bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanical antithrombogenic properties by vibrational excitation of the impeller in a magnetically levitated centrifugal blood pump
Authors: Murashige Tomotaka , Hijikata Wataru
Published: July 2019

Mechanical circulatory support devices have been used clinically for patients with heart failure for over 10 years. However, thrombus formation inside blood pumps remains a risk to patient life, causing pump failure and contributing to neurological damage through embolization. In this article, we propose a method for preventing thrombus formation by applying vibrational excitation to the impeller. We evaluate the ability of this method to enhance the antithrombogenic properties of a magnetically levitated centrifugal blood pump and ensure that the impeller vibration does not cause undue hemolysis. First, 3 vibrational conditions were compared using an isolated pump without a mock circulation loop; the vibrational excitation frequencies and amplitudes for the impeller were set to (a) 0 Hz‐0 μm, (b) 70 Hz‐10 μm, and (c) 300 Hz‐2.5 μm. The motor torque was measured to detect thrombus formation and obtain blood coagulation time by calculating the derivative of the torque. Upon thrombus detection, the pump was stopped and thrombi size were evaluated. The results showed an increase in the blood coagulation time and a decrease in the rate of thrombus formation in pumps with the impeller vibration. Second, an in vitro hemolysis test was performed for each vibrational condition to determine the effect of impeller vibration on hemolysis. The results revealed that there was no significant difference in hemolysis levels between each condition. Finally, the selected vibration based on the above test results and the non‐vibration as control were compared to investigate antithrombogenic properties under the continuous flow condition. The blood coagulation time and thrombi size were investigated. As a result, vibrational excitation of the impeller at a frequency of 300 Hz and amplitude of 2.5 μm was found to significantly lengthen clotting time, decreasing the rate of pump thrombus compared to the non‐vibration condition. We indicate the potential of impeller vibration as a novel mechanical antithrombogenic mechanism for rotary blood pumps.
Addition of Wakame seaweed (Undaria pinnatifida) stalk to animal feed enhances immune response and improves intestinal microflora in pigs
Authors: Shimazu Tomoyuki , Borjigin Liushiqi , Katoh Kazuo , Roh Sang‐gun , Kitazawa Haruki , Abe Keietsu , Suda Yoshihito , Saito Hayato , Kunii Hiroshi , Nihei Ken , Uemoto Yoshinobu , Aso Hisashi , Suzuki Keiichi
Published: July 2019

This study was conducted to evaluate the effects of supplementation of Wakame seaweed stalks on the immunity and intestinal microflora of pigs. Three separate experiments were performed: Relatively young (start at 20–30 kg; Experiments 1 and 2) and fattening period (70 kg; Experiment 3). All pigs (including the control group) were fed the same commercial feed, free from antibiotic additives, but in the feed for the treatment groups, 1% seaweed powder was added. There were no group differences observed in daily weight gain and feed intake in Experiments 1 and 2 between groups; however, daily weight gain was significantly higher in the treatment group compared to the control group in Experiment 3. The percentage of peripheral blood natural killer cells of the treatment group was significantly higher than that of the control group in all experiments. Although addition of seaweed changed the gene expression of cytokine and toll‐like receptors of the small intestinal Peyer's patches slightly, seaweed seems to alter intestinal microflora preferentially, for instance, there was an increase in Lactobacillus and a decrease of Escherichia coli observed. These results suggest that Wakame seaweed can be used as supplement for pig feed to improve the gut health and immunity of pigs.
Doctors and diversity: Using interfaith literacy and interfaith dialogue to improve patient care
Authors: Bellwood Leslie
Published: July 2019

In an increasingly diversifying world, how can doctors and other healthcare professionals improve patient care? Currently, many doctors do not understand how to approach religious differences or recognize their effect on patient health. Doctors must acquire interfaith literacy in medical school through required courses and learn the skills necessary to engage in interfaith dialogue with patients in their practice in order to provide the best patient care in areas with growing diverse patient populations.
Helvétius's challenge: Moral luck, political constitutions, and the economy of esteem
Authors: Blank Andreas
Published: July 2019

This article explores a historical challenge for contemporary accounts of the role that the desire of being esteemed can play in exercising social control. According to Geoffrey Brennan and Philip Pettit, the economy of esteem normally has two aspects: it is supportive of virtuous action and it occurs spontaneously. The analysis of esteem presented by the 18th‐century materialist Claude‐Adrien Helvétius challenges the intuition that these two aspects go together unproblematically. This is so because, in Helvétius's view, the desire for esteem is always triggered by sensible interest. In the frequent situations where sensible interest diverges from the demands of virtue, the economy of esteem thus can be spontaneous but will not be supportive of virtue. Helvétius allows for cases of moral luck where sensible interest coincides with the demands of virtue but regards these cases as rare occurrences. This is why he believes that a functioning economy of esteem crucially depends on political constitutions—in which case the economy of esteem can be supportive of virtue but will not be spontaneous.
The Autoimmune Regulator (Aire) transactivates HLA‐G gene expression in thymic epithelial cells
Authors: Melo‐Lima Breno Luiz , Poras Isabelle , Passos Geraldo Aleixo , Carosella Edgardo D. , Donadi Eduardo Antonio , Moreau Philippe
Published: July 2019

The Autoimmune Regulator (Aire) protein coordinates the negative selection of developing thymocytes by inducing the expression of hundreds of tissue‐specific antigens within the thymic medulla, which is also a primary site of the expression of the immune checkpoint HLA‐G molecule. Considering the immunomodulatory properties of Aire and HLA‐G, and considering that the role of the constitutive thymus expression of HLA‐G has not been elucidated, we studied the effect of AIRE cDNA transfection on HLA‐G expression in 4D6 thymic cells and in the HLA‐G‐positive JEG‐3 choriocarcinoma cells. Aire promoted the transactivation of HLA‐G gene by increasing the overall transcription, inducing the transcription of at least G1 and G2/G4 isoforms, and incrementing the occurrence and distribution of intracellular HLA‐G protein solely in 4D6 thymic cells. Luciferase‐based assays and chromatin immunoprecipitation experiments performed in 4D6 cells revealed that Aire targeted at least two regions within the 5′‐untranslated regulatory region (5′‐URR) extending 1·4 kb from the first ATG initiation codon. The interaction occurs independently of three putative Aire‐binding sites. These results indicate that the Aire‐induced upregulation of HLA‐G in thymic cells is likely to act through the interaction of Aire with specific HLA‐G 5′‐URR DNA‐binding factors. Such a multimeric transcriptional complex might operate in the thymus during the process of promiscuous gene expression.
Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis
Authors: Mauro Maria Francisca F.P. , Papelbaum Marcelo , Brasil Marco Antônio Alves , Carneiro João Regis Ivar , Coutinho Evandro Silva Freire , Coutinho Walmir , Appolinario José Carlos
Published: July 2019

Bariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity. The objective of the study is to conduct a systematic review and meta‐analysis of studies investigating the relationship between psychiatric comorbidity and weight regain. A systematic review through PubMed, Web of Science, Cochrane Library, Scopus, and PsycINFO was performed, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). After a stepwise selection, 13 articles were included in the qualitative analysis and 5 were included for a meta‐analysis. Women was majority in most of the studies (87.6%), and a bypass procedure was the bariatric intervention most evaluated (66.8%), followed by gastric banding (32.1%) and sleeve (1.1%). Higher rates of postbariatric surgery eating psychopathology were reported in patients with weight regain. However, the association between general psychopathology and weight regain was not consistent across the studies. In the meta‐analysis, the odds of eating psychopathology in the weight regain group was higher compared with the nonweight regain group (OR = 2.2, 95% CI 1.54‐3.15). Postbariatric surgery eating psychopathology seems to play an important role in weight regain.
Identification of a novel allele, MICA*088N, in a Chinese Kazakh individual
Authors: Wang ZhenFang , Guo Wen Tao , Tursun Mikrban , Tian Wei , Hasim Ayshamgul
Published: July 2019

The novel MICA*088N allele has a single nucleotide mismatch in exon 4 compared to MICA*027.
Optimal Design of a Parallel Robot for Dental Articulation
Authors: Kizghin Dilmurat A. , Nelson Carl A.
Published: July 2019

A dental articulator is a mechanical device used to simulate the relative position and motion between the upper and lower jaw when testing dental work or dental treatments (implants or bridges). Typically, it can be adjusted to approximate patient-specific jaw kinematics. However, the use of dental articulators is essentially a trial-and-error method in order to fine-tune fit and function of the dental work. In this paper we propose a robotic articulator suitable for reproducing tracked movements of the patient’s jaw. Based on an asymmetric-leg parallel structure, dimensional synthesis is performed to optimize performance over the range of motion typical of the human jaw. The resulting robotic device is expected to improve workflow in the processing of dental implants. Fabrication and testing of a prototype robot is also presented.
Transitioning a Research Tool Into a Consumer Product: The Wheelchair In-Seat Activity Tracker
Authors: Sprigle Stephen , Sonenblum Sharon , O’Brien J. J.
Published: July 2019

Pressure ulcers remain a significant secondary complication for many wheelchair users, having significant adverse impacts on the health, function and independence of wheelchair users. Research suggests that both the magnitude and duration of loading on tissues can lead to tissue necrosis. This motivated research to measure the in-seat movement of wheelchair users as a means to characterize time of loading. During these research activities, the consistent finding was that persons were not adhering to their weight shift regimens as taught during rehabilitation. This served as motivation to develop a consumer product to inform users of their activities. The transition from a research tool to a consumer product is endowed with challenges. This paper describes the technology as well as the activities required to make this transition. Specific design challenges included attention to usability and device engagement and the need for near real-time data management and analysis to inform users of their in-seat movements.
Multimaterial 3D Printing for the Fabrication of Functional Stethoscopes
Authors: Popkin Rachel , Lobo Fluvio , Stubbs Jack
Published: July 2019

Stethoscopes are ubiquitous across the healthcare system. For the most part, stethoscopes do not represent a financial burden, mostly throughout the developed world. Further reducing the cost of stethoscopes has both humanitarian and prophylactic goals. The Glia project pioneered the concept of 3D printing stethoscopes for war or poverty-stricken regions of the world. Cross-contamination concerns have led researchers and manufacturers to develop single-use stethoscopes. Our aim is to develop a fully printed, multi-material, functional stethoscope to alleviate these concerns. Our team also seeks to establish a framework for the on-demand manufacturing of medical devices to reduce costs associated with shipping, distribution, and inventory.
Towards a Generalized Model of Multivariable Ankle Impedance During Standing Based on the Lower Extremity Muscle EMG
Authors: Knop Lauren , Aramizo Ribeiro Guilherme , Rastgaar Mo
Published: July 2019

The ankle mechanical impedance of healthy subjects was estimated during the standing pose while they co-contracted their lower-leg muscles. Subsequently, the impedance parameters were modeled as a function of the level of co-contraction using machine learning regression methods. From the experimental results, the average ankle stiffness coefficients in dorsi-plantar flexion (DP) showed more dependence to the muscle contraction than stiffness in inversion-eversion (IE): 4.6 Nm/rad per %MVC (percent of the maximum voluntary contraction) and 1.1 Nm/rad per %MVC, respectively. To accurately estimate the ankle impedance parameters as a function of the electromyography (EMG) signals, multiple EMG feature selection methods, regression models, and types of models were evaluated. Using a 1-vs-All model validation approach, the best regression model to fit the stiffness and damping in DP was the Least Square method with Regularization, and the best IE stiffness was the Gaussian Process Regression. No model was able to estimate the IE damping well, possibly because this parameter is not modulated with a changing co-contraction of the lower-leg muscles.
Primary angiosarcoma of the breast: a radiation oncologist’s perspective with a concise review of the literature
Authors: Singh Rajpal , Chufal Kundan Singh , Pahuja Anjali K , Suresh Tamilarasu , Chowdhary Rahul Lal , Ahmad Irfan
Published: July 2019

A 28-year-old premenopausal woman presented with a painful rapidly growing mass in her right breast and was evaluated with a core needle biopsy, which was suggestive of poorly differentiated carcinoma. Immunohistochemical evaluation revealed primary angiosarcoma of breast. Whole body18flouro-deoxyglucose positron emission tomography CT showed few metabolically active soft tissue lesions in upper inner quadrant of right breast. The patient underwent breast conservation surgery and in view of positive surgical margins, received adjuvant radiation therapy. Post-treatment completion, the patient has been disease free for 6 months. Primary angiosarcoma of the breast is a rare malignancy which is best managed with a surgery as first approach, with due importance being given to the patient’s perspective on their disease and choices for adjuvant treatment. Decisions in addition to adjuvant radiotherapy need to be made in the multidisciplinary clinic, due to paucity of data.
Percutaneous removal of a retained appendicolith causing recurrent perihepatic abscesses between the liver and diaphragm
Authors: Abdullah Hafez Mohammad Ammar , Atiq Muslim , Yeager Terry
Published: July 2019

Many cases of appendicitis can be associated with appendicoliths. These may sometimes be lost during appendectomies and may be lodged in the body. Most of these cases lead to recurrent abscess formation, and these appendicoliths invariably need removal. Typically, this used to be done as an open surgery or laparoscopically. Here we describe the case of a transcutaneous removal of an appendicolith that was lodged between the liver and diaphragm that led to recurrent perihepatic abscess formation in a 24-year-old otherwise healthy man. The patient made a successful recovery without any recurrence. A transcutaneous approach to remove a retained appendicolith may be a feasible, a safe and an easy method to extract appendicoliths that are accessible for transcutaneous removal.
Are community health workers effective in retaining women in the maternity care continuum? Evidence from India
Authors: Agarwal Smisha , Curtis Sian , Angeles Gusavo , Speizer Ilene , Singh Kavita , Thomas James
Published: July 2019

Objectives

Despite the recognised importance of adopting a continuum of care perspective in addressing the care of mothers and newborns, evidence on specific interventions to enhance engagement of women along the maternity care continuum has been limited. We use the example of the Accredited Social Health Activist (ASHA) programme in India, to understand the role of community health workers in retaining women in the maternity care continuum.

Methods

Using the Indian Human Development Survey data from 2011 to 2012, we assess the association between individual and cluster-level exposure to ASHA and four key components along the continuum of care—at least one antenatal care (ANC) visit, four or more ANC visits, presence of a skilled birth attendance (SBA) at the time of birth and postnatal care for the mother or child within 48 hours of birth, for 13 705 women with a live birth since 2005. To understand which of these services experience maximum dropout along the continuum, we use a linear probability model to calculate the weighted percentages of using each service. We assess the association between exposure to ASHA and number of services utilised using a multinomial logistic regression model adjusted for a range of confounding variables and survey weights.

Results

Our study indicates that exposure to the ASHA is associated with an increased probability of women receiving at least one ANC and SBA. In terms of numbers of services, exposure to ASHA accounts for a 12% (95% CI: 9.1 to 15.1) increase in women receiving at least some of the services, and an 8.8% (95% CI: −10.2 to −7.4) decrease in women receiving no services. However, exposure to ASHA does not increase the likelihood of women utilising all the services along the continuum.

Conclusions

While ASHA is effective in supporting women to initiate and continue care along the continuum, it does not significantly affect the completion of all services along the continuum.
Performance of primary care in different healthcare facilities: a cross-sectional study of patients’ experiences in Southern Malawi
Authors: Dullie Luckson , Meland Eivind , Hetlevik Øystein , Mildestvedt Thomas , Kasenda Stephen , Kantema Constance , Gjesdal Sturla
Published: July 2019

Objective

In most African countries, primary care is delivered through a district health system. Many factors, including staffing levels, staff experience, availability of equipment and facility management, affect the quality of primary care between and within countries. The purpose of this study was to assess the quality of primary care in different types of public health facilities in Southern Malawi.

Study design

This was a cross-sectional quantitative study.

Setting

The study was conducted in 12 public primary care facilities in Neno, Blantyre and Thyolo districts in July 2018.

Participants

Patients aged ≥18 years, excluding the severely ill, were selected to participate in the study.

Primary outcomes

We used the Malawian primary care assessment tool to conduct face-to-face interviews. Analysis of variance at 0.05 significance level was performed to compare primary care dimension means and total primary care scores. Linear regression models at 95% CI were used to assess associations between primary care dimension scores, patients’ characteristics and healthcare setting.

Results

The final number of respondents was 962 representing 96.1% response rate. Patients in Neno hospitals scored 3.77 points higher than those in Thyolo health centres, and 2.87 higher than those in Blantyre health centres in total primary care performance. Primary care performance in health centres and in hospital clinics was similar in Neno (20.9 vs 19.0, p=0.608) while in Thyolo, it was higher at the hospital than at the health centres (19.9 vs 15.2, p<0.001). Urban and rural facilities showed a similar pattern of performance.

Conclusion

These results showed considerable variation in experiences among primary care users in the public health facilities in Malawi. Factors such as funding, policy and clinic-level interventions influence patients’ reports of primary care performance. These factors should be further examined in longitudinal and experimental settings.
Spatial-Domain Low-Coherence Quantitative Phase Microscopy to Improve the Cytological Diagnosis of Pancreatic Cancer
Authors: Ma Hongbin , Wang Pin , Shang Dong , Liu Yang
Published: July 2019

Use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology to detect pancreatic cancer is limited, with a high false negative rate mainly due to the relatively fewer number of completely cancerous cells. To improve the accuracy of EUS-FNA cytological diagnosis, we evaluated a novel optical system—spatial-domain low-coherence quantitative phase microscopy (SL-QPM)—to analyze nanoscale nuclear architecture on original cytology samples, especially those diagnosed as indeterminate for malignancy, with the goal of maintaining high specificity and reducing false positive rate. We performed SL-QPM on original cytology samples obtained by EUS-FNA from 40 patients with suspicious pancreatic solid lesions (27 adenocarcinomas, 5 neuroendocrine tumor, 8 chronic pancreatitis), including 13 cases that were cytologically indeterminate. Each diagnosis had been confirmed by follow-up surgical pathology. The SL-QPM-derived nanoscale nuclear architectural parameters distinguished pancreatic cancer from cytologically indeterminate cells. A logistic regression model using nuclear entropy and SD increased the sensitivity of cytology in identifying pancreatic cancer from 72% to 94% while maintaining 100% specificity. The SL-QPM-derived nanoscale nuclear architecture properties show great promise in improving the cytological diagnosis of EUS-FNA for pancreatic cancer and could be used when traditional cytopathology does not get an accurate diagnosis, and can be easily translated into a traditional clinical device.
Triaxial stress path tests on artificially prepared analogue alpine permafrost soil
Authors: Yamamoto Yuko , Springman Sarah M.
Published: July 2019

Some degrading rock glaciers have been exhibiting deepening depressions, accelerating strain rates, and, in some rare cases, sudden release of mass movements. Warming permafrost already mobilizes lower strength as temperatures rise; however, unusual stress paths with lateral stresses greater than vertical stresses, instead of vice versa, could exacerbate this condition with lower strength at failure, and hence higher vulnerability. This paper investigates the mechanical behaviour of artificially frozen soil specimens at temperatures between –3.0 and –0.3 °C under various stress paths: axial (A) and lateral (L), compression (C), and extension (E), for total stress paths AC, AE, LE, LC. Acoustic emissions were detected during shearing to expose how the deformation mechanisms develop from a microstructural point of view. Deviatoric stress mobilized in the stress path tests was linearly dependent on the temperature (within the ranges tested): a temperature increase resulted in a decrease in residual deviatoric stress. Comparison between the residual deviatoric stresses obtained from the different stress path tests indicates that (i) values mobilized with radial stress greater than axial stress were lower than vice versa, (ii) more strength was mobilized when changing lateral stress paths than axial, with (iii) the lowest strength mobilized in AE beneath a depression.
Habitat loss, fragmentation, and the genetic status of Roanoke bass
Authors: Eschenroeder Jackman C. , Roberts James H.
Published: July 2019

Roanoke bass (Ambloplites cavifrons) persist in five river basins in the eastern US, where they are threatened by invasive species, habitat loss and degradation, and hydrologic fragmentation. We conducted the first conservation genetic study of A. cavifrons, analyzing variation at 19 nuclear microsatellite DNA loci and the cytochrome b mitochondrial DNA gene to estimate population structure and demography, genetic relationships among populations, and the role of landscape features in regulating genetic diversity and differentiation. Most streams harbored genetically distinguishable populations, with high connectivity among reaches within streams but no contemporary dispersal among streams. In contrast, mitochondrial divergence within and among basins was weak, suggesting historically higher range-wide connectivity. Most populations exhibited small effective population sizes and evidence of past population bottlenecks. Genetic diversity correlated positively with patch size but negatively with watershed urban and agricultural development, suggesting that habitat loss, degradation, and fragmentation have acted in concert to reduce population viability. Mitigating these impacts may require a combination of tactics, including restoring habitat, limiting the spread of invasive competitors, and reestablishing historical connectivity.
Reducing parasitic absorption and recombination losses in silicon solar cells through transition metal doped glass frit
Authors: Jiang Xing , Gao Zhou , Wang Xingbo , Chen Yongji , Liu Jian , Zhang Mingjian , Lin Yuan , Pan Feng
Published: July 2019

Efficient electron selective contacts, smoother rear silicon surface and passivation of silicon-electrode interfaces could reduce parasitic light absorption and electron-hole recombination. Therefore, they are necessary for high conversion efficiency in silicon solar cells. In this work, a novel transition metal doped glass frit is fabricated and introduced into pristine Al paste. As a result, the average power conversion efficiency (PCE) of cells is improved from 17.9 to 18.3%. Combining several results, the improvement can be attributed to three key factors: (a) a thicker back surface field (BSF) layer that blocks electrons; (b) a smoother rear silicon surface which leads to less parasitic absorption; and (c) glass frit coating on aluminum particles which may facilite hole-transfer from silicon layer to aluminum electrode.
Recov-R
Authors: Uzor Stephen , Baillie Lynne
Published: July 2019

Rehabilitation has proven effective to significantly reduce fall risk in seniors; however, low adherence to home rehabilitation and a lack of feedback on performance and progress indicate that seniors might not receive the amount of therapy necessary to reduce their risk of falling. We present a tailored exergame system for the home (called Recov-R) to motivate seniors to exercise and facilitate effective recovery by promoting optimal quality of movement during exercise. Based on an 8-week field study, with 38 participants, we present results on the use of the Recov-R system, versus standard care, in the home. Our findings suggest that the use of the system can increase adherence to exercise and reduce fall risk by improving outcomes of physical function—mobility and balance. We also highlight opportunities, based on these results, for the design of effective exergame technologies for musculoskeletal rehabilitation in the home.
A Framework for Adaptive Residual Streaming for Single-Player Cloud Gaming
Authors: Chen De-Yu , El-Zarki Magda
Published: July 2019

Applying cloud technology to 3D interactive multimedia applications is a promising way to provide flexible and cost-efficient online high-bandwidth immersive services to a large population of end users. One main reason cloud systems are popular among users is the fact that it relaxes the hardware requirements for high-end interactive visual applications. As most of the computational tasks are done on cloud servers, users no longer need to upgrade their hardware as frequently to keep up with the ever-increasing high-end computing requirements of the latest applications. Moreover, cloud systems make it easier for a user to enjoy applications on different platforms, including mobile devices that are usually not powerful enough to run high-end, memory-intensive services. In short, applying cloud technology to high-end immersive applications has advantages in cost-efficiency and flexibility both for the end users and the service providers. However, there are two main drawbacks to applying cloud technology to 3D interactive multimedia services: (1) high-bandwidth utilization and (2) latency. In this article, we propose a framework that addresses the two problems for single-player cloud gaming by using a combination of collaborative rendering, progressive meshes, and 3D image warping techniques. The experimental results show that the proposed system can reduce the bandwidth usage and improve the visual quality by utilizing local computing power on the client. The results also show that the interaction latency can be reduced somewhat by sacrificing some degree of visual quality in the end system.
Use of Complementary and Alternative Medicine among Young Patients with Breast Cancer
Authors: Hammersen Friederike , Pursche Telja , Fischer Dorothea , Katalinic Alexander , Waldmann Annika
Published: July 2019

Background: Complementary and alternative medicine (CAM) has received increasing attention in Western countries and is especially common among breast cancer (BC) patients. So far, its effectiveness has not been well studied, which is in part due to the contextuality of CAM along with a lack of information of why patients use it. Objectives: Young BC patients constitute a special patient group regarding clinical characteristics, QOL, and their role in society. Since little is known about their CAM use, this study aimed at exploring it as well as their reasons for CAM use. Methods: Data on CAM and sociodemographics were collected via questionnaire in the context of a rehabilitation program for young mothers with BC. Initial BC diagnoses were between 2009 and 2014 (recruitment period 2012–2015). Clinical characteristics were derived from the patient files. Descriptive statistics were used to describe frequencies and statistically significant differences were tested. Results: Among the 827 patients, with an average age of 39.6 years, 62.5% had used CAM with regard to their cancer. CAM use was significantly higher in women with higher educational level, higher employment status, and statutory health insurance, respectively. The average monthly expenses on CAM were EUR 50. Every 5th woman used CAM without her physician’s knowledge. The types most often used were dietary supplements with vitamins or minerals. The most frequent reasons for CAM use were to strengthen the immune system, support conventional medicine, and combat side effects. Conclusions: CAM plays an important role for young BC patients with regard to prevalence and monthly expenses, and was used for a wide range of reasons. Certain subgroups with more frequent CAM use could be identified. Physicians should therefore proactively talk about CAM with their young BC patients, so that patients do not need to rely on information sources on CAM outside the medical system.
Televisão e ideologia
Authors: Maurey Andrei
Published: July 2019

A expansão da televisão mundial para novos modos de transmissão vem impulsionando a produção de ficções seriadas e alcançando vastas audiências. Com isso em mente, é imprescindível observarmos o alcance dessas obras audiovisuais e, sobretudo, compreendermos todo o seu potencial reprodutor e difusor de ideologia. De acordo com John B. Thompson, a ideologia pode ser veiculada pelas formas simbólicas que carregam sentido, podendo ser ele atribuído para estabelecer e sustentar relações de poder sistematicamente assimétricas. Com o objetivo de demonstrar essa reprodução no campo da ficção seriada, este artigo se propõe a uma análise do seriado Homeland: segurança nacional (2011), a fim de verificar certos usos sociais das formas simbólicas que reproduzem relações de dominação em um contexto socio-histórico contemporâneo.
Multivoxel Pattern Analysis Reveals a Neural Phenotype for Trust Bias in Adolescents
Authors: Tashjian Sarah M. , Guassi Moreira João F. , Galván Adriana
Published: July 2019

The extent to which individuals are inclined to judge unfamiliar others as trustworthy can have important implications for social functioning. Using multivariate pattern analysis, a neural phenotype of trust bias was identified in 48 human adolescents (ages 14–18 years, 26 female). Adolescents who exhibited more similar brain response to faces at the extremes of a trustworthy gradient were more likely to rate neutral faces as trustworthy. This relation between neural pattern representation and trust bias was evinced in the amygdala. Amygdala–insula connectivity dissimilarity to faces at the extremes of the trustworthy gradient was associated with greater trust bias to neutral faces, serving as a distinct circuit-level contributor to decision-making over and above of amygdala pattern similarity. These findings aid understanding of neural mechanisms contributing to individual differences in social evaluations of ambiguity.
Antifibrotic Potential of MiR-335-3p in Hereditary Gingival Fibromatosis
Authors: Gao Q. , Yang K. , Chen D. , Song Y. , Qiao W. , Sun X. , Meng L. , Bian Z.
Published: July 2019

Hereditary gingival fibromatosis (HGF) is a highly genetically heterogeneous disease, and current therapeutic method is limited to surgical resection with a high recurrence rate. MicroRNAs (miRNAs) are able to fine-tune large-scale target genes. Here we established a simple but effective computational strategy based on available miRNA target prediction algorithms to pinpoint the most potent miRNA that could negatively regulate a group of functional genes. Based on this rationale, miR-335-3p was top ranked by putatively targeting 85 verified profibrotic genes and 79 upregulated genes in HGF patients. Experimentally, downregulation of miR-355-3p was demonstrated in HGF-derived gingival fibroblasts as well as in transforming growth factor β–stimulated normal human gingival fibroblasts (NHGFs) compared to normal control. Ectopic miR-335-3p attenuated, whereas knockdown of miR-335-3p promoted, the fibrogenic activity of human gingival fibroblasts. Mechanically, miR-335-3p directly targeted SOS1, SMAD2/3, and CTNNB1 by canonical and noncanonical base paring. In particular, different portfolios of fibrotic markers were suppressed by silencing SOS1, SMAD2/3, or CTNNB1, respectively. Thus, our study first proposes a novel miRNA screening approach targeting a functionally related gene set and identifies miR-335-3p as a novel target for HGF treatment. Mechanically, miR-335-3p suppresses the fibrogenic activity of human gingival fibroblasts by repressing multiple core molecules in profibrotic networks. Our strategy provides a new paradigm in the treatment for HGF as well as other diseases.
A Method of treating Atrophic Rhinitis with Ozæna based on an Alteration in Composition and Reaction of the Substrate on which the Bacterial Ferments are acting
Authors: Benians T. H. C.
Published: July 2019

[This paper is published in extenso in the Journal of Laryngology, September, 1919, p. 20.]
President's Address
Authors: Langdon-Down R.
Published: July 2019

The principal reference of the Royal Commission was certification and detention, and treatment without certification of persons suffering from mental disorder.

The general principles laid down as the result of the inquiry are set forth and shown to accord with the views of the medical profession.

The Commission supports the medical view that greater facilities should be granted for treating mental disorders in their early stages without certification and repudiates the contention that grave abuses exist.

It makes proposals for avoiding the stigma of certification by admitting patients to treatment under a provisional order without full certification. The real objection of the public to certification appears to lie in the judicial intervention and the legal formalities. Since these are accentuated in the proposed method, it is very little different from the present procedure. The reason for this anomaly appears to be adherence to what is said to be “an inviolable principle of law.”

This principle is violated in the present law, in the proposals of the Royal Commission and was disregarded prior to 1890.

A scheme is put forward to avoid these objections by extending the present facilities on the lines of the Report and simplifying the procedure, thus eliminating the magistrate from the proceedings prior to admission unless the patient desires his intervention, and placing the authorization for treatment on the relatives and friends in all cases where the patient does not apply voluntarily for treatment. The Board of Control is the safeguard in these matters. These two procedures would be applicable to all cases in the first instance; but should the friends prefer full certification, that should be possible at any stage.

The proposals for voluntary boarders are approved with the proviso that it should not be necessary to apply these proposals where restraint is neither necessary nor, in fact, applied.

The protection that doctors signing certificates need is considered and it is proposed that a medical assessor should advise the judge to whom application to stay an action is made.

It is held that if the law is at present wrongly interpreted and unjust, this should be cleared up by public action rather than that a doctor should have to go through the anxiety and expense of appeal to the House of Lords.

In the main the Report commands professional approval, but in points of the greatest importance to doctors practising psychiatry and to their patients it is unsatisfactory.
Some Public Health Aspects of Juvenile Rheumatism
Authors: Miller Reginald
Published: July 2019

(1) The prevalence of juvenile rheumatism is shown by the incidence of heart disease in 1·5 to 2 per cent. of urban elementary school children. The annual mortality from rheumatic heart disease is probably about 20,000 deaths a year.

(2) The age-incidence is due to the three factors of tonsillitis, exposure, and the diminished resistance to infection of childhood. Where these three factors overlap we get the heavy incidence of the infection. The class-incidence shows a rheumatic stratum of society in the upper poorer classes. The disease is therefore not a “poverty disease” strictly so-called; some added factor is also at work.

(3) Juvenile rheumatism is clearly an environmental disease, for if the children of the poor are transported from their homes to residential schools they remain free from rheumatic infection. What is the factor at work amongst the poor which produces the disease in their own homes? The evidence that cold damp houses have an important influence in producing juvenile rheumatism is considerable. Overcrowding seems to protect to some extent, owing to the prevention of cold. The environmental causes of the disease must centre largely round the production of tonsillar infection.

(4) The organized effort needed to prevent and control juvenile rheumatism consists in increased attention to housing conditions; increased endeavour in early detection by the School Medical Service; increased supervision by hospitals and practitioners of their rheumatic patients; and increased accommodation for prolonged treatment of heart disease.
The Pathogenesis of Rheumatic Fever in its Climatological Relationship to a Possible Insect Carrier
Authors: Clarke J. Tertius
Published: July 2019

A short while ago a special sub-committee of the British Medical Association [1] sat to inquire into the problem of rheumatic heart disease in children, and suggested, among other conclusions, that the material for any accurate world map of the incidence of rheumatism was probably not available. My objects in presenting this paper are:—

To provide data for this map. To show that the geographical distribution of rheumatic fever coincides with that of the common rat flea, Ceratophyllus fasciatus, and To suggest that this disease is caused by a protozoön, spirochæte or allied organism, which is carried by that flea.
Some Observations on Naso-Pharyngeal Epidemics in Public Schools
Authors: Glover J. A.
Published: July 2019

Over 80 per cent. of school sickness, whether judged by the number of cases or by the time lost, is transmitted by “droplet” infection.

The alleged increase in sickness in public schools is partly apparent, due to increased attention to minor febricula and partly real, due (1) to increased influenza prevalence, the aftermath of the great epidemic of 1918, and (2) to the increased demand for public school education leading to pressure upon accommodation, and especially to overcrowding in dormitories.

The bulk of the droplet infections are accounted for by (1) influenza; (2) feverish cold, chill, or P.U.O.; (3) tonsillitis; regular infectious diseases make a comparatively small showing. The incidence and bacteriological findings and the variations in the incidence of pneumonia and otitis media are discussed. Are these complications really secondary epidemics? Tonsillitis, bacteriological findings, milk.

Prophylaxis.—Efficacy of vaccines uncertain. Some evidence that they may diminish the onset of complications. If given vaccines should be administered before the danger period, i.e., not later than November.

Intensive prophylaxia other than vaccines during the first half of the Lent term would probably amply repay any trouble. It should include:—

Special efforts to prevent boys returning to school after the Christmas holidays infected with influenza or febricula. Temperature taking for three weeks. Immediate isolation of all pyrexias and catarrhs. No work before breakfast for at least the first six weeks of the term. All hot baths and showers taken during the day or after games to be followed by cold showers. Prevention of chill in watching games, etc. Increased provision for drying clothes, uniforms and boots.

Infection mainly takes place in sleeping quarters, and proper spacing out of beds and thorough “cross” ventilation in dormitories is of paramount importance; instances of cross infection due to proximity of beds; illustrated by bed charts and bacteriological findings; standards of wall space, floor space and cubic space, laid down by the Royal Commission, Board of Education.

No school authority has done its duty to its pupils unless it has provided dormitory accommodation allowing at least 3 ft. of clear space between the edges of beds, and thorough and through ventilation. Until these essential wants are met, the provision of properly sited, amply spaced and “cross” ventilated dormitories should take precedence of all other building requirements.

Milk should be pasteurized.
The Primary Lung Focus of Tuberculosis in Children
Authors: Blacklock John W. S.
Published: July 2019

Of 1,800 consecutive autopsies on children whose ages ranged from a few hours to between 12 and 13 years, and who lived in Glasgow and the West of Scotland, 283 (15·7%) were found to have tuberculous lesions.—Of the total tuberculous cases, the lungs or tracheo-bronchial lymph nodes were the seat of tuberculous lesions in 173 (61·1%), and of these 168 (97·1%) died as a result of the tuberculous disease.—A primary lung lesion was found in 148 of the cases classified as having the primary site of infection in the thorax. The primary lung lesion consisted of a localized patch of caseous broncho pneumonia and in the great majority of cases was single. Calcification of these lesions was unusual and only about one-third showed evidence of surrounding fibrosis, the incidence of which increased with the age of the children.—Most of the primary lung lesions were subpleural in position and the right lung was more often the seat of such lesions than the left; the right upper lobe being most frequently involved and then, in order, the right lower, left upper, left lower, and right middle.—The tuberculous adenitis in the tracheo-bronchial glands was related both anatomically and pathologically to the primary lesion in the lungs, the involvement of the glands being secondary to the lung lesion.—In 25 of the cases considered as primary thoracic infections, no primary lung lesions were found.—In a series of cases in which the type of infection was investigated, 173 human and 3 (2·7%) bovine strains were found in cases with the primary site of the infection in the thorax.—Only human strains were obtained from cases with primary lung lesions.—These findings were in marked contrast to those found in children in the same series with the primary site of infection in the abdomen where 81·8% of the infecting bacilli were of the bovine type, and also in cases of bone and joint tuberculosis—a blood-borne infection, in which 34·6% of the causal organisms were bovine strains.—From the pathological and bacteriological evidence, it is concluded that the focus described as the primary lung lesion is indeed such, and that it is due to direct infection of the lungs through the air passages.
The Surgical Treatment of Pyorrhœa Alveolaris
Authors: Stones H. H.
Published: July 2019

(1) The technique of eradicating the pockets and occasionally trimming the alveolar margin is described. (2) Instruments designed for the operation are illustrated. (3) The whole mouth can be treated at one sitting. (4) The flap operation, in which the gum is reflected before scraping the alveolus and finally sutured, is not advisable. (5) Pyorrhœa can be eradicated by surgical measures in cases favourable for treatment. (6) Recurrence of the disease is due to: ( a) Lack of suitable preliminary treatment. ( b) Insufficient attention to detail when performing the operation. ( c) Lack of suitable post-operative care by dental surgeon or patient. ( d) Selection of cases not suitable for operation.
Calcaneo-Scaphoid Coalition
Authors: Seddon H. J.
Published: July 2019

Calcaneo-scaphoid coalition occurs in a number of forms, having one feature in common, namely, a skeletal abnormality of the calcaneo-scaphoid gap. The condition is congenital, but nothing is known of its causation. Ranking at first as merely an anatomical curiosity, it was later recognized to be frequently associated with spasmodic flat-foot. Probably 25% of all cases of spasmodic flat-foot show this skeletal anomaly in some form or other.

Clinically, this variety of spasmodic flat-foot is indistinguishable from the better-known condition in which the bones are apparently normal. Diagnosis made radiographically; essential that an oblique lateral view of the foot should be taken.

Causal relation of the condition to peroneal spasm.

All the usual forms of treatment employed for the relief of spasmodic flat-foot fail when a calcaneo-scaphoid coalition is present. Resection of the offending bar is of no proven value, but may be worth further trial. If symptoms persist, subastragaloid arthrodesis is necessary.
An Examination of Tropical Neurasthenia
Authors: Culpin Millais
Published: July 2019

The nineteenth century conception of neurasthenia is giving way to a psychological ætiology and classification. Quotations show that the older conception dies hard, and varied physical factors are invoked as causes of tropical neurasthenia.

Australian experience shows the physical factors present without “neurasthenia.” It is suggested that mal-adjustment is not physiological but sociological.

The possibility of psychoneuroses appearing in the guise of tropical diseases.

Effect of selection of personnel in reducing breakdown.

The writer doubts the existence of a neurasthenia special to the tropics, and urges that the use of the phrase “tropical neurasthenia” should be discontinued.