bluuebunny/crossref_metadata_2025 huggingface dataset:
A Statistical Analysis of the Colombo Stock Returns
Authors: Zhang Zili , Nadarajah Saralees
Published: October 2018

We study statistical properties of the daily log returns of the historical stock price indices of the Colombo Stock Exchange in Sri Lanka. We fitted the data by a range of time-series processes. The value at risk of the best model was computed.
Utility of neutrophil gelatinase-associated lipocalin in the management of acute kidney injury: A prospective, observational study
Authors: Işıkkent Ali , Yılmaz Serkan , Özturan İbrahim Ulaş , Doğan Nurettin Özgür , Yaka Elif , Gültekin Haldun , Kum Tuğba , Pekdemir Murat
Published: October 2018

Background:

Utilization of renal biomarkers such as neutrophil gelatinase-associated lipocalin in the management of acute kidney injury may be useful as a diagnostic tool in the emergency department.

Objective:

The aim of this study is to determine the relationship between serum neutrophil gelatinase-associated lipocalin level and the severity of the acute kidney injury based on the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) classification, and to investigate the role of the serum neutrophil gelatinase-associated lipocalin level in differentiating the etiology and predicting the 30-day mortality rate and need for dialysis.

Methods:

This prospective, observational study was conducted from March 2015 to 2016. Adult patients with acute kidney injury in the emergency department were enrolled in the study. Demographic and clinical features such as hypovolemic state, nephrotoxic substance exposure, renal functions, and serum neutrophil gelatinase-associated lipocalin level were evaluated. After the etiology of the acute kidney injury was ascertained, the severity of the acute kidney injury was determined according to RIFLE criteria. Primary outcome was defined as the correlation between serum neutrophil gelatinase-associated lipocalin level and the severity of the acute kidney injury according to RIFLE classification. Secondary outcomes were defined as the relationship between the serum neutrophil gelatinase-associated lipocalin level and the etiology of the acute kidney injury; need for dialysis and 30-day mortality were defined as poor outcomes.

Results:

A total of 87 patients were included in the study. Mean serum neutrophil gelatinase-associated lipocalin levels were 380.14 ± 276.65 ng/mL in RIFLE-R, 425.80 ± 278.99 ng/mL in RIFLE-I, and 403.60 ± 293.15 ng/mL in RIFLE-F groups. There was no statistically significant relationship between the severity of acute kidney injuries and serum neutrophil gelatinase-associated lipocalin level. Initial serum neutrophil gelatinase-associated lipocalin levels in the emergency department did not indicate a statistically significant ability to predict the etiology of acute kidney injury, 30-day mortality rates, or need for dialysis.

Conclusion:

Initial serum neutrophil gelatinase-associated lipocalin level in the emergency department is not a determinant tool for predicting the severity, etiology, 30-day mortality rates, or need for dialysis in cases of acute kidney injuries.
Heightened anxiety state among parents of sick children attending emergency department using State‐Trait Anxiety Inventory
Authors: Embong Hashim , Ting Chiew Yuen , Ramli Muhamad Supi , Harunarashid Husyairi
Published: October 2018

Background:

The anxiety and stress level of both parent and child seeking treatment at the emergency department is assumed to be high. However, it is rarely quantified as to ascertain any need for intervention.

Objective:

The study seeks to quantify anxiety of parents accompanying sick children presenting acutely to the emergency department and to explore possible pre‐visit factors that may contribute to anxiety.

Methods:

A 12‐month cross‐sectional study was conducted at the Emergency Department, Universiti Kebangsaan Malaysia Medical Centre. All parents accompanying a child presenting to the study location, fitting the inclusion and exclusion criteria, were invited to participate. Parents required to fill a self‐administered questionnaire on anxiety, State‐Trait Anxiety Inventory and any related factors that can influence anxiety.

Results:

A total of 233 subjects were recruited. The mean state anxiety score was 53.48 ± 11.36, compared to the mean score for trait anxiety of 39.85 ± 7.66, suggesting a heightened state of anxiety. Majority of subjects (65.7%) had reported clinically detected anxiety as defined by state anxiety score above 49. There was no significant association between parental anxiety level with pre‐visit factors: children's age, duration of illness, the presence of co‐morbidities, time of presentation, prior medical contact and primary care referral. The child's state of illness was the dominant psychosocial factor associated with parental anxiety reported by the subjects.

Conclusion:

Parental anxiety upon arrival appeared to be significantly higher than expected, suggesting intervention may be needed.
Pathology of blackleg in cattle in California, 1991–2015
Authors: Abreu Camila C. , Blanchard Patricia C. , Adaska John M. , Moeller Robert B. , Anderson Mark , Navarro Mauricio A. , Diab Santiago S. , Uzal Francisco A.
Published: October 2018

Blackleg is an infectious disease of cattle and rarely other ruminants, produced by Clostridium chauvoei and characterized by necrotizing myositis. In most cases of blackleg, the large muscles of the pectoral and pelvic girdles are affected, with other skeletal muscles and the heart involved less frequently. We studied 29 blackleg cases selected from the archives of the California Animal Health and Food Safety Laboratory, 1991–2015. Immunohistochemistry was also evaluated to detect C. chauvoei in formalin-fixed, paraffin-embedded (FFPE) tissues of cattle. Nineteen animals had gross and/or microscopic lesions in both skeletal muscle and heart, 9 had lesions in the skeletal musculature alone, and 1 in the heart alone. Gross lesions in the skeletal musculature involved the following muscle groups: hindquarters ( n = 8), forequarters ( n = 5), neck ( n = 5), lumbar area ( n = 3), brisket ( n = 2), diaphragm ( n = 2), abdominal wall ( n = 1), thoracic wall ( n = 1), and tongue ( n = 1). Of the 20 animals that had lesions in the heart, 11 had pericarditis and myocarditis; 7 had pericarditis, myocarditis, and endocarditis; and 1 each had pericarditis and myocarditis. Immunohistochemistry was 100% sensitive to detect C. chauvoei in FFPE skeletal muscle and/or heart of cattle with blackleg. Simultaneous lesions in skeletal musculature and heart were relatively common in blackleg cases in California; the most affected skeletal muscles were those of the hindlimbs.
Impact of Culture on the Pursuit of Beauty: Evidence from Five Countries
Authors: Madan Shilpa , Basu Shankha , Ng Sharon , Ching Lim Elison Ai
Published: October 2018

Human beings have always coveted beautiful objects, but the desire to look good is reaching new heights worldwide. Although the pursuit of beauty appears universal, industry evidence suggests that it is particularly strong in Asia. This research examines the effect of culture on the pursuit of beauty. Three studies provide converging evidence that interdependent self-construal increases the likelihood of using appearance-enhancing products. Study 1 operationalizes culture through nationality and self-construal and shows that Easterners (more interdependent) are more likely to use appearance-enhancing products than Westerners (less interdependent). This use is driven by interdependents’ tendency to conform to societal norms, which in turn leads to heightened self-discrepancy (Study 2). The use of appearance-enhancing tools helps minimize this discrepancy. Study 3 shows that strength of norms moderates the impact of interdependence on the use of appearance-enhancing tools. When norms are loosely defined and adherence is not strictly enforced, interdependents’ appearance enhancement tendency is reduced. This research offers actionable insights into the pursuit of beauty, marketing of beauty brands, policy making, and consumer well-being.
A Survey on the Awareness and Attitude of Physicians on Direct Oral Anticoagulants in Qatar
Authors: El-Bardissy Ahmed , Elewa Hazem , Mohammed Shaban , Shible Ahmed , Imanullah Rizwan , Mohammed Abdul Moqeeth
Published: October 2018

Direct oral anticoagulants (DOACs) are more commonly prescribed since their introduction. Reports on inappropriate prescribing have been observed which may indicate poor awareness on these agents. In this study, we aim to evaluate the extent of the physicians’ knowledge on DOACs and its possible impact on physicians’ confidence to prescribe these medications. A prospective cross-sectional survey was developed based on the literature review. Eligible participants were physicians and surgeons currently practicing at Hamad General Hospital in Qatar. The survey included questions on demographic and professional characteristics. It also evaluated the awareness and attitudes regarding safety, efficacy, and prescribing of DOACs. Over 6-month period, 175 practitioners responded to the survey. Overall awareness score was moderate (61% ± 18%). These scores were in alignment with participants’ self-satisfaction with knowledge on DOACs (66% were not satisfied) and participants’ confidence toward prescribing DOACs (48% were not confident). Age, degree of education, and years of experience had significant positive influence on awareness score. This survey indicates that practitioners have moderate awareness on DOACs. Future work should focus on reassessing practitioners’ knowledge after providing well-designed education campaigns
The Influence of Masculinity on Male Latino Adolescents’ Perceptions Regarding Dating Relationships and Dating Violence
Authors: Haglund Kristin , Belknap Ruth Ann , Edwards Lisa M. , Tassara Marcel , Hoven James Van , Woda Aimee
Published: October 2018

In the United States, teen dating violence (TDV) is a concern across ethnic groups. Attitudes and correlates of violence differ by gender, culture, and acculturation. This study used a qualitative interpretive approach. Data were obtained in focus groups with 23 Latino male adolescents. Themes reflected contexts of participants’ lives, and definitions and nature of dating relationships and TDV. Participants described the importance of respecting dating partners, the destructive effects of TDV, and the pressure to display masculinity that can lead some young men to perpetrate TDV. These results may advance culturally relevant interventions to promote healthy relationships and prevent dating violence.
Effectiveness of a Psychiatric–Mental Health Nurse Residency Program on Retention
Authors: Pelletier Luc R. , Vincent Chandra , Woods Loralie , Odell Cheryl , Stichler Jaynelle F.
Published: October 2018

BACKGROUND: Nurse residency programs (NRPs) provide new graduate nurses (NGNs) with social support and experiential activities as a formal transition to clinical practice. AIMS: The study was conducted to answer the question: What is the effectiveness of an NRP in retaining NGNs in a psychiatric–mental health setting? METHOD: This study used a quantitative time-sequenced comparative study of multiple cohorts of NGNs hired into an NRP at a freestanding hospital in California. RESULTS: The study yielded a turnover rate of 11.7% in Year 1 (88.3% retention) and 2.9% in Year 2 (97.1% retention rate), which are lower than reported turnover rates (17.5% and 33.5%, respectively). Significant correlations are described in the workplace domains of knowledge and skills, social support, organizational citizenship behavior, civility, coping self-efficacy, organizational and occupational commitment, person–organizational fit, and burnout. CONCLUSIONS: NRPs are effective in attracting and retaining competent, confident NGNs in psychiatric–mental health nursing.
Current status of dialysis and vascular access in Taiwan
Authors: Chen Chun-Fan , Chen Fu-An , Lee Tsung-Lun , Liao Li-Feng , Chen Cheng-Yen , Tan Ann Charis , Chan Chia-Hao , Lin Chih-Ching
Published: October 2018

Due to the implementation of the National Health Insurance system in 1995, the number of patients receiving maintenance dialysis has increased rapidly. This contributed to Taiwan to be in an unfortunate position of possessing the highest prevalence of end-stage renal disease globally. Although the age-standardized incidence of end-stage renal disease gradually decreased to −1.1% in 2014, the huge economic burden that comes with dialysis is detrimental to the quality of dialysis treatment. To achieve a balance between economy and quality of care requires multidisciplinary cooperation. Through a variety of chronic kidney disease–related care projects, we have gradually reversed this situation and achieved good results. Further promotion of kidney transplantation and hospice care for terminal patients will improve the situation. With respect to vascular access, the “fistula first” policy is carried out and percutaneous transluminal angioplasty is the mainstay of treatment to resolve vascular access dysfunction. The medical expenses for dialysis and vascular access management are both fully paid for by the National Health Insurance, and patients do not have to worry about the medical expenses. However, the statistics and vascular access monitoring are relatively insufficient in the past. The comprehensive integration of vascular access management into public policy related to kidney disease will complete the missing piece of the puzzle of overall care.
Lost in translation: Problematizing the localization of transnational activism
Authors: Minami Daisuke
Published: October 2018

Existing studies on human rights change posit that activists use transnational networks to organize global and local movements against governments. However, this explanation assumes that international rights claims gain local support and underestimates how difficult it could be for activists to translate global movements into local movements. I address this issue by proposing three mechanisms through which activists face such difficulties and fail to pressure governments. First, misrepresentation occurs when international organizations accept and support activists who do not represent local voices and cannot get local support for their rights claims. Second, misperception happens when activists introduce global norms into local debates but local audiences, unfamiliar with these “foreign” concepts, misperceive them and thus do not support international rights claims. Third, mismatch occurs when pre-existing local movements mistakenly use international rights claims for their own goals, lead local discussions, and overshadow transnational activism. Due to these problems of misrepresentation, misperception, and mismatch, activists may fail to localize their transnational activism. This, in turn, makes it difficult to realize their claims at home. I demonstrate my argument by analyzing the indigenous peoples’ movements in Japan, tracing the success and failure of Ainu and Okinawan activists to domesticate the global indigenous peoples’ movement.
Adoptive parents’ experiences of dyadic developmental psychotherapy
Authors: Wingfield Megan , Gurney-Smith Ben
Published: October 2018

Dyadic developmental psychotherapy (DDP) is an attachment-focused therapy frequently used with adoptive and foster families. While the evidence base for DDP is building, national guidance has called for further trials and qualitative evidence. This study aimed to understand the experience of adoptive parents who have completed DDP therapy. Semi-structured interviews with 12 adoptive parents were analysed using interpretative phenomenological analysis. Four superordinate themes were identified: (1) increased understanding, (2) ‘It’s a different method of parenting generally’, (3) the DDP journey and (4) ‘It’s a shared kind of experience you go through and come out together’. Parents felt they had increased insight into their child’s mind and how to better support their child. They felt DDP was a good fit to their unique situations and it appeared to promote acceptance. The DDP journey started with parents feeling uncertainty and questioning the effectiveness of DDP. However, generally parents became committed to the therapy once they saw change and expressed fear and sadness at ending. Parents acknowledged the dyadic nature of DDP, feeling it helped build trust and security and supported co-regulation. Parents also acknowledged the therapist’s role in conveying the core DDP principles. Further implications for practice and research are highlighted.
‘Life has actually become more clear’: An examination of resilience among LGBTQ young adults
Authors: Schmitz Rachel M , Tyler Kimberly A
Published: October 2018

Though lesbian, gay, bisexual, transgender and queer (LGBTQ) young adults in the USA experience identity-based adversities, they also develop resilience. Research overemphasizes these young people's risks without fully considering their unique social environments. This study documents how LGBTQ young people subjectively and contextually interpret arduous life experiences. Based on 46 LGBTQ young adults aged 19–26 who are either homeless or attending college, we examine how LGBTQ young people with diverse contextual life situations develop understandings of resilience. Findings underscore nuanced processes young people use to reframe their identity-related challenges that enrich their lives in meaningful, resilience-building ways.
The social silos of journalism? Twitter, news media and partisan segregation
Authors: Wihbey John , Joseph Kenneth , Lazer David
Published: October 2018

The present work proposes social media as a tool to understand the relationship between journalists’ social networks and the content they produce. Specifically, we ask, “what is the association between the partisan nature of the accounts journalists follow on Twitter and the news content they produce?” Using standard text scaling techniques, we analyze partisanship in a novel dataset of more than 300,000 news articles produced by 644 journalists at 25 different US news outlets. We then develop a novel, semi-supervised model of partisanship of Twitter following relationships and show a modest correlation between the partisanship of whom a journalist follows on Twitter and the content she produces. The findings provide insight into the partisan dynamics that appear to characterize the US media ecosystem in its broad contours, dynamics that may be traceable from social media networks to published stories.
Ethnographic toolkit: Strategic positionality and researchers’ visible and invisible tools in field research
Authors: Reyes Victoria
Published: October 2018

For many, reflexivity is a core tenet in qualitative research. Often, scholars focus on how one or two of their socio-demographic traits compare to their participants and how it may influence field dynamics. Research that incorporates an intersectionality perspective, which brings attention to how people’s multiple identities are entwined, also has a long history. Yet, researchers tend to pay less attention to how we strategically draw on our multiple social positions in the course of field work. Drawing on data I have collected over the past several years and extending recent sociological work that goes beyond a reflexive accounting of one or two of researchers’ demographic characteristics, I argue that each researcher has their own ethnographic toolkit from which they strategically draw. It consists of researchers’ visible (e.g. race/ethnicity) and invisible tools (e.g. social capital) and ties qualitative methodologies to research on how culture is strategically and inconsistently used.
Dioquis: Being without doing in the migrant agricultural labor process
Authors: Griesbach Kathleen
Published: October 2018

Being on call without being on the clock is an important but underappreciated source of insecurity among low-wage workers. Drawing on fieldwork with 20 agricultural workers of the Texas-Mexico border region, this paper identifies several stages where workers are made to wait without pay and links these stages to economic precarity. These intervals occur at the local bus station, a hub for recruitment and departure, at home in both the US and Mexico, during travel to distant work sites, and in seasonal lodging. Workers use the Spanish colloquial term ‘ dioquis’, which they define as ‘being without doing’, to describe such uncertain periods of waiting which are required for them to work. Through dioquis, a liminal state, employers displace industry risk onto workers, leading to long-term instability. Expanding the implications of dioquis, the paper reveals the significance of temporal uncertainty for the marginalized across other contexts of work and waiting.
Response to Greckhamer et al (2018): Studying configurations with qualitative comparative analysis
Authors: Miller Danny
Published: October 2018

I agree with the majority of the points made by Greckhamer et al. some of which echo and address the concerns raised in my essay. However, the authors on their pages 5–6 may have misinterpreted several of my critiques and recommendations and so it is worth providing some clarification.
The major educational policies, models and ideas that have influenced Botswana’s education system
Authors: Bagwasi Mompoloki Mmangaka
Published: October 2018

Botswana’s education system, like many other African systems, is greatly influenced by western educational ideas and models. This article reviews Botswana’s education system by examining the policies, models and ideas that have influenced its development. Specifically, the review involves tracing the development of the education system of Botswana from the pre-colonial era to the present and highlighting the educational ideas and models in use at each stage. Since most of the educational ideas are based on western models, the article seeks whatever Platonic underpinnings that might belie these ideas. This is because Plato is considered to be one of the greatest thinkers of all time whose ideas on education are pervasive. His ideas have influenced western education systems as well as modern intellectual and educational thinking.
Sorted for Memes and Gifs: Visual Media and Everyday Digital Politics
Authors: Dean Jonathan
Published: October 2018

This article identifies an unease, or even squeamishness, in the way in which political science addresses social media and digital politics, and argues that we urgently need to avoid such squeamishness if we are to adequately grasp the texture and character of contemporary digitally mediated politics. The first section highlights some of the methodological assumptions that underpin this squeamishness. Section ‘Visual Culture and the “Memeification” of Politics’, drawing on a recent research project on the changing shape of the British left, highlights a number of key trends in digital politics which deserve more attention from political scientists. In particular, I stress the ways in which politics is enacted in and through visual media such as gifs, memes and other forms of shareable visual content. Section ‘Re-Orienting the Study of Digital Politics’ then mines recent literature in media and communication studies to highlight a range of conceptual and methodological approaches that might be better able to capture the contours of these emergent forms of digitally mediated politics. In the section ‘The Pleasures and Passions of Socially Mediated Politics: Towards a Research Agenda’, I articulate a possible research agenda. Overall, I encourage political scientists to see the production and exchange of digital visual media not as some frivolous activity on the margins of politics, but as increasingly central to the everyday practices of politically engaged citizens.
Aortic Remodeling After Total Endovascular Aortic Repair With Multilayer Stents: Computational Fluid Dynamics Analysis of Aortic Remodeling Over 3 Years of Follow-up
Authors: Costache Victor S. , Yeung Kak K. , Solomon Crina , Popa Radu , Melnic Tatiana , Sandu Mihai , Bucurenciu Cristian , Candea Gabriela , Santa Adrian , Costache Andreea
Published: October 2018

Purpose: To report Multilayer Flow Modulator (MFM) implantation from the sinotubular junction to the distal infrarenal aorta in the treatment of type B aortic dissection (TBAD) and demonstrate aortic remodeling using computational fluid dynamics (CFD) analysis over the course of 3-year follow-up. Case Report: A hypertensive patient with complicated TBAD required thoracic endovascular aortic repair due to severe thoracic pain associated with rapid progression of the false lumen aneurysm toward the distal aortic arch. Under general anesthesia, 2 aortic multilayer stents were placed over a 0.035-inch stiff guidewire in the compressed true lumen. The aorta was covered with 2 MFM stents between the sinotubular junction and the distal infrarenal aorta. Serial computed tomography scans showed progressive remodeling of the entire dissected aortic wall, with an excellent result at 24 months. Morphological and CFD vascular analysis confirmed the aortic remodeling, with a false lumen index drop from a preoperative 4.04 to 0.01 at 36 months. Conclusion: Endovascular aortic repair with multilayer stents is a promising treatment for complicated TBAD due to the unique ability of these devices to stabilize the entire aortic wall without compromising the flow in the major aortic side branches.
Aortic Lumen Area Is Increased in Ruptured Abdominal Aortic Aneurysms and Correlates to Biomechanical Rupture Risk
Authors: Siika Antti , Lindquist Liljeqvist Moritz , Hultgren Rebecka , Gasser T. Christian , Roy Joy
Published: October 2018

Purpose: To investigate how 2-dimensional geometric parameters differ between ruptured and asymptomatic abdominal aortic aneurysms (AAAs) and provide a biomechanical explanation for the findings. Methods: The computed tomography angiography (CTA) scans of 30 patients (mean age 77±10 years; 23 men) with ruptured AAAs and 60 patients (mean age 76±8 years; 46 men) with asymptomatic AAAs were used to measure maximum sac diameter along the center lumen line, the cross-sectional lumen area, the total vessel area, the intraluminal thrombus (ILT) area, and corresponding volumes. The CTA data were segmented to create 3-dimensional patient-specific models for finite element analysis to compute peak wall stress (PWS) and the peak wall rupture index (PWRI). To reduce confounding from the maximum diameter, 2 diameter-matched groups were selected from the initial patient cohorts: 28 ruptured AAAs and another with 15 intact AAAs (diameters 74±12 vs 73±11, p=0.67). A multivariate model including the maximum diameter, the lumen area, and the ILT area of the 60 intact aneurysms was employed to predict biomechanical rupture risk parameters. Results: In the diameter-matched subgroup comparison, ruptured AAAs had a significantly larger cross-sectional lumen area (1954±1254 vs 1120±623 mm2, p=0.023) and lower ILT area ratio (55±24 vs 68±24, p=0.037). The ILT area (2836±1462 vs 2385±1364 mm2, p=0.282) and the total vessel area (3956±1170 vs 4338±1388 mm2, p=0.384) did not differ statistically between ruptured and intact aneurysms. The PWRI was increased in ruptured AAAs (0.80 vs 0.48, p<0.001), but the PWS was similar (249 vs 284 kPa, p=0.194). In multivariate regression analysis, lumen area was significantly positively associated with both PWS (p<0.001) and PWRI (p<0.01). The ILT area was also significantly positively associated with PWS (p<0.001) but only weakly with PWRI (p<0.01). The lumen area conferred a higher risk increase in both PWS and PWRI when compared with the ILT area. Conclusion: The lumen area is increased in ruptured AAAs compared to diameter-matched asymptomatic AAAs. Furthermore, this finding may in part be explained by a relationship with biomechanical rupture risk parameters, in which lumen area, irrespective of maximum diameter, increases PWS and PWRI. These observations thus suggest a possible method to improve prediction of rupture risk in AAAs by measuring the lumen area without the use of computational modeling.
Working Mothers Represent: How Children Affect the Legislative Agenda of Women in Congress
Authors: Bryant Lisa A. , Marin Hellwege Julia
Published: October 2018

Issues and policies pertaining to children and families are often labeled “women’s issues” and assumed to be on the radar of all women, but we argue that they are more salient for mothers, particularly working mothers, than for other women. This study examines the role of motherhood as an identity for women in Congress by looking at the introduction of bills that affect children and families from 1973 through 2013. We define working mothers as women who have children below 18 years of age at home while they are in office, as opposed to those who have adult children or no children. Our findings show that Congressional working mothers are more likely to introduce legislation that address issues specific to parents and children. We also find that legislation specifically dealing with children’s health and welfare is more likely to be introduced by members with children than those without.
Adamantane/Cucurbituril: A Potential Pretargeted Imaging Strategy in Immuno-PET
Authors: Strebl Martin G. , Yang Jane , Isaacs Lyle , Hooker Jacob M.
Published: October 2018

Positron emission tomography (PET) imaging with biological macromolecules greatly expands the possibilities of molecular imaging. There are, however, practical aspects limiting the potential of the approach, including the dosimetric consequences of the slow kinetics of radiolabeled biomacromolecules. Pretargeting strategies have led to impactful improvements in the field but are themselves limited by shortcomings of available bioconjugation methodology. We report our initial findings concerning the suitability of the adamantane/cucurbit[7]uril system for pretargeted immuno-PET imaging and provide proof-of-concept PET/computed tomography imaging experiments to establish the stability and rapid formation of host–guest complexes in vivo. The adamantane/cucurbit[7]uril system itself without antibody conjugation has shown remarkably fast association kinetics and clearance in vivo. We further demonstrate the modulation of biodistribution achievable by cucurbituril complexation with relevance for pharmaceutical formulation as well as the radiosynthetic access to relevant reporter molecules labeled with 11C or 18F. This work, an early proof-of-concept, supports the notion that the adamantane/cucurbit[7]uril system warrants further exploration in pretargeted PET imaging applications.
A local algorithm to approximate the global clustering of streams generated in ubiquitous sensor networks
Authors: Rodrigues Pedro Pereira , Araújo João , Gama João , Lopes Luís
Published: October 2018

In ubiquitous streaming data sources, such as sensor networks, clustering nodes by the data they produce gives insights on the phenomenon being monitored. However, centralized algorithms force communication and storage requirements to grow unbounded. This article presents L2GClust, an algorithm to compute local clusterings at each node as an approximation of the global clustering. L2GClust performs local clustering of the sources based on the moving average of each node’s data over time: the moving average is approximated using memory-less statistics; clustering is based on the furthest-point algorithm applied to the centroids computed by the node’s direct neighbors. Evaluation is performed both on synthetic and real sensor data, using a state-of-the-art sensor network simulator and measuring sensitivity to network size, number of clusters, cluster overlapping, and communication incompleteness. A high level of agreement was found between local and global clusterings, with special emphasis on separability agreement, while an overall robustness to incomplete communications emerged. Communication reduction was also theoretically shown, with communication ratios empirically evaluated for large networks. L2GClust is able to keep a good approximation of the global clustering, using less communication than a centralized alternative, supporting the recommendation to use local algorithms for distributed clustering of streaming data sources.
Determination of No-Observed-Adverse-Effect Level Ammonia in White Mice Through CD4 Expression
Authors: Tualeka Abdul Rohim , Faradisha Jihan , Maharja Rizky
Published: October 2018

Background:

Ammonia is one of the chemical compounds that can cause acute and chronic effects to the workers. The purpose of this study is to determine the no-observed-adverse-effect level (NOAEL) ammonia in white mice.

Methods:

This study applied a laboratory experimental with design post test-only control group design using white mice as an object. The process of finding the safe limit began by determining the highest dose and the lowest dose of ammonia without effect in white mice.

Results:

The latest research showed that the highest dose without effect is 0.0456 mg/kg and the lowest dose without effect is 0.0046 mg/kg. After determining the highest and the lowest dose of ammonia, the researcher started to determine the middle dose. The middle dose is the dose between the highest and the lowest doses with the multiplication of 1.5 starting from the lowest dose (there are 5 middle-dose variations from 5 middle concentration variations), consisting of 0.0872, 0.1309, 0.1963, 0.2944, and 0.4416 mg/m3.

Conclusion:

From the result of the middle dose and the lowest dose without effect, it is found the value of the highest NH3 dose without effect, which showed the highest Index Remmele Scale (IRS) CD4 before the reduction of IRS. The study concludes that the NOAEL of ammonia contained in white mice is 0.0103 mg/kg body weight of the mice.
A model-free control method for estimating the joint angles of the knee exoskeleton
Authors: Zhang Yan , Wang Jianzhou , Li Wei , Wang Jie , Yang Peng
Published: October 2018

This article describes a model-free adaptive control method for knee joint exoskeleton, which avoids the complexity of human–exoskeleton modeling. An important feature of the proposed controller is that it uses the input and output data of the knee joint angle to control the exoskeleton. Furthermore, discrete sliding mode control law and prior torque are introduced to improve the accuracy and robustness of the system. Prior torque of knee joint is obtained through the walking simulation of human–exoskeleton modeling. Specially, the experiment is carried out by using the co-simulation automatic dynamic analysis of mechanical systems and MATLAB. Data from these assessments indicate that the proposed strategy enables the knee exoskeleton to track the trajectory of angle well and has a good performance on walking assistance.
Mepolizumab in the management of severe eosinophilic asthma in adults: current evidence and practical experience
Authors: Emma Rosalia , Morjaria Jaymin B. , Fuochi Virginia , Polosa Riccardo , Caruso Massimo
Published: October 2018

Asthma is a chronic inflammatory condition involving the airways with varying pathophysiological mechanisms, clinical symptoms and outcomes, generally controlled by conventional therapies including inhaled corticosteroids and long-acting β2 agonists. However, these therapies are unable to successfully control symptoms in about 5–10% of severe asthma patients. Atopic asthma, characterized by high immunoglobulin (Ig)E or eosinophilia, represents about 50% of asthmatic patients. Interleukin (IL)-5 is the main cytokine responsible of activation of eosinophils, hence therapeutic strategies have been investigated and developed for clinical use. Biologics targeting IL-5 and its receptor (first mepolizumab and subsequently, reslizumab and benralizumab), have been recently approved and used as add-on therapy for severe eosinophilic asthma resulting in a reduction in the circulating eosinophil count, improvement in lung function and exacerbation reduction in asthma patients. Despite these biologics having been approved for stratified severe asthma patients that remain uncontrolled with high doses of conventional therapy, a number of patients may be eligible for more than one biologic. Presently, the lack of head-to-head studies comparing the biological agents among themselves and with conventional therapy make the choice of optimal therapy for each patient a challenge for clinicians. Moreover, discontinuation of these treatments, implications for efficacy or adverse events, in particular in long-term treatment, and needs for useful biomarkers are still matters of debate. In this review we evaluate to date, the evidence on mepolizumab that seems to demonstrate it is a well-tolerated and efficacious regimen for use in severe eosinophilic asthma, though more studies are still required.
Afatinib in the first-line treatment of patients with non-small cell lung cancer: clinical evidence and experience
Authors: Ricciuti Biagio , Baglivo Sara , De Giglio Andrea , Chiari Rita
Published: October 2018

Epidermal growth factor receptor ( EGFR) gene mutations identify a molecularly defined subset of non-small cell lung cancer (NSCLC) patients who display an excellent sensitivity to EGFR tyrosine kinase inhibitors (TKIs). First-generation reversible EGFR TKIs, gefitinib and erlotinib have been proven to improve the objective response rate and to prolong the progression-free survival compared with standard chemotherapy in large phase III trials. Unfortunately, virtually all patients develop resistance to treatment, usually within 9–12 months. Afatinib is an irreversible ErbB family inhibitor initially designed to overcome the development of resistance. Compared with gefitinib in a first-line setting, afatinib prolonged progression-free survival and time to treatment failure, without impacting on overall survival in the general population of EGFR-mutant patients. However, afatinib has been shown to prolong overall survival in the subset of patients with an EGFR exon 19 deletion compared with chemotherapy. The aim of this review is to summarize the clinical evidence available to date and to critically discuss the place in therapy of afatinib in the rapidly expanding landscape of EGFR-mutant NSCLC first-line therapy.
Criteria for indication and treatment modification in a cohort of patients with prostate cancer treated with hormone therapy
Authors: Lebret Thierry , Ruffion Alain , Latorzeff Igor , Zerbib Marc , Moreau Jean-Luc , Rossi Dominique , Pello-Leprince-Ringuet Nathalie , Perrot Valérie , Hennequin Christophe
Published: October 2018

Background:

No published studies have specifically assessed whether treatment modifications to androgen deprivation therapy (ADT) for prostate cancer (PCa) are frequently carried out in routine clinical practice. The current study was conducted to determine what proportion of patients who had initiated hormone therapy with a gonadotropin-releasing hormone (GnRH) analogue then had their treatment regimen modified during the first 24 months.

Methods:

A prospective, noninterventional study was carried out in routine clinical practice in France. Patients with locally advanced or metastatic PCa were followed up for 2 years after treatment initiation with a GnRH analogue. The primary endpoint was the proportion of patients with a modification to their initial hormone therapy.

Results:

In total, 1301 patients were enrolled into the study by 204 physicians, and the primary endpoint could be evaluated for 891 patients. The GnRH analogue treatment was initiated for metastatic PCa (24.2%), locally advanced PCa without planned local treatment (20.6%), locally advanced PCa in association with radiotherapy (31.6%), and biochemical recurrence after local treatment (21.4%). Hormonal treatment was modified in 43.8% (390/891) of patients during the 24-month follow-up period after GnRH analogue initiation. In 61.3% of cases (239/390), the type of modification involved a change of GnRH analogue formulation or switch to another GnRH analogue. A total of five significant predictive factors for GnRH analogue treatment modification were identified: metastatic stage; physician sector; physician speciality; presence or absence of urinary symptoms; and intermittent versus continuous ADT.

Conclusions:

This study shows that in 43.8% of the patients with advanced PCa, ADT is modified in the first 2 years after initiation in routine clinical practice. Predictive factors for alteration of ADT were metastatic stage and the choice of an intermittent schedule.
Help is close at hand? Proximity and the effectiveness of peacekeepers
Authors: Goldring Edward , Hendricks Michael
Published: October 2018

How do the national origins of peacekeepers influence peacekeeping operations’ success? We argue that peacekeeping operations better protect civilians when a higher percentage of peacekeepers come from geographically proximate countries. These peacekeepers have been exposed to similar societal and cultural norms and are more invested in preventing conflict diffusion. Peacekeepers from proximate countries can better collect and analyze intelligence, are more effective at separating combatants, and are therefore more successful at protecting civilians. In making this argument, we also challenge the theory that diversity in a peacekeeping operation matters. We find support for both our mechanisms and show that the importance of diversity may have been overstated. Where a peacekeeping operation is present in civil conflicts, if a quarter of its personnel come from proximate countries, then all things being equal, it would completely prevent civilians dying. The results show policymakers the importance of recruiting peacekeepers from countries near to conflicts.
Managing vulvovaginal atrophy after breast cancer
Authors: Sassarini Jenifer , Perera Mahesh , Spowart Keith , McAllister Kay , Fraser Judith , Glasspool Ros , Harrand Rosie , Chitoni Marina , Stallard Sheila , Lumsden Mary-Ann
Published: October 2018

Cancer treatment may result in loss of ovarian function through surgical removal of the ovaries, chemotherapy or radiation. While menopausal symptoms, such as hot flushes, night sweats, sleep disturbance, memory concerns and mood issues can be extremely bothersome to some women going through menopause naturally, women who undergo an induced menopause usually experience more sudden and severe symptoms. Pain and vaginal dryness can occur whether a woman has a sexual partner or not. In women with breast cancer, the aetiology of impaired sexual functioning, and lowered sexual desire, is often multifactorial, and may be related to physical and/or psychological reasons. Pain and vaginal dryness in women without a history of breast cancer can usually be safely treated with vaginal estrogens, in the form of a cream, pessary or ring, and simple lubricants or vaginal moisturisers. Safe usage of vaginal estrogen replacement therapy in breast cancer patients has not been studied within randomised clinical trials of long duration; the guidelines below reflect a clinical consensus.
Fatigue is common and severe in patients with mastocytosis
Authors: Omdal Roald , Skoie Inger Marie , Grimstad Tore
Published: October 2018

Chronic fatigue is a common phenomenon in inflammatory and autoimmune conditions, in cancer, and in neurodegenerative diseases. Although pain and psychological factors influence fatigue, there is an increasing understanding that there is a genetic basis, and that activation of the innate immune system is an essential generator of fatigue. Mast cells are important actors in innate immunity and serve specialized defense responses against parasites and other pathogens. They are also major effector cells in allergic reactions. Primary disorders causing constitutively hyperactivity of mast cells are called mastocytosis and are frequently due to a gain-of-function mutation of the KIT gene encoding the transmembrane tyrosine kinase receptor. It is a clinical experience that patients with mast cell disorders suffer from fatigue, but there is a lack of scientific literature on the phenomenon. We performed a controlled study of fatigue in mastocytosis patients and document a 54% prevalence of clinical significant fatigue.
Elevated uric acid levels in premenopausal female systemic lupus erythematosus patients: Association with potential or existing renal damage
Authors: Liu Haijun , Cai Xiaoyan , Dai Lie , Ma Jianda , Mo Yingqian
Published: October 2018

Do premenopausal female systemic lupus erythematosus (SLE) patients have a low incidence of hyperuricaemia (HU) as healthy premenopausal females? As of yet, there have been few studies. This study aims to investigate the serum uric acid (UA) levels of premenopausal female SLE patients and the associated clinical risk factors. 107 premenopausal female SLE patients were divided into two groups: the high UA SLE group (n = 45) and the normal UA SLE group (n = 62). In total, 50 age-matched healthy premenopausal females served as the control group. Serum UA concentration, kidney damage index, lupus index, disease activity score of lupus and serum lipid index were collected and compared between the SLE subgroups. Binary logistic regression and multiple linear regression analyses were used to analyse the association of high UA levels with clinical features. The mean UA level of the SLE group was significantly higher than that of the control group (509.73 ± 150.28 μmol/L vs 296.78 ± 69.87 μmol/L, P < 0.001), as was the incidence of HU (42.06% vs 14.00%, P = 0.01). The UA levels of the high UA SLE group and the normal UA SLE group were 515.91 ± 120.64 μmol/L and 245.71 ± 63.18 μmol/L, respectively, which was statistically significant ( P < 0.001). None of the patients with HU had current or previous gout attacks. The frequency of patients with renal manifestations in the high UA SLE group was significantly higher than that in the normal UA SLE group (χ2 = 26.278, P < 0.001). In the SLE group, the medications azathioprine and cyclosporine were not associated with HU ( P = 0.689), as analysed by binary linear regression. Using multiple linear regression analysis, it was found that urinary blood ( P = 0.048), creatinine ( P = 0.016), triglycerides ( P = 0.029), peripheral white blood cells ( P = 0.007) and renal manifestation ( P < 0.001) were associated with HU in the SLE group. Our results demonstrate that premenopausal SLE patients had higher levels of UA than healthy premenopausal females, which may be associated with potential or existing renal damage.
Hemodynamic Effects of Paracentesis in a Patient With a Fontan Circulation
Authors: Rajpal Saurabh , Opotowsky Alexander R. , Rutherford Anna , Wu Fred
Published: October 2018

Recurrent ascites is a common manifestation of failing Fontan circulation. We present the hemodynamic response to large-volume paracentesis in a patient with Fontan circulation and Fontan-associated liver disease, documenting an immediate and substantial decline in systemic venous pressure and increase in cardiac output. These preliminary observations may have implications for the management of ascites in adults with Fontan circulation.