bluuebunny/crossref_metadata_2025 huggingface dataset:
Recombinant Polypeptides Derived from the Fibrin Binding Domain of Fibronectin Are Potential Agents for the Imaging of Blood Clots
Authors: Ezov N , Nimrod A , Parizada B , Werber M M , Goldlust A , Greenstein L A , Vogel T , Drizlich N , Levanon A , Reich S , Gorecki M , Panet A
Published: July 2018

Thrombus formation in the circulation is accompanied by covalent linkage of fibronectin (FN) through transglutamination of glutamine no. 3 in the fibrin binding amino terminal domain (FBD) of FN. We have exploited this phenomenon for thrombus detection by the employment of radioactively-labelled recombinant polypeptide molecules derived from the 5-finger FBD of human FN. Three recombinant FBD polypeptides, 12 kDa (“2 fingers”), 18.5 kDa (“3 fingers”) and 31 kDa FBD (“5 fingers”), were prepared and compared to native FN-derived 31 kDa-FBD with respect to their ability to attach to fibrin clots in vitro and in vivo. The accessibility of Gln-3 in these molecules was demonstrated by the incorporation of stoichiometric amounts of 14C- putrescine in the presence of plasma transglutaminase. Competitive binding experiments to fibrin have indicated that, although the binding affinities of the FBD molecules are lower than that of FN, substantial covalent linkage was obtained in the presence of transglutaminase, and even in the presence of excess FN or heparin. The biological clearance rates of radioactively labelled FBD molecules in rats and rabbits were much higher than those of FN and fibrinogen, thus indicating their potential advantage for use as a diagnostic imaging tool. Of the three molecules, the 12 kDa FBD exhibited the highest rate of clearance. The potential of the 12 kDa and 31 kDa FBDs as imaging agents was examined in a stainless steel coil-induced thrombus model in rats and in a jugular vein thrombus model in rabbits, using either [125I] or [111ln]-labelled materials. At 24 h, clot-to-blood ratios ranged between 10 and 22 for [125I]-12 kDa FBD and 40 and 60 for [luIn]-12 kDa FBD. In the rat model, heparin did not inhibit the uptake of FBD. Taken together, the results indicate that recombinant 12 kDa FBD is a good candidate for the diagnosis of venous thrombosis.
Location on the Human Genetic Linkage Map of 26 Genes Involved in Blood Coagulation
Authors: Koeleman Bobby P C , Reitsma Pieter H , Bakker Egbert , Bertina Rogier M
Published: July 2018

Several human genetic linkage maps have been constructed as part of the Human Genome Project. These maps show the positional order of closely linked, highly informative AC-repeat polymorphisms on each human chromosome, and are extremely useful in genetic linkage analysis of inheritable diseases. For a candidate gene approach the current linkage maps are less useful, since they consist mainly of anonymous markers rather than of specific genes. This situation also applies for inheritable disorders of blood coagulation. Numerous genes are involved in the blood coagulation cascade and its regulation, and can be considered as candidate genes for unexplained haemophilia and thrombophilia. We have selected 29 candidate genes that seem to be the ones most likely to be involved in thrombophilia. For 19 genes genotype data were already present in the CEPH database (version 7.0). We typed 7 additional genes in the CEPH reference families, i.e. the factor V, factor XII, protein C, protein S, prothrombin, thrombomodulin, and heparin cofactor II gene. The genotype data were used to integrate these 26 genes in the current genetic linkage map, and to identify closely linked AC-repeat polymorphisms. This information will benefit the investigation of inheritable disorders of blood coagulation, especially thrombophilia.
Early Platelet-Collagen Interactions in Whole Blood and Their Modifications by Aspirin and Dipyridamole Evaluated by a New Method (Basic Wave)
Authors: Pérez-Requejo José Luís , Aznar Justo , Santos M Teresa , Vallés Juana
Published: July 2018

It is shown that the supernatant of unstirred whole blood at 37° C, stimulated by 1 μg/ml of collagen for 10 sec, produces a rapid generation of pro and antiaggregatory compounds with a final proaggregatory activity which can be detected for more than 60 min on a platelet rich plasma (PRP) by turbidometric aggregometry. A reversible aggregation wave that we have called BASIC wave (for Blood Aggregation Stimulatory and Inhibitory Compounds) is recorded. The collagen stimulation of unstirred PRP produces a similar but smaller BASIC wave. BASIC’s intensity increases if erythrocytes are added to PRP but decreases if white blood cells are added instead. Aspirin abolishes “ex vivo” the ability of whole blood and PRP to generate BASIC waves and dipyridamole “in vitro” significantly reduces BASIC’s intensity in whole blood in every tested sample, but shows little effect in PRP.
In Vitro Effects of the Acylated StreptokinasePlasminogen Activator Complex BRL 33 575 Incubated with Normal Human Plasma
Authors: Lämmle B , Noll G , Tran T H , Lohri A , Duckert F
Published: July 2018

Thrombolysis with acylated streptokinase-plasminogen complexes is aimed to achieve fibrinolysis without systemic fibrinogenolysis. The p-aminobenzoyl-streptokinase-(Lys)-plasminogen-complex (BRL 33 575) should be particularly useful due to its slow deacylation rate. Unexpectedly, repeated doses of 10 mg of BRL 33 575 (corresponding to 310'000 streptokinase equivalent units) induced systemic effects in patients though less than streptokinase alone. In vitro incubation of normal human plasma with BRL 33 575 at concentrations used in patients resulted in nearly complete consumption of α2-antiplasmin and plasminogen and significant fibrinogenolysis within 3 hr. This demonstrates that - despite of slow deacylation of BRL 33 575 - the small amounts of activator generated are highly efficacious in activating plasma plasminogen under conditions in which no physiological clearance of the free activator takes place. Simulating the calculated activator release from BRL 33 575 by infusing equivalent amounts of streptokinase into plasma resulted in less pronounced effects. This is probably explained by anti-streptokinase antibodies which will neutralize the initially infused streptokinase but will be bound by BRL 33 575.

Our in vitro experiments indicate that further clinical studies should be done with lower doses of BRL 33 575 or prolonged dosage intervals.
The Fibrinolytic System in Experimental Prostate Tumor
Authors: Al-Mondhiry Hamid , Drago Joseph , Bartholomew Mary J
Published: July 2018

Hypofibrinogenemia and disseminated intravascular coagulation are common events in patients with metastatic prostate carcinoma. This study tests the hypothesis that prostate tumor growth and metastasis is associated with sustained activation of fibrinolysis secondary to increased release of plasminogen activator. We implanted an androgen-insensitive prostate tumor into an inbred strain of rats and serially measured plasminogen, plasminogen activator, plasmin and fibrinogen. Control groups included animals without tumor and a group implanted with transitional cell bladder carcinoma, a locally infiltrating tumor not usually associated with hemostatic complications. Our results showed a significant and steady rise in plasma plasminogen activator, plasmin and fibrinogen levels in animals implanted with prostate cancer. This, however, is not specific for prostate tumor. Similar, perhaps more profound changes were noted in animals implanted with the transitional cell carcinoma.
Association of High Blood Homocysteine and Risk of Increased Severity of Ischemic Stroke Events
Authors: Rasyid Al , Kurniawan Mohammad , Mesiano Taufik , Hidayat Rakhmad , Harris Salim
Published: July 2018

Stroke is the leading cause of death and disability in the world as well as in Indonesia. Initial stroke severity is an important factor that affects short- and long-term stroke outcomes. This cross-sectional study was conducted in Cipto Mangunkusumo Hospital from July 2017 to January 2018 to investigate the factors that affect stroke severity. A total of 77 acute ischemic stroke patients were divided into three groups, which include low blood homocysteine levels (< 9 μmol/L), moderate blood homocysteine levels (9–15 μmol/L), and high blood homocysteine levels (> 15 μmol/L). The acquired data were analyzed using Kruskal–Wallis test and a significant difference of initial National Institute of Health Stroke Scale (NIHSS) and blood homocysteine levels (H = 13.328, p = 0.001) were seen, with a mean rank of 25.86 for low blood homocysteine levels, 33.69 for moderate blood homocysteine levels, and 48.94 for high blood homocysteine levels. The patients were then divided into two groups based on the NIHSS (≤5 and > 5) to calculate the risk correlation of blood homocysteine levels and NIHSS by using regression. We found that patients with high blood homocysteine levels had 14.4 times higher risk of having NIHSS > 5 compared with those with low blood homocysteine levels (p = 0.002, 95% confidence interval [CI] [2.714–76.407]), and 3.9 times higher risk compared with those with moderate blood homocysteine levels (p = 0.011, 95% CI [1.371–11.246]). We concluded that homocysteine is a risk factor for a higher stroke severity. Future studies to evaluate the usefulness of homocysteine-lowering therapy in stroke patients are recommended.
Safe sex in chick lit: a ‘novel' analysis of sexual health references in popular women’s fiction
Authors: Lim Megan S.C. , Hellard Margaret E. , Horyniak Danielle
Published: July 2018

Background
Media, including fiction novels, influences health behaviours in women’s lives. This research measures the prevalence of sexual content and explores the portrayal of sexual health topics in ‘chick lit’, a genre of fiction characterised by neoliberal feminism. Methods: Fifty bestselling chick lit novels were identified from the book-related website, Goodreads. Information was extracted on sexual encounters taking place: characters involved, behaviours depicted, references to contraception and other (un)safe sex practices. Descriptive statistics were used to analyse key features of sexual encounters, and thematic analysis conducted to explore the portrayal of (un)safe sex. Results: Forty-five books (90%) contained at least one sexual scene (total: 199 scenes). 110 scenes explicitly described sexual behaviours, mostly commonly vaginal intercourse (72%), manual stimulation of a woman (28%) or oral stimulation of a man (15%) or woman (15%), and 53% of scenes implied sexual intercourse occurred but did not describe the event. Condom use was described in 43% of scenes with clearly described vaginal intercourse, almost exclusively in scenes involving dating or casual partners. Condoms were portrayed as a ‘necessary evil’; although use was normalised, they were described as having negative effects on pleasure and intimacy. Conclusions: Portrayals of sexual encounters in chick lit are realistic and recognise that safe sex does not always occur. Despite references to condom use being prevalent, the portrayal of condoms in a negative light could discourage young women from their use. Chick lit could provide a ‘novel’ opportunity to model positive behaviours and promote discussion of safer sex practices.
Supporting teacher responsiveness in assessment for learning through disciplined noticing
Authors: Cowie Bronwen , Harrison Christine , Willis Jill
Published: July 2018

Assessment for learning (AfL) practices are commonly recommended as effective classroom strategies for providing teachers with information about student understanding. For teachers, the substantive potential of these AfL practices to inform student learning actions depends on what teachers notice and select as a focus and how they interpret and act on the information they have. This paper suggests research on teacher professional noticing has something to offer in understanding how teacher AfL attention and actions are framed in the moment. It explains noticing as a responsive act that invites action that is an inclusive, dynamic and purposeful response to evidence of student ideas. Noticing is what enables a teacher to act on the fly because it informs and underpins possible actions. Three frames of noticing are introduced to guide noticing and action – curriculum connoisseurship, cultural and community connectedness, and collaborative ways of working. Through consideration of classroom events using these frames, teachers become better prepared to choose to respond in the moment creatively. The three frames provide teachers and researchers with a conceptual language to articulate and sharpen their AfL practices as part of a flexible and rigorous responsiveness to their students’ learning.
“The suits care about us”: employee perceptions of workplace chaplains
Authors: Miller David W. , Ngunjiri Faith Wambura , Lorusso James D.
Published: July 2018

Workplace chaplaincy is an intriguing phenomenon, wherein organizations hire clergy persons to serve the social, spiritual, and psychological needs of their employees. The authors interviewed 56 employees in nine organizations to explore employee perceptions and experiences with chaplaincy.
The results indicate that employees perceive chaplaincy as a demonstration of management’s care and concern for then as whole persons by having chaplains meet their work and nonwork needs. Employees report that workplace chaplains care for them in five ways: attending to their work-related
issues; addressing their practical and social needs; meeting their psychotherapeutic needs; facilitating urgent care as first responders in a crisis; and providing religious or pastoral services. The study suggests that employees’ experience of such care from chaplains can be interpreted
as perceived organizational support, which enhances their sense of well-being and their organizational commitment. The article concludes with recommendations for future research.
2. History
Authors: Jefferson Philip N.
Published: July 2018

Poverty is an ancient problem. In the pre-modern period, poverty was synonymous with hunger, but the kind of poverty we recognize today arose with the emergence of the market economy. ‘History’ considers the range of factors acting within and across societies that had negative effects on vulnerable people in different historical periods: the agricultural societies before the 16th century; societal and governmental responses to poverty during the 16th and 17th centuries; the effects of colonialism in the 18th and 19th centuries; globalization, industrialization, and the expansion of international trade in the late 19th and early 20th centuries; and the precursors to modern anti-poverty programs after the Great Depression of the 1930s.
4. Living: here and there
Authors: Jefferson Philip N.
Published: July 2018

What it means to live in poverty depends on where in the world you are. Developed countries have their own brand of poverty that differs qualitatively from that in the developing world. ‘Living: here and there’ compares and contrasts five dimensions of life that underpin our notion of well-being: family structure, health, education, assets (financial and non-financial), and the environment. The focus is on qualitative characteristics that seem to persist over time, although some data are included in order to provide broader context. The consequences of family structure, health, education, assets, and the environment often manifest themselves in the labour market.
2. The high medieval empire
Authors: Whaley Joachim
Published: July 2018

‘The high medieval empire: from the Salians to the Hohenstaufen’ describes the Salian and Hohenstaufen dynasties who ruled until the mid-13th century; the increasingly problematic relationship between empire and papacy; and the development of a German identity. It begins with the early Salian kings, Conrad II (r. 1024–39) and Henry III (r. 1039–56), who achieved consolidation of the empire and church reform. Conflict with the papacy increased during the reigns of Henry IV (r. 1056–1106) and Henry V (r. 1106–25). The Hohenstaufen dynasty inherited the imperial aspirations of the Ottonians and Salians, but after increasing problems in Italy, the dynasty ended in failure with the death of Frederick II in 1250.
Stoicism, then and now
Authors: Inwood Brad
Published: July 2018

‘Stoicism, then and now’ describes how, despite the contrast between the contemporary reception of Stoicism and the study of the ancient school that inspires it, by looking at the history of Stoicism’s influence since its rediscovery in the Renaissance we have seen one way these approaches can be brought into contact with each other: the prominence of Epictetus and Marcus Aurelius (and to a lesser degree Seneca) in the contemporary reception of Stoicism has made it natural to focus primarily on its potential as a source for moral advice and self-improvement. But what about Stoic physics? How does the modern Stoic deal with the now obsolete science of our world?
Synthetic Biology: A Very Short Introduction
Authors: Davies Jamie A.
Published: July 2018

Synthetic biology is one of the 21st century’s fastest growing fields of research. Building on traditional genetic engineering, synthetic biology uses multi-gene modules and pathways to make very significant changes to what cells can do. Synthetic Biology: A Very Short Introduction provides a concise explanation of what synthetic biology is, and how it is beginning to affect many fields of technology, such as new drug manufacture, biofuel production, tackling pollution, and medical diagnostics. There is also the possibility of creating new life from non-living starting materials. The considerable controversies surrounding synthetic biology are also discussed, including fears that the dangers of engineering life are worse than its benefits.
Introduction
Authors: Marcus Laura
Published: July 2018

Autobiography continues to be one of the most popular forms of writing, produced by authors from across the social and professional spectrum. It is also central to the work of literary critics, philosophers, historians, and psychologists, who have found in autobiographies not only an understanding of the ways in which lives have been lived, but the most fundamental accounts of what it means to be a self in the world. The Introduction describes what autobiography means and compares it to other forms of ‘life-writing’. Autobiographical writing is seen to act as a window on to concepts of self, identity, and subjectivity, and into the ways in which these are themselves determined by time and circumstance.
2. The journeying self
Authors: Marcus Laura
Published: July 2018

There is a close connection between the rise of autobiography in the late 18th and early 19th century and the growing fascination with travel for its own sake, or for the sake of self-development. ‘The journeying self’ explains that with the rise of European Romanticism, Rousseau’s celebration of walking, Goethe’s Italian Journey, his fiction of Wilhelm Meister’s Wanderjahre, and his autobiography, and Wordsworth ‘wandering’ in the Lake District initiate a pattern of links between life-writing and travel, which continued through the American ‘road trip’ and more recent ‘urban walking’ and the literature of landscape. The autobiographical writings of Waldo Emerson, Henry Thoreau, Benjamin Franklin, Walt Whitman, and Alfred Kazin are discussed.
4. Autobiography and psychoanalysis
Authors: Marcus Laura
Published: July 2018

Life-writing has been central to psychoanalysis, which created its own form of biographical narrative. The psychoanalytic case study draws upon the dreams and reminiscences of patients to reconstruct their stories. Psychoanalysis has also profoundly shaped autobiographical consciousness. While psychoanalytic theories and therapies have led to new ways of thinking and writing about the self, psychoanalytic thought also takes up much earlier models of the mind and identity. Through the works of Sigmund Freud and Carl Jung, among others, ‘Autobiography and psychoanalysis’ explains how psychoanalysis has been a shaping force on 20th-century autobiography. The model of the ‘inside out’ suggests an exploration of the autobiographer’s inner world, which is then turned outwards, through writing and towards a readership.
5. Family histories and the autobiography of childhood
Authors: Marcus Laura
Published: July 2018

The years of childhood have become increasingly central to autobiographical writing. Historians have linked this development to the new ideas about life-stages that emerged in the early modern period. Philippe Ariès (1914–84) made a key contribution in 1960 with a book on the child and family life in the ancien régime, known in English as Centuries of Childhood. ‘Family histories and the autobiography of childhood’ considers how genealogy (the tracing of family history) and the shaping of family relations by cultural and social forces have been central concerns for many modern autobiographers. It also looks closely at the relationship between child and parent and at the impact of mixed cultures.
6. Public selves
Authors: Marcus Laura
Published: July 2018

While autobiography is often associated with the private and personal, there are many examples that focus less on individual experience, or on self-exploration, than on the nature of the times in and through which the writer has lived. The autobiographical ‘I’ becomes a traveller through, and at times a guide to, wider cultural and historical forces, as the individual life-course intersects with, and is shaped by, collective events and experiences. ‘Public selves’ focuses on various categories of public autobiography: the life-writings of politicians, those of ‘public intellectuals’, and celebrity autobiography, which is frequently ‘ghosted’ by a writer paid to work for and/or with the celebrity, and to produce a ‘first-person narrative’.
7. Self-portraiture, photography, and performance
Authors: Marcus Laura
Published: July 2018

The relationship between visual and literary self-portraits is mutual. Portraiture and self-portraiture in art have frequently been linked to biography and autobiography. This is true in particular of serial representations, as in the sequence of over eighty portraits of himself that Rembrandt painted or drew at different stages of his life, from youth to old age, which have often been described as Rembrandt’s autobiography. ‘Self-portraiture, photography, and performance’ considers the autobiographies of Benvenuto Cellini and John Ruskin, then the new and heightened relationship between text and visual image that emerged after the advent of photography in the early 19th century. The role of autobiography as performance is also discussed.
Stabilization for Schrödinger equation with a distributed time delay in the boundary input
Authors: Cui Haoyue , Xu Genqi , Chen Yunlan
Published: July 2018

In this study, the stabilization problem for Schrödinger equation with distributed input time delay is considered. The main idea of solving the stabilization problem is transformation. The original time delay system is firstly transformed into the undelayed system, and then the feedback control law which can stabilize the undelayed system is found. Finally, we prove that the feedback control law can also exponentially stabilize the time delay system.
Virtual element methods for the obstacle problem
Authors: Wang Fei , Wei Huayi
Published: July 2018

We study virtual element methods (VEMs) for solving the obstacle problem, which is a representative elliptic variational inequality of the first kind. VEMs can be regarded as a generalization of standard finite element methods with the addition of some suitable nonpolynomial functions, and the degrees of freedom are carefully chosen so that the stiffness matrix can be computed without actually computing the nonpolynomial functions. With this special design, VEMS can easily deal with complicated element geometries. In this paper we establish a priori error estimates of VEMs for the obstacle problem. We prove that the lowest-order ($k=1$) VEM achieves the optimal convergence order, and suboptimal order is obtained for the VEM with $k=2$. Two numerical examples are reported to show that VEM can work on very general polygonal elements, and the convergence orders in the $H^1$ norm agree well with the theoretical prediction.
Validity of World Health Organisation prescribing indicators in Namibia’s primary healthcare: findings and implications
Authors: Niaz Q , Godman B , Massele A , Campbell S , Kurdi A , Kagoya H R , Kibuule D
Published: July 2018

Objective

World Health Organization/International Network of Rational use of Drugs (WHO/INRUD) indicators are widely used to assess medicine use. However, there is limited evidence on their validity in Namibia’s primary health care (PHC) to assess the quality of prescribing. Consequently, our aim was to address this.

Design, setting, participants and interventions

An analytical cross-sectional survey design was used to examine and validate WHO/INRUD indicators in out-patient units of two PHC facilities and one hospital in Namibia from 1 February 2015 to 31 July 2015. The validity of the indicators was determined using two-by-two tables against compliance to the Namibian standard treatment guidelines (NSTG). The receiver operator characteristics for the WHO/INRUD indicators were plotted to determine their accuracy as predictors of compliance to agreed standards. A multivariate logistic model was constructed to independently determine the prediction of each indicator.

Main outcomes and results

Out of 1243 prescriptions; compliance to NSTG prescribing in ambulatory care was sub-optimal (target was >80%). Three of the four WHO/INRUD indicators did not meet Namibian or WHO targets: antibiotic prescribing, average number of medicines per prescription and generic prescribing. The majority of the indicators had low sensitivity and/or specificity. All WHO/INRUD indicators had poor accuracy in predicting rational prescribing. The antibiotic prescribing indicator was the only covariate that was a significant independent risk factor for compliance to NSTGs.

Conclusion

WHO/INRUD indicators showed poor accuracy in assessing prescribing practices in ambulatory care in Namibia. There is need for appropriate models and/or criteria to optimize medicine use in ambulatory care in the future.
The low-mass population of the Vela OB2 association from Gaia
Authors: Armstrong Joseph J , Wright Nicholas J , Jeffries R D
Published: July 2018

The first Gaia Data Release presents an opportunity to characterize the low-mass population of OB associations, providing larger statistical samples and better constraints on the formation and evolution of clusters and associations. Using previously known low-mass members in a small region of Vela OB2, we have designed selection criteria that combine Gaia and 2MASS photometry, independently of any astrometric information, to identify low-mass pre-main-sequence stars over the wider association area. Our method picks out the known clusters of young stars around γ2 Velorum and NGC-2547, but also identifies other overdensities that may represent previously unknown clusters. There are clear differences in the spatial distributions of the low-mass and the high-mass OB populations, suggesting either that the structure and dynamics of these populations has evolved separately or that the initial mass function can vary considerably on small scales within a single association.
Mechanisms of Broad Host Range Necrotrophic Pathogenesis in Sclerotinia sclerotiorum
Authors: Liang Xiaofei , Rollins Jeffrey A.
Published: July 2018

Among necrotrophic fungi, Sclerotinia sclerotiorum is remarkable for its extremely broad host range and for its aggressive host tissue colonization. With full genome sequencing, transcriptomic analyses and the increasing pace of functional gene characterization, the factors underlying the basis of this broad host range necrotrophic pathogenesis are now being elucidated at a greater pace. Among these, genes have been characterized that are required for infection via compound appressoria in addition to genes associated with colonization that regulate oxalic acid (OA) production and OA catabolism. Moreover, virulence-related secretory proteins have been identified, among which are candidates for manipulating host activities apoplastically and cytoplasmically. Coupled with these mechanistic studies, cytological observations of the colonization process have blurred the heretofore clear-cut biotroph versus necrotroph boundary. In this review, we reexamine the cytology of S. sclerotiorum infection and put more recent molecular and genomic data into the context of this cytology. We propose a two-phase infection model in which the pathogen first evades, counteracts and subverts host basal defense reactions prior to killing and degrading host cells. Spatially, the pathogen may achieve this via the production of compatibility factors/effectors in compound appressoria, bulbous subcuticular hyphae, and primary invasive hyphae. By examining the nuances of this interaction, we hope to illuminate new classes of factors as targets to improve our understanding of broad host range necrotrophic pathogens and provide the basis for understanding corresponding host resistance.
Surgical Treatment of Subfibular Ossicle in Children: A Retrospective Study of 36 Patients with Functional Instability
Authors: Moukoko Didier , Henric Nicolas , Gouron Richard , Peyronnet Antoine , Bin Kim
Published: July 2018

Backgrounds:

To evaluate the surgical management of a symptomatic subfibular ossicle after severe ankle sprain with functional instability and pain sequelae in children.

Methods:

We analyzed 36 patients complaining of functional instability without laxity, 1 year after an ankle inversion trauma associated with the observation of a subfibular ossicle. We systematically suggested the open excision of the residual ossicles, followed by 6 weeks of immobilization and proprioceptive physiotherapy. Seventeen of them, constituting the “resection” group accepted this surgical approach. The remaining 19 patients, the “control” group, received only rehabilitative care. The American Orthopaedic Foot and Ankle Society ankle pain and function score was evaluated in both groups.

Results:

The mean latest follow-up was 4 years and 4 months (range, 1 y 8 mo to 14 y 7 mo). A significant improvement of the American Orthopaedic Foot and Ankle Society score was observed and was significantly higher in the resection group with a mean gain of 31 points (SD=31.8), versus 7 points (SD=7) in the control group (P<0.001).

Conclusions:

We conclude that in the absence of objective laxity, excision of the os subfibulare appears as a simple and effective technique in the treatment of posttraumatic functional instability and ankle pain.

Level of Evidence:

Level IV—retrospective case-control study.
Clinical Outcomes After Implantation of 320°-Arc Length Intrastromal Corneal Ring Segments in Keratoconus
Authors: Torquetti Leonardo , Cunha Priscila , Luz Allan , Kwitko Sérgio , Carrion Márcio , Rocha Guilherme , Signorelli Armando , Coscarelli Sandro , Ferrara Guilherme , Bicalho Frederico , Neves Renato , Ferrara Paulo
Published: July 2018

Purpose:

To evaluate the clinical outcomes after implantation of a new 320°-arc length Ferrara intrastromal corneal ring segment (320-ICRS) in eyes of patients with keratoconus.

Methods:

A multicentric nonrandomized study was conducted in which a new 320-ICRS was placed in 138 eyes of 130 patients with keratoconus. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal volume, asphericity, lines of vision gain/loss, and vectorial analysis were assessed preoperatively and at the final follow-up visit after the procedure.

Results:

The mean follow-up time was 6.2 ± 3.3 (SD) months (range 3–12 months). Mean UDVA improved from 20/250 to 20/60. Mean CDVA improved from 20/100 to 20/40. Mean Q improved from −1.12 ± 0.49 preoperatively to −0.28 ± 0.51 postoperatively (P< 0.001). Mean corneal volume increased from 56.2 ± 4.28 mm3preoperatively to 57.6 ± 4.74 postoperatively (P< 0.001). Mean Km reduced from 53.3 ± 5.5 D preoperatively to 47.8 ± 4.6 D postoperatively (P< 0.001). The change in UDVA, CDVA, and topographic astigmatism was statistically significant (P< 0.0001).

Conclusions:

The 320-ICRS can efficiently and safely improve visual acuity in keratoconus, modifying the corneal shape to a more physiologic, aspheric shape.
Yield of Malignant Pleural Effusion for Detection of Oncogenic Driver Mutations in Lung Adenocarcinoma
Authors: DeMaio Andrew , Clarke Jeffrey M. , Dash Rajesh , Sebastian Siby , Wahidi Momen M. , Shofer Scott L. , Cheng George Z. , Li Xuechan , Wang Xiaofei , Mahmood Kamran
Published: July 2018

Background:

Pleural fluid can be used to assess targetable mutations in patients with lung adenocarcinoma. The primary objective of this study was to assess the yield of pleural fluid cytology for targetable oncogenic mutations (EGFR, KRAS, BRAF, ALK, and ROS1 gene rearrangements). We also assessed pleural fluid volume necessary for molecular testing.

Methods:

Retrospective review was performed of 134 consecutive patients with lung adenocarcinoma associated malignant pleural effusions. EGFR and KRAS testing was done using PCR amplification followed by DNA sequencing, or next generation sequencing in more recent cases that included BRAF assessment. Fluorescence in situ hybridization employing break-apart probes was used to test for ALK and ROS1 rearrangements.

Results:

Mutation analysis on pleural fluid cell-block was performed on 56 patients. It was adequate for complete analysis ordered including EGFR, KRAS, BRAF, ALK, and ROS1 rearrangements on 40 (71.4%) samples. For individual mutations, EGFR testing was possible in 38 of 49 (77.6%); KRAS 22 of 28 (78.6%); BRAF 10 of 13 (76.9%), ALK gene rearrangement 42 of 51 (82.4%) and ROS1 gene rearrangement in 21 of 28 (75%) pleural fluid specimens. The analysis was satisfactory in 13 of 19 (68.4%) samples with ≤100 mL versus 27 of 37 (72.9%) with >100 mL of fluid tested (P-value=0.7).

Conclusion:

Genetic mutation analysis can be performed on malignant pleural effusions secondary to lung adenocarcinoma, independent of fluid volume.
Food cravings and body weight: a conditioning response
Authors: Myers Candice A. , Martin Corby K. , Apolzan John W.
Published: July 2018

Purpose of review

To provide current information on interventions that alter food cravings. Specifically, dietary, physical activity, pharmacologic, and bariatric surgery interventions are examined. Lastly, the effects of social determinants and current controversies on food cravings are outlined.

Recent findings

Dietary, pharmacologic, and bariatric surgery weight loss interventions decrease food cravings. Physical activity interventions also decrease cravings. There is potential to see differential responses in food cravings in different demographic and socioeconomic groups, but more research is needed.

Food cravings influence body weight. Food craving reductions are because of reductions in the frequency of consuming craved foods, independent of energy content, but further research is warranted. Most findings continue to support the conditioning model of food cravings.
Approach and Safety of Esophageal Dilation for Treatment of Strictures in Children With Epidermolysis Bullosa
Authors: Anderson Bradley T. , Feinstein James A. , Kramer Robert E. , Narkewicz Michael R. , Bruckner Anna L. , Brumbaugh David E.
Published: July 2018

Objective:

The aim of the study is to analyze a large series of esophageal balloon dilations in patients with epidermolysis bullosa (EB) to determine procedural approach and frequency of post‐endoscopic adverse events (AEs).

Methods:

Retrospective chart review for AE occurrence and clinical outcomes in children and adolescents with EB, age 1 to 19, who underwent esophageal dilation for esophageal stricture(s) from January 2003 to April 2016 at an academic, tertiary care, free‐standing children's hospital. The primary outcome measure was occurrence of procedural AEs (defined as events occurring within 72 hours after endoscopic dilation procedure).

Results:

A total of 231 fluoroscopy‐guided esophageal balloon dilation procedures (209 anterograde, 20 retrograde, 2 both) were performed in 24 patients. Strictures were more common in the proximal portion of the esophagus with median stricture location 13 cm from the lips. From 2003 to 2012, 4.1% of dilations were retrograde. From 2013 to 2016, 20.2% of dilations were retrograde. AEs attributable to dilation occurred after 10.0% of procedures, and the most common AEs were vomiting, pain, and fever. No esophageal perforations, serious bleeding events, or deaths occurred secondary to dilation. The rate of post‐dilation hospitalization was 6.9%. Dilation approach (anterograde vs retrograde) did not impact the likelihood of AEs.

Conclusions:

The characteristic esophageal lesion in EB is a single, proximal esophageal stricture. EB patients can safely undergo repeat pneumatic esophageal balloon dilations with minimal risk for severe complication. We observed a trend towards increased use of retrograde esophageal dilation.
Can We Estimate Quality of Life in Pediatric Inflammatory Bowel Disease Patients? An Asian Multicenter Study
Authors: Kim Seung , Park Sowon , Kang Yunkoo , Kim Jung Eun , Kang Ben , Choe Byung‐Ho , Lee Yeoun Joo , Park Jae Hong , Yang Hye Ran , Lee Sung Hee , Kim Kyung Mo , Ryoo Eell , Tchah Hann , Shim Jung Ok , Koh Hong
Published: July 2018

Objectives:

Inflammatory bowel disease (IBD) is a chronic lifelong condition and is related to poor quality of life (QoL). The aim of this study was to evaluate the QoL of Asian pediatric patients with IBD and to determine the clinical factors that can influence QoL.

Methods:

Children and adolescents aged 9 to 18 years diagnosed with IBD were enrolled from 7 hospitals. The patients completed the IMPACT‐III questionnaire, and clinical data were collected. The results of the questionnaire and the correlation with clinical data were analyzed.

Results:

A total of 208 patients (Crohn disease: n = 166; ulcerative colitis: n = 42) were enrolled. There was no definite QoL difference according to the Paris classification. Female sex (−5.92 ± 2.97, P = 0.0347) and active disease status (−10.79 ± 3.11, P = 0.0006) were significantly associated with poor QoL. Extreme body weight z score and older age at diagnosis were also associated with worse QoL.

Conclusions:

Various clinical factors may affect the QoL in patients with IBD, but determining the overall QoL of patients using only these clinical factors is difficult. Therefore, regular direct measurements of QoL are necessary to better understand patients with IBD.
Measuring Return on Investment for Professional Development Activities
Authors: Opperman Cathleen , Liebig Debra , Bowling Judith , Johnson Carol Susan
Published: July 2018

What is the return on investment for the time and resources spent for professional development activities? This is an update of the two articles published in 2016, which reviewed literature and demonstrated how financial analysis of educational activities can drive decision-making. Professional development activities are routinely planned based on needs assessments, implemented with evidence-based learning modalities, and evaluated for effectiveness through linkage to outcomes. The next level of evaluation is consideration of the economic impact of professional development activities. This article includes a review of the most recent studies that provide cost of educational interventions along with a description of economic outcomes and an update to the “Known Costs of Outcomes Table.”
Cognitive Behavior Therapy’s Effect in a Weight Loss Program Among Obese Iranian Women
Authors: Seif-Barghi Tohid , Akbari-Fakhrabadi Maryam , Teimori Mohammad Pasha , Tashk Anahita , Alizadeh Zahra , Memari Amir Hossein
Published: July 2018

Obesity is a global health concern with a higher prevalence among women than men. Cognitive behavioral therapy (CBT) for obesity is a form of behavior therapy in combating obesity, which has rarely been used in developing countries. In a single-blind clinical trial, we evaluated the effect of CBT on the adherence to low-calorie diets (LCDs) with increased physical activity and anthropometric indices in a 4-month follow-up study of obese Iranian women. In this single-blind clinical trial, 72 Iranian women with obesity were recruited and divided into 2 study groups. The intervention group in addition to an individual LCD and a speed walking program received CBT. Assessments were accomplished on 3 time points (baseline and after 2 and 4 months). Anthropometric measurements showed a significant decrease in the intervention group compared with the control group over time (P < .001). Adherence to diet (80% vs 74%) and mean steps counted (24 590 vs 20 466) were significantly higher in the intervention group compared with the control group after 4 months of follow-up, respectively (P < .05). Changes in motivations with CBT can improve adherence to exercise and a healthy LCD among obese women in developing countries.
The Top 10 Questions About Food and Fitness After 50
Authors: Rosenbloom Christine , Murray Bob
Published: July 2018

Life expectancy for those in the United States who reach 65 years old is an additional 20 years. Healthy food choices, dietary patterns, and physical activity that promotes functional fitness can help make older adults more independent and improve quality of life in their later years. This article answers the top questions about food and fitness after 50 years old that are posed by older adults with answers to help health professionals encourage their patients, clients, friends, and family eat well, move well, and be well. Questions range from “best” foods, diets, and exercise to maintain fitness, as well as questions on hydration, calcium intake, and dietary supplements.
Fake Science/Nutrition News: Part 2—Trust
Authors: Rowe Sylvia , Alexander Nick
Published: July 2018

As has been widely explored in the literature, the evolving science-communication landscape has posed challenges to the credibility and trustworthiness of nutrition and health communicators. Especially, the Internet-mediated democratization of expertise, where every blogger and Web site owner becomes a subject-matter expert, has been problematic for communicators. This article, the second in a Nutrition Today series examining evolving communication issues in the digital age, explores the implications of the reported declining trust in science communications. The authors cite a new definition of trust, suggested at a National Academies of Science workshop, and they report recent survey findings on public trust. After a detailed discussion of the implications of these findings, the authors offer some guidance to nutrition and health communicators on meeting evolving trust challenges.
Cholera: recent updates
Authors: Weil Ana A. , Ryan Edward T.
Published: July 2018

Purpose of review

In this review, we will examine updates in cholera epidemiology, advances in our understanding of pathogenesis and protective immunity, and changes to prevention strategies.

Recent findings

New modeling techniques and molecular epidemiology have led to advancements in our understanding of how Vibrio cholerae has persisted and re-emerged in new areas during the seventh pandemic. Use of next-generation sequencing has shed new light on immune responses to disease and vaccination, and the role of the gut microbiome in cholera. Increased efficacy and availability of vaccines have made long-term goals of global control of cholera more achievable.

Advancements in our understanding of immunity and susceptibility to V. cholerae, in addition to an increased global commitment to disease prevention, have led to optimism for the future of cholera prevention.
Radiology of Chronic Cavitary Infections
Authors: Ketai Loren , Currie Bart J. , Holt Michael R. , Chan Edward D.
Published: July 2018

Chronic cavitary lung disease is an uncommon manifestation of pulmonary infection, and is a pattern which worldwide is most commonly caused by reactivation tuberculosis. Other organisms, however, can cause similar radiologic patterns. Endemic fungi have long been recognized as potential causes of this pattern in North and South America, but the frequency with which these diseases present with chronic cavities in North America is relatively small. Nontuberculous mycobacteria and chronic aspergillus infections are recognized with increasing frequency as causes of this pattern. Melioidosis, a bacterial infection that can also cause chronic lung cavities, was previously understood to be relevant primarily in Southeast Asia, but is now understood to have a wider geographic range. While cultures, serologies, and other laboratory methods are key to identifying the infectious causes of chronic lung cavities, radiologic evaluation can contribute to the diagnosis. Differentiating the radiologic patterns of these diseases from reactivation tuberculosis depends on subtle differences in imaging findings and, in some cases, appreciation of underlying lung disease.
Prognostic Value of Tissue Oxygen Saturation Using a Vascular Occlusion Test in Patients in the Early Phase of Multiorgan Dysfunction Syndrome
Authors: Haertel Franz , Reisberg Diana , Peters Martin , Nuding Sebastian , Schroeder Jochen , Werdan Karl , Ebelt Henning
Published: July 2018

Background:

Multiple organ dysfunction syndrome (MODS) is a common disease pattern in intensive care units which is associated with an increased mortality. The aim of this study was to investigate whether a near-infrared spectroscopy (NIRS)-based noninvasive ischemia–reperfusion test (vascular occlusion test) using the parameter of tissue oxygen saturation (StO2) contains prognostic information for patients in the early phase of MODS.

Methods:

Within a period of 18 months between 2010 and 2012, 56 patients who newly developed MODS (≤24 h after diagnosis, Acute Physiology and Chronic Health Evaluation [APACHE] II score ≥20, subgroups: cardiogenic MODS [cMODS] and septic MODS [sMODS]) were included into the study. The StO2 was determined non-invasively in the area of the thenar muscles using a bedside NIRS device, InSpectra Tissue Spectrometer Model 650 (Hutchinson Technology Inc., Hutchinson, MN). The VOT was carried out by inflating a blood pressure cuff on the upper arm 30 mmHg above systolic blood pressure for 5 min. The parameters occlusion slope (OS) and recovery slope (RS) were recorded.

Results:

Fifteen patients with cMODS and 41 patients with sMODS were included in the study (age: 62.5 ± 14.4 years, 40 men and 16 women, APACHE II score: 34.6 ± 6.4). Twenty-eight-day-mortality was 55.4% (cMODS: 7 out of 15 patients, sMODS: 24 out of 41 patients). The measurement of StO2 while applying the VOT at baseline showed an OS of −11.7 ± 3.7%/min and an RS of 2.2 ± 1.5%/s. Survivors had significantly better values compared with non-survivors at baseline regarding OS (−12.8 ± 3.5%/min vs. −9.8 ± 3.4%/min; P = 0.016) and RS (2.6 ± 1.7%/s vs. 1.6 ± 1.0%/s; P = 0.022). Receiver-operating characteristic (ROC) curves show that the area under the curve (AUC) for OS was found to be significantly related to 28-day mortality (AUC: 0.7; 95% confidence interval [CI]: 0.56–0.85; P = 0.01). However, using both univariate and multivariate binary logistic regression models, RS was significantly associated with increased 28-day mortality (OR [univariate model]: 1.21 [95% CI: 1.1–1.8]; OR [multivariate model]: 1.23 [95% CI: 1.1–1.3]).

Conclusions:

Impaired values of the VOT-parameters OS and RS are associated with an increased 28-day mortality in patients in the early phase of MODS.