bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Cystic Pancreatic Neuroendocrine Tumors an Indolent Entity Results from a Single-Center Surgical Series
Authors: Paiella Salvatore , Marchegiani Giovanni , Miotto Marco , Malpaga Anna , Impellizzeri Harmony , Montagnini Greta , Pollini Tommaso , Nessi Chiara , Butturini Giovanni , Capelli Paola , Posenato Ilaria , Scarpa Aldo , D'Onofrio Mirko , De Robertis Riccardo , Cingarlini Sara , Boninsegna Letizia , Bassi Claudio , Salvia Roberto , Landoni Luca
Published: June 2017

Introduction: Cystic pancreatic neuroendocrine tumors (CPanNETs) represent an uncommon variant of pancreatic neuroendocrine tumors (PanNETs). Due to their rarity, there is a lack of knowledge with regard to clinical features and postoperative outcome. Methods: The prospectively maintained surgical database of a high-volume institution was queried, and 46 resected CPanNETs were detected from 1988 to 2015. Clinical, demographic, and pathological features and survival outcomes of CPanNETs were described and matched with a population of 92 solid PanNETs (SPanNETs) for comparison. Results: CPanNETs accounted for 7.8% of the overall number of resected PanNETs (46/587). CPanNETs were mostly sporadic (n = 42, 91%) and nonfunctioning (39%). Two functioning CPanNETs were detected (4.3%), and they were 2 gastrinomas. The median tumor diameter was 30 mm (range 10-120). All tumors were well differentiated, with 38 (82.6%) G1 and 8 (17.4%) G2 tumors. Overall, no CPanNET showed a Ki-67 >5%. A correct preoperative diagnosis of a CPanNET was made in half of the cases. After a median follow-up of >70 months, the 5- and 10-year overall survival of resected CPanNETs was 93.8 and 62.5%, respectively, compared to 92.7 and 84.6% for SPanNETs (p > 0.05). The 5- and 10-year disease-free survival rates were 94.5 and 88.2% for CPanNETs and 81.8 and 78.9% for SPanNETs, respectively (p > 0.05). Conclusion: In the setting of a surgical cohort, CPanNETs are rare, nonfunctional, and well-differentiated neoplasms. After surgical resection, they share the excellent outcome of their well-differentiated solid counterparts for both survival and recurrence.
Memorial do Projeto De Um Dispositivo Mecânico Autocontrolado Por Encoder Óptico e Controlado Remotamente Via Bluetooth
Authors: Bisinotto Gustavo Alencar , Cancian Caio Garcia , De Oliveira Luis Felipe Gomes
Published: June 2017

Neste trabalho são descritas as etapas de desenvolvimento de um dispositivo proposto como projeto da disciplina de Introdução ao Projeto de Sistemas Mecânicos (PMR3202) da Escola Politécnica da Universidade de São Paulo (EPUSP). O dispositivo deveria recolher o maior número de objetos de uma região delimitada e transportá-los até um local estipulado durante determinado período de tempo, devendo realizar parte do circuito de forma autônoma. A máquina foi concebida de forma a atender uma série de requisitos, identificados a partir das restrições do projeto. Para sua execução, ao longo do projeto, fez-se: a avaliação das soluções elaboradas com o uso de uma Matriz de Decisão, dimensionamento dos componentes mecânicos através de formulações, projeto do sistema para desempenho autônomo da máquina, programação do microcontrolador para comando dos sensores e atuadores, fabricação e montagem completa. Pelos resultados obtidos foi possível concluir que a máquina atendeu de maneira aceitável aos requisitos e também identificar aspectos que poderiam ser aperfeiçoados para melhorar o desempenho do dispositivo.(Apêndices: clique em "Documentos Suplementares" no menu à direita para baixá-los )
Análise de Métodos de Detecção de Vazamento com Foco em Operações de Offloading
Authors: Abou Rejaili Rodrigo Pereira
Published: June 2017

A pesquisa foi realizada para obter-se uma comparação entre diferentes sensores, avaliando a aplicabilidade desses na detecção e mitigação de vazamentos na operação de Offloading (transferência de óleo entre a plataforma e a FPSO). Para tal, avaliou-se diferentes métodos de detecção de vazamento em água, óleo e gás quanto a instalação, manutenção, precisão, entre outros aspectos, definindo-se pesos para cada um deles. A partir disso, cada método recebeu uma nota, que possibilitou a escolha da solução mais adequada.
Impact of the Publication of Appropriate Use Criteria on Utilization Rates of Myocardial Perfusion Imaging Studies in Ontario, Canada: A Population‐Based Study
Authors: Roifman Idan , Austin Peter C. , Qiu Feng , Wijeysundera Harindra C.
Published: June 2017

Background

Concern regarding overutilization of cardiac imaging has led to the development of appropriate use criteria (
AUC
). Myocardial perfusion imaging (
MPI
) is one of the most commonly used cardiac imaging modalities worldwide. Despite multiple iterations of AUC, there is currently no evidence regarding their real‐world impact on population‐based utilization rates of
MPI
. Our goal was to assess the impact of the AUC on rates of
MPI
in Ontario, Canada. We hypothesized that publication of the AUC would be associated with a significant reduction in
MPI
rates.

Methods and Results

We conducted a retrospective cohort study of the adult population of Ontario from January 1, 2000, to December 31, 2015. Age‐ and sex‐standardized rates were compared from 4 different periods intersected by 3 published iterations of the AUC. Overall, 3 072 611
MPI
scans were performed in Ontario during our study period. The mean monthly rate increased from 14.1/10 000 in the period from January 2000 to October 2005 to 18.2/10 000 between November 2005 and June 2009. After this point in time, there was a reduction in rates, falling to a mean monthly rate of 17.1/10 000 between March 2014 and December 2015. Time series analysis revealed that publication of the 2009
AUC
was associated with a significant reduction in
MPI
rates (
P
<0.001). This translated into ≈88 849 fewer
MPI
scans at a cost savings of ≈72 million Canadian dollars.

Conclusions

Our results reflect a potential real‐world impact of the 2009
MPI AUC
by demonstrating evidence of a significant effect on population‐based rates of
MPI
.
Differences in Characteristics and Outcomes Between Asian and Non-Asian Patients in the TIAregistry.org
Authors: Hoshino Takao , Uchiyama Shinichiro , Wong Lawrence K.S. , Sissani Leila , Albers Gregory W. , Bornstein Natan M. , Caplan Louis R. , Donnan Geoffrey A. , Ferro José M. , Hennerici Michael G. , Labreuche Julien , Lavallée Philippa C. , Molina Carlos , Rothwell Peter M. , Steg Philippe Gabriel , Touboul Pierre-Jean , Vicaut Éric , Amarenco Pierre
Published: June 2017

Background and Purpose—

This study provides the contemporary causes and prognosis of transient ischemic attack (TIA) and minor stroke in Asians and the direct comparisons with non-Asians.

Methods—

The TIAregistry.org enrolled 4789 patients (1149 Asians and 3640 non-Asians) with a TIA or minor ischemic stroke within 7 days of onset. Every participating facility had systems dedicated to urgent intervention of TIA/stroke patients by specialists. The primary outcome was a composite of cardiovascular death, nonfatal stroke, and nonfatal acute coronary syndrome.

Results—

Approximately 80% of patients were evaluated within 24 hours of symptom onset. At 1 year, there were no differences in the rates of composite cardiovascular events (6.8% versus 6.0%;
P
=0.38) and stroke (6.0% versus 4.8%;
P
=0.11) between Asians and non-Asians. Asians had a lower risk of cerebrovascular disease (stroke or TIA) than non-Asians (adjusted hazard ratio, 0.79; 95% confidence interval, 0.63–0.98;
P
=0.03); the difference was primarily driven by a lower rate of TIA in Asians (4.2% versus 8.3%;
P
<0.001). Moderately severe bleeding was more frequent in Asians (0.8% versus 0.3%;
P
=0.02). In multivariable analysis, multiple acute infarcts (
P
=0.005) and alcohol consumption (
P
=0.02) were independent predictors of stroke recurrence in Asians, whereas intracranial stenosis (
P
<0.001), ABCD
2
score (
P
<0.001), atrial fibrillation (
P
=0.008), extracranial stenosis (
P
=0.03), and previous stroke or TIA (
P
=0.03) were independent predictors in non-Asians.

Conclusions—

The short-term stroke risk after a TIA or minor stroke was lower than expected when urgent evidence-based care was delivered, irrespective of race/ethnicity or region. However, the predictors of stroke were different for Asians and non-Asians.
Sexuality at the Northern Border of Early African American Print Culture
Authors: Saillant John
Published: June 2017

This essay attributes an 1815 condemnation of fornication, published in Vermont, to Lemuel Haynes (1753-1833). Redressing a deficit of scholarly attention to sexuality in early African American print culture, it contextualizes Haynes's document within a spectrum of similar texts, and notes the variety of print culture instruments available to early African American authors, including anonymous publication, financial subscription, and publishing under a white author's name.
Louisa May Alcott as Poet: Transcendentalism and the Female Artist
Authors: Gurley Jennifer
Published: June 2017

This essay presents Louisa May Alcott's conception of an artist, one that gives nineteenth century women access to that title. Based in her poetry, Alcott's notion of art both draws from and resists Transcendentalist theology as it counters sentimentalist cliches about women writers. Ellen Sturgis Hooper is revealed as a major influence on Alcott.
“L'homme religieux réformateur” The First French Translation of Emerson in Adam Mickiewicz's Revolutionary TRIBUNE DES PEUPLES
Authors: Koch Daniel
Published: June 2017

‘Man the Reformer’ was the first of Emerson's works to be published in French translation. It appeared in a radical newspaper edited by the celebrated Polish author Adam Mickiewicz in Paris in 1849. This article is the first to examine this unique work, setting it in the context the revolutionary events of 1848-49.
Noch mehr Kleinigheiten. Teil 1
Authors: Radt Stefan
Published: June 2017

Critical notes to different texts.
The Care Drain and its Effects on the Families Left Behind: A Case Study of Sri Lanka
Authors: Cooray Devoushi
Published: June 2017

As growing numbers of women from the global South leave behind their own families to take up domestic work in wealthier countries, this shift in care and emotional resources has created a “care drain” in many migrant-exporting nations. Drawing on in-depth interviews with the families of migrant domestic workers in Sri Lanka, this paper examines how the care deficit caused by low-skilled female migration affects family structures, household relations, and the psychosocial wellbeing of migrants’ families. Highlighting the tension between the economic benefits and social costs of migration, the overall findings of this study suggest that despite economic benefits, low-skilled female migration often works to the social and emotional detriment of the families left behind.
The Enigma of Arabic and Hebrew Palladius
Authors: Pormann Peter E. , Barry Samuel , Carpentieri Nicola , van Dalen Elaine , Karimullah Kamran I. , Mimura Taro , Obaid Hammood
Published: June 2017

This article reassesses the attribution of the Aphorisms commentary preserved in the Haddad Memorial Library (MS Ḥaddād) to Palladius. Where the evidence for the commentary in Greek sources is virtually non-existent, Arabic testimonia are more numerous. We discuss Arabic fragments in Muḥammad ibn Zakarīyā al-Rāzī’s Comprehensive Book (al-Kitāb al-Ḥāwī) and Arabic commentaries on the Hippocratic Aphorisms. These fragments demonstrate that Palladius wrote a commentary on the Aphorisms. Analysis of MS Ḥaddād, however, reveals that the commentary it preserves cannot be a translation of Palladius’ Greek text. Philological evidence occasions the conclusion that MS Ḥaddād contains an anonymous Arabic Aphorisms commentary written in the early ʿAbbāsid period. We discuss two Hebrew manuscripts that purport to be translations of Palladius’ commentary. Although more work on the Hebrew Palladius is needed, it is clear that the Hebrew commentaries are different translations of the anonymous Aphorisms commentary in MS Ḥaddād.
Revision of the circumtropical glasseye fish Heteropriacanthus cruentatus (Perciformes: Priacanthidae), with resurrection of two species
Authors: FERNANDEZ-SILVA IRIA , HO HSUAN-CHING
Published: June 2017

The glasseye fish Heteropriacanthus, previously known as a monotypic genus, is now divided into three species based on morphological and genetic features. After examination on the type specimens and literature, herein we resurrect two junior binomens, H. carolinus (Cuvier, 1829) from the Indo-Pacific Ocean and H. fulgens (Lowe, 1838) from the northeastern Atlantic Ocean. Heteropriacanthus cruentatus (Lacepède, 1801) is now considered to be restricted to the Atlantic and southwestern Indian oceans. In light of these observations we discuss the evolutionary history of the genus.
A new species of iguana Brachylophus Cuvier 1829 (Sauria: Iguania: Iguanidae) from Gau Island, Fiji Islands
Authors: FISHER ROBERT N. , NIUKULA JONE , WATLING DICK , HARLOW PETER S.
Published: June 2017

The south Pacific iguanas (Brachylophus) currently have three recognized living species in Fiji.  Recent surveys have uncovered more specific variation (morphological and genetic) within the genus and have better defined the geographic ranges of the named species.  One of these recent discoveries is a strikingly different iguana from all other island populations in Fiji which is restricted to Gau Island of the Lomaiviti Province.  Gau is the fifth largest island in Fiji and maintains excellent upland forests in the higher elevations.  We describe this population from Gau Island as a new species, Brachylophus gau sp. nov., in recognition of its type locality.
Validation of a Syndromic Case Definition for Detecting Emergency Department Visits Potentially Related to Marijuana
Authors: DeYoung Kathryn , Chen Yushiuan , Beum Robert , Askenazi Michele , Zimmerman Cali , Davidson Arthur J.
Published: June 2017

Objectives:

Reliable methods are needed to monitor the public health impact of changing laws and perceptions about marijuana. Structured and free-text emergency department (ED) visit data offer an opportunity to monitor the impact of these changes in near-real time. Our objectives were to (1) generate and validate a syndromic case definition for ED visits potentially related to marijuana and (2) describe a method for doing so that was less resource intensive than traditional methods.

Methods:

We developed a syndromic case definition for ED visits potentially related to marijuana, applied it to BioSense 2.0 data from 15 hospitals in the Denver, Colorado, metropolitan area for the period September through October 2015, and manually reviewed each case to determine true positives and false positives. We used the number of visits identified by and the positive predictive value (PPV) for each search term and field to refine the definition for the second round of validation on data from February through March 2016.

Results:

Of 126 646 ED visits during the first period, terms in 524 ED visit records matched ≥1 search term in the initial case definition (PPV, 92.7%). Of 140 932 ED visits during the second period, terms in 698 ED visit records matched ≥1 search term in the revised case definition (PPV, 95.7%). After another revision, the final case definition contained 6 keywords for marijuana or derivatives and 5 diagnosis codes for cannabis use, abuse, dependence, poisoning, and lung disease.

Conclusions:

Our syndromic case definition and validation method for ED visits potentially related to marijuana could be used by other public health jurisdictions to monitor local trends and for other emerging concerns.
Explaining job insecurity for temporary agency workers: A comparison between Sweden and Belgium
Authors: Håkansson Kristina , Pulignano Valeria , Isidorsson Tommy , Doerflinger Nadja
Published: June 2017

Current research has shed critical light on the insecurity characterizing temporary agency work. To understand how this insecurity is produced, this article shows that we have to go beyond national and industrial regulation and analyse how this regulation shapes workplace practices and access to a collective voice. Thus, connecting the national and workplace levels is crucial in understanding job insecurity for agency workers. Job insecurity is shaped not only by the type of contract; it is primarily formed by how the national regulation, inclusive of collective bargaining and representation structures, shapes the modalities in accordance to which temporary agency workers are used at workplaces. The article is based on a cross-national comparative case study methodology, and compares two similar workplaces in two different institutional settings, those of Sweden and Belgium.
Preoperative Tracheostomy Is Associated with Poor Disease‐Free Survival in Recurrent Laryngeal Cancer
Authors: Birkeland Andrew C. , Rosko Andrew J. , Beesley Lauren , Bellile Emily , Chinn Steven B. , Shuman Andrew G. , Prince Mark E. , Wolf Gregory T. , Bradford Carol R. , Brenner J. Chad , Spector Matthew E.
Published: June 2017

Objectives

It is unknown if preoperative tracheostomy for persistent/recurrent laryngeal squamous cell carcinoma (LSCC) plays a role in unrecognized local disease spread and disease recurrence after salvage laryngectomy. The goals of this study were to determine the effect of preoperative tracheostomy on disease‐free survival (DFS) in patients with recurrent/persistent LSCC undergoing salvage laryngectomy.

Study Design

Retrospective case series derived from prospectively maintained database.

Setting

Tertiary care academic center.

Subjects

Patients with recurrent/persistent LSCC after radiation/chemoradiation (RT/CRT) who underwent salvage laryngectomy at the University of Michigan from 1997 to 2015.

Methods

Demographic, clinical, pathologic, and survival data were collected. Kaplan‐Meier survival estimates were performed.

Results

DFS was worse for patients with tracheostomy prior to laryngectomy than patients without a tracheostomy (5 year: 39% vs 67%; P <. 001). Patients with tracheostomy prior to RT/CRT compared to patients with tracheostomy after RT/CRT or patients without a tracheostomy had worse DFS (5‐year: 25%, 49%, and 67%, respectively; P <. 001). In bivariable analyses controlling for T classification, N classification, or overall stage, preoperative tracheostomy was associated with worse DFS. In multivariable analysis, presence of a preoperative tracheostomy had a worse DFS (hazard ratio, 1.63; 95% confidence interval, 1.00‐2.67; P =. 048).

Conclusion

Preoperative tracheostomy is associated with disease recurrence in patients with persistent/recurrent LSCC undergoing salvage laryngectomy, particularly in patients who had tracheostomy prior to completion of initial RT/CRT. Notably, preoperative tracheostomy as a causal factor vs marker for disease recurrence is difficult to ascertain. Nevertheless, clinicians should be aware of the increased risk of locoregional recurrence in patients with preoperative tracheostomy when counseling on surgical salvage and when considering the role of additional therapy.
Reemergence of the Natural History of Otolaryngologic Infections: Lessons Learned from 2 American Presidents
Authors: Naples James , Schwartz Marissa , Eisen Marc
Published: June 2017

Presidents George Washington and Theodore Roosevelt suffered complications of epiglottitis and otomastoiditis, respectively. The introduction of antibiotics and vaccinations against Haemophilus influenzae and Streptococcus pneumoniae has significantly reduced the incidence of these otolaryngologic infections, such that the natural history of the disease is rarely encountered. However, antibiotic resistance and pathogenic evolution has raised concern about increased virulence of these common organisms. A retrospective evaluation of the complications suffered by Washington and Roosevelt provides valuable insight to the natural history of common otolaryngologic infections that may reemerge as a result of organism evolution in response to antibiotics and vaccines.
Volatile Organic Compounds in the Breath of Oral Squamous Cell Carcinoma Patients: A Pilot Study
Authors: Hartwig Stefan , Raguse Jan D. , Pfitzner Dorothee , Preissner Robert , Paris Sebastian , Preissner Saskia
Published: June 2017

Objective

To assess the feasibility of detecting signature volatile organic compounds in the breath of patients with oral squamous cell carcinoma.

Study Design

Prospective cohort pilot study.

Setting

University hospital.

Subjects and Methods

Using gas chromatography and mass spectrometry, emitted volatile organic compounds in the breath of patients before and after curative surgery (n = 10) were compared with those of healthy subjects (n = 4). It was hypothesized that certain volatile organic compounds disappear after surgical therapy. A characteristic signature of these compounds for diseased patients was compiled and validated.

Results

Breath analyses revealed 125 volatile organic compounds in patients with oral cancer. A signature of 8 compounds that were characteristic for patients with oral cancer could be detected: 3 from this group presented were absent after surgery.

Conclusion

The presented results confirmed the hypothesis of an absence of cancer‐associated volatile organic compounds in the breath after therapy. In this pilot study, we proved the feasibility of this test approach. Further studies should be initiated to establish protocols for usage in a clinical setting.
Antibody Profile of Colostrum and the Effect of Processing in Human Milk Banks: Implications in Immunoregulatory Properties
Authors: Rodríguez-Camejo Claudio , Puyol Arturo , Fazio Laura , Rodríguez Analía , Villamil Emilia , Andina Eliana , Cordobez Vanira , Díaz Hernán , Lemos Mary , Siré Gabriela , Carroscia Lilián , Castro Mara , Panizzolo Luis , Hernández Ana
Published: June 2017

Background:

When feeding preterm infants, donor milk is preferred if the mother’s own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds.

Research aim:

This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies’ level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-β2) in the neonatal gut.

Methods:

This is a descriptive cross-sectional study of a convenience sample of 67 donated colostrum samples at different days after delivery, both raw and pasteurized. Antibody profiles were analyzed at different times during breastfeeding, and total and specific antibodies (IgM, IgA, and IgG subclasses) were compared with tetanus toxoid and ovalbumin using enzyme-linked immunosorbent assay. The processing effect on total and specific antibodies, as well as TGF-β2, was evaluated by paired analyses.

Results:

No variations in immunological compounds were observed throughout the colostrum stage. The TGF-β2, antibodies’ concentrations, and antibodies’ specific reactivity after pasteurization did not vary significantly as days of lactation varied. Changes in antibody levels were dependent on isotype and IgG subclass, and IgG4 showed remarkable resistance to heating. Moreover, the effect of the pasteurization on specific reactivity was antigen dependent.

Conclusion:

The supply of relevant immunological components is stable throughout the colostrum stage. The effects of pasteurization on antibodies depend on isotype, subclass, and specificity. This information is relevant to improving the immunological quality of colostrum, especially for preterm newborns.
Chlamydia trachomatis infection positivity rates determined by nucleic acid amplification test in patients of hospitals in the northeastern region of Ukraine
Authors: Belozorov Alexei , Fedets Olga , Chastii Tatjana , Milutina Elena , Sokol Oksana , Grigorova Ritsa , Unuchko Sergey
Published: June 2017

There are no accurate data regarding the prevalence of Chlamydia trachomatis infection in Ukraine. This study aims to estimate the prevalence in the northeastern region of the country through reviewing nucleic acid amplification test results in patients of medical institutions in the Kharkov region during 2014–2016. Samples from 6920 patients (5028 women and 1892 men) aged 12–76 years were tested. The overall positivity rate was 4.5% (95% CI 4.0–5.0): 3.9% (95% CI 3.4–4.5) in women and 6.1% (95% CI 5.1–7.3) in men. The highest prevalence was found in the 16–20 (8.5%, CI 6.3–11.4) and 21–25 (8.0%, CI 6.7–9.4) year age groups. The prevalence in men was higher than in women in all investigated groups. The results show the need for more attention to the prevention, diagnosis, and treatment of chlamydial infection in these age groups of women and men in this region.
The relationships between the expenditures and resources of public libraries and children’s and young adults’ use: An exploratory analysis of Institute of Museum and Library Services public library statistics data
Authors: Joo Soohyung , Cahill Maria
Published: June 2017

Children’s librarians have long recognized the value of libraries for the development of children and adolescents and have championed for appropriate funding to support programs and services targeted to children, adolescents, and families. Using data from the Institute of Museum and Library Services National Public Library Survey, this study examined the relationships between the expenditures and resources of public libraries and children’s and young adults’ use. Three groups of variables were chosen from the dataset to represent expenditures, resources, and children’s and young adults’ library use respectively. Correlation analysis results reveal that most of the expenditures and resources variables were significantly correlated with children’s and young adults’ library use in libraries of all sizes. Further, analyses of material circulation and program attendance rates reveal that children’s materials account for more than one-third of total library material circulations and 70% of public library program participants attend programs designed for children. The findings of this study provide empirical evidence to support the investment in library resources and services for children and young adults and are discussed in light of expansion of library services and programming focused on informal learning.
The role of “responsiveness” within the self in transitions to university
Authors: Gomes Ramon , Dazzani Virgínia , Marsico Giuseppina
Published: June 2017

Entering university is a complex psychosocial phenomenon that can create several new stressful situations that students need to face. The transition into university may be accompanied by some psychosocial problems such as reduced self-esteem and academic achievement, increased social anxiety, and a critical rise in the probability of dropout. How does a person use cultural elements to cope with stress? Responding to this question requires an understanding of the multivocal and ambivalent self. The paper aims at introducing and discussing the concept of Educational Self and the role of the responsiveness for explaining the complexity of the transition to a new educational context in Cultural Psychology perspective. The notion of responsiveness plays a crucial role in the “reconfiguration” of the multivocal and ambivalent self in transition.
Freshman Flu Vaccination Behavior and Intention During a Nonpandemic Season
Authors: Ratnapradipa Kendra L. , Norrenberns Ryan , Turner J. Austin , Kunerth Allison
Published: June 2017

Objective. To examine predictors of flu vaccination and vaccination intention among college freshmen during a nonpandemic influenza season using the health belief model (HBM). Participants. A total of 184 college freshmen at a single institution participated in a mixed-mode (paper or online) survey in October-November 2015. Method. Flu vaccination and intention to vaccinate were predicted using binomial logistic regression on HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and availability), prior flu vaccination history, family and peer reference behaviors, and demographics. Results. Overall, 31.5% of participants received the seasonal flu vaccine by mid-November, and 25% intended to receive it. In full models, history of past flu vaccination (adjusted odds ratio [aOR] = 7.90; 95% confidence interval [CI] = 2.55-24.49) was significant for vaccination while availability (aOR = 2.00; 95% CI = 1.32-3.01) and family intention (aOR = 250.59; 95% CI = 3.77 to >999) were positively associated with intent to vaccinate. Significant confounding by past behavior and family intentions existed for both outcomes. Conclusions. Past flu vaccination behavior and family member intentions to vaccinate were better predictors of annual flu vaccination behavior and intention than HBM constructs among college freshmen. College campuses may enhance flu vaccine coverage by highlighting benefits and availability to students and families.
In vivo Portal Imaging Dosimetry Identifies Delivery Errors in Rectal Cancer Radiotherapy on the Belly Board Device
Authors: Peca Stefano , Sinha Richie Siddhartha , Brown Derek Wilson , Smith Wendy Lani
Published: June 2017

Purpose:

We recently developed a novel, open-source in vivo dosimetry that uses the electronic portal imaging device to detect dose delivery discrepancies. We applied our method on patients with rectal cancer treated on a belly board device.

Methods:

In vivo dosimetry was performed on 10 patients with rectal cancer treated prone on the belly board with a 4-field box arrangement. Portal images were acquired approximately once per week from each treatment beam. Our dosimetry method used these images along with the planning CT to reconstruct patient planar dose at isocenter depth.

Results:

Our algorithm proved sensitive to dose discrepancies and detected discordances in 7 patients. The majority of these were due to soft tissue differences between planning and treatment, present despite matching to bony anatomy. As a result of this work, quality assurance procedures have been implemented for our immobilization devices.

Conclusion:

In vivo dosimetry is a powerful quality assurance tool that can detect delivery discrepancies, including changes in patient setup and position. The added information on actual dose delivery may be used to evaluate equipment and process quality and to guide for adaptive radiotherapy.
Electrosensitization Increases Antitumor Effectiveness of Nanosecond Pulsed Electric Fields In Vivo
Authors: Muratori Claudia , Pakhomov Andrei G. , Heller Loree , Casciola Maura , Gianulis Elena , Grigoryev Sergey , Xiao Shu , Pakhomova O. N.
Published: June 2017

Nanosecond pulsed electric fields are emerging as a new modality for tissue and tumor ablation. We previously reported that cells exposed to pulsed electric fields develop hypersensitivity to subsequent pulsed electric field applications. This phenomenon, named electrosensitization, is evoked by splitting the pulsed electric field treatment in fractions (split-dose treatments) and causes in vitro a 2- to 3-fold increase in cytotoxicity. The aim of this study was to show the benefit of split-dose treatments for in vivo tumor ablation by nanosecond pulsed electric field. KLN 205 squamous carcinoma cells were embedded in an agarose gel or grown subcutaneously as tumors in mice. Nanosecond pulsed electric field ablations were produced using a 2-needle probe with a 6.5-mm interelectrode distance. In agarose gel, splitting a pulsed electric field dose of 300, 300-ns pulses (20 Hz, 4.4-6.4 kV) in 2 equal fractions increased cell death up to 3-fold compared to single-train treatments. We then compared the antitumor effectiveness of these treatments in vivo. At 24 hours after treatment, sensitizing tumors by a split-dose pulsed electric field exposure (150 + 150, 300-ns pulses, 20 Hz, 6.4 kV) caused a 4- and 2-fold tumor volume reduction as compared to sham and single-train treatments, respectively. Tumor volume reduction that exceeds 75% was 43% for split-dose–treated animals compared to only 12% for single-dose treatments. The difference between the 2 experimental groups remained statistically significant for at least 1 week after the treatment. The results show that electrosensitization occurs in vivo and can be exploited to assist in vivo cancer ablation.
Egyptian experience in increasing utilization of reperfusion therapies in acute ischemic stroke
Authors: Zakaria Magd Fouad , Aref Hany , Abd ElNasser Azza , Fahmy Nagia , Tork Mohamed Amir , Fouad Mohamed Mahmoud , ElBokl Ahmed , Roushdy Tamer , ElFaramawy Sara , El-Shiekh Mohammad Abdullah , Moustafa Ramez Reda
Published: June 2017

Background

The rate of alteplase (tPA) thrombolysis utilization in acute stroke in Egypt is <1%. We report on the causes of this low rate of reperfusion therapies and take corrective action to improve it.

Methods

Two prospective observational studies were conducted at Ain Shams University hospitals. The first included 269 acute stroke patients admitted to the hospital over a six-month period. Obstacles to reperfusion therapy were identified, and based on the results, a corrective action plan was implemented including making alteplase(tPA) available, training, and establishing a standardized local protocol for reperfusion therapy. A second study was then conducted that included 284 acute ischemic stroke patients over another six-month period.

Results

In the first study, 53/269 patients (19.7%) arrived at hospital within 4.5 h and were eligible for reperfusion therapy. Of those, seven (13.2%) received alteplase(tPA), representing 2.6% of the total ischemic stroke patients admitted. The main causes for not giving thrombolytic therapy was unavailability of alteplase(tPA) (56.5%), wrong treatment decision (17.4%), missed window while performing brain imaging (15%), and unavailability of intermediate care bed (10.9%). The second study showed that out of 284 cases admitted with acute ischemic stroke, 37 were eligible for thrombolysis and 35 received alteplase(tPA) (94.3%), representing 12.3% of the total ischemic stroke admissions.

Conclusion

A comprehensive action plan that centers around making the drug available and training resulted in a significant improvement of reperfusion therapy utilization in Egypt.
Shoulder-specific outcomes 1 year after nontraumatic full-thickness rotator cuff repair: a systematic literature review and meta-analysis
Authors: Gurnani Navin , van Deurzen Derek F. P. , van den Bekerom Michel P. J.
Published: June 2017

Background

Nontraumatic full-thickness rotator cuff tears are commonly initially treated conservatively. If conservative treatment fails, rotator cuff repair is a viable subsequent option. The objective of the present meta-analysis is to evaluate the shoulder-specific outcomes one year after arthroscopic or mini-open rotator cuff repair of nontraumatic rotator cuff tears.

Methods

A literature search was conducted in PubMed and EMBASE within the period January 2000 to January 2017. All studies measuring the clinical outcome at 12 months after nontraumatic rotator cuff repair of full-thickness rotator cuff tears were listed.

Results

We included 16 randomized controlled trials that met our inclusion criteria with a total of 1.221 shoulders. At 12 months after rotator cuff repair, the mean Constant score had increased 29.5 points; the mean American Shoulder and Elbow Score score increased by 38.6 points; mean Simple Shoulder Test score was 5.6 points; mean University of California Los Angeles score improved by 13.0 points; and finally, mean Visual Analogue Scale score decreased by 4.1 points.

Conclusions

Based on this meta-analysis, significant improvements in the shoulder-specific indices are observed 12 months after nontraumatic arthroscopic or mini-open rotator cuff repair.
Intraorganizational Communication and Job Satisfaction Among Flemish Hospital Nurses: An Exploratory Multicenter Study
Authors: Vermeir Peter , Downs Cal , Degroote Sophie , Vandijck Dominique , Tobback Els , Delesie Liesbeth , Mariman An , De Veugele Myriam , Verhaeghe Rik , Cambré Bart , Vogelaers Dirk
Published: June 2017

Intraorganizational communication affects job satisfaction and turnover. The goal of this study was to explore relationships between communication and job satisfaction, intention to leave, and burnout among Flemish hospital nurses. A multicenter questionnaire study was conducted in three hospitals using the Communication Satisfaction Questionnaire, the Turnover Intention subscale of the Questionnaire on the Experience and Evaluation of Work, and the Maslach Burnout Inventory. A visual analog scale measured job satisfaction. The mean job satisfaction score was 7.49/10 (±1.43). Almost 7% of nurse participants (93/1,355) reported a high intent to leave, and 2.9% of the respondents (41/1,454) had a score indicative of burnout. All dimensions of communication were associated with job satisfaction. A low score on any dimension of communication satisfaction, except “Relationship With Employees,” was associated with higher intent to leave and burnout. Study findings support the need for management interventions to enhance efficient communication and ensure high-quality care and patient safety.
In-depth PtdIns(3,4,5)P3 signalosome analysis identifies DAPP1 as a negative regulator of GPVI-driven platelet function
Authors: Durrant Tom N. , Hutchinson James L. , Heesom Kate J. , Anderson Karen E. , Stephens Len R. , Hawkins Phillip T. , Marshall Aaron J. , Moore Samantha F. , Hers Ingeborg
Published: June 2017

Key Points

We present the first in-depth analysis of platelet PtdIns(3,4,5)P3-binding proteins, providing a valuable resource for future studies. The PtdIns(3,4,5)P3-binding protein, DAPP1, negatively regulates glycoprotein VI–driven platelet activation and thrombus formation.
The effects of basal insulin peglispro vs. insulin glargine on lipoprotein particles by NMR and liver fat content by MRI in patients with diabetes
Authors: Orchard Trevor J. , Cariou Bertrand , Connelly Margery A. , Otvos James D. , Zhang Shuyu , Antalis Caryl J. , Ivanyi Tibor , Hoogwerf Byron J.
Published: June 2017

Background

In Phase 2/3 studies of basal insulin peglispro (BIL) compared to insulin glargine, patients with type 1 or type 2 diabetes previously treated with insulin and randomized to BIL had an increase in serum triglycerides (TGs). To further understand lipoprotein changes, a lipid substudy which included liver fat content was designed to assess relationships among the measured variables for each diabetes cohort and compare the hepato-preferential insulin BIL to glargine.

Methods

In three cohorts of patients with diabetes (type 1, type 2 insulin naïve, and type 2 previously on insulin; n = 652), liver fat content (LFC) was determined by magnetic resonance imaging (MRI) and blood lipids were analyzed by nuclear magnetic resonance (NMR) spectroscopy at baseline, 26 and 52 weeks of treatment. Apolipoproteins, adiponectin, and other lipid parameters were also measured. Descriptive statistics were done, as well as correlation analyses to look for relationships among LFC and lipoproteins or other lipid measures.

Results

In patients with type 1 diabetes treated with BIL, but not glargine, small LDL and medium and large VLDL subclass concentrations increased from baseline. In patients with type 2 diabetes previously on insulin and treated with BIL, large VLDL concentration increased from baseline. In insulin naïve patients with type 2 diabetes treated with BIL, there were very few changes, while in those treated with glargine, small LDL and large VLDL decreased from baseline. Baseline LFC correlated significantly in one or more cohorts with baseline large VLDL, small LDL, VLDL size, and Apo C3. Changes in LFC by treatment showed generally weak correlations with lipoprotein changes, except for positive correlations with large VLDL and VLDL size. Adiponectin was higher in patients with type 1 diabetes compared to patients with type 2 diabetes, but decreased with treatment with both BIL and glargine.

Conclusions

The lipoprotein changes were in line with the observed changes in serum TGs; i.e., the cohorts experiencing increased TGs and LFC with BIL treatment had decreased LDL size and increased VLDL size. These data and analyses add to the currently available information on the metabolic effects of insulins in a very carefully characterized cohort of patients with diabetes.

Clinicaltrials.gov registration numbers and dates NCT01481779 (2011), NCT01435616 (2011), NCT01454284 (2011), NCT01582451 (2012)
Frontline Science: Aspirin-triggered resolvin D1 controls herpes simplex virus-induced corneal immunopathology
Authors: Rajasagi Naveen K , Bhela Siddheshvar , Varanasi Siva Karthik , Rouse Barry T
Published: June 2017

Stromal keratitis (SK) is a chronic immunopathological lesion of the eye, caused by HSV-1 infection, and a common cause of vision impairment in humans. The inflammatory lesions in the cornea are primarily caused by neutrophils with the active participation of CD4+ T cells. Therefore, the targeting of these immune cell types and their products represents a potentially valuable form of therapy to reduce the severity of disease. Resolvin D1 (RvD1) and its epimer aspirin-triggered RvD1 (AT-RvD1) are lipid mediators derived from docosahexaenoic acid (DHA) and were shown to promote resolution in several inflammatory disease models. In this report, we examined whether AT-RvD1 administration, begun before infection or at a later stage after ocular infection of mice with HSV-1, could control the severity of SK lesions. Treatment with AT-RvD1 significantly diminished the extent of corneal neovascularization and the severity of SK lesions. AT-RvD1-treated mice had fewer numbers of inflammatory cells that included neutrophils as well as Th1 and Th17 cells in the infected cornea. The mechanisms by which AT-RvD1 acts appear to be multiple. These include inhibitory effects on proinflammatory mediators, such as IL-1β, IL-6, IL-12, CXCL1, MCP-1, MIP-2, vascular endothelial growth factor (VEGF)-A, matrix metalloproteinase 9 (MMP-9), and proinflammatory miRNA, such as miR-155, miR-132, and miR-223, which are involved in SK pathogenesis and corneal neovascularization. In addition, AT-RvD1 attenuated STAT1, which plays an important role in Th1 cell differentiation and IFN-γ expression. These findings demonstrate that AT-RvD1 treatment could represent a useful strategy for the management of virus-induced immunopathological lesions.
The effects of moderate intensity training in a hypoxic environment on transcriptional responses in Thoroughbred horses
Authors: Davie Allan J. , Wen Li , Cust Andrew R. E. , Beavers Rosalind , Fyfe Tom , Zhou Shi
Published: June 2017

This study investigated the effects of six weeks of normobaric hypoxic training on transcriptional expression of the genes associated with mitochondrial and glycolytic activities in Thoroughbred horses. Eight horses were divided into two groups of four. They completed an identical incremental, moderate intensity training program, except that one group trained in a hypoxic chamber with 15% oxygen for 30 minutes on alternate days except Sundays (HT), while the other group trained in normal air (NC). Prior to and post the training, heart rate and blood lactate were measured during an incremental treadmill test. Muscle biopsy samples were taken prior to and 24 hours post the training period for qPCR analysis of mRNA changes in VEGF, PPARγ, HIF-1α, PGC-1α, COX4, AK3, LDH, PFK, PKm and SOD-2. No significant differences between the HT and NC were detected by independent-samples t-test with Bonferroni correction for multiple comparisons (P>0.05) in relative changes of mRNA abundance. There were no significant differences between groups for heart rate and blood lactate during the treadmill test. The outcomes indicated that this hypoxia training program did not cause a significant variation in basal level expression of the selected mRNAs in Thoroughbreds as compared with normoxic training.
Classifying Economics: A History of theJELCodes
Authors: Cherrier Beatrice
Published: June 2017

In this paper, I suggest that the history of the classification system used by the American Economic Association (AEA) to list economic literature and scholars is a relevant proxy to understand the transformation of economics science throughout the twentieth century. Successive classifications were fashioned through heated discussions on the status of theoretical and empirical work, data and measurement, and proper objects of analysis. They also reflected the contradictory demands of users, including economists but also civil servants, journalists, publishers, librarians, and the military, and reflected rapidly changing institutional and technological constraints. Until the late 1940s, disagreements on the general structure of the classification dominated AEA discussions. As the subject matters, methods, and definition of economics rapidly evolved after the war, methodological debates raged on the status of theoretical and empirical work and the degree of unification of the discipline. It was therefore the ordering and content of major categories that was closely discussed during the 1956 revision. The 1966 revision, in contrast, was fueled by institutional and technical transformations rather than intellectual ones. Classifiers essentially reacted to changes in the way economists' work was evaluated, the nature and size of the literature they produced, the publishing industry, and the use of computer facilities. The final 1988–90 revision was an attempt by the Journal of Economic Literature (JEL) editors to translate the mature core fields structure of their science into a set of codes and accommodate the new types of applied work economists identified themselves with. The 1990 classification system was only incrementally transformed in the next twenty years, but that the AEA is currently considering a new revision may signal more profound changes in the structure of economics. (JEL A14)
A Review Essay on Isabel Sawhill's Generation Unbound: Drifting into Sex and Parenting without Marriage and Laurence Steinberg's Age of Opportunity: Lessons from the New Science of Adolescence
Authors: Aizer Anna
Published: June 2017

Sawhill and Steinberg approach risky behavior among youth from two different angles: Steinberg argues for intervention during the adolescent years to alter behavior in ways that prioritize patience and self-regulation, while Sawhill advocates interventions that mitigate the negative effects of risky behavior. Both argue that disadvantaged youth suffer worse consequences as a result of risky behavior and therefore stand to gain the most from interventions. While the authors develop strong arguments for adolescent interventions, the existing evidence on their effectiveness is less compelling. To reconcile the promise with the reality, I argue that growing up in environments of significant uncertainty reduces the returns to forward-thinking behavior in the daily lives of disadvantaged youths. Interventions to develop adolescent decision-making skills so as to reduce risky behavior will not be effective if they are inconsistent with the incentives generated by a local environment that is often characterized by uncertainty. (JEL J12, J13)
Failure of the Ricardian Equivalence Theory in Economies with Incomplete Markets
Authors: Divino José Angelo , Orrillo Jaime
Published: June 2017

We investigate whether or not the Ricardian Equivalence Theorem (RET) holds in a naive economy with incomplete financial markets. Even in this artificially favorable environment, where public debt has a perfect substitute, the RET fails if we allow the payoff matrix to vary. For the RET to hold, we need to assume that the risk-free payoff belongs to the asset span of the economy and the law of one price is valid. Given that these are strong assumptions, we show that the failure of the RET is robust, in the sense that there exists an open set of payoff matrices such that the RET fails.