bluuebunny/crossref_metadata_2025 huggingface dataset:
The Person-Centred Care Guideline: From Principle to Practice
Authors: Moody Lesley , Nicholls Brett , Shamji Hannah , Bridge Erica , Dhanju Suman , Singh Simron
Published: April 2018

Background:

A standardized definition and approach for the delivery of person-centered care (PCC) in cancer care that is agreed upon by all key policy makers and clinicians is lacking. The PCC Guideline defines core PCC principles to outline a level of service that every person accessing cancer services in Ontario, Canada should expect to receive. This article describes the dissemination of the PCC Guideline in practice.

Methods:

Three strategies were utilized: (1) educational intervention via a PCC video, (2) media engagement, and (3) research/knowledge user networks.

Results:

As of October 2016, the PCC video has been viewed 7745 times across 92 countries. Significant mean differences pre- and post-PCC video were found for understanding of PCC principles ( P < .001) and perceived ability to bring these PCC principles to practice ( P < .001). Through content analysis, the PCC Guideline recommendations were referenced 236 times, with “Enabling Patients to Actively Participate in their Care” (n = 81), and “Essential Requirements of Care” (n = 79) being referenced most frequently.

Conclusions:

These strategies are an effective way to target multiple PCC stakeholders in the health-care system to increase awareness of the PCC Guideline, in order to further impart knowledge of PCC behaviors.
Improving spatial decision making using interactive maps: An empirical study on interface complexity and decision complexity in the North American hazardous waste trade
Authors: Vincent Kristen , Roth Robert E , Moore Sarah A , Huang Qunying , Lally Nick , Sack Carl M , Nost Eric , Rosenfeld Heather
Published: April 2018

Spatial decisions increasingly are made by both professional and citizen stakeholders using interactive maps, yet few empirically-derived guidelines exist for designing interactive maps that support complex reasoning and decision making across problem contexts. We address this gap through an online map study with 122 participants with varying expertise. The study required participants to assume two hypothetical scenarios in the North American hazardous waste trade, review geographic information on environmental justice impacts using a different interactive map for each scenario, and arrive at an optimal decision outcome. This study followed a 2 × 2 factorial design, varying interface complexity (the number of supported interaction operators) and decision complexity (the number of decision criteria) as the independent variables and controlling for participant expertise with the hazardous waste trade and other aspects of cartographic design. Our findings indicate that interface complexity, not decision complexity, influenced decision outcomes, with participants arriving at better decisions using the simpler interface. However, expertise was a moderating effect, with experts and non-experts using different interaction strategies to arrive at their decisions. The research contributes to cartography, geovisualization, spatial decision science, urban planning, and visual analytics as well as to scholarship on environmental justice, the geography of hazardous waste, and participatory mapping.
YM155 decreases radiation-induced invasion and reverses epithelial–mesenchymal transition by targeting STAT3 in glioblastoma
Authors: Zhang Xin , Wang Xuehai , Xu Ran , Ji Jianxiong , Xu Yangyang , Han Mingzhi , Wei Yuzhen , Huang Bin , Chen Anjing , Zhang Qing , Li Wenjie , Wang Jian , Li Xingang , Qiu Chen
Published: April 2018

Background

Radiotherapy constitutes a standard arm of therapy in the multimodal treatment of patients with glioblastoma (GBM). Ironically, studies have recently revealed that radiation can augment malignant progression, by promoting migration and invasion, which make the disease especially difficult to cure. Here, we investigated the anticancer effects of YM155, a purported radiosensitizer, in GBM cell lines.

Methods

GBM cell lines U251 and U87 were treated with YM155 to assess cytotoxicity and activity of the molecule in vitro. Nude mice were implanted with cells to generate orthotopic xenografts for in vivo studies. Response of cells to treatment was examined using cell viability, immunofluorescence, wound healing, and the Transwell invasion assay. Molecules potentially mediating response were examined through western blot analysis, phospho-kinase arrays, and qPCR. Cells were transfected with siRNA knockdown and gene expression constructs to identify molecular mediators of response.

Results

YM155 reduced viability of U251 and U87 cells and enhanced radiosensitivity through inhibition of homologous recombination. Besides, YM155 decreased invasion caused by radiation and led to expression changes in molecular markers associated with EMT. STAT3 was one of 10 molecules identified on a phosphokinase array exhibiting significant change in phosphorylation under YM155 treatment. Transfection with STAT3 siRNAs or expression constructs demonstrated that EMT changes were achieved by inhibiting the phosphorylation of STAT3 and were survivin-independent. Finally, combining YM155 and radiation in orthotopic xenografts reduced growth and prolonged overall survival of animals.

Conclusions

YM155 decreased radiation-induced invasion in GBM cell lines in vitro and in vivo through inhibition of STAT3.
The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial
Authors: Sloan Robert A. , Kim Youngdeok , Sahasranaman Aarti , Müller-Riemenschneider Falk , Biddle Stuart J. H. , Finkelstein Eric A.
Published: April 2018

Objective

A recent meta-analysis surmised pedometers were a useful panacea to independently reduce sedentary time (ST). To further test and expand on this deduction, we analyzed the ability of a consumer-wearable activity tracker to reduce ST and prolonged sedentary bouts (PSB). We originally conducted a 12-month randomized control trial where 800 employees from 13 organizations were assigned to control, activity tracker, or one of two activity tracker plus incentive groups designed to increase step count. The primary outcome was accelerometer measured moderate-to-vigorous physical activity.

Results

We conducted a secondary analysis on accelerometer measured daily ST and PSB bouts. A general linear mixed model was used to examine changes in ST and prolonged sedentary bouts, followed by between-group pairwise comparisons. Regression analyses were conducted to examine the association of changes in step counts with ST and PSB. The changes in ST and PSB were not statistically significant and not different between the groups (P < 0.05). Increases in step counts were concomitantly associated with decreases in ST and PSB, regardless of intervention (P < 0.05). Caution should be taken when considering consumer-wearable activity trackers as a means to reduce sedentary behavior.

Trial registration NCT01855776 Registered: August 8, 2012
Potentially modifiable respiratory variables contributing to outcome in ICU patients without ARDS: a secondary analysis of PRoVENT
Authors: Simonis Fabienne D. , Barbas Carmen S. V. , Artigas-Raventós Antonio , Canet Jaume , Determann Rogier M. , Anstey James , Hedenstierna Goran , Hemmes Sabrine N. T. , Hermans Greet , Hiesmayr Michael , Hollmann Markus W. , Jaber Samir , Martin-Loeches Ignacio , Mills Gary H. , Pearse Rupert M. , Putensen Christian , Schmid Werner , Severgnini Paolo , Smith Roger , Treschan Tanja A. , Tschernko Edda M. , Vidal Melo Marcos F. , Wrigge Hermann , de Abreu Marcelo Gama , Pelosi Paolo , Schultz Marcus J. , Neto Ary Serpa ,   For the PRoVENT investigators,   The PROVE Network investigators, Neto Ary Serpa , Barbas Carmen S. V. , Artigas-Raventós Antonio , Canet Jaume , Determann Rogier M. , Dixon Barry , Hedenstierna Goran , Hemmes Sabrine N. T. , Hermans Greet , Hiesmayr Michael , Hollmann Markus W. , Jaber Samir , Martin-Loeches Ignacio , Mills Gary H. , Pearse Rupert M. , Putensen Christian , Schmid Werner , Severgnini Paolo , Smith Roger , Treschan Tanja A. , Tschernko Edda M. , Vidal Melo Marcos F. , Wrigge Hermann , de Abreu Marcelo Gama , Pelosi Paolo , Schultz Marcus J. , Simonis Fabienne D.
Published: April 2018

Background

The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients.

Methods

The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality. The primary endpoint was all-cause in-hospital mortality.

Results

935 Patients were included. In-hospital mortality was 21%. Compared to patients who died, patients who survived had a lower risk of ARDS according to the ‘Lung Injury Prediction Score’ and received lower maximum airway pressure (Pmax), driving pressure (ΔP), positive end-expiratory pressure, and FiO2 levels. Tidal volume size was similar between the groups. Higher Pmax was a potentially modifiable ventilatory variable associated with in-hospital mortality in multivariable analyses. ΔP was not independently associated with in-hospital mortality, but reliable values for ΔP were available for 343 patients only. Non-modifiable factors associated with in-hospital mortality were older age, presence of immunosuppression, higher non-pulmonary sequential organ failure assessment scores, lower pulse oximetry readings, higher heart rates, and functional dependence.

Conclusions

Higher Pmax was independently associated with higher in-hospital mortality in mechanically ventilated critically ill patients under mechanical ventilatory support for reasons other than ARDS.

Trial Registration ClinicalTrials.gov (NCT01868321).
Behavioural Computer Science: an agenda for combining modelling of human and system behaviours
Authors: Pedersen Tore , Johansen Christian , Jøsang Audun
Published: April 2018

The rapidly increasing pervasiveness and integration of computers in human society calls for a broad discipline under which this development can be studied. We argue that to design and use technology one needs to develop and use models of humans and machines in all their aspects, including cognitive and memory models, but also social influence and (artificial) emotions. We call this wider discipline Behavioural Computer Science (BCS), and argue in this paper for why BCS models should unify (models of) the behaviour of humans and machines when designing information and communication technology systems. Thus, one main point to be addressed is the incorporation of empirical evidence for actual human behaviour, instead of making inferences about behaviour based on the rational agent model. Empirical studies can be one effective way to constantly update the behavioural models. We are motivated by the future advancements in artificial intelligence which will give machines capabilities that from many perspectives will be indistinguishable from those of humans. Such machine behaviour would be studied using BCS models, looking at questions aboutmachine trustlike “Can a self driving car trust its passengers?”, orartificial influencelike “Can the user interface adapt to the user’s behaviour, and thus influence this behaviour?”. We provide a few directions for approaching BCS, focusing on modelling of human and machine behaviour, as well as their interaction.
Prevalence and antibiotic resistance of bacteria isolated from the cerebrospinal fluid of neurosurgical patients at Peking Union Medical College Hospital
Authors: Chang Jian-bo , Wu Hao , Wang He , Ma Bai-tao , Wang Ren-zhi , Wei Jun-ji
Published: April 2018

Background

Postoperative central nervous system infections (PCNSIs) represent a serious complication, and the timely use of antibiotics guided by the identification of the causative pathogens and their antibiotic sensitivities is essential for treatment. However, there are little data regarding the prevalence of PCNSI pathogens in China. The aim of this study is to investigate the features of pathogens in patients with PCNSIs, which could help clinicians to choose the appropriate empirical antibiotic therapy.

Methods

We retrospectively examined the positive CSF cultures in patients who underwent craniotomy between January 2010 and December 2015. We collected data, including demographic characteristics, type of neurosurgery, laboratory data, causative organisms and antimicrobial susceptibility testing results.

Results

A total of 62 patients with 90 isolates out of 818 patients with 2433 CSF culture samples were available for data analysis. The estimated incidence and culture-positive rate of PCNSIs were approximately 0.9 and 7.5%, respectively. The predominant organism was coagulase-negative staphylococci, of which most were methicillin-resistant coagulase-negative staphylococci (MRCoNS). All were susceptible to vancomycin, linezolid, rifampicin and amoxicillin-clavulanate. Acinetobacter baumannii was the most frequent causative Gram-negative agent and was resistant to 12 out of 18 antimicrobials tested. The sensitivity rates for tigecycline and minocycline were only 40 and 33%, respectively.

Conclusion

PCNSIs could lead to high mortality. Although the MRCoNS were the predominant organism, the management of Acinetobacter baumannii was a major clinical challenge with few effective antimicrobials in PCNSIs.
Development of a patient-centred intervention to improve knowledge and understanding of antibiotic therapy in secondary care
Authors: Rawson Timothy M. , Moore Luke S. P. , Castro-Sanchez Enrique , Charani Esmita , Hernandez Bernard , Alividza Vivian , Husson Fran , Toumazou Christofer , Ahmad Raheelah , Georgiou Pantelis , Holmes Alison H.
Published: April 2018

Background

We developed a personalised antimicrobial information module co-designed with patients. This study aimed to evaluate the potential impact of this patient-centred intervention on short-term knowledge and understanding of antimicrobial therapy in secondary care.

Methods

Thirty previous patients who had received antibiotics in hospital within 12 months were recruited to co-design an intervention to promote patient engagement with infection management. Two workshops, containing five focus-groups were held. These were audio-recorded. Data were analysed using a thematic framework developed deductively based on previous work. Line-by-line coding was performed with new themes added to the framework by two researchers. This was used to inform the development of a patient information module, embedded within an electronic decision support tool (CDSS).

The intervention was piloted over a four-week period at Imperial College Healthcare NHS Trust on 30 in-patients. Pre- and post-intervention questionnaires were developed and implemented to assess short term changes in patient knowledge and understanding and provide feedback on the intervention. Data were analysed using SPSS and NVIVO software.

Results

Within the workshops, there was consistency in identified themes. The participants agreed upon and co-designed a personalised PDF document that could be integrated into an electronic CDSS to be used by healthcare professionals at the point-of-care. Their aim for the tool was to provide individualised practical information, signpost to reputable information sources, and enhance communication between patients and healthcare professionals.

Eighteen out of thirty in-patients consented to participant in the pilot evaluation with 15/18(83%) completing the study. Median (range) age was 66(22–85) years. The majority were male (10/15;66%). Pre-intervention, patients reported desiring further information regarding their infections and antibiotic therapy, including side effects of treatment. Deployment of the intervention improved short term knowledge and understanding of individuals infections and antibiotic management with median (IQR) scores improving from 3(2–5)/13 to 10(6–11)/13. 13/15(87%) reported that they would use the intervention again.

Conclusion

A personalised, patient-centred intervention improved understanding and short-term knowledge of infections and antibiotic therapy in participating patients’. Long term impact on attitudes and behaviours post discharge will be further investigated.
Vancomycin-resistant Enterococcus faecium sequence type 796 - rapid international dissemination of a new epidemic clone
Authors: Mahony Andrew A. , Buultjens Andrew H. , Ballard Susan A. , Grabsch Elizabeth A. , Xie Shirley , Seemann Torsten , Stuart Rhonda L. , Kotsanas Despina , Cheng Allen , Heffernan Helen , Roberts Sally A. , Coombs Geoffrey W. , Bak Narin , Ferguson John K. , Carter Glen C. , Howden Benjamin P. , Stinear Timothy P. , Johnson Paul D. R.
Published: April 2018

Background

Vancomycin-resistant Enterococcus faecium (VRE) is a leading cause of hospital-acquired infections. New, presumably better-adapted strains of VRE appear unpredictably; it is uncertain how they spread despite improved infection control. We aimed to investigate the relatedness of a novel sequence type (ST) of vanB E. faecium - ST796 - very near its time of origin from hospitals in three Australian states and New Zealand.

Methods

Following near-simultaneous outbreaks of ST796 in multiple institutions, we gathered then tested colonization and bloodstream infection isolates’ antimicrobial resistance (AMR) phenotypes, and phylogenomic relationships using whole genome sequencing (WGS). Patient meta-data was explored to trace the spread of ST796.

Results

A novel clone of vanB E. faecium (ST796) was first detected at one Australian hospital in late 2011, then in two New Zealand hospitals linked by inter-hospital transfers from separate Melbourne hospitals. ST796 also appeared in hospitals in South Australia and New South Wales and was responsible for at least one major colonization outbreak in a Neonatal Intensive Care Unit without identifiable links between centers. No exceptional AMR was detected in the isolates. While WGS analysis showed very limited diversity at the core genome, consistent with recent emergence of the clone, clustering by institution was observed.

Conclusions

Evolution of new E. faecium clones, followed by recognized or unrecognized movement of colonized individuals then rapid intra-institutional cross-transmission best explain the multi-center, multistate and international outbreak we observed.
Strain, disinfectant, concentration, and contact time quantitatively impact disinfectant efficacy
Authors: West Alyssa M. , Teska Peter J. , Lineback Caitlinn B. , Oliver Haley F.
Published: April 2018

Background

Transmission of healthcare-associated infections caused by antibiotic- and multi-drug resistant (MDR) pathogens (e.g. Methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa) are a major concern in patient care facilities. Disinfectant usage is critical to control and prevent pathogen transmission, yet the relationships among strain, disinfectant type, contact time, and concentration are not well-characterized. We hypothesized that there would be significant differences in disinfectant efficacy among clinically relevant strains under off-label disinfectant conditions, but there would be less no differences among at registered label use concentrations and contact times. The purpose of this study was to quantify the effect of disinfectant concentration and contact time on the bactericidal efficacy of clinically relevant strains of S. aureus and P. aeruginosa.

Methods

Accelerated hydrogen peroxide (AHP), quaternary ammonium compounds (Quat), and sodium hypochlorite were tested at label and reduced contact times and concentrations against four MDR P. aeruginosa strains and four MRSA strains. Quantitative EPA method MB-25-02 was used to measure disinfectant efficacy reported as log10 reduction.

Results

Both off-label disinfectant concentrations and contact times significantly affected efficacy of all disinfectants tested. Bactericidal efficacy varied among MRSA and P. aeruginosa strains.

Conclusions

The quantitative disinfectant efficacy method used highlights the inter-strain variability that exists within a bacterial species. It also underscores the need for a disinfectant validation method that takes these variances into account.
Pet owner and vet interactions: exploring the drivers of AMR
Authors: Smith Matt , King Caroline , Davis Mark , Dickson Adele , Park Jeni , Smith Fraser , Currie Kay , Flowers Paul
Published: April 2018

Background

Antimicrobial resistance (AMR) is a growing public health problem across the world. As the negative consequences of AMR become apparent at local, national and international levels, more attention is being focussed on the variety of mechanisms by which AMR is potentiated. We explore how interactions between pet owners and veterinarians represent a key arena in which AMR-related behaviours can be shaped.

Methods

In depth semi-structured interviews were carried out with pet owners (n = 23) and vets (n = 16) across the UK in 2017. A thematic analysis approach was taken, with inductively gathered data analysed deductively using a behavioural framework to identified key behaviours emerging from participant accounts which were amenable to change.

Results

Interactions between vets and pet owners were characterised by misunderstandings and misconceptions around antibiotics by pet owners, and a lack of clarity about the positions and intentions of the other party. Vets and pet owners had differing perceptions of where pressure to prescribe antibiotics inappropriately originated. Vets perceived it was mostly pet owners who pushed for inappropriate antibiotics, whereas pet owners reported they felt it was vets that overprescribed. Low levels of understanding of AMR in general were apparent amongst pet owners and understandings with regard to AMR in pets specifically were almost non-existent in the sample.

Conclusions

Improved use of antibiotics could be assisted by educating the pet owning public and by guideline development for companion animal vets, concurrent development of mandatory legislation, increased consultation time to facilitate better communication, development of vet training on antimicrobial therapy and stewardship led interactions with pet owners, and increased levels of knowledge of pet-related AMR amongst pet owners.
Uncovering the Oppenheimer Siddur: using scientific analysis to reveal the production process of a medieval illuminated Hebrew manuscript
Authors: Wijsman Suzanne , Neate Sarah , Kogou Sotiria , Liang Haida
Published: April 2018

The aim of this research was to use non-invasive scientific analysis to uncover evidence of the planning process and relationship between pigments used in text copying and artwork production in the Oppenheimer Siddur (Oxford Bodleian Library MS Opp. 776), an illuminated 15th-century Hebrew prayer book. In many medieval Hebrew illuminated manuscripts, the authorship of the artwork is unknown. This manuscript’s colophon states that it was copied by its scribe-owner for personal family use but does not confirm who was responsible for the artwork. Prior deductive analysis suggested that the scribe-owner may also have been the manuscript’s artist, based on common motifs and an apparent shared colour palette appearing in both texts and artwork. Visual examination using high resolution digital images also identified points of contact between pigments used in the manuscript’s texts and artwork, raising questions about the pigment application sequence, and concurrent versus sequential text copying and artwork production. An in-house developed remote spectral imaging system (PRISMS) with 10 filters spanning the spectral range from 400 to 880 nm was modified for close-range application to image two of the folios to examine the sequence of production, identify the pigments and compare the materials used for the illumination and the text. Optical microscopy and Fourier Transform Infrared spectroscopy in the attenuated total reflection mode (FTIR-ATR) were used directly on the folios to complement the spectral imaging data in binding media and pigment identification. The results revealed close matches in reflectance spectra for the colorants and inks used in both text copying and illuminations, suggesting that the same mixture of colorants and inks have been used. The spectral imaging in the near infrared bands revealed a hidden underdrawing, indicating a design change during production of the manuscript, and the outlining of letters prior to coloured pigment being applied. The pigment use, the variation in the binder for different pigments and some elements of its production were found to be consistent with those described in historical sources. The evidence from this study supports the hypothesis that the scribe applied pigments for the manuscript’s artwork at the same time he did some of the scribal work which has implications for understandings of Jewish medieval visual cultures.
Reconstructing Van Gogh’s palette to determine the optical characteristics of his paints
Authors: Geldof Muriel , Proaño Gaibor Art Ness , Ligterink Frank , Hendriks Ella , Kirchner Eric
Published: April 2018

The colors of Field with Irises near Arles, painted by Van Gogh in Arles in 1888, have changed considerably. To get an idea of how this painting, as well as other works by Van Gogh, looked shortly after their production, the Revigo (Re-assessing Vincent van Gogh’s colors) research project was initiated. The aim of this project was to digitally visualize the original colors of paintings and drawings by Vincent van Gogh, using scientific methods backed by expert judgement where required. We adopted an experimental art technological approach and physically reconstructed Van Gogh’s full palette of oil paints, closely matching those he used to paint Field with Irises near Arles. Sixteen different paints were reconstructed, among which the most light-sensitive pigments and linseed oil, which is prone to yellowing, were produced according to 19th century practice. The resulting pigments and oils were chemically analyzed and compared to those used by Van Gogh. The ones that resembled his paints the most were used in the paint reconstructions. Other pigments were either obtained from the Cultural Heritage Agency’s collection of historical pigments, or purchased from Kremer Pigmente. The reconstructed paints were subsequently used to calculate the absorption K and scattering S parameters of the individual paints. Using Kubelka–Munk theory, these optical parameters could in turn be used to determine the color of paint mixtures. We applied this method successfully to digitally visualize the original colors of Field with Irises near Arles. Moreover, the set of optical parameters presented here can similarly be applied to calculate digital visualizations of other paintings by Van Gogh and his contemporaries.
A technical study of the materials and manufacturing process used in the Gallery wall paintings from the Jokhang temple, Tibet
Authors: Song Yan , Gao Feng , Nevin Austin , Guo Juwen , Zhou Xiao , Wei Shuya , Li Qianqian
Published: April 2018

Wall paintings from the Jokhang temple, Lhasa, Tibet, China cover over 4000 m2. In order to protect these valuable paintings and to provide more conclusive information regarding the date of the painting scheme from the outer north Gallery, painting materials and techniques have been studied using optical and scanning electron microscopy, X-ray diffraction and raman spectroscopy. Organic materials were analysed with pyrolysis-gas chromatography–mass spectrometry. The wall painting technique is typical of Tibetan paintings and includes multiple layers of locally sourced materials. Analytical results demonstrate the presence of natural and synthetic pigments, including cinnabar (HgS), malachite (CuCO3·Cu(OH)2), azurite (2CuCO3·Cu(OH)2), orpiment (As2S3), red lead (Pb3O4), synthetic ultramarine blue (Na3CaAl3Si3O12S) and emerald green (Cu(C2H3O2)2·3Cu(AsO2)2) which allow us to date the paintings from the mid to late nineteenth century. The binding media is a kind of animal glue which is likely to be bovine or yak glue, the traditional medium used in Tibet. Gilding was applied as gold powder or gold foil. In the past a sealing material or varnish containing drying oil (maybe tung oil) and pine resin was applied to the surface to protect the paintings.
Putting transitivity to the test: a review of the Sydney and Cardiff models
Authors: Bartley Leanne Victoria
Published: April 2018

In Systemic Functional Linguistics (SFL), the system of Transitivity is a common means by which to analyse both isolated clauses as well as clauses in context. To date, two Transitivity models have emerged. The first and more established of the two is the Sydney model, which was proposed by Halliday (Journal of Linguistics 3(1):37–81, 1967; An introduction to functional grammar, 1985; An introduction to functional grammar, 1994) and more latterly developed by himself and Christian Matthiessen (Halliday and Matthiessen, An introduction to functional grammar, 2004; Halliday’s introduction to functional grammar, 2014). The second is the Cardiff Grammar (CG) model put forward by Fawcett (Cognitive linguistics and social interaction: Towards an integrated model of a systemic functional grammar and the other components of a communicating mind, 1980; The semantics of clause and verb for relational processes in English, 1987) as an alternative to the former and, which has subsequently been elaborated by Neale (More delicate Transitivity: Extending the process type system networks for English to include full semantic classifications, 2002; Matching corpus data and system networks, 2006). Although both models have various strengths, neither model is void of limitations. Thus, the aim of this paper is to describe, compare and draw on the inadequacies associated with either one or both of the aforementioned systems, which have come to light following substantial research on Transitivity. All in all, several issues are raised here in order to highlight particular areas that need to be addressed if we are to ensure a systematic and delicate analysis of Transitivity patterns across texts.
Nasopharyngeal brushing: a convenient and feasible sampling method for nucleic acid‐based nasopharyngeal carcinoma research
Authors: Zhang Pei‐Fen , Zheng Xiao‐Hui , Li Xi‐Zhao , Tian Tian , Zhang Shao‐Dan , Hu Ye‐Zhu , Jia Wei‐Hua
Published: April 2018

Background

Tissue specimens for nasopharyngeal carcinoma (NPC) research are scarce because of sampling difficulties. Previous studies have suggested non‐invasive nasopharyngeal brushing as an effective sampling method for NPC diagnosis. The present study aimed to evaluate the feasibility of nasopharyngeal brushing in the acquisition of NPC nucleic acids for research.

Methods

Nasopharyngeal brushing samples were acquired from 24 healthy individuals and 48 NPC patients. Tissues from 48 NPC and 18 nasopharyngitis patients were collected by endoscopic biopsy. The expression levels of tumor suppressor genes (TSGs) and Epstein–Barr virus (EBV)‐encoded microRNAs as well as EBV DNA copy number were measured by quantitative polymerase chain reaction in both types of samples.

Results

Among six TSGs examined, the expression levels of two genes were significantly decreased in nasopharyngeal brushing and tissue samples from NPC patients as compared with those from healthy/nasopharyngitis individuals. Four EBV‐encoded microRNAs, mir‐bart1‐5p, mir‐bart5, mir‐bart6‐5p, and mir‐bart17‐5p, were significantly up‐regulated in both NPC brushing and tissue samples compared with those from healthy/nasopharyngitis controls (P < 0.001). EBV DNA was significantly increased in both nasopharyngeal brushing samples (P < 0.001) and tissue samples (P < 0.001) from NPC patients in comparison with those from healthy controls.

Conclusions

Nasopharyngeal brushing can obtain sufficient tumoral materials for the analysis of viral nucleic acid, including EBV‐encoded microRNAs and EBV DNA. For the detection of TSG expression, nasopharyngeal brushings was feasible but inferior to tissue samples. This study confirms nasopharyngeal brushing as an applicable sampling method that can aid in nucleic acid‐based NPC research.
Performance of the Brazilian version of GloboDiet software for dietary intake assessment
Authors: Marchetti Beatriz Schirrmeister , Steluti Josiane , Fisberg Regina Mara , Marchioni Dirce Maria Lobo
Published: April 2018

Background

GloboDiet is a software that conducts the interview of the 24-h dietary recall (24HR) guided by a standardized routine. The successful experience of adapting this software in different cultural contexts in Europe led to the extension of the project to Latin American countries. Brazil was one of the selected countries to start the project in collaboration with IARC, and a Brazilian version of the GloboDiet software was developed. Therefore, this study aimed to estimate food intake using the Brazilian version of GloboDiet software and compare whether there is concordance of the estimated intake of energy, carbohydrates, protein, and lipids between the GloboDiet and Nutrition Data System for Research—NDSR software.

Methods

We considered a sub-sample of 100 adult individuals from ISA-Capital 2008 survey, a population-based study of resident in the urban area of São Paulo, Brazil. We obtained dietary intake data through the 24HR using the NDSR software. In this study, the 24HR of the same 100 individuals were entered in GloboDiet software—Brazilian version. Then, statistical analyses were performed considering Bland and Altman analysis and Kappa statistic to evaluate the agreement between the software. It also used the terciles of energy and macronutrients.

Results

The mean (SD) obtained for energy, protein, carbohydrate, and lipids in the NDSR was 2386.47 (444.25) kcal, 100.08 (35.33) g, 286.75 (84.02) g, and 87.34 (28.32) g, respectively. In comparison, the SD obtained in the GloboDiet for those same variables was 2279.67 (655.50) kcal, 92.94 (38.35) g, 277.62 (93.86) g, and 83.12 (33.69) g, respectively. The mean (95% CI of agreement limits) of the differences between two measurements for energy, protein, carbohydrate, and lipids is 106.8 (− 961.3; 1174.9) kcal, 7.142 (− 58.6; 72.9) g, 9.1 (− 128.958; 147.208), and 4.2 (− 64.039; 72.489) g, respectively. From the Kappa statistic, we verified a slight and significant agreement (p < 0.05) considering the tertiles of energy and macronutrient between the software.

Conclusions

The Brazilian version of GloboDiet software seems to have a good performance when compared to NDSR software. However, further researchers are needed to validate the dietary intake from GloboDiet.
Workflow for improvement of 3D anisotropic CSEM resistivity inversion and integration with seismic using cross-gradient constraint to reduce exploration risk in a complex fold-thrust belt in offshore northwest Borneo
Authors: Meju Max A. , Saleh Ahmad Shahir , Mackie Randall L. , Miorelli Federico , Miller Roger V. , Mansor Noor Kartini S.
Published: April 2018

The focus of hydrocarbon exploration has now moved into frontier regions where structural complexity, heterogeneous overburden, and hydrocarbon system fundamentals are significant challenges requiring an integrated exploration approach. Three-dimensional controlled-source electromagnetic (CSEM) anisotropic resistivity imaging is emerging as a technique to combine with seismic imaging in such regions. However, the typically reconstructed horizontal resistivity [Formula: see text] and vertical resistivity [Formula: see text] models often have conflicting depth structures that are difficult to explain in terms of subsurface geology. It is highly desirable to reduce ambiguity or subjectivity in depth interpretation of [Formula: see text] and [Formula: see text] models and also achieve comparability with other coincidentally located subsurface models. We have developed a workflow for integrating information from seismic well-based inversion, interpreted seismic horizons, and resistivity well logs in a cross-gradient-guided simultaneous 3D CSEM inversion for geologically realistic [Formula: see text] and [Formula: see text] models whose parameter estimates for a selected reservoir interval can then be better optimized to aid reservoir characterization. We developed our workflow using exploration data from a complex fold-thrust belt. We found that the integrated cross-gradient approach led to [Formula: see text] and [Formula: see text] models that have a common depth structure, are consistent with seismic and resistivity logs, and are hence less ambiguous for geologic interpretation and reservoir parameter estimation.
Cumulative Burden of Morbidity Among Testicular Cancer Survivors After Standard Cisplatin-Based Chemotherapy: A Multi-Institutional Study
Authors: Kerns Sarah L. , Fung Chunkit , Monahan Patrick O. , Ardeshir-Rouhani-Fard Shirin , Abu Zaid Mohammad I. , Williams AnnaLynn M. , Stump Timothy E. , Sesso Howard D. , Feldman Darren R. , Hamilton Robert J. , Vaughn David J. , Beard Clair , Huddart Robert A. , Kim Jeri , Kollmannsberger Christian , Sahasrabudhe Deepak M. , Cook Ryan , Fossa Sophie D. , Einhorn Lawrence H. , Travis Lois B. ,   for the Platinum Study Group
Published: April 2018

Purpose

In this multicenter study, we evaluated the cumulative burden of morbidity (CBM) among > 1,200 testicular cancer survivors and applied factor analysis to determine the co-occurrence of adverse health outcomes (AHOs).

Patients and Methods

Participants were ≤ 55 years of age at diagnosis, finished first-line chemotherapy ≥ 1 year previously, completed a comprehensive questionnaire, and underwent physical examination. Treatment data were abstracted from medical records. A CBM score encompassed the number and severity of AHOs, with ordinal logistic regression used to assess associations with exposures. Nonlinear factor analysis and the nonparametric dimensionality evaluation to enumerate contributing traits procedure determined which AHOs co-occurred.

Results

Among 1,214 participants, approximately 20% had a high (15%) or very high/severe (4.1%) CBM score, whereas approximately 80% scored medium (30%) or low/very low (47%). Increased risks of higher scores were associated with four cycles of either ifosfamide, etoposide, and cisplatin (odds ratio [OR], 1.96; 95% CI, 1.04 to 3.71) or bleomycin, etoposide, and cisplatin (OR, 1.44; 95% CI, 1.04 to 1.98), older attained age (OR, 1.18; 95% CI, 1.10 to 1.26), current disability leave (OR, 3.53; 95% CI, 1.57 to 7.95), less than a college education (OR, 1.44; 95% CI, 1.11 to 1.87), and current or former smoking (OR, 1.28; 95% CI, 1.02 to 1.63). CBM score did not differ after either chemotherapy regimen ( P = .36). Asian race (OR, 0.41; 95% CI, 0.23 to 0.72) and vigorous exercise (OR, 0.68; 95% CI, 0.52 to 0.89) were protective. Variable clustering analyses identified six significant AHO clusters (χ2P < .001): hearing loss/damage, tinnitus (OR, 16.3); hyperlipidemia, hypertension, diabetes (OR, 9.8); neuropathy, pain, Raynaud phenomenon (OR, 5.5); cardiovascular and related conditions (OR, 5.0); thyroid disease, erectile dysfunction (OR, 4.2); and depression/anxiety, hypogonadism (OR, 2.8).

Conclusion

Factors associated with higher CBM may identify testicular cancer survivors in need of closer monitoring. If confirmed, identified AHO clusters could guide the development of survivorship care strategies.
Immune-Mediated Myelopathies
Authors: Wingerchuk Dean M.
Published: April 2018

PURPOSE OF REVIEW

This article reviews the clinical presentation, diagnostic evaluation, and management of immune-mediated myelopathies.

RECENT FINDINGS

The discovery of several neural autoantibodies and their antigenic targets has revolutionized the investigation and treatment of immune-mediated myelopathies. Detection of these serologic biomarkers can support or establish a diagnosis of an autoimmune myelopathy, and, in the case of paraneoplastic syndromes, indicate the likely presence of an underlying malignancy. Distinctive lesion patterns detected on spinal cord or brain MRI narrow the differential diagnosis in patients with acute or subacute inflammatory myelopathies, including those not associated with autoantibody markers.

Immune-mediated myelopathies usually present acutely or subacutely and have a broad differential diagnosis. A systematic diagnostic approach using data from the clinical setting and presentation, MRI lesion patterns, CSF data, and autoantibody markers can differentiate these disorders from noninflammatory myelopathies, often with precise disease classification. This, in turn, provides prognostic information, especially whether the disorder is likely to relapse, and facilitates therapeutic decision making. Diagnostic accuracy informs selection of acute immunotherapy aimed at arresting and reversing recent neurologic injury and, when necessary, selection of long-term treatment for prevention of disease progression or relapse.
Liability for Referrals to Other Physicians
Authors: Kass Joseph S.
Published: April 2018

This article presents four hypothetical cases that demonstrate ways in which neurologists may be vulnerable to liability for how they manage patients they refer to other physicians for consultations. This article also discusses the importance of protecting neurologists from claims of negligence through documentation, which includes the rationale for ordering a consultation, deferring a consultation, or disagreeing with a consultant’s recommendations. Lastly, the article discusses the importance of including patients in the decision-making process and detailing these conversations in the medical record.
Functional domains of the FSHD-associated DUX4 protein
Authors: Mitsuhashi Hiroaki , Ishimaru Satoshi , Homma Sachiko , Yu Bryant , Honma Yuki , Beermann Mary Lou , Miller Jeffrey Boone
Published: April 2018

Aberrant expression of the full-length isoform of DUX4 (DUX4-FL) appears to underlie pathogenesis in facioscapulohumeral muscular dystrophy (FSHD). DUX4-FL is a transcription factor and ectopic expression of DUX4-FL is toxic to most cells. Previous studies showed that DUX4-FL-induced pathology requires intact homeodomains and that transcriptional activation required the C-terminal region. In this study, we further examined the functional domains of DUX4 by generating mutant, deletion, and fusion variants of DUX4. We compared each construct to DUX4-FL for (i) activation of a DUX4 promoter reporter, (ii) expression of the DUX4-FL target gene ZSCAN4, (iii) effect on cell viability, (iv) activation of endogenous caspases, and (v) level of protein ubiquitination. Each construct produced a similarly sized effect (or lack of effect) in each assay. Thus, the ability to activate transcription determined the extent of change in multiple molecular and cellular properties that may be relevant to FSHD pathology. Transcriptional activity was mediated by the C-terminal 80 amino acids of DUX4-FL, with most activity located in the C-terminal 20 amino acids. We also found that non-toxic constructs with both homeodomains intact could act as inhibitors of DUX4-FL transcriptional activation, likely due to competition for promoter sites.
Size as an Important Determinant of Chest Blow–induced Commotio Cordis
Authors: MADIAS CHRISTOPHER , MARON BARRY J. , DAU NATHAN , ESTES NATHAN A. MARK , BIR CYNTHIA , LINK MARK S.
Published: April 2018

Purpose

Commotio cordis is sudden cardiac death caused by a relatively innocent blow to the left chest wall. Adolescents account for the majority of the cases; whether this is due to the higher frequency of adolescents playing ball sports or whether there is some maturational reduction of risk is not known.

Methods

In a swine model of commotio cordis, the effect of body weight/size (directly related to age) to the susceptibility of chest impact–induced ventricular fibrillation (VF) is examined.

Methods

Ball impacts were delivered at escalating velocities from 48.3 to 96.9 km·h−1 (30–60 mph) to 128 swine ranging in weight from 5 to 54 kg.

Results

VF occurred in 29% of impacts to the smallest animals compared with 34% in the 14- to 239-kg group, 27% in the 24- to 33.9-kg group, 30% in 34- to 43-kg group, and 15% in the 44- to 54-kg animals. The highest-weight group was associated with a significantly lower incidence of VF compared with other weights (P = 0.002). In a multivariate logistic regression analysis, controlling for repeated measures, four variables predicted VF: body weight (P = 0.0008), velocity (P < 0.0001), distance from the center of the heart, (P < 0.0001), and peak left ventricular pressure induced by the blow (P = 0.0007).

Conclusions

In this experimental model, animals weighing <44 kg seem to have a similar susceptibility to commotio cordis, whereas animals weighing ≥44 kg have a lower susceptibility. An increase in size of the individual, rather than reduced play of ball sports, is the likely reason for the decreased commotio cordis incidence in older individuals.
Factors influencing the decision to commit violence in Thai male juvenile offenders: A phenomenological study
Authors: Wongin Wasinee , Paileeklee Suchada
Published: April 2018

Background: Violence is a social problem that affects the physical and mental health of adolescents. For a long time, Thailand has adopted strategies formulated by the World Health Organization to reduce violence but has been unsuccessful. The aim of the current qualitative study was to understand the decision of adolescents to commit violence and to identify factors contributing to violence among male juvenile delinquents.

Methods: Data were collected from 50 male juvenile offenders at the Department of Juvenile Observation and Protection detention facilities located in 5 regions of Thailand through in-depth interviews focusing on delinquent violence committed in the past year.

Results: Adolescents who decide to use violence have been associated with and live in environments where they face conflicts in their neighborhood and violence in their community. Mostly, juveniles were found to drop out of school, engage in abuse and supply of drugs, consume alcohol, and experienced domestic violence problems and family divorce. Juvenile offenders typically experience and learn about violence from family and peers, which creates a positive attitude toward violent behavior in them. These offenses can be categorized into intentional violence, which involves seeking revenge or resolving prior conflicts and requires premeditation, and unintentional violence, which results from a situation escalating quickly and usually requiring no preplanning, such as insults, conflicts, power struggles, self-defense, or protecting peers.

Conclusions: A violence prevention model and guidelines need to be introduced into Thailand’s youth health care system. This study identified a lack of both decision-making skills and socially adequate adjustment to difficult situations among adolescent perpetrators as precursors to violent behavior.