bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vivo Hyperoxic Preconditioning Prevents Myocardial Infarction by Expressing Bcl-2
Authors: Choi Hong , Kim Sang-Hyun , Chun Yang-Sook , Cho Young-Suk , Park Jong-Wan , Kim Myung-Suk
Published: July 2017

Preconditioning with oxidative stress has been demonstrated in vitro to stimulate the cellular adaptation to subsequent severe oxidative stress. However, it is uncertain whether this preconditioning works in vivo. In the present study, we examined in vivo the beneficial effect of oxidative preconditioning. After rats were pretreated with whole-body hyperoxygenation (100% 02 at 3 atmosphere for 20 mins, four cycles with 20-min intermission), isolated hearts were subjected to 45-min ischemia followed by 90-min reperfusion. This hyperoxic preconditioning significantly reduced infarct size, cytochrome-c release, DNA fragmentation, and terminal deoxynucleotidyl transferase-mediated dUTD nick-end labeling-positive cell frequency in the left ventricle, biphasically with an early (30-min) and a delayed (48-hr) effect after the hyperoxygenation. Mechanistically, the NF-κB activity and Bcl-2 expression were enhanced in the hearts, and a NF-κB inhibitor, pyrrolidine dithiocarbamate, abolished the Bcl-2 induction as well as the infarct-limiting effect. An antioxidant, N-acetylcysteine, and protein kinase C (PKC) inhibitors chelerythrine and Gö 6983 also blocked the preconditioning effects. These results indicate that hyperoxia induces myocardial tolerance against ischemia-reperfusion injury in association with Bcl-2 induction by NF-κB activation through reactive oxygen species and PKC-dependent signaling pathway.
Molecular Mechanisms of Prothrombotic Risk Due to Genetic Variations in Platelet Genes: Enhanced Outside-In Signaling Through the Pro33Variant of Integrin β3
Authors: Vijayan K. Vinod , Bray Paul F.
Published: July 2017

In recent years inherited variations in platelet proteins have emerged as potential risk factors that could predispose individuals to arterial thrombosis. Although many studies have examined the association of platelet gene polymorphisms with particular disease states, the underlying mechanisms by which most of these polymorphisms contribute to the pathophysiology of thrombosis have remained largely unexplored. This review will focus on the cellular and molecular features by which these genetic changes affect platelet physiology. Although many genes have been investigated in this regard, only the genes encoding integrins β3and α2, and the platelet Fc receptor, FcγRIIA, have been studied in any depth. In some cases (such as integrin α2), evidence supports a quantitative trait locus. For other genes, nonsynonymous nucleotide substitutions lead to structural and functional consequences. A large portion of this review will focus on the widely studied Leu33Pro (PIA) polymorphism of integrin β3, and will consider the potential mechanisms by which the Pro33polymorphism could induce a prothrombotic risk. A detailed understanding of how polymorphisms modulate platelet physiology will be important for understanding individual differences in response to antiplatelet therapy.
Alterations of Fas and Fas-Related Molecules in Patients with Silicosis
Authors: Otsuki Takemi , Miura Yoshie , Nishimura Yasumitsu , Hyodoh Fuminori , Takata Akiko , Kusaka Masayasu , Katsuyama Hironobu , Tomita Masafumi , Ueki Ayako , Kishimoto Takumi
Published: July 2017

Persons with silicosis have not only respiratory disorders but also autoimmune diseases. To clarify the mechanisms involved in the dysregulation of autoimmunity found in patients with silicosis, we have been focusing on Fas and Fas-related molecules in the Fas-mediated apoptotic pathway, because Fas is one of the most important molecules regulating autoimmunity involving T cells. Our findings showed that patients with silicosis exhibited elevated serum soluble Fas levels, an increased relative expression of the soluble fas and dcr3 genes in peripheral blood mononuclear cells, high levels of other variant messages of the fas transcript, relatively decreased expression of genes encoding several physiological inhibitors (such as survivin and toso), and dominancy of lower-membrane Fas expressers in lymphocytes, which transcribe soluble fas dominantly, compared with soluble fas transcription in healthy donors. These findings are consistent with known features regarding immunological factors, such as serum immunogulobulin G levels and the titer of anti-nuclear autoantibodies in silicosis. In addition, anti-caspase 8 autoantibody and anti-Fas autoantibody were detected in serum specimens from patients with silicosis, and a functional assay showed that anti-Fas antibody stimulated Fas-mediated apoptosis. We hypothesize that there are two subpopulations of silicosis lymphocytes. One is a long-term surviving fraction that includes self-recognizing clones showing lower levels of membrane Fas and inhibition of Fas/Fas ligand binding in extracellular spaces. The other subpopulation exhibits apoptosis caused by silica and silicates, is recruited from bone marrow, shows higher levels of membrane Fas, and is sensitive to anti-Fas autoantibody. Further investigation should be performed to confirm the effects of silica and silicates on the human immune system.
Activin Signaling and Its Role in Regulation of Cell Proliferation, Apoptosis, and Carcinogenesis
Authors: Chen Ye-Guang , Wang Qiang , Lin Shi-Lung , Chang C. Donald , Chung Jody , Ying Shao-Yao
Published: July 2017

Activins, cytokine members of the transforming growth factor-β superfamily, have various effects on many physiological processes, including cell proliferation, cell death, metabolism, homeostasis, differentiation, immune responses endocrine function, etc. Activins interact with two structurally related serine/threonine kinase receptors, type I and type II, and initiate downstream signaling via Smads to regulate gene expression. Understanding how activin signaling is controlled extracellularly and intracellularly would not only lead to more complete understanding of cell growth and apoptosis, but would also provide the basis for therapeutic strategies to treat cancer and other related diseases. This review focuses on the recent progress on activin-receptor interactions, regulations of activin signaling by ligand-binding proteins, receptor-binding proteins, and nucleocytoplasmic shuttling of Smad proteins.
Dynamic Adhesion of T Lymphocytes to Endothelial Cells Revealed by Atomic Force Microscopy
Authors: Zhang Xiaohui , Wojcikiewicz Ewa P. , Moy Vincent T.
Published: July 2017

The recruitment of T lymphocytes to lymphoid organs or sites of inflammation is a crucial step in adaptive immunity. These processes require endothelial activation and expression of adhesion molecules, including E- and P-selectins, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1). However, the complete characterization of the adhesion strength and dynamics between lymphocytes and endothelial cells has been hampered by the lack of sensitive quantitative techniques. Here we report on the application of atomic force microscopy to characterize the interaction between individual pairs of living T lymphocytes (i.e., Jurkat cells) and human umbilical vein endothelial cells (HUVECs). The detachment of individual cell–cell conjugates was a complex process involving several step-like rupture events and the viscoelastic deformation of cells on the scale of several microns. Adhesion between Jurkat cells and activated endothelial cells increased with compression force and contact time, with the most dramatic changes occurring within the first half second of contact. After 0.25 sec of contact, E-selectin, ICAM-1, and VCAM-1 contributed to 18%, 39%, and 41% of total adhesion strength, respectively, suggesting that ICAM-1 and VCAM-1 contributed more than the selectins in supporting cell attachment.
Effects of Commensal Bacteria on Intestinal Morphology and Expression of Proinflammatory Cytokines in the Gnotobiotic Pig
Authors: Shirkey T. W. , Siggers R. H. , Goldade B. G. , Marshall J. K. , Drew M. D. , Laarveld B. , Kessel A. G. Van
Published: July 2017

A germ-free neonatal pig model was established to determine the effects of bacterial colonization by different species on small intestinal morphology and proinflammatory cytokine gene expression. Two experimental groups of 16 pigs were aseptically delivered by cesarian section and allocated into 4 gnotobiotic isolators. Pigs were either maintained germ-free (GF), or were orally inoculated with either a single strain of nonpathogenic Escherichia coli (EC) or Lactobacillus fermentum (LF) or conventionalized with adult porcine feces (CV). After 13 days tissue samples were collected at 5 regions corresponding to 5%, 25%, 50%, 75%, and 95% of the small intestine (SI) length. In Experiment 2, the GF isolator became contaminated with Staphylococcus epidermidis (SE). In general, intestinal responses to bacterial colonization were similar among GF, LF, and SE pigs, and intestinal responses in EC pigs were more similar to CV pigs. Responses to bacterial colonization were most pronounced in the distal SI regions (50%–95%), suggesting that nonmicrobiai factors may be more important in the proximal SI. Relative to CV pigs, the distal intestines of GF, LF, and SE pigs were characterized by long villi, shallow crypts, Increased relative intestinal mass, and decreased lamina propria cellularity, whereas SI morphology was intermediate in EC pigs. Relative expression of proinflammatory cytokines interleukin-1β (IL-1β) and IL-6 generally increased distally in the SI and was highest in EC and CV pigs. We observed regional variation in SI morphology and proinflammatory cytokine expression, which differed with bacterial species. This study demonstrates that bacterial species differentially affect intestinal morphology and expression of proinflammatory cytokines and suggests that neonatal bacterial colonization patterns may have long-term effects on intestinal health and development
The Origin of Life and the Left-Handed Amino-Acid Excess: The Furthest Heavens and the Deepest Seas?
Authors: Goodman Geoffrey , Gershwin M. Eric
Published: July 2017

The origin of life is an extraordinary problem that leads back to the structure and dynamics of the cosmos and early development of organic molecules. Within that wider question lies an unsolved problem that has troubled biologists for 150 years. What is the origin of the dominant presence of left-handed stereoisomers of amino acids in nature even though their synthesis normally results in an equal mixture of the right- and left-handed molecular forms? We propose that asymmetric Earth rotation caused at dawn and dusk circularly polarized UV light (CPUVL) of opposite polarity and reversed temperature profiles in the oceans. Destruction of the d-isomer by CPUVL at dusk in a sea surface hotter than at dawn created a daily l-isomer excess protected from radiation by nightfall, preserved by down-flow (diffusive, mechanical) into cold, darker regions, eventually initiating an l-amino-acid excess embodied in early marine forms. Innumerable mechanisms have been proposed for the origin of l-chiral dominance in amino acids and none proven. Since the thalidomide tragedy, homochirality of amino acids has been a growing practical issue for medicine. Understanding its origin may bring further and unexpected benefits. It may also be a modest pointer to the possibility of positive answers to whether intelligent life will have the capacity to continue to protect itself from conditions inimical to survival.
Pulmonary Exposure to Diesel Exhaust Particles Enhances Coagulatory Disturbance with Endothelial Damage and Systemic Inflammation Related to Lung Inflammation
Authors: Inoue Ken-ichiro , Takano Hirohisa , Sakurai Miho , Oda Toshio , Tamura Hiroshi , Yanagisawa Rie , Shimada Akinori , Yoshikawa Toshikazu
Published: July 2017

Pulmonary exposure to diesel exhaust particles (DEP) enhances lung inflammation related to bacterial endotoxin (lipopolysaccharide [LPS]) in mice. Severe lung inflammation can reportedly induce coagulatory abnormalities and systemic inflammation. This study examined the effects of components of DEP on lung inflammation, pulmonary permeability, coagulatory changes, systemic inflammatory response, and lung-to-systemic translocation of LPS in a murine model of lung inflammation. ICR mice were divided into six experimental groups that intratracheally received vehicle, LPS (2.5 mg/kg), organic chemicals in DEP (DEP-OC; 4 mg/kg) extracted with dicloromethane), residual carbonaceous nuclei of DEP (washed DEP: 4 mg/kg), DEP-OC + LPS, or washed DEP + LPS. Both DEP components exacerbated lung inflammation, vascular permeability, and the increased fibrinogen and E-selectin levels induced by LPS. With overall trends, the exacerbation was more prominent with washed DEP than with DEP-OC. Washed DEP + LPS significantly decreased activated protein C and antithrombin-III and elevated circulatory levels of interleukin (IL)-6, keratinocyte chemoattractant (KC), and LPS as compared with LPS alone, whereas DEP-OC + LPS elevated IL-6, KC, and LPS without significance. These results show that DEP components, especially washed DEP, amplify the effects if LPS on the respiratory system and suggest that they contribute to the adverse health effects of particulate air pollution on the sensitive populations with predisposing vascular and/or pulmonary diseases, including ischemic vascular diseases and respiratory infection.
Kinetics of Cisplatin and Its Monohydrated Complex with Sulfur-Containing Compounds Designed for Local Otoprotective Administration
Authors: Videhult Pernilla , Laurell Göran , Wallin Inger , Ehrsson Hans
Published: July 2017

The anticancer drug cisplatin can cause permanent inner ear damage. We have determined the second-order degradation rate constant, kNU, of cisplatin and its more toxic monohydrated complex (MHC) in the presence of each of the sulfur-containing nucleophiles N-acetyl-l-cysteine, l-cysteine methyl ester, 1,3-dimethyl-2-thiourea, d-methionine, and thiosulfate, compounds that are under evaluation for local administration to prevent cisplatin-induced ototoxicity. MHC was isolated from a hydrolysis solution of cisplatin using liquid chromatography (LC). The degradations were evaluated by measuring the disappearance of MHC and cisplatin at 37°C and pH 7.4 in the presence of each of the nucleophiles using LC and photometric detection. The kNU of MHC and of cisplatin was 0.044 M 1sec 1 and 0.012 M 1sec 1 with N-acetyl-l-cysteine, 0.24 M 1sec 1 and 0.067 M 1sec 1 with l-cysteine methyl ester, 0.16 M 1sec 1 and 0.074 M 1sec 1 with 1,3-dimethyl-2-thiourea, 0.070 M 1sec 1 and 0.069 M 1sec 1 with d-methionine, and 3.9 M 1sec 1 and 0.091 M 1sec 1 with thiosulfate, respectively. Our results suggest that thiosulfate, as being the strongest nucleophile, is a promising candidate for local application in order to reduce the inner ear content of MHC and cisplatin. However, otoprotection is a multifactorial event, and it remains to be established how important nucleophilicity is for the effectiveness of the protecting agent.
A Poetical Journey: The Evolution of a Research Question
Authors: Leung Doris , Lapum Jennifer
Published: July 2017

Rarely does literature make explicit the lessons learned in the journey to a research question. In this article, the authors demonstrate how they have engaged poetry in the evolution of a research question. Poetry has taken them beyond the traditional limits of knowing and allowed them to conceptualize their research questions by situating and locating their selves within their research. By explicating this journey to a research question, the authors hope that others encounter and reflect on an understanding of what it means to make this process transparent and to support ways of enhancing rigor within their particular and locally conceived research phenomena. As well, they hope to inspire scholarly reflection and critique of poetry as a method in the research process.
Task-Diaries: A Valuable Qualitative Tool for Occupational Health Research on Teacher Workloads
Authors: Newhook Julia Temple
Published: July 2017

This article discusses the usefulness of a qualitative tool called a “task-diary,” in combination with individual in-depth interviews, for occupational health research on teacher workloads. I describe my use of task-diaries to examine primary and elementary teachers' workloads in Newfoundland and Labrador, Canada, discuss the most useful aspects of task-diaries for this research, and suggest further applications of this tool in the workload research field.
Local stress analysis of a defective rolling bearing using an explicit dynamic method
Authors: Zhang Zhinan , Ding Weimin , Ma Huifang
Published: July 2017

This article provides insights into the localized stress in a defect zone of the rolling bearings when the rolling elements pass through the defect. A dynamic finite element model of a rolling bearing with an artificial round defect in its outer raceway is solved numerically using the explicit dynamic finite element software package, ABAQUS. The maximum Mises stress and maximum contact pressure in the defect zone are obtained in the simulation. The effects of radial load, rotation speed, and initial defect size on the stress level are investigated. The results show that higher stresses are generated during the rolling balls passing through the defect. The radial load and defect size have significant effects on the stress level of defect, while low-level rotation speed has neglected effects.
Public-participant quick cable force investigation method using smartphone for bridges in disaster area
Authors: Zhao Xuefeng , Ding Yanbing , Yu Yan , Han Ruicong , Guan Quanhua , Hu Weitong , Li Mingchu
Published: July 2017

Numerous infrastructures, especially the bridge, require some safe inspection and assessment at the soonest when hit by a disaster like catastrophic earthquake. However, plenty of bridges within disaster area and limited resources for inspections may lead to the traffic delays and hampering the quick post-disaster assessment and rebuilt. In this article, a public-acceptant method, where cable force of bridges can be investigated quickly based on ubiquitous smartphones, was proposed to raise the efficiency of inspection and assessment in post-disaster emergency. First, public-participant post-disaster emergency disposal system was supported by the developed mobile software Orion-CC. Second, the lab’s comparison experiment was conducted with the mature wireless monitoring method, which verified the feasibility of the above-mentioned method. Third, the field experiment in totally three bridges in Dalian including Hualu Bridge which used three iPhones demonstrated the feasibility, practicability, high efficiency, and stability of the novel method, and showed its huge potential for the application in bridges’ quick health investigation. Besides, utilizing the smartphone-based cable force investigation method as the breakthrough, the data collection network and the framework of public-participant post-disaster emergency disposal system were preliminary established.
Characterization of postsynaptic calcium signals in the pyramidal neurons of anterior cingulate cortex
Authors: Li Xu-Hui , Song Qian , Chen Tao , Zhuo Min
Published: July 2017

Calcium signaling is critical for synaptic transmission and plasticity. N-methyl-D-aspartic acid (NMDA) receptors play a key role in synaptic potentiation in the anterior cingulate cortex. Most previous studies of calcium signaling focus on hippocampal neurons, little is known about the activity-induced calcium signals in the anterior cingulate cortex. In the present study, we show that NMDA receptor-mediated postsynaptic calcium signals induced by different synaptic stimulation in anterior cingulate cortex pyramidal neurons. Single and multi-action potentials evoked significant suprathreshold Ca2+ increases in somas and spines. Both NMDA receptors and voltage-gated calcium channels contributed to this increase. Postsynaptic Ca2+signals were induced by puff-application of glutamate, and a NMDA receptor antagonist AP5 blocked these signals in both somas and spines. Finally, long-term potentiation inducing protocols triggered postsynaptic Ca2+ influx, and these influx were NMDA receptor dependent. Our results provide the first study of calcium signals in the anterior cingulate cortex and demonstrate that NMDA receptors play important roles in postsynaptic calcium signals in anterior cingulate cortex pyramidal neurons.
Do You Believe the Field of Psychological Science Is Headed in the Right Direction?
Authors: Levenson Robert W.
Published: July 2017

The state of psychological science is considered in terms of current issues and suggestions for the future.
Expanding or postponing? Patterns of negotiation in multi-party interactions in social work
Authors: Dall Tanja , Caswell Dorte
Published: July 2017

In this article, we examine patterns of negotiation in multi-party decision making in social work. We draw on Strauss’ theory of negotiated order and a discourse analytical approach, seeking to gain insight into the complex accomplishment of making a decision in an inter-professional and multi-party setting. Working with data from 97 team meetings in a social work setting, we identify two patterns of negotiation in talk: expanding and postponing. ‘Expanding’ covers a group of interactional actions involving turn-taking and closure, while ‘postponing’ includes a group of actions whereby assessments or topics are avoided or made irrelevant. Both are examples of the complex ways in which team members negotiate both the institutional order and the decision to be made in the specific case in situ.
Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids with seizures and central pyrexia, in a patient requiring tracheal intubation and mechanical ventilation: A case report
Authors: Wall Rosemary J
Published: July 2017

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) has been described in multiple case reports since it was first described in the literature in 2010. The patient described is a 54-year-old man with no significant medical history who presented with ataxia, diplopia and hearing and taste disturbances. His GCS reduced to the point at which he required intubation and he was treated for 50 days on an intensive care unit. The patient’s course also includes seizures, first described in 2014, and central pyrexia, which has not been previously described in case reports of CLIPPERS. Intravenous methylprednisolone resulted in a rapid and significant recovery; neurological rehabilitation is ongoing 10 months from diagnosis. The importance of recognition of unusual radiological findings and rapid treatment cannot be overemphasised in improving patient’s long-term outcomes.
Outcomes of sympathectomy and vascular bypass for digital ischaemia in connective tissue disorders
Authors: Shammas R. L. , Hwang B. H. , Levin L. S. , Richard M. J. , Ruch D. S. , Mithani S. K.
Published: July 2017

All patients (36 hands) with connective tissue disorders who underwent periarterial sympathectomy of the hand alone or in conjunction with vascular bypass at our institution between 1995–2013 were reviewed. The durable resolution of ulcers was significantly higher in patients treated by periarterial sympathectomy and bypass than in patients treated by periarterial sympathectomy alone. Although there were more digital amputations in patients treated by periarterial sympathectomy alone, the difference was not statistically significant. Vascular bypass in conjunction with sympathectomy may be better than sympathectomy alone in patients with digital ischaemia related to connective tissue disorders.

Level of evidence: IV
Autism in adults
Authors: Buckley Carole
Published: July 2017

Autism spectrum disorder is a complex life-long neurodevelopmental disorder that affects 1.1% of the UK population. It is a social communication disorder that is characterised by rigid and repetitive routines or behaviours. It is also commonly associated with difficulties in cognition, behavioural flexibility, sensory processing, emotional regulation, and altered sensory sensitivity.
Complexity of macrophage migration inhibitory factor (MIF) and other angiogenic biomarkers profiling in pulmonary arterial hypertension
Authors: Marshall Jeffrey D. , Sauler Maor , Tonelli Adriano , Rao Youlan , Bucala Richard , Lee Patty J. , Fares Wassim H.
Published: July 2017

Macrophage migration inhibitory factor (MIF) and 22 a priori selected biomarkers were measured from pulmonary arterial hypertension (PAH) patients. Significant positive correlations were found between MIF and several angiogenic factors suggesting a possible MIF regulation role in PAH angiogenesis and pathobiology, but simultaneously highlighting the biomarkers profiling complexity in PAH.
Hypercapnic acidosis attenuates pressure‐dependent increase in whole‐lung filtration coefficient (Kf)
Authors: Bommakanti Nikhil , Isbatan Ayman , Bavishi Avni , Dharmavaram Gourisree , Chignalia Andreia Z. , Dull Randal O.
Published: July 2017

Hypercapnic acidosis (HCA) has beneficial effects in experimental models of lung injury by attenuating inflammation and decreasing pulmonary edema. However, HCA increases pulmonary vascular pressure that will increase fluid filtration and worsen edema development. To reconcile these disparate effects, we tested the hypothesis that HCA inhibits endothelial mechanotransduction and protects against pressure‐dependent increases in the whole lung filtration coefficient (Kf). Isolated perfused rat lung preparation was used to measure whole lung filtration coefficient (Kf) at two levels of left atrial pressure (PLA = 7.5 versus 15 cm H2O) and at low tidal volume (LVt) versus standard tidal volume (STVt) ventilation. The ratio of Kf2/Kf1was used as the index of whole lung permeability. Double occlusion pressure, pulmonary artery pressure, pulmonary capillary pressures, and zonal characteristics (ZC) were measured to assess effects of HCA on hemodynamics and their relationship to Kf2/Kf1. An increase in PLA2from 7.5 to 15 cm H2O resulted in a 4.9‐fold increase in Kf2/Kf1during LVtand a 4.8‐fold increase during STVt. During LVt, HCA reduced Kf2/Kf1by 2.7‐fold and reduced STVtKf2/Kf1by 5.2‐fold. Analysis of pulmonary hemodynamics revealed no significant differences in filtration forces in response to HCA. HCA interferes with lung vascular mechanotransduction and prevents pressure‐dependent increases in whole lung filtration coefficient. These results contribute to a further understanding of the lung protective effects of HCA.
A review of financial-literacy education programs for children and adolescents
Authors: Amagir Aisa , Groot Wim , Maassen van den Brink Henriëtte , Wilschut Arie
Published: July 2017

In this systematic literature review, we evaluate the effectiveness of financial-literacy education programs and interventions for children and adolescents. Furthermore, the key characteristics of the design of a successful financial-education curriculum are described. The evidence shows that school-based financial-education programs can improve children’s and adolescents’ financial knowledge and attitudes. Studies that assess the intention to practice good behavior and studies based on self-reported behavior also report positive effects. However, studies that assess the effects of financial education on children’s and adolescent’s actual financial behavior are scarce, and show hardly any effect. A promising method to teach financial literacy to children and adolescents in primary and secondary school is “experiential learning.” In college, the focus should be on specific “life events” of students. The findings may be useful for designing an effective school-based financial education program.
Management of myocardial infarction in the elderly. Insights from Spanish Minimum Basic Data Set
Authors: Ariza-Solé Albert , Alegre Oriol , Elola Francisco J , Fernández Cristina , Formiga Francesc , Martínez-Sellés Manuel , Bernal José L , Segura José V , Iñíguez Andrés , Bertomeu Vicente , Salazar-Mendiguchía Joel , Sánchez Salado José C , Lorente Victòria , Cequier Angel
Published: July 2017

Background:

We aimed to assess the impact of implementation of reperfusion networks, the type of hospital and specialty of the treating physician on the management and outcomes of ST segment elevation myocardial infarction in patients aged ⩾75 years.

Methods:

We analysed data from the Minimum Basic Data Set of the Spanish public health system, assessing hospital discharges between 2004 and 2013. Discharges were distributed in three groups depending on the clinical management: percutaneous coronary intervention, thrombolysis or no reperfusion. Primary outcome measure was all cause in-hospital mortality. For risk adjustment, patient comorbidities were identified for each index hospitalization.

Results:

We identified 299,929 discharges, of whom 107,890 (36%) were in-patients aged ⩾75 years. Older patients had higher prevalence of comorbidities, were less often treated in high complexity hospitals and were less frequently managed by cardiologists ( p<0.001). Both percutaneous coronary intervention and fibrinolysis were less often performed in elderly patients ( p<0.001). A progressive increase in the rate of percutaneous coronary intervention was observed in the elderly across the study period (from 17% in 2004 to 45% in 2013, p<0.001), with a progressive reduction of crude mortality (from 23% in 2004 to 19% in 2013, p<0.001). Adjusted analysis showed an association between being treated in high complexity hospitals, being treated by cardiologists and lower in-hospital mortality ( p <0.001).

Conclusions:

Elderly patients with ST segment elevation myocardial infarction are less often managed in high complexity hospitals and less often treated by cardiologists. Both factors are associated with higher in-hospital mortality.
Bilateral diaphragmatic paresis following pediatric liver transplantation
Authors: Olmscheid Jillian , Molero Helena , Gershan William , Demirel Nadir
Published: July 2017

Background:

Although diaphragm paresis or paralysis is fairly common following cardiac procedures; it is a less common complication following liver transplantation. Unilateral diaphragm paresis, usually right sided, has been described following liver transplantation in adults and has been rarely described in children.

Purpose:

Diaphragmatic injury following LT is often unrecognized and is typically unilateral, involving the right hemidiaphragm. Bilateral diaphragm dysfunction following liver transplantation in children is a rare complication.

Methods:

This is a case report of bilateral diaphragm paresis in a young child following a repeat liver transplantation.

Conclusion:

Bilateral diaphragm paresis following liver transplantation in children is rare and spontaneous resolution is possible. A conservative approach with noninvasive ventilation as a first line treatment to allow the diaphragm to regain function should be considered.
Obesity and ovarian cancer risk: A systematic review
Authors: Foong Ke Wei , Bolton Helen
Published: July 2017

The association between obesity and ovarian cancer risk has been extensively investigated, but studies have yielded inconsistent findings. This review aims to summarise and discuss the evidence generated to date. Articles published in English prior to August 2016 were retrieved from PubMed. Keywords included obesity, overweight, body size, body mass index, waist–hip ratio, waist circumference, body weight, ovarian cancer, ovarian carcinoma, ovarian neoplasm, and ovarian tumour. Eligible studies compared two or more groups of women, with at least one group in the overweight or obese category and one comprising normal weight controls. Summary data in the form of relative risk, hazard ratio, or odds ratio for each comparison group from individual studies were collated and reviewed. Forty-three studies were included in the final analysis, with a total of 3,491,943 participants. All studies included body mass index as an exposure measure, and a majority relied on self-reported measures from participants; 14 studies found a statistically significant positive association between ovarian cancer risk and higher body mass index, 26 studies found no significant association, and 3 studies found a negative association between ovarian cancer risk and higher body mass index. This review concludes that there is limited, inconsistent evidence of a positive association between obesity and ovarian cancer risk.
From Online Disagreement to Offline Action: How Diverse Motivations for Using Social Media Can Increase Political Information Sharing and Catalyze Offline Political Participation
Authors: Lane Daniel S. , Kim Dam Hee , Lee Slgi S. , Weeks Brian E. , Kwak Nojin
Published: July 2017

Amid growing concerns over the contentious tenor of online political discourse, scholars have begun to recognize that the social contexts and affordances provided by social media may present indirect pathways from online political discussion to offline political participation. Less work has addressed how users’ motivations for using social media might influence such dynamics. In this study, we use two-wave panel survey data collected in the United States to test the possibility that online cross-cutting discussion involving political disagreement can encourage users to share political information on social media, which in turn can increase their offline political engagement. We also test how specific motivations for using social media (i.e., political engagement, relationship maintenance, and self-promotion) moderate the amount users share political information on social media when engaged in conversations involving political disagreement. Our results find that increased online cross-cutting political discussion indirectly affects offline political participation through the influence of social media political information sharing. We also observe that this indirect effect is stronger for users who are motivated to use social media for either political engagement or relationship maintenance (but not self-promotion) purposes. Our findings advance one route from online political disagreement to offline political action, which can impact both politically and nonpolitically motivated social media users.
Dural Tears in Adult Deformity Surgery: Incidence, Risk Factors, and Outcomes
Authors: Iyer Sravisht , Klineberg Eric O. , Zebala Lukas P. , Kelly Michael P. , Hart Robert A. , Gupta Munish C. , Hamilton D. Kojo , Mundis Gregory M. , Sciubba Daniel , Ames Christopher P. , Smith Justin S. , Lafage Virginie , Burton Douglas , Kim Han Jo ,   for the International Spine Study Group (ISSG)
Published: July 2017

Study Design:

Retrospective cohort study.

Objectives:

Describe the rate of dural tears (DTs) in adult spinal deformity (ASD) surgery. Describe the risk factors for DT and the impact of this complication on clinical outcomes.

Methods:

Patients with ASD undergoing surgery between 2008 and 2014 were separated into DT and non-DT cohorts; demographics, operative details, radiographic, and clinical outcomes were compared. Statistical analysis included t tests or χ2 tests as appropriate and a multivariate analysis.

Results:

A total of 564 patients were identified. The rate of DT was 10.8% (n = 61). Patients with DT were older (61.1 vs 56.5 years, P = .005) and were more likely to have had prior spine surgery (odds ratio [OR] = 2.0, 95% confidence interval [CI] = 1.2-3.3, P = .007). DT patients had higher pelvic tilt, lower lumbar lordosis, and greater pelvic-incidence lumbar lordosis mismatch than non-DT patients ( P < .05). DT patients had longer operative times (424 vs 375 minutes, P = .008), were more likely to undergo interbody fusions (OR = 2.0, 95% CI = 1.1-3.6, P = .021), osteotomies (OR = 2.2, 95% CI = 1.1-4.0, P = .012), and decompressions (OR = 2.3, 95% CI = 1.3-4.3, P = .003). In our multivariate analysis, only decompressions were associated with an increased risk of DT (OR = 3.2, 95% CI = 1.4-7.6, P = .006). There were no significant differences in patient outcomes at 2 years.

Conclusions:

The rate of DT was 10.8% in an ASD cohort. This is similar to rates of DT reported following surgery for degenerative pathology. A history of prior spine surgery, decompression, interbody fusion, and osteotomies are all associated with an increased risk of DT, but decompression is the only independent risk factor for DT.
Book Review: Towards Legal Literacy: An Introduction to Law in India. Edited by Kamala Sankaran & Ujjwal Kumar Singh
Authors: Chakraborty Debarati
Published: July 2017

Towards Legal Literacy: An Introduction to Law in India. Edited by Kamala Sankaran & Ujjwal Kumar Singh, Oxford University Press, New Delhi, India, 2008, Pp. 212, ₹495, ISBN 0195692225, ISBN 9780195692228
Learning Race and Racism While Learning: Experiences of International Students Pursuing Higher Education in the Midwestern United States
Authors: Mitchell Donald , Steele Tiffany , Marie Jakia , Timm Kathryn
Published: July 2017

Researchers have documented how race and racism influence the college experiences of U.S. citizens. However, research on the ways that race and racism affect international students warrants similar attention. This qualitative study explored how international students learned about U.S. concepts of race and racism and how such concepts shaped their college experiences. The participating international college students learned about U.S. concepts of race and racism through media, relationships, formal education, and lived experiences. They defined these concepts in varying ways and had varying racial ideologies.
Tools for Teaching Virtual Teams: A Comparative Resource Review
Authors: Larson Barbara , Leung Opal , Mullane Kenneth
Published: July 2017

As the ubiquity of virtual work—and particularly virtual project teams—increases in the professional environment, management and other professional programs are increasingly teaching students skills related to virtual work. One of the most common forms of teaching virtual work skills is a virtual team project, in which students collaborate with each other at a distance (and sometimes between multiple institutions) to accomplish a shared task. These projects differ from most management topics in their technology requirements. In this comparative review, we describe the features and trade-offs inherent in some of the asynchronous and synchronous communication technology tools commonly used to run virtual team projects.
Interactional Scaffolding for Reading Comprehension
Authors: Reynolds Dan
Published: July 2017

Understanding how to support student reading comprehension has long been a goal for education research. Yet no existing literature review links interactional scaffolding, defined as the responsive in-person support an expert reader offers to a novice, and reading comprehension. This review employed theories of scaffolding and reading comprehension to establish a theoretical framework, used an iterative search process to account for the terminological diversity of research on interactional scaffolding, and coded the resulting 57 studies according to their research designs and findings. Conclusions about research designs indicate that the observational studies predominate with fewer experimental, mixed methods, and correlational studies. In addition, study populations are overwhelmingly in K–5 settings. Synthesizing the studies’ findings produced four themes: (a) diversity in taxonomies of scaffolding, (b) a focus on contingency, (c) ways contextual and mediational resources shape scaffolding, and (d) potential pitfalls when scaffolding does not go as planned. Suggestions for future research include addressing gaps in research designs, extending and refining existing scaffolding taxa, linking specific forms of scaffolding across contexts to reading outcomes, advancing understanding of the mediational means that underpin comprehension, and deepening knowledge of developmental trajectories for comprehension scaffolding.
A multiobjective optimization model for locating affordable housing investments while maximizing accessibility to jobs by public transportation
Authors: Zhong Qing , Karner Alex , Kuby Michael , Golub Aaron
Published: July 2017

This paper develops a new optimal location model for siting affordable housing units to maximize the accessibility of low-income workers to appropriate jobs by public transportation. Transit-accessible housing allows disadvantaged populations to reduce their reliance on automobiles, which can lead to savings on transportation-related expenditures. The housing location model developed here maximizes transit accessibility while reducing the clustering of affordable housing units in space. Accessibility is maximized using a high-resolution space-time metric of public transit accessibility, originally developed for service equity analysis. The second objective disperses subsidized housing projects across space using a new minimax dispersion model based on spatial interaction principles. The multiobjective model trades off accessibility maximization and affordable housing dispersion, subject to upper and lower bounds on the land acquisition and construction budget. The model is tested using data for Tempe, AZ including actual data for vacant parcels, travel times by light rail and bus, and the location of low-wage jobs. This model or similar variants could provide insightful spatial decision support to affordable-housing providers or tax-credit administrators, facilitating the design of flexible strategies that address multiple social goals.
Sepsis in the burn patient: a different problem than sepsis in the general population
Authors: Greenhalgh David G.
Published: July 2017

Sepsis has recently been defined as “life-threatening organ dysfunction caused by a dysregulated host response to infection”. A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns. The reason for the exclusion is that the sepsis found in burn patients is different than that of the general population. The early treatment strategies, such as those directed by the Surviving Sepsis Campaign, focus on patients presenting to hospitals with recent signs of infection. Burn patients lose their primary barrier to infection, the skin, and thus the risk of infection persists as long as that barrier is absent. Efforts have been made to define sepsis, septic shock and infection in the burn population but there is constant need for revisions. One focus of this review is to discuss the differences in burn sepsis versus sepsis of the general population. Children often have profound responses to sepsis but can also make remarkable recoveries. This review will also explore problems specific to pediatric burns. The treatment of burns requires a continuous vigilance to watch for the subtle early signs of sepsis and then expeditious initiation of aggressive therapy. Strategies covering optimal management of pediatric burn sepsis will also be summarized.
Comparative Toxicity and Effectiveness of Trastuzumab-Based Chemotherapy Regimens in Older Women With Early-Stage Breast Cancer
Authors: Reeder-Hayes Katherine E. , Meyer Anne Marie , Hinton Sharon Peacock , Meng Ke , Carey Lisa A. , Dusetzina Stacie B.
Published: July 2017

Purpose

The combination of chemotherapy and trastuzumab is the standard of care for adjuvant treatment of human epidermal growth factor receptor 2–positive breast cancer. Two regimens have been widely adopted in the United States: doxorubicin, cyclophosphamide, paclitaxel, and trastuzumab (ACTH) and docetaxel, carboplatin, and trastuzumab (TCH). No head-to-head comparison of these regimens has been conducted in a clinical trial, and existing trial data have limited generalizability to older patients.

Methods

We used SEER-Medicare data from 2005 to 2013 to compare outcomes of ACTH versus TCH among patients age older than 65 years. Propensity score matching was used to balance cohort characteristics between treatment arms. Outcomes included toxicity-related hospitalization, survival, and trastuzumab completion. Data from 1,077 patients receiving ACTH or TCH were analyzed, and the propensity-matched subsample included 416 women.

Results

There was a significant shift toward TCH over time, with 88% of patients receiving ACTH in 2005 compared with 15% by 2011. Among propensity score–matched patients, we found no difference between regimens in health care use overall or for chemotherapy-related adverse events (ACTH, 34% v TCH, 36.5%; P = .46). Patients receiving TCH were significantly more likely to complete trastuzumab (89% v 77%; P = .001). There was no difference in 5-year breast cancer–specific survival (ACTH, 92% v TCH, 96%; hazard ratio, 2.08; 95% CI, 0.90 to 4.82) or overall survival.

Conclusion

Among a matched sample of older patients, ACTH compared with TCH was not associated with a higher rate of serious adverse events or hospitalizations, but it was associated with less completion of adjuvant trastuzumab. We did not detect a difference in 5-year survival outcomes for ACTH compared with TCH. In the context of limited evidence in older patients, selection between these two regimens on the basis of concerns about differential toxicity or efficacy may not be appropriate.
Association of Physician Orders for Life-Sustaining Treatment Form Use With End-of-Life Care Quality Metrics in Patients With Cancer
Authors: Pedraza Sandra L. , Culp Stacey , Knestrick Mark , Falkenstine Evan , Moss Alvin H.
Published: July 2017

Purpose:

Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs).

Methods:

We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016. Data from the Vital Registration Office (date, site, and cause of death) were merged with those from the registry (form type, completion date, and hospice admission). The primary outcome variables were out-of-hospital death (OHD) and hospice admission.

Results:

The percentage of patients with OHD was 85.7% for patients with POLST forms compared with 72.0% for those with ADs ( P < .001). The odds of OHD for patients with POLST forms were 2.33 times those of patients with ADs. The percentage of patients admitted to hospice was 49.9% for those with POLST forms compared with 27.0% for those with ADs ( P < .001). The odds of being admitted to hospice for patients with POLST forms were 2.69 times those of patients with ADs.

Conclusion:

Advance care planning with completion of POLST forms compared with ADs in patients with advanced cancer was associated with two quality end-of-life care metrics: OHD and hospice admission. Our study suggests that goals-of-care discussions including POLST form completion may improve end-of-life care for patients with advanced cancer.