bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence and treatment of bleeding episodes in non-severe haemophilia A patients with inhibitors
Authors: Velzen Alice S. van , Eckhardt Corien L. , Streefkerk Nina , Peters Marjolein , Hart Daniel P. , Hamulyak Karly , Klamroth Robert , Meijer Karina , Nijziel Marten , Schinco Piercarla , Yee Thynn T. , Bom Johanna G. van der , Fijnvandraat Karin ,   for the INSIGHT study group
Published: November 2015

The development of an inhibitory antibody in non-severe haemophilia A patients may aggravate the bleeding phenotype considerably. Effective treatment of bleeding episodes may be challenging, with ensuing severe complications. At present, evidence is scarce for optimal treatment of bleeding episodes in this patient group. The aim of this study was to describe the incidence and the treatment of bleeding episodes in inhibitor patients in a population-based unselected cohort of non-severe haemophilia A patients with clinically relevant inhibitors. Data were available for 100 of the 107 non-severe haemophilia A patients (factor VIII (FVIII) baseline, 2–40 lU/dl) from 29 centres in Europe and one centre in Australia who had developed a clinically relevant inhibitor between 1980 and 2011. The majority (89 %) of the patients were treated during the inhibitor period for bleeding episodes or a surgical intervention: 66 % needed treatment for bleeding episodes, at a median annual bleeding rate (ABR) of 1.1 (interquartile range (IQR) 0.1–2.5) and a median total of 2 (IQR 1–6) bleeding episodes. Compared to the median ABR before inhibitor development of 0.095 bleeds per year (IQR 0.02–0.42), the increase in ABR is more than a 10-fold. More than 90 % of the bleeding episodes were treated with only one type of product, most frequently (51 %) FVIII concentrates. This study provides the incidence of bleeding episodes and treatment choices in non-severe haemophilia A patients with inhibitors. The 10-fold increase to a median ABR of 1.1 episodes per year emphasizes the impact of inhibitor development for non-severe haemophilia A patients.
Identification of the (Pro)renin Receptor as a Novel Regulator of Low-Density Lipoprotein Metabolism
Authors: Lu Xifeng , Meima Marcel E. , Nelson Jessica K. , Sorrentino Vincenzo , Loregger Anke , Scheij Saskia , Dekkers Dick H.W. , Mulder Monique T. , Demmers Jeroen A.A. , M-Dallinga-Thie Geesje , Zelcer Noam , Danser A.H. Jan
Published: November 2015

Rationale:

The (pro)renin receptor ([P]RR) interacts with (pro)renin at concentrations that are >1000× higher than observed under (patho)physiological conditions. Recent studies have identified renin–angiotensin system–independent functions for (P)RR related to its association with the vacuolar H
+
-ATPase.

Objective:

To uncover renin–angiotensin system–independent functions of the (P)RR.

Methods and Results:

We used a proteomics-based approach to purify and identify (P)RR-interacting proteins. This resulted in identification of sortilin-1 (SORT1) as a high-confidence (P)RR-interacting protein, a finding which was confirmed by coimmunoprecipitation of endogenous (P)RR and SORT1. Functionally, silencing
(P)RR
expression in hepatocytes decreased SORT1 and low-density lipoprotein (LDL) receptor protein abundance and, as a consequence, resulted in severely attenuated cellular LDL uptake. In contrast to LDL, endocytosis of epidermal growth factor or transferrin remained unaffected by silencing of the (P)RR. Importantly, reduction of LDL receptor and SORT1 protein abundance occurred in the absence of changes in their corresponding transcript level. Consistent with a post-transcriptional event, degradation of the LDL receptor induced by (P)RR silencing could be reversed by lysosomotropic agents, such as bafilomycin A1.

Conclusions:

Our study identifies a renin–angiotensin system–independent function for the (P)RR in the regulation of LDL metabolism by controlling the levels of SORT1 and LDL receptor.
Exercise Strain Echocardiography in Patients With a Hemodynamically Significant Myocardial Bridge Assessed by Physiological Study
Authors: Kobayashi Yukari , Tremmel Jennifer A. , Kobayashi Yuhei , Amsallem Myriam , Tanaka Shigemitsu , Yamada Ryotaro , Rogers Ian S. , Haddad Francois , Schnittger Ingela
Published: November 2015

Background

Although a myocardial bridge (
MB
) is often regarded as a benign coronary variant, recent studies have associated
MB
with focal myocardial ischemia. The physiological consequences of
MB
on ventricular function during stress have not been well established.

Methods and Results

We enrolled 58 patients with
MB
of the left anterior descending artery, diagnosed by intravascular ultrasound. Patients underwent invasive physiological evaluation of the
MB
by diastolic fractional flow reserve during dobutamine challenge and exercise echocardiography. Septal and lateral longitudinal strain (LS) were assessed at rest and immediately after exercise and compared with strain of matched controls. Absolute and relative changes in strain were also calculated. The mean age was 42.5±16.0 years. Fifty‐five patients had a
diastolic fractional flow reserve
≤0.76. At rest, there was no significant difference between the 2 groups in septal LS (19.0±1.8% for patients with
MB
versus 19.2±1.5% for control,
P
=0.53) and lateral
LS
 (20.1±2.0% versus 20.0±1.6%,
P
=0.83). With stress, compared with controls, patients with
MB
had a lower peak septal
LS
(18.9±2.6% versus 21.7±1.6%,
P
<0.001) and lower absolute (−0.1±2.1% versus 2.5±1.3%,
P
<0.001) and relative change (−0.6±11.2% versus 13.1±7.8%,
P
<0.001) in septal
LS
, whereas there was no significant difference in lateral
LS
. In multivariate analysis,
diastolic fractional flow reserve
and length were independent determinants of lower changes in septal LS.

Conclusions

Patients with a hemodynamically significant
MB
, determined by invasive
diastolic fractional flow reserve
, have significantly lower change in septal
LS
on exercise echocardiography, suggesting that septal
LS
may be useful for noninvasively assessing the hemodynamic significance of an
MB
.
SeIns: Semantic Instability in Art
Authors: Muth Claudia , Carbon Claus-Christian
Published: November 2015

Many artworks defy determinacy of meaning by inducing a variety of potential meanings. We aim to describe different kinds of such semantic instability (which we call ‘SeIns’) by comparing related concepts as well as specific phenomena in order to arrive at concise definitions. These analyses will be positioned in the framework of Predictive Coding. Furthermore, this article fathoms the specifics of semantic instability in art and presents a psycho-aesthetic account on the appeal of semantic instability in art. We propose that one factor for the appeal of semantic instability might be that it offers the opportunity of rewarding insight. Furthermore, we suggest that positive affect can be gained not only by arriving at an insight but also by anticipating it — a crucial point with regard to those kinds of semantic instability that are not ‘resolvable’ into semantic stability. Current challenges within this field of research include the necessity of an empirical approach to classes of semantic instability, the lack of a specification of psycho-aesthetic theories on the appeal of each class, as well as the need for an integration of context- and person-related facets of the experience of art.
Implementation of Web-Based Autism Screening in an Urban Clinic
Authors: Brooks Bianca A. , Haynes Kiauhna , Smith Joy , McFadden Terri , Robins Diana L.
Published: November 2015

Screening toddlers for autism spectrum disorder (ASD) with the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) has been shown to lower age of diagnosis by 2 years. In order to streamline ASD screening, research is exploring the use of web-based screening during well-child checkups. The current study examined implementation of the web-based M-CHAT-R in an urban pediatric clinic in Atlanta, Georgia. Toddlers (N = 2557; 87% African American) were screened during well-child visits ( Mage = 22.43 months, SD = 3.65). Using the web-based version resulted in a 58.5% increase in the number of cases screened per month. A similar proportion of toddlers in each modality screened positive ( P = .43), but significantly fewer children were missing “Follow-up” in the web-based administration ( P < .001). These results suggest that it is feasible to implement web-based screening in underserved populations. Future research is necessary to understand factors that facilitate successful implementation of web-based ASD screening.
From ISIS to ICISS: A critical return to the Responsibility to Protect report
Authors: Cunliffe Philip
Published: November 2015

In light of the post-intervention crisis in Libya, this article revisits critically the vision of the Responsibility to Protect (R2P) offered in the 2001 report of the International Commission on Intervention and State Sovereignty (ICISS) – frequently taken as the conceptual bedrock for R2P doctrine. It is argued that the perverse effect of ICISS doctrine is to replace political responsibility with paternalism. The demand that states be made accountable to the international community ends by making states accountable for their people rather than to their people. The argument is developed across five critical theses. These include claims that R2P changes the burden of justification for intervention, that it usurps popular sovereignty in favour of state power, and that it diffuses post-conflict responsibilities. The article concludes that pre-emptive ‘human protection’ efforts risk crowding out questions of systemic transformation, i.e. what kind of an international order we want to live in.
What’s Age Got to Do With It? Comparing Juveniles and Adults on Drugs and Crime
Authors: Leal Wanda , Mier Carrie
Published: November 2015

Age and drugs are both well-known correlates of crime, with the age–crime curve being a staple in criminology. However, the relationship between age and crime (especially certain types of crime) is still highly debated. For drug use, the evidence is mixed when it comes to the effects of age. Unfortunately, there is little research on how age affects the relationship between drugs and crime. The current study aims to determine whether there are differences in the relationship between drugs and crime depending on age by conducting the same analysis on a sample of adults and adolescents. The results indicate that there are substantial differences between the adult and juvenile samples, in terms of their drug use and criminal involvement.
Local Coherence and Preemptive Digging-in Effects in German
Authors: Paape Dario , Vasishth Shravan
Published: November 2015

SOPARSE predicts so-called local coherence effects: locally plausible but globally impossible parses of substrings can exert a distracting influence during sentence processing. Additionally, it predicts digging-in effects: the longer the parser stays committed to a particular analysis, the harder it becomes to inhibit that analysis. We investigated the interaction of these two predictions using German sentences. Results from a self-paced reading study show that the processing difficulty caused by a local coherence can be reduced by first allowing the globally correct parse to become entrenched, which supports SOPARSE’s assumptions.
Abdominal migraine
Authors: Napthali Kate , Koloski Natasha , Talley Nicholas J
Published: November 2015

Background

Abdominal migraine (AM) is a syndrome usually recognised in childhood. The syndrome is characterised by episodic attacks of severe abdominal pain and vasomotor symptoms, nausea and vomiting. It is a poorly understood disorder largely due to a limited recognition of this condition by the medical community. However, the publication of AM diagnostic guidelines by the International Headache Society a decade ago and the recognition of AM in the Rome Classification of functional gastrointestinal disorders have helped to legitimise this disorder and facilitate research.

Overview

AM is relatively common, affecting up to 4% of the paediatric population. Whilst AM is not believed to continue into adulthood for the majority of children, it has the propensity to develop into probable migraine and recurrent abdominal pain in adulthood. The pathophysiology of this condition remains unclear and as a result treatment for this condition is suboptimal with avoidance of triggers and prophylactic treatment currently recommended when an episode begins.

Conclusion

The recognition of AM by the IHS and the Rome Foundation should help facilitate future research into the pathophysiology of this debilitating condition and as a result better treatments for AM should emerge. Randomised controlled trials should be a priority.
Articular Cartilage Degenerates After Subtotal/Total Lateral Meniscectomy but Radiographic Arthrosis Progression Is Reduced After Meniscal Transplantation
Authors: Lee Bum-Sik , Bin Seong-Il , Kim Jong-Min
Published: November 2015

Background:

Little is known about the degree of articular cartilage degeneration after subtotal/total lateral meniscectomy in patients who later undergo isolated lateral meniscal allograft transplantation (LMAT). It has not yet been studied whether arthritic changes as shown on radiographs were lower during the posttransplantation period than during the meniscus-deficient period.

Hypothesis:

Articular cartilage will significantly degenerate during the meniscus-deficient period, but the progression in radiographic arthrosis is reduced after LMAT.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study retrospectively reviewed 49 patients who underwent subtotal/total lateral meniscectomy before isolated LMAT performed over 1 year later by the same surgeon. International Cartilage Repair Society (ICRS) grades of the femorotibial joint at the time of subtotal/total meniscectomy and at LMAT were compared. Radiographic evaluation was performed at the time of initial meniscectomy, LMAT, and the latest follow-up in 38 patients (after 11 patients whose radiographs showed incomplete ossification at the time of meniscectomy were excluded). Arthrosis, based on Kellgren-Lawrence (K-L) grades, was determined on standing anteroposterior views. Joint space width (JSW) was measured on weightbearing flexion posteroanterior views.

Results:

Over a mean meniscus-deficient period of 4.5 years (range, 1-13 years), articular cartilage significantly degenerated on the femoral and tibial sides ( P < .001). Grade ≥3 degeneration on the lateral tibial plateau was observed in 13 patients (27%) at the time of initial meniscectomy; this incidence doubled to 28 patients (57%) by the time of LMAT. The K-L grades worsened ( P < .001) and JSWs narrowed significantly (–0.65 ± 1.09 mm; P = .001) during the mean meniscus-deficient period of 3.1 years. At radiographic assessment, however, the K-L grades ( P = .097) and JSWs (4.06 ± 1.19 vs 3.92 ± 1.21 mm; mean difference, –0.14 ± 0.68 mm; P = .213) did not significantly change during the mean posttransplantation period of 3.8 years. The changes in ICRS grade and JSW during the meniscus-deficient period were not associated with age, body mass index, mechanical axis deviation, or Tegner activity level ( P > .05 for all relationships).

Conclusion:

Patients who underwent isolated LMAT showed substantial articular cartilage degeneration at the time of initial subtotal/total lateral meniscectomy, and this degeneration progressed thereafter. Further progression of radiographic arthrosis was delayed after LMAT.
Motivations Associated With Nondisclosure of Self-Reported Concussions in Former Collegiate Athletes
Authors: Kerr Zachary Y. , Register-Mihalik Johna K. , Kroshus Emily , Baugh Christine M. , Marshall Stephen W.
Published: November 2015

Background:

Previous studies examining nondisclosure among athletes in various settings have found substantial proportions of athletes with undisclosed concussions. Substantial gaps exist in our understanding of the factors influencing athletes’ disclosure of sports-related concussions.

Purpose:

To examine the prevalence of, and factors associated with, nondisclosure of recalled concussions in former collegiate athletes.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Former collegiate athletes (N = 797) completed an online questionnaire. Respondents recalled self-identified sports-related concussions (SISRCs) that they sustained while playing sports in high school, college, or professionally, and whether they disclosed these SISRCs to others. Respondents also recalled motivations for nondisclosure. The prevalence of nondisclosure was calculated among those who recalled SISRCs. Multivariate binomial regression estimated adjusted prevalence ratios (PRs) with 95% CIs, controlling for sex, level of contact in sports, and year the athletes began playing collegiate sports.

Results:

A total of 214 respondents (26.9%) reported sustaining at least 1 SISRC. Of these, 71 (33.2%) reported not disclosing at least 1 SISRC. Former football athletes were most likely to report nondisclosure (68.3% of those recalling SISRCs); female athletes who participated in low/noncontact sports were the least likely to report nondisclosure (11.1% of those recalling SISRC). The prevalence of nondisclosure was higher among men than women in the univariate analysis (PR, 2.88; 95% CI, 1.62-5.14), multivariate analysis (PR, 2.11; 95% CI, 1.13-3.96), and multivariate analysis excluding former football athletes (PR, 2.11; 95% CI, 1.12-3.94). The most commonly reported motivations were as follows: did not want to leave the game/practice (78.9%), did not want to let the team down (71.8%), did not know it was a concussion (70.4%), and did not think it was serious enough (70.4%).

Conclusion:

Consistent with previous studies, a substantial proportion of former athletes recalled SISRCs that were not disclosed. Male athletes were less likely to disclose all of their SISRCs than female athletes.
Who’s “King of the Mountain”?: “Nature” as a Criterion of Distinction in a Resort Town
Authors: Steward Shelly
Published: November 2015

This project examines how three groups in a winter resort town develop criteria of distinction through their everyday interactions. These groups—working-class locals, ski bums from privileged backgrounds holding low-wage jobs, and wealthy vacationers—each employ the idea of “nature” to distinguish themselves. Locals perform their perceived connection to “nature”—their interaction with and dependence on physical surroundings—to ski bums. Ski bums then draw on prior knowledge to redefine “nature,” stressing its separation from humans, in order to apply it as a criterion of exclusion back toward the locals. Vacationers adopt a similar definition and use it to ally themselves with the ski bums, exclude the locals, and establish their own legitimacy. Challenging most models of cultural diffusion, the privileged ski bums and vacationers implicitly recognize the terms of distinction set by the marginalized locals, indicating that group’s potential for cultural innovation.
Mode of detection: an independent prognostic factor for women with breast cancer
Authors: Hofvind Solveig , Holen Åsne , Román Marta , Sebuødegård Sofie , Puig-Vives Montse , Akslen Lars
Published: November 2015

Objectives

To investigate breast cancer survival and risk of breast cancer death by detection mode (screen-detected, interval, and detected outside the screening programme), adjusting for prognostic and predictive tumour characteristics.

Methods

Information about detection mode, prognostic (age, tumour size, histologic grade, lymph node status) and predictive factors (molecular subtypes based on immunohistochemical analyses of hormone receptor status (estrogen and progesterone) and Her2 status) were available for 8344 women in Norway aged 50–69 at diagnosis of breast cancer, 2005–2011. A total of 255 breast cancer deaths were registered by the end of 2011. Kaplan-Meier method was used to estimate six years breast cancer specific survival and Cox proportional hazard model to estimate hazard ratio (HR) for breast cancer death by detection mode, adjusting for prognostic and predictive factors.

Results

Women with screen-detected cancer had favourable prognostic and predictive tumour characteristics compared with interval cancers and those detected outside the screening programme. The favourable characteristics were present for screen-detected cancers, also within the subtypes. Adjusted HR of dying from breast cancer was two times higher for women with symptomatic breast cancer (interval or outside the screening), using screen-detected tumours as the reference.

Conclusions

Detection mode is an independent prognostic factor for women diagnosed with breast cancer. Information on detection mode might be relevant for patient management to avoid overtreatment.
A Quasi-Experimental Study of Trauma-Informed Psychiatric Residential Treatment for Children and Adolescents
Authors: Boel-Studt Shamra Marie
Published: November 2015

Purpose:

The purpose of this study was to examine the effectiveness of a trauma-informed approach that was adapted for psychiatric residential treatment (PRT) for children aged 5–17.

Methods:

Data were extracted from case files of 100 youths who received traditional PRT and 105 youths who received trauma-informed PRT (TI-PRT). Outcome measures included change in functional impairment, physical restraints and locked seclusion room incidents, length of time in care, and discharge placement type.

Results:

Results of a repeated measures analysis of variance demonstrated that youth who received TI-PRT experienced greater improvements in functional impairment. Results of a zero-inflated Poisson showed that youth in TI-PRT had fewer seclusion room incidents. Finally, the average length of time in care was significantly shorter for the TI-PRT group.

Discussion:

The results support trauma-informed PRT as a promising approach for helping youth achieve greater stability in functioning and for addressing issues of long-standing concern in residential care settings.
Measuring Adolescent Social and Academic Self-Efficacy
Authors: Minter Anthony , Pritzker Suzanne
Published: November 2015

Objective:

This study examines the psychometric strength, including cross-ethnic validity, of two subscales of Muris’ Self-Efficacy Questionnaire for Children: Academic Self-Efficacy (ASE) and Social Self-Efficacy (SSE).

Methods:

A large ethnically diverse sample of 3,358 early and late adolescents completed surveys including the ASE and SSE. Analyses focused on the subscales’ psychometric properties for the aggregate sample as well as for specific racial/ethnic subgroups.

Results:

For the ASE, Cronbach’s α for the aggregate sample is .85, ranging from .84 to .86 across racial/ethnic subgroups. For the SSE, the aggregate Cronbach’s α is .81, ranging from .77 to .86 across these subgroups.

Conclusions:

While aggregate findings indicate psychometric strength, analyses of cross-ethnic validity find some factor structure and item loading differences across racial/ethnic subgroups, indicating the need to ensure accurate measurement of self-efficacy across diverse youth samples.
Renal Angiomyolipoma With Sarcoid Granulomas
Authors: Tarjan Gabor , Kim George J. , Haroon Al Rasheed Mohamed Rizwan
Published: November 2015

Angiomyolipoma is a mesenchymal neoplasm characterized by the coexpression of melanocytic and smooth muscle markers. Sarcoidosis is a multisystem disorder of unknown etiology, which presents with characteristic nonnecrotizing granulomas and rarely involves the kidney. The coexistence of renal sarcoidosis with renal neoplasms is exceedingly rare and was reported only with renal cell carcinoma. Renal sarcoidosis associated with a nonepithelial renal neoplasm, such as an angiomyolipoma has never been reported. We present the first reported case of sarcoid granulomas in a renal angiomyolipoma, including morphologic and immunohistochemical features.
Dependent modal space control: Experimental test rig
Authors: Serra Mattia , Resta Ferruccio , Ripamonti Francesco
Published: November 2015

This article presents the experimental validation of a new control technique for reducing vibration in flexible structures: Dependent modal space control. While the classic independent modal space control allows only the frequency and the damping of the controlled modes to be changed, dependent modal space control can also impose the controlled mode shapes. Depending on the kind and number of sensors and actuators available for control, the mode shape can be imposed in both a direct and an indirect way. Owing to the need for modal sensors and actuators for direct mode shape imposition, the second methodology is often preferred in many engineering applications. In the indirect method, the optimal closed loop mode shapes set is computed with an optimization algorithm in order to minimize an Input-Output Performance Index. The worsening spillover effects due to errors in the estimates of the system state variables are considered when computing the gain matrix and play an important role in the entire control logic. Experimental validation on a cantilevered beam shows the effectiveness of the dependent modal space control and a good match between the numerical and the experimental results.
Adult ADHD Symptoms and Satisfaction With Life: Does Age and Sex Matter?
Authors: Oerbeck Beate , Overgaard Kristin , Pripp Are Hugo , Aase Heidi , Reichborn-Kjennerud Ted , Zeiner Pål
Published: November 2015

Objective: To investigate adult ADHD symptoms and satisfaction with life, with a focus on age and sex differences. Method: This study is based on parents in the Norwegian Mother and Child Cohort Study (MoBa). The Adult Self-Report Scale (ASRS-6) and Satisfaction With Life Scale (SWLS) scores were analyzed from 33,210 men and 41,983 women from young to middle adulthood. Results: Mean ASRS total score was significantly higher in men, where 5.1% scored above cutoff, compared with 2.9% in women. Factor loadings supported the two ASRS subscales: Inattention (Inatt) and Hyperactivity-Impulsivity (HyImp) in both sexes. A significant decline with age was found on HyImp, whereas Inatt scores were reasonably stable in men and u-curved in women. High ASRS scores were associated with lower SWLS, but poor satisfaction with life was found only in high-scoring women. Conclusion: Our findings suggest caution to age and sex when using the ASRS-6.
Chinese hotel guest perception of international chain hotels under the same hotel brand in different travel destinations
Authors: Sun Sunny , Tong Karen TszLun , Law Rob
Published: November 2015

A qualitative approach was employed to examine how Chinese hotel guests perceive international chain hotels in different travel destinations (i.e. China and abroad) under the same brand. A total of 13,204 reviews were retrieved from online hotel review Web sites, namely DaoDao.com and Ctrip.com . Content analysis of the reviews showed discrepancies in the perceptions. Chinese favoritism toward the West affected the perception of hotel service quality. Empirical results revealed the belief that hotel services in Western cities and Hong Kong are better compared with those of hotels in China. However, the perception in terms of location, rooms and facilities, cleanliness, and value was mainly affected by the experience during the actual hotel stay. No noticeable influence of Chinese favoritism was found.
Linking event quality to economic impact
Authors: Andersson Tommy D , Armbrecht John , Lundberg Erik
Published: November 2015

The aim of this study is to develop and test, in an event context, a model describing the relationships between perceived quality, satisfaction, use value and consumer expenditures. A model is proposed and tested using data from a Web and telephone survey of 326 visitors to a Swedish music festival. Findings from bivariate correlation, multiple regression and structural equation models show that links are significant and support a chain of dependencies. Better managed festivals seem to generate higher economic impact at the destination as well as in the festival area. Implications of this are that festival managers can influence the economic impact by careful design, planning and operation of the festival and that the DMO can positively influence the economic impact by monitoring the quality of publicly supported festivals and events. Quality standards and quality certification could provide means for such developments.
The disclosure of police-held ‘non-conviction information’ to employers
Authors: Marshall Daniel , Thomas Terry
Published: November 2015

The police have been disclosing criminal records and other non-conviction information to employers for the last 30 years as part of the pre-employment screening of job applicants. This employment has largely consisted of work with children and vulnerable adults. The Criminal Records Bureau (CRB) took some of this work – the disclosure of criminal records – off the police in 2002 and its successor, the Disclosure and Barring Service (DBS), has continued to do so since 2012. The police, however, have always been left with the residual task of deciding what other ‘non-conviction information’ should be passed to employers. This article seeks to critically examine the disclosure of non-conviction information to employers by the police. The background and legal and ethical context surrounding this area of police decision-making are considered, as are the guidance provided to the police, the practicalities of decision-making and the additional guidance published for the police on similar disclosures; we also consider the court judgements that have been both supportive and critical of this area of police decision-making.
Endovascular vs Open Aneurysm Repair in the Young
Authors: Kontopodis Nikolaos , Antoniou Stavros A. , Georgakarakos Efstratios , Ioannou Christos V.
Published: November 2015

Purpose: To examine the results of elective abdominal aortic aneurysm (AAA) repair in young patients (<70 years old) and compare the outcome of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) techniques. Methods: The MEDLINE, CENTRAL, and OpenGray databases were searched from January 2000 to March 2015. Periprocedural (30-day mortality and morbidity, length of hospitalization) and long-term outcomes (long-term mortality, rate of secondary procedures) were compared between young patients undergoing EVAR and OSR. For the meta-analysis of comparative studies, the random effects model was used to calculate combined overall effect sizes of pooled data. One randomized control trial and 8 observational studies were included in the analysis. Data are presented as the odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI). Results: EVAR was associated with a decreased risk of 30-day mortality (OR 0.25, 95% CI 0.14 to 0.42, p<0.001) and 30-day morbidity (OR 0.36, 95% CI 0.22 to 0.58, p<0.001) and shorter length of hospitalization (MD −4.28 days, 95% CI −4.86 to −3.70, p<0.001). Moreover, a potential long-term survival benefit did not reach statistical significance (OR 0.48, 95% CI 0.17 to 1.34, p=0.16), whereas the need for reintervention was similar between EVAR and OSR groups (OR 0.94, 95% CI 0.61 to 1.54, p=0.89). Conclusion: There are insufficient data for definite conclusions to be drawn regarding the relative effectiveness of EVAR and OSR in young subjects. Contemporary evidence suggests that EVAR should not be discouraged in this cohort of patients based solely on the age criterion.
Common Iliac Artery Aneurysm Repair Using a Sac-Anchoring Endograft to Preserve the Internal Iliac Artery
Authors: ter Mors Thijs G. , van Sterkenburg Steven M. M. , van den Ham Leo H. , Reijnen Michel M. P. J.
Published: November 2015

Purpose: To report the application of the Nellix endovascular aneurysm sealing system to successfully treat a unilateral common iliac aneurysm and preserve the internal iliac artery. Case Report: An 85-year-old man presented with right-sided necrosis of the third and fourth toe. Computed tomography angiography (CTA) showed a right 40-mm popliteal aneurysm and a 38-mm left fusiform common iliac artery aneurysm. After endovascular exclusion of the popliteal aneurysm, the Nellix device was positioned to exclude the common iliac artery aneurysm while preserving the internal iliac artery. Postoperative CTA showed no endoleak and a patent internal iliac artery. At 1 year, duplex ultrasound documented a common iliac aneurysm diameter of 32 mm without complications. Conclusion: Endovascular sealing using the Nellix device can be applied to exclude selected common iliac artery aneurysms with an adequate length and a minimal distal neck, with preservation of the internal iliac artery. The endobag can be positioned such that the aneurysm is completely excluded while the orifice of the side branch is not endangered.
Gendered Self-Concepts and Drinking Behavior in a National Sample of Emerging Adults
Authors: Clinkinbeard Samantha S. , Barnum Timothy C.
Published: November 2015

Despite evidence that males drink more than females, there is much to be learned about gendered explanations for sex differences in alcohol use. We use the National Longitudinal Study of Adolescent to Adult Health data to investigate gendered self-concept as related to alcohol use and related consequences among a sample of emerging adults. Dominance Masculinity (e.g., being aggressive, forceful, dominant) was the most consistent predictor of alcohol-related outcomes for both males and females. Endorsement of feminine characteristics (e.g., compassion, understanding, sympathetic) was protective against binge drinking and social consequences for males whereas endorsement of general masculine characteristics (e.g., independent, assertive, leader) protected against social consequences for females.
Measuring thumb range of motion in first carpometacarpal joint arthritis: The inter-rater reliability of the Kapandji Index versus goniometry
Authors: Jha Bhavana , Ross Mark , Reeves Samuel WSL , Couzens Gregory B , Peters Susan E
Published: November 2015

Introduction

Goniometric measurement of thumb range of motion is often used as an outcome measure in assessing patients with first carpometacarpal osteoarthritis. Despite common use and demonstrated construct validity, the reliability of this technique has not been well established. The Kapandji Index is an alternate functional measure of thumb motion suitable for use with this client group. The purpose of this study was to examine the inter-rater reliability of the goniometric measures for thumb joint range of motion compared to the Kapandji Index in patients with first carpometacarpal joint osteoarthritis.

Methods

Two independent assessors, who were blind to each other’s measurements, measured thumb range of motion in 33 patients (54 thumbs). All participants were undergoing treatment for carpometacarpal joint osteoarthritis. Active range of motion was measured with a goniometer for all the thumb joints using a standardised measurement protocol. The Kapandji Index score was recorded. Relative reliability was assessed by using the intraclass correlation coefficient. Absolute reliability was also calculated by determining the standard error of measurement (SEM68) and the minimal detectable difference (MDD90).

Results

Inter-rater reliability for the goniometer was highly variable ranging from poor to excellent (intraclass correlation coefficient 0.128–0.860). The SEM68 ranged from 9° to 13°, and the resulting MDD90 varied from 21° to 31° for the different thumb joints. The Kapandji Index had excellent inter-rater reliability among the different raters (intraclass correlation coefficient 0.772–0.917).

Conclusions

Measurement of goniometric active range of motion of the thumb may have limited utility as a measure of clinical effectiveness for patients with carpometacarpal joint osteoarthritis. However, the Kapandji Index is a reliable measure of functional range of motion.
Early interventions for tentorial dural arteriovenous fistula
Authors: Chen Pin Yu , Lai Siang Hui , Seela Raj Santhosh Raj , Lim Winston Eng Hoe
Published: November 2015

Dural arteriovenous fistulae (DAVF) constitute 10–15% of all intracranial vascular malformations. As a subtype of DAVF, tentorial DAVF are even rarer, but their aggressive nature warrants early intervention. With regards to symptoms, 70–88% of the cases present with bruits or tinnitus, 60–74% with intracranial haemorrhages, 23–42% with central nerve deficits, 14–17% with cranial nerve deficits, and finally 8–25 % with headaches. Here we report three cases of tentorial DAVF with a primary manifestation of headaches: the first patient is a 44-year-old woman who presented with a severe, persistent sharp occipital headache for 1 day. She deteriorated quickly after admission and required emergency posterior fossa decompression for evacuation of an acute right cerebellar haematoma. Intra-operative and pathological findings suggested a cerebellar arteriovenous malformation. She subsequently underwent transarterial embolisation and surgical excision of the lesion. A review of the histopathological features will be presented. The second case is a 61-year-old male with a 3–4-day history of headache and vomiting prior to presenting to the emergency department with acute delirium secondary to subarachnoid haemorrhage in the posterior fossa. The third case is a 55-year-old woman with moderate, recurrent generalised headaches for 4–5 years. She was managed expediently with transarterial embolisation and had a good outcome. In view of the poor prognosis associated with DAVF rupture, early diagnosis and treatment is warranted to achieve favourable outcomes.
Model Fitting Versus Curve Fitting: A Model of Renormalization Provides a Better Account of Age Aftereffects Than a Model of Local Repulsion
Authors: O’Neil Sean F. , Mac Amy , Rhodes Gillian , Webster Michael A.
Published: November 2015

Recently, we proposed that the aftereffects of adapting to facial age are consistent with a renormalization of the perceived age (e.g., so that after adapting to a younger or older age, all ages appear slightly older or younger, respectively). This conclusion has been challenged by arguing that the aftereffects can also be accounted for by an alternative model based on repulsion (in which facial ages above or below the adapting age are biased away from the adaptor). However, we show here that this challenge was based on allowing the fitted functions to take on values which are implausible and incompatible across the different adapting conditions. When the fits are constrained or interpreted in terms of standard assumptions about normalization and repulsion, then the two analyses both agree in pointing to a pattern of renormalization in age aftereffects.
Erectile dysfunction following end-to-end urethroplasty in pelvic fracture urethral distraction defect patients
Authors: Patwardhan Sujata K , Shelke Umesh R , Ismail Attar Mohammad , Kaje Yogesh D , Singh Abhishek G , Daga Sudarshan
Published: November 2015

Objectives:

The close relationship of the neuro-vascular bundle, cavernosal tissue of the penis and the bony pelvis results in high risk of concomitant injury associated with pelvis fractures, with resultant urethral defect and erectile dysfunction (ED). The present study aims to analyse and correlate the type of trauma, number of surgical interventions, urethral defect length and surgical steps performed during urethroplasty with erectile function.

Method:

This was an observational study. All patients with pelvis fracture urethral distraction defect (PFUDD) who required end-to-end urethroplasty (E-E urethroplasty) from August 2010 to July 2014 were included.

Results:

Thirty-four per cent had defect length of 0.5–2 cm, 50% had defect length of 2.1–4 cm. Of 32, 34% required re-intervention. Inferior pubectomy was required in 36% in the 0.5–2 cm group and in 94% in the 2.1–4 cm group. On follow-up, 22% of patients had neurogenic ED, and 63% had vascular ED, of whom 44% had arterial, 3% had venous, and 16% had mixed aetiology. Patients with neurogenic aetiology had shorter urethral defect and 43% needed inferior pubectomy. Patients with vascular aetiology had longer urethral defect, 90% required inferior pubectomy.

Conclusions:

ED is related to the length of urethral defect, and operative manoeuvers performed during E-E urethroplasty.
Severe Congenital Obstruction of the Left Main Coronary Artery Coexisting With Supravalvular Aortic Stenosis in Williams Syndrome
Authors: Szaflik Katarzyna , Kaźmierczak Piotr , Moll Jacek Jan , Moll Jadwiga Anna
Published: November 2015

Congenital obstruction of the left main coronary artery is a complicating feature of supravalvular aortic stenosis. We describe an eight-month-old female patient with Williams syndrome, supravalvular aortic stenosis, and branch pulmonary artery stenosis, with concomitant anomaly of severe obstruction of the left coronary artery orifice.
Fiscal Policy and Economic Growth in Nigeria
Authors: Agu Sylvia Uchenna , Okwo Ifeoma Mary , Ugwunta Okelue David , Idike Adeline
Published: November 2015

This article aims at determining the impact of various components of fiscal policy on the Nigerian economy. We simply used descriptive statistics to show contribution of government fiscal policy to economic growth, and to ascertain and explain growth rates, and an ordinary least square (OLS) in a multiple form to ascertain the relationship between economic growth and government expenditure components after ensuring data stationarity. Findings revealed that total government expenditures have tended to increase with government revenue, with expenditures peaking faster than revenue. Investment expenditures were much lower than recurrent expenditures evidencing the poor growth in the country’s economy. Hence, there is some evidence of positive correlation between government expenditure on economic services and economic growth. Therefore, in public spending, it is important to note that the effectiveness of the private sector depends on the stability and predictability of the public incentive framework, which promotes or crowds out private investment.
Low-Molecular-Weight Heparin Prophylaxis Dosing
Authors: Minze Molly G. , Kwee Yu-Yu , Hall Ronald G.
Published: November 2015

Objective. To evaluate the pharmacokinetic, safety, and effectiveness data of dosing low-molecular-weight heparins (LMWHs) for prophylaxis of venous thromboembolic events (VTEs) in obese people. Data Sources. A PubMed search (1966 to September 2015) was performed of published English articles using the following keywords: low-molecular-weight heparin, prophylaxis, and obesity. Study Selection and Data Extraction. In all, a total of 11 articles were included in this review. The search was conducted to identify pharmacokinetic studies, clinical trials (phases I-IV), or retrospective evaluations of the impact of weight and/or obesity on anti-Xa levels as well as the safety and effectiveness of LMWHs used for VTE prophylaxis. Data Synthesis. The vast majority of the available data focus on enoxaparin. Pharmacokinetic, effectiveness, and safety data all support increased enoxaparin dosing in obese patients. However, the optimal adjustment remains uncertain. For now, we recommend using 40 mg twice daily as the data for effectiveness use this regimen. Dalteparin dosing should not be adjusted in class I-II obese (body mass index 30.0-39.9 kg/m2) patients. Data regarding the impact of class III obesity (body mass index ≥40 kg/m2) on dalteparin effectiveness is needed. Total body weight dosing of tinzaparin can be used to optimize anti-Xa levels, but safety and effectiveness data are needed before weight-based tinzaparin dosing is routine medical practice for obese patients. Conclusions. The data regarding dosing of LMWHs for VTE prophylaxis are quite limited. High-quality studies are needed to help optimize dosing for obese adults requiring LMWH prophylaxis.
Cystic Pulmonary Airway Malformation in Abidjan (Côte d’Ivoire)
Authors: Konaté Issa , Gnaoulé Debato T. , Kouassi Kouame P. B. , Bravo-Tsri Akoli E. B. , Tanoh Kesse E. , Asse Kouadio V. , N’dri Kouadio
Published: November 2015

Cystic pulmonary airway malformation, or Craig’s disease, is a rare congenital abnormality of lung development. Medical imaging, particularly Doppler ultrasound, is currently one of the recommended methods for prenatal diagnosis and for the monitoring of this condition. We report three cases of Craig’s disease diagnosed at ultrasound: one at 26 weeks of amenorrhea and two others at 30 weeks of amenorrhea. We discuss according to the literature the main ultrasound aspects and specify the place of other radiographic explorations during the monitoring of this condition.
Is there a best TKI for chronic phase CML?
Authors: Larson Richard A.
Published: November 2015

The development of BCR/ABL1 tyrosine kinase inhibitors (TKIs) over the past 20 years has dramatically improved the outcomes for patients with every stage of Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML). Clinicians now have access to 5 oral, generally well-tolerated, and highly effective TKIs. How should these agents be used for an individual patient to ensure the best possible duration and quality-of-life, to avoid treatment-related complications, and potentially to achieve a cure at an affordable cost? Because CML patients may need to continue TKI therapy indefinitely, the long-term safety of each treatment option must be considered. Evidence-based care requires an understanding of the optimal use of these drugs, their specific early and late toxicities, the prognostic significance of achieving treatment milestones, and the critical importance of molecular monitoring. Efficacy is important, but treatment choice does not depend only on efficacy. Choosing among various treatment options is informed by understanding the distinct benefits and risks of each agent, along with careful consideration of patient-specific factors, such as risk status, age, and comorbidities.