bluuebunny/crossref_metadata_2025 huggingface dataset:
Solitary Rectal Ulcer Syndrome: A Paediatric Case Report
Authors: Abreu Marlene , Azevedo Alves Raquel , Pinto João , Campos Miguel , Aroso Sofia
Published: March 2017

Introduction: Solitary rectal ulcer syndrome (SRUS) is an uncommon benign rectal disease. Mostly young adults are affected, and it is rare in paediatric populations. Clinical Case: We present a 12-year-old girl with a 6-month history of tenesmus, frequent defaecation, and bloody stools with mucus. There was no previous history of constipation or other symptoms. At the first visit, physical examination and routine laboratory test results were normal. A stool examination for bacteria and parasites was negative. Colonoscopy revealed a single ulcer in the distal rectum 6 cm from the anal margin. SRUS was confirmed by biopsy. Despite conservative measures, the symptoms persisted. A defaecation proctography showed a small rectocele with no rectal mucosal prolapse. Because of its proximity to the anal sphincter, no surgical intervention was performed. Conclusion: The present case illustrates how difficult the management of SRUS is. Multicentre studies are needed to establish treatment protocols for children.
Intestinal Obstruction by Giant Meckel's Diverticulum
Authors: Capelão Gustavo , Santos Miguel , Hilário Sandra , Laureano Mónica , Nobre João , Gonçalves Inês
Published: March 2017

Background: Meckel's diverticulum is the most common congenital anomaly of the small bowel and is caused by the incomplete obliteration of the omphalomesenteric duct during the eighth week of gestation. Methods: We report the case of a 51-year-old male who presented to the emergency department with epigastric pain, vomiting, and abdominal distension. Clinically, he had a high intestinal obstruction without any mechanical cause on computed tomography scan. A median laparotomy was proposed. Results: An internal ileum hernia was identified twisted around a giant Meckel's diverticulum with a mesodiverticular artery, coursing from the base of the mesentery to the diverticulum. A small bowel segmental resection was performed, containing the diverticulum. Histology revealed a 15-cm long Meckel's diverticulum with no heterotopic mucosa. Conclusion: Small bowel obstruction due to an internal ileum hernia twisted around a giant Meckel's diverticulum with a mesodiverticular artery is very rare, and its diagnosis is challenging, requires a high level of suspicion, and it is only performed by exploratory surgery.
Splenic Rupture as a Complication of Colonoscopy
Authors: Barbeiro Sandra , Atalaia-Martins Catarina , Marcos Pedro , Nobre João , Gonçalves Cláudia , Aniceto Cristina
Published: March 2017

Splenic rupture is a rare but serious complication after colonoscopy, with high global mortality (5%). Diagnosis requires a high index of suspicion because presentation can be subtle, nonspecific, and delayed from hours to days and then not easily attributed to a recent endoscopy. Urgent splenectomy is the most common treatment option. A 73-year-old woman was admitted to the emergency department 8 h following a diagnostic colonoscopy. She presented abdominal pain and syncope. The diagnosis of splenic rupture was made and a splenectomy was urgently performed. The patient's postoperative recovery was uneventful. Splenic rupture is a rare complication of colonoscopy which cannot be underestimated in the differential diagnosis of abdominal pain after this procedure. Splenic injuries may occur in apparently uncomplicated, easy colonoscopies performed by experienced endoscopists, with no risk factors identified, as in this case.
A Case Series of Anal Carcinoma Misdiagnosed as Idiopathic Chronic Anal Fissure
Authors: Barbeiro Sandra , Atalaia-Martins Catarina , Marcos Pedro , Gonçalves Cláudia , Cotrim Isabel , Vasconcelos Helena
Published: March 2017

Chronic anal fissure is a linear ulcer in the anal canal that has not cicatrized for more than 8-12 weeks of treatment. Most anal fissures are idiopathic and are located in the posterior midline. Squamous cell carcinoma of the anus commonly presents as bleeding and anal pain. It may also present as a mass, nonhealing ulcer, itching, discharge, fecal incontinence and fistulae. Not uncommonly, small and early cancers are misdiagnosed as benign anorectal disorders like anal fissures or hemorrhoids. The clinical suspicion of squamous cell carcinoma of the anus is of paramount importance in patients with nonhealing anal fissures, fissures in atypical positions or with indurated or ulcerated anal tags and in patients with risk factors for the development of anal squamous intraepithelial lesions that are precursors of invasive anal squamous cell carcinoma. The authors present 3 cases of squamous cell carcinoma of the anus initially misdiagnosed as benign chronic anal fissure.
Endoscopic Treatment for Gastric Antral Vascular Ectasia: Current Options
Authors: Zepeda-Gómez Sergio
Published: March 2017

Gastric antral vascular ectasia (GAVE) is a capillary-type vascular malformation located primarily in the gastric antrum. Patients can present with iron-deficiency anemia, overt gastrointestinal bleeding, or both. Diagnosis and characterization is made at endoscopic examination, and the preferred management of patients with GAVE is endoscopic therapy. Herein, we present a review of the evidence about the efficacy, complications, and outcomes of the most frequently used endoscopic therapies for GAVE.
Gastric Adenomyoma: The Unexpected Mimicker
Authors: Duran Álvarez Marcela Adriana , Gómez López Juan Ramón , Guerra Garijo Teresa
Published: March 2017

Gastric adenomyoma is a rare benign tumor composed of epithelial structures and smooth muscle stroma. Here, we report an unusual case of gastric adenomyoma mostly composed of smooth muscle that was incidentally found during a laparoscopic intervention. On radiology, it mimicked an acquired hypertrophic pyloric stenosis in an adult patient, and pathologically it resembled a pure smooth muscle hamartoma. Complete submission of the lesion for histology was necessary to find the epithelial component and make the right diagnosis. As a mimicker of benign and malignant entities, gastric adenomyoma is usually an unexpected finding after surgery. The aim of this report is to analyze this adenomyoma variant in the setting of an unexplained thickening of the gastric wall, with explanations concerning histogenesis and biological potential.
Trabeculectomy with Ologen versus Mitomycin C in Juvenile Open-Angle Glaucoma: A 1-Year Study
Authors: El-Sayyad Fathi , El-Saied Heba Magdy Ahmed , Abdelhakim Mohamad Amr Salah Eddin
Published: March 2017

Background: We assessed bleb morphology and the intraocular pressure (IOP)-lowering effect of trabeculectomy with ologen compared to mitomycin C (MMC) in juvenile open-angle glaucoma (JOAG). Methods: This is a prospective interventional comparative study conducted on 40 eyes (20 patients) with medically uncontrolled JOAG, randomly operating one eye for trabeculectomy with ologen (group A: 20 eyes) and the other with MMC (group B: 20 eyes). IOP measurement, SITA standard perimetry, and spectral domain optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL) thickness were all done pre- and postoperatively. Postoperative blebs were assessed clinically using the Moorfields bleb grading system (MBGS) and anterior segment OCT (AS-OCT). All patients were examined for up to 1 year postoperatively. Results: The mean postoperative IOP was statistically significantly lower than the mean preoperative IOP at each follow-up in each group. At 1 year, the mean postoperative IOP was significantly lower in group A. According to the MBGS, blebs with an ologen implant showed significantly better scoring than those with MMC. AS-OCT showed that ologen-induced blebs had significantly more fluid-filled spaces, cleavage planes, and less fibrosis. Conclusion: Ologen resulted in a lower long-term postoperative IOP, a better bleb morphology, and fewer complications. Our results suggest that ologen may be a useful alternative to MMC in JOAG.
Attenuation of Oxidative Stress-Induced Osteoblast Apoptosis by Curcumin is Associated with Preservation of Mitochondrial Functions and Increased Akt-GSK3β Signaling
Authors: Dai Panpan , Mao Yixin , Sun Xiaoyu , Li Xumin , Muhammad Ibrahim , Gu Weiyan , Zhang Dafeng , Zhou Yu , Ma Jianfeng , Ni Zhenyu , Huang Shengbin
Published: March 2017

Background: Osteoblast apoptosis induced by oxidative stress plays a crucial role in the development and progression of osteoporosis. Curcumin, a natural antioxidant isolated from Curcuma longa, has highly protective effects against osteoporosis. However, the effects of curcumin on oxidative stress-induced osteoblast apoptosis remain unclear. This study aimed to explore the effect of curcumin on hydrogen peroxide (H2O2) induced osteoblast apoptosis and the underlying mechanisms. Methods: An osteoblastic cell line (Saos-2) was exposed to various concentrations of H2O2 with or without curcumin treatment. Cell viability was evaluated by MTT assays. The apoptosis rate was analyzed by flow cytometry and TUNEL assays. Mitochondrial ROS and membrane potential were determined using a fluorescence microscope. Mitochondrial respiratory enzyme activity was measured using a spectrophotometer. Protein levels were detected by western blotting. Results: Curcumin was cytoprotective because it greatly improved the viability of Saos-2 cells exposed to H2O2 and attenuated H2O2-induced apoptosis. Curcumin treatment also preserved the mitochondrial redox potential, decreased the mitochondrial oxidative status, and improved the mitochondrial membrane potential and functions. Furthermore, curcumin treatment markedly increased levels of phosphorylated protein kinase B (Akt) and phosphorylated glycogen synthase kinase-3β (GSK3β). Conclusion: Curcumin administration ameliorates oxidative stress-induced apoptosis in osteoblasts by preserving mitochondrial functions and activation of Akt-GSK3β signaling. These data provide experimental evidence supporting the clinical use of curcumin for prevention or treatment of osteoporosis.
Stingless Bee Honey, the Natural Wound Healer: A Review
Authors: Abd Jalil Mohd Azri , Kasmuri Abdul Razak , Hadi Hazrina
Published: March 2017

Background: The stingless bee is a natural type of bee that exists in almost every continent. The honey produced by this bee has been widely used across time and space. The distinctive feature of this honey is that it is stored naturally in the pot (cerumen), thus contributing to its beneficial properties, especially in the wound healing process. Methods: In this article, several studies on stingless bee honey that pointed out the numerous therapeutic profiles of this honey in terms of its antioxidant, antimicrobial, anti-inflammatory, as well as moisturizing properties are reviewed. All of these therapeutic properties are related to wound healing properties. Results: Antioxidant in stingless bee honey could break the chain of free radicals that cause a detrimental effect to the wounded area. Furthermore, the antimicrobial properties of stingless bee honey could overcome the bacterial contamination and thus improve the healing rate. Moreover, the anti-inflammatory attribute in this honey could protect the tissue from highly toxic inflammatory mediators. The moisturizing properties of the honey could improve wound healing by promoting angiogenesis and oxygen circulation. Conclusion: The application of honey to the wound has been widely used since ancient times. As a result, it is essential to understand the pharmacological mechanism of the honey towards the physiology of the wounded skin in order to optimize the healing rate in the future.
Feasibility of Rapid Linear-Endocardial and Epicardial Ventricular Ablation Using an Irrigated Multipolar Radiofrequency Ablation Catheter
Authors: Nazer Babak , Walters Tomos E. , Duggirala Srikant , Gerstenfeld Edward P.
Published: March 2017

Background—

A common strategy for ablation of scar-based ventricular tachycardia is delivering multiple lesions in a linear pattern.

Methods and Results—

We tested the efficacy of a novel linear irrigated multipolar ablation catheter capable of creating linear lesions with a single application. Healthy swine underwent endocardial and epicardial linear ablation using a novel linear irrigated ablation catheter; control animals underwent focal lesions in a linear pattern over 3.5 cm with an irrigated radiofrequency catheter. The linear catheter contained 7 irrigated electrodes spaced over 3.5 cm and could deliver ≤25 W to each electrode. Linear ablation required significantly less radiofrequency time than focal ablation (56±11 versus 497±110 seconds;
P
<0.0001). At gross pathology, linear (n=18) epicardial lines were longer than focal (n=8) epicardial lines (3.3±0.7 versus 2.1±0.9 cm;
P
<0.0005), with greater volume (3.8±2.9 versus 1.5±1.6 cm
3
;
P
=0.002). There was no difference between linear (n=22) and focal (n=7) endocardial line length or volume. Gaps (length 2.8±0.9 mm) were present in 53% of focal lines and 0% of linear ablation lines. No perforations, steam pops, or thrombus were noted.

Conclusions—

Compared with sequential focal radiofrequency ablation in a linear pattern, an irrigated multipolar linear ablation catheter safely delivers contiguous endocardial or epicardial lesions without gaps in a single ablation. This catheter shows promise for decreasing ventricular tachycardia ablation procedure time and improving outcome.
Evaluation of Right Ventricular Systolic Function in Chagas Disease Using Cardiac Magnetic Resonance Imaging
Authors: Moreira Henrique T. , Volpe Gustavo J. , Marin-Neto José A. , Ambale-Venkatesh Bharath , Nwabuo Chike C. , Trad Henrique S. , Romano Minna M.D. , Pazin-Filho Antonio , Maciel Benedito C. , Lima João A.C. , Schmidt André
Published: March 2017

Background—

Right ventricular (RV) impairment is postulated to be responsible for prominent systemic congestion in Chagas disease. However, occurrence of primary RV dysfunction in Chagas disease remains controversial. We aimed to study RV systolic function in patients with Chagas disease using cardiac magnetic resonance.

Methods and Results—

This cross-sectional study included 158 individuals with chronic Chagas disease who underwent cardiac magnetic resonance. RV systolic dysfunction was defined as reduced RV ejection fraction based on predefined cutoffs accounting for age and sex. Multivariable logistic regression was used to verify the relationship of RV systolic dysfunction with age, sex, functional class, use of medications for heart failure, atrial fibrillation, and left ventricular systolic dysfunction. Mean age was 54±13 years, 51.2% men. RV systolic dysfunction was identified in 58 (37%) individuals. Although usually associated with reduced left ventricular ejection fraction, isolated RV systolic dysfunction was found in 7 (4.4%) patients, 2 of them in early stages of Chagas disease. Presence of RV dysfunction was not significantly different in patients with indeterminate/digestive form of Chagas disease (35.7%) compared with those with Chagas cardiomyopathy (36.8%) (
P
=1.000).

Conclusions—

In chronic Chagas disease, RV systolic dysfunction is more commonly associated with left ventricular systolic dysfunction, although isolated and early RV dysfunction can also be identified.
Adrenergic Signaling Strengthens Cardiac Myocyte Cohesion
Authors: Schinner Camilla , Vielmuth Franziska , Rötzer Vera , Hiermaier Matthias , Radeva Mariya Y. , Co Thu Kim , Hartlieb Eva , Schmidt Andreas , Imhof Axel , Messoudi Ahmed , Horn Anja , Schlipp Angela , Spindler Volker , Waschke Jens
Published: March 2017

Rationale:

The sympathetic nervous system is a major mediator of heart function. Intercalated discs composed of desmosomes, adherens junctions, and gap junctions provide the structural backbone for coordinated contraction of cardiac myocytes.

Objective:

Gap junctions dynamically remodel to adapt to sympathetic signaling. However, it is unknown whether such rapid adaption also occurs for the adhesive function provided by desmosomes and adherens junctions.

Methods and Results:

Atomic force microscopy revealed that β-adrenergic signaling enhances both the number of desmoglein 2-specific interactions along cell junctions and the mean desmoglein 2-mediated binding forces, whereas N-cadherin-mediated interactions were not affected. This was accompanied by increased cell cohesion in cardiac myocyte cultures and murine heart slices. Enhanced desmoglein 2-positive contacts and increased junction length as revealed by immunofluorescence and electron microscopy reflected cAMP-induced reorganization of intercellular contacts. The mechanism underlying cAMP-mediated strengthening of desmoglein 2 binding was dependent on expression of the intercalated disc plaque protein plakoglobin (Pg) and direct phosphorylation at S665 by protein kinase A: Pg deficiency as well as overexpression of the phospho-deficient Pg-mutant S665A abrogated both cAMP-mediated junctional remodeling and increase of cohesion. Moreover, Pg knockout hearts failed to functionally adapt to adrenergic stimulation.

Conclusions:

Taken together, we provide first evidence for positive adhesiotropy as a new cardiac function of sympathetic signaling. Positive adhesiotropy is dependent on Pg phosphorylation at S665 by protein kinase A. This mechanism may be of high medical relevance because loss of junctional Pg is a hallmark of arrhythmogenic cardiomyopathy.
China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients
Authors: Men Xi , Sun Wei , Fan Fangfang , Zhao Min , Huang Xiao , Wang Yu , Liu Lishun , Liu Ran , Sun Weiping , Peng Qing , Qin Xianhui , Tang Genfu , Li Jianping , Zhang Yan , Cai Yefeng , Hou Fan Fan , Wang Binyan , Xu Xiping , Cheng Xiaoshu , Sun Ningling , Huang Yining , Huo Yong
Published: March 2017

Background

The optimal range of blood pressure variability remains unclear. We aimed to stratify the degree of risk of stroke based on visit‐to‐visit systolic blood pressure (SBP) variability in a large Chinese hypertensive population in 32 communities.

Methods and Results

We retrospectively analyzed the data of 20 702 hypertensive patients from the China Stroke Primary Prevention Trial. The participants were randomized into 2 treatment groups to receive either enalapril or enalapril plus folic acid. Their blood pressures were measured every 3 months. The outcome was the first stroke. Three parameters of SBP variability were calculated: standard deviation, coefficient of variation, and average real variability. The records of first 4, 6, 8, 10 and 12 visits at which SBP was measured were used to calculate SBP variability and to predict subsequent stroke risk in adjusted Cox regression models. After median follow‐up of 4.5 years, 597 patients had experienced stroke. Visit‐to‐visit SBP variability was an independent predictor of subsequent stroke (eg, the hazard ratio for the highest quintile of average real variability [22.67–61.07 mm Hg] over 6 visits was 1.55, 95% CI 1.07–2.25,
P
=0.021), independent of mean SBP over the follow‐up period. Its value was more predictive when more blood pressure records were used.

Conclusions

Visit‐to‐visit SBP variability is an independent predictor of primary stroke in Chinese hypertensive patients. This predictive value depends on the number of blood pressure measurements used to calculate variability but is independent of mean SBP.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00794885.
Lay Bystanders' Perspectives on What Facilitates Cardiopulmonary Resuscitation and Use of Automated External Defibrillators in Real Cardiac Arrests
Authors: Malta Hansen Carolina , Rosenkranz Simone Mørk , Folke Fredrik , Zinckernagel Line , Tjørnhøj‐Thomsen Tine , Torp‐Pedersen Christian , Sondergaard Kathrine B. , Nichol Graham , Hulvej Rod Morten
Published: March 2017

Background

Many patients who suffer an out‐of‐hospital cardiac arrest will fail to receive bystander intervention (cardiopulmonary resuscitation [CPR] or defibrillation) despite widespread CPR training and the dissemination of automated external defibrillators (AEDs). We sought to investigate what factors encourage lay bystanders to initiate CPR and AED use in a cohort of bystanders previously trained in CPR techniques who were present at an out‐of‐hospital cardiac arrest.

Methods and Results

One‐hundred and twenty‐eight semistructured qualitative interviews with CPR‐trained lay bystanders to consecutive out‐of‐hospital cardiac arrest, where an AED was present were conducted (from January 2012 to April 2015, in Denmark). Purposive maximum variation sampling was used to establish the breadth of the bystander perspective. Twenty‐six of the 128 interviews were chosen for further in‐depth analyses, until data saturation. We used cross‐sectional indexing (using software), and inductive in‐depth thematic analyses, to identify those factors that facilitated CPR and AED use. In addition to prior hands‐on CPR training, the following were described as facilitators: prior knowledge that intervention is crucial in improving survival, cannot cause substantial harm, and that the AED will provide guidance through CPR; prior hands‐on training in AED use; during CPR performance, teamwork (ie, support), using the AED voice prompt and a ventilation mask, as well as demonstrating leadership and feeling a moral obligation to act.

Conclusions

Several factors other than previous hands‐on CPR training facilitate lay bystander instigation of CPR and AED use. The recognition and modification of these factors may increase lay bystander CPR rates and patient survival following an out‐of‐hospital cardiac arrest.
Risk of Inhospital Stroke or Death Is Associated With Age But Not Sex in Patients Treated With Carotid Endarterectomy for Asymptomatic or Symptomatic Stenosis in Routine Practice: Secondary Data Analysis of the Nationwide German Statutory Quality Assurance Database From 2009 to 2014
Authors: Schmid Sofie , Tsantilas Pavlos , Knappich Christoph , Kallmayer Michael , König Thomas , Breitkreuz Thorben , Zimmermann Alexander , Kuehnl Andreas , Eckstein Hans‐Henning
Published: March 2017

Background

Guideline recommendations on carotid endarterectomy are based predominantly on randomized, controlled trials, in which women or elderly patients are often under‐represented. This study analyzed the association of age and sex with the risk of in‐hospital stroke or death following carotid endarterectomy under routine conditions in Germany.

Methods and Results

Secondary data analysis using the Statutory German Quality Assurance Database on all carotid endarterectomy procedures (n=142 074) performed between 2009 and 2014. Primary outcome was any stroke or death until discharge; secondary outcomes were any in‐hospital stroke (alone), and death (alone). Descriptive statistics and multilevel multivariable regression analyses were applied. Patients were predominately male (68%), with mean age 71 years. Carotid stenosis was symptomatic in 40%. Primary outcome occurred in 1.8% of women and 1.9% of men. Multivariable regression analysis revealed that more‐advanced age was associated with a higher primary outcome rate (relative risk [RR] per 10‐year increase: 1.19; 95%
CI
, 1.14–1.24). Risk of death (alone) was associated with age (
RR
, 1.68; 95%
CI
, 1.54–1.84). Age was associated with the risk of stroke (alone;
RR
, 1.05; 95%
CI
, 1.00–1.11). Sex was not associated with primary outcome rate (1.01; 95%
CI
, 0.93–1.10), nor did it significantly modify the age effect.

Conclusions

This study shows that increasing age, but not sex, is associated with a higher risk of in‐hospital stroke or death following carotid endarterectomy under everyday conditions in Germany. Whereas the risk of death (alone) is significantly associated with age, the association between age and the risk of stroke (alone) can be considered of minor importance.
Mff‐Dependent Mitochondrial Fission Contributes to the Pathogenesis of Cardiac Microvasculature Ischemia/Reperfusion Injury via Induction of mROS‐Mediated Cardiolipin Oxidation and HK2/VDAC1 Disassociation‐Involved mPTP Opening
Authors: Zhou Hao , Hu Shunying , Jin Qinhua , Shi Chen , Zhang Ying , Zhu Pingjun , Ma Qiang , Tian Feng , Chen Yundai
Published: March 2017

Background

The cardiac microvascular system ischemia/reperfusion injury following percutaneous coronary intervention is a clinical thorny problem. This study explores the mechanisms by which ischemia/reperfusion injury induces cardiac microcirculation collapse.

Methods and Results

In wild‐type mice, mitochondrial fission factor (Mff) expression increased in response to acute microvascular ischemia/reperfusion injury. Compared with wild‐type mice, homozygous Mff‐deficient (Mff
gt
) mice exhibited a smaller infarcted area, restored cardiac function, improved blood flow, and reduced microcirculation perfusion defects. Histopathology analysis demonstrated that cardiac microcirculation endothelial cells (
CMECs
) in Mff
gt
mice had an intact endothelial barrier, recovered phospho‐endothelial nitric oxide synthase production, opened lumen, undivided mitochondrial structures, and less
CMEC
death. In vitro, Mff‐deficient
CMEC
s (derived from Mff
gt
mice or Mff small interfering RNA–treated) demonstrated less mitochondrial fission and mitochondrial‐dependent apoptosis compared with cells derived from wild‐type mice. The loss of Mff inhibited mitochondrial permeability transition pore opening via blocking the oligomerization of voltage‐dependent anion channel 1 and subsequent hexokinase 2 separation from mitochondria. Moreover, Mff deficiency reduced the cyt‐c leakage into the cytoplasm by alleviating cardiolipin oxidation resulting from damage to the electron transport chain complexes and mitochondrial reactive oxygen species overproduction.

Conclusions

This evidence clearly illustrates that microcirculatory ischemia/reperfusion injury can be attributed to Mff‐dependent mitochondrial fission via voltage‐dependent anion channel 1/hexokinase 2–mediated mitochondrial permeability transition pore opening and mitochondrial reactive oxygen species/cardiolipin involved cyt‐c release.
Impact of Glycemic Control on Efficacy of Clopidogrel in Transient Ischemic Attack or Minor Stroke Patients With
CYP2C19
Genetic Variants
Authors: Lin Yi , Wang Anxin , Li Jiejie , Lin Jinxi , Wang David , Meng Xia , Ou Lixian , Chen Weiqi , Zhao Xingquan , Liu Liping , Wang Yilong , Wang Yongjun
Published: March 2017

Background and Purpose—

Dysglycemia may influence the predictive value of
CYP2C19
loss-of-function allele for clinical efficacy of antiplatelet drug, but the role of glycated albumin (GA) remains unclear in patients with stroke on antiplatelet drugs.

Methods—

The CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) included 2933 patients who had GA levels and
CYP2C19
genotyping. Cox proportional hazards model was used to assess the interaction between
CYP2C19
loss-of-function allele (*2, *3) carrier status and the effect of antiplatelet therapy based on their GA levels.

Results—

There was significant interaction between carrier status and antiplatelet therapy regimen on the risk of recurrent stroke (
P
=0.03) in patients with GA levels of ≤15.5%, but not in those with GA levels of >15.5% (
P
=0.48). Only in noncarriers with low GA levels, dual-antiplatelet therapy reduced stroke recurrence (3.5%) compared with those on aspirin alone (14.7%; hazard ratio, 0.23; 95% confidence interval, 0.10–0.49;
P
<0.001). Similar effects were observed when examined the combined vascular event or ischemic stroke. No significant difference in bleeding was found among groups.

Conclusions—

In patients with minor stroke or high-risk transient ischemic attack, clopidogrel–aspirin when compared with aspirin alone reduced stroke recurrence only in noncarriers of
CYP2C19
loss-of-function allele and normal GA levels.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00979589.
Gadoria (Antirrhineae, Plantaginaceae): A new genus, endemic from Sierra de Gádor, Almería, Spain
Authors: GÜEMES JAIME , MOTA JUAN F.
Published: March 2017

The surprising discovery of a population of a new species of Antirrhineae (Plantaginaceae) has also given rise to the description of a new genus situated in the subtribe Maurandyinae: Gadoria falukei. This is supported by the characteristics of the flower, pollen grains, seeds and capsule, and phylogenetic results based on DNA sequences. The species is endemic from Sierra de Gádor, Almería, Spain. Scanning electron microscopy was used to explore micromorphology of the capsule, indument, and seed and pollen grains ornamentation. Additionally, chromosomal number, preliminary insights on reproductive biology, phylogenetic position within Antirrhineae, ecological data and conservation status of the new species are provided.
Tuber sinoniveum, a new white Chinese truffle species from Yunnan, China
Authors: XU WENJUN , WAN SHANPING , HUANG LANLAN , ZHENG YI , GONG HEDE , YU FUQIANG
Published: March 2017

We describe a new species of Tuber from Yunnan Province, China, based on molecular and morphological data. This species is characterized by its snow-white ascomata, pubescent peridia and subglobose or globose ascospores. Tuber sinoniveum sp. nov. is phylogenetically closely related to T. sinosphaerosporum but differs in having ascospores with more meshes (3–9 along) and glabrous peridia. Phylogenetic placement of this novel Tuber species is in the Puberulum group.
Application of Physical Filter Initialization in 4DVar
Authors: Peng Wei , Liang Xudong , Zhang Xin , Huang Xiangyu , Lu Bing , Fu Qiao
Published: March 2017

Generally, the results of data assimilation are not well balanced dynamically due to errors in background, observations, or the model itself. So, initialization methods have been introduced to remove spurious gravity waves from the analysis. One of the initialization methods is digital filter initialization (DFI), which has been used in operational forecast systems, though its physical meaning is not well understood. Other methods eliminate high-frequency noise in optimized initial conditions by introducing physical constraints, such as the model constraint scheme, which minimizes the time tendency of model variables. In this study, a physical filter initialization (PFI) scheme, based on the model constraint scheme, is implemented in the four-dimensional variational data assimilation (4DVar) system of the Weather Research and Forecasting (WRF) Model. The impacts of the PFI scheme are examined by both single-observation and real-data experiments. The results indicate that the PFI scheme can eliminate high-frequency noise effectively, obtain flow-dependent analysis increments, and shorten forecast spinup time. Consequently, the precipitation forecast is improved to a certain extent, especially during the first few hours thanks to the shorter spinup time.
Laser-Induced Breakdown Spectroscopy for the Rapid Characterization of Lead-Free Gunshot Residues
Authors: Fambro Lashaundra A. , Vandenbos Deidre D. , Rosenberg Matthew B. , Dockery Christopher R.
Published: March 2017

This study investigated the use of laser-induced breakdown spectroscopy (LIBS) and scanning electron microscopy energy dispersive X-ray spectroscopy (SEM-EDX) as means of characterizing gunshot residue (GSR) originating from commercially available lead-free rounds. Data from two experiments are presented in this work. One experiment focused on identifying prominent analytical markers present in lead-free GSR by LIBS while the other applied SEM-EDX to determine the degree of evidence preservation after LIBS analysis. Samples of GSR were collected via tape-lift method from the hands of volunteer shooters and instrumental analyses were conducted in triplicate. As a result, the lead-free ammunition analyzed in this work generated GSRs comprising primarily Ba, Al, Si, and/or K. Trace amounts of Ti, Fe, and S were also apparent in some compositions. Through SEM-EDX analysis, a spheroidal geometry consistent with traditional lead-containing GSR was observed. Additionally, it was determined that evidence is preserved after LIBS analysis which supports the implementation of LIBS as a rapid preliminary screening method followed by confirmatory testing via SEM-EDX on the preserved evidence.
Stigma of Seeking Psychological Services: Examining College Students Across Ten Countries/Regions
Authors: Vogel David L. , Strass Haley A. , Heath Patrick J. , Al-Darmaki Fatima R. , Armstrong Patrick I. , Baptista Makilim N. , Brenner Rachel E. , Gonçalves Marta , Lannin Daniel G. , Liao Hsin-Ya , Mackenzie Corey S. , Mak Winnie W. S. , Rubin Mark , Topkaya Nursel , Wade Nathaniel G. , Wang Ying-Fen , Zlati Alina
Published: March 2017

Stigma is an important barrier to seeking psychological services worldwide. Two types of stigma exist: public stigma and self-stigma. Scholars have argued that public stigma leads to self-stigma, and then self-stigma is the primary predictor of attitudes toward seeking psychological services. However, this assertion is largely limited to U.S. samples. The goal of this research was to provide a first step in understanding the relationship between public stigma, self-stigma, and attitudes toward seeking psychological services in international contexts ( N = 3,276; Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, United Arab Emirates, and United States). Using structural equation modeling, we found that self-stigma mediated the relationship between public stigma and attitudes toward seeking services among college students in each country and region. However, differences in path strengths emphasize the need to pay attention to the role of public and self-stigma on attitudes toward seeking psychological services throughout the world.
Acculturative Stress, Psychological Distress, and Religious Coping Among Latina Young Adult Immigrants
Authors: Silva Nicole Da , Dillon Frank R. , Verdejo Toni Rose , Sanchez Mariana , De La Rosa Mario
Published: March 2017

Religion is a source of strength in Latina/o culture during challenging life transitions, such as the immigration process. Guided by a sociological stress–process model, this study examines relations between dimensions of religious coping, acculturative stress, and psychological distress among 530 young Latina women (ages 18-23 years) who recently immigrated to the United States (i.e., approximately 12 months prior to assessment). Higher levels of acculturative stress were associated with higher levels of psychological distress. Negative religious coping (i.e., the tendency to struggle with faith) moderated the relation between acculturative stress and psychological distress. Participants experiencing higher levels of acculturative stress reported greater psychological distress when they indicated more negative religious coping. Positive religious coping (i.e., the tendency to relate to faith with comfort and certainty) was not linked with acculturative stress or psychological distress. Implications for culturally tailored counseling interventions for this underserved and understudied population are discussed.
Positive Sexual Self-Schemas of Women Survivors of Childhood Sexual Abuse
Authors: Hitter Tracie L. , Adams Eve M. , Cahill Elizabeth J.
Published: March 2017

The purpose of this qualitative study was to examine the experiences of eight women survivors of childhood sexual abuse who view themselves as having a positive sexual self-schema, including their experiences of sexual satisfaction. Through thematic analysis, we developed the following themes: The Context for Sexual Development, Sexual Exploration, Coping Strategies, and Embracing the Sexual Self as Whole. The findings highlight the importance of relational, interpersonal, and community healing. Integral to women’s healing were experiences of sexual risk that allowed them to gain a sense of agency and empowerment. The themes that emerged provide additional support for Relational Cultural Theory as well as post-traumatic growth. We discuss the implications of these results in relation to counseling practice, training, and research.
What makes a mobile app successful in supporting health behaviour change?
Authors: Fitzgerald Martin , McClelland Tracy
Published: March 2017

Introduction:

Health promotion apps designed to support and reinforce health behaviours or to reduce risk behaviours are the most commonly downloaded apps. Such technologies have the potential to reach and deliver health care to new populations. But the extent to which they are successful in enabling the adoption of new and desired behaviours can vary. Some apps are more effective than others, some are free to download while others require a nominal or substantial charge. Cost alone is not indicative of quality or effectiveness. This is important because the use of health apps by the public will likely increase, as is the expectation that health care professionals understand this technology and its heuristic role in personalised health. Practitioners therefore need to be better informed regarding what makes a health app appealing to service users and successful as an intervention to facilitate behaviour change.

Objective:

This paper describes and discusses how the structure and content of health care apps can facilitate or inhibit behavioural change. The aim is to support practitioners in the screening and identification of suitable apps for clinical use.

Method:

Theory and literature review.

Conclusion:

App content that involved clinician input at the design stage and included internal drivers such as motivation, self-efficacy and illness understanding and external drivers such as illness information, social networking and user compatibility tend to do better in facilitating behaviour change than those that do not. Of these factors, motivation is considered to be the most important.
Everyday Heroism in Practicing Psychology
Authors: Friedman Harris L.
Published: March 2017

Heroism requires acting altruistically in the face of considerable risk. Professions such as psychology are based on working toward a public good and accordingly provide offsetting privileges for the sacrifices expected. Consequently, psychologists occasionally face professional dilemmas that provide everyday heroic opportunities. Examples of such opportunities during one psychologist’s career path are presented and implications for others in the profession are explored. These are put into the context of heroism as a transpersonal act that can be based on self-expansiveness in which someone goes beyond identifying with their self as an isolated entity and, instead, experiences a sense of interconnectedness with others, the world, and even the cosmos.
Characteristics of Parent Center Assistance From the Federation for Children With Special Needs
Authors: Cooc North , Bui Oanh T.
Published: March 2017

To assist parents of children with disabilities with navigating the special education system, the Individuals With Disabilities in Education Act (IDEA) established Parent Training and Information (PTI) Centers and Community Parent Resource Centers (CPRC) in each state. However, little is known about the 103 total Parent Centers currently operating across the country and whom they serve. We address this research gap by analyzing administrative data on 29,194 parents served over a 13-year period through the only PTI in Massachusetts, the Federation for Children With Special Needs (FCSN). Results show White parents and parents of children with autism spectrum disorders were more likely to contact the FCSN, while parents from rural and economically disadvantaged backgrounds were less likely to do so. Consistent across all backgrounds and disability categories, parents came to the FCSN most frequently for assistance related to individualized education programs (IEPs). Implications related to how Parent Centers can improve family outreach efforts and work with schools and community-based organizations are provided.
Gender, Attitudes Toward War, and Masculinities in Japan
Authors: Morinaga Yasuko , Sakamoto Yuiri , Nakashima Ken’ichiro
Published: March 2017

Previous studies have argued that masculinity is linked to war. We conducted a web-based survey to examine relationships between gender, attitudes toward war, and masculinities within a sample of Japanese adults of both sexes ( N = 366). Our results indicated that while men were more likely than women to accept war, the relationship between attitudes toward war and masculinities was inconclusive. Moreover, the results suggested that favorable attitudes toward war among men could be attenuated by interpersonal orientations. Based on our findings, we recommend a reexamination of attitudes toward war within the Japanese population.
Teachers’ English Proficiency and Classroom Language Use: A Conversation Analysis Study
Authors: Van Canh Le , Renandya Willy A.
Published: March 2017

How does teachers’ target language proficiency correlate with their ability to use the target language effectively in order to provide optimal learning opportunities in the language classroom? Adopting a conversation analysis approach, this study examines the extent to which teachers’ use of the target language in the classroom creates learning opportunities for L2 learners. The article also explores the relationship between teachers’ target language proficiency and the ways in which they use the target language in the classroom to engage learners in the learning process. Analyses of the lesson extracts show a complex relationship between teachers’ general language proficiency and their ability to make use of their proficiency to support student learning in the L2 classroom. The article concludes that while teachers’ general proficiency significantly affects the way they use language in the classroom to promote learning, their classroom proficiency is at least as important as their general proficiency. This has implications both for teachers and teacher educators.
One Country, Two Nationalisms: Center-Periphery Relations between Mainland China and Hong Kong, 1997–2016
Authors: Fong Brian C. H.
Published: March 2017

According to the Sino-British Joint Declaration and Basic Law, Hong Kong was to exercise a high degree of autonomy under the framework of “one country, two systems” after the British handover of its sovereignty to China in 1997. In the initial post-handover period, Beijing adopted a policy of nonintervention in Hong Kong, but the outbreak of the July 1, 2003 protest triggered a subsequent change of policy. Since then, Beijing has embarked on state-building nationalism, adopting incorporation strategies so as to subject Hong Kong to greater central control over the political, economic, and ideological arenas. Ironically, instead of successfully assimilating Hongkongese into one Chinese nation, Beijing’s incorporation strategies are leading to a rise of peripheral nationalism in the city-state and waves of counter-mobilization. This article analyzes mainland–Hong Kong relations on the eve of the twentieth anniversary of the handover and offers insights from an emerging case study that builds upon the nationalism literature.
Does the native language influence lexical composition in very preterm children at the age of two years? A cross-linguistic comparison study of Italian and Finnish children
Authors: Stolt Suvi , Savini Silvia , Guarini Annalisa , Caselli Maria Cristina , Matomäki Jaakko , Lapinleimu Helena , Haataja Leena , Lehtonen Liisa , Alessandroni Rosina , Faldella Giacomo , Sansavini Alessandra
Published: March 2017

This cross-linguistic study investigated whether the native language has any influence on lexical composition among Italian ( N = 125) and Finnish ( N = 116) very preterm (born at <32 gestational weeks) children at 24 months (controls: 125 Italian and 146 Finnish full-term children). The investigation also covered the effect of maternal education (ME) on lexical composition. The Italian/Finnish MacArthur Communicative Development Inventory was used for gathering the data. Although the lexicons of the preterm children were smaller than those of the controls, the native language had no major effect on their lexical composition. The ME had a significant effect on preterm children’s lexical composition, especially in the Finnish children. The findings indicate that lexical composition is not strongly affected by preterm birth. They also imply that lexical composition is a robust phenomenon that is connected to lexicon size and is not language-specific when analysed in broad terms, although some language-specific features were also detected.
Otoacoustic Emissions in Rural Nicaragua: Cost Analysis and Implications for Newborn Hearing Screening
Authors: Wong Lye‐Yeng , Espinoza Francisca , Alvarez Karen Mojica , Molter Dave , Saunders James E.
Published: March 2017

Objective

(1) Determine the incidence and risk factors for congenital hearing loss. (2) Perform cost analysis of screening programs.

Study Design

Proportionally distributed cross‐sectional survey.

Setting

Jinotega, Nicaragua.

Subjects and Methods

Otoacoustic emissions (OAEs) were used to screen 640 infants <6 months of age from neonatal intensive care unit, institutional, and home birth settings. Data on 15 risk factors were analyzed. Cost of 4 implementation strategies was studied: universal screening, screening at the regional health center (RHC), targeted screening, and screening at the RHC plus targeted screening. Cost‐effectiveness analysis over 10 years was based on disability‐adjusted life year estimates, with the World Health Organization standard of cost‐effectiveness ratio (CER) / gross domestic product (GDP) <3, with GDP set at $4884.15.

Results

Thirty‐eight infants failed the initial OAE (5.94%). In terms of births, 325 (50.8%) were in the RHC, 69 (10.8%) in the neonatal intensive care unit, and 29 (4.5%) at home. Family history and birth defect were significant in univariate analysis; birth defect was significant in multivariate analysis. Cost‐effectiveness analysis demonstrated that OAE screening is cost‐effective without treatment (CER/GDP = 0.06‐2.00) and with treatment (CER/GDP = 0.58‐2.52).

Conclusions

Our rate of OAE failures was comparable to those of developed countries and lower than hearing loss rates noted among Nicaraguan schoolchildren, suggesting acquired or progressive etiology in the latter. Birth defects and familial hearing loss correlated with OAE failure. OAE screening of infants is feasible and cost‐effective in rural Nicaragua, although highly influenced by estimated hearing loss severity in identified infants and the high travel costs incurred in a targeted screening strategy.