bluuebunny/crossref_metadata_2025 huggingface dataset:
Chemotherapy Use at the End of Life in Uganda
Authors: Low Daniel , Merkel Emily C. , Menon Manoj , Lyman Gary H. , Ddungu Henry , Namukwaya Elizabeth , Leng Mhoira , Casper Corey
Published: February 2017

Purpose

Avoiding chemotherapy during the last 30 days of life has become a goal of cancer care in the United States and Europe, yet end-of-life chemotherapy administration remains a common practice worldwide. The purpose of this study was to determine the frequency of and factors predicting end-of-life chemotherapy administration in Uganda.

Methods

Retrospective chart review and surveys and interviews of providers were performed at the Uganda Cancer Institute (UCI), the only comprehensive cancer center in the area, which serves a catchment area of greater than 100 million people. All adult patients at the UCI with reported cancer deaths between January 1, 2014, and August 31, 2015 were included. All UCI physicians were offered a survey, and a subset of physicians were also individually interviewed.

Results

Three hundred ninety-two patients (65.9%) received chemotherapy. Age less than 55 years (odds ratio [OR], 2.30; P = .004), a cancer diagnosis greater than 60 days before death (OR, 9.13; P < .001), and a presenting Eastern Cooperative Oncology Group performance status of 0 to 2 (OR, 2.47; P = .001) were associated with the administration of chemotherapy. More than 45% of patients received chemotherapy in the last 30 days of life. No clinical factors were predictive of chemotherapy use in the last 30 days of life, although doctors reported using performance status, cancer stage, and tumor chemotherapy sensitivity to determine when to administer chemotherapy. Patient expectations and a lack of outcomes data were important nonclinical factors influencing chemotherapy administration.

Conclusion

Chemotherapy is administered to a high proportion of patients with terminal cancer in Uganda, raising concern about efficacy. Late presentation of cancer in Uganda complicates end-of-life chemotherapy recommendations, necessitating guidelines specific to sub-Saharan Africa.
Influence of Fraction of Inspired Oxygen on Noninvasive Hemoglobin Measurement: Parallel Assessment of 2 Monitors
Authors: Gayat Etienne , Imbert Nicolas , Roujansky Ariane , Lemasle Léa , Fischler Marc
Published: February 2017

BACKGROUND:

Previous reports have brought specific attention to the relationship between oxygenation of the patient and the accuracy of noninvasive measurement of hemoglobin (Hb) using an optical sensor. This study aimed to assess prospectively the relationship between fraction of inspired oxygen (Fio
2) and the bias of the measurement of Hb by the use of 2 different noninvasive monitors compared with the classic invasive technique.

METHODS:

Forty-four patients were included prospectively. In each individual, Hb level was determined noninvasively by monitor Pronto-7™ (Masimo Corporation, Irvine, CA) and by monitor NBM-200MP™ (OrSense Ltd, Petah-Tikva, Israel), with the probe placed on 2 fingers on the same hand of the patient. Three measures were performed, first under breathing air and 2 others when fraction of expired oxygen rose to 50% ± 5% and to 90 ± 5%. Simultaneously, a nurse collected a venous blood sample, which was sent immediately to the hematology laboratory for Hb measurement. The main outcome measurement was the mean bias between noninvasive and invasive measurements.

RESULTS:

Results show no change in median bias [interquartile range] with Fio
2 for Pronto-7 (from 1.1 g/dL [0.0–2.0] in Fio
2 21% to 1.0 g/dL [0.2–1.5] in Fio
2 100%), but increasingly negative median bias with increasing Fio
2 for NBM-200MP (from −0.3 g/dL [−1.3 to 0.3] in Fio
2 21% to −0.8 g/dL [−1.5 to −0.1] in Fio
2 100%, P = .04).

DISCUSSION:

This study showed that noninvasive measurement of Hb could be influenced by inspired fraction of oxygen when the monitor NBM-200MP is used.
Red Cell Transfusion–Associated Hemolysis in Cardiac Surgery: An Observational Cohort Study
Authors: Karkouti Keyvan , Callum Jeannie L. , Acker Jason P. , Yip Paul , Rao Vivek
Published: February 2017

BACKGROUND:

Red cell viability is impaired during storage, resulting in excess hemolysis during storage and after transfusion. As a result, transfusions may oversaturate the hemoglobin clearance pathways, resulting in cell-free hemoglobin and iron toxicity in susceptible patients, such as those undergoing cardiac surgery with cardiopulmonary bypass. To explore this hypothesis, we assessed the relationship of red cell transfusions with cell-free hemoglobin and transferrin saturation levels in a consecutive cohort of cardiac surgical patients.

METHODS:

Laboratory measures of hemolysis were obtained in consecutive cardiac surgical patients 15 to 30 minutes after bypass. Multivariable regression models controlling for important confounders were constructed to determine the independent relationship of red cell transfusions during bypass with cell-free hemoglobin and transferrin saturation levels post-bypass, analyzed as continuous variables (linear regression) and categorized at the 90th percentiles (logistic regression).

RESULTS:

Of the 543 included patients, 82 (15.1%) received red cell transfusions during bypass (median 1; interquartile range 1–2 units). Cell-free hemoglobin was detected in all patients (mean 11.3; standard deviation ± 9.3; 90th percentile 18 μmol/L), and transferrin saturations were relatively high (mean 41 ± 19%; 90th percentile 66%). After controlling for confounders, transfusions were not associated with cell-free hemoglobin (P> .25 in linear and logistic regression) but were directly associated with transferrin saturation levels (P< .001 in linear and logistic regression). Transfused patients had a 6.2-fold (95% confidence interval: 2.4–16.1) risk-adjusted increase in the odds of having high (>66%) transferrin saturation levels.

CONCLUSIONS:

The findings support the hypothesis that transfusion-related adverse events may be in part caused by the excessive hemolysis of transfused red cells, which can lead to acute iron overload and related toxicity. This suggests that strategies aimed at avoiding or mitigating transfusion-related acute iron overload may improve the safety of red cell transfusions.
Pathogenic Link Between Postextubation Pneumonia and Ventilator-Associated Pneumonia: An Experimental Study
Authors: Rezoagli Emanuele , Zanella Alberto , Cressoni Massimo , De Marchi Lorenzo , Kolobow Theodor , Berra Lorenzo
Published: February 2017

BACKGROUND:

The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours. Subsequently, we assessed the incidence of lung colonization and PEP at 48 hours after extubation in sheep previously ventilated for 24 hours.

METHODS:

To simulate intubated intensive care unit patients placed in semirecumbent position, 14 sheep were intubated and mechanically ventilated with the head elevated 30° above horizontal. Seven of them were euthanized after 24 hours (Control Group), whereas the remaining were euthanized after being awaken, extubated, and left spontaneously breathing for 48 hours after extubation (Awake Group). Criteria of clinical diagnosis of pneumonia were tested. Microbiological evaluation was performed on autopsy in all sheep.

RESULTS:

Only 1 sheep in the Control Group met the criteria of VAP after 24 hours of mechanical ventilation. However, heavy pathogenic bacteria colonization of trachea, bronchi, and lungs (range, 104–109 colony-forming unit [CFU]/g) was reported in 4 of 7 sheep (57%). In the Awake Group, 1 sheep was diagnosed with VAP and 3 developed PEP within 48 hours after extubation (42%), with 1 euthanized at 30 hours because of respiratory failure. On autopsy, 5 sheep (71%) confirmed pathogenic bacterial growth in the lower respiratory tract (range, 103–109 CFU/g).

CONCLUSIONS:

Twenty-four hours of intubation and mechanical ventilation in semirecumbent position leads to significant pathogenic colonization of the lower airways, which can promote the development of PEP. Strategies directed to prevent pathogenic microbiological colonization before and after mechanical ventilation should be considered to avert the onset of PEP.
Disease Campaigns and the Decline of Treatment Advocacy
Authors: Best Rachel Kahn
Published: February 2017

In the past fifty years, disease advocacy organizations have multiplied and gained political influence, but they have often been reluctant to ask the government to intervene in health care provision. This article asks why. Using original quantitative and qualitative data on the goals and political claims of over one thousand organizations from 1960 through 2014, I find that many early disease advocacy organizations prioritized health care access. But unfavorable political climates discouraged new organizations from focusing on access to treatment. When health care became particularly controversial, even organizations with health care-related missions refrained from pursuing this goal politically. Eventually, politically active organizations began to drop treatment provision from their missions. Over the decades, the troubled politics of health care reshaped the field of disease advocacy, diminishing its focus on medical treatment.
Automated cell tracking identifies mechanically oriented cell divisions during Drosophila axis elongation
Authors: Wang Michael F. Z. , Hunter Miranda V. , Wang Gang , McFaul Christopher , Yip Christopher M. , Fernandez-Gonzalez Rodrigo
Published: February 2017

Embryos extend their anterior-posterior (AP) axis in a conserved process known as axis elongation. Drosophila axis elongation occurs in an epithelial monolayer, the germband, and is driven by cell intercalation, cell shape changes, and oriented cell divisions at the posterior germband. Anterior germband cells also divide during axis elongation. We developed image analysis and pattern-recognition methods to track dividing cells from confocal microscopy movies in a generally applicable approach. Mesectoderm cells, forming the ventral midline, divided parallel to the AP axis, while lateral cells displayed a uniform distribution of division orientations. Mesectoderm cells did not intercalate and sustained increased AP strain before cell division. After division, mesectoderm cell density increased along the AP axis, thus relieving strain. We used laser ablation to isolate mesectoderm cells from the influence of other tissues. Uncoupling the mesectoderm from intercalating cells did not affect cell division orientation. Conversely, separating the mesectoderm from the anterior and posterior poles of the embryo resulted in uniformly oriented divisions. Our data suggest that mesectoderm cells align their division angle to reduce strain caused by mechanical forces along the AP axis of the embryo.
Regional differences in the preferred e-vector orientation of honeybee ocellar photoreceptors
Authors: Ogawa Yuri , Ribi Willi , Zeil Jochen , Hemmi Jan M.
Published: February 2017

In addition to compound eyes, honeybees (Apis mellifera) possess three single lens eyes called ocelli located on the top of the head. Ocelli are involved in head-attitude control and in some insects have been shown to provide celestial compass information. Anatomical and early electrophysiological studies have suggested that UV and blue-green photoreceptors in ocelli are polarization sensitive. However, their retinal distribution and receptor characteristics have not been documented. Here, we used intracellular electrophysiology to determine the relationship between the spectral and polarization sensitivity of photoreceptors and their position within the visual field of the ocelli. We first determined a photoreceptor’s spectral response through a series of monochromatic flashes (340 - 600 nm). We found UV and Green receptors, with peak sensitivities at 360 nm and 500 nm respectively. We subsequently measured polarization sensitivity at the photoreceptor’s peak sensitivity wavelength by rotating a polarizer with monochromatic flashes. Polarization sensitivity (PS) values were significantly higher in UV receptors (3.8±1.5, N=61) than Green receptors (2.1±0.6, N=60). Interestingly, most receptors with receptive fields below 35° elevation were sensitive to vertically polarized light while the receptors with visual fields above 35° were sensitive to a wide range of polarization angles. These results agree well with anatomical measurements showing differences in rhabdom orientations between dorsal and ventral retinae. We discuss the functional significance of the distribution of polarization sensitivities across the visual field of ocelli by highlighting the information the ocelli are able to extract from the bee’s visual environment.
Advancing viral RNA structure prediction: measuring the thermodynamics of pyrimidine-rich internal loops
Authors: Phan Andy , Mailey Katherine , Saeki Jessica , Gu Xiaobo , Schroeder Susan J.
Published: February 2017

Accurate thermodynamic parameters improve RNA structure predictions and thus accelerate understanding of RNA function and the identification of RNA drug binding sites. Many viral RNA structures, such as internal ribosome entry sites, have internal loops and bulges that are potential drug target sites. Current models used to predict internal loops are biased toward small, symmetric purine loops, and thus poorly predict asymmetric, pyrimidine-rich loops with >6 nucleotides (nt) that occur frequently in viral RNA. This article presents new thermodynamic data for 40 pyrimidine loops, many of which can form UU or protonated CC base pairs. Uracil and protonated cytosine base pairs stabilize asymmetric internal loops. Accurate prediction rules are presented that account for all thermodynamic measurements of RNA asymmetric internal loops. New loop initiation terms for loops with >6 nt are presented that do not follow previous assumptions that increasing asymmetry destabilizes loops. Since the last 2004 update, 126 new loops with asymmetry or sizes greater than 2 × 2 have been measured. These new measurements significantly deepen and diversify the thermodynamic database for RNA. These results will help better predict internal loops that are larger, pyrimidine-rich, and occur within viral structures such as internal ribosome entry sites.
Efficacy of Computed Tomography (CT) Attenuation Values and CT Findings in the Differentiation of Pleural Effusion
Authors: Yalçin-Şafak Kadihan , Umarusman-Tanju Neslihan , Ayyıldız Muhammet , Yücel Nihal , Baysal Tamer
Published: February 2017

Background: The aim of this study was to investigate the efficacy of computed tomography (CT) findings for characterizing pleural effusions with the use of attenuation values.

Material/Methods: One hundred and twenty eight patients with pleural effusions on thoracic CT who underwent thoracentesisis within two weeks were studied. Pleural effusions were classified as exudates or transudates according to the Light’s criteria. A region of interest was placed for the measurement of Hounsfield Unit (HU) values in the area of the greatest amount of effusion on each slice of the three slices used. CT features that were evaluated for distinguishing pleural exudates from transudates included pleural nodules, pleural thickening and loculation.

Results: Thirty three (26%) of the 128 pleural effusions were transudates and 95 (74%) were exudates. The mean HU values of the exudates (8.82±7.04) were significantly higher than those of the transudates (2.91±8.53), (p<0.001). No statistically significant difference was found between transudate and exudate patients in terms of pleural thickness, pleural nodules and loculation (p>0.05).

Conclusions: HU values can help in differentiating exudative pleural effusions from transudative pleural effusions. Because of overlapping HU values, correlation with clinical findings is essential.
Analytic Response Curves of Clinical Breast Cancer IHC Tests
Authors: Vani Kodela , Sompuram Seshi R. , Schaedle Anika K. , Balasubramanian Anuradha , Bogen Steven A.
Published: February 2017

An important limitation in the field of immunohistochemistry (IHC) is the inability to correlate stain intensity with specific analyte concentrations. Clinical immunohistochemical tests are not described in terms of analytic response curves, namely, the analyte concentrations in a tissue sample at which an immunohistochemical stain (1) is first visible, (2) increases in proportion to the analyte concentration, and (3) ultimately approaches a maximum color intensity. Using a new immunostaining tool ( IHControls), we measured the analytic response curves of the major clinical immunohistochemical tests for human epidermal growth factor receptor type II (HER-2), estrogen receptor (ER), and progesterone receptor (PR). The IHControls comprise the analytes HER-2, ER, and PR at approximately log concentration intervals across the range of biological expression, from 100 to 1,000,000 molecules per test microbead. We stained IHControls of various concentrations using instruments, reagents, and protocols from three major IHC vendors. Stain intensity at each analyte concentration was measured, thereby generating an analytic response curve. We learned that for HER-2 and PR, there is significant variability in test results between clinical kits for samples with analyte concentrations of approximately 104 molecules/microbead. We propose that the characterization of immunostains is an important step toward standardization.
Estimated Glomerular Filtration Rate and Albuminuria Are Associated with Biomarkers of Cardiac Injury in a Population-Based Cohort Study: The Maastricht Study
Authors: Martens Remy J H , Kimenai Dorien M , Kooman Jeroen P , Stehouwer Coen D A , Tan Frans E S , Bekers Otto , Dagnelie Pieter C , van der Kallen Carla J H , Kroon Abraham A , Leunissen Karel M L , van der Sande Frank M , Schaper Nicolaas C , Sep Simone J S , Schram Miranda T , van Suijlen Jeroen D , van Dieijen-Visser Marja P , Meex Steven J R , Henry Ronald M A
Published: February 2017

BACKGROUND

Chronic kidney disease (CKD) is associated with an increased cardiovascular disease mortality risk. It is, however, less clear at what point in the course from normal kidney function to CKD the association with cardiovascular disease appears. Studying the associations of estimated glomerular filtration rate (eGFR) and albuminuria with biomarkers of (subclinical) cardiac injury in a population without substantial CKD may clarify this issue.

METHODS

We examined the cross-sectional associations of eGFR and urinary albumin excretion (UAE) with high-sensitivity cardiac troponin (hs-cTn) T, hs-cTnI, and N-terminal probrain natriuretic-peptide (NT-proBNP) in 3103 individuals from a population-based diabetes-enriched cohort study.

RESULTS

After adjustment for potential confounders, eGFR and UAE were associated with these biomarkers of cardiac injury, even at levels that do not fulfill the CKD criteria. For example, eGFR 60–<90 mL · min−1 ·(1.73 m2)−1 [vs ≥90 mL · min−1 · (1.73 m2)−1] was associated with a [ratio (95% CI)] 1.21 (1.17–1.26), 1.14 (1.07–1.20), and 1.19 (1.12–1.27) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively. The association of eGFR with hs-cTnT was statistically significantly stronger than that with hs-cTnI. In addition, UAE 15–<30 mg/24 h (vs <15 mg/24 h) was associated with a 1.04 (0.98–1.10), 1.08 (1.00–1.18), and 1.07 (0.96–1.18) times higher hs-cTnT, hs-cTnI, and NT-proBNP, respectively.

CONCLUSIONS

eGFR and albuminuria were already associated with biomarkers of (subclinical) cardiac injury at levels that do not fulfill the CKD criteria. Although reduced renal elimination may partly underlie the associations of eGFR, these findings support the concept that eGFR and albuminuria are, over their entire range, associated with cardiac injury.
The place of practice in tertiary popular music studies: An epistemology
Authors: Weston Donna
Published: February 2017

This article explores the potential role of popular music studies when integrated into popular music practice programmes in higher education, and proposes that purely theoretical popular music studies could inform creative practice in the education of popular music practitioners. In bringing popular music studies and popular music practice together under the banner of popular music education, it is proposed that popular music practice educators should consider the study of popu- lar music from a sociocultural perspective as well as a practical one. The argument is informed by two field reports that map higher education in popular music in the United Kingdom and in Australia, respectively, supported by responses of students to the integration of popular music studies into an Australian popular music prac- tice programme. The findings show that students of popular music practice benefit- ted from the inclusion of popular music studies into their curriculum through the development of critical listening skills and songwriting ability, expansion of a range of vocational skills and a stronger sense of purpose within the music industry.
Book Reviews
Authors: Hjelm Titus , Kelley Jamey
Published: February 2017

Heavy Metal Studies and Popular Culture, Brenda Gardenour Walter, Gabby Riches, Dave Snell and Bryan Bardine (2016) Basingstoke: Palgrave, 214 pp., ISBN: 978-1-137-45667-0, h/bk, £68.00

Playing Along: Digital Games, Youtube, and Virtual Performance, Kiri Miller (2012) New York, NY: Oxford University Press, 272 pp., ISBN: 019-9-753-466, p/bk, $31.95
The power of popular music in China’s music education: From the Chinese dream and personal dreams to Confucianism
Authors: Ho Wai-Chung
Published: February 2017

The ‘Chinese dream’, a term popularized by the Chinese socialist state and put forth by Chinese President Xi Jinping in 2013, refers to the collective aspiration of a great rejuvenation of the Chinese nation, as well as the personal dreams of its individual citizens to attain healthy, happy and productive lives. Attempts to integrate this vision into people’s thoughts have been made via Chinese propaganda songs broadcast through state-run media and textbook materials. The ‘core socialist values’ linked to the Chinese dream reflect the wish for all Chinese to have a better future through national rejuvenation. The current rise of Confucianism is a manifestation of cultural nationalism in education that has emerged from the growing political and economic power of China. In terms of soft power, transmitting select popular music through education and culture is one way to bring about harmony in the changing society of mainland China. With particular and sustained attention to the power of China’s popular music, this article examines how music education (with a particular selection of songs adopted for official propaganda and state-approved music textbooks) responds to the rule of the Communist Party of China and its attempts to consolidate power in a global age.
(Un)popular music and young audiences: Exploring the classical chamber music concert from the perspective of young adult listeners
Authors: Dearn Lucy K. , Pitts Stephanie E.
Published: February 2017

This empirical study explores the responses of 40 young people to a chamber music concert, considering how their greater experience of popular music listening formed a frame of reference for their responses to live classical music. Using qualitative methods including the ‘Write-Draw’ technique to investigate the young people’s responses before, during and after the concert, we demonstrate how the emotional, responsive listening of popular music conflicted with the etiquette of the concert hall and the structures of classical music. Our study sheds new light on the continued decline of young audiences for classical concerts and presents a challenge to music education to equip young people for all kinds of live musical experience.
Facilitation in popular music education
Authors: Cremata Radio
Published: February 2017

This article explores the evolving role of facilitators in popular music education contexts, building on research in music education related to a range of topics such as calls for reform, informal learning, experiential learning, popular music and technology based music learning contexts. A popular music education facilitator employs constructivist learning approaches through student-centred experiential processes. A series of case studies were conducted at various schools including middle schools, high schools and post-secondary contexts. Participants’ classroom management styles ranged from from low-control to high-control facilitation. Student perspectives indicated that facilitation promoted democracy, autonomy, diversity, hospitality, differentiation, exploration, creativity, collaboration and inclusivity. The findings and implications of this research apply to the music education profession, calling into question foundations of student-centred learning, autonomy and increased student agency in music learning contexts.
Through the looking glass: A study of the role of reflection in the musical development of popular music undergraduates at the University of Liverpool
Authors: Esslin-Peard Monica
Published: February 2017

Much has been written about musical practice and performance, with little consensus over what practice means, or how musicians progress by practising. Studies have focused primarily on individual Western classical musicians in the conservatoire, with more recent research turning to popular, jazz and folk musicians. Informal and collaborative practices are central in popular musicians’ learning. The current research project focuses on the practice and performance of undergraduate popular musicians, described in students’ reflective essays. This article presents highlights in the musical development of one cohort of popular musicians over the 3 years of their study, including examples of practice behaviours, development of technique, collaboration with band members through rehearsals, creating original material, and gigging on and off campus. Findings indicate the possible role of reflection to support musical development of students, motivated by membership of bands and increasing technical prowess, linked to set lists and band aspirations to perform off-campus.
The longer revolution: The rise of vernacular musics as ‘new channels of general learning’
Authors: Wright Ruth
Published: February 2017

This article takes as its point of origin an extract from Apple’s (2013) book Can Education Change Society? Beginning with the concept of ‘radical democratic egalitarianism’ the author examines the extent to which many current models of music education meet the criteria for ‘robust egalitarianism’ with reference to their inclusion of popular culture. With reference to Williams’ (1961) seminal work in cultural studies The Long Revolution, consideration is given to the extent to which progress towards cultural, musical democracy has been made in music education. These considerations are juxtaposed against the thought of key sociological theorists Apple; E. O. Wright; Bourdieu; Marx and Engels; and Day. The article then discusses research in the area of youth and popular music and surveys international approaches to popular music education. Finally the article turns to pedagogical considerations in relation to popular music. Utilizing Bennett’s (2000) assessment of popular music as one of the primary cultural resources of contemporary social life for young people, an analogy is drawn between Williams’ heralding of the democratic benefits of the introduction of vernacular language as the new channel of general instruction and the possibilities of extending popular music as the new channel of general musical learning. It is suggested that such a change might move the Long Revolution forward in music education and in the cultural lives of young people.
Revolución íntima y revolución universal: una lectura de Vuelos de victoria de Ernesto Cardenal
Authors: Famin Victoria
Published: February 2017

Este trabajo propone una lectura del poemario Vientos de victoria (1984) del poeta nicaragüense Ernesto Cardenal, teniendo en cuenta los principios del exteriorismo al que el autor adhiere y sus propias exigencias poéticas. En tal sentido, se tratará de identificar las particularidades de estos poemas concebidos en estrecha relación con el contexto político y social de la Nicaragua de finales de los años 80. Siguiendo las líneas de la poesía impura proclamada por Neruda, Cardenal asume un rol de poeta profeta y lleva adelante en este poemario una revolución poética a la vez íntima y universal.
CNS tuberculosis: diagnostic challenges and review of recent laboratory investigations
Authors: Gautam Vinod , Gupta Renu
Published: February 2017

Tuberculosis of the central nervous system poses a diagnostic and therapeutic challenge to the physicians. Early diagnosis is warranted to reduce morbidity and mortality associated with this disease. Microbiological investigations for the diagnosis of tuberculosis of central nervous system are of paramount significance. However, due to relative inaccessibility of approaching infected lesions in eloquent area of brain and difficulty in retrieving pathological sample from deep located regions of the brain and spinal cord without causing any neurological deficit, there is need to review the relevance of available microbiological and biochemical tests. Some tests which may be very specific like AFB microscopy and culture may not be positive in many cases due to paucibacillary CSF sample or pus or granulation tissue from the brain or spine. So, authors have reviewed different biochemical and microbiological tests and suggested a pragmatic and step wise practical approach for use of laboratory investigations in clinical management of CNS TB patients.
O papel de gestor: Percepções de professores-gestores de uma Universidade Federal Brasileira
Authors: Barbosa Milka Alves Correia , Ney Matos Fátima Regina , Mendonça José Ricardo Costa , Paiva Kely César Martins , Cassundé Fernanda Roda de Souza Araújo
Published: February 2017

Esta investigação teve como objetivo analisar como professores de ensino superior de uma universidade federal percebem o papel de professor-gestor.  Para tanto, realizou-se um estudo qualitativo interpretativo básico, cujos participantes foram os professores-gestores da Universidade Federal do Vale do São Francisco. Os dados foram coletados por meio de entrevistas semiestruturadas e análise documental. A Análise de Conteúdo foi adotada para o tratamento dos dados, com o suporte do software Atlas Ti. Com os relatos dos professores foi possível identificar dimensões compartilhadas por eles ao se referirem ao papel de professor-gestor (faceta convencional), em torno das quais esses sujeitos se agregam e que caracterizaram o papel de professor-gestor como uma categoria social. Como também, foi possível reconhecer as interpretações e significações individuais que constituem a faceta idiossincrática do papel de professor-gestor. A pesquisa de campo mostrou-se frutífera ao aproximar empiricamente os processos de identificação e categorização do papel social, respectivamente oriundos da Teoria da Identidade e da Teoria da Identidade Social, mostrando que a complementaridade entre abordagens tradicionalmente oponentes. Ao situar a temática do papel professor-gestor na Universidade Federal do Vale do São Francisco (Univasf), a pesquisa proporcionou a construção de conhecimento sobre os papéis, atividades, desafios e tarefas com os quais mestres e doutores em início de carreira, lotados em universidades federais convivem.
Impact of internal migration movements on the schooling process in Turkey: Supervisors’ views
Authors: Akar Hanife , Şen Derya
Published: February 2017

This study attempted to examine the impact of interregional and urban–rural population movements on schools located in areas subjected to high in-migration and out-migration flows in Turkey based on data collected from primary school supervisors (N=150). A cross-sectional survey design was utilized to examine the most pressing problems confronted  in those schools, and possible actions that could be taken by various stakeholders were sought. Overall data suggest that those schools  serve mostly disadvantaged populations with poor households. Among the main challenges revealed are lack of adequate school resources and poor facilities, problems caused due to ineffective and untimely implementation of the program, high personnel turnover and recruitment of largely inexperienced and relatively less qualified educational staff, and lower levels of parental involvement in children’s schooling. Accordingly, proposed recommendations focused on measures to eliminate capacity and resource constraints, improve hiring practices, and secure adequate supervision and support for educational staff, meet academic and socio-emotional needs of students and facilitate parental involvement in the education of children.
Evaluation of the photocatalytic ability of a sol-gel-derived MgO-ZrO2 oxide material
Authors: Ciesielczyk Filip , Szczekocka Weronika , Siwińska-Stefańska Katarzyna , Piasecki Adam , Paukszta Dominik , Jesionowski Teofil
Published: February 2017

This paper deals with the synthesis and characterization of a novel group of potential photocatalysts, based on sol-gel-derived MgO-ZrO2oxide material. The material was synthesized in a typical sol-gel system using organic precursors of magnesia and zirconia, ammonia as a promoter of hydrolysis and methanol as a solvent. All materials were thoroughly analyzed, including morphology and particle sizes, chemical composition, identification of characteristic functional groups, porous structure parameters and crystalline structure. The proposed methodology of synthesis resulted in obtaining pure MgO-ZrO2oxide material with micrometric-sized particles and a relatively high surface area. The samples underwent an additional calcination process which led to the crystalline phase of zirconia being formed. The key element of the study was the evaluation of the effectiveness of decomposition of C.I. Basic Blue 9 dye. It was shown that the calcined materials exhibit both satisfactory adsorption and photocatalytic activity with respect to the decomposition of a selected model organic impurity. Total dye removal varied in the range of 50-70%, and was strongly dependent on process parameters such as quantity of photocatalyst, time of irradiation, and the addition of promoters.
Therapeutic Drug Monitoring in Rheumatic Diseases
Authors: NG Hoi-Yan Alexandra , Mok Chi Chiu
Published: February 2017

The ultimate goal of treating rheumatic disease is to achieve rapid suppression of inflammation, while at the same time minimizing the toxicities from rheumatic drugs. Different patients have different individual pharmacokinetics that can affect the drug level. Moreover, different factors, such as renal function, age or even different underlying diseases, can affect the drug level. Therefore, giving the same dosage of drugs to different patients may result in different drug levels. This article will review the usefulness of therapeutic drug monitoring in maximizing drug efficacy, while reducing the risk of toxicities in Hydroxychloroquine, Mycophenolate Mofetil, Tacrolimus and Tumor Necrosis Factor inhibitors (TNF Inhibitors).
Involvement of the guanine nucleotide exchange factor Vav3 in central nervous system development and plasticity
Authors: Ulc Annika , Gottschling Christine , Schäfer Ina , Wegrzyn David , van Leeuwen Simon , Luft Veronika , Reinhard Jacqueline , Faissner Andreas
Published: February 2017

Small GTP-hydrolyzing enzymes (GTPases) of the RhoA family play manifold roles in cell biology and are regulated by upstream guanine nucleotide exchange factors (GEFs). Herein, we focus on the GEFs of the Vav subfamily. Vav1 was originally described as a proto-oncogene of the hematopoietic lineage. The GEFs Vav2 and Vav3 are more broadly expressed in various tissues. In particular, the GEF Vav3 may play important roles in the developing nervous system during the differentiation of neural stem cells into the major lineages, namely neurons, oligodendrocytes and astrocytes. We discuss its putative regulatory roles for progenitor differentiation in the developing retina, polarization of neurons and formation of synapses, migration of oligodendrocyte progenitors and establishment of myelin sheaths. We propose that Vav3 mediates the response of various neural cell types to environmental cues.
Oral self-translation of stand-up comedy and its (mental) text: a theoretical model
Authors: Palmieri Giacinto
Published: February 2017

This paper investigates the phenomenon of stand-up comedians performing in more than one language, which poses the question of whether and how they translate their material. Past research on stand-up comedy underlines its conversational nature, sometimes at the expense of recognizing its content. Empirical evidence collected from interviews with bilingual stand-up comedians, on the other hand, suggests that they perform a form of oral self-translation, which implies atertium comparationis, the transfer of content. The notion ofmental text, borrowed from ethnography, is then productively used to define this content. As is then suggested, two types of memory, namelydeclarativeandprocedural, are involved in the memorization of this mental text. The declarative part accounts for what is repeatable across performances and is the part involved in conscious translation; its minimal content is identified in the punch lines. The procedural part accounts for variation, improvisation and interaction. A model of the oral-self translation process of stand-up is then proposed. I conclude that re-focusing on the (mental) text of stand-up comedy can offer a better understanding of its translation, which in turn can contribute to a better understanding of humor in a multilingual and multicultural context in future research.
Manipulating humor styles: Engaging in self-enhancing humor reduces state anxiety
Authors: Ford Thomas E. , Lappi Shaun K. , O’Connor Emma C. , Banos Noely C.
Published: February 2017

We conducted three experiments to determine if engaging in self-enhancing humor can alleviate state anxiety associated with an anticipated stressful event. In all three experiments, participants imagined they were about to take a stressful math test. In Experiment 1 participants who engaged in self-enhancing humor while anticipating taking the test experienced less state anxiety than those who engaged in self-defeating humor or no humor at all. Experiment 2 demonstrated that engaging in self-enhancing humor reduced state anxiety more than mere instructions to adopt a non-serious, humorous outlook in the stressful situation. Experiment 3 revealed that self-enhancing humor alone induced participants to adopt a humorous perspective on the stressful math test, but that participants responded with the least state anxiety when they were also given instructions about how to use the humor to reframe the math test. Collectively, our findings corroborate and extend previous correlational studies showing that self-enhancing humor can alleviate state anxiety associated with a stressful event.
Sensory Characteristics of Maillard Reaction Products Obtained from Sunflower Protein Hydrolysates and Different Sugar Types
Authors: Karangwa Eric , Habimana Jean de Dieu , Jingyang Yu , Murekatete Nicole , Zhang Xiaoming , Masamba Kingsley , Duhoranimana Emmanuel , Muhoza Bertrand
Published: February 2017

The effect of different sugar types on the sensory characteristics of Maillard reaction products (MRPs) obtained from sunflower protein hydrolysates was evaluated. MRPs were prepared at 120 °C for a time of 2 h and a pH of 7.4. Results showed that the browning intensity, colour development and free and total amino acids of MRPs were highly affected by the sugar types. Peptide-xylose-cysteine (PXC) were more dark-brown in colour with lower free and total amino acid (FAA and TAA) content compared to the other MRPs. However, PXC showed great mouthfulness and continuity taste with stronger meat-like flavour and umami taste compared to MRPs. MRPs from hexose except PGaC, showed acceptable mouthfulness and continuity taste while PLC and PMC and PGaC showed higher caramel-like flavour and bitter taste. Furthermore, pentose sugars (xylose) were the great precursor of sulphur-containing compounds. It could be concluded that sunflower peptides, xylose, cysteine model system could be a good precursor of flavour enhancers.
Potential analysis of multidisciplinary biopsychosocial rehabilitation for patients with chronic low back pain / Potentialanalyse der multidisziplinären biopsychosozialen Rehabilitation für Patienten/-innen mit chronischen Rückenschmerzen
Authors: Schüßler Beate , Abel Angsar , Holzer Milena , Meise Ruth , Voigt-Radloff Sebastian , Schäfer Axel
Published: February 2017

Health problem

The prevalence of low back pain ranges from 74 to 85%, almost everybody in Germany suffers from low back pain once in his or her life. The recurrence rate within twelve months is 62%, which often leads to inability to work and reduction in earning capacity. The rate of chronic manifestation of low back pain is 5%. Subsequent loss of mobility and functional disability lowers quality of life and participation in private life and at work.

Evidence

A recent Cochrane review (Kamper et al., 2014) analysed six (outcome disability) and seven (outcome pain) studies with 722 and 821 participants respectively and showed that multidisciplinary rehabilitation compared to usual care has a small, but clinically relevant effect (pain: SMD -0,21 [CI 95% -0,37; -0,04]; disability: SMD -0,23 [CI 95% -0,4; -0,06]). There is a lack of evidence about the intervention conception, patient-centred outcomes and the cost effectiveness.

Implication for research

Prior to a randomised controlled trial a feasibility study about individualised multidisciplinary biopsychosocial rehabilitation compared to usual care considering people with chronic low back pain at employable age in Germany is needed. The applicability of available manuals, patient-centred outcomes and cost effectiveness should be explored.
Development and evaluation of interdisciplinary preoperative patient education in foot and ankle surgery: immediate effects on knowledge, satisfaction and anxiety / Entwicklung und erste Evaluation eines präoperativen interdisziplinären Schulungskonzeptes für Patienten/-innen der Fußchirurgie: unmittelbare Effekte auf Wissenszuwachs, Zufriedenheit und Angst
Authors: Schäfer Axel , Jettkowski Katrin , Kretschmann Julia , Wurg Marco , Stukenborg-Colsmann Christina , Plaaß Christian
Published: February 2017

Background and objective

Foot and ankle surgery is increasing due to demographic and lifestyle changes. Most often, patients are required to unload their foot postoperatively, resulting in signifcant impairment of activities of daily living without adequate preparation for this situation. The aim of the study was the development and evaluation of a preoperative patient education intervention.

Methods

Based on current research, a patient education intervention was developed. To investigate immediate effects, a longitudinal study with two points of measurement before and after the education session was conducted. Outcomes were increase in knowledge, satisfaction and preoperative anxiety, which were measured with a selfdeveloped questionnaire. Additionally, five short interviews were conducted.

Results

56 patients (63% female) with a mean age of 56,7 (SD=14,8) years were included. Patients had a signifcant increase in knowledge following the intervention from mean 3,93 (SD=1,78) to 5,48 (SD=2,29) correctly answered questions (out of 10). Patients felt that they were better informed and more satisfied with the information provided. Patients evaluated the way of information delivery, the content of information, the group and the location as positive.The expectations of patients relating to postoperative load-bearing capacity and coping with everyday life as well as preoperative anxiety did not change following the intervention.

Conclusion

The education intervention could be implemented in the clinical routine and showed positive effects. However, regarding realistic expectations and preoperative anxiety no change was observed. Long-term post operative effectivity and effciency of patient education should be further examined within a randomized controlled trial.
Performance Investigation of Different Modulation Schemes in RoF Systems under the Influence of Self Phase Modulation
Authors: Nain Abhimanyu , Kumar Suresh
Published: February 2017

The Radio over Fiber (RoF) system has emerged out a promising solution to the last mile connectivity along with higher data rates making it the preference for future communication networks. But fiber nonlinearities induce crosstalk and degrade the performance of the system. This paper presents a simulative investigation & comparison of Mach Zehender Modulator (MZM) and Optical Phase Modulator (OPM) including the effects of Self Phase Modulation. A single channel RoF system has been designed using MZM and OPM respectively. The model is analyzed for different ranges of dispersion and input channel power. It is observed that as the dispersion modulus increases the SPM induced pulse broadening also increases. The pulse broadening also increases with increase in the channel input power. Further it is revealed that MZM offers 0.3 dB more channel output power compared to OPM when dispersion is increased from 2 to 10 ps/nm/km. With the increase in channel input power from 10 to 17.5 dBm, OPM suppress SPM effects better than MZM and provides 2 dB more channel output power.
Diffusion kurtosis imaging of gliomas grades II and III - a study of perilesional tumor infiltration, tumor grades and subtypes at clinical presentation
Authors: Delgado Anna F. , Fahlström Markus , Nilsson Markus , Berntsson Shala G. , Zetterling Maria , Libard Sylwia , Alafuzoff Irina , van Westen Danielle , Lätt Jimmy , Smits Anja , Larsson Elna-Marie
Published: February 2017

Background

Diffusion kurtosis imaging (DKI) allows for assessment of diffusion influenced by microcellular structures. We analyzed DKI in suspected low-grade gliomas prior to histopathological diagnosis. The aim was to investigate if diffusion parameters in the perilesional normal-appearing white matter (NAWM) differed from contralesional white matter, and to investigate differences between glioma malignancy grades II and III and glioma subtypes (astrocytomas and oligodendrogliomas).

Patients and methods

Forty-eight patients with suspected low-grade glioma were prospectively recruited to this institutional review board-approved study and investigated with preoperative DKI at 3T after written informed consent. Patients with histologically proven glioma grades II or III were further analyzed (n=35). Regions of interest (ROIs) were delineated on T2FLAIR images and co-registered to diffusion MRI parameter maps. Mean DKI data were compared between perilesional and contralesional NAWM (student’s t-test for dependent samples, Wilcoxon matched pairs test). Histogram DKI data were compared between glioma types and glioma grades (multiple comparisons of mean ranks for all groups). The discriminating potential for DKI in assessing glioma type and grade was assessed with receiver operating characteristics (ROC) curves.

Results

There were significant differences in all mean DKI variables between perilesional and contralesional NAWM (p=<0.000), except for axial kurtosis (p=0.099). Forty-four histogram variables differed significantly between glioma grades II (n=23) and III (n=12) (p=0.003−0.048) and 10 variables differed significantly between ACs (n=18) and ODs (n=17) (p=0.011−0.050). ROC curves of the best discriminating variables had an area under the curve (AUC) of 0.657−0.815.

Conclusions

Mean DKI variables in perilesional NAWM differ significantly from contralesional NAWM, suggesting altered microstructure by tumor infiltration not depicted on morphological MRI. Histogram analysis of DKI data identifies differences between glioma grades and subtypes.