico y la prostitución. No obstante, las acciones de Medellín y muchos de sus habitantes se han dirigido en la actualidad a conseguir mejores condiciones materiales que faciliten las vidas de sus habitantes, quienes siguen sometidos a unos escandalosos índices de pobreza, marginalidad y violencia, debido a la debilidad del Estado en amplias zonas territoriales. A pesar de este  difícil panorama, la ciudad ha realizado profundos esfuerzos que, aunque limitados, han mejorado la perspectiva con que se observa Medellín, que hoy es considerada un ejemplo de transformación urbana y social dentro de América Latina. De este modo, megaproyectos como el Cinturón Verde, el Jardín Circunvalar, entre otros, sirven para comenzar a superar esos años de extrema violencia y deslegitimación del Estado que han llevado la expansión de la ciudad hacia zonas de alto riesgo para la vida humana y el ambiente.
The importance for business owners of drawing up a will
Authors: Lynn Angharad
Published: February 2019

Having a will in place is important, especially for business owners. This way they can ensure that their family get a fair share and inheritance taxation is kept to a minimum. Angharad Lynn sets out the main legal issues to think about.
The value of knowledge: business assets
Authors: Bernstein Adam
Published: February 2019

Every business has assets, and keeping these properly valued is not only important to understand the company's financial situation, is is a legal requirement. Adam Bernstein explain what constitutes an asset and how and when to perform a valuation.
Ombudsman assesses areas of complaint in social care
Authors: Frankova Helena
Published: February 2019

The annual report about complaints received by the Local Government and Social Care Ombudsman (LGSCO) shows charging, assessement and care planning as the main problem areas. Helena Frankova discusses the report more in depth.
Improving staff retention with learning opportunities
Authors: Ashurst Adrian
Published: February 2019

Continuous professional development is key for all heatlh professionals. But nurses are often pressed for time and work irregular hours, here e-learning can help. Adrian Ashurst highlights the ways staff can be supported with learning.
Achieving medicine optimisation with cross-sector cooperation
Authors: McGraw Caroline
Published: February 2019

Many care home residents take multiple medicines, which improve their functioning and quality of life, but prescribing medicines to older people is not always beneficial. Caroline McGraw describes the dangers of polypharmacy and advises on how to avoid it
Trial shows antipsychotics to be ineffective for treating delirium
Authors: Palmer Sarah
Published: February 2019

Confusion is common in older people, but an acute confused state or altered perception of reality can indicate delirium. There is presently no medication available to treat this condition, but there are other ways to manage it.
The Mediating Role of Prospective Teachers’ Teaching Self-Efficacy between Self-Efficacy Sources and Attitude towards Teaching Profession
Authors: Arslan Ali
Published: February 2019

The purpose of this study was to investigate a predictive power of prospective teachers’ self-efficacy sources on their teaching self-efficacy and attitude towards the teaching profession. Design of the study was the correlational research. The study was conducted on 315 prospective teachers studying pedagogical formation education in a 2017-18 academic year. Instruments were “Prospective Teachers’ Self-Efficacy Sources Scale”, “Teaching Self-Efficacy Scale” and “Attitude Scale of Teaching Profession”. Pearson Product Moment Correlation Coefficient and PATH analysis methods were used to analyze the data. Results indicated that emotional states, mastery experience, and verbal persuasion were significant predictors of prospective teachers’ teaching self-efficacy and attitudes towards teaching profession. 