bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk of damage and mortality in SLE patients fulfilling the ACR or only the SLICC classification criteria. A 10-year, inception cohort study
Authors: Inês L , Rodrigues M , Jesus D , Fonseca F P , Silva J A P
Published: September 2017

Objective

To compare damage and mortality, from inception up to 10-year follow-up, between SLE patients meeting at baseline the 1997 ACR criteria or only the 2012 SLICC classification criteria.

Methods

Patients fulfilling the ACR and/or the SLICC classification criteria for SLE were enrolled at inception and followed-up to 10 years at an academic lupus clinic. Damage was defined as SLICC Damage Index (SDI) score ≥1. We assessed with multivariate Cox models the damage and mortality outcomes, according to SLE classification status at inception, adjusting for potential baseline confounders.

Results

We recruited 192 patients (69.8% fulfilling at inception the ACR criteria and 30.2% only the SLICC criteria). During follow-up, 24.0% of patients accrued organ damage and 4.2% died. Patients meeting ACR criteria compared to those with SLICC criteria alone presented during follow-up with more cases of lupus nephritis (35.1% versus 13.8%, p < 0.01), but less thrombotic antiphospholipid syndrome (4.5% versus 17.2%, p < 0.01). The Cox models showed no significant differences in risk for damage [hazard ratio (HR) (95% CI) 0.991 (0.453–2.167)] or death [hazard ratio (HR) (95% CI) 0.694 (0.107–4.506)] between groups.

Conclusion

The SLE classification status at inception identified different patterns of clinical phenotype, but did not influence damage accrual or mortality up to 10-year follow-up.
Population metrics for suicide events: A causal inference approach
Authors: He Hua , Lu Naiji , Stephens Brady , Xia Yinglin , Bossarte Robert M , Kane Cathleen P , Tang Wan , Tu Xin M
Published: September 2017

Large-scale public health prevention initiatives and interventions are a very important component to current public health strategies. But evaluating effects of such large-scale prevention/intervention faces a lot of challenges due to confounding effects and heterogeneity of study population. In this paper, we will develop metrics to assess the risk for suicide events based on causal inference framework when the study population is heterogeneous. The proposed metrics deal with the confounding effect by first estimating the risk of suicide events within each of the risk levels, number of prior attempts, and then taking a weighted sum of the conditional probabilities. The metrics provide unbiased estimates of the risk of suicide events. Simulation studies and a real data example will be used to demonstrate the proposed metrics.
Dignity in nursing care: What does it mean to nursing students?
Authors: Mullen Rosemary F , Kydd Angela , Fleming Anne , McMillan Laura
Published: September 2017

Background:

Despite growing interest in the potential of nursing education to enhance dignity in nursing care, relatively little is known about what dignity means to nursing students.

Research question:

What meaning does dignity in nursing care have for nursing students?

Research design:

Photo-elicitation was embedded within a Nominal Group Technique and responses were analysed by qualitative and quantitative content analysis.

Participants and research context:

Participants were recruited from each year of a 3-year undergraduate preregistration adult nursing programme in Scotland. In total, 31 nursing students participated in the study.

Ethical considerations:

The study was approved by the Ethics Committee of the School of Health, Nursing and Midwifery, University of the West of Scotland.

Findings:

Participants articulated the meaning of dignity in nursing care in terms of the relationships and feelings involved. A total of 10 categories of meaning were identified.

Discussion:

The significance of the nature of the nurse–patient interaction to preserving dignity in nursing care is highlighted.

Conclusion:

Understanding the meaning of dignity for nursing students may help prepare future nurses more able to preserve dignity in nursing care.
Nursing adherence to ethical codes in pediatric oncology wards
Authors: Beykmirza Raziyeh , Nikfarid Lida , Atashzadeh-Shoorideh Foroozan , Nasiri Maliheh
Published: September 2017

Background:

The nature of children’s cancer comes with lots of ethical issues. Nurses are encouraged to adhere to ethical codes in their practice.

Objectives:

This study aimed to compare the perspectives of nurses and mothers of children with cancer regarding the adherence of nurses to ethical codes.

Research design:

In this descriptive-comparative study, a researcher-made questionnaire was used to assess the amount of adherence to Iranian nurses’ code of ethics in perspectives of pediatric oncology nurses and mothers. As a convention, the total scores were categorized as optimal, average, and low adherence.

Participants and context:

A total of 200 mothers and 60 nurses in pediatric oncology wards of five major hospitals in Tehran, Iran, participated in 2016.

Ethical considerations:

Organizational approval by the university and informed consent were ensured before conducting the research. The principles of voluntariness, confidentiality, and anonymity were respected during the research process.

Findings:

Results showed the mean score of the adherence to ethical codes by nurses, as per the nurses is 86.71 (12.57) and as per the mothers is 78.67 (16.09). The highest frequency for “Low adherence” and “Optimal adherence” to code of ethics by nurses were “Respect for individual autonomy and decision-making” (mothers, 72% and nurses, 70%) and “Commitment to confidentiality” (mothers, 64% and nurses, 74%), respectively. This revealed a significant difference between the responses of the nurses and the mothers (p = 0.001).

Discussion:

The results support the other studies in Iran about the difference between the perspectives of patients and nurses about adherence of nurses to ethical codes.

Conclusion:

Integration of family-centered and conventional care in addition to more attention to the education of professional ethical principles could be helpful to improve the ethical performance of nurses in oncology pediatric wards.
Controversial Terminology
Authors: Jones Chris , Mauntel Christoph , Oschema Klaus
Published: September 2017

In recent years, research on the concept of ‘empire’ has seen an upswing of interest in both Political Science and History. Definitions of ‘empire’ abound, as they do for words such as ‘discourse’, ‘performance’ and ‘culture’. Countless books and edited volumes concerning questions of ‘empire’ have been published since the turn of the century. On the most general level, however, the majority of studies on questions of ‘empire’ tend to neglect the European Middle Ages. Medievalists continue to associate the Latin terms imperium and imperator primarily with the (Holy) Roman Empire. A closer examination of the existing material in Latin and the vernacular languages reveals that many late medieval authors were far from limited in their use of imperial terminology. This introductory essay establishes the historiographical context for an exploration of this terminology as it was employed in the Latin West in two instances. The first is imperial self-designation, cases where rulers explicitly adopted or avoided the language of empire in referring to themselves or their realms. The second is the use of imperial terminology by authors from Latin Europe to describe and characterise distant and foreign regions of the world.
Imperial Rule in Medieval Spain
Authors: Drews Wolfram
Published: September 2017

With the coronation of Alfonso VII of Léon and Castile as ‘emperor of all Spain’ in Toledo in 1135 the imperial aspirations of the Leonese kings reached a climax. Their origins, however, go back to the tenth century, when individual kings were called ‘imperator’ in charters.

This article traces the origins of this tradition within the context of political history and outlines the phenomenon of imperial self-ascriptions on the Iberian Peninsula. While modern research traditionally focused on the question of whether or not the kings of León pursued an ‘imperial programme’ and, if they did, what fundamental ideas lay behind such a programme, this article proposes a different approach: by focusing on the interdependencies between Christian and Muslim powers, it argues that the coronation of Alfonso VII could have been a direct response to the proclamation of ‘Abd al-Mu’min as caliph of the Almohad Empire in 1132. A close analysis of the royal and imperial titles already used by Alfonso’s grandfather Alfonso VI shows that he imitated the traditional caliphal title to be ‘ruler of the faithful’, although religious references were not a traditional part of Christian imperial titles. By examining Leonese and Almohad imperial self-ascriptions, the article offers a model by which we can explore the ways in which neighbouring imperial powers influenced each other and developed competing claims to power. The article establishes that Christian use of imperial titles on the Iberian Peninsula came to an abrupt end once competition with Muslim rivals became obsolete. It underlines the importance of the individual context in which a title was used, a point that stands in stark contrast to the received view that there was an unchanging ‘conceptual core’ to the notion of ‘empire’ as it was used by the peninsula’s kings. The article also highlights the hegemonic connotations of imperial notions in medieval Iberia and the importance of a motif of rulership that included subjects of both Christian and Muslim belief.
Design and analysis of a morphing drag rudder on the aerodynamics, structural deformation, and the required actuating moment
Authors: Li Daochun , Liu Qichen , Wu Yining , Xiang Jinwu
Published: September 2017

The split drag rudder is an important yawing control device for the tailless flying-wing aircraft. In this article, a new morphing drag rudder is proposed based on the chordwise continuous variable camber technology. The designs of the structure and actuation system are first presented. A comparative study on the aerodynamics of the morphing and traditional drag rudders is performed numerically. The results show that the morphing drag rudder experiences a larger aerodynamic drag than the traditional one at small angles of attack. The analysis on the structural deformation and the required actuating moment at zero angle of attack are performed. The results show that the deformation due to the aerodynamic load increases more and more slowly with the angle of deflection. Besides, the relationship between the required actuating moment and the trailing edge deformation is linear, which indicates the applicability of using morphing drag rudder for yawing control.
Pericytes Make Spinal Cord Breathless after Injury
Authors: Almeida Viviani M. , Paiva Ana E. , Sena Isadora F. G. , Mintz Akiva , Magno Luiz Alexandre V. , Birbrair Alexander
Published: September 2017

Traumatic spinal cord injury is a devastating condition that leads to significant neurological deficits and reduced quality of life. Therapeutic interventions after spinal cord lesions are designed to address multiple aspects of the secondary damage. However, the lack of detailed knowledge about the cellular and molecular changes that occur after spinal cord injury restricts the design of effective treatments. Li and colleagues using a rat model of spinal cord injury and in vivo microscopy reveal that pericytes play a key role in the regulation of capillary tone and blood flow in the spinal cord below the site of the lesion. Strikingly, inhibition of specific proteins expressed by pericytes after spinal cord injury diminished hypoxia and improved motor function and locomotion of the injured rats. This work highlights a novel central cellular population that might be pharmacologically targeted in patients with spinal cord trauma. The emerging knowledge from this research may provide new approaches for the treatment of spinal cord injury.
Feeling Heard and Not Judged: Perspectives on Substance Use Services Among Youth Formerly in Foster Care
Authors: Braciszewski Jordan M. , Tran Tanya B. , Moore Roland S. , Bock Beth C. , Tzilos Wernette Golfo K. , Chamberlain Patricia , Stout Robert L. , Vose-O’Neal Adam
Published: September 2017

Youth in foster care have limited access to substance use services for a variety of reasons. Attempts to unpack this health disparity have focused on foster care systems, administrators, providers, and foster parents. This study seeks to understand the perspectives of youth themselves, with the hope of understanding their experiences with and preferences for such services. Analyses of focus groups with youth who had recently left foster care suggested concrete and perceptual facilitators/barriers to treatment. Concrete facilitators/barriers included the need for expanding social support, access to multiple service options, and tailored intervention approaches. Perceptual concerns revolved around understanding each individual’s readiness to change, feeling judged by authority figures, and desiring help from people with lived experience. Participants also described novel intervention ideas, including a focus on technology-based approaches. By relying on youth voices, we can improve upon the current state of substance use interventions within foster care.
Pulse: From Death to Resurrection and Back Again
Authors: Johnson Amber
Published: September 2017

This autopoetic narrative centers on identity negotiation in a time of crisis and how we learn and unlearn to respond. After compartmentalizing my sensitivity to gun violence, the Orlando Pulse shooting resurrected in me a strong sense of grief, connection and suffering.
After Orlando
Authors: Pelias Ronald J.
Published: September 2017

Following in the tradition of poetic inquiry, I offer a series of poems to explore the aftermath of Orlando, Florida shooting on June 12, 2016. The poems call upon the speculative and the imaginative to make its empathic case. The poems, offering distinct perspectives directly connected to the shooting, rely upon news accounts, but do not contain the specific words of any individual.
Critical Qualitative Inquiry Is/as Love
Authors: Ulmer Jasmine B.
Published: September 2017

What if we expressed critical qualitative inquiry is/as love?
A Bayesian Decision-Support Tool for Child Sexual Abuse Assessment and Investigation
Authors: Tadei Alessandro , Pensar Johan , Corander Jukka , Finnilä Katarina , Santtila Pekka , Antfolk Jan
Published: September 2017

In assessments of child sexual abuse (CSA) allegations, informative background information is often overlooked or not used properly. We therefore created and tested an instrument that uses accessible background information to calculate the probability of a child being a CSA victim that can be used as a starting point in the following investigation. Studying 903 demographic and socioeconomic variables from over 11,000 Finnish children, we identified 42 features related to CSA. Using Bayesian logic to calculate the probability of abuse, our instrument—the Finnish Investigative Instrument of Child Sexual Abuse (FICSA)—has two separate profiles for boys and girls. A cross-validation procedure suggested excellent diagnostic utility (area under the curve [AUC] = 0.97 for boys and AUC = 0.88 for girls). We conclude that the presented method can be useful in forensic assessments of CSA allegations by adding a reliable statistical approach to considering background information, and to support clinical decision making and guide investigative efforts.
Cross-Validation and Development of Empirically Derived ADHD Assessment Strategies: Insights From the National Longitudinal Study of Adolescent Health (Add Health)
Authors: Shemmassian Shirag K. , Lee Steve S.
Published: September 2017

Objective: There is replicated evidence that individual ADHD symptoms differentially predict ADHD diagnostic status, and that non– Diagnostic and Statistical Manual of Mental Disorders (DSM)-based symptom algorithms are superior to DSM criteria for ruling in or ruling out ADHD. However, these findings have been limited to case-control samples, despite the need to replicate them in independent and more representative samples and to increase their generalizability. Method: We analyzed the base rates and psychometric properties of ADHD symptoms in the population-based National Longitudinal Study of Adolescent Health (Add Health; http://www.cpc.unc.edu/projects/addhealth ) sample, and evaluated the predictive utility of empirically derived ADHD symptoms against the DSM approach with respect to academic, health, and relational functional outcomes. The sample consisted of 11,247 (54% female) ethnically diverse (45% non-White) individuals who retrospectively self-reported the severity of their ADHD symptoms from 5 to 12 years. Results: Individual ADHD symptoms variably predicted ADHD status, and whereas most symptoms were most predictive when endorsed at the two highest severity levels in previous studies, symptoms in Add Health were often most predictive of ADHD when endorsed at the highest severity level. Conclusion: The divergence in optimal severity thresholds for ADHD symptoms potentially reflects the different symptom base rates in clinical versus population-based samples. The accuracy of the different classification approaches also suggested that different symptom algorithms may be superior to evaluate ADHD depending on the assessment setting.
Gender Effects in a Multischool Alcohol Media Literacy Study With Preadolescents
Authors: Gordon Chloe S. , Howard Steven J. , Kervin Lisa K. , Jones Sandra C.
Published: September 2017

Objective. Alcohol media literacy (AML) programs have achieved positive results for alcohol prevention; however, gender may moderate program effectiveness. This study investigated gender differences for an Australian AML intervention. Method. Fifth and sixth graders ( N = 165), allocated to an intervention or wait-list control group, participated in an AML program. Student questionnaires were administered at three time points. Results. The intervention resulted in significantly higher media deconstruction skills but did not lead to less preference for branded merchandise or greater understanding of persuasive intent, and these effects did not differ by gender. Gender differences were present in social norms for drinking and alcohol expectancies. Conclusions. AML education likely has appeal and benefit to both genders as it connects with students’ lifeworlds. Social norms may be more difficult to shift for males due to a more ingrained drinking culture. Future research could explore contextual factors responsible for gender differences.
Historiometry in Organizational Science
Authors: Crayne Matthew P. , Hunter Samuel T.
Published: September 2017

Historiometric analysis (HMA), an organized set of content analytic techniques, allows researchers to convert historical information into numeric data that are appropriate for complex statistical analyses and modeling. The HMA method has been present in the social sciences for more than a century, yet is largely absent from the management and organizational sciences literatures. In this article, we make the case for increased attention to HMA in organizational research, and describe research scenarios for which the techniques prescribed by HMA are particularly well-suited. We also provide a comprehensive guide for conducting historiometric analysis including practical guidelines, procedural instructions, and analysis of potential obstacles to the research process.
The Stability of Implicit Racial Bias in Police Officers
Authors: James Lois
Published: September 2017

Research on police officers has found that they tend to associate African Americans with threat. Little is known however about the stability of implicit racial bias in police officers, whose attitudes could be expected to fluctuate based on their day-to-day encounters or from internal stressors such as fatigue. To investigate, this study tested 80 police officers using the Weapons Implicit Association Test (IAT) on four separate occasions. Officers’ sleep was also monitored using wrist actigraphy. Officers’ IAT scores varied significantly across the testing days ( f = 2.36; df = 1.468; p < .05), and differences in IAT scores were associated with officers’ sleep ( f = 6.49; df = 1.468; p < .05). These findings indicate that implicit racial bias was not stable among officers, and that when officers slept less prior to testing they demonstrated stronger association between Black Americans and weapons. The implications of these findings within the current climate of police–citizen unrest are discussed.
Cognitive impairment and the regional distribution of cerebellar lesions in multiple sclerosis
Authors: Tobyne Sean M , Ochoa Wilson B , Bireley J Daniel , Smith Victoria MJ , Geurts Jeroen JG , Schmahmann Jeremy D , Klawiter Eric C
Published: September 2017

Background:

Cerebellar lesions are often reported in relapsing-remitting multiple sclerosis (RRMS) and have been associated with impaired motor function and cognitive status. However, prior research has primarily focused on summary measures of cerebellar involvement (e.g. total lesion load, gray/white matter volume) and not on the effect of lesion load within specific regions of cerebellar white matter.

Objective:

Spatially map the probability of cerebellar white matter lesion (CWML) occurrence in RRMS and explore the relationship between cognitive impairment and lesion (CWML) location within the cerebellum.

Methods:

High-resolution structural magnetic resonance imaging (MRI) was acquired on 16 cognitively impaired (CI) and 15 cognitively preserved (CP) RRMS subjects at 3T and used for lesion identification and voxel-based lesion-symptom mapping (VLSM).

Results:

CI RRMS demonstrated a predilection for the middle cerebellar peduncle (MCP). VLSM results indicate that lesions of the MCP are significantly associated with CI in RRMS. Measures of cerebellar lesion load were correlated with age at disease onset but not disease duration.

Conclusion:

A specific pattern of cerebellar lesions involving the MCP, rather than the total CWML load, contributes to cognitive dysfunction in RRMS. Cerebellar lesion profiles may provide a biomarker of current or evolving risk for cognitive status change in RRMS.
Patient-reported safety incidents as a new source of patient safety data: an exploratory comparative study in an acute hospital in England
Authors: Armitage Gerry , Moore Sally , Reynolds Caroline , Laloë Pierre-Antoine , Coulson Claire , McEachan Rosie , Lawton Rebecca , Watt Ian , Wright John , O’Hara Jane
Published: September 2017

Objectives

To compare a new co-designed, patient incident reporting tool with three established methods of detecting patient safety incidents and identify if the same incidents are recorded across methods.

Method

Trained research staff collected data from inpatients in nine wards in one university teaching hospital during their stay. Those classified as patient safety incidents were retained. We then searched for patient safety incidents in the corresponding patient case notes, staff incident reports and reports to the Patient Advice and Liaison Service specific to the study wards.

Results

In the nine wards, 329 patients were recruited to the study, of which 77 provided 155 patient reports. From these, 68 patient safety incidents were identified. Eight of these were also identified from case note review, five were also identified in incident reports, and two were also found in the records of a local Patient Advice and Liaison Service. Reports of patients covered a range of events from their immediate environment, involving different health professionals and spanning the entire spectrum of care.

Conclusion

Patient safety incidents reported by patients are unlikely to be found through other established methods of incident detection. When hospitalized patients are asked about their care, they can provide a unique perspective on patient safety. Co-designed, real-time reporting could be a helpful addition to existing methods of gathering patient safety intelligence.
Preliminary validation of the Claudication Symptom Instrument (CSI)
Authors: Edwards Todd C , Lavallee Danielle C , Clowes Alexander W , Devine Emily B , Flum David R , Meissner Mark H , Thomason Ellen T , Barbic Skye P , Beck Sara J , Patrick Donald L
Published: September 2017

This article describes the development of the Claudication Symptom Instrument (CSI) and its measurement properties for evaluating the symptom experience of patients diagnosed with intermittent claudication (IC). We conducted semi-structured qualitative interviews with IC patients for item development and cognitive interviews in which patient comprehension of items was tested. We evaluated measurement properties using data collected and analyzed in the context of an observational comparative effectiveness study of IC treatments. Items measuring five symptom important to patients were developed and cognitively tested: Pain, Numbness, Heaviness, Cramping, and Tingling. Item means (higher means worse) ranged from 1.1 (Tingling) to 2.3 (Pain) (range: 0 ‘none’ to 4 ‘extreme’). Rasch analysis yielded support for an overall score (χ2=26.5, df=20, p=0.15). The total CSI score differed by clinician-rated severity of mild versus moderate ( p<0.05), but not moderate versus severe. Re-administration of the CSI 5–10 days after baseline yielded an intra-class correlation coefficient of 0.86. Changes in CSI total score and VASCUQOL total score between baseline and 6 months post-treatment were correlated at −0.52 ( p<0.05). The CSI preliminarily meets accepted measurement standards for content validity, internal consistency and test-retest reliability, construct validity, and sensitivity for detecting change. Because of its high test-retest reliability, it may also be useful in clinical care with individual patients. It takes approximately 3 minutes to complete.
Optimal design of cyclically symmetric trusses with frequency constraints using cyclical parthenogenesis algorithm
Authors: Kaveh A , Zolghadr A
Published: September 2017

Special kinds of structures exhibit repetitive patterns that can be used in the process of structural analysis in order to decrease the required computational time. This is especially helpful when a structure should be analyzed numerous times as in the structural optimization problems. In this article, weight optimization of cyclically symmetric spatial trusses subjected to frequency constraints is performed utilizing such repetitive patterns. Large initial eigenproblems are first decomposed into smaller and less time-consuming problems using an efficient block diagonalization technique. A recently developed meta-heuristic method, cyclical parthenogenesis algorithm, is then utilized to perform the optimization task. Three numerical examples are optimized to illustrate the viability and efficiency of the proposed method.
Oxidative Stress Assessment in Alzheimer’s Disease: A Clinic Setting Study
Authors: Vergallo Andrea , Giampietri Linda , Baldacci Filippo , Volpi Leda , Chico Lucia , Pagni Cristina , Giorgi Filippo Sean , Ceravolo Roberto , Tognoni Gloria , Siciliano Gabriele , Bonuccelli Ubaldo
Published: September 2017

Background:

Oxidative stress (OS) is a physiological age-related brain process, dramatically overexpressed in neurodegenerative disorders like Alzheimer’s disease (AD). Nevertheless, the pathophysiological role of OS in AD pathology has not been clarified yet. OS as a biomarker for AD is a controversial issue. A comparison of previous data is difficult due to a remarkable methodological variability. Most of the previous studies have shown higher levels of OS markers and lower antioxidant power in patients with dementia when compared to mild cognitive impairment (MCI) and healthy controls.

Methods:

We followed a strict protocol in order to limit intrasite variability of OS assessment. In addition, we have taken into account possible confounding factors.

Results:

In agreement with previous reports, we found both lower plasmatic OS and higher plasmatic antioxidant defenses when comparing patients with AD having dementia that is stably treated to patients with MCI-AD.

Discussion:

A speculative hypothesis based on correlative data is provided.
Newly Developed Laparoscopic Needle Holder That Facilitates Knot Tying Makes Vaginal Cuff Suturing Easy in Single-Port Laparoscopic Hysterectomy
Authors: Biler Alper , Kale Ahmet , Terzi Hasan , Solmaz Ulas
Published: September 2017

Background. To evaluate vaginal cuff closure times of a single-port laparoscopic hysterectomy using a newly developed Turkish-made laparoscopic needle holder (TMLNH) with a single-port laparoscopic hysterectomy using a laparoscopic needle holder with pistol handle (LNHPH). Methods. We retrospectively reviewed 68 patients who underwent single-port laparoscopic hysterectomy using a TMLNH (n = 38) or a LNHPH (n = 30). Patients’ age, parity, body mass index, mean operating time, mean vaginal cuff suturing time, uterine weight, estimated blood loss, drop of hemoglobin level, return of bowel activity, hospital stay, conversion to multiport access, conversion to laparotomy, and postoperative and intraoperative outcomes were analyzed. Results. The TMLNH group had a shorter operative time ( P < .001) and a shorter vaginal cuff suturing time ( P < .001) compared with the LNHPH group during a single-port laparoscopic hysterectomy. There was no difference in intraoperative and postoperative complications. Conclusion. The TMLNH facilitates vaginal cuff suturing and decreases operation time during a single-port laparoscopic hysterectomy. We proposed that the TMLNH is a promising technique for suturing and vaginal cuff closure in a single-port laparoscopic hysterectomy.
Iatrogenic Injuries in Percutaneous Pinning Techniques for Fifth Metacarpal Neck Fractures
Authors: Akinleye Sheriff D. , Garofolo-Gonzalez Garret , Culbertson Maya Deza , Choueka Jack
Published: September 2017

Background: There is little information regarding anatomic structures at risk during closed percutaneous treatment of fifth metacarpal neck fractures. This study evaluates a variety of common percutaneous techniques with the hypothesis that each approach presents unique risks to tendons and neurovascular structures. Methods: Seven cadaveric hands were used for this study. The senior author, a board-certified hand surgeon with more than 20 years of experience, used a mini-C arm to pass 1.6-mm Kirschner wires (K-wires). The 4 percutaneous techniques employed were anterograde, retrograde, cross-pinning, and transverse fixations. Meticulous superficial dissection was carried out, with fixation from all 4 techniques left in place, to identify any tendons or neurovascular structures penetrated by the K-wires. Results: All techniques demonstrated penetration of at least 1 adjacent structure. The anterograde technique showed penetration of the extensor carpi ulnaris tendon in 5 out of 7 cadavers. In the retrograde approach, the K-wire impaled either the extensor digitorum communis or the extensor digitorum minimi tendons in 4 out of 7 cadavers. The transverse pinning technique exhibited injury to the dorsal cutaneous ulnar nerve in 2 of the specimens. In the retrograde cross-pin technique, there were 2 penetrations of the digital branch of the dorsal cutaneous ulnar nerve. Conclusions: None of the described percutaneous techniques for treating fifth metacarpal neck fractures eliminate the potential for damage to surrounding tendons or nerves. Each technique has at risk structures that the treating surgeon should be aware of in order to anticipate potential complications and counsel patients accordingly.
Cerebrovascular reactivity measurement in cerebral small vessel disease: Rationale and reproducibility of a protocol for MRI acquisition and image processing
Authors: Thrippleton Michael J , Shi Yulu , Blair Gordon , Hamilton Iona , Waiter Gordon , Schwarzbauer Christian , Pernet Cyril , Andrews Peter JD , Marshall Ian , Doubal Fergus , Wardlaw Joanna M
Published: September 2017

Background

Impaired autoregulation may contribute to the pathogenesis of cerebral small vessel disease. Reliable protocols for measuring microvascular reactivity are required to test this hypothesis and for providing secondary endpoints in clinical trials.

Aims

To develop and assess a protocol for acquisition and processing of cerebrovascular reactivity by MRI, in subcortical tissue of patients with small vessel disease and minor stroke.

Methods

We recruited 15 healthy volunteers, testing paradigms using 1- and 3-min 6% CO2 challenges with repeat scanning, and 15 patients with history of minor stroke. We developed a protocol to measure cerebrovascular reactivity and delay times, assessing tolerability and reproducibility in grey and white matter areas.

Results

The 3-min paradigm yielded more reproducible data than the 1-min paradigm (CV respectively: 7.9–15.4% and 11.7–70.2% for cerebrovascular reactivity in grey matter), and was less reproducible in white matter (16.1–24.4% and 27.5–141.0%). Tolerability was similar for the two paradigms, but mean cerebrovascular reactivity and cerebrovascular reactivity delay were significantly higher for the 3-min paradigm in most regions. Patient tolerability was high with no evidence of greater failure rate (1/15 patients vs. 2/15 volunteers withdrew at the first visit). Grey matter cerebrovascular reactivity was lower in patients than in volunteers (0.110–0.234 vs. 0.172–0.313%/mmHg; p < 0.05 in 6/8 regions), as was the white matter cerebrovascular reactivity delay (16.2–43.9 vs. 31.1–47.9 s; p < 0.05 in 4/8 regions).

Conclusions

An effective and well-tolerated protocol for measurement of cerebrovascular reactivity was developed for use in ongoing and future trials to investigate small vessel disease pathophysiology and to measure treatment effects.
Distinction at the Class-Fraction Level? A Re-Examination of Bourdieu’s Dataset
Authors: Brisson Romain , Bianchi Renzo
Published: September 2017

This study examines the consistency of Pierre Bourdieu’s homology thesis by assessing, at a class-fraction level, the statistical significance of the differences in taste and lifestyle reported in Distinction. According to Bourdieu, taste and lifestyle vary not only from one social class to another, but also within social classes themselves, depending on the type of capital (notably, cultural or economic) that prevails among class fractions. In this article, we estimate the cultural distance separating eight fractions of the middle and upper classes by performing bilateral between-proportion comparison tests. Two levels of analysis are considered: the intra-class and the inter-class fraction levels. The first level only involves within-class comparisons. It aims to test the empirical basis of the concept of capital composition. The second level only involves comparisons between middle-class and upper-class fractions. It aims to test Bourdieu’s representation of social space. Results indicate that 1) the composition of capital is associated with taste variability in both the middle and upper classes, and 2) taste similarities and dissimilarities between fractions belonging to different classes are linked to cultural capital. In sum, this study provides additional evidence for the consistency of Bourdieu’s homology thesis.
Increasing Marriage Rates Despite High Individualization: Understanding the Role of Internal Reference in Swedish Marriage Discourse
Authors: Strandell Jacob
Published: September 2017

Individualization remains the most prominent theoretical explanation for the shifts in European demographic trends since the 1960s, including decreasing marriage and fertility rates and increasing divorce rates. Demographic theorists suggest that a shift from traditional to individualized values, such as autonomy and self-realization, has been driving these trends. However, conceptualizing individualization as a set of values cannot account for why Swedish marriage rates have increased since 1998, despite highly individualized values. This article suggests re-thinking individualization as a form of internally referring attributions in causal and moral reasoning about human behavior, emphasizing agency and internal causes over structure or context. As such, individualization shapes peoples’ perceptions and understandings of the world, including their expectations of marriage and close relationships. Data from focus groups support this conceptualization and show how participants individualize risks, while perceiving marriage itself as inconsequential. In line with previous research, individualized reasoning obfuscated assumptions that were less individualized and implicit.
The Sociology of Culture in the Soviet Union and Russia: The Missed Turn
Authors: Kurakin Dmitry
Published: September 2017

This article maps the development of the sociology of culture in the Soviet Union and Russia from pre-Soviet to post-Soviet times. The analysis highlights the effects of two groups of factors – one cultural, the other structural – the combination of which brought about various patterns at each stage of the discipline’s development. Because of the political environment within which they worked, Soviet researchers of culture had to employ strategies of resistance to survive. The three most common were: finding niches in related, ideologically neutral disciplines; doing purely empirical work; or, in contrast, critiquing ‘bourgeois social theories’. They also opted to work in the modes of reading rather than writing, oral discussions rather than publishing, and communication with like-minded colleagues rather than debates with opponents. Contemporary Russian sociology of culture displays this inheritance in being structured by the opposition between isolation and international integration, as well as the tension between an elitist vision of culture and the economically centered worldview which has been dominant since the 1990s.
The clinical course after glucocorticoid treatment in patients with inflammatory bowel disease is linked to suppression of the hypothalamic–pituitary–adrenal axis: a retrospective observational study
Authors: Ibrahim Aghil , Dahlqvist Per , Olsson Tommy , Lundgren David , Werner Mårten , Suhr Ole B. , Karling Pontus
Published: September 2017

Background:

Adrenal insufficiency (AI) secondary to treatment with glucocorticoids (GCs) is common in patients with inflammatory bowel disease (IBD), but little is known about the relationship between AI and the clinical course in IBD. The aim of the study was to compare the clinical course in IBD patients with normal adrenal function versus patients with subnormal adrenal function.

Methods:

A retrospective observational study on 63 patients with IBD who had performed a low-dose short Synacthen test (LDSST) (1 μg) immediately (1–7 days) after a standard course of GCs. A subnormal LDSST was defined as serum cortisol <550 nmol/L. Outcomes were time to next flare and fecal calprotectin levels.

Results:

Sixty-three percent ( n = 40) of the IBD patients had a subnormal LDSST. Patients who were steroid-free ( n = 41) after the LDSST were observed for 3 years. Patients with a peak serum cortisol <400 nmol/L immediately after GC treatment had significantly longer time until the next flare-up of their IBD and tended to use a lower cumulative prednisolone dose during the study period in comparison to the other subgroups. Fecal calprotectin levels were significantly lower in patients with a peak s-cortisol <550 nmol/L versus patients with peak s-cortisol ⩾550 nmol/L (median 336 µg/g (IQR 521) versus 955 µg/g (IQR 1867); p = 0.012).

Conclusions:

GC-induced AI is common in patients with IBD and is associated with lower disease activity. This suggests a link between responsiveness to GC treatment and suppression of the hypothalamic–pituitary–adrenal axis in IBD.
Step-by-step strategy in the management of residual hepatolithiasis using post-operative cholangioscopy
Authors: Wen Xu-dong , Wang Tao , Huang Zhu , Zhang Hong-jian , Zhang Bing-yin , Tang Li-jun , Liu Wei-hui
Published: September 2017

Hepatolithiasis is the presence of calculi within the intrahepatic bile duct specifically located proximal to the confluence of the left and right hepatic ducts. The ultimate goal of hepatolithiasis treatment is the complete removal of the stone, the correction of the associated strictures and the prevention of recurrent cholangitis. Although hepatectomy could effectively achieve the above goals, it can be restricted by the risk of insufficient residual liver volume, and has a 15.6% rate of residual hepatolithiasis. With improvements in minimally invasive surgery, post-operative cholangioscopy (POC), provides an additional option for hepatolithiasis treatment with higher clearance rate and fewer severe complications. POC is very safe, and can be performed repeatedly until full patient benefit is achieved. During POC three main steps are accomplished: first, the analysis of the residual hepatolithiasis distribution indirectly by imaging methods or directly endoscopic observation; second, the establishment of the surgical pathway to relieve the strictures; and third, the removal of the stone by a combination of different techniques such as simple basket extraction, mechanical fragmentation, electrohydraulic lithotripsy or laser lithotripsy, among others. In summary, a step-by-step strategy of POC should be put forward to standardize the procedures, especially when dealing with complicated residual hepatolithiasis. This review briefly summarizes the classification, management and complications of hepatolithiasis during the POC process.
Simulations of coalescence of two colliding liquid drops using lattice Boltzmann method
Authors: Wei Yi-Kun , Li Zhe-Hong , Zhang Yi-Fan
Published: September 2017

In this paper, two-dimensional numerical simulations of the head-on and off-center binary collision of liquid drops are carried out using lattice Boltzmann method. The coalescence process of drops colliding is freely captured, regardless of tracking equations and drops model. Special attention is paid to investigate the effect of the Weber number, impact velocity, drop size ratio on the coalescence process. The research results demonstrate that numerical results of lattice Boltzmann method are in agreement with qualitatively experimental data in the same Weber number. It is also noted that the first oscillation period is invariably shorter than the second period, regardless of the Weber number. It is further found that variation of the first period of oscillation in off-center collision of two equal-size drops as function of Weber number are higher than the variation of the first period of oscillation in head-on collision of two equal-size drops in the same Weber number.
X-inactive-specific transcript of peripheral blood cells is regulated by exosomal Jpx and acts as a biomarker for female patients with hepatocellular carcinoma
Authors: Ma Xiang , Yuan Tingdong , Yang Chao , Wang Zusen , Zang Yunjin , Wu Liqun , Zhuang Likun
Published: September 2017

Background:

Long noncoding ribonucleic acid (lncRNA) X-inactive-specific transcript (Xist) was reported to affect cell proliferation and metastasis in hepatocellular carcinoma (HCC). However, there are rare reports focusing on the diagnostic evaluation and regulatory mechanism of Xist expression from peripheral blood cells of patients with HCC.

Methods:

In this study, a cohort of 206 female participants including healthy volunteers (HVs) and patients with chronic hepatitis B (CHB), cirrhosis and HCC was recruited. Coculture system was used to evaluate the effects of exosomal JPX transcript, XIST activator (Jpx) on Xist expression of blood cells.

Results:

First, Xist expressions of both peripheral blood mononuclear cells and granulocytes were upregulated in female patients with HCC, and showed significantly increased discriminatory power when differentiating female patients with early-stage HCC from controls or differentiating female patients with HCC from patients with CHB and cirrhosis, compared with alpha fetoprotein (AFP). Then, another lncRNA Jpx that was an activator of Xist was upregulated in exosomes, mononuclear cells and granulocytes of female patients with HCC. Furthermore, our results showed that Jpx could be delivered from HCC cells to blood cells via exosomes and activate Xist expression of blood cells by repressing the transregulatory effects of CCCTC-binding factor (CTCF).

Conclusions:

This study revealed an exosome-mediated regulation of Xist expression in blood cells and suggested that Xist expressions of mononuclear cells and granulocytes would be promising biomarkers for diagnosis of female patients with HCC.
Biophysical Stimuli: A Review of Electrical and Mechanical Stimulation in Hyaline Cartilage
Authors: Vaca-González Juan J. , Guevara Johana M. , Moncayo Miguel A. , Castro-Abril Hector , Hata Yoshie , Garzón-Alvarado Diego A.
Published: September 2017

Objective

Hyaline cartilage degenerative pathologies induce morphologic and biomechanical changes resulting in cartilage tissue damage. In pursuit of therapeutic options, electrical and mechanical stimulation have been proposed for improving tissue engineering approaches for cartilage repair. The purpose of this review was to highlight the effect of electrical stimulation and mechanical stimuli in chondrocyte behavior.

Design

Different information sources and the MEDLINE database were systematically revised to summarize the different contributions for the past 40 years.

Results

It has been shown that electric stimulation may increase cell proliferation and stimulate the synthesis of molecules associated with the extracellular matrix of the articular cartilage, such as collagen type II, aggrecan and glycosaminoglycans, while mechanical loads trigger anabolic and catabolic responses in chondrocytes.

Conclusion

The biophysical stimuli can increase cell proliferation and stimulate molecules associated with hyaline cartilage extracellular matrix maintenance.
The clinical evaluation of needle-based confocal laser endomicroscopy in the assessment of pancreatic cystic lesion: A pilot study
Authors: Chin Yung Ka , Khor Christopher Jen Lok , Goh Brian Kim Poh , Lim Tony Kiat Hon , Tan Damien Meng Yew
Published: September 2017

Background/aim:

Pancreatic cystic lesions are increasingly diagnosed from cross-sectional imaging done for other indications. The challenge lies in the ability to correctly identify the high-risk individuals for resection surgery, which carries high morbidity and mortality. Unfortunately, present diagnostic techniques are suboptimal. Needle-based confocal laser endomicroscopy (nCLE) has been designed to bridge this diagnostic gap. We aim to assess the feasibility and safety of nCLE in the assessment of pancreatic cystic lesions.

Methods:

We prospectively recruited patients referred for assessment of pancreatic cystic lesions from August 2014 until July 2015. All pancreatic cystic lesions were examined with nCLE miniprobe via endoscopic ultrasound followed by fine-needle aspiration. Information regarding the cysts (morphology, location, fluid analysis etc.) was documented. Adverse event was recorded.

Results:

Fourteen patients were recruited, six were male with a mean age of 66.5 (range 48–80) years. Only 12 completed nCLE examination of the pancreatic cystic lesions. nCLE imaging was successful in 83.3% (10/12). Average nCLE imaging duration was 5 min 18 s. There was one (10%) adverse event. nCLE impressions were correct in eight cases (five malignant and three benign) compared with final diagnosis. Three patients underwent surgery, histology showed ductal adenocarcinoma, pancreatic neuroendocrine tumor and gastric-subtype of intraductal papillary mucinous neoplasm. The sensitivity and specificity of the nCLE impression when compared with final diagnosis were 83.3% and 75% respectively. The accuracy of nCLE was 80%.

Conclusion:

Our results have demonstrated that nCLE assessment of pancreatic cystic lesions is safe and feasible. It may complement the existing diagnostic modalities to improve diagnostic yield.