bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond pros and cons – developing a patient decision aid to cultivate dialog to build relationships: insights from a qualitative study and decision aid development
Authors:   on behalf of the IP-SDM Team;, Yu Catherine H. , Ke Calvin , Jovicic Aleksandra , Hall Susan , Straus Sharon E.
Published: September 2019

Background

An individualized approach using shared decision-making (SDM) and goal setting is a person-centred strategy that may facilitate prioritization of treatment options. SDM has not been adopted extensively in clinical practice. An interprofessional approach to SDM with tools to facilitate patient participation may overcome barriers to SDM use. The aim was to explore decision-making experiences of health professionals and people with diabetes (PwD), then develop an intervention to facilitate interprofessional shared decision-making (IP-SDM) and goal-setting.

Methods

This was a multi-phased study. 1) Feasibility: Using a descriptive qualitative study, individual interviews with primary care physicians, nurses, dietitians, pharmacists, and PwD were conducted. The interviews explored their experiences with SDM and priority-setting, including facilitators and barriers, relevance of a decision aid for priority-setting, and integration of SDM and a decision aid into practice. 2) Development: An evidence-based SDM toolkit was developed, consisting of an online decision aid, MyDiabetesPlan, and implementation tools. MyDiabetesPlan was reviewed by content experts for accuracy and comprehensiveness. Usability assessment was done with 3) heuristic evaluation and 4) user testing, followed by 5) refinement.

Results

Seven PwD and 10 clinicians participated in the interviews. From interviews with PwD, we identified that: (1) approaches to decision-making were diverse and dynamic; (2) a trusting relationship with the clinician and dialog were critical precursors to SDM; and, (3) goal-setting was a dynamic process. From clinicians, we found: (1) complementary (holistic and disease specific) approaches to the complex patient were used; (2) patient-provider agendas for goal-setting were often conflicting; (3) a flexible approach to decision-making was needed; and, (4) conflict could be resolved through SDM. Following usability assessment, we redesigned MyDiabetesPlan to consist of data collection and recommendation stages. Findings were used to finalize a multi-component toolkit and implementation strategy, consisting of MyDiabetesPlan, instructional card and videos, and orientation meetings with participating patients and clinicians.

Conclusions

A decision aid can provide information, facilitate clinician-patient dialog and strengthen the therapeutic relationship. Implementation of the decision aid can fit into a model of team care that respects and exemplifies professional identity, and can facilitate intra-team communication.

Trial registration

Clinicaltrials.gov Identifier: NCT02379078. Date of Registration: 11 February 2015.
Patient satisfaction with peri-operative anesthesia care and associated factors at two National Referral Hospitals: a cross sectional study in Eritrea
Authors: Andemeskel Yonatan Mehari , Elsholz Traudl , Gebreyohannes Ghidey , Tesfamariam Eyasu H.
Published: September 2019

Background

Measuring patient satisfaction has become an important parameter of the continuous quality assessment and improvement in anaesthesia services. The aim of this study was to assess the level of patient satisfaction with perioperative anaesthesia care and to determine the factors that influence satisfaction.

Method

This study is an cross sectional design, conducted on 470 patients who underwent different types of surgeries at two National Referral Hospitals in Asmara, Eritrea between January and March of 2018. Patients were interviewed 24 h after the operation using a Tigrigna translated Leiden Perioperative Care Patient Satisfaction questionnaire (LPPSq). Descriptive and inferential analysis were made using SPSS (version 22). Statistical significance level was set at P < 0.05.

Results

The overall satisfaction score was 68.8%. Less fear and concern was observed among patients with satisfaction scores of 87.5%. Staff-patient relationship satisfaction score was 75%. Patients were least satisfied with information provision (45%). Multivariable analysis revealed that satisfaction of patients who did surgery at Halibet hospital is significantly higher (p < 0.001) than those patients who did at Orotta hospital. Moreover, those patients who did elective surgery had higher level of satisfaction that those who did emergency surgery (p < 0.001).

Conclusion

Moderate level of satisfaction was observed among the patients. Generally, the study emphasized that the information provision about anesthesia and surgery was low. Patients described better staff-patient relationship and low fear and concern related to anesthesia and surgery was observed.
Responding to adverse patient safety events in Viet Nam
Authors: Harrison Reema , Sharma Anurag , Walton Merrilyn , Esguerra Esmond , Onobrakpor Seinyenede , Nghia Bui Trung , Chinh Nguyen Duc
Published: September 2019

Background

The psychological and professional impact of adverse events on doctors and nurses is well-established, but limited data has emerged from low- and middle-income. This article reports the experiences of being involved in a patient safety event, incident reporting and organisational support available to assist health professionals in Viet Nam to learn and recover.

Method

Doctors and nurses (1000) from all departments of a 1500-bed surgical and trauma hospital in Viet Nam were invited to take part in a cross-sectional survey. The survey explored respondents’ involvement in adverse events and/or near miss, their emotional, behavioural and coping responses, experiences of organisational incident reporting, and the learning and/or other consequences of the event. Survey items also assessed the availability of organisational support including peer support and mentorship.

Results

Of the 497 respondents, 295 (59%) experienced an adverse event in which a patient was harmed, of which 86 (17%) resulted in serious patient harm. 397 (80%) of respondents experienced a near miss, with 140 of these (28%) having potential for serious harm. 386 (77%) reporting they had been affected professionally or personally in some way, with impacts to psychological health (416; 84%), physical health (388; 78%), job satisfaction (378; 76%) and confidence in their ability (276; 56%) commonly reported. Many respondents were unable to identify local improvements (373; 75%) or organisation-wide improvements following safety events (359; 72%) and 171 (34%) admitted that they had not reported an event to their organisation or manager that they should have.

Conclusions

Health professionals in Viet Nam report impacts to psychological and physical health as a result of involvement in safety events that reflect those of health professionals internationally. Reports of limited organisational learning and improvement following safety events suggest that patient safety culture is underdeveloped in Viet Nam currently. In order to progress work on patient safety cultures and incident reporting in Viet Nam, health professionals will need to be convinced not only that they will not be exposed to punitive action, but that learning and positive changes will occur as a result of reporting safety events.
Cold-induced lipid dynamics and transcriptional programs in white adipose tissue
Authors: Xu Ziye , You Wenjing , Zhou Yanbing , Chen Wentao , Wang Yizhen , Shan Tizhong
Published: September 2019

Background

In mammals, cold exposure induces browning of white adipose tissue (WAT) and alters WAT gene expression and lipid metabolism to boost adaptive thermogenesis and maintain body temperature. Understanding the lipidomic and transcriptomic profiles of WAT upon cold exposure provides insights into the adaptive changes associated with this process.

Results

Here, we applied mass spectrometry and RNA sequencing (RNA-seq) to provide a comprehensive resource for describing the lipidomic or transcriptome profiles in cold-induced inguinal WAT (iWAT). We showed that short-term (3-day) cold exposure induces browning of iWAT, increases energy expenditure, and results in loss of body weight and fat mass. Lipidomic analysis shows that short-term cold exposure leads to dramatic changes of the overall composition of lipid classes WAT. Notably, cold exposure induces significant changes in the acyl-chain composition of triacylglycerols (TAGs), as well as the levels of glycerophospholipids and sphingolipids in iWAT. RNA-seq and qPCR analysis suggests that short-term cold exposure alters the expression of genes and pathways involved in fatty acid elongation, and the synthesis of TAGs, sphingolipids, and glycerophospholipids. Furthermore, the cold-induced lipid dynamics and gene expression pathways in iWAT are contrary to those previously observed in metabolic syndrome, neurodegenerative disorders, and aging, suggesting beneficial effects of cold-induced WAT browning on health and lifespan.

Conclusion

We described the significant alterations in the composition of glyphospholipids, glycerolipids, and sphingolipids and expression of genes involved in thermogenesis, fatty acid elongation, and fatty acid metabolism during the response of iWAT to short-term cold exposure. We also found that some changes in the levels of specific lipid species happening after cold treatment of iWAT are negatively correlated to metabolic diseases, including obesity and T2D.
Modeling human temperament and character on the basis of combined theoretical approaches
Authors: Fountoulakis Konstantinos N. , Gonda Xenia
Published: September 2019

Background

Although there are several models on the structure of human temperament, character and personality, the majority follow a single approach, providing a unilateral and overly theoretical construct which is unsuitable for clinical application. The current study aimed to develop a complex and comprehensive model of temperament and character by empirically combining relevant existing theories.

Methods

The study included 734 healthy general population subjects aged 40.80 ± 11.48 years, who completed the TEMPS-A, TCI and NEO-PI-3 questionnaires. Data were analyzed in a multistep approach using Exploratory Factor analysis and forward stepwise linear regression.

Results

The results yielded two highest order factors (Self and Self–Environment Interaction), six middle order factors (Emotional Self, Cognitive Self, Social Emotionality, Emotional and Cognitive Control, Ethical Emotionality and Behavior, Social Emotionality and Behavior) and 12 factors at the bottom (Ego Resiliency, Ego Strength, Intrapersonal Emotion, Personal Space Cognition, Interpersonal Cognition, Emotional Creativity, Externalized Interpersonal Emotion, Internalized Interpersonal Emotion, Emotional Motivation, Self-Discipline, Ethical Values and Ethical Behavior).

Conclusions

The current study developed a complex hierarchical model of temperament and character on the basis of empirical data from several temperament theories. An important feature of the new temperamental model is the frequent admixture of emotional and cognitive processes within the same module. This model expands the field to include elements probably corresponding to meta-cognition mechanisms and complex interactions between affective and cognitive control, which may provide useful in understanding and treating affective disorders as well.
Preoxygenation before intubation in adult patients with acute hypoxemic respiratory failure: a network meta-analysis of randomized trials
Authors: Fong Ka Man , Au Shek Yin , Ng George Wing Yiu
Published: September 2019

Background

Patients with acute hypoxemic respiratory failure are at risk for life-threatening complications during endotracheal intubation. Preoxygenation might help reduce the risk of hypoxemia and intubation-related complications. This network meta-analysis summarizes the efficacy and safety of preoxygenation methods in adult patients with acute hypoxemic respiratory failure.

Methods

We searched PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2019 for randomized controlled trials (RCT) that studied the use of conventional oxygen therapy (COT), high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), and HFNC and NIV as preoxygenation before intubation in patients with acute hypoxemic respiratory failure. Citations’ screening, study selection, data extraction, and risk of bias assessment were independently performed by two authors. The primary outcome was the lowest SpO2 during the intubation procedure.

Results

We included 7 RCTs (959 patients). Patients preoxygenated with NIV had significantly less desaturation than patients treated with COT (mean difference, MD 5.53, 95% CI 2.71, 8.34) and HFNC (MD 3.58, 95% CI 0.59, 6.57). Both NIV (odds ratio, OR 0.43, 95% CI 0.21, 0.87) and HFNC (OR 0.49, 95% CI 0.28, 0.88) resulted in a lower risk of intubation-related complications than COT. There were no significant mortality differences among the use of NIV, HFNC, COT, and HFNC and NIV during preoxygenation.

Conclusions

In adult patients with acute hypoxemic respiratory failure, NIV is a safe and probably the most effective preoxygenation method.
First bloodstream infection caused by Prevotella copri in a heart failure elderly patient with Prevotella-dominated gut microbiota: a case report
Authors: Posteraro Patrizia , De Maio Flavio , Menchinelli Giulia , Palucci Ivana , Errico Federica Maria , Carbone Mariantonietta , Sanguinetti Maurizio , Gasbarrini Antonio , Posteraro Brunella
Published: September 2019

Background

Bloodstream infection (BSI) is a constant threat for hospitalized patients, and elderly patients are particularly susceptible to BSI caused by anaerobic bacteria. Changes in the gut microbiota composition may lead to pathogen overgrowth and translocation into the bloodstream. Consequently, domination of specific taxa in the intestinal bacterial community seems to be associated with a higher risk of bacteremia in some patient populations.

Case presentation

Here, we report the case of a 90-year-old heart failure (HF) patient who was admitted to the hospital for an acute state of cardiac decompensation. Twenty days after admission, he was febrile to 38.2 °C whereas his white blood count and C-reactive protein increased to 6190 cells/μL and 31.2 mg/L, respectively. Of the patient’s blood culture (BC) bottle pairs collected under the suspicion of infection, the anaerobic bottle yielded an organism that was later identified as Prevotella copri. Concomitantly, the patient’s fecal sample was obtained for the intestinal microbiota characterization by sequencing the V3/V4/V6 regions of the bacterial 16S rRNA gene. The analysis revealed highest relative abundances of Bacteroidales (34.1%), Prevotellaceae (19.0%), Prevotella (15.2%), and P. copri (6.1%) taxa, indicating that the patient’s gut microbiota was dominated by Prevotella organisms. The patient was successfully treated with metronidazole, and was discharged to a long-term care facility at 35 days of admission.

Conclusions

We provide the first evidence for a clinically significant BSI caused by P. copri and its relationship to a Prevotella-rich gut microbiota in the HF patient setting. When strengthening the pathogenicity of P. copri, the present case suggests that the gut may be a source of BSI caused by the rare anaerobic organism. Future studies are necessary to assess the role of the gut microbiota profiling for precise identification and targeted treatment of patients at high risk of BSI.
Delays in diagnosis and treatment of pulmonary tuberculosis in patients seeking care at a regional referral hospital, Uganda: a cross sectional study
Authors: Muttamba Winters , Kyobe Samuel , Komuhangi Alimah , Lakony James , Buregyeya Esther , Mabumba Eldad , Basaza Robert K.
Published: September 2019

Objective

A cross-sectional survey involving 134 pulmonary TB patients started on TB treatment at the TB Treatment Unit of the regional referral hospital was conducted to ascertain the prevalence of individual and health facility delays and associated factors. Prolonged health facility delay was taken as delay of more than 1 week and prolonged patient delay as delay of more than 3 weeks. A logistic regression model was done using STATA version 12 to determine the delays.

Results

There was a median total delay of 13 weeks and 110 (82.1%) of the respondents had delay of more than 4 weeks. Patient delay was the most frequent and greatest contributor of total delay and exceeded 3 weeks in 95 (71.6%) respondents. At multivariate analysis, factors that influenced delay included poor patient knowledge on TB (adjOR 6.904, 95% CI 1.648–28.921; p = 0.04) and being unemployed (adjOR 3.947, 95% CI 1.382–11.274; p = 0.010) while being female was found protective of delay; adjOR 0.231, 95% CI 0.08–0.67; p = 0.007). Patient delay was the most significant, frequent and greatest contributor to total delay, and factors associated with delay included being unemployed, low knowledge on TB while being female was found protective of delay.
An audit of mother to child HIV transmission rates and neonatal outcomes at a tertiary hospital in South Africa
Authors: Benali Ghad , Ramdin Tanusha , Ballot Daynia
Published: September 2019

Objective

The aim of this study was to explore the prevalence of congenital HIV infection of neonates at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) between 2015 and 2017, as well as compare the HIV PCR positive and HIV PCR negative neonates.

Results

A total number of 1443 HIV exposed neonates was examined for the study period out of a total of 5029 admissions (HIV exposure 28.6%) The study found that the rate of HIV transmission at birth was 2.52%. The majority of infants had low birth weight and were also born prematurely. These results show that, despite the introduction of the extended mother to child transmission programme, HIV transmission is high.
Screening circulating proteins to identify biomarkers of fetal macrosomia
Authors: Cruickshank Tess , Kaitu’u-Lino Tu’uhevaha J. , Cannon Ping , Harper Alesia , Nguyen Tuong-Vi , Dane Kirsten M. , Middleton Anna L. , Kyritsis Valerie P. , Hastie Roxanne , Tong Stephen , Walker Susan P. , MacDonald Teresa M.
Published: September 2019

Objective

Fetal macrosomia is a major risk factor for shoulder dystocia, which can lead to birth asphyxia, maternal and neonatal traumatic injuries, and perinatal death. If macrosomia is diagnosed in the antenatal period, labour can be induced to decrease shoulder dystocia. But current clinical methods to diagnose fetal macrosomia antenatally perform with poor accuracy. Therefore, improved methods to accurately diagnose fetal macrosomia are required. Blood biomarkers that predict fetal macrosomia could be one such novel diagnostic strategy. We undertook a nested case–control study from a prospective collection of 1000 blood samples collected at 36 weeks’ gestation. We analysed plasma samples from 52 women who subsequently delivered a macrosomic (> 95th centile for gestational age) infant and 106 controls. Circulating concentrations of the proteins COBLL1, CSH1, HSD3B1, EGFL6, XAGE3, S100P, PAPPA-1, ERBB2 were assessed for their ability to predict macrosomic infants.

Results

We did not identify any significant changes in the plasma concentrations of COBLL1, CSH1, HSD3B1, EGFL6, XAGE3, S100P, PAPPA-1, ERBB2 from women who subsequently delivered macrosomic neonates relative to control samples. Although we have not identified any potential biomarkers of fetal macrosomia, we have ruled out these particular eight protein candidates.
Awareness of complications of diabetes mellitus and its associated factors among type 2 diabetic patients at Addis Zemen District Hospital, northwest Ethiopia
Authors: Belsti Yitayeh , Akalu Yonas , Fekadu Haileab , Animut Yaregal
Published: September 2019

Objectives

Awareness about complications is important to reduce diabetes related morbidity and mortality. This study aimed to assess awareness of diabetes complications and associated factors among type 2 diabetic patients. Institution based cross sectional study was conducted from April to June, 2019, using simple random sampling technique, and interviewer administered questionnaires.

Results

The mean age was 41 ± 1.46 years and 56% were females. Awareness regarding diabetic complications was 48.5% with 95% CI (43.3, 52.7%). Male sex (AOR: 4.67, 95% CI (2.53, 8.61)), age of 31–45 years (AOR: 7.30, 95% CI (3.10, 17.17)), 46–70 years old (AOR: 15.02, 95% CI (6.11, 36.92)), read and write (AOR: 3.79, 95% CI (1.78, 8.06)), primary school (AOR: 9.58, 95% CI (3.26, 28.18)), high school and above (AOR: 7.46, 95% CI (3.02, 18.44)), NGO employee (AOR: 7.24, 95% CI (2.68, 19.53)), having a family history of DM (AOR: 5.55, 95% CI (2.53, 12.20)); income of 1001–1500 (AOR: 3.22, 95% CI (1.28, 8.10)), 1501–2500 (AOR: 11.73, 95% CI (4.32, 31.81)) and > 2500 Ethiopian birr (AOR: 7.18, 95% CI (1.70, 30.28)) ≥ 2500 ETB (AOR: 7.18, 95% CI (1.70, 30.28)) were significantly associated with good awareness. To improve patient’s awareness on DM complications providing health education for type 2 diabetic patients is crucial.
Sensitivity analysis for a new class of generalized parametric nonlinear ordered variational inequality problems in ordered Banach spaces
Authors: Nisar Kottakkaran Sooppy , Sarfaraz Mohd. , Morsy Ahmed , Ahmad Md. Kalimuddin
Published: September 2019

In this study, we introduce a class of new generalized parametric nonlinear ordered variational inequality problems and discuss its existence result. Also, we prove the sensitivity of the solution for the parametric inequality class with the help of B-restricted-accretive method in ordered Banach spaces. Some special cases of the main results are also discussed.
Structurally isolated photoactuation of graphene-mixed temperature-responsive hydrogels in soft-rigid series structure
Authors: Watanabe Tomoki , Yokoyama Yoshiyuki , Hayakawa Takeshi
Published: September 2019

This paper presents fabrication and actuation methods for a soft microrobot with a hybrid structure composed of soft microactuators and a rigid supporting body. This hybrid structure enables actuation of the microrobot with independent driving of multiple actuators to provide complex movement like that of living microorganisms. We use the temperature-responsive hydrogel poly(N-isopropylacrylamide) (PNIPAAm) as a soft microactuator. PNIPAAm swells with water at low temperature but shrinks at high temperature. This volume change thus allows PNIPAAm to be used as an actuator by controlling its temperature. We successfully fabricated the microrobot with its soft-rigid hybrid structure composed of PNIPAAm and rigid photoresist using a multilayered microfabrication process. In addition, we used a sacrificial layer process to release the fabricated microrobot from the substrate to allow it to move freely. To actuate the microrobot, we mixed PNIPAAm with graphene, which has a high photothermal conversion efficiency. The temperature of the soft actuator when mixed with graphene can be increased by irradiating it with light. Therefore, actuation of the microrobot is achieved by sequentially irradiating the microactuators with focused light. We present the fabrication, release and partial actuation of the microrobot to demonstrate the feasibility of the proposed microrobot with the soft-rigid hybrid structure in this paper.
Species delimitation within the Glaucidium brodiei owlet complex using bioacoustic tools
Authors: Gwee Chyi Yin , Eaton James A. , Ng Elize Y. X. , Rheindt Frank E.
Published: September 2019

Background

The taxonomy of the Collared Owlet (Glaucidium brodiei) species complex is confused owing to great individual variation in plumage colouration seemingly unrelated to their distribution. Although generally recognised as a single species, vocal differences among the subspecies have been noted by field recordists. However, there is no study assessing the vocal differences among these four subspecies.

Methods

We obtained 76 sound recordings of the G. brodiei species complex comprising all four subspecies. We conducted bioacoustic examinations using principal component analysis and the Isler criterion to quantitatively test species boundaries within the G. brodiei complex. In addition, we compared plumage colouration among 13 specimens of the G. brodiei complex deposited at the Natural History Museum at Tring, UK and the Lee Kong Chian Natural History Museum, Singapore to ascertain the presence of plumage differences across taxa.

Results

We found the Bornean and Sumatran populations vocally similar to each other, but distinctly different from the mainland and Taiwan populations. The vocal pattern seems to corroborate plumage distinctions in the colouration of neck collars: the Bornean and Sumatran taxa share a white neck collar, whereas the continental and Taiwan taxa share a rufous neck collar.

Conclusions

We propose the taxonomic elevation of the Sumatran and Bornean populations to species level as Sunda Owlet G. sylvaticum, with one subspecies on Sumatra (G. s. sylvaticum) and Borneo (G. s. borneense) each. Our study corroborates the importance of bioacoustics in ascertaining species boundaries in non-passerines, and emphasises the significance of incorporating multiple species delimitation approaches when making taxonomic decisions.
Characterization the effects of nanofluids and heating on flow in a baffled vertical channel
Authors: Al-Obaidi Ali Assim , Salman Ali J. , Yousif Ali Raheem , Al-Mamoori Dalya H. , Mussa Mohamed H. , Gaaz Tayser Sumer , Kadhum Abdul Amir H. , Takriff Mohd S. , Al-Amiery Ahmed A.
Published: September 2019

The laminar 2-D blended convection of the nanofluids at different volume fractions has gained interest in the last decade due to an enormous application in technology. The laminar-flow stream system can be further modified by changing the geometry of the channel, adding an external heating source, and changing the initial conditions at which the stream is being influenced. The investigation of this system includes the variation of the geometrical parameters of the channel, Reynolds number, Nusselt number, and type of the nanoparticles used in preparing the nanofluid with water as the base fluid. These parameters constitute a very successful leading to utilize the numerical solutions by using a finite volume method. Regarding heat flow, one side of the channel was supplied by the heat while the temperature of the other side was kept steadily. The upstream walls of the regressive confronting step were considered as adiabatic surfaces. The nanofluids were made by adding aluminum oxide (Al2O3), copper oxide (CuO), silicon dioxide (SiO2), or zinc oxide (ZnO) nanoparticles to various volume fractions in the scope of 1 to 4% and diverse nanoparticle diameters of 25 to 80 nm. The calculations were performed with heat flux, Reynolds numbers (Re), and step height (S) at a range of 100 <  < 600 W/m2, 100 <  Re  < 500, and 3 ≤ S ≤ 5.8, respectively. The numerical study has shown that the nanofluid with SiO2 has the highest value of the Nusselt number (Nu). The distribution area and the Nu increase as Reynolds number increases and diminish as the volume fraction diminishes with the increase of the nanoparticle diameter. The outcome of this paper has shown that assisting flow has shown superiority over the opposing flow when Nu increases.
Laparoscopic surgical management of a mature presacral teratoma: a case report
Authors: Wang Liming , Hirano Yasumitsu , Ishii Toshimasa , Kondo Hiroka , Hara Kiyoka , Ishikawa Shintaro , Okada Takuhisa , Obara Nao , Yamaguchi Shigeki
Published: September 2019

Background

Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery.

Case presentation

A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas.

Conclusions

Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.
[11C]Carbon monoxide: advances in production and application to PET radiotracer development over the past 15 years
Authors: Taddei Carlotta , Pike Victor W.
Published: September 2019

[11C]Carbon monoxide is an appealing synthon for introducing carbon-11 at a carbonyl position (C=O) in a wide variety of chemotypes (e.g., amides, ketones, acids, esters, and ureas). The prevalence of the carbonyl group in drug molecules and the present-day broad versatility of carbonylation reactions have led to an upsurge in the production of this synthon and in its application to PET radiotracer development. This review focuses on the major advances of the past 15 years.
Systemic anaplastic large cell lymphoma presenting as a huge mediastinal mass in a case of hyper IgE syndrome: a case report
Authors: Kheyrollahiyan Atefeh , Sharifi Akbar , Mirza-Aghazadeh-Attari Mohammad
Published: September 2019

Background

Hyper IgE syndrome is a rare heterogeneous immunodeficiency syndrome which is characterized by recurrent episodes of cutaneous and respiratory tract infections and development of cold abscesses. This syndrome is also associated with malignancies, most notability hematologic malignancies.

Case presentation

In this case report, we discuss a 27-year-old male with proven hyper IgE syndrome and effected by tuberculosis, who developed an anaplastic large cell lymphoma, a very rare and aggressive subtype of lymphoma. We will discuss imaging findings in this rare case. The case presented here had a large mediastinal mass, which had encircled the aorta, and was accompanied by subcarinal lymphadenopathy and inguinal lymphadenopathy.

Conclusions

Systemic anaplastic large cell lymphoma is a rare subtype of lymphoma which is rarely associated with hyper IgE syndrome. In this case, both lymphoma and tuberculosis infection were witnessed in the same patient, showing a classic example of immune dysregulation.
The weeks before 100 persecutory delusions: the presence of many potential contributory causal factors
Authors: Freeman Daniel , Morrison Anthony , Bird Jessica C. , Chadwick Eleanor , Bold Emily , Taylor Kathryn M. , Diamond Rowan , Collett Nicola , Černis Emma , Isham Louise , Lister Rachel , Kirkham Miriam , Teale Ashley-Louise , Twivy Eve , Waite Felicity
Published: September 2019

Background

The period before the formation of a persecutory delusion may provide causal insights. Patient accounts are invaluable in informing this understanding.

Aims

To inform the understanding of delusion formation, we asked patients about the occurrence of potential causal factors – identified from a cognitive model – before delusion onset.

Method

A total of 100 patients with persecutory delusions completed a checklist about their subjective experiences in the weeks before belief onset. The checklist included items concerning worry, images, low self-esteem, poor sleep, mood dysregulation, dissociation, manic-type symptoms, aberrant salience, hallucinations, substance use and stressors. Time to reach certainty in the delusion was also assessed.

Results

Most commonly it took patients several months to reach delusion certainty (n = 30), although other patients took a few weeks (n = 24), years (n = 21), knew instantly (n = 17) or took a few days (n = 6). The most frequent experiences occurring before delusion onset were: low self-confidence (n = 84); excessive worry (n = 80); not feeling like normal self (n = 77); difficulties concentrating (n = 77); going over problems again and again (n = 75); being very negative about the self (n = 75); images of bad things happening (n = 75); and sleep problems (n = 75). The average number of experiences occurring was high (mean 23.5, s.d. = 8.7). The experiences clustered into six main types, with patients reporting an average of 5.4 (s.d. = 1.0) different types.

Conclusions

Patients report numerous different experiences in the period before full persecutory delusion onset that could be contributory causal factors, consistent with a complex multifactorial view of delusion occurrence. This study, however, relied on retrospective self-report and could not determine causality.

Declaration of interest

None.
Management of Osteoporosis in Survivors of Adult Cancers With Nonmetastatic Disease: ASCO Clinical Practice Guideline
Authors: Shapiro Charles L. , Van Poznak Catherine , Lacchetti Christina , Kirshner Jeffrey , Eastell Richard , Gagel Robert , Smith Sean , Edwards Beatrice J. , Frank Elizabeth , Lyman Gary H. , Smith Matthew R. , Mhaskar Rahul , Henderson Tara , Neuner Joan
Published: September 2019

PURPOSE

The aim of this work is to provide evidence-based guidance on the management of osteoporosis in survivors of adult cancer.

METHODS

ASCO convened a multidisciplinary Expert Panel to develop guideline recommendations based on a systematic review of the literature.

RESULTS

The literature search of the 2018 systematic review by the US Preventive Services Task Force in the noncancer population was used as the evidentiary base upon which the Expert Panel based many of its recommendations. A total of 61 additional studies on topics and populations not covered in the US Preventive Services Task Force review were also included. Patients with cancer with metastatic disease and cancer survival outcomes related to bone-modifying agents are not included in this guideline.

RECOMMENDATIONS

Patients with nonmetastatic cancer may be at risk for osteoporotic fractures due to baseline risks or due to the added risks that are associated with their cancer therapy. Clinicians are advised to assess fracture risk using established tools. For those patients with substantial risk of osteoporotic fracture, the clinician should obtain a bone mineral density test. The bone health of all patients may benefit from optimizing nutrition, exercise, and lifestyle. When a pharmacologic agent is indicated, bisphosphonates or denosumab at osteoporosis-indicated dosages are the preferred interventions.
Left-Wing Kuhnianism
Authors: Rorty Richard
Published: September 2019

In this brief essay Rorty comments on how some fear that Thomas Kuhn’s widely persuasive view of science can and is being used to denigrate science or to reduce our sense of its difference from literature. Rorty goes on to argue that no part of culture should be invidiously set against another as in any way privileged. Questions about the epistemological status or rationality of different disciplines or areas of culture should be dismissed, he claims, as pointless. He calls this perspective “left-wing Kuhnianism” and discusses its importance for the journal Common Knowledge, in whose twenty-fifth anniversary issue this essay appears.
On Nonscalability
Authors: Tsing Anna Lowenhaupt
Published: September 2019

Because computers zoom across magnifications, it is easy to conclude that both knowledge and things exist by nature in precision-nested scales. The technical term is “scalable,” the ability to expand without distorting the framework. But it takes hard work to make knowledge and things scalable, and this article shows that ignoring nonscalable effects is a bad idea. People stumbled on scalable projects through the same historical contingencies that such projects set out to deny. They cobbled together ways to make things and data self-contained and static, and thus amenable to expansion. In European New World plantations, the natives were wiped out; coerced and alienated plants and workers came to substitute for them. Profits were made because extermination and slavery could be discounted from the books. Such historically indeterminate encounters formed models for later projects of scalability. This essay explores scalability projects from the perspective of an emergent “nonscalability theory” that pays attention to the mounting pile of ruins that scalability leaves behind. The article concludes that, if the world is still diverse and dynamic, it is because scalability never fulfills its own promises.
Love and Money
Authors: Rorty Richard
Published: September 2019

In this essay Rorty argues that care or concern alone is inadequate for dealing with problems of Third World poverty; neither is there likely to be a convenient technological fix. There is no evading the hard decisions that global poverty will require of the rich nations, and there is no way past E. M. Forster’s dictum, in Howard’s End, that “We are not concerned with the very poor. They are unthinkable and only to be approached by the statistician or the poet.” Most of Rorty’s essay focuses on works of Forster demonstrating that, in Rorty’s words, “tenderness only appears . . . when there is enough money to produce a little leisure, a little time in which to love. . . . The cash value of the Christian ideal of universal brotherhood has, for the last two centuries, been the conviction that once science and technology have produced enough wealth—and enlightened, unselfish political initiatives have redistributed it—there will be no one left who is incapable of tenderness. All human beings will live in the light; all of them will be possible characters in novels.”
Radiographic changes in TMJ in relation to serology and disease activity in RA patients
Authors: Youssef Mohamed Mostafa Mahmoud , Dahaba Mushira M. , Farid Mary Medhat , Ali Elsayed Adel Mahmoud
Published: September 2019

Objectives:

This study was undertaken as an attempt to assess radiographic temporomandibular joint (TMJ) changes in relation to rheumatoid factor (RF), anticitrullinated protein (ACCP) antibodies and disease activity score 28 (DAS28) in rheumatoid arthritis (RA) patients to find the best predictor of rheumatoid affection of the TMJ with the ultimate goal of maintaining TMJ function and preventing joint damage.

Methods:

20 Rheumatoid Arthritis patients as well as 20 volunteers were included in this study. RA group were assessed for RF, ACCP, DAS28. Both groups were assessed by CBCT for TMJ dimensions and radiographic osteoarthritic changes. All data were statistically analyzed.

Results:

Rheumatoid Arthritis group showed significantly less condylar height and more radiographic osteoarthritic changes than the control group. RF showed no significant correlation with either TMJ measurements or TMJ radiographic osteoarthritic changes. ACCP showed significant inverse correlation with condylar height and anteroposterior (AP) dimensions, but non-significant relation with mediolateral dimension and radiographic osteoarthritic changes. DAS28 showed significant inverse correlation with condylar AP and mediolateral dimensions. It also showed significant correlation with flattening of the TMJ condylar head and flattening of the articular fossa. Patients with high and moderate disease activity showed significantly smaller AP TMJ dimension than patients with low disease activity. Disease activity showed statistically significant direct correlation with all osteoarthritic changes except for erosions of the glenoid fossa and condyle.

Conclusion:

Disease Activity Score28 score and disease activity are strong indicators of TMJ affection in RA patients when compared to RF and ACCP. ACCP is a better indicator of changes in condylar measurements than TMJ osteoarthritic changes. While RF is the least efficient indicator of TMJ involvement in RA patients.
Constituição de Empresa Individual de Responsabilidade Limitada por magistrados
Authors: Ávila Conselheiro Henrique
Published: September 2019

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4. Certamen
Authors: Kivilo Maarit
Published: September 2019

[No abstract]
A.2. Pindarlektüre an der Academia Gustaviana: Henricus Vogelmannus' Ode Prosphonetike
Authors: Päll Janika
Published: September 2019

[No abstract]
A.1. Vergil's Aeneid VIII and the Shield of Aeneas: recurrent topics and cyclic structures
Authors: Vella Horatio Caesar Roger
Published: September 2019

Book VIII of the Aeneid can be said to be the turning point in Aeneas' fulfilment of his mission indicated to him in Troy. In it Vergil formed two separate artistic structural patterns making up the length of the whole book while, at the same time, elaborating on the significance of the most symbolic object mentioned in the whole of the Aeneid, the Shield of Aeneas. This ecphrasis is characterized by literary embellishments, which compare well with those found in Homer's and Hesiod's poems. Both sections of this book are interrelated, since Hercules, in the site of the future Rome, foreshadows Aeneas, who then receives and lifts the shield representing, at its boss, Augustus' victory over Mark Antony and Cleopatra at the Battle of Actium. The book ends as it starts, the preparations being underway for the war against Mezentius.
A.2. Das Haupt des Appius
Authors: Ryan Francis X.
Published: September 2019

It is shown that the attestation of the principate of Ap. Claudius Pulcher (Cos. 143) is due to the alchemistic procedure of ancient writers. Other ostensible facts about Appius are also examined: a supposed testimonium for his censorship, his supposedly fixed date of death, and his supposed augurate.
B.2. Kollaboration von der Antike bis zum 21. Jahrhundert. Ein Diskussionsbeitrag
Authors: Ungern-Sternberg Jürgen von
Published: September 2019

'Collaboration' got its negative meaning only in the special situation of the Vichy-Régime in front of the victorious German Reich. But it could be of some use to look for similar cases in earlier historical periods: the collaboration of many Greeks with the Persian Empire in the fifth century B.C. and with Rome in the second century B.C. Another one could be Caupo, chief of the Livonians, in the period of the occupation of the eastern region of the Baltic Sea by the Germans.
A.1. Phrynichos kommt vor Gericht
Authors: Ryan Francis X.
Published: September 2019

Since Herodotos says that the playwright Phrynichos was fined by "the Athenians," historians have often inferred that he was condemned by a popular tribunal. The context of the statement shows however that this formulation of Herodotos is of no avail in identifying the authority which meted out justice to Phrynichos. The amount of the fine and the outlawry of the play are better indications of popular involvement in the affair.
A.2. P.Lond.Lit. 207 and the origin of the nomina sacra: a tentative proposal
Authors: Barker Don C.
Published: September 2019

The origin and development of the nomina sacra (sacred names written in an abbreviated form) found in early Christian texts is much debated in scholarly circles and no agreement has been reached. However the use of the nomina sacra in P.Lond.Lit. 207 may help to resolve some of the questions that surround the puzzle of their origin. P.Lond.Lit. 207 is a portion of papyrus that has broken off from a roll (24.5 X 25.7 cm), covering Psalms 11(12):7 to 14(15):4. The scribe of P.Lond.Lit. 207 has consistently written Kurios in an abbreviated form (nomen sacrum), giving only the first and last letters, and a supralinear bar drawn above the abbreviation. On the other hand, Theos is always written uncontracted. This is quite unusual given that Theos in Christian texts is always written as a nomen sacrum. Could the reason for this practice in P.Lond.Lit. 207 be found in the Semitic custom of contracting personal names to the first and last letter? Is Kurios abbreviated in this Semitic fashion to notify the reader that the word is being used to translate the personal name (the Tetragrammaton) of the Hebrew deity?
A.3. Farming in the ancient Greek world: how should the small free producers be defined?
Authors: Gallego Julián
Published: September 2019

In recent studies on the rural world in ancient Greece the application of the notion of peasant to the rural homestead has received several objections. Some scholars have preferred to use the notion of farmer to characterise the family smallholding. In this paper I first review these standpoints, and then reconsider the evidence concerning the Greek words georgos and autourgos and also concerning the patterns of settlement and agricultural systems produced by archaeological surveys. Finally, I offer my own view based on a model of multiple social and economic situations in which Greek smallholders could be involved along the family life cycle.
A.1. Isocrate et la question des mercenaires
Authors: Bouchet Christian
Published: September 2019

Quand il évoque les mercenaires, Isocrate les traite soit comme des soldats, combattants vaillants, soit comme des stipendiés, contraints par la misère à louer leurs services, soit comme des étrangers (le xenos peut alors signifier le mercenaire), soit enfin comme des vagabonds. Si les jugements qu'il porte sur ces hommes sont parfois très durs, impitoyables, il faut noter aussi — et c'est ce sur quoi j'insiste ici — que le portrait qu'il brosse est beaucoup plus complexe : selon le contexte, les circonstances (kairoi) et le régime politique impliqué, il se fait accusateur ou bien plus humain, prenant en compte les difficultés économiques et familiales de ces individus.
A.1. Re-interpreting the Robinson Skyphos
Authors: Muccigrosso John D.
Published: September 2019

The scene on the Robinson skyphos was wrongly identified for years as a depiction of clay‐working, either in a kiln or other preparation area. Recent scholarship has correctly identified it instead as one related to the grain harvest. This article presents a new examination of the scene, pointing out details the importance of which had not previously been noted. It also brings to bear comparanda from Egyptian art which put the identification of the scene beyond doubt.
A.2. Stolen fire: Aeschylean imagery and Thoreau’s identification of the Graius homo of Lucretius with Prometheus
Authors: Seelinger Robert A.
Published: September 2019

In his Journal for April 26, 1856, Thoreau noted that he had quickly looked over the first 200 lines of the De Rerum Natura but was “…struck only with the lines referring to Promethius (sic)—whose vivida vis animi…extra/processit longe flammantia moenia mundi.” (1.72–73) During this time (i.e., late April and into May) Thoreau was reading the Roman agricultural writers Columella and Palladius, and it is unclear what led him to pick up the De Rerum Natura and then discard it so quickly. Perhaps most curious is Thoreau’s comment that lines 72–73 refer to Prometheus. No commentator in the context of Thoreau has noted that Lucretius is not actually referring to Prometheus in these lines but to Epicurus. The goal of this paper is to show how these lines in their wording and imagery may have reminded Thoreau of Aeschylus’ description of Prometheus in Prometheus Bound and led him to conclude that lines 1.72–73 of the De Rerum Natura refer to Prometheus.
Clinical Guideline Highlights for the Hospitalist: Diagnosis and Management of Clostridium difficile in Adults
Authors: Parsons Andrew S , Burger Alfred , Pahwa Amit K
Published: September 2019

GUIDELINE TITLE

2018 Infectious Disease Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) Clostridium difficile infection (CDI) clinical practice guideline

RELEASE DATE

February 15, 2018

PRIOR VERSION

2010 Infectious Disease Society of America (IDSA)/Society for Healthcare Epidemiology of America (SHEA) Clostridium difficile infection (CDI) clinical practice guideline

DEVELOPER

A panel of 14 multidisciplinary experts

FUNDING SOURCE

IDSA and SHEA

TARGET POPULATION

Adult and pediatric patients at risk for or diagnosed with Clostridium difficile infection based on a literature review with a defined search period of 2009–2016. This review will focus on adult patients.