bluuebunny/crossref_metadata_2025 huggingface dataset:
PCB118-Induced Cell Proliferation Mediated by Oxidative Stress and MAPK Signaling Pathway in HELF Cells
Authors: Hashmi Muhammad Zaffar , Hasnain Ahmad , Syed Jabir Hussain , Tariq Muhammad , Su Xiaomei , Mubarak Hussani , Nasim Wajid , Shen Chaofeng
Published: January 2018

The present study used human lung fibroblast (HELF) cells as a test model to evaluate the role of oxidative stress (OS) and extracellular signal-regulated kinases 1/2 (ERK1/2) protein in HELF cell proliferation exposed to PCB118. Results from 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide demonstrated that PCB118 at lower concentrations stimulated proliferation of HELF cell and abrogate proliferative effect at higher dose concentrations and in a time-dependent manner. Moreover, reactive oxygen species, malondialdehyde (MDA), and superoxide dismutase showed a significant increase at higher concentrations of PCB118 than the lower concentrations with the passage of time. Antioxidant enzymes such as glutathione peroxidase exhibited decreasing trends in dose- and time-dependent manner. Lipid peroxidation assay resulted in a significant increase in MDA level in PCB118-treated HELF cells compared with controls, suggesting that OS plays a key role in PCB118-induced toxicity. Comet assay indicated a significant increase in genotoxicity at higher concentrations of PCB118 exposure than the lower concentrations. It was found that PCB118 showed expression of ERK1/2 protein after 4 hours, while after 48 hours, the protein expression was less, indicating PCB toxicity to MAPK protein of HELF cell. Oxidative stress, ERK1/2, and HELF cell proliferation exhibited correlation. The results will elaborate toxicological evaluation of PCB118 to HELF cells and will help to develop drug for PCB-induced diseases.
Which pen? A comparative study of surgical site markers
Authors: Bathla Sonia , Nevins Edward J , Moori Parisa L , Vimalachandran Dale
Published: January 2018

A preoperative requirement is the correct and clear marking of a specific surgical site. We aimed to compare the ability of marker pens to withstand surgical preparation. Five volunteers with different Fitzpatrick skin types were marked with ten pens. Marked skin sites were prepared with chlorhexidine followed by chlorhexidine, betadine followed by chlorhexidine, and betadine followed by betadine. Each site was photographed in theatre. Two volunteers ranked the top three most visible marker pens from each photograph. The results showed that Sharpie® W10 black, Dual Tip (Purple Surgical), and Easimark modern regular tip (Leonhard Lang) were the best performers across all skin types. Red pen should be avoided with betadine skin preparation. The study concludes that the above named three markers are the best at withstanding surgical skin preparation. Different skin types require different colour ink for maximal clarity in marking. Biro and drywipe markers should never be used for surgical marking.
European memory beyond the state: Baltic, Russian and European memory interactions (1991–2009)
Authors: Perchoc Philippe
Published: January 2018

This article claims that the rapid institutional transformations after 1991 in the Baltic states altered the relationship of memory and power. In order to get an accurate picture of this phenomenon, one needs to take into account not only the national stage but also the international environment, because both neighbouring countries (primarily Russia) and the European institutions play a role in the transformation of the memory figuration.
A real-time fall detection system based on the acceleration sensor of smartphone
Authors: Lee Youngmin , Yeh Hongjin , Kim Ki-Hyung , Choi Okkyung
Published: January 2018

Falls are a major problem for the elderly people leading to injury, disability, and even death. In this article, we propose a fall detection system that uses the acceleration sensor of a smartphone to detect a senior citizen falling in real time and to use the communication capabilities of the smartphone to notify the administrator of such an event. The proposed system conducts real-time location tracking using Google’s Map and 3D information to cope with a critical situation and to make an urgent intervention in an emergency. Since Google’s 3D mapping service can provide information on the surrounding buildings and their shapes with more precision than a 2D service or text-based service, it is possible to ensure a prompt response for senior citizens when such location information is available. To verify the validity and efficiency of this article, we measured the change in acceleration sensor value by classifying the subjects by age group and gender. As a result, we found that the signal vector magnitude value of the acceleration sensor value variation showed a great difference in daily life such as walking, running, sitting, and falling.
The most influential countries in market orientation
Authors: Valenzuela-Fernández Leslier , Merigó José M , Nicolas Carolina
Published: January 2018

The purpose of this article is to analyze the most productive and influential countries engaging in market orientation (MO) research between 1990 and 2016. This article shows the general trajectories of these countries, the relationships among them, and their research in the area of MO by analyzing results on citations and publications. The article uses applied bibliometric techniques on available information found in the Web of Science. The results show that the 10 leading countries produce more than 70% of total publications, where the United States leads in all indicators, followed by the United Kingdom and China. Furthermore, although there has been a steady increase in overall number of publications, this trend is not shared evenly among different nations.
Motivations for Participation in an Online Social Media Community for Diabetes
Authors: White Katherine , Gebremariam Achamyeleh , Lewis Dana , Nordgren Weston , Wedding James , Pasek Josh , Garrity Ashley , Hirschfeld Emily , Lee Joyce M.
Published: January 2018

Background:

Our objectives were to describe individuals’ motivations for participation in an online social media community and to assess their level of trust in medical information provided by medical professionals and community members.

Methods:

A purposive survey was delivered to participants recruited through posts on the CGM in the Cloud group, Twitter, and blogs. Individuals were asked a series of demographic and social media use questions.

Results:

A total of 1268 members of the CGM in the Cloud community responded to the survey. The majority were non-Hispanic White (92.1%) and caregivers of an individual with diabetes (80.9%). Mean age was 41 years old, and 74.8% were female. Primary goals of the Facebook group were to learn more about Nightscout technology and to receive technological assistance. Individuals provided assistance to the community through spreading awareness, technical assistance, support, and donation. Respondents put a high level of trust in their peers versus health professionals in many health situations with nearly 40% of individuals reported to be helped by following advice found in the Facebook group, and 99% reported no harm.

Conclusions:

Our findings suggest that patients with diabetes and their caregivers use social media for many health-related purposes including medical recommendations and technical support for medical devices and systems as well as emotional support.
Do Postoperative Hallux Angles Correlate With Outcome in MP1 Fusion? Our Experience With 71 Cases
Authors: Paredes-Carnero Xavier , Fernández-Cebrián Antonio María , Villardefrancos-Gil Silvia
Published: January 2018

Purpose: To determine if the postoperative alignment of the hallux influences the final clinical outcome of hallux metatarsophalangeal joint (first MTPJ) arthrodesis. Methods: A total of 71 consecutive cases (hallux rigidus) were studied in stages 3 and 4. They were operated through arthrodesis between 2008 and 2014. The follow-up mean was 7.3 years. The AOFAS (American Orthopaedic Foot and Ankle Society) test was performed preintervention and per annum. In radiology, both the hallux valgus angle and the dorsiflexion angle of the first MTPJ were studied. Furthermore, clinical outcomes were evaluated according to the type of implant used. Results: Preoperative AOFAS score was 27.5, rising to 91.3 after the intervention ( P < .01). The improvement test average was 63.6. There were 17 local complications (23%), 7 of them were considered to be major complications (9%), 6 of which needed reoperation (8.5%). The dorsiflexion angle postoperative mean was 21.7°. The hallux valgus angle postoperative mean was 10.9°. No correlations between both angles, and improved AOFAS score or complications ( P > .4 and P > .5, respectively), were found. Patients who had a dorsiflexion angle higher than 20° had greater improvement in the AOFAS score compared with those who had angles lower than 20° (64.5 vs 59.6 points). Nevertheless, this result was not statistically significant ( P = .059). No differences in AOFAS score improvement regarding arthrodesis plate ( P > .1) were found. Conclusion: First MTPJ arthrodesis is a good alternative for patients in advanced hallux rigidus stages when conservative treatment fails. We could not confirm if a better postoperative alignment may influence in clinical outcomes. However, better results are obtained with dorsiflexion angle greater than 20° than with those with less than 20°. Likewise, any differences between the 2 arthrodesis plates have been able to confirm.

Levels of Evidence: Level III: Retrospective cohort study
A taxonomy of digital media types for Learner-Generated Digital Media assignments
Authors: Reyna Jorge , Hanham Jose , Meier Peter
Published: January 2018

The notion of students as co-creators of content in higher education is gaining popularity, with an ever-increasing emphasis on the development of digital media assignments. In a separate paper, the authors introduced the Digital Media Literacies Framework, which is composed of three interrelated domains: (1) conceptual, (2) functional, and (3) audiovisual, each of which defines a set of prosumer principles used to create digital artefacts. This framework fills a gap in the literature and is the first step towards the provision of a systematic approach to designing digital media assignments. This paper expands on the Digital Media Literacies Framework through the incorporation of Technological Proxies and proposes a taxonomy of digital media types to help educators and students to visualise the skills needed to complete Learner-Generated Digital Media assignments. A taxonomy of digital media types is presented considering the conceptual, functional, and audiovisual domains of the Digital Media Literacies Framework. The taxonomy spans a range of Learner-Generated Digital Media assignments, from the creation of an audio podcast to the complexity of blended media or game development. Implications of the taxonomy for teaching and learning in higher education are discussed.
Impaired systemic oxygen extraction in treated exercise pulmonary hypertension: a new engine in an old car?
Authors: Faria‐Urbina Mariana , Oliveira Rudolf K.F. , Segrera Sergio A. , Lawler Laurie , Waxman Aaron B. , Systrom David M.
Published: January 2018

Ambrisentan in 22 patients with pulmonary hypertension diagnosed during exercise (ePH) improved pulmonary hemodynamics; however, there was only a trend toward increased maximum oxygen uptake (VO2max) secondary to decreased maximum exercise systemic oxygen extraction (Ca‐vO2). We speculate that improved pulmonary hemodynamics at maximum exercise “unmasked” a pre‐existing skeletal muscle abnormality.
Characteristics and prognosis of heart failure with improved compared with persistently reduced ejection fraction: A systematic review and meta-analyses
Authors: Jørgensen Mads E , Andersson Charlotte , Vasan Ramachandran S , Køber Lars , Abdulla Jawdat
Published: January 2018

Aims

We assessed the clinical characteristics and prognosis of chronic heart failure patients with improved ejection fraction (HFIEF) compared with persistently reduced ejection fraction (HFpREF) after evidence-based therapy.

Methods and results

We performed a meta-analysis including 24 eligible observational studies comparing 2663 HFIEF (≥5% left ventricular ejection fraction (LVEF) improvement) versus 8355 HFpREF patients who received recommended drug therapy, cardiac resynchronization therapy and/or intracardiac defibrillator. LVEF was assessed at baseline and reassessed after 19 ± 19 months. The primary endpoints were all-cause mortality and appropriate shocks. The mean duration of follow-up was 39 ± 12 months. Among HFIEF patients, LVEF improved 16.3 percentage points (95% confidence interval 15.9–16.6, p < 0.0001). Compared with HFpREF patients, HFIEF patients had a comparable mean age (60.9 years vs. 62.4 years, p = 0.11), were more often women (33% vs. 25%), had a higher prevalence of non-ischaemic heart failure (58% vs. 53%), less diabetes (27% vs. 28%), higher systolic blood pressure (127.5 ± 9 vs. 122 ± 12 mmHg) and lower left ventricle end-diastolic diameter (64.1 ± 3.7 vs. 67.4 ± 4.9 mmHg), all p-values < 0.05. Absolute risk of all-cause mortality was lower in HFIEF (5.8%) compared with HFpREF (17.5%) with a risk ratio of 0.34 (95% confidence interval 0.28-0.41), p < 0.001. Risk of appropriate shocks was significantly lower in HFIEF versus HFpREF (risk ratio 0.58 (95% confidence interval 0.46–0.74), p < 0.001).

Conclusion

In heart failure patients, we identified several baseline characteristics in favour of an improved LVEF, in response to evidence based therapy. Patients with improved LVEF had significantly lower risks of mortality and appropriate shocks compared with patients with persistently reduced LVEF.
Delayed celiac disease diagnosis predisposes to reduced quality of life and incremental use of health care services and medicines: A prospective nationwide study
Authors: Fuchs Valma , Kurppa Kalle , Huhtala Heini , Mäki Markku , Kekkonen Leila , Kaukinen Katri
Published: January 2018

Background

Celiac disease is challenging to recognize, predisposing to long diagnostic delay. Currently, associated factors and significance of the delay remain obscure.

Objective

The objective of this article is to investigate associated sociodemographic risk factors and health consequences of diagnostic delay in celiac disease.

Methods

Altogether 611 patients were surveyed at diagnosis and after one year on a gluten‐free diet regarding sociodemographic variables, well‐being and use of medicines and health care services. Quality of life was measured by a validated Psychological General Well‐Being (PGWB) questionnaire. The results were compared between patients with and without delayed (≥3 years) diagnosis.

Results

A total of 332 (54%) individuals reported a delay of ≥3 years. Associated with the delay were being a student or homemaker, but not gender, marital or occupational status, site of diagnosis or place of residence. Patients with the delay also had decreased self‐perceived health and poorer PGWB scores compared to those without delay; in anxiety and general health this was seen even on a gluten‐free diet. Days of sickness and doctor visits as well as use of drugs for dyspepsia and antidepressants were increased in the delay group both before and after diagnosis.

Conclusion

A delay in celiac disease diagnosis predisposes to reduced well‐being and incremental use of medicines and health care services, both before diagnosis and one year after diagnosis.
Maternal morbidity and mortality associated with retroperitoneal haematomas in pregnancy
Authors: Rafi Junaid , Khalil Haroona
Published: January 2018

Retroperitoneal haematomas in obstetrics are uncommon. The causes and pathogenesis of retroperitoneal haematomas lack clarity and the aim of this review is to recognise retroperitoneal haematomas as a separate entity from commonly seen vaginal and pelvic haematomas. It is time to raise awareness among obstetricians to recognise retroperitoneal haematomas as an important cause of maternal morbidity and mortality which requires high clinical suspicion and multidisciplinary input. As retroperitoneal haematomas are rare but can cause serious threat to maternal wellbeing, resources should be directed towards their management. Existing guidelines of maternal collapse and morbidity during pregnancy and puerperium need to include retroperitoneal haematomas as one of the important causes of maternal shock or morbidity. New learning pathways should be opted for to increase awareness of retroperitoneal haematomas among obstetricians enabling them to reflect on their implications while managing retroperitoneal haematomas. Management of retroperitoneal haematomas is complex and continues to improve with advancements in the investigative strategies, treatment options and multidisciplinary involvement.
Staged Palliation of Cyanotic Obstructive Lesions With a Modified Right Ventricular Outflow Procedure
Authors: Batlivala Sarosh P. , Hood Mary K. , Dodge-Khatami Jannika , Shakti Divya , Taylor Mary B. , Ebeid Makram R. , Salazar Jorge D. , Dodge-Khatami Ali
Published: January 2018

Background:

Traditional palliation for biventricular cyanotic congenital heart lesions often involves staging with systemic-to-pulmonary arterial shunts to secure pulmonary blood flow (PBF) in the newborn period prior to complete repair. However, shunts may lead to life-threatening events secondary to shunt occlusion or acute coronary steal. They may be associated with morbidity secondary to diastolic runoff, systemic steal and volume loading, and do not provide pulsatile flow which has the potential to promote pulmonary artery (PA) growth. We have alternatively performed modified right ventricular outflow (mRVO) procedures by establishing antegrade right ventricle-to-PA flow.

Methods:

Retrospective review of data on all patients who underwent the mRVO procedure from 2013 to 2016, including anatomy, number of interstage catheterizations, reoperations, intensive care unit admissions, hypercyanotic episodes, interval to complete repair, and mortality.

Results:

Seventeen nonconsecutive patients included tetralogy of Fallot (n = 14), pulmonary valve stenosis (n = 2), and 1 with pulmonary atresia-intact septum; 14 had significant branch PA stenosis. Median age of first mRVO procedure was 14 days (range 5-193), and median duration of follow-up was 15.3 months (range 4-47 months). No patients had post-palliation acute hypercyanotic episodes. Nine were admitted to the ICU for persistent interstage hypoxemia, 7 of whom required reintervention prior to complete repair, which was achieved in 11 patients. Two late deaths unrelated to mRVO occurred.

Conclusions:

The mRVO procedure is a potential option with satisfactory results. It avoids potential shunt-related sudden death. The physiology of the mRVO palliation may provide unique benefits by providing antegrade pulsatile PBF, facilitates catheter interventions, and avoids branch PA distortion and stenosis.
Primary Arterial Switch Operation for Late Referral of Transposition of the Great Arteries with Intact Ventricular Septum in the Current Era: Do We Still Need a Rapid Two-Stage Operation?
Authors: Ota Noritaka , Sivalingam Sivakumar , Pau Kiew Kong , Hew Chee Chin , Dillon Jeswant , Latiff Haifa Abdul , Samion Hasri , Yakub Mohd Azhari
Published: January 2018

Objective:

We introduced primary arterial switch operation for the patient with transposition of great arteries and intact ventricular septum (TGA-IVS) who had more than 3.5 mm of posterior left ventricle (LV) wall thickness.

Methods:

Between January 2013 and June 2015, a total of 116 patients underwent arterial switch operation. Of the 116 patients, 26 with TGA-IVS underwent primary arterial switch operation at more than 30 days of age.

Results:

The age and body weight (mean ± SD) at the operation were 120.4 ± 93.8 days and 4.1 ±1.0 kg, respectively. There was no hospital mortality. The thickness of posterior LV wall (preoperation vs postoperation; mm) was 4.04 ± 0.71 versus 5.90 ± 1.3; P < .0001; interval: 11.8 ± 6.5 days. The left atrial pressure (mm Hg; postoperative day 0 vs 3) was 20.0 ± 3.2 versus 10.0 ± 2.0; P < .0001; and the maximum blood lactate level (mmol/dL) was 4.7 ± 1.4 versus 1.4 ± 0.3; P < .0001, which showed significant improvement in the postoperative course. All cases had delayed sternal closure. The patients who belonged to the thin LV posterior wall group (<4 mm [preoperative echo]: n = 13) had significantly longer ventilation time (days; 10.6 ± 4.8 vs 4.8 ± 1.7, P = .0039), and the intensive care unit stay (days) was 14 ± 9.2 versus 7.5 ± 3.5; P = .025, compared with thick LV wall group (≥4.0 mm: n = 13).

Conclusions:

The children older than 30 days with TGA-IVS can benefit from primary arterial switch operation with acceptable results under our indication. However, we need further investigation for LV function.
Self-Determination Theory With Application to Employee Health Settings
Authors: Ross Brenda M. , Barnes Donelle M.
Published: January 2018

Occupational health nurses motivate employees to engage in healthy behaviors. Both clinicians and researchers need strong theories on which to base decisions for health programs (e.g., healthy diet) and experimental interventions (e.g., workplace walking). The self-determination theory could be useful as it includes concepts of individual autonomy, competence to perform healthy behaviors, and relationships as predictors of health behaviors and outcomes. In this article, the self-determination theory is described and evaluated using Walker and Avant’s criteria. The theory is applied to a population of federal employees who smoke. By increasing employees’ ability to autonomously choose smoking cessation programs, support their competence to stop smoking, and improve their relationships with both others who smoke and employee health services, smoking cessation should increase.
Divergent Pathways on the Road to Sustainability: A Multilevel Model of the Effects of Geopolitical Power on the Relationship between Economic Growth and Environmental Quality
Authors: Greiner Patrick Trent , McGee Julius Alexander
Published: January 2018

The authors examine the effect of a country’s placement in the world system in 1960 on its ability to use wealth to mitigate environmental impacts. They use random-coefficients models to examine if countries belonging to core, semiperiphery, and periphery categories are able to use growth in gross domestic product (GDP) per capita to reduce CO2 emissions per capita. The findings indicate that core nations have an attenuated relationship between GDP per capita and carbon dioxide emissions per capita at higher levels of economic activity. However, nations in the semiperiphery have a relationship between GDP per capita and CO2 per capita that approximates the curve of a U. Furthermore, the authors highlight the ability of random-coefficients models to examine which levels of analysis variation in the dependent variable is most associated with. They find that the majority of variation in CO2 emissions is correlated with time-invariant variables, not with time-variant predictors, such as GDP.
Reimagining Discipleship: The Lisu Life–Rhythm of Shared Christian Practices
Authors: Arrington Aminta
Published: January 2018

The Lisu people of southwest China have reimagined Christian discipleship to emphasize various shared practices. Lisu Christian practices, such as singing hymns together, attending Christian festivals, abstaining from smoking and drinking alcohol, interceding for one another in prayer, and greeting one another with the traditional salutation and handshake, are less personal and more communal, less inward and more outward, less emotional and more embodied. Embedded in every practice are meaning, significance, and worldview; the practices are not empty. This article shows how Lisu Christians have transformed their faith into a life rhythm of practice–oriented discipleship appropriate for the agrarian context of this communal people.
On-the-Go Settlements: Understanding Urban Informality Through Its Digital Substructure
Authors: Janu Swati
Published: January 2018

This article investigates the digital networks within informal settlements in Delhi through an ethnographic and practice-based research methodology. 1 By studying top-up and media consumption at the ubiquitous phone recharge shop and uncovering the persistence of video game parlours in squatter settlements, the article presents the subversive, low-tech nature of this digital nexus. It looks at the parallels and intersections between the networked realities of these technologies and the alternative model of urbanism offered by the informally built areas where they thrive.
Looking Strategically to the Future of Restaurants: Casual Dining or Fast Casual?
Authors: Dixon Deirdre P. , Miscuraca Jill A. , Koutroumanis Dean A.
Published: January 2018

The partners of Clean Eating stood outside of their newly launched restaurant, gazing upon the long line of guests waiting to enter the newest fast casual restaurant concept to open for business in Jacksonville, FL. The concept had generated a great deal of media “buzz” due to its core competency of sourcing and serving all natural and fresh ingredients. The partners’ first concept, Fresh Mexican, a casual dining restaurant, had been a successful venture for 20 plus years. Fresh Mexican had sustained year to year growth and had been consistently profitable. The focus of the case centered on the owners’ strategic and financial analysis as well as leadership process in determining the future direction of their company. Should the partners expand their successful full service restaurant concept or continue the development and growth of their new fast casual restaurant concept? Students will explore the robust entrepreneurial, strategic, and financial constructs typically faced by growing enterprises. The case is appropriate for both undergraduate and graduate level courses in entrepreneurship and strategy. The situations described in the case were based on actual events. The names of the restaurants, parties involved, and location have been altered to preserve anonymity.
Correcting source and receiver scaling for virtual source imaging and monitoring
Authors: Bakulin Andrey , Alexandrov Dmitry , Saragiotis Christos , Al Ramadan Abdullah , Kashtan Boris
Published: January 2018

Virtual source redatuming is a data-driven interferometric approach that relies on constructive and destructive interference, and as a result it is quite sensitive to input seismic trace amplitudes. Land surveys are prone to amplitude changes that are unrelated to subsurface geology (source/receiver coupling, etc.). We have determined that such variations may be particularly damaging to construct a virtual-source signal for imaging and seismic monitoring applications, and they need to be correctly compensated before satisfactory images, repeatability, and proper relative amplitudes are achieved. We examine two methods to correct for these variations: a redatuming approach based on multidimensional deconvolution and multisurvey surface-consistent (SC) scaling. Using synthetic data, we discover that the first approach can only balance time-dependent variations between repeat surveys, e.g., compensate for variable shot scaling. In contrast, a multisurvey SC approach can compensate for shot and receiver scaling within each survey and among the surveys. As a result, it eliminates redatuming artifacts, brings repeat surveys to a common amplitude level, while preserving relative amplitudes required for quantitative interpretation of 4D amplitude differences. Applying an SC approach to a land time-lapse field data set with buried receivers from Saudi Arabia, we additionally conclude that separate SC scaling of early arrivals and deep reflections may produce better image and repeatability. This is likely due to the significantly different frequency content of early arrivals and deep reflections.
Words matter: after more than a century ‘schizophrenia’ needs rebranding
Authors: Lasalvia Antonio
Published: January 2018

Professionals, patients and patient organisations have advocated for the renaming of ‘schizophrenia’, seeing the term as misleading, stigmatising and a barrier to specialised care. In countries where a name change has occurred (e.g. Japan), the advantages of renaming seem to far outweigh disadvantages. Nevertheless, a name change would be a long and complex process that would not be useful if it were not accompanied by parallel changes in legislation, services and the education of professionals and the public.

DECLARATION OF INTEREST

None.
Effect of singing interventions on symptoms of postnatal depression: three-arm randomised controlled trial
Authors: Fancourt D. , Perkins R.
Published: January 2018

This study assessed whether a novel psychosocial intervention could reduce symptoms of postnatal depression (PND) in the first 40 weeks post-birth. Analyses were carried out of 134 mothers with symptoms of PND randomised into 10 weeks of group singing workshops or group play workshops for them and their babies, or usual care (trial registration: NCT02526407). Overall, among all mothers with symptoms of PND, there was a non-significant faster improvement in symptoms in the singing group (F4,262 = 1.66, P = 0.16, η2 = 0.012). When isolating mothers with moderate–severe symptoms of PND, this result became significant, with a faster improvement in symptoms in the singing group (F3.9,139.8 = 2.74, P = 0.033, η2 = 0.028).

Declaration of interest

None.
Unchaining people with mental disorders: medication is not the solution
Authors: Patel Vikram , Bhui Kamaldeep
Published: January 2018

Chaining of people with mental disorders, and their incarceration and abuse in prisons or mental hospitals, is an affront to psychiatry and humanity. Although mental healthcare always needs attention to cultural and social contexts, this must never be at the cost of allowing human rights violations to go unchallenged. A rights-based approach must enforce well-established international human rights conventions, and scale-up comprehensive community services around the needs and preferences of people affected by mental disorders.

Declaration of interest

None.

Copyright and usage

© The Royal College of Psychiatrists 2018.
Substance use and misuse in psychiatric wards
Authors: Williams Richard , Cohen Jeff
Published: January 2018

Substance use has reached endemic proportions. Inevitably, the world of psychiatric wards must reflect issues arising in our society. Given that the populations of psychiatric wards are disproportionately younger, male and socially disadvantaged (quite apart from the impact of patients' problems that prompt admission), one might expect that drug misuse in them would match, if not outstrip, the general trend. Recognition of its impact is a key issue for patients and staff alike.
Triage: a waiting list initiative in a child mental health service
Authors: Jones Elizabeth , Lucey Clare , Wadland Liz
Published: January 2018

Aims and Method

Long waiting lists and failure to attend appointments are a common problem in child and adolescent psychiatry. We introduced a novel ‘triage’ stage waiting list initiative to decrease the long waiting time fora first appointment at our child mental health service.

Results

The waiting time to first appointment was significantly reduced and increased satisfaction with this process was expressed by clinicians, the referred families and referrers.

Clinical Implications

The reduction in waiting time was sustained over time and the triage process has now been implemented as routine practice. Following this implementation, there is no longer a lengthy waiting list for treatment after initial assessment. We would recommend this initiative, which screened referrals more efficiently and accurately, as a successful model for other child and adolescent services with long waiting lists.
Part-time training: will it lead to part-time consultant?
Authors: Caswell Lucy , Lowe Kate
Published: January 2018

Aims and Method

To determine the preference of flexible trainees in psychiatry for consultant posts. A questionnaire survey was conducted among all flexible trainees in psychiatry in the West Midlands Region.

Results

The overall response rate was 19 out of 21 (90%). The majority 15 out of 19 (68%) hoped to gain such a post at the end of their training. Of those wanting a consultant post, 15 of the 19 (79%) would only consider working part-time. If such a parttime consultant post was not available, 12 of the15 (80%) said they would considera non-career grade post.

Clinical Implications

In the West Midlands Region there has been an exponential growth in the number of flexible trainees. Approximately a third are within psychiatry alone and most wish to continue flexible working patterns as consultants. This has major workforce planning implications for the future.
Use of Section 5(2) in clinical practice
Authors: Pourgourides Christina , Prasher V. P. , Oyebode Femi
Published: January 2018

The Mental Health Act (1983) came into being eight years ago but few studies into its use have been reported (West, 1987; Sackett, 1987). The Act provided for the setting up of the Mental Health Act Commission to safeguard the interests of detained patients and to monitor the use of the Act. The Commission visits ordinary psychiatric hospitals on an annual basis and writes a report of the visit. The Commission also submits a Biennial Report to Parliament. These reports address important issues but do not provide detailed information on the use of the various sections of the Act in differing hospitals.
Can psychiatrists predict which new referrals will fail to attend?
Authors: Woods Jonathan P.
Published: January 2018

It is not uncommon to hear a psychiatrist claim to be able to judge from general practitioners' letters which new referrals will attend and which will fail to turn up. However operational research has failed to define clear characteristics of patients who do not keep first appointments (Hillis and Alexander, 1990; Skuse, 1975; Zegleman, 1988). Also the standard of referral letters has been criticised in the past and shown more recently to omit key items of information (Pullen & Yellowlees, 1985). The aim of this study is to test the ability of psychiatrists of varying experience to predict non-attenders.
Medical Certificates
Authors: Lutwidge R. W. S.
Published: January 2018

Instructions.—Every medical certificate most be according to the subjoined form,∗ prescribed by the “Lunatics Care and Treatment,” and “Lunatic Asylums” Acts, 1853.
Observations on Cholera,
Authors: Boyd Robt.
Published: January 2018

“He came, he went, like the simoon, That harbinger of fate and gloom, Beneath whose widely-wasting breath, The very cypress droops to death.’'—Byron.

The frequent occurrence of Cholera, in different parts of the United Kingdom, of late years, and its prevalence at present, secms to point out the necessity of our being prepared for its appearance, particularly in public institutions, and amongst others, Lunatic Asylums, which in some instances have suffered severely from this disease. In the West Riding of York Asylum, containing 633 patients, 98 are reported to have died from cholera in the autumn of 1849. The private asylums for pauper lunatics generally about London and in some other places, suffered more or less from the same epidemic; whether from cholera or some other cause, the mortality in the Lancaster Asylum was unusually high, 48 per cent in 1833, according to “a table of patients admitted, &c,” in the annual reports of that institution.
Notice of the Eighth Report of the Commissioners in Lunacy,
Authors: Conolly John
Published: January 2018

The Commissioners in Lunacy have done great service to the public by drawing up their Eighth Report to the Lord Chancellor, and especially by publishing the answers received to their circular enquiring particularly into the employment or disuse of instrumental restraint or seclusion.
Report of the Meerenberg Asylum for 1852–3
Authors: Tuke D. H.
Published: January 2018

It has afforded us great pleasure to receive a Report of the Asylum of Meerenberg (North Holland) for 1852–3; and, as we believe but few of our readers are acquainted with this excellent establishment, we propose to lay before them the most important information contained in it. To those who already know something of this asylum, a few extracts from the Report before us will also be interesting.
On the Statistics of County Asylums,
Authors: Parsey W.
Published: January 2018

From the last Report of the Commissioners in Lunacy I have calculated the rates of recovery and mortality in the different county asylums, so as to obtain a mean average for the five years over which their enquiries in Appendix (H) extend. The results may be thought interesting to many readers of the Asylum Journal, who have not leisure or inclination to go through the detail of such matters for themselves.
On the Employment of Seclusion in the Treatment of the Insane,
Authors: Bucknill J. C.
Published: January 2018

The witty Brillat Savarin wrote: “Quand j'écris et parle de moi an singulier, cela suppose une confabulation avec la lecteur; il pent examiner, discuter, douter et même rire; mais quand je m'arme du redoutable nouz je professe, il faut se soumettre.” Physiologie du Gout.
Health, Work, and Play; Suggestions
Authors: Acland Henry W. , Robertson C. Lockhart
Published: January 2018

A distinguished member of this Association opens the Sixteenth Annual Report ∗ of his quiet unobtrusive labours with the remark that the opinion that mental disease is becoming more prevalent has been universally adopted, and that it is confirmed by the experience of all who have to deal with the crimes, the misfortunes, the diseases of mankind, by the observation of all who watch the progress either of individuals or nations.
On the various Forms of Mental Disorder, (being the substance of Lectures delivered at the York School of Medicine,)
Authors: Tuke Daniel H.
Published: January 2018

The Forms of insanity hitherto described have been regarded as naturally referrible to the first class, that, namely, of mental disorders involving the intellect. I now pass on to the consideration of those of the second class, that which comprises the disorders of the moral sentiments. I reserve for a future occasion, some remarks on the distinction between this group of diseases, and that comprehended under the third division, or disorders of the animal propensities.
Observations on Epilepsy
Authors: Boyd Robert
Published: January 2018

In a former number of this Journal (15) instances where Convulsions had occurredamongst patients, not epileptics, in this asylum were given. Nine cases attended with convulsions have also been recorded. by me in the Edmburql: Medical Journal.” of which three were adults and six infants. Congestion of blood in the brain was found in three of the infants, effusion of blood in one, fluid in the ventricles it) one, and enlarged brain in one; the foramen ovale and ductus arteriosus of the heart were open in one. In the male adult there was general dropsy, and the heart kidneys and liver were enlarged; convulsions preceded death; and in the two female adults convulsions were symptomatic of suppression of urine in one and of Bright's kidneys in the other. Instances of convulsions aye frequent in cases of general paralysis, in cases of melancholia, especially where it is combined with pulmon- ary phthisis; and also, but much Jess frequently, in mania; and these convulsions it is sometimes very difficult to distinguish from epilepsy.
Flemish Interiors, by the writer of “A Glance behind the Grilles.” Longmans, 1856
Authors: Robertson C. Lockhart
Published: January 2018

Notes on Belgian Lunatic Asylums, by John Webster, M.D., F.R.S. Part I. Journal of Psychological Medicine, January, 1857.

A small volume styled “Flemish Interiors,” being notes of a tour of religious enquiry through Belgium, written by some recent convert to the Roman system, is a very readable book, and contains some interesting observations on the establishments for the insane, under the care of the religious orders in Belgium. These observations we were led to compare with a paper by Dr. Webster, in the present number of the “Psychological -Ioumal,” on the lunatic Asylums of Relgium; and the contrast between the hard dry facts of the man of science, and the bright colours which the religious votary throws over the same scenes, seemed to us worthy of being brought out in our pages.
On the Use of Opium in the Treatment of Insanity
Authors: Noble Daniel
Published: January 2018

Of all the available resources of the Materia Medica, opium, in its beneficial efficacy, is probably surpassed by none. It calms irritability, it soothes pain, it assuages spasm, and restores sleep. And when, in the course of disease, these indications have to be fulfilled, there is no drug like opium upon which we can place such uniform reliance. It is no wonder, then, that its advantages have been solicited, and realised, in the practice of psychological medicine.
Tumor-Specific T-Cells Engineered to Overcome Tumor Immune Evasion Induce Clinical Responses in Patients With Relapsed Hodgkin Lymphoma
Authors: Bollard Catherine M. , Tripic Tamara , Cruz Conrad Russell , Dotti Gianpietro , Gottschalk Stephen , Torrano Vicky , Dakhova Olga , Carrum George , Ramos Carlos A. , Liu Hao , Wu Meng-Fen , Marcogliese Andrea N. , Barese Cecilia , Zu Youli , Lee Daniel Y. , O’Connor Owen , Gee Adrian P. , Brenner Malcolm K. , Heslop Helen E. , Rooney Cliona M.
Published: January 2018

Purpose

Transforming growth factor-β (TGF-β) production in the tumor microenvironment is a potent and ubiquitous tumor immune evasion mechanism that inhibits the expansion and function of tumor-directed responses; therefore, we conducted a clinical study to discover the effects of the forced expression of a dominant-negative TGF-β receptor type 2 (DNRII) on the safety, survival, and activity of infused tumor-directed T cells.

Materials and Methods

In a dose escalation study, eight patients with Epstein Barr virus–positive Hodgkin lymphoma received two to 12 doses of between 2 × 107 and 1.5 × 108 cells/m2 of DNRII-expressing T cells with specificity for the Epstein Barr virus–derived tumor antigens, latent membrane protein (LMP)-1 and LMP-2 (DNRII-LSTs). Lymphodepleting chemotherapy was not used before infusion.

Results

DNRII-LSTs were resistant to otherwise inhibitory concentrations of TGF-β in vitro and retained their tumor antigen–specific activity. After infusion, the signal from transgenic T cells in peripheral blood increased up to 100-fold as measured by quantitative polymerase chain reaction for the transgene, with a corresponding increase in the frequency of functional LMP-specific T cells. Expansion was not associated with any acute or long-term toxicity. DNRII-LSTs persisted for up to ≥ 4 years. Four of the seven evaluable patients with active disease achieved clinical responses that were complete and ongoing in two patients at > 4 years, including in one patient who achieved only a partial response to unmodified tumor-directed T cells.

Conclusion

TGF-β–resistant tumor-specific T cells safely expand and persist in patients with Hodgkin lymphoma without lymphodepleting chemotherapy before infusion. DNRII-LSTs can induce complete responses even in patients with resistant disease. Expression of DNRII may be useful for the many other tumors that exploit this potent immune evasion mechanism.
Drosophila female-specific Ilp7 motoneurons are generated by Fruitless-dependent cell death in males and by a double-assurance survival role for Transformer in females
Authors: Garner Sarah Rose C. , Castellanos Monica C. , Baillie Katherine E. , Lian Tianshun , Allan Douglas W.
Published: January 2018

Female-specific Ilp7 neuropeptide-expressing motoneurons (FS-Ilp7 motoneurons) are required in Drosophila for oviduct function in egg laying. Here, we uncover cellular and genetic mechanisms underlying their female-specific generation. We demonstrate that programmed cell death (PCD) eliminates FS-Ilp7 motoneurons in males, and that this requires male-specific splicing of the sex-determination gene fruitless (fru) into the FruMC isoform. However, in females, fru alleles that only generate FruM isoforms failed to kill FS-Ilp7 motoneurons. This blockade of FruM-dependent PCD was not attributable to doublesex gene function but to a non-canonical role for transformer (tra), a gene encoding the RNA splicing activator that regulates female-specific splicing of fru and dsx transcripts. In both sexes, we show that Tra prevents PCD even when the FruM isoform is expressed. In addition, we found that FruMC eliminated FS-Ilp7 motoneurons in both sexes, but only when Tra was absent. Thus, FruMC-dependent PCD eliminates female-specific neurons in males, and Tra plays a double-assurance function in females to establish and reinforce the decision to generate female-specific neurons.
The G protein-coupled receptor Gpr161 regulates forelimb formation, limb patterning and skeletal morphogenesis in a primary cilium-dependent manner
Authors: Hwang Sun-hee , White Kevin A. , Somatilaka Bandarigoda N. , Shelton John M. , Richardson James A. , Mukhopadhyay Saikat
Published: January 2018

The role of basal suppression of the sonic hedgehog (Shh) pathway and its interaction with Indian hedgehog (Ihh) signaling during limb/skeletal morphogenesis is not well understood. The orphan G protein-coupled receptor Gpr161 localizes to primary cilia and functions as a negative regulator of Shh signaling by promoting Gli transcriptional repressor versus activator formation. Here, we show that forelimb buds are not formed in Gpr161 knockout mouse embryos despite establishment of prospective limb fields. Limb-specific deletion of Gpr161 resulted in prematurely expanded Shh signaling and ectopic Shh-dependent patterning defects resulting in polysyndactyly. In addition, endochondral bone formation in forearms, including formation of both trabecular bone and bone collar was prevented. Endochondral bone formation defects resulted from accumulation of proliferating round/periarticular-like chondrocytes, lack of differentiation into columnar chondrocytes, and corresponding absence of Ihh signaling. Gpr161 deficiency in craniofacial mesenchyme also prevented intramembranous bone formation in calvarium. Defects in limb patterning, endochondral and intramembranous skeletal morphogenesis were suppressed in the absence of cilia. Overall, Gpr161 promotes forelimb formation, regulates limb patterning, prevents periarticular chondrocyte proliferation and drives osteoblastogenesis in intramembranous bones in a cilium-dependent manner.
Towards stem cell based therapies for Parkinson's disease
Authors: Parmar Malin
Published: January 2018

Treating neurodegenerative diseases with cell transplantation has been within reach since the first pioneering clinical trials in which dopamine neuron progenitors from the fetal brain were transplanted to individuals with Parkinson's disease. However, the use of fetal tissue is problematic in terms of low availability and high variability, and it is also associated with ethical concerns that vary between countries. For decades, the field has therefore investigated new scalable source of therapeutic cells from stem cells or via reprogramming. Now it is possible to generate authentic midbrain dopaminergic neurons from pluripotent stem cells and clinical trials using such cells are rapidly approaching.