bluuebunny/crossref_metadata_2025 huggingface dataset:
What Predicts a Positive Response to Acupuncture? A Secondary Analysis of Three Randomised Controlled Trials of Insomnia
Authors: Yeung Wing-Fai , Chung Ka-Fai , Yu Yee-Man Branda , Lao Lixing
Published: August 2016

Objective

Few studies have investigated the predictors of the specific and non-specific effects of acupuncture. The aim of this secondary analysis was to determine patient characteristics that may predict a better treatment response to acupuncture for insomnia.

Methods

We pooled the data of three randomised, double-blind, placebo-controlled trials of acupuncture for insomnia to examine sociodemographic variables, clinical characteristics, baseline sleep-wake variables, and treatment expectancy in relation to acupuncture response. Subjects with an improvement in insomnia severity index (ISI) scores of ≥8 points from baseline to 1 week post-treatment were classified as responders. Factors were compared between responders and non-responders, and also by univariate and multivariate logistic regression analysis.

Results

A total of 116 subjects who received traditional needle acupuncture were included, of which 37 (31.9%) were classified as responders. Acupuncture responders had a higher educational level (p<0.01) and higher baseline ISI score (p<0.05), compared to non-responders. In the multivariate logistic regression analysis, only the number of years spent in full-time education remained significant as a predictor of treatment response (OR 1.21, 95% CI 1.06 to 1.38, p<0.01).

Conclusions

Consistent with previous studies, our data suggest that the response to acupuncture is difficult to predict. Although the predictive power of educational level is weak overall, our findings provide potentially valuable information that could be built upon in further research (including a larger sample size), and may help to inform patient selection for the treatment of chronic insomnia with acupuncture in the future.

Trial registration number

ClinicalTrials.gov: #NCT00839592; Results, #NCT00838994; Results, and #NCT01707706; Results.
Association of volunteering with mental well-being: a lifecourse analysis of a national population-based longitudinal study in the UK
Authors: Tabassum Faiza , Mohan John , Smith Peter
Published: August 2016

Objectives

The association of volunteering with well-being has been found in previous research, but mostly among older people. The aim of this study was to examine the association of volunteering with mental well-being among the British population across the life course.

Design

British Household Panel Survey, a population-based longitudinal study.

Setting

UK.

Participants

66 343 observations (person-years).

Main outcome measures

Mental well-being was measured by using the General Health Questionnaire (GHQ-12 or GHQ); high values denote high mental disorder. Four groups of volunteering participation were created: frequent (once a week), infrequent (once a month/several times a year), rare (once or less a year) and never. Multilevel linear models were used to analyse variations in mental well-being over the life course by levels of volunteering.

Results

When not considering age, those who engaged in volunteering regularly appeared to experience higher levels of mental well-being than those who never volunteered. To explore the association of volunteering with the GHQ across the life course, interaction terms were fitted between age and volunteering. The interactions were significant, demonstrating that these associations vary by age. The association between volunteering and well-being did not emerge during early adulthood to mid-adulthood, instead becoming apparent above the age of 40 years and continuing up to old age. Moreover, in early adulthood, the absence of engagement in voluntary activity was not related to mental well-being, but GHQ scores for this group increased sharply with age, levelling off after the age of 40 and then increasing again above the age of 70 years. The study also indicates variation in GHQ scores (65%) within individuals across time, suggesting evidence of lifecourse effects.

Conclusions

We conclude that volunteering may be more meaningful for mental well-being at some points of time in the life course.
Endovascular treatment for AIS with underlying ICAD
Authors: Al Kasab Sami , Almadidy Zayed , Spiotta Alejandro M , Turk Aquilla S , Chaudry M Imran , Hungerford John P , Turner Raymond D
Published: August 2016

Background

Acute large vessel occlusion (LVO) can result from thromboemboli or underlying intracranial atherosclerotic disease (ICAD). Although the technique for revascularization differs significantly for these two lesions (simple thrombectomy for thromboemboli and balloon angioplasty and stenting for ICAD), the underlying etiology is often unknown in acute ischemic stroke (AIS).

Objective

To evaluate whether procedural complications, revascularization rates, and functional outcomes differ among patients with LVO from ICAD or thromboembolism.

Methods

A retrospective review of thrombectomy cases from 2008 to 2015 was carried out for cases of AIS due to underlying ICAD. Thirty-six patients were identified. A chart and imaging review was performed to determine revascularization rates, periprocedural complications, and functional outcomes. Patients with ICAD and acute LVO were compared with those with underlying thromboemboli.

Results

Among patients with ICAD and LVO, mean National Institutes of Health Stroke Scale (NIHSS) score on admission was 12.9±8.5, revascularization (Thrombolysis In Cerebral Infarction, TICI ≥2b) was achieved in 22/34 (64.7%) patients, 11% had postprocedural intracerebral hemorrhage (PH2), and 14/33 (42.4%) had achieved a modified Rankin Scale (mRS) score of 0–2 at the 3-month follow-up. Compared with patients without underlying ICAD, there was no difference in NIHSS on presentation, or in the postprocedural complication rate. However, procedure times for ICAD were longer (98.5±59.8 vs 37.1±34.2 min), there was significant difference in successful revascularization rate between the groups (p=0.001), and a trend towards difference in functional outcome at 3 months (p=0.07).

Conclusions

Despite AIS with underlying ICAD requiring a more complex, technically demanding recanalization strategy than traditional thromboembolic AIS, it appears safe, and good outcomes are obtainable.
Electrophysiology for biomedical engineering students: a practical and theoretical course in animal electrocorticography
Authors: Albarracín Ana L. , Farfán Fernando D. , Coletti Marcos A. , Teruya Pablo Y. , Felice Carmelo J.
Published: August 2016

The major challenge in laboratory teaching is the application of abstract concepts in simple and direct practical lessons. However, students rarely have the opportunity to participate in a laboratory that combines practical learning with a realistic research experience. In the Biomedical Engineering career, we offer short and optional courses to complement studies for students as they initiate their Graduation Project. The objective of these theoretical and practical courses is to introduce students to the topics of their projects. The present work describes an experience in electrophysiology to teach undergraduate students how to extract cortical information using electrocorticographic techniques. Students actively participate in some parts of the experience and then process and analyze the data obtained with different signal processing tools. In postlaboratory evaluations, students described the course as an exceptional opportunity for students interested in following a postgraduate science program and fully appreciated their contents.
Impact of WHO 2010 Guidelines on Antiretroviral Therapy Initiation among Patients with HIV-Associated Tuberculosis in Clinics with and without Onsite HIV Services in the Democratic Republic of Congo
Authors: Yotebieng Marcel , Tabala Martine , Batumbula Marie Louise , Wenzi Landry , Basaki Emmanuel , Mungoyo Eugenie , Mangala Richard , Behets Frieda
Published: August 2016

Background. We assessed the impact of WHO’s 2010 guidelines that removed the requirement of CD4 count before ART, on timely initiation of ART among HIV/TB patients in the Democratic Republic of Congo (DRC).Methods. Data collected to monitor implementation of provider initiated HIV testing and counseling (PITC) and linkage to HIV care from 65 and 13 TB clinics in Kinshasa and Kisangani, respectively, between November 2010 and June 2013.Results. Prior to the WHO’s 2010 guidelines, in Kinshasa, 79.1% (401/507) of HIV/TB patients referred for HIV services were initiated on ART in clinics with onsite ART services compared to 50.0% (63/123) in clinics without. Following the implementation of the new guidelines, 89.8% (714/795) and 93.0% (345/371) of HIV/TB patients referred for HIV services were initiated on ART, respectively, in clinics with onsite and without onsite ART services. Similarly, in Kisangani, 69.7% (53/120) and 36.4% (16/44) in clinics with and without onsite ART service, respectively, were initiated on ART prior to the 2010 guidelines and 88.8% (135/152) and 72.6% (106/146), respectively, after the new guidelines.Conclusion. Though implementation of the 2010 guidelines increased the proportion of HIV/TB patients initiated on ART substantially, it remained below the 100% target, particularly in clinics without onsite ART services.
Prognostic Factors for Visual Outcome in Traumatic Cataract Patients
Authors: Qi Ying , Zhang Yan F. , Zhu Yu , Wan Ming G. , Du Shan S. , Yue Zhen Z.
Published: August 2016

Purpose. To investigate the prognostic factors for visual outcome in traumatic cataract patients.Methods. The demographic features of traumatic cataract patients in Central China were studied. The factors that might influence the visual outcome were analyzed. The sensitivity and specificity of OTS (ocular trauma score) in predicting VA were calculated.Results. The study enrolled 480 cases. 65.5% of patients achieved VA at >20/60. The factors associated with the final VA were initial VA, injury type, wound location, the way of cataract removal, and IOL implantation. The sensitivities of OTS in predicting the VA at NLP (nonlight perception), LP/HM (light perception/hand motion), and ≥20/40 were 100%. The specificity of OTS to predict the final VA at 1/200-19/200 and 20/200-20/50 was 100%.Conclusion. The prognostic factors were initial VA, injury type, wound location, cataract removal procedure, and the way of IOL implantation. The OTS has good sensitivity and specificity in predicting visual outcome in traumatic cataract patients in long follow-up.
Olecranon Bursitis Caused byCandida parapsilosisin a Patient with Rheumatoid Arthritis
Authors: Gamarra-Hilburn Carla F. , Rios Grissel , Vilá Luis M.
Published: August 2016

Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of3.1×103/μL(41% neutrophils, 30% lymphocytes, and 29% monocytes). Fluid culture was positive forCandida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications.
Comparative Pharmacokinetics and Bioavailability of Epimedin C in Rat after Intramuscular Administration of Epimedin C, a Combination of Four Flavonoid Glycosides and Purified Herba Epimedii Extract
Authors: Xu Shunjun , Yu Jiejing , Yang Liu , Zhu Yaling , Sun Shuai , Xu Zhengdi
Published: August 2016

Chuan-Ke-Zhi (CKZ), a purified Herba Epimedii extract, is a potent Chinese medicine preparation whose main bioactive components are a class of flavonoid glycosides such as epimedins A, B, and C and icariin. And epimedin C is far more abundant than other flavones in this extract. This study aims to investigate the pharmacokinetic and bioavailability of epimedin C and what effects, if any, other ingredients in CKZ have on its pharmacokinetics. Epimedin C, CKZ, and a combination of epimedins A, B, and C and icariin were, respectively, administrated to rats, and then the pharmacokinetic parameters of epimedin C in the three groups were calculated and compared. The result indicated thatCLZ,MRT0–∞, andAUC0–∞of epimedin C were significantly different among the three groups (P<0.05), and compared with the epimedin C group, the absorption of epimedin C significantly increased in the CKZ group. Furthermore, in this study the absolute bioavailability of epimedin C was also investigated by comparing intramuscular and intravenous administration of epimedin C. As a result, epimedin C could be quickly absorbed with extremely high absolute bioavailability after intramuscular administration.
An Optimal Stopping Problem for Jump Diffusion Logistic Population Model
Authors: Sun Yang , Ai Xiaohui
Published: August 2016

This paper examines an optimal stopping problem for the stochastic (Wiener-Poisson) jump diffusion logistic population model. We present an explicit solution to an optimal stopping problem of the stochastic (Wiener-Poisson) jump diffusion logistic population model by applying the smooth pasting technique (Dayanik and Karatzas, 2003; Dixit, 1993). We formulate this as an optimal stopping problem of maximizing the expected reward. We express the critical state of the optimal stopping region and the optimal value function explicitly.
On the Linkage between the Extreme Drought and Pluvial Patterns in China and the Large-Scale Atmospheric Circulation
Authors: Zhang Zengxin , Jin Qiu , Chen Xi , Xu Chong-Yu , Jiang Shanshan
Published: August 2016

China is a nation that is affected by a multitude of natural disasters, including droughts and floods. In this paper, the variations of extreme drought and pluvial patterns and their relations to the large-scale atmospheric circulation have been analyzed based on monthly precipitation data from 483 stations during the period 1958–2010 in China. The results show the following:(1)the extreme drought and pluvial events in China increase significantly during that period. During 1959–1966 timeframe, more droughts occur in South China and more pluvial events are found in North China (DSC-PNC pattern); as for the period 1997–2003 (PSC-DNC pattern), the situation is the opposite.(2)There are good relationships among the extreme drought and pluvial events and the Western Pacific Subtropical High, meridional atmospheric moisture flux, atmospheric moisture content, and summer precipitation.(3)A cyclone atmospheric circulation anomaly occurs in North China, followed by an obvious negative height anomaly and a southern wind anomaly at 850 hPa and 500 hPa for the DSC-PNC pattern during the summer, and a massive ascending airflow from South China extends to North China at ~50∘N. As for the PSC-DNC pattern, the situation contrasts sharply with the DSC-PNC pattern.
Bayesian Estimation of Sensitivity and Specificity of Rose Bengal, Complement Fixation, and Indirect ELISA Tests for the Diagnosis of Bovine Brucellosis in Ethiopia
Authors: Getachew T. , Getachew G. , Sintayehu G. , Getenet M. , Fasil A.
Published: August 2016

Test evaluation in the absence of a gold standard test was conducted for the diagnosis and screening of bovine brucellosis using three commercially available tests including RBPT, CFT, and I-ELISA in National Animal Health Diagnostic and Investigation Center (NAHDIC) Ethiopia. A total of 278 sera samples from five dairy herds were collected and tested. Each serum sample was subjected to the three tests and the results obtained were recorded and the test outcomes were cross-classified to estimate the sensitivity and specificity of the tests using Bayesian model. Prior information generated on the sensitivity and specificity of bovine brucellosis from published data was used in the model. The three test-one population Bayesian model was modified and applied using WinBug software with the assumption that the dairy herds have similar management system and unknown disease status. The Bayesian posterior estimate for sensitivity was 89.6 (95% PI: 79.9–95.8), 96.8 (95% PI: 92.3–99.1), and 94 (95% PI: 87.8–97.5) and for specificity was 84.5 (95% PI: 68–94.98), 96.3 (95% PI: 91.7–98.8), and 88.5 (95% PI: 81–93.8) for RBT, I-ELISA, and CFT, respectively. In this study I-ELISA was found with the best sensitivity and specificity estimates 96.8 (95% PI: 92.3–99.1) and 96.3 (95% PI: 91.7–98.8), compared to both CFT and RBPT.
Development of Low-Noise Small-Area 24 GHz CMOS Radar Sensor
Authors: Yoon Min , Ryu Jee-Youl
Published: August 2016

We present a low-noise small-area 24 GHz CMOS radar sensor for automotive collision avoidance. This sensor is based on direct-conversion pulsed-radar architecture. The proposed circuit is implemented using TSMC 0.13 μm RF (radio frequency) CMOS (fT/fmax=120/140 GHz) technology, and it is powered by a 1.5 V supply. This circuit uses transmission lines to reduce total chip size instead of real bulky inductors for input and output impedance matching. The layout techniques for RF are used to reduce parasitic capacitance at the band of 24 GHz. The proposed sensor has low cost and low power dissipation since it is realized using CMOS process. The proposed sensor showed the lowest noise figure of 2.9 dB and the highest conversion gain of 40.2 dB as compared to recently reported research results. It also showed small chip size of 0.56 mm2, low power dissipation of 39.5 mW, and wide operating temperature range of −40 to +125°C.
Pretreatment Lymphocyte Monocyte Ratio Predicts Long-Term Outcomes in Patients with Digestive System Tumor: A Meta-Analysis
Authors: Zhang Jingwen , Chen Lishan , Zhou Rui , Sun Huiying , Liao Yulin , Liao Wangjun
Published: August 2016

Purpose.The prognostic value of pretreatment lymphocyte monocyte ratio (LMR) in digestive system cancer patients remains controversial. The aim of this study was to quantify the prognostic impact of this biomarker and assess its consistency in digestive system tumors.Methods.We searched “PubMed,” “Embase,” and “CBM” for published eligible studies before June 2016 and conducted a meta-analysis to estimate the pooled hazard ratios (HRs) for disease recurrence and mortality focusing on LMR. Subgroup analyses, meta-regression, and sensitivity analyses were also performed.Results.A total of 22 cohort studies enrolling 12829 patients with digestive system cancer were included. The summary results showed that lower LMR was significantly associated with worse overall survival (OS), cancer-specific survival (CSS), and tumor disease or recurrence-free survival (DFS/RFS) in analyses using the studies reporting HRs either by the univariate analyses (HR = 1.32, HR = 1.35, and HR = 1.26 for OS, CSS, and DFS/RFS, resp.) or by multivariate analyses (HR = 1.21, HR = 1.18, and HR = 1.26 for OS, CSS, and DFS/RFS, resp.).Conclusion.Our results support the fact that decreased LMR indicates worse prognosis in multiple digestive system tumors.
RNA Sequencing Identifies Transcriptionally Viable Gene Fusions in Esophageal Adenocarcinomas
Authors: Blum Andrew E. , Venkitachalam Srividya , Guo Yan , Kieber-Emmons Ann Marie , Ravi Lakshmeswari , Chandar Apoorva K. , Iyer Prasad G. , Canto Marcia I. , Wang Jean S. , Shaheen Nicholas J. , Barnholtz-Sloan Jill S. , Markowitz Sanford D. , Willis Joseph E. , Shyr Yu , Chak Amitabh , Varadan Vinay , Guda Kishore
Published: August 2016

Esophageal adenocarcinoma is a deadly cancer with increasing incidence in the United States, but mechanisms underlying pathogenesis are still mostly elusive. In addressing this question, we assessed gene fusion landscapes by comprehensive RNA sequencing (RNAseq) of 55 pretreatment esophageal adenocarcinoma and 49 nonmalignant biopsy tissues from patients undergoing endoscopy for Barrett's esophagus. In this cohort, we identified 21 novel candidate esophageal adenocarcinoma–associated fusions occurring in 3.33% to 11.67% of esophageal adenocarcinomas. Two candidate fusions were selected for validation by PCR and Sanger sequencing in an independent set of pretreatment esophageal adenocarcinoma (N = 115) and nonmalignant (N = 183) biopsy tissues. In particular, we observed RPS6KB1–VMP1 gene fusion as a recurrent event occurring in approximately 10% of esophageal adenocarcinoma cases. Notably, esophageal adenocarcinoma cases harboring RPS6KB1–VMP1 fusions exhibited significantly poorer overall survival as compared with fusion-negative cases. Mechanistic investigations established that the RPS6KB1–VMP1 transcript coded for a fusion protein, which significantly enhanced the growth rate of nondysplastic Barrett's esophagus cells. Compared with the wild-type VMP1 protein, which mediates normal cellular autophagy, RPS6KB1–VMP1 fusion exhibited aberrant subcellular localization and was relatively ineffective in triggering autophagy. Overall, our findings identified RPS6KB1–VMP1 as a genetic fusion that promotes esophageal adenocarcinoma by modulating autophagy-related processes, offering new insights into the molecular pathogenesis of esophageal adenocarcinomas. Cancer Res; 76(19); 5628–33. ©2016 AACR.
Genetic and Methylation-Induced Loss of miR-181a2/181b2 within chr9q33.3 Facilitates Tumor Growth of Cervical Cancer through the PIK3R3/Akt/FoxO Signaling Pathway
Authors: Mei Qian , Li Xiang , Zhang Kang , Wu Zhiqiang , Li Xiaolei , Meng Yuanguang , Guo Mingzhou , Luo Guangbin , Fu Xiaobing , Han Weidong
Published: August 2016

Purpose: Loss of Chr9q31–33 is one of the most common chromosome imbalances of cervical cancer, but the underlying mechanism has not been well documented.

Experimental Design: The loss of heterozygosity (LOH) status of Chr9q31–33 was investigated utilizing 26 microsatellite markers. We detected the expression of miR-181a2/181b2 by qRT-PCR analysis of cervical cancer cell lines and 100 paired tumor samples and corresponding adjacent non-tumor tissues. Kaplan–Meier and Cox proportional hazard regression analyses were performed to identify the prognostic value of miR-181a2/181b2. Regulation of expression was analyzed by methylation-specific PCR. The tumor-suppressing effects of miR-181a2/181b2 were determined in vitro and in vivo. The target gene and signaling pathway that mediated the function of miR-181a2/181b2 were also identified.

Results: Chr9q33.3 was identified as one of the most deleted regions in cervical cancer. Underexpression of miR-181a2/181b2 was detected in 46% of cervical cancer and was induced by the LOH of chr9q33.3 and promoter hypermethylation. Attenuated miR-181a2/181b2 expression predicted a poor prognostic phenotype and advanced clinical stage of cervical cancer. miR-181a2/181b2 prominently dampened cell-cycle progression, suppressed cell growth, and promoted apoptosis of tumor cells in vitro. They also effectively impeded tumor formation and growth in vivo. miR-181a2/181b2 exert the tumor suppressor ability by depressing the direct target PIK3R3 (p55γ) and consequently modulating the PIK3R3/Akt/FoxO signaling pathway.

Conclusions: We demonstrated a cause-and-effect event beginning from loss of chr9q33.3, a frequent event in cervical cancer, to the underexpression of miR-181a2/181b2, leading to the elevated activation of the PI3K pathway. Clin Cancer Res; 23(2); 575–86. ©2016 AACR.
Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial
Authors: Memarpour Mahtab , Dadaein Shorangize , Fakhraei Ebrahim , Vossoughi Mehrdad
Published: August 2016

Early childhood caries, a serious health problem among young children, can be prevented with effective intervention. The aim of this study was to evaluate the efficacy of oral health education and a fluoride varnish in the prevention of caries in children under the age of 3 years. For this single-blind randomized parallel group 1-year clinical trial in Shiraz, 300 children aged 12-24 months with sound primary teeth were selected and randomly divided into three groups (n = 100): (1) control: no preventive intervention; (2) oral health counseling, and (3) oral health counseling and fluoride varnish at baseline and 6 months later. At baseline and 4, 8 and 12 months after the intervention, caries risk reduction was recorded as the primary outcome. The mothers' knowledge and performance regarding oral health in children was used as a secondary outcome. A total of 260 children (mean age: 20.49 ± 7.33 months) completed the study. Compared to group 1, caries risk reduction in group 2 was 28% (95% CI: -39.05 to -17.45) and 31% in group 3 (95% CI: -41.88 to -21.73). However, there was no significant difference between groups 2 and 3 (95% CI: -8.58 to 1.47). In all groups, mothers' knowledge and performance at baseline were low; however, they increased significantly in follow-up appointments in groups 2 and 3 (p < 0.001). Oral health education increased mothers' knowledge and performance regarding oral health in children. Oral health counseling alone or associated with the use of fluoride varnish reduced the caries incidence in young children.
Do Bioimpedance Measurements of Over-Hydration Accurately Reflect Post-Haemodialysis Weight Changes?
Authors: Tangvoraphonkchai Kamonwan , Davenport Andrew
Published: August 2016

Introduction: Bioelectrical impedance spectroscopy (BIS) devices are being used to determine ultrafiltration requirements to achieve target weight for haemodialysis (HD) patients. Pre-dialysis measurements are more convenient for both patients and staff. We wished to compare the changes in pre- and post-dialysis hydration measured by BIS with actual weight loss. Methods: We compared paired BIS measurements made pre and post HD using a BIS device based on a 3-compartmental model, designed to provide information on extracellular water (ECW) excess. Results: BIS was measured in 49 HD patients, 35 male (71.4%) with mean age 67.6 ± 14.2. Weight fell significantly from 69.2 ± 17.8 to 67.6 ± 17.4 kg, and BIS over hydration (OH) from 4.5 ± 3.3.4 to 3.4 ± 2.9 litres, and ECW from 16.8 ± 4.8 to 15.5 ± 4.4 litres, but there was no change in the amount of intracellular water. Weight loss correlated positively with the change in ECW, but exceeded the fall in OH; mean bias -0.58 (95% confidence limits -3.6 to 4.8 kg). Summary: We measured OH pre and post HD, but did not find that the change in OH correlated with changes in body weight. Although there was a correlation between changes in OH and ECW, there was none for weight. Our findings do not support total reliance on pre-dialysis BIS alone for assessing volume status in HD patients, but rather BIS should be considered an aid to clinical assessment of volume status.
Long-Term Outcome of Nephron-Sparing Surgery Compared to Radical Nephrectomy for Renal Cell Carcinoma ≥4 cm - A Matched-Pair Single Institution Analysis
Authors: Kalogirou Charis , Fender Hendrik , Muck Patricia , Hey Valentin , Krebs Markus , Riedmiller Hubertus , Vergho Daniel
Published: August 2016

Purpose: We investigated the long-term oncological and functional outcome of nephron-sparing surgery/partial nephrectomy (PN) versus radical nephrectomy (RN) for any renal cell carcinoma (RCC) ≥4 cm. Patients and Methods: Between 1997 and 2013, we identified 128 patients undergoing PN for RCC ≥4 cm and matched this collective to 128 patients undergoing RN. We then compared overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS) and functional parameters in both groups. The median follow-up time was 58 months (3-210 months). Results: Compared to RN, patients with a PN showed a significantly higher 10-year OS (77.0 vs. 63.0%, p = 0.04), CSS (90.6 vs. 71.7%, p = 0.002) and PFS (82.9 vs. 57.4%, p ≤ 0.001). Renal function preservation was better in the PN group (24 months estimated glomerular filtration rate: 68.2 ml/min for PN vs. 40.6 ml/min for RN, p ≤ 0.01) with significantly less new onset chronic kidney diseases. Total complication rate was comparable, whereas PN procedures showed more Clavien-Dindo grade I + II complications, portraying the technical challenge of PN in larger RCCs. Conclusions: Whenever feasible, PN should be considered for renal masses ≥4 cm, as this technique shows better long-term results regarding disease-specific survival and renal function preservation in our study group.
Influencing Clients in Counterinsurgency: U.S. Involvement in El Salvador's Civil War, 1979–92
Authors: Ladwig Walter C.
Published: August 2016

After a decade and a half of counterinsurgency operations in Iraq and Afghanistan, U.S. policymakers want to change their approach to COIN by providing aid and advice to local governments rather than directly intervening with U.S. forces. Both this strategy and U.S. counterinsurgency doctrine in general, however, do not acknowledge the difficulty of convincing clients to follow U.S. COIN prescriptions. The historical record suggests that, despite a shared aim of defeating an insurgency, the United States and its local partners have had significantly different goals, priorities, and interests with respect to the conduct of their counterinsurgency campaigns. Consequently, a key focus of attention in any future counterinsurgency assistance effort should be on shaping the client state's strategy and behavior. Although it is tempting to think that providing significant amounts of aid will generate the leverage necessary to affect a client's behavior and policies, the U.S. experience in assisting the government of El Salvador in that country's twelve-year civil war demonstrates that influence is more likely to flow from tight conditions on aid than from boundless generosity.
The Origins of Transnational Alliances: Rulers, Rebels, and Political Survival in the Congo Wars
Authors: Tamm Henning
Published: August 2016

Despite their catastrophic proportions, the Congo Wars have received little attention from international relations scholars. At the heart of these conflicts were alliances between rebel groups and neighboring rulers. What are the origins of such transnational alliances, which have been a major feature of nearly all civil wars in post–Cold War Africa? Recent scholarship on external support for rebel groups does not offer a clear answer, either providing long lists of the goals that state sponsors may have or avoiding the question of motives altogether. A focus on political survival reveals that African rulers form alliances with rebels in nearby states to reduce the threats of rebellions and military coups that the rulers themselves face at home. Transnational alliances serve either to weaken a ruler's domestic enemies by undermining their foreign sponsors or to ensure the continued allegiance of key domestic supporters by providing them with opportunities for enrichment. Case studies of the alliance decisions made in the two Congo Wars by the rulers of Angola, Rwanda, Sudan, Uganda, and Zimbabwe show that their struggles for political survival account for why they sided either with their Congolese counterparts or with Congolese rebels.
Inequalities in Higher Education: Applying the Sociology of Basil Bernstein
Authors: Donnelly Michael
Published: August 2016

This article seeks to re-invigorate debate about how we theorise inequalities in higher education. The work of sociologist Basil Bernstein has not yet been brought to bear in this area, despite the affordances it brings in teasing out the implicit rules that perpetuate inequalities in higher education. Drawing on empirical findings from a qualitative study into the impact of university-led ‘outreach’ work in the UK context, the article applies and tests the work of Bernstein. It is argued that his framework offers the analytical precision to expose the implicit rules and principles that underlie young people’s encounters with higher education.
Microbial barrier properties of healthcare professional uniforms
Authors: Rogina-Car Beti , Budimir Ana , Katovic Drago
Published: August 2016

In this study, the microbial barrier properties of textiles for two bacterial endospores were investigated. The reusable hospital textiles (PET/cotton and Tencel®) most commonly recommended for the manufacture of healthcare professional uniforms were tested for microorganism permeability. The three-layer textile laminate PET/PU/PET, which meets the European standards for surgical drapes EN 13795, was used as the reference material in this study. The microbial barrier properties of PET/cotton, Tencel®, PET/PU/PET, and corresponding seams were tested after 1, 10, 20, 30 and 50 washing-and-sterilization cycles. Washing and sterilization were performed by hospital laundry services under strict and controlled conditions. The testing of dry textile materials was conducted under newly developed methods. The most resistant forms of microorganisms of apathogenic bacterial endospores of the Bacillus genus Geobacillus stearothermophilus and Bacillus atrophaeus were used for investigating the microbial barrier permeability of textiles. This research is the first to investigate the permeability of these microorganisms in dry conditions. Additionally, the microbial barrier properties of the seams of these textiles were investigated. Regression analyses were performed and the effects of the seams on microorganism permeability were determined. It can be concluded that the two most commonly used seam types for the manufacture of healthcare uniforms do not have a significant influence on microbial barrier efficacy; however, the seam type 1.01.05/504.504.301 is more suitable for the manufacture of healthcare professional uniforms.
The dyadic construction of romantic conflict recovery sabotage
Authors: Haydon Katherine C. , Jonestrask Cassandra , Guhn-Knight Haley , Salvatore Jessica E.
Published: August 2016

This longitudinal study of 100 couples assessed individual and dyadic processes associated with romantic conflict recovery or how couples behave in the moments following conflict. Couples completed measures of attachment anxiety and avoidance; a conflict discussion during which affect, behavior, and conflict resolution were coded; a cooldown discussion during which post-conflict behavior was coded; and measures of relationship satisfaction and stability one year later. Recovery sabotage (negative behavior and perseveration on conflict in the moments following conflict) was associated with high attachment anxiety and low avoidance. Recovery sabotage was unrelated to affect expressed during conflict and was instead tied to whether partners aired or suppressed grievances. Consistent with the demand–withdraw conflict pattern, recovery sabotage was associated with lower actor conflict avoidance but higher partner conflict avoidance. These effects were independent of conflict resolution, which was not significantly associated with recovery sabotage when other features of conflict were controlled. Recovery sabotage and conflict resolution also differentially predicted satisfaction and stability one year later. Findings suggest recovery sabotage is a distinct, developmentally organized relationship process tied to attachment history and behavioral, rather than affective, transactions between partners during conflict.
‘Sex isn’t better than love’: Exploring South African Indian teenage male and female desires beyond danger
Authors: Bhana Deevia
Published: August 2016

This article analyses how South African Indian teenage men and women conceptualise desire, sex and love, their resistance to and accommodation of gender inequalities within relationship dynamics. It calls attention to a reconceptualisation of childhoods that extends agency to sexuality beyond a preoccupation with sexual danger. By focusing on the diversity of sexual meanings, attention is given to the plurality of childhood sexual experiences among South African Indian teenagers. Finally, the article argues that deeper insight into teenage pleasure and power can sharpen interventions that promote healthy teenage sexualities.
Molecular dynamics simulation study on ablation of silicon by water-jet-guided laser
Authors: Zhou Weiguo , Gong Keyu , Wan Jie , Quan Lulu , Chu Yuchuan , Cao Yong
Published: August 2016

Stillinger–Weber potential and Z-layer energy model were adopted in molecular dynamics simulation to study the ablation of silicon by water-jet-guided femtosecond laser, and comparison was made by ablating silicon with or without water-jet cooling in our simulations. Simulation results indicated that with water-jet cooling, the thermal-affected zone could be reduced in area, and the peak of density could disappear more quickly. It was therefore concluded that water-jet-guided laser could be used to considerably improve the ablation quality of silicon.
Feasibility investigation of large-scale model suspended by cable-driven parallel robot in hypersonic wind tunnel test
Authors: Wang Xiaoguang , Peng Miaojiao , Hu Zhenghong , Chen Yueshi , Lin Qi
Published: August 2016

Cable-driven parallel robot is a special kind of robot, which is actuated by cables. It is already applied in the low speed wind tunnel to get aerodynamic measurement of aircraft model, and the aircraft pose could be adjusted by changing the cable length. Whether it can be used in hypersonic wind tunnel still needs further discussion. This paper presents the dynamics and aerodynamics analysis of a large-scale model supported by 6-DOF cable-driven parallel robot to investigate the feasibility of this special kind of suspension system in hypersonic wind tunnel. The description of this setup with a X-51A-like model is given, and then based on the system dynamic equations, aerodynamic force and stiffness matrix are derived. In the simulation, properties of dynamics and aerodynamics are mainly concerned. A typical shock tunnel with flow duration of about 100 milliseconds is taken as an example, and results show that the system is stable enough to meet the fundamental static wind tunnel test. From the cable tension variation under impact load and the sensitivity analysis, it is likely accessible to derive the aerodynamic forces. Compared with the sting suspension method, cable-driven parallel robot has the priority of higher inherent frequency and more flexible degrees. The interference to the flow field induced by cables is also preliminarily proved to be small by the CFD simulation, which can be acceptable and corrected. Researches conducted show the feasibility of cable-driven parallel robot’s application in hypersonic wind tunnel.
The story of ‘Oh’, Part 1: Indexing structure, animating transcript
Authors: Macbeth Douglas , Wong Jean , Lynch Michael
Published: August 2016

The expression ‘Oh’ in natural conversation is a signal topic in the development of the Epistemic Program (EP). This article attempts to bring into view a sense of place for this simple expression in the early literature, beginning with ‘Oh’ as a ‘change-of-state token’ and through its subsequent treatments in the production of assessments. It reviews them with an interest in two allied developments. One is the rendering of ‘Oh’ as an expression that ‘indexes’ epistemic structure. The other, pursued in the detail of transcript in Part 2, is how, as of this rendering, the literature manages its tasks of ‘animating transcript’, or how we portray ordinary talk as social action. We think these two moves are closely connected within the EP. And we think they yield a very different ‘vocabulary of motives’, different from the natural language studies of conversation analysis (CA). Our discussions address in turn the central phrases of our title.
Safety profile of lamotrigine in overdose
Authors: Alabi Akintunde , Todd Adam , Husband Andrew , Reilly Joe
Published: August 2016

Background:

Lamotrigine is an anticonvulsant as well as a mood stabilizer. Apart from its established use in the treatment of epilepsy, there has been an expansion of its use in the treatment of mental disorders. Patients with epilepsy as well as those with mental disorders are at increased risk of deliberate drug overdoses. An evidence base for the safety profile of lamotrigine in overdose is an essential tool for prescribers. The objective of this study was to carry out a narrative synthesis of the existing evidence for the safety profile of lamotrigine in overdose.

Methods:

A systematic search was conducted of EMBASE (1974 to December 2015), MEDLINE (1946 to December 2015), PsycINFO (1806 to December 2015) and CINAHL (1981 to December 2015) databases. Studies were included in which there was a deliberate or accidental single drug overdose of lamotrigine, with its toxic effects described. Studies that did not involve an overdose were excluded. A narrative synthesis of the described toxic effects was carried out.

Results:

Out of 562 articles identified, 26 studies were included, mainly in the form of case reports and series. The most commonly described toxic effects of lamotrigine were on the central nervous system, specifically seizures, movement disorders and reduced consciousness. Other toxic effects included QTc interval and QRS complex prolongations, hypersensitivity reactions, serotonin syndrome as well as rhabdomyolysis possibly due to seizures and/or agitation. Deaths were recorded in two studies, with cardiovascular and neurological toxic effects described.

Conclusions:

Even though lamotrigine has been reported to be well tolerated, there is a risk of toxic effects which can be life threatening in overdose. This needs to be borne in mind when prescribing to patients at an increased risk of deliberate drug overdose.
Why Do Adults With ADHD Choose Strength-Based Coaching Over Public Mental Health Care? A Qualitative Case Study From the Netherlands
Authors: Schrevel Samuel J. C. , Dedding Christine , Broerse Jacqueline E. W.
Published: August 2016

For this qualitative case study, 23 semistructured interviews were conducted with clients of a private coaching center in the Netherlands. We explored why adults with attention deficit/hyperactivity disorder (ADHD) prefer coaching, which is financed out-of-pocket, over public mental health care and what the perceived added value is for them. The participants highly valued the optimistic strength-based and solution-focused approach, which was contrasted with what they have experienced as a deficit and symptom-centered approach in public mental health care. Coaching was perceived as a joint venture, resulting in a more thorough understanding of how one approaches life and can be better equipped to deal with future problems. This study identified a group of adults with ADHD who feel that their needs are currently unsatisfactorily addressed in public mental health care. Future research should further explore whether this is a specific group of adults or whether these experiences are more common.
Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants
Authors: Hay-Smith E. Jean C. , Brown Melanie , Anderson Lynley , Treharne Gareth J.
Published: August 2016

Background

Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research.

Methods

Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014) for primary studies or first-person reflexive reports of clinician-researchers’ dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB) and independently cross-checked by another (JHS). All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes.

Results

Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences – ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy) and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation). Clinician-researchers use their clinical skills in health research in ways that set up a relationship resembling that of clinician-patient. Clinicians’ ingrained orientation to patients’ needs can be in tension with their research role, and can set up ethical and methodological challenges.

Conclusion

The typology we developed outlines the common ways dual-role is experienced in research involving clinician-researchers and patient-participants, and perhaps the inevitability of the experience given the primacy accorded to patient well-being. The typology offers clinician-researchers a framework for grappling with the ethical and methodological implications of dual-role throughout the research process, including planning, implementation, monitoring and reporting.
Effective elliptic arc selection from connected edge points
Authors: Masuzaki Tomonari , Sugaya Yasuyuki
Published: August 2016

Extracting edge points from an image and fitting ellipses to them is a fundamental technique for computer vision applications. However, since the extracted edge points sometimes contain non-elliptic arcs such as line segments, it is a very difficult to extract only elliptic arcs from them. In this paper, we propose a new method for extracting elliptic arcs from a spatially connected point sequence. We first fit an ellipse to an input point sequence and segment the sequence into partial arcs at the intersection points of the fitted ellipse. Next, we compute residuals of the fitted ellipse for all input points and select elliptic arcs among the segmented arcs by checking the curvatures of the residual graph. Then, we fit an ellipse to the selected arcs and repeat the above process until the selected arcs do not change. By using simulated data and real images, we compare the performance of our method with existing methods and show the efficiency of our proposed method.
Wilson Disease
Authors: Pfeiffer Ronald F.
Published: August 2016

Purpose of Review: This article reviews the clinical features of Wilson disease, focusing on the neurologic and psychiatric abnormalities, and addresses the diagnostic workup and treatment approaches to managing the disease.

Recent Findings: The list of known mutations causing Wilson disease continues to grow, but advances in genetic testing may soon make it feasible to routinely perform genetic testing on individuals suspected of having Wilson disease.

Summary: Wilson disease is a rare genetic disorder with protean manifestations that should be considered in the differential diagnosis of any individual presenting with unexplained neurologic, psychiatric, or hepatic dysfunction. Appropriate diagnostic testing should be expeditiously performed and treatment promptly initiated and maintained since failure to diagnose and treat Wilson disease will result in progressive and ultimately irreversible damage to the neurologic and other systems.
Expect the unexpected
Authors: Morrison Johnpaul
Published: August 2016

What's it like to be a dental nurse in the Royal Army Dental Corps? Johnpaul Morrison talks us through his 11 years
What is a professional?
Authors: Wake Charlotte
Published: August 2016

Charlotte Wake investigates how, for the dental nurse, it's not just a title, it's a way of life