bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of copolymer scaffolds delivering human demineralised dentine matrix for bone regeneration
Authors: Munir Arooj , Døskeland Anne , Avery Steven J , Fuoco Tiziana , Mohamed-Ahmed Samih , Lygre Henning , Finne-Wistrand Anna , Sloan Alastair J , Waddington Rachel J , Mustafa Kamal , Suliman Salwa
Published: May 2019

Poly(L-lactide-co-ε-caprolactone) scaffolds were functionalised by 10 or 20 µg/mL of human demineralised dentine matrix. Release kinetics up to 21 days and their osteogenic potential on human bone marrow stromal cells after 7 and 21 days were studied. A total of 390 proteins were identified by mass spectrometry. Bone regeneration proteins showed initial burst of release. Human bone marrow stromal cells were cultured on scaffolds physisorbed with 20 µg/mL and cultured in basal medium (DDM group) or physisorbed and cultured in osteogenic medium or cultured on non-functionalised scaffolds in osteogenic medium. The human bone marrow stromal cells proliferated less in demineralised dentine matrix group and activated ERK/1/2 after both time points. Cells on DDM group showed highest expression of IL-6 and IL-8 at 7 days and expressed higher collagen type 1 alpha 2, SPP1 and bone morphogenetic protein-2 until 21 days. Extracellular protein revealed higher collagen type 1 and bone morphogenetic protein-2 at 21 days in demineralised dentine matrix group. Cells on DDM group showed signs of mineralisation. The functionalised scaffolds were able to stimulate osteogenic differentiation of human bone marrow stromal cells.
Solitary round pulmonary lesions in the pediatric population: a pictorial review
Authors: Arkoudis Nikolaos-Achilleas , Pastroma Angeliki , Velonakis Georgios , Tsochatzis Athanasios , Mazioti Argyro , Vakaki Marina , Alexopoulou Efthymia
Published: May 2019

The purpose of this current pictorial review is to define the solitary round pulmonary lesion (SRPL), to familiarize with its prevalence in the pediatric population, and, moreover, to educate radiologists on its vast differential diagnosis and imaging manifestations. Furthermore, by highlighting valuable clues, it intends to assist radiologists efficiently partake in its diagnosis, work-up, and follow-up in order to narrow down the differential diagnosis by working alongside the clinician and combining clinical information, lab results, and radiological findings.
Association of CTLA4 and NFKB1 polymorphisms with chronic heart failure: a case-control study in the Chinese population
Authors: Zhao Yue , Gu Zhenying , Zhao Xiaoge , Wang Liqin , Gao Meizhu
Published: May 2019

Previous works have demonstrated the involvement of cytotoxic T-lymphocyte antigen 4 (CTLA-4) and nuclear factor kappa B (NF-κB) in maintaining the normal physiology of the heart. Polymorphisms in genes encoding these proteins may affect their normal functions, which could subsequently lead to chronic heart failure (CHF). In this work, we examined the association of CTLA4 and NFKB1 polymorphisms with CHF in a Chinese population. The −318C>T and +49A>G polymorphisms of CTLA4 and −94 insertion/deletion ATTG polymorphism of NFKB1 were genotyped on 538 patients with CHF and 1076 healthy controls. Our data indicate that the CTLA4 +49A>G and NFKB1 polymorphisms could confer susceptibility to CHF among Chinese. A significantly increased CHF risk was observed for the mutant CTLA4 +49GG genotype ( P = 0.0093), and both heterozygous ATTG1/ATTG2 ( P = 0.0142) and mutant ATTG2/ATTG2 ( P = 0.0018) genotypes of NFKB1. Our data suggest that there is a potential use of these polymorphisms for early genetic screening for CHF.
Where Inspiration Generates Art: A Critical Analysis of Shaffer’s “Amadeus”
Authors: Mousa Ahmed Hasan
Published: May 2019

This research article is mainly concerned with the dialectic of art and theology with reference to Peter Shaffer’s play “Amadeus.” It delineates comparing divine and artistic creativity as a vital segment of the Greek theology and philosophy of art, and the Christian religious beliefs. The divine forces of the antiquated Greek pantheon are divided into different classifications. In their theology, art and many other concepts of life are not man-made; humans are nothing but tools of several gods, and those gods inspire them to present their arts through these tools and in several forms. Christians think about God and artist in a like manner discourse postulating that God resembles an artist who utilizes his creative energy and makes a universe of rich differing qualities; hence, they likewise do as such in their more scholarly and philosophical compositions.
Increased circulating cell-derived microparticle levels in deep infiltrating endometriosis patients with larger implants
Authors: Munrós Jordina , Tàssies Dolors , Reverter Joan Carles , Carmona Francisco , Martínez-Zamora María Ángeles
Published: May 2019

Objective:

Circulating cell-derived microparticles have been reported to be elevated in inflammatory and procoagulant conditions including deep infiltrating endometriosis. The objective of this pilot study was to investigate whether higher circulating cell-derived microparticle levels may be associated with specific clinical features and the extension or severity of deep infiltrating endometriosis.

Methods:

This is an observational analytical cross-sectional study, including three groups of patients undergoing gynecological surgery. The DIE group included 75 patients with deep infiltrating endometriosis, the control group (C group) consisted of 39 patients without endometriosis, and a positive control group was composed of 31 patients with ovarian endometriomas but not deep infiltrating endometriosis (OE group). Venous blood samples for circulating cell-derived microparticle determinations in plasma were obtained before surgery. The following variables were assessed: severe dysmenorrhea, dyspareunia, non-cyclic chronic pelvic pain, dyschezia, dysuria, hematuria, rectal bleeding, sterility, presence of ovarian endometrioma, adenomyosis, and adhesions, rASRM (revised American Society for Reproductive Medicine) stage, Enzian classification, number of sites affected, and the cumulative size of deep infiltrating endometrial implants.

Results:

Circulating cell-derived microparticle levels were statistically higher in the DIE group compared with the C group ( p-value = 0.001). None of the variables analyzed showed higher levels of circulating cell-derived microparticles in the DIE group, except for a significant positive correlation between the cumulative size of deep infiltrating endometrial lesions and circulating cell-derived microparticle levels ( r = 0.264, p = 0.022).

Conclusion:

Patients having deep infiltrating endometriosis with a larger cumulative size of endometriotic implants showed higher circulating cell-derived microparticle levels suggesting an increased inflammatory and/or hypercoagulable systemic status in this more severe form of the disease. Further research is needed to assess our findings and to explore the role of circulating cell-derived microparticles in the pathophysiology of deep infiltrating endometriosis.
Employers’ Perspectives on Workplace Communication Skills: The Meaning of Communication Skills
Authors: Coffelt Tina A. , Grauman Dale , Smith Frances L. M.
Published: May 2019

Employers provide their interpretation of the meaning of communication skills in this qualitative study of 22 managers. Employers understand written communication to be types of documents, a way to write, and a mode of communication. Oral communication skills mean a style of interacting, presenting, and conducting meetings. Visual communication skills were understood to be data visualization or nonverbal communication. Electronic communication was interpreted as email. The findings contribute to closing-the-gap research by highlighting areas where meaning converges for employers and instructors. Faculty members in communication disciplines can incorporate these findings into their course design and learning outcome discussions.
Experiences With Chiropractic Care for Patients With Low Back or Neck Pain
Authors: Hays Ron D , Sherbourne Cathy D , Spritzer Karen L , Hilton Lara G , Ryan Gery W , Coulter Ian D , Herman Patricia M
Published: May 2019

Background:

Musculoskeletal disorders are the second leading cause of disability worldwide.

Objective:

Examine experiences of chiropractic patients in the United States with chronic low back or neck pain.

Method:

Observational study of 1853 chronic low back pain and neck pain patients (74% female) who completed an online questionnaire at the 3-month follow-up that included Consumer Assessment of Healthcare Providers and Systems (CAHPS) items assessing their experiences with care.

Results:

We found similar reports of communication for the chiropractic sample and patients in the 2016 CAHPS National Database, but 85% in the database versus 79% in the chiropractic sample gave the most positive response to the time spent with provider item. More patients in the CAHPS database rated their provider at the top of the scale (8 percentage points). More chiropractic patients reported always getting answers to questions the same day (16 percentage points) and always being seen within 15 minutes of their appointment time (29 percentage points).

Conclusions:

The positive experiences of patients with chronic back and neck pain are supportive of their use of chiropractic care.
Shoulder Arthrodesis in the Management of Glenohumeral Pathologies
Authors: Kamineni Srinath , Unger R Zackary , Desai Rasesh
Published: May 2019

Background

In an era of advanced shoulder stabilization procedures, arthroplasty implants and techniques, shoulder arthrodesis is considered an end-stage salvage procedure with negative connotations. However, in correctly selected patients, arthrodesis can alleviate pain, provide acceptable and stable motion, with a resultant functional shoulder.

Methods

The current literature on shoulder arthrodesis was reviewed to determine the indications, surgical technique, post-operative rehabilitation, complications and outcomes.

Results

Indications for shoulder arthrodesis include brachial plexus injuries, paralytic disorders, pseudo paralysis from combined severe/irreparable rotator cuff and deltoid injuries, inflammatory arthritis with severe rotator cuff pathology, persistent refractory instability, and tumor resection. Shoulder arthrodesis generally involves compression screws with or without plate fixation and bone graft. The arthrodesis is positioned to optimize the function of the extremity, primarily for activities of daily living. Postoperatively, most patients are immobilized for 8 to 10 weeks, dependent on the completeness of radiological fusion. Complications include nonunion, shoulder girdle muscle atrophy, painful hardware, periprosthetic fractures, and infection.

Discussion

With the use of recent biological innovations, the nonunion rate has declined, and rehabilitation technologies have allowed maintenance of muscle mass for future conversion to shoulder arthroplasty. Hence, in carefully selected patients, shoulder arthrodesis provides a valuable option for a stable, functional, and pain-free shoulder and should be retained as part of the treatment algorithm for complex shoulder pathology.
Everyday resilience, reworking, and resistance in North Jakarta’s kampungs
Authors: Betteridge Brittany , Webber Sophie
Published: May 2019

In the kampungs of North Jakarta, people make their lives in the face of a variety of transformations. While Jakarta has always experienced flooding from the coast and from its rivers, flooding is getting worse, and has dramatic effects on kampungs and their residents. At the same time, flood mitigation efforts by the government of Jakarta involve new infrastructures, such as sea walls and land reclamation, which interrupt livelihood practices in the kampungs and have led to violent evictions. Residents of North Jakarta’s kampungs must negotiate the surprise impacts of both flooding and the government’s attempts to manage flooding. In this article, we catalogue the social and material practices that support life and livelihoods in the contexts of these urban environmental transformations, drawing from fieldwork conducted in three North Jakarta kampungs and from recent critical geographical research about urban resilience and urban political ecologies. We describe these practices as everyday acts of resilience, reworking, and resistance. These everyday practices are social and material, drawing from and remaking social and material relations. Although everyday practices of resilience, reworking, and resistance require investments in social relations, we also demonstrate that the dividends filter through existing power structures in the kampungs.
A point-of-care neutrophil elastase activity assay identifies bronchiectasis severity, airway infection and risk of exacerbation
Authors: Shoemark Amelia , Cant Erin , Carreto Luis , Smith Alexandria , Oriano Martina , Keir Holly R. , Perea Lidia , Canto Elisabet , Terranova Leonardo , Vidal Silvia , Moffitt Kelly , Aliberti Stefano , Sibila Oriol , Chalmers James D.
Published: May 2019

Introduction

Neutrophil elastase activity in sputum can identify patients at high risk of airway infection and exacerbations in bronchiectasis. Application of this biomarker in clinical practice is limited, because no point-of-care test is available. We tested whether a novel semi-quantitative lateral flow device (neutrophil elastase airway test stick – NEATstik®) can stratify bronchiectasis patients according to severity, airway infection and exacerbation risk.

Methods

Sputum samples from 124 patients with stable bronchiectasis enrolled in the UK and Spain were tested using the NEATstik®, which scores neutrophil elastase concentration from 0 (<8 µg·mL−1elastase activity) to 10 (maximum detectable neutrophil elastase activity). High neutrophil elastase activity was regarded as a NEATstik® grade >6. Severity of disease, airway infection from sputum culture and exacerbations over the 12 months were recorded. An independent validation was conducted in 50 patients from Milan, Italy.

Measurements and main results

Patients had a median age of 69 years and forced expiratory volume in 1 s (FEV1) 69%. High neutrophil elastase activity was associated with worse bronchiectasis severity using the bronchiectasis severity index (p=0.0007) and FEV1(p=0.02). A high NEATstik® grade was associated with a significant increase in exacerbation frequency, incident rate ratio 2.75 (95% CI 1.63–4.64, p<0.001). The median time to next exacerbation for patients with a NEATstik® grade >6 was 103 days compared to 278 days. The hazard ratio was 2.59 (95% CI 1.71–3.94, p<0.001). Results were confirmed in the independent validation cohort.

Conclusions

A novel lateral flow device provides assessment of neutrophil elastase activity from sputum in minutes and identifies patients at increasing risk of airway infection and future exacerbations.
Phenotype characterisation ofTBX4mutation and deletion carriers with neonatal and paediatric pulmonary hypertension
Authors: Galambos Csaba , Mullen Mary P. , Shieh Joseph T. , Schwerk Nicolaus , Kielt Matthew J. , Ullmann Nicola , Boldrini Renata , Stucin-Gantar Irena , Haass Cristina , Bansal Manish , Agrawal Pankaj B. , Johnson Joyce , Peca Donatella , Surace Cecilia , Cutrera Renato , Pauciulo Michael W. , Nichols William C. , Griese Matthias , Ivy Dunbar , Abman Steven H. , Austin Eric D. , Danhaive Olivier
Published: May 2019

Rare variants in the T-box transcription factor 4 gene (TBX4) have recently been recognised as an emerging cause of paediatric pulmonary hypertension (PH). Their pathophysiology and contribution to persistent pulmonary hypertension in neonates (PPHN) are unknown. We sought to define the spectrum of clinical manifestations and histopathology associated withTBX4variants in neonates and children with PH.

We assessed clinical data and lung tissue in 19 children with PH, including PPHN, carryingTBX4rare variants identified by next-generation sequencing and copy number variation arrays.

Variants included six 17q23 deletions encompassing the entireTBX4locus and neighbouring genes, and 12 likely damaging mutations. 10 infants presented with neonatal hypoxic respiratory failure and PPHN, and were subsequently discharged home. PH was diagnosed later in infancy or childhood. Three children died and two required lung transplantation. Associated anomalies included patent ductus arteriosus, septal defects, foot anomalies and developmental disability, the latter with a higher prevalence in deletion carriers. Histology in seven infants showed abnormal distal lung development and pulmonary hypertensive remodelling.

TBX4mutations and 17q23 deletions underlie a new form of developmental lung disease manifesting with severe, often biphasic PH at birth and/or later in infancy and childhood, often associated with skeletal anomalies, cardiac defects, neurodevelopmental disability and other anomalies.
Mean nocturnal respiratory rate predicts cardiovascular and all-cause mortality in community-dwelling older men and women
Authors: Baumert Mathias , Linz Dominik , Stone Katie , McEvoy R. Doug , Cummings Steve , Redline Susan , Mehra Reena , Immanuel Sarah
Published: May 2019

Respiratory frequency (fR) predicts in-hospital and short-term mortality in patients with a variety of pathophysiological conditions, but its predictive value for long-term cardiovascular and all-cause mortality in the general population is unknown. Here, we investigated the relationship between mean nocturnalfRand mortality in community-dwelling older men and women.

We measured mean nocturnalfRduring sleep from overnight polysomnography in 2686 men participating in the Osteoporotic Fractures in Men Study (MrOS) Sleep study and 406 women participating in the Study of Osteoporotic Fractures (SOF) to investigate the relationship between mean nocturnalfRand long-term cardiovascular and all-cause mortality.

166 (6.1%) men in the MrOS cohort (8.9±2.6 years’ follow-up) and 46 (11.2%) women in the SOF cohort (6.4±1.6 years’ follow-up) died from cardiovascular disease. All-cause mortality was 51.2% and 26.1% during 13.7±3.7 and 6.4±1.6 years’ follow-up in the MrOS Sleep study and the SOF cohorts, respectively. Multivariable Cox regression analysis adjusted for significant covariates demonstrated thatfRdichotomised at 16 breaths·min−1was independently associated with cardiovascular mortality (MrOS: hazard ratio (HR) 1.57, 95% CI 1.14–2.15; p=0.005; SOF: HR 2.58, 95% CI 1.41–4.76; p=0.002) and all-cause mortality (MrOS: HR 1.18, 95% CI 1.04–1.32; p=0.007; SOF: HR 1.50, 95% CI 1.02–2.20; p=0.04).

In community-dwelling older men and women, polysomnography-derived mean nocturnalfR≥16 breaths·min−1is an independent predictor of long-term cardiovascular and all-cause mortality. Whether nocturnal meanfRcan be used as a risk marker warrants further prospective studies.
Effect of preoperative immunonutrition on complications after salvage surgery in head and neck cancer
Authors: Mueller Simon Andreas , Mayer Catherine , Bojaxhiu Beat , Aeberhard Carla , Schuetz Philipp , Stanga Zeno , Giger Roland
Published: May 2019

Background

Patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma are at high risk of postoperative complications due to the adverse effects of radiotherapy on wound healing. Malnutrition is an additional risk factor and we tested the hypothesis that preoperative administration of immunonutrition would decrease complications in this high risk population.

Methods

This single armed study with historical control included consecutive patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma. We compared outcomes before and after implementation of preoperative immunonutrition and adjusted the regression analysis for gender, age, body mass index, Nutritional Risk Screening (NRS 2002), tobacco and alcohol consumption, tumor localization, tumor stage, and type of surgery. The primary endpoint was overall complications from surgery within a follow-up of 30 days.

Results

Ninety-six patients were included (intervention group: 51, control group: 45). Use of preoperative immunonutrition was associated with a significant reduction in overall complications (35% vs. 58%, fully-adjusted odds ratio 0.30 (95%CI 0.10–0.91, p = 0.034). Length of hospital stay was also significantly reduced (17 days vs. 6 days, p = < 0.001). No differences in mortality and hospital readmission were found. These results remained robust in multivariate analysis.

Conclusions

In patients undergoing salvage surgery for recurrent head and neck squamous cell carcinoma, preoperative immunonutrition exhibited favorable effects on the complication rate and consequently reduced the length of hospital stay. By improving both tissue regeneration and immune response, immunonutrition may help to improve surgical outcomes in this high-risk population.
Student Learning Dispositions: Multidimensional Profiles Highlight Important Differences among Undergraduate STEM Honors Thesis Writers
Authors: Dowd Jason E. , Thompson Robert J. , Schiff Leslie , Haas Kelaine , Hohmann Christine , Roy Chris , Meck Warren , Bruno John , Reynolds Julie A.
Published: May 2019

Various personal dimensions of students—particularly motivation, self-efficacy beliefs, and epistemic beliefs—can change in response to teaching, affect student learning, and be conceptualized as learning dispositions. We propose that these learning dispositions serve as learning outcomes in their own right; that patterns of interrelationships among these specific learning dispositions are likely; and that differing constellations (or learning disposition profiles) may have meaningful implications for instructional practices. In this observational study, we examine changes in these learning dispositions in the context of six courses at four institutions designed to scaffold undergraduate thesis writing and promote students’ scientific reasoning in writing in science, technology, engineering, and mathematics. We explore the utility of cluster analysis for generating meaningful learning disposition profiles and building a more sophisticated understanding of students as complex, multidimensional learners. For example, while students’ self-efficacy beliefs about writing and science increased across capstone writing courses on average, there was considerable variability at the level of individual students. When responses on all of the personal dimensions were analyzed jointly using cluster analysis, several distinct and meaningful learning disposition profiles emerged. We explore these profiles in this work and discuss the implications of this framework for describing developmental trajectories of students’ scientific identities.
Burnout and Mental Health Problems in Biomedical Doctoral Students
Authors: Nagy Gabriela A. , Fang Caitlin M. , Hish Alexander J. , Kelly Lisalynn , Nicchitta Christopher V. , Dzirasa Kafui , Rosenthal M. Zachary
Published: May 2019

Although burnout and mental health problems may adversely impact quality of scientific research, academic productivity, and attrition in biomedical doctoral training programs, very little research has been done on this topic. Recent studies have used brief survey methods to begin to explore burnout and mental health problems in biomedical doctoral students. In this pilot study, biomedical doctoral students ( N = 69; 12% of enrolled biomedical doctoral students at a large research institution’s school of medicine in the United States) were administered standardized psychiatric interviews and self-report questionnaires focused on dimensions of burnout, mental health symptoms, and academic outcomes. We discovered high levels of burnout, depression, and anxiety. Additionally, we identified that burnout was significantly associated with thoughts related to dropping out, subjective appraisal of employment opportunities, functional impairment due to a mental health problem, and having at least one current psychiatric disorder. These findings extend prior research indicating the presence of significant emotional health challenges doctoral students in biomedical graduate programs face involving high burnout and difficulties with the training environment. We outline several recommendations and next steps to programmatically understand and address these emerging emotional wellness concerns in biomedical doctoral students.
Understanding the use of ground-penetrating radar for assessing clandestine tunnel detection
Authors: Diamanti Nectaria , Annan A. Peter
Published: May 2019

We provide a coherent approach for developing an understanding of how and where ground-penetrating radar (GPR) can be deployed for tunnel detection. While tunnels in general are of interest, the more specific focus is tunnels that are hand dug or created with a minimal amount of equipment and resources for clandestine purposes. Determining whether GPR can be used for tunnel detection is impossible without an in-depth knowledge of the operational environment and constraints. To effectively address the question, we define the general characteristics of clandestine tunnels, discuss how to estimate the responses amplitude, define the dominant noise types associated with GPR data, and point out how those factors are affected by the GPR system. The key aspects are illustrated using a controlled field case study.
Validation of flow capacity and state-of-stress models in unconventional reservoirs by implementation of numerical models of diagnostic fracture injection tests
Authors: Buijs Hernán , Ponce Jorge , Veeken Paul
Published: May 2019

Diagnostic fracture injection tests contain critical information for reservoir characterization and hydraulic fracturing design, defining every input and output of the simulation modeling process. They help to assess the expected fracture geometry, proppant pack conductivity, formation flow capacity, and optimum hydraulic fracture design. At the same time, these data provide the necessary means to place a frac job adequately. However, interpretation challenges and inherent modeling nonuniqueness demonstrate the need for more constraints to reduce the solution space. Proprietary workflows have been applied using a 3D planar shear decoupled hydraulic fracture simulator to several vertical wells in the Vaca Muerta play in Argentina. The generated information makes it possible to build models consistent with multiple independent measurements from bottom-hole gauges, near wellbore, and far-field assessments of fracture geometry, which permit us to better understand production performance of the wells. The proposed workflow can be utilized to collapse the learning curve in a significant and meaningful way, playing a vital role in the optimization of horizontal wells and the field development strategy.
Theories of Depersonalization: A Re-appraisal
Authors: Sedman G.
Published: May 2019

Introduction There have been many theories put forward to explain the not uncommon symptoms of depersonalization. They were aptly summarized by Ackner (1954) in the following way. There are theories which regard depersonalization as a symptom with an organic basis; there are theories which consider it a disturbance of a particular psychological function; there are analytic theories; and finally there is a theory which would suggest that depersonalization is a form of schizophrenia. This paper is concerned with a re-appraisal of all these theories in the light of recent and current research on the subject.
Neurosis and Marital Interaction: II. Time Sharing and Social Activity
Authors: Kreitman Norman , Collins Joyce , Nelson Barbara , Troop Jane
Published: May 2019

This paper is concerned with certain aspects of the marital interaction of male neurotics and their wives: more specifically it was designed to test hypotheses advanced to explain the findings of an earlier study (Kreitman, 1964), partly confirmed in Part I of this inquiry. The findings in question were (i) that the patients' spouses had a higher level of morbidity than controls, a discrepancy which tended to increase with lengthening of the marriage, and (ii) that patients and their spouses had low or zero correlations on measures of personality and pathology in the early years of marriage, but with the passage of time the interspouse correlation increased, with the spouse coming increasingly to resemble the patient, especially with regard to symptoms: conversely, the control couples generally showed positive correlations early in marriage, but thereafter declined in their level of similarity.
Hypnoanalysis and Analytic Psychotherapy: A Comparative Study
Authors: More Joseph
Published: May 2019

In recent years there has been a reawakening of interest in the practical application of hypnosis in the different medical fields. In the realm of psychotherapy, the evidence for such interest can be found in the many specialized works on the subject, as well as in such texts as the American Handbook of Psychiatry (1), and the Comprehensive Textbook of psychiatry (2).
Brain Damage and Personality Change after Subarachnoid Haemorrhage
Authors: Storey P. B.
Published: May 2019

This paper reports on the personality changes found in 261 patients after proven subarachnoid haemorrhage, and in particular on the association between these changes and the site and severity of damage to the brain. Psychiatric symptoms and details of intellectual impairment are not considered but will be reported elsewhere.
Sexual Deviants Two Years after Electric Aversion
Authors: Marks Isaac , Gelder Michael , Bancroft John , O'Neill Maureen
Published: May 2019

This paper presents the results of electric aversion therapy in 24 patients with transvestism, fetishism, and sado-masochism. Preliminary findings have been reported elsewhere, together with a review of the literature and a discussion of the process of change during treatment (Marks and Gelder, 1967; Bancroft and Marks, 1968; Gelder and Marks, 1969). In these studies the available evidence indicated that the manifestations of the sexual disorder were diminished by treatment, and this appeared to be directly due to aversion rather than to non-specific components of treatment. The present report is concerned with the clinical outcome of these cases, with prognostic variables, and with the part aversion therapy should play in the treatment of these sexual disorders.
Affective Disorders in Iraq
Authors: Bazzoui Widad
Published: May 2019

Already an extensive literature exists on affective disorders, particularly depressive illness, in various developing countries of the world (Carothers, 1947; Tooth, 1950; Lambo, 1956 and 1960; Asuni, 1962; Pfeiffer, 1962 and 1963; Yap, 1965). Different authors have commented on different aspects of these disorders, and variations in their incidence, symptomatology and course have aroused widespread speculation regarding possible cultural influences on aetiology and clinical picture.
‘Mandrax’ as an Hypnotic for Psychiatric In-patients: A Comparative Trial with Chloral Hydrate
Authors: Adamson John D.
Published: May 2019

Mandrax (Roussel, Ltd.) is a combination of methaqualone 250 mg. and diphenhydramine 25 mg. and there have been several reports on its efficacy, as an hypnotic, which are cited by Derbez and Grauer (1967) and Haider (1968). It has been found to have approximately the same potency as various commonly used hypnotics, and it has been particularly recommended because of indications that overdosage is not associated with severe respiratory depression, as is the case with barbiturates (Lawson and Brown, 1967), and also because it does not reduce REM sleep as barbiturates do (Davison et al., 1970). It is stated to be particularly suitable for elderly patients. There is however, only one published trial on its use with patients with a variety of psychiatric diagnoses (Burke and Mahadevan, 1966); it is not specified in that report whether the patients were acute or chronic.
The Classification of Depressive Illnesses
Authors: Eysenck H. J.
Published: May 2019

As is well known, there has been a good deal of discussion about the unitary or binary nature of depression. Mapother (1926) and Lewis (1934) made a strong case for the unitary view on clinical grounds, Curran (1937) concurring. Kendell (1968) has reviewed the history of this argument; it is marred by confusion which has persisted through recent attempts to use statistical techniques of factor analysis and discriminant function analysis in an effort to find a more objective and empirical solution. It is the purpose of this brief note to draw attention to this confusion, to show how it has affected arguments of both adherents and opponents of the binary position, and to argue that the data are in fact in sufficient agreement to make possible a valid answer to both problems. It is suggested that the apparent disagreement between workers such as those of the Newcastle group (Kiloh and Garside, 1963; Carney, Roth and Garside, 1965) and the London (Maudsley) group (Kendell, 1968) is in fact quite irrelevant and is based on a misunderstanding of the statistical properties of factors, a misunderstanding apparently introduced in one of the first studies of this kind to be concerned with the problem of the classification of depressive illness, that by Hamilton and White (1959).
The Clinical Distinction between the Affective Psychoses and Schizophrenia
Authors: Kendell R. E. , Gourlay Jane
Published: May 2019

The distinction between schizophrenic and affective illnesses has been one of the cornerstones of psychiatric classification ever since Kraepelin introduced the twin concepts of dementia praecox and manic depressive psychosis at the turn of the century. It has also long been recognized that some patients have both schizophrenic and affective symptoms, and various interpretations have been placed on these mixed states. To some continental psychiatrists they constitute a third group of psychoses distinct from both schizophrenia and manic-depressive psychosis—the degeneration psychoses of Kleist or the cycloid psychoses of Leonhard. By others they are regarded as genuine mixed states, with the implication that elements of both schizophrenia and manic depressive illnesses are contributing, perhaps because the genetic or constitutional endowment is mixed, perhaps because two alternative defence mechanisms are being utilized simultaneously. Often, however, mixed symptomatology is simply ignored, either by discounting the schizophrenic symptoms and focusing attention on the mood change, or, as most American psychiatrists do, by glossing over the affective symptoms and regarding the illness as a form of schizophrenia differing in no significant respect from other schizophrenias.
The Dyad Grid: A Modification of Repertory Grid Technique
Authors: Ryle A. , Lunghi M.
Published: May 2019

We have previously reported the use of repertory grid testing to extend the understanding of psychopathology in neurotic patients and to test predictions about the effects of therapy (Ryle, 1967; Ryle and Lunghi, 1969). In these tests the elements were people known to the subject, and the constructs were elicited from him. Repertory grid testing can supplement the data obtained from clinical interviews, notably in the following ways:
Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: ASCO Clinical Practice Guideline Update—Integration of Results From TAILORx
Authors: Andre Fabrice , Ismaila Nofisat , Henry N. Lynn , Somerfield Mark R. , Bast Robert C. , Barlow William , Collyar Deborah E. , Hammond M. Elizabeth , Kuderer Nicole M. , Liu Minetta C. , Van Poznak Catherine , Wolff Antonio C. , Stearns Vered
Published: May 2019

PURPOSE

This focused update addresses the use of Onco type DX in guiding decisions on the use of adjuvant systemic therapy.

METHODS

ASCO uses a signals approach to facilitate guideline updating. For this focused update, the publication of the Trial Assigning Individualized Options for Treatment (TAILORx) evaluating noninferiority of endocrine therapy alone versus chemoendocrine therapy for invasive disease–free survival in women with Onco type DX scores provided a signal. An expert panel reviewed the results of TAILORx along with other published literature on the Onco type DX assay to assess for evidence of clinical utility.

UPDATED RECOMMENDATIONS

For patients with hormone receptor–positive, axillary node–negative breast cancer whose tumors have Onco type DX recurrence scores of less than 26, there is little to no benefit from chemotherapy, especially for patients older than age 50 years. Clinicians may recommend endocrine therapy alone for women older than age 50 years. For patients 50 years of age or younger with recurrence scores of 16 to 25, clinicians may offer chemoendocrine therapy. Patients with recurrence scores greater than 30 should be considered candidates for chemoendocrine therapy. Based on informal consensus, the panel recommends that oncologists may offer chemoendocrine therapy to these patients with recurrence scores of 26 to 30. Additional information can be found at www.asco.org/breast-cancer-guidelines .
Development and Implementation of a Cancer Quality Index in Queensland, Australia: A Tool for Monitoring Cancer Care
Authors: Walpole Euan T. , Theile David E. , Philpot Shoni , Youl Philippa H. ,   for Cancer Alliance Queensland
Published: May 2019

PURPOSE:

Many cancer-specific assessment tools to measure health care performance have been developed. However, reporting on quality indicators at a population level is uncommon. We describe the development and implementation of a Cancer Quality Index (CQI) and examine the sensitivity of the index to detect change over time.

METHODS:

In developing the CQI, we reviewed existing indices, guidelines, and cancer care pathways. Our choice of indicators was additionally guided by the availability of population-wide data. A series of pilot indicators underwent trial use and were evaluated, and outcomes were discussed before a final set of indicators was established. The process was overseen by a clinician-led quality assurance committee that included hospital administrators and data custodians.

RESULTS:

The CQI includes five quality dimensions and 16 indicators for public and private cancer services using population-wide information. The following are the five indicators: Effective, Efficient, Safe, Accessible, and Equitable. We demonstrated the sensitivity of the CQI to measure change over time by examining outcomes such as time to first treatment and 30-day surgical mortality, using linked cancer registry and health administrative data for 99,728 patients with cancer diagnosed between 2005 and 2009 and 2010 and 2014.

CONCLUSION:

The CQI is a valuable tool to track progress in delivering safe, quality cancer care within health care services. Critical to its development and implementation has been the involvement of clinicians from several disciplines and the availability of population-based data. We found the CQI to be a sensitive tool able to detect changes over time.
Stress-Induced Suppression of Milk Protein Is Involved in a Noradrenergic Mechanism in the Mammary Gland
Authors: Chiba Takeshi , Maeda Tomoji , Fujita Yu , Takeda Rika , Kikuchi Akihiko , Kudo Kenzo
Published: May 2019

Stress decreases milk components such as milk protein and milk yield. The objective of this study was to investigate whether noradrenaline (NA) in milk constituted a factor associated with stress-induced changes in milk proteins such as β-casein. Breast milk obtained from eight healthy, nursing women contained NA at concentrations ranging from 12.7 to 115.5 nM. The expression of tyrosine hydroxylase (TH), a rate-limiting enzyme of NA synthesis, was observed in primary normal human mammary epithelial cells (HMECs), and in MCF-12A and MCF-10A cell lines. The mean NA concentration in culture medium used by MCF-12A transfected with TH small interfering RNA (siRNA) was significantly lower than that of cells transfected with control siRNA. NA concentration in milk in restraint-stressed nursing mice was significantly higher than that in nonstressed nursing mice, owing to elevated TH expression in the mammary epithelium. The mean β-casein concentration in milk in restraint-stressed mice was significantly lower than that in nonstressed mice. NA treatment resulted in a concentration-dependent decrease in β-casein expression in HMECs. β2 adrenergic receptor (ADRB2) expression was observed in HMECs, MCF-12A, and MCF-10A, and immunohistochemical analysis of ADRB2 using mammary epithelium sections obtained from mice at day 10 of lactation showed that ADRB2 was expressed at the apical membrane of mammary epithelium. Treatment with salbutamol, an ADRB2 stimulant, decreased β-casein expression in a concentration-dependent manner in MCF-12A. Our results showed that endogenous NA derived from mammary epithelial cells likely comprises one of the factors involved in stress-induced changes in milk proteins such as β-casein.
SREBP Plays a Regulatory Role in LH/hCG Receptor mRNA Expression in Human Granulosa-Lutein Cells
Authors: Li Yin-Xia , Guo Xingzi , Gulappa Thippeswamy , Menon Bindu , Menon K M J
Published: May 2019

Context

LH receptor (LHR) expression has been shown to be regulated posttranscriptionally by LHR mRNA binding protein (LRBP) in rodent and human ovaries. LRBP was characterized as mevalonate kinase. The gene that encodes mevalonate kinase is a member of a family of genes that encode enzymes involved in lipid synthesis and are regulated by the transcription factor sterol regulatory element binding proteins (SREBPs).

Objective

The current study examined the regulation of LHR mRNA expression in human granulosa-lutein cells in response to alterations in cholesterol metabolism.

Design

Using atorvastatin, an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase to inhibit cholesterol biosynthesis, we examined its effect on LHR mRNA expression. The effect of atorvastatin on SREBP and mRNA expression as well as LHR mRNA binding protein expression was examined. Finally, the effect of atorvastatin on human chorionic gonadotropin (hCG)–stimulated progesterone production and the expression of key steroidogenic enzymes was also examined.

Results

Statin treatment reduced LHR mRNA expression by increasing the levels of SREBP1a and SREBP2, leading to an increase in LRBP. RNA gel shift assay showed that increased binding of LHR mRNA to LRBP occurred in response to atorvastatin, leading to LHR mRNA degradation. The granulosa-lutein cells pretreated with atorvastatin also showed decreased responsiveness to hCG by decreasing the mRNA and protein expression of steroidogenic enzymes. Atorvastatin also attenuated LH/hCG-induced progesterone production.

Conclusion

These results imply that LHR mRNA expression by the human granulosa-lutein cells is regulated by cholesterol, through a mechanism involving SREBP and SREBP cleavage activating protein serving as the cholesterol sensor.
Migration through physical constraints is enabled by MAPK-induced cell softening via actin cytoskeleton re-organization
Authors: Rudzka Dominika A. , Spennati Giulia , McGarry David J. , Chim Ya-Hua , Neilson Matthew , Ptak Aleksandra , Munro June , Kalna Gabriela , Hedley Ann , Moralli Daniela , Green Catherine , Mason Susan , Blyth Karen , Mullin Margaret , Yin Huabing , Olson Michael F.
Published: May 2019

Cancer cells are softer than the normal cells, and metastatic cells are even softer. These changes in biomechanical properties contribute to cancer progression by facilitating cell movement through physically constraining environments. To identify properties that enabled passage through physical constraints, cells that were more efficient at moving through narrow membrane micropores were selected from established cell lines. By examining micropore-selected human MDA MB 231 breast cancer and MDA MB 435 melanoma cancer cells, membrane fluidity and nuclear elasticity were excluded as primary contributors. Instead, reduced actin cytoskeleton anisotropy, focal adhesion density and cell stiffness were characteristics associated with efficient passage through constraints. By comparing transcriptomic profiles between the parental and selected populations, increased Ras/MAPK signalling was linked with cytoskeleton rearrangements and cell softening. MEK inhibitor treatment reversed the transcriptional, cytoskeleton, focal adhesion and elasticity changes. Conversely, expression of oncogenic KRas in parental MDA MB 231 cells, or oncogenic BRaf in parental MDA MB 435 cells, significantly reduced cell stiffness. These results reveal that MAPK signalling, in addition to tumour cell proliferation, has a significant role in regulating cell biomechanics.

This article has an associated First Person interview with the first author of the paper.
Molecular mechanisms of chemotropism and cell fusion in unicellular fungi
Authors: Martin Sophie G.
Published: May 2019

In all eukaryotic phyla, cell fusion is important for many aspects of life, from sexual reproduction to tissue formation. Fungal cells fuse during mating to form the zygote, and during vegetative growth to connect mycelia. Prior to fusion, cells first detect gradients of pheromonal chemoattractants that are released by their partner and polarize growth in their direction. Upon pairing, cells digest their cell wall at the site of contact and merge their plasma membrane. In this Review, I discuss recent work on the chemotropic response of the yeast models Saccharomyces cerevisiae and Schizosaccharomyces pombe, which has led to a novel model of gradient sensing: the cell builds a motile cortical polarized patch, which acts as site of communication where pheromones are released and sensed. Initial patch dynamics serve to correct its position and align it with the gradient from the partner cell. Furthermore, I highlight the transition from cell wall expansion during growth to cell wall digestion, which is imposed by physical and signaling changes owing to hyperpolarization that is induced by cell proximity. To conclude, I discuss mechanisms of membrane fusion, whose characterization remains a major challenge for the future.
Synthesis of the Soluble Precursors of Tetrabenzoporphyrin: Control of the Solubility and the Conversion Temperature
Authors: Okujima Tetsuo , Hashimoto Yusuke , Furuta Tomoya , Yamanaka Ritsuko , Jin Guangnan , Otsubo Saika , Aramaki Shinji , Mori Shigeki , Yamada Hiroko , Uno Hidemitsu , Ono Noboru
Published: May 2019

Novel thermally convertible precursors of tetrabenzoporphyrin (TBP) were synthesized by tetramerization of the corresponding bicyclo[2.2.2]octadiene(BCOD)-fused pyrroles. These precursors showed high solubility and were converted into TBPs by heating at 180–330 °C depending on the structure of BCOD moieties. This strategy provided easy access to pure PtTBP from the precursor with high conversion temperature in a good yield. Organic field effect transistors based on TBP were fabricated by thermal conversion after spin-coating of the precursors.
An Empirical Model for Stereochemical Control in the Cyclization of Cyclopropanetricarboxylic Acid Esters
Authors: Tanaka Kento , Manabe Hitomi , Irie Raku , Oikawa Masato
Published: May 2019

Here, we report an empirical model for diastereoselective cyclopropanation of fumarate/maleate diesters with chloroacetate, sulfonium ylide, or ammonium ylide. With symmetrical fumarate/maleate diesters, cyclopropanation was found to proceed with a high level of diastereoselectivity in favor of the chiral isomer. In contrast, production of the meso isomer was observed in 38–48% diastereoselectivity when unsymmetrical fumarate/maleate was employed. An improved synthesis of (N-desmethy)dysibetaine CPa in both racemic and enantiomerically pure forms was furthermore achieved. Configurational analysis by experimental and calculated 13C NMR data is also reported.