bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a Single-Board Computer High-Resolution Microendoscope (PiHRME) to Detect Cervical Cancer in Low-Resource Settings
Authors: Parra Sonia , Keahey Pelham , Schmeler Kathleen , Maza Mauricio , Castle Philip , Richards-Kortum Rebecca R.
Published: July 2016

Abstract 35

Almost 90% of cervical cancer deaths occur in developing countries, with the highest incidence rates occurring in Central and South America and sub-Saharan Africa.1 While early detection and treatment of cervical precancerous lesions effectively prevent the development of invasive cervical cancer, limited resources and infrastructure make it difficult to implement standard cervical cancer screening methods in low-resource areas. In many low-resource areas, health workers use visual inspection of the cervix following the application of acetic acid (VIA) to identify precancerous lesions. While VIA reduces cervical cancer mortality, it is associated with a low specificity. A number of recent studies have shown that high-resolution optical imaging can identify precancerous lesions in vivo with higher specificity than VIA; however, the cost of these imaging systems is a barrier to wider scale implementation. We therefore have developed a low-cost, high-resolution microendoscope controlled by a single-board computer (PiHRME) to detect cervical precancerous lesions at the point-of-care. The PiHRME allows healthcare providers to image the cervix in vivo and view cervical epithelial cells in real time with sub-cellular resolution. Here we demonstrate that a low cost ($35) single-board computer, the Raspberry Pi, can be used to reduce the cost and improve the mobility of a high-resolution optical imaging system without compromising its spatial resolution. Thus, HRME screening of cervical cancer can be made more accessible in low-resource areas. The PiHRME is currently being evaluated in a pilot study in El Salvador to assess its effectiveness at the point-of-care.

1American Cancer Society. Global Cancer Facts & Figures 3rd Edition. Atlanta: American Cancer Society; 2015.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

Sonia Parra No relationship to disclose Pelham Keahey No relationship to disclose Kathleen Schmeler Research Funding: Cepheid Patents, Royalties, Other Intellectual Property: UpToDate Mauricio Maza No relationship to disclose Philip Castle Honoraria: Roche, Cepheid Consulting or Advisory Role: Cepheid, GE Healthcare, Guided Therapeutics, ClearPath, Merck, Genticel, Teva, Inovio Pharmaceuticals, Hologic Rebecca R. Richards-Kortum Honoraria: Jannsen Global Services Research Funding: Merck Patents, Royalties, Other Intellectual Property: Patents
Successful Implementation of a Pediatric Early Warning Score in a Resource-Limited Pediatric Oncology Hospital in Guatemala
Authors: Agulnik Asya , Soberanis Vasquez Dora Judith , García Ortiz Jose Emigdio , Mora Robles Lupe Nataly , Mack Ricardo , Antillón Federico , Kleinman Monica , Rodriguez-Galindo Carlos
Published: July 2016

Abstract 25

Background:

Hospitalized pediatric oncology patients are at high risk for clinical decline and mortality, particularly in resource-limited settings. Pediatric Early Warning Scores (PEWS) are commonly used to aid with early identification of clinical deterioration; however, these scores have never been studied in oncology patients in low-resource settings. We describe the successful implementation of a modified PEWS at Unidad Nacional de Oncología Pediátrica (UNOP), a national pediatric oncology hospital in Guatemala.

Methods:

The PEWS used at Boston Children's Hospital (BCH) was modified through key informant meetings at UNOP, adjusting for practice variations between the two hospitals. After an initial pilot of the tool, the PEWS was implemented in all non-ICU inpatient areas at UNOP (60 beds with about 2,000 admissions/year). During implementation, systems were created to monitor errors in calculating PEWS, patient transfers to a higher level of care, and high PEWS scores for ongoing quality improvement.

Results:

Hospital-wide implementation occurred over 6 months, when 113 nurses were trained in the PEWS tool and algorithm. Compliance with PEWS performance and documentation was 100% by the end of the implementation period, with 300 to 400 PEWS measured daily and less than 10% errors. Monitoring of PEWS results reports an average of 5 high PEWS per week with 30% transferring to a higher level of care. Among patients requiring ICU transfer, 86% had an abnormal PEWS prior to transfer, which is similar to results at BCH (90%). Staff surveys showed a high degree of satisfaction with PEWS (4.6/5) and minimal difficulty using the score (2.3/5) (n=67).

Conclusions:

We describe the successful implementation of a PEWS in a pediatric oncology hospital in Guatemala. This work demonstrates that PEWS is a feasible, well-accepted, and low-cost quality improvement measure in this resource-limited setting. We now plan to evaluate the effects of this implementation on patient care and outcomes.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
Introduction of Radiotherapy in Suriname: Impact on the Treatment of Cervical Cancer
Authors: Dams E.T.M. , Hawkins W.B. , Lichtveld M.Y.
Published: July 2016

Abstract 7

Background:

Cervical cancer is the second most frequent cancer and is the leading cause of cancer-related death in Surinamese women. Radiotherapy is an essential part of treatment, but until recently was not available in Suriname. Previously, affected women were treated abroad. This study evaluated the effect of the introduction of radiotherapy in 2012 on treatment coverage and quality of care.

Methods:

A retrospective cohort study was conducted, comparing treatment of women diagnosed with cervical cancer in the period 2008-2011, prior to introduction of radiotherapy, to treatment of women diagnosed in the period 2012-2013, who received radiotherapy locally.

Results:

During the study period January 2008–December 2013, 339 women received a first diagnosis of cervical cancer, corresponding to an average annual incidence rate of 21.3 ± 1.7 per 100,000 female population, with no significant changes during the study period. More than 80% of the women presented with late-stage disease. Creoles and indigenous women showed much higher incidence rates than the other ethnic groups. The proportion of women receiving appropriate radiotherapy increased from 71.6% in the period 2008-2011 to 82.4% in 2012-2013. The waiting time between diagnosis and treatment diminished with 38 days on average. In addition, the percentage women with a delay of >150 days decreased from 29% to 7%.

Conclusion:

Cervical cancer continues to pose an important health problem for women in Suriname. The introduction of radiotherapy has demonstrated improved treatment of invasive cervical cancer. However, additional prevention and early detection strategies are needed to lower incidence and mortality rates.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
Higher Serum Selenium Concentration is Associated with a Higher Prevalence of Esophageal Squamous Dysplasia in Bomet, Kenya
Authors: Pritchett Natalie R. , Mwachiro Michael M. , Burgert Stephen L. , Murphy Gwen , Brockman John D. , Abnet Christian C. , Dawsey Sanford M.
Published: July 2016

Abstract 15

Background:

East Africa is a region of high esophageal squamous cell carcinoma (ESCC) incidence, and is known to have low soil selenium levels. Low selenium status measured in blood has been associated with ESCC risk. We measured serum selenium in a cross-sectional study of subjects from Bomet, Kenya, a region with a high incidence of ESCC and esophageal squamous dysplasia (ESD), its precursor lesion.

Methods:

An age and sex-stratified sample of 294 asymptomatic adult residents completed questionnaires and underwent endoscopy with Lugol's iodine and biopsy for detection of ESD in this community-based study. Serum selenium concentrations were measured using instrumental neutron activation analysis. Odds ratios (OR) and confidence intervals (95% CI) for associations between serum selenium and ESD were calculated using unconditional logistic regression, adjusting for multiple potential confounders. Ethical approval was obtained from the National Cancer Institute, Tenwek Hospital, and Kenyatta National Hospital.

Results:

Higher serum selenium (quartile 4) was associated with prevalence of ESD (OR: 3.03; 95% CI:1.05, 8.74) relative to lower serum selenium (quartile 1). This association remained significant after adjusting for potential confounders (Q4 vs Q1: OR: 4.24; 95% CI: 1.16, 15.46). Serum selenium concentration did differ significantly by geographic location (p=0.001); however, this did not explain the association between selenium and ESD.

Conclusions:

We found a significant adverse association between higher serum selenium levels and risk of ESD. These results are in contrast to our hypothesis derived from previous observations of an inverse association between selenium and ESCC. The discrepancy may be due to the difference in endpoint of ESD rather than ESCC. Further work is needed to better understand the potential role of selenium in esophageal cancer prevention and control strategies. Funding: This work was supported by the Intramural Research Program, Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

Natalie R. Pritchett No relationship to disclose Michael M. Mwachiro No relationship to disclose Stephen L. Burgert Employment: Centers for Gastroenterology, Fort Collins, Colorado, USA Research Funding: Covidien Gwen Murphy No relationship to disclose John D. Brockman No relationship to disclose Christian C. Abnet No relationship to disclose Sanford M. Dawsey No relationship to disclose
High-Risk Human Papillomavirus (HR-HPV) Genotypes Among Women With Cervical Precancer and Cancer in Myanmar
Authors: Shwe Mu Mu , Nyunt Kyi Kyi , Aye Khin Saw , Thu Hlaing Myat , Mo Hla Myat Mo , Win Zin Mon Kay Knine , Kyaw Ohnmar , Maw Khin Than , Thant Kyaw Zin
Published: July 2016

Abstract 11

In Myanmar, cervical cancer ranks as the first most frequent cancer among women aged between 15 to 44 years and Human Papillomavirus (HPV) vaccination program is not established yet. Information on HPV genotypes distribution in cervical cancer is crucial to predict the future impact of HPV vaccines. This study aimed to determine the HPV-DNA and genotypes among women with cervical pre-cancer and cancer in Myanmar. A cross-sectional descriptive study was performed in 169 women with cervical neoplasia during 2012 to 2014. After obtaining informed consent, cervical cells were collected from 134 women with cervical intraepithelial neoplasia (CIN) and 35 with squamous cell carcinoma (SCC) of the cervix attending Sanpya General Hospital, Yangon, and Central Women Hospital, Mandalay. HPV-DNA testing and genotyping was performed by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). HR-HPV was identified in CINI (39.3%), CINII (58.6%), CINIII (66.7%), and SCC (77.1%). Overall, the most common genotypes were HPV-16 (68.1%), followed by HPV-31 (16.5%), HPV-18 (7.7%), HPV-58 (6.6%), and HPV-35 (1.1%). Among SCC, HPV-16 was the most common genotype (66.7%) followed by HPV-18 (14.8%), HPV-31 (11.1%), HPV-35 (3.7%), and HPV-58 (3.7%). In CINI, the most common genotype were HPV-16 (69.7%) followed by HPV-31 (21.2%), HPV-18 (6.1%) and HPV-58 (3.0%). In CINII, HPV-16 was most commonly determined (52.9%) followed by HPV-31 (23.5%), HPV-58 (17.6%), and HPV-18 (5.9%). In CINIII, HPV-16 was also the most common genotype (85.7%) followed by HPV-31 (7.1%) and HPV-58 (7.1%). Vaccine preventable genotype, HPV-16 was the most common genotype in Myanmar. This study highlighted that the establishment of National HPV vaccination program is needed to reduce the incidence and mortality of cervical cancer in Myanmar.[Table: see text][Table: see text]

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
ASCP's Partners for Cancer Diagnosis and Treatment in Africa
Authors: Milner Danny A. , Holladay Blair
Published: July 2016

Abstract 38

A primary goal of any health care system should be to attain universal access for all patients within a catchment area. The cancer care model requires that physicians encountering patients who they suspect of having a malignancy have access to a system that ensures rapid, accurate, and reliable pathology for primary diagnosis of cancer. Sub-Saharan Africa faces immense challenges in providing adequate coverage. Each region, country, and district has unique obstacles to overcome when meeting the health needs of the population. The American Society of Clinical Pathology (ASCP), in partnership with the White House Office of Science Technology Policy and the Clinton Global Initiative, recently launched a $26.5 million multi-year initiative. The initiative begins with assessment of potential countries with the greatest need--including collaboration and capacity program building with local officials and staff--to deploy full service pathology infrastructure for eligible countries to strategically meet their population needs. Working in parallel and together, steering committees for Diagnostics and Technology, Care and Treatment, In-Country Medical Education, Bioethics, and Monitoring & Evaluation have focused on each potential country to optimize success. The maximal intervention includes deployment of automated histopathology systems and integrated whole slide imaging systems. Imaging systems are linked through a customized laboratory information system to a dedicated team of pathologists from the United States. This long-term project will roll out to 10 or more countries in Africa as well as Haiti. An overview of the project will be presented as well as experiences data from countries launched to date.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from either author.
Using a Novel Peer Mentoring Program to Foster Conversion from Mentee to Mentor Among Clinician/Researchers-in-Training in Uganda
Authors: Phipps Warren T. , Kafeero James , Orem Jackson , Kansiime Rachel , Casper Corey , Morrow Rhoda Ashley
Published: July 2016

Abstract 54

Program Purpose:

The Uganda Cancer Institute (“UCI”)/Hutchinson Center Cancer Alliance studies infection-related cancers and builds capacity for research and medical care. Weekly research in progress (RIP) meetings for Alliance scientists and staff were started in 2010 and, in 2013, were converted to a structured, facilitated Peer-driven Mentoring and Career Development program (“PMCD”). PMCD includes weekly RIP, monthly consultant lectures or skills workshops (N=16), monthly peer-run journal clubs (N=16), and, recently, quarterly bioethics workshops (N=2). Long-term goals of PMCD include: 1) developing leadership and 2) generating confident, skilled mentors.

Evaluation:

Confidential surveys (30 questions; 18 scaled 1-5) were conducted at PMCD launch, after one year, and, reported here, after two years (N=58; including 6 Alliance junior investigators, 28 UCI medical/nursing officers, 21 staff, and 3 students). Surveys probed history of PMCD participation and PMCD usefulness. Scaled questions (1=strongly disagree to 5=strongly agree) measured confidence, leadership, and research skills.

Outcomes:

Eleven (26%) respondents indicated they “often” (vs sometimes, rarely or never) mentored others in the previous year for research-related issues (“R-Mentors”); most (82-91%) had attended PMCD activities for >12 months. Weighted averages of R-Mentors were significantly higher (t-test) than non-mentors (N=32) for career confidence, leadership, and sense of support from PMCD: “I have developed ability to lead research team members.” (4.50 vs 2.97; P<0.001). “PMCD has helped develop my leadership skills (4.70 vs 3.61; P<0.001); or confidence.” (4.27 vs 3.48; P<0.05). “I feel a sense of community in PMCD meetings.” (4.60 vs 3.87; P<0.05) “I know where to turn for help.” (4.36 vs 3.72; P<0.05) “I do not feel alone in facing research challenges.” (4.70 vs 3.52; P<0.001)

Conclusion:

PMCD is a cost-effective, transferable method to foster development of clinician-scientists who have the leadership, confidence and support to mentor others; a major step toward building capacity for independent research science in Uganda.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

Warren T. Phipps No relationship to disclose James Kafeero No relationship to disclose Jackson Orem No relationship to disclose Rachel Kansiime No relationship to disclose Corey Casper Leadership: Temptime Coporation Consulting or Advisory Role: Janssen Pharmaceuticals Research Funding: Janssen Pharmaceuticals Travel, Accommodations, Expenses: Temptime Corporation, Glaxo Smith Kline Rhoda Ashley Morrow No relationship to disclose
Demographic Characteristics and Preliminary Outcomes in a Cohort of HIV-Positive Patients With Kaposi's Sarcoma in a High ART Coverage Setting: A Report from Botswana
Authors: Elmore Shekinah N. , Bigger Elizabeth S. , Kayembe Mukendi K.A. , Musimar Zola , Suneja Gita , Efstathiou Jason A. , Dryden-Peterson Scott
Published: July 2016

Abstract 50

Objective:

Despite antiretroviral treatment coverage exceeding 90% by government estimates, Kaposi sarcoma (KS) remains the most prevalent malignancy in Botswana. Incidence has decreased minimally over the last decade. We sought to explore reasons for persistent high incidence and describe KS outcomes.

Methods:

Since 2010, consenting patients presenting to one of three oncology centers for KS treatment were enrolled prospectively and followed quarterly. Baseline HIV testing performed and records abstracted through April 2015.

Results:

207 KS patients enrolled, 60% (125) with clinical diagnosis, 34% (71) with pathologic diagnosis, and 11 (6%) with radiologic/other diagnosis. Median age at diagnosis was 37 years (IQR: 11.9) and 63% (133) male. At presentation, 65% (134) had cutaneous and 24% (49) had disseminated disease. Revised ACTG staging was 8% (17) stage I, 54% (112) stage II, 35% (73) stage III. Nearly all, 98% (199), were HIV-infected with median nadir CD4 190 cells/μL (IQR: 208). Among HIV-infected patients, 68% (109) were not on ART at time of KS diagnosis and 26% (42) were diagnosed within first six months of ART. Of those not yet on ART, 72% (47) of men and 28% (18) of women had CD4 <250 cells/μL, p=.0004. Few cases, 6 (10%), developed in patients on ART for >6 months. Patients not on ART were referred to start. 71% (146) received chemotherapy and 7% (15) required radiation. After median follow-up 19 months, 21% (43) patients had died. Estimated 3-year OS was 76% (95% CI: 69-82%). Gender, ART duration, disease extent, and stage did not significantly predict survival.

Conclusions:

With high population ART coverage, KS development among individuals with CD4<250 cells/μL accounts for majority of cases referred for oncologic treatment. ART delay, particularly among men, also contributed to persistent KS burden. Overall survival with KS in Botswana is similar to US and Europe. Initiation of ART at higher CD4 thresholds is needed to control the KS epidemic.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

Shekinah N. Elmore No relationship to disclose Elizabeth S. Bigger No relationship to disclose Mukendi K.A. Kayembe No relationship to disclose Zola Musimar No relationship to disclose Gita Suneja No relationship to disclose Jason A. Efstathiou Honoraria: Medivation/Astellas, Bayer Healthcare Pharmaceuticals Consulting or Advisory Role: Medivation/Astellas, Bayer Healthcare Pharmaceuticals Scott Dryden-Peterson Patents, Royalties, Other Intellectual Property: UpToDate
A Prospective Study on Breast Cancer in Surgical Department of Port Moresby General Hospital, a Tertiary Care Hospital in Papua New Guinea
Authors: Waine Arnold , Keith Pristley , Waine Solah A. , Taufa Shalon , John Lucy Ninmogo
Published: July 2016

Abstract 22

Breast cancer is increasing at an alarming rate amongst young women in developing countries. In Papua New Guinea, the incidence of breast cancer is the second highest after cervical cancer and is the top five cause of mortality due to cancer. A prospective audit was done to assess the changing trend of women who presents with breast lumps to the surgical clinic at the only tertiary (level 7) hospital in Papua New Guinea. The number of breast cancer has been shown to increase at a rate of 60% per year over the last eight (8) years. Infections, ulcers and benign breast lumps can mimic breast cancer on clinical presentation. However, more than half (about 59%) of breast cancers patients presents initially to the surgical clinic with breast lumps, and the commonest histological diagnosis is lobular carcinoma. Despite improvement in surgical care, most patients' outcomes are poor and often high mortality. The late clinical presentation, poor oncology and supporting care, high rate of treatment failures and defaulters are major causes of poor outcom es. There is a greater need for effective and efficient management of breast cancer patient at the tertiary health care centre in Papua New Guinea.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
International Society of Paediatric Oncology Nurses Working Group: Supporting and Learning From Colleagues in Limited-Resource Countries
Authors: Abramovitz Linda Z. , Punjwani Rehana , Challinor Julia
Published: July 2016

Abstract 44

Purpose:

Globally, nurses caring for children and adolescents with cancer work in diverse practice settings. Nurses in low- and middle-income countries (LMIC) are challenged by the limited scope of their professional practice, resources and education. Opportunities for education, networking and professional growth inspire and empower nurses to improve the care of patients and families. Nurses are key members of the International Society of Paediatric Oncology (SIOP), which provides ongoing professional development. In 2010, the SIOP Pediatric Oncology in Developing Countries Committee's Nursing Working Group was formed to support and learn from nurses working in LMIC.

Methods:

Utilizing the Cure4Kids website from St Jude, the group holds monthly business and educational meetings and continues to network and collaborate on numerous projects. PODC Nursing Working Group recently published baseline standards for pediatric oncology nursing care in LMIC. A survey will now assess the implementation of baseline standards. LMIC nurses are being mentored to write abstracts and grants to increase global recognition of their work. In addition, an education repository of teaching materials is being established.

The PODC Nursing Working Group and project groups are well established and achieving project deadlines. Educational programs including topics on abandonment, nursing in LMIC and abstracts have been well received by both nurses and physicians from LMIC and HIC. Challenges have included internet connectivity and scheduling meetings during daylight hours across the multiple time zones. Following the launch of monthly meetings in late 2015, our membership has increased by 20% from 61 to 76 members from 29 countries.

Conclusions:

The SIOP PODC Nursing Group has created a sustainable nursing community and continues to work collaboratively beyond the annual conference. The compassion and commitment to support patients and their families by providing the best care possible is the common thread for pediatric oncology nurses.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
Profile of Paediatric Malignancies in Yangon Children Hospital: A Three Year Study
Authors: Mon Ssu Wynn , Khaing Aye Aye , Win Han , Hnin Tint Myo , Thu Ye Myat , Thwin Theingi , Thant Kyaw Zin
Published: July 2016

Abstract 13

Although paediatric malignancy is one of the major health threats worldwide and its incidence is on rise, little is known about its epidemiology. In Myanmar also, reports on the pattern of childhood cancer are very few. Reliable paediatric cancer data are essential for assessing the magnitude of this problem and for qualified paediatric cancer care. This study aimed to describe the relative frequencies of various paediatric malignancies in Yangon Children Hospital (YCH) according to age and sex. This hospital based retrospective study covered all children aged 0 to 14 years with confirmed malignancies using 3 years hospital records of Haematology-Oncology Unit, from January 2012 to December 2014. Total 609 patients were diagnosed as cancer during study period. Among them, 379 cases (62.2%) were haematological malignancies and 230 cases (37.8%) were solid tumours. Acute lymphoblastic leukemia (27.5%), Acute myeloblastic leukemia (14.3%), Non-Hodgkin's lymphoma (14%) and Retinoblastoma (9.7%) were four most common childhood malignancies. Wilm's tumour (6.8%), Neuroblastoma (6.7%), Germ cell tumour (4.1%) and Rhabdomyosarcoma (3.6%) were also common. Less common were brain tumours (2.1%), Hodgkin's lymphoma (1.5%) and Burkitt's lymphoma (1.0%). Prevalence was higher in boys (58.6%) than girls (41.4%) with male to female ratio 1.5:1. About half (50.9%) of the patients were younger than 5 years and prevalence was less in more than 10 years age group (15.7%). As the data were collected from hospital, findings from this study might not be the representation of our national statistics. But as Haematology-Oncology unit, YCH is one of the two paediatric oncology centers in Myanmar and patients from most regions attend this hospital for specialist care, these findings could reflect the burden of paediatric malignancy in our country.

AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST:

No COIs from the authors.
A Step Toward Balance: Thrombin Generation Improvement via Procoagulant Factor and Antithrombin Supplementation
Authors: Mitrophanov Alexander Y. , Szlam Fania , Sniecinski Roman M. , Levy Jerrold H. , Reifman Jaques
Published: July 2016

BACKGROUND:

The use of prothrombin complex concentrates in trauma- and surgery-induced coagulopathy is complicated by the possibility of thromboembolic events. To explore the effects of these agents on thrombin generation (TG), we investigated combinations of coagulation factors equivalent to 3- and 4-factor prothrombin complex concentrates with and without added antithrombin (AT), as well as recombinant factor VIIa (rFVIIa), in a dilutional model. These data were then used to develop a computational model to test whether such a model could predict the TG profiles of these agents used to treat dilutional coagulopathy.

METHODS:

We measured TG in plasma collected from 10 healthy volunteers using Calibrated Automated Thrombogram. TG measurements were performed in undiluted plasma, 3-fold saline-diluted plasma, and diluted plasma supplemented with the following factors: rFVIIa (group rFVIIa); factors (F)II, FIX, FX, and AT (group “combination of coagulation factors” [CCF]-AT); or FII, FVII, FIX, and FX (group CCF-FVII). We extended an existing computational model of TG to include additional reactions that impact the Calibrated Automated Thrombogram readout. We developed and applied a computational strategy to train the model using only a subset of the obtained TG data and used the remaining data for model validation.

RESULTS:

rFVIIa decreased lag time and the time to thrombin peak generation beyond their predilution levels (P< 0.001) but did not restore normal thrombin peak height (P< 0.001). CCF-FVII supplementation decreased lag time (P= 0.034) and thrombin peak time (P< 0.001) and increased both peak height (P< 0.001) and endogenous thrombin potential (P= 0.055) beyond their predilution levels. CCF-AT supplementation in diluted plasma resulted in an improvement in TG without causing the exaggerated effects of rFVIIa and CCF-FVII supplementation. The differences between the effects of CCF-AT and supplementation with rFVIIa and CCF-FVII were significant for lag time (P< 0.001 andP= 0.005, respectively), time to thrombin peak (P< 0.001 andP= 0.004, respectively), velocity index (P< 0.001 andP= 0.019, respectively), thrombin peak height (P< 0.001 for both comparisons), and endogenous thrombin potential (P= 0.034 andP= 0.019, respectively). The computational model generated subject-specific predictions and identified typical patterns of TG improvement.

CONCLUSIONS:

In this study of the effects of hemodilution, CCF-AT supplementation improved the dilution-impaired plasma TG potential in a more balanced way than either rFVIIa alone or CCF-FVII supplementation. Predictive computational modeling can guide plasma dilution/supplementation experiments.
Childhood flu immunisation programme: Learning from the Scottish experience
Authors: Bhardwa Seeta
Published: July 2016

The childhood flu immunisation programme in England is planned to be rolled out to all primary schools. Seeta Bhardwa looks at the strategies used by school nurses in Scotland, where all primary school-aged children are already being offered the vaccine, to maximise uptake.
Fear of change: Helping children and young people cope
Authors: Thornton Stephanie
Published: July 2016

Stephanie Thornton looks at the impact change can have on children and young people's mental health and wellbeing and strategies to help them cope in a rapidly transforming world.
We still have a lot to do when it comes to children's rights
Authors: Feuchtwang Anna
Published: July 2016

The UN's assessment on our performance on children's rights makes for uncomfortable reading, says Anna Feuchtwang.
Suitability of Substrate for Laboratory Studies with the Subterranean Termite Reticulitermes grassei (Clément) (Isoptera: Rhinotermitidae)
Authors: Gallardo Patricia , Cardenas Ana M , Murillo Raquel
Published: July 2016

Two substrates, sand and vermiculite, were tested in rearing laboratory experiments with Reticulitermes grassei at different culture periods (2, 4 and 6 weeks). Although information is available regarding procedures to keep species of Reticulitermes in lab, none of them is referred to the Mediterranean termite R. grassei. The suitability of substratum was assessed in terms of survival of termites. The highest survival rate was in the experiment with sand and short-time duration, but after six weeks exposure, survival was significantly lower on this substrate. These differences among substrates were not significant for any of the treatments.
Older people’s motivations for participating in community singing in Australia
Authors: Lee Juyoung , Davidson Jane W. , Krause Amanda E.
Published: July 2016

The aim of this project was to investigate the motivations of older people who regularly attend community singing groups in Australia. Four focus group interviews were conducted with 64 participants belonging to three community singing groups. Participants explained their motivation to attend and sing with others in the groups. A total of eight motivating factors were identified via an inductive thematic analysis, including (1) the importance of singing in my life; (2) enormous pleasure of singing with little pressure; (3) challenge and achievement; (4) spiritual and uplifting emotions; (5) strength in overcoming my age, disease and hardship; (6) good leadership; (7) fellowship with others; and (8) purpose and meaning of group singing. The themes were discussed from various perspectives including positive psychology and the PERMA well-being model. The findings suggest that the older participants seem to experience different motivation factors while at different stages of their engagement in the groups.
Encouraging ‘Dependence’ in adult concert band settings
Authors: Rohwer Debbie
Published: July 2016

Debbie Rohwer started the Denton New Horizons Band in 1998 and over the years she has reflected on adult music education, and also completed research studies about which instructional techniques might work best for adult learners. The following article is a description of some of the techniques that have worked well in her setting, and the ideas are presented with the hope that directors can envision new, contextual, beneficial techniques to use in their own community settings.
The nomadic illustration
Authors: Morgan Catrin
Published: July 2016

This article proposes the existence of nomadic illustrations – single images that are repeatedly repurposed and recontextualized. News photographs, stock illustration and photography have been used like this for some time; one stock photograph might illustrate the covers of two
different novels; a news photograph may be used by different newspapers to support different arguments. Due to the ease with which images are appropriated online, however, this is no longer solely the province of professionally made images, and when illustrations do migrate they are being
reused in a wider range of contexts. By giving examples of nomadic illustrations and tracing their movements between contexts, this article will consider the way in which certain images become associated with particular narratives and look at what might be causing some illustrations to move
while others remain stationary.
Aquaporins in ovine amnion: responses to altered amniotic fluid volumes and intramembranous absorption rates
Authors: Cheung Cecilia Y. , Anderson Debra F. , Brace Robert A.
Published: July 2016

Aquaporins (AQPs) are transmembrane channel proteins that facilitate rapid water movement across cell membranes. In amniotic membrane, the AQP‐facilitated transfer of water across amnion cells has been proposed as a mechanism for amniotic fluid volume (AFV) regulation. To investigate whether AQPs modulate AFV by altering intramembranous absorption (IMA) rate, we tested the hypothesis that AQP gene expression in the amnion is positively correlated with IMA rate during experimental conditions when IMA rate and AFV are modified over a wide range. The relative abundances of AQP1, AQP3, AQP8, AQP9, and AQP11 mRNA and protein were determined in the amnion of 16 late‐gestation ovine fetuses subjected to 2 days of control conditions, urine drainage, urine replacement, or intraamniotic fluid infusion. AQP mRNA levels were determined by RT‐qPCR and proteins by western immunoblot. Under control conditions, mRNA levels among the five AQPs differed more than 20‐fold. During experimental treatments, mean IMA rate in the experimental groups ranged from 100 ± 120 mL/day to 1370 ± 270 mL/day. The mRNA levels of the five AQPs did not change from control and were not correlated with IMA rates. The protein levels of AQP1 were positively correlated with IMA rates (r2 = 38%, P = 0.01) while the remaining four AQPs were not. These findings demonstrate that five AQPs are differentially expressed in ovine amnion. Our study supports the hypothesis that AQP1 may play a positive role in regulating the rate of fluid transfer across the amnion, thereby participating in the dynamic regulation of AFV.
Responsibility and Well-Being: Resource Integration under Responsibilization in Expert Services
Authors: Anderson Laurel , Spanjol Jelena , Jefferies Josephine Go , Ostrom Amy L. , Nations Baker Courtney , Bone Sterling A. , Downey Hilary , Mende Martin , Rapp Justine M.
Published: July 2016

Responsibilization, or the shift of functions and risks from providers and producers to consumers, has become an increasingly common policy in service systems and marketplaces (e.g., financial, health, governmental). Because responsibilization is often considered synonymous with consumer agency and well-being, the authors take a transformative service research perspective and draw on resource integration literature to investigate whether responsibilization is truly associated with well-being. The authors focus on expert services, for which responsibilization concerns are particularly salient, and question whether this expanding policy is in the public interest. In the process, they develop a conceptualization of resource integration under responsibilization that includes three levels of actors (consumer, provider, and service system), the identification of structural tensions surrounding resource integration, and three categories of resource-integration practices (access, appropriation, and management) necessary to negotiate responsibilization. The findings have important implications for providers, public and institutional policy makers, and service systems, all of which must pay more active attention to the challenges consumers face in negotiating responsibilization and the resulting well-being outcomes.
The Influence of Training Age on the Annual Development of Physical Qualities Within Academy Rugby League Players
Authors: Till Kevin , Darrall-Jones Joshua , Weakley Jonathon J. , Roe Greg A. , Jones Ben L.
Published: July 2016

Till, K, Darrall-Jones, J, Weakley, JJ, Roe, GA, and Jones, BL. The influence of training age on the annual development of physical qualities within academy rugby league players. J Strength Cond Res 31(8): 2110–2118, 2017—Previous research in academy rugby league players has evaluated the development of physical qualities according to chronological age. However, no study has considered the training age, defined as the number of formalized years of strength and conditioning training, of these players. Therefore, the purpose of this study was to present and compare the annual changes in physical qualities of academy rugby league players according to training age. Sixty-one academy players undertook a fitness testing assessment, including anthropometric (height, body mass, sum of 4 skinfolds) and physical (10 and 20 m sprint, 10m momentum, vertical jump, Yo-Yo intermittent recovery test level 1 [Yo-Yo IRTL1], one-repetition maximum [1RM] squat, bench press and prone row) measures at the start of preseason on 2 consecutive annual occasions. Players were categorized into one of 3 training age groups (i.e., 0, 1, or 2 years) and were analyzed using magnitude-based inferences. Almost certain, very likely or likely annual improvements were identified for body mass, 10m momentum, Yo-Yo IRTL1, vertical jump, and all strength measures for the 3 training age groups. When training age groups were compared, 1 year showed possibly or likely lower strength increases than 0 years training age. However, the 2 years training age group demonstrated possibly or likely increased strength changes compared with 1 year. These findings suggest that training age is an important consideration for strength and conditioning practitioners but it is likely to be a combination of chronological age, biological maturity, and training experience alongside dynamic interplayer variability that influences the physical development of academy rugby league players.
Detecting Heterogeneity in Population Structure Across the Genome in Admixed Populations
Authors: McHugh Caitlin , Brown Lisa , Thornton Timothy A
Published: July 2016

The genetic structure of human populations is often characterized by aggregating measures of ancestry across the autosomal chromosomes. While it may be reasonable to assume that population structure patterns are similar genome-wide in relatively homogeneous populations, this assumption may not be appropriate for admixed populations, such as Hispanics and African-Americans, with recent ancestry from two or more continents. Recent studies have suggested that systematic ancestry differences can arise at genomic locations in admixed populations as a result of selection and nonrandom mating. Here, we propose a method, which we refer to as the chromosomal ancestry differences (CAnD) test, for detecting heterogeneity in population structure across the genome. CAnD can incorporate either local or chromosome-wide ancestry inferred from SNP genotype data to identify chromosomes harboring genomic regions with ancestry contributions that are significantly different than expected. In simulation studies with real genotype data from phase III of the HapMap Project, we demonstrate the validity and power of CAnD. We apply CAnD to the HapMap Mexican-American (MXL) and African-American (ASW) population samples; in this analysis the software RFMix is used to infer local ancestry at genomic regions, assuming admixing from Europeans, West Africans, and Native Americans. The CAnD test provides strong evidence of heterogeneity in population structure across the genome in the MXL sample (p=1e−5), which is largely driven by elevated Native American ancestry and deficit of European ancestry on the X chromosomes. Among the ASW, all chromosomes are largely African derived and no heterogeneity in population structure is detected in this sample.
The Importance of Transition from Micro to Nano Clay Size in Improving the Engineering Properties of Sandy Soils (Poorly Graded Sand)
Authors: J. Sufiyan  , A. Uromeihy  , M.R. Nikudel
Published: July 2016

Nano-clays are a broad class of naturally occurring inorganic minerals in the form of plate-like alumina-silicate layers with thickness between 1nano-meter to 10micro-meters. Due to the very small sizes of nanoparticle, they provide a large specific surface area which make them to absorb water and fill the voids within the soil particles.The aim of this paper is to investigate the use of nano-clays for modifying the engineering properties of granular soils. This type of soil covers large parts of the land surface and cause many problems for the development of urban areas, infrastructure projects and instability of slopes along the railways and road networks.The mineral composition of the granular soil mainly consists of quartz grains and the soil types are classified as poorly- to well-grade materials. In order to evaluate the effect of micro and nano clay on modification of geotechnical properties of the sand, different percentage of 0.5%, 1%, 2% and 4% of micro-clay and percentage 0.5%, 1%, 2%, 4%, 6%, 8%, 10%, 12% and 14% nano-clay. In order to determine the value of its peak were done. Then mixed with the sand and a number of tests such as compaction test, direct shear test are conducted on the samples. The result shows that maximum dry unit weight and maximum optimum moisture content were obtained when 10% nano-clay mixed with the sand. It was also was noted that the increment of nano-clay and micro-clay causes gradual increases and gradual decreases of the shear strength of the sample, respectively.
Determination of Director Angle for Flow Aligning Nematic Liquid Crystals under Couette Geometry
Authors: Bagisa Mukherjee
Published: July 2016

We consider steady state flow of nematic liquid crystals in a Couette geometry driven by the relative rotation of the two concentric cylinders. We use the standard Ericksen-Leslie continuum model. The director, a unit vector, represents the average molecular orientation. We assume strong anchoring conditions at the walls of the flow which fixes the director orientation, and find an explicit expression of the director angle as a function of its distance from the common axis of the rotating cylinders.
Numerical Study of a Turbulent Single-Stage Axial Flow
Authors: Majid Almas
Published: July 2016

This paper studies the flow in an axial fan with a rotor in front and stators (vanes) in the rear. This configuration is typical of a single-stage axial flow turbo machine. The standard Â model with enhanced wall treatment. Interaction between these components is determined considering the rotor and stator together in a single calculation. Numerical calculations have been performed to investigate the effects of different angular velocities on pressure contours, mass flow rates and total pressure and the results have been shown and discussed through figures. The results show that the increase of angular velocity has a significant effect on the governing physical parameters.
Renewable Energy Resources and Their Importance in Rural Areas in Turkey
Authors: D. Bostan Budak  , Z. Zaimoglu  , F. Budak
Published: July 2016

Turkey is a net importer of energy and its imports continue to grow. As fossil fuel energy becomes scarcer, Turkey will likely face higher energy prices, energy disruptions, and greater energy insecurity within the next few decades unless important steps and measures towards alternative energy supplies, conservation, and proactive government policies are taken. Turkey has substantial renewable energy potential. Primary renewable energy resources in Turkey are hydro, biomass, wind, geothermal and solar. Turkey has several advantages to utilize renewable energy sources, but the potential benefits of renewable sources are not fully realized. Investments in renewable energy sources will not only reduce energy costs to rural consumers but they will also create new job opportunities for rural populations. Rural area households and industries in developing countries suffer greatly from energy scarcity. Energy, an essential need for every individual and for economic development, has always been lacking in rural areas of developing countries. The income of these rural populations depends largely on farming. Energy is needed primarily for pumping water for agriculture and domestic activities. Most of the energy needs in rural areas are met with traditional biomass for household cooking and heating, and human animal power for agriculture. Energy efficiency and production on the farm are important components for agriculture sustainability. This paper analyzes the potential of renewable energy sources and examines the negative effects of energy insufficiency in rural areas.
Female Students’ Fear of Crime and It’s Correlation with the Environmental Features of the Campus
Authors: Kyung-Hoon Lee  , Young-Ho Bang
Published: July 2016

The purpose of this study is to create safer campus outdoor spaces for female students during the night. For this, a literature review, a mapping survey of criminally vulnerable spots, and a questionnaire were carried out to derive the environmental characteristics affecting the fear of crime and to measure the fear of crime felt by female students at the outdoor spaces of campus. Based on the survey, the correlation between the fear of crime of female students and environmental characteristics of outdoor spaces was analyzed. This study is significant in suggesting ways to alleviate the female students' fear of crime in the college campus.
Global College Rankings
Authors: Kaufui Vincent Wong
Published: July 2016

It is difficult to find consensus regarding the global criteria for college rankings. The worldwide open market for intellectual professionals would be less problematic if there are some standards. There is a question of costs, and which party would be responsible for the expenses. In all the most widely known global rankings, U.S. colleges still generally rule the college rankings. The total research budget in the U.S.A. continues to dominate in the world. Most academic publications on this subject are about the original college ranking used, and many of the newer college ranking systems are not mentioned. The current work serves to fill this gap. The reputation factor is very important in college rankings. As with human reputation (which is the only thing that survives when a human dies) college reputation seems to be one of the few lasting characteristics. If affordability is an important factor, then one of the newer college rankings would be more useful.
Ascending Series Analysis of the Transition Layer
Authors: S. Alzahrani  , M. H. Hamdan  , I. Gadoura 
Published: July 2016

This work considers existing formulation of a recent problem introduced in the literature and involves flow through a transition porous layer, whose solution has been found in terms of Airy’s functions and evaluated using asymptotic series. Ascending series expressions are derived in this work and used in the computations of the solution, namely the computations of Airy’s functions and the recently introduced Nield-Kuznetsov function that arises in the solution to inhomogeneous Airy’s equation. Ascending series expressions developed in this work represent a viable methodology in analyzing flow through the variable permeability transition layer, and are shown to produce results as accurate as the asymptotic series results available in the literature. Both thin and fat transition layers are considered in this work which compares friction factors, velocity profiles, and mean velocities in the two types of layers, Flow through a channel over a Darcy porous layer is also considered in this work and the computed results agree with known results.