bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive resection of a giant left atrial myxoma: a case report
Authors: Gaisendrees Christopher , Mader Navid , Sabashnikov Anton , Schlachtenberger Georg , Suhr Laura , Wahlers Thorsten
Published: August 2019

Cardiac tumors are a rarity. Most diagnosed primary tumors of the heart are benign, with an incidence ranging between 0.001% and 0.03%. Cardiac myxoma is one of these benign entities. A 44-year-old Caucasian woman who presented with symptoms of a common cold was diagnosed with a massive obstructing myxoma of the left atrium. Despite its large size, the tumor was completely removed using minimally invasive access through right anterior thoracotomy. However, the myxoma was adherent to the left atrial septum and was excised in toto. Pathological examinations confirmed the diagnosis of a primary cardiac myxoma. Total resection of obstructive cardiac myxomas is the therapy of choice, whereas minimally invasive surgical approach might be feasible despite large size and septal localization, but is technically challenging.
What influences patients’ decisions regarding palliative care in advance care planning discussions? Perspectives from a qualitative study conducted with advanced cancer patients, families and healthcare professionals
Authors: Lin Cheng-Pei , Evans Catherine J , Koffman Jonathan , Sheu Shuh-Jen , Hsu Su-Hsuan , Harding Richard
Published: August 2019

Background:

The concept of advance care planning is largely derived from Western countries. However, the decision-making process and drivers for choosing palliative care in non-Western cultures have received little attention.

Aim:

To explore the decision-making processes and drivers of receiving palliative care in advance care planning discussions from perspectives of advanced cancer patients, families and healthcare professionals in northern Taiwan.

Method:

Semi-structured qualitative interviews with advanced cancer patients, their families and healthcare professionals independently from inpatient oncology and hospice units. Thematic analysis with analytical rigour enhanced by dual coding and exploration of divergent views.

Results:

Forty-five participants were interviewed ( n = 15 from each group). Three main decision-making trajectories were identified: (1) ‘choose palliative care’ was associated with patients’ desire to reduce physical suffering from treatments, avoid being a burden to families and society, reduce futile treatments and donate organs to help others; (2) ‘decline palliative care’ was associated with patients weighing up perceived benefits to others as more important than benefits for themselves; and (3) ‘no opportunity to choose palliative care’ was associated with lack of opportunities to discuss potential benefits of palliative care, lack of staff skill in end-of-life communication, and cultural factors, notably filial piety.

Conclusion:

Choice for palliative care among advanced cancer patients in Taiwan is influenced by three decision-making trajectories. Opinions from families are highly influential, and patients often lack information on palliative care options. Strategies to facilitate decision-making require staff confidence in end-of-life discussions, working with the patients and their family while respecting the influence of filial piety.
The use of personal narratives in hospital-based palliative care interventions: An integrative literature review
Authors: Roikjær Stine Gundtoft , Missel Malene , Bergenholtz Heidi Maria , Schønau Mai Nanna , Timm Helle Ussing
Published: August 2019

Background:

People living with life-threatening illness experience unmet existential needs despite the growing research and clinical field of palliative care. Narrative interventions show promise in managing these problems, but more knowledge is needed on the characteristics of narrative interventions and the feasibility of using personal narratives in a hospital.

Aim:

To review the literature on personal narratives in hospital-based palliative care interventions and to strengthen palliative care practices.

Design:

We conducted a systematic integrative review with qualitative analysis and narrative synthesis in accordance with PRISMA where applicable (PROSPERO#:CRD42018089202).

Data sources:

We conducted a systematic search in PubMed, Embase, Scopus, Cinahl, SocINDEX and PsychInfo for primary research articles published until June 2018. We assessed full-text articles against the eligibility criteria followed by a discussion of quality using the Critical Appraisal Skills Programme.

Results:

Of 480 articles, we found 24 eligible for this review: 8 qualitative, 14 quantitative and 2 mixed methods. The articles reported on dignity therapy, legacy building, outlook, short-term life review and life review. Data analysis resulted in five themes: core principles, theoretical framework, content of narrative, outcome and, finally, acceptability and feasibility.

Conclusion:

Various types of systematic palliative care interventions use personal narratives. Common to these is a shared psychotherapeutic theoretical understanding and aim. Clinical application in a hospital setting is both feasible and acceptable but requires flexibility regarding the practices of the setting and the needs of the patient.
Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members: A cross-sectional study
Authors: Möllerberg Marie-Louise , Årestedt Kristofer , Swahnberg Katarina , Benzein Eva , Sandgren Anna
Published: August 2019

Background:

There is evidence indicating that family sense of coherence predicts quality of family life and promotes family well-being. In families living with the palliative phase of cancer, low hope, anxiety and symptoms of depression are common in both persons with cancer and their family members.

Aim:

To determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression, respectively, in persons with cancer in the palliative phase and their family members.

Design:

An observational, cross-sectional, multicentre study was conducted. Nested linear regression analyses were performed in two blocks to determine whether family sense of coherence was associated with hope, anxiety and symptoms of depression.

Setting/participants:

Persons with cancer ( n = 179) and their family members ( n = 165) were recruited from two oncology clinics and two palliative centres in three regions in Sweden.

Results:

The main findings showed that family sense of coherence was significantly and independently associated with hope, anxiety and symptoms of depression. Stronger family sense of coherence was associated with higher hope and lower anxiety and symptoms of depression levels in both persons with cancer and their family members.

Conclusion:

Health care providers should strive to identify families with weak family sense of coherence, because of its associations with hope, anxiety and symptoms of depression, in order to offer them professional support and thereby achieve increased well-being during the palliative phase of cancer. Future studies should expand our knowledge of family sense of coherence and how to identify families at risk of lower levels of well-being.
Empathy in stroke rats is modulated by social settings
Authors: Shinozuka Kazutaka , Tajiri Naoki , Ishikawa Hiroto , Tuazon Julian P , Lee Jea-Young , Sanberg Paul R , Zarriello Sydney , Corey Sydney , Kaneko Yuji , Borlongan Cesario V
Published: August 2019

Rodents display “empathy” defined as perceived physical pain or psychological stress by cagemates when co-experiencing socially distinct traumatic events. The present study tested the hypothesis that empathy occurs in adult rats subjected to an experimental neurological disorder, by allowing co-experience of stroke with cagemates. Psychological stress was measured by general locomotor activity, Rat Grimace Scale (RGS), and plasma corticosterone. Physiological correlates were measured by Western blot analysis of advanced glycation endproducts (AGE)-related proteins in the thymus. General locomotor activity was impaired in stroke animals and in non-stroke rats housed with stroke rats suggesting transfer of behavioral manifestation of psychological stress from an injured animal to a non-injured animal leading to social inhibition. RGS was higher in stroke rats regardless of social settings. Plasma corticosterone levels at day 3 after stroke were significantly higher in stroke animals housed with stroke rats, but not with non-stroke rats, indicating that empathy upregulated physiological stress level. The expression of five proteins related to AGE in the thymus reflected the observed pattern of general locomotor activity, RGS, and plasma corticosterone levels. These results indicate that stroke-induced psychological stress manifested on both the behavioral and physiological levels and appeared to be affected by empathy-associated social settings.
Effect of articular capsule repair on postoperative dislocation after primary total hip replacement by the anterolateral approach
Authors: Lu Yiran , Wu Zongming , Tang Xianzhong , Gu Mengzhen , Hou Bo
Published: August 2019

Objective

Artificial hip dislocation is one of the most serious complications following total hip replacement. This study was performed to assess articular capsule repair in primary total hip replacement with the anterolateral approach (Watson-Jones incision) and its effect on postoperative dislocation.

Methods

Patients who underwent primary total hip replacement by the anterolateral approach in Tongren Hospital of Shanghai Jiao Tong University School of Medicine from June 2007 to June 2014 were retrospectively analyzed. The patients were divided into the repair and dissection groups based on the articular capsule repair status during surgery. Postoperative dislocation rates were compared between the two groups using the chi-squared test.

Results

The repair and dissection groups comprised 137 and 248 patients, respectively. All patients were followed up for 6 months to 5 years (average, 3.75 years). The mean age, sex, disease composition, and follow-up time were not significantly different between the two groups. Early postoperative dislocation occurred in 1 hip (0.7%) in the repair group and 13 hips (5.2%) in the dissection group.

Conclusions

During the anterolateral approach for primary total hip replacement, articular capsule repair may reduce the occurrence of early postoperative dislocation of the hip joint.
Examining Predisposing Factors and Program Performance Indicators Associated With Program Completion: A Comparison of Opioid and Non-Opioid-Preferring Participants in Drug Court
Authors: Shannon Lisa M. , Jones Afton Jackson , Newell Jennifer , Nichols Elizabeth
Published: August 2019

Opioid use and abuse, as well as criminal justice involvement, have increased dramatically in the past two decades. Drug court is a community-based rehabilitation program for individuals with substance abuse issues involved in the criminal justice system. Given unique treatment needs associated with opioids, the current study examined predisposing factors and program performance indicators associated with drug court completion based on individuals’ opioid preference. Secondary data (i.e., participant assessment and drug court Management Information System) as well as conviction information from a statewide database were examined for a sample of drug court participants ( N = 534). Data analyses compared opioid-preferring ( n = 267) and non-opioid-preferring ( n = 267) program participants. For non-opioid-preferring participants, a combination of predisposing characteristics, including both social/demographic characteristics and substance use (i.e., education, drug court site, lifetime benzodiazepine use), as well as program performance indicators (i.e., number of days in drug court, number of positive drug tests, and sanctions/therapeutic responses) influenced drug court completion. For opioid-preferring participants, only program performance indicators emerged as important for program completion, specifically number of days in drug court, number of positive drug tests, and sanctions/therapeutic responses. Findings for non-opioid-preferring participants are consistent with past research, suggesting that individual predisposing characteristics and program performance indicators are influential on program completion. However, findings suggesting that only program performance indicators are influential for opioid-preferring participants adds a unique contribution to the literature. This information may help provide more individualized program planning and ultimately more programmatic success.
Sensing ethnic difference: A kinesthetic reading of Proverbs 7.1-27
Authors: Park Wongi
Published: August 2019

The historical identity of the נכריה‎/אשה זרה‎ in Proverbs 7 has been a vexing quandary in modern biblical scholarship. Although many proposals have been offered, there is, as of yet, no critical consensus. My aim is not to settle the matter once and for all, but to approach the problem from a different angle. This article offers a fresh reading of Proverbs 7.1-27 in order to shift attention away from who the Foreign Woman might be historically to how her foreignness is constructed ideologically. Specifically, the argument draws on kinesthetic theory to reexamine the pedagogical use of sensory data to enhance persuasion. As we shall see, the father deploys a visceral narrative that transmits the ethnicized and gendered otherness of the Foreign Woman in sensory fashion (e.g. aural, gustative, tactile, visual, olfactory). This pedagogical tactic functions as a strategic form of kinesthetic empathy that subconsciously inscribes social and religious boundary markers in the sensorium. In this way, the father’s instruction encodes an ethnic sensory that is neurologically wired, so to speak, to perceive Lady Wisdom as more appealing than the seductions of the Foreign Woman. By drawing attention to the didactic strategy of shaping wisdom in the sensorium, this kinesthetic reading highlights the critical role of sensory perception in mediating ideologies of difference.
Neuromodulation in urology, state of the art
Authors: Ammirati Enrico , Giammò Alessandro , Manassero Alberto , Carone Roberto
Published: August 2019

Sacral neuromodulation is an approved and validated treatment for overactive bladder syndrome, chronic non-obstructive retention, and chronic pelvic pain. Percutaneous tibial nerve stimulation is a less invasive approach of neuromodulation. We performed a literature research to assess the current evidence available about neuromodulation. Both techniques appear to be effective and safe third-line treatments. The overall success rate ranges from 43% to 85% for sacral neuromodulation and from 40% to 79.5% for percutaneous tibial nerve stimulation. Sacral neuromodulation has a higher incidence of complications in comparison to percutaneous tibial nerve stimulation, due to the more invasive surgical technique and the presence of a permanent implant. The incidence of surgical revision ranges between 9% and 33%. The most frequent complication with sacral neuromodulation is pain at implant site (15%–42%), followed by lead migration (4%–21%), pain at lead site (5.4%–19.1%), leg pain (18%), and infection (5.7%–6.1%). The quality of the studies on sacral neuromodulation and percutaneous tibial nerve stimulation in literature is quite modest, because of the shortage of good randomized clinical trial; most of the studies are prospective observational studies with mid-term follow-up.
Brains and psyches: Child psychological and psychiatric expertise in a Swedish newspaper, 1980–2008
Authors: Skagius Peter
Published: August 2019

Most children and families have not had direct contact with child psychological and psychiatric experts. Instead they encounter developmental theories, etiological explanations and depictions of childhood disorders through indirect channels such as newspapers. Drawing on actor–network theory, this article explores two child psychological and psychiatric modes of ordering children’s mental health discernible in Sweden’s largest morning newspaper, Dagens Nyheter, during the years 1980 to 2008: a psychodynamic mode and a neuro-centered mode. In the article I show how these two relatively contemporaneous modes greatly differed in how they enacted children’s mental health. The psychodynamic mode stressed the parents’ role in structuring and affecting the child’s unconscious and saw them as the primary cause of any mental illness. In contrast, the neuro-centered mode highlighted that mental issues were related to the child’s brain and proposed different solutions depending on whether the child’s brain functioned in a ‘normal’ or ‘atypical’ manner. Each mode moreover suggested differing contexts to their discussions, with the psychodynamic mode solely discussing the parental milieu while the neuro-centered mode mainly focused on how society affected children with ‘atypical’ brains. The two modes thus had significantly diverging implications for the reader on how to understand and manage children and their psychological well-being. I further argue in the article for the relevance of actor–network theory in historical studies of psychology and psychiatry.
The history of the brain and mind sciences
Authors: Freeborn Alfred
Published: August 2019

This review article critically surveys the following literature by placing it under the historiographical banner of ‘the history of the brain and mind sciences’: Fernando Vidal and Francisco Ortega, Being Brains: Making the Cerebral Subject (New York: Fordham University Press, 2017); Katja Guenther, Localization and its Discontents: A Genealogy of Psychoanalysis & the Neuro Disciplines (Chicago: University of Chicago Press, 2015); Stephen Casper and Delia Gavrus (eds), The History of the Brain and Mind Sciences: Technique, Technology, Therapy (Rochester: University of Rochester Press, 2017); Jonna Brenninkmeijer, Neurotechnologies of the Self: Mind, Brain and Subjectivity (London: Palgrave Macmillan, 2016). This framework highlights contemporary attempts to historicize the integrative project of neuroscience and set the correct limits to interdisciplinary collaboration. While attempts to critically engage with the ‘neuro’ rhetoric of contemporary neuroscientists can seem at odds with historians seeking to write the history of neuroscience from the margins, it is argued that together these two projects represent a positive historiographical direction for the history of the neurosciences after the decade of the brain.
Curve recognition algorithm based on edge point curvature voting
Authors: Wang Qidong , Wei Zhenya , Wang Jiaen , Chen Wuwei , Wang Naihan
Published: August 2019

In this paper, a new curve-lane recognition algorithm is proposed. The algorithm uses edge point curvature voting to determine the region of interest based on near-vision straight-lane information. First, information is detected in the near-vision area regarding the straight lines to the left and right of the current lane. Near-vision lane-line extraction includes lane image filtering, as well as edge detection of the region of interest below the vanishing line. The vanishing point is positioned by determining the position of the edge point and distribution of the direction angle. In addition, the straight line is extracted based on the position of the vanishing point. The straight lines that are constructed for the current lane in this way are selected and used as supplementation, in combination with the lane model. Next, the road curvature range isometry is divided into multiple subdivision regions. The near-vision lane straight-line curvature parameters extending from each edge point in the region of interest are computed by combining the straight-line near-vision lane information with the curve lane model in the pixel coordinate system. Subsequently, voting and counting are carried out for the curvature regions of each edge point to which the corresponding curvature computing values belong. Finally, the counting maximum from the corresponding curvature regions of the straight lines located to the left and right of the current lane are searched for, and the curvature region is converted, to obtain the lane line corresponding to the curvature parameter values. Experimental results indicate that the proposed curve-lane recognition algorithm can effectively detect the curve lanes of different curvatures. The results also indicate that the proposed curve detection method is highly accurate, and the algorithm is very robust in different environments.
A tale of two explanatory styles in cognitive psychology
Authors: Shapiro Lawrence
Published: August 2019

The development of a theory of mechanistic explanation has been a welcome advance over previous theories of explanation, such as deductive nomological explanation. However, despite the claims of some supporters of mechanistic explanation, not all explanation in cognitive science is or should be mechanistic. I defend the claim that functional analysis remains a distinct and legitimate form of explanation within cognitive science.
Cluster and DEMATEL Analysis of Key RFID Implementation Factors Across Different Organizational Strategies
Authors: Vishvakarma Niraj Kumar , Singh Rohit Kumar , Sharma R. R. K.
Published: August 2019

The purpose of this study is to explore the critical success factor of radio frequency identification (RFID) implementation and to establish a relationship between critical success factor of RFID and organizational strategies. This article uses DEMATEL (Decision Making Trial and Evaluation Laboratory) and cluster analysis technique to identify the complex relationship between RFID implementation critical success factors (ICSFs) and organizational strategies. The result indicates that extrinsic critical success factors such as privacy and security, potential legislation and cost-effective reusable tags are the three most important RFID ICSFs that are essential for all the organization’s strategy types, whereas the order of priority of other ICSFs depends on organizational strategy types. Implementation of RFID enhances utilization of resources and information. It gives a competitive advantage to businesses. The study significantly contributes to the body of knowledge as applied to theory and practice in RFID implementation.
Relationship of Velopharyngeal Insufficiency With Face Mask Therapy in Patients With Cleft Lip and Palate
Authors: Helal Narmin , Ford Matthew , Basri Osama , Schuster Lindsay , Martin Brian , Losee Joseph
Published: August 2019

Objective:

To determine whether orthodontic/dentofacial orthopedic maxillary protraction face mask therapy induces changes in velopharyngeal functioning in a cohort of pediatric patients having cleft palate with or without cleft lip.

Design:

Retrospective chart review.

Setting:

A children’s hospital in the United States.

Participants:

Forty-three pediatric patients with cleft palate, with or without cleft lip, syndromic or with isolated clefts, who received face mask therapy from January 2009 to April 2016.

Intervention:

Clinical data were extracted for review and analysis from medical records obtained from the Cleft Database/Research Registry (CDB-RR).

Main Outcome Measures:

Pittsburgh Weighted Speech Scores (PWSS) before and after therapy.

Results:

There was a significant increase in PWSS after face mask therapy for patients with a PWSS score of 0 prior to treatment. Patients with PWSS >0 before treatment remained largely stable after face mask therapy. Maxillary advancement was not significantly associated with change in PWSS or fistula presence/absence.

Conclusions:

There is an increased risk of velopharyngeal insufficiency with maxillary protraction face mask treatment in patients with cleft palate. Patient counseling and obtaining consent regarding speech changes during treatment are recommended.
Rap and Political Participation: Using Rap as a Creative Method in Research with Children and Young People
Authors: Byrne Lorcan , O’Connell Cathal , O’Sullivan Siobhan
Published: August 2019

This article explores how rap music workshops can be an effective method when researching neighbourhood regeneration and refurbishment with children and young people, especially in disadvantaged communities. The article draws a research with 78 children and young people in a large social housing estate which is undergoing regeneration and refurbishment in Cork City in the South of Ireland. The focus of this article is on a sub-group of six teenagers who participated in a rap workshop. The research demonstrates that rap music workshops are an insightful data collection method, particularly in contexts where rap music is already an embedded part of the local youth culture. This research also reveals how children and young people have the imaginative capacity to make an informed analysis of their communities and that they hold a strong desire to influence the decision-making process. This article will be of interest to researchers concerned with creative methodologies designed to elicit and understand children’s and young people’s experiences and perspectives.
Transient Contrast Neurotoxicity After Percutaneous Coronary Intervention Mimicking Subarachnoid Hemorrhage in a Patient With Chronic Kidney Disease
Authors: Şimşek Ersin Çagri , Ertürk Elif , Uçar Roza , Yilmaz Artun Onat , Ekmekçi Cenk , Mutlu İnan , Sari Cenk
Published: August 2019

Transient contrast neurotoxicity is a rare but well-recognized complication of angiography that is due to neurotoxicity of the contrast agent. Patients with renal dysfunction may be inclined to develop contrast medium neurotoxicity due to delayed elimination of the contrast medium in renal metabolism. In this report, we present an unusual case of transient neurotoxicity in a patient with severe chronic kidney disease following percutaneous coronary intervention mimicking clinically and radiologically subarachnoid hemorrhage. The patient’s clinical symptoms improved rapidly and fully recovered after hemodialysis and conservative treatment. We believe that performing early hemodialysis is an effective treatment to improve symptoms in end-stage renal disease patients with contrast-induced encephalopathy.
The genetic diversity of multiple sclerosis risk among Hispanic and African American populations living in the United States
Authors: Beecham AH , Amezcua L , Chinea A , Manrique CP , Rubi C , Isobe N , Lund BT , Santaniello A , Beecham GW , Burchard EG , Comabella M , Patsopoulos N , Fitzgerald K , Calabresi PA , De Jager P , Conti DV , Delgado SR , Oksenberg JR , McCauley JL
Published: August 2019

Background:

Substantial progress has been made toward unraveling the genetic architecture of multiple sclerosis (MS) within populations of European ancestry, but few genetic studies have focused on Hispanic and African American populations within the United States.

Objective:

We sought to test the relevance of common European MS risk variants outside of the major histocompatibility complex ( n = 200) within these populations.

Methods:

Genotype data were available on 2652 Hispanics (1298 with MS, 1354 controls) and 2435 African Americans (1298 with MS, 1137 controls). We conducted single variant, pathway, and cumulative genetic risk score analyses.

Results:

We found less replication than statistical power suggested, particularly among African Americans. This could be due to limited correlation between the tested and causal variants within the sample or alternatively could indicate allelic and locus heterogeneity. Differences were observed between pathways enriched among the replicating versus all 200 variants. Although these differences should be examined in larger samples, a potential role exists for gene–environment or gene–gene interactions which alter phenotype differentially across racial and ethnic groups. Cumulative genetic risk scores were associated with MS within each study sample but showed limited diagnostic capability.

Conclusion:

These findings provide a framework for fine-mapping efforts in multi-ethnic populations of MS.
Rolling bearing fault diagnosis based on adaptive smooth ITD and MF-DFA method
Authors: Yuan Zhe , Peng Tingting , An Dong , Cristea Daniel , Pop Mihai Alin
Published: August 2019

To effectively utilize a feature set to further improve fault diagnosis of a rolling bearing vibration signal, a method based on multi-fractal detrended fluctuation analysis (MF-DFA) and smooth intrinsic time-scale decomposition (SITD) was proposed. The vibration signal was decomposed into several proper rotation components by applying this new SITD method to overcome noise effects, preserve the effective signal, and improve the signal-to-noise ratio. Wavelet analysis was embedded in iteration procedures of intrinsic time-scale decomposition (ITD). For better results, an adaptive threshold function was used for signal recovery from noisy proper rotation components in the wavelet domain. Additionally, MF-DFA was used to reveal the multi-fractality present in the instantaneous amplitude of the proper rotation components. Finally, linear local tangent space alignment was applied for feature dimension reduction and to obtain fault characteristics of different types, further improving identification accuracy. The performance of the proposed method is determined to be superior to that of the ITD-MF-DFA method.
Is It a Duty to Vote and to be Informed?
Authors: Blais André , Galais Carol , Mayer Danielle
Published: August 2019

We know that many people feel that they have a duty to vote in elections, but we know little about what other civic duties they believe they ought to fulfill. In this study, we address the question of whether people feel that they have both a duty to vote and to be informed. We use an original Canadian survey which includes questions about whether respondents construe voting and keeping informed as duties or a matter of choice. We find that the duty to vote is more widespread than the duty to be informed and that almost half of those who say that they have a moral obligation to vote indicate that they do not have a duty to keep informed. The better educated are more likely to feel that they have a moral obligation to both vote and keep informed while younger respondents are more prone to reject both duties.
Re-gendering the UK House of Commons: The Academic Critical Actor and Her ‘Feminist in Residence’
Authors: Childs Sarah , Challender Chloe
Published: August 2019

Parliaments are everywhere highly masculinized institutions, created by and for men. Yet they are not unchanging institutions. The UK has just undergone an Inter-Parliamentary Union’s Gender Sensitive Parliament’s audit. This was one of the recommendations of the 2016 The Good Parliament Report. With its 43 recommendations, The Good Parliament Report was a blueprint for a diversity sensitive House of Commons. Since then, and through the newly established Commons Reference Group on Representation and Inclusion, Westminster has addressed some of its diversity insensitivities. This article reflects back on the author’s secondment to Parliament and how her relationship with a feminist official was critical to the success of Report and indeed the day-to-day practice of seeking to be an impactful academic change actor.
Improved mechanical, physical and biological properties of chitosan films using Aloe vera and electrospun PVA nanofibers for wound dressing applications
Authors: Rafieian Shirin , Mahdavi Hamid , Masoumi Mir Esmaeil
Published: August 2019

Natural polymers such as chitosan and Aloe vera are widely used in novel wound dressings due to their biocompatibility and biodegradability. A problem associated with these polymers is their poor mechanical behavior. Efforts have been made to improve the mechanical properties by mixing synthetic polymers such as PVA, but the role of chitosan and Aloe vera in the final dressing is dimmed. The techniques are also time-consuming and costly and there is still a need for an acceptable and affordable wound dressing which can be made through easily accessible techniques. A new but very simple method is introduced in this work for incorporating PVA nanofibers with Aloe vera-containing chitosan films. Using this method the levels of Aloe vera and chitosan in the system can be optimized at higher scales while benefiting from PVA best mechanical properties as a composite layer. Higher amounts of Aloe vera and chitosan in the system lead to lower product costs and more biocompability. The biological properties of films were examined through cell cytotoxicity and antibacterial tests and compared with Atomic force microscopy results. Physical and mechanical properties of films containing PVA nanofibers were characterized by water vapor permeability, swelling ratio, and tensile tests. The morphology of fibers before and after applying on the films was also observed by scanning electron microscopy. According to the results, this combination of natural and synthetic polymers has led to an affordable, biocompatible, and flexible film for wound dressing applications.
Current evidence for vitamin D in intestinal function and disease
Authors: Hassanshahi Mohammadhossein , Anderson Paul H , Sylvester Cyan L , Stringer Andrea M
Published: August 2019

Vitamin D activity is associated with the modulation of a wide variety of biological systems, in addition to its roles in calcium homeostatic mechanisms. While vitamin D is well known to promote gastrointestinal calcium absorption, vitamin D also plays a role in attenuating and/or preventing the progression of several gastrointestinal diseases including Crohn’s disease, ulcerative colitis, and colorectal cancer, and may also play a role in chemotherapy-induced intestinal mucositis. The pro-differentiation, immunomodulatory, and anti-inflammatory effects of vitamin D, which has been reported in numerous circumstances, are key potential mechanisms of action in the prevention of gastrointestinal disorders. While the debate of the effectiveness of vitamin D to treat bone pathologies continues, the clinical importance of vitamin D therapy to prevent gastrointestinal disorders should be investigated given current evidence, using both nutritional and pharmaceutical intervention approaches.

Impact statement

The non-skeletal functions of vitamin D play an important role in health and disease. The anti-inflammatory properties and maintenance of intestinal function fulfilled by vitamin D impact other systems in the body though downstream processing. This review provides insight into the mechanisms underpinning the potential benefits of vitamin D in both maintaining intestinal homeostasis and associated diseased states.
Organ donor intervention trials and risk to bystanders: An ethical analysis
Authors: Cohen Ivan Glenn
Published: August 2019

There are two distinct problems about bystander effects raised by organ donor intervention research. The first is the problem of “bystander organs”—sometimes called “non-target organs”—which Kimmelman discusses in his case presentation. How do we treat the recipients of organs that are not the subject of the intervention research but nonetheless might be directly affected by the research? The second problem is not about altering the organ but the pattern of distribution of organs. Each of these cases shows bystander effects that matter for real people. This article examines how research ethics should approach each of these cases.
Kindergarten teachers’ perceptions of whole-child development: The roles of leadership practices and professional learning communities
Authors: Keung Chrysa Pui Chi , Yin Hongbiao , Tam Winnie Wing Yi , Chai Ching Sing , Ng Clement Ka Kit
Published: August 2019

This study examined the relationships between leadership practices, professional learning communities, teachers’ efficacy beliefs and perceptions of whole-child development in the context of kindergarten education. A sample of 2120 teachers from 153 Hong Kong kindergartens participated in a questionnaire survey. The results showed that principals’ leadership practices had significant effects on all five professional learning community components. Leadership practices were also positively related to teachers’ perceptions of whole-child development directly and indirectly through the mediation of three professional learning community components, namely a shared sense of purpose, collaborative activities and a collective focus on children’s learning. Moreover, three professional learning community components (i.e. a collective focus on children’s learning, deprivatized practice and reflective dialogue) were positively associated with teachers’ perceptions of whole-child development via their efficacy beliefs. The findings support the mediating role of professional learning communities in developing kindergarten teachers’ collaboration for improving their efficacy beliefs and perceptions of the whole-child development of children. Kindergarten principals play a key role in cultivating a supportive culture and facilitating teacher learning.
British Thyroid Association 2014 classification ultrasound scoring of thyroid nodules in predicting malignancy: Diagnostic performance and inter-observer agreement
Authors: Weller Alexander , Sharif Ban , Qarib Mohammad H , St Leger Dominic , De Silva Hakkini SL , Lingam Ravi K
Published: August 2019

Objectives

To assess the inter-observer agreement amongst five observers of differing levels of expertise in applying the British Thyroid Association (2014) guidelines for ultrasound scoring of thyroid nodules (BTA-U score) in the management of thyroid cancer, and to assess the U-score diagnostic performance in predicting malignancy.

Method

A total of 73 consecutive patients were included over a two-year period (July 2012 to July 2014), after referral to a tertiary head and neck oncology centre for ultrasound plus fine needle aspiration and cytology. Our five observers retrospectively and independently reviewed static ultrasound images on PACS and scored the thyroid nodules according to BTA-U classification. The observers were blinded to each other’s scoring, cytology and histology results. Either the Kappa-statistic or intra-class correlation was used to assess the level of inter-observer agreement, plus agreement between the radiological and cytological diagnoses. The diagnostic performance of U-scoring for predicting final histological diagnosis was assessed with sensitivity, specificity, positive and negative predictive values.

Results

A Kappa-value of 0.73 (95% CI: 0.68–0.77) confirmed substantial inter-observer agreement amongst the five observers. All 17 histology confirmed malignant nodules were correctly classified as potentially malignant by all observers. The sensitivity and negative predictive value of BTA-U score in detecting and predicting malignancy were 100%, whereas the specificity and positive predictive values were 34% and 32%, respectively.

Conclusions

There is good inter-observer agreement in using the BTA-U score amongst different observers at differing levels of expertise. Adhering to BTA-U scoring can potentially achieve 100% sensitivity in selecting malignant nodules for sampling.
Autophagy inhibition of cancer stem cells promotes the efficacy of cisplatin against non-small cell lung carcinoma
Authors: Hao Chengcheng , Liu Guiping , Tian Guangliang
Published: August 2019

Background:

Clinical treatment of non-small cell lung carcinoma (NSCLC) by cisplatin eventually results in drug resistance, which cancer stem cells and autophagy are believed to be involved in. In the present study, we aimed to explore the effect of autophagy-inhibited cancer stem cells in NSCLC.

Methods:

Cancer stem cells were identified by CD133 expression levels detected by immunochemistry, real-time polymerase chain reaction, western blot, and flow cytometry. Stemness was detected by sphere-forming assays of tumor cells. Autophagy was determined by LC3-II expression at mRNA and protein levels. The effect of chloroquine (CQ) on autophagy was detected by real-time polymerase chain reaction, western blot and sphere-forming assay in vitro, and tumor growth in male NOD/SCID mice.

Results:

Cisplatin (CDDP) treatment enhanced CD133+ cell ratios in clinical NSCLC specimens and NSCLC cell line A549. The CD133+ cells enriched by CDDP exhibited higher autophagy levels. Autophagy inhibition by CQ inhibited CD133+ stemness and promoted CDDP efficiency in A549 cells. In addition, the combination of CDDP and CQ treatment significantly inhibited autophagy levels and cancer stem cell proportions in vitro, and dramatically suppressed tumor growth compared with individual agents.

Conclusion:

Autophagy inhibition of cancer stem cells could promote the efficacy of cisplatin against NSCLC. The reviews of this paper are available via the supplemental material section.
A wind-tunnel case study: Increasing road cycling velocity by adopting an aerodynamically improved sprint position
Authors: Crouch Timothy , Menaspà Paolo , Barry Nathan , Brown Nicholas , Thompson Mark C , Burton David
Published: August 2019

The main aim of this study was to evaluate the potential to reduce the aerodynamic drag by studying road sprint cyclists’ positions. A male and a female professional road cyclist participated in this wind-tunnel study. Aerodynamic drag measurements are presented for a total of five out-of-seat sprinting positions for each of the athletes under representative competition conditions. The largest reduction in aerodynamic drag measured for each athlete relative to their standard sprinting positions varied between 17% and 27%. The majority of this reduction in aerodynamic drag could be accounted for by changes in the athlete’s projected frontal area. The largest variation in repeat drag coefficient area measurements of out-of-seat sprint positions was 5%, significantly higher than the typical <0.5% observed for repeated testing of time-trial cycling positions. The majority of variation in repeated drag coefficient area measurements was attributed to reproducibility of position and sampling errors associated with time-averaged force measurements of large fluctuating forces.
Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence
Authors: Tennent Duncan , Green Gemma
Published: August 2019

Introduction

Partial articular sided rotator cuff tears are described as being a common cause of shoulder pain and to have a significant impact of patient quality of life. The natural history of partial articular supraspinatus tendon avulsion lesions is not clearly defined and there is limited evidence to determine optimal management.

Aims

To perform a systematic review of the literature regarding the evidence for partial articular supraspinatus tendon avulsion repair and to determine whether there is any difference between operative and non-operatively managed patients.

Methods

Conventional and grey literature were searched with defined terms to identify studies in human adults concerning management of partial articular sided supraspinatus avulsions.

Results

Out of 86 papers identified by the search terms, 28 were deemed eligible for review including 1966 shoulders. 4/28 papers were of level I–II evidence but all were comparing techniques. 4/28 papers were biomechanical cadaveric studies, assessing strength of repair and effect on stability. The remaining 20 studies were level IV–V evidence and consisted of case series and technical notes identifying varying techniques of repair and their outcomes.

Conclusion

Current literature suggests that all techniques used to repair partial articular supraspinatus tendon avulsion lesions give increased functional scores and reduced pain. However, this represents a heterogeneous group of patients with variable degrees of tear and is not reproducible. There are limited controlled studies to determine whether partial articular supraspinatus tendon avulsion lesions require repair. Current classification systems represent a single plane and are open to user variation. No evidence exists to determine which tears are stable and which may progress.
Latarjet as a primary and revision procedure for anterior shoulder instability – A comparative study of survivorship, complications and functional outcomes in the medium to long-term
Authors: Yapp Liam Z , Nicholson Jamie A , McCallum Charlotte , Macdonald Deborah J , Robinson C Michael
Published: August 2019

Background

This retrospective study aims to compare the outcome of the Latarjet procedure when used as a primary or revision procedure for recurrent anterior gleno-humeral instability.

Methods

One hundred and ninety-seven patients underwent 205 open Latarjet procedures during the period 2006–2015 (mean follow-up 5.6 years). Sixty shoulders had failure of a previous stabilisation requiring revision to the Latarjet procedure. Outcomes were measured using the Western Ontario Shoulder Instability Index and Quick Disabilities of the Arm, Shoulder and Hand score. Survival analyses were performed using Kaplan–Meier curves, and multiple linear regression modelling was utilised to identify predictors of functional outcome (p < 0.05).

Results

Two shoulders had recurrent dislocations in the cohort of 205 (1.0%). Six shoulders underwent further surgery for non-instability complications (2.9%). There were no significant differences in the clinical or functional outcome between patients undergoing a primary Latarjet procedure and those who required revision of a failed soft-tissue stabilisation. Ninety-two per cent of patients were satisfied with their shoulder following surgery. Patient-reported instability and satisfaction was significantly associated with poorer functional scores.

Discussion

The Latarjet procedure successfully prevents recurrent anterior instability and is associated with high levels of satisfaction. Patient-reported outcome measures suggest no difference between primary and revision procedures.
Efficacy of dimethyl fumarate in Japanese multiple sclerosis patients: interim analysis of randomized, double-blind APEX study and its open-label extension
Authors: Kondo T , Kawachi I , Onizuka Y , Hiramatsu K , Hase M , Yun J , Matta A , Torii S
Published: August 2019

Background

Current data for the use of dimethyl fumarate (DMF) in Japanese patients with relapsing–remitting multiple sclerosis (RRMS) is limited.

Objectives

To assess the efficacy of DMF in Japanese patients with RRMS.

Methods

The phase 3, multinational APEX study (ClinicalTrials.gov identifier: NCT01838668) consisted of two parts: a 24-week double-blind part where subjects were randomized to receive DMF 240 mg or placebo twice daily in East Asian and Eastern European countries, and an open-label extension part where all subjects received DMF. The primary endpoint was the total number of new gadolinium-enhancing lesions in Weeks 12–24. In this interim analysis, we report efficacy data in the Japanese subgroup (DMF n = 56; placebo n = 58) over 72 weeks, including an extension phase.

Results

DMF reduced the total number of new gadolinium-enhancing lesions in Weeks 12–24 by 85% versus placebo ( p < 0.0001). At Week 24, the annualized relapse rate was also reduced by 48% with DMF, versus placebo. DMF reduced the probability of relapse from Week 8 and was sustained. The number of gadolinium-enhancing lesions was maintained through 72 weeks.

Conclusions

DMF demonstrated sustained efficacy in this Japanese subgroup. The results were consistent with those observed in studies of DMF enrolling primarily Caucasian patients.