bluuebunny/crossref_metadata_2025 huggingface dataset:
Reasons of unsuccessful implantation of short-term hemodialysis catheters in jugular veins using real-time ultrasound
Authors: Martins Marrocos Mauro Sergio , S Gentil Thais Marques , de C Lima Fernanda , R Laranja Sandra Maria
Published: March 2018

Purpose:

Real-time ultrasound is indicated for hemodialysis catheters’ insertion in internal jugular veins. We evaluated unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound between patients with and without previous short-term catheters.

Methods:

Observational open-label study of unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound from July 2013 to August 2014.

Results:

A total of 185 procedures were compared in 122 individuals; 120 (64.86%) had previously used short-term catheters. There were 5 (8%) unsuccessful implantation among 62 catheterizations without previous short-term catheter and 41 (33.6%) among 122 with previous short-term catheter (p = 0.001 Pearson’s chi-squared, odds ratio = 5.77, 95% confidence interval = 2.15–15.50, p = 0.001). Non-progressing guidewire occurred in 2 (3.2%) of 62 patients without previous short-term catheter and in 18 (14.8%) of 122 with previous short-term catheter (p = 0.018 Pearson’s chi-squared, odds ratio = 5.19, 95% confidence interval = 1.16–23.15, p = 0.031). No difference was observed between size of the veins with or without non-progressing guidewire. All 11 cases of venous thrombosis occurred in patients who had previous short-term catheter removed due to infection.

Conclusion:

Previous use of short-term catheter is pivotal in the occurrence of unsuccessful implantation of short-term catheter in internal jugular veins using real-time ultrasound.
Angioplasty to promote arteriovenous fistula maturation and maintenance
Authors: Abreo Kenneth , Buffington Mary , Sachdeva Bharat
Published: March 2018

The arteriovenous fistula is currently the best permanent access for the hemodialysis patient. Unfortunately, stenosis impairs maturation, long-term survival, and function of the arteriovenous fistula. Angioplasty currently is the best procedure for the treatment of immature and dysfunctional arteriovenous fistulas. In this review, the authors discuss the optimum time to evaluate arteriovenous fistulas for maturity, methods of evaluation for maturity, and the role of angioplasty in salvaging immature arteriovenous fistulas. The review also discusses the effect of stenosis on dysfunction in mature arteriovenous fistulas and the role of angioplasty to treat this complication. Finally, the impact of cutting balloons and drug-eluting balloons in the treatment of resistant and recurrent stenosis, respectively, is also discussed.
Use of 8-cm 22G-long peripheral cannulas in pediatric patients
Authors: Pacilli Maurizio , Bradshaw Catherine J , Clarke Simon A
Published: March 2018

Introduction:

Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery.

Methods:

Following ethical approval, we prospectively collected data in children requiring medium-term intravenous access. The 22G-8-cm-long peripheral cannulas were inserted with a Seldinger technique in a peripheral vein. Position was checked by flushing and aspirating the catheter. Results are reported as mean ± standard deviation.

Results:

A total of 18 children were included. Indications for medium-term intravenous therapy included perforated appendicitis (n = 14), infected central venous port (n = 2), fungal infection (n = 1) and septic arthritis (n = 1). In all, 15 (83%) patients underwent the procedure under general anaesthetic. The procedure failed in an 8-year-old patient. Insertion time was 8 ± 3.7 min. Age at insertion was 6.3 ± 4.9 years. Duration of intravenous therapy was 6.4 ± 5.1 days. About 13 (76%) patients completed the treatment with no complications. Three (17%) lines occluded by day 3 needed removal; one (7%) line needed removal on day 3 because of redness/pain noted around the insertion site.

Conclusion:

Long peripheral cannulas represent a valid option for medium-term intravenous access in children undergoing surgery. Majority of patients will be successfully treated with one long peripheral cannula for the duration of their treatment without the need for further cannulation.
Subclavian steal syndrome in a hemodialysis patient after percutaneous transluminal angioplasty of arteriovenous access
Authors: Kaneko Yoko , Yanagawa Takamoto , Taru Yoshinori , Hayashi Sonoko , Zhang Hong , Tsukahara Tomoki , Matsunaga Tsuneaki , Ishizu Takashi
Published: March 2018

Introduction:

We describe a hemodialysis patient who developed subclavian steal syndrome via an arteriovenous fistula after percutaneous transluminal angioplasty.

Case description:

A 55-year-old female with end-stage renal failure due to polycystic kidney disease had been treated with hemodialysis for 10 years. Because of an autologous arteriovenous fistula stenosis, percutaneous transluminal angioplasty was performed. After successful treatment with percutaneous transluminal angioplasty, the patient developed dizziness. Magnetic resonance imaging with angiography of the brain and neck revealed normal bilateral subclavian and carotid arteries. However, flow in the left vertebral artery was not detected in time-of-flight magnetic resonance angiography. The left vertebral artery showed completely reversed blood flow as detected by color duplex ultrasound. We also confirmed anterograde flow in the left vertebral artery by color duplex ultrasound with arteriovenous fistula compression. Arteriovenous flows before the arteriovenous fistula stenosis and post-percutaneous transluminal angioplasty were 1146 and 2239 mL/min, respectively. These findings suggested high-flow arteriovenous fistula led to the subclavian steal syndrome. The patient was subsequently treated by a flow reduction in the high-flow arteriovenous access using a modified graft inclusion technique. We decreased the arteriovenous fistula flow to 851 mL/min, which remained under 850 mL/min, 1 year later. The brain natriuretic peptide level and right-ventricular pressure also decreased after treatment. A modified graft inclusion technique was successful in decreasing the high flow of the arteriovenous fistula, and improved subclavian steal syndrome symptom and cardiac overload.

Conclusion:

This case shows that percutaneous transluminal angioplasty for an arteriovenous fistula may induce subclavian steal syndrome, and a modified graft inclusion technique was useful in improving the high flow of an arteriovenous fistula.
Role of stents in hemodialysis vascular access
Authors: Abreo Kenneth , Sequeira Adrian
Published: March 2018

Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents. The latest randomized control trials reveal that stents decrease the number of interventions required to maintain patency but do not improve the overall access survival. Furthermore, bare metal stents have been shown to be inferior to stent grafts. This review discusses indications for stent deployment in the hemodialysis access, the current evidence for their use, and briefly touches on their complications.
Efficient Acceleration of the Pair-HMMs Forward Algorithm for GATK HaplotypeCaller on Graphics Processing Units
Authors: Ren Shanshan , Bertels Koen , Al-Ars Zaid
Published: March 2018

GATK HaplotypeCaller (HC) is a popular variant caller, which is widely used to identify variants in complex genomes. However, due to its high variants detection accuracy, it suffers from long execution time. In GATK HC, the pair-HMMs forward algorithm accounts for a large percentage of the total execution time. This article proposes to accelerate the pair-HMMs forward algorithm on graphics processing units (GPUs) to improve the performance of GATK HC. This article presents several GPU-based implementations of the pair-HMMs forward algorithm. It also analyzes the performance bottlenecks of the implementations on an NVIDIA Tesla K40 card with various data sets. Based on these results and the characteristics of GATK HC, we are able to identify the GPU-based implementations with the highest performance for the various analyzed data sets. Experimental results show that the GPU-based implementations of the pair-HMMs forward algorithm achieve a speedup of up to 5.47× over existing GPU-based implementations.
Aboriginal ways of seeing and being: informing professional learning for Australian teachers
Authors: Buxton Lisa
Published: March 2018

This article describes consolidating elements of professional learning for teachers, increasing their efficacy in incorporating Aboriginal ways of seeing into classroom practice. Included are findings from the first school in the second phase of ongoing research in which the first phase had established what teachers already know and would like provided in professional learning. This stage of the study took place within the theoretical framework of adult education and teacher professional development. Design-based research methodology provided the flexibility of ongoing improvement. Teacher participants evaluated the professional learning that comprised a day on Country providing background concepts. Thereafter, a follow-up day facilitated in-classroom translation of concepts into practice for teachers’ own context and year level. Participants took part in group interviews, providing feedback that has informed incremental changes to the professional learning. The main findings were that teachers recommended 2 days on Country but not at the expense of the in-school follow-up; in addition, they requested ongoing support through a blog.
Pacific university graduates in New Zealand: what helps and hinders completion
Authors: Theodore Reremoana , Taumoepeau Mele , Tustin Karen , Gollop Megan , Unasa Charlotte , Kokaua Jesse , Taylor Nicola , Ramrakha Sandhya , Hunter Jackie , Poulton Richie
Published: March 2018

Increasing the numbers of Pacific Island students who graduate from New Zealand universities is important for the students’ futures, their families, communities and society in general. In this study, Pacific graduates ( N = 365) who are participants in the Graduate Longitudinal Study New Zealand were asked to describe what factors helped or hindered their qualification completion. Graduates from all eight New Zealand universities were surveyed between July and December 2011. Pacific graduates identified external (e.g. family), institutional (e.g. university staff) and student or personal (e.g. motivation) factors that both helped and hindered the successful completion of their studies. Understanding the hindrance factors faced by Pacific students and the factors that have contributed to their educational success can help to inform policy and practice to achieve national priorities of equity and successful outcomes for Pacific learners.
Digitally crafting a resistant professional identity: The case of Brazilian ‘dirty’ bloggers
Authors: Barros Marcos
Published: March 2018

We explore how the consequences of disidentification from prevailing professional identities impacted the creation of a new identity and how social media tools enabled and shaped this process. We investigate these phenomena through the struggle of a group of Brazilian journalists who strived to escape the regulation of traditional media identity, creating their own identity as progressive bloggers. Analyzing blog entries and press articles, we uncover four distinctive forms of identity work—historical construction, embracing stigma, establishing authenticity, and satirical deconstruction—fueled by four journalism macro-discourses. Our article contributes to existing literature by uncovering the dynamics of disidentification, its consequences, and identity creation. We also add to the debate on the interaction between identity and resistance by proposing the concept of resistant-identity work, where—beyond being a form or a result of identity work—resistance might enact this process. Finally, we contribute to the study of online-identity processes by demonstrating how the characteristics of social media enable and shape a new form of identity work that is collective and visible.
Association of smoking but not HLA-DRB1*15:01, APOE or body mass index with brain atrophy in early multiple sclerosis
Authors: Graetz Christiane , Gröger Adriane , Luessi Felix , Salmen Anke , Zöller Daniela , Schultz Janine , Siller Nelly , Fleischer Vinzenz , Bellenberg Barbara , Berthele Achim , Biberacher Viola , Havla Joachim , Hecker Michael , Hohlfeld Reinhard , Infante-Duarte Carmen , Kirschke Jan S , Kümpfel Tania , Linker Ralf , Paul Friedemann , Pfeuffer Steffen , Sämann Philipp , Toenges Gerrit , Weber Frank , Zettl Uwe K , Jahn-Eimermacher Antje , Antony Gisela , Groppa Sergiu , Wiendl Heinz , Hemmer Bernhard , Mühlau Mark , Lukas Carsten , Gold Ralf , Lill Christina M , Zipp Frauke
Published: March 2018

Background:

The course of multiple sclerosis (MS) shows substantial inter-individual variability. The underlying determinants of disease severity likely involve genetic and environmental factors.

Objective:

The aim of this study was to assess the impact of APOE and HLA polymorphisms as well as smoking and body mass index (BMI) in the very early MS course.

Methods:

Untreated patients ( n = 263) with a recent diagnosis of relapsing-remitting (RR) MS or clinically isolated syndrome underwent standardized magnetic resonance imaging (MRI). Genotyping was performed for single-nucleotide polymorphisms (SNPs) rs3135388 tagging the HLA-DRB1*15:01 haplotype and rs7412 (Ɛ2) and rs429358 (Ɛ4) in APOE. Linear regression analyses were applied based on the three SNPs, smoking and BMI as exposures and MRI surrogate markers for disease severity as outcomes.

Results:

Current smoking was associated with reduced gray matter fraction, lower brain parenchymal fraction and increased cerebrospinal fluid fraction in comparison to non-smoking, whereas no effect was observed on white matter fraction. BMI and the SNPs in HLA and APOE were not associated with structural MRI parameters.

Conclusions:

Smoking may have an unfavorable effect on the gray matter fraction as a potential measure of MS severity already in early MS. These findings may impact patients’ counseling upon initial diagnosis of MS.
Balance worsening associated with nabiximols in multiple sclerosis
Authors: Castelli Letizia , Prosperini Luca , Pozzilli Carlo
Published: March 2018

We performed a dual-task experiment to explore the effect of nabiximols on postural control in 22 patients with multiple sclerosis. They were assessed with static posturography and Stroop test in single- and dual-task conditions at treatment start and after 1, 3 and 12 months. At follow-up, we found more impaired postural control in single-task ( F = 3.07, p = 0.044) and dual-task ( F = 4.90, p = 0.005) conditions in patients who continued treatment (continuers, n = 11) compared with those who discontinued (quitters, n = 11). Continuers were more impaired at Stroop test only in dual-task condition ( F = 3.17, p = 0.038). Our findings suggest that nabiximols had a detrimental effect on postural control, especially in multi-tasking conditions.
Realism, empiricism and causal inquiry in International Relations: What is at stake?
Authors: Humphreys Adam R C
Published: March 2018

Discussions of causal inquiry in International Relations are increasingly framed in terms of a contrast between rival philosophical positions, each with a putative methodological corollary — empiricism is associated with a search for patterns of covariation, while scientific realism is associated with a search for causal mechanisms. Scientific realism is, on this basis, claimed to open up avenues of causal inquiry that are unavailable to empiricists. This is misleading. Empiricism appears inferior only if its reformulation by contemporary philosophers of science, such as Bas van Fraassen, is ignored. I therefore develop a fuller account than has previously been provided in International Relations of Van Fraassen’s ‘constructive empiricism’ and how it differs from scientific realism. In light of that, I consider what is at stake in calls for the reconstitution of causal inquiry along scientific realist, rather than empiricist, lines. I argue that scientific realists have failed to make a compelling case that what matters is whether researchers are realists. Constructive empiricism and scientific realism differ only on narrow epistemological and metaphysical grounds that carry no clear implications for the conduct of causal inquiry. Yet, insofar as Van Fraassen has reformed empiricism to meet the scientific realist challenge, this has created a striking disjunction between mainstream practices of causal inquiry in International Relations and the vision of scientific practice that scientific realists and contemporary empiricists share, especially regarding the significance of regularities observed in everyday world politics. Although scientific realist calls for a philosophical revolution in International Relations are overstated, this disjunction demands further consideration.
Understanding Skin-cutting in Adolescence
Authors: Le Breton David
Published: March 2018

Adolescents are said to be, figuratively speaking, thin-skinned. But their thin-skinnedness is also real: both ambivalent and ambiguous, the border between self and other is, for many young people, a source of constant turmoil. The recourse to bodily self-harm is a means of dealing with this turmoil and the feelings of powerlessness it generates. Drawing on extensive semi-structured interviews conducted over the course of the last twenty years, this article explores the experiences of adolescents who engage in self-cutting. A deliberate and controlled use of pain, this ‘symbolic homeopathy’ – that is, harming oneself to feel less pain – acts as a defence against externally imposed suffering. Far from being destructive, self-harm practices can paradoxically be understood as survival techniques. Part of a long-term, ongoing project investigating adolescent risk-taking, this article seeks to better understand the experiences of teens who injure themselves through skin-cutting.
Skin Work
Authors: Lafrance Marc , Carey R Scott
Published: March 2018

In this article, we carry out a four-part study of why and how those with acne work on their skin. In the first part, we engage extensively with the clinical literature and reflect critically on what it has to offer. In the second part, we present our notion of ‘skin work’ and how it allows for a consideration of how acne sufferers relate reflexively to the surface of their bodies. In the third part, we discuss our data – which consists of over 200 threads from the electronic support group acne.org – and how we approach it in order to better understand the everyday practices associated with working on the skin. Finally, in the fourth part, we discuss our findings by focusing on three prevalent types of skin work and how they both shape and are shaped by identity categories such as gender and sexuality.
Emergence of a higher education born global in Africa
Authors: Bueno Merino Pascale , Lavissière Alexandre , Mandják Tibor
Published: March 2018

The aim of this article is to identify the role of the business network in the emergence of a higher education born global in Africa, which must become international as soon as it is created in order to ensure its longevity. The emergence of a new international business school in Togo is analyzed from a business network perspective. The establishment of key interorganizational relations thanks to signs of institutional and individual trust participates in the emergence of a new organization in an environment characterized by strong barriers to entry (national and international accreditations, media rankings, etc.). The application of theories borrowed from business networks and international entrepreneurship in the higher education sector is an original contribution to the research. Our results are focused on the emergence phase of the business network and greatly enrich the works that are more dedicated to the network consolidation phase.
Playing for social equality
Authors: Nielsen Lasse
Published: March 2018

This article claims that the protection of children’s capability for play is a central social-political goal. It provides the following three-premise argument in defense of this claim: (i) we have strong and wide-ranging normative reasons to be concerned with clusters of social deficiency; (ii) particular fertile functionings play a key role for tackling clusters of social deficiency; and finally (iii) the capability for childhood play is a crucial, ontogenetic prerequisite for the development of those particular fertile functionings. Thus, in so far as we consider it a central political goal to tackle social deficiency, we should be concerned with protection of childhood play capability. This conclusion raises new insights on the importance – for global development policy as well as for welfare states’ aim to secure social justice – of protecting children’s capability to engage in playful activities.
Social support predicts self-care confidence in patients with heart failure
Authors: Fivecoat Hayley C , Sayers Steven L , Riegel Barbara
Published: March 2018

Background:

Self-care for patients with heart failure includes engaging in behaviours that maintain medical stability and manage problematic symptoms, as well as the confidence in one’s ability to carry out such behaviours. Given the social context of self-care behaviours in heart failure, there has been increasing interest in social support as a predictor of self-care.

Aim:

The goal of the present study was to examine the role of social support in self-care across time for persons with heart failure.

Methods:

Using data from an observational study of patients with chronic heart failure ( n = 280), we examined the role of three types of support – instrumental support, emotional support and assistance with self-care – in the longitudinal course of self-care maintenance, management and confidence. Self-report questionnaire data were collected at baseline and at three and six months later.

Results:

We found that instrumental and emotional support predicted better self-care confidence on average and that self-care confidence improved at a faster rate for those with less instrumental support. Emotional support was positively associated with self-care management and self-care confidence, and assistance with self-care was positively associated with self-care maintenance.

Conclusion:

These findings highlight the contribution of social support to self-care in heart failure and provide guidance for future family-based interventions to improve self-care.
Comparative analysis of the psychometric parameters of two quality-of-life questionnaires, the SGRQ and CAT, in the assessment of patients with COPD exacerbations during hospitalization: A multicenter study
Authors: Folch Ayora Ana , Macia-Soler Loreto , Orts-Cortés María Isabel , Hernández Carmen , Seijas-Babot Nuria
Published: March 2018

The aim of this study was to assess health-related quality of life (HRQL) in patients with chronic obstructive pulmonary disease (COPD) and to discuss the different tools available for its assessment. The most widely used assessments are the St. George respiratory questionnaire (SGRQ) and the COPD assessment test (CAT) questionnaire. Both have a different difficulty in exam completion, calculation, and scoring. No studies exist that analyze the validity and internal consistency of using both questionnaires on patients admitted to the hospital for a COPD exacerbation. A multicenter, cross-sectional analytic observational study of patients admitted to the hospital due to a COPD exacerbation (CIE 491.2). During their hospital stay, they were administered the SGRQ and the CAT questionnaire within the framework of a therapeutic education program (APRENDEPOC). Descriptive and comparative analysis, correlations between the scales (Pearson’s correlation index), consistency and reliability calculations (Cronbach’s α), and a forward stepwise multiple linear regression were performed, with significant correlations in both questionnaires considered p < 0.01 with the total scores. A statistical significance of p < 0.05 was assumed. Altogether, 231 patients were admitted for a COPD exacerbation ( n = 77) at Hospital Clínic of Barcelona (HCB) and ( n = 154) at Hospital Universitario General of Castellón (HUGC). The sample profile was not homogeneous between both centers, with significant differences in HRQL between hospitals. Correlation were noted between both scales ( p < 0.01), along with high levels of internal consistency and reliability (CAT 0.836 vs. SGRQ 0.827). The HRQL is related to dyspnea, wheezing, daytime drowsiness, and edema, as well as to the need to sleep in a sitting position, anxiety, depression, and dependence on others in the execution of daily activities. Our regression analysis showed that the SGRQ questionnaire could predict more changes in HRQL with a higher number of variables.
Self-Determination Theory Can Help You Generate Performance and Well-Being in the Workplace: A Review of the Literature
Authors: Manganelli Lara , Thibault-Landry Anaïs , Forest Jacques , Carpentier Joëlle
Published: March 2018

The Problem

According to self-determination theory (SDT), employees can experience different types of motivation with respect to their work. The presence of the different types of motivation is important given that, compared with controlled regulation (introjected and extrinsic motivation), autonomous regulation (intrinsic and identified motivation) leads to a host of positive individual and organizational outcomes. Despite this empirically validated phenomenon, managers remain unaware of the outcomes of motivation in the workplace and of the practices that can foster autonomous regulation through psychological need satisfaction. The focus of the article will be to review relevant literature to reveal the benefits that SDT principles can bring to the workplace.

The Solution

Managers are encouraged to promote autonomous regulation first by assessing their employees’ motivation for a particular outcome and by structuring three elements of the work environment (job design, interpersonal relationships/leadership, and compensation) in such a way as to facilitate need satisfaction (autonomy, competence, and relatedness). Some questions we try to answer are as follows: What are the outcomes of different motivation types in the workplace? Why are an employee’s basic psychological needs important to consider? What kinds of tools are available to assess employees’ motivation with regard to their work? Which work practices are likely to encourage autonomous regulation?

The Stakeholders

Employees, managers (individuals in direct contact with employees), leaders (individuals who oftentimes are in a position to influence organizational strategies and processes) and human resource development (HRD) practitioners interested in stimulating optimal functioning at work.
Service Learning Trips Abroad Benefit Both Communities and Seasoned Health Educators
Authors: Gan Jody C.
Published: March 2018

Service learning experiences abroad provide an excellent opportunity for seasoned health educators to share their skills with underresourced communities in other parts of the world while enriching their own professional development. Health educators have not traditionally participated in short-term medical service trips, which have become a popular humanitarian effort, yet their contributions can expand the scope of these efforts. With our responsibilities often focused on assessing needs, planning, implementing, and evaluation, seasoned health educators can provide guidance for new initiatives and share health promotion materials and other resources with communities in other parts of the world. In this commentary, I detail my experience as the first health educator to volunteer with a medical brigade that has served a rural community in Honduras for nearly two decades, and describe my added contribution of a brief intervention to address teen pregnancy during the brigade’s annual, medically oriented visit. I also reflect on the benefits to my professional growth from this opportunity to immerse myself in four very familiar areas of responsibility for health education in a new and unknown setting.
From the FEC to the Ballot Box: Voter Accountability for Campaign Finance Law Violations
Authors: Gaskins Ben , Seljan Ellen , Lochner Todd , Kowal Katie , Dundon Zane , Gold Maya
Published: March 2018

Scholarship suggests the Federal Election Commission lacks adequate enforcement tools to deter those who would violate campaign finance laws. But can and do voters hold political candidates accountable for violating these laws? In this article, we employ two studies to empirically evaluate these questions. The first examines the extent to which media cover campaign finance violations, and how they do so. The second employs an experimental approach to test the effects of such media coverage on evaluations of political candidates, in particular whether knowledge of a candidate’s violation of campaign finance laws erodes voter support. We find that the media are more likely to cover campaign finance impropriety for high-profile offices, when criminal action is alleged, and for most serious violations. We also show that voters care about campaign violations, and certain violations lower voter support similar to other types of political scandal.
Achieving the Dream, Uncertain Futures: The Postbaccalaureate Decision-Making Process of Latinx Undocumented Students
Authors: Lara Argelia , Nava Pedro E.
Published: March 2018

This qualitative study examined the decision-making process of undocumented college students pursuing graduate degrees, and how their commitment to matriculate in higher education programs is shaped by a myriad of social, familial, financial, and institutional factors. This study drew on 2 years of ethnographic data from a sample of 20 undocumented graduate students. The authors used critical race theory and LatCrit in education as guiding frameworks. The findings revealed that family marginalization, guided pathways, and social activism inform student decisions to pursue graduate school. The article concluded with a discussion of implications and areas of future research on undocumented students pursuing a graduate education in a DACA context.
Professors Practicing Mindfulness: An Action Research Study on Transformed Teaching, Research, and Service
Authors: Brendel William , Cornett-Murtada Vanessa
Published: March 2018

In this 2-year action research study, 33 university professors attended a 4-day faculty seminar titled “Mindfulness Meditation in Teaching,” which included guided insight meditation, dialogic inquiry, and action planning. Participants generated and committed to 26 novel methods for integrating mindfulness practice with teaching, research, and service. These practices grouped into four areas including mindful grading and assessment, awareness of students in the classroom, practicing mindfulness in and out of the classroom, and cultivating self-awareness in teaching. A mixed-methods analysis of transformative learning illustrates three fundamental shifts in perspectives and behaviors: balancing expertise with a “beginner’s mind” approach for greater innovative capacity, deepening appreciation for subject matter and communion with students, supporting a genuine sense of community across academic silos, and advocating for a more mindful university culture through six new university-wide initiatives.
A Novel Technique for Synchronous Laparoscopic Splenectomy and Azygoportal Disconnection With Hepatectomy
Authors: Jiang Guoqing , Bai Dousheng , Chen Ping , Qian Jianjun , Jin Shengjie
Published: March 2018

Background. Liver resection was not formerly recommended in patients with both hepatocellular carcinoma (HCC) and portal hypertension because of difficult perioperative bleeding control and postoperative liver failure. Splenectomy is a proven method with which to overcome these problems. To investigate the safety and feasibility of synchronous laparoscopic splenectomy and azygoportal disconnection with hepatectomy (LSDH) for treatment of portal hypertension accompanied with HCC, we describe a clinical cohort of 10 patients who underwent a new technique of synchronous LSDH. Methods. A cohort of 10 cirrhotic patients with HCC, esophageal/gastric variceal bleeding, and hypersplenism received LSDH. A 6-port method was used for LSDH. This procedure comprises 5 steps: laparoscopic splenectomy, intraoperative splenic blood salvage, laparoscopic azygoportal disconnection, laparoscopic partial hepatectomy, and removal of spleen and liver specimens. Intraoperative autologous cell salvage was performed before hepatectomy. Results. LSDH was successful in all patients. There was no conversion to open operations. The operative time was 220.5 ± 19.8 minutes, blood loss was 264.0 ± 160.3 mL, and postoperative hospital stay was 10.2 ± 1.8 days. Conclusions. Selective synchronous LSDH is a feasible, effective, and safe surgical procedure with satisfactory short-term efficacy. It is a promising minimally invasive treatment option for patients with cirrhotic HCC and portal hypertension.
Litigation Following Carpal Tunnel Release
Authors: Ganesh Kumar Nishant , Hricz Nicholas , Drolet Brian C.
Published: March 2018

Background: Carpal tunnel release (CTR) is the most common hand surgery operation performed in the United States. While serious complications are rare, they can be life-altering to patients. In some cases, patients will pursue malpractice claims against the surgeon. This study aimed to understand the patient, procedure, and surgeon factors involved in CTR malpractice litigation. Methods: The Westlaw legal database was queried for all recorded CTR malpractice cases resulting in jury verdicts and settlements. Only cases directly related to injury after CTR were included in this study. Cases were reviewed to determine plaintiff demographics, defendant training, liability, injury, outcomes, and monetary awards. Results: Ninety-two unique cases were identified. Plaintiffs were predominantly female (n = 65, 71%). Most surgeons were orthopedic-trained (n = 37, 52%). Only 27% of defendants (n = 19) were hand fellowship-trained. Only 19% of cases resulting in a monetary award were against surgeons who had hand fellowship training. The majority of cases (n = 61, 66%) were found in favor of the defendant. Monetary awards averaged $305 923 (range = $12 000-1 338 147), while settlements averaged $266 250. Alleged liability was most for surgeon negligence (n = 69, 75%) with a third of cases resulting in monetary awards. Median nerve injury was claimed in 41 cases (45%), with 17 (41%) resulting in monetary awards. Conclusion: Although CTR is generally safe and effective, some patients will experience complications. Median nerve injury was the most common reason for successful litigation in this study. Adequate training and experience in hand surgery may lower the risk of injuries resulting in successful malpractice suits.
Poly(A) Polymerase Specifically Implicated in the Mechanism of Chemotherapeutic Drug Action during Cell Apoptosis
Authors: Atabasides H. , Tsiapalis C.M. , Havredaki M.
Published: March 2018

It has recently been established that most anticancer drugs act through the mechanism of apoptosis. It has also been clinically confirmed that drug combinations are more effective than single drugs and various chemotherapeutic strategies have therefore been developed. The experiments described here concern the induction of apoptosis with dimethylsulfoxide (DMSO), a substance with multiple activity especially as an inducer of differentiation, and interferon (IFN), a cytokine well known for its antiviral and antineoplastic effects; they are used alone or in combination. Apoptosis may be regulated at all levels of gene expression including the addition of the poly(A) tail to the 3’ end of mRNAs. Poly(A) polymerase (PAP) [EC.2.7.7.19], the enzyme that catalyzes the addition of the poly(A) tail to mRNAs, changes in the process of development, differentiation, transformation and apoptosis. In the present study the induction of HeLa cells to apoptosis (65%) with a DMSO/rIFN-α combination resulted in pronounced PAP dephosphorylation and activity reduction. HeLa cells induced to apoptosis (35%) with DMSO gave lower levels of PAP dephosphorylation and reduction of activity and cells induced to apoptosis (18%) with rIFN-α gave only limited PAP dephosphorylation and reduction of activity. The implications of these observations for chemotherapeutic drug action at the level of mRNA polyadenylation point to the possible use of PAP as a biological marker for the evaluation of this action.
The Expression of Sel1L and Tan-1 in Normal and Neoplastic Cells
Authors: Cattaneo M. , Orlandi R. , Ronchini C. , Granelli P. , Malferrari G. , Menard S. , Biunno I.
Published: March 2018

We have previously reported on the isolation and chromosomal mapping of a novel human gene (SEL1L), which shows sequence similarity to sel-1, an extragenic suppressor of C. elegans. sel-1 functions as a negative regulator of lin-12 activity, the latter being implicated in the control of diverse cellular differentiation events. In the present study we compare the expression patterns of SEL1L and TAN-1, the human ortholog of lin-12 in normal and neoplastic cells. We found that, whereas both genes are expressed in fetal tissues at similar levels, they are differentially expressed in normal adult and neoplastic cells. In normal adult cells SEL1L is generally present at very low levels; only in the cells of the pancreas does it show maximum expression. By contrast, SEL1L is generally well represented in most neoplastic cells but not in those of pancreatic and gastric carcinomas, where transcription is either downregulated or completely repressed. TAN-1 on the other hand is well represented in almost all normal and neoplastic cells, with very few exceptions. Our observations suggest that SEL1L is presumably implicated in pancreatic and gastric carcinogenesis and that, along with TAN-1, it is very important for normal cell function. Alterations in the expression of SEL1L may be used as a prognostic marker for gastric and pancreatic cancers.
Tissue-Type Plasminogen Activator (tPA) Content in Colorectal Cancer and in Surrounding Mucosa: Relationship with Clinicopathologic Parameters and Prognostic Significance
Authors: Raigoso P. , Junco A. , Andicoechea A. , Gonzalez A. , García-Muñiz J.L. , Allende M.T. , García-Morán M. , Vizoso F.
Published: March 2018

The aim of this study was to evaluate the cytosolic tissue-type plasminogen activator (tPA) content in colorectal cancer, its possible relationship with the clinicopathologic parameters of tumors, and its prognostic significance. We have therefore examined by immunoenzymatic assay the cytosolic tPA content in tumors and paired surrounding normal mucosa samples from 162 colorectal cancer patients. Cytosolic tPA levels were significantly higher in surrounding normal mucosa samples than in neoplastic tissues (4.01±5.07 vs 2.63±5.82 ng/mg protein; p<0.0001). By contrast, no significant correlation was found between tPA content and clinicopathologic tumor parameters such as location, Dukes’ stage, histologic grade, and DNA content or S-phase fraction. However, the results indicated that a high cytosolic tPA content (>0.75 ng/mg protein) in tumors predicted for a shorter relapse-free and overall survival (both p<0.05) in 123 resectable colorectal cancer patients who were prospectively evaluated during a mean follow-up period of 32.2 months. This suggests that tPA may give additional information to that provided by other biochemical markers currently used in colorectal cancer.
EORTC External Quality Assurance Program for ER and PgR Measurements: Trial 1998/1999
Authors: Sweep C.G.J. , Geurts-Moespot J.
Published: March 2018

Steroid receptor assays have clinical relevance in selecting women who would benefit from endocrine intervention. As the degree of benefit from endocrine therapy is directly related to the quantity of receptor present in the tumour, the quality of the steroid receptor assays is important. Moreover, since patients entered in multi-centre trials often include stratification based on the receptor status, receptor assays should be comparable between different institutes. ER- and PgR-assays have been evaluated in quality assessment studies for almost 20 years by the EORTC Receptor and Biomarker Study Group. During the QA trial 1998/1999 results were reported by 42 participants performing the Ligand Binding Assay (LBA) and by 39 participants using the Enzyme Immuno-Assay (EIA) kit. Each participant received a set of 12 QA vials to be analysed two at a time at two-monthly intervals. The between-laboratory CVs of ER LBA and EIA amounted to 40–50%. For PgR the between-lab CVs for the EIA method are lower as compared with LBA but still are approx. 30%. Notwithstanding the high deviation in reported values and the high between-lab CVs, the consistency of the participants over the year is acceptable, which pave the way for calibration. Indeed, after normalization of assay results the mean between-lab CVs dropped to 11% for ER LBA, 14% for ER EIA, 9% for PgR LBA and 11% for PgR EIA. Such a reduction of between-laboratory CVs is an essential requirement for the use of steroid receptor data in multicentre clinical studies.
Long-Term Follow-Up Confirms Prognostic Impact of Pai-1 and Cathepsin D and L in Primary Breast Cancer
Authors: Harbeck N. , Alt U. , Berger U. , Kates R. , Krüger A. , Thomssen C. , JÄnicke F. , Graeff H. , Schmitt M.
Published: March 2018

After long-term follow-up, the prognostic impact of the following proteolytic factors associated with tumor invasion and metastasis was evaluated in 276 primary breast cancer patients: uPA (urokinase-type plasminogen activator), PAI-1 (uPA inhibitor type 1), and cathepsins B, D and L. The median follow-up of patients still alive at the time of analysis was 109 months. To date 119 patients (43%) have relapsed and 117 (42%) have died. Antigen levels of uPA and PAI-1 were determined by ELISA in detergent extracts; cathepsin B, D, and L content was determined in cytosol fractions of the primary tumor: cathepsin D by ELSA and cathepsin B and L by ELISA.

In multivariate analysis (Cox model) for disease-free survival (DFS), lymph node status (p<0.001; RR=3.8), cathepsin L (p<0.001; RR=2.6) and PAI-1 (p=0.027; RR=1.7) were significant factors in all patients. In addition to these factors, grading was significant for overall survival (OS). In another multivariate approach, CART (Classification And Regression Trees) analysis, lymph node status (p<0.001) turned out to be the strongest discriminator for patients at high risk of relapse. In the node-negative patient subset, PAI-1 was the strongest risk group discriminator (p<0.001): in this subset, patients with low levels of both PAI-1 and cathepsin D had a very low relapse rate of only 3.2% compared to 39% in the remaining node-negative patients. In node-positive patients cathepsin L gave the best risk group assessment (p=0.001).

In conclusion, tumor-associated PAI-1 and cathepsins D and L provide significant, statistically independent prognostic information for DFS and OS in primary breast cancer, even after a median follow-up period of almost 10 years.
Independent Prognostication and Therapy Monitoring of Breast Cancer Patients by Dna/Rna Typing of Minimal Residual Cancer Cells
Authors: Giesing M. , Austrup F. , BÖckmann B. , Driesel G. , Eder C. , Kusiak I. , Suchy B. , Uciechowski P. , Grill H.-J.
Published: March 2018

Clinical relevance, purification techniques and molecular characterization of minimal residual cancer cells (MRCC) is a controversial topic in the literature. An analytical concept including a novel isolation procedure and a panel of tests for DNA and RNA typing of MRCCs is described and clinically evaluated in this paper. The purification procedure exploiting the physical characteristics of MRCCs shows superior performance leading to >50% pure and viable tumor cells. Proof of the presence and purity of MRCCs in an isolated sample is given by multiparametric DNA typing (amplifications, mutations, losses of heterozygosity). On the basis of the proven presence of MRCCs tumor-relevant mRNAs can be adequately analyzed by normalized quantitative real-time RT-PCR. The molecular characterization of MRCCs isolated from blood of breast cancer patients could have a strong clinical impact on prognostication, drug targeting and therapy monitoring.
A New Approach to Phenotyping Disseminated Tumor Cells: Methodological advances and Clinical Implications
Authors: Noack F. , Schmitt M. , Bauer J. , Helmecke D. , Krüger W. , Thorban S. , Sandherr M. , Kuhn W. , Graeff H. , Harbeck N
Published: March 2018

At the time of primary therapy (surgery, systemic chemotherapy and/or radiation), disseminated tumor cells in the bone marrow can be found in almost one-third of patients with cancer of the breast, ovary, esophagus, stomach, colon, and other solid tumors. Whereas the prognostic impact of the mere presence of these cells is still a matter of debate, it has been shown that expression of tumor-associated antigens in disseminated tumor cells is linked to more aggressive disease. Therefore, further characterization of disseminated tumor cells at the protein and gene level has become increasingly important. To date, the most common detection method for disseminated tumor cells in the bone marrow is an immunocytochemical approach using cytokeratin-directed antibodies for detection of epithelial cells and the APAAP system for their visualization. We have established a new double immunofluorescence technique enabling simultaneous detection, phenotyping, and antigen quantification of disseminated tumor cells. Mononuclear cells from bone marrow are enriched by Ficoll gradient centrifugation and cytospins are prepared. Double immunofluorescence is performed using antibodies against cytokeratins 8/18/19 (mAb A45B/B3) and the uPA receptor CD87 (pAb HU277). CD87 expression is recorded by confocal laser scanning microscopy (CLSM) using fluorescence labeled latex beads as the reference; staining intensities of all the scans are then summed and quantified (extended focus). This protocol, originally designed for disseminated tumor cells in bone marrow, can also be applied to disseminated tumor cells in blood, to leukapheresis cells or to cells present in malignant ascites or other malignant effusions. The tumor cells detected may be used for gene and mRNA analyses. Furthermore, disseminated tumor cells also represent interesting targets for clinical studies on patient prognosis or prediction of therapy response as well as for specific tumor-biological therapies.