bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of EGFR mutation testing by the fully-automated qPCR-based Idylla on whole slide and biopsy tumor tissue of non-small cell lung cancer.
Authors: Ilie Marius , Heeke Simon , Butori Catherine , Tanga Virginie , Washetine Kevin , Lassalle Sandra , Long Elodie , Maitre Priscilla , Bordone Olivier , Lespinet Virginie , Leroy Sylvie , Mouroux Jerome , Marquette Charles Hugo , Hofman Veronique , Hofman Paul ,   Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University Côte d’Azur
Published: July 2018

e20632

Background: The use in routine clinical practice of the EGFR tyrosine kinase inhibitors is limited to patients with advanced or metastatic non-squamous non-small cell lung cancer (NSCLC) who have known EGFR mutations. Currently, patient care has to respond to several imperatives to make it broadly available to all patients; fast and accurate detection of EGFR mutations by a sensitive and specific standardized cost-effective method, easy-to-implement in settings with limited expertise in molecular diagnostics. The possibility to obtain EGFR testing results in less than few hours in a large number of pathology laboratories is recently guaranteed by the Idylla system. Methods: We evaluated the Idylla system (Biocartis) for the detection of EGFR mutations in archived formalin-fixed paraffin-embedded (FFPE) tumor samples from a series of 18 patients with lung adenocarcinoma and compared these results with those obtained by the Therascreen EGFR Pyro assay (Qiagen)-ISO 15189 accredited laboratory method. The results obtained with the two methods were compared on both whole tumor sections from surgical specimens and on tissue sections from three artificially constructed small biopsies (~1 mm diameter) from the same FFPE blocks. Cost-effectiveness and turnaround time comparison between the two methods was performed. Results: In the first assessment on whole tissue sections, the Idylla and pyrosequencing results had an agreement of 94%. When assessed on biopsy cores, Idylla demonstrated agreement with pyrosequencing in 16 of 18 cases (89%). The Idylla EGFR mutation assay produced results faster (sample to result time was about 180 minutes with about 2 minutes of hands on time) than pyrosequencing (sample to result time about 12 hours). For each patient, the Idylla was more cost-effective than pyrosequencin. Conclusions: The Idylla system showed a good sensitivity and was cost-saving in our setting. Because of the easy workflow, the Idylla system has the potential to expand EGFR testing to more pathology laboratories in a reliable and fast manner.
FSH, Bone Mass, Body Fat, and Biological Aging
Authors: Zaidi Mone , Lizneva Daria , Kim Se-Min , Sun Li , Iqbal Jameel , New Maria I , Rosen Clifford J , Yuen Tony
Published: July 2018

The Study of Women’s Health Across the Nation has taught us that impending ovarian failure during late perimenopause is associated with a sharp rise in serum FSH, which coincides with the most rapid rate of bone loss and the onset of visceral adiposity. At this time in a woman’s life, serum estrogen levels are largely unaltered, so the hypothesis that hypoestrogenemia is the sole cause of bone loss and visceral obesity does not offer a full explanation. An alternative explanation, arising from animal models and human data, is that both physiologic aberrations, obesity and osteoporosis, arise at least in part from rising FSH levels. Here, we discuss recent findings on the mechanism through which FSH exerts biological actions on bone and fat and review clinical data that support a role for FSH in causing osteoporosis and obesity. We will also provide a conceptual framework for using a single anti-FSH agent to prevent and treat both osteoporosis and obesity in women across the menopausal transition.
Early Identification of Primary Hypothyroidism in Neonates Exposed to Intralymphatic Iodinated Contrast: A Case Series
Authors: Cherella Christine E , Breault David T , Thaker Vidhu , Levine Bat-Sheva , Smith Jessica R
Published: July 2018

Context

In neonates, iatrogenic hypothyroidism can result from topical or IV iodine exposure. Data on intralymphatic iodine exposure, risk factors for disease severity, and timing of hypothyroidism are limited.

Case Descriptions

We report 4 cases of premature neonates with previously normal thyroid function tests (TFTs) who developed hypothyroidism after intralymphatic iodinated contrast. Patients 1 and 2, premature infants with complex medical histories, had chylous effusions and high-volume chest tube output requiring imaging with lymphangiograms on day of life (DOL) 97 and DOL 43, respectively. They developed severe, primary hypothyroidism with TSH of 335.7 mIU/mL (reference range, 1.7 to 9.1) on DOL 111 and TSH of 470.2 mIU/mL (reference range, 1.7 to 9.1) on DOL 68. Patient 3 had prenatally diagnosed fetal hydrops manifesting with chylous effusions and high-volume chest tube output. The infant underwent lymphangiography on DOL 90 and was noted to have an elevated TSH of 13.35 mIU/mL (reference range, 1.7 to 9.1) 4 days later with spot urine iodine of 1742 µg/L (normal, <200). Patient 4 had a lymphatic malformation and underwent sclerotherapy with doxycycline with intralymphatic iodine exposure on DOL 4 and was found to have a TSH of 16.7 µU/mL (reference range, 1.7 to 9.1) 3 days later with spot urine iodine of 228,712 µg/L (normal, <200). The TFT results for all patients improved after levothyroxine administration.

Conclusion

Intralymphatic iodine should be considered a major risk factor in the development of iatrogenic primary hypothyroidism, especially in premature neonates soon after exposure. Close monitoring of TFTs is imperative to avoid potential long-term adverse outcomes in this population.
Assessment and Management of Anti-Insulin Autoantibodies in Varying Presentations of Insulin Autoimmune Syndrome
Authors: Church David , Cardoso Luís , Kay Richard G , Williams Claire L , Freudenthal Bernard , Clarke Catriona , Harris Julie , Moorthy Myuri , Karra Efthmia , Gribble Fiona M , Reimann Frank , Burling Keith , Williams Alistair J K , Munir Alia , Jones T Hugh , Führer Dagmar , Moeller Lars C , Cohen Mark , Khoo Bernard , Halsall David , Semple Robert K , Führer-Sakel Dagmar
Published: July 2018

Context

Insulin autoimmune syndrome (IAS), spontaneous hyperinsulinemic hypoglycemia due to insulin-binding autoantibodies, may be difficult to distinguish from tumoral or other forms of hyperinsulinemic hypoglycemia, including surreptitious insulin administration. No standardized treatment regimen exists.

Objectives

To evaluate an analytic approach to IAS and responses to different treatments.

Design and Setting

Observational study in the UK Severe Insulin Resistance Service.

Patients

Six patients with hyperinsulinemic hypoglycemia and detectable circulating anti–insulin antibody (IA).

Main Outcome Measures

Glycemia, plasma insulin, and C-peptide concentrations by immunoassay or mass spectrometry (MS). Immunoreactive insulin was determined in the context of polyethylene glycol (PEG) precipitation and gel filtration chromatography (GFC). IA quantification using ELISA and RIA, and IA were further characterized using radioligand binding studies.

Results

All patients were diagnosed with IAS (five IgG, one IgA) based on a high insulin/C-peptide ratio, low insulin recovery after PEG precipitation, and GFC evidence of antibody-bound insulin. Neither ELISA nor RIA result proved diagnostic for every case. MS provided a more robust quantification of insulin in the context of IA. One patient was managed conservatively, four were treated with diazoxide without sustained benefit, and four were treated with immunosuppression with highly variable responses. IA affinity did not appear to influence presentation or prognosis.

Conclusions

IAS should be considered in patients with hyperinsulinemic hypoglycemia and a high insulin/C-peptide ratio. Low insulin recovery on PEG precipitation supports the presence of insulin-binding antibodies, with GFC providing definitive confirmation. Immunomodulatory therapy should be customized according to individual needs and clinical response.
Accumulation and excretion of manganese ion in the kidney of the Mytilus galloprovincialis
Authors: Wakashin Hidefumi , Seo Eriko , Seo Yoshiteru
Published: July 2018

T1-weighted magnetic resonance imaging (T1w-MRI) was employed to detect the accumulation of manganese ion (Mn2+) in urine in the kidney of Mytilus galloprovincialis, and the longitudinal relaxation rates (1/T1=R1) were measured. When the mussel exposed to seawater containing 10 µM Mn2+, the T1w-MR image intensity and R1 of the kidney, stomach and digestive glands were increased. Mn2+ might be taken into the hemolymph via the gastrointestinal tract, and then filtrated into the pericardium via the auricles. While the image intensity in the pericardium was not affected by manganese, an image intensity enhancement was observed in the distal part of the renopericardial communication canals between the pericardium and kidneys, indicating Mn2+ concentration in the excretion pathway. As the seawater Mn2+ concentration ([Mn2+]SW) was increased from 3 to 50 µM, R1 of the kidney (R1K) were elevated. When the mussels were immersed in 3 - 10 µM [Mn2+]SW for 24 hrs, the Mn2+ concentration in the kidney ([Mn2+]K) increased by 15 fold, compared to the ambient [Mn2+]SW concentration. In the range of [Mn2+]SW from 10 to 50 µM, R1K reached a plateau level that corresponded to 200 µM [Mn2+]K. As [Mn2+]K fell transiently, voluntary excretion of urine from the kidney was assumed. The decreases in intensity were not synchronized between the right and left kidneys, and the closure of the shells might not essential for the urinary excretion. The voluntary excretion suggested an additional explanation for the large variety of metal concentration in the kidneys of the mussel.
FT-IR/NIR Spectroscopic Study of the Hydrogen-Bonding of CH to Water in 1-Fluoroheptane
Authors: Iwamoto Reikichi , Harui Rika
Published: July 2018

The aim of the present study is to investigate how F substitution influences the hydrogen-bonding of the CH to water of an alkane. For this purpose we have comparatively studied the hydrogen bonding of the CH to water of heptane CH3(CH2)5CH3 and 1-fluoroheptane CH2F(CH2)5CH3. The property was analyzed from the separated OH stretching spectra of water dissolved in neat liquids and 1-fluoroheptane solution in heptane as solvent. It has been found that the CH of heptane does not interact with water but the CH of 1-fluoroheptane is hydrogen-bonded as a proton donor to water in the manner of CH⋯OH2. The hydration pattern was supported by the observed effects of hydration on the overtone and combination bands of the CH vibrations of CHCl3, of which the CH acts as a proton donor to water. The present study has spectroscopically shown that the CH, which can be activated by the substitution at the Cα position, of an aliphatic hydrocarbon chain may contribute to the hydrogen-bonding interactions with water in organic and biological materials.
Ethnographic Meeting of 1929 as a Communicative Meeting And Advocacy Space
Authors: Соловей Т. , Solovey T.
Published: July 2018

The formation of a mass society in the first third of the 20th century was inextricably linked with the formation of a system of mass communications and a sharp increase in the importance of communication in General. With regard to science in Soviet Russia, this set a number of goals: to establish a dialogue with society and new communication within science. In article ethnographic meeting of 1929 is investigated as communicative and propaganda space. Here we have tested different strategies of influence and persuasion – academic (normativists) model (P. F. Preobrazhensky), rectilinear propagation (N.M. Matorin), manipulation (V. B. Aptekar) The specifics of the situation in Ethnography of the late 1920s was such that the academic model has already exhausted itself, rectilinear propaganda of the 1930s has not worked, came to the fore manipulative forms of persuasion that appealed not to logic and racio, but to emotions and prejudices.
Reflection of Iranian Women’s Gender Identity in their Traditional and Modern Lifestyle
Authors: Хадем Махсус Хоссейни Лейла , Hadem Mahsus Hosseyni Leyla
Published: July 2018

The paper aims at representing reflection of Iranian women’s gender identity in their lifestyle. It applies the ideas of Judith Butler on performativity, based on which the repetition of actions create and naturalize the artificial constructions of gender. It seeks to illuminate the traces of gender identity in lifestyle. Comparing the traditional and modern lifestyle, it explores how discourse has constructed Iranian woman and how through repetition of action or failure of repetition they sustain or modify the gender identity. It is concluded that Iranian women, in both traditional and modern lifestyle are performing the conventions of gender and are identified by their gender of womanliness.
Traffic Signal Optimization: Combining Static and Dynamic Models
Authors: Köhler Ekkehard , Strehler Martin
Published: July 2018

In this paper, we present a cyclically time-expanded network model for simultaneous optimization of traffic assignment and traffic signal parameters, in particular, offsets, split times, and phase orders. Since travel times are of great importance for developing realistic solutions for traffic assignment and traffic signal coordination in urban road networks, we perform an extensive analysis of the model. We give an example showing that a linear time-expanded model can reproduce realistic nonconvex travel times especially for use with traffic signals and we verify this by simulation. Furthermore, we show how exact mathematical programming techniques—namely, mixed-integer linear programming—can be used for optimizing the control of traffic signals. We provide computational results for real-world instances and demonstrate the capabilities of the cyclically time-expanded model by simulation results obtained with state-of-the-art traffic simulation tools.
As origens históricas do civil law e do common law
Authors: De Queiroz Barboza Estefânia Maria
Published: July 2018

O artigo estuda o histórico do common law inglês, trazendo o desenvolvimento do equity, enquanto conjunto de regras supletivas ao lado do  crescimento do direito jurisprudencial naquele sistema. Também serão estudados os limites do common law à suposta supremacia do Parlamento britânico.  Do mesmo modo, o artigo traz a racionalidade do direito jurisprudencial naquele país como forma de dar estabilidade e segurança jurídica ao sistema. Examina o desenvolvimento do common law nos Estados Unidos, partindo-se da aparente oposição ao direito inglês ao estabelecer forte limitação ao Parlamento pelo sistema de checks and balances com primazia do Poder Judiciário para controlar a compatibilidade das leis em relação a uma Constituição escrita e suprema. Também enfrenta o desenvolvimento histórico do sistema de civil law, que teve em sua origem a preocupação com a completude do sistema jurídico a ser realizado por meio da codificação, como um modo de garantia de segurança jurídica e previsibilidade do sistema. Conclui que, a partir do séc. XX, os Sistemas vêm se aproximando a partir dos direitos humanos positivados nas Constituições escritas europeias, ou servindo de limites aos distintos Parlamentos estatais.
O ESTADO BRASILEIRO, SUA ORGANIZAÇÃO POLÍTICO-ADMINISTRATIVA E O FINANCIAMENTO PÚBLICO DOS DIREITOS FUNDAMENTAIS. ANÁLISE APLICADA AO FINANCIAMENTO DA SAÚDE NA REGIÃO DO RECÔNCAVO DA BAHIA
Authors: Portella André Alves , Machado Luana Braga
Published: July 2018

Este trabalho objetiva conhecer a realidade do financiamento público da saúde na região do Recôncavo da Bahia, considerando-o no contexto da estrutura político-administrativa do Estado brasileiro. A pesquisa desenvolvida para este fim possui caráter tanto bibliográfico, documental, como empírico, baseada na doutrina especializada e na legislação, e na utilização dos dados disponibilizados no Portal da Transparência do Ministério da Saúde, e do Sistema de Informações Sobre Orçamentos Públicos em Saúde (SIOPS), no período referente ao primeiro semestre de 2016. A partir de uma perspectiva crítica, procura-se apresentar a realidade do financiamento da saúde e as peculiaridades de cada município do território considerado, partindo do pressuposto constitucional de que saúde é um direito fundamental, que deve ser oferecido de forma plena, com qualidade e respeito à dignidade humana, sempre segundo índices estabelecidos tanto pela legislação vigente, como por organismos especializados.
O DIREITO COMO PRESSUPOSTO DO HORIZONTE LITERÁRIO: UMA NOVA COMPREENSÃO DA REALIDADE JURÍDICA
Authors: Oliveira Júlia Francieli Neves , ROCHA LEONEL SEVERO
Published: July 2018

Neste artigo, pretende-se desenvolver uma reflexão da importância da literatura no direito de família a partir das narrativas de Sartre e da teoria dos sistemas. O objetivo é analisar as relações familiares que são extremamente complexas e ressignificadas, questões que apelam à autonomia social e à consciência política e filosófica. O resultado da pesquisa é as respostas nem sempre se encerrarão na legislação crua, mas sim deverão ser criadas, em observância aos contextos fáticos e ao que o imaginário coletivo anseia há sim a possibilidade dos setores sociais atingirem bom grau de autonomia, inclusive através da literatura, pois a sociedade encurrala o Estado sobre as possibilidades de auto-organização, ganhando espaço para sua própria racionalidade no seu interior. As considerações finais demonstram que o direito pode assumir como pressuposto o horizonte literário, propiciando a compreensão da realidade jurídica fazendo com que o direito de família reaja quase exclusivamente à racionalidade da vida privada e sua criação normativa espontânea, ou seja, o direito de família está preparando suas estruturas dogmáticas para a realidade atual sob a perspectiva da justiça discursiva policontextural. O método da pesquisa é teórica sistêmica que se dá pela abordagem sociológica, tanto conceitual quanto empírica dos sistemas jurídico.
A mojicones
Authors: Sánchez José J. Jiménez
Published: July 2018

En este texto se trata de incidir en la modernidad y actualidad del pensamiento de Hobbes. La importancia de su obra no radica en su contractualismo, que funda la república, ni en que conciba al soberano como poder absoluto e irrestricto. Lo relevante se halla, primero, en que Hobbes diseña de forma novedosa un paso intermedio –el pueblo como persona artificial- entre los hechos, la mayoría u opinión pública de una sociedad, y el soberano absoluto, que construye necesariamente como un poder fáctico a fin de considerarlo como un poder ilimitado. En segundo lugar, Hobbes defiende que el poder de ese soberano no radica sino en el poder de la misma multitud
Organisational impact of the V150 nurse prescribing qualification
Authors: Smith Charlotte , Coucill Cath , Nuttall Dilyse
Published: July 2018

An initial literature search identified a deficit in the non-medical prescribing evidence base in relation to V150 community practitioner nurse prescribing. Nineteen V150 prescribers from eight professional roles, and prescribing for a variety of conditions, along with three NMP leads, participated in this evaluation. The evaluation used a mixed methodology of questionnaires and telephone interviews; 19 V150 prescribers participated, with all of them completing the online questionnaire. Two of these also consented to a follow-up telephone interview. Three NMP leads completed the online questionnaire. The findings suggested a benefit to the wider health organisation with regard to reduced attendance at walk-in centres, GP practices and the emergency department. It is anticipated that the findings from this study may be prove useful to NMP leads, NMP groups and commissioners, as well as V150 prescribers.
Hopelessness, life dissatisfaction and boredom among older people
Authors: Hoeyberghs Lieve , Verté Emily , Verté Dominique , De Witte Nico , Schols Jos
Published: July 2018

Identifying frail older people, and in particular, people who are psychologically frail in a community setting is difficult. This article investigates predictors of psychological frailty and constructs a short and effective pre-detection tool for highly psychologically frail older people. The Belgian Ageing Studies, a cross-sectional study (n=28.245) was used. Measures included four items of the Geriatric Depression Scale, the psychological domain of the Comprehensive Frailty Assessment Instrument. First bivariate analyses were used. Afterwards, Chi-squared automatic interaction detector (CHAID) analysis was applied to gain an insight into the hierarchical order of predictors for high psychological frailty. Findings indicate that the combination of hopelessness and life dissatisfaction predicts high psychological frailty in 68.4% of cases. Early detection of frailty offers opportunities to start early interventions, and can delay or reduce frailty. In order to detect older people who are psychologically frail, a simple two question pre-detection tool was developed. To conclude: if a patient answers ‘yes’ to feeling hopeless and ‘no’ to having life satisfaction, this predicts with great probability (68.4%) high psychological frailty.
Mental health and informal carers
Authors: Barber Christopher Francis
Published: July 2018

Informal carers or caregivers – those who care for a family member, relative or friend – comprise a significant part of society that often goes unrecognised and that, conversely, saves the national economy many billions of pounds each year. This article focuses on the experiences of informal carers/caregivers who care for a person who experiences a mental health issue or who experience a mental health issue themselves before taking on a carer role or as a direct result of being a caregiver. The support role of the nurse is also highlighted. A range of support implications for nurses is then explored.
Children and young people with attention deficit hyperactivity disorder: the nurse's role
Authors: Ryan Noreen , McDougall Tim
Published: July 2018

The recently updated National Institute of Health and Care Excellence guideline for attention deficit hyperactivity disorder (ADHD) emphasises the need for psychoeducation as part of ongoing assessment, treatment and management. Noreen Ryan and Tim McDougall discuss the implications for supporting children and young people with ADHD and the vital roles that nurses can play during assessment and treatment.
Student nurse perceptions of experiential learning to understand personality disorder
Authors: Warrender Dan , Macpherson Scott
Published: July 2018

People with personality disorder diagnoses have been described as a challenging group to work with, and this has led to negative perceptions and stigmatisation of the clinical label. A hypothesis that these negative perceptions are rooted in a lack of empathy, directly related to a lack of understanding of the lived experience of these conditions, led to the development of a teaching session using experiential learning. The session used simulation to allow students to adopt the role of a person diagnosed with a personality disorder and interact in a facilitated scenario. A qualitative and phenomenological design saw the perceptions of four student nurses captured through a focus group and interview. Students described the teaching session as beneficial in having improved their empathy and increased their understanding of the experience of people living with personality disorder diagnoses, allowing them the understanding to be able to challenge stigma, giving them a desire to role model good practice to others and increasing their confidence in working with people with personality disorder diagnoses. This has clear implications for practice through increasing understanding and reducing the potential for negative perceptions, thus potentially improving the experience of mental health care for people with personality disorders.
Parenthood: Uncharted territory?
Authors: Winter George F
Published: July 2018

New technologies can solve reproductive dilemmas—and create others. But, asks George Winter, when new routes to parenthood are being mapped out, who decides how far they may go?
Overcoming the barriers of vitamin D in pregnancy: A midwifery public health perspective
Authors: Sanders Ruth , Mitchell Kathryn
Published: July 2018

Vitamin D deficiency remains a significant public health issue for childbearing women in the UK. As the effect of vitamin D appears to be unclear, and supplementation outcomes for maternal and fetal health debatable, there has been widespread confusion, with midwives unclear about recommendations and women unsure about supplementation. A partnership approach allows women to understand the public health context and view vitamin uptake as beneficial for neonatal health, with women and midwives working together to break down barriers and optimise supplementation and endogenous vitamin D intakes. Many women find a balanced diet in the childbearing continuum period difficult to achieve, and midwives can only address vitamin D deficiency on an individual, case-by-case basis. Communication, and an acknowledgement that women come from a variety of cultural and social backgrounds, can be key to public health success, via a thorough exploration of women's barriers to vitamin D uptake.
Cultural qualities and antenatal care for black African women: A literature review
Authors: Esegbona-Adeigbe Sarah
Published: July 2018

Background

There have been assumptions made in maternal mortality reports that culture is a relevant quality in determining black African women's use of antenatal services in the UK, but these cultural qualities are not defined. It is therefore important to explore the association between cultural qualities and the use of antenatal care for these women.

Aims

To examine cultural qualities relevant in antenatal care for black African women.

Methods

A literature review was conducted on the CINAHL Plus, Medline, POPLINE, PubMed, Cochrane and Scopus databases with a timeframe from January 2000 to August 2017, to capture the first noted increase in mortality for black African mothers in the UK.

Findings

A subjective, complex mix of several factors intertwined with culture may impact on adequate use of antenatal care by black African women, resulting in an increased risk of maternal mortality and morbidity.

Conclusion

The need to consider black African women's cultural beliefs and practices during antenatal care provision has been highlighted in this literature review. It is noted that there are other factors that may affect black African women's access and engagement with antenatal care, and women themselves have highlighted a lack of cultural sensitivity and valuing of sociocultural norms when asked about their experiences of antenatal care.
The role of context in midwifery
Authors: Donovan Patricia
Published: July 2018

All midwives are given similar training, but practice may differ based on setting. Patricia Donovan reflects on her experiences as a midwife educator in Malawi, Seychelles and the UK
The value of a midwife
Authors: Axcell Claire
Published: July 2018

International organisations are recognising the many ways in which midwives can provide solutions to urgent problems of maternal mortality and morbidity. Claire Axcell explains
A tale of two exotic diseases from northern Scotland
Authors: Bate Simon
Published: July 2018

This case report seeks to highlight the possibility that exotic vector-borne disease may be present in dogs anywhere within the UK, including the northern parts of Scotland. Perhaps more importantly, it also demonstrates that multiple infections may be present in one patient, and that clinical disease may not be apparent until years after any history of foreign travel. Clinical signs and laboratory abnormalities associated with ehrlichiosis and heartworm may be relatively mild and non-specific, therefore a high index of suspicion may be necessary for successful diagnosis.
A practical guide to prescribing statins in primary care
Authors: Rees Sharon
Published: July 2018

Statins can be controversial. Sharon Rees provides a guide to safe and effectice practice when managing patients taking these drugs

Statins remain a controversial drug group and can cause problems for practice nurses who are prescribing them, and/or supporting medicines concordance. This article aims to provide an update into the current thinking underpinning statin use, and to guide the clinician regarding safe and effective practice when managing patients on these drugs. Alternatives to statin therapy are briefly outlined.
Stepping down therapies in COPD
Authors: Bostock-Cox Beverley
Published: July 2018

Beverley Bostock-Cox explains why clinicians should regularly review their use of inhaled therapies and in some cases, step down treatment or take people off therapies

The National Institute for Health and Care Excellence (NICE) guidelines for chronic obstructive pulmonary disease (COPD) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have key differences in treatment. These discrepancies reflect a growing understanding about the risks and benefits of the inhaled therapies on the market, which was not available when NICE published its guidance but which is reflected in the GOLD guidelines. Clinicians should be able to differentiate between different COPD phenotypes based on the history and the GOLD ABCD algorithm, and recognise the different drug classes which are indicated for each category. It is important to regularly review patients' use of inhaled therapies and in some cases, step people with COPD down or off treatment.
‘Hooked on reading’
Authors: Hart Karen
Published: July 2018

Karen Hart talks to author Guy Bass about where he finds inspiration for his children's novels and how he ensures they are a springboard for learning.
Understand world events
Authors: Davis John
Published: July 2018

Following on from his first two articles focusing on the British political system, John Davis provides a historical perspective on international affairs and their global impact.
Implant density is not related to patient-reported outcome in the surgical treatment of patients with idiopathic scoliosis
Authors: Charalampidis A. , Möller A. , Wretling M-L. , Brismar T. , Gerdhem P.
Published: July 2018

Aims

There is little information about the optimum number of implants to be used in the surgical treatment of idiopathic scoliosis. Retrospective analysis of prospectively collected data from the Swedish spine register was undertaken to discover whether more implants per operated vertebra (implant density) leads to a better outcome in the treatment of idiopathic scoliosis. The hypothesis was that implant density is not associated with patient-reported outcomes, the correction of the curve or the rate of reoperation.

Patients and Methods

A total of 328 patients with idiopathic scoliosis, aged between ten and 20 years at the time of surgery, were identified in the Swedish spine register (Swespine) and had patient reported outcomes including the Scoliosis Research Society 22r instrument (SRS-22r) score, EuroQol 5 dimensions quality of life, 3 level (EQ-5D-3L) score and a Viual Analogue Score (VAS) for back pain, at a mean follow-up of 3.1 years and reoperation data at a mean follow-up of 5.5 years. Implant data and the correction of the curve were assessed from radiographs, preoperatively and a mean of 1.9 years postoperatively. The patients were divided into tertiles based on implant density. Data were analyzed with analysis of variance, logistic regression or log-rank test. Some analyses were adjusted for gender, age at the time of surgery, the flexibility of the major curve and follow-up.

Results

The mean number of implants per operated vertebra in the low, medium and high-density groups were 1.36 (1.00 to 1.54), 1.65 (1.55 to 1.75) and 1.91 (1.77 to 2.00), respectively. There were no statistically significant differences in the correction of the curve, the SRS-22r total score, EQ-5D-3L index or number of reoperations between the groups (all p > 0.34). In the SRS-22r domains, self-image was marginally higher in the medium implant density group (p = 0.029) and satisfaction marginally higher in the high implant density group (p = 0.034).

Conclusion

These findings suggest that there is no clear advantage in using a high number of implants per operated vertebra in the surgical treatment of patients with idiopathic scoliosis. Cite this article: Bone Joint J 2018;100-B:1080–6.
Reverse hybrid total hip arthroplasty
Authors: Jain S. , Magra M. , Dube B. , Veysi V. T. , Whitwell G. S. , Aderinto J. B. , Emerton M. E. , Stone M. H. , Pandit H. G.
Published: July 2018

Aims

This study aimed to evaluate implant survival of reverse hybrid total hip arthroplasty (THA) at medium-term follow-up.

Patients and Methods

A consecutive series of 1082 THAs in 982 patients with mean follow-up of 7.9 years (5 to 11.3) is presented. Mean age was 69.2 years (21 to 94). Of these, 194 (17.9%) were in patients under 60 years, 663 (61.3%) in female patients and 348 (32.2%) performed by a trainee. Head size was 28 mm in 953 hips (88.1%) or 32 mm in 129 hips (11.9%). Survival analysis was performed and subgroups compared using log rank tests.

Results

Ten-year survival (122 hips at risk) was 97.2% (95% confidence interval (CI) 95.77 to 98.11) for all-cause revision. There was no difference in survival by age (p = 0.50), gender (p = 0.78), head size (p = 0.63) or surgeon grade (p = 0.36). No acetabular components underwent revision for aseptic loosening in the entire series. Four (0.4%) aseptic stem failures occurred early at a mean of 2.5 years (0.6 to 4.8) and were associated with age under 60 years (p = 0.015). There was no difference in survival by gender (p = 0.12), head size (p = 0.43) or surgeon grade (p = 0.77) for stem revision.

Conclusion

This is the largest reported study into reverse hybrid THA and it confirms successful outcomes, irrespective of age, gender, head size and surgeon grade. Cite this article: Bone Joint J 2018;100-B:1010–17.
PRECISE MATHEMATICS COMMUNICATION: THE USE OF FORMAL AND INFORMAL LANGUAGE
Authors: McGinn Kelly M. , Booth Julie L.
Published: July 2018

INTRODUCTION. When explaining their reasoning, students should communicate their mathematical thinking precisely, however, it is unclear if formal terminology is necessary or if students can explain or describe mathematical concepts using everyday language. This paper reports the results of two studies. The first explores the relation between students’ use of formal and informal mathematical language and procedural knowledge in mathematics; the second replicates and extends these findings using a longitudinal design over the course of an entire school year. METHOD. Study 1 uses a pre-test, intervention, post-test method across one unit of study. Study 2 uses the same pre-test, intervention, post-test method, however, it implements a longitudinal design across an entire school year using growth curve analysis. RESULTS. Findings show that students benefit most when they attempt to describe the targeted mathematical concepts, regardless of the type of language used. This finding is consistent with prior work showing that having students go through the process of self-explaining, independent of the quality of those explanations, yields benefits to learning (i.e. Chi, 2000). DISCUSSION. Although teachers should still use formal language in their classrooms; they should not be discouraged if students are initially unable to use formal language correctly. We suggest that teachers allow students to explain their reasoning using either formal or informal terms, especially while students are in the midst of developing an understanding the mathematical concepts.
SUM THING TO TALK ABOUT: CAREGIVER-PRESCHOOLER MATH TALK IN LOW-INCOME FAMILIES FROM THE UNITED STATES
Authors: Daubert Emily , Ramani Geetha , Rowe Meredith , Eason Sarah , Leech Kathryn
Published: July 2018

INTRODUCTION. The early home environment is critical for laying a strong numerical foundation for young children’s development. Participation in math-related informal learning activities in the home is associated with caregiver and child talk about math; however, it is unclear which activities promote different types of math talk. METHOD. We observed whether the math talk that 33 families from low-income backgrounds from the United States engaged in varied across three math-related activities – book reading, puzzle solving, and board game play. Math talk was coded into five categories: counting, numeral identification, cardinality, ordinal relations, and arithmetic. RESULTS. There was substantial variability in the amount of caregiver and child math talk. The amount and types of math talk caregivers and children engaged in varied by activity. Of the three activities, the board game elicited the most math talk. The most frequent type of talk during an activity corresponded to the specific numerical content embedded in each activity. DISCUSSION. Findings suggest that caregivers are responding to the play context when engaging in math-related informal learning activities. Understanding factors that influence math talk could inform the type of activities used in future home-based interventions aimed at reducing the gap in early mathematical understanding between children from lower- and higher-income backgrounds in the United States.
RETRACTED:Quantitative two-photon microscopy imaging analysis of human skin to evaluate enhanced transdermal delivery by hybrid-type multi-lamellar nanostructure
Authors: Ahn Jinhyo , Kim Kyeong Hu , Choe Kibaek , Lim Joo Hyuck , Lee Seung Ki , Kim Yeon Sook , Kim Pilhan
Published: July 2018

Transdermal skin delivery is a method to transport various topical
formulations to a deeper skin layer non-invasively. Permeability
analysis of many delivering agents has been mostly conducted by a
simple tape stripping method. However, it cannot reveal a detailed
depth-dependent distribution profile of transdermally delivered agents
in the skin. In this work, we achieved a cellular-level depth-defined
visualization of fluorophore-labelled human epidermal growth factor
(EGF) transdermally delivered to human skin by using encapsulation
with common liposomes and newly fabricated multi-lamellar
nanostructures using a custom-design two-photon microscopy system. It
was able to generate 3D reconstructed images displaying the
distribution of human EGF inside the human skin sample with
high-resolution. Based on a depthwise fluorescence intensity profile
showing the permeation of human EGF, a quantitative analysis was
performed to assess the transdermal delivery efficacy achieved by each
formulation, showing a significant improvement of the efficacy with
the utilization of multi-lamellar nanostructure.
‘Very much like any other Japanese RPG you’ve ever played’: Using undirected topic modelling to examine the evolution of JRPGs’ presence in anglophone web publications
Authors: Pelletier-Gagnon Jérémie
Published: July 2018

What types of discourses characterize Japanese role-playing games (JRPGs) as a genre of video games? Why is the genre so difficult to define, and why has it become polarizing within the gaming community? This article suggests an outline of the evolution of the discourse surrounding JRPGs based on a macroanalysis of the anglophone online gaming press. Using undirected topic modelling text mining methodology to analyse a corpus of 2053 JRPG reviews gathered from ten different online journalistic outlets posted between 1992 and 2014, this article demonstrates the circumstances of the gradual introduction of the term Japanese role-playing games in online publication, first as an extension of other examples Japanese pop culture in the late 1990s and early 2000s, and subsequently as its own genre appropriated by anglophone gaming culture in the mid-2000s onwards and subjected to this community’s particular regime of values.
‘It’s called Change’: Regenring, reconfiguring and representation
Authors: English Fiona
Published: July 2018

This article is built around an art piece, which depicts a particular phenomenon in physics concerning the process of transition and transformation; in other words, change. In itself the art piece is an example of ‘regenring’ in that it re-presents information that has previously been produced in other genres (scientific papers, mathematical formulae) by producing it using a different genre: a mixed media collaged picture displayed on a wall. In keeping with the theme of transformation and change, the article uses four different genres in discussing the piece: account of what is observed, interview with the maker of the piece, reflection-in-action shown in italics and reflection-on-action shown in boxes (the distinction of reflection-in- and reflection-on- action is taken from Schön) and in so doing explores, through these different lenses, how the art piece helps or hinders the unpacking of the science that it represents. It also provides a multilayered reflection on the theme of change itself since every aspect of this article, the topic, the art piece, the physics and the textual activity of how the discussion is represented, revolves around representing and observing through different lenses, regenring and transformation.
The Us in Museum: Promoting student engagement through regenring academic writing and collaborations
Authors: Palmer Polly , Lindley Julian
Published: July 2018

This case study describes a collaboration between the creative design programme at the University of Hertfordshire and the Museum of St Albans. This four-year project, now entering its third year, explores ways of better engaging design and craft students in the academic strand of the course. One approach is to find fresh ways of addressing theoretical aspects of study by taking the work out of the lecture room and exploring the same concepts through practical activity; a process of ‘regenring’ academic research and writing. Intrinsically linked to this approach is the perceived need to engage all students in a reflective process of design in which theoretical, social, cultural and historical aspects are embedded in studio practice. This article reports on a curatorial project undertaken this year as part of the collaboration, which is effectively enthusing the students and giving them a new understanding of the relevance of theoretical and contextual knowledge in the designer’s skill set. The extent of their engagement in the project is expressed in their chosen title, The Us in Museum, which implies their total immersion in and identification with the task. Three different perspectives are used to present this project: the tutor, the curator and the student.
Slaying the beast: Writing, learning and experiencing in a post-dissertation world
Authors: Hoon Will
Published: July 2018

This article looks at the motivation behind the removal of the final-year dissertation from the fashion, textiles and footwear undergraduate programmes at the University of Northampton. The removal process was not straightforward and occurred over a number of years and through a process of ‘mini actions’ that in large part were driven by student response to changes implemented by the programme team. The title ‘Slaying the beast: Writing, learning and experiencing in a post-dissertation world’ is intended to suggest both the iconic status the final-year dissertation within undergraduate study has and methods of engagement that can be used to replace this set-piece academic exercise. The discussion is organized under five sections with offer reflections on the process and issues involved in this transition, each with a title that is designed to capture the experience: Identifying the beast; Taking aim; The misery of choice; To B or not to B; Taking down the beast; Burying the beast; and finally Looking back on the quest.
An open letter to colleagues working to improve student success in higher education
Authors: Clughen Lisa
Published: July 2018

Choosing to write a letter rather than a conventional article has enabled me to use a more personal voice when talking about the frustrations and joys of my twenty years of working in literacy ­development. It has allowed me to feel freer to play with language so that I could express an overtly embodied form of reasoning which, to paraphrase Peter Elbow, felt right in my mouth and sounded right in my ear.
A Importância dos Valores Pessoais e da Motivação para a Atividade Letiva no Bem-Estar Psicológico dos Professores
Authors: Cordeiro Carla , Gamboa Vítor , Paixão Olímpio
Published: July 2018

Neste estudo foi analisada a relação entre os valores pessoais e o comportamento motivacional dos professores no desempenho de duas tarefas específicasda atividade docente, bem como os efeitos destas duas variáveis nos níveis de bem-estar psicológico, à luz da Teoria da Autodeterminação (SDT) e da Teoria dos Valores Humanos de Schwartz. Participaram 345 professores (80.3% mulheres) do 2º e 3º Ciclo do Ensino Básico e do Ensino Secundário, com uma média de idades de 49.41 anos (DP = 7.17) e com uma média de 25.07 anos (DP = 7.37) de experiência profissional na atividade docente. Os resultados obtidos parecem estar de acordo com os pressupostos da SDT de que os valores intrínsecos facilitam um comportamento motivacional mais autodeterminado, enquanto os valores extrínsecos promovem os tipos menos autodeterminados de motivação. Os resultados sugerem ainda que os valores pessoais e o funcionamento motivacional produzem efeitos independentes no bem-estar psicológico dos professores.
Jovens que Não Aprendem? Pesquisa-intervenção a partir do Teatro-Conversação
Authors: Neves Libéria Rodrigues , Santiago Ana Lydia Bezerra
Published: July 2018

O presente artigo refere-se à apresentação de uma pesquisa-intervenção realizada com jovens identificados na escola em situação de fracasso escolar, noque concerne à aprendizagem e/ou ao comportamento. A pesquisa foi desenvolvida junto a quatro turmas de alunos do 3º Ciclo do Ensino Fundamental no Brasil, e teve como objetivo aprender e intervir naquilo que aparece como sintoma na escola. Aqui serão descritos o processo e o resultado referente a uma dessas turmas, a dos alunos considerados, por parte de seus professores, incapazes de aprender. O trabalho aposta na metodologia da Conversação de orientação psicanalítica, introduzindo-se recursos teatrais na produção da palavra, constituindo-se o Teatro-Conversação.
Recensão ao Livro Los valores en la educación de África. De ayer a hoy.
Authors: Damião Maria Helena
Published: July 2018

Hernández Diaz, José María, & Eyeang, Eugénie (eds.) (2017). Losvalores en la educación de África. De ayer a hoy. Salamanca, EdicionesUniversidad de Salamanca, 799 pp.
A RELAÇÃO ENTRE A PERCEPÇÃO DOS IMPACTOS DO TURISMO E OS FATORES PESSOAIS: Uma análise do Destino Trujillo, Peru
Authors: Kraus Camila Belli , Fiuza Thamires Foletto , Silveira Kathleen Karoline Brandt , Zucco Fabrícia Durieux
Published: July 2018

A compreensão da perspectiva dos residentes de um destino turístico é fundamental para facilitar o desenvolvimento da comunidade para maior apoio em benefício ao turismo. A cidade de Trujillo, escolhida como objeto de estudo está localizada na costa norte do Peru, no distrito de La Libertad, cujos atrativos turísticos são principalmente culturais e arqueológicos. Assim, o objetivo deste estudo é analisar a influência dos fatores pessoais na percepção dos impactos promovidos pelo turismo na cidade de Trujillo (Peru). A metodologia aplicada é de caráter exploratório, de abordagem quantitativa. Os resultados demonstraram a existência de diferença estatisticamente significativa em quatro das cinco dimensões de análise e em diversos fatores pessoais dos residentes, confirmando a teoria e demonstrando a influência de tais fatores no processo de percepção dos impactos do turismo em destinos.