bluuebunny/crossref_metadata_2025 huggingface dataset:
Gamma Knife radiosurgery for glossopharyngeal neuralgia: A study of 21 patients with long-term follow-up
Authors: Borius Pierre-Yves , Tuleasca Constantin , Muraciole Xavier , Negretti Laura , Schiappacasse Luis , Dorenlot Antoine , Marguet Maud , Zeverino Michele , Donnet Anne , Levivier Marc , Regis Jean
Published: March 2017

Objective

Glossopharyngeal neuralgia (GPN) is a very rare condition, affecting the patient’s quality of life. We report our experience in drug-resistant, idiopathic GPN, treated with Gamma Knife radiosurgery (GKRS), in terms of safety and efficiency, on a very long-term basis.

Methods

The study was opened, self-controlled, non-comparative and bicentric (Marseille and Lausanne University Hospitals). Patients treated with GKRS between 2003 and 2015 (models C, 4C and Perfexion) were included. A single 4-mm isocentre was positioned in the cisternal portion of the glossopharyngeal nerve, with a targeting based both on magnetic resonance imaging (MRI) and computed tomography (CT). The mean maximal dose delivered was 81.4 ± 6.7 Gy (median = 85 Gy, range = 60–90 Gy at the 100% isodose line).

Results

Twenty-one patients (11 women, 10 men) benefited from 25 procedures. The mean follow-up period was 5.2 ± 3 years (range = 0.9–12.1 years). Seventeen (81%) were initially pain-free after GKRS. At three months, six months and one year after radiosurgery, the percentage of patients with good outcome (BNI classes I to IIIA) was 87.6%, 100% and 81.8%, respectively. Ten cases (58.8%) from the initial pain-free ones had a recurrence, after a mean period of 13.6 ± 10.4 months (range = 3.1–36.6 months). Only three patients (14.2%) had recurrences (two for each one of them) requiring further surgeries. Three patients underwent a second GKRS procedure; one case needed a third GKRS. The former procedures were performed at 7, 17, 19 and 30 months after the first one, respectively. Furthermore, two patients needed additional interventions. At last follow-up, 17 cases (80.9%) were still pain-free without medication. The actuarial pain relief without new surgery was 83%. A transient complication (paraesthesia of the edge of the tongue) was seen in one case (4.8%).

Conclusion

GKRS is a valuable, minimally invasive, surgical alternative for idiopathic GPN, with a very high short- and long-term efficacy and without permanent complications. A quality imaging, including T2 CISS/Fiesta MRI and bone CT acquisitions for good visualisation of the nerve and the other bony anatomic landmarks, is essential for targeting accuracy and successful therapy.
Classification and Analysis of Attritional Glenoid Bone Loss in Recurrent Anterior Shoulder Instability
Authors: McNeil John W. , Beaulieu-Jones Brendin R. , Bernhardson Andrew S. , LeClere Lance E. , Dewing Christopher B. , Lynch Joseph R. , Golijanin Petar , Sanchez George , Provencher Matthew T.
Published: March 2017

Background:

Recognition and proper treatment of glenoid bone loss (GBL) are important for successful management of anterior shoulder instability. Although GBL has been described as the amount of bony loss from the front of the glenoid, there is also a fragment of bone that is usually displaced and often undergoes attrition. Thus, due to attritional bone loss (ABL) of the fragment, insufficient bone is left to fully reconstruct the glenoid.

Purpose:

To (1) evaluate ABL of the glenoid fragment in recurrent anterior shoulder instability and (2) correlate ABL with clinical history, fragment size, and radiographic findings.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

GBL was evaluated on 3-dimensional computed tomography (3D CT) en-face view and was measured as percentage loss. The bone fragment size was measured, and attrition of the fragment was determined by evaluation of the amount remaining relative to the initial defect; patients were stratified into minimal (<34%), moderate (34% to <67%), and severe (≥67%) attritional loss groups. Clinical history and demographics were correlated to ABL, and GBL and ABL were compared.

Results:

The overall median percentage GBL was 15.3% (interquartile range [IQR], 9.9%-20.0%), with a mean (±SD) percentage GBL of 16.5% ± 9.0%. Study participants had a corresponding median percentage ABL of 75.8% (IQR, 53.8%-95.7%) and a mean percentage ABL of 72.0% ± 24.4%. A total of 61.2% of patients (n = 85) exhibited severe ABL, while 30.2% had moderate ABL and 8.6% had minimal ABL. The total time of instability was significantly associated with percentage of attritional bone loss ( P < .05). In addition, the time of instability was greatest in patients in the third tertile of ABL (≥87.5%; P = .08). A significant difference was found in total time of instability among patients in the highest tertile of ABL (38.6 months) versus both the middle (26.7 months) and lowest (32.8 months) tertiles ( P < .05).

Conclusion:

The study results indicate that in the majority of patients with recurrent anterior instability, GBL presents with extensive attrition of the bone fragment independent of initial glenoid bone loss; therefore, surgeons should be cognizant that the remaining bone fragment is unable to reconstitute glenoid bone stock. In addition, the results showed more attritional bone loss in patients with a longer duration of instability symptoms, indicating a role for incorporating symptom duration in determining proper management.
Breaking the waves
Authors: Neergaard Helle , Christensen Dorthe Refslund
Published: March 2017

Learning is related to the environment created for the learning experience. This environment is often highly routinized and involves a certain social structure, but in entrepreneurship education, such routinization and structure may actually counteract the learning goals. This article investigates how classroom routines and rituals impact on entrepreneurship education in order to problematize how existing classroom environments may hinder critical learning experiences from taking place. This article builds on extensive insights from six cohorts of students at two Scandinavian universities over a 4-year period (2012–2015). The data were procured using an experiential–explorative research approach in which the researchers were personally involved in reflective processes as co-learners. The findings illustrate how educators can use rituals actively to change how students learn. However, students are very wary of embracing new structures and rituals; indeed, some feel so comfortable with the old rituals that they would prefer not to change from being receivers of knowledge to co-creators of the learning situation. It is therefore important to exchange existing rituals with new ones that enhance the feeling of safety and involve the students in creating the change. This is achieved through scaffolding and setting up ritual markers, which are continuously repeated.
A mystagogical view of ‘withness’ in entrepreneurship education
Authors: Refai Deema , Higgins David
Published: March 2017

This article provides a philosophical conceptualization of how learners engage in entrepreneurial learning from within by focusing on the role of the inner identity and mission of the learner. Klapper and Neergaard add ‘withness’ to the learning frameworks of entrepreneurship education (EE), but there is scant literature discussing the implications of learning from within in this context. Fayolle calls for an investigation of how learners learn in order to address the vast differences among audiences in EE and thus to understand the rationale behind ‘effective didactical design’. This article adopts a postmodernist perspective to understand the role of the self in EE and draws on the learning onion model for learning from within. A mystagogical perspective is proposed to help learners engage with their inner missions and identities and improve their core reflection skills, thus highlighting an inspirational dimension of EE.
Healthcare contacts among patients lost to follow-up in HIV care: review of a large regional cohort utilizing electronic health records
Authors: Connors William J , Krentz Hartmut B , Gill M John
Published: March 2017

In the United States 40% of HIV patients are lost to follow-up (LTFU) following linkage to HIV care and an estimated 30–61% of new HIV transmissions are attributed to this group. To characterize those LTFU and healthcare contacts they make, we retrospectively analyzed a large regional HIV cohort in Calgary, Canada, utilizing a province-wide electronic health record. Adults engaged in HIV care between January 2010 and August 2014 who had >12 months without HIV clinic contact were identified as LTFU. Of 1928 individuals engaged in care, 176 became LTFU with 64% having no healthcare contacts, 20% receiving HIV care elsewhere, and 16% making non-HIV healthcare contacts. Those LTFU making non-HIV healthcare contacts did so a median of six times (interquartile range 2–8), 76% attending emergency departments (ED). Compared to those retained in care, LTFU patients were younger (median age 43 versus 47 years), had lower CD4+ cell counts (median 420 versus 500 × 106/l) and more commonly resided outside of the centralized HIV clinic’s city (odds ratio 4.58) (all p < 0.01). Our finding that a majority of those LTFU did not make healthcare contacts suggests that community and HIV clinic-based relinkage programs are needed. For those LTFU who make healthcare contacts enhanced ED-based relinkage programs could engage a majority.
Cathelicidin (LL-37) and its correlation with pro-oxidant, antioxidant balance and disease activity in systemic lupus erythematosus: a cross-sectional human study
Authors: Sahebari M , Roshandel G , Saadati N , Saghafi M , Abdolahi N , Rezaieyazdi Z
Published: March 2017

Background

Cathelicidin (LL-37), an endogenous antimicrobial peptide, has recently been involved in the pathogenesis of autoimmune diseases. To assess whether LL-37 reflects disease activity, we measured serum levels of it in systemic lupus erythematosus (SLE) patients with active and inactive disease compared to healthy controls. LL-37 was also compared between new and old cases. Moreover, the correlation of LL-37 and pro-oxidant, antioxidant balance (PAB) was measured.

Methods

The study population consisted of 50 SLE patients and 28 healthy controls. Of those, 39 patients had active and 11 patients had inactive disease. Serum levels of LL-37 were measured by ELISA and PAB values by a special method.

Results

There was no difference in levels of LL-37 between patients and healthy controls (50.9 ± 20.8 vs. 67.7 ± 43.3 ng/ml, P = 0.31). LL-37 did not correlate with SLEDAI and its items in total patients. LL-37 had a positive correlation with SLEDAI in active patients ( P = 0.01, r = 0.4). In active patients (78% of patients), multivariate regression analysis showed significant negative correlation between LL-37 and C3 ( P = 0.01, standardized beta –0.50). No difference was found in levels of PAB between patients and controls (90.4 ± 34.1 vs. 86.9 ± 25.6 HK, P = 0.4).There was no difference in the levels of PAB between patients with active and inactive disease (93.2 ± 34.1 vs. 80.2 ± 33.7 HK, P = 0.27). No correlation was found between levels of PAB and SLEDAI items and total score. However, a positive correlation between the levels of LL-37 and PAB in SLE patients was found ( r = 0.3, P < 0.01).

Conclusion

Based on this study, serum LL-37 and PAB did not increase in lupus compared with healthy individuals. LL-37 serum values rose in parallel with SLEDAI in active disease. Positive correlation between serum PAB and LL-37 could be a great achievement of this study that may suggest the role of antioxidants in controlling NETosis.
Translation and Testing of the Italian Version of FAMCARE-2: Measuring Family Caregivers’ Satisfaction With Palliative Care
Authors: D’Angelo Daniela , Punziano Antonella Cinzia , Mastroianni Chiara , Marzi Annamaria , Latina Roberto , Ghezzi Valerio , Piredda Michela , De Marinis Maria Grazia
Published: March 2017

Family satisfaction is an important outcome of palliative care and is a critical measure for health care professionals to address when assessing quality of care. The FAMCARE-2 is a widely used measure of family satisfaction with the health care received by both patient and family in palliative care. In this study, a team of Italian researchers culturally adapted the FAMCARE-2 to the Italian language and psychometrically tested the instrument by measuring satisfaction of 185 family caregivers of patients admitted into two palliative care services. FAMCARE-2 showed excellent levels of internal consistency (Cronbach’s α coefficient = .96) and test–retest reliability ( r = .98, p < .01). The confirmatory factor analysis showed a single-factor structure with good fit. Satisfaction levels were significantly correlated with family caregivers being females with less education, patient length of care, and place of assistance and death. This scale can help health care professionals identify which aspects of care need improvement and enable family caregivers to manage their challenging role.
Safe handling of monoclonal antibodies: Too large to be hazardous?
Authors: de Lemos Mário L , Badry Nadine , Kletas Victoria , Fabbro Joan , Tew Amber
Published: March 2017

It has been argued that the larger molecular weight of hazardous monoclonal antibodies may prevent their dermal absorption via occupational exposure. However, this assertion does not seem to be supported by direct evidence. Although the larger molecular weight may render monoclonal antibodies less probable to achieve therapeutic systemic level through dermal absorption, the concern in occupational health is whether these drugs can possibly attain a detectable level through repeated dermal exposure. Currently, there is no direct evidence to support a particular molecular weight above which a drug cannot achieve a detectable level following repeated occupational exposure. Therefore, the precautionary principle would dictate that repeated exposure of healthcare workers to hazardous monoclonal antibodies should be kept to a minimum.
The efficacy of teriflunomide in patients who received prior disease-modifying treatments: Subgroup analyses of the teriflunomide phase 3 TEMSO and TOWER studies
Authors: Freedman Mark S , Wolinsky Jerry S , Comi Giancarlo , Kappos Ludwig , Olsson Tomas P , Miller Aaron E , Thangavelu Karthinathan , Benamor Myriam , Truffinet Philippe , O’Connor Paul W ,   for the TEMSO and TOWER Study Groups
Published: March 2017

Teriflunomide is a once-daily oral immunomodulator approved for relapsing-remitting multiple sclerosis (MS). The objective of this post hoc analysis of the phase 3, pooled TEMSO (NCT00134563) and TOWER (NCT00751881) dataset is to evaluate the effect of teriflunomide treatment on annualised relapse rate and disability worsening across patient subgroups defined according to prior disease-modifying therapy exposure. This analysis provides further supportive evidence for a consistent effect of teriflunomide across a broad range of patients with relapsing MS, including patients who have used and discontinued other disease-modifying therapies.
The impact of breast cancer awareness interventions on breast screening uptake among women in the United Kingdom: A systematic review
Authors: Anastasi Natasha , Lusher Joanne
Published: March 2017

The impact of breast screening awareness campaigns on mammography attendance among British women was explored. British Nursing Index, Medline, PsycINFO, Embase and Cumulative Index to Nursing and Allied Health were searched between October 2012 and February 2013. Searches identified research on breast cancer awareness interventions and breast self-examination. In total, 867 articles were identified and 14 met criteria for review. Breast cancer awareness interventions were found to increase the uptake of breast self-examination behaviours and increase the likelihood of breast cancer screening attendance. Predicting the impact of these interventions on survivability and general morbidity/mortality outcomes remains a challenge due to a shortage of suitably evaluated campaigns.
Heart-rate variability depression in porcine peritonitis-induced sepsis without organ failure
Authors: Jarkovska Dagmar , Valesova Lenka , Chvojka Jiri , Benes Jan , Danihel Vojtech , Sviglerova Jitka , Nalos Lukas , Matejovic Martin , Stengl Milan
Published: March 2017

Depression of heart-rate variability (HRV) in conditions of systemic inflammation has been shown in both patients and experimental animal models and HRV has been suggested as an early indicator of sepsis. The sensitivity of HRV-derived parameters to the severity of sepsis, however, remains unclear. In this study we modified the clinically relevant porcine model of peritonitis-induced sepsis in order to avoid the development of organ failure and to test the sensitivity of HRV to such non-severe conditions. In 11 anesthetized, mechanically ventilated and instrumented domestic pigs of both sexes, sepsis was induced by fecal peritonitis. The dose of feces was adjusted and antibiotic therapy was administered to avoid multiorgan failure. Experimental subjects were screened for 40 h from the induction of sepsis. In all septic animals, sepsis with hyperdynamic circulation and increased plasma levels of inflammatory mediators developed within 12 h from the induction of peritonitis. The sepsis did not progress to multiorgan failure and there was no spontaneous death during the experiment despite a modest requirement for vasopressor therapy in most animals (9/11). A pronounced reduction of HRV and elevation of heart rate developed quickly (within 5 h, time constant of 1.97 ± 0.80 h for HRV parameter TINN) upon the induction of sepsis and were maintained throughout the experiment. The frequency domain analysis revealed a decrease in the high-frequency component. The reduction of HRV parameters and elevation of heart rate preceded sepsis-associated hemodynamic changes by several hours (time constant of 11.28 ± 2.07 h for systemic vascular resistance decline). A pronounced and fast reduction of HRV occurred in the setting of a moderate experimental porcine sepsis without organ failure. Inhibition of parasympathetic cardiac signaling probably represents the main mechanism of HRV reduction in sepsis. The sensitivity of HRV to systemic inflammation may allow early detection of a moderate sepsis without organ failure.

Impact statement

A pronounced and fast reduction of heart-rate variability occurred in the setting of a moderate experimental porcine sepsis without organ failure. Dominant reduction of heart-rate variability was found in the high-frequency band indicating inhibition of parasympathetic cardiac signaling as the main mechanism of heart-rate variability reduction. The sensitivity of heart-rate variability to systemic inflammation may contribute to an early detection of moderate sepsis without organ failure.
Morphological and morphometric analysis of the effects of intralesional tamoxifen on keloids
Authors: Soares-Lopes Lauro R , Soares-Lopes Ione M , Filho Lauro LL , Alencar Airlane P , da Silva Benedito B
Published: March 2017

The aim of this study was to evaluate the effect of intralesional tamoxifen on keloids, particularly on the concentration of fibroblasts, dermal inflammatory infiltrate, and collagen degeneration. A prospective study was carried out to evaluate keloids in 13 patients of both genders pre- and post-treatment with intralesional tamoxifen. Two samples of keloid lesions were obtained by 4-mm punch biopsies during the study: the first at the time of diagnostic confirmation of keloid and the other eight weeks later at the end of intralesional tamoxifen treatment. The biopsy samples were placed in 10% buffered formalin for HE staining and morphological and morphometric study. The degree of collagen fiber reduction and inflammatory infiltration were analyzed. Student’s t-test was used for statistical analysis of the mean number of fibroblasts before and following tamoxifen treatment ( P < 0.05). The degree of collagen fiber reduction and inflammatory infiltration were absent before treatment and present in 100% of cases after treatment, while the mean number of fibroblasts was significantly lower after intralesional tamoxifen treatment ( P < 0.0001). We conclude that intralesional administration of tamoxifen promoted an inflammatory stimulus and collagen fiber reduction as well as a significant reduction in the number of fibroblasts that produce collagen.

Impact statement

Effective treatment of keloid that is a commonly recurrent dermatosis is very difficult, even after standard treatment. Standard treatment consists of partial resection of the lesion (shaving excision), in addition to local corticosteroid injection. Therefore, there is interest in alternative forms of topical treatment, e.g., selective estrogen receptor modulators, particularly tamoxifen has demonstrated in vitro studies to be a promising drug. Nevertheless, there is scarcity of publications on the effects of intralesional tamoxifen on keloids have been found, leading us to the conception of the present study. In this study, tamoxifen has proven to be an interesting alternative drug for the topical treatment of keloid, allowing us to conclude that the intralesional application of tamoxifen in keloids promotes a variable but ever-present inflammatory stimulus, associated with intense reduction of collagen fiber, in addition to a significant decrease in the number of fibroblasts that produce collagen and are involved in disease maintenance.
A comprehensive computational multidisciplinary design optimization approach for a tidal power plant turbine
Authors: Munjulury Raghu Chaitanya , Nadali Najafabadi Hossein , Safavi Edris , Ölvander Johan , Krus Petter , Karlsson Matts
Published: March 2017

Multidisciplinary design optimization has become a powerful technique to facilitate continuous improvement of complex and multidisciplinary products. Parametric modeling is an essential part with tremendous impact on the flexibility and robustness of multidisciplinary design optimization. This article investigates the effect of relational and non-relational parameterization techniques on the robustness and flexibility of the conceptual design of a multidisciplinary product. Bench marking between relational and non-relational parameterization and their effect on flexibility and robustness indicate that the relational parameterization is an efficient method in the multidisciplinary design optimization process. The inherent properties of the method contribute to an efficient parametric modeling with improved communication between different disciplines. This enhances the performance of the multidisciplinary design optimization process and allows a more flexible and robust design. The considered disciplines are computer-aided design, computational fluid dynamics, finite element analysis, and dynamic simulation. A high-fidelity geometry created in a computer-aided design environment is computer-aided design centric approach and later used in computational fluid dynamics, finite element analysis for a better understanding of the product as it leads to precise outcomes. The proposed approach is implemented for the conceptual design of a novel product, a tidal power plant developed by Minesto AB using a multidisciplinary design optimization process.
Challenges to conclude elemental impurities risk assessment for pharmaceutical dosage form and submission in regulatory dossier
Authors: Prajapati Jignesh
Published: March 2017

ICH Q3D defines a science and risk-based assessment process to identify, evaluate, and define controls to limit elemental impurities in drug products. The present article comprise challenges and simplified approach to draw elemental impurities risk assessment and control in final drug product to satisfy current regulatory requirements using different calculation options. Detail risk assessment depends on information/knowledge of most significant potential sources of elemental impurities, i.e. drug product components, manufacturing process of drug substance or drug product, container closer system, etc. If there is lack of information available, the applicant may carry out end product testing as the initial strategy for risk assessment using option 3 calculation.
Forty years’ personal experience
Authors: Norton-Taylor Richard
Published: March 2017

This article reflects a journalist’s personal experience of reporting on the UK military, analysing the relationship between senior military figures and the Ministry of Defence (their political masters) and the media. Topics covered include manipulation of the media and the popularity of the armed forces, as well as unpopular, ill-planned, military operations, notably Iraq and Afghanistan. The author also examines other operations, notably the wars in the Falklands and Kosovo, the 1991 Gulf War and the Scott Arms-to-Iraq Inquiry. The article goes on to explore leaks by frustrated military; tensions between military commanders and ministers; the 2010 Strategic Defence and Security Review; military chiefs not speaking truth to power; ministers jealous of the military’s close relations with journalists; and the Defence Advisory Notice Committee. The author reveals how official secrecy is honoured more in the breach than in its observance, especially concerning the special forces.
A unique case of massive gastrointestinal bleeding
Authors: Kida Akihiko , Matsuda Koichiro , Matsuda Mitsuru , Sakai Akito , Noda Yatsugi
Published: March 2017

Objectives:

Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation.

Methods/Results:

We report a case of massive gastrointestinal bleeding from a jejunal lipoma combined with intussusception. A preoperative diagnosis of gastrointestinal bleeding derived from a jejunal lipoma combined with intussusception was made based on double-balloon enteroscopy and contrast-enhanced computed tomography, and partial resection of the small intestine was performed. After surgery, there was no additional gastrointestinal bleeding.

Conclusion:

There have only been a few reports about cases of jejunal lipoma involving simultaneous bleeding and intussusception. Double-balloon enteroscopy is useful for preoperatively diagnosing bleeding from a lipoma. Our case highlights that jejunal lipoma can cause massive unexplained gastrointestinal bleeding.
Current ESWL practice and outcomes in the UK: A multicentre snapshot
Authors: Doherty R , Manley K , Gordon S , Irving S , Kumar S , Masood J , Philip J , Bultitude M , Wiseman OJ
Published: March 2017

Objectives:

The objective of this article is to investigate the current clinical practice and outcomes of extracorporeal shock wave lithotripsy (SWL) in the United Kingdom.

Patients and methods:

Patient demographics, stone characteristics and SWL protocols were collected prospectively for 30 consecutive new patient referrals at each of seven contributing UK institutions performing SWL. Final outcomes in terms of stone-free rates (SFRs), and complications were recorded.

Results:

Completed demographic data were available for 204 patients. Treatment protocols varied between centres. Mean patient age was 51 years. Over 70% of stones treated measured between 5 and 10 mm, and one-third were in the ureter, with two-thirds in the kidney, where the majority (31% overall) were in the lower pole. The overall cumulative SFR was 50.3% (range 33–70% between centres). SWL was notably more effective for ureteric stones (SFR 59.3% overall) than for renal calculi (SFR 45.6% overall). Complications were noted in six patients.

Conclusion:

This study provides a valuable snapshot of real-life clinical practice and demonstrates considerable variability in the application of SWL in the UK. The results support existing data which suggest that SWL is a safe and well tolerated treatment modality; however, overall SFRs were low.
Assessment of treatment patterns associated with injectable disease-modifying therapy among relapsing–remitting multiple sclerosis patients
Authors: Nicholas J , Ko JJ , Park Y , Navaratnam P , Friedman HS , Ernst FR , Herrera V
Published: March 2017

Background

Availability of oral disease-modifying therapy (DMT) for relapsing–remitting multiple sclerosis (RRMS) may affect injectable DMT (iDMT) treatment patterns.

Objective

The objective of this paper is to evaluate iDMT persistency, reasons for persistency lapses, and outcomes among newly diagnosed RRMS patients.

Methods

Medical records of 300 RRMS patients initiated on iDMT between 2008 and 2013 were abstracted from 18 US-based neurology clinics. Eligible patients had ≥3 visits: pre-iDMT initiation, iDMT initiation (index), and ≥1 visit within 24 months post-index. MS-related symptoms, relapses, iDMT treatment patterns (i.e. persistency, discontinuation, switching, and restart), and reasons for non-persistency were tracked for 24 months.

Results

At 24 months, iDMT persistency was 61.0%; 28.0% of patients switched to another DMT, 8.0% discontinued, and 3.0% stopped and restarted the same iDMT. The most commonly identified reasons for non-persistency were perceived lack of efficacy (22.2%), adverse events (18.8%), and fear of needles/self-injecting (9.4%). At 24 months, 38.0% of patients had experienced a relapse and 11.0% had changes in MRI lesion counts. Patients without MS-related symptoms at index reported increases in the incidence of these symptoms at 24 months.

Conclusions

Non-persistency with iDMT remains an issue in the oral DMT age. Many patients still experienced relapses and disease progression, and should consider switching to more effective therapies.
Transgender people in Swedish healthcare: The experience of being met with ignorance
Authors: Westerbotn Margareta , Blomberg Tobias , Renström Evelina , Saffo Nina , Schmidt Lina , Jansson Britten , Aanesen Arthur
Published: March 2017

In meetings with healthcare professionals, transgender people are often met with ignorance. The meetings tend to focus more on the person’s gender identity rather than reasons for the contact and therefore may be perceived as being offensive to that person. The aim of the study was to describe transgender people’s experiences in their meetings with healthcare professionals. Fourteen transgender persons were interviewed in this descriptive qualitative study. The semi-structured interviews were audiotaped. Data were collected during January–February 2015 and analysed using content analysis. Three themes were identified: ‘Experience of treatment by healthcare professionals’, ‘Expectations of meeting with healthcare professionals’ and ‘Consequences of meetings with healthcare professionals’. Findings revealed that healthcare professionals do not always respect the patient’s gender identity. This could lead to their avoiding contact with healthcare services. More education/training of healthcare personnel for the treatment of transgender people seeking care is requested.
The Millennial Generation
Authors: Pyöriä Pasi , Ojala Satu , Saari Tiina , Järvinen Katri-Maria
Published: March 2017

This article puts to the test the notion that younger generations, most notably the Millennials, value work less than older generations do. The analysis, deploying a linear probability model, is based on Statistics Finland’s Quality of Work Life Surveys, 1984 to 2013. Focusing on labour market entrants aged 15 to 29, we address two main themes: the value given to work, leisure and family life, and work commitment. Regardless of age, the value given to work has remained consistently high for the past three decades. At the same time, leisure and family life have gained increasing importance, not only among the Millennials but also among older generations. The Millennials are more prepared to change to a different occupational field than older employees, but this is not a new tendency, and therefore the generational gap remains unaffected. The evidence does not support the argument that the Millennials are less work-oriented than older generations.
Reconcilingshariawith “Negara Kesatuan Republik Indonesia”: The ideology and framing strategies of the Indonesian Forum of Islamic Society (FUI)
Authors: Munabari Fahlesa
Published: March 2017

This study attempts to examine the ideologies and framing strategies of an active yet insufficiently studied Islamic revivalist movement in Indonesia that seeks to implement sharia (Islamic law) called Forum Umat Islam (FUI, or the Indonesian Forum of Islamic Society). Research in Islamic revivalist movements that emerged after the demise of the authoritarian Suharto regime in 1998 has been largely focused upon movements such as Hizbut Tahrir Indonesia (HTI, or the Indonesian Party of Liberation), Forum Pembela Islam (FPI,or Islamic Defenders Front), and Majelis Mujahidin Indonesia (MMI, or the Council of Indonesian Holy Warriors). This is unfortunate because since its emergence in 2005, FUI has been playing an active role in social movement activities such as mass protests, public gatherings, media statements, and so forth. The study analyzes the ideology and framing strategies of FUI as it engages in a contestation of meaning in the country’s contemporary socio-political milieu. Based upon qualitative fieldwork in Indonesia, this study suggests that the manner in which FUI frames its pro- sharia issues is deliberately oriented toward convincing the Indonesian public that its pro- sharia programs and agendas are indeed for the betterment of the Republic of Indonesia—“NKRI” (Negara Kesatuan Republik Indonesia which is The Unitary State of the Republic of Indonesia). This is done through, for example, reinterpreting and redefining Pancasila (Five Principles), which serves as the basic philosophy of the Republic of Indonesia.
Source wavelet and local wave propagation effects on the amplitude-variation-with-offset response of thin-layer models: A physical modeling study
Authors: Assis Carlos A. M. , Oliveira Sérgio A. M. , Misságia Roseane M. , de Ceia Marco A. R.
Published: March 2017

In target layers with thicknesses below the vertical seismic resolution as thin layers, the tuning effect/interference between the wave propagation modes may increase the challenge of doing amplitude-variation-with-offset (AVO) analysis because it is difficult to recover the primary PP amplitudes embedded in the data by further seismic data processing. Thus, we have investigated the importance of the primary PP reflections, locally P-SV converted waves, and internal multiple reflections in the amplitude response of two thin-layer seismic physical models. One model consists of a thin water layer embedded between two nylon plates, and another model with a thin acrylic layer surrounded by water. Numerical modeling using the reflectivity method was applied to analyze each wave propagation mode and the source waveform role in the experimental data. Before the experimental reflection data acquisition, we characterized two source and receiver piezoelectric transducer (PET) pairs: one with a circular plane face and the other with a semispherical face. We measured the source wavelet, its dominant frequency, and the PETs’ directivity pattern. Semispherical PETs were chosen to acquire common midpoint reflection data. Thereafter, a processing workflow was applied to remove linear events interfering with the target reflections and to correct amplitudes due to transmission losses, source/receiver directivity, and geometric spreading effects. Finally, we investigated the thin-layer targets near incidence angle amplitude and the AVO response. The results showed that the interference between the primary PP reflections and the locally converted shear waves may considerably affect the observed amplitude response. The source wavelet bandwidth appeared as a second-order effect, and the internal multiple reflections were practically negligible. These results suggested that in real data sets, it is important to investigate the wave propagation modes and source wavelet role in the amplitudes observed, before deciding the AVO analysis/inversion workflow that should be adopted.
Processing and quality-control strategies for consistent time-lapse seismic attributes: A case history on an internal blowout using vintage data
Authors: Dinh Hung Nho , van der Baan Mirko , Landrø Martin
Published: March 2017

Many vintage reflection seismic surveys exist that have nonrepeated acquisition geometries or final-stacked/migrated sections are obtained using different or nonconsistent processing flows. This may lead to derived time-lapse attributes that are not internally consistent or even conflicting. For instance, we have focused on a subsurface gas blowout that occurred in 1989 in the Norwegian sector of the North Sea. The 2D site survey data were acquired in 1988 and 1990, and the 3D data were acquired in 1991 and 2005. The various sets of legacy data are plagued by poor repeatability among data acquisitions, application of different processing strategies, missing prestack data, and the presence of multiples. All of these factors severely complicate even qualitative interpretation of the gas migration associated with the underground blowout. Careful time-lapse processing may provide useful information even from such challenging legacy data by first computing numerous attributes including instantaneous amplitude differences, time shifts, time-lapse attenuation, and impedance inversions. Then, judicious quality control, invoked by comparing the various attributes, was used to check for internally consistent results.
Inversion of airborne geophysics over the DO-27/DO-18 kimberlites — Part 2: Electromagnetics
Authors: Fournier Dominique , Kang Seogi , McMillan Michael S. , Oldenburg Douglas W.
Published: March 2017

We focus on the task of finding a 3D conductivity structure for the DO-18 and DO-27 kimberlites, historically known as the Tli Kwi Cho (TKC) kimberlite complex in the Northwest Territories, Canada. Two airborne electromagnetic (EM) surveys are analyzed: a frequency-domain DIGHEM and a time-domain VTEM survey. Airborne time-domain data at TKC are particularly challenging because of the negative values that exist even at the earliest time channels. Heretofore, such data have not been inverted in three dimensions. In our analysis, we start by inverting frequency-domain data and positive VTEM data with a laterally constrained 1D inversion. This is important for assessing the noise levels associated with the data and for estimating the general conductivity structure. The analysis is then extended to a 3D inversion with our most recent optimized and parallelized inversion codes. We first address the issue about whether the conductivity anomaly is due to a shallow flat-lying conductor (associated with the lake bottom) or a vertical conductive pipe; we conclude that it is the latter. Both data sets are then cooperatively inverted to obtain a consistent 3D conductivity model for TKC that can be used for geologic interpretation. The conductivity model is then jointly interpreted with the density and magnetic susceptibility models from a previous paper. The addition of conductivity enriches the interpretation made with the potential fields in characterizing several distinct petrophysical kimberlite units. The final conductivity model also helps better define the lateral extent and upper boundary of the kimberlite pipes. This conductivity model is a crucial component of the follow-up paper in which our colleagues invert the airborne EM data to recover the time-dependent chargeability that further advances our geologic interpretation.
3D structure and formation of hydrothermal vent complexes at the Paleocene-Eocene transition, the Møre Basin, mid-Norwegian margin
Authors: Kjoberg Sigurd , Schmiedel Tobias , Planke Sverre , Svensen Henrik H. , Millett John M. , Jerram Dougal A. , Galland Olivier , Lecomte Isabelle , Schofield Nick , Haug Øystein T. , Helsem Andreas
Published: March 2017

The mid-Norwegian margin is regarded as an example of a volcanic-rifted margin formed prior to and during the Paleogene breakup of the northeast Atlantic. The area is characterized by the presence of voluminous basaltic complexes such as extrusive lava and lava delta sequences, intrusive sills and dikes, and hydrothermal vent complexes. We have developed a detailed 3D seismic analysis of fluid- and gas-induced hydrothermal vent complexes in a [Formula: see text] area in the Møre Basin, offshore Norway. We find that formation of hydrothermal vent complexes is accommodated by deformation of the host rock when sills are emplaced. Fluids are generated by metamorphic reactions and pore-fluid expansion around sills and are focused around sill tips due to buoyancy. Hydrothermal vent complexes are associated with doming of the overlying strata, leading to the formation of draping mounds above the vent contemporary surface. The morphological characteristics of the upper part and the underlying feeder structure (conduit zone) are imaged and studied in 3D seismic data. Well data indicate that the complexes formed during the early Eocene, linking their formation to the time of the Paleocene-Eocene thermal maximum at c. 56 Ma. The well data further suggest that the hydrothermal vent complexes were active for a considerable time period, corresponding to a c. 100 m thick transition zone unit with primary Apectodinium augustum and redeposited very mature Cretaceous and Jurassic palynomorphs. The newly derived understanding of age, structure, and formation of hydrothermal vent complexes in the Møre Basin contributes to the general understanding of the igneous plumbing system in volcanic basins and their implications for the paleoclimate and petroleum systems.
Characterization of hydrate-bearing sediments recovered from the Shenhu area of the South China Sea
Authors: Liu Changling , Meng Qingguo , Hu Gaowei , Li Chengfeng , Sun Jianye , He Xingliang , Wu Nengyou , Yang Shengxiong , Liang Jinqiang
Published: March 2017

The characteristics of the hydrate-bearing layer are important parameters for gas hydrate exploration and exploitation, which can be provided by laboratory analysis. We have carried out a systematic analysis of modern instruments, including the laser grain size analyzer, X-ray computed tomography, scanning electron microscopy, X-ray diffraction (XRD), Raman spectroscopy, gas chromatography, and isotope mass spectrometry, on the hydrate-bearing sediment samples recovered from the Shenhu area in the South China Sea in 2016. We focused on the structure, hydration number, and gas composition of the gas hydrate samples. We also evaluated the effects of sediments on the occurrence and distribution of gas hydrate. Our results showed that the sediments are much finer than those recovered from the Shenhu area in 2007. Some samples are found to contain calcareous microfossils and foraminifera, which are beneficial for dispersed gas hydrate formation. Whereas the only visible hydrate sample (FC4) has not found any bioclast in the sediments. Based on the Raman data and the XRD analysis, the gas hydrates demonstrate typical structure I (sI) hydrates, with cage occupancies of methane molecules higher than 99.3% in large cages and 81.5%–91.4% in small cages, respectively. The crystal lattice parameter is 11.89 Å with the hydration number being approximately 6.0. Methane is obviously the dominant component, ranging from 97.6% to 99.95% in these samples. Comprehensive study of carbon and hydrogen isotopes suggests that the hydrate-bound gases are from biogenic and thermogenic gases in the study area.
SMC5/6 is required for the formation of segregation-competent bivalent chromosomes during meiosis I in mouse oocytes
Authors: Hwang Grace , Sun Fengyun , O’Brien Marilyn , Eppig John J. , Handel Mary Ann , Jordan Philip W.
Published: March 2017

SMC complexes include three major classes: cohesin, condensin, and SMC5/6. However, the localization pattern and genetic requirements for the SMC5/6 complex during mammalian oogenesis had not previously been examined. In mouse oocytes, the SMC5/6 complex is enriched at the pericentromeric heterochromatin, and also localizes along chromosome arms during meiosis. The infertility phenotypes of females with a Zp3-Cre-driven conditional knockout (cKO) of Smc5 demonstrated that maternally expressed SMC5 protein is essential for early embryogenesis. Interestingly, protein levels of SMC5/6 complex components in oocytes decline as wild-type females age. When SMC5/6 complexes were completely absent in oocytes during meiotic resumption, homologous chromosomes failed to segregate accurately during meiosis I. Despite what appears to be an inability to resolve concatenation between chromosomes during meiosis, localization of topoisomerase II alpha to bivalents was not affected; however, localization of condensin along the chromosome axes was perturbed. Taken together, these data demonstrate that the SMC5/6 complex is essential for the formation of segregation-competent bivalents during meiosis I, and findings suggest that age-dependent depletion of the SMC5/6 complex in oocytes could contribute to increased incidence of oocyte aneuploidy and spontaneous abortion in aging females.
Tubulin isotype substitution revealed that isotype combination modulates microtubule dynamics in C. elegans embryos
Authors: Honda Yu , Tsuchiya Kenta , Sumiyoshi Eisuke , Haruta Nami , Sugimoto Asako
Published: March 2017

Microtubules (MTs) are polymers composed of α- and β-tubulin heterodimers that are generally encoded by genes at multiple loci. Despite implications of distinct properties depending on the isotype, how these heterodimers contribute to the diverse MT dynamics in vivo remains unclear. Here, by using genome editing and depletion of tubulin isotypes following RNAi, we demonstrate that four tubulin isotypes (hereafter referred to as α1, α2, β1 and β2) cooperatively confer distinct MT properties in Caenorhabditis elegans early embryos. GFP insertion into each isotype locus reveals their distinct expression levels and MT incorporation rates. Substitution of isotype coding regions demonstrates that, under the same isotype concentration, MTs composed of β1 have higher switching frequency between growth and shrinkage compared with MTs composed of β2. Lower concentration of β-tubulins results in slower growth rates, and the two α-tubulins distinctively affect growth rates of MTs composed of β1. Alteration of ratio and concentration of isotypes distinctively modulates both growth rate and switching frequency, and affects the amplitude of mitotic spindle oscillation. Collectively, our findings demonstrate that MT dynamics are modulated by the combination (ratio and concentration) of tubulin isotypes with distinct properties, which contributes to create diverse MT behaviors in vivo.
Fixing the stimulus-as-fixed-effect fallacy in task fMRI
Authors: Westfall Jacob , Nichols Thomas E. , Yarkoni Tal
Published: March 2017

Most functional magnetic resonance imaging (fMRI) experiments record the brain’s responses to samples of stimulus materials (e.g., faces or words). Yet the statistical modeling approaches used in fMRI research universally fail to model stimulus variability in a manner that affords population generalization, meaning that researchers’ conclusions technically apply only to the precise stimuli used in each study, and cannot be generalized to new stimuli. A direct consequence of this stimulus-as-fixed-effect fallacy is that the majority of published fMRI studies have likely overstated the strength of the statistical evidence they report. Here we develop a Bayesian mixed model (the random stimulus model; RSM) that addresses this problem, and apply it to a range of fMRI datasets. Results demonstrate considerable inflation (50-200% in most of the studied datasets) of test statistics obtained from standard “summary statistics”-based approaches relative to the corresponding RSM models. We demonstrate how RSMs can be used to improve parameter estimates, properly control false positive rates, and test novel research hypotheses about stimulus-level variability in human brain responses.