bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial Load Stability of Different Trachea Suture Techniques: Tests on an Ex Vivo Model
Authors: Kirschbaum Andreas , Abing Helen , Mirow Nikolas
Published: February 2018

Objective

Tracheal anastomosis can be performed with different suture techniques. In this experimental work, the resilience of anastomotic techniques to pressure and tensile stress was studied.

Study Design

Ex vivo pig model.

Setting

Experimental.

Subjects and Methods

The trachea with the 2 main bronchi in freshly slaughtered pigs was isolated and intubated (CH 8.0). Both main bronchi were closed distally by a stapler. After resection of the trachea, an anastomosis (n = 15 per group) was created: group 1, single interrupted sutures; group 2, continuous running suture; group 3, mixed technique. A continuous tensile stress of 0, 500, 1000, or 1500 g was applied to the preparations. Mechanical ventilation with a maximum pressure of 70 mbar was initiated. The airtightness of the anastomosis was verified by submerging the entire preparation under water.

Results

At tensile loads of 0.5 and 1.0 kg, all anastomoses created in the single‐stitch technique were airtight; at 1.5 kg, 93.3% were without leaks. In the continuous suture technique, the airtightness of anastomoses decreased with increasing tensile load: from 93.3% at 500 g to 73.3% at 1 kg and 66.6% at 1.5 kg (P =. 02 at 1.5 kg). Anastomoses in the mixed technique were airtight in 80% at 500 g, 66.6% at 1 kg, and 46.6% at 1.5 kg (P =. 01 in comparison with single stitches).

Conclusion

Anastomoses created with single interrupted sutures showed the highest resilience against combined pressure and tensile stress.
Opioid Stewardship in Otolaryngology: State of the Art Review
Authors: Cramer John D. , Wisler Brad , Gouveia Christopher J.
Published: February 2018

Objective

The United States is facing an epidemic of opioid addiction. Deaths from opioid overdose have quadrupled in the past 15 years and now surpass annual deaths during the height of the human immunodeficiency virus epidemic. There is a link between opioid prescriptions after surgery, opioid misuse, opioid diversion, and use of other drugs of abuse. As surgeons, otolaryngologists contribute to this crisis. Our objective is to outline the risk of abuse from opioids in the management of acute postoperative pain in otolaryngology–head and neck surgery (OHNS) and strategies to avoid misuse.

Data Sources

PubMed/MEDLINE.

Review Methods

We conducted a review of the literature on the rate of opioid abuse after surgery, methods of safe opioid use, and strategies to minimize the dangers of opioids.

Conclusions

Otolaryngologists have a responsibility to treat pain. This begins preoperatively by discussing perioperative pain control and developing a personalized pain control plan. Patients should be aware that opioids carry significant risks of adverse events and abuse. Perioperative use of multimodal nonopioid agents enables pain control and avoidance of opioids in many otolaryngologic cases. When this approach is inadequate, opioids should be used in short duration under close surveillance. Institutional standards for opioid prescribing after common procedures can minimize misuse.

Implications for Practice

Otolaryngologists need to acknowledge the potential harm that opioids cause. It is essential that we evaluate our practices to ensure that opioids are used responsibly. Furthermore, opioid stewardship should become a priority in otolaryngology.
Effect of Cash Holding Policy of Financially Constrained Firms on Their Market Performance
Authors: Singh Nidhi
Published: February 2018

Our study is based on the methodology suggested by Faulkender and Wang (2006) in the Indian context, to discuss the various aspects of cash holding policy with respect to financially constrained (FC) and unconstrained firms. Primary goal of the study is to understand shareholders’ perception on the level of cash holdings in constrained and unconstrained firms, and how much value they give to excess cash holdings with respect to cash level and capital structure of a firm. This study also analyzes the shareholders’ perception, which is measured by stock return, and market value of asset, by determining the variation, in excess return and Tobin’s Q over the last 10 years. The result shows less or no effect of excess cash holding either in average firms or in constrained firms. Findings also suggests that shareholders, prefer large firms to maintain excess cash for investment, or to fulfil their liabilities on time. Overall the findings determine the importance of cash level but also indicate the presence of other determinants of the firms, to enhance market return and build shareholders perception.
European Urban Traditions: An Anthropologist's View on Polis, Urbs, and Civitas
Authors: Prato Giuliana B.
Published: February 2018

The argument developed in this article originates from the reflection that what constitutes a city or what is meant by urban are differently understood in different parts of the world and by different scholars. Thus, I first address the problematic of incommensurability. I argue that this key issue in the philosophy of science is central to how the debate on urban anthropology has developed. Then I ask whether this problematic extends to cross-disciplinary debate among the contemporary social sciences and what relevance the resulting understanding of the city has outside the academic world. I maintain that social analysis should endeavour to bring out the political, economic, and socio-cultural complexity of urban life. Having carried out research in urban Europe, I offer an analysis of the city that encompasses the meaning of urbs, polis, and civitas. Finally, I discuss the epistemological significance of urban ethnography, drawing on my field research in Brindisi, a South-Italian city.
Characteristics and outcomes of patients with cold‐related local injuries and accidental hypothermia from emergency department–based surveillance network in northern region of South Korea
Authors: Kim Tae Han , Lee Seung Chul , Seo Jun Seok , Song Kyoung Jun , Hong Ki Jeong , Song Sung Wook , Lee Yu Jin
Published: February 2018

Background:

Cold weather has been known to cause various cold‐related local injuries as well as accidental hypothermia.

Objectives:

The aim of this study is to investigate the basal characteristics, outcomes, and risk factors of patients with cold‐related comorbidities using prospective emergency department–based surveillance system in high‐risk area.

Methods:

We designed a prospective emergency department–based surveillance system throughout northern part of Gyeonggi province located in the northernmost of South Korea. A total of 20 emergency departments participated in the surveillance system. Patients who visited emergency department with cold‐related comorbidities from 1 December 2012 to 28 February 2013 were prospectively enrolled in final analysis. We analyzed risk factors associated with outcome and correlation between climate factor (wind‐chill index) and incidence.

Results:

During the study period, 54 patients with cold‐related comorbidities were used for final analysis, including 35 hypothermia, 15 frostbite, and 4 trench foot. Among 35 patients with accidental hypothermia, 11 patients were admitted to intensive care unit and defined to have major adverse outcome. Hypothermic patient with major adverse outcome had lesser possession of coat as outwear when exposed to the cold (9.1% vs 58.3%, p < 0.01). Lower wind‐chill index was likely to develop higher incidence of cold‐related comorbidities (incidence rate ratio per 1°C decrease in wind‐chill index: 1.086 (95% confidence interval: 1.038–1.135)).

Conclusion:

Patients with cold‐related comorbidities were successfully monitored with emergency department–based surveillance system. Absence of coat was associated with major adverse outcomes in patient with accidental hypothermia. Lower wind‐chill index was associated with higher incidence of cold‐related comorbidities.
Treatment outcomes in cerebral artery dissection and literature review
Authors: Urasyanandana Karanarak , Songsang Dittapong , Aurboonyawat Taweesak , Chankaew Ekawut , Withayasuk Pattarawit , Churojana Anchalee
Published: February 2018

Methods

Patients with cerebral artery dissections were reviewed in a hospital setting from 2008 to 2015. Clinical presentations, lesion locations, treatment modalities, functional outcomes, and mortality were reviewed. Parent artery occlusion was the first choice for surgery or endovascular treatment of a hemorrhagic dissecting cerebral artery. Endovascular or surgical reconstructive treatment was indicated in patients whose parent artery could not be occluded. Favorable functional outcomes were determined using modified Rankin Scale (mRS) scores of 0–2.

Results

In total, 61 patients with cerebral artery dissections were admitted to the hospital. Seven (11.5%) had traumatic dissections. All traumatic dissections were located in the internal carotid arteries. Overall favorable outcome rate was about 57% (4/7). Spontaneous cerebral artery dissections were found in 54 patients. No difference in favorable outcomes was observed between parent vessel occlusion and selective occlusion with parent vessel preservation (or vessel reconstruction) (70% and 63%, respectively, p = 1.000). Patients who presented with spontaneous dissection without intracranial hemorrhage had more favorable outcomes than those with intracranial hemorrhage (79% and 52%, respectively, p = 0.045). The mortality rate of patients with spontaneous dissection was 7.4%.

Conclusions

Most of the traumatic dissections were located on the internal carotid arteries and spontaneous dissections were commonly located on vertebral arteries. Nonhemorrhagic spontaneous cerebral dissections had better functional outcomes after treatment. Endovascular and surgical management were effective treatments by parent vessel occlusion or reconstructions.
Clinical Problem-Solving: Fever and Rapidly Progressive Weakness in an Immunocompromised Patient
Authors: Albertson Asher J. , Dietz Alexander R. , Younce John R. , Varadhachary Arun S.
Published: February 2018

Here we report the challenging case of a 41-year-old man with HIV complicated by AIDS and a history of prior neurologic injury from progressive multifocal leukoencephalopathy who presented with headache, fevers, lower extremity weakness, hyperreflexic upper extremities, and diminished lower extremity reflexes. We review the clinical decision-making and differential diagnosis for this presentation as the physical examination evolved and diagnostic testing changed over time.
Fine-tuning of FOXO3A in cHL as a survival mechanism and a hallmark of abortive plasma cell differentiation
Authors: Osswald Clarissa D. , Xie Linka , Guan Hanfeng , Herrmann Franziska , Pick Sarah M. , Vogel Marion J. , Gehringer Franziska , Chan Fong Chun , Steidl Christian , Wirth Thomas , Ushmorov Alexey
Published: February 2018

Key Points

FOXO3A expression indicates an abortive PC differentiation state in cHL. Tight regulation of FOXO3A is essential for the cHL oncogenic program.
Painting the Palace of Apries I: ancient binding media and coatings of the reliefs from the Palace of Apries, Lower Egypt
Authors: Brøns Cecilie , Rasmussen Kaare Lund , Di Crescenzo Marta Melchiorre , Stacey Rebecca , Lluveras-Tenorio Anna
Published: February 2018

This study gives an account of the organic components (binders and coatings) found in the polychromy of some fragmented architectural reliefs from the Palace of Apries in Memphis, Egypt (26th Dynasty, ca. 589-568 BCE). A column capital and five relief fragments from the collections of the Ny Carlsberg Glyptotek in Copenhagen were chosen for examination, selected because of their well-preserved polychromy. Samples from the fragments were first investigated using Fourier transform infrared (FTIR) spectroscopy to screen for the presence of organic materials and to identify the chemical family to which these materials belong (proteinaceous, polysaccharides or lipid). Only the samples showing the potential presence of organic binder residues were further investigated using gas chromatography with mass spectrometry detection (GC–MS) targeting the analysis towards the detection and identification of compounds belonging to the chemical families identified by FTIR. The detection of polysaccharides in the paint layers on the capital and on two of the fragments indicates the use of plant gums as binding media. The interpretation of the sugar profiles was not straightforward so botanical classification was only possible for one fragment where the results of analysis seem to point to gum arabic. The sample from the same fragment was found to contain animal glue and a second protein material (possibly egg). While the presence of animal glue is probably ascribable to the binder used for the ground layer, the second protein indicates that either the paint layer was bound in a mixture of different binding materials or that the paint layer, bound in a plant gum, was then coated with a proteinaceous material. The surface of two of the investigated samples was partially covered by translucent waxy materials that were identified as a synthetic wax (applied during old conservation treatments) and as beeswax, respectively. It is possible that the beeswax is of ancient origin, selectively applied on yellow areas in order to create a certain glossiness or highlight specific elements.
Cyclooxygenase inhibition with curcumin in Helicobacter pylori infection
Authors: Santos António Mário , Lopes Teresa , Oleastro Mónica , Pereira Teresa , Alves Carolina Coimbra , Seixas Elsa , Chaves Paula , Machado Jorge , Guerreiro António Sousa
Published: February 2018

Background

Helicobacter pylori (H. pylori) infection increases the expression of cyclooxygenase-2 (COX-2) on the host’s gastric mucosa. The inhibition of COX-2 activity with natural products would be a major advantage. This study aims to clarify the possible effect of curcumin on COX-2 inhibition in gastric mucosa of H. pylori infected mice.

Methods

We inoculated 30 pathogen-free male C57BL/6 mice with H. pylori (SS1 Sidney strain) that were randomly divided in two different groups: infected group (IG) treated with phosphate-buffered saline (PBS) (n = 15) and infected group treated with curcumin 500 mg/kg (IG + C) (n = 15). A group of 15 non-infected mice were used as control (CG). Two weeks post-infection, both IG and CG groups received 0.5 ml of PBS, while the IG + C group received curcumin for 6, 18, and 27 weeks.

Results

The analysis by immunohistochemistry and by PCR array at 6, 18, and 27 weeks post-infection showed a significant increase on COX-2 expression on the IG mice compared to the CG mice. The group treated with curcumin (IG + C) showed a significant downregulation of COX-2 at all points of the experiment, when compared to the IG + C mice.

Conclusion

Chronic H. pylori infection induces a significant increase in COX-2 expression. Treatment with curcumin significantly decreases the COX-2 expression, and the addition of curcumin to the diet may be an interesting approach for areas of high H. pylori prevalence.
Methodology to Forecast Volume and Cost of Cancer Drugs in Low- and Middle-Income Countries
Authors: Martei Yehoda M. , Chiyapo Sebathu , Grover Surbhi , Hanna Christina , Dryden-Peterson Scott , Pusoentsi Malebogo , Shulman Lawrence N. , Tapela Neo
Published: February 2018

Purpose

In low- and middle-income countries (LMICs), frequent outages of the stock of cancer drugs undermine cancer care delivery and are potentially fatal for patients with cancer. The aim of this study is to describe a methodologic approach to forecast chemotherapy volume and estimate cost that can be readily updated and applied in most LMICs.

Methods

Prerequisite data for forecasting are population-based incidence data and cost estimates per unit of drug to be ordered. We used the supplementary guidelines from the WHO list of essential medicines for cancer to predict treatment plans and ordering patterns. We used de-identified aggregate data from the Botswana National Cancer Registry to estimate incident cases. The WHO Management Sciences for Health International Price Indicator was used to estimate unit costs per drug.

Results

Chemotherapy volume required for incident cancer cases was estimated as the product of the standardized dose required to complete a full treatment regimen per patient, with a given cancer diagnosis and stage, multiplied by the total number of incident cancer cases with the respective diagnosis. The estimated chemotherapy costs to treat the 10 most common cancers in the public health care sector of Botswana is approximately 2.3 million US dollars. An estimated 66% of the budget is allocated to costs of rituximab and trastuzumab alone, which are used by approximately 10% of the cancer population.

Conclusion

This method provides a reproducible approach to forecast chemotherapy volume and cost in LMICs. The chemotherapy volume and cost outputs of this methodology provide key stakeholders with valuable information that can guide budget estimation, resource allocation, and drug-price negotiations for cancer treatment. Ultimately, this will minimize drug shortages or outages and reduce potential loss of lives that result from an erratic drug supply.
Desire for Information and Preference for Participation in Treatment Decisions in Patients With Cancer Presenting to the Department of General Surgery in a Tertiary Care Hospital in India
Authors: Sankar Sushmitha Dharani , Dhanapal Baskaran , Shankar Gomathi , Krishnaraj Balamourougan , Karra Sandhya , Natesan Vignesh
Published: February 2018

Purpose

Providing appropriate information to patients about their illness helps them to cope with the diagnosis. Shared decision making is a key concept in managing patients with cancer. There are no data available about the desire for information and preference for participation in treatment decisions among Indian patients with cancer. The objective of this study was to estimate the proportion of patients who have information needs and to study the patient preference for participation in treatment decisions and the factors associated with them.

Methods

A cross-sectional survey was conducted among patients with cancer older than 18 years. They were interviewed with a questionnaire after signing an informed consent. The association of sex, educational level, residence, diagnosis (type of cancer), Eastern Cooperative Oncology Group performance status, and treatment status with information needs and decision-making preference was analyzed using χ2 test

Results

Approximately 81% of patients said that they had an absolute need to know if the illness was cancer, and > 70% of patients either had an absolute need to know or would like to know about the prognosis, treatment options, and adverse effects. Regarding the decision-making preferences, 97% wanted their treating physicians to make the decision regarding their treatment, and 66% preferred to share decision making with their family.

Conclusion

The majority of the patients with cancer expressed a need for knowing whether they had cancer. When it comes to treatment decisions, most of them preferred a passive role, and the majority wanted to involve their families in the decision-making process. We recommend that the treating physician should elicit the patient’s preference in participating in treatment decisions and their preference about involving their family in making treatment decisions
Readmission Patterns After GI Cancer Hospitalizations: The Medical Versus Surgical Patient
Authors: Manzano Joanna-Grace M. , Yang Ming , Zhao Hui , Elting Linda S. , George Marina C. , Luo Ruili , Suarez-Almazor Maria E.
Published: February 2018

Purpose:

Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes.

Patients and Methods:

We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data. We included elderly Texas residents diagnosed with GI cancer and identified risk factors for unplanned readmission using generalized estimating equations, comparing medical with surgical cancer-related hospitalizations.

Results:

We analyzed 69,693 hospitalizations from 31,736 patients. The unplanned readmission rate was higher after medical hospitalizations than after surgical hospitalizations (21.6% v 13.4%, respectively). Shared risk factors for readmission after medical and surgical hospitalizations included advanced disease stage, high comorbidity index, and emergency room visit and radiation therapy within 30 days before index hospitalization. Several other associated factors and reasons for readmission were noted to be unique to medical or surgical hospitalizations alone.

Conclusion:

Unplanned readmissions among elderly patients with GI cancer are more common after medical hospitalizations compared with surgical hospitalizations. There are shared risk factors and unique risk factors for these hospitalizations that can inform policy, health care delivery, and interventions to reduce readmissions. Other findings underscore the importance of care coordination and comorbidity management in this patient population.
System-Level Health-Care Integration and the Costs of Cancer Care Across the Disease Continuum
Authors: Kaye Deborah R. , Min Hye Sung , Norton Edward C. , Ye Zaojun , Li Jonathan , Dupree James M. , Ellimoottil Chad , Miller David C. , Herrel Lindsey A.
Published: February 2018

Purpose:

Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care.

Methods:

We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval. For each phase, we aggregated all claims with the primary cancer diagnosis and identified patients treated in an integrated delivery network (IDN), as defined by the Becker Hospital Review list of the top 100 most integrated health delivery systems. We then determined if care provided in an IDN was associated with decreased payments across cancers and for each individual cancer by phase and across phases.

Results:

We identified 428,300 patients diagnosed with one of 10 common cancers. Overall, there were no differences in phase-based payments between IDNs and non-IDNs. Average adjusted annual payments by phase for IDN versus non-IDNs were as follows: initial, $14,194 versus $14,421, respectively ( P = .672); continuing, $2,051 versus $2,099 ( P = .566); and end of life, $16,257 versus $16,232 ( P = .948). However, in select cancers, we observed lower payments in IDNs. For bladder cancer, payments at the end of life were lower for IDNs ($11,041 v $12,331; P = .008). Of the four cancers with the lowest 5-year survival rates (ie, pancreatic, lung, esophageal, and liver), average expenditures during the initial and continuing-care phases were lower for patients with liver cancer treated in IDNs.

Conclusion:

For patients with one of 10 common malignancies, treatment in an IDN generally is not associated with lower costs during any phase of cancer care.
Epileptic Encephalopathies
Authors: Hussain Shaun A.
Published: February 2018

PURPOSE OF REVIEW

This article reviews the manifestations and treatment of the epileptic encephalopathies, which are a heterogeneous group of disorders characterized by both seizures and neurocognitive impairment.

RECENT FINDINGS

Next-generation (exome- and genome-based) sequencing technologies are revolutionizing the identification of single-gene causes of epileptic encephalopathy but have only had a modest impact on patient-specific treatment decisions. The treatment of most forms of epileptic encephalopathy remains a particularly challenging endeavor, with therapeutic decisions chiefly driven by the electroclinical syndrome classification. Most antiseizure drugs are ineffective in the treatment of these disorders, and treatments that are effective often entail significant risk and cost.

The epileptic encephalopathies continue to pose a major challenge in diagnosis and treatment, with most patients experiencing very poor outcomes, although a significant minority of patients respond to, or are even cured by, specific therapies.
Pediatric Traumatic Brain Injury and Concussion
Authors: Choe Meeryo , Barlow Karen M.
Published: February 2018

PURPOSE OF REVIEW

This article summarizes the impact and complications of mild traumatic brain injury and concussion in children and outlines the recent evidence for its assessment and early management. Useful evidence-based management strategies are provided for children who have a typical recovery following concussion as well as for those who have persistent postconcussion syndrome. Cases are used to demonstrate the commonly encountered pathologies of headache, cognitive issues, and mood disturbances following injury.

RECENT FINDINGS

A clinical risk score using risk factors for poor recovery (eg, female sex, adolescence, previous migraine, and a high degree of acute symptoms) can be used to help the clinician plan follow-up in the community. Prolonged periods of physical and cognitive rest should be avoided. Multidisciplinary treatment plans are often required in the management of persistent postconcussion syndrome.

A paucity of research exists for the treatment of postconcussion syndrome. Current treatments target individual symptoms.
Transition From Pediatric to Adult Neurologic Care
Authors: Tilton Ann H. , de Gusmao Claudio Melo
Published: February 2018

PURPOSE OF REVIEW

With advances in medical care, the number of youths surviving with medically complex conditions has been steadily increasing. Inadequate transition planning and execution can lead to gaps in care, unexpected emergency department visits, and an increase in health care costs and patient/caregiver anxiety. Many barriers that prevent adequate transition have been identified, including insufficient time or staff to provide transition services, inadequate reimbursement, resistance from patients and caregivers, and a dearth of accepting adult providers.

RECENT FINDINGS

Transition is distinct from transfer of care. Transition is a planned multistage process, while transfer refers to a point in time where responsibility of care shifts from one provider to another. Key differences exist between the pediatric and adult models of care. A successful transition should empower the patient to understand and take responsibility in managing his or her condition; foster independent functioning to the extent that is possible; integrate educational, legal, and community resources in the care plan; and identify appropriate adult health care providers at the time of transfer. Different models have been proposed to streamline the transition process, with improvement in patients' knowledge of their condition, self-efficacy, and confidence.

Neurologists have a key role in supporting their patients in the transition to adulthood. This article reviews basic tenets and provides tools to assist in navigating the complex transition process. These tenets are intended to improve quality of care and decrease clinician burden and remain an active area of research.
Intensive Care Unit Enhanced Recovery Pathway for Patients Undergoing Orthotopic Liver Transplants Recipients: A Prospective, Observational Study
Authors: King Adam B. , Kensinger Clark D. , Shi Yaping , Shotwell Matthew S. , Karp Seth J. , Pandharipande Pratik P. , Wright J. Kelly , Weavind Liza M.
Published: February 2018

BACKGROUND:

Liver transplant recipients continue to have high perioperative resource utilization and prolonged length of stay despite improvements in perioperative care. Enhanced recovery pathways have been shown in other surgical populations to produce reductions in hospital resource utilization.

METHODS:

A prospective, observational study was performed to examine the effect of an enhanced recovery pathway for postoperative care after liver transplantation. Outcomes from patients undergoing liver transplantation from November 1, 2013, to October 31, 2014, managed by the pathway were compared to transplant recipients from the year before pathway implementation. Multivariable regression analysis was used to assess the association of the clinical pathway on clinical outcomes.

RESULTS:

The intervention and control groups included 141 and 106 patients, respectively. There were no demographic differences between the control and intervention group including no differences between the length of surgery and cold ischemic time. Median intensive care unit length of stay was reduced from 4.4 to 2.6 days (P < .001). The intervention group had a higher likelihood of earlier discharge (hazard ratio [95% CI], 2.01 [1.55–2.62]; P < .001), and a 69% and 65% lower odds of receiving a plasma (P < .001) or packed red blood cell (P < .001) transfusion. There was no significant effect on hospital mortality (P = .40), intensive care unit readmission rates (P = .75), or postoperative infections (urinary traction infections: P = .09; pneumonia: P = .27).

CONCLUSIONS:

An enhanced recovery pathway focused on milestone-based elements of intensive care unit management and predetermined management triggers including hemodynamic goals, fluid therapy, perioperative antibiotics, glycemic control, and standardized transfusion triggers led to reductions in intensive care unit length of stay without an increase in perioperative complications.
Power-to-Strength Ratio Influences Performance Enhancement with Contrast Training
Authors: SCHNEIKER KNUT THOMAS , FYFE JACKSON JAMES , BILLAUT FRANÇOIS , BISHOP DAVID JOHN
Published: February 2018

Purpose

The effectiveness of contrast training (CST) for improving explosive exercise performance is modulated by various individual characteristics; however, further work is required to define these factors.

Methods

Subelite male Australian Football players (n = 22; age, 19 ± 2 yr; body mass, 80.4 ± 9.4 kg; one-repetition maximum [1-RM] half squat, 172 ± 18 kg; mean ± SD) completed two experimental trials involving two sets of squat jumps (six repetitions at 30% 1-RM) performed either alone (CTL condition) or after half squats (six repetitions at 85% 1-RM; CST condition).

Results

Squat jump peak power was similar between CTL and CST during set 1 (mean change: ±90% confidence interval, 2.8% ± 2.0%; effect size [ES]: ±90% confidence interval, 0.13 ± 0.09; P = 0.079) and set 2 (0.3% ± 1.7%; ES, 0.01 ± 0.08; P = 0.781). Peak power enhancement with CST was not related to maximal (1-RM half squat) strength (r
2 = 0.001, P = 0.884), but was negatively correlated with both baseline peak power (r
2 = 0.44, P < 0.001) and power-to-strength ratio (PSR); that is, the ratio between baseline peak power and 1-RM half squat strength (r
2 = 0.65, P < 0.001). Using a median split, analyses were performed in participants with a low PSR (LPSR group; PSR = 15.4–19.1 W·kg−1; n = 11) or high PSR (HPSR group, PSR = 19.4–24.7 W·kg−1; n = 11). Peak power was enhanced with CST for the LPSR (8.1% ± 3.9%; ES, 0.44 ± 0.21; P = 0.004) but not HPSR (−2.1% ± 1.3%; ES, −0.14 ± 0.09; P = 0.010) groups.

Conclusion

The PSR appears to influence the effectiveness of CST, with performance enhancement more likely in those with a lower PSR.
Aerobic Training Improves Quality of Life in Women with Polycystic Ovary Syndrome
Authors: COSTA EDUARDO CALDAS , DE SÁ JOCELINE CÁSSIA FEREZINI , STEPTO NIGEL KEITH , COSTA INGRID BEZERRA BARBOSA , FARIAS-JUNIOR LUIZ FERNANDO , MOREIRA SIMONE DA NÓBREGA TOMAZ , SOARES ELVIRA MARIA MAFALDO , LEMOS TELMA MARIA ARAÚJO MOURA , BROWNE RODRIGO ALBERTO VIEIRA , AZEVEDO GEORGE DANTAS
Published: February 2018

Purpose

To investigate the effects of a supervised aerobic exercise training intervention on health-related quality of life (HRQL), cardiorespiratory fitness, cardiometabolic profile, and affective response in overweight/obese women with polycystic ovary syndrome (PCOS).

Methods

Twenty-seven overweight/obese inactive women with PCOS (body mass index, ≥ 25 kg·m−2; age 18 to 34 yr) were allocated into an exercise group (n = 14) and a control group (n = 13). Progressive aerobic exercise training was performed three times per week (~150 min·wk−1) over 16 wk. Cardiorespiratory fitness, HRQL, and cardiometabolic profile were evaluated before and after the intervention. Affective response (i.e., feeling of pleasure/displeasure) was evaluated during the exercise sessions.

Results

The exercise group improved 21% ± 12% of cardiorespiratory fitness (P < 0.001) and HRQL in the following domains: physical functioning, general health, and mental health (P < 0.05). Moreover, the exercise group decreased body mass index, waist circumference, systolic and diastolic blood pressure, and total cholesterol level (P < 0.05). The affective response varied from “good” to “fairly good” (i.e., positive affective response) in an exercise intensity-dependent manner during the exercise training sessions.

Conclusions

Progressive aerobic exercise training improved HRQL, cardiorespiratory fitness, and cardiometabolic profile of overweight/obese women with PCOS. Moreover, the participants reported the exercise training sessions as pleasant over the intervention. These results reinforce the importance of supervised exercise training as a therapeutic approach for overweight/obese women with PCOS.
Image-guided biopsy of small (≤4 cm) renal masses: the effect of size and anatomical location on biopsy success rate and complications
Authors: Seager Matthew J , Patel Uday , Anderson Christopher J , Gonsalves Michael
Published: February 2018

Objective:

To study the influence of tumour diameter and anatomy on the success and complication rates of small renal mass (SRM, ≤4 cm) core biopsy.

Methods:

Retrospective analysis of SRMs that underwent ultrasound or CT-guided biopsy. Diagnostic and complication rates were compared according to tumour size (subcategorised as axial diameter ≤2 cm, >2 to– ≤3 cm, >3–≤4 cm) and anatomical disposition (exophytic/endophytic, centrality, polar location and anterior/posterior).

Results:

94 patients (54 male; age range 21.8–84.3 years) with 95 SRMs underwent biopsy. The first biopsy was diagnostic in 81/95 (85.3%). Seven patients underwent repeat biopsy (6/7 diagnostic), to give an overall diagnostic rate of 91.5%. The primary diagnostic rates in the ≤2, >2–≤3 , >3–≤4 cm groups were 21/25 (84%); 38/44 (86.4%) and 22/26 (84.6%) respectively and were similar (p = 1.00). Anterior and upper pole SRMs were more likely to fail initial biopsy (odds ratio 13.8, p < 0.01; and odds ratio 4.35, p = 0.04) respectively, but other anatomical factors were not relevant. Complications occurred in 14% (all conservatively managed perinephric haematomas; Clavien-Dindo Grade 1) and size or location were not relevant.

Conclusion:

Image-guided biopsy of SRMs has a high diagnostic rate irrespective of tumour size. Anterior and upper pole location had lower diagnostic rates. Biopsy should be considered for all patients with SRMs, if the result will impact on management and we list specific scenarios where an SRM biopsy may be helpful.

Advances in knowledge:

SRM size does not affect the likelihood of a diagnostic biopsy.
Histogram analysis derived from apparent diffusion coefficient (ADC) is more sensitive to reflect serological parameters in myositis than conventional ADC analysis
Authors: Meyer Hans Jonas , Emmer Alexander , Kornhuber Malte , Surov Alexey
Published: February 2018

Objective:

Diffusion-weighted imaging (DWI) has the potential of being able to reflect histopathology architecture. A novel imaging approach, namely histogram analysis, is used to further characterize tissues on MRI. The aim of this study was to correlate histogram parameters derived from apparent diffusion coefficient (ADC) maps with serological parameters in myositis.

Methods:

16 patients with autoimmune myositis were included in this retrospective study. DWI was obtained on a 1.5 T scanner by using the b  -values of 0 and 1000 s mm–  2. Histogram analysis was performed as a whole muscle measurement by using a custom-made Matlab-based application. The following ADC histogram parameters were estimated: ADCmean, ADCmax, ADCmin, ADCmedian, ADCmode, and the following percentiles ADCp10, ADCp25, ADCp75, ADCp90, as well histogram parameters kurtosis, skewness, and entropy. In all patients, the blood sample was acquired within 3 days to the MRI. The following serological parameters were estimated: alanine aminotransferase, aspartate aminotransferase, creatine kinase, lactate dehydrogenase, C-reactive protein (CRP) and myoglobin. All patients were screened for Jo1-autobodies.

Results:

Kurtosis correlated inversely with CRP (p = –0.55 and 0.03). Furthermore, ADCp10 and ADCp90 values tended to correlate with creatine kinase (p = –0.43, 0.11, and p = –0.42, = 0.12 respectively). In addition, ADCmean, p10, p25, median, mode, and entropy were different between Jo1-positive and Jo1-negative patients.

Conclusion:

ADC histogram parameters are sensitive for detection of muscle alterations in myositis patients.

Advances in knowledge:

This study identified that kurtosis derived from ADC maps is associated with CRP in myositis patients. Furthermore, several ADC histogram parameters are statistically different between Jo1-positive and Jo1-negative patients.
Typification of the Linnaean name Staticelimonium (Plumbaginaceae)
Authors: Ferrer-Gallego P. Pablo , Rosselló Josep A. , Guacchio Emanuele Del , Iamonico Duilio
Published: February 2018

The typification of the Linnaean name Statice limonium (≡ Limonium vulgare) is discussed. Original material preserved at BM, LINN and UPS is heterogeneous and belongs to several species. The specimen at LINN (No. 395.3) is designated as the lectotype to preserve the current usage of the name.
Determinants of HIV provider-initiated testing and counseling screening service used by pregnant women in primary health centers in Surabaya
Authors: Handayani Samsriyaningsih , Andajani Susilowati , Djuari Lilik
Published: February 2018

Background: Offering free HIV screening service for pregnant women in primary health center in Surabaya has become obligatory since 2014, but only 70% used the service. Prior studies on HIV screening mostly focused on Voluntary Counseling and Testing.Methods: This was a cross-sectional study. Interviews were conducted with 150 pregnant women attending antenatal care in 1 of 9 public health centers (PHCs) in Surabaya and offered HIV screening within the same PHC. The eligibility criterium was pregnant women attending antenatal care in PHCs. The exclusion criteria were having been counseled for HIV prior to the interviews and/or experiencing an obstetric emergency. Using PRECEDE Framework with the concept of a comprehensive framework, this study focuses on identifying determinants of HIV PITC service use in PHCs in Surabaya. Binary logistic regressions and multiple binary logistic regressions were used in analyses.Results: The service use was associated with self-confidence of getting blood drawn for the test (p<0.001, adjusted OR=12.368, 95% CI=3.237–47.250) and past use of midwife private service for current pregnancy (p=0.029, adjusted OR=3.902, 95% CI=1.150–13.246). Self-confidence of getting blood drawn for HIV test mediated the effect of past use of midwife’s private service on HIV screening use.Conclusion: Past use of midwife’s private service affected self-confidence of getting blood drawn for HIV test on HIV screening use, and self-confidence affected the use of HIV PITC. This study results suggest that more midwives’ private practices are needed to increase the use of HIV PITC screening in PHC.
Bryophyllum pinnatum leaves ethanol extract inhibit maturation and promote apoptosis of systemic lupus erythematosus BALB/c mice B cells
Authors: Handono Kusworini , Dantara Tri W.I. , Dewi Elvira S. , Pratama Mirza Z. , Nurdiana Nurdiana
Published: February 2018

Background: B cells play a key role in systemic lupus erythematosus (SLE). Targeting B cells as SLE therapy is a plausible approach. This study investigated the potential effects of Bryophyllum pinnatum leaves with ethanol extract in decreasing percentages of maturation, increasing percentages of apoptosis, and decreasing NF-κB p65 expressions of SLE BALB/c mice B cells.Methods: Culturing B cells from pristane induced SLE BALB/c mice’s spleen will resulted in this in vitro study. B cells were activated by BAFF, LPS, IL-4, and anti-CD40 yielding CD19+ >80%. B cells were cultured by adding those stimulants with and without B. pinnatum leaves (0, 0.02, 0.1, or 0.5 µg/ml) for 72 hours at 37°C. Flow cytometry was performed to determine The Percentages of maturation (CD19+CD38+) and apoptosis (Annexin V+PI+) of B cells.  Further analysis to determine the expressions of transcription factor of maturation and apoptosis of B cells, NF-ĸB p65, were performed using immunocytochemistry. Data were analyzed using SPSS version 22.Results: Flow cytometry assay showed significant decrease in percentages of maturation of B cells in all doses and significant increase in percentage of apoptosis of B cells in dose 0.5 µg/ml. Immunocytochemistry results showed significant decrease expressions of NF-ĸB p65 in all doses. Percentages of maturation, apoptosis, and expressions of NF-ĸB p65 of B cells were significantly correlated.Conclusion: This in vitro study revealed that B. pinnatum leaves with ethanol extract decreased the percentages of maturation, increased the percentage of apoptosis, and decreased NF-κB p65 expressions of SLE BALB/c mice B cells significantly.
Say My Name: Nameplate Jewelry and the Politics of Taste
Authors: Flower Isabel , Rosa-Salas Marcel
Published: February 2018

This essay is about the social and material history of nameplate jewelry and its significance in American culture. We argue that the nameplate is an object where conversations and contentions surrounding identity, style, and power converge. Whether it be a necklace, ring, or pair of earrings, the nameplate is both specific to the wearer and exemplary of a collective style, therefore existing in a space of simultaneous conformity and nonconformity. By examining the nameplate’s genesis in mass American culture, we will examine how the discourse surrounding the style’s ostensible “tackiness” is rooted in notions of taste and aesthetics that are shaped by hierarchical race, class and gender politics. Engaging with Bourdieu and Duchamp’s theories on taste, we show how the myriad forms the nameplate takes and the conversations about style that circulate around them reveal struggles of cultural dominance and appropriation. We will close with a discussion of how the expression of personhood can be a political act and claim to citizenship.
The Effects of Children’s Literature on Preservice Early Childhood Mathematics Teachers’ Thinking
Authors: Jett Christopher
Published: February 2018

In this article, the author shares an intervention of using children’s literature as a pedagogical frame for an undergraduate mathematics content course with early childhood education majors to influence their thinking about mathematics teaching and learning. With this case study of 29 preservice teachers, the author found that literature increased preservice elementary teachers’ excitement about mathematics, heightened their self-efficacy in mathematics, and motivated them to design innovative mathematics lessons. By elaborating on these findings, the author makes a case for the continued need for mathematically competent teachers in elementary classroom spaces, and the author advocates for the incorporation of literature as a means to do this work. Finally, the author provides implications for future research and practice with other SoTL-related projects involving children’s literature.
Digital Video as a Personalized Learning Assignment: A Qualitative Study of Student Authored Video using the ICSDR Model
Authors: Campbell Laurie O. , Cox Thomas
Published: February 2018

Students within this study followed the ICSDR (Identify, Conceptualize/Connect, Storyboard, Develop, Review/Reflect /Revise) development model to create digital video, as a personalized and active learning assignment. The participants, graduate students in education, indicated that following the ICSDR framework for student authored video guided their video creation process, resulting in focus for their ideas, and increasing motivation to learn more about their content.  Finally, the participants indicated that creating a digital video was an authentic and personalized learning experience that fostered personal choice and voice and peer collaboration. Evidence from the qualitative study supports students following a development framework for video creation.
Reflections versus Extended Quizzes: Which is Better for Student Learning and Self-Regulation?
Authors: Clinton Virginia
Published: February 2018

Both quizzes and reflections have been found to benefit student learning, but have been typically compared to passive or superficial controls. The purpose of this quasi-experiment is to test the relative effectiveness of brief quizzes followed by reflections compared to longer quizzes. Participants (N = 218) were introductory psychology students enrolled in two different courses, one in which students engaged in weekly brief quizzes and reflections and a second in which students engaged in longer quizzes. Results indicated that the two conditions were similar in effectiveness in terms of learning and self-reports of self-regulation.
Modelagem e História da Ciência: uma abordagem pedagógica para a estrutura atômica no 9° Ano do Ensino Fundamental
Authors: Gandra Lucas Pereira , Da Silva Geilson Rodrigues
Published: February 2018

La estructura atómica es uno de los conceptos más abstractos y difíciles de enseñar y aprender, por esta razón en este trabajo nos proponemos a aplicar y evaluar una estrategia didáctica fundamentada en la modelación relacionada con los presupuestos de paradigmas de Thomas Kunh, de tal forma que podamos demostrar que los modelos son representaciones parciales, a los cuales no necesariamente se le atribuyen todas las propiedades macroscópicas. La perspectiva pedagógica fue desarrollada en el transcurso de seis clases con duración de 50 minutos cada una, en un curso de noveno grado de educación básica secundaria de un colegio particular del Brasil, en total participaron 27 estudiantes. Para la toma de datos, utilizamos los modelos producidos para el experimento de la caja negra, así como, los modelos producidos por los estudiantes para la teoría atómica de Dalton, Thomson, Rutherford y Bohr; al final del proceso de modelación aplicamos un cuestionario con cinco preguntas abiertas. Para analizar los datos, evaluamos inicialmente la “caja negra” y los modelos elaborados de acuerdo con las orientaciones del modelo TWA (Teaching With Analogies), además seguimos las orientaciones del análisis de contenido para evaluar el cuestionario. Los estudiantes elaboraron diversas representaciones pictóricas para la actividad I, que ofreció la oportunidad de establecer paralelos entre el proceso de aprendizaje de forma similar al proceso de desarrollo de la propia ciencia. En lo que corresponde al análisis de los modelos producidos, verificamos que los estudiantes comprendieron las limitaciones y potencia de los modelos. De esta forma la perspectiva pedagógica de modelación en un contexto de Historia de la Ciencia les permitió a los estudiantes la formulación de concepciones sobre la estructura atómica, reconociendo el papel fundamental de cada una de ellas a lo largo de la historia de la ciencia.