bluuebunny/crossref_metadata_2025 huggingface dataset:
The Quantum Revolution in Philosophy
Authors: Healey Richard
Published: July 2017

Quantum theory launched a revolution in twentieth-century physics. But we have yet to appreciate the revolution’s significance for philosophy. Most studies of the conceptual foundations of quantum theory first try to interpret the theory—to say how the world could possibly be the way the theory says it is. But, though fundamental, quantum theory is enormously successful without describing the world in its own terms. When properly applied, models of quantum theory offer good advice on the significance and credibility of claims about the world expressed in other terms. This first of several philosophical lessons of the quantum revolution dissolves the quantum measurement problem. Pragmatist treatments of probability and causation show how quantum theory may be used to explain the non-localized correlations that have been thought to involve ‘spooky’ instantaneous action at a distance. Given environmental decoherence, a pragmatist inferentialist approach to content shows when talk of quantum probabilities is licensed, resolves any residual worries about whether a quantum measurement has a determinate outcome, and solves a dilemma about the ontology of a quantum field theory. This approach to meaning and reference also reveals the nature and limits of objective description in the light of quantum theory. While these pragmatist approaches to probability, causation, explanation, and content may be independently motivated by philosophical argument, their successful application here illustrates their practical importance in helping philosophers come to terms with the quantum revolution.
Investigating Party Organization
Authors: Scarrow Susan E. , Webb Paul D.
Published: July 2017

Political parties in democratic countries use very different procedures to make their most important decisions, and they follow different approaches to mobilizing their supporters. What, if any, are the political consequences of these differences? This chapter argues that we should answer this question by systematically testing causal links in mid-level theories. To this end, the authors present a framework that divides parties’ organizations into three key dimensions: structures, resources, and representational strategies. They further divide these dimensions into sub-dimensions that have been identified as politically relevant by previous research, and show how they relate to specific hypotheses about the impact of parties’ organizational differences. These hypotheses are the basis of key research questions examined in the other chapters of this book. This chapter also introduces the new data source that will be used for all the analyses in this volume, the Political Party Database.
Still Connecting with Society?
Authors: Allern Elin Haugsgjerd , Verge Tània
Published: July 2017

How parties structure their interaction with social groups is a key determinant of their capacity to provide linkage between the institutions of government and the public at large. This chapter investigates the extent to which modern political parties use formal measures to connect to relevant societal interests and strengthen their anchorage in society. The analysis centres on parties’ use of formal rules governing affiliation and representation to link with externally organized interests and parties’ establishment of sub-organizations with representation rights within the party. The chapter authors develop and test several hypotheses concerning cross-country and within-country sources of variation in formal linkage and test them empirically. In addition, they examine whether formal status and representation rights shape parties’ ability to represent descriptively the associated latent social interests focusing on the case of women and ethnic minorities.
Gerald of Wales
Authors: Staunton Michael
Published: July 2017

This chapter looks at Gerald of Wales as a historian. Gerald was a prolific writer, and a polymath, and he has seldom been studied as a historian alone. Here the focus will be on Gerald’s historical works, his influences, and methods. The first influence identified is Sallust, whose writings provided an example of the historical monograph, of character descriptions and invented speeches. But Gerald drew on a wide range of pagan Christian writings, and used exempla from their works as a way of interpreting more recent events. Paying special attention to Gerald’s Vita Galfridi and De Principis Instructione, it is argued that Gerald used exempla from earlier histories in a way comparable to a hagiographer: drawing on a repertoire of models and choosing those most appropriate.
Richard of Devizes, Walter Map, and Richard de Templo
Authors: Staunton Michael
Published: July 2017

This chapter looks at the work of three historians—Richard of Devizes, Walter Map, and Richard de Templo—and the connection between history and literature. Richard of Devizes, though a Benedictine monk, wrote a chronicle whose tone is worldly and satirical and owes more to Juvenal than to the English chronicle tradition. In Walter Map’s work, fanciful stories coexist with commentary on recent historical events. Richard de Templo’s Itinerarium is largely based on a French verse work, but even those sections that are not show the influence of the chanson de geste tradition. Here these works are used to address questions of authorial intention and audience reception, the relationship between history and fiction, and the overlap between Latin prose and French verse historiography.
The Battles of God and King Richard
Authors: Staunton Michael
Published: July 2017

This chapter looks at the representation of King Richard in war, particularly in the Holy Land and on the way there. English historians’ accounts of King Richard’s wars have usually been examined for the information they provide of military engagements, or for how they illustrate his image as the ideal knight-king. Here the emphasis is instead on the role of the divine. References to God’s role in battle are so obvious in medieval histories that they may easily be ignored, but, as shown here, there is much complexity in the presentation of such a role by these twelfth-century historians of Angevin England.
The Trials of the Lionheart
Authors: Staunton Michael
Published: July 2017

This chapter examines how English historians explained and interpreted the setbacks that King Richard experienced at the end of his campaign in the Holy Land. Despite his extraordinary heroism, he failed to regain Jerusalem, and on his way home he was captured and subjected to a humiliating and damaging captivity. These reversals prompted the question of why good causes do not immediately appear to meet with success, and why the virtuous suffer trial. Here special attention is paid to an idea of inversion widely found in these histories: that defeat may sometimes be more truly seen as victory, that the weak can overcome the strong, and that adversity reveals virtue.
Church and Government from Becket to Longchamp
Authors: Staunton Michael
Published: July 2017

This chapter examines church and government in Angevin England, and especially the representation of those who held leading positions in both. The first subject is the shadow cast by the figure of Thomas Becket over later ecclesiastical matters and their representation. Although the Becket dispute itself is not prominent in these histories, churchmen of the last quarter of the century were often judged in comparison to Becket. The rest of the chapter concentrates on the career of William Longchamp, bishop of Ely, papal legate, and royal chancellor. The extraordinary invectives against Longchamp written by contemporaries reflect the real hostility that he provoked, but also the emergence of negative depictions of men in government, drawn from recent history but also from imperial Rome.
Outsiders
Authors: Staunton Michael
Published: July 2017

This chapter examines how the historians of Angevin England represented those outside the secular and ecclesiastical elite that dominated their pages. First, representations of Eleanor of Aquitaine are discussed as a way of analysing how these writers wrote about women more generally. The next group to be discussed is the urban poor, as seen in accounts of the revolt of William Longbeard in London in 1196. Thirdly, discussions of heresy are examined for what they show us of continental influence on English writers. Finally, more attention is paid to accounts of the attacks on England’s Jews in 1189 and 1190, with a special focus on William of Newburgh’s interpretation of the events.
The English and their Neighbours
Authors: Staunton Michael
Published: July 2017

This chapter addresses English attitudes to their neighbours. Much scholarly attention has focused on hostile attitudes expressed towards the Scots, Welsh, and Irish, but here some qualifications are proposed to the accepted narrative. Paying particular attention to the accounts of the invasion of Ireland, it is shown that while most English writers characterized their ‘Celtic’ neighbours as barbarous, they also recognized that they were fellow Christians. And while their Christianity was often seen as deficient, a large body of Christian opinion stood against attacks on one’s co-religionists. English aggression against the Irish was not only often criticized, but it was discussed in ways that recalled earlier criticisms of violence by Christians against Christians.
Conclusion
Authors: Staunton Michael
Published: July 2017

The conclusion is a personal reflection on the historians of Angevin England, and how the author’s views changed over the course of writing the book. Convictions about the quality of the works, and the opportunity provided by the subject remained unchanged. As described here, however, these works challenged the author’s assumptions about the political or social utility of medieval historiography, and about its didactic purpose.
Recursion
Authors: Lobina David J.
Published: July 2017

This book provides a comprehensive account of the role of recursion in language in two distinct but interconnected ways. First, it examines how recursion applies at different levels within a full description of natural language. Specifically, it identifies and evaluates recursion as: a) a central property of the computational system underlying the faculty of language; b) a possible feature of the derivations yielded by this computational system; c) a global characteristic of the structures generated by the language faculty; and d) a probable factor in the parsing operations employed during the processing of recursive structures. Secondly, the volume orders these different levels into a tripartite explanatory framework. According to this framework, the investigation of any particular cognitive domain must begin by first outlining what sort of mechanical procedure underlies the relevant capacity (including what sort of structures it generates). Only then, it argues, can we properly investigate its implementation, both at the level of abstract computations typical of competence-level analyses, and at the level of the real-time processing of behaviour.
Putting it all together
Authors: Lobina David J.
Published: July 2017

Recursion as a concept can apply to four different theoretical constructs, all of them to some extent independent but with potential points of contact: a) as part of a definition by induction, and thus of possible use to various sciences; b) as a central property of mechanical procedures, as in production systems and merge; c) as a feature of computational processes, when an operation calls itself, yielding chains of deferred operations; and d) as a characteristic of data structures, as in an ‘X within an X’ template. It is of the utmost importance to separate the four meanings and to not conflate them into a single phenomenon; moreover, it is equally important to recognize that these theoretical constructs may well refer to different mental realities that require different levels of explanation/description, in some cases reflecting properties of mental faculties (knowledge base), in others of processing modules (real-time phenomena).
Aegean Interactions
Authors: Constantakopoulou Christy
Published: July 2017

This book addresses the history of interaction in the Aegean world during the third century BC. The main focus is the island of Delos and its important regional sanctuary. Through a thorough investigation of the Delian epigraphic and material evidence, it explores how and to which degree the islands of the southern Aegean formed active networks of political, religious, and cultural interaction. The book aims to show that this kind of regional interaction in the southern Aegean resulted in the creation of a regional identity, which was expressed, among other things, in the existence of a federal union of the islands, the so-called Islanders’ League. It is structured along the lines of four case studies which explore different types of networks around Delos: the federal organization of islands (Islanders’ League), the participation of Delian and other agents in the processes of monumentalization of the Delian landscape, the network of honours, and the social dynamics of dedication through the record of dedicants in the Delian inventories.
Social Investment
Authors: Nolan Brian
Published: July 2017

Social investment has come to play a major part in debates about the role of social spending and the future of welfare states in Europe, in part because it has significant appeal to different audiences. This chapter argues that social investment can be seen as a (new) paradigm for social policies and spending, as a conceptual base and framework for analysis, and as a basis for political or rhetorical advocacy. There may, however, be a tension between these functions which needs to be recognized. This is brought out when one asks whether social investment can credibly be presented as the paradigm most likely to underpin strong job-friendly economic growth, and whether the distinction between social ‘investment’ and other social spending is conceptually and empirically robust. Finally, the chapter wonders whether focusing on that distinction, and on a narrowly economic rationale, is the most productive way to frame the debate.
The Politics of Social Investment
Authors: Häusermann Silja , Palier Bruno
Published: July 2017

Recent research on the development of social investment has demonstrated reform progress not only in different regions of Europe, but also in Latin America and South-East Asia. However, the specific substance of the social investment agendas varies strongly between these regions. Why have social investment ideas and policies been more developed in some regions and countries than in others? Building on the theoretical framework of this volume, our chapter suggests that the content of regional social investment agendas depends on policy legacies in terms of investment vs consumption-oriented policies and their interaction with structural pressures. In a second step, we argue that the chances of social investment agendas to be implemented depend on the availability of political support coalitions between organizational representatives of the educated middle classes and either business or working-class actors. We illustrate our claims with reference to family policy developments in France, Germany, and Switzerland.
What Makes Time Special?
Authors: Callender Craig
Published: July 2017

As we navigate through life, we model time as flowing, the present as special, and the past as “dead.” This model of time—manifest time—develops in childhood and later thoroughly infiltrates our language, thought, and behavior. It is part of what makes a human life recognizably human. Yet if physics is correct, this model of the world is deeply mistaken. This book is about this conflict between manifest and physical time. The first half dives into the physics and philosophy to establish the conflict’s existence; but it also argues that the claim that physics “spatializes” time is overstated. Rather, even relativity theory makes time special in deep and significant ways. The second half turns to psychology, biology, and more, seeking to understand why creatures like us develop manifest time. The novel picture that results is that manifest time is a natural reaction to the many cognitive and evolutionary challenges that we face. For subjects embedded in our circumstances, it makes sense to develop—even if fundamentally wrong.
Materials for the 21st Century
Authors: Segal David
Published: July 2017

The book is a general text that shows how materials can contribute to solving problems facing nations in the 21st century. It is illustrated with diverse applications and highlights the potential of existing materials for everyday life, healthcare and the economies of nations. There are 13 chapters and a glossary of 500 materials with their descriptions, historical development, their use or potential use and a range of references. Specific areas include synthetic polymers (e.g. nylon), natural polymers (e.g. proteins, cellulose) and the role of materials in the development of digital computers and in healthcare. Solid-state lighting, energy supplies in the 21st century, disruptive technologies and intellectual property, in particular patents, are discussed. The book concludes by asking how the 21st century will be characterised. Will it be the Silicon Age, Genomic Age or New Polymer Age, as examples?
Assessment of Commercial Soybean Cultivars for Resistance Against Prevalent Heterodera glycines Populations of South Dakota
Authors: Acharya K. , Tande C. , Byamukama E.
Published: July 2017

Soybean cyst nematode (SCN; Heterodera glycines) is the most important yield limiting factor of soybean production in South Dakota and the main management practice is planting SCN-resistant cultivars. The effectiveness of host resistance is often limited by the diversity of SCN populations that can reproduce on resistant varieties. A greenhouse study was set up to determine the response of SCN-resistant commercial soybean cultivars with PI 88788 as the source of SCN resistance genes to the three commonly found SCN H. glycines (HG) types in South Dakota. To screen the soybean cultivars, 3,000 SCN eggs and juveniles of the prevalent HG types 0, 2.5.7, and 7 were each inoculated to 34 commercial soybean cultivars and also a susceptible cultivar, Williams 82, as the control. The female index (FI) was calculated based on the average number of females (cysts) found on each cultivar relative to the susceptible check after 35 days. Cultivars showed a varied response to HG types with all 34 cultivars showing resistance or moderate resistance to HG 0. Less than 9% of the cultivars tested had resistance response and between 82 to 88% had moderate resistance response to both HG 7 and 2.5.7 types. Only one cultivar was rated as susceptible to both HG 7 and 2.5.7. These results indicate that host resistance is still effective in managing SCN in South Dakota. However, use of these cultivars should be combined with crop rotation and rotation within soybean cultivars derived from different resistance sources for sustainable SCN management.
Nutrition, Exercise, and Skin Integrity among Frail Older Adults in Taiwan
Authors: Chen Chia-Te , Tung Heng-Hsin , Tung Tao-Hsin , Denq Jong-Chyou
Published: July 2017

OBJECTIVE:

The purpose was to determine the correlation between nutrition status and skin integrity in the frail older adult population.

DESIGN AND SETTING:

Participants (N = 94) in this cross-sectional study were recruited through convenience sampling from the neurology and geriatrics outpatient department at a regional teaching hospital in Northern Taiwan. Study tools included a Basic Participant Profile Fill-in Sheet, which assesses demographic and exercise habit; the Comorbidity Index; Skin Integrity Evaluation Chart; Mini-Nutritional Assessment–Short Form; and Taiwan International Physical Activity Questionnaire Form. Data were analyzed by independent-samples t tests, χ
2 tests, linear regressions, and logistic regression analyses.

RESULTS:

Significant correlations were found among nutrition status, aging, and exercise habits, as well as between participants’ demographics and their skin integrity. Logistic linear regression showed that the decline of skin integrity can be predicted by nutrition status.

CONCLUSIONS:

Exercise programs and a balanced diet should be planned for frail older adults, and their nutrition status should be monitored closely. Those with declining nutrition status should be provided with nutrition supplements. In addition, clinicians should evaluate the skin condition of frail older adults to prevent the development of pressure injuries.
Understanding Moisture-Associated Skin Damage, Medical Adhesive-Related Skin Injuries, and Skin Tears
Authors: Zulkowski Karen
Published: July 2017

GENERAL PURPOSE:

To provide information on superficial skin issues related to moisture-associated skin damage, medical adhesive-related skin injury, and skin tears.

TARGET AUDIENCE:

This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After participating in this educational activity, the participant should be better able to:

1. Examine the anatomy of skin, including changes that occur from aging and chronic wounds.

2. Identify issues related to moisture-associated skin damage, medical adhesive-related skin injury, and skin tears, including techniques for prevention.

The purpose of this continuing education article is to examine the superficial skin issues related to moisture-associated damage, medical adhesive-related skin injury, and skin tears. Similarities, differences, prevention, and treatment will be described.
Paraphilic Thoughts, Behaviors and Sex Addiction in a Sample of Persons Who Use Drugs: A Cross-Sectional Study
Authors: Clemente Jales , Pillon Sandra Cristina , Mari Jair de Jesus , da Silva Claudio Jeronimo , Santana Paulo Roberto Henrique , Diehl Alessandra
Published: July 2017

Objective:

The aim of this study was to evaluate the prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction and sexual-related conditions in a sample of substance disorder patients.

Methods:

This was a cross-sectional study of substance-dependent individuals who sought outpatient treatment in São Paulo, Brazil. Data included sociodemographic information, drug of choice, responses to questions about sexual behavior, and to the following standardized questionnaires: (a) Sexual Addiction Screening Test, and (b) Childhood Trauma Questionnaire.

Results:

The sample comprised 134 persons who use drug, predominantly men (76.1%), 39.6% were aged between 18 and 29 years, and 54.9% were single. Most were persons who use polydrug, 73.9% were alcohol and cocaine users, 63.4% marijuana users, 81.1% tobacco users, and 5.2% steroid users. Prevalence of paraphilic thoughts/behaviors (including paraphilic disorders) with and without sexual addiction was 47%. The HPV/herpes and hepatitis B rates were 7.9% (P = 0.021) and 6.3% (P = 0.046) respectively. Paraphilic and nonparaphilic thoughts/behaviors were associated to the presence of childhood physical neglect (odds ratios [OR] = 4.7, 95% confidence interval [CI] 1.0 to 21.9), low educational level (OR = 7.2, 95% CI 1.4 to 36), heterosexuality (OR = 3.8, 95% CI 1.1 to 12.8) and youth (age 18 to 20 years) (OR = 5.6, 95% CI 1.4 to 11.8).

Conclusions:

The high prevalence of paraphilic thoughts/behaviors with or without sex addiction in persons who use drugs may be related to the experience of physical and emotional neglect during childhood and this possibility should routinely be investigated in clinical practice.
Metformin Exposure During Pregnancy and Lactation Did Not Cause Vascular Reactivity Alteration in Adult Male Offsprings
Authors: Novi Daniella R. B. S. , Forcato Simone , Vidigal Camila B. , Loiola Guilherme H. , Gerardin Daniela C. C. , Ceravolo Graziela S.
Published: July 2017

Metformin has been used for the treatment of some metabolic diseases during gestation and the beneficial effects of metformin to the vascular system have been described in diabetic and obese animal models. Nevertheless, the long-term consequences to the vascular system of offsprings maternally exposed to metformin have not yet been characterized. Therefore, we want to test the hypothesis that gestational and lactational exposure to metformin would be safe for the vascular reactivity of male adult offsprings. Wistar female rats were treated with metformin 293 mg·kg−1·d−1, by gavage, from gestational day (GD) 0 to GD 21 (METG) or GD 0 until postnatal day 21 (METGL). Control dams received water by gavage in the same periods (CTRG and CTRGL). In male offsprings (75 days), the aortic reactivity to phenylephrine, acetylcholine, and sodium nitroprusside in the presence or absence of endothelium were evaluated. The results demonstrated that aortic contraction and relaxation were similar between groups. These data showed that metformin exposure during pregnancy and lactation did not interfere with aortic reactivity, suggesting that metformin exposure during gestational and lactation are safe for the offsprings' vascular system.
Cross-cultural Adaptation of the Self-care of Hypertension Inventory Into Brazilian Portuguese
Authors: Silveira Luana Claudia Jacoby , Rabelo-Silva Eneida Rejane , Ávila Christiane Whast , Beltrami Moreira Leila , Dickson Victoria Vaughan , Riegel Barbara
Published: July 2017

Background:

Lifestyle changes and treatment adherence still constitute a challenge to healthcare providers involved in the care of persons with hypertension. The lack of validated instruments measuring the ability of hypertensive patients to manage their disease has slowed research progress in this area. The Self-care of Hypertension Inventory, originally developed in the United States, consists of 23 items divided across 3 scales: Self-care Maintenance, Self-care Management, and Self-care Confidence. These scales measure how well patients with hypertension adhere to treatment and manage elevated blood pressure, as well as their confidence in their ability to perform self-care. A rigorous cross-cultural adaptation and validation process is required before this instrument can be used in other countries.

Objective:

The aims of this study were to translate the Self-care of Hypertension Inventory into Brazilian Portuguese with cross-cultural adaptation and to evaluate interobserver reliability and temporal stability.

Methods:

This methodological study involved forward translation, synthesis of forward translations, back-translation, synthesis of back-translations, expert committee review, and pretesting. Interobserver agreement and the temporal stability of the scales were assessed.

Results:

The expert committee proposed semantic and cultural modifications to some items and the addition of guidance statements to facilitate administration of the scale. Interobserver analysis demonstrated substantial agreement. Analysis of temporal stability showed near-perfect agreement.

Conclusions:

Cross-cultural adaptation of the Self-care of Hypertension Inventory successfully produced a Portuguese-language version of the instrument for further evaluation of psychometric properties. Once that step is completed, the scale can be used in Brazil.
Decreased Average Power of the Hip External Muscles as a Predictive Parameter for Lower Extremity Injury in Women: A Prospective Study
Authors: Verrelst Ruth , Van Tiggelen Damien , De Ridder Roel , Witvrouw Erik
Published: July 2017

Objective:

To prospectively identify hip strength associated risk factors contributing to the development of lower extremity (LE) injury.

Design:

Data were prospectively collected on healthy female physical education students.

Setting:

This study was conducted in the institution of the University of Ghent.

Participants:

Eighty-nine female physical education students aged 19.53 ± 1.07 years.

Assessment of Risk Factors:

Testing included isokinetic hip strength measurements of abductors, adductors, internal rotators, and external rotators (ERs).

Main Outcome Measures:

Follow-up of the participants was assessed using a weekly online questionnaire and a 3-month retrospective control questionnaire. Lower extremity injury was diagnosed by an experienced medical doctor. Cox regression was used to identify the potential risk factors for the development of an LE injury.

Results:

Thirty-four participants were diagnosed with an LE injury during follow-up. This study identified that decreased average power (AP) (P = 0.031) on concentric ER strength was found to be a significant risk factor for LE injury. No other hip strength parameters were found to be significant contributors to the development of LE injury.

Conclusions:

Decreased AP of the hip ER muscles was identified as a significant predictor for LE injury, whereas no hip abduction weakness or peak torque parameters were found to be predictive. Because controlling LE extremity movements is an important function of the hip muscles, they might be more challenged in a dynamic measure such as AP than in a point measure such as peak torque. Concentric AP of hip ER muscles can therefore be seen as an interesting factor to include in LE injury screening protocols.
Is there a standard-of-care for transfusion therapy in thalassemia?
Authors: Franchini Massimo , Forni Gian L. , Liumbruno Giancarlo M.
Published: July 2017

Purpose of review

Thalassemia is the most common form of inherited anemia, characterized by variable clinical phenotypes. The purpose of this review is to summarize the transfusion support in thalassemia patients and the management of transfusion-related iron overload.

Recent findings

The most recent evidence on transfusion strategy and iron chelation therapy in thalassemia arising from clinical trials as well as from recommendation guidelines are critically discussed.

Enhancements in the global care of thalassemia, resulting from the combination of an appropriate transfusion approach and iron chelation therapy, have produced a significant improvement in the quality of life and, finally, in the prognosis of patients affected by this inherited hematologic disorder.
Cochlear implantation in children under 12 months of age
Authors: McKinney Samantha
Published: July 2017

Purpose of review

Children with congenital hearing loss are being identified earlier, leading to earlier intervention. Current US Food and Drug Administration (FDA) criteria states a child must be 12 months or older for cochlear implantation. The purpose of this article is to review recent publications regarding the benefits of implanting infants under 12 months of age. Topics include: safety and efficacy of surgery, speech and language acquisition outcomes, audiologic components, and limitations.

Recent findings

Since the early 1990s, the candidacy criteria evolved drastically. However, the FDA criteria for cochlear implantation in children has remained at 12 months of age or older since 2000. Recent research indicates implanting below 12 months of age a safe and effective procedure. Speech and language outcomes showed better speech and language advantages. In addition, infants implanted earlier showed normal auditory skills as early as 3 months post cochlear implant activation. This article will also address recent findings on the limitations of earlier implantation.

Recent research demonstrates positive outcomes in children implanted under 12 months of age. Developing research on earlier implantation could lead to a change in the current FDA criteria allowing infants to reach their speech and hearing potential faster.
The Impact of Iron Overload in Acute Leukemia: Chronic Inflammation, But Not the Presence of Nontransferrin Bound Iron is a Determinant of Oxidative Stress
Authors: Olcay Lale , Serteser Mustafa , Kolay Murat , Balci Havva F. , Yildirim Ülkü M. , Tekgündüz Sibel A. , Hazirolan Tuncay , Terzi Yunus K.
Published: July 2017

In the literature, studies on the oxidant effects of nontransferrin bound iron [NTBI (eLPI assay)] during chemotherapy of acute lymphoblastic leukemia and acute myeloblastic leukemia are lacking. We established NTBI and oxidative stress determinants (OSD), iron parameters, high-sensitive C-reactive protein (hs-CRP) levels, liver tests, cumulative chemotherapeutic doses, and transfused blood in 36 children with acute leukemia throughout chemotherapy. These parameters were determined at the beginning and end of chemotherapy blocks (11 time points) and in 20 healthy children using enzyme-linked immunosorbent assay, and colorimetric and fluorometric enzymatic methods. In acute lymphoblastic leukemia, NTBI, OSD, and hs-CRP were higher than controls at 4/11, 7/11, and 9/11 time points (P<0.05). At 3 time points, NTBI and OSD concurrently increased. Ferritin, soluble transferrin receptor, serum iron, and transferrin saturation were higher than in controls at 5 to 11/11 time points (P<0.05). Those with NTBI had higher iron parameters than those without NTBI (P<0.05), but showed similar OSD, hs-CRP, liver enzymes, cumulative chemotherapeutics, and transfused blood (P>0.05). OSD did not correlate with NTBI, but correlated with hs-CRP. In conclusion, NTBI is a poor predictor of OSD in acute leukemia possibly because of the heterogeneity of NTBI and chronic inflammation. Further studies are needed to delineate the pathophysiology of these diseases.
Loss of CDKN1C in a Recurrent Atypical Teratoid/Rhabdoid Tumor
Authors: Tran Dustin , Camelo-Piragua Sandra , Gupta Avneesh , Gowans Kate , Robertson Patricia L. , Mody Rajen , Koschmann Carl
Published: July 2017

Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant tumor that is commonly associated with biallelic alterations of SMARCB1. Recurrent or refractory AT/RT has not been molecularly characterized as well. We present the case of a child with recurrent AT/RT who underwent clinically integrated molecular profiling (germline DNA and tumor DNA/RNA sequencing). This demonstrated a somatic lesion in CDKN1C alongside hallmark loss of SMARCB1. This data allowed us to explore potential personalized therapies for this patient and expose a molecular driver that may be involved in similar cases.
Multiplexing Prisms for Field Expansion
Authors: Peli Eli , Jung Jae-Hyun
Published: July 2017

PURPOSE

Prisms used for field expansion are limited by the optical scotoma at a prism apex (apical scotoma). For a patient with two functioning eyes, fitting prisms unilaterally allows the other eye to compensate for the apical scotoma. A monocular patient’s field loss cannot be expanded with a conventional or Fresnel prism because of the apical scotoma. A newly invented optical device, the multiplexing prism (MxP), was developed to overcome the apical scotoma limitation in monocular field expansion.

METHODS

A Fresnel–prism–like device with alternating prism and flat elements superimposes shifted and see-through views, thus creating the (monocular) visual confusion required for field expansion and eliminating the apical scotoma. Several implementations are demonstrated and preliminarily evaluated for different monocular conditions with visual field loss. The field expansion of the MxP is compared with the effect of conventional prisms using calculated and measured perimetry.

RESULTS

Field expansion without apical scotomas is shown to be effective for monocular patients with hemianopia or constricted peripheral field. The MxPs are shown to increase the nasal field for a patient with only one eye and for patients with bitemporal hemianopia. The MxPs placed at the far temporal field are shown to expand the normal visual field. The ability to control the contrast ratio between the two images is verified.

CONCLUSIONS

A novel optical device is demonstrated to have the potential for field expansion technology in a variety of conditions. The devices may be inexpensive and can be constructed in a cosmetically acceptable format.
Geriatric Assessment and Tools for Predicting Treatment Toxicity in Older Adults With Cancer
Authors: Li Daneng , Soto-Perez-de-Celis Enrique , Hurria Arti
Published: July 2017

Cancer is a disease of older adults, and the majority of new cancer cases and deaths occur in people 65 years or older. However, fewer data are available regarding the risks and benefits of cancer treatment in older adults, and commonly used assessments in oncology fail to adequately evaluate factors that affect treatment efficacy and outcomes in the older patients. The geriatric assessment is a multidisciplinary evaluation that provides detailed information about a patient’s functional status, comorbidities, psychological state, social support, nutritional status, and cognitive function. Among older patients with cancer, geriatric assessment has been shown to identify patients at risk of poorer overall survival, and geriatric assessment-based tools are significantly more effective in predicting chemotherapy toxicity than other currently utilized measures. In this review, we summarize the components of the geriatric assessment and provide information about existing tools used to predict treatment toxicity in older patients with cancer.
The Changing Paradigm of Radiotherapy in the Elderly Population
Authors: Pfeffer Myer Raphael , Blumenfeld Philip
Published: July 2017

There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques. Despite the fact that the elderly are a growing significant proportion of cancer patients, and the need for radiotherapy in the elderly is expected to rise with increasing life expectancy, they are underrepresented in most clinical studies of radiotherapy, and there are few studies specifically investigating radiotherapy in the elderly. The treatment of early-stage primary lung cancer with stereotactic body radiotherapy is a prime example how new highly conformal techniques and shortened treatment protocols are changing the approach to radiotherapy in the elderly. With improved imaging and radiotherapy treatment precision, it is expected that such techniques will become increasingly used in other cancer sites. It is important for radiation oncologists to be aware of the special needs of the elderly cancer patient and in particular to assess these patients based on functional status and not only chronological age. In addition, geriatric oncologists should be aware of modern radiotherapy techniques that can be particularly appropriate for the elderly patient.
Early Stage Cancer in Older Adults
Authors: Narayan Vikram , Jiang Song , Warlick Christopher A.
Published: July 2017

The diagnosis of prostate cancer in elderly men is likely to increase over the next several decades, owing to changing demographics and a rising population of men older than 65 years. Given the heterogeneity and well-documented challenges in screening, diagnosing, and managing indolent versus aggressive prostate cancer, the geriatric patient population is particularly vulnerable to prostate cancer treatment nuances. Clinicians must become familiar with geriatric assessment tools to better answer life-expectancy questions prior to counseling patients on treatment options. The preferences and values of patients and their families must always be considered when making screening and treatment decisions. Careful selection of patients following a holistic evaluation will not only minimize overtreatment and undertreatment of prostate cancer, but may also allow for the early identification of unique geriatric vulnerabilities and permit quicker interventions to improve the quality of life of these men during their elderly years.
Cancer Screening in the Elderly
Authors: Kotwal Ashwin A. , Schonberg Mara A.
Published: July 2017

There are relatively limited data on outcomes of screening older adults for cancer; therefore, the decision to screen older adults requires balancing the potential harms of screening and follow-up diagnostic tests with the possibility of benefit. Harms of screening can be amplified in older and frail adults and include discomfort from undergoing the test itself, anxiety, potential complications from diagnostic procedures resulting from a false-positive test, false reassurance from a false-negative test, and overdiagnosis of tumors that are of no threat and may result in overtreatment. In this paper, we review the evidence and guidelines on breast, colorectal, lung and prostate cancer as applied to older adults. We also provide a general framework for approaching cancer screening in older adults by incorporating evidence-based guidelines, patient preferences, and patient life expectancy estimates into shared screening decisions.
The Impact of Polypharmacy on Patient Outcomes in Older Adults With Cancer
Authors: Nightingale Ginah , Skonecki Emily , Boparai Manpreet K.
Published: July 2017

Polypharmacy is prevalent in older adults with cancer and may be advantageous for the management of certain chronic disease states, but uncertainty exists regarding potential hazards and consequences. Cancer-related therapy adds to the prevalence of polypharmacy, which can lead to compromised cancer management plans (i.e., postoperative complications, treatment delays, and/or premature treatment discontinuation). Polypharmacy has been identified as one of the domains commonly included in the Comprehensive Geriatric Assessment likely because of the potential influence on health outcomes. This review summarizes existing evidence regarding health outcomes associated with polypharmacy in older adults with cancer. Preliminary evidence demonstrated that relationships exist between polypharmacy and health outcomes including adverse drug events, falls, frailty, hospitalization, postoperative complications, and mortality. This research is limited by study confounders, inconsistent definitions for polypharmacy, heterogeneous cancer types and stages, and the complex relationship between medication regimens and outcomes. Additional studies are needed to enhance the accuracy and replicability of this research.
Iterative Reconstruction May Improve Diagnosis of Gout
Authors: Diekhoff Torsten , Kotlyarov Maximilian , Mews Jürgen , Hamm Bernd , Hermann Kay-Geert Armin
Published: July 2017

Objectives

We hypothesize that, compared with filtered back projection (FBP), iterative reconstruction (IR) increases the detected volume of uric acid, which serves as a measure of the sensitivity of the method, and therefore allows examinations with lower radiation exposure. Thus, the aim of our study was to evaluate the role of IR in dual-energy computed tomography (DECT) for gout assessment and volumetry in an ex vivo gout model using an epoxy phantom and a biophantom.

Materials and Methods

We prepared specimens with different concentrations of monosodium uric acid in ultrasound gel (30%–50%) and inserted them into an epoxy-based phantom and a porcine foreleg. Computed tomography scanning was performed on a 320-row single-source DECT scanner in volume mode with an ascending order of tube currents. Image data sets were reconstructed using FBP and IR with 2 iteration levels (IR1 and IR2). Measurements in regions of interest (ROIs) and volumetric measurements were performed using either fixed parameters for the analysis software (epoxy phantom) or parameters specifically adapted for each data set (porcine phantom). Seven retrospectively identified clinical data sets were used for validation in patients. Rm-ANOVA was used for statistical analysis. No institutional review board approval was required.

Results

We found no differences in Hounsfield units between the different reconstruction algorithms (P = 0.09 and 0.05 for 80 and 135 kVp, respectively) and the calculated dual-energy gradient (P = 0.27). Filtered back projection detected less uric acid compared with IR (with fixed parameters: 6.0 ± 0.3 cm3 for FBP and 6.1 ± 0.2 for IR1 and IR2; with adapted thresholds: 1.2 ± 0.3 cm3 for FBP and 1.8 ± 0.1 and 2.0 ± 0.1 for IR1 and IR2, respectively). The differences were significant for all measurements (P = 0.0003). Also in the test cases, FBP detected significantly fewer tophi (mean volume, 1.38 ± 2.1 cm3) compared with IR1 (1.86 ± 2.9) and IR2 (2.07 ± 3.1) (P = 0.04).

Conclusions

Iterative reconstruction has the potential to improve the sensitivity of a DECT scan for gouty tophi, to decrease radiation exposure, or to combine both options.
Totally Laparoscopic Resection for Low Sigmoid and Rectal Cancer Using Natural Orifice Specimen Extraction Techniques
Authors: Shimizu Hideharu , Adachi Kensuke , Ohtsuka Hideo , Osaka Itaru , Takuma Kunio , Takanishi Kijuro , Matsumoto Jun
Published: July 2017

Background:

A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique.

Methods:

From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers. A prospectively maintained database was reviewed to assess the outcomes after surgery.

Results:

In total, 40 patients had high anterior resections using transanal specimen extraction, and 32 patients had low anterior resections with transanal pull-through. Eight patients (11%) reported conversion to conventional laparoscopic colorectal resections; anastomotic leakages occurred in 4 patients (5.6%). No mortality or cancer recurrence was observed during 42.5±16.2 months of follow-up.

Conclusions:

One natural orifice specimen extraction technique, known as transanal specimen extraction, has emerged as a promising form of totally laparoscopic surgical intervention for early-stage cancers of the low sigmoid colon and rectum.
Salvage Endoscopic Argon Plasma Coagulation After Chemoradiotherapy for Inoperable Esophageal Cancer
Authors: Matsutani Takeshi , Nomura Tsutomu , Hagiwara Nobutoshi , Matsuda Akihisa , Uchida Eiji
Published: July 2017

Purpose:

The purpose of this study is to evaluate the effectiveness of salvage endoscopic argon plasma coagulation (APC) therapy for local failure occurring after definitive chemoradiotherapy (CRT) in patients with inoperable esophageal cancer.

Patients and Methods:

A total of 47 patients with esophageal squamous cell carcinoma received CRT from January 2009 through November 2011 in our hospital. Thirty-five of these patients were excluded because of long-term disease-free status or because they received salvage surgery, systemic chemotherapy, or best supportive care. The other 12 patients had local relapse (n=8) or residual lesions (n=4) after definitive CRT and received salvage APC therapy. Local failures after definitive CRT were divided into 2 groups: the superficial growth group (n=6) and the submucosal growth group (n=6). The primary endpoints were relapse-free survival and overall survival after 60 months of follow-up.

Results:

Six patients in the superficial growth group and 1 patient in submucosal growth group had a complete response after salvage APC. The rates of both relapse-free survival and overall survival were higher in the superficial growth group than in the submucosal growth group. No complications occurred after APC.

Conclusions:

Salvage APC is a potentially curative treatment for patients who have local failure associated with superficial tumors after CRT for esophageal squamous cell carcinoma.