bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiovascular Adverse Events Complicating the Administration of Rituximab: Report of Two Cases
Authors: Passalia Caterina , Minetto Paola , Arboscello Eleonora , Balleari Enrico , Bellodi Andrea , Del Corso Lisette , Molinari Elisa , Ponassi Irene , Oneto Caterina , Sicbaldi Vera , Ghio Riccardo
Published: February 2018

Rituximab is a murine/human chimeric monoclonal antibody directed against the CD20 antigen. It is widely used in combination with polychemotherapy regimens for the treatment of hematological disorders. There is no evidence of direct cardiotoxicity of the drug but a few cases of cardiovascular adverse events have been reported in the literature.

We report on two patients affected by stage IV non-Hodgkin lymphoma with bone marrow infiltration and peripheral blood involvement who experienced cardiovascular accidents temporally related to rituximab infusion. In both cases the monoclonal antibody was administered in association with a polychemotherapy regimen but administration was postponed several days later in order to avoid severe cytokine release syndrome because of the high tumor burden.

The first case concerns an episode of atrial fibrillation in a patient with a diagnosis of small B-cell lymphoma. The episode happened immediately after rituximab infusion. In the second case there was an episode of chest pain associated with fever and chills during rituximab infusion in a patient with a diagnosis of mantle cell lymphoma. In both cases we noticed an unusual correlation between symptom recurrence and the speed of rituximab infusion. Both patients presented several cardiovascular risk factors but preliminary cardiac function assessment excluded signs of heart dysfunction.

The pathogenesis of cardiovascular events during rituximab infusion remains unclear. A key role might be played by cytokine release from B cells as a consequence of rituximab activity. Moreover, pre-existing silent cardiac damage could be co-responsible for the clinical manifestations we reported.

We consider our clinical experience relevant because it raises an issue of good clinical practice: despite rituximab's good tolerability profile, patients with cardiovascular risk factors should undergo accurate cardiac assessment so that silent heart disease can be detected. If the suspicion of cardiac damage is high, more extensive cardiac assessment is recommended.
Sequential Dose-dense 5-fluorouracil, Epirubicin and Cyclophosphamide Followed by Docetaxel in Patients with Early Breast Cancer with Four or more Positive Lymph Nodes
Authors: Murialdo Roberto , Gallo Maurizio , Boy Davide , Zoppoli Gabriele , Tixi Lucia , Gonella Roberta , Ballestrero Alberto , Patrone Franco
Published: February 2018

Aim

The aim of present study was to investigate the feasibility of a densified sequence of FEC75 (5-fluorouracil 600 mg/m2, epirubicin 75 mg/m2, cyclophosphamide 600 mg/m2) and docetaxel 100 mg/m2 (D100) in patients with primary operable highrisk breast cancer.

Methods

Fifty-one consecutive patients with resectable breast cancer and 4 or more positive axillary lymph nodes were enrolled. After a common regimen of 4 cycles of FEC75 given every 14 days, patients received 4 cycles of D100 every 14 days. Prophylactic granulocyte colony-stimulating factor was administered subcutaneously at 5 mg/kg daily from days 5 to 10 to each patient.

Results

The primary endpoint was the proportion of subjects receiving at least 85% of the relative dose intensity (rDI) both in the FEC and docetaxel parts of the regimen. In view of the high percentage of grade 3–4 skin toxicity (32%) observed in the first 25 patients (Group A) during D100 treatment, it was decided to continue the study using a docetaxel dose reduced by 15% (85 mg/m2; D85). This second group of 26 patients was defined as Group B. Of the total 51 patients, 38 (75%) received docetaxel rDI ≥85%, 23/26 patients (88.5%) and 15/25 patients (60.0%) in Group B and Group A, respectively. The observed grade 3–4 hematological and nonhematological toxicities were in line with data from the literature. The only significant difference was the higher percentage of grade 3–4 skin toxicity experienced with D100.

Conclusion

This study failed to demonstrate the feasibility of a dose-dense FEC-D regimen with docetaxel 100 mg/m2. Docetaxel 85 mg/m2 seems to allow a higher rDI than docetaxel 100 mg/m2 but this should be confirmed in a larger cohort of patients.
Prognostic Function of Ki-67 for Pathological Complete Response Rate of Neoadjuvant Chemotherapy in Triple-negative Breast Cancer
Authors: Zhang Guojing , Xie Wanqing , Liu Zhaozhe , Lin Chao , Piao Ying , Xu Long , Guo Fang , Xie Xiaodong
Published: February 2018

Aims and Background

Triple-negative breast cancer (TNBC) has fluctuating pathological complete response (pCR) rates to neoadjuvant chemotherapy (NAC) according to published reports. Biomarkers predicting pCR rates of NAC would improve TNBC patients' outcomes. We conducted a meta-analysis to estimate the prognostic function of Ki-67 in relation to pCR rates of NAC in TNBC.

Methods and Study Design

Relevant publications in the literature from January 2006 to March 2013 were selected by searching PubMed, SpringerLink, Web of Science, Scopus and the Cochrane Library. The quality of prognostic studies was evaluated according to the standard reported by Hayden et al. Relative risk (RR) and 95% confidence interval (CI) were used to estimate the prognostic function of Ki-67 for pCR rates in TNBC. The fail-safe number was used to detect possible publication bias. Review Manager and MIX software was used to merge extracted data.

Results

The pCR rate of TNBC with high Ki-67 expression was 3.36 times that of low Ki-67 expression TNBC. The merged RR was 3.36 (95% CI: 1.61–7.02) and the fail-safe number was 34. No obvious publication bias but heterogeneity of the case series was detected.

Conclusions

Ki-67 was a predictor of pCR rates to NAC in TNBC.
Evaluation of Linear Accelerator-based Stereotactic Radiosurgery in the Management of Glomus Jugulare Tumors
Authors: Sager Omer , Beyzadeoglu Murat , Dincoglan Ferrat , Gamsiz Hakan , Demiral Selcuk , Uysal Bora , Oysul Kaan , Dirican Bahar , Sirin Sait
Published: February 2018

Aims and Background

Although mostly benign and slow-growing, glomus jugulare tumors have a high propensity for local invasion of adjacent vascular structures, lower cranial nerves and the inner ear, which may result in substantial morbidity and even mortality. Treatment strategies for glomus jugulare tumors include surgery, preoperative embolization followed by surgical resection, conventionally fractionated external beam radiotherapy, radiosurgery in the form of stereotactic radiosurgery or fractionated stereotactic radiation therapy, and combinations of these modalities. In the present study, we evaluate the use of linear accelerator (LINAC)-based stereotactic radiosurgery in the management of glomus jugulare tumors and report our 15-year single center experience.

Methods and Study Design

Between May 1998 and May 2013, 21 patients (15 females, 6 males) with glomus jugulare tumors were treated using LINAC-based stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. The indication for stereotactic radiosurgery was the presence of residual or recurrent tumor after surgery for 5 patients, whereas 16 patients having growing tumors with symptoms received stereotactic radiosurgery as the primary treatment.

Results

Median follow-up was 49 months (range, 3–98). Median age was 55 years (range, 24–77). Of the 21 lesions treated, 13 (61.9%) were left-sided and 8 (38.1%) were right-sided. Median dose was 15 Gy (range, 10–20) prescribed to the 85%-100% isodose line encompassing the target volume. Local control defined as either tumor shrinkage or the absence of tumor growth on periodical follow-up neuroimaging was 100%.

Conclusions

LINAC-based stereotactic radiosurgery offers a safe and efficacious management strategy for glomus jugulare tumors by providing excellent tumor growth control with few complications.
Comparing Five Diagnostic Criteria for Multiple Myeloma: A Retrospective Study of 227 Cases
Authors: Junxun Li , Juan Li , Xiuzhen Tong , Juan Ouyang , Bohuang Zeng , Junru Liu
Published: February 2018

Aims and Background

Several diagnostic criteria for multiple myeloma are used in clinical practice, and it can be difficult to reach a diagnosis when a patient's clinical presentation is consistent with one criterion but not with another. However, no study to date has compared the superiority of the different diagnostic criteria. The aim of this research is to compare the efficacy of five diagnostic criteria for multiple myeloma and to find the reasons for misdiagnosis of atypical multiple myeloma cases.

Methods and Study Design

A total of 227 multiple myeloma cases were retrospectively studied. The clinical data (including plasma cell morphology, flow cytometry, immunofixation electrophoresis, imaging information and clinical manifestations) were scrutinized and the reasons underlying the misdiagnoses analyzed.

Results

The Traditional Domestic criteria had the highest misdiagnosis rate due to the high fixed bone marrow plasma cell percentage and serum M-protein thresholds. The WHO criteria and the International Myeloma Working Group 2009 criteria exhibited relatively low misdiagnosis rates due to their lower bone marrow plasma cell percentage thresholds, flexible criteria and detailed end-organ damage descriptions. The 2003 International Myeloma Working Group criteria and the 2011 Chinese Myeloma Working Group criteria exhibited perfect performance, as each focused on monoclonal plasma cell proliferation and not on fixed bone marrow plasma cell percentage and serum M-protein thresholds.

Conclusions

The 2003 International Myeloma Working Group criteria and the 2011 Chinese Myeloma Working Group criteria have advantages in diagnosing early or atypical multiple myeloma cases. To avoid misdiagnosing some atypical cases of multiple myeloma, attention should be paid to evidence of monoclonal plasma cell proliferation, and flow cytometry may be a useful tool for discovering monoclonal plasma cell proliferation. Advanced imaging techniques should be used to confirm any suspected or atypical findings on metastatic bone survey.
Darbepoetin Alfa Administered Once Every Three Weeks for the Treatment of Anemia in Elderly Patients with Non-myeloid Tumors Receiving Chemotherapy
Authors: Esquerdo Gaspar , Doménech Mercedes , López Pilar , Pedro Carme , Villadiego Kenny , Constenla Manuel , Sánchez-Rovira Pedro , Gasquet José A , Rodríguez César A ,   AVANT study group
Published: February 2018

Aims and Background

The present study aims to describe the hematological response to darbepoetin alfa (DA) under daily clinical practice conditions in anemic elderly patients with non-myeloid tumors receiving chemotherapy.

Methods and Study Design

This was a prospective, observational, multicenter study in elderly (≥65 years) patients with non-myeloid cancer receiving DA (500 g every 3 weeks) for chemotherapy-induced anemia (hemoglobin [Hb] level ≤11.0 g/dL).

Results

A total of 102 anemic patients with solid tumors and 51 with hematological malignancies were included in 28 centers in Spain. Mean age (±SD) was 73.4 (±5.8) years, and mean baseline Hb level was 10.0 (±0.8) g/dL. DA was administered for a median of 8 weeks. Of the 115 subjects with a post-baseline Hb value, the percentage of patients who achieved a hematopoietic response (Hb increase ≥2 g/dL or reaching ≥12 g/dL without transfusions in the previous 28 days) was 69.7% (95% CI 56.1% to 83.3%). Functional Assessment of Cancer Therapy-Fatigue subscale scores increased during the study (median change 1.0 [Q1 −5.0, Q3 9.0], P = 0.04). One patient (0.7%) experienced a non-serious adverse reaction (cutaneous rash).

Conclusion

The study results suggest that DA is an effective and well-tolerated therapy for the treatment of chemotherapy-induced anemia in elderly patients.
Minimizing a Tricky Situation in Breast Irradiation with Helical Tomotherapy
Authors: Franco Pierfrancesco , Zeverino Michele , Migliaccio Fernanda , Torielli Paolo , Angelini Veronica , Sciacero Piera , Girelli Giuseppe , Cante Domenico , Arrichiello Cecilia , Borca Valeria Casanova , Numico Gianmauro , La Porta Maria Rosa , Tofani Santi , Ricardi Umberto
Published: February 2018

We report on a patient with breast cancer undergoing adjuvant intensity-modulated whole breast and lymph node irradiation with static angle tomotherapy (TomoDirect), who experienced a traumatic ipsilateral humeral fracture and was able to continue radiotherapy with helical tomotherapy and daily dosimetric monitoring by means of the Planned Adaptive module.
A Case of Lung Adenocarcinoma with Postoperative Recurrence of Multiple Bone Metastases that Showed a Gradual Complete Response to Combined Administration of Erlotinib and Zoledronic Acid
Authors: Kosaka Takayuki , Yamaki Ei , Mogi Akira , Kuwano Hiroyuki
Published: February 2018

We describe a case of lung adenocarcinoma with multiple postoperative bone metastases that showed a gradual but complete response to combined administration of erlotinib and zoledronic acid. A 76-year-old man with moderately differentiated adenocarcinoma underwent a radical left upper lobectomy and mediastinal lymph node dissection. Three and a half years after the operation, serum carcinoembryonic antigen (CEA) was elevated and 18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) revealed multiple bone metastases. Pretreatment evaluation of EGFR mutations in the resected primary adenocarcinoma specimen showed an L858R mutation in exon 21. Gefitinib was started as first-line treatment. However, evaluation 1 month after administration revealed progressive disease. Erlotinib was started as second-line treatment, and evaluation 1 month after administration revealed that the disease was stable. Administration of zoledronic acid was then begun with continuation of erlotinib. After 2 courses of zoledronic acid, the serum CEA level had not changed but the maximum standardized uptake values of each region uniformly decreased. Furthermore, the uptake of 18FDG completely disappeared after 6 courses. Subsequently, the serum CEA level continued to decrease and the disappearance of 18FDG uptake was confirmed after 10 courses (12 months after initiation of erlotinib administration). Our results suggest that the combined administration of both drugs is effective against bone metastases.
Gefitinib Leads to Complete Resolution of Postoperative Cervical Chyloma and Chylothorax in a Lung Cancer Patient
Authors: Huang Chia-Luen , Chang Hung , Lee Jih-Chin , Dai Ming-Shen
Published: February 2018

Cervical chyloma is a not uncommon complication after neck surgery, especially following diagnostic excision of supraclavicular lymph nodes. Conservative treatment remains the standard approach but is inevitably distressful. We describe the case of a 60-year-old Asian woman who was diagnosed as having adenocarcinoma of the lung with cervical and supraclavicular node involvement. She developed persistent cervical chyle leak after excisional biopsy of the supraclavicular nodes and proved refractory to all management. Subsequent gefitinib therapy led to rapid resolution of chyloma and tumor regression. This case provided a unique experience of managing intractable postoperative chyloma in a cancer patient.
Hospitalized Adolescents’ Use of Mobile Technologies for Learning, Communication, and Well-Being
Authors: Maor Dorit , Mitchem Katherine
Published: February 2018

Hospitalized adolescents experience significant needs beyond medical treatment. They require emotional support for anxiety and stress, educational support for learning, and social support to reduce isolation. This qualitative study explored the use of mobile technologies to connect students to their schools, classmates, and families in an effort to reduce their isolation and disrupted schooling experiences. We conducted in-depth interviews with 18 hospitalized adolescents aged 12 to 18, 29 teachers, and four parents about the affordances of mobile technologies. We found that mobile technology use in a hospital school was critical to engage adolescents in learning and keep them up-to-date with schoolwork. Mobile technologies should be available and accessible in hospital for adolescent patients for the purpose of meeting their learning, communication, and well-being needs. In particular, mobile technology should be used as a therapeutic tool to overcome hospitalized adolescents’ social isolation and improve their well-being.
Souvenirs from ECAL 2017: create, play, experiment, discover – revealing the experimental power of virtual worlds
Authors: Knibbe Carole
Published: February 2018

This report presents some highlights from ECAL 2017, the Fourteenth European Conference on Artificial Life, which was held on 4–8 September 2017 in Lyon, France.
Do Schools That Screen for Body Mass Index Have Recommended Safeguards in Place?
Authors: Sliwa Sarah A. , Brener Nancy D. , Lundeen Elizabeth A. , Lee Sarah M.
Published: February 2018

The Centers for Disease Control and Prevention recommends that schools adopt 10 safeguards before launching a body mass index (BMI) screening program; however, little is known about schools’ safeguard adoption. Authors identified questions from the 2014 School Health Policies and Practices Study that aligned with 4 of the 10 safeguards to estimate safeguard prevalence among schools that screened students for BMI (40.7%, N = 223). Among these schools, 3.1% had all four safeguards and 56.5% had none or one. The most prevalent safeguard was having reliable and accurate equipment (54.1%, 95% confidence interval [CI] = [46.1, 62.1]). Providing staff with appropriate expertise and training was the least prevalent; respondents in 26.4% (95% CI [17.1, 35.6]) of schools received recent training on weight status assessment, weight management, and eating disorder identification. School-based BMI screening is common, but adopting multiple recommended safeguards is not. Absent these safeguards, BMI screening programs may fall short of intended outcomes and potentially incur unintended consequences.
Does Self-Esteem Have an Interpersonal Imprint Beyond Self-Reports? A Meta-Analysis of Self-Esteem and Objective Interpersonal Indicators
Authors: Cameron Jessica J. , Granger Steve
Published: February 2018

Self-esteem promises to serve as the nexus of social experiences ranging from social acceptance, interpersonal traits, interpersonal behavior, relationship quality, and relationship stability. Yet previous researchers have questioned the utility of self-esteem for understanding relational outcomes. To examine the importance of self-esteem for understanding interpersonal experiences, we conducted systematic meta-analyses on the association between trait self-esteem and five types of interpersonal indicators. To ensure our results were not due to self-esteem biases in perception, we focused our meta-analyses to 196 samples totaling 121,300 participants wherein researchers assessed interpersonal indicators via outsider reports. Results revealed that the association between self-esteem and the majority of objective interpersonal indicators was small to moderate, lowest for specific and distal outcomes, and moderated by social risk. Importantly, a subset of longitudinal studies suggests that self-esteem predicts later interpersonal experience. Our results should encourage researchers to further explore the link between self-esteem and one’s interpersonal world.
Generalized Pustular Psoriasis Induced by Infliximab in a Patient With Inflammatory Bowel Disease
Authors: Almutairi Dalal , Sheasgreen Christopher , Weizman Adam , Alavi Afsaneh
Published: February 2018

The incidence of anti–tumour necrosis factor (TNF)–induced psoriasiform eruptions has ranged in the literature between 0.5% and 10.9% of patients with inflammatory bowel disease (IBD). The morphology of the rash varies, with plaque psoriasis being the most common form. Generalized pustular eruption is reported in 10.2% of cases of anti–TNF-induced psoriasis. We are reporting a unique case of anti–TNF-associated psoriasiform eruption due to the severity of the rash presenting as a generalized pustular eruption in association with plaque psoriasiform rash requiring systemic therapy.
Collaborative approaches to government travel advisories in Australia between Australia’s travel industry leadership and the Australian Department of Foreign Affairs and Trade, 2003–2017
Authors: Beirman David
Published: February 2018

The October 2002 Bali bombing was a catalyst for the Australian Department of Foreign Affairs and Trade (DFAT) to radically alter its approach to the content and dissemination of Australian government travel advisories. Integral to DFAT’s post-Bali strategy was its decision to seek the collaborative support of the Australian outbound travel industry leadership to broaden dissemination of travel advisories to outbound Australian travellers. Although initial contacts between DFAT and the Australian travel industry leaders in early 2003 were contentious, subsequent negotiations resulted in the world’s first signed agreement between a foreign ministry and a national travel industry leadership in June 2003. The initial agreement, the Charter for Safe Travel involved the Australian travel industry’s commitment to disseminate DFAT travel advisories in exchange for a viable consultative role in their content. Australia’s collaborative model was adopted in the UK from 2004, in Canada from 2005 and New Zealand since 2016. Globally, consultation between national travel industry leaders and national foreign ministries is rare, despite the support of the United Nations World Tourism Organization, the World Travel and Tourism Council and the Pacific Asia Travel Association. Through participant observation research, in the context of collaboration and stakeholder theories, this article discusses the evolution of a consultative relationship between DFAT and the Australian outbound travel industry leadership and other relevant stakeholders between 2003 and 2017. The observations made in this study reveal that collaborative consultation has achieved positive changes to travel advisories which feature regionally specific, timely and comprehensible content. These qualitative enhancements have been complemented by enhanced dissemination of Australian government travel advisories. Australia’s Consular Consultative Group serves as a working model for similar collaboration, in the interests of global tourism safety.
A numerical model for considering the bond-slip effect in axially loaded circular concrete-filled tube columns
Authors: Hwang Ju-young , Kwak Hyo-Gyoung , Kwon Yangsu
Published: February 2018

This article introduces a numerical model that simulates the bond-slip behaviour in axially loaded circular concrete-filled tube columns without applying double nodes required in the use of the classical bond-link element. After calculating the nodal displacements of in-filled concrete, the deformation in the steel tube at each node has been found through the back-substitution technique from the first to the final steel element using a governing equation constructed on the basis of the force equilibrium and displacement compatibility at each node. Finally, correlation studies between analytical and experimental results are conducted to verify the efficiency and applicability of the introduced model.
The ephemeral politics of feminist accompaniment networks in Mexico City
Authors: Krauss Amy
Published: February 2018

This article examines the tension in Hannah Arendt’s thought between the creativity of political action and the worldlessness of labour in light of fieldwork with feminist activists in Mexico City. Drawing from my ethnographic research, I explore how labour and action are knitted together in the feminist practice of accompanying women who seek safe abortion in the city. Bringing Arendt’s thought into dialogue with anthropologies of illness experience as well as the reflections of my interlocutors in the field, I shift from an approach to the situation of abortion as a decision-making event, to ask other questions about autonomy and dependency, freedom and necessity, mortality and political life. I argue that what is interesting about Arendt’s conceptualisation of the labouring body is not that she separates ‘bare life’ from the political sphere of ‘men’, but rather that it alerts us to the uncertain way our life is implicated with others. In conclusion, I argue that feminist accompaniment networks foster an ephemeral relation of care between activists and women in situations of abortion, one that invites us to re-imagine the temporality of political action and to ask, again, what it is to make a new world versus make this world livable.
Method development for the determination of 1,1-dimethylhydrazine by the high-performance liquid chromatography–mass spectrometry technique
Authors: Susinskis Igors , Mekss Peteris , Hmelnickis Juris
Published: February 2018

Unsymmetrical dimethyl hydrazine is highly toxic, carcinogenic compound, widely used for organic synthesis and drug development. Therefore, due to its high reactivity, direct analysis is problematic. Current study proposes to use derivatization reaction to increase selectivity and sensitivity of high-performance liquid chromatography–mass spectrometry method. Different derivatization agents were tested and optimal reaction media was found. Derivatization was performed by using small amounts of reagents to lower the cost of analysis. The full validation of the method was performed and it can be used in a routine control in pharmaceutical analysis. Method sensitivity is 0.15 ppm, and linearity range is 0.15–2.70 ppm.
Development and mechanical properties of adaptive fiber-reinforced plastics
Authors: Ashir Moniruddoza , Nocke Andreas , Cherif Chokri
Published: February 2018

Textile-based lightweight structures offer various possibilities for the design of tailored structures by the selective choice of materials and their processing into textile semi-finished products and fiber-reinforced plastics. Lightweight structures with a high mechanical load capacity are feasible by developing fiber-reinforced plastics with adaptive properties that are able to adapt their characteristics, e.g. geometry or stiffness, to external influences. Thus, the application potential of fiber-reinforced plastics can be further expanded. In this paper, we present novel adaptive fiber-reinforced plastics based on textile semi-finished products with integrated shape memory alloys and their mechanical characterization. The shape memory alloy is textile technically integrated and converted into friction spun hybrid yarn. Next, the produced hybrid yarn is integrated with plain, twill and satin woven reinforcement fabric in the weft direction during the shedding operation in weaving. Adaptive fiber-reinforced plastics are developed by infusing textile semi-finished products. Subsequently, the mechanical characterization of the adaptive fiber-reinforced plastics is carried out. Results show that, by integrating shape memory alloys into adaptive reinforced fabrics, the mechanical performance of fiber-reinforced plastics can be tailored.
The Increasing Racialization of American Electoral Politics, 1988-2016
Authors: Enders Adam M. , Scott Jamil S.
Published: February 2018

In this article, we examine the relationship between racial resentment and a host of political attitudes, predispositions, and behaviors across 28 years and 7 presidential elections. We find, contrary to the suggestions of recent work of the role of race in the Obama era, that the racialization of seemingly nonracial political issues began many years before the debut of Barack Obama and extends beyond his presidency. More specifically, we find, controlling for other factors, that the relationships between racial resentment and partisan and ideological self-identifications, evaluations of the major party presidential candidates, and attitudes about health insurance and governmental services have strengthened each subsequent year beginning in 1988 through 2016. This trend reflects the growing extent to which racial considerations are brought to bear on individual evaluations of and orientations toward the political world.
Movement screens: Are we measuring movement dysfunction or movement skill?
Authors: Vidal Anthony D , Nakajima Mimi , Wu Will FW , Becker James
Published: February 2018

Movement screens are commonly used for assessing athletic readiness or injury potential. However, these screens fail to distinguish between movement dysfunction and movement skill. The purpose of this study was to compare performance on a common movement screen test, the overhead squat, when using no instructions (Baseline), instruction from a commercial movement screen, and instructions which include verbal cues, demonstration, and practice (Instructions, Demonstration, and Practice [IDP]). Fourteen individuals performed the overhead squat under the three different conditions while their movements were recorded using a 12-camera motion capture system. Specific scoring criteria for the overhead squat such as joint angles, depth of squat, torso and shank orientation, and weight distribution were compared between instructional conditions. Compared to the Baseline and commercial movement screen conditions, IDP resulted in greater vertical center of mass displacement, better alignment of the torso and shank segments, and greater peak flexion at the hip and knee. These results show that incorporating verbal cues, providing demonstration, and allowing for practice during movement screening significantly improve performance in the overhead squat assessment. Based on these results, the authors recommend that coaches or clinicians using movement screens to identify movement dysfunction should provide demonstrations of the movement, allow the participant to practice, provide verbal instructions about the movement prior to assessment, and provide corrective feedback during practice. Excluding these elements limits the ability to distinguish between true dysfunctional movement patterns and a simple lack of movement skill.
Tactical skill in Australian youth soccer: Does it discriminate age-match skill levels?
Authors: Keller Brad S , Raynor Annette J , Iredale Fiona , Bruce Lyndell
Published: February 2018

Objectives

Football Federation Australia (FFA) has identified that Australian athletes are proficient physically, however often lack the technical and tactical skills to excel internationally. The aim of the current study was to assess if a video-based decision-making test could discriminate different age-matched skill levels of talent in Australian soccer.

Design

Cross-sectional observational.

Methods

Sixty-two youth male soccer players completed a video-based decision-making test.

Results

An ANOVA test showed that the video-based test significantly discriminated between all three groups, with the national elite athletes selecting more correct responses than the state elite (65.3 ± 8.1%; 56.0 ± 9.1%, respectively). The state elite were more accurate than the sub-elite (45.9 ± 8.8%).

Conclusions

Results suggest that a video-based test may be a suitable tool to use in the selection of athletes as a measure of decision-making skill. The low accuracy scores, even for the national elite cohort, suggest that decision-making skill at the youth level has room for improvement and should be prioritised as an area for development.
Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
Authors: Novaretti João Victor , Franciozi Carlos Eduardo , Forgas Andrea , Sasaki Pedro Henrique , Ingham Sheila Jean McNeill , Abdalla Rene Jorge
Published: February 2018

Background:

There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR).

Hypotheses:

Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not. Additionally, quadriceps strength deficit cutoff values of 80% and 90% would differentiate patients who returned to preinjury sports level from those who did not.

Study Design:

Cohort study.

Level of Evidence:

Level 3.

Methods:

A retrospective search was conducted to identify all patients who underwent ACLR and completed isokinetic evaluation, postural stability analysis, and drop vertical jump testing at 6 months postoperatively. Patients were asked to complete 3 questionnaires at a minimum 1 year after surgery. Chi-square and logistic regression analyses were used for categorical dependent variables, while the Student t test, Pearson correlation, or analyses of variance with Bonferroni post hoc testing were used for continuous dependent variables. A post hoc power analysis was completed. Based on the results regarding correlations between return to preinjury level and all other variables, effect sizes from 0.24 to 3.03 were calculated. With these effect sizes, an alpha of 0.05 and sample size of 58, a power ranging from 0.15 to 0.94 was calculated.

Results:

The rates of return to preinjury level and to any sports activity were 53.4% and 84.4%. Those who were able to return to their preinjury level of sport (n = 33) showed significantly higher Lysholm (91.6 ± 9.7 vs 76.7 ± 15.4) and International Knee Documentation Committee (IKDC) (83.6 ± 10.6 vs 69.8 ± 14.6) values compared with those who were unable to return to their preinjury level of sport (n = 25) ( P < 0.001). No significant differences were found for the clinical evaluations between those who were and those who were not able to return at the same level for the clinical evaluations (isokinetic evaluation, postural stability, drop vertical jump test) ( P > 0.05). No significant differences were found when comparing quadriceps strength deficit with cutoff values of 80% and 90% for return to preinjury activity level (Tegner), Lysholm, and IKDC scores.

Conclusion:

Quadriceps strength deficit, regardless of cutoff value (80% or 90%), at 6 months after ACLR does not predict return to preinjury level of sport. Patients who returned to sport at their preinjury level were more satisfied with their reconstruction compared with those who did not.

Clinical Relevance:

Quadriceps strength deficit is not a reliable predictor of return to sports, and therefore it should not be used as the single criterion in such evaluations.
From Ambridge to the world? Class returns to rural population geographies
Authors: Halfacree Keith
Published: February 2018

Smith and Phillips make a powerful case both for investigating rural population change within much of the Global North from a class-foregrounded gentrification perspective and for undertaking this investigation in an internationally comparative manner. Neither aspect has been sufficiently developed within scholarship to date. While endorsing such a call, this commentary briefly presents three additional contextual framings: describing and explaining the very late coming of age of explicit ‘rural gentrification’ research; reiterating the challenge that geographical transferability of concepts and terminology presents; and insisting on the central but not exclusive role class must play within critical discourse on populations in the contemporary countryside.
Low Self-Control, Parental Intervention, and Delinquency Among Native American Youth
Authors: Baek Hyunin , Nicholson Jason A. , Higgins George E.
Published: February 2018

Researchers in criminal justice literature have relatively underexamined the delinquency among Native American (NA) youth. Using data from the Drug Use Among Young Indians: Epidemiology and Prediction study, the present study tested assumptions in Gottfredson and Hirschi’s self-control theory. This study found evidence supporting the theory. Low self-control was a significant predictor to NA adolescents’ delinquency. However, parental intervention as an opportunity measure and it was not a mediation between low self-control and delinquency. Moreover, while parental intervention significantly decreased delinquency by female adolescents, parental intervention significantly increased delinquency by male adolescents. In addition, the mediation effect in structural equation modeling for males occurred; in contrast, the effect in the female model did not happen. On the other hand, low self-control was still the crucial predictor to adolescents’ delinquency across gender. Thus, future studies will need to account for the etiology of NA adolescents’ delinquency across gender using different approaches.
XRF and reflectance hyperspectral imaging on a 15th century illuminated manuscript: combining imaging and quantitative analysis to understand the artist’s technique
Authors: de Viguerie Laurence , Rochut Sophie , Alfeld Matthias , Walter Philippe , Astier Sophie , Gontero Valérie , Boulc’h Florence
Published: February 2018

We present here the combination of in situ non invasive techniques to investigate a precious 15th century illuminated manuscript of Petrarch’s work, De remediis utriusque fortunae held in the Méjanes library in Aix-en-Provence (France). X-Ray fluorescence spectroscopy, mapping and point analysis, and visible reflectance hyperspectral imaging allow an unprecedented analysis of this manuscript. They provide new clues for its attribution by revealing a partly hidden coat of arms and describing the illuminator’s palette and techniques in detail. We reveal the identity of the first possessor of this manuscript, Tanguy IV du Châtel, known as a 15th century bibliophile close to Louis XI. This information is a further element contributing to the attribution of the richly illuminated folio 6 of this manuscript to François Le Barbier. Pigments and dyes used for this folio have been investigated with particular emphasis on the study of the superimposed colours thus providing a better understanding of the artist’s technique and know-how.
Correlation Coefficients: Appropriate Use and Interpretation
Authors: Schober Patrick , Boer Christa , Schwarte Lothar A.
Published: February 2018

Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from –1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.
Treatment Patterns and Clinical Outcomes in Neonates Diagnosed With Respiratory Distress Syndrome in a Low-Income Country: A Report From Bangladesh
Authors: Hubbard Richard M. , Choudhury Kamal M. , Lim Grace
Published: February 2018

Respiratory distress syndrome remains a leading cause of neonatal mortality worldwide. This retrospective study describes practice patterns for respiratory distress syndrome in a resource-limited setting and seeks to identify both risk factors for mortality and beneficial treatment modalities. Health, demographic, and treatment data were collected. Potential associations were analyzed using univariable and multivariable logistic regression. Of 104 children included for analysis, 38 died. Although most children were initially treated with noninvasive respiratory support, 59 progressed to invasive ventilation. Requirement for invasive ventilation was associated with death. A clear trend toward improved survival in mechanically ventilated patients was seen with surfactant administration.
Does A Low 6-Minute Walk Distance Predict Elevated Postoperative Troponin?
Authors: Dhillon Anahat K. , Disque Andrew A. , Nguyen-Buckley Christine T. , Grogan Tristan R. , Russell Dana L. , Gritsch H. Albin , Neelankavil Jacques P.
Published: February 2018

Our study of 100 major vascular and renal transplant patients evaluated the 6-minute walk test (6MWT) as an indicator of perioperative myocardial injury, using troponin as a marker. Using logistic regression and the area under the receiving operator characteristic curve, we compared the 6MWT to the Revised Cardiac Risk Index and metabolic equivalents. Only the 6MWT was associated with elevated postoperative troponins (95% CI, 0.98–0.99). However, the 6MWT area under the receiving operator characteristic curve (0.71 [95% CI, 0.57–0.85]) was not different from the Revised Cardiac Risk Index (P = .23) or metabolic equivalents (P = .14). The 6MWT may have a role in cardiac risk stratification in the perioperative setting.
Point-of-Care Fibrinogen Testing in Pregnancy
Authors: Katz Daniel , Hamburger Joshua , Batt Dorian , Zahn Jeffrey , Beilin Yaakov
Published: February 2018

Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8–51.9) with a standard deviation of 52.8 mg/dL. Calculated limits of agreement were 140.2 mg/dL (95% CI, 166.3–114.6) and −66.6 mg/dL (95% CI, −40.8 to −92.5), within the maximum allowable difference of 165 mg/dL. We therefore conclude that while most measurements fell within the limits of agreement, more work is needed to clearly define the role of this test in the obstetric population.
Research Needs Assessment for Children With Obstructive Sleep Apnea Undergoing Diagnostic or Surgical Procedures
Authors: Murto Kimmo T. , Chen Wesley , Katz Sherri L. , Schwengel Deborah A. , Elden Lisa M. , Belani Kumar G. , Gozal David
Published: February 2018

Recent concerns have been raised about the quality and safety of adenotonsillectomy, a common surgery performed to treat obstructive sleep apnea (OSA) in children. OSA is a risk factor for opioid-related perioperative respiratory complications including those associated with anoxic brain injury or death. Our objective was to identify controversial issues related to the care of children with OSA. A standardized Delphi consensus technique involving an interdisciplinary group of 24 pediatric OSA experts identified 3 key issues: “postoperative disposition, preoperative screening, and pain management.” These topics are prime candidates for future systematic reviews and will guide Society of Anesthesia and Sleep Medicine–related research endeavors.
The Migration of Caudally Threaded Thoracic Epidural Catheters in Neonates and Infants
Authors: Simpao Allan F. , Gálvez Jorge A. , Wartman Elicia C. , England W. Randall , Wu Lezhou , Rehman Mohamed A. , Ngo Thienkim V.
Published: February 2018

BACKGROUND:

The migration of pediatric thoracic epidural catheters via a thoracic insertion site has been described. We assessed the migration of caudally threaded thoracic epidural catheters in neonates and infants at our institution.

METHODS:

The anesthesia records and diagnostic imaging studies of neonates and infants who had caudal epidural catheters placed during a 26-month period at our hospital were analyzed. Imaging studies were reviewed for changes in epidural catheter tip position.

RESULTS:

Eighty-five patients 1–325 days of age (median, 51 days; interquartile range, 39–78 days) and weights of 2.5–9.5 kg (median, 5 kg; interquartile range, 4.3–5.8 kg) met the study criteria. Fifty-four (64%) of the patients (95% CI, 52%–73%) experienced catheter migration of 1 or more vertebral levels (range, 3 levels caudad [outward] to 3 levels cephalad [inward]), and 23 (27%) of the patients (95% CI, 18%–38%) experienced catheter migration to the T4 level or higher. Migration of 2 or more vertebral levels occurred only in children who weighed <6 kg and were under 73 days of age.

CONCLUSIONS:

Epidural catheter migration occurs commonly in neonates and infants. Postoperative imaging is crucial to confirm catheter tip location after epidural catheter placement, as failure to assess catheter migration might result in suboptimal analgesia or other undesirable outcomes.
Development and Initial Evaluation of a Novel, Ultraportable, Virtual Reality Bronchoscopy Simulator: The Computer Airway Simulation System
Authors: Casso Gabriele , Schoettker Patrick , Savoldelli Georges L. , Azzola Andrea , Cassina Tiziano
Published: February 2018

BACKGROUND:

Virtual reality (VR) simulation is an effective and safe method of teaching bronchoscopic skills. Few VR bronchoscopy simulators exist; all are expensive. The present study aimed to describe the design, development, and evaluation of a new, affordable, VR bronchoscopy simulator.

METHODS:

Anesthesiologists and engineers collaborated to design and develop the Computer Airway Simulation System (CASS), an iPad-based, high-fidelity, VR bronchoscopy simulator. We describe hardware and software development, as well as the technical and teaching features of the CASS. Twenty-two senior anesthesiologists evaluated various aspects of the simulator (using a 5-point Likert scale) to assess its face validity.

RESULTS:

Anesthesiologists performed a simulated bronchoscopy (mouth to carina) with a median (range) procedural time of 66 seconds (30–96). The simulator’s ease of use was rated 4.3 ± 0.8 and the bronchoscope proxy’s handling 4.0 ± 0.7. Criticisms included that excessive system reactivity created handling difficulties. Anatomical accuracy, 3-dimensional bronchial segmentation, and mucosal texture were judged to be very realistic. The simulator’s usefulness for teaching and its educational value were highly rated (4.9 ± 0.3 and 4.8 ± 0.4, respectively).

CONCLUSIONS:

We describe the design, development, and initial evaluation of the CASS—a new, ultraportable, affordable, VR bronchoscopy simulator. The simulator’s face validity was supported by excellent assessments from senior anesthesiologists with regard to anatomical realism, quality of graphics, and handling performance, even though some future refinements are required. All the practitioners agreed on the significant educational potential of the CASS.
Classification in hyperspectral images by independent component analysis, segmented cross-validation and
uncertainty estimates
Authors: Galindo-Prieto Beatriz , Westad Frank
Published: February 2018

Independent component analysis combined with various strategies for cross-validation, uncertainty estimates by
jack-knifing and critical Hotelling’s T2 limits estimation, proposed in this paper, is used for classification purposes in
hyperspectral images. To the best of our knowledge, the combined approach of methods used in this paper has not been
previously applied to hyperspectral imaging analysis for interpretation and classification in the literature. The data analysis
performed here aims to distinguish between four different types of plastics, some of them containing brominated flame
retardants, from their near infrared hyperspectral images. The results showed that the method approach used here can be
successfully used for unsupervised classification. A comparison of validation approaches, especially leave-one-out
cross-validation and regions of interest scheme validation is also evaluated.