bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in imaging of brain abnormalities in neuromuscular disease
Authors: Angelini Corrado , Pinzan Elena
Published: May 2019

Brain atrophy, white matter abnormalities, and ventricular enlargement have been described in different neuromuscular diseases (NMDs). We aimed to provide a comprehensive overview of the substantial advancement of brain imaging in neuromuscular diseases by consulting the main libraries ( Pubmed, Scopus and Google Scholar) including the more common forms of muscular dystrophies such as dystrophinopathies, dystroglycanopathies, myotonic dystrophies, facioscapulohumeral dystrophy, limb-girdle muscular dystrophy, congenital myotonia, and congenital myopathies. A consistent, widespread cortical and subcortical involvement of grey and white matter was found. Abnormalities in the functional connectivity in brain networks and metabolic alterations were observed with positron emission tomography (PET) and single photon emission computed tomography (SPECT). Pathological brain changes with cognitive dysfunction seemed to be frequently associated in NMDs. In particular, in congenital muscular dystrophies (CMDs), skeletal muscular weakness, severe hypotonia, WM abnormalities, ventricular dilatation and abnormalities in cerebral gyration were observed.

In dystroglycanopathy 2I subtype (LGMD2I), adult patients showed subcortical atrophy and a WM periventricular involvement, moderate ventriculomegaly, and enlargement of subarachnoid spaces. Correlations with clinical features have been observed with brain imaging characteristics and alterations were prominent in congenital or childhood onset cases. In myotonic dystrophy type 2 (DM2) symptoms seem to be less severe than in type 1 (DM1).

In Duchenne and Becker muscular dystrophies (DMD, BMD) cortical atrophy is associated with minimal ventricular dilatation and WM abnormalities.

Late-onset glycogenosis type II (GSD II) or Pompe infantile forms are characterized by delayed myelination. Only in a few cases of oculopharyngeal muscular dystrophy (OPMD) central nervous system involvement has been described and associated with executive functions impairment.
A design methodology for quiet and long endurance MAV rotors
Authors: Serré Ronan , Fournier Hugo , Moschetta Jean-Marc
Published: May 2019

Over the last 10 years, the use of micro air vehicles has rapidly covered a broad range of civilian and military applications. While most missions require optimizing the endurance, a growing number of applications also require acoustic covertness. For rotorcraft micro air vehicles, combining endurance and covertness heavily relies on the capability to design new propulsion systems. The present paper aims at describing a complete methodology for designing quiet and efficient micro air vehicle rotors, ranging from preliminary aerodynamic prediction to aeroacoustic optimization to experimental validation. The present approach is suitable for engineering purposes and can be applied to any multirotor micro air vehicle. A fast-response and reliable aerodynamic design method based on the blade-element momentum theory has been used and coupled with an extended acoustic model based on the Ffowcs Williams and Hawkings equation as well as analytical formulations for broadband noise. The aerodynamic and acoustic solvers have been coupled within an optimization tool. Key design parameters include the number of blades, twist and chord distribution along the blade, as well as the choice of an optimal airfoil. An experimental test bench suitable for non-anechoic environment has been developed in order to assess the benefit of the new rotor designs. Optimal rotors can maintain high aerodynamic efficiency and low acoustic signature with noise reductions in the order of 10 dB(A).
What do hospital doctors and nurses think wastes their time?
Authors: Bagheri Lankarani Kamran , Ghahramani Sulmaz , Roozitalab Marjan , Zakeri Mohammadreza , Honarvar Behnam , Kasraei Hengameh
Published: May 2019

Objective:

With regard to limitation in national budget, the relevant authorities of healthcare and treatment throughout the globe are seeking the use of available resources in a way that no wastage of money or time—which is, of course, convertible to money—is acceptable. This study sought the opinions of hospital doctors and nurses on those activities at work that wasted their time.

Methods:

A questionnaire designed to identify activities that waste time during hospital care was completed based on the review of previous studies and including hospital wastes items. The authors designed a questionnaire, which was filled out by 209 nurses and 30 doctors in the surgery wards in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). The items for time wasting activities were extracted from previous studies, and the reliability of the questionnaire was more than 0.785 using Cronbach’s alpha. The response rate was more than 60%.

Results:

The mean age of the participating nurses and doctors was 30.24 ± 6.85 and 32.77 ± 7.05 years. In all aspects, more time was wasted during the morning and evening shifts in comparison with the night shifts. The activity that was thought to waste time in hospital care the most was paper-based documentation. Preventable wasted time during the shift was 16%–30% in the nurses’ view and 18%–34% in the doctors’ view. For both nurses and doctors, the highest-rated preventable wasted time was related to time spent waiting in ward for lab data responses, transfer of patients, or delivery of care.

Conclusion:

Hospital working environment is complex, and opportunities for improvement of the efficiency of the nurses’ and doctors’ workload should be analyzed, case by case, in each hospital and work group. Process change (for the decrease in the wasted time for waiting in wards), simple innovative ways (for the decrease in the wasted time for searching the needed equipment), using hospital information system technology for documentation, communication, and the better design of the wards (to decrease the wasted time due to transfer between the ward and restroom) could be helpful for improving efficiency and for a safer and acceptable delivery of care.
Case of Erdheim–Chester presenting with xanthelasma-like eruption and osteolytic bone lesions: A case report
Authors: Chinchilla Evelyn Alarcon , Gourde Marie-Pascale , Turcotte Karine , Mathieu Steve , Amin-Hashem Mohamed
Published: May 2019

Erdheim–Chester disease is a rare multisystemic non-Langerhans cell histiocytosis presenting 95% with skeletal lesions. Erdheim–Chester disease is due to mutations in the RAS-MEK-ERK pathway where 50% are due to BRAF-V600E mutations. Typical histopathological, clinical, and radiologic features are necessary for the diagnosis of Erdheim–Chester disease. Prognosis depends on the extent of the systemic involvement, and central nervous system involvement has a poorer outcome. We present a 30-year-old Moroccan woman with diabetes insipidus, bone marrow, and asymmetrical axial osteolytic bone lesions. Biopsies were consistent with Erdheim–Chester disease. Despite no treatment, the patient has demonstrated clinical improvement.
Limb threatening thigh hematoma diagnosis accelerated by emergency physician bedside ultrasound
Authors: Eicken John J , Morrow Dustin
Published: May 2019

Introduction:

Compartment syndrome is a serious condition that requires prompt diagnosis, specialty consultation, and definitive management to prevent significant morbidity. Traditionally, compartment syndrome is identified by physical exam findings including the presence of pain, pallor, paresthesia, pulselessness, and paralysis involving the affected limb. Identifying the presence of compartment syndrome prior to the onset of signs that portend a poor outcome (i.e. pallor, pulselessness, and paralysis) can be challenging since many other less serious traumatic conditions can lead to paresthesia and pain in a limb. Bedside ultrasound is increasingly being utilized by emergency providers to expedite identification of various emergent diagnoses and guide care for patients who present to emergency departments. Bedside ultrasound allows emergency providers to visualize pathologic processes occurring that may be difficult to identify through traditional physical exam findings. This case report highlights the use of bedside ultrasound to promptly identify the presence of a traumatic thigh hematoma, which led to expedited advanced imaging and specialty consultation for compartment syndrome prior to the onset of physical exam findings consistent with compartment syndrome.

Conclusion:

The identification of compartment syndrome in the early stages is challenging given the overlap of signs and symptoms with other less emergent conditions. Early diagnosis of compartment syndrome is important to decrease morbidity, which can result from a delayed diagnosis of compartment syndrome. To our knowledge, this is the first case report to describe the use of bedside ultrasound to aid in the diagnosis of compartment syndrome and accelerate the care for a patient who presented with a traumatic thigh hematoma, which rapidly progressed to compartment syndrome and required emergent operative intervention.
Coping with my own way: Mediating roles of emotional expression and social support seeking in the associations between individual differences and posttraumatic growth
Authors: Yeung Nelson CY , Chow Tak Sang
Published: May 2019

This study examined the associations between individual differences and posttraumatic growth, and coping strategies as mediators among 454 trauma-exposed American college students. Results showed that relational-interdependent self-construal, optimism, emotional expression, and social support seeking were associated with higher posttraumatic growth. Moreover, social support seeking and emotional expression partially mediated between relational-interdependent self-construal and posttraumatic growth, such that relational-interdependent self-construal was associated with posttraumatic growth through increased support seeking and emotional expression. However, the association between optimism and posttraumatic growth was partially mediated only by increased emotional expression, but not social support seeking. Findings imply that individual differences may facilitate posttraumatic growth through different coping mechanisms.
What Affects What? Perceived Cannabis Availability and Its Use Among Czech Urban Youth—A Multilevel Sociogeographic Analysis
Authors: Kážmér Ladislav , Chomynová Pavla , Csémy Ladislav
Published: May 2019

Although there is already considerable research on the connection between the availability of substance and the prevalence of its use, the relative effect that one factor has on the other is rather unclear. The present study aims to scrutinize the mutual relationship between subjectively perceived cannabis availability and the prevalence of cannabis use among 15- to 16-year-old students, applying an integrative multilevel analytic framework. The Czech 2011 European School Survey Project on Alcohol and Other Drugs (ESPAD) dataset ( N = 8,069 respondents) entered multilevel regression analyses to examine the sociogeographical inequalities in both perceived availability and adolescent frequent cannabis use (individuals [Level 1] nested within schools [Level 2] and localities [Level 3]). At the same time, the mutual relationship of the two cannabis indicators was demonstrated. At the level of individuals (Level 1), the simultaneous equations modeling (SEM) approach was applied to estimate the relative effect of perceived cannabis availability on the frequency of cannabis use and compare it vice versa. Adolescents coming from highly urbanized areas perceived cannabis to be more readily available, and they had a higher prevalence of frequent cannabis use. The higher availability mediated the sociogeographic inequalities in cannabis use. The locality unemployment rate was unrelated to either of the two cannabis indicators. At the individual level of the adolescent respondent, the effect of perceived availability on cannabis use appears to be much stronger than that of the effect of cannabis use on perceived availability when reversed. Perceived availability was found to mediate sociogeographic inequalities in cannabis use among Czechs adolescents. If a higher availability increases opportunities for adolescent substance misuse, then alongside other preventive measures, a spatially integrated approach should be applied in the national drug policy.
Promoting the Development of Evidence-Based Concussion Education for Power-5 Collegiate Athletes: The Influences of Organizational Elements on Perceived Vestedness
Authors: Adame Bradley J. , Adame Elissa A. , Liu Yanqin , Posteher Karlee A. , Tsai Jiun-Yi , Corman Steven R.
Published: May 2019

Concussions present a significant health concern for collegiate athletes, team leaders, and university administrators. The consequences of these injuries can affect athletes’ scholastic and athletic performance in the short term, and manifest later in life, long after their athletic career ends. Present educational efforts are ineffective because they neglect important influences on athletes’ decisions to report potential concussion injuries. Here, we present research that examines organization-based influences on vestedness in attitudes related to athletes’ perceived risk of concussion consequences and team commitment. Examining a sample of 435 collegiate athletes from 11 universities, participating in six Division I/Power-5 conference high-concussion-risk sports, our findings support that organizational-based perceptions exert influence on these key concussion–related variables. In synthesizing the results, we offer evidence-based recommendations that organizational members can use to create environments that promote concussion injury reporting and adherence to recovery protocols. This research contributes to the growing body of literature calling for the development of educational concussion injury education modules that recognize contextual influences grounded in communication theory and provide a persuasive impetus.
Doublecortin Mutation in an Adolescent Male
Authors: Zare Isabelle , Paul Dustin , Moody Shade
Published: May 2019

Doublecortin (DCX) mutations cause abnormal development of the DCX protein that normally aids in neuronal migration during fetal development. These mutations lead to lissencephaly, or the appearance of a “smooth brain,” which is varying levels of pachygyria or agyria in severe cases. Many genetic variants of the mutation have been identified, and an even greater range of phenotypic presentations have been described in the literature. The X-linked lissencephaly (DCX) mutation leads to an X-linked gender-dependent condition that causes subcortical heterotopia in females and lissencephaly in males. The authors report the case of a 13-year-old male who presented to our clinic for new-onset seizure disorder. He had a past medical history of developmental delay and features of autism spectrum disorder which was diagnosed at age 5 years at an outside clinic. Magnetic resonance imaging (MRI) brain at age 5 years showed pachygyria of the frontal and temporal lobes. After extensive genetic testing over the course of over a decade, the patient was found to have a de novo mutation in the DCX gene diagnosed via whole-exome sequencing. Specifically, he was found to have a mosaic mutation of the DCX gene as a c.30-31 deletion. His previous MRI findings were consistent with a diagnosis of X-linked sporadic lissencephaly sequence and included mainly a diffuse bilateral pachygyria (isolated lissencephaly sequence X chromosome). Thickening of the cortex and pachygyria or agyria are classic findings of lissencephaly, but do not help specify any mutation in the gene, of which there are over 70 possibilities. Our patient is unique in that most individuals with DCX mutation have infantile seizures, severe intellectual disability, orthopedic complications, and postnatal microcephaly, which our patient does not have.
A Conceptual Framework of Entrepreneurial Finance
Authors: Clement Tom , Silvernagel Craig
Published: May 2019

This article proposes a framework and core content for entrepreneurial finance (EF) that distinguishes EF from corporate finance. The Realms of Entrepreneurial Finance (REF) framework builds on existing literature along with theories and methodologies from psychology and entrepreneurship. This study also offers a set of EF learning goals and objectives as well as suggestions for teaching EF. The REF framework benefits entrepreneurship educators and scholars in furthering the understanding, maturation, and legitimacy of EF education.
Sumatriptan activates TRPA1
Authors: Babes Alexandru , Neacsu Cristian , Fischer Michael JM , Messlinger Karl
Published: May 2019

Background:

Migraine therapy with sumatriptan may cause adverse side effects like pain at the injection site, muscle pain, and transient aggravation of headaches. In animal experiments, sumatriptan excited or sensitized slowly conducting meningeal afferents. We hypothesized that sumatriptan may activate transduction channels of the “irritant receptor,” the transient receptor potential ankyrin type (TRPA1) expressed in nociceptive neurons.

Methods:

Calcium microfluorometry was performed in HEK293t cells transfected with human TRPA1 (hTRPA1) or a mutated channel (TRPA1-3C) and in dissociated trigeminal ganglion neurons. Membrane currents were recorded in the whole-cell patch clamp configuration.

Results:

Sumatriptan (10 and 400 µM) evoked calcium transients in hTRPA1-expressing HEK293t cells also activated by the TRPA1 agonist carvacrol (100 µM). In TRPA1-3C-expressing HEK293t cells, sumatriptan had hardly any effect. In rat trigeminal ganglion neurons, sumatriptan, carvacrol, and the transient receptor potential vanillod type 1 agonist capsaicin (1 µM) generated robust calcium signals. All sumatriptan-sensitive neurons (8% of the sample) were also activated by carvacrol (14%) and capsaicin (48%). In HEK293-hTRPA1 cells, sumatriptan (100 µM) evoked outwardly rectifying currents, which were almost completely inhibited by the TRPA1 antagonist HC-030031 (10 µM).

Conclusion:

Sumatriptan activates TRPA1 channels inducing calcium inflow and membrane currents. TRPA1-dependent activation of primary afferents may explain the painful side effects of sumatriptan.
Energy Market Integration in ASEAN: Locational Marginal Pricing and Welfare Implications
Authors: Chang Youngho , Lee Justin , Xiang Ang Wei , Yi Chua Jing
Published: May 2019

Energy market integration (EMI) in the ASEAN through the ASEAN Power Grid (APG) is considered to improve the welfare of the economy. In the simulation analyses of cross-border power trading, charging only a tariff as a function of the distance transmitted as access costs appears to ignore the effect of a marginal change in demand or supply from consumers and generators, respectively, on the transmission grid. This, in turn, leads to a poor signal to the market, making suboptimal decisions by economic agents. This study aims to analyse how the locational marginal pricing (LMP) of transmission losses influences an optimal energy mix and energy trading in the ASEAN and derive policy implications for completing the APG. Energy trading with the LMP mechanism of transmission losses appears to provide benefits to the countries under the APG as the total cost of electricity generation declines when power trade increases among ASEAN countries. The underpinnings of positive results strongly suggest that ASEAN member countries seriously consider enhancing grid interconnection to realise the efficiency of power trading infrastructure.

JEL Codes: F15, O13, Q49
Challenging liver lesions in noncirrhotic patients: Report of three cases
Authors: Franceschini Tania , Malvi Deborah , Maroni Lorenzo , Ravaioli Matteo , Cescon Matteo , D’Errico Antonia , Vasuri Francesco
Published: May 2019

We describe three cases of liver lesions, characterized by a discrepancy between presurgical imaging and histological features, in which the final histological diagnosis was quite different from what the surgeons expected. We present (1) a case of primary liver angiomyolipoma associated with focal nodular hyperplasia, (2) a case of perivascular epithelioid cell tumor, and (3) a case of liver splenosis associated with focal nodular hyperplasia. In all cases, a presurgical diagnosis of hepatocellular adenoma was made. Due to nonspecific clinical and radiological features, these rare liver lesions are often presurgically misdiagnosed, especially in young noncirrhotic patients. The association among different lesions represents one additional diagnostic challenge.
Fetal Echocardiographic Detection of Cardiac Tumors: A Case Report of Multiple Fetal Cardiac Rhabdomyomas
Authors: Sarff Bailey , Floyd Randall , Bildner Amy , Stormo Janell , Fisher Kelsy
Published: May 2019

Cardiac rhabdomyomas are the most common fetal cardiac tumor. They can be detected in the second and third trimesters. Rhabdomyomas are most commonly associated with the genetic disorder tuberous sclerosis complex. When associated with tuberous sclerosis complex, cardiac rhabdomyomas usually regress within the first few years of life, without complications. Symptoms depend on the size, number, and location of the rhabdomyomas. A case report of multiple cardiac rhabdomyomas that was found at 35 weeks’ gestation and is discussed.
Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso
Authors: Brabin Bernard , Gies Sabine , Roberts Stephen A. , Diallo Salou , Lompo Olga M. , Kazienga Adama , Brabin Loretta , Ouedraogo Sayouba , Tinto Halidou
Published: May 2019

Background

Iron supplementation before a first pregnancy may improve the future health of mother and baby by reducing maternal anaemia. Iron supplementation could, however, increase malaria infections, notably in primigravidae who are most susceptible. The pathogenicity of other iron-utilizing pathogens could also increase, causing inflammation leading to increased risk of adverse birth outcomes. This paper reports pre-specified secondary birth outcomes from a safety trial in Burkina Faso in an area of high malaria endemicity. Primary outcomes from that trial had investigated effects of long-term weekly iron supplementation on malaria and genital tract infections in non-pregnant and pregnant women.

Methods

A double-blind, randomized controlled trial. Nulliparous, mainly adolescent women, were individually randomized periconceptionally to receive weekly either 60 mg elemental iron and 2.8 mg folic acid, or 2.8 mg folic acid alone, continuing up to the first antenatal visit for those becoming pregnant. Secondary outcomes were ultrasound-dated gestational age, fetal growth, placental malaria, chorioamnionitis and iron biomarkers. Seasonal effects were assessed. Analysis was by intention to treat.

Results

478 pregnancies occurred to 1959 women: 258/980 women assigned iron and folic acid and 220/979 women assigned folic acid alone. Malaria prevalence at the first antenatal visit was 53% (iron) and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213 g, P = 0.033). Mean gestational ages were 264 days (iron) and 269 days (controls) (P = 0.012), with 27.5% under 37 weeks compared to 13.9% in controls (adjRR = 2.22; 95% CI 1.39–3.61) P < 0.001). One-third of babies were growth restricted, but incidence did not differ by trial arm. Half of placentae had evidence of past malaria infection. C–reactive protein > 5 mg/l was more common prior to births < 37 weeks (adjRR = 2.06, 95% CI 1.04–4.10, P = 0.034). Preterm birth incidence during the rainy season was ~ 50% in the iron arm and < 20% in controls (P = 0.001). Chorioamnionitis prevalence peaked in the dry season (P = 0.046), with no difference by trial arm (P = 0.14).

Conclusion

Long-term weekly iron supplementation given to nulliparous women in a malaria endemic area was associated with higher risk of preterm birth in their first pregnancy.

Trial Registration NCT01210040. Registered with Clinicaltrials.gov on 27th September 2010
Prevalence and experience of harassment of people with mental health problems living in the community
Authors: Berzins Kathryn M. , Petch Alison , Atkinson Jacqueline M.
Published: May 2019

Background

The levels and experiences of harassment of people with mental health problems in the community compared with those of the general population have not been explored.

Aims

To measure the levels and experience of harassment experienced by people with mental health problems in the community in Scotland and compare them with the general population.

Method

Experiences of harassment were collected by interviewing 165 individuals with mental health problems and a control group of 165 people from the general population.

Results

Harassment in the community was found to be twice as common for individuals with mental health problems (41%) than for those in the general population (15%). The harassment commonly involved verbal abuse referring to the individual's mental health problems and was committed primarily by teenagers and neighbours.

Conclusions

Harassment has a significantly higher prevalence among individuals with mental health problems living in the community and is believed to have a detrimental effect on mental health.
Childhood origins of violent behaviour in adults with schizophreniform disorder
Authors: Arseneault Louise , Cannon Mary , Murray Robin , Poulton Richie , Caspi Avshalom , Moffitt Terrie E.
Published: May 2019

Background

People with psychosis have an elevated risk of violence.

Aims

To examine whether violent behaviour in adults with psychosis can be accounted for by psychotic symptoms or physical aggression in childhood.

Method

We used data from a prospective longitudinal study of a complete birth cohort born in New Zealand. When cohort members were 26 years old, information was obtained on past-year psychiatric diagnosis of schizophreniform disorder and on violent behaviour. Childhood psychotic symptoms were measured at age 11 years using a diagnostic interview, and childhood physical aggression was assessed by teachers when cohort members were aged 7, 9 and 11 years.

Results

Participants with schizophreniform disorder were more likely to be violent than participants without, even after controlling for sociodemographic variables and concurrent substance dependence disorders. Childhood psychotic symptoms were a strong risk factor for violence in adults with schizophreniform disorder, as was childhood physical aggression, allthough to a lesser extent.

Conclusions

Violence by individuals with schizophreniform disorder could be prevented by monitoring early signs of psychotic symptoms and by controlling childhood physical aggression.
Diet, smoking and cardiovascular risk in people with schizophrenia
Authors: McCreadie R. G. ,   Scottish Schizophrenia Lifestyle Group
Published: May 2019

Background

Physical health of people with schizophrenia is poor and they die early from cardiovascular disease.

Aims

To describe the lifestyle of people with schizophrenia through diet, smoking habits, weight and exercise, and to report risk of coronary heart disease (CHD).

Method

Dietary habits of 102 community-dwelling people with schizophrenia were assessed by the Scottish Health Survey Questionnaire. Also assessed were smoking habits, physical activity biochemical indices of nutrition and future risk of CHD.

Results

Fewer males, compared with the general population, reached acceptable levels for consumption of fruit, vegetables, milk, potatoes and pulses. Fewer females reached the levels for consumption of milk and potatoes. Mean number of fruit and vegetable portions consumed per week was 16 (s.d.=14); 71 (70%) were smokers; 25 (86%) females and 50 (70%) males were overweight or obese; 59 (59%) considered themselves physically active; 46 (53%) had a raised cholesterol: high-density lipoprotein ratio, and 64 (74%) a low α-tocopherol: cholesterol ratio. Mean 10-year risk of CHD in males was 10.5% (s.d.=8) and in females 7% (s.d.=6).

Conclusions

The lifestyle of people with schizophrenia must give cause for concern in relation to CHD Care from secondary care services must address physical as well as mental health.
Psychosis Research at Maastricht University, The Netherlands
Authors: van Os Jim , Delespaul Philippe
Published: May 2019

The academic department of psychiatry at Maastricht University is situated not only in the university hospital, but crucially also in nearly all the affiliated mental health institutions in a region with a source population of 650 000. This set-up is funded by a central government grant, allowing academic personnel to work in affiliated mental health institutions. Research projects are carried out on the basis of 4-year PhD contracts, or, in the case of doctors with specialist training, through research psychiatrist appointments in the regional academic psychiatric network. Strong links exist with the Institute of Psychiatry in London.
End-Expiratory Occlusion Test to Predict Fluid Responsiveness Is Not Suitable for Laparotomic Surgery
Authors: Weil Gregoire , Motamed Cyrus , Monnet Xavier , Eghiaian Alexandre , Le Maho Anne-Laure
Published: May 2019

BACKGROUND:

The end-expiratory occlusion test predicts fluid responsiveness in ventilated intensive care patients; however, its utility in the operating room is questioned. We assessed end-expiratory occlusion test in laparotomic surgery for predicting volume expansion.

METHODS:

Forty-six patients were included in this study: stage 1 (n = 26) with an end-expiratory occlusion test of 15 seconds, followed by volume expansion, which consisted of 250 mL of colloid over 5 minutes and stage 2 (n = 20) with an end-expiratory occlusion test of 25 seconds followed by volume expansion. The last 10 patients had transdiaphragmatic pressures probed. Patients with an increase in cardiac index >15% after volume expansion were responders. Pulse pressure variation, stroke volume (SV) index, and cardiac index were analyzed. Receiver operating characteristic curves were established for changes in SV and pulse pressure induced by end-expiratory occlusion test and pulse pressure variation using the responders status for volume expansion as outcome.

RESULTS:

A total of 44 (38%) volume expansions were deemed responders. After end-expiratory occlusion test of 15 seconds, no hemodynamic variables were significantly increased. After end-expiratory occlusion test of 25 seconds, SV index increased in responders (37.1 ± 8.8 mL/m2 after end-expiratory occlusion test of 25 seconds versus 35.7 ± 8.6 before; P < .0001). End-expiratory occlusion test could not discriminate responders from nonresponders. Only pulse pressure variation had significantly different area under the curve from that expected by chance (0.7 [0.57–0.81]; P = .002 for end-expiratory occlusion test of 15 seconds; and 0.78 [0.64–0.89]; P = .0001 for end-expiratory occlusion test of 25 seconds). After laparotomy, gastric pressure decreased significantly (4 [2.75–5] vs 2 [2–4] cm H2O; P = .0417); no difference was noticed in the transdiaphragmatic gradient.

CONCLUSIONS:

End-expiratory occlusion test was not reliable to discriminate responders from nonresponders after volume expansion during laparotomic surgery.
Retrospective Analysis of the Safety and Efficacy of Sugammadex Versus Neostigmine for the Reversal of Neuromuscular Blockade in Children
Authors: Gaver Renee S. , Brenn Bruce R. , Gartley Alison , Donahue Brian S.
Published: May 2019

BACKGROUND:

Sugammadex, with its novel mechanism of action of encapsulation and noncompetitive binding of aminosteroid neuromuscular-blocking agents (rocuronium and vecuronium), may offer distinct advantage to pediatric patients where residual neuromuscular blockade may be poorly tolerated. Data describing its use in the pediatric population are limited, and no large-scale studies are available evaluating the occurrence of adverse event across the full spectrum of ages. We sought to measure the occurrence of adverse events, assess the severity and clinical significance of the events, and quantify a surrogate measure of efficacy of sugammadex compared to neostigmine in a large population and in the full age range of children.

METHODS:

Beginning in September 2016 through initiation of data collection, we identified from our data warehouse that all patients were treated with sugammadex for reversal of neuromuscular blockade, from birth through adolescence, and retrospectively matched, by case type and age group, to historical neostigmine-treated controls. From subsequent chart review, we quantified occurrence of adverse events and administration of medications to treat adverse events. All cases in the originally identified cohort treated with epinephrine after administration of sugammadex underwent chart review to elicit the cause, in the event that an infrequently occurring event was not captured after the case-matching process. “End-Interval Time,” the time from administration of reversal agent to time out of the procedure room, was measured as an indirect assessment of efficacy.

RESULTS:

Fewer cases of bradycardia were observed in the sugammadex group compared to the neostigmine group in the overall cohort (P < .001) and in the subgroups of older children (P < .001) and adolescents (P < .001). End-interval time, the time measured from administration of neuromuscular blockade (NMB) reversal agent to time out of the operating room, was significantly shorter in sugammadex-treated groups in the overall cohort (mean difference, 2.8; 95% CI, 1.85–3.77; P < .001) and all age groups except for first year (31 days through 12 months). This observation was most pronounced in the neonatal subgroup (mean difference, 11.94 minutes; 95% CI, 4.79–19.1; P < .001). No other adverse events measured were found to be different between treatment groups.

CONCLUSIONS:

This study provides data supporting the safe and effective use of sugammadex for reversal of neuromuscular blockade throughout the entire range of ages in the pediatric population. Within age groups, sugammadex demonstrates faster completion of operation compared with neostigmine, with the greatest difference observed in the neonatal population.
(Com)Post-Capitalism
Authors: Jones Bradley M.
Published: May 2019

This article explores the cultivation of life in ruins. At the foothills of Appalachia, I focus on a permaculture farmer—Sally of Clearwater Creek—fostering arts of (making a) living on a damaged planet. Ethnography in the Anthropocene requires tending and attending to those making the best of the mess that’s been made: a commitment to noticing things not (only) falling apart, but (also) coming back together again. In other words, an attention to compost—the (de)compositional processes and collaborative assemblages nourishing all life on earth. Building on “more-than-human” and “human economy” theorizing in the environmental humanities and economic anthropology respectively, this article develops the concept of the “more-than-human economy” to better understand the “problem of living despite economic and ecological ruination” (Tsing 2015). At Clearwater Creek a multi-species ecological ethic recursively informs an economic paradigm for making ends meet with others, where surpluses born of synergies feed back into a resilient system, revaluing weeds and waste. Sally’s labors reflect a new form of ethical, ecological, and economic entanglement that crops up in the interstitial spaces and disturbed landscapes of the Anthropocene. Permaculture praxis—an embodied relationship with more-than-human others and an attention to symbiotic communities of co-flourishing—contributes to the cultivation of “arts of attentiveness” (van Dooren et al. 2016) necessary for living (well) on a damaged planet. Promising, yet precarious, these emergent forms of life offer hope in a blasted landscape (Kirksey et al. 2014).
Itineraries of Conflict in Arundhati Roy’sWalking with the Comrades
Authors: Amatya Alok
Published: May 2019

This article studies the depiction of indigenous struggles against the grab of minerals, crude oil, and other natural resources by private and government corporations in works such as Arundhati Roy’s travel essay “Walking with the Comrades” (2010). Roy’s narrative of her journey across the dense forests of Bastar in east-central India re-articulates the significance of this contested environmental space from the perspective of the region’s indigenous minorities. Traveling with a troop of indigenous rebels hailing from the Gond, Halba, and Muria communities for more than two weeks, Roy describes their armed struggle to a global English audience. Exploring Roy’s role both as an itinerant narrator and a global cultural mediator, the author argues that descriptive accounts of travel through contested zones of extraction can foster a vocabulary of resistance that the author calls an itinerary of conflict. Drawing from Michel de Certeau’s conception of the tour as a descriptive approach to space, the author posits the itinerary of conflict as a spatial trope produced in Roy’s essay when the writer’s embodied travel narrative is inflected by indigenous journeys and spatial practices, such as marches across contested zones and ritual processions to sacred sites. Itineraries of conflict enact a semiotic and political resistance to resource grabs conducted by state agencies and powerful corporations, exemplified by the usurpation of tribal lands rich in iron ore, coal, and other minerals in Chhattisgarh state. Further, itineraries of conflict emphasize the embodied presence of indigenous communities and their activists in areas demarcated for the extraction of minerals, timber, and other resources in the face of continued armed conflict or toxic pollution. More broadly, the author suggests that narratives of conflict over the extraction of natural resources can be studied as the corpus of “resource conflict literature,” thus generating a global comparative framework for the study of contemporary indigenous struggles.
Making Live and Letting Die
Authors: Lykke Nina
Published: May 2019

With a focus on global cancer epidemics, the article discusses biopolitics in the Anthropocene against the background of a notion of dual governmentality, implying that efforts to make populations live and tendencies to let them die are intertwined. The conceptualization is based on postcolonial scholar Achille Mbembe’s notion of necropolitics and cultural critic Lauren Berlant’s notion of slow death, developing Foucauldian understandings of biopower. Liver cancer and breast cancer serve as cases showing the operations of an Anthropocene necropolitics, that is, its modes of working through political neglect of carcinogenic effects of conditions of poverty in postcolonial capitalism and chemical modernity. The article introduces Anthropocene necropolitics as an analytics, useful for a critical understanding of the global cancer epidemics. But it aims also to transgress a merely critical approach and to contribute to the search for critically affirmative points of exit into new and more promising worlding practices. Therefore, it engages in the discussion of the Anthropocene concept’s lack of potentials to go beyond critique. Instead, the author tries out Donna Haraway’s proposal to complement the Anthropocene concept with the figuration of Chthulucene, calling for a shift of ethical stance and position of enunciation from the sovereign (white, Western) “I,” waging “war” on cancer to a “we,” based on a planetwide kinship of vulnerable bodies. Underlining that this shift can also commit to alternative modes of writing, the article ends with a poem, “Anthropos and the Canary in the Mine.” The poem situates the analysis in the entanglement of political, ethical, theoretical, and personal passions brought about by the author’s process of mourning her life partner’s cancer death.
Outside Inside
Authors: Dickinson Adam
Published: May 2019

Through the proliferation of plastics, and chemical pollution more generally, petrochemicals constitute forms of social, material, and biological writing. How might contemporary writers respond to the capacity of petrochemical hyperobjects to influence social formations or alter human metabolism? This selection of poems is an attempt to work within a necessarily expanded notion of what constitutes reading and writing in the Anthropocene. Incorporating the results of biomonitoring tests for phthalates on the author’s own urine, the poems consider the “metabolic poetics” of endocrine disrupting chemicals. By focusing on the “outside” that is “inside,” the poems draw attention to the coextensive and intra-active nature of the body with its environment and the consequent implications for linking the human to the nonhuman and the personal to the global in environmental ethics.
Toxic Bodies
Authors: Straube Wibke
Published: May 2019

Tracing ticks in two different artworks and Leslie Feinberg’s activist writing, Wibke Straube takes their lead in this article from philosopher Donna Haraway and her suggestion to think about engagement with the environment through an “ethics of response-ability.” By deploying close readings, Straube discusses the affects represented in the video installation Act on Instinct (2013) by Elin Magnusson, a sequence of the film Something Must Break (2014) by Ester Martin Bergsmark, and blog entries from the “Lyme Series” by the late trans activist Leslie Feinberg. Through these works, Straube explores the meaning of this correlation between ticks and transing bodies for environmental ethics as well as for the forging of livable lives for trans people. Toxicity surfaces as a link in these works. The notion of feminist figuration, developed by philosopher Rosi Braidotti among others, allows Straube to discuss toxicity as a material-discursive figuration, which highlights how human societies in a Western context approach the body of the Other, in this case the transgender body as a human Other and the tick as animal Other. As a figuration, toxicity then becomes a shared meeting site that helps to problematize the Western pathologization of trans bodies and asks what ethics emerge in this proximity between ticks and trans bodies. Toxicity exists in the discussed works in particular as a complex material-discursive trajectory. Although some discourses on toxicity uphold social hierarchies and racist assumptions, as illustrated by Mel Y. Chen, for example, the works here seem to reappropriate the status of the toxic body as a strategy for adjustment and alliance and a site of ethical engagement with the world. The tick is Straube’s guide in weaving together stories of different bodies and of what Deborah Bird Rose and Thom van Dooren call the “unloved other.”
Muscle Stiffness of the Vastus Lateralis in Sprinters and Long-Distance Runners
Authors: MIYAMOTO NAOKAZU , HIRATA KOSUKE , INOUE KAKERU , HASHIMOTO TAKESHI
Published: May 2019

Purpose

The stiffness of muscle–tendon units and of tendons in the lower legs plays important roles in sprinting and long-distance running. However, the association of muscle stiffness with sprinting and running remains unknown. This study aimed to identify the characteristics of muscle stiffness in sprinters and long-distance runners, and to determine how muscle stiffness is related to the performance of these athletes.

Methods

In 22 male sprinters (SPR group), 22 male long-distance runners (LDR group), and 19 healthy untrained control male subjects (CON group), the muscle shear wave speed (a proxy for stiffness) of the vastus lateralis (VL) was measured under passive (resting) and active (contracting the knee extensors at 50% of maximal voluntary contraction) conditions, by using ultrasound shear wave elastography.

Results

The passive VL shear wave speed in SPR group was significantly lower than that in LDR group (P = 0.039). The active VL shear wave speed in LDR group was significantly higher than that in SPR (P = 0.022) and CON (P < 0.001) groups. In SPR group, the 100-m race time was negatively correlated to the passive VL shear wave speed (r = −0.483, P = 0.023) and positively correlated to the active VL shear wave speed (r = 0.522, P = 0.013). In the LDR group, the 5000-m race time was positively correlated to the passive VL shear wave speed (r = 0.438, P = 0.047) but not to the active VL shear wave speed.

Conclusion

The muscles of sprinters and long-distance runners exhibit characteristic stiffness that can be beneficial to their athletic performance. Passive and active muscle stiffness may play different roles in human locomotion, depending on locomotion speeds.
Conservative treatment of Fibrous Dysplasia
Authors: Kaynak Besime Ahu
Published: May 2019

Fibrous Dysplasia (FD) is a developmental disorder of bone that can affect one bone (monostotic type) or multiple bones (polyostotic type). The disease can be associated with hyperpigmentation and endocrinological disorders. In general, FD is found in teenagers, in the second decade of life. It often involves the long bones, craniofacial bones, ribs and pelvis. Approximately 30% of monostotic FD (MFD) lesions are found in the cranial, rather facial bones. It frequently appears in the posterior region of the jaw bone and is usually unilateral. The etiology of FD is not clear but even so genetic predisposition is suspected. The diagnosis is based on radiological and histopathological examination.

We present an unusual case of symptomatic FD. A 15-year-old female patient was admitted to the clinic, complaining gradually increased swelling on her left side of the mandible one year ego with severe and unusual pain at related region. The bony enlargement was extending from median mandible to the crestal marginal level. Surgical shaving and recountering of mandible through the delicate preservation of the mental nerve in the left side of mandible was carried out.

The aim of this report is to present the conservative treatment as sufficient treatment modality for the treatment of FD during puberty.

doi: https://doi.org/10.12669/pjms.35.3.14

How to cite this:Kaynak BA. Conservative treatment of Fibrous Dysplasia. Pak J Med Sci. 2019;35(3):873-876. doi: https://doi.org/10.12669/pjms.35.3.14

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.