bluuebunny/crossref_metadata_2025 huggingface dataset:
Age matters when comparing hemiarthroplasty and total hip arthroplasty for femoral neck fractures in Medicare patients
Authors: Eskildsen Scott M , Kamath Ganesh V , Del Gaizo Daniel J
Published: December 2018

Introduction:

The optimal treatment of patients with a displaced intracapsular femoral neck fracture remains controversial. We utilised a national database of Medicare patients to determine if there was any difference in complications and reoperation rate of patients undergoing total hip arthroplasty (THA) or hemiarthroplasty (HA) for femoral neck fractures.

Methods:

This study utilised the PearlDiver Patient Records Database, a national for-fee database of Medicare patient procedure and diagnosis records from 2005 to 2012. Outcome procedures and diagnoses including revision, dislocation, infection, and cardiovascular events that occurred during the study time period were also identified over the entire study period as well as 90 days and 2 years.

Results:

We identified 275,439 patients with femoral neck fractures who underwent HA and 26,017 patients who underwent THA, respectively. Patients undergoing HA had significantly lower rates ( p < 0.0001) of revision 2.48% versus 3.85% (OR = 0.633; 95% CI, 0.592–0.678), dislocation 1.76% versus 3.39% (0.512; 0.476–0.551), infection 3.44% versus 4.87% (0.694; 0.657–0.737). There was no statistical significant difference in 2-year cardiac morbidity ( p = 0.252). However, when controlling for age, patients 65–69 years showed no significant difference in infection or revision over the study period or at 2 years.

Conclusions:

In this study, patients who underwent THA for femoral neck fractures had a higher rate of dislocations, infections and increased rates of repeat surgery than those who underwent HA but this difference was not significant in patients 65–69 years. Hemiarthroplasty may result in fewer complications in older Medicare patients although this difference may not be present in younger Medicare patients.
The transtelephonic electrocardiogram-based triage is an independent predictor of decreased hospital mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention
Authors: Papai Gyorgy , Csato Gabor , Racz Ildiko , Szabo Gabor , Barany Tamas , Racz Agnes , Szokol Miklos , Sarman Balazs , Edes Istvan F , Czuriga Daniel , Kolozsvari Rudolf , Edes Istvan
Published: December 2018

Introduction

The transtelephonic electrocardiogram has been shown to have a great value in the management of out-of-hospital chest pain emergencies. In our previous study it not only improved the pre-hospital medical therapy and time to intervention, but also the in-hospital mortality in ST-segment elevation myocardial infarction. It was hypothesised that the higher in-hospital survival rate could be due to improved transtelephonic electrocardiogram-based pre-hospital management (electrocardiogram interpretation and teleconsultation) and consequently, better coronary perfusion of patients at the time of hospital admission. To test this hypothesis, our database of ST-segment elevation myocardial infarction patients was evaluated retrospectively for predictors (including transtelephonic electrocardiogram) that may influence in-hospital survival.

Methods and results

The ST-segment elevation myocardial infarction patients were divided into two groups, namely (a) hospital death patients ( n = 49) and (b) hospital survivors (control, n = 726). Regarding pre-hospital medical management, the transtelephonic electrocardiogram-based triage (odds ratio 0.48, confidence interval 0.25–0.92, p = 0.0261) and the administration of optimal pre-hospital medical therapy (acetylsalicylic acid and/or clopidogrel and glycoprotein IIb/IIIa inhibitor) were the most important independent predictors for a decreased risk in our model. At the same time, age, acute heart failure (Killip class >2), successful pre-hospital resuscitation and total occlusion of the infarct-related coronary artery before percutaneous coronary intervention were the most important independent predictors for an increased risk of in-hospital mortality.

Discussion

In ST-segment elevation myocardial infarction patients, (a) an early transtelephonic electrocardiogram-based teleconsultation and triage, (b) optimal pre-hospital antithrombotic medical therapy and (c) the patency and better perfusion of the infarct-related coronary artery on hospital admission are important predictors of a lower in-hospital mortality rate.
Study of burner geometry effects on non-premixed flame response under acoustic excitation
Authors: Zhou Hao , Meng Sheng , Tao Chengfei , Liu Zihua
Published: December 2018

The study of the flame under the acoustic excitation contributes to the study of flame self-excited thermoacoustic instability. Although non-premixed combustion is widely used in industry, research on its combustion instability characteristics is relatively few. This paper experimentally studies the response of a non-premixed swirl flame under excitation. The geometry modifications are the length of the inlet section which is set to be 0.245 m, 0.345 m and 0.445 m and the installation of separation plates. Through the analysis of flame response behavior at different excitation frequencies, combined with the calculation of acoustic mode, we find that for the 0.245 m and 0.345 m inlet length cases, the maximum flame heat release fluctuation responds near 144 Hz. This mode is due to the resonance of the fuel pipe. For the 0.445 m inlet length cases, the maximum flame heat release responds near 134 Hz. This mode is a mixed mode of fuel pipe and combustion chamber. The maximum flame response occurs at the point where the pressure fluctuation reaches the maximum in the inlet section. The image analysis shows the same mode distinction trend between short and long inlet length. Besides, the removing of separation plates leads to a more stable response of the flame in low inlet airflow rate. However, at high airflow rate, the flame tends to be more unstable. Moreover, the higher acoustic forcing frequency than quarter-wave mode will cause the quarter-wave resonant frequency to appear. The results of our work can benefit the implications of thermoacoustic instability in non-premixed flame.
Whence, how and when psychological capital enhances job performance: Insights from an east–west conceptual synthesis
Authors: Venkatanagarajan V , Kamalanabhan TJ
Published: December 2018

The positive core construct of psychological capital (PsyCap) continues to garner a great deal of enduring heed from academicians and practitioners alike. While studies have continually been attesting to PsyCap’s positive influence on job performance, there is an obvious silence in the literature as to the cross-cultural implications for PsyCap formation and management. Besides, little is known about the underlying mechanisms and the team-level boundary conditions of the PsyCap–job performance relationship. Addressing these gaps, this article speculates a blend of ancient Indian and contemporary Western psychological perspectives. In particular, we theorize the role of trigunas (three trait-like components namely sattwa, rajas and tamas) on PsyCap formation, the mediating role of organization-based self-esteem (OBSE) in the PsyCap–job performance relationship and the moderating role of supervisors’ authentic leadership behaviour in the relationship between trigunas, PsyCap, OBSE and job performance of their followers at the individual level. Research propositions based on the proposed conceptual model are presented. Implications of such a conceptual blend for cross-cultural management and future research directions conclude the article.
Embracing intersectionality to create a collective living theory of practice
Authors: Woolf Sara B , Wamba Nathalis G
Published: December 2018

In this paper, we describe pivotal experiences that have shaped our respective professional journeys when teaching action research. We situate these experiences in relation to how they have contributed to our collective living theory of practice. This discussion unfolded as we explored ways to improve our own practices and the practices of our students. We conclude that this and similar questions can only be authentically answered when we as practitioners and faculty in higher education settings are willing to interrogate the contexts within which we interact and the complex intersections between our own intentional practices and selves and our students’ willingness to engage in critical discourse.
A parametric investigation into the flexural properties of singly curved composites reinforced with 3D-integrated woven fabrics
Authors: Dastan Tohid , Hejazi Sayyed MAHDI , Sheikhzadeh Mohammad
Published: December 2018

In this study, the effect of curvature on the flexural behavior of 3D integrated woven fabric composites was initially investigated. After optimizing the effect of curvature, two strengthening methods (thickening upper skin and foam-filling) were applied on curved 3D integrated woven fabric composites separately and simultaneously. Normalized-weight flexural properties were used as an efficiency index to analyze and compare the efficiency of both methods. Results showed that as curvature increases from 0 to 0.007 and 0.014 cm−1, peak load increases about 29.8 and 36.7%, respectively. In addition, as upper skin thickness increases, most of flexural properties increase and then decrease. Moreover, flexural properties improved by injecting polyurethane foam into the empty core. Furthermore, applying both methods on curved 3D integrated woven fabric composite sample made an outstanding improvement in flexural properties. That is, the flexural peak load, stiffness, and total energy absorption increased 244.4, 142.7, and 496.4%, respectively, in comparison to the unreinforced 3D integrated woven fabric composite sample. Based on the normalized results, it could be concluded that applying thickening upper skin and foam-filling the core methods separately have no considerable improvement in specific flexural properties; however, applying both methods simultaneously improved specific peak load and specific total energy absorption 35.3 and 134.1%, respectively.
The manufacture and characterization of auxetic, self-curling, and self-folding woven fabrics by helical auxetic yarns
Authors: Liu Sai , Pan Xingxing , Zheng Dongming , Liu Gui , Du Zhaoqun
Published: December 2018

Auxetic fabrics with traditional filaments and auxetic structures have been provided by knitting method; however, the auxetic behavior and applicability of woven fabric with auxetic yarns remain to be studied. Thus, the paper aims to present the special characters of woven fabrics with heliacal auxetic yarns. Auxetic yarns with the maximum value of Poisson's ratio −0.88 were used as weft yarns to do the weaving by the semi-automatic loom. Then the properties of the fabrics have been tested and analyzed under tensions of different directions (warp, weft, and diagonal). The results indicated that the fabric presented auxetic effect with the maximum value of Poisson's ratio −0.3 under diagonal tension and also showed self-curling and self-folding behavior in natural state. Moreover, the relationship between properties and fabric weaves was also discussed and analyzed. It is expected that the study of fabrics with helical auxetic yarns could promote the practical applications of auxetic textiles such as the self-folding property for smart cladding materials.
Introduction: Trans TV as concept and intervention into contemporary television
Authors: Goddard Michael N , Hogg Christopher
Published: December 2018

This dossier is the first of two to emerge out of the recent Trans TV conference held at the University of Westminster in September 2017. The focus of this specific dossier is in tracking the latest developments and emergent trends affecting contemporary television, especially as delivered via new online streaming services such as Netflix and Amazon. The article and series of interventions within this dossier set out to challenge both popular and scholarly discourse around these contemporary transformations, pointing not only to technological shifts in television but also to changes in terms of branding, regional and transnational delivery of content, viewing practices, mobile consumption and ‘transfandom’, among other factors. The dossier poses the key questions that if television is undergoing a process of transformation as the title Trans TV suggests, what is television becoming and to what extent and in what aspects can we still recognise it as television? While there are a variety of answers to these questions within the dossier, there is a consensus that in the light of these multiple transformations of television, many of the key concepts and assumptions of television studies now require a thorough reconsideration.
Health literacy practices in social virtual worlds and the influence on health behaviour
Authors: McElhinney Evelyn , Kidd Lisa , Cheater Francine M.
Published: December 2018

This study explored how health information accessed via a 3D social virtual world and the representation of ‘self’ through the use of an avatar impact physical world health behaviour.

In-depth interviews were conducted in a sample of 25 people, across 10 countries, who accessed health information in a virtual world (VW): 12 females and 13 males. Interviews were audio-recorded via private in-world voice chat or via private instant message. Thematic analysis was used to analyse the data.

The social skills and practices evidenced demonstrate how the collective knowledge and skills of communities in VWs can influence improvements in individual and community health literacy through a distributed model. The findings offer support for moving away from the idea of health literacy as a set of skills which reside within an individual to a sociocultural model of health literacy. Social VWs can offer a place where people can access health information in multiple formats through the use of an avatar, which can influence changes in behaviour in the physical world and the VW. This can lead to an improvement in social skills and health literacy practices and represents a social model of health literacy.
Cost-effectiveness of low-dose rivaroxaban and aspirin versus aspirin alone in people with peripheral or carotid artery disease: An Australian healthcare perspective
Authors: Zomer Ella , Si Si , Hird Thomas R , Liew Danny , Owen Alice J , Tonkin Andrew , Reid Christopher M , Ademi Zanfina
Published: December 2018

Aims

Peripheral artery disease affects 1.2% of the population globally and is associated with an increased risk of atherothrombotic cardiovascular events, major adverse limb events and mortality. The Cardiovascular Outcomes for People Using Anti-coagulation Strategies (COMPASS) trial demonstrated positive results of rivaroxaban plus aspirin therapy compared to aspirin therapy alone in those with peripheral artery disease or carotid artery disease. We sought to estimate the cost-effectiveness from the Australian healthcare system perspective.

Methods and results

A Markov model was developed to simulate the experiences of a hypothetical population of 1000 individuals with peripheral artery disease or carotid artery disease, profiled on the COMPASS trial, treated with rivaroxaban plus aspirin therapy versus aspirin therapy alone. With each annual cycle, individuals were at risk of having non-fatal cardiovascular disease events, major adverse limb events, or dying. Individuals were also at risk of non-fatal major bleeding. The model had a lifetime time horizon. Costs and utilities were sourced from the literature and discounted at 5.0% annually. Rivaroxaban plus aspirin therapy prevented 143 non-fatal cardiovascular disease events, 118 major adverse limb events and 10 deaths compared to aspirin therapy alone. Conversely, 156 additional major non-fatal bleeds were accrued. With an additional 256 quality-adjusted life years gained, at an additional cost of AUD$6,858,103, the incremental cost-effectiveness ratio was AUD$26,769 (discounted) per quality-adjusted life year gained, which is below Australia’s arbitrary willingness to pay threshold of AUD$50,000.

Conclusion

In those with peripheral artery disease or carotid artery disease, rivaroxaban plus aspirin therapy is effective and cost-effective in the prevention of recurrent cardiovascular disease compared to aspirin therapy alone.
Electrophysiological testing in concussion: A guide to clinical applications
Authors: Papathanasiou Eleftherios S , Cronin Thomas , Seemungal Barry , Sandhu Jaswinder
Published: December 2018

The diagnosis of mild traumatic brain injury in concussion is difficult since it is often unwitnessed, the patient’s recall is unreliable and initial clinical examination is often unrevealing, correlating poorly with the extent of brain injury. At present, there are no objective biomarkers of mild traumatic brain injury in concussion. Thus, a sensitive gold standard test is required to enable the effective and safe triage of patients who present to the acute services. As well as triage, objective monitoring of patients’ recovery over time and separate from clinical features that patients may develop following the injury (e.g. depression and migraine) is also needed. In contrast to neuroimaging, which is widely used to investigate traumatic brain injury patients, electrophysiology is readily available, is cheap and there are internationally recognized standardised methodologies. Herein, we review the existing literature on electrophysiological testing in concussion and mild traumatic brain injury; specifically, electroencephalogram, polysomnography, brainstem auditory evoked potentials, electro- and videonystagmography, vestibular evoked myogenic potentials, visually evoked potentials, somatosensory evoked potentials and transcranial magnetic stimulation.
Injury Risk and Injury Burden Are Related to Age Group and Peak Height Velocity Among Talented Male Youth Soccer Players
Authors: Bult Hans Jan , Barendrecht Maarten , Tak Igor Joeri Ramon
Published: December 2018

Background:

The relationship between injury risk (IR) in age groups and periods around peak height velocity (PHV) remains unclear. PHV is defined as the moment of the largest increase in body height.

Purpose:

To investigate injury risk and injury burden as functions of growth velocity (periods around PHV) and chronological age groupings (under 12 years [U12] to U19) in talented youth male soccer players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 170 players from the youth academy of a Dutch soccer club (highest professional league: Eredivisie) were observed for 1 to 3 seasons. Injuries, exposure, PHV age, and chronological age were registered. The injury incidence density (IID) and injury burden per 1000 hours of soccer participation, with 95% CIs, were calculated for 5 PHV periods and 7 age groups. These were compared with the overall cohort results using incidence ratios (IRs) and burden ratios (BRs) with 95% CIs.

Results:

The mean age at PHV was 14.4 ± 0.65 years (range, 12.8-16.5 years). The mean IID for the total cohort was 8.34 injuries per 1000 hours (95% CI, 7.71-9.02). Compared with the overall mean, a significantly higher IID was found for PHV period 4+5 (IR, 1.31 [95% CI, 1.00-1.71]; P = .049) and for the U15 group (IR, 1.49 [95% CI, 1.24-1.79]; P < .001). The overall injury burden was 58.37 injury days per 1000 hours (95% CI, 56.66-60.13). In PHV period 4+5, the injury burden was significantly higher (BR, 1.53 [95% CI, 1.39-1.68]; P < .001) when compared with the overall mean. Also, compared with the overall mean, the injury burden was higher in the U16 (BR, 1.48 [95% CI, 1.39-1.58]; P < .001), U15 (BR, 1.28 [95% CI, 1.19-1.38]; P < .001), and U17 groups (BR, 1.21 [95% CI, 1.13-1.31]; P < .001).

Conclusion:

Talented young soccer players were more prone to injuries during the 6 months after PHV (31% above overall mean) as well as in the U15 group (49% above overall mean). Based on the higher injury burden in the U16 (48%), U15 (28%), and U17 (21%) groups, we suggest that research on injury risk factors and preventive measures should primarily target these age groups. Additional interventions based on PHV may be of limited value from a screening perspective. Further research is needed on the interaction between age groups and PHV periods.
A novel RAG1 mutation reveals a critical in vivo role for HMGB1/2 during V(D)J recombination
Authors: Thwaites Daniel T. , Carter Clive , Lawless Dylan , Savic Sinisa , Boyes Joan M.
Published: December 2018

The Recombination Activating Genes, RAG1 and RAG2, are essential for V(D)J recombination and adaptive immunity. Mutations in these genes often cause immunodeficiency, the severity of which reflects the importance of the altered residue or residues during recombination. Here, we describe a novel RAG1 mutation that causes immunodeficiency in an unexpected way: The mutated protein severely disrupts binding of the accessory protein, HMGB1. Although HMGB1 enhances RAG cutting in vitro, its role in vivo was controversial. We show here that reduced HMGB1 binding by the mutant protein dramatically reduces RAG cutting in vitro and almost completely eliminates recombination in vivo. The RAG1 mutation, R401W, places a bulky tryptophan opposite the binding site for HMG Box A at both 12- and 23-spacer recombination signal sequences, disrupting stable binding of HMGB1. Replacement of R401W with leucine and then lysine progressively restores HMGB1 binding, correlating with increased RAG cutting and recombination in vivo. We show further that knockdown of HMGB1 significantly reduces recombination by wild-type RAG1, whereas its re-addition restores recombination with wild-type, but not the mutant, RAG1 protein. Together, these data provide compelling evidence that HMGB1 plays a critical role during V(D)J recombination in vivo.
Outcomes of Peer Review for Radiotherapy Treatment Plans With Palliative Intent
Authors: Thompson Dina , Cox Kimberly , Loudon James , Yeung Ivan , Wells Woodrow
Published: December 2018

Purpose:

Peer review of a proposed treatment plan is increasingly recognized as an important quality activity in radiation medicine. Although peer review has been emphasized in the curative setting, applying peer review for treatment plans that have palliative intent is receiving increased attention. This study reports peer review outcomes for a regional cancer center that applied routine interprofessional peer review as a standard practice for palliative radiotherapy.

Methods and Materials:

Peer review outcomes for palliative radiotherapy plans were recorded prospectively for patients who began radiotherapy between October 1, 2015, and September 30, 2017. Recommended and implemented changes were recorded. The content of detailed discussions was recorded to gain insight into the complexities of palliative treatment plans considered during peer review.

Results:

Peer review outcomes were reviewed for 1,413 treatment plans with palliative intent. The proportions of detailed discussions and changes recommended were found to be 139 (9.8%) and 29 (2.1%), respectively. The content of detailed discussions and changes recommended was categorized. Major changes represented 75.9% of recommended changes, of which 84.2% were implemented clinically.

Conclusion:

Many complexities exist that are specific to palliative radiotherapy. Interprofessional peer review provides a forum for these complexities to be openly discussed and is an important activity to optimize the quality of care for patients with treatment plans that have palliative intent.
Comparison of Quality Oncology Practice Initiative Metrics in Solid Tumor Oncology Clinic With or Without Concomitant Supportive Oncology Consultation
Authors: Rosenblum Rachel , Huo Ran , Scarborough Bethann , Goldstein Nathan , Smith Cardinale B.
Published: December 2018

Purpose:

The Quality Oncology Practice Initiative (QOPI) is a quality measurement and improvement program designed to assess practice performance for various consensus-based and evidence-based measures. In this study, we evaluated differences in QOPI metrics met among patients with advanced solid cancer receiving routine oncologic care alone (routine care) compared with patients receiving integrated oncology and specialty-level palliative care (supportive care).

Methods:

We conducted a retrospective chart review of 100 randomly selected patients treated between June 2013 and June 2015 from our supportive care group and matched these patients to 100 routine care group patients on the basis of tumor type and initial oncology visit date. We used the electronic medical record to collect data regarding patient demographics, palliative care–specific QOPI metrics, intensive care unit admissions, and hospice enrollment. We performed multivariate analysis comparing differences between the two groups.

Results:

A total of 200 patients were included. Both groups had similar baseline characteristics. Supportive care consultation improved the absolute number of QOPI metrics met ( P = .01). The QOPI metrics more likely to be met included the following: pain appropriately addressed ( P < .01), advance care directives documented by third office visit ( P < .01), and longer hospice enrollment ( P < .01).

Conclusion:

Integrating palliative care consultation with routine oncologic care improved pain management and end-of-life planning and care. Properly addressing pain and guiding advance care discussions require specialized skills. These data support the need for increased primary palliative care education for oncologists and further development of supportive oncology practices.
Evaluation of the Measuring and Improving Quality in Palliative Care Survey
Authors: Dy Sydney M. , Sharma Ritu , Kuchinad Kamini , Liew Zi-Rou , Abu Al Hamayel Nebras , Hannum Susan M. , Zhu Junya , Kamal Arif H. , Walling Anne M. , Lorenz Karl A. , Isenberg Sarina R.
Published: December 2018

Purpose:

To evaluate the reliability, content validity, and variation among sites of a survey to assess facilitators and barriers to quality measurement and improvement in palliative care programs.

Methods:

We surveyed a sample of diverse US and Canadian palliative care programs and conducted postcompletion discussion groups. The survey included constructs addressing educational support and training, communication, teamwork, leadership, and prioritization for quality measurement and improvement. We tested internal consistency reliability, described variation among sites, and reported descriptive feedback on content validity.

Results:

Of 103 respondents in 11 sites, the most common roles were attending physician (38.9%) and nurse practitioner, clinical nurse specialist, or physician assistant (16.5%). Internal consistency reliability was acceptable (Cronbach’s α = .70 to .99) for all but one construct. Results varied across sites by more than 1 point on the 1 to 5 scales between the 10th and 90th percentiles of sites for two constructs in recognition and focus on quality measurement (score range by site, 1.7 to 4.8), one construct in teamwork (score range, 3.1 to 4.6), and five constructs in quality improvement (score range, 1.8 to 4.6). In descriptive content validity evaluation, respondents described the survey as an opportunity for assessing quality initiatives and discussing potential improvements, particularly improvements in communication, training, and engagement of team members regarding program quality efforts.

Conclusion:

This survey to assess palliative care team perspectives on barriers and facilitators for quality measurement and improvement demonstrated reliability, content validity, and initial evidence of variation among sites. Our findings highlight how palliative care team members’ perspectives may be valuable to plan, evaluate, and monitor quality-of-care initiatives.
Lessons From Reporting National Performance Measures in a Regional Setting: Washington State Community Cancer Care Report
Authors: Panattoni Laura , Fedorenko Catherine , Kreizenbeck Karma , Sun Qin , Li Lily , Conklin Ted , Lyman Gary H. , Ramsey Scott D.
Published: December 2018

Regional public reporting of performance measures in oncology can facilitate local decision making across stakeholders, but small numbers of patients and clinics pose a challenge to creating statistically robust measures. In this article, we describe our development of the Community Cancer Care in Washington State: Quality and Cost Report, the first publicly available report showing clinic-level quality and cost measures at the regional level. We learned key lessons in how to adapt national performance reporting to our regional setting using a registry-linked multipayer claims database. In short, limited numbers of eligible patients for some nationally recognized metrics led us to group metrics and use a 3-year performance window. After completing clinic attribution and other requirements of metric construction, the final metrics included between 62.9% and 88.4% of the eligible patients. To link total costs to some quality measures, we had to define a treatment and surveillance episode of care. Risk adjustment was challenged by the ability to include a limited number of risk adjustors and their potential concentration in a few clinics. We used a different quality score than national performance reporting to account for variation in the range of risk-standardized rates. Current methodology does not permit us to determine whether clinically meaningful differences in quality or costs exist, which inhibits value comparisons. Stakeholder engagement was critical for providing methodologic feedback. In conclusion, we found that refining national metrics was necessary to facilitate public reporting in a regional setting. Further methodologic development can strengthen public reporting and future applications.
Impact of Closed Facebook Group Participation on Female Hematology/Oncology Physicians
Authors: Graff Stephanie L. , Close Julia , Cole Suzanne , Matt-Amaral Laurie , Beg Rasha , Markham Merry-Jennifer
Published: December 2018

Purpose:

Meaningful connections are an important aspect of career satisfaction. The Hematology Oncology Women Physician Group (HOWPG) is a private Facebook (FB) group of 936 women who practice within the hematology/oncology (H/O) field. We hypothesized that HOWPG adds value to education, emotional wellness, and practice of oncology for its membership. A survey was conducted within HOWPG to define group impact on members.

Materials and Methods:

A voluntary, anonymous 12-question online survey was distributed to members of HOWPG by sharing the survey link within the FB group. Participants were surveyed regarding demographics, general FB versus exclusive HOWPG use, and opinions regarding HOWPG value and impact.

Results:

A total of 169 members completed the survey; 9% were fellows, 65% had been in practice less than 10 years, and 26% had been in practice 10 years or more; 97% were age younger than 50 years; 85% practiced adult H/O, and the remainder divided their practice among pediatric H/O, radiation oncology, surgical specialty, and palliative care; 90% used FB at least daily, with 82% accessing HOWPG at least daily. The most common uses for the site included education (65% to 89%), advice on complex cases (65%), emotional support (65%), and networking (55%). On a scale of 1 to 10, learning from clinical cases (9.0) and emotional support (8.4) were rated the most beneficial aspects. Respondents felt HOWPG, when compared with FB in general, was more likely to improve career satisfaction and reduce professional burnout.

Conclusion:

HOWPG provides an opportunity for education and clinical and emotional support. Social media can be an effective venue to educate physicians, augment patient care via advice, foster networking, reduce burnout, and improve career satisfaction among female physicians in the field of H/O.
Widespread cis-regulation of RNA editing in a large mammal
Authors: Lopdell Thomas J. , Hawkins Victoria , Couldrey Christine , Tiplady Kathryn , Davis Stephen R. , Harris Bevin L. , Snell Russell G. , Littlejohn Mathew D.
Published: December 2018

Post-transcriptional RNA editing may regulate transcript expression and diversity in cells, with potential impacts on various aspects of physiology and environmental adaptation. A small number of recent genome-wide studies in Drosophila, mouse, and human have shown that RNA editing can be genetically modulated, highlighting loci that quantitatively impact editing of transcripts. The potential gene expression and physiological consequences of these RNA-editing quantitative trait loci (edQTL), however, are almost entirely unknown. Here, we present analyses of RNA editing in a large domestic mammal (Bos taurus), where we use whole-genome and high-depth RNA sequencing to discover, characterize, and conduct genetic mapping studies of novel transcript edits. Using a discovery population of nine deeply sequenced cows, we identify 2413 edit sites in the mammary transcriptome, the majority of which are adenosine to inosine edits (98.6%). Most sites are predicted to reside in double-stranded secondary structures (85.1%), and quantification of the rates of editing in an additional 355 cows reveals editing is negatively correlated with gene expression in the majority of cases. Genetic analyses of RNA editing and gene expression highlight 152 cis-regulated edQTL, of which 15 appear to cosegregate with expression QTL effects. Trait association analyses in a separate population of 9989 lactating cows also shows 12 of the cis-edQTL coincide with at least one cosegregating lactation QTL. Together, these results enhance our understanding of RNA-editing dynamics in mammals, and suggest mechanistic links by which loci may impact phenotype through RNA editing mediated processes.
Association between gout and atrial fibrillation: A meta-analysis of observational studies
Authors: Leung Keith Sai Kit , Gong Mengqi , Liu Yingzhi , Lai Rachel Wing Chuen , Ju Chengsheng , Liu Fangzhou , Lam Michael Huen Sum , Roever Leonardo , Chang Dong , Xia Yunlong , Liu Tong , Tse Gary , Li Ka Hou Christien
Published: December 2018

Background: Gout is a systemic inflammatory arthritis characterized by the deposition of monosodium urate crystals due to hyperuricemia. Previous studies have explored the link between gout and atrial fibrillation (AF). Given the increasing prevalence and incidence of gout, there is a need to quantify the relationship between gout and the risk of AF. Therefore, we conducted a systematic review and meta-analysis on this topic.

Methods: PubMed and Embase were searched for studies that reported the association between gout and AF using the following search term: (‘Gout’ and ‘Arrhythmia’). The search period was from the start of the database to 3rd August 2018 with no language restrictions.

Results: A total of 75 and 22 articles were retrieved from PubMed and Embase, respectively. Of these, four observational studies (three cohort studies, one case-control study) including 659,094 patients were included. Our meta-analysis demonstrated that gout was significantly associated with increased risk of AF (adjusted hazard ratio: 1.31; 95% confidence interval: 1.00-1.70; P = 0.05; I2 = 99%) after adjusting for significant comorbidities and confounders.

Conclusions: Our meta-analysis confirms the significant relationship between gout and AF. More data are needed to determine whether this risk can be adequately reduced by urate-lowering therapy.
A systematic review and critical evaluation of immunohistochemical associations in hidradenitis suppurativa
Authors: Frew John W. , Hawkes Jason E. , Krueger James G.
Published: December 2018

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory disease with significant morbidity and impact on quality of life. Our understanding of the pathophysiology is incomplete, impairing efforts to develop novel therapeutic targets. Immunohistochemistry studies have produced conflicting results and no systematic evaluation of study methods and results has been undertaken to date.

Methods: This systematic review aimed to collate and describe all reports of immunohistochemical staining in HS. This systematic review was registered with PROSPERO and conducted in line with the PRISMA reporting guidelines. Potential bias was assessed using the NIH Criteria and antibodies used across various studies were tabulated and compared.

Results: A total of 22 articles were identified describing results from 494 HS patients and 168 controls. 87 unique immunohistochemical targets were identified. The overall quality of studies was sub-optimal with staining intensity confounded by active treatment. Conflicting data was identified and able to be reconciled through critical evaluation of the study methodology.

Conclusions: Keratinocyte hyperplasia with loss of cytokeratin markers co-localizes with inflammation comprising of dendritic Cells, T-lymphocytes and macrophages, which are known to play central roles in inflammation in HS. Primary follicular occlusion as a pathogenic paradigm and the principal driver of HS is not consistent with the findings of this review. Inflammation as a primary driver of disease with secondary hyperkeratosis and follicular occlusion is more consistent with the current published data.
The impact of market segmentation and social marketing on uptake of preventive programmes: the example of voluntary medical male circumcision. A literature review
Authors: Gomez Anabel , Loar Rebecca , England Kramer Andrea
Published: December 2018

Background: The business world has long recognized the power of defining discrete audiences within a target population. However, market segmentation’s full potential has not been applied to the public health context. While some broad elements of market segmentation (e.g., age, geography) are considered, a nuanced look at behavioural and psychographic segmentation, which could greatly enhance the possibility of lasting behaviour change, is often missing.  

Segmentation, and the associated mindset which acknowledges the multi-dimensional differences between people, allows service providers, implementers, policymakers, and government officials to target initiatives and lead to a greater likelihood of lasting behavioural change.

This paper investigates what segmentation is, how it has been applied to voluntary medical male circumcision (VMMC), how it can be applied in development, and the challenges in both measuring and adopting segmentation as part of program design.

Methods: We performed a detailed search of peer-reviewed literature using PubMed, ProQuest, ScienceDirect, Google Scholar, and the abstract directories of the International AIDS Society (IAS) published between January 2015 and September 2018. We also accessed articles from business databases such as the Harvard Business Review.  

Results: Results from a VMMC-focused intervention that successfully designed and delivered segmentation-based programs in two countries demonstrated that it is possible to adapt private sector approaches. However, within the sector of global development that is most familiar with segmentation, these efforts rarely go beyond basic demographic segments.

Conclusions: Existing published material tends not to measure the impact of segmentation itself, but the impact of the intervention to which segmentation was applied, which makes it challenging for the development sector to invest in the approach without evidence that it works. Nonetheless, the experiences of segmentation and demand creation for VMMC do highlight the opportunity for better integrating this approach in HIV prevention and in global development and measurement initiatives.
Addressing fidelity within complex health behaviour change interventions: A protocol of a scoping review of intervention fidelity frameworks and models.
Authors: Roy Rebekah , Colquhoun Heather , Byrne Molly , Lorencatto Fabiana , Matvienko-Sikar Karen , McCleary Nicola , Nathan Nicole , Toomey Elaine
Published: December 2018

Intervention fidelity is crucial to facilitate accurate interpretation of research outcomes, but has been inadequately addressed within complex health behaviour change interventions. Recent research has highlighted a need for practical guidance to improve understanding and use of existing fidelity frameworks and models within complex health behaviour change intervention research. The aim of this paper is to present a protocol for a scoping review of existing intervention fidelity frameworks and models. 

In accordance with scoping review guidelines, the following stages will be conducted: (1) identifying the research question, (2) identifying potentially relevant studies of fidelity frameworks and models, (3) study screening and selection, (4) charting and extracting data from identified frameworks and models, (5) collating, summarising and reporting the results and (6) consultation with stakeholders. Two reviewers will independently conduct the screening and extraction stages. Identified frameworks will be collated, summarized and categorized iteratively by one reviewer in consultation with the review team.

The findings of this review will provide a useful resource by identifying and comparing existing fidelity frameworks and models. It is intended that increased clarity and understanding in this area will facilitate the appropriate selection and application of fidelity frameworks for complex health behaviour change interventions, inform areas for future research, and ultimately contribute towards improving how intervention fidelity is addressed in this area.
Dietary change, noncommunicable disease and local knowledge: results of a small-scale study of the views of older Malawians
Authors: Vaughan Megan , Dube Albert , Namadingo Hazel , Crampin Amelia , Gondwe Levie , Kapira Green , Mbughi Joyce , Nyasulu Maisha
Published: December 2018

Interviews were conducted with a small group of Malawians over the age of 60 in rural Karonga district and in Area 25 of the capital, Lilongwe. We asked their views on the changes in diet that had taken place over their lifetimes and also on the causes of 'noncommunicable' diseases, such as Type 2 diabetes and hypertension in their communities. Their answers generally confirmed research showing that dietary diversity is decreasing in Malawi, but many of our interviewees also recalled that hunger was more frequently experienced in the past. Our interviews revealed that though the essential rural diet based on either maize or cassava appears superficially largely unchanged, there have been significant changes in the varieties of crops grown, methods of production and food processing. Many of our interviewees were concerned that the application of chemical fertiliser and pesticides was harming their health.
Primary Radiation Stress, Inflammatory Reaction and the Mechanism of Early Postradiation Reparative Processes in Irradiated Tissues
Authors: Васин М. , Vasin M. , Соловьев В. , Solov'ev V. , Мальцев В. , Maltsev V. , Андрианова И. , Andrianova I. , Лукьянова С. , Luk'yanova S.
Published: December 2018

The products of radiolysis released from cellular compartment under the influence of ionizing radiation: highly mobile groups of proteins, damaged nuclear and mitochondrial DNA, extracellular ATP and oxidized low density lipoproteins, cause stress activation in irradiated tissues through a pattern of the receptors with start of the cascade r53 and NF-κB of pro-inflammatory ways conducting to an expression of pro-inflammatory genes stimulating synthesis of cytokines of the IL-1 family. Excessive activation of pro-inflammatory way under the influence of a radioactive stress is limited to synthesis, anti-inflammatory cytokines: IL-4, IL-10, IL-11, IL-13 and also antagonists of IL-1 receptor and TGF-β. G-CSF and MG-CSF induced by action of pro-inflammatory cytokines have anti-inflammatory and anti-apoptotic properties decreasing level of pro-inflammatory cytokines IL-6 and TNF. Glucocorticoids participate in regulation of primary radioactive stress, suppressing an excessive expression of genes of pro-inflammatory cytokines. Increased IL-1 level stimulates secretion of corticosteroids through mechanism of feedback. Adrenergic stimulation is capable to raise a gene IL-1β expression. The mechanism of radiation apoptosis of stem cells is implemented through p53-Puma way which blocks interaction anti-apoptotic proteins of Bcl-2 with pro-apoptotic proteins of Bax and Bak. After release from mitochondrion of cytochrome C and apoptosis-inducing factor there is an activation of effector caspases: caspases 3, 6 and 7 through caspase 9, and final cell destruction. Wnt way is crucial for post-radiation repair. Potential of the regenerative response of hemopoietic tissue to radiation injury depends on catenin and ability of Wnt way to stimulate post-radiation bone marrow reparation. Mesenchymal stem cells of bone marrow play a large role in post-radiation regeneration of hemopoietic tissue. Their main action is carried out through TLR2 and TLR4 receptors. Mobilization of hemopoietic stem cells is bound to release proteases from bone marrow, including neutrophil elastase and cathepsin G, and a matrix metalproteinase-9. Radioprotective properties of exogenous IL-1 aren’t limited only by induction of raised G-CSF and GM-CSF production. The larger role in radiation protection is played by the reaction induced by IL-1 in the form of feedback with production anti-apoptotic and anti-inflammatory factors. Primary radioactive stress limits time of radiomitigable effect of IL-1 by 1-2 h after its application after radiation.
Family-child lifestyle: results of a socio-demographic study
Authors: Антонов Анатолий , Antonov Anatoly , Жаворонков Александр , Zhavoronkov Aleksandr , Синельников Александр , Sinel'nikov Aleksandr , Новоселова Елена , Novoselova Elena , Карпова Вера , Karpova Vera , Грудина Татьяна , Grudina Tat'yana , Ляликова Софья , Lyalikova Sofia
Published: December 2018

The collective monograph is a continuation of a series of publications containing results of social-demographic surveys, conducted in 2014-2016 in 10 regions of Russia (Family, children – life values and attitudes. M. 2015, Familycentrism: a myth or reality. M. 2016). A comparative analysis of family lifestyle in 70ies of XX century and in second decade of XXI century reveals the dynamic of family’s and person’s family values and reproductive orientations, which allows defining the tendencies of family-demographic processes in coming decade. The monograph is recommended for graduates, postgraduates, lectures of social and psychological departments and for all who are interested in familistic and scientific evidence in family-demographic policy
O MAGO ANTI-HERÓI DE ERIC NOVELLO
Authors: Chiovatto Ana Carolina Lazzari
Published: December 2018

Tradicionalmente, na fantasia, a figura do mago associa-se à do ancião sábio que direciona a aventura do herói. Seu papel, desde o Merlin medieval até importantes releituras contemporâneas, como Gandalf, em O Senhor dos Anéis (1955), de J.R.R. Tolkien (1892-1973), ou Alvo Dumbledore, em Harry Potter (1997-2007), de J.K. Rowling (1965), pode conter pequenas ambivalências, mas, em geral, porta-se como a figura de autoridade dotada dos conhecimentos necessários para possibilitar a “jornada do herói”, cuja preocupação costuma atuar na esfera do coletivo e do bem comum. No entanto, o mago também existe enquanto anti-herói, seguindo uma tradição bem mais recente, própria da literatura insólita contemporânea. Neste artigo, analisaremos o mago exorcista Tiago Boanerges, do escritor carioca Eric Novello (1978), personagem do romance Exorcismos, Amores e uma Dose de Blues (2014), em contraste com outros magos dessas duas tradições, pois a personagem de Novello apresenta particularidades em sua trajetória narrativa que o enquadram no grande arquétipo do anti-herói, guardando apenas uma relação distante com os grandes magos da literatura de fantasia ocidental e, ao mesmo tempo, identificando-se com seus pares em obras anglófonas contemporâneas, como John Constantine, personagem da aclamada série de HQs Hellblazer, e Harry Dresden, de Jim Butcher, na série de romances The Dresden Files.