bluuebunny/crossref_metadata_2025 huggingface dataset:
GESTÃO DE PESSOAS COMO IMPULSIONADORA DO DESENVOLVIMENTO ESTRATÉGICO DAS ORGANIZAÇÕES BRASILEIRAS CONTEMPORÂNEAS
Authors: Casagrande Diego José
Published: June 2018

O acelerado processo de globalização econômico e o desenvolvimento contínuo dos negócios exigem das organizações uma postura cada vez mais flexível e voltada para a obtenção de vantagens competitivas duradouras. Diante deste contexto, os gestores buscam planejar e definir suas estratégias com o intuito de otimizar a utilização de seus recursos e alcançar seus objetivos propostos. Neste sentido, um dos principais recursos das empresas são as pessoas. Baseado nas características do cenário organizacional contemporâneo, o moderno conceito de gerir pessoas vem deixando de lado os aspectos burocráticos e legais do antigo departamento de recursos humanos, tornando-se uma área que trabalha em consonância com os objetivos estratégicos empresariais em sua totalidade. O principal objetivo deste trabalho é demonstrar como a evolução na área de gestão de pessoas influencia os modelos gerenciais das organizações. Para isso, utilizou-se a revisão bibliográfica como metodologia de pesquisa. Concluiu-se que as pessoas tornaram-se peças fundamentais para o sucesso organizacional.
Faktor yang Berhubungan dengan Kasus Skizofrenia pada Pasien Rawat Inap Rumah Sakit Khusus Jiwa Soeprapto Provinsi Bengkulu
Authors: Hermiati Dilfera , Harahap Resnia Madona
Published: June 2018

The purpose of this study was to determine the factors associated with the incidence of schizophrenia in patients in the Inpatient Room of Soeprapto Special Base Hospital of Bengkulu Province.The method used is descriptive research design with cross sectional approach. Data were collected using primary and secondary data, primary data obtained from the questionnaires to the 67 families of patients treated in inpatient Special Hospital Mental Soeprapto Bengkulu province, while secondary data is taken from the patient's medical record. The sampling technique is by proportional random sampling technique. The analysis showed the majority of respondents, 39  who suffered from schizophrenia, the majority of respondents, 15 contained genetic factors, the majority of respondents, 24 Which there are psychosocial factors, and some of the respondents are 24 people that there are environmental factors. The results of the bivariate analysis showed no significant relationship between genetic schizophrenia in patients in the inpatient unit Special Hospital Mental Soeprapto Bengkulu province, there is a significant relationship between psychosocial with schizophrenia in patients in the inpatient unit Special Hospital Mental Soeprapto Bengkulu province, and there are A significant relationship between the environment and schizophrenia in patients in the inpatient rooms of Soeprapto Special Base Hospital of Bengkulu Province. Keywords: Genetic, Psychosocial, Environmental, Schizophrenia
Complications associated with microscopic and endoscopic transsphenoidal pituitary surgery: experience of 1153 consecutive cases treated at a single tertiary care pituitary center
Authors: Agam Matthew S. , Wedemeyer Michelle A. , Wrobel Bozena , Weiss Martin H. , Carmichael John D. , Zada Gabriel
Published: June 2018

OBJECTIVE

Pituitary adenomas (PAs) are benign neoplasms that are frequently encountered during workup for endocrinopathy, headache, or visual loss. Transsphenoidal surgery remains the first-line approach for PA resection. The authors retrospectively assessed complication rates associated with transsphenoidal PA resection from an institutional database.

METHODS

A retrospective analysis of 1153 consecutive transsphenoidal pituitary adenoma resections performed at the Keck Hospital of USC between November 1992 and March 2017 was conducted. Microscopic transsphenoidal resection was performed in 85.3% of cases, and endoscopic transsphenoidal resection was performed in 14.7%. Analysis of perioperative complications and patient and tumor risk factors was conducted.

RESULTS

The overall median hospital stay was 3 days. There was 1 perioperative death (0.1%). Surgical complications included postoperative cerebrospinal fluid leak (2.6%), epistaxis (1.1%), postoperative hematoma (1.1%), meningitis (1.0%), cranial nerve paresis (0.8%), hydrocephalus (0.8%), vision loss (0.6%), stroke (0.3%), abdominal hematoma or infection (0.2%), carotid artery injury (0.1%), and vegetative state (0.2%). Perioperative medical complications included bacteremia/sepsis (0.5%), pneumonia (0.3%), myocardial infarction (0.3%), and deep venous thrombosis/pulmonary embolism (0.1%). Endocrine complications were the most frequent, including transient diabetes insipidus (4.3%), symptomatic hyponatremia (4.2%), new hypopituitarism (any axis) (3.6%), permanent diabetes insipidus (0.3%), and adrenal insufficiency (0.2%). There were no significant differences between microscopic and endoscopic approaches with regard to surgical complications (6.4% vs 8.8%, p = 0.247) or endocrine complications (11.4 vs 11.8%, p = 0.888). Risk factors for surgical complications included prior transsphenoidal surgery (11.4% vs 6.8%, p = 0.025), preoperative vision loss (10.3% vs 6.8%, p = 0.002), and presence of PA invasion on MRI (8.5% vs 4.4%, p = 0.007).

CONCLUSIONS

In this single tertiary center study assessing complications associated with transsphenoidal PA resection, the rate of death or major disability was 0.26%. Risk factors for complications included prior surgical treatment and PA invasion. No differences in complication rates between endoscopic and microscopic surgery were observed. When performed at experienced pituitary centers, transsphenoidal surgery for PAs may be performed with a high degree of safety.
Extracranial glioblastoma diagnosed by examination of pleural effusion using the cell block technique: case report
Authors: Hori Yusuke S. , Fukuhara Toru , Aoi Mizuho , Oda Kazunori , Shinno Yoko
Published: June 2018

Metastatic glioblastoma is a rare condition, and several studies have reported the involvement of multiple organs including the lymph nodes, liver, and lung. The lung and pleura are reportedly the most frequent sites of metastasis, and diagnosis using less invasive tools such as cytological analysis with fine needle aspiration biopsy is challenging. Cytological analysis of fluid specimens tends to be negative because of the small number of cells obtained, whereas the cell block technique reportedly has higher sensitivity because of a decrease in cellular dispersion. Herein, the authors describe a patient with a history of diffuse astrocytoma who developed intractable, progressive accumulation of pleural fluid. Initial cytological analysis of the pleural effusion obtained by thoracocentesis was negative, but reanalysis using the cell block technique revealed the presence of glioblastoma cells. This is the first report to suggest the effectiveness of the cell block technique in the diagnosis of extracranial glioblastoma using pleural effusion. In patients with a history of glioma, the presence of extremely intractable pleural effusion warrants cytological analysis of the fluid using this technique in order to initiate appropriate chemotherapy.
Regression of a nonfunctioning pituitary macroadenoma on the CDK4/6 inhibitor palbociclib: case report
Authors: Anderson Emily , Heller Robert S. , Lechan Ronald M. , Heilman Carl B.
Published: June 2018

A 71-year-old female patient was referred in 2013 for evaluation of an asymptomatic nonsecreting pituitary adenoma. The adenoma, measuring 13 mm in height by 10 mm in width, was discovered incidentally on imaging in 2012. Biochemical testing demonstrated a nonfunctioning adenoma. Given the relatively small lesion size and the lack of symptoms, observation was preferred over surgical intervention. The patient was monitored with routine MRI, which until 2016 demonstrated minimal growth. In early 2016, the patient developed recurrence of metastatic breast cancer and was treated with palbociclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor. This inhibitor acts on a pathway believed to be involved in pituitary adenoma tumorigenesis. One year after starting palbociclib, routine imaging demonstrated significant regression of her pituitary adenoma. The authors hypothesize that inhibition of the CDK4/6 pathway by palbociclib contributed to adenoma regression in this patient, and that palbociclib may represent a possible adjuvant therapy for the treatment of nonfunctioning pituitary adenomas.
Chimeric antigen receptor T-cell immunotherapy for glioblastoma: practical insights for neurosurgeons
Authors: Choi Bryan D. , Curry William T. , Carter Bob S. , Maus Marcela V.
Published: June 2018

The prognosis for glioblastoma (GBM) remains exceedingly poor despite state-of-the-art multimodal therapy. Immunotherapy, particularly with cytotoxic T cells, represents a promising alternative. Perhaps the most prominent T-cell technology is the chimeric antigen receptor (CAR), which in 2017 received accelerated approval from the Food and Drug Administration for the treatment of hematological malignancies. Several CARs for GBM have been recently tested in clinical trials with exciting results. The authors review these clinical data and discuss areas of ongoing research.
Cost-effectiveness of preoperative motor mapping with navigated transcranial magnetic brain stimulation in patients with high-grade glioma
Authors: Butenschön Vicki M. , Ille Sebastian , Sollmann Nico , Meyer Bernhard , Krieg Sandro M.
Published: June 2018

OBJECTIVE

Navigated transcranial magnetic stimulation (nTMS) is used to identify the motor cortex prior to surgery. Yet, there has, until now, been no published evidence on the economic impact of nTMS. This study aims to analyze the cost-effectiveness of nTMS, evaluating the incremental costs of nTMS motor mapping per additional quality-adjusted life year (QALY). By doing so, this study also provides a model allowing for future analysis of general cost-effectiveness of new neuro-oncological treatment options.

METHODS

The authors used a microsimulation model based on their cohort population sampled for 1000 patients over the time horizon of 2 years. A health care provider perspective was used to assemble direct costs of total treatment. Transition probabilities and health utilities were based on published literature. Effects were stated in QALYs and established for health state subgroups.

RESULTS

In all scenarios, preoperative mapping was considered cost-effective with a willingness-to-pay threshold < 3*per capita GDP (gross domestic product). The incremental cost-effectiveness ratio (ICER) of nTMS versus no nTMS was 45,086 Euros/QALY. Sensitivity analyses showed robust results with a high impact of total treatment costs and utility of progression-free survival. Comparing the incremental costs caused by nTMS implementation only, the ICER decreased to 1967 Euros/QALY.

CONCLUSIONS

Motor mapping prior to surgery provides a cost-effective tool to improve the clinical outcome and overall survival of high-grade glioma patients in a resource-limited setting. Moreover, the model used in this study can be used in the future to analyze new treatment options in neuro-oncology in terms of their general cost-effectiveness.
Outpatient neurosurgery in neuro-oncology
Authors: Marigil Miguel , Bernstein Mark
Published: June 2018

Technological breakthroughs along with modern application of awake craniotomy and new neuroanesthesia protocols have led to a progressive development in outpatient brain tumor surgery and improved surgical outcomes. As a result, outpatient neurosurgery has become a standard of care at the authors’ center due to its clinical benefits and impact on patient recovery and overall satisfaction. On the other hand, the financial savings derived from its application is also another favorable factor exerting influence on patients, health care systems, and society.

Although validated several years ago and with recent data supporting its application, outpatient brain tumor surgery has not gained the traction that it deserves, based on scientific skepticism and perceived potential for medicolegal issues. The goal of this review, based on the available literature and the senior author’s experience in outpatient brain tumor surgery, was to evaluate the most important aspects regarding indications, clinical outcomes, economic burden, and patient perceptions.
Setup presentation and clinical outcome analysis of treating highly language-eloquent gliomas via preoperative navigated transcranial magnetic stimulation and tractography
Authors: Sollmann Nico , Kelm Anna , Ille Sebastian , Schröder Axel , Zimmer Claus , Ringel Florian , Meyer Bernhard , Krieg Sandro M.
Published: June 2018

OBJECTIVE

Awake surgery combined with intraoperative direct electrical stimulation (DES) and intraoperative neuromonitoring (IONM) is considered the gold standard for the resection of highly language-eloquent brain tumors. Different modalities, such as functional magnetic resonance imaging (fMRI) or magnetoencephalography (MEG), are commonly added as adjuncts for preoperative language mapping but have been shown to have relevant limitations. Thus, this study presents a novel multimodal setup consisting of preoperative navigated transcranial magnetic stimulation (nTMS) and nTMS-based diffusion tensor imaging fiber tracking (DTI FT) as an adjunct to awake surgery.

METHODS

Sixty consecutive patients (63.3% men, mean age 47.6 ± 13.3 years) suffering from highly language-eloquent left-hemispheric low- or high-grade glioma underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by awake surgery for tumor resection. Both nTMS language mapping and DTI FT data were available for resection planning and intraoperative guidance. Clinical outcome parameters, including craniotomy size, extent of resection (EOR), language deficits at different time points, Karnofsky Performance Scale (KPS) score, duration of surgery, and inpatient stay, were assessed.

RESULTS

According to postoperative evaluation, 28.3% of patients showed tumor residuals, whereas new surgery-related permanent language deficits occurred in 8.3% of patients. KPS scores remained unchanged (median preoperative score 90, median follow-up score 90).

CONCLUSIONS

This is the first study to present a clinical outcome analysis of this very modern approach, which is increasingly applied in neurooncological centers worldwide. Although human language function is a highly complex and dynamic cortico-subcortical network, the presented approach offers excellent functional and oncological outcomes in patients undergoing surgery of lesions affecting this network.
Tectal gliomas: assessment of malignant progression, clinical management, and quality of life in a supposedly benign neoplasm
Authors: Mohme Malte , Fritzsche Friederike S. , Mende Klaus C. , Matschke Jakob , Löbel Ulrike , Kammler Gertrud , Westphal Manfred , Emami Pedram , Martens Tobias
Published: June 2018

OBJECTIVE

Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology.

METHODS

Clinical data analysis of 23 cases of tectal glioma (involving 9 children and 14 adults) was performed retrospectively. Radiographic data were analyzed longitudinally and MR images were evaluated for tumor volume, contrast enhancement, and growth progression. Quality of life was assessed using the EORTC BN20 and C30 questionnaires during follow-up in a subgroup of patients.

RESULTS

The patients’ mean age at diagnosis was 29.2 years. The main presenting symptom at diagnosis was hydrocephalus (80%). Six patients were treated by primary tumor resection (26.1%), 3 patients underwent biopsy followed by resection (13.1%), and 3 patients underwent biopsy only (13.1%). For additional treatment of hydrocephalus, 14 patients (60.9%) received shunts and/or endoscopic third ventriculostomy. Radiographic tumor progression was observed in 47.9% of the 23 cases. The mean time between diagnosis and growth progression was 51.5 months, and the mean time to contrast enhancement was 69.7 months. Histopathological analysis was obtained in 12 cases (52.2%), resulting in 5 cases of high-grade glioma (3 cases of glioblastoma multiforme [GBM], grade IV, and 2 of anaplastic astrocytoma, grade III), 5 cases of pilocytic astrocytoma, 1 diffuse astrocytoma, and 1 ganglioglioma. Malignant progression was observed in 2 cases, with 1 case progressing from a diffuse astrocytoma (grade II) to a GBM (grade IV) within a period of 13 years. Quality-of-life measurements demonstrated distinct functional deficits compared to a healthy sample as well as glioma control cohorts.

CONCLUSIONS

Analysis of this case series shows that a major subpopulation of tectal gliomas show progression and malignant transformation in children as well as in adolescents. These tumors therefore cannot be considered inert lesions and require histological confirmation and close follow-up. Quality-of-life questionnaires show that tectal glioma patients might benefit from special psychological support in emotional, social, and cognitive functionality.
Disparities in health care determine prognosis in newly diagnosed glioblastoma
Authors: Chandra Ankush , Rick Jonathan W. , Dalle Ore Cecilia , Lau Darryl , Nguyen Alan T. , Carrera Diego , Bonte Alexander , Molinaro Annette M. , Theodosopoulos Philip V. , McDermott Michael W. , Berger Mitchel S. , Aghi Manish K.
Published: June 2018

OBJECTIVE

Glioblastoma (GBM) is an aggressive brain malignancy with a short overall patient survival, yet there remains significant heterogeneity in outcomes. Although access to health care has previously been linked to impact on prognosis in several malignancies, this question remains incompletely answered in GBM.

METHODS

This study was a retrospective analysis of 354 newly diagnosed patients with GBM who underwent first resection at the authors’ institution (2007–2015).

RESULTS

Of the 354 patients (median age 61 years, and 37.6% were females), 32 (9.0%) had no insurance, whereas 322 (91.0%) had insurance, of whom 131 (40.7%) had Medicare, 45 (14%) had Medicaid, and 146 (45.3%) had private insurance. On average, insured patients survived almost 2-fold longer (p < 0.0001) than those who were uninsured, whereas differences between specific insurance types did not influence survival. The adjusted hazard ratio (HR) for death was higher in uninsured patients (HR 2.27 [95% CI 1.49–3.33], p = 0.0003). Age, mean household income, tumor size at diagnosis, and extent of resection did not differ between insured and uninsured patients, but there was a disparity in primary care physician (PCP) status—none of the uninsured patients had PCPs, whereas 72% of insured patients had PCPs. Postoperative adjuvant treatment rates with temozolomide (TMZ) and radiation therapy (XRT) were significantly less in uninsured (TMZ in 56.3%, XRT in 56.3%) than in insured (TMZ in 75.2%, XRT in 79.2%; p = 0.02 and p = 0.003) patients. Insured patients receiving both agents had better prognosis than uninsured patients receiving the same treatment (9.1 vs 16.34 months; p = 0.025), suggesting that the survival effect in insured patients could only partly be explained by higher treatment rates. Moreover, having a PCP increased survival among the insured cohort (10.7 vs 16.1 months, HR 1.65 [95% CI 1.27–2.15]; p = 0.0001), which could be explained by significant differences in tumor diameter at initial diagnosis between patients with and without PCPs (4.3 vs 4.8 cm, p = 0.003), and a higher rate of clinical trial enrollment, suggesting a critical role of PCPs for a timelier diagnosis of GBM and proactive cancer care management.

CONCLUSIONS

Access to health care is a strong determinant of prognosis in newly diagnosed patients with GBM. Any type of insurance coverage and having a PCP improved prognosis in this patient cohort. Higher rates of treatment with TMZ plus XRT, clinical trial enrollment, fewer comorbidities, and early diagnosis may explain survival disparities. Lack of health insurance or a PCP are major challenges within the health care system, which, if improved upon, could favorably impact the prognosis of patients with GBM.
Safety and outcomes of resection of butterfly glioblastoma
Authors: Dayani Fara , Young Jacob S. , Bonte Alexander , Chang Edward F. , Theodosopoulos Philip , McDermott Michael W. , Berger Mitchel S. , Aghi Manish K.
Published: June 2018

OBJECTIVE

Butterfly glioblastoma (bGBM) is a rare type of GBM, characterized by a butterfly pattern on MRI studies because of its bihemispheric involvement and invasion of the corpus callosum (CC). There is a profound gap in the knowledge regarding the optimal treatment approach as well as the safety and survival benefits of resection in treating this aggressive brain tumor. In this retrospective study, authors add to our understanding of these tumors by identifying the clinical characteristics and outcomes of patients with bGBM.

METHODS

An institutional database was reviewed for GBM cases treated in the period from 2004 to 2014. Records were reviewed to identify adult patients with bGBM. Cases of GBM with invasion of the CC without involvement of the contralateral hemisphere and bilateral GBMs without involvement of the CC were excluded from the study. Patient and tumor characteristics were gleaned from the medical records, and volumetric analysis was performed using T1-weighted MRI studies.

RESULTS

From among 1746 cases of GBM, 39 cases of bGBM were identified. Patients had a mean age of 57.8 years at diagnosis. Headache and confusion were the most common presenting symptoms (48.7% and 33.3%, respectively). The median overall survival was 3.2 months from diagnosis with an overall 6-month survival rate of 38.1%. Age, Karnofsky Performance Status at diagnosis, preoperative tumor volume, postoperative tumor volume, and extent of resection were found to significantly impact survival in the univariate analysis. On multivariate analysis, preoperative tumor volume and treatment approach of resection versus biopsy were identified as independent prognostic factors regardless of the patient-specific characteristics of age and KPS at diagnosis. Resection and biopsy were performed in 35.9% and 64.1% of patients, respectively. Resection was found to confer a better prognosis than biopsy (HR 0.37, p = 0.009) with a minimum extent of resection of 86% to observe survival benefits (HR 0.054, p = 0.03). The rate of persistent neurological deficits from resection was 7.14%. Patients younger than 70 years had a better prognosis (HR 0.32, p = 0.003). Patients undergoing resection and receiving adjuvant chemoradiation had a better prognosis than patients who lacked one of the three treatment modalities (HR = 0.34, p = 0.015).

CONCLUSIONS

Resection of bGBM is associated with low persistent neurological deficits, with improvement in survival compared to biopsy. A more aggressive treatment approach involving aggressive resection and adjuvant chemoradiation has significant survival benefits and improves outcome.
5-ALA–induced fluorescence as a marker for diagnostic tissue in stereotactic biopsies of intracranial lymphomas: experience in 41 patients
Authors: Kiesel Barbara , Millesi Matthias , Woehrer Adelheid , Furtner Julia , Bavand Anahita , Roetzer Thomas , Mischkulnig Mario , Wolfsberger Stefan , Preusser Matthias , Knosp Engelbert , Widhalm Georg
Published: June 2018

OBJECTIVE

Stereotactic needle biopsies are usually performed for histopathological confirmation of intracranial lymphomas to guide adequate treatment. During biopsy, intraoperative histopathology is an effective tool to avoid acquisition of nondiagnostic samples. In the last years, 5-aminolevulinic acid (5-ALA)–induced fluorescence has been increasingly used for visualization of diagnostic brain tumor tissue during stereotactic biopsies. Recently, visible fluorescence was reported in the first cases of intracranial lymphomas as well. The aim of this study is thus to investigate the technical and clinical utility of 5-ALA–induced fluorescence in a large series of stereotactic biopsies for intracranial lymphoma.

METHODS

This prospective study recruited adult patients who underwent frameless stereotactic needle biopsy for a radiologically suspected intracranial lymphoma after oral 5-ALA administration. During biopsy, samples from the tumor region were collected for histopathological analysis, and presence of fluorescence (strong, vague, or no fluorescence) was assessed with a modified neurosurgical microscope. In tumors with available biopsy samples from at least 2 different regions the intratumoral fluorescence homogeneity was additionally investigated. Furthermore, the influence of potential preoperative corticosteroid treatment or immunosuppression on fluorescence was analyzed. Histopathological tumor diagnosis was established and all collected biopsy samples were screened for diagnostic lymphoma tissue.

RESULTS

The final study cohort included 41 patients with intracranial lymphoma. Stereotactic biopsies with assistance of 5-ALA were technically feasible in all cases. Strong fluorescence was found as maximum level in 30 patients (75%), vague fluorescence in 2 patients (4%), and no visible fluorescence in 9 patients (21%). In 28 cases, samples were obtained from at least 2 different tumor regions; homogenous intratumoral fluorescence was found in 16 of those cases (57%) and inhomogeneous intratumoral fluorescence in 12 (43%). According to histopathological analysis, all samples with strong or vague fluorescence contained diagnostic lymphoma tissue, resulting in a positive predictive value of 100%. Analysis showed no influence of preoperative corticosteroids or immunosuppression on fluorescence.

CONCLUSIONS

The data obtained in this study demonstrate the technical and clinical utility of 5-ALA–induced fluorescence in stereotactic biopsies of intracranial lymphomas. Thus, 5-ALA can serve as a useful tool to select patients not requiring intraoperative histopathology, and its application should markedly reduce operation time and related costs in the future.
Craniopharyngioma: a roadmap for scientific translation
Authors: Gupta Saksham , Bi Wenya Linda , Giantini Larsen Alexandra , Al-Abdulmohsen Sally , Abedalthagafi Malak , Dunn Ian F.
Published: June 2018

OBJECTIVE

Craniopharyngiomas are among the most challenging of intracranial tumors to manage because of their pattern of growth, associated morbidities, and high recurrence rate. Complete resection on initial encounter can be curative, but it may be impeded by the risks posed by the involved neurovascular structures. Recurrent craniopharyngiomas, in turn, are frequently refractory to additional surgery and adjuvant radiation or chemotherapy.

METHODS

The authors conducted a review of primary literature.

RESULTS

Recent advances in the understanding of craniopharyngioma biology have illuminated potential oncogenic targets for pharmacotherapy. Specifically, distinct molecular profiles define two histological subtypes of craniopharyngioma: adamantinomatous and papillary. The discovery of overactive B-Raf signaling in the adult papillary subtype has led to reports of targeted inhibitors, with a growing acceptance for refractory cases. An expanding knowledge of the biological underpinnings of craniopharyngioma will continue to drive development of targeted therapies and immunotherapies that are personalized to the molecular signature of each individual tumor.

CONCLUSIONS

The rapid translation of genomic findings to medical therapies for recurrent craniopharyngiomas serves as a roadmap for other challenging neurooncological diseases.
Evaluation of fontanel size variation and closure time in children followed up from birth to 24 months
Authors: Boran Perran , Oğuz Fatma , Furman Andrzej , Sakarya Sibel
Published: June 2018

OBJECTIVE

Anterior fontanel size and closure time can be useful clinical signs for the early diagnosis of diseases. Knowing age-related normal variations is important to decide on further investigations. The authors of this study aimed to describe fontanel size variation according to age, determine fontanel closure time, and identify the optimal method for assessing fontanel size.

METHODS

For this prospective cohort study, 321 healthy term babies who fulfilled the inclusion criteria were consecutively recruited. Percentile charts for the mean anterior fontanel size and oblique measurements from birth to 24 months of age were created.

RESULTS

The mean fontanel closure time was 9.7 ± 5.0 months (girls 10.3 ± 4.7 months, boys 9.2 ± 5.1 months). No differences were observed between the traditional method and oblique measurements. Early fontanel closure was not associated with microcephaly.

CONCLUSIONS

Oblique measurements can be used because they are as accurate as the traditional method. Children with fontanels measuring above the 95th percentile should be monitored closely and investigated further for potentially associated diseases.
The role of family and personal psychiatric history in postconcussion syndrome following sport-related concussion: a story of compounding risk
Authors: Legarreta Andrew D. , Brett Benjamin L. , Solomon Gary S. , Zuckerman Scott L.
Published: June 2018

OBJECTIVE

Sport-related concussion (SRC) has become a major public health concern. Prolonged recovery after SRC, named postconcussion syndrome (PCS), has been associated with several biopsychosocial factors, yet the role of both family and personal psychiatric histories requires investigation. In a cohort of concussed high school athletes, the authors examined the role(s) of family and personal psychiatric histories in the risk of developing PCS.

METHODS

A retrospective cohort study of 154 high school athletes with complete documentation of postconcussion symptom resolution or persistence at 6 weeks was conducted. PCS was defined as 3 or more symptoms present 6 weeks after SRC. Three groups were defined: 1) positive family psychiatric history and personal psychiatric history (FPH/PPH), 2) positive FPH only, and 3) negative family and personal psychiatric histories (controls). Three bivariate regression analyses were conducted: FPH/PPH to controls, FPH only to controls, and FPH/PPH to FPH. Post hoc bivariate regression analyses examined specific FPH pathologies and PCS.

RESULTS

Athletes with FPH/PPH compared with controls had an increased risk of PCS (χ2 = 8.90, p = 0.018; OR 5.06, 95% CI 1.71–14.99). Athletes with FPH only compared with controls also had an increased risk of PCS (χ2 = 6.04, p = 0.03; OR 2.52, 95% CI 1.20–5.30). Comparing athletes with FPH/PPH to athletes with FPH only, no added PCS risk was noted (χ2 = 1.64, p = 0.247; OR 2.01, 95% CI 0.68–5.94). Among various FPH diagnoses, anxiety (χ2 = 7.48, p = 0.021; OR 2.99, 95% CI 1.36–6.49) and bipolar disorder (χ2 = 5.13, p = 0.036; OR 2.74, 95% CI 1.14–6.67) were significantly associated with the presence of PCS.

CONCLUSIONS

Concussed high school athletes with FPH/PPH were greater than 5 times more likely to develop PCS than controls. Athletes with only FPH were over 2.5 times more likely to develop PCS than controls. Those with an FPH of anxiety or bipolar disorder are specifically at increased risk of PCS. These results suggest that not only are athletes with FPH/PPH at risk for slower recovery after SRC, but those with an FPH only—especially anxiety or bipolar disorder—may also be at risk. Overall, this study supports taking a detailed FPH and PPH in the management of SRC.
Hydroformylation of Dicyclopentadiene to Monoformyltricyclodecenes over Supported Ultra-Low Content Rh Catalysts
Authors: Li Chengyang , Li Hongyi , Zhang Libo , Ma Yubo , Wang Tianfu
Published: June 2018

Five types of 0.006 wt% Rh catalyst supported on the surfaces of Al2O3, ZnO, TiO2(rutile), TiO2(anatase) and CeO2 were prepared by the incipient wetness method and used to catalyse the conversion of dicyclopentadiene (DCPD) to monoformyltricyclodecenes (MFTD). The 0.006 wt% Rh/ZnO catalyst showed the highest performance of the catalysts investigated and a 95.5% MFTD yield with 100% MFTD selectivity could be achieved. This suggested that there may be a key role for the carrier on the catalytic performance in the DCPD hydroformylation. Furthermore, the kinetic profiles for DCPD hydroformylation over the 0.006 wt% Rh/ZnO catalyst have been examined systematically to explore the effect of reaction temperature on the catalytic performance. These data collectively suggested that a specific reaction temperature might enhance DCPD hydroformylation, possibly owing to agglomeration of the active sites at higher reaction temperatures.
Subjective Sleep Quality is not Associated with Incident Dementia: The Rotterdam Study
Authors: Lysen Thom S. , Wolters Frank J. , Luik Annemarie I. , Ikram M. Kamran , Tiemeier Henning , Ikram M. Arfan
Published: June 2018

Background:

Poor sleep is related to higher dementia risk, but this association is more equivocal for subjective sleep quality specifically. This study investigates the link between subjective sleep quality and dementia risk in the general population.

Objective:

To study the role of subjective sleep quality in the risk of dementia in the general population.

Methods:

In the prospective population-based Rotterdam Study, 4,835 persons (mean age 72 years, 58% women) underwent a home interview (2002– 2006) that included the validated Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Participants were followed until 2015 for incident dementia, through in-person screening and continuous monitoring of medical records. We used Cox regression models to associate sleep quality with dementia risk, adjusting for age, sex, education, smoking, employment, coffee consumption, alcohol consumption, activities of daily living, cardiovascular risk factors, anxiety, depressive symptoms, cognition, and snoring.

Results:

During 41,385 person-years (8.5 years mean), 420 participants developed dementia, of whom 320 Alzheimer’s disease (AD). Poorer subjective sleep quality was not associated with the risk of all-cause dementia (hazard ratio [HR] per SD increase in PSQI score: 0.91, 95% CI 0.82– 1.02) or AD (HR 0.92, 95% CI 0.81– 1.05). Similarly, individual components of the PSQI were also not associated with dementia. Several sensitivity analyses, i.e., excluding last years of the follow-up time duration or restricting to those with best MMSE scores at baseline, did not reveal subgroups with increased risks.

Conclusion:

In this study, we found no association of poor subjective sleep quality with higher risk of dementia.
Honokiol Alleviates Cognitive Deficits of Alzheimer’s Disease (PS1V97L) Transgenic Mice by Activating Mitochondrial SIRT3
Authors: Li Haitao , Jia Jianping , Wang Wei , Hou Tingting , Tian, Yuanruhua , Wu Qiaoqi , Xu Lingzhi , Wei Yiping , Wang Xiu
Published: June 2018

Accumulating evidence has demonstrated that mitochondrial dysfunction is a prominent early event in the progression of Alzheimer’s disease (AD). Whether protecting mitochondrial function can reduce amyloid-β oligomer (AβO)-induced neurotoxicity in PS1V97L transgenic mice remains unknown. In this study, we examined the possible protective effects of honokiol (HKL) on mitochondrial dysfunction induced by AβOs in neurons, and cognitive function in AD PS1V97Ltransgenic mice. We determined that HKL increased mitochondrial sirtuin 3 (SIRT3) expression levels and activity, which in turn markedly improved ATP production and weakened mitochondrial reactive oxygen species production. We demonstrated that the enhanced energy metabolism and attenuated oxidative stress of HKL restores AβO-mediated mitochondrial dysfunction in vitro and in vivo. Consequently, memory deficits in the PS1V97L transgenic mice were rescued by HKL in the early stages. These results suggest that HKL has therapeutic potential for delaying the onset of AD symptoms by alleviating mitochondrial impairment and increasing hyperactivation of SIRT3 in the pathogenesis of preclinical AD.
Childhood Lead Exposure and Adult Neurodegenerative Disease
Authors: Reuben Aaron
Published: June 2018

Millions of Americans now entering midlife and old age were exposed to high levels of lead, a neurotoxin, as children. Evidence from animal-model and human observational studies suggest that childhood lead exposure may raise the risk of adult neurodegenerative disease, particularly dementia, through a variety of possible mechanisms including epigenetic modification, delayed cardiovascular and kidney disease, direct degenerative CNS injury from lead remobilized from bone, and lowered neural and cognitive reserve. Within the next ten years, the generation of children with the highest historical lead exposures, those born in the 1960s, 1970s, and 1980s, will begin to enter the age at which dementia symptoms tend to emerge. Many will also enter the age in which lead stored in the skeleton may be remobilized at greater rates, particularly for women entering menopause and men and women experiencing osteoporosis. Should childhood lead exposure prove pro-degenerative, the next twenty years will provide the last opportunities for possible early intervention to forestall greater degenerative disease burden across the aging lead-exposed population. More evidence is needed now to characterize the nature and magnitude of the degenerative risks facing adults exposed to lead as children and to identify interventions to limit long-term harm.
Altered Cortico-Limbic Network Connectivity in Parkinsonian Depression: The Effect of Antidepressants
Authors: Morgan Howard E. , Ledbetter Christina R. , Ferrier Christopher , Zweig Richard M. , Disbrow Elizabeth A.
Published: June 2018

Background:

Depression is a common comorbidity of Parkinson’s disease (PD); however, the impact of antidepressant status on cortical function in parkinsonian depression is not fully understood. While studies of resting state functional MRI in major depression have shown that antidepressant treatment affects cortical connectivity, data on connectivity and antidepressant status in PD is sparse.

Objective:

We tested the hypothesis that cortico-limbic network (CLN) resting state connectivity is abnormal in antidepressant-treated parkinsonian depression.

Methods:

Thirteen antidepressant-treated depressed PD and 47 non-depressed PD participants from the Parkinson’s Progression Markers Initiative (PPMI) database were included. Data was collected using 3T Siemens TIM Trio MR scanners and analyzed using SPM and CONN functional connectivity toolbox. Volumetric analysis was also performed using BrainSuite.

Results:

We found decreased connectivity in the antidepressant-treated depressed PD group when compared to non-depressed PD between the left frontal operculum and bilateral insula, and also reduced connectivity between right orbitofrontal cortex and left temporal fusiform structures. Increased depression scores were associated with decreased insular-frontal opercular connectivity. No ROI volumetric differences were found between groups.

Conclusion:

Given the relationship between depression scores and cortico-limbic connectivity in PD, the abnormal insular-frontal opercular hypoconnectivity in this cohort may be associated with persistent depressive symptoms or antidepressant effects.
Flexural Performance of Hybrid Engineered Cementitious Composite Layered Reinforced Concrete Beams
Authors: Krishnaraja Ammapalayam Ramasamy , Kandasamy Shanmughasundaram
Published: June 2018

This paper presents the experimental investigation to evaluate the flexural performance of newly developed hybrid Engineered Cementitious Composite (ECC) layer at tension zone around the main reinforcement of beam. Four different ECC mixes are used in the beam to evaluate the flexural performance, hybrid ECC based on the low modulus poly vinyl alcohol (PVA) and high modulus steel short random fibre reinforcement. The aim of hybridation is to improve the flexural, energy absorption and ductility performance of reinforced concrete beams. In addition to the compressive strength, young’s modulus, uniaxial tensile strength and bond strength of ECC mixes are determined. ECC with PVA fibre with 2.0% volume fraction mix is kept as reference mix, hybridation is made with PVA (1.35%) and steel (0.65%), PVA (1.00%) and steel (1.00%) and finally with PVA (0.65%) and steel (1.35%). This hybridization has a remarkable achievement in mechanical properties and in the flexural behavior in ECC layered RC beam. From the results, it has been observed that mono fiber ECC reinforced with PVA of 2.0% and hybrid fiber ECC reinforced with 1.35 % of PVA fiber and 0.65% of steel fiber has reasonable flexural characteristics than the conventional beam.
Advances in Integrating Genomics and Bioinformatics in the Plant Breeding Pipeline
Authors: Hu Haifei , Scheben Armin , Edwards David
Published: June 2018

With the global human population growing rapidly, agricultural production must increase to meet crop demand. Improving crops through breeding is a sustainable approach to increase yield and yield stability without intensifying the use of fertilisers and pesticides. Current advances in genomics and bioinformatics provide opportunities for accelerating crop improvement. The rise of third generation sequencing technologies is helping overcome challenges in plant genome assembly caused by polyploidy and frequent repetitive elements. As a result, high-quality crop reference genomes are increasingly available, benefitting downstream analyses such as variant calling and association mapping that identify breeding targets in the genome. Machine learning also helps identify genomic regions of agronomic value by facilitating functional annotation of genomes and enabling real-time high-throughput phenotyping of agronomic traits in the glasshouse and in the field. Furthermore, crop databases that integrate the growing volume of genotype and phenotype data provide a valuable resource for breeders and an opportunity for data mining approaches to uncover novel trait-associated candidate genes. As knowledge of crop genetics expands, genomic selection and genome editing hold promise for breeding diseases-resistant and stress-tolerant crops with high yields.
Speckle Reduction on Ultrasound Liver Images Based on a Sparse Representation over a Learned Dictionary
Authors: Jabarulla Mohamed Yaseen , Lee Heung-No
Published: June 2018

Ultrasound images are corrupted with multiplicative noise known as speckle, which reduces the effectiveness of image processing and hampers interpretation. This paper proposes a multiplicative speckle suppression technique for ultrasound liver images, based on a new signal reconstruction model known as sparse representation (SR) over dictionary learning. In the proposed technique, the non-uniform multiplicative signal is first converted into additive noise using an enhanced homomorphic filter. This is followed by pixel-based total variation (TV) regularization and patch-based SR over a dictionary trained using K-singular value decomposition (KSVD). Finally, the split Bregman algorithm is used to solve the optimization problem and estimate the de-speckled image. The simulations performed on both synthetic and clinical ultrasound images for speckle reduction, the proposed technique achieved peak signal-to-noise ratios of 35.537 dB for the dictionary trained on noisy image patches and 35.033 dB for the dictionary trained using a set of reference ultrasound image patches. Further, the evaluation results show that the proposed method performs better than other state-of-the-art denoising algorithms in terms of both peak signal-to-noise ratio and subjective visual quality assessment.
Correction: Park, B.Y., et al. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports. Behav. Sci. 2016, 6, 17
Authors: Park Brian Y. , Wilson Gary , Berger Jonathan , Christman Matthew , Reina Bryn , Bishop Frank , Klam Warren P. , Doan Andrew P. ,   Behavioral Sciences Editorial Office
Published: June 2018

The conflict of interest section of the published paper[...]
The Feasibility of a Novel School Peer-Led Mentoring Model to Improve the Physical Activity Levels and Sedentary Time of Adolescent Girls: The Girls Peer Activity (G-PACT) Project
Authors: Owen Michael B. , Kerner Charlotte , Taylor Sarah L. , Noonan Robert J. , Newson Lisa , Kosteli Maria-Christina , Curry Whitney B. , Fairclough Stuart J.
Published: June 2018

Regular physical activity (PA) is associated with numerous physical and psychological health benefits. Adolescents, specifically girls, are at risk of physical inactivity. To date, there is limited research on PA interventions involving peers, which could encourage more adolescent girls to engage in PA. The investigation aimed to evaluate the feasibility of a novel school three-tier peer-led mentoring model designed to improve PA levels and reduce sedentary time (ST) of adolescent girls. Two-hundred and forty-nine Year 9 adolescent girls (13–15 years old) from three UK secondary schools were invited to participate in a peer-led mentoring intervention (Girls Peer Activity (G-PACT) project). The peer-led mentoring model was delivered in all three schools. Two of the schools received an additional after-school PA component. PA and ST were assessed through wrist-worn accelerometry. Girls who received an exercise class after-school component significantly increased their whole day moderate-to-vigorous PA (MVPA) (3.2 min, p = 0.009, d = 0.33). Girls who received no after-school component significantly decreased their MVPA (3.5 min, p = 0.016, d = 0.36) and increased their ST (17.2 min, p = 0.006, d = 0.43). The G-PACT intervention demonstrated feasibility of recruitment and data collection procedures for adolescent girls. The peer-led mentoring model shows promise for impacting girls’ MVPA levels when combined with an after-school club PA opportunity.
Quantum Thermodynamics at Strong Coupling: Operator Thermodynamic Functions and Relations
Authors: Hsiang Jen-Tsung , Hu Bei-Lok
Published: June 2018

Identifying or constructing a fine-grained microscopic theory that will emerge under specific conditions to a known macroscopic theory is always a formidable challenge. Thermodynamics is perhaps one of the most powerful theories and best understood examples of emergence in physical sciences, which can be used for understanding the characteristics and mechanisms of emergent processes, both in terms of emergent structures and the emergent laws governing the effective or collective variables. Viewing quantum mechanics as an emergent theory requires a better understanding of all this. In this work we aim at a very modest goal, not quantum mechanics as thermodynamics, not yet, but the thermodynamics of quantum systems, or quantum thermodynamics. We will show why even with this minimal demand, there are many new issues which need be addressed and new rules formulated. The thermodynamics of small quantum many-body systems strongly coupled to a heat bath at low temperatures with non-Markovian behavior contains elements, such as quantum coherence, correlations, entanglement and fluctuations, that are not well recognized in traditional thermodynamics, built on large systems vanishingly weakly coupled to a non-dynamical reservoir. For quantum thermodynamics at strong coupling, one needs to reexamine the meaning of the thermodynamic functions, the viability of the thermodynamic relations and the validity of the thermodynamic laws anew. After a brief motivation, this paper starts with a short overview of the quantum formulation based on Gelin & Thoss and Seifert. We then provide a quantum formulation of Jarzynski’s two representations. We show how to construct the operator thermodynamic potentials, the expectation values of which provide the familiar thermodynamic variables. Constructing the operator thermodynamic functions and verifying or modifying their relations is a necessary first step in the establishment of a viable thermodynamics theory for quantum systems. We mention noteworthy subtleties for quantum thermodynamics at strong coupling, such as in issues related to energy and entropy, and possible ambiguities of their operator forms. We end by indicating some fruitful pathways for further developments.