bluuebunny/crossref_metadata_2025 huggingface dataset:
Spaces & Places: Understanding Sense of Belonging and Cultural Engagement Among Indigenous Youth
Authors: Liebenberg Linda , Wall Darlene , Wood Michele , Hutt-MacLeod Daphne
Published: May 2019

Indigenous youth continue to live with a socioeconomic and political legacy of colonization and marginalization, confronted by environments harmful to their psychosocial development. Resource strained communities may compound these experiences and outcomes for many youth. Increasingly, research points to the mitigating effects of resilience for youth exposed to contextual risks. Resilience is however dependent on both personal capacities and the availability of relevant resources within families, schools, and communities. Meaningful connection to community together with cultural continuity are important contributors to resilience. However, without critical examination of the conditions that support such youth engagement, attempts at fostering these connections may be largely unsuccessful. Spaces & Places explored the cultural continuity and civic engagement of Indigenous youth living in three communities of Atlantic Canada. Using an interactive, transactional theory of resilience, we explored how youth interact with community resources, and how these interactions impact connections with their community and culture. Participatory qualitative image-based methods were used to explore the availability of spaces and how they establish a sense of belonging to community and culture for youth. We used video capture of a day-in-the-life of participants with photo elicitation in reflective interviews, within a Participatory Action Research framework. Youth and community partners actively participated in the research process, including data analysis and knowledge mobilisation.
Researching Sensitive Topics in Sensitive Zones: Exploring Silences, “The Normal,” and Tolerance in Chile
Authors: Cornejo Marcela , Rubilar Gabriela , Zapata-Sepúlveda Pamela
Published: May 2019

Based on their research experiences, three female Chilean researchers from the capital city and the north of the country reflect on political trauma and violence, poverty and exclusion, and the processes underlying the mobility of Colombian women in Chile’s northern border. In all of these research areas, “the sensitive” not only becomes a research topic but also confronts both researchers and participants as the main characters of a particular and socially situated relationship. Through their research experiences, proposals, devices, and several methodological strategies for addressing these issues are critically presented, with an emphasis on what qualitative research makes possible, challenges, questions, and faces.
Low-density lipoprotein cholesterol lowering for the prevention of cardiovascular outcomes in patients with ischemic stroke
Authors: Ntaios George , Milionis Haralampos
Published: May 2019

Background

Low-density lipoprotein (LDL) cholesterol has been long associated with the risk for ischemic stroke, myocardial infarction, and cardiovascular death. For more than a decade, the main pharmacological option to prevent stroke and myocardial infarction through LDL-cholesterol lowering was the use of statins. During the recent years, two novel classes of drugs have proven their efficacy and safety to reduce LDL-cholesterol and prevent cardiovascular events in large, well-conducted randomized controlled trials: ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.

Aims

The present review summarizes the evidence arising from the latest trials of lipid-lowering treatment for cardiovascular outcomes prevention and discusses their implications for secondary prevention strategies in patients with ischemic stroke.

Summary of review

There is strong evidence which confirms the hypothesis that the lower the LDL-cholesterol, the less frequent the cardiovascular events are and underlines the importance of treating our ischemic stroke patients with intensive statin treatment aiming at low LDL-cholesterol levels. The very low levels of LDL cholesterol seem to be safe, even in the mid/long term but longer follow-up data are needed. Currently there are no tools to reliably predict cardiovascular outcomes in the specific population of ischemic stroke patients.

Conclusions

Stroke physicians should aim for low LDL-cholesterol levels by intensive statin treatment in all ischemic stroke patients. For those patients who are at the highest risk for recurrent stroke or another cardiovascular event and have unacceptable LDL-cholesterol levels despite intensive statin treatment, PCSK9 inhibitors should be considered.
Tofacitinib in the treatment of ulcerative colitis: efficacy and safety from clinical trials to real-world experience
Authors: D’Amico Ferdinando , Parigi Tommaso Lorenzo , Fiorino Gionata , Peyrin-Biroulet Laurent , Danese Silvio
Published: May 2019

Tofacitinib is an oral small molecule directed against the JAK/STAT pathway, blocking the inflammatory cascade. Oral formulation of tofacitinib has recently been approved for the treatment of patients with moderate–severe ulcerative colitis. Its efficacy and safety have been demonstrated in three phase III clinical trials and confirmed by promising real-life data. The purpose of this review is to summarize the available evidence on the efficacy and safety of tofacitinib and to define its role and position in the treatment algorithms for patients with ulcerative colitis.
Brain and spine melanotic schwannoma: A rare occurrence and diagnostic dilemma
Authors: Alamer Ali , Tampieri Donatella
Published: May 2019

Purpose

Melanotic schwannoma (MS) was formerly known as a rare variant of schwannoma. The behavior of MS is unpredictable, with a tendency for recurrence and metastasis. The purpose of this study was to illustrate the imaging characteristics of these rare and misdiagnosed tumors. The prognosis of MS is discussed, along with the importance of follow-up exams to assess for recurrence and metastasis. Furthermore, we compare our results with those previously published on MS in order to have a better understanding of this rare entity.

Methods

Three MS cases were encountered between 2008 and 2015 at our institute. All available data were reviewed, including the clinical history, imaging findings, operative notes, and the histopathology results. A follow-up magnetic resonance imaging (MRI) scan was also reviewed up to 23 months post surgery to assess for recurrence.

Results

Three cases of MS are included: one in the brain and two in the spine. The brain lesion was in the occipital region. The spine lesions were thoracic intramedullary and sacral intradural. All cases were hypointense on T2-weighted imaging. Gross total resection was achieved for all lesions without adjuvant therapy. To date, the brain lesion recurred 15 months after surgery.

Conclusions

MS is a rare and distinct entity rather than a variant of schwannoma, and it poses both diagnostic and management dilemmas. Although MS has characteristic MRI features, including T1 and T2 shortening, the preoperative diagnosis is always challenging. Accurate diagnosis is crucial for management planning, including long-term follow-up exams to assess for recurrence and metastasis.
SREAT presenting as decades of intractable seizures and isolated delusional episodes with clinical, laboratory, and EEG confirmation of treatment response
Authors: Tjong Elysia , Gardner Rachael , Peng Yen-Yi
Published: May 2019

We report a case of a 60-year-old woman with a history of intractable seizures and isolated delusional psychosis who was later diagnosed with steroid-responsive encephalopathy associated with autoimmune thyroiditis. The patient underwent right temporal lobectomy (epilepsy surgery) 15 years before coming to this clinic, but continued to have focal seizures, resulting in frequent emergency room visits thereafter. After admission for intensive inpatient video electroencephalogram monitoring and subsequent 7 months of close follow-up, both the electroencephalogram abnormalities and isolated delusional psychosis were found to be responsive to immunotherapy. This suggests that her epilepsy may be autoimmune in nature. Steroid-responsive encephalopathy associated with autoimmune thyroiditis was diagnosed after 26 years since the onset of seizures. Performing invasive epilepsy surgery in patients with autoimmune epilepsy cannot reverse the inflammatory process; therefore, it is reasonable to test for autoimmune etiologies before excision surgery on patients with medically intractable epilepsy. This case demonstrates the clinical use of quantitative electroencephalogram in assisting with the diagnosis of steroid-responsive encephalopathy associated with autoimmune thyroiditis and supports that it is a spectrum disorder with protean manifestations.
Koebner phenomenon in leukocytoclastic vasculitis: A case report and an updated review of the literature
Authors: Kassam Farah , Nurmohamed Sabrina , Haber Richard M
Published: May 2019

Leukocytoclastic vasculitis is the most common form of cutaneous vasculitis. It is a neutrophilic small vessel vasculitis resulting from the deposition of circulating immune complexes. Henoch-Schonlein purpura is a systemic type of leukocytoclastic vasculitis, characterized by immunoglobulin A-mediated blood vessel injury. We present a case of Henoch-Schonlein purpura in an adult female manifesting with a vasculitic rash with Koebner phenomenon.
Degrees of Freedom: Exploring Agency, Narratives, and Technological Affordances in the #TakeAKnee Controversy
Authors: Rosenbaum Judith E.
Published: May 2019

This study extends current research into social media platforms as counterpublic spaces by examining how the social media narratives produced by the #TakeAKnee controversy negotiate technological affordances and existing discourses surrounding American national identity. Giddens’ Structuration Theory is used to explore the nature of user agency on social media platforms and the extent to which this agency is constrained or enabled by the interplay between the systems and structures that guide social media use. Exploratory qualitative content analysis was used to analyze and compare tweets and Instagram posts using the #TakeAKnee hashtag shared in September 2017. Results showed that narratives are dominated by four themes, freedom, unity, equality and justice, and respect and honor. Users actively employ technological affordances to create highly personalized meanings, affirming that agency operates at the intersection of reflexivity and self-efficacy.
Polypoid gallbladder tumors with a deep hypoechoic area and a conically thickened outermost hyperechoic layer suggest shallow T2 carcinoma
Authors: Fujimoto Taketoshi , Kato Yo
Published: May 2019

Background

Ultrasound findings of shallow T2 gallbladder carcinoma (GBC) with a favorable prognosis are not known.

Purpose

To confirm the criteria for ultrasound diagnosis of shallow T2 GBC.

Material and Methods

A detailed analysis of ultrasound and pathological correlation was conducted in two patients with pT1 GBC and seven with shallow pT2 GBC (subserosal-invasion depth ≤ 2 mm) at our institution from January 1988 to December 2017.

Results

A polypoid gallbladder tumor with a deep hypoechoic area represented a papillary adenocarcinoma invading the subserosa accompanied by abundant fibrosis and lymphocytic infiltration. Two cases of pT1 GBC did not present a deep hypoechoic area, whereas all seven cases of shallow pT2 GBC did. One case of pT1b GBC and four cases of pT2 GBC showed conical thickening of the outermost hyperechoic layer, whereas one case of pT1a GBC and three cases of pT2 GBC presented no change of the layer thickness. All shallow T2 GBCs showing a conically thickened outermost hyperechoic layer provided good postoperative prognoses.

Conclusion

Ultrasound images of shallow T2 GBC show a deep hypoechoic area with conical thickening or unchanging of an outermost hyperechoic layer. The former demonstrates pulling up the top of the layer at first and then thinning later as carcinoma invades with enlargement of the hypoechoic area, whereas the latter thinning of the layer from the beginning. Polypoid gallbladder tumors with a deep hypoechoic area and a conically thickened outermost hyperechoic layer suggest shallow T2 GBC and may provide good postoperative prognoses.
Resolution of Postsurgical Diplopia, Paresthesia, and Weakness Following Inpatient Massage Therapy: A Case Report
Authors: Hauschulz Jennifer , Clark Stephanie , Bauer Brent , Chon Tony
Published: May 2019

Massage therapy is utilized in hospitals for patients experiencing pain, anxiety, sleeplessness, among other symptoms. Postsurgical pain is one of the most common reasons massage therapy is ordered. We present a case of a 45-year-old woman who underwent ventral hernia repair. Postoperative day 2, she began to experience multiple symptoms, including double-vision, left-sided facial numbness, tremors, pain, and weakness in her left fingers, arm, and leg. A static magnetic resonance image of the brain and cervical spine were obtained, which revealed disc protrusions at C3/C4, C5/C6, C6/C7, and mild deformity of the spinal cord. The patient’s pain was difficult to control and she was unable to be weaned from intravenous pain medication. Massage therapy was ordered on postoperative days 6 and 7. During both massage sessions, as upper neck muscle tension was reduced, the therapist and patient observed several audible “pops” of the cervical spine with immediate relief of symptoms. In this particular case, massage therapy, though requested to address pain, had a secondary benefit in relieving her diplopia, left-sided facial numbness, tremors, and weakness. Although the mechanism of action is not clear, this case highlights the significant secondary beneficial effects that often occur with massage therapy.
Subjective Social Status and Possible Selves Among Emerging Adult College Students
Authors: Zorotovich Jennifer , Johnson Elizabeth I. , Anders Kristin
Published: May 2019

Possible selves and strategies serve a number of functions across the life span and are particularly relevant to emerging adulthood. Building on past research, which suggests that possible selves and strategies are contextually bound, the current study examined the relationship between objective and subjective social status and possible selves and strategies among emerging adult college students. Data were collected through an online survey ( n = 282), and multiple regressions with alpha-adjustment procedures were used. Results indicated a negative relationship between family subjective social status and expected material/lifestyles possible selves and strategies and a positive relationship between individual subjective social status and expected material/lifestyle possible selves. Findings emphasize the relationship between social status and material/lifestyle possible selves and strategies among a sample of emerging adults, which is increasingly important during this time when many are navigating pathways toward independence while balancing continued reliance on their families.
Do Clinical Outcomes and Sagittal Parameters Differ Between Diabetics and Nondiabetics for Degenerative Spondylolisthesis Undergoing Lumbar Fusion?
Authors: Khan Jannat M. , Michalski Joseph , Basques Bryce A. , Louie Philip K. , Chen Oscar , Hayani Zayd , Kalish Chaim , Elboghdady Islam , Colman Matthew , An Howard
Published: May 2019

Study Design:

Retrospective cohort study.

Objective:

To assess the effect of diabetes mellitus (DM) on clinical and radiographic outcomes in patient with degenerative spondylolisthesis undergoing posterior lumbar spinal fusion.

Methods:

Analysis of patients who underwent open posterior lumbar spinal fusion from 2011 to 2018. Patients being medically treated for DM were identified and separated from nondiabetic patients. Visual analogue scale Back/Leg pain and Oswestry Disability Index (ODI) were collected, and achievement of minimal clinically important difference was evaluated. Lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and PI-LL difference were measured on radiographs. Rates of postoperative complications were also collected.

Results:

A total of 850 patients were included; 78 (9.20%) diabetic patients and 772 (90.80%) nondiabetic patients. Final PI-LL difference was significantly larger ( P = .032) for patients with diabetes compared to no diabetes, but there were no other significant differences between radiographic measurements, operative time, or postoperative length of stay. There were no differences in clinical outcomes between the 2 groups. Diabetic patients were found to have a higher rate of discharge to a facility following surgery ( P = .018). No differences were observed in reoperation or postoperative complication.

Conclusions:

While diabetic patients had more associated comorbidities compared with nondiabetic patients, they had similar patient-reported and radiographic outcomes. Similarly, there are no differences in rates of reoperation or postoperative complications. This study indicates that diabetic patients who have undergone thorough preoperative screening of related comorbidities and appropriate selection should be considered for lumbar spinal fusion.
How to Automatically Document Data With the codebook Package to Facilitate Data Reuse
Authors: Arslan Ruben C.
Published: May 2019

Data documentation in psychology lags behind not only many other disciplines, but also basic standards of usefulness. Psychological scientists often prefer to invest the time and effort that would be necessary to document existing data well in other duties, such as writing and collecting more data. Codebooks therefore tend to be unstandardized and stored in proprietary formats, and they are rarely properly indexed in search engines. This means that rich data sets are sometimes used only once—by their creators—and left to disappear into oblivion. Even if they can find an existing data set, researchers are unlikely to publish analyses based on it if they cannot be confident that they understand it well enough. My codebook package makes it easier to generate rich metadata in human- and machine-readable codebooks. It uses metadata from existing sources and automates some tedious tasks, such as documenting psychological scales and reliabilities, summarizing descriptive statistics, and identifying patterns of missingness. The codebook R package and Web app make it possible to generate a rich codebook in a few minutes and just three clicks. Over time, its use could lead to psychological data becoming findable, accessible, interoperable, and reusable, thereby reducing research waste and benefiting both its users and the scientific community as a whole.
Development and external validation of 1- and 2-year mortality prediction models in cystic fibrosis
Authors: Stanojevic Sanja , Sykes Jenna , Stephenson Anne L. , Aaron Shawn D. , Whitmore George A.
Published: May 2019

Introduction

We aimed to develop a clinical tool for predicting 1- and 2-year risk of death for patients with cystic fibrosis (CF). The model considers patients' overall health status as well as risk of intermittent shock events in calculating the risk of death.

Methods

Canadian CF Registry data from 1982 to 2015 were used to develop a predictive risk model using threshold regression. A 2-year risk of death estimated conditional probability of surviving the second year given survival for the first year. UK CF Registry data from 2007 to 2013 were used to externally validate the model.

Results

The combined effect of CF chronic health status and CF intermittent shock risk provided a simple clinical scoring tool for assessing 1-year and 2-year risk of death for an individual CF patient. At a threshold risk of death of ≥20%, the 1-year model had a sensitivity of 74% and specificity of 96%. The area under the receiver operating curve (AUC) for the 2-year mortality model was significantly greater than the AUC for a model that predicted survival based on forced expiratory volume in 1 s <30% predicted (AUC 0.95versus0.68 respectively, p<0.001). The Canadian-derived model validated well with the UK data and correctly identified 79% of deaths and 95% of survivors in a single year in the UK.

Conclusions

The prediction models provide an accurate risk of death over a 1- and 2-year time horizon. The models performed equally well when validated in an independent UK CF population.
Cost-effectiveness of intrapleural use of tissue plasminogen activator and DNase in pleural infection: evidence from the MIST2 randomised controlled trial
Authors: Luengo-Fernandez Ramon , Penz Erika , Dobson Melissa , Psallidas Ioannis , Nunn Andrew J. , Maskell Nick A. , Rahman Najib M.
Published: May 2019

The MIST2 (Second Multicentre Intrapleural Sepsis Trial) trial showed that combined intrapleural use of tissue plasminogen activator (t-PA) and recombinant human DNase was effective when compared with single agents or placebo. However, the treatment costs are significant and overall cost-effectiveness of combined therapy remains unclear.

An economic evaluation of the MIST2 trial was performed to assess the cost-effectiveness of combined therapy. Costs included were those related to study medications, initial hospital stay and subsequent hospitalisations. Outcomes were measured in terms of life-years gained. All costs were reported in euro and in 2016 prices.

Mean annual costs were lowest in the t-PA–DNase group (EUR 10 605 for t-PA, EUR 17 856 for DNase, EUR 13 483 for placebo and EUR 7248 for t-PA–DNase; p=0.209). Mean 1-year life expectancy was 0.988 for t-PA, 0.923 for DNase, and 0.969 for both placebo and t-PA–DNase (p=0.296). Both DNase and placebo were less effective, in terms of life-years gained, and more costly than t-PA. When placebo was compared with t-PA–DNase, the incremental cost per life-year gained of placebo was EUR 1.6 billion, with a probability of 0.85 of t-PA–DNase being cost-effective.

This study demonstrates that combined t-PA–DNase is likely to be highly cost-effective. In light of this evidence, a definitive trial designed to facilitate a thorough economic evaluation is warranted to provide further evidence on the cost-effectiveness of this promising combined intervention.
Molecular pattern of lncRNAs in hepatocellular carcinoma
Authors: Mai Haoming , Zhou Bin , Liu Li , Yang Fu , Conran Carly , Ji Yuan , Hou Jinlin , Jiang Deke
Published: May 2019

Hepatocellular carcinoma (HCC) is one of the most notable lethal malignancies worldwide. However, the molecular mechanisms involved in the initiation and progression of this disease remain poorly understood. Over the past decade, many studies have demonstrated the important regulatory roles of long non-coding RNAs (lncRNAs) in HCC. Here, we comprehensively review recent discoveries regarding HCC-associated lncRNA functions, which we have classified and described according to their mechanism models.
Application of very fast simulated annealing and differential evolution in the search for FO-CRS wavefield attributes
Authors: Garabito German , Cruz João Carlos R.
Published: May 2019

The finite-offset common-reflection-surface (FO-CRS) stack method can be used to simulate any common-offset (CO) seismic section by stacking prestack seismic data along the surfaces defined by the paraxial hyperbolic traveltime approximation. In two dimensions, the FO-CRS stacking operator depends on five kinematic wavefield attributes for every time sample of the target CO section. The main problem with this method is identifying a computationally efficient data-driven search strategy for accurately determining the best set of FO-CRS attributes that produce the optimal coherence measure of the seismic signal in the prestack data. Identifying a global optimization algorithm with the best performance is a challenge when solving this optimization problem. This is because the objective function is multimodal and involves a large volume of data, which leads to high computational costs. We introduced a comparative and competitive study through the application of two global optimization algorithms that simultaneously search the FO-CRS attributes from the prestack seismic data, very fast simulated annealing (VFSA) and the differential evolution (DE). By applying this FO-CRS stack to the Marmousi synthetic seismic data set, we have compared the performances of the two optimization algorithms with regard to their efficiency and effectiveness in estimating the five FO-CRS attributes. To analyze the robustness of the two algorithms, we apply them to real land seismic data and show their ability to find the near-optimal attributes and to improve reflection events in noisy data with a very low fold. We reveal that VFSA is efficient in reaching the optimal coherence value with the lowest computational costs, and that DE is effective and reliable in reaching the optimal coherence for determining the best five searched-for attributes. Regardless of the differences, the FO-CRS stack produces enhanced and regularized high-quality CO sections using both global optimization methods.
Compressive least-squares migration with on-the-fly Fourier transforms
Authors: Witte Philipp A. , Louboutin Mathias , Luporini Fabio , Gorman Gerard J. , Herrmann Felix J.
Published: May 2019

Least-squares reverse time migration is a powerful approach for true-amplitude seismic imaging of complex geologic structures, but the successful application of this method is currently hindered by its enormous computational cost, as well as its high memory requirements for computing the gradient of the objective function. We have tackled these problems by introducing an algorithm for low-cost sparsity-promoting least-squares migration using on-the-fly Fourier transforms. We formulate the least-squares migration objective function in the frequency domain (FD) and compute gradients for randomized subsets of shot records and frequencies, thus significantly reducing data movement and the number of overall wave equations solves. By using on-the-fly Fourier transforms, we can compute an arbitrary number of monochromatic FD wavefields with a time-domain (TD) modeling code, instead of having to solve individual Helmholtz equations for each frequency, which becomes computationally infeasible when moving to high frequencies. Our numerical examples demonstrate that compressive imaging with on-the-fly Fourier transforms provides a fast and memory-efficient alternative to TD imaging with optimal checkpointing, whose memory requirements for a fixed background model and source wavelet are independent of the number of time steps. Instead, the memory and additional computational costs grow with the number of frequencies and determine the amount of subsampling artifacts and crosstalk. In contrast to optimal checkpointing, this offers the possibility to trade the memory and computational costs for image quality or a larger number of iterations and is advantageous in new computing environments such as the cloud, where computing is often cheaper than memory and data movement.
Unsupervised physics-based neural networks for seismic migration
Authors: Vamaraju Janaki , Sen Mrinal K.
Published: May 2019

We have developed a novel framework for combining physics-based forward models and neural networks to advance seismic processing and inversion algorithms. Migration is an effective tool in seismic data processing and imaging. Over the years, the scope of these algorithms has broadened; today, migration is a central step in the seismic data processing workflow. However, no single migration technique is suitable for all kinds of data and all styles of acquisition. There is always a compromise on the accuracy, cost, and flexibility of these algorithms. On the other hand, machine-learning algorithms and artificial intelligence methods have been found immensely successful in applications in which big data are available. The applicability of these algorithms is being extensively investigated in scientific disciplines such as exploration geophysics with the goal of reducing exploration and development costs. In this context, we have used a special kind of unsupervised recurrent neural network and its variants, Hopfield neural networks and the Boltzmann machine, to solve the problems of Kirchhoff and reverse time migrations. We use the network to migrate seismic data in a least-squares sense using simulated annealing to globally optimize the cost function of the neural network. The weights and biases of the neural network are derived from the physics-based forward models that are used to generate seismic data. The optimal configuration of the neural network after training corresponds to the minimum energy of the network and thus gives the reflectivity solution of the migration problem. Using synthetic examples, we determine that (1) Hopfield neural networks are fast and efficient and (2) they provide reflectivity images with mitigated migration artifacts and improved spatial resolution. Specifically, the presented approach minimizes the artifacts that arise from limited aperture, low subsurface illumination, coarse sampling, and gaps in the data.
Course of Illness and Predictors of Outcome in Chronic Schizophrenia: Implications for Pathophysiology
Authors: Breier Alan , Schreiber Judith L. , Dyer Janyce , Pickar David
Published: May 2019

Two critically important areas of research are the long-term course of illness and predictors of outcome in chronic schizophrenia. Although these two areas have been actively investigated throughout the 20th century, there is still a lack of agreement about even basic features of the long-term outcome of schizophrenia as well as a lack of validating evidence for putative predictors of outcome. Determining the long-term outcome of schizophrenia has implications for the pathophysiology and public health policy of this illness. For example, a course of illness that is marked by progressive deterioration may suggest a degenerative disease process, whereas a course that remains stable or improves over time may be more consistent with non-degenerative hypotheses such as neurodevelopmental, infectious, or toxic processes. In terms of public health policy, the allocation of resources related to issues such as community-based versus hospital-based care will be heavily influenced by knowledge of the level of chronicity and impairment associated with schizophrenia throughout the lifetime of affected individuals. Validation of predictors of outcome will have immediate clinical relevance, as well as providing support for pathophysiological hypotheses.
The Pilot Project ‘Soteria Berne’ Clinical Experiences and Results
Authors: Ciompi Luc , Dauwalder Hans-Peter , Maier Christian , Aebi Elisabeth , Trütsch Karl , Kupper Zeno , Rutishauser Charlotte
Published: May 2019

We still do not know enough about the aetiology and pathogenesis of schizophrenia, nor are the therapeutic methods generated by our definition of it satisfactory. Therefore, innovative approaches to treating schizophrenic patients, even if they only promise some partial progress, warrant consideration. The purpose of the pilot project ‘Soteria Berne’ is to assess the effectiveness of an open residential programme which has been providing mainly psychotherapy, sociotherapy, and milieu therapy instead of standard pharmacotherapy to about 60 acute schizophrenic patients for more than six years.
Biological and Cognitive Vulnerability Factors in Schizophrenia: Implications for Treatment
Authors: Brenner Hans D. , Hodel Bettina , Genner Ruth , Roder Volker , Corrigan Patrick W.
Published: May 2019

Cognitive disorders have long assumed a central position in describing the pathognomonic characteristics of schizophrenia. Kraepelin's (1902) and Bleuler's (1911) uniquely innovative descriptions of attentional dysfunctions and associational loosening in thought processes laid the groundwork for the concept of basic disorder devised by authors who embraced a phenomenological approach to psychopathology in German-speaking countries (Huber, 1983; Janzarik, 1983), and for experimental research endeavours in English-speaking countries to identify a ‘core psychological deficit’ in schizophrenia (Lang & Buss, 1965). Recent research has identified specific information-processing deficits in affected individuals. These include (a) problems with elementary functions such as selective attention towards relevant stimuli and sustained attention over prolonged periods of time (Oltmanns & Neale, 1975; Nuechterlein, 1977); (b) problems with more complex functions such as encoding and recognition of familiar cues, storing information for future retrieval, or drawing deductive or analogous conclusions from available information (Broga & Neufeld, 1981; Brenner, 1983; Nuechterlein & Dawson, 1984b); and (c) problems with executive functions and response selection (Broen & Storms, 1967; Weinberger et al, 1986, 1988).
Complementary and Integrative Medicine Use in Individuals Seeking Conventional Medical Oncology Care in Chile: Prevalence and Patient Characteristics
Authors: Lopez Gabriel , Salas Claudio Alejandro , Cadiz Fernando , Barriga Carolina , Gonzalez Pilar , Acevedo Sandra , Raimilla Patricia , Pincheira Pia , Naing Aung , Quiroga Marta
Published: May 2019

PURPOSE

Complementary and integrative medicine (CIM) use during cancer care has increased in Western medical settings. Little is known about interest in and use of CIM approaches by oncology patients in Chile and South America.

PATIENTS AND METHODS

Patients presenting for conventional outpatient or inpatient medical oncology care at the Clinica Alemana in Santiago, Chile, from March to June 2017 were asked to complete a survey about their interest in and use of CIM approaches. Goals included determining the prevalence of CIM use and exploring associations between CIM use and patient characteristics. Statistical analyses included a two-tailed t test for continuous variables, Fischer’s exact test for categorical variables, and logistic regression for association between CIM use and other variables.

RESULTS

Of 432 patients surveyed, 66.9% were diagnosed with breast cancer, 84.8% were women, the majority of patients (58.1%) were between age 40 and 60 years, and 51.5% (n = 221) reported CIM use. No association was found between CIM use and the sociodemographic variables of sex, age, education, or income. In all, 44.6% of patients with breast cancer reported CIM use compared with 64.8% of patients with other cancer types ( P > .001). Most commonly reported types of CIM used included herbals (49.1%), vitamins and minerals (40.8%), and prayer or meditation (40.4%). Most frequent reasons for CIM use were to “do everything possible” (72%) and to “improve my immune function” (67.8%). Most patients (43.4%) reported starting CIM use at the time of cancer diagnosis, with only 55.4% sharing information regarding CIM use with their medical team.

CONCLUSION

The majority of patients surveyed reported engaging in CIM use, with just over half the users communicating with their oncology team about their CIM use. Increased awareness of regional differences in CIM use may help increase communication regarding this subject and contribute to improved outcomes.
Life Without a Breast: Exploring the Experiences of Young Nigerian Women After Mastectomy for Breast Cancer
Authors: Olasehinde Olalekan , Arije Olujide , Wuraola Funmilola Olanike , Samson Marguerite , Olajide Olawumi , Alabi Timothy , Arowolo Olukayode , Boutin-Foster Carla , Alatise Olusegun Isaac , Kingham Thomas Peter
Published: May 2019

PURPOSE

The majority of women managed for breast cancer in Nigeria are relatively young, many in their forties. Mastectomy, the most common surgical treatment, raises psychosocial concerns. Understanding these concerns may help address the fears of women who refuse treatment and aid in the care of those who have had mastectomy.

METHODS

Using qualitative methods, we purposively sampled women 45 years of age and younger who underwent mastectomy for breast cancer at a Nigerian teaching hospital. One-on-one in-depth interviews were conducted using an unstructured interview guide. Data were transcribed verbatim and analyzed to identify themes and subthemes.

RESULTS

The study identified six major themes on the impact of mastectomy on psychosocial lives of women, namely decision for mastectomy, postmastectomy transition, body image changes, relationship with husband and sexual life, coping with life postmastectomy, and social support.

CONCLUSION

Our findings highlight the importance of addressing individual patient’s psychosocial needs and preferences when discussing breast cancer treatment with young women. The experiences of women described in this study reveal several useful themes for planning treatment protocols and postmastectomy care.
Morphometric models for estimating bite force in Mus and Rattus: mandible shape and size do better than lever-arm ratios
Authors: Ginot Samuel , Herrel Anthony , Claude Julien , Hautier Lionel
Published: May 2019

Morphological traits are frequently used as proxies for functional outputs such as bite force performance. This allows researchers to infer and interpret the impacts of functional variation, notably in adaptive terms. Despite their mechanical bases, the predictive power of these proxies for performance is not always tested. In particular, their accuracy at the intraspecific level is rarely assessed, and they have sometimes been shown to be unreliable. Here, we compare the performance of several morphological proxies in estimating in vivo bite force, across five species of murine rodents, at the interspecific and intraspecific levels. Proxies used include the size and shape of the mandible, as well as individual and combined muscular mechanical advantages (temporal, superficial masseter and deep masseter). Maximum voluntary bite force was measured in all individuals included. To test the accuracy of predictions allowed by the proxies, we combined linear regressions with a leave-one-out approach, estimating an individual bite force based on the rest of the dataset. The correlations between estimated values and the in vivo measurements were tested. At the interspecific and intraspecific levels, size and shape were better estimators than mechanical advantages. Mechanical advantage showed some predictive power at the interspecific level, but generally not within species, except for the deep masseter in Rattus. In few species, size and shape did not allow us to predict bite force. Extrapolations of performance based on mechanical advantage should therefore be used with care, and are mostly unjustified within species. In the latter case, size and shape are preferable.
High-Intensity Interval Training for Cardiometabolic Disease Prevention
Authors: CAMPBELL WAYNE W. , KRAUS WILLIAM E. , POWELL KENNETH E. , HASKELL WILLIAM L. , JANZ KATHLEEN F. , JAKICIC JOHN M. , TROIANO RICHARD P. , SPROW KYLE , TORRES ANDREA , PIERCY KATRINA L. , BARTLETT DAVID B.
Published: May 2019

Purpose

The 2018 Physical Activity Guidelines Advisory Committee systematically searched existing literature reviews to assess the relationship between high-intensity interval training (HIIT) and reduction in cardiometabolic disease risk.

Methods

Duplicate independent screenings of 260 articles identified from PubMed®, Cochrane Library, and CINAHL databases yielded suitable data from one systematic review and two meta-analyses. Search terms included a combination of “high intensity” “physical activity/exercise” and “interval training” and outcome-specific terms. The quality of the included reviews was assessed using a tailored version of the AMSTARExBP report on quality. Exposure Subcommittee members graded scientific evidence strength based on a five-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable.

Results

Moderate evidence indicates that HIIT can improve insulin sensitivity, blood pressure, and body composition in adults with group mean ages ranging from ~20 to ~77 yr. These HIIT-induced improvements in cardiometabolic disease risk factors are comparable with those resulting from moderate-intensity continuous training, and they are more likely to occur in adults at higher risk of cardiovascular disease and diabetes than in healthy adults. Moderate evidence also indicates that adults with overweight or obesity classification are more responsive than adults with normal weight to HIIT-related improvements in insulin sensitivity, blood pressure, and body composition. Insufficient evidence was available to determine whether a dose–response relationship exists between the quantity of HIIT performed and several risk factors for cardiovascular disease and diabetes, or whether the effects of HIIT on cardiometabolic disease risk factors are influenced by age, sex, race/ethnicity, or socioeconomic status.

Conclusions

HIIT by adults, especially those with overweight and obesity classification, can improve insulin sensitivity, blood pressure, and body composition, comparable with those resulting from moderate-intensity continuous training.
Effects of Physical Activity in Knee and Hip Osteoarthritis: A Systematic Umbrella Review
Authors: KRAUS VIRGINIA B. , SPROW KYLE , POWELL KENNETH E. , BUCHNER DAVID , BLOODGOOD BONNY , PIERCY KATRINA , GEORGE STEPHANIE M. , KRAUS WILLIAM E.
Published: May 2019

Introduction

We conducted a systematic umbrella review to evaluate the literature relating to effects of physical activity on pain, physical function, health-related quality of life, comorbid conditions and osteoarthritis (OA) structural disease progression in individuals with lower-extremity OA.

Methods

Our primary search encompassed 2011 to February 2018 for existing systematic reviews (SR), meta-analyses (MA) and pooled analyses dealing with physical activity including exercise (not mixed with any other intervention and compared to a no-activity control group). A supplementary search encompassed 2006 to February 2018 for original research related to physical activity (including exercise) and lower limb OA progression. Study characteristics were abstracted, and risk of bias was assessed.

Results

Physical activity decreased pain and improved physical function (strong evidence) and improved health-related quality of life (moderate evidence) among people with hip or knee OA relative to less active adults with OA. There was no evidence to suggest accelerated OA progression for physical activity below 10,000 steps per day. Both physical activity equivalent to the 2008 Physical Activity Guidelines for Americans (150 min·wk−1 of moderate-intensity exercise in bouts ≥10 min) and lower levels of physical activity (at least 45 total minutes per week of moderate-intensity) were associated with improved or sustained high function. No SR/MA addressing comorbid conditions in OA were found. Measurable benefits of physical activity appeared to persist for periods of up to 6 months following cessation of a defined program.

Conclusions

People with lower-extremity OA should be encouraged to engage in achievable amounts of physical activity, of even modest intensities. They can choose to accrue minutes of physical activity throughout the entire day, irrespective of bout duration, and be confident in gaining some health and arthritis-related benefits.
Recent advances in understanding and managing male infertility
Authors: Fainberg Jonathan , Kashanian James A.
Published: May 2019

Infertility is a prevalent condition affecting an estimated 70 million people globally. The World Health Organization estimates that 9% of couples worldwide struggle with fertility issues and that male factor contributes to 50% of the issues. Male infertility has a variety of causes, ranging from genetic mutations to lifestyle choices to medical illnesses or medications. Recent studies examining DNA fragmentation, capacitation, and advanced paternal age have shed light on previously unknown topics. The role of conventional male reproductive surgeries aimed at improving or addressing male factor infertility, such as varicocelectomy and testicular sperm extraction, have recently been studied in an attempt to expand their narrow indications. Despite advances in the understanding of male infertility, idiopathic sperm abnormalities still account for about 30% of male infertility. With current and future efforts examining the molecular and genetic factors responsible for spermatogenesis and fertilization, we may be better able to understand etiologies of male factor infertility and thus improve outcomes for our patients.
Are we missing ‘previously treated’ smear-positive pulmonary tuberculosis under programme settings in India? A cross-sectional study
Authors: Shewade Hemant Deepak , Gupta Vivek , Satyanarayana Srinath , Kharate Atul , Murali Lakshmi , Deshpande Madhav , Kumar Naresh , Pandey Prabhat , Bajpai U N , Tripathy Jaya Prasad , Kathirvel Soundappan , Pandurangan Sripriya , Mohanty Subrat , Ghule Vaibhav Haribhau , Sagili Karuna D , Prasad Banuru Muralidhara , Nath Sudhi , Singh Priyanka , Singh Kamlesh , Jayaraman Gurukartick , Rajeswaran P , Srivastava Binod Kumar , Biswas Moumita , Mallick Gayadhar , Bera Om Prakash , Jaisingh A James Jeyakumar , Naqvi Ali Jafar , Verma Prafulla , Ansari Mohammed Salauddin , Mishra Prafulla C , Sumesh G , Barik Sanjeeb , Mathew Vijesh , Lohar Manas Ranjan Singh , Gaurkhede Chandrashekhar S , Parate Ganesh , Bale Sharifa Yasin , Koli Ishwar , Bharadwaj Ashwin Kumar , Venkatraman G , Sathiyanarayanan K , Lal Jinesh , Sharma Ashwini Kumar , Kumar Ajay MV , Chadha Sarabjit S
Published: May 2019

Background: In 2007, a field observation from India reported 11% misclassification among ‘new’ patients registered under the revised national tuberculosis (TB) control programme. Ten years down the line, it is important to know what proportion of newly registered patients has a past history of TB treatment for at least one month (henceforth called ‘misclassification’).

Methods: A study was conducted among new smear-positive pulmonary TB patients registered between March 2016 and February 2017 in 18 randomly selected districts to determine the effectiveness of an active case-finding strategy in marginalised and vulnerable populations. We included all patients detected through active case-finding. An equal number of randomly selected patients registered through passive case-finding from marginalised and vulnerable populations in the same districts were included. Before enrolment, we enquired about any history of previous TB treatment through interviews.

Results: Of 629 patients, we interviewed 521, of whom, 11% (n=56) had past history of TB treatment (public or private) for at least a month: 13% (34/268) among the active case-finding group and 9% (22/253) among the passive case-finding group (p=0.18). No factors were found to be significantly associated with misclassification.

Conclusion: Around one in every ten patients registered as ‘new’ had previous history of TB treatment. Corrective measures need to be implemented, followed by monitoring of any change in the proportion of ‘previously treated’ patients among all registered patients treated under the programme at national level.