bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Effect of Diacetyl Morphine on Salivary Factors and their Changes after Methadone Therapy
Authors: Akbari Majid , Afshari Reza , Sharifi Mahsa , Hashemy Seyed Isaac , Majidinia Sara , Tousi Naser Karimian
Published: March 2015

Objectives

Psychoactive drugs are responsible for pathological changes in the mouth including dental caries, which most troublesome. The aim of the present study was to evaluate the effect of heroin on several salivary factors which are involved in the oral health and their changes after methadone maintenance therapy (MMT).

Materials and methods

Forty patients with heroin abuse history, who referred to Imam Reza Hospital for MMT were included.

Saliva sampling was carried out two times; at the first visit (time 1) and repeated 1 month after MMT (time 2). The saliva was analyzed immediately to evaluate the total volume, Ph, CPR, the Uric acid concentration, nitric oxide and antioxidant capacity.

Results

The mean values for saliva volume, pH, CRP, Uric acid, antioxidant and nitric oxide were 0.38 ± 0.14, 7.63 ± 1.22, 5.2 ± 2.3, 1.47 ± 0.8, 0.80 ± 0.23, and 0.26 ± 0.03, respectively at first visit and 0.34 ± 0.22, 7.37 ± 1.01, 6.1 ± 2.6, 2.18 ± 0.9, 0.74 ± 0.3 and 0.29 ± 0.08 after 1 month of MMT.

These values are below the normal ranges; however, there was no significant difference between two times in term of saliva volume, pH and saliva component (p > 0.05).

Conclusion

Heroin addiction changed the effective salivary factors and therefore could negatively contribute to oral health. These factors were not return to the normal range after 1 month of MMT. Physicians should be informed about focusing on oral health in patients under MMT.

Clinical significance

Heroin addiction changed the effective salivary factors and these factors were not return to the normal range after 1 month of MMT.

How to cite this article

Akbari M, Afshari R, Sharifi M, Hashemy SI, Majidinia S, Tousi NK. Evaluation of the Effect of Diacetyl Morphine on Salivary Factors and their Changes after Methadone Therapy. J Contemp Dent Pract 2014;15(6):730-734.
Analysis of the Proliferative Potential of Odontogenic Epithelial Cells of Pericoronal Follicles
Authors: Cimadon Natalia , Lauxen Isabel Silva , Carrard Vinicius Coelho , Filho Manoel Sant'Ana , Rados Pantelis Varvaki , Oliveira Márcia Gaiger
Published: March 2015

Aim

To evaluate the proliferative potential and the cell proliferation rate of odontogenic epithelial cells.

Materials and methods

Forty-two cases of pericoronal follicles of impacted third molars were submitted to silver impregnation technique for quantification of argyrophilic nucleolar organizer regions (AgNOR) and immunohistochemical staining for EGFR and Ki-67. For AgNOR quantification, the mean number of active nucleolar organizer regions per nucleus (mAgNOR) and the percentage of cells with 1, 2, 3 and 4 or more AgNORs per nucleus (pAgNOR) were quantified. Ki-67 immunolabeling was quantified, whereas for EGFR, a descriptive analysis of staining patterns (membrane, cytoplasm or membrane + cytoplasm positivity) was performed. We evaluated the reduced epithelium of the enamel organ and/or islands of odontogenic epithelium present in the entire connective tissue.

Results

mAgNOR were 1.43 (1.0-2.42) and were significantly different among pericoronary follicles from upper and lower teeth (p = 0.041). Immunostaining of Ki-67 was negative in all cases. EGFR immunolabeling was found mainly in the cytoplasm and was more intense in islands and cords when compared to reduced epithelium of the enamel organ.

Conclusion

Odontogenic epithelial cells of some pericoronal follicles have proliferative potential, suggesting their association with the development of odontogenic lesions.

Clinical significance

The authors suggest that nonerupted, especially of the lower teeth, should be monitored and if necessary removed.

How to cite this article

Cimadon N, Lauxen IS, Carrard VC, Filho MSA, Rados PV, Oliveira MG. Analysis of the Proliferative Potential of Odontogenic Epithelial Cells of Pericoronal Follicles. J Contemp Dent Pract 2014;15(6):761-765.
Interannual variability of isotopic composition in water vapor over western Africa and its relationship to ENSO
Authors: Okazaki A. , Satoh Y. , Tremoy G. , Vimeux F. , Scheepmaker R. , Yoshimura K.
Published: March 2015

Abstract. This study was performed to examine the relationship between isotopic composition in near-surface vapor (δ18Ov) over western Africa during the monsoon season and El Niño–Southern Oscillation (ENSO) activity using the Isotope-incorporated Global Spectral Model. The model was evaluated using a satellite and in situ observations at daily to interannual timescales. The model provided an accurate simulation of the spatial pattern and seasonal and interannual variations of isotopic composition in column and surface vapor and precipitation over western Africa. Encouraged by this result, we conducted a simulation stretching 34 years (1979–2012) to investigate the relationship between atmospheric environment and isotopic signature on an interannual timescale. The simulation indicated that the depletion in the monsoon season does not appear every year at Niamey. The major difference between the composite fields with and without depletion was in the amount of precipitation in the upstream area of Niamey. As the interannual variation of the precipitation amount is influenced by the ENSO, we regressed the monsoon season averaged δ18Ov from the model and annually averaged NINO3 index and found a statistically significant correlation (R = 0.56, P < 0.01) at Niamey. This relationship suggests that there is a possibility of reconstructing past western African monsoon activity and ENSO using climate proxies.
Water vapor observations up to the lower stratosphere through the Raman lidar during the Maïdo Lidar Calibration Campaign
Authors: Dionisi D. , Keckhut P. , Courcoux Y. , Hauchecorne A. , Porteneuve J. , Baray J. L. , Leclair de Bellevue J. , Vérèmes H. , Gabarrot F. , Payen G. , Decoupes R. , Cammas J. P.
Published: March 2015

Abstract. A new lidar system devoted to tropospheric and lower stratospheric water vapor measurements has been installed at the Maïdo altitude station facility of Réunion island, in the southern subtropics. To evaluate the performances and the capabilities of the new system with a particular focus on UTLS (Upper Troposphere Lower Stratosphere) measurements, the Maïdo Lidar Calibration Campaign (MALICCA) was performed in April 2013. Varying the characteristics of the transmitter and the receiver components, different system configuration scenarios were tested and possible parasite signals (fluorescent contamination, rejection) were investigated. A hybrid calibration methodology has been set up and validated to insure optimal lidar calibration stability with time. In particular, the receiver transmittance is monitored through the calibration lamp method that, at the moment, can detect transmittance variations greater than 10–15%. Calibration coefficients are then calculated through the hourly values of IWV (Integrated Water Vapor) provided by the co-located GPS. The comparison between the constants derived by GPS and Vaisala RS92 radiosondes launched at Maïdo during MALICCA, points out an acceptable agreement in terms of accuracy of the mean calibration value (with a difference of approximately 2–3%), but a significant difference in terms of variability (14% vs. 7–9%, for GPS and RS92 calibration procedures, respectively). We obtained a relatively good agreement between the lidar measurements and 15 co-located and simultaneous RS92 radiosondes. A relative difference below 10% is measured in the low and middle troposphere (2–10 km). The upper troposphere (up to 15 km) is characterized by a larger spread (approximately 20%), because of the increasing distance between the two sensors. To measure water vapor in the UTLS region, nighttime and monthly water vapor profiles are presented and compared. The good agreement between the lidar monthly profile and the mean WVMR profile measured by satellite MLS (Microwave Limb Sounder) has been used as a quality control procedure of the lidar product, attesting the absence of significant wet biases and validating the calibration procedure. Due to its performance and location, the MAIDO H2O lidar will become a reference instrument in the southern subtropics, insuring the long-term survey of the vertical distribution of water vapor. Furthermore, this system allows the investigation of several scientific themes, such as stratosphere–troposphere exchange, tropospheric dynamics in the subtropics, and links between cirrus clouds and water vapor.
Cross-validation of IASI/MetOp derived tropospheric δD with TES and ground-based FTIR observations
Authors: Lacour J.-L. , Clarisse L. , Worden J. , Schneider M. , Barthlott S. , Hase F. , Risi C. , Clerbaux C. , Hurtmans D. , Coheur P.-F.
Published: March 2015

Abstract. The Infrared Atmospheric Sounding Interferometer (IASI) flying onboard MetOpA and MetOpB is able to capture fine isotopic variations of the HDO to H2O ratio (δD) in the troposphere. Such observations at the high spatio-temporal resolution of the sounder are of great interest to improve our understanding of the mechanisms controlling humidity in the troposphere. In this study we aim to empirically assess the validity of our error estimation previously evaluated theoretically. To achieve this, we compare IASI δD retrieved profiles with other available profiles of δD, from the TES infrared sounder onboard AURA and from three ground-based FTIR stations produced within the MUSICA project: the NDACC (Network for the Detection of Atmospheric Composition Change) sites Kiruna and Izaña, and the TCCON site Karlsruhe, which in addition to near-infrared TCCON spectra also records mid-infrared spectra. We describe the achievable level of agreement between the different retrievals and show that these theoretical errors are in good agreement with empirical differences. The comparisons are made at different locations from tropical to Arctic latitudes, above sea and above land. Generally IASI and TES are similarly sensitive to δD in the free troposphere which allows one to compare their measurements directly. At tropical latitudes where IASI's sensitivity is lower than that of TES, we show that the agreement improves when taking into account the sensitivity of IASI in the TES retrieval. For the comparison IASI-FTIR only direct comparisons are performed because the sensitivity profiles of the two observing systems do not allow to take into account their differences of sensitivity. We identify a quasi negligible bias in the free troposphere (−3‰) between IASI retrieved δD with the TES, which are bias corrected, but important with the ground-based FTIR reaching −47‰. We also suggest that model-satellite observation comparisons could be optimized with IASI thanks to its high spatial and temporal sampling.
Observation of electron biteout regions below sporadic E layers at polar latitudes
Authors: Lehmacher G. A. , Larsen M. F. , Croskey C. L.
Published: March 2015

Abstract. The descent of a narrow sporadic E layer near 95 km altitude over Poker Flat Research Range in Alaska was observed with electron probes on two consecutive sounding rockets and with incoherent scatter radar during a 2 h period near magnetic midnight. A series of four trimethyl aluminum chemical releases demonstrated that the Es layer remained just slightly above the zonal wind node, which was slowly descending due to propagating long-period gravity waves. The location of the layer is consistent with the equilibrium position due to combined action of the wind shear and electric fields. Although the horizontal electric field could not be measured directly, we estimate that it was ~ 2 mV m−1 southward, consistent with modeling the vertical ion drift, and compatible with extremely quiet conditions. Both electron probes observed deep biteout regions just below the Es enhancements, which also descended with the sporadic layers. We discuss several possibilities for the cause of these depletions; one possibility is the presence of negatively charged, nanometer-sized mesospheric smoke particles. Such particles have recently been detected in the upper mesosphere, but not yet in immediate connection with sporadic E. Our observations of electron depletions suggest a new process associated with sporadic E.
Multi-isotope labelling of organic matter by diffusion of 2H/18O-H2O vapour and 13C-CO2 into the leaves and its distribution within the plant
Authors: Studer M. S. , Siegwolf R. T. W. , Leuenberger M. , Abiven S.
Published: March 2015

Abstract. Isotope labelling is a powerful tool to study elemental cycling within terrestrial ecosystems. Here we describe a new multi-isotope technique to label organic matter (OM). We exposed poplars (Populus deltoides × nigra) for 14 days to an atmosphere enriched in 13CO2 and depleted in 2H218O. After 1 week, the water-soluble leaf OM (δ13C = 1346 ± 162‰) and the leaf water were strongly labelled (δ18O = −63 ± 8, δ2H = −156 ± 15‰). The leaf water isotopic composition was between the atmospheric and stem water, indicating a considerable back-diffusion of vapour into the leaves (58–69%) in the opposite direction to the net transpiration flow. The atomic ratios of the labels recovered (18O/13C, 2H/13C) were 2–4 times higher in leaves than in the stems and roots. This could be an indication of the synthesis of more condensed compounds in roots and stems (e.g. lignin vs. cellulose) or might be the result of O and H exchange and fractionation processes during phloem transport and biosynthesis. We demonstrate that the three major OM elements (C, O, H) can be labelled and traced simultaneously within the plant. This approach could be of interdisciplinary interest in the fields of plant physiology, palaeoclimatic reconstruction or soil science.
Evaluation of the global aerosol microphysical ModelE2-TOMAS model against satellite and ground-based observations
Authors: Lee Y. H. , Adams P. J. , Shindell D. T.
Published: March 2015

Abstract. The TwO-Moment Aerosol Sectional (TOMAS) microphysics model has been integrated into the state-of-the-art general circulation model, GISS ModelE2. This paper provides a detailed description of the ModelE2-TOMAS model and evaluates the model against various observations including aerosol precursor gas concentrations, aerosol mass and number concentrations, and aerosol optical depths. Additionally, global budgets in ModelE2-TOMAS are compared with those of other global aerosol models, and the ModelE2-TOMAS model is compared to the default aerosol model in ModelE2, which is a one-moment aerosol (OMA) model (i.e. no aerosol microphysics). Overall, the ModelE2-TOMAS predictions are within the range of other global aerosol model predictions, and the model has a reasonable agreement (mostly within a factor of 2) with observations of sulfur species and other aerosol components as well as aerosol optical depth. However, ModelE2-TOMAS (as well as ModelE2-OMA) cannot capture the observed vertical distribution of sulfur dioxide over the Pacific Ocean, possibly due to overly strong convective transport and overpredicted precipitation. The ModelE2-TOMAS model simulates observed aerosol number concentrations and cloud condensation nuclei concentrations roughly within a factor of 2. Anthropogenic aerosol burdens in ModelE2-OMA differ from ModelE2-TOMAS by a few percent to a factor of 2 regionally, mainly due to differences in aerosol processes including deposition, cloud processing, and emission parameterizations. We observed larger differences for naturally emitted aerosols such as sea salt and mineral dust, as those emission rates are quite different due to different upper size cutoff assumptions.
Impacto del programa de alfabetización informacional en la Universidad de las Ciencias Informáticas
Authors: Rodríguez Castilla Liuris
Published: March 2015

La investigación describe la evaluación y el impacto de la Alfabetización Informacional en la Universidad de las Ciencias Informáticas, a partir de la aplicación de un programa de formación en cursos de posgrado. Para la obtención de los resultados se utilizaron las técnicas de la encuesta, el análisis estadístico y la constatación, seleccionando una muestra de 84 involucrados en los cursos, clasificados en egresados y capacitadores. La evaluación de los resultados se divide en dos etapas: antes y después de impartir el programa de alfabetización informacional, a partir de un conjunto de indicadores. Los cursos han tenido gran aceptación en la universidad, considerándose muy útil y necesario tanto para estudiantes como para capacitadores.
Une espérance post-critique ? Enjeux critiques de la conception ricœurienne de l'imaginaire social
Authors: AVEZ PEGGY
Published: March 2015

RésuméLa fondation anthropologique de la fonction critique – socialement endossée par l’imaginaire utopique – et son lien dynamique avec la tâche intégrative de l’idéologie permettent à Ricœur de repenser sur le plan socio-politique la double nécessité du soupçon et de l’espérance. En reliant l’analyse de la structure contradictoire et analogisante de l’imaginaire social aux perspectives antérieurement développées sur “la liberté selon l’espérance,” notre propos vise à expliciter ses enjeux émancipateurs. Les apories auxquelles les médiations symboliques contraignent l’agir doivent nourrir la double nécessité d’un “devoir de vigilance” et d’une “timide espérance”: telle est à la fois la difficulté irréductible et la force critique de l’analyse ricœurienne de l’imagination socialisante.Mots-clés: imaginaire social, critique, idéologie, utopie, espérance.AbstractThe anthropological foundation of the critical function—endorsed by the utopian imaginary—and its dynamic relation with the integrative task of ideology allow Ricœur to rethink, at a social and political level, the necessity of both suspicion and hope. Linking Ricœur’s analysis of the contradictory and analogizing structure of the social imaginary to perspectives on “freedom in the light of hope,” which were developed earlier, it is my intention to make explicit certain emancipatory issues. The aporiae to which symbolic mediations constrict acting must provide for the necessity of both an “obligation for vigilance” and a “tentative hope.” Such is the irreducible difficulty but also the critical force of Ricœur’s analysis of the socializing imagination.Keywords: Social Imaginary, Criticism, Ideology, Utopia, Hope.
INTRODUCTION
Authors: AMALRIC Jean-Luc
Published: March 2015

LA QUESTION DE L'IMAGINAIRE SOCIAL ET POLITIQUE
Explaining Prejudice with Merton’s Typology and the Film Black Like Me
Authors: Booker Teresa A.
Published: March 2015

N/A
Peddling Pedagogies: The Winners and Losers of a Standardized Testing Economy
Authors: Steele Lucy Arnold
Published: March 2015

This review compares the ethnographic research of Jessica Zacher Pandya’s Overtested: How High-Stakes Accountability Fails English Language Learners with the programmatic prescriptions of Yvette Jackson’s Pedagogy of Confidence. Both texts are concerned with the impact of standardized testing on urban students, but the focus of each book is quite different in terms of public policy on education and the way teacher roles are construed.
Introduction to Radical Teacher's 100th Issue
Authors: Bennett Michael , Dittmar Linda , Lauter Paul
Published: March 2015

Introduction to Radical Teacher's 100th Issue.
Editorial
Authors: Editorial Group Radical Teacher
Published: March 2015

Editorial from first issue of Radical Teacher.
Quilts and Women's Culture
Authors: Hedges Elaine
Published: March 2015

My interest in women's needlework, and especially quilts, began with a course I team-taught several years ago on women's art and literature. Because those of us teaching the course were concerned to break down class and race barriers, and distinctions between "high" and "low" art, or crafts, as well as distinctions between art and work, we were especially interested in women's needlework, as a form of activity that is universal ‒ not confined to any one class or race ‒ and that has combined the practical with the esthetic or artistic. It has always been necessary for women to sew, and, wherever and whenever extra time and energy have allowed, sewing has become "esthetic," in the sense of giving expression to an artistic impulse, providing its practitioners with an outlet for their creativity.
Annals of Academic Life: An Exemplary Tale
Authors: Kampf Louis
Published: March 2015

The narrator of the following vignette is not to be mistaken for the author. Though the tale appears to be autobiographical, it must be a fiction. Academic institutions, as we know, are the repositories of rationality. Professors have been bequeathed the patrimony of the Enlightenment. Such evidence indicates that the events described below could not possibly have happened.
Historical Reflections on Accountability
Authors: Ohmann Richard
Published: March 2015

Imagine that almost all academics think of ourselves as responsible to others, and, if pressed, might allow substitution of "accountable." Responsibility to our employers is contractual, and the professional ethos urges responsibility to students (our clients), to colleagues, and to vague but strong principles of intellectual conduct that obtain in our disciplines. The professional idea calls for responsibility to society as well: we earn our privileges not just by guarding and augmenting our special bodies of knowledge, but by undertaking to put those knowledges to work for the good of all.
Jamming the Works: Art, Politics and Activism Introduction
Authors: Dittmar Linda , Entin Joseph
Published: March 2015

As we enter the second decade of the 21st century, art that aims to actively challenge the social order continues to spark controversy and encounter resistance. In one recent instance, the University of California at San Diego threatened to revoke the tenure of Ricardo Dominguez, a professor of visual art, who developed what he calls “transborder immigrant tools”—recycled cell phones loaded with GPS software that point border-crossers to caches of fresh water in the desert. Dominquez has called the phones, which feature an audio application that plays inspirational poetry to migrants, a “mobile Statue of Liberty.”
Oliphant, T., & McNally, M. (2014). Professional Decline and Resistance: The Case of Library and Archives Canada. Radical Teacher, 99, 54-61. doi:10.5195/rt.2014.105
Authors: Editor Managing
Published: March 2015

Correction to “Professional Decline and Resistance: The Case of Library and Archives Canada” by Tami Oliphant and Michael McNally, published in Radical Teacher 99.
Effect of Interferon α2a in Cystoid Macular Edema due to Intraocular Infection
Authors: Qian Zhuyun , Fardeau Christine , Cardoso Joao Nobre , Jellab Badr , Fan Xianqun , LeHoang Phuc
Published: March 2015

Purpose

Cystoid macular edema (CME) is a severe complication and a major cause of visual loss in patients with intraocular infection. In this type of CME, therapeutic strategies remain controversial. We aimed to investigate the efficacy and tolerability of interferon (IFN)-α2a in cystoid macular edema caused by intraocular infection.

Methods

In this retrospective, noncomparative, interventional case series, 5 patients (6 eyes) who were diagnosed with intraocular infection with chronic CME were included. Interferon-α2a (3 million units 3 times a week) was administered subcutaneously. Clinical observations were recorded before and after treatment.

Results

The average duration of CME before treatment with IFN-α was 26 months. According to the preset criteria, IFN-α2a therapy was shown to be effective in 2 patients (3 eyes), effective dose-dependent in 2 patients, and partly effective in 1 patient, and was well-tolerated in 4 patients. The most common side effect was flu-like symptoms.

Conclusions

Interferon α-2a may be an effective alternative treatment for CME due to intraocular infection that is resistant to other treatment. Studies with larger sample sizes are required to confirm this conclusion.
The Intracavitary ECG Method for Insertion of a Tunneled Dialysis Catheter without using Fluoroscopy
Authors: Cho Seong , Lee Yu-Ji , Kim Sung-Rok
Published: March 2015

Purpose

Recently, there have been many reports that exact central vein catheter tip positioning was possible using intracardiac electrocardiographic (ECG) monitoring. Ultrasonic guidance in combination with intracardiac ECG monitoring may allow for a tunneled dialysis catheter to be inserted at the bedside without using fluoroscopy. Therefore we report on the intracavitary ECG method for insertion of a tunneled dialysis catheter with ultrasound guidance and the feasibility, safety, effectiveness, complications and limitations of this method.

Methods

From April 2012 to June 2014, we evaluated 142 hemodialysis (HD) patients who were dialyzed by a tunneled dialysis catheter that was inserted using intracardiac ECG monitoring without fluoroscopic usage. We checked the intracardiac P wave and the point at which it gradually rose to the highest P wave morphology, we stopped inserting the catheter.

Results

Catheter flow during dialysis was adequate in 139 cases. There were three cases where it malfunctioned. Catheter malposition occurred in 6 out of 142 cases. The correct matching rate between the intracardiac ECG and chest posteroanterior (PA) view was 98.5%. No significant complications developed.

Conclusions

To conclude, in this single-center study, the intracavitary ECG method for assessing the position of the tip of tunneled dialysis catheter was proven to be safe and feasible in virtually all adult patients who had an evident P wave at the basal ECG tracking.
Minimally Invasive Video-assisted Thyroidectomy for Papillary Thyroid Cancer: A Prospective 5-year follow-up Study
Authors: Del Rio Paolo , Maestroni Umberto , Sianesi Mario , Viani Lorenzo , Vicente Diego , Stojadinovic Alexander , Avital Itzhak
Published: March 2015

Background

Minimally invasive video-assisted thyroidectomy (MIVAT) was initially introduced for the treatment of selected patients who met certain thyroid volume, nodule size and pathological criteria. Recent studies indicate that the completeness of resection of malignant nodules is comparable to that obtained with conventional thyroidectomy.

Aims

To compare the 5-year outcomes in patients with papillary thyroid carcinoma (PTC) treated with MIVAT versus conventional thyroidectomy.

Methods

In this prospective cohort study conducted over 2 years (July 2005–June 2007), 172 patients with node-negative, nonmetastatic PTC underwent either MIVAT (n = 67) or conventional thyroidectomy (n = 105). Study outcomes were 1) the cumulative dose of radioactive iodine (RAI) to achieve a disease-free state, defined as a stimulated serum thyroglobulin (Tg) level <2 ng/mL with negative Tg antibody and no tumor on a whole-body scan or cross-sectional imaging, and 2) the 5-year serum Tg level.

Results

The clinical parameters of the MIVAT and conventional thyroidectomy groups were comparable except for age (mean 43 ± 12 vs. 59 ± 17 years, respectively; p = 0.03) and operative time (mean 69 ± 24 vs. 53 ± 16 minutes, p = 0.02); the mean tumor size was similar between groups (1.3 ± 0.7 vs. 1.6 ± 0.9 cm, p = 0.14). Surgical morbidity was similar in both groups. Median follow-up was 5 years. RAI dose (mean 72 ± 38 vs. 96 ± 47 mCu, p = 0.34) and serum Tg at 5 years (mean 0.3 ± 0.2 vs. 0.5 ± 0.3 ng/mL, p = 0.30) were not significantly different between the MIVAT and conventional thyroidectomy groups.

Conclusions

MIVAT can be safely utilized in patients with localized PTC, providing comparable completeness of resection and oncological outcome to conventional thyroidectomy.
Management of Patients with Recurrent Glioblastoma using Hypofractionated Stereotactic Radiotherapy
Authors: Dincoglan Ferrat , Beyzadeoglu Murat , Sager Omer , Demiral Selcuk , Gamsiz Hakan , Uysal Bora , Ebruli Cuneyt , Akin Mustafa , Oysul Kaan , Sirin Sait , Dirican Bahar
Published: March 2015

Background

Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. The chance of cure is very limited due to treatment-refractory disease course with frequent recurrences despite aggressive multimodality management. In this retrospective study, we evaluated treatment outcomes of hypofractionated stereotactic radiotherapy (HFSRT) in the management of recurrent GBM and report our single-center experience.

Methods

Twenty-eight patients receiving HFSRT for recurrent GBM between September 2008 and February 2014 were retrospectively assessed. Total radiotherapy dose was 25 Gy delivered in 5 fractions over 5 consecutive days for all patients. High-precision, image-guided volumetric modulated arc therapy was delivered with a linear accelerator using 6-MV photons using the frameless technique. Analyzed prognostic factors were age, gender, Karnofsky performance status (KPS), tumor location, planning target volume (PTV) size, overall survival (OS), progression-free survival (PFS), time interval between completion of treatment with Stupp protocol at primary diagnosis and recurrence.

Results

Median follow-up time was 42 months (range 2–68). Median time interval between primary chemoradiotherapy and HFSRT was 11.2 months (range 4–57.9). Median OS and PFS calculated from reirradiation was 10.3 months and 5.8 months, respectively. Longer interval between initial treatment and recurrence (p = 0.01), smaller PTV size (p = 0.001), KPS ≥70 (p = 0.005) and younger age (p = 0.004) were associated with longer OS on statistical analysis.

Conclusion

HFSRT offers a feasible and effective salvage treatment option for recurrent GBM management. Prognostic factors associated with longer OS in our study were longer interval between initial treatment and recurrence, smaller PTV size, KPS ≥70 and younger age.
De la donnée personnelle au bien commun
Authors: Fortin Sabrina
Published: March 2015

La recherche sur les populations permet d’améliorer nos conditions de vie en identifiant les facteurs de risque attribuables aux liens entre l’environnement et certains déterminants socio-sanitaires. Elle nécessite de vastes échantillons qui proviendront souvent de renseignements personnels ou de matériel biologique déjà recueillis. Pour les utiliser, la règle générale veut qu’un consentement individuel soit obtenu. Cependant, dans la pratique, il est souvent impossible d’obtenir un tel consentement sans affecter la qualité et la capacité de généralisation des résultats de recherche. Cette obligation de consentement est fondée sur la primauté de la personne et la dignité humaine, qui ont été intégrées dans le droit des personnes à la fin de la Seconde Guerre mondiale. Ce principe fondamental a également été inséré au coeur de l’encadrement de la recherche scientifique. La philosophie personnaliste en serait à l’origine. Cet article, après avoir établi la provenance philosophique et historique du principe de dignité humaine, tente de rétablir un certain équilibre entre les intérêts individuels et collectifs impliqués dans la recherche populationnelle.
La théologie chrétienne et la société sécularisée et pluri-religieuse : un défi réciproque
Authors: Siegwalt Gérard
Published: March 2015

La société actuelle, dans beaucoup de pays du monde dit occidental, a à conjuguer sa sécularité avec la présence en elle de plusieurs religions, tout comme à l’inverse ces dernières doivent conjuguer à la fois leur pluralité entre elles-mêmes et en même temps avec la société séculière. La condition de possibilité pour cette mise en relation est d’un côté la distinction entre le temporel et le spirituel, de l’autre côté la référence de toutes les parties prenantes au bien commun et donc à l’intérêt général. Dans la présente contribution, il en va de montrer que la société sécularisée et pluri-religieuse constitue une situation de décision et donc un défi pour tous ceux qui sont concernés par elle. C’est principalement le défi adressé à la théologie chrétienne par la société sécularisée et pluri-religieuse qui est approfondi ici, dans le sens d’éclairer la vocation chrétienne dans ladite situation.
Identité et sentiment d’appartenance chez les jeunes anglophones de Montréal
Authors: Gérin-Lajoie Diane
Published: March 2015

Résultat d’une construction sociale, l’identité ne peut être considérée comme linéaire et figée. Elle représente plutôt un phénomène fluide, fortement influencé par des pratiques sociales imbriquées dans des rapports de pouvoir précis. Ce phénomène est d’autant plus vrai dans le cas des minorités linguistiques que celles-ci sont amenées à vivre à la frontière de deux langues et de deux cultures – et parfois même de trois dans le cas de minorités ethniques. Les résultats de notre analyse sont tirés d’une étude ethnographique effectuée en milieu scolaire anglophone dans la région de Montréal. Au terme de trois années de terrain, nous avons fait trois constatations : qu’une identité bilingue ou trilingue était présente chez ces jeunes, que diverses représentations de la communauté anglophone et de l’appartenance de groupe coexistaient, et enfin que les jeunes participants ont dit ne pas se sentir intégrés à la majorité francophone de la province, même si leur discours ne démontre aucunement qu’ils éprouvent un sentiment de minorisation dans leurs rapports avec le groupe majoritaire.
La scène musicale anglo-québécoise : institutionnalisation, mutations et représentations
Authors: Robineau Anne
Published: March 2015

Cet article interroge le lien entre la plus grande reconnaissance attribuée à une partie de la scène musicale anglo-québécoise et le développement d’institutions et d’organismes artistiques et culturels anglophones au Québec. Certaines représentations sociales quant au mythe des deux solitudes tendent à se reproduire dans le monde des arts, mais à se transformer aussi dans le cas de coproductions franco et anglo-québécoises qui attirent un public nouveau, encore mal circonscrit, un public bilingue et principalement montréalais. Nous abordons ce sujet en traitant de l’identité anglo-québécoise et de son rapport à la culture, en décrivant plusieurs aspects de l’institutionnalisation et de la professionnalisation des artistes anglophones du Québec depuis les années 1960, puis en tentant d’identifier les mutations récentes de la scène musicale anglo-montréalaise en abordant la question de la relève et de la diversité culturelle.
What are the constraints and opportunities for HIVST scale‐up in Africa? Evidence from Kenya, Malawi and South Africa
Authors: van Rooyen Heidi , Tulloch Olivia , Mukoma Wanjiru , Makusha Tawanda , Chepuka Lignet , Knight Lucia C , Peck Roger B , Lim Jeanette M , Muturi Nelly , Chirwa Ellen , Taegtmeyer Miriam
Published: March 2015

Introduction

HIV self‐testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub‐Saharan Africa and is on the brink of scale‐up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country‐preparedness for scale‐up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub‐Saharan countries.

Methods

Fifty‐four key informant interviews were conducted in Kenya (n=16), Malawi (n=26) and South Africa (n=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter‐country analysis to identify common and divergent themes across contexts.

Results

Respondents welcomed the idea of an accurate, easy‐to‐use, rapid HIV self‐test which could increase testing across all populations. High‐risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community‐based distribution points. HIVST is already endorsed in Kenya, and political support for scale‐up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context‐specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self‐testing.

Conclusions

Stakeholders in three HIV endemic sub‐Saharan countries felt that HIVST will be an important complement to existing community and facility‐based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale‐up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance.
Do Doppler Studies Enhance Surveillance of Uncomplicated Monochorionic Diamniotic Twins?
Authors: Pessel Cara , Merriam Audrey , Vani Kavita , Brubaker Sara G. , Zork Noelia , Zhang Yuan , Simpson Lynn L. , Gyamfi-Bannerman Cynthia , Miller Russell
Published: March 2015

Objectives

To determine whether isolated abnormal Doppler indices before 28 weeks predict adverse pregnancy outcomes in uncomplicated monochorionic diamniotic (MCDA) twins.

Methods

A retrospective cohort study of MCDA twin pregnancies receiving antenatal testing at a single center between 2007 and 2013 was conducted. Sonographic surveillance, including Doppler velocimetric studies of the umbilical artery, ductus venosus, and middle cerebral artery of each twin, was initiated by 28 weeks and repeated at least every 2 weeks. All pregnancies were deemed “uncomplicated” at initial sonography, without evidence of polyhydramnios, oligohydramnios, intrauterine growth restriction, twin growth discordance of at least 20%, structural or chromosomal anomalies, or unclear chorionicity. Pregnancies were divided into 2 groups: those with isolated Doppler abnormalities before 28 weeks and those with normal Doppler indices. The primary outcome was a composite including twin‐twin transfusion syndrome, intrauterine growth restriction of more than 1 twin, growth discordance of at least 20%, preterm delivery before 34 weeks for fetal indications, or demise of more than 1 fetus.

Results

Ninety‐six patients were included, with 22 (22.9%) having isolated Doppler abnormalities before 28 weeks. The incidence of the primary outcome did not differ between groups (36.4% versus 28.4%; P = .47). The abnormal Doppler group underwent a greater number of sonographic examinations (15 versus 10; P= .001) and more antenatal admissions for fetal concerns (50.0% versus 12.2%; P < .001).

Conclusions

Isolated Doppler abnormalities are commonly encountered in uncomplicated MCDA pregnancies before 28 weeks yet are not clearly predictive of twin‐specific complications. Doppler abnormalities were associated with increased sonographic surveillance and antenatal hospitalizations, suggesting an influence on physician practice patterns. Data may not support Doppler studies before 28 weeks for routine MCDA twin monitoring.
Sonographically Guided Posteromedial Approach for Intra‐articular Knee Injections
Authors: Tresley Jonathan , Jose Jean
Published: March 2015

Osteoarthritis of the knee can be a debilitating and extremely painful condition. In patients who desire to postpone knee arthroplasty or in those who are not surgical candidates, percutaneous knee injection therapies have the potential to reduce pain and swelling, maintain joint mobility, and minimize disability. Published studies cite poor accuracy of intra‐articular knee joint injections without imaging guidance. We present a sonographically guided posteromedial approach to intra‐articular knee joint injections with 100% accuracy and no complications in a consecutive series of 67 patients undergoing subsequent computed tomographic or magnetic resonance arthrography. Although many other standard approaches are available, a posteromedial intra‐articular technique is particularly useful in patients with a large body habitus and theoretically allows for simultaneous aspiration of Baker cysts with a single sterile preparation and without changing the patient's position. The posteromedial technique described in this paper is not compared or deemed superior to other standard approaches but, rather, is presented as a potentially safe and efficient alternative.
A review of the clinical utility of serum clozapine and norclozapine levels
Authors: Ellison Justin C. , Dufresne Robert L.
Published: March 2015

Treatment refractory schizophrenia is a serious issue affecting at least 30% of all patients with schizophrenia despite the continued emergence of new agents aimed at treating this disease. Clozapine therapy remains the most efficacious treatment for patients with schizophrenia who have failed two prior antipsychotics or those deemed an imminent harm to themselves or others. Because data are lacking on how to proceed if a patient should prove nonresponsive to clozapine therapy, the utmost care should be taken to ensure the optimization of clozapine. Therapeutic drug monitoring (TDM) is used with many other psychoactive agents to ensure the optimal therapeutic efficacy while minimizing adverse effects. The unique pharmacology of clozapine and the inter- and intraindividual variations in its pharmacokinetics make it a difficult agent with which to use TDM. The consensus is that 350 ng/mL is the lower threshold of therapeutic efficacy to define an adequate trial of clozapine. As of this writing, no clearly defined threshold exists for the upper limit of therapeutic efficacy or toxicity. TDM of clozapine can be useful in the following circumstances: when a clozapine-induced central nervous system toxicity is suspected, a medication that can inhibit or induce the metabolism of clozapine is being added or withdrawn, a change in smoking status has occurred, concerns for medication nonadherence are present, or decompensation while on a previously effective clozapine dosage is observed. The psychiatric pharmacist may play a crucial role in the interpretation and effective utilization of serum clozapine and norclozapine levels. This review will examine the current evidence for the clinical utility of monitoring serum levels of clozapine and its metabolites.
Clozapine-induced myocarditis may warrant cardiac monitoring protocol
Authors: Miller Lacey J. , Grande Rachel E.
Published: March 2015

Background

Myocarditis, or inflammation of the heart muscle, is a black box warning associated with the use of clozapine. Although the incidence of clozapine-induced myocarditis is only 0.015% to 1.2%, recent retrospective studies have found that up to 66% of clozapine patients develop nonspecific symptoms consistent with myocarditis. Because of the difficulty in distinguishing these symptoms (including fever, tachycardia, and fatigue) from clozapine dose titration, myocarditis may be difficult to recognize. If left undetected, the condition could be fatal.

Patient Case

A 25-year-old Filipino male with a history of schizoaffective disorder, bipolar type, continued to endorse persistent and distressing command auditory and visual hallucinations despite therapy with olanzapine, 40 mg daily. Clozapine was initiated for refractory psychosis and titrated up to 125 mg over 17 days. On day 14, the patient reported “feeling sick,” having chills, a nonproductive cough, and fatigue; he was febrile and tachycardic. Abnormal laboratory values included elevated troponin-1, C-reactive protein (CRP), and creatinine phosphokinase (CPK). The last dose of clozapine was administered on day 17 with resolution of the above-mentioned signs and symptoms within 3 days.

Discussion

A literature search revealed several cases demonstrating a strong association between clozapine and myocarditis. Despite suggestions from case reports for cardiac monitoring at baseline, there are no universal monitoring guidelines.

Conclusion

As a result of this patient case of clozapine-induced myocarditis, the Veterans Affairs Palo Alto Health Care System Clozapine Tracking Team developed a cardiac monitoring protocol for veterans being initiated on clozapine.
Feeding ecology of chimpanzees (Pan troglodytes verus) inhabiting a forest‐mangrove‐savanna‐agricultural matrix at Caiquene‐Cadique, Cantanhez National Park, Guinea‐Bissau
Authors: Bessa Joana , Sousa Cláudia , Hockings Kimberley J.
Published: March 2015

With rising conversion of “natural” habitat to other land use such as agriculture, nonhuman primates are increasingly exploiting areas influenced by people and their activities. Despite the conservation importance of understanding the ways in which primates modify their behavior to human pressures, data are lacking, even for well‐studied species. Using systematically collected data (fecal samples, feeding traces, and direct observations), we examined the diet and feeding strategies of an unhabituated chimpanzee community (Pan troglodytes verus) at Caiquene‐Cadique in Guinea‐Bissau that inhabit a forest‐savanna‐mangrove‐agricultural mosaic. The chimpanzees experienced marked seasonal variations in the availability of plant foods, but maintained a high proportion of ripe fruit in the diet across months. Certain wild species were identified as important to this community including oil‐palm (Elaeis guineensis) fruit and flower. Honey was frequently consumed but no other insects or vertebrates were confirmed to be eaten by this community. However, we provide indirect evidence of possible smashing and consumption of giant African snails (Achatina sp.) by chimpanzees at this site. Caiquene‐Cadique chimpanzees were confirmed to feed on nine different agricultural crops, which represented 13.6% of all plant species consumed. Consumption of fruit and nonfruit crops was regular, but did not increase during periods of wild fruit scarcity. Crop consumption is an increasing and potentially problematic behavior, which can impact local people's tolerance toward wildlife. To maximize the potential success of any human–wildlife coexistence strategy (e.g., to reduce primate crop feeding), knowledge of primate behavior, as well as multifaceted social dimensions of interactions, is critical. Am. J. Primatol. 77:651–665, 2015. © 2015 Wiley Periodicals, Inc.
Co‐transcriptional mRNP formation is coordinated within a molecular mRNP packaging station in S. cerevisiae
Authors: Meinel Dominik M. , Sträßer Katja
Published: March 2015

In eukaryotes, the messenger RNA (mRNA), the blueprint of a protein‐coding gene, is processed and packaged into a messenger ribonucleoprotein particle (mRNP) by mRNA‐binding proteins in the nucleus. The steps of mRNP formation – transcription, processing, packaging, and the orchestrated release of the export‐competent mRNP from the site of transcription for nuclear mRNA export – are tightly coupled to ensure a highly efficient and regulated process. The importance of highly accurate nuclear mRNP formation is illustrated by the fact that mutations in components of this pathway lead to cellular inviability or to severe diseases in metazoans. We hypothesize that efficient mRNP formation is realized by a molecular mRNP packaging station, which is built by several recruitment platforms and coordinates the individual steps of mRNP formation.