bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between Ischemic Stroke Follow-Up, Socioeconomic Status, and Adherence to Secondary Preventive Drugs in Southern Sweden: Observations from the Swedish Stroke Register (Riksstroke)
Authors: Ullberg Teresa , Glader Eva-Lotta , Zia Elisabet , Petersson Jesper , Eriksson Marie , Norrving Bo
Published: February 2017

Background: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. Methods: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention. Primary adherence at 4 months and persistence at 14 months post-stroke were calculated for warfarin, statins, antihypertensive, and antiplatelet drugs. Results: The 90-day follow-up rate was 75%. Patients not receiving a 90-day follow-up had lower age-adjusted OR of persistent drug use at 14 months for antihypertensive agents (OR = 0.74, 95% CI 0.60-0.91) and for antiplatelet drugs (OR = 0.72, 95% CI 0.60-0.87). Drug adherence rates 14 months post-stroke were 85% for antiplatelet drugs, 69% for warfarin, 88% for antihypertensive agents, and 76% for statins. One in three patients discontinued using one or more drug class within 14 months, and nonadherence was associated with activities of daily living dependency at 3 months (age-adjusted OR 0.63, 95% CI 0.57-0.69), but not with age, gender, or educational status. Conclusions: The use of secondary preventive drugs decreases over the first year after stroke and remains suboptimal. Specific reasons for nonadherence warrant further study.
Performance of Emergency Department Screening Criteria for an Early ECG to Identify ST‐Segment Elevation Myocardial Infarction
Authors: Yiadom Maame Yaa A. B. , Baugh Christopher W. , McWade Conor M. , Liu Xulei , Song Kyoung Jun , Patterson Brian W. , Jenkins Cathy A. , Tanski Mary , Mills Angela M. , Salazar Gilberto , Wang Thomas J. , Dittus Robert S. , Liu Dandan , Storrow Alan B.
Published: February 2017

Background

Timely diagnosis of
ST
‐segment elevation myocardial infarction (
STEMI
) in the emergency department (
ED
) is made solely by
ECG
. Obtaining this test within 10 minutes of
ED
arrival is critical to achieving the best outcomes. We investigated variability in the timely identification of
STEMI
across institutions and whether performance variation was associated with the
ED
characteristics, the comprehensiveness of screening criteria, and the
STEMI
screening processes.

Methods and Results

We examined
STEMI
screening performance in 7
ED
s, with the missed case rate (
MCR
) as our primary end point. The
MCR
is the proportion of primarily screened
ED
patients diagnosed with
STEMI
who did not receive an
ECG
within 15 minutes of
ED
arrival.
STEMI
was defined by hospital discharge diagnosis. Relationships between the
MCR
and
ED
characteristics, screening criteria, and
STEMI
screening processes were assessed, along with differences in door‐to‐
ECG
times for captured versus missed patients. The overall
MCR
for all 7
ED
s was 12.8%. The lowest and highest
MCR
s were 3.4% and 32.6%, respectively. The mean difference in door‐to‐
ECG
times for captured and missed patients was 31 minutes, with a range of 14 to 80 minutes of additional myocardial ischemia time for missed cases. The prevalence of primarily screened
ED STEMI
s was 0.09%.
ED
s with the greatest
informedness
(sensitivity+specificity−1) demonstrated superior performance across all other screening measures.

Conclusions

The 29.2% difference in
MCRs
between the highest and lowest performing
ED
s demonstrates room for improving timely
STEMI
identification among primarily screened
ED
patients. The
MCR
and informedness can be used to compare screening across
ED
s and to understand variable performance.
Otto Neurath's Visual Politics: An Introduction to “Pictorial
Statistics Following the Vienna Method”
Authors: Hartle Johan Frederik
Published: February 2017

This text introduces a programmatic text of Otto Neurath on the educational use of the method of pictorial statistics. Neurath emphasizes the importance of a visual method to transfer scientific knowledge to popular audiences. At the same time, his Vienna Method attempts to adapt the popular educational strategy to an increasingly visual modernity. The specific educational interest of Neurath's Vienna Method consists in political education, in transferring basic knowledge about the general structure and dominant developments of society. His program thus echoes his contemporaries’ debates on the possibilities of social realism. To understand the historical significance of Neurath the introductory text accentuates three lines of possible discussion. It points out the importance of Neurath's visual pedagogy for the tradition of contemporary discussions around the so-called Bildwissenschaften. It also contextualizes Neurath's visual pedagogy in the Austrian tradition of Second International Social Democracy and in the context of the philosophical debates of the Vienna circle. Against this double historical background, the text eventually tries to understand the educational achievements and political pitfalls of Neurath's attempt to represent general societal developments visually.
Gurdjieff, Art, and the Legominism of Ashiata Shiemash
Authors: Pittman Michael
Published: February 2017

Gurdjieff’s theory of art brings together several strands of thought expressed in his magnum opus Beelzebub’s Tales to His Grandson (1950). In particular, Gurdjieff presents art as a means for the transmission of certain ideas through history, and interpreted by properly informed individuals. In one chapter, Beelzebub’s grandson, Hassein, asks him about the meaning of “legominism.” Beelzebub describes legominism as, “one of the means existing there of transmitting from generation to generation information about certain events of long-past ages, through just those three-brained beings who are thought worthy to be and who are called initiates” (Gurdjieff 349). This article will first briefly consider Gurdjieff’s presentation of art, particularly as it reflects Gurdjieff’s notion of legominism, and the transmission of knowledge to subsequent generations. I will then focus on Ashiata Shiemash, one of the chief exemplars found in Beelzebub’s Tales that exhibits the potentialities of an authentic legominism. As I will offer, the continuing potency of Gurdjieff’s narrative is that it operates on both a deconstructive level, to destroy or wipe away the destructive notions, past and present, just as it creates a space for a more positive view of the potential for certain aspects of cultural forms, such as art and religion.
Gurdjieff in the Theater
Authors: Christof Catharine
Published: February 2017

This article focuses on the links between revolutionary and iconoclastic Polish theater director Jerzy Grotowski (1933–1999), and G. I. Gurdjieff. Grotowski is widely honored in the theater world, and understood to have been involved in creating what have been called spiritual experiences within theater movements of the late twentieth century. His work articulated experiences of the spiritual within the body; achieving a removal of spirituality from ecclesial authorities and a relocation of it within the body of the performer. This article explores the manifold resonances between concepts used in Grotowski’s work and that of Gurdjieff, demonstrating how Grotowski’s transformative theater work shows strong elements of Gurdjieff’s influence. Because of the striking and numerous similarities explored herein, a place can be affirmed for Grotowski as an independent Western Fourth Way spiritual teacher, working in theater.
A morphology based key to the genera of the tribe Nemoriini (Lepidoptera: Geometridae, Geometrinae)
Authors: VIIDALEPP JAAN
Published: February 2017

A diagrammatic key to the genera of the Nemoriini tribe (Lepidoptera, Geometridae) is presented and illustrated. The genera studied exhibit two main character sets, corresponding to the Nemoria lineage and the Phrudocentra lineage. The spatulate type of uncus is associated with multicolor wing markings on both hemispheres. A rod-shaped uncus, often slightly bulbed at its tip, is common in the Neotropics, the genera involved having their wing markings reduced to white lines or brown-grey vein marks on a plain green ground color.
Detection of Subclinical Peripheral Artery Ischemia in Healthy Male Smokers by an Ankle–Brachial Index After Exercise: Sasayama Study
Authors: Kubota Yoshimi , Higashiyama Aya , Marumo Mikio , Konishi Masami , Yamashita Yoshiko , Tashiro Chikara , Okamura Tomonori , Miyamoto Yoshihiro , Wakabayashi Ichiro
Published: February 2017

We investigated the relationship between smoking and the risk of nonnormal (≤0.99) ankle–brachial index (ABI) at rest and after ankle plantar flexion exercise in healthy male community dwellers. A cross-sectional study was performed including 228 Japanese men aged 40 to 64 years without a history of cardiovascular diseases. Participants were classified as never, ex-, and current smokers. We estimated the multivariate-adjusted odds ratios (ORs) for nonnormal ABI of ex- and current smokers in relation to never smokers after adjusting for age and other confounding factors. At rest, the prevalence of nonnormal ABI was not significantly different by smoking status. After exercise, the prevalence of nonnormal ABI increased from 1.8% to 11.5% in ex-smokers and from 3.8% to 17.0% in current smokers, while the prevalence did not significantly change in never smokers. The multivariate-adjusted OR for nonnormal ABI after ankle plantar flexion exercise, in relation to never smokers, was 3.85 (95% confidence interval [CI]: 0.79-18.9) for ex-smokers and 6.97 (95% CI: 1.32-36.7) for current smokers. Our results suggest that ABI after ankle plantar flexion exercise is useful for early detection of subclinical peripheral artery ischemia in male smokers without typical symptoms.
The Hero-Journey, Hamlet and Positive Psychological Transformation
Authors: Bray Peter
Published: February 2017

Joseph Campbell’s proposal that the lives of human beings might be seen as variations on a single unifying grand narrative, provides the energy for this article. From a therapeutic perspective, Campbell’s monomythic metaphor of the hero-journey suggests that individuals may choose how they respond to challenging life events, and his pantheon intersects with humanistic principles of self-actualization and traditional concepts of psychospiritual transformation and growth. Thus, the painful passage through trauma may lead to greater awareness of the self and enhanced psychological functioning. In this work, the plotline of Shakespeare’s Hamlet and its protagonist, arguably the most traumatized hero in literature, are presented alongside a bare and heavily edited text of Campbell’s The Hero With a Thousand Faces to provide one simple case reading. In addition, models incorporating S. Grof and C. Grof’s paradigm of psychospiritual transformation and Tedeschi and Calhoun’s posttraumatic growth are used to establish a link to current therapeutic practice that test the utility of Campbell’s metaphor in this context. It is hoped that the simultaneous weaving of Campbell’s and Shakespeare’s work with humanistic psychology’s core principles will shed further light on the experiences of individuals affected by trauma and their opportunities to become heroines and heroes.
The Psychological Benefits of Receiving Real-Life Altruism
Authors: Hoffman Edward , Gonzalez-Mujica Jenniffer , Acosta-Orozco Catalina , Compton William C.
Published: February 2017

This study investigates the impact of receiving real-life altruism on such positive attitudinal aspects as empathy, optimism, and motivation to help others. A mixed convenience/snowball sample of 148 participants (79 men, 67 women, 2 gender unknown), responded to an online questionnaire. Most were between 21 and 40 years of age, and had at least a college degree; all but eight were born in Venezuela, and the remainder were from other Hispanic/Latino countries. Participants were asked to describe an experience in which they had received unexpected altruism and rate its impact on their subsequent view of life. They were also asked to rate its effect on their optimism about human nature, trust in social relationships, appreciation for life, sense of gratitude, self-esteem, sense of being valued by others, empathy for others, motivation to help others, energy and enthusiasm in general, and religious faith. A total of 64.2% reported an unexpected altruistic experience. Of those, almost 75% reported the experience changed their view of life at least “strongly” and only 4.2% stated that it had little or no effect. The intensity of their change in life view correlated significantly with all 10 dependent variables except for gratitude. Women were significantly more likely to report that their experience boosted their gratitude for others, and participants whose altruistic experiences were attitudinally more life-changing were significantly more likely to indicate that religion was very important to them. The implications of these findings for understanding the psychological benefits of altruistic experience are discussed and avenues for future research are suggested.
Computational model-based design of leadership support based on situational leadership theory
Authors: Bosse Tibor , Duell Rob , Memon Zulfiqar A , Treur Jan , van der Wal C Natalie
Published: February 2017

This paper introduces the design of an agent-based leadership support system exploiting a computational model for development of individuals or groups. It is to be used, for example, as a basis for systems to support a group leader in the development of individual group members or a group as a whole. Using a computational model for Situational Leadership Theory and model-based reasoning techniques, the system monitors and analyzes the development level over time and provides support to the group leader by proposing for different points in time the most effective leadership behavior according to Situational Leadership Theory. The support model has been formally designed and, within a dedicated software environment, simulation experiments have been performed.
Modified drug-eluting balloon angioplasty to treat high-risk carotid in-stent restenosis
Authors: Lai Chih-Hung , Su Chieh-Shou , Lee Wen-Lieng , Tsuei Yuang-Seng
Published: February 2017

Carotid artery stenting is commonly used to treat carotid artery stenosis. However, carotid in-stent restenosis remains a challenging problem. Herein, we report a difficult case of recurrent severe carotid in-stent restenosis with total contralateral internal carotid artery occlusion treated with repeat drug-eluting balloon inflations. The outcome after one year of follow-up showed a good result.
Trading sex for security: Unemployment and the unequal HIV burden among young women in developing nations
Authors: Austin Kelly F , Choi Michelle M , Berndt Virginia
Published: February 2017

Young women in their late teens and early twenties are especially susceptible to HIV infection in developing nations, as incidence of HIV is growing most rapidly among females aged 15–24 years. While prior research considers the role of various social and economic gender stratification measures to explain trends in the female HIV burden, the potential influence of unemployment has not yet been considered, nor has there been explicit focus on the empirical drivers of young women’s HIV. This article considers the role of unemployment in predicting the female HIV burden among 15- to 24-year-olds using regression analyses. The results demonstrate that unemployment among young women significantly impacts the proportion of female HIV cases among those aged 15–24. However, labor force participation also does not guarantee against HIV transmission. These results support ideas related to the increased likelihood of concurrent partners, transactional sex, and ‘sugar daddies’ among young women who are unemployed, having a lack of means to meet their resource needs otherwise. The patterns revealed demonstrate the importance of economic insecurity through unemployment in contributing to the HIV burden among young women in developing nations.
Neurochemical responses to chromatic and achromatic stimuli in the human visual cortex
Authors: Bednařík Petr , Tkáč Ivan , Giove Federico , Eberly Lynn E , Deelchand Dinesh K , Barreto Felipe R , Mangia Silvia
Published: February 2017

In the present study, we aimed at determining the metabolic responses of the human visual cortex during the presentation of chromatic and achromatic stimuli, known to preferentially activate two separate clusters of neuronal populations (called “blobs” and “interblobs”) with distinct sensitivity to color or luminance features. Since blobs and interblobs have different cytochrome-oxidase (COX) content and micro-vascularization level (i.e., different capacities for glucose oxidation), different functional metabolic responses during chromatic vs. achromatic stimuli may be expected. The stimuli were optimized to evoke a similar load of neuronal activation as measured by the bold oxygenation level dependent (BOLD) contrast. Metabolic responses were assessed using functional 1H MRS at 7 T in 12 subjects. During both chromatic and achromatic stimuli, we observed the typical increases in glutamate and lactate concentration, and decreases in aspartate and glucose concentration, that are indicative of increased glucose oxidation. However, within the detection sensitivity limits, we did not observe any difference between metabolic responses elicited by chromatic and achromatic stimuli. We conclude that the higher energy demands of activated blobs and interblobs are supported by similar increases in oxidative metabolism despite the different capacities of these neuronal populations.
Alimony Panic, Gold Diggers, and the Cultural Foundations of Early Twentieth-century Marriage Reform in the United States
Authors: Donovan Brian L.
Published: February 2017

By the late 1920s, the belief that US men were being exploited by the so-called gold diggers seeking advantageous divorces was widespread. Organizations like the Alimony Payers’ Protective Association and the Alimony Reform League were created to combat the perceived problem of gold digging ex-wives. Several states considered legislation to restrict alimony payments. Yet, the overall instances of alimony were relatively rare. This article explains the rise of anti-alimony sentiment during the late 1920s through an examination of the gold digger trope. Anti-alimony agitation represented a response to the changes in women’s roles and sexual norms in the 1920s.
Examining Completion Rates in Web Surveys via Over 25,000 Real-World Surveys
Authors: Liu Mingnan , Wronski Laura
Published: February 2017

A survey’s completion rate is one of its most important data quality measures. There are quite a few published studies examining web survey completion rate through experimental approaches. In this study, we expand the existing literature by examining the predictors of web survey completion rate using 25,080 real-world web surveys conducted by a single online panel. Our findings are consistent with the literature on some dimensions, such as finding a negative relationship between completion rate and survey length and question difficulty. Also, surveys without progress bars have higher completion rates than surveys with progress bars. This study also generates new insights into survey design features, such as the impact of the first question type and length on completion rate.
MiR-122 promotes renal cancer cell proliferation by targeting Sprouty2
Authors: Wang Zijie , Qin Chao , Zhang Jing , Han Zhijian , Tao Jun , Cao Qiang , Zhou Wanli , Xu Zhen , Zhao Chunchun , Tan Ruoyun , Gu Min
Published: February 2017

MicroRNAs are short non-coding RNAs, which have been implicated in several biological processes. Aberrant expression of the microRNA miR-122 has frequently been reported in malignant cancers. However, the mechanism underlying the effects of miR-122 in renal cell carcinoma remains unknown. The aim of this study was to determine the biological function of miR-122 in renal cell carcinoma and to identify a novel molecular target regulated by miR-122. We measured the expression levels of Sprouty2 in six renal cell carcinoma tissue samples and adjacent non-tumor tissues by western blot analysis. We then used reverse transcription polymerase chain reaction to measure miR-122 levels in 40 primary renal cell carcinoma and adjacent non-malignant tissue samples. The effects of miR-122 down-regulation or Sprouty2 knockdown were evaluated via Cell Counting Kit-8 assay, flow cytometry, and western blot analysis. The relationship between miR-122 and Sprouty2 was determined using dual-luciferase reporter assays. Sprouty2 was down-regulated in renal cell carcinoma tissue samples compared with adjacent normal tissue. In contrast, miR-122 was up-regulated in primary renal cell carcinoma tissue samples compared with adjacent normal tissue samples. Down-regulation of miR-122 substantially weakened the proliferative ability of renal cell carcinoma cell lines in vitro. In contrast, Sprouty2 knockdown promoted the in vitro proliferation of renal cell carcinoma cell lines. The spry2 gene could therefore be a direct target of miR-122. In conclusion, miR-122 could act as a tumor promoter and potentially target Sprouty2. MiR-122 promotes renal cell carcinoma cell proliferation, migration, and invasion and could be a molecular target in novel therapies for renal cell carcinoma.
Association of a common variant of SYNPO2 gene with increased risk of serous epithelial ovarian cancer
Authors: Ma Li , Zhang Wei , Ding Zhaoli , Wu Stephen G , Jin Yaofeng , Jiang Na , Du Hongyan , Cai Dongge , Miao Li , Chen Xiaoli
Published: February 2017

In China, the majority of ovarian cancer patients (80%–90%) are women who are diagnosed with epithelial ovarian cancer. The SYNPO2 gene has recently been reported to be associated with epithelial ovarian cancer in Europeans. To investigate the association of common variants of SYNPO2 gene with epithelial ovarian cancer in Han Chinese individuals, we designed a case–control study with 719 epithelial ovarian cancer patients and 1568 unrelated healthy controls of Han Chinese descent. A total of 49 tagging single-nucleotide polymorphisms were genotyped; single-single-nucleotide polymorphism association, imputation, and haplotypic association analyses were performed. The single-nucleotide polymorphism rs17329882 was found to be strongly associated with serous epithelial ovarian cancer and with ages ≤49 years, consistent with the pre-menopausal status of analyzed epithelial ovarian cancer cases. Odds ratios and 95% confidence intervals provided evidence of the risk effects of the C allele of the single-nucleotide polymorphism on epithelial ovarian cancer. Imputation analyses also confirmed the results with a similar pattern. Additionally, haplotype analyses indicated that the haplotype block that contained rs17329882 was significantly associated with epithelial ovarian cancer risk, specifically with the serous epithelial ovarian cancer subtype. In conclusion, our results show that SYNPO2 gene plays an important role in the etiology of epithelial ovarian cancer, suggesting that this gene may be a potential genetic modifier for developing epithelial ovarian cancer.
Downregulation of a novel long noncoding RNA TRPM2-AS promotes apoptosis in non–small cell lung cancer
Authors: Huang Cheng , Qin Yingzhi , Liu Hongsheng , Liang Naixin , Chen Yeye , Ma Dongjie , Han Zhijun , Xu Xiaohui , Zhou Xiaoyun , He Jia , Li Shanqing
Published: February 2017

Non–small cell lung cancer is one of the most common types of cancer, and the prognosis of non–small cell lung cancer is still poor. Recent evidence has proved that long noncoding RNA is involved in tumorigenesis. For non–small cell lung cancer, the expression profile of long noncoding RNA has been studied. Here, we identified a novel long noncoding RNA TRPM2-AS from published dataset and found TRPM2-AS is widely upregulated in non–small cell lung cancer tissues compared with adjacent non-tumor tissues. Higher expression level of TRPM2-AS was correlated with higher TNM stages and larger tumor size. Patients with high TRPM2-AS expression level had poor survival than those with low TRPM2-AS level. We silenced TRPM2-AS by small interfering RNA and found that cell proliferation was significantly inhibited after knockdown of TRPM2-AS. Annexin V/propidium iodide staining and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay confirmed that cell apoptosis increased after TRPM2-AS knockdown. Further experiments showed that silence of TRPM2-AS upregulated SHC1 and silence of SHC1 partially reversed cell apoptosis after TRPM2-AS knockdown. In summary, the novel long noncoding RNA TRPM2-AS upregulated in non–small cell lung cancer, and downregulation of TRPM2-AS promotes apoptosis in vitro.
Perioperative Care of Patients With Liver Cirrhosis: A Review
Authors: Abbas Naeem , Makker Jasbir , Abbas Hafsa , Balar Bhavna
Published: February 2017

The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients. Perioperative management of patients with cirrhosis warrants special attention to nutritional status, fluid and electrolyte balance, control of ascites, excluding preexisting infections, correction of coagulopathy and thrombocytopenia, and avoidance of nephrotoxic and hepatotoxic medications. Transjugular intrahepatic portosystemic shunt may improve the CTP class, and semielective surgeries may be feasible. Emergency surgery, whenever possible, should be avoided.
In Vitro Cell Death Determination for Drug Discovery: A Landscape Review of Real Issues
Authors: Méry Benoite , Guy Jean-Baptiste , Vallard Alexis , Espenel Sophie , Ardail Dominique , Rodriguez-Lafrasse Claire , Rancoule Chloé , Magné Nicolas
Published: February 2017

Cell death plays a crucial role for a myriad of physiological processes, and several human diseases such as cancer are characterized by its deregulation. There are many methods available for both quantifying and qualifying the accurate process of cell death which occurs. Choosing the right assay tool is essential to generate meaningful data, provide sufficient information for clinical applications, and understand cell death processes. In vitro cell death assays are important steps in the search for new therapies against cancer as the ultimate goal remains the elaboration of drugs that interfere with specific cell death mechanisms. However, choosing a cell viability or cytotoxicity assay among the many available options is a daunting task. Indeed, cell death can be approached by several viewpoints and require a more holistic approach. This review provides an overview of cell death assays usually used in vitro for assessing cell death so as to elaborate new potential chemotherapeutics and discusses considerations for using each assay.
APACHE II score cannot predict successful weaning from prolonged mechanical ventilation
Authors: Rojek-Jarmuła Anna , Hombach Rainer , Krzych Łukasz J
Published: February 2017

At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62–77) years), hospitalized between 1 January 2012, and 31 December 2013. APACHE II score was assessed based on the worst values taken during the first 24 hours after admission. Glasgow coma scale was excluded from calculations due to the likely influence of sedative agents. The outcome was defined as freedom from mechanical ventilation, with or without tracheostomy on discharge. Among survivors ( n = 115), 88.2% were successfully liberated from mechanical ventilation and 60.9% from tracheostomy. APACHE II failed to predict freedom from mechanical ventilation (area under the receiver–operating characteristic curve [AUROC] = 0.534; 95% confidence interval [CI]: 0.439–0.628; p = 0.65) and tracheostomy tube removal (AUROC = 0.527; 95% CI: 0.431–0.621; p = 0.63). Weaning outcome was unrelated to the aetiology of respiratory failure on admission ( p = 0.41). APACHE II cannot predict weaning outcome in patients requiring PMV.
Associations Among Work-Related and Leisure-Time Physical Activity With Level of Nausea During Pregnancy
Authors: Connolly Christopher P. , Mudd Lanay M. , Pivarnik James M.
Published: February 2017

Objective:

Pregnancy-induced nausea and vomiting are common maladies during early pregnancy and may be related to physical activity (PA). Our objective was to determine relations among work-related PA (work PA), leisure-time physical activity (LTPA), and nausea during the first trimester.

Study design:

Online or mailed surveys with questions on pregnancy-related nausea, work PA, and LTPA were completed by 70 women at 15 to 30 months postpartum. Women recalled nausea during the first trimester (none, ≤1 h/d, 2-3 h/d, 4-6 h/d, ≥6 h/d) as well as LTPA frequency, duration, and type. Women also recalled total working hours in their first trimester and percentage of time sitting, standing, and walking at work.

Results:

A total of 42 women (60%) were categorized as having high nausea (≥2 h/d). Mann-Whitney U tests showed that women with low nausea had significantly more MET minutes per week of LTPA (P = .05) and hours per week spent standing at work (P = .03). Logistic regression analyses showed standing for ≥20 h/wk at work was related to reduced odds of high nausea (adjusted odds ratio = 0.23; 95% CI = 0.06-0.96), whereas meeting LTPA guidelines was nonsignificantly related to reduced odds.

Conclusion:

These findings suggest an inverse relationship between first trimester PA and level of nausea. Further investigation is needed to determine the directionality of these relations.
No benefits of hypothermia in patients treated with hemicraniectomy for large ischemic stroke
Authors: Schneider Hauke , Krüger Philipp , Algra Ale , Hofmeijer Jeannette , van der Worp H Bart , Jüttler Eric , Vahedi Katayoun , Schackert Gabriele , Reichmann Heinz , Puetz Volker
Published: February 2017

Background

Space-occupying middle cerebral artery brain infarcts are associated with the development of brain edema, which may lead to cerebral herniation and death despite early hemicraniectomy.

Aims

To evaluate the benefit of therapeutic hypothermia in patients with space-occupying cerebral infarction treated with hemicraniectomy within 48 h of stroke onset.

Methods

Patients aged 18–60 years with space-occupying cerebral infarction treated with hemicraniectomy within 48 h and hypothermia (33–34°C) were selected from a single university hospital between 2001 and 2010 (n = 53). Patients treated with hemicraniectomy alone served as comparison group (n = 58), originating from three randomized controlled trials evaluating the effects of early decompressive surgery (DECIMAL, DESTINY, HAMLET). Primary outcome was the score on the modified Rankin scale at 12 months dichotomized between modified Rankin scale 0–3 and modified Rankin scale 4–6. Secondary outcome measures were modified Rankin scale score 0–4 and survival. Risk ratios were adjusted with Poisson regression.

Results

Mean patient age was 48 years. Median time from stroke onset to hemicraniectomy was 23.5 h in both treatment groups. Treatment with hypothermia had no effect on the primary outcome (modified Rankin scale 0–3 versus 4–6 (13/53 (25%) versus 24/58 (41%)); adjusted risk ratio 0.66, 95% confidence interval 0.38–1.13). Fewer patients treated with hypothermia had a modified Rankin scale score of 0–4 (21/53 (40%) versus 42/58 (72%); adjusted risk ratio 0.53, 95% confidence interval 0.37–0.76) and fewer patients survived (26/53 (49%) versus 46/58 (79%); adjusted risk ratio 0.60, 95% confidence interval 0.44–0.82).

Conclusions

In patients with space-occupying cerebral infarction, treatment with hypothermia had no additional benefit on functional outcome compared with treatment with hemicraniectomy alone.
Diagnostic accuracy of proton magnetic resonance spectroscopy and perfusion-weighted imaging in brain gliomas follow-up: a single institutional experience
Authors: Anselmi Monica , Catalucci Alessia , Felli Valentina , Vellucci Valentina , Di Sibio Alessandra , Gravina Giovanni Luca , Di Staso Mario , Di Cesare Ernesto , Masciocchi Carlo
Published: February 2017

Objectives

The objective of this study was to evaluate whether proton magnetic resonance spectroscopy and perfusion magnetic resonance imaging (MRI) are able to increase diagnostic accuracy in the follow-up of brain gliomas, identifying the progression of disease before it becomes evident in the standard MRI; also to evaluate which of the two techniques has the best diagnostic accuracy.

Methods

Eighty-three patients with cerebral glioma (50 high-grade gliomas (HGGs), 33 low-grade gliomas (LGGs)) were retrospectively enrolled. All patients underwent standard MRI, H spectroscopic and perfusion echo-planar imaging MRI. For spectroscopy variations of choline/creatine, choline/N-acetyl-aspartate ratio, and lipids and lactates peak were considered. For perfusion 2.0 was considered the cerebral blood volume cut-off for progression. The combination of functional parameters gave a multiparametric score (0–2) to predict outcome. Diagnostic performance was determined by the receiver operating characteristic curve, with sensitivity, specificity, positive predictive and negative predictive values.

Results

In patients with LGGs a combined score of at least 1 was the best predictor for progression (odds ratio (OR) 3.91) with 8.4 months median anticipation of diagnosis compared to standard MRI. The individual advanced magnetic resonance technique did not show a diagnostic accuracy comparable to the combination of the two. Overall diagnostic accuracy area under the curve (AUC) was 0.881. In patients with HGGs the multiparametric score did not improve diagnostic accuracy significantly. Perfusion MRI was the best predictor of progression (OR 3.65), with 6.7 months median anticipation of diagnosis. Overall diagnostic accuracy AUC was 0.897. Then spectroscopy and perfusion MRI are able to identify tumour progression during follow-up earlier than standard MRI.

Conclusion

In patients with LGGs the combination of the functional parameters seems to be the best method for diagnosis of progression. In patients with HGGs perfusion is the best diagnostic method.
Comparative study on treatment satisfaction and health perception in children and adolescents with type 1 diabetes mellitus on multiple daily injection of insulin, insulin pump and sensor-augmented pump therapy
Authors: Hussain Tara , Akle Mariette , Nagelkerke Nico , Deeb Asma
Published: February 2017

Objectives:

Diabetes management imposes considerable demands on patients. Treatment method used has an impact on treatment satisfaction. We aim to examine the relationship between treatment satisfaction and health perception with the method used for treatment of type 1 diabetes mellitus in children and adolescents.

Subjects and method:

We have interviewed patients with type 1 diabetes mellitus using questionnaires to assess treatment satisfaction and health perception. Patients were divided into three groups based on treatment used: multiple daily injection, insulin pump and sensor-augmented pump therapy. Comparison of scores was done between the groups.

Results:

A total of 72 patients were enrolled (36 males). Mean age (standard deviation) was 11.4 (4.4) years and duration of diabetes of 4.9 (3.5) years. Mean (standard deviation) HbA1c was 8.1 (1.2). Median (range) duration of sensor use was 17.7 (3–30) days/month. Mean scale for treatment satisfaction and health perception questions was 25.3, 29.7 and 31.7 and 60, 79.7 and 81 for the multiple daily injection, pump and sensor-augmented pump, respectively (p = 0.00). Significant difference was seen between the multiple daily injection and both other groups. Sensor-augmented pump group scored higher than the pump group. However, the difference was not statistically significant. Duration of sensor use showed no correlation with treatment satisfaction.

Conclusion:

The method used for diabetes treatment has an impact on patients’ satisfaction and health perception in children and adolescents with type 1 diabetes mellitus. Insulin pump users have a higher treatment satisfaction and better health perception than those on multiple daily injection. Augmenting pump therapy with sensor use adds value to treatment satisfaction without correlation with the duration of the sensors use.
Creatinine Assay Attainment of Analytical Performance Goals Following Implementation of IDMS Standardization
Authors: Lee Elizabeth Sunmin , Collier Christine P. , White Christine A.
Published: February 2017

Background:

The international initiative to standardize creatinine (Cr) assays by tracing reference materials to Isotope Dilution Mass Spectrometry (IDMS) assigned values was implemented to reduce interlaboratory variability and improve assay accuracy.

Objective:

The aims of this study were to examine whether IDMS standardization has improved Cr assay accuracy (bias), interlaboratory variability (precision), total error (TE), and attainment of recommended analytical performance goals.

Methods:

External Quality Assessment (EQA) data (n = 66 challenge vials) from Ontario, Canada, were analyzed. The bias, precision, TE, and the number of EQA challenge vials meeting performance goals were determined by assay manufacturer before (n = 32) and after (n = 34) IDMS implementation.

Results:

The challenge vials with the worst bias and precision were spiked with known common interfering substances (glucose and bilirubin). IDMS standardization improved assay bias (10.4%-1.6%, P < .001), but precision remained unchanged (5.0%-4.7%, P = .5) with performance goals not consistently being met. Precision and TE goals based on biologic variation were attained by only 29% to 69% and 32% to 62% of challenge vials.

Conclusions:

While IDMS standardization has improved Cr assay accuracy and thus reduced TE, significant interlaboratory variability remains. Contemporary Cr assays do not currently meet the standards required to allow for accurate and consistent estimated glomerular filtration rate assessment and chronic kidney disease diagnosis across laboratories. Further improvements in Cr assay performance are needed.
Unicompartmental knee arthroplasty for spontaneous osteonecrosis
Authors: Ma Tong , Tu Yihui , Xue Huaming , Wen Tao , Mei Jiong
Published: February 2017

Background:

Unicompartmental knee arthroplasty (UKA) is an effective treatment option for medial compartment osteoarthritis (OA) of the knee. Whether spontaneous osteonecrosis of the knee (SPONK) can be successfully treated with UKA remains controversial. This study evaluated the clinical and radiological results of patients with SPONK who were treated by UKA using Oxford phase III prostheses.

Methods:

We compared a prospective series of 23 UKA cases operated for SPONK with 235 UKA cases operated for OA. All patients underwent Magnetic Resonance Imaging (MRI) to confirm the diagnosis and exclude any major lesion in the lateral compartment. The stage, condylar ratio, and volume of the necrotic lesion were evaluated. The pre and postoperative Oxford knee scores (OKSs) were compared.

Results:

The mean follow-up was 60 months. No statistical differences in complication rates between the groups were found. The mean OKS improved from 39.48 ± 5.69 to 18.83 ± 3.82 ( p < 0.05). There were no significant differences in the pre and postoperative OKS between the different groups.

Conclusion:

SPONK can be successfully treated with UKA, with a favorable short- to mid-term follow-up.
Pneumococcal Antibody Titers
Authors: Abghari Pamella F. , Poowuttikul Pavadee , Secord Elizabeth
Published: February 2017

Purpose: Immunoglobulin replacement is the mainstay treatment in patients with humoral immunodeficiencies, yet a handful of patients continue to develop sinopulmonary infections while on therapy. The objective of our study was to compare immunoglobulin G (IgG) pneumococcal antibody levels in patients with humoral immune deficiencies who have been on intravenous immunoglobulin (IVIG) replacement for at least 1 year to those on subcutaneous immunoglobulin (SCIG) therapy for at least 1 year. Methods: A retrospective chart review was completed on 28 patients. These patients’ ages ranged between 1 and 61 years. Pneumococcal serotype titers obtained at least 1 year after initiating therapy were compared between patients on IVIG (19 patients) and SCIG (9 patients). Results: A comparison between the groups demonstrated that SCIG achieved a higher percentage of serotype titers protective for noninvasive disease (≥1.3) and 100% protection for invasive disease (≥0.2). Our data also demonstrated a similar lack of protection (less than 50% ≥1.3) in 9N, 12F, and 23F on IVIG and 4, 9N, 12F, and 23F on SCIG. Conclusions: Our data demonstrated that serotypes 1, 3, 4, 9N, 12F, and 23F exhibited the lowest random IgG means while on IVIG, which was comparable to other published studies that looked at the mean IgG levels. In addition, our retrospective chart review demonstrated a greater number of therapeutic pneumococcal titers with SCIG in comparison to IVIG.
‘Involve Me and I Learn’: Development of an Assessment Program for Research and Critical Analysis
Authors: Mullan Judy R , Mansfield Kylie J , Weston Kathryn M , Rich Warren , Burns Pippa , Brown Christine , McLennan Peter L
Published: February 2017

Evidence-based medical practice is best achieved by developing research understanding in medical practitioners. To this end, medical councils worldwide increasingly recognise the importance of medical schools graduating students with well-developed research skills and research capacity. To meet this need, the principles of programmatic assessment were implemented in designing a research and critical analysis curriculum and assessment program that aimed to enhance the research and critical analysis skills of medical students. The program was developed by mapping assessment tasks to a research capabilities framework that was in turn scaffolded to different levels of Miler’s pyramid. The curriculum and assessments were integrated with the science, clinical, and professional aspects of the medical course. The progressive longitudinal development of research skills, with feedback and academic mentoring, culminated in the students’ capacity to undertake an independent research project. Designing an assessment program for learning encouraged students to develop their research capacity by involving them in their learning.
Satyagraha: The Gandhian Way
Authors: Jahanbegloo Ramin
Published: February 2017

This article highlights the key concepts of Gandhi’s philosophy of Satyagraha and its intellectual origins by drawing extensively on his formulations of the right to civil disobedience and non-cooperation with unjust laws. This is followed by a detailed examination of the relevance of Gandhi's idea of Satyagraha. The author concludes that Gandhi’s practice of Satyagraha provides us with a desperately needed alternative in the 21st century.
Irom Sharmila’s Struggle against Military Repression: A Critique
Authors: Haksar Nandita
Published: February 2017

This article argues that although Irom Sharmila’s 16-year-old fast from November 2000 to August 2016 has earned her the status of an icon of non-violent protest, yet she did not seek these appellations; her only aim was to put moral pressure on the government to repeal the Armed Forces (Special Powers) Act, 1958.

The article seeks to assess the efficacy of Irom Sharmila’s protest and how far it has helped or hindered in mobilizing public opinion against the Act. It propounds that the publicity around Irom Sharmila put her on a pedestal and trapped her in her own image, made invisible entire histories of sufferings of people in the northeast, including Manipur, and their struggles against the Armed Forces (Special Powers) Act. The gains of many struggles and efforts were wiped out of the collective memory of the nation and the only image of Manipur was this frail woman with a tube hanging from her nose. The article also argues that there is a kind of fetish in the way the media celebrates non-violence without reference to the political context.
Acquired mutations associated with ibrutinib resistance in Waldenström macroglobulinemia
Authors: Xu Lian , Tsakmaklis Nicholas , Yang Guang , Chen Jiaji G. , Liu Xia , Demos Maria , Kofides Amanda , Patterson Christopher J. , Meid Kirsten , Gustine Joshua , Dubeau Toni , Palomba M. Lia , Advani Ranjana , Castillo Jorge J. , Furman Richard R. , Hunter Zachary R. , Treon Steven P.
Published: February 2017

Key Points

BTKCys481 mutations, including multiple mutated variants within individual patients are common in ibrutinib-progressing WM patients. BTKCys481 mutations were associated with mutated CXCR4 in WM patients progressing on ibrutinib.
Characterizing the O-glycosylation landscape of human plasma, platelets, and endothelial cells
Authors: King Sarah L. , Joshi Hiren J. , Schjoldager Katrine T. , Halim Adnan , Madsen Thomas D. , Dziegiel Morten H. , Woetmann Anders , Vakhrushev Sergey Y. , Wandall Hans H.
Published: February 2017

Key Points

Human platelets, endothelial cells, and plasma proteins are extensively O-glycosylated, with >1123 O-glycosites identified in this study. O-glycosites can be classified into functional subgroups; one important function includes the protection from proteolytic processing.
Volatolomics of breath as an emerging frontier in pulmonary arterial hypertension
Authors: Nakhleh Morad K. , Haick Hossam , Humbert Marc , Cohen-Kaminsky Sylvia
Published: February 2017

There is accumulating evidence in support of the significant improvement in survival rates and clinical outcomes when pulmonary arterial hypertension (PAH) is diagnosed at early stages. Nevertheless, it remains a major clinical challenge and the outcomes are dependent on invasive right heart catheterisation.

Resulting from pathophysiological processes and detectable in exhaled breath, volatile organic compounds (VOCs) have been proposed as noninvasive biomarkers for PAH. Studies have confirmed significant alterations of the exhaled VOCs among PAH patients when compared to controls and/or patients with other respiratory diseases. This suggests exhaled breath analysis as a potential noninvasive medical application in the field of PAH.

In this article, we review and discuss the progress made so far in the field of exhaled volatolomics (the omics of VOCs) as a potential noninvasive diagnostics of PAH. In addition, we propose a model including possible biochemical pathways on the level of the remodelled artery, in which specific VOCs could be detectable in exhaled breath during the early phases of PAH. We debate the different analytical approaches used and recommend a diagram including a “bottom–top” strategy, from basic to translational studies, required for promoting the field.