bluuebunny/crossref_metadata_2025 huggingface dataset:
Considering Culturally Responsive Teaching, Children, and Place in the Music Room
Authors: Wiens Kimberly Friesen
Published: July 2015

In this article, the author explores how culturally responsive teaching and the concept of children and place relate in the music room. The article begins with a brief explanation of both culturally responsive teaching and children and place. Through the use of anecdotes and ideas to consider, this article provides elementary music teachers with practical suggestions to use in the music room. It also provides opportunities for music teachers to reflect on their current practices with another frame of reference.
Reliability of the Colorado Family Support Assessment
Authors: Richmond Melissa K. , Pampel Fred C. , Zarcula Flavia , Howey Virginia , McChesney Brenda
Published: July 2015

Purpose:

Family support programs commonly use self-sufficiency matrices (SSMs) to measure family outcomes, however, validation research on SSMs is sparse. This study examined the reliability of the Colorado Family Support Assessment 2.0 (CFSA 2.0) to measure family self-reliance across 14 domains (e.g., employment).

Methods:

Ten written case studies were developed. Family advocates ( n = 24) independently coded each case study on each domain of the CFSA 2.0. Intraclass correlation (ICC) coefficients were calculated to determine the level of agreement between participants. Rating accuracy was calculated by subtracting the correct score for each domain and case study from the score given by the raters.

Results:

ICCs ranged from .79 to .96. Across all domains and case studies, family advocates were 84.4% accurate. Allowing for minor deviations (off by 1 on the 5-point scale) shows 96% accuracy.

Discussion:

A well-constructed SSM can be used to collect reliable and objective data on family self-sufficiency.
Stand Up and Move; Your Musculoskeletal Health Depends on It
Authors: Davis Kermit G. , Kotowski Susan E.
Published: July 2015

The new trend in office ergonomics is installing dynamic workstations that include sit-to-stand tables, treadmills, stationary bicycles, and exercise balls. The question is whether it is worth the investment to try to reduce musculoskeletal pain via these dynamic workstations. Postural change is good, but the most effective workstation seems to be the sit-to-stand table with respect to reducing discomfort suffered by office workers. Treadmills and cycle workstations do have the ability to increase energy expenditure and heart rate and thus are potentially beneficial in addressing obesity that results from sedentary work. For all outcomes, the key is to periodically get up and move around.
Coexistence of Malakoplakia and Papillary Urothelial Carcinoma of the Urinary Bladder
Authors: Lee Song Liang Joshua , Teo Jin Kiat , Lim Sey Kiat Terence , Salkade Hema Parag , Mancer Kent
Published: July 2015

Malakoplakia is a rare granulomatous disease that commonly involves the genitourinary tract, with the urinary bladder being the most frequently affected site. Grossly, malakoplakia can present as soft yellow plaques, nodules, bladder mass, or even without any visible lesion. In this article, we present a 74-year-old female with a background of hypertension, hyperlipidemia, and poorly controlled diabetes who presented with sepsis of unknown origin. During the course of the investigation of the source of her sepsis, an incidental bladder tumor was discovered. She subsequently underwent transurethral resection of the bladder tumor. Histology revealed ordinary low-grade papillary urothelial carcinoma that had small colonies of malakoplakia that appeared to have developed secondary to the tumor and presented concurrently. We seek to demonstrate the rare association of papillary urothelial carcinoma and malakoplakia.
Investigating Love’s Universal Attributes
Authors: Jankowiak William , Shen Yifei , Yao Shiyu , Wang Cancan , Volsche Shelly
Published: July 2015

There are no cognitive studies of love conducted in an Asian culture. Our study is the first to probe the cognitive qualities that urban Chinese youth associate with what it means to be in love. To this end, we build on de Munck et al.’s pioneering studies in two European cultures (Russia, Lithuanian) and in the United States. Expanding on their study, we used a similar questionnaire that also includes additional questions designed to probe the youth of urban China’s perception and understanding of romantic love as an emotional and psychological force. We found that Chinese youths’ responses are similar to the Euro-American five core findings that all individuals, regardless of gender, experience when “in love.” These core attributes are as follows: “I will do anything for the person I love” (or altruism), “I constantly think about the person I am in love with” (or intrusive thinking), “romantic love is the supreme happiness of life” (or self-actualization), my “love makes my partner stronger and a better person,” (or emotional fulfillment), and “sexual attraction is necessary for love” (biology).
Fact, fiction and value in the Museum of Innocence
Authors: Tekgül Duygu
Published: July 2015

This article explores the complexities of ethnography and aesthetics in the Museum of Innocence, a museum in Istanbul based on a novel by Orhan Pamuk. A cross between a museum and an art gallery, the Museum of Innocence houses objects described in the eponymous novel in display cabinets corresponding to the chapters of the book. The present contribution looks into the issue of legitimacy and value, from multiple perspectives, in a cultural institution that combines two epistemologies with a postmodern blurring of artefact and art. In doing so, it traces the parallels between the empirical reality portrayed in the novel and the display arrangements in the Museum, touching upon the tension between the various curatorial choices. Through objects and textual supplements, the Museum engages in cultural translation while eventually asserting aesthetic autonomy. Pointing out the multivalent nature of the collection, this study aims to encourage a reconsideration of dualistic understandings of value in museums and art galleries.
Health care services and maternal education in South Africa
Authors: Susuman A. Sathiya
Published: July 2015

Aims: The aim of the study is to investigate the influence of maternal education on the utilization of maternal health care services in selected areas of the Eastern Cape. Moreover, the study’s aim also is to examine the reasons for non-use as well as determinants and levels of maternal health care utilization. Methods: From the 422 participants sampled, 345 fully completed questionnaires were returned and included in the analysis. The study used multilevel analyses. The dependent variables included antenatal care, delivery care, and postnatal care within 2 months after birth. The independent variables were socioeconomic and demographic factors selected based on literature on the subject. Results: Use of antenatal and delivery care services was high in the study areas, but postnatal check-ups were reported below 50%. The majority of the women (50%) reported that the ambulance arrived too late, and, as such, they did not use health facilities when giving birth. Women with four or more children use antenatal and delivery care less than women with one child, while women with four or more children use postnatal care more than women with just one child. Conclusions: This study will be immense useful for the policy-makers, public health research managers and concerned health care decision-makers.
Dipeptidyl peptidase-4 inhibitor sitagliptin improves pancreatic β-cell function in hypertensive diabetic patients treated with angiotensin receptor blockers
Authors: Fukui Kensuke , Kawahito Hiroyuki , Wakana Noriyuki , Kikai Masakazu , Terada Kensuke , Yamamoto Keita , Irie Daisuke , Kato Taku , Miyagawa Sonoko , Yamada Hiroyuki
Published: July 2015

Introduction:

Dipeptidyl peptidase (DPP)-4 inhibitors, a novel oral anti-diabetic agents, exert a protective effect on pancreatic β-cell function in patients with type 2 diabetic mellitus (T2DM). However, their beneficial effect in hypertensive T2DM patients treated with angiotensin receptor blockers (ARBs) has not been investigated.

Methods:

In this open-label multicenter randomized study, a total of 55 hypertensive T2DM patients treated with ARBs were randomly assigned to receive the DPP-4 inhibitor sitagliptin or sulfonylurea (SU).

Results:

After 24 weeks of treatment, a significant reduction in fasting blood glucose was only observed in the sitagliptin group, while HbA1c was significantly reduced in both groups. Homeostasis model assessment of insulin resistance was not significantly improved in either group. Indicators of pancreatic β-cell function, including proinsulin to insulin ratio and homeostasis model assessment of β-cell function, were significantly improved in the sitagliptin group, but not in the SU group. The beneficial effects of sitagliptin were observed in hypoglycemic drug naïve patients, but not in patients who had received SU monotherapy prior to the study.

Conclusion:

Treatment with the DPP-4 inhibitor sitagliptin might exert beneficial effects on pancreatic β-cell function in ARB-treated T2DM patients and its efficacy might be more pronounced in hypoglycemic drug naïve patients.
Association of ACE insertion or deletion polymorphisms with the risk of coronary restenosis after percutaneous coronary intervention: A meta-analysis
Authors: Miao Hai-Wei , Gong Hui
Published: July 2015

Objective:

Previous case-control studies on the relationship between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphisms and coronary restenosis did not reach the same conclusion. In the present study, we aimed to further evaluate the relationship between the ACE gene I/D polymorphisms and coronary restenosis, after percutaneous coronary intervention (PCI).

Methods:

By searching PubMed, EMBase, the Chinese Biomedical Literature Database and Wanfang database, we selected 16 case-control studies related to ACE gene I/D polymorphism and coronary restenosis after PCI. To test for heterogeneity in each study, we utilized the Q-test and I2 test. To merge the odds ratio (OR) and 95% CI, we utilized the random effects model during the analyses.

Results:

The present study included 4693 subjects: 1241 patients with coronary restenosis and 3452 without coronary restenosis. By meta-analysis, we found there was significant association of ACE gene I/D polymorphism with coronary restenosis (D allele versus I allele: OR = 1.92; 95% CI (1.40–2.43); p < 0.001). A subgroup analysis, by stratification according to ethnicity, also showed that this association was found not only in the Caucasian population ((D allele versus I allele: OR = 1.94; 95% CI (1.38–2.80); p < 0.001)), but also in the Asian population ((D allele versus I allele: OR = 1.83; 95% CI (1.05–3.20); p = 0.03)). After stratification according to age, we found that the D allele carriers have a higher risk for development of coronary restenosis in subjects < 60 years old (OR = 2.13; 95% CI: 1.40–3.24; p = 0.0004); while in the subjects ⩾ 60 years old, the association was present with bordering significance (OR = 1.48; 95%CI: 0.98–2.25; p = 0.06).

Conclusions:

The present study suggested that the ACE gene I/D polymorphism was associated with coronary restenosis, regardless of age and ethnicity.
Campaign Money, Congress, and Perceptions of Corruption
Authors: Bowler Shaun , Donovan Todd
Published: July 2015

Many Americans think campaign money has a corrupting influence on Congress. Yet how they think about money in politics is a relatively unexplored topic. This article investigates how the public reasons about campaign money and corruption. Our survey experiments demonstrate that attitudes about campaign money are structured by partisan interest and are also driven by information about sources of campaign money and the amount spent (particularly for large independent expenditures made possible by Citizens United), the method of delivery, and about what the money is spent on. Mass perceptions about corruption of Congress, furthermore, may reflect aversion to negative campaigns as well as attitudes about campaign financiers having undue influence over representatives. These findings not only provide a more nuanced picture of attitudes about campaign money but also have consequences for how we assess reform proposals relating to money and politics.
The Meaning and Measurement of Responsibility Attributions
Authors: Rudolph Thomas J.
Published: July 2015

This article advances a theory of responsibility attributions in which such judgments are rooted in considerations of intensity and comparability. Informed by insights from the study of attitudinal ambivalence, the article contributes to the attribution literature in three important ways. First, we propose a new technique for measuring responsibility judgments, one that explicitly incorporates information about intensity and comparability into a single scale. Second, from a methodological standpoint, we demonstrate that our new measures of comparative responsibility ratings have greater construct validity than traditional ratings-based measures and outperform them as predictors of political evaluations. More substantively, we show that comparative responsibility ratings are politically consequential and strongly influenced presidential approval, presidential vote choice, and congressional vote choice in the United States during the 2012 elections.
Sample size adjustment based on promising interim results and its application in confirmatory clinical trials
Authors: Chen YH Joshua , Li Caiyan , Lan KK Gordon
Published: July 2015

Background:

For a carefully planned and well-designed Phase 3 confirmatory trial, there is still a potential risk of failing to meet the study objective due to possible differences between Phase 2 and Phase 3 studies. As illustrated by the ENGAGE trial, potential sample size increase at an interim analysis can mitigate the risk for an otherwise underpowered study. Many approaches for sample size adjustment (SSA) require certain modifications to the conventional statistical method, such as changing critical values or using a weighted Z-statistic for final hypothesis testing. Without modification, the type I error rate can be inflated, primarily caused by sample size increase for nonpromising interim observation that is close to null or no treatment effect. As illustrated by the TOPICAL trial, increasing sample size for nonpromising interim result could waste limited resource on ineffective treatment. The modifications in these approaches are therefore unnecessary costs of flexibility/interpretability for unnecessary scenarios of sample size increase.

Purpose:

To discuss and illustrate the appropriateness of SSA based on promising interim results, that is, conditional power being greater than 50% (or CDL approach), in a carefully planned and well-designed Phase 3 confirmatory trial.

Methods:

Two clinical trials are used to illustrate the clinical setting for the CDL approach and appropriateness of its application. Operating characteristics are assessed and compared to other methods using numeric computation. Hypothetical trials based on real clinical data are used to illustrate the approach.

Results:

The CDL approach for SSA leads to a small increase in expected sample size resulting in a small power gain versus the fixed design. This indicates that adding SSA will not on average substantially affect the budget at the portfolio level. However, when the interim result is promising, the CDL approach can dramatically increase the conditional power therefore mitigating the risk of an otherwise underpowered study.

Limitations:

Implementation challenges of the SSA methods are not in the scope of this paper. SSA is not intended to replace careful design of a confirmatory trial; instead, it can mitigate the risk for a well-designed trial.

Conclusions:

The CDL approach for SSA based on promising interim results, that is, conditional power being greater than 50%, is particularly useful in mitigating the risk for a carefully planned and well-designed Phase 3 confirmatory trial. No modification to the conventional statistical procedure is necessary while the type I error rate is controlled. Such a feature of ''no interference,'' or no change to the conventional statistical procedure with or without sample size adjustment, is important for the interpretation of a confirmatory trial. Similar to the fixed design, carefully planned and well-designed group sequential studies can also benefit from SSA to mitigate the risk of failing to meet the study objective.
A Quest for the Meaning of Rising Love
Authors: Lamy Lubomir
Published: July 2015

The commentaries by Cacioppo and Cacioppo (2016), Jankowiak (2016), Marazziti (2016), and Aron and Aron (2016) admirably illustrate the multifaceted nature of love and the difficulty of bringing together such diverse perspectives. Rising love is still far from being the subject of true experimental study since the experimenter often only observes the consequences thereof, and attempts to reconstitute in hindsight the circumstances of its onset.
Association between caffeine consumption and nonalcoholic fatty liver disease: a systemic review and meta-analysis
Authors: Shen Huafeng , Rodriguez Andrea C. , Shiani Ashok , Lipka Seth , Shahzad Ghulamullah , Kumar Ambuj , Mustacchia Paul
Published: July 2015

Objectives:

Caffeine consumption is reported to be associated with reduced hepatic fibrosis in patients with chronic liver diseases. We performed a systematic review and meta-analysis to assess the association between caffeine consumption and prevalence or hepatic fibrosis of nonalcoholic fatty liver disease (NAFLD) in observational studies.

Methods:

We searched the literature of all languages from PubMed, EMBASE, and the Cochrane library from 1 January 1980 through 10 January 2015. Total caffeine consumption was defined as the daily intake of caffeine (mg/day) from all caffeine-containing products. Combined and subgroup analyses stratified by study designs, study locations, and type of caffeine intake were performed.

Results:

Four cross-sectional and two case control studies with a total of 20,064 subjects were included in the meta-analysis. Among these, three studies with 18,990 subjects were included in the analysis for prevalence of NAFLD while the other three studies with 1074 subjects were for hepatic fibrosis. Total caffeine consumption (mg/day) was not significantly associated with either the prevalence [pooled mean difference (MD) 2.36; 95% confidence interval (CI) −35.92 to 40.64] or hepatic fibrosis (higher versus lower stages; pooled MD −39.95; 95% CI −132.72 to 52.82) of NAFLD. Subgroup analyses stratified by study designs and locations were also not significant. However, after stratifying by type of caffeine intake, regular coffee caffeine intake (mg/day) was significantly associated with reduced hepatic fibrosis of NAFLD (pooled MD −91.35; 95% CI −139.42 to −43.27; n = 2 studies).

Conclusion:

Although total caffeine intake is not associated with the prevalence or hepatic fibrosis of NAFLD, regular coffee caffeine consumption may significantly reduce hepatic fibrosis in patients with NAFLD.
An exploration of physical activity and wellbeing in university employees
Authors: Cooper Kay , Barton Gillian C
Published: July 2015

Aims:

The aim was to explore levels of physical activity (PA) and mental wellbeing in university employees, as well as barriers to and incentives for workplace PA.

Methods:

An electronic survey was distributed to all staff at one UK university. The survey consisted of a PA stages of change questionnaire, an international PA questionnaire (short-form), the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), questions on perceived barriers to and incentives for workplace PA, questions on methods of enhancing employee wellbeing and demographics. A self-selected sample participated in two focus groups to explore key themes arising from the survey. Descriptive statistics were reported for survey data; associations between PA and wellbeing were tested for using Kruskal–Wallis with post hoc Mann–Whitney. Descriptive, thematic analysis was performed on focus group transcripts.

Results:

A total of 502 surveys were completed (34% response rate); 13 staff participated in focus groups. In all, 42% of the sample reported PA below the recommended guideline amount. Females were less active than males ( p < 0.005). The mean WEMWBS was 49.2 (95% confidence interval (CI): 48.3–49.9). Low PA levels were related to lower WEMWBS scores, with statistically significant differences in WEMWBS demonstrated between low and moderate PA ( p = 0.05) and low and high PA ( p = 0.001). Lack of time and perceived expense of facilities were common barriers to workplace PA. The main focus group finding was the impact of university culture on workplace PA and wellbeing.

Conclusion:

University staff demonstrate PA levels and a relationship between PA and wellbeing similar to the general population. Carefully designed strategies aimed at enhancing PA and wellbeing in university staff are required. The specific cultural and other barriers to workplace PA that exist in this setting should be considered. These results are being used to inform PA and wellbeing interventions whose effectiveness will be evaluated in future research.
Struggling with internal crisis communication: A balancing act between paradoxical tensions
Authors: Heide Mats , Simonsson Charlotte
Published: July 2015

The aim of this article is to elucidate the complexity of internal crisis communication by identifying and discussing different paradoxical tensions embedded within a large, complex, multi-professional organization. This article is based on a qualitative case study of a university hospital. Internal dimensions of crisis management have long been neglected within the field of crisis communication research. In the first part of the article, two theoretical approaches are presented – the functionalist and social constructionist which are based on different ontological and epistemological assumptions. We take a social constructionist perspective on crisis communication, which focuses on aspects such as complexity, sensemaking, and symmetrical relations. In the first part, we also give a brief overview of the small, but growing research into internal crisis communication. In the second part of the article, five different paradoxical tensions are identified and discussed: (1) episodic–emergent, (2) centralized–decentralized, (3) professional–organizational, (4) planning–improvisation, and (5) external–internal. While the complexity of internal crisis communication demands a both-and perspective, we have found a tendency to a simplistic either-or thinking. In the concluding discussions, several explanations of the one-sided polarization within the tensions are offered. Furthermore, we discuss various ways of responding to paradoxical tensions. Metacommunication is presented as important in order to increase organization members’ understanding and thereby facilitate a more reflexive and broader approach to crisis management.
Making history: Reflections on memory and elite interviews in public relations research
Authors: Fitch Kate
Published: July 2015

Drawing on research into recent Australian public relations history, this article reflects on the significance of memory for historical research. The personal testimony of senior practitioners is perceived to offer authentic insights into the development of public relations. Given the lack of alternate evidence, retrospective accounts such as those narrated in memoirs and interviews have become the de facto history of public relations. The findings indicate that these narratives can be meaningful but point to the need for public relations researchers to adopt a critical approach to historical research, recognising the subjectivity and retrospectivity of personal accounts and the ways in which widely accepted industry narratives and professional networks constrain and structure those accounts. The significance of this study is that it offers evidence of how certain discourses of Australian public relations continue to inform contemporary understandings of its development and limit alternative perspectives.
HBCUs as relics or reminders race remains relevant in a ‘Post-Racial’ society? Exploring and expanding the role of memory in public relations
Authors: Waymer Damion , Street Joshua
Published: July 2015

In this article, the authors broaden the scope of the communication, public relations, and memory research by both critically analyzing the post-racial society collective memory narrative and postulating the public relations–oriented defensive strategies, which racially stigmatized organizations contesting the same narrative might employ. To make this argument, we choose Historically Black Colleges and Universities (HBCUs) as cases for analysis. This study contributes to the post-racial society discussions by highlighting the ways in which HBCUs are not antiquated relics of a period gone by in the history of the United States but rather serve as a standing institutional reminder that racial injustices exist and persist in contemporary United States.
Racial Disparity in Juvenile Diversion
Authors: Ericson Rebecca D. , Eckberg Deborah A.
Published: July 2015

Purpose:

Interpretations of focal concerns and “loose coupling” are used to explain juvenile diversion decisions by police and prosecutors from a large metropolitan county in the Midwest.

Methods:

Juveniles eligible for police diversion are compared to those actually diverted using a population of juveniles arrested in eight police urban and suburban agencies. Multinomial logistic regression is used to analyze data on juveniles referred for charging in the same county.

Results:

Non-White juveniles were significantly less likely to be diverted by police, formally entering them into the juvenile justice system earlier than their White counterparts. Prosecutors charged, rather than diverted, non-White juveniles significantly more frequently than White juveniles, particularly for theft cases.

Conclusion:

The racial disparity observed may result from differing focal concerns and loose coupling in the first stages of the justice system.
Assessment of deterrence and missile defense in East Asia: A power transition perspective
Authors: Kang Kyungkook , Kugler Jacek
Published: July 2015

This paper explores the stability of deterrence in East Asia and the effects of missile defense on regional security. In particular, we evaluate the policy implications derived from the power transition perspective for the development of the US missile defense system in the Asia-Pacific region. Over the short term, we anticipate that the stability of deterrence in East Asia will be increased by the deployment of ballistic missile defenses that creates a power preponderance of satisfied challengers against potential regional challengers. The long-term horizon is, however, tenuous because the rapid expansion of US-led missile defense systems may significantly alter the trajectory of China’s missile strategy by increasing its dissatisfaction with the status quo. One fundamental implication is that, without further restrictions, long-term deployment stability in East Asia will become increasingly fragile.
Single- and double-pass FSW lap joining of AA5456 sheets with different thicknesses
Authors: Behmand S. A. , Mirsalehi S. E. , Omidvar H. , Safarkhanian M. A.
Published: July 2015

Friction stir welding of AA5456 aluminium alloy with different thicknesses was investigated for single- and double-pass lap joint configurations. The influences of tool tilt angle in first and second passes, and rotational and welding speeds in second pass on metallurgical structure and joint strength were studied. The results indicated that tilt angle significantly influences material flow and imperfection formation, and accordingly controls the weld mechanical properties. The best results were achieved by tilt angle of 5° for single pass, and tilt angle, rotational speed and traverse speed of 5°, 250 rev min− 1 an 50 mm min− 1 respectively for double-pass. The characteristics of hooking and cold lap defects were used as criteria to recognise the influence of processing conditions on joint performance.
Bias influence on titanium interlayer for titanium nitride films
Authors: Lain G. C. , Cemin F. , Menezes C. M. , Aguzzoli C. , Baumvol I. J. R. , Tomiello S. S. , Figueroa C. A.
Published: July 2015

This work investigates the deposition of TiN thin films by cathodic arc evaporation on stainless steel AISI 304 substrate for decorative applications. The applied voltage bias on the substrate during the Ti interlayer deposition was varied, and several properties were determined. The chemical profile, crystalline structure and microstructural properties were analysed by glow discharge optical emission spectroscopy, glancing angle X-ray diffraction and SEM techniques respectively. In addition, nanoindentation and sliding tests were performed in order to evaluate the hardness and scratch resistance of TiN thin films. The results showed that the applied voltage bias during the Ti interlayer deposition step could modify some properties of the TiN thin films. Indeed, lower oxygen contents and higher critical loads to start a plastic deformation (scratch resistance) of the TiN thin films are achieved at higher applied voltage biases during the Ti interlayer deposition. A higher scratch resistance is capable of imparting a long term durability of metallic pieces for decorative applications.
Trends in mortality associated with opening of a full-capacity public emergency department at the main tertiary-level hospital in Tanzania
Authors: Sawe Hendry R. , Mfinanga Juma A. , Mwafongo Victor , Reynolds Teri A. , Runyon Michael S.
Published: July 2015

Background

Emergency medicine is an emerging specialty in Sub-Saharan Africa, and most hospitals do not have a fully functional emergency department (ED). We describe the mortality rates of the Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania before and after the opening of a full-capacity ED.

Methods

This retrospective study investigated ED and hospital mortality rates for patients admitted to MNH from January 2008 to January 2012. This period represents 2 years before and 2 years after the opening of the full-capacity ED in January 2010. Trained abstractors analyzed patient care logbooks, attendance registers, nurse report books, and death certificates. The January 2008 to December 2009 data are from the limited-capacity casualty room (precursor of the ED), and for February 2010 to January 2012, they are from the new ED. Data are presented as proportions or differences with 95 % confidence intervals (CIs).

Results

During the 4-year study period, the number of visits increased from 53,660 (January 2008 to December 2009) in the casualty room to 77,164 (February 2010 to January 2012) in the new ED. During this time, the overall hospital mortality rate decreased from 13.6 % (95 % CI 13.3–13.9 %) in the January 2008 to December 2009 period to 8.2 % (95 % CI 8.0–8.3 %) in the February 2010 to January 2012 period. The corresponding casualty room and ED mortality rates were 0.34 % (95 % CI 0.25–0.35 %) and 0.74 % (95 % CI 0.68–0.80 %), respectively. In the casualty room, the most commonly reported cause of death was lower respiratory tract infection and least common was poisoning. In the new ED, the most commonly reported cause of death was congestive cardiac failure and the least common was cancer.

Conclusions

The opening of a full-capacity ED in a tertiary-level hospital in sub-Saharan Africa was associated with a significant decrease in hospital mortality. This is despite a small, but significant, increase in the mortality rate in the ED as compared to that in the casualty room that it replaced.
The role of interleukin-1 beta in the pathophysiology of Schnitzler’s syndrome
Authors: de Koning Heleen D. , Schalkwijk Joost , Stoffels Monique , Jongekrijg Johanna , Jacobs Joannes F. M. , Verwiel Eugène , Koenen Hans J. P. M. , Preijers Frank , Holzinger Dirk , Joosten Irma , van der Meer Jos W. M. , Simon Anna
Published: July 2015

Introduction

Schnitzler’s syndrome (SchS) is a disabling autoinflammatory disorder, characterized by a chronic urticarial rash, an M-protein, arthralgia, and other signs of systemic inflammation. Anti-interleukin-1 (IL-1) beta antibodies are highly effective, but the pathophysiology is still largely unknown. Here we studied the effect of in-vivo IL-1 inhibition on serum markers of inflammation and cellular immune responses.

Methods

Eight patients with SchS received monthly subcutaneous (s.c.) injections with 150 mg canakinumab for six months. Blood was drawn for measurement of serum markers of inflammation (12 times per patient) and for functional and phenotypic analysis of both freshly isolated and toll-like receptor (TLR)-ligand-stimulated peripheral blood mononuclear cells (PBMCs) (five times per patient). All data were compared to results of healthy controls.

Results

IL-6 levels in serum and in lysates of freshly isolated PBMCs and serum myeloid-related protein (MRP8)/14 and S100A12 levels correlated with disease activity. In vitro, LPS stimulation resulted in higher IL-6 and IL-1 beta production in PBMCs from symptomatic SchS patients compared to healthy controls, whereas patient cells were relatively hyporesponsive to poly:IC and Pam3Cys. The mRNA microarray of PBMCs showed distinct transcriptomes for controls, symptomatic patients and anti-IL-1-treated patients. Numbers of T- and B-cell subsets as well as M-protein concentrations were not affected by IL-1 inhibition. Free light chain levels were elevated in 4 out of 8 patients.

Conclusions

In conclusion, patient PBMCs are hyperresponsive to LPS, and clinical efficacy of IL-1 beta inhibition in patients with SchS is associated with in-vivo and ex-vivo suppression of inflammation. Interestingly, patient PBMCs showed divergent responses to TLR2/6, TLR3 and TLR4 ligands. Our data underscore that IL-1 beta plays a pivotal role in SchS.
A prospective evaluation of ultrasound as a diagnostic tool in acute microcrystalline arthritis
Authors: Zufferey Pascal , Valcov Roxana , Fabreguet Isabelle , Dumusc Alexandre , Omoumi Patrick , So Alexander
Published: July 2015

Introduction

The performance of ultrasound (US) in the diagnosis of acute gouty (MSU) arthritis and calcium pyrophosphate (CPP) arthritis is not yet well defined. Most studies evaluated US as the basis for diagnosing crystal arthritis in already diagnosed cases of gout and few prospective studies have been performed.

Methods

One hundred nine consecutive patients who presented an acute arthritis of suspected microcrystalline arthritis were prospectively included. All underwent an US of the symptomatic joints(s) and of knees, ankles and 1st metatarsopalangeal (MTP) joints by a rheumatologist “blinded” to the clinical history. 92 also had standard X-rays. Crystal identification was the gold standard.

Results

Fifty-one patients had MSU, 28 CPP and 9 had both crystals by microscopic analysis. No crystals were detected in 21. One had septic arthritis. Based on US signs in the symptomatic joint, the sensitivity of US for both gout and CPP was low (60 % for both). In gout, the presence of US signs in the symptomatic joint was highly predictive of the diagnosis (PPV = 92 %). When US diagnosis was based on an examination of multiple joints, the sensitivity for both gout and CPP rose significantly but the specificity and the PPV decreased. In the absence of US signs in all the joints studied, CPP arthritis was unlikely (NPV = 87 %) particularly in patients with no previous crisis (NPV = 94 %). X-ray of the symptomatic joints was confirmed to be not useful in diagnosing gout and was equally sensitive or specific as US in CPP arthritis.

Conclusions

Arthrocenthesis remains the key investigation for the diagnosis of microcrystalline acute arthritis. Although US can help in the diagnostic process, its diagnostic performance is only moderate. US should not be limited to the symptomatic joint. Examination of multiple joints gives a better diagnostic sensitivity but lower specificity.
Cabinet Tree: an orthogonal enclosure approach to visualizing and exploring big data
Authors: Yang Yalong , Zhang Kang , Wang Jianrong , Nguyen Quang Vinh
Published: July 2015

Treemaps are well-known for visualizing hierarchical data. Most related approaches have been focused on layout algorithms and paid little attention to other display properties and interactions. Furthermore, the structural information in conventional Treemaps is too implicit for viewers to perceive. This paper presents Cabinet Tree, an approach that: i) draws branches explicitly to show relational structures, ii) adapts a space-optimized layout for leaves and maximizes the space utilization, iii) uses coloring and labeling strategies to clearly reveal patterns and contrast different attributes intuitively. We also apply the continuous node selection and detail window techniques to support user interaction with different levels of the hierarchies. Our quantitative evaluations demonstrate that Cabinet Tree achieves good scalability for increased resolutions and big datasets.
Propolis: a new frontier for wound healing?
Authors: Martinotti Simona , Ranzato Elia
Published: July 2015

Propolis is a resin produced by honeybees by mixing wax, pollen, salivary secretions, and collected natural resins.

The precise composition of propolis varies with the source, and over 300 chemical components belonging to the flavonoids, terpenes, and phenolic acids have been identified in propolis. Moreover, its chemical composition is subjected to the geographical location, botanical origin, and bee species.

Propolis and its compounds have been the focus of many works due to their antimicrobial and anti-inflammatory activity; however, it is now recognized that propolis also possesses regenerative properties.

There is an increasing interest in the healing potential of natural products, considering the availability and low cost of these products. Propolis contains a huge number of compounds that explicate some biological effects that speeds up the healing process and is widely used in folk remedies.

This review aims to condense the results on the mechanism of activity of propolis and its compounds.
High Prevalence of Hereditary Cancer Syndromes in Adolescents and Young Adults With Colorectal Cancer
Authors: Mork Maureen E. , You Y. Nancy , Ying Jun , Bannon Sarah A. , Lynch Patrick M. , Rodriguez-Bigas Miguel A. , Vilar Eduardo
Published: July 2015

Purpose

Established guidelines recommend evaluation for hereditary cancer syndromes in patients younger than 50 years diagnosed with colorectal cancer (CRC). This group has been well described in the literature; however, patients diagnosed as adolescents and young adults are not well represented in CRC studies. Here, we define the clinical profile, including the extent of hereditary cancer syndromes and family history of cancer, in patients diagnosed with CRC at age 35 or younger.

Patients and Methods

We reviewed patients who underwent genetic counseling at our institution during 5 years (2009 to 2013). Data were collected regarding demographics, clinicopathologic information, tumor and genetic testing, and family history. Patients with an identified hereditary cancer syndrome were compared with those without a syndrome.

Results

Of the 193 patients with evaluable data, 35% had an identifiable hereditary cancer syndrome, including 23 with Lynch syndrome, 22 with mutation-negative Lynch syndrome, 16 with familial adenomatous polyposis, two with constitutional mismatch repair deficiency, two with biallelic MUTYH mutations, and one with Li-Fraumeni syndrome. Patients without a hereditary syndrome more frequently presented with metastatic disease, whereas patients with a syndrome were more likely to present at earlier stages and to have a family history of cancer. Nevertheless, a substantial proportion of the hereditary syndromes (19%) were diagnosed in individuals with no family history of the disease.

Conclusion

We conclude that patients diagnosed with CRC at age 35 years or younger should receive genetic counseling regardless of their family history and phenotype.
Improving the Evidence Base for Treating Older Adults With Cancer: American Society of Clinical Oncology Statement
Authors: Hurria Arti , Levit Laura A. , Dale William , Mohile Supriya G. , Muss Hyman B. , Fehrenbacher Louis , Magnuson Allison , Lichtman Stuart M. , Bruinooge Suanna S. , Soto-Perez-de-Celis Enrique , Tew William P. , Postow Michael A. , Cohen Harvey J.
Published: July 2015

The American Society of Clinical Oncology (ASCO) convened a subcommittee to develop recommendations on improving the evidence base for treating older adults with cancer in response to a critical need identified by the Institute of Medicine. Older adults experience the majority of cancer diagnoses and deaths and make up the majority of cancer survivors. Older adults are also the fastest growing segment of the US population. However, the evidence base for treating this population is sparse, because older adults are underrepresented in clinical trials, and trials designed specifically for older adults are rare. The result is that clinicians have less evidence on how to treat older adults, who represent the majority of patients with cancer. Clinicians and patients are forced to extrapolate from trials conducted in younger, healthier populations when developing treatment plans. This has created a dearth of knowledge regarding the risk of toxicity in the average older patient and about key end points of importance to older adults. ASCO makes five recommendations to improve evidence generation in this population: (1) Use clinical trials to improve the evidence base for treating older adults with cancer, (2) leverage research designs and infrastructure for generating evidence on older adults with cancer, (3) increase US Food and Drug Administration authority to incentivize and require research involving older adults with cancer, (4) increase clinicians' recruitment of older adults with cancer to clinical trials, and (5) use journal policies to improve researchers' reporting on the age distribution and health risk profiles of research participants.
Serum Immunoproteomics Combined With Pathological Reassessment of Surgical Specimens Identifies TCP-1ζ Autoantibody as a Potential Biomarker in Thyroid Neoplasia
Authors: Belousov Pavel V. , Bogolyubova Apollinariya V. , Kim Yan S. , Abrosimov Alexander Y. , Kopylov Arthur T. , Tvardovskiy Andrey A. , Lanshchakov Kirill V. , Sazykin Alexei Y. , Dvinskikh Nina Y. , Bobrovskaya Yana I. , Selivanova Lilia S. , Shilov Evgeniy S. , Schwartz Anton M. , Shebzukhov Yuriy V. , Severskaia Natalya V. , Vanushko Vladimir E. , Moshkovskii Sergei A. , Nedospasov Sergei A. , Kuprash Dmitry V.
Published: July 2015

Context:

Current methods of preoperative diagnostics frequently fail to discriminate between benign and malignant thyroid neoplasms. In encapsulated follicular-patterned tumors (EnFPT), this discrimination is challenging even using histopathological analysis. Autoantibody response against tumor-associated antigens is a well-documented phenomenon with prominent diagnostic potential; however, autoantigenicity of thyroid tumors remains poorly explored.

Objectives:

Objectives were exploration of tumor-associated antigen repertoire of thyroid tumors and identification of candidate autoantibody biomarkers capable of discrimination between benign and malignant thyroid neoplasms.

Design, Setting, and Patients:

Proteins isolated from FTC-133 cells were subjected to two-dimensional Western blotting using pooled serum samples of patients originally diagnosed with either papillary thyroid carcinoma (PTC) or EnFPT represented by apparently benign follicular thyroid adenomas, as well as healthy individuals. Immunoreactive proteins were identified using liquid chromatography-tandem mass-spectrometry. Pathological reassessment of EnFPT was performed applying nonconservative criteria for capsular invasion and significance of focal PTC nuclear changes (PTC-NCs). Recombinant T-complex protein 1 subunitζ (TCP-1ζ) was used to examine an expanded serum sample set of patients with various thyroid neoplasms (n = 89) for TCP-1ζ autoantibodies. All patients were included in tertiary referral centers.

Results:

A protein demonstrating a distinct pattern of EnFPT-specific seroreactivity was identified as TCP-1ζ protein. A subsequent search for clinicopathological correlates of TCP-1ζ seroreactivity revealed nonclassical capsular invasion or focal PTC-NC in all TCP-1ζ antibody-positive cases. Further studies in an expanded sample set confirmed the specificity of TCP-1ζ autoantibodies to malignant EnFPT.

Conclusions:

We identified TCP-1ζ autoantibodies as a potential biomarker for presurgical discrimination between benign and malignant encapsulated follicular-patterned thyroid tumors. Our results suggest the use of nonconservative morphological criteria for diagnosis of malignant EnFPT in biomarker identification studies and provide a peculiar example of uncovering the diagnostic potential of a candidate biomarker using incorporation of pathological reassessment in the pipeline of immunoproteomic research.
“Spanish Is a Language Tu”: Hemingway's Cubist Spanglish
Authors: Rogers Gayle
Published: July 2015

This essay analyzes the infamously strange dialogue of For Whom the Bell Tolls (1940), in which characters speak English through a modified version of Spanish syntax, false cognates, and peculiar diction. It argues that Hemingway's creation of an Anglo-Spanish literary dialect represents not a political statement on the Spanish Civil War but an attempt to synthesize and recover the moments of interpenetration between English and Spanish since the 1600s. Hemingway's mode of dialogue in the novel is thus a “structural Spanglish” rather than the common code-switching form; it is a mode of interlingual writing that suspends the typical transaction of translation permanently between languages. Hemingway accomplishes this by using Spanish as a laboratory for his overlooked experiments in modernist mistranslation, which I trace through his development of cubist techniques in the novel and his debts to Ezra Pound. As he flattens semantic depth and fuses the syntaxes of two tongues, Hemingway actually invents an aesthetic language that corresponds to neither English nor Spanish, all filtered through a narrator who corrupts the translational process. He thereby creates a critical late modernist novel that looks forward to the depthless anti-epistemology of postmodernist writing. The essay concludes by sketching his place in this genealogy of contemporary writing.
Importing the Novel: The Arabic Novel in and as Translation
Authors: Johnson Rebecca C.
Published: July 2015

Taking as a case study the first known novel to be originally written in Arabic, Khalīl al-Khūrī’s Alas, I Am Not a Foreigner, this essay addresses the centrality of translation to the Arabic novel as it circulated in transnational Arabic print networks as part of both Arab enlightenment (nahḍa) discourse and material culture. Early original Arabic novels were serialized alongside translations, incorporated translated excerpts into their narratives, or were prefaced by comments that situated them in a literary marketplace dominated by translated fiction. This essay reads one such novel within larger debates surrounding the importation and use of foreign objects. By focusing on how translation enables texts to move, we see how these novels help engender transformations in form, how they create but also destabilize imagined communities, and how they provoke new assessments of literary, cultural, and commercial value. The novel is a special kind of import produced self-consciously through translation that resituates the original form. The novel at large, early Arab novelists show us, is not a form that is translated but one formed in and by translation.