bluuebunny/crossref_metadata_2025 huggingface dataset:
Education and training
Authors: Hain Richard D.W. , Jassal Satbir Singh
Published: December 2016

Paediatric palliative medicine was recognized in the UK as a subspecialty of paediatrics in 2009. Unusually amongst paediatric subspecialties, paediatric palliative medicine is defined by the needs of individual patients, rather than by their diagnosis or diseased organ system (which may indeed not be known), and competencies in paediatric palliative medicine often overlap with those in other paediatric specialties, as well as with adult palliative medicine and palliative care. This chapter describes the four levels of competence currently recognized in palliative medicine, as well as provides information on the small, but growing, number of curriculums in paediatric palliative medicine. This includes the competencies required by the Royal College of Paediatrics and Child Health and the Association for Paediatric Palliative Medicine.
The innate ‘You’: the basic package
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that there is converging evidence that attests to the intrinsic relational nature of human beings at the subpersonal level. Also, developmental psychology demonstrates that intersubjectivity is an innate, primary system of motivation that organizes human behaviour towards valued goals felt as need and desire by human beings. There are two such valued goals for the intersubjectivity motivational system: the first is the need to read the feelings and intentions of another; the second is the need to establish or re-establish self-cohesion and self-identity. We need to know where we are situated and what the others are going to do. When we are intersubjectively disorientated, a special kind of basic anxiety arises. The second felt need is that for the Other’s recognition: we need a ‘You’ who looks at us to form our basic self and personal identity.
Epiphanies of alterity: drive
Authors: Stanghellini Giovanni
Published: December 2016

This chapter explains that we encounter alterity in two main domains: in ourselves, and in the external world. In the first case alterity is in the involuntary dimension of ourselves, as (for instance) our un-chosen ‘character’, including needs, desires, emotions, and habits. In the external world, alterity is encountered in the challenging otherness of the events and in the meetings with other persons that constellate our life. This involuntary dimension of my being the person that I am includes what is a priori given in my existence, the raw material that constitutes the sedimented dispositions of my being and sets the boundaries of my freedom. The roots of the involuntary are my history, my body, and the world into which I am thrown. A relevant part of the involuntary is drive. Drive is the principle of all obscurity in my will. Its two basic profiles are need and desire.
A closer look at moods and affects: intentionality and temporality
Authors: Stanghellini Giovanni
Published: December 2016

This chapter shows that moods and affects differ from each other in terms of intentionality and temporality. Intentionality is the aspect of a psychic state of being ‘about’ something. Moods are experienced as unintentional, affects as intentional. Whereas affects point to an explicit experience such as a dangerous situation, moods point to my being the person I am in a given situation. Temporality is understood as how the person experiences time and how the existence of the person is inevitably formed and developed in time. Affects are often briefer than moods. They captivate me, and thereby move me to a determinate action within a restricted period of time. Moods, on the contrary, may last for days or even years in that they paralyse my thoughts and retain me from acting (sadness), or throw me into weird actions without any thoughts of the past or the future (euphoria).
Alterity and the other person: the anatomy of recognition
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that another kind of teleology at play in human emotional experience is the desire for recognition. I long for the Other to appreciate me as I am rather than how I should be. Recognition entails five basic steps. First, I must acknowledge that the life-world of the other person is not like my own. Second, I need to grant the meaningfulness of the other person’s actions as embedded in the other person’s life-world. Third, I must learn to neutralize my natural attitude that would make me evaluate the other’s experience as if it took place in a world like my own. Fourth, I must try to reconstruct the existential structures of the world the other lives in. Fifth, I can finally attempt to understand the other’s experience as meaningfully situated in a world that is indelibly marked by the other person’s particular existence.
The basic need for recognition
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that the need to be recognized and to be accepted, respected, forgiven, and loved is a fundamental disposition in human existence. My existence is conditioned by the value of social recognition alongside the organic values of my biological life. Yet, the need for recognition can even be stronger than other needs rooted in my organic values. We as human persons can choose to renounce, at least in part, our material gains (e.g. a part of one’s salary) in order to achieve social recognition (e.g. the acknowledgement of one’s capacities). There are three paradigmatic forms of recognition: Love, whereby the person experiences the recognition of his particular needful nature in order to attain that affective security that allows him to articulate his needs; Law, the subject experiences that juridical institutions guarantee the recognition of his autonomy; and Solidarity, the subject experiences the recognition of the value of his capacities.
The truth about symptoms
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that the main aim of early psychoanalytic thinking is to answer the question: ‘What is the origin or cause of this psychical symptom?’. But at the same time, early psychoanalysis paved the way for the quest for the meaning of the symptom: ‘What does that symptom mean?’. In contrast to the biomedical paradigm, in the psychodynamic approach the symptom asks to be heard and deciphered, rather than explained and removed. The psychodynamic understanding of ‘symptom’ completely reverses the biomedical concept. A person’s symptom is not accidental (synbebekos) to that person; rather it is the manifestation of his or her true identity. Someone’s symptom could even be the most authentic thing he possesses. A symptom has a similar structure to Heidegger’s aletheia (literally: un-hiddenness): it is the place where truth about oneself manifests while hiding itself.
Conflicting values: the case with post partum depression
Authors: Stanghellini Giovanni
Published: December 2016

This chapter reformulates the concept of ‘conflict’, arguing that conflicts do not inevitably involve an unconscious desire—they involve plurality. Conflicts go with being human because we are intrinsically plural, as we are inhabited by alterity. Plurality implies disunion. This does not amount merely to internal conflicts in a strict psychoanalytical sense; rather, it is the ubiquitous presence of non-coincidence and eccentricity. Human existence constantly escapes any coinciding with an essence. Disunion means that I am called to take a position in front of myself, and more specifically in front of the otherness I experience in my existence. One does not coincide with his experience. To be human is to deal with this reflective duplicity by taking upon myself the responsibility for articulating, making sense of, coping with, and appropriating. All this is explained through a clinical example: post partum depression.
The body as alterity: the case with gender dysphoria
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that gender dysphoria—a person suffering from an incongruence between experienced gender and assigned gender—is another illustration of the vulnerable duplicity inherent in the human condition. I am not merely the matter of which I am made. Rather, I am that matter plus the form that I impose upon it. In trying to shape my matter, I experience myself as an autonomous person and, simultaneously, as a person whose autonomy is limited by the matter itself. Between sex and gender there is the same relationship as between matter and form. We can shape the matter we are ‘thrown into’ and give it the form we desire, obviously within the boundaries delimited by matter itself and by our capacity for autonomy. Being the person that I am is a task and a responsibility that consists in becoming who I am through what I am.
The portrait of the clinician as a globally minded citizen
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that the specialist in mental health care should have the ability to think what it might be like to be in the shoes of a person different from oneself, to be an intelligent reader of that person’s story, and to understand the emotions, wishes, and desires that someone so placed might have. She should be trained to confront human vulnerability, the evidence of our animality and fragile rationality, the anxieties for our mortality, the dilemmas of autonomy and authority, and the conflicts of inclusion and exclusion, and in general with the encounter with Otherness that characterizes human life. Also, she should possess the ability to have concern for the lives of others, to imagine a variety of complex issues affecting the story of a human life, and to see other persons, especially marginalized people, as fellows with equal rights and look at them with respect.
The chiasm
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that Eros is the principle of opacity in human life, the epicentre of human suffering and pathology, since it includes organic as well as spiritual values: the need for sexual satisfaction as well as for recognition, for lust and intimacy, for possession and proximity. Eros is the principle of human vulnerability, for it bases its aspirations on the conflicting values of identity and of alterity. Love is also the hybrid of reality and imagination. The lover’s discourse adheres to the image like a glove, much more than it adheres to the loved one. Focusing on the image of Other is not just the case with erotomanic desire, but a general rule of the teleology of desire. Patients who focus on their phantasm, rather than on the flesh-and-blood Other, disregard the Other’s freedom not to correspond to their own desire, and their incapacity to tolerate this.
Position-taking
Authors: Stanghellini Giovanni
Published: December 2016

This chapter argues that the extreme variability of schizophrenic phenotypes is a paradigmatic case study for explicating the dialectics between uncanny feelings of depersonalization/derealization and the attitude of the person who experiences them. Why do persons who suffer from these kinds of anomalous self-, body-, and world-experiences develop either a delusional form of schizophrenia or a ‘pauci-symptomatic’ type of this illness, or a schizotypal personality disorder? Why do delusions in people with schizophrenia take on so many different themes, and not only ontological ones, but also, for example, persecutory, hypochondriac, of reference, of agnition (filiation), external influence, etc.? If we subscribe to the ‘one root–many branches’ conceptualization of the manifold of schizophrenia, then we must be able to explain why, arising from the common root of self-disorders, schizophrenic phenotypes take on so many different features. A plausible answer is that self-disorder, being at the core of the vulnerability to schizophrenia, is refracted through the prism of the person’s background of values and beliefs that determine what things and events in the world mean for them. This personal background is a pre-reflective context of meaning and significance within which and against which persons understand themselves, others, and their world.
Responsibility
Authors: Stanghellini Giovanni
Published: December 2016

This chapter discusses how the vulnerability to madness, as the cypher of condicio humana, imbues responsibility. Schizophrenia and melancholia represent two opposite polarities of distorted agency and of responsibility. In the former, the person, while performing a given action, does not feel that he is the one who is voluntarily acting. He feels that the source of his actions is placed beyond the boundaries of the Self, and thus is out of control. Persons affected by melancholia, vice versa, attribute to themselves the cause of effects that, from another perspective, cannot be attributed to them. But they also experience a total passivity with respect to their capacity for modifying a given state of affairs. It is essential to maintain responsibility (and to avoid blame) in order to enable the patient to re-establish a dialogue with himself, that is, with the chiasm of voluntary and involuntary that constitutes a human person.
Personal life-history
Authors: Stanghellini Giovanni
Published: December 2016

This chapter describes the process of progressive decentring of two partners taking part in a dialogue. Phenomenological unfolding is the taking of a third-person perspective on one’s own experiences. The hermeneutic moment consists in position-taking and perspective-taking with respect to one’s own experiences and their meanings. It requires the capacity to distance oneself from one’s own habits in interpreting and understanding the ‘facts’ of one’s own life, and to make of these very habits the object for reflection and for understanding. The psychodynamic moment consists in positing both phenomenological unfolding and hermeneutic analysis in a larger historical context, according great importance to the role of life events, of tradition and prejudice in the development of any form of habitus in interpreting one’s experiences, and of limit-situations in jeopardizing one’s defensive ‘housings’ and showing their vulnerability. This means acknowledging and accepting contingency as the necessity of one’s own story.
Headache
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter on headache discusses the classification, clinical features, treatment regimes, and evidence for treatment of primary (including migraine, tension-type headache, and trigeminal autonomic cephalalgias) and secondary headache (idiopathic intracranial hypertension and medication overuse headache) disorders.
Vertigo
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter on vertigo discusses the classification of vertiginous disorders (peripheral: benign paroxysmal positional vertigo (BPPV), vestibular neuronitis/labyrinthitis, Ménière’s disease, and vestibular paroxysmia; and central: vestibular migraine, posterior circulation stroke, multiple sclerosis, and episodic ataxias), clinical features, treatment regimes, and evidence for treatment.
B
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [B]
D
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [D]
F
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [F]
G
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [G]
R
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [R]
T
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [T]
U
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [U]
Z
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [Z]
P
Authors: Nageshwaran Sathiji , Wilson Heather C , Dickenson Anthony , Ledingham David
Published: December 2016

This chapter includes drugs beginning with the letter [P]
Atrial fibrillation and supraventricular arrhythmias
Authors: Katritsis Demosthenes , Camm A John
Published: December 2016

This chapter discusses the acute management of patients presenting with tachyarrhythmias suggestive of regular supraventricular tachycardias (SVT) and/or atrial fibrillation (AF). A classification of narrow- and wide-QRS tachycardias is presented, and the differential diagnosis of narrow- and wide-QRS tachycardias is discussed. Principles of acute therapy are presented either in the context of acute therapy before establishing a definitive diagnosis or for particular arrhythmia entities with an established diagnosis of a regular SVT or AF.
Congenital heart disease in adults
Authors: Price Susanna , Keogh Brian F , Swan Lorna
Published: December 2016

The number of patients with congenital heart disease surviving to adulthood is increasing, with many requiring ongoing medical attention. Although recommendations are that these patients should be cared for in specialist centres, the clinical state of the acutely unwell patient may preclude transfer prior to the instigation of lifesaving treatment. Although the principles of resuscitation in this patient population differ little from those with acquired heart disease, the acutely unwell adult congenital heart disease patient presents a challenge, with potential pitfalls in examination, assessment/monitoring, and intervention. Keys to avoiding errors include: knowledge of the primary pathophysiology, any interventions that have been undertaken, residual lesions present (static or dynamic), and the normal physiological status for that patient-to determine the precise cause for the acute deterioration and to appreciate the effects (detrimental or otherwise) that any supportive and/or therapeutic interventions might have. Expert advice should be sought at the earliest opportunity.
Acute pain in the intensive cardiac care unit
Authors: Jaggar Siân , Laycock Helen
Published: December 2016

◆ Cardiac intensive care units admit a heterogeneous patient group

◆ Pain is common, occurring in up to 70% of medical and surgical patients

◆ Effective analgesia is important

◆ Pain is under-recognized and inadequately treated, particularly in medical patients

◆ Consequences of pain are widespread, involving multisystem physiological changes

◆ Pain causes significant psychological sequelae for patients, and ethical implications for physicians

◆ Pain management should utilize a systematic approach. Ensuring optimal patient comfort requires:

○ Understanding of the potential causes of pain in cardiac intensive care

○ Using validated pain assessment tools to identify the presence of pain and evaluate treatment effects

○ Employing a multimodal, multidisciplinary management strategy
The ultraluminous X-ray source HoII X-1: kinematic evidence of its escape from a cluster
Authors: Egorov Oleg V. , Lozinskaya Tatiana A. , Moiseev Alexei V.
Published: December 2016

We analyse the structure and kinematics of ionized gas in the vicinity of the ultraluminous X-ray source (ULX) HoII X-1 in the Holmberg II galaxy using observational data obtained with a scanning Fabry–Perot interferometer in the Hα, [S ii] and [O iii] emission lines at the Russian 6-m telescope. Decomposition of the line profiles allows us to identify the broad component of emission lines caused by the ULX action. We found evidence of an expanding superbubble around the young star cluster located in the region studied. We conclude that the blueshifted ‘arc’ around the ULX observed in the line-of-sight velocity field may correspond to a bow shock caused by the ULX movement from that nearby young star cluster. If this interpretation is correct, it will be the first kinematic evidence of a ULX's escape from its parent star cluster.
Objective vortex detection in an astrophysical dynamo
Authors: Rempel E. L. , Chian A. C.-L. , Beron-Vera F. J. , Szanyi S. , Haller G.
Published: December 2016

A novel technique for detecting Lagrangian vortices is applied to a helical magnetohydrodynamic dynamo simulation. The vortices are given by tubular level surfaces of the Lagrangian averaged vorticity deviation, the trajectory integral of the normed difference of the vorticity from its spatial mean. This simple method is objective, i.e. invariant under time-dependent rotations and translations of the coordinate frame. We also adapt the technique to use it on magnetic fields and propose the method of integrated averaged current deviation to determine precisely the boundary of magnetic vortices. The relevance of the results for the study of vortices in solar plasmas is discussed.
Lotus japonicus NF-YA1 Plays an Essential Role During Nodule Differentiation and Targets Members of the SHI/STY Gene Family
Authors: Hossain Md Shakhawat , Shrestha Arina , Zhong Sihui , Miri Mandana , Austin Ryan S. , Sato Shusei , Ross Loretta , Huebert Terry , Tromas Alexandre , Torres-Jerez Ivone , Tang Yuhong , Udvardi Michael , Murray Jeremy D. , Szczyglowski Krzysztof
Published: December 2016

Legume plants engage in intimate relationships with rhizobial bacteria to form nitrogen-fixing nodules, root-derived organs that accommodate the microsymbiont. Members of the Nuclear Factor Y (NF-Y) gene family, which have undergone significant expansion and functional diversification during plant evolution, are essential for this symbiotic liaison. Acting in a partially redundant manner, NF-Y proteins were shown, previously, to regulate bacterial infection, including selection of a superior rhizobial strain, and to mediate nodule structure formation. However, the exact mechanism by which these transcriptional factors exert their symbiotic functions has remained elusive. By carrying out detailed functional analyses of Lotus japonicus mutants, we demonstrate that LjNF-YA1 becomes indispensable downstream from the initial cortical cell divisions but prior to nodule differentiation, including cell enlargement and vascular bundle formation. Three affiliates of the SHORT INTERNODES/STYLISH transcription factor gene family, called STY1, STY2, and STY3, are demonstrated to be among likely direct targets of LjNF-YA1, and our results point to their involvement in nodule formation.
Mediators of Treatment Effect in the Back In Action Trial
Authors: Mansell Gemma , Hill Jonathan C. , Main Chris J. , Von Korff Michael , van der Windt Daniëlle
Published: December 2016

Objectives:

To test whether change in fear-avoidance beliefs was a mediator of the effect of treatment on disability outcome, and to test an analytical approach, latent growth modeling, not often applied to mediation analysis.

Methods:

Secondary analysis was carried out on a randomized controlled trial designed to compare an intervention addressing fear-avoidance beliefs (n=119) with treatment as usual (n=121) for patients with low back pain, which found the intervention to be effective. Latent growth modelling was used to perform a mediation analysis on the trial data to assess the role of change in fear-avoidance beliefs on disability outcome. The product of coefficients with bias-corrected bootstrapped confidence intervals was used to calculate the mediating effect.

Results:

A statistically significant mediating effect of fear-avoidance beliefs on the effect of treatment on disability outcome was found (standardized indirect effect −0.35; bias-corrected 95% CI, −0.47 to −0.24). Poor fit of the model to the data suggested that other factors not accounted for in this model are likely to be part of the same mediating pathway.

Discussion:

Fear-avoidance beliefs were found to mediate the effect of treatment on disability outcome. Measurement of all potential mediator variables in future studies would help to more strongly identify which factors explain observed treatment effects. Latent growth modelling was found to be a useful technique to apply to studies of treatment mediation, suggesting that future studies could use this approach.
Use of Simulation in End-of-Life Care Education
Authors: Grabow Debra
Published: December 2016

Death and dying encompasses the period when individuals present with a limited prognosis and are near death or have recently died. Using simulation to educate nurses on end-of-life (EOL) care helps focus more on the needs of the learner rather than the patient, and allows the learner to process feelings in preparation for a real experience. Incorporating simulation with a spiritual perspective is essential and needed in EOL nursing care.
Combination of Panaxadiol and Panaxatriol Type Saponins and Ophioponins From Shenmai Formula Attenuates Lipopolysaccharide-induced Inflammatory Injury in Cardiac Microvascular Endothelial Cells by Blocking NF-kappa B Pathway
Authors: Zhu Jinqiang , Liang Yubin , Yue Shaoqian , Fan Guanwei , Zhang Han , Zhang Meng
Published: December 2016

Vascular inflammatory injury leads to vascular endothelial dysfunction, thereby resulting in a variety of cardiovascular diseases (CVDs). Thus, attenuating vascular inflammatory injury has great significance for the prevention and treatment of CVDs. In China, Shenmai formula, a well-known ancient Chinese prescription, has been widely used to treat CVDs, such as coronary atherosclerosis and viral myocarditis. In vivo study has demonstrated that the optimal combination of 3 major active components from Shenmai formula, panaxadiol and panaxatriol type saponins and ophioponins, in a ratio of 1:2:2 might exert significant cardioprotective effects and anti-inflammatory activities. The aim of this study was to investigate whether the combination may exert anti-inflammatory effects on lipopolysaccharide-induced inflammatory injury in cardiac microvascular endothelial cells by blocking nuclear factor-kappa B (NF-κB) pathway. We found that the combination could exert anti-inflammatory effects by inhibiting the mRNA and protein expression of interleukin-1, interleukin-6, tumor necrosis factor alpha, and intercellular adhesion molecule, as well as reducing the lactate dehydrogenase content in lipopolysaccharide-injured cardiac microvascular endothelial cells supernatant. Further experiments showed that the combination could suppress the NF-κB p65 expression and IκBα phosphorylation in these cells. These findings suggested that the combination inhibits vascular inflammatory injury by blocking NF-κB pathway, which proves a new molecular mechanism of the Shenmai formula to treat CVDs.
OCULAR FINDINGS IN A PATIENT WITH ECTODERMAL DYSPLASIA
Authors: Çalişkan Sinan , Köşker Mustafa , Biçer Tolga , Çelikay Osman , Gürdal Canan
Published: December 2016

Purpose:

Ectodermal dysplasia (ED) results from abnormal development of the ectodermal layer. Although coexistence of ED and retinal pathology has been described, concomitance with retinal venous tortuosity has not been reported in the literature.

Methods:

Case report.

Results:

We report the case of a 23-year-old man with ED with bilateral retinal venous tortuosity, trichomegaly, meibomian gland dysfunction, and dry eye. Although the coexistence of ED with trichomegaly and meibomian gland dysfunction has been previously reported, to the best of our knowledge, this is the first reported case of retinal venous tortuosity associated with ED.

Conclusion:

Coexistence of retinal venous tortuosity and ED may be the consequence of a genetic mutation affecting cellular signaling pathways during retinal angiogenesis.
Characterizing the Occluded Lacrimal Punctum Using Anterior Segment Optical Coherence Tomography
Authors: Timlin Hannah M. , Keane Pearse A. , Rose Geoffrey E. , Ezra Daniel G.
Published: December 2016

Purpose:

Epiphora is sometimes associated with an absent or occluded lacrimal drainage punctum (or puncta). This study uses noninvasive “enhanced depth” anterior segment optical coherence tomography (OCT) to give improved characterization and understanding of absent or fully occluded puncta and the underlying canaliculus.

Methods:

Anterior segment spectral domain OCT images were collected prospectively from 9 lower puncta of 6 patients with epiphora and absent or fully occluded puncta, not amenable to dilation in clinic, to see if a canaliculus was visible on OCT imaging below the occluded punctum.

Results:

An epithelial lined canalicular lumen was visible on OCT in 4 lower eyelid puncta from 2 patients and OCT identified 80% (4/5) of the canaliculi that were located on microscope-assisted punctal exploration. These lumens were seen within 580 μm depth from the eyelid margin surface. A half of the eyes in which a canaliculus was identified on OCT (the 2 eyes in a single patient) had resolution of epiphora following punctoplasty, and the other patient was found to have coexisting nasolacrimal duct stenosis and required later dacryocystorhinostomy. The positive predictive value for identifying a canaliculus on lower eyelid punctal exploration in acquired complete punctal occlusion (excluding the congenital case) was 1, with a negative predictive value of 1.

Conclusions:

This study demonstrates that canaliculi can be imaged with OCT where formal access is precluded by an occluded punctum. This noninvasive investigation might help predict the likelihood of successful retrieval of a canaliculus at surgical exploration.
Amelanotic Cellular Blue Nevus of the Eyelid
Authors: Charles Norman C. , Meehan Shane A. , Palu Richard N.
Published: December 2016

The authors describe an isolated, yellowish papular lesion of the upper eyelid in a 63-year-old man. Following excision, histopathologic analysis showed the features of a benign hypopigmented cellular blue nevus, the first and only case involving the eyelid skin.
Prevalence and Risk Factors of Prolonged Corrected QT Interval Among Children and Adolescents Treated With Antipsychotic Medications
Authors: Palanca-Maresca Inmaculada , Ruiz-Antorán Belén , Centeno-Soto Gustavo Adolfo , Forti-Buratti Maria Azul , Siles Ana , Usano Ana , Avendaño-Solá Cristina
Published: December 2016

Purpose

This study aimed to describe the prevalence of corrected QT (QTc) interval disorders and the possible predisposing factors in children and adolescents treated with antipsychotic (AP) medications in a real-world population with a long-term follow-up.

Methods

Data were obtained from the SafEty of NeurolepTics in Infancy and Adolescence (SENTIA) registry (https://sentia.es). The SENTIA includes patients younger than 18 years who are currently taking or initiating treatment with AP medications and have agreed to participate in the registry. The SENTIA's follow-up includes an electrocardiogram (ECG) assessment before starting treatment and at 1, 3, and 6 months after treatment initiation or after any changes in the patient's AP medication treatment. Thereafter, all participants undergo an ECG every 6 months. A QTc interval more than 450 milliseconds, increases in QTc interval of 60 milliseconds or more, or QTc dispersion more than 100 milliseconds were considered abnormal.

Results

Since January 1, 2011, 101 patients have been enrolled in SENTIA and have had at least 1 ECG assessment. The mean age at inclusion was 11.5 years; 75% of the patients were men. The mean follow-up time was 20.0 ± 15.1 months. The most frequently prescribed AP medications were risperidone (52.2%) and aripiprazole (45.5%). Seven patients (6.9%) had abnormal changes in QTc. No patient had a QTc interval more than 500 milliseconds. All patients were asymptomatic. The QTc changes were observed at different times of exposure, with a range of 1 to 39 months after beginning AP treatment. Concomitant use of attention deficit and hyperactivity disorder drugs seemed a possible factor associated with QTc disorders.

Conclusions

Patients should undergo a baseline ECG assessment before starting AP medication treatment, particularly patients with concomitant use of attention deficit and hyperactivity disorder drugs or a family/personal history of heart disease.
Examining Associations of Functional Deficits and Mood States With Empathic Responses of Stroke Family Caregivers
Authors: Jin Chen , Lobchuk Michelle , Chernomas Wanda , Pooyania Sepideh
Published: December 2016

Background: Stroke is one of the most prevalent chronic illnesses worldwide. Family caregivers can make a significant contribution toward patients’ recovery. However, the patient’s functional deficits and the caregiver’s mood states can impact the caregiver’s motivation to engage in empathic responses toward patients. Clinicians need help in recognizing patients at risk for not receiving empathic responses from family caregivers who are pivotal in long-term help and emotional support. Objective: The aim of this study was to examine possible associations of family caregiver perceptions of functional deficits of patients who are poststroke and caregiver mood states with their empathic responses toward patients who are poststroke. Methodology: As guided by Davis’ organizational model on empathy, we conducted a correlational descriptive study of associations among patient functional deficits, caregiver mood states, and caregiver empathic responses toward patients who are poststroke. Participants were requested to complete four questionnaires. Results: Caregiver fatigue was the only mood state significantly associated with their empathic responses toward patients who are poststroke. Conclusions: The results of the current study contribute to the current state of the literature on poststroke care at home by highlighting the impact of caregiver mood states, particularly caregiver fatigue, on their empathic responses toward patients who are poststroke. Recommendations for clinical practice and future studies were made based on this study’s results.
Noninvasive estimation of liver fibrosis in biopsy-proven hepatitis C virus-infected patients: angiogenic fibrogenic link
Authors: Toson El-Shahat A. , Shiha Gamal E. , El-mezayen Hatem A. , Samir Waleed , El-khininy Mohamed M.
Published: December 2016

Background/aim

The assessment of liver fibrosis provides useful information not only for diagnosis but also for therapeutic decisions. This study aimed to develop and evaluate a predictive score named the angiogenic index (Angio-Index) for liver fibrosis staging and to compare Angio-Index by King, Gotebörg University Cirrhosis Index, Lok, FIB-4, and aspartate aminotranferase/alanine aminotranferase scores in hepatitis C virus-infected patients.

Patients and methods

Serum levels of angiopoietin-2, basic fibroblast growth factor, hepatocyte growth factor, and endostatin were assayed using an enzyme-linked immunosorbent assay in 122 HCV patients represented in two sets (estimation group and validation group). Stepwise linear discriminant analysis and area under receiver-operating characteristic curves (AUCs) were utilized to produce a predictive score comprising significant angiogenic biomarkers.

Results

A novel score named the Angio-Index score was created on the basis of a combination of angiopoietin-2, basic fibroblast growth factor, hepatocyte growth factor, and endostatin. Angio-Index produces an AUC of 0.90 for significant fibrosis, 0.865 for advanced fibrosis, and 0.857 for cirrhosis. The Angio-Index score correctly classified 71% of the significant fibrosis (F2–F4) with a sensitivity of 93% and a specificity of 91%. The Angio-Index had a similar AUC in the validation study. The above six scores showed lower AUCs than Angio-Index.

Conclusion

Whereas liver biopsy is invasive, costly, and associated with complications, Angio-Index is simple, noninvasive, and more accurate; it may decrease the need for liver biopsy in Egyptian patients.
New and Emerging Diagnostic and Prognostic Immunohistochemical Biomarkers in Prostate Pathology
Authors: Giannico Giovanna A. , Arnold Shanna A. , Gellert Lan L. , Hameed Omar
Published: December 2016

The diagnosis of minimal prostatic adenocarcinoma can be challenging on prostate needle biopsy, and immunohistochemistry may be used to support the diagnosis of cancer. The International Society of Urologic Pathology currently recommends the use of the basal cell markers high–molecular-weight cytokeraratin and p63, and α-methylacyl-coenzyme-A racemase. However, there are caveats associated with the interpretation of these markers, particularly with benign mimickers. Another issue is that of early detection of presence and progression of disease and prediction of recurrence after clinical intervention. There remains a lack of reliable biomarkers to accurately predict low-risk cancer and avoid over treatment. As such, aggressive forms of prostate cancer may be missed and indolent disease may be subjected to unnecessary radical therapy. New biomarker discovery promises to improve early detection and prognosis and to provide targets for therapeutic interventions. In this review, we present the emerging immunohistochemical biomarkers of prostate cancer PTEN, ERG, FASN, MAGI-2, and SPINK1, and address their diagnostic and prognostic advantages and limitations.
The HIV Care Cascade Among Female Sex Workers in Zimbabwe: Results of a Population-Based Survey From the Sisters Antiretroviral Therapy Programme for Prevention of HIV, an Integrated Response (SAPPH-IRe) Trial
Authors: Cowan Frances M. , Davey Calum B. , Fearon Elizabeth , Mushati Phillis , Dirawo Jeffrey , Cambiano Valentina , Napierala Mavedzenge Sue , Hanisch Dagmar , Wong-Gruenwald Ramona , Chemhuru Milton , Masuka Nyasha , Hatzold Karin , Mugurungi Owen , Busza Joanna , Philips Andrew N. , Hargreaves James R.
Published: December 2016

Introduction:

Female sex workers (FSW) in sub-Saharan Africa have a higher prevalence of HIV than other women of reproductive age. Social, legal, and structural barriers influence their access to care. Little is known about the HIV diagnosis and care cascade in most countries in Southern Africa. We aimed to describe the HIV diagnosis and care cascade among FSW in Zimbabwe.

Methods:

We conducted cross-sectional respondent driven sampling (RDS) surveys of FSW in 14 sites across Zimbabwe as the baseline for a cluster-randomised controlled trial investigating a combination HIV prevention and care package. We administered a questionnaire, tested women for HIV and measured viral load. We report the mean, minimum, and maximum respondent-driven sampling-2 weighted site values.

Results:

The survey included 2722 women, approximately 200 per site. The mean HIV prevalence was 57.5% (42.8–79.2 site minimum and maximum). Of HIV-positive women, 64.0% (51.6–73.7) were aware of their status, 67.7% (53.4–84.1) of these reported taking antiretroviral therapy, and 77.8% (64.4–90.8) of these had a suppressed HIV viral load (<1000 copies/mL). Among all HIV-positive women, 49.5% had a viral load < 1000 copies/mL.

Conclusions:

Although most HIV-positive women aware of their status are accessing antiretroviral therapy, 36.0% of HIV-positive women are unaware of their status and 29.3% of all FSW have an unsuppressed HIV viral load. Investigation and investment into models of testing, treatment, and care are necessary to reach UNAIDS targets for HIV elimination.
Ligand-forced dimerization of copper(I)–olefin complexes bearing a 1,3,4-thiadiazole core
Authors: Ardan Bohdan , Kinzhybalo Vasyl , Slyvka Yurii , Shyyka Olga , Luk`yanov Mykhaylo , Lis Tadeusz , Mys`kiv Marian
Published: December 2016

As an important class of heterocyclic compounds, 1,3,4-thiadiazoles have a broad range of potential applications in medicine, agriculture and materials chemistry, and were found to be excellent precursors for the crystal engineering of organometallic materials. The coordinating behaviour of allyl derivatives of 1,3,4-thiadiazoles with respect to transition metal ions has been little studied. Five new crystalline copper(I) π-complexes have been obtained by means of an alternating current electrochemical technique and have been characterized by single-crystal X-ray diffraction and IR spectroscopy. The compounds are bis[μ-5-methyl-N-(prop-2-en-1-yl)-1,3,4-thiadiazol-2-amine]bis[nitratocopper(I)], [Cu2(NO3)2(C6H9N3S)2], (1), bis[μ-5-methyl-N-(prop-2-en-1-yl)-1,3,4-thiadiazol-2-amine]bis[(tetrafluoroborato)copper(I)], [Cu2(BF4)2(C6H9N3S)2], (2), μ-aqua-bis{μ-5-[(prop-2-en-1-yl)sulfanyl]-1,3,4-thiadiazol-2-amine}bis[nitratocopper(I)], [Cu2(NO3)2(C5H7N3S2)2(H2O)], (3), μ-aqua-(hexafluorosilicato)bis{μ-5-[(prop-2-en-1-yl)sulfanyl]-1,3,4-thiadiazol-2-amine}dicopper(I)–acetonitrile–water (2/1/4), [Cu2(SiF6)(C5H7N3S2)2(H2O)]·0.5CH3CN·2H2O, (4), and μ-benzenesulfonato-bis{μ-5-[(prop-2-en-1-yl)sulfanyl]-1,3,4-thiadiazol-2-amine}dicopper(I) benzenesulfonate–methanol–water (1/1/1), [Cu2(C6H5O3S)(C5H7N3S2)2](C6H5O3S)·CH3OH·H2O, (5). The structure of the ligand 5-methyl-N-(prop-2-en-1-yl)-1,3,4-thiadiazol-2-amine (Mepeta), C6H9N3S, was also structurally characterized. BothMepetaand 5-[(prop-2-en-1-yl)sulfanyl]-1,3,4-thiadiazol-2-amine (Pesta) (denotedL) reveal a strong tendency to form dimeric {Cu2L2}2+fragments, being attached to the metal atom in a chelating–bridging modeviatwo thiadiazole N atoms and an allylic C=C bond. Flexibility of the {Cu2(Pesta)2}2+unit allows the CuIatom site to be split into two positions with different metal-coordination environments, thus enabling the competitive participation of different molecules in bonding to the metal centre. ThePestaligand in (4) allows the CuIatom to vary between water O-atom and hexafluorosilicate F-atom coordination, resulting in the rare case of a direct CuI...FSiF52−interaction. Extensive three-dimensional hydrogen-bonding patterns are formed in the reported crystal structures. Complex (5) should be considered as the first known example of a CuI(C6H5SO3) coordination compound. To determine the hydrogen-bond interactions in the structures of (1) and (2), a Hirshfeld surface analysis has been performed.
Enhancing internal communication to build social capital amongst hospitality employees – the role of social media
Authors: King Ceridwyn , Lee Hyemi
Published: December 2016

Purpose

Adopting a social capital theoretical (SCT) lens, this study aims to propose a conceptual framework of effective internal communication (IC) for the hospitality industry. The study explores how to enhance current practices and the suitability of social media as an augmentation to traditional IC channels.

Design/methodology/approach

A qualitative research methodology, consisting of 20 semi-structured interviews with hospitality employees, was adopted. Following a “reduction” and “interpretation” process, 16 themes related to effective IC were identified which informed a conceptual framework.

Findings

Characteristics of effective IC were identified in addition to IC benefits at both employee and organizational levels. Considering the limitations of current practices, the applicability of social media was explored. Requirements of effective IC suggest that new channels (e.g. social media) should be adopted to build social capital.

Research limitations/implications

The study informs SCT from a meso-level (process) perspective. The articulation of an IC framework informs how social capital can be built through effective IC, providing a foundation for further empirical examination as to the impact of various channels on the IC process. Adoption of a case study design suggests that results and implications can only be generalized to similar environments.

Practical implications

The study details the characteristics of effective IC and its subsequent benefits, highlighting how social media can augment current IC practices in a hospitality organization.

Originality/value

Being a 24/7 labor-intensive operation makes employee communication to ensure service excellence challenging in the hospitality industry. Through the application of SCT and the exploration of social media in a workplace setting to enhance IC, significant theoretical and practical insights are realized.
A systematic review of China’s outbound tourism research
Authors: Law Rob , Sun Sunny , Fong Davis Ka Chio , Fong Lawrence Hoc Nang , Fu Hui
Published: December 2016

Purpose

This paper aims to identify the changes of researched destinations along with the Approved Destination Status scheme to investigate the development of research problems, and to track the changes of research topics in the context of the development of China’s outbound tourism. The research methods and applied theories are also identified and analyzed.

Design/methodology/approach

Three large databases, namely, ScienceDirect, EBSCOhost and Google Scholar, were selected to search for published articles (i.e. 107 empirical articles and 15 review/policy articles) related to China’s outbound tourism. Thereafter, the retrieved articles were categorized and analyzed. Finally, a theoretical framework was provided for future studies on China’s outbound tourism.

Findings

The major findings indicated that the main topics related to China’s outbound tourism included market segmentation, travel motivation and travel behavior. One or two theories are generally applied to investigate a certain topic. The most common research methods are interviews and a questionnaire survey.

Research limitations/implications

Future studies are suggested to apply more theories to investigate one topic. A single theory can also be applied to investigate different topics. Adopting different and innovative research methods, such as online interaction observation, can also be considered.

Originality/value

This study contributes to the literature through an in-depth qualitative assessment of China’s outbound tourism literature, comparing researched destinations with the Approved Destination Status policies, and reviewing articles based on research.
Setting limits in uneasy times – healthy diets in underprivileged families
Authors: Ditlevsen Kia , Nielsen Annemette
Published: December 2016

Purpose

The purpose of this paper is to provide knowledge on barriers to preventive action on early childhood overweight in non-western migrant families. It investigates the underlying understandings of the parental role in relation to weight control present in health-care professionals and in families.

Design/methodology/approach

The study is based on qualitative interviews with parents who are engaged in interventions aimed at helping them and their children to adopt a healthier life style, and on interviews with health-care professionals.

Findings

This study shows that the participating parents, all low SES and living under different forms of insecurity, perceived their parental task for the present as creating well-being for their children, and they were, therefore, reluctant to enforce dietary changes. The health-care professionals, in contrast, considered the need for change through a perspective on future risks.

Research limitations/implications

The results are based on a rather small sample and the link between insecurity, family dynamics and health practice needs further research.

Originality/value

The participating parents represented a group that is rarely included in scientific research and the study, therefore, contributes valuable knowledge on health behavior in ethnic minority families. The empirical analysis provides new insights for health professionals regarding the suitability of the universal model of parental feeding styles. It illuminates the implications of implicitly applying this model in health interventions which involve vulnerable categories of parents such as refugees to western societies.