bluuebunny/crossref_metadata_2025 huggingface dataset:
A quasi-experimental evaluation of dried blood spot testing through community pharmacies in the Tayside region of Scotland
Authors: Radley Andrew , Melville Karen , Tait Jan , Stephens Brian , Evans Josie M M , Dillon John F
Published: January 2017

Objective

Comparison of uptake of dried blood spot testing (DBST) for hepatitis C virus (HCV) infection between community pharmacies and established services.

Design

Quantitative evaluation of a service development with qualitative process evaluation undertaken in parallel.

Setting

Six pharmacies from 36 community pharmacies within Dundee City, a large urban settlement with high levels of socioeconomic deprivation.

Participants

Patients in receipt of opioid substitution therapy (OST) not tested for HCV within 12 months. The 6 pharmacies provided OST for approximately 363 patients from a cohort of 1385 patients within Dundee City.

Intervention

Provision of DBST by pharmacists.

Main outcome measure

Receipt of DBST between January and December 2014.

Results

43 of 143 service users with no record of testing from the 6 community pharmacies accepted DBST. Of 561 from the remaining 1022 service users with no record of testing, 75 were tested for HCV (30% vs 13%). The OR for increased uptake of testing within the 6 pharmacies was 2.25 (95% CI 1.48 to 3.41, Z statistic=3.81, p=<0.0001) compared with other services. The DBST taken by the pharmacies provided 12 patients with a reactive test. The process evaluation identified key themes important to staff and recipients of the service. A logic model was constructed.

Limitations

Non-experimental service evaluation performed in community pharmacies records service activity in one location across a single time period.

Interpretation

Some evidence that DBST from community pharmacies may be feasible. Service users received the service positively. Staff reported that DBST was straightforward and achievable.
Intravenous thrombolysis before endovascular therapy for large vessel strokes can lead to significantly higher hospital costs without improving outcomes
Authors: Rai Ansaar T , Boo SoHyun , Buseman Chelsea , Adcock Amelia K , Tarabishy Abdul R , Miller Maurice M , Roberts Thomas D , Domico Jennifer R , Carpenter Jeffrey S
Published: January 2017

Background

Limited efficacy of IV recombinant tissue plasminogen activator (rt-PA) for large vessel occlusions (LVO) raises doubts about its utility prior to endovascular therapy.

Purpose

To compare outcomes and hospital costs for anterior circulation LVOs (middle cerebral artery, internal carotid artery terminus (ICA-T)) treated with either primary endovascular therapy alone (EV-Only) or bridging therapy (IV+EV)).

Methods

A single-center retrospective analysis was performed. Clinical and demographic data were collected prospectively and relevant cost data were obtained for each patient in the study.

Results

90 consecutive patients were divided into EV-Only (n=52) and IV+EV (n=38) groups. There was no difference in demographics, stroke severity, or clot distribution. The mean (SD) time to presentation was 5:19 (4:30) hours in the EV-Only group and 1:46 (0:52) hours in the IV+EV group (p<0.0001). Recanalization: EV-Only 35 (67%) versus IV+EV 31 (81.6%) (p=0.12). Favorable outcome: EV-Only 26 (50%) versus IV+EV 22 (58%) (p=0.45). For patients presenting within 4.5 hours (n=64): Recanalization: EV-Only 21/26 (81%) versus IV+EV 31/38 (81.6%) (p=0.93). Favorable outcome: EV-Only 14/26 (54%) versus IV+EV 22/38 (58%) (p=0.75). There was no significant difference in rates of hemorrhage, mortality, home discharge, or length of stay. A stent retriever was used in 67 cases (74.4%), with similar recanalization, outcomes, and number of passes in the EV-Only and IV+EV groups. The mean (SD) total hospital cost was $33 810 (13 505) for the EV-Only group and $40 743 (17 177) for the IV+EV group (p=0.02). The direct cost was $23 034 (8786) for the EV-Only group and $28 711 (11 406) for the IV+EV group (p=0.007). These significantly higher costs persisted for the subgroup presenting in <4.5 hours and the stent retriever subgroup. IV rt-PA administration independently predicted higher hospital costs.

Conclusions

IV rt-PA did not improve recanalization, thrombectomy efficacy, functional outcomes, or length of stay. Combined therapy was associated with significantly higher total and direct hospital costs than endovascular therapy alone.
Wire escalation in emergent revascularization procedures of internal carotid artery occlusions: the use of high tip stiffness microguidewires
Authors: Cohen José E , Leker Ronen R , Gomori John M , Itshayek Eyal
Published: January 2017

Objective

We examined the usefulness and safety of high tip stiffness cardiac microguidewires in the endovascular revascularization of selected cases of internal carotid artery (ICA) occlusion.

Methods

Files of patients with acute ischemic symptoms due to ICA occlusions managed from August 2010 to August 2016 by urgent endovascular revascularization were retrospectively reviewed with a waiver of informed consent. Cases where there was escalation to stiff tipped cardiovascular microguidewires after at least two failed attempts to cross the carotid occlusion with standard neuro-microguidewires were included. Radiological and interventional data were recorded.

Results

63 patients with acute carotid occlusions underwent emergent endovascular revascularization in the study period; 5/63 patients met the inclusion criteria. In 4/5 patients, there was no angiographic evidence of the remnant origin of the ICA; in 1/5 there was a wide round shaped proximal calcified cap that precluded soft guidewire entry. In all cases, antegrade wiring was achieved only after switching to stiffer guidewires designed for the management of chronic cardiac occlusions. The use of these stiffer tip wires was considered of critical importance in achieving the successful performance of the ICA revascularization procedure. In all patients, revascularization was achieved, and 90 day modified Rankin Scale score ranged from 0 to 2.

Conclusions

When regular neuro-guidewires do not allow antegrade wiring in cases of ICA occlusion, wire escalation to high tip stiffness guidewires may improve success. These wires, designed to deal with chronic total coronary occlusions, can serve as a platform for new neuro-guidewires to be used in the challenging field of resistant supra-aortic occlusions.
Posterior circulation perforator aneurysms: a proposed management algorithm
Authors: Buell Thomas J , Ding Dale , Raper Daniel M S , Chen Ching-Jen , Hixson Harry R , Crowley R Webster , Evans Avery J , Jensen Mary E , Liu Kenneth C
Published: January 2017

Introduction

Subarachnoid hemorrhage (SAH) from posterior circulation perforator aneurysms (PCPAs) is rare and its natural history is unknown. Diagnosis may be difficult, acute management is poorly defined, and long-term recurrent SAH rates and clinical outcome data are lacking.

Methods

We searched our institution's records for cases of PCPA rupture and analyzed patient demographics, Hunt and Hess (HH) grades, diagnostic imaging, management, and clinical outcomes. We conducted telephone interviews to calculate modified Rankin Scale (mRS) scores.

Results

We identified 9 patients (6 male, 3 female) with a ruptured PCPA who presented to the University of Virginia Health System (Charlottesville, VA, USA) between 2010 and 2016. Median and mean ages were 62 and 63 years, respectively. Median HH grade was 3. Seven of nine (78%) PCPAs were angiographically occult on initial imaging and median time to diagnosis was 5 days. Three conservatively managed patients had a mean mRS score of 0.67 (range 0–1) at mean follow-up of 35.3 months. Antifibrinolytic therapy was administered to all conservatively managed patients without thrombotic complication. Six patients receiving endovascular treatment had a mean mRS score of 2.67 (range 0–6) at mean follow-up of 49.2 months. No cases of recurrent SAH were seen in the study.

Conclusions

The rarity of PCPA has precluded long-term clinical follow-up until now. Our experience suggests low recurrent SAH rates. Until further studies are performed, conservative management, possibly combined with antifibrinolytic therapy, may be a viable treatment with acceptable long-term outcome.
The performance of the Alere HIV combo point-of-care test on stored serum samples; useful for detection of early HIV-1 infections?
Authors: van Tienen Carla , Rugebregt Sharona , Scherbeijn Sandra , Götz Hannelore , Geurts van Kessel Corine
Published: January 2017

Introduction

The Alere HIV-1/2 Antigen/Antibody Combo point-of-care test is a commercially available 4th-generation rapid test for the diagnosis of HIV infection, including acute infection. We evaluated the sensitivity of this test in samples from patients with acute, recent or chronic HIV-1 infection.

Methods

A validation of the test was performed using 89 HIV-positive serum samples collected in 2008–2016, that were stored at −20°C. Twenty-three samples were only p24-positive (acute infection); 49 samples were antibody-positive and p24-positive (recent infection); 17 samples were only antibody-positive (chronic infection). HIV infection was confirmed by standard-of-care assays and PCR. Samples came from patients attending an outpatient clinic for STDs at the Public Health Department and from patients within the Erasmus Medical Center, Rotterdam, the Netherlands.

Results

The overall sensitivity of the test for diagnosing HIV infection based on detection of p24 antigen and/or antibodies was 92% (95% CI 86% to 98%) (82/89). In acute sera with only p24 antigen positivity, the sensitivity of the test decreased to 65% (95% CI 46% to 85%) (15/23). When both antibody and antigen testing were positive, the p24 sensitivity was only 24% (95% CI 12% to 36%) (12/49), but in these sera the final test result was positive in all sera (49/49) due to the positive antibody component.

Conclusions

In a laboratory setting, this test has an overall sensitivity of 92% to detect any stage of HIV-1 infection using sera specimens. It performs relatively well in detecting early HIV and may be beneficial as an initial screening in patients with a recent exposure to HIV. Additional testing in a laboratory setting remains mandatory as a proportion of acute HIV-1 infections are missed with this test.
Seroprevalence and risk factors of exposure to caprine arthritis‐encephalitis virus in southern Spain
Authors: Barrero Domínguez B. , Luque I. , Maldonado A. , Huerta B. , Sánchez M. , Gomez Laguna J. , Astorga R.
Published: January 2017

The aim of the present transversal descriptive study was to determine the exposure and risk factors associated with caprine arthritis‐encephalitis virus (CAEV) in southern Spain. A total of 3,312 serum samples were collected from goat belonging to three different breeds coming from 48 flocks located in different geographic areas from southern Spain. In addition, health and productive parameters were surveyed during the visit to the herds. Serum samples were analysed by INgezim Maedi Screening (Ingenasa®) ELISA kit. The total percentage of herds exposed to CAEV was 87.71% (CI95 78.42–97.00). A total of 733 goats were seropositive with overall seroprevalence of 23.22% (CI95 21.78–24.65). The intraherd seroprevalence was 20.82%±24.07. Multivariate logistic regression showed significant association between CAEV and the next variables: (i) herd size (P<0.0001; OR: 2.07; CI95: 1.73–2.50), (ii) kidding area (P<0.0020; OR: 1.38; CI95: 1.13–1.69), (iii) cleaning and disinfection program (P<0.0067; OR: 1.90; CI95: 1.43–2.53), (iv) natural mating (P<0.0026; OR: 2.22; CI95: 1.73–2.86) and (v) multiparous (P<0.0001; OR: 2.90; CI95: 2.17–3.87). The results indicate a widespread of CAEV in goat herds in southern Spain, with herd size, existence of kidding area, absence of a cleaning and disinfection programme, natural mating and multiparous goats being risk factors for exposure to CAEV.
Phenobarbital administration every eight hours: improvement of seizure management in idiopathic epileptic dogs with decreased phenobarbital elimination half‐life
Authors: Stabile F. , Barnett C. R. , De Risio L.
Published: January 2017

Estimated prevalence of canine idiopathic epilepsy is 0.6 per cent in the first‐opinion canine population in the UK. Phenobarbital monotherapy has been reported to reduce/eradicate seizure activity in 60–93 per cent of idiopathic epileptic dogs (IEDs). The objective of this study was to evaluate safety and efficacy of the administration of phenobarbital orally every eight hours in IEDs with phenobarbital elimination half‐life less than 20 hours. Medical records of 10 IEDs in which steady state trough serum phenobarbital levels were within the reference range and phenobarbital elimination half‐life had become less than 20 hours following prolonged administration every 12 hours were reviewed. Side effects and seizure frequency when phenobarbital was administered every 12 hours or 8 hours were compared. In all dogs the side effects of the antiepileptic medication treatment improved. When phenobarbital was administered every eight hours, 9/10 dogs experienced improvement in seizure frequency and 8/10 dogs maintained seizure freedom for a period three times longer than the longest interictal interval period previously recorded. Reduction in the severity and number of clusters of seizures was recorded in one of the remaining two dogs. The administration of phenobarbital orally every eight hours in IEDs with decreased phenobarbital elimination half‐life appears safe and can improve seizure management. The results of this study were presented in abstract form (poster) for the 28th symposium of the European Society of Veterinary Neurology – European College of Veterinary Neurology (ESVN), September 18–19, 2015, Amsterdam, Netherlands
Sex-specific effects of sex steroids on alveolar epithelial Na+ transport
Authors: Haase Melanie , Laube Mandy , Thome Ulrich H.
Published: January 2017

Alveolar fluid clearance mediates perinatal lung transition to air breathing in newborn infants, which is accomplished by epithelial Na+ channels (ENaC) and Na-K-ATPase. Male sex represents a major risk factor for developing respiratory distress, especially in preterm infants. We previously showed that male sex is associated with reduced epithelial Na+ transport, possibly contributing to the sexual dimorphism in newborn respiratory distress. This study aimed to determine sex-specific effects of sex steroids on epithelial Na+ transport. The effects of testosterone, 5α-dihydrotestosterone (DHT), estradiol, and progesterone on Na+ transport and Na+ channel expression were determined in fetal distal lung epithelial (FDLE) cells of male and female rat fetuses by Ussing chamber and mRNA expression analyses. DHT showed a minor effect only in male FDLE cells by decreasing epithelial Na+ transport. However, flutamide, an androgen receptor antagonist, did not abolish the gender imbalance, and testosterone lacked any effect on Na+ transport in male and female FDLE cells. In contrast, estradiol and progesterone increased Na+ transport and Na+ channel expression especially in females, and prevented the inhibiting effect of DHT in males. Estrogen receptor inhibition decreased Na+ channel expression and eliminated the sex differences. In conclusion, female sex steroids stimulate Na+ transport especially in females and prevent the inhibitory effect of DHT in males. The ineffectiveness of testosterone suggests that Na+ transport is largely unaffected by androgens. Thus, the higher responsiveness of female cells to female sex steroids explains the higher Na+ transport activity, possibly leading to a functional advantage in females.
Plasma membrane wounding and repair in pulmonary diseases
Authors: Cong Xiaofei , Hubmayr Rolf D. , Li Changgong , Zhao Xiaoli
Published: January 2017

Various pathophysiological conditions such as surfactant dysfunction, mechanical ventilation, inflammation, pathogen products, environmental exposures, and gastric acid aspiration stress lung cells, and the compromise of plasma membranes occurs as a result. The mechanisms necessary for cells to repair plasma membrane defects have been extensively investigated in the last two decades, and some of these key repair mechanisms are also shown to occur following lung cell injury. Because it was theorized that lung wounding and repair are involved in the pathogenesis of acute respiratory distress syndrome (ARDS) and idiopathic pulmonary fibrosis (IPF), in this review, we summarized the experimental evidence of lung cell injury in these two devastating syndromes and discuss relevant genetic, physical, and biological injury mechanisms, as well as mechanisms used by lung cells for cell survival and membrane repair. Finally, we discuss relevant signaling pathways that may be activated by chronic or repeated lung cell injury as an extension of our cell injury and repair focus in this review. We hope that a holistic view of injurious stimuli relevant for ARDS and IPF could lead to updated experimental models. In addition, parallel discussion of membrane repair mechanisms in lung cells and injury-activated signaling pathways would encourage research to bridge gaps in current knowledge. Indeed, deep understanding of lung cell wounding and repair, and discovery of relevant repair moieties for lung cells, should inspire the development of new therapies that are likely preventive and broadly effective for targeting injurious pulmonary diseases.
Alcohol drivesS-nitrosylation and redox activation of protein phosphatase 1, causing bovine airway cilia dysfunction
Authors: Price Michael E. , Pavlik Jacqueline A. , Liu Miao , Ding Shi-Jian , Wyatt Todd A. , Sisson Joseph H.
Published: January 2017

Individuals with alcohol (ethanol)-use disorders are at increased risk for lung infections, in part, due to defective mucociliary clearance driven by motile cilia in the airways. We recently reported that isolated, demembranated bovine cilia (axonemes) are capable of producing nitric oxide (∙NO) when exposed to biologically relevant concentrations of alcohol. This increased presence of∙NO can lead to protein S-nitrosylation, a posttranslational modification signaling mechanism involving reversible adduction of nitrosonium cations or∙NO to thiolate or thiyl radicals, respectively, of proteins forming S-nitrosothiols (SNOs). We quantified and compared SNO content between isolated, demembranated axonemes extracted from bovine tracheae, with or without in situ alcohol exposure (100 mM × 24 h). We demonstrate that relevant concentrations of alcohol exposure shift the S-nitrosylation status of key cilia regulatory proteins, including 20-fold increases in S-nitrosylation of proteins that include protein phosphatase 1 (PP1). With the use of an ATP-reactivated axoneme motility system, we demonstrate that alcohol-driven S-nitrosylation of PP1 is associated with PP1 activation and dysfunction of axoneme motility. These new data demonstrate that alcohol can shift the S-nitrothiol balance at the level of the cilia organelle and highlight S-nitrosylation as a novel signaling mechanism to regulate PP1 and cilia motility.
The RAS–Effector Interaction as a Drug Target
Authors: Keeton Adam B. , Salter E. Alan , Piazza Gary A.
Published: January 2017

About a third of all human cancers harbor mutations in one of the K-, N-, or HRAS genes that encode an abnormal RAS protein locked in a constitutively activated state to drive malignant transformation and tumor growth. Despite more than three decades of intensive research aimed at the discovery of RAS-directed therapeutics, there are no FDA-approved drugs that are broadly effective against RAS-driven cancers. Although RAS proteins are often said to be “undruggable,” there is mounting evidence suggesting it may be feasible to develop direct inhibitors of RAS proteins. Here, we review this evidence with a focus on compounds capable of inhibiting the interaction of RAS proteins with their effectors that transduce the signals of RAS and that drive and sustain malignant transformation and tumor growth. These reports of direct-acting RAS inhibitors provide valuable insight for further discovery and development of clinical candidates for RAS-driven cancers involving mutations in RAS genes or otherwise activated RAS proteins. Cancer Res; 77(2); 221–6. ©2017 AACR.
A Conference of New Ideas in Cancer—Challenging Dogmas
Authors: Gandhi Varsha , Jalali Rakesh
Published: January 2017

In 2016, Tata Memorial Center in Mumbai, India, reached its platinum jubilee milestone (75 years), which was celebrated with conferences. The first of these was entitled, "A Conference of New Ideas in Cancer – Challenging Dogmas.” The aim of the conference was to take an honest appraisal about the state of cancer research today, to debate “currently entrenched versus contrarian viewpoints” and to reflect upon whether the current research and therapeutic strategies are appropriate and whether resources are being optimally utilized in meaningful ways. Below, we describe major highlights of this meeting. Cancer Res; 77(2); 234–7. ©2017 AACR.
Mutated Chromatin Regulatory Factors as Tumor Drivers in Cancer
Authors: Koschmann Carl , Nunez Felipe J. , Mendez Flor , Brosnan-Cashman Jacqueline A. , Meeker Alan K. , Lowenstein Pedro R. , Castro Maria G.
Published: January 2017

Genes encoding proteins that regulate chromatin structure and DNA modifications [i.e., chromatin regulatory factors (CRF)] and genes encoding histone proteins harbor recurrent mutations in most human cancers. These mutations lead to modifications in tumor chromatin and DNA structure and an altered epigenetic state that contribute to tumorigenesis. Mutated CRFs have now been identified in most types of cancer and are increasingly regarded as novel therapeutic targets. In this review, we discuss DNA alterations in CRFs and how these influence tumor chromatin structure and function, which in turn leads to tumorigenesis. We also discuss the clinical implications and review concepts of targeted treatments for these mutations. Continued research on CRF mutations will be critical for our future understanding of cancer biology and the development and implementation of novel cancer therapies. Cancer Res; 77(2); 227–33. ©2017 AACR.
Metastatic Melanoma Patient Had a Complete Response with Clonal Expansion after Whole Brain Radiation and PD-1 Blockade
Authors: Haymaker Cara L. , Kim DaeWon , Uemura Marc , Vence Luis M. , Phillip Ann , McQuail Natalie , Brown Paul D. , Fernandez Irina , Hudgens Courtney W. , Creasy Caitlin , Hwu Wen-Jen , Sharma Padmanee , Tetzlaff Michael T. , Allison James P. , Hwu Patrick , Bernatchez Chantale , Diab Adi
Published: January 2017

We report here on a patient with metastatic melanoma who had extensive brain metastases. After being treated with the sequential combination of whole brain radiation therapy followed by the PD-1–inhibitory antibody, pembrolizumab, the patient had a durable complete response. Retrospective laboratory studies of T cells revealed that, after treatment with anti-PD-1 commenced, effector CD8+ T cells in the blood expanded and the ratio of CD8+:Treg T cells increased. A CD8+ T-cell clone present in the initial brain metastases was expanded in the blood after anti-PD-1 treatment, which suggested an antitumor role for this clone. Immunohistochemical analysis confirmed the presence of CD8+ T cells and low PD-L1 expression in the brain metastases before immunotherapy initiation. This sequence of therapy may provide an option for melanoma patients with unresponsive brain metastases. Cancer Immunol Res; 5(2); 100–5. ©2017 AACR.
Performance Analysis of Quantized Feedback JLS Precoder in CoMP transmission
Authors: Fahmy Yasmine
Published: January 2017

Joint Processing (JP) in Coordinated Multi-Point (CoMP) transmission allows user data to be jointly processed by several interfering base stations to achieve high performance and large capacity gain. This is achieved by making use of timing advance mechanisms; to ensure that the desired signals from the cooperating cells reach the mobile station at exactly the same time. The Joint Leakage Suppression (JLS) precoder is a suitable linear precoding scheme in this scenario. In this paper, JLS performance analysis is considered under real assumptions such as the presence of asynchronous reception of the interfering signals and the effect of the finite capacity backhaul links. The effect of quantizing the feedback channel on the sum rate is derived, and a tight upper bound of the rate loss due to quantization is obtained. Simulation results are provided to validate these results.
Hierarchical mask creation for intelligent image coding using saliency maps
Authors: Vargic Radoslav , Polec Jaroslav
Published: January 2017

In this paper we analyze basic mask creation methods for intelligent image coding using saliency maps. For saliency maps based image coding we use specific extension of SPIHT algorithm called SM SPIHT related to region of interest encoding but extending this approach further, ending with individual weight of importance for each pixel in image using the form of saliency map. This approach is proved to be effective. In this article we analyze impact of different basic hierarchical mask creation methods, which have impact on error separation between salient and not salient parts of the image. The results indicate that proposed mask creation method outperforms JPEG2000 based mask tree creation method.
Power-Efficiency Comparison of Spectrum-Efficient Optical Networks
Authors: Iyer Sridhar
Published: January 2017

With steady traffic volume growth in the core networks, it is predicted that the future optical network communication will be constrained mainly by the power consumption. Hence, for future internet sustainability, it will be a mandate to ensure power-efficiency in the optical networks. Two paradigms known to support both, the traffic heterogeneity and high bandwidth requests are the: (i) next generation flexible (or elastic) orthogonal frequency division multiplexing (OFDM) based networks which provide flexible bandwidth allocation per wavelength, and (ii) currently deployed mixed-line-rate (MLR) based networks which provision the co-existence of 10/40/100 Gbps on varied wavelengths within the same fiber. In this work, the power-efficiency of an OFDM, and a MLR based network has been compared for which, a mixed integer linear program (MILP) model has been formulated considering deterministic traffic between every network source-destination pair. The simulation results show that in regard to power-efficiency, the OFDM based network outperforms the MLR based network.
Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different
Authors: Abilleira Sònia , Ribera Aida , Cardona Pedro , Rubiera Marta , López-Cancio Elena , Amaro Sergi , Rodríguez-Campello Ana , Camps-Renom Pol , Cánovas David , de Miquel Maria Angels , Tomasello Alejandro , Remollo Sebastian , López-Rueda Antonio , Vivas Elio , Perendreu Joan , Gallofré Miquel , Martí-Fàbregas J. , Delgado-Mederos R. , Martínez-Domeño A. , Marín R. , Roquer J. , Ois Á. , Jiménez-Conde J. , Guimaraens L. , Chamorro Á. , Obach V. , Urra X. , Macho J.M. , Blasco J. , San Roman L. , Martínez-Yélamos A. , Quesada H. , Lara B , Cayuela N. , Aja L. , Mora P. , Molina C. , Ribó M. , Pagola J. , Rodríguez-Luna D. , Muchada M. , Coscojuela P. , Dávalos A. , Millán M. , Pérez de la Ossa N. , Gomis M. , Dorado L. , Castaño C. , Garcia M.C. , Estela J. , Krupinski J. , Huertas-Folch S. , Nicolás-Herrerias M.C. , Gómez-Choco M. , García S. , Martínez R. , Sanahuja J. , Purroy F. , Serena J. , Castellanos M. , Silva Y. , Marés R. , Pellisé A. , Ustrell X. , Baiges J.J. , Garcés M. , Saura J. , Soler-Insa J.M. , Aragonés J.M. , Cocho D. , Palomeras E.
Published: January 2017

Background and Purpose—

Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.

Methods—

Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel–Haenszel test statistic.

Results—

We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74–1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74–1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25–1.27).

Conclusions—

This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.
The Puzzle of John 21:15-17
Authors: Lee John A.L.
Published: January 2017

The alternation of the words for “love” in John 21:15-17 is a long-standing puzzle that has defied solution. It is suggested in this note that ἀγαπῶ and φιλῶ carry a slight difference of “formality” as a result of their history and that this can account for the interplay.
“To Be or to Be Thought to Be”
Authors: Curran John
Published: January 2017

Recent research on the textual tradition of Latin versions of the Testimonium Flavianum prompts another enquiry into the original text and the transmission of the famous passage. It is suggested here that the Greek/Latin versions highlight a western/eastern early history of the Testimonium and that in turn directs our attention back to the original circumstances of its composition and publication in the city of Rome in the later years of the first century. Restored to its original historical context, the Testimonium emerges as a carefully crafted attack upon the post-Pauline community of Christ-followers in the city.
αὐτάρκης in Stoicism and Phil 4:11
Authors: Arnold Bradley
Published: January 2017

This article contends that many nt scholars have read the Stoics and their view of αὐτάρκης through a post-Enlightenment (specifically Kantian) ethical framework, which assumes notions like individualism and detachment are fundamental to the ethical subject. When Stoicism is not distorted with these modernist assumptions about the ethical subject, a fairer comparison can be made between the Stoics and Paul. This article demonstrates this by providing an outline of Stoicism in such a manner, emphasizing how their ethical theory is grounded in a teleological and communitarian framework and maintains a psychologically holistic view of the self, which then sets up an exploration of the Stoic understanding of αὐτάρκης not clouded by individualist strands of thinking. This provides material for a more equitable comparison with Paul’s use of this term in Phil 4:11, where it can be seen that the scope, sources, and basis of Stoic and Pauline contentment are similar.
Blaspheming Heaven
Authors: Yeates Paul Henry
Published: January 2017

In Rev 13:6, the Beast is said to blaspheme God as well as the ones who dwell in heaven. This paper addresses two questions in relation to this verse, firstly, Who are the heaven-dwellers? And secondly, How were they blasphemed by the Beast? The text of Revelation is read as narrative and in the context of the cosmological dimension of Roman imperial ideology, which is established by examining literary texts and material artefacts. The heaven-dwellers of Rev 13:6 are identified as martyred saints and it is argued that they were blasphemed by Rome’s claim to authority which was both derived from heaven and extended into heaven. The blasphemous implication of Rome’s cosmology was that faithful saints had no place of security and vindication in heaven but were abandoned to an earthly existence of hardship and defeat.
Mother of Gods, Mother of Harlots
Authors: Jeffcoat Schedtler Justin
Published: January 2017

One of the primary interpretive challenges in the study of Revelation 17 has been to ascertain the identity of an historical personage or entity evoked by the description “Whore of Babylon.” This paper explores a previously neglected figure, Cybele the “Great Mother” Goddess. Through an examination of the artistic, archaeological, and literary evidence relating to the Mother Goddess during the time of her greatest flourishing in the Roman periods, several elements of the description of the Harlot in Rev 17 can be understood to evoke Cybele. Insofar as the Mother Goddess was closely associated with Roman socio-political-religious systems, this scene constitutes an attack on the Roman Imperial apparatus.
Elite mobility among college graduated men in Sweden
Authors: Bihagen Erik , Nermo Magnus , Stern Charlotta , Åberg Yvonne
Published: January 2017

Using Swedish registry data, we study the chances of mobility into the Swedish labour market elite for men who graduated in the years 1985−2005. The elite is defined as top earners within mid- and large sized firms and within the public sector organisations (henceforth, we use organisation for both firms and public organisations). Using discrete time event history models, we study the incidence of elite entry in terms of external recruitment and internal promotion. The choice of field of study and of college or university are important, as are personality and, to a limited extent, cognitive ability. What is most striking is that having kin in elite positions increases the chance of elite entry in general, and having parents in top positions in the same organisation increases the likelihood of internal promotion. In sum, elite entry among college-educated males is associated with a diversity of factors, suggesting that complex explanations for labour market success should be considered, where skills, personality, and family ties all seem to matter.
Territoriality among Icelandic Fishermen
Authors: Pálsson Gísli
Published: January 2017

The article discusses the nature and significance of strategies of managing access to fishing territories. The data relate to the indigenous and private strategies used by Icelandic fishermen Such strategies vary with time and with fishing technology. The article discusses changes in the control of access and their implications for the management of information among skippers. Several scholars have reported claims of territoriality among fishermen and have referred to them as manifestations of property rights and ownership. It is argued here that territorial claims should be seen as pragmatic attempts to manage the conduct of fishing
Informal Organization and Status Inequality: A Sociological View of Social Relations in North Sea Oil Production
Authors: Remøe Svend Otto
Published: January 2017

This article deals with the generation and reproduction of informal organ ization on board Norwegian oil installations in the North Sea. The process through which change comes about is considered. After a general discussion of informal organization, the article focuses on the formal organizational set-up and the managerial strategies for control, which provide the frame work or background for the informal organization offshore. Examples from offshore life are utilized to analyse offshore working conditions and to demonstrate the importance of informal organization in the world of North Sea oil. The hierarchical structure of platform organizations is critically reviewed in the concluding section.
Health Education and its Ideological Content
Authors: Riska Elianne
Published: January 2017

The paper reviews the growing interest in preventive health care measures in advanced industrial societies - self care and health education being typical examples. It is argued that health education has an ideological and normative content which reflects the concern of vanous power groups in society.
Anterior Tragal Crease Is Associated With Atherosclerosis: A Study Evaluating Carotid Artery Intima–Media Thickness
Authors: Rerknimitr Pawinee , Pongpairoj Korbkarn , Kumtornrat Chanat , Panchaprateep Ratchathorn , Hurst Cameron P. , Chutinet Aurauma , Asawanonda Pravit , Suwanwela Nijasri C.
Published: January 2017

The utility of the ear crease sign, anterior tragal crease (ATC), as a marker of atherosclerosis is yet to be established. The intima–media thickness of the common carotid artery (IMT-CCA) has been used as a noninvasive surrogate marker for atherosclerosis. History of traditional risk factors for atherosclerosis was obtained from 147 volunteers; ear examination was also performed and venous blood was drawn for laboratory analysis. The volunteers then underwent an ultrasonography measurement of the IMT-CCA. In univariate analysis, presence of ATC, age, underlying hypertension, diabetes mellitus, ischemic heart disease, cerebrovascular disease, cigarette smoking, low-density lipoprotein, and high-sensitivity C-reactive protein were significantly associated with the IMT-CCA. Further multivariate analysis confirmed a significant association between the presence of ATC and IMT-CCA, when adjusted for other factors (adjusted βATC = .010, 95% confidence interval: 0.0021-0.019). Anterior tragal crease is a potential clinical sign that can predict atherosclerosis. The sign is easily recognizable and may help health-care professionals to identify those at risk of atherosclerosis, especially in people with no clinical signs of the disease.
Ewing Sarcoma of the Head and Neck
Authors: Ellis Mark A. , Gerry Daniel R. , Neskey David M. , Lentsch Eric J.
Published: January 2017

Objectives:

Ewing sarcoma is a rare tumor of the head and neck. Previous efforts to characterize Ewing sarcoma of the head and neck (ES-HN) have been limited to small retrospective series. The objective of this study was to analyze the demographic, clinicopathologic, treatment, and survival characteristics of ES-HN compared to Ewing sarcoma at other locations (ES-other).

Methods:

Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared 183 patients with ES-HN to 3177 patients with ES-other. Patient characteristics were analyzed with chi-square or t test. Ten-year disease-specific survival (DSS) and overall survival (OS) were estimated via the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was used to determine if HN location was an independent prognosticator.

Results:

The ES-HN displayed a lower tumor size ( P < .001) and metastatic rate ( P < .001) compared to ES-other. The ES-HN had a better 10-year DSS and OS than ES-other ( P = .001, P = .015, respectively). The HN location did not achieve statistical significance on multivariate Cox regression analysis ( P = .88).

Conclusion:

ES-HN does not appear to be a separate clinical entity compared to ES-other; rather, its associated improved prognosis is likely secondary to its smaller size and lower metastatic rate compared to ES-other.
Mucosal Sparing Radiation Therapy in Resected Oropharyngeal Cancer
Authors: Gamez Mauricio E. , Halyard Michele Y. , Hinni Michael L. , Hayden Richard E. , Nagel Thomas H. , Vargas Carlos E. , Wong William W. , Curtis Kelly K. , Zarka Matthew A. , Ma Daniel , Patel Samir H.
Published: January 2017

Purpose:

To report the outcomes of patients with favorable risk oropharyngeal cancer that underwent adjuvant radiation therapy with omission of the primary site from the clinical target volume (CTV).

Material/Methods:

A retrospective study of 40 patients treated with transoral surgery (TOS) followed by neck only radiation using intensity modulated radiation therapy (IMRT) with exclusion of the primary site. For all patients, a CTV of the primary surgical bed was contoured to obtain the estimated incidental dose to the primary site.

Results:

Median follow-up was 51 months (range, 13-155 months). The median radiation therapy (RT) dose to the neck was 6000 cGy (range, 5400-6400 cGy). The mean incidental dose to the primary tonsillar site was 4320 cGy (SD ± 480 cGy) and to the primary base of tongue site was 4060 cGy (SD ± 420 cGy). There were no local failures and only 1 regional failure, resulting in 97.5% locoregional control rate at 4 years. Two patients developed distant metastases, without evidence of locoregional recurrence, for a 4-year overall survival rate of 97%.

Conclusions:

Our analysis suggests that mucosal sparing RT after TOS in favorable risk oropharyngeal cancer patients may provide comparable oncologic and improved functional outcomes compared to conventional treatment in selected patients.
Personalized Medicine Approach for an Exceptional Response to Multiple-recurrent and Metastatic HER2-positive Oropharyngeal Squamous Cell Carcinoma
Authors: Seim Nolan B. , Kang Stephen Y. , Bhandari Milan , Jones Riley G. , Teknos Theodoros N.
Published: January 2017

Introduction:

Advanced stage squamous cell carcinoma of the head and neck carries an overall poor prognosis, and survivorship gains have remained relatively stagnant compared to other malignancies due to its complex tumor biology and lack of proven effective targeting agents.

Methods:

We present a case of an exceptional responder to molecular-targeted therapy for metastatic oropharyngeal squamous cell carcinoma using a chemotherapeutic agent FDA approved for breast cancer and targeting the HER2/Neu receptor in order to discuss the larger clinical implications.

Results:

The National Cancer Institute (NCI) has recently instituted the Exceptional Responders Initiative in order to identify such patients with unexpected outcomes in order to expedite the development of additional targeted therapies. This case illustrates the opportunity for cure using targeted oncogene identification in a scenario of recurrent squamous cell carcinoma with lung metastasis typically considered fatal.

Conclusions:

Molecular tumor analysis is an infrequently utilized tool in head and neck squamous cell carcinoma; however, as understanding of biologic mechanisms improves, additional molecular targets will become available and expand treatment opportunities such as HER2/Neu targeting. The Exceptional Responders Initiative is a unique strategy with potential to expedite progress.
Inorganic Arsenic Determination in Food: A Review of Analytical Proposals and Quality Assessment Over the Last Six Years
Authors: Llorente-Mirandes Toni , Rubio Roser , López-Sánchez José Fermín
Published: January 2017

Here we review recent developments in analytical proposals for the assessment of inorganic arsenic (iAs) content in food products. Interest in the determination of iAs in products for human consumption such as food commodities, wine, and seaweed among others is fueled by the wide recognition of its toxic effects on humans, even at low concentrations. Currently, the need for robust and reliable analytical methods is recognized by various international safety and health agencies, and by organizations in charge of establishing acceptable tolerance levels of iAs in food. This review summarizes the state of the art of analytical methods while highlighting tools for the assessment of quality assessment of the results, such as the production and evaluation of certified reference materials (CRMs) and the availability of specific proficiency testing (PT) programmes. Because the number of studies dedicated to the subject of this review has increased considerably over recent years, the sources consulted and cited here are limited to those from 2010 to the end of 2015.
A Tale of Smoking Cessation Promotion: The Utilization of a Children’s Book to Increase Screening and Counseling in the Pediatric Clinic
Authors: Thomas Katharine E.H. , Kisely Steve , Urrego Fernando
Published: January 2017

Objectives: The rate at which pediatricians promote smoking cessation in clinical settings is low. The literature demonstrates that interventions paired with tangible health promotion materials may significantly increase screening rates to the pediatric office. The aim of this study was to investigate whether the addition of a children’s book in the pediatric clinic could result in an increase in the rate in which pediatricians screened for secondhand smoke exposure (SHSe) and counseled caregivers to stop smoking. Study Design: This randomized controlled study was performed at 7 pediatric clinics. Methods: Seven pediatric clinic sites were randomly assigned to either an intervention or control group. Pediatricians in the intervention group were given children’s books about SHSe to distribute to their patients while the control group did not receive any materials. Results: At baseline, there was no difference between the control group and intervention group in rates at which pediatricians screened for SHSe ( P = .8728) and counseled caregivers to stop smoking ( P = .29). After the intervention, screening for SHSe and counseling caregivers to stop smoking were statistically significantly greater in the intervention group, when compared to controls ( P < .01 and P < .001, respectively). Conclusions: The use of a health promotion children’s book in the pediatric setting can increase the rate at which pediatricians screen for SHSe and counsel caregivers to stop smoking. Future research should examine the effect of the storybook on various parameters of smoking cessation and future smoking behaviors.
A Randomized Trial of User-Controlled Text Messaging to Improve Asthma Outcomes: A Pilot Study
Authors: Britto Maria T. , Rohan Jennifer M. , Dodds Cassandra M. , Byczkowski Terri L.
Published: January 2017

We enrolled 64 patients age 12 to 22 years with a diagnosis of poorly controlled persistent asthma in a 6-month longitudinal crossover study. During the 3 intervention months, participants created personalized text messages to be sent to their phones. Adherence was objectively monitored in 22 of the participants. The adolescent participants gave high ratings on the acceptability of the text messaging system. Asthma control improved from baseline to month 1 regardless of whether teens were in the texting or control group. While participants were in the texting group, their quality of life improved and worry about their asthma decreased. Receiving the text intervention resulted in an increase in adherence of 2.75% each month relative to no intervention, but the improvements were not sustained. There was modest improvement in asthma control and quality of life outcomes, as well as improved adherence during the texting intervention.
Mediating the Relationship Between Parental Control/Support and Offspring Delinquency: Self-Efficacy for a Conventional Lifestyle Versus Self-Efficacy for Deviance
Authors: Walters Glenn D.
Published: January 2017

This study sought to determine whether self-efficacy for a conventional lifestyle mediated the relationship between parental control/support and offspring delinquency using longitudinal data supplied by 2,252 (1,145 boys, 1,107 girls) high school students surveyed in the 10th, 11th, and 12th grades. The results of a three-regression negative binomial analysis revealed that self-efficacy for a conventional lifestyle mediated the relationships between Wave 1 parental monitoring and attachment, on one hand, and Wave 3 delinquency, on the other hand. Comparison pathways mediated by self-efficacy for deviance, consistent with predictions, did not achieve significance. These results indicate that a social cognitive variable, self-efficacy for a conventional lifestyle, may be partially responsible for the delinquency-inhibiting effects of parental control (monitoring) and support (attachment).