bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Metabolic Syndrome Factors on Testosterone and SHBG in Type 2 Diabetes Mellitus and Metabolic Syndrome
Authors: Mohammed Mukhtar , AL-Habori Molham , Abdullateef Ahmed , Saif-Ali Riyadh
Published: July 2018

Objective. Several studies have often reported low testosterone and SHBG to be associated with type 2 DM and the metabolic syndrome (MetS). Our objective was to determine the impact of metabolic syndrome and diabetic parameters on testosterone and SHBG in both MetS subjects and type 2 DM patients. Methods. In this study, 120 Yemeni male aged 30–70 years old were enrolled, 30 of whom were healthy subjects with BMI < 25 kg/m2 that served as control, 30 MetS, 30 type 2 DM without MetS, and 30 type 2 DM with MetS according to IDF criteria. Results. Testosterone (free and total) and SHBG were significantly lower in MetS subjects and modestly reduced in type 2 DM with and without MetS. Stepwise linear regression showed free and total testosterone to be negatively affected by waist circumference, and univariate analysis shows this significant difference to disappear when adjusted for waist circumference. On the other hand, stepwise linear regression showed SHBG to be positively affected by testosterone and age and negatively affected by FBG and TG. Univariate analysis shows this observed significant difference to disappear when adjusted for testosterone. Conclusion. Abdominal obesity is a major determinant of low testosterone levels irrespective of diabetes status. Thus, supporting evidence suggesting that the causative relationship between the often low testosterone and type 2 DM might be bidirectional or even multidirectional and interrelated with obesity, MetS, and IR.
Using a Computational Approach for Generalizing a Consensus Measure to Likert Scales of Any Size n
Authors: Abdal Rahem Mushtaq , Darrah Marjorie
Published: July 2018

There are many consensus measures that can be computed using Likert data. Although these measures should work with any number n of choices on the Likert scale, the measurements have been most widely studied and demonstrated for n = 5. One measure of consensus introduced by Akiyama et al. for n = 5 and theoretically generalized to all n depends on both the mean and variance and gives results that can differentiate between some group consensus behavior patterns better than other measures that rely on either just the mean or just the variance separately. However, this measure is more complicated and not easy to apply and understand. This paper addresses these two common problems by introducing a new computational method to find the measure of consensus that works for any number of Likert item choices. The novelty of the approach is that it uses computational methods in n-dimensional space. Numerical examples in three-dimensional (for n=6) and four-dimensional (for n=7) spaces are provided in this paper to assure the agreement of the computational and theoretical approach outputs.
TGF-β Inhibitor SB431542 Promotes the Differentiation of Induced Pluripotent Stem Cells and Embryonic Stem Cells into Mesenchymal-Like Cells
Authors: Leyendecker Junior Alessander
Published: July 2018

Due to their potential for tissue engineering applications and ability to modulate the immune system and reduce inflammation, mesenchymal stem cells (MSCs) have been explored as a promising option for the treatment of chronic diseases and injuries. However, there are problems associated with the use of this type of cell that limit their applications. Several studies have been exploring the possibility to produce mesenchymal stem cells from pluripotent stem cells (PSCs). The aim of these studies is to generate MSCs with advantageous characteristics of both PSCs and MSCs. However, there are still some questions concerning the characteristics of MSCs derived from the differentiation of PSCs that must be answered before they can be used to treat diseases and injuries. The objective of this study was, therefore, to determine if PSCs exposed to SB431542, a TGF-β inhibitor, are able to differentiate to MSCs, judging by morphology, expression of mesenchymal and pluripotent stem cell markers, expression of pluripotency-related genes, and ability to differentiate to osteocytes and adipocytes. The results obtained demonstrated that it is possible to induce the differentiation of both embryonic stem cells and induce pluripotent stem cells into cells with characteristics that highly resemble those from MSCs through the inhibition of the TGF-β pathway.
Class III Treatment with Skeletal and Dental Anchorage: A Review of Comparative Effects
Authors: Clemente Roberta , Contardo Luca , Greco Christian , Di Lenarda Roberto , Perinetti Giuseppe
Published: July 2018

Objectives. This review addresses the comparative effects of skeletal anchored maxillary protraction (MP) versus dental anchored MP. Materials and Methods. The studies retrieved had to have both test and control groups treated by the use of a facemask with or without the use of skeletal anchorage though either (palatal/buccal) maxillary or mandibular miniscrews/miniplates, respectively. Results. Nine articles were included. Dentoalveolar changes were seen in all the studies. In particular, a significant proclination of the upper incisors was documented in the group treated with a dental anchorage facial mask, as compared to that treated with skeletal anchorage. Comparing the two methods, almost all the studies indicated a greater maxillary advancement in the group treated with skeletal anchorage. Conclusions. Therapies with skeletal anchorage produce greater maxillary protraction, reducing undesirable dental effects.
Minimization of Stress State of a Hub of Friction Pair
Authors: Mirsalimov Vagif M. , Akhundova Parvana E.
Published: July 2018

The function of displacements of external contour points of a friction pair hub that could provide minimization of stress state of a hub was determined on the basis of minimax criterion. The problem is to decrease stress state at that place where it is important. The rough friction surface model is used. To solve a problem of optimal design of friction unit the closed system of algebraic equations is constructed. Increase of serviceability of friction pair parts may be controlled by design-engineering methods, in particular by geometry of triboconjugation elements. Minimization of maximum circumferential stress on contact surface of friction unit is of great importance in the design stage for increasing the serviceability of friction pair. The obtained function of displacements of the hub’s external contour points provides the serviceability of friction pair elements. The calculation of friction pair for oil-well sucker-rod pumps is considered as an example.
Risk Factors for Microvascular Complications of Diabetes in a High-Risk Middle East Population
Authors: Cheema Sohaila , Maisonneuve Patrick , Zirie Mahmoud , Jayyousi Amin , Alrouh Hekmat , Abraham Amit , Al-Samraye Sura , Mahfoud Ziyad , Al-Janahi Ibrahim Mohammed , Ibrahim Buthaina , Lowenfels Albert B. , Mamtani Ravinder
Published: July 2018

Aims. Much of the diabetes burden is caused by its complications. This cross-sectional study aimed to determine the prevalence and risk factors for diabetic microvascular complications (retinopathy, nephropathy, and neuropathy) in a high-risk population. Methods. We collected information via a structured questionnaire and directly from the patient’s record on 1034 adult type 2 diabetic patients who were attending outpatient clinics in Qatar. Results. The mean age of the patients was 55 ± 10 years, and the mean duration of diabetes was 12.4 ± 8.9 years. Forty-five percent had one or more microvascular complications. Shared risk factors for multiplicity and for individual complications included family history, severity and duration of diabetes, and hypertension, but some risk factors were specific for individual microvascular complications. Early age at onset of diabetes was strongly associated with multiplicity of complications (P=0.0003). Conclusions. About half the diabetics in this high-risk population had one or more microvascular complications. Several well-established risk factors were associated with multiplicity and individual microvascular complications, but each separate microvascular complication was linked to a somewhat different constellation of risk factors.
Adaptive Resistance to EGFR-Targeted Therapy by Calcium Signaling in NSCLC Cells
Authors: Mulder Celine , Prust Nadine , van Doorn Sander , Reinecke Maria , Kuster Bernhard , van Bergen en Henegouwen Paul , Lemeer Simone
Published: July 2018

Targeted therapies against oncogenic receptor tyrosine kinases (RTK) show promising results in the clinic. Unfortunately, despite the initial positive response, most patients develop therapeutic resistance. Most research has focused on acquired resistance occurring after an extensive time of treatment; however, the question remains as to how cells can survive an initial treatment, as early resistance to apoptosis will enable cells to develop any growth-stimulating mechanism. Here, the non–small cell lung cancer (NSCLC) PC9 cell line was used to systematically profile, by mass spectrometry, changes in the proteome, kinome, and phosphoproteome during early treatment with the EGFR inhibitor afatinib. Regardless of the response, initial drug-sensitive cells rapidly adapt to targeted therapy, and within days, cells regained the capacity to proliferate, despite persisting target inhibition. These data reveal a rapid reactivation of mTOR and MAPK signaling pathways after initial inhibition and an increase in abundance and activity of cytoskeleton and calcium signaling–related proteins. Pharmacologic inhibition of reactivated pathways resulted in increased afatinib efficacy. However more strikingly, cells that were restricted from accessing extracellular calcium were extremely sensitive to afatinib treatment. These findings were validated using three additional inhibitors tested in four different NSCLC cell lines, and the data clearly indicated a role for Ca2+ signaling during the development of adaptive resistance. From a therapeutic point of view, the increased inhibitor efficacy could limit or even prevent further resistance development.

Implications: Combined targeting of calcium signaling and RTKs may limit drug resistance and improve treatment efficacy. Mol Cancer Res; 16(11); 1773–84. ©2018 AACR.
Patientenerwartungen optimieren: Beschreibung einer präoperativen Kurzintervention am Beispiel von Patienten vor einer Bypass-Operation
Authors: Salzmann Stefan , Laferton Johannes , Auer Charlotte , Shedden-Mora Meike , Wambach Katrin , Rief Winfried
Published: July 2018

Hintergrund: Patientenerwartungen gelten als wichtige Wirkmechanismen bei psychotherapeutischen und medizinischen Behandlungen und spielen für die Genesung eine große Rolle. Vor diesem Hintergrund wurde eine psychologische präoperative Kurzintervention zur Erwartungsoptimierung entwickelt, um den Genesungsprozess nach Herzoperationen positiv zu beeinflussen. Dieser Artikel beschreibt die psychologische Kurzintervention (EXPECT) und stellt Evaluationsergebnisse der Intervention aus Patientensicht dar. Patienten und Methoden: 124 herzchirurgische Patienten wurden randomisiert und einer von drei Interventionen zugeteilt: a) Erwartungsoptimierung, b) supportive Therapie oder c) ausschließlich medizinische Standardbehandlung. In der Erwartungsintervention, die 2 Sitzungen und 2 Telefonate vor der Operation umfasst, wurden systematisch verhaltens- und behandlungsbezogene Ergebniserwartungen optimiert. Die Patienten wurden mithilfe von Fragebögen zu ihrer Zufriedenheit mit der Intervention befragt. Mittelwerte wurden berechnet. Ergebnisse: Die Zufriedenheit der Patienten mit beiden psychologischen Interventionen war im Mittel hoch bis sehr hoch. In der Erwartungsinterventionsgruppe fühlten sich die Patienten noch besser informiert und erwarteten einen positiveren Heilungsverlauf als die Patienten, die eine supportive Therapie erhielten. Ein Großteil der Patienten erlebte die Interventionen als hilfreich und erwartete durch diese positivere Ergebnisse, was sich auch im längsschnittlichen Verlauf bestätigte. Somit können präoperative Interventionen bei herzchirurgischen Eingriffen das bestehende Behandlungsangebot sinnvoll erweitern. Schlussfolgerungen: Die Optimierung von verhaltens- und ergebnisbezogenen Patientenerwartungen vor der eigentlichen Intervention kann zu einer Verbesserung von Behandlungsergebnissen beitragen. Eine solche psychologische Intervention wird gut angenommen und ist im Rahmen eines herzchirurgischen Settings durchführbar. Die Förderung positiver Erwartungen und die Veränderung ungünstiger Ausgangserwartungen von Patienten sollten sowohl bei psychotherapeutischen als auch bei herzchirurgischen Behandlungen stärker berücksichtigt werden.
Ist Wahn indirekt veränderbar? Ein stimmungsverbesserndes Konzept der kognitive Verhaltenstherapie für die stationäre Standardversorgung von Patienten mit schizophrenen Störungen
Authors: Lamster Fabian , Kiener Jasmin , Wagner Katrin , Rief Winfried , Görge Simone Carina , Iwaniuk Sarah , Leube Dirk , Falkenberg Irina , Kluge Ina , Kircher Tilo , Mehl Stephanie
Published: July 2018

Hintergrund: Die kognitive Verhaltenstherapie bei schizophrenen Störungen (cognitive-behavioral therapy for psychosis; CBT-p) wird für alle Phasen der Erkrankung empfohlen. Das Ziel der vorliegenden Pilotstudie war die Prüfung der Akzeptanz einer Implementierung sowie die Abschätzung der möglichen Wirksamkeit eines neuen CBT-p-Behandlungskonzepts zur Veränderung von Wahn, das auf Befunden der Grundlagenforschung zum Zusammenhang zwischen Depressivität und paranoidem Wahn basiert. Patienten und Methoden: 16 Patienten einer psychiatrischen Schwerpunktstation für Schizophrenie erhielten zusätzlich zur üblichen Behandlung eine manualisierte CBT zur Stimmungsstabilisierung im Einzelsetting. In einer Baseline- und einer Post-Messung wurden das Wahnerleben, die allgemeine Symptomatik, die Depressivität und die Chlorpromazin-Äquivalenzdosen erfasst und mit Messwiederholungsverfahren analysiert. Ergebnisse: Die Positiv- und Wahnsymptomatik reduzierten sich zwischen der Baseline- und der Post-Messung signifikant mit großen Effekten sowohl in Selbst- als auch in verblindeten Fremdratings (Effektstärken zwischen 0,69 und 1,19). Die depressive Symptomatik reduzierte sich ebenfalls signifikant mit großer Effektstärke (1,21). Schlussfolgerungen: Die Ergebnisse der vorliegenden Pilotstudie sprechen für die Wirksamkeit und Implementierbarkeit eines stimmungsstabilisierenden CBT-Konzepts für Patienten mit Schizophrenie im stationären Setting und zeigen, dass ein solches Konzept in Bezug auf Positivsymptome einer Schizophrenie sowie Wahn wirksam sein könnte. Um die Befundlage zu festigen und die vorgestellten Interventionen weiterentwickeln zu können, sollten diese Ergebnisse in einem randomisiert-kontrollierten Studiendesign repliziert werden.
The Diagnostic Work-Up of Hypereosinophilia
Authors: Wang Sa A.
Published: June 2018

Hypereosinophilia (HE) is defined as a persistent elevated eosinophil count of ≥1.5 × 109/L. HE can be one of the dominant manifestations of a hematopoietic myeloid neoplasm or secondary/reactive to an underlying medical condition. If a cause of HE and its associated tissue/organ damage is not determined, the condition is considered to be idiopathic hypereosinophilic syndrome (HES). The work-up of HE can be challenging due to a broad range of causes of HE that can be either reactive or neoplastic. In recent years, with the advent of molecular genetic testing and the introduction of targeted therapy in the management of these patients, there is a growing interest in better characterization of these diseases. Using a multimodality approach and following a proper ­algorithm, a diagnosis can be made in a large proportion of patients. In idiopathic HES, myeloid neoplasm associated ­somatic mutations as evidence of clonality are reported in ­20–25% patients; however, the mutation data should be ­interpreted cautiously considering the prevalence of clonal hematopoiesis of indeterminate potential (CHIP). Bone marrow morphology has been shown to have important value in the identification of a true myeloid neoplasm in these disorders. A genome-wide study may be needed to understand the “idiopathic” cases that would ultimately lead to better patient care.
Persistence and Transcription of Paternal mtDNA Dependent on the Delivery Strategy Rather than Mitochondria Source in Fish Embryos
Authors: Peng Liangyue , Wen Ming , Liu Qizhi , Peng Jingyi , Tang Sibei , Hong Yunhan , Liu Shaojun , Xiao Yamei
Published: June 2018

Background/Aims: Mitochondria (MT) and mitochondrial DNA (mtDNA) show maternal inheritance in most eukaryotic organisms; the sperm mtDNA is usually delivered to the egg during fertilization and then rapidly eliminated to avoid heteroplasmy, which can affect embryogenesis. In our previous study, fertilization-delivered sperm mtDNA exhibited late elimination and transcriptional quiescence in cyprinid fish embryos. However, the mechanisms underlying elimination and transcriptional quiescence of paternal mtDNA are unclear. Methods: Goldfish and zebrafish were used to investigate the fate of mtDNAs with different parental origins delivered by fertilization or microinjection in embryos. Goldfish MT from heart, liver and spermatozoa were microinjected into zebrafish zygotes, respectively. Specific PCR primers were designed so that the amplicons have different sizes to characterize goldfish and zebrafish cytb genes or their cDNAs. Results: The MT injection-delivered paternal mtDNA from sperm, as well as those from the heart and liver, was capable of persistence and transcription until birth, in contrast to the disappearance and transcriptional quiescence at the heartbeat stage of fertilization-delivered sperm mtDNA. In addition, the exogenous MT-injected zebrafish embryos have normal morphology during embryonic development. Conclusions: The fate of paternal mtDNA in fishes is dependent on the delivery strategy rather than the MT source, suggesting that the presence of sperm factor(s) is responsible for elimination and transcriptional quiescence of fertilization-delivered sperm mtDNA. These findings provide insights into the mechanisms underlying paternal mtDNA fate and heteroplasmy in cyprinid fishes.
Corpos sublimes: o teatro-festa de Pippo Delbono Il vangelo della teatralità
Authors: Ribeiro Martha
Published: July 2018

Pippo Delbono, em suas narrativas de viagem, nos revela um estado de real e profunda experiência com o mundo que o toca. Seus olhos realmente se viram para o mundo, mas não para conformar esse mundo, visto e olhado, em informação – não são absolutamente narrativas de informação. Sua narrativa nos transporta para seu mundo íntimo, sem pudores. A vida que Pippo parece buscar é aquela do silêncio, do tempo dilatado, da espera, da escuridão, para depois converter todo esse silêncio em gritos: gritos mudos, gritos libertários, gritos de dor, gritos de alegria, gritos desumanos, para enfim encontrar o que há de mais sublime.
Leaf epidermal descriptors applied to the taxonomy of Lauraceae, including new anatomical characters
Authors: GOMES-BEZERRA KADJA MILENA , GOMES SUELI MARIA , SILVEIRA CONCEIÇÃO ENEIDA DOS SANTOS , SOARES-SILVA LUCIA HELENA
Published: July 2018

The difficulty of identifying Lauraceae species is well known. The leaf epidermis of 18 species from the Federal District, Brazil, was analyzed to test more characters as an aid to the taxonomy of this family. New anatomical characters are proposed here, such as sinus number, internal angles and number of sides of the common epidermal cells, their arrangement around the trichome base, and the shape and width of the subsidiary cells in relation to the guard cells. Epidermal characters that can aid in the identification of the studied species are: the contour of the common cells on both leaf surfaces and their anticlinal wall width, number of sides of the polygonal cells, sinus number, presence of angles greater than 180°, presence and type of indumentum, common cells with radial arrangement around the trichome base, stomatal position relative to the rest of the epidermis and width of the subsidiary cells in relation to the guard cells. Glabrous and glabrescent leaves are distinguished. Two species have unique characters: Aniba heringeri, with papillae on the abaxial surface, and Cryptocarya moschata, with peculiar horseshoe-shaped subsidiary cells. Characters of the epidermis together with the external leaf morphology are sufficient to distinguish the studied species. Additionally, we report for the first time the occurrence of Mezilaurus crassiramea and Ocotea diospyrifolia for the flora of Federal District, Brazil.
Russula darjeelingensis, a new species from Eastern Himalaya, India
Authors: PALOI SOUMITRA , DAS KANAD , ACHARYA KRISHNENDU
Published: July 2018

Russula darjeelingensis is characterized by its small sized white pileus with a tall and narrow stipe, white spore print, basidiospores with amyloid suprahilar spot and a pileipellis containing encrusted pileocystidia and absence of primordial hyphae. The combination of all these characters and molecular phylogenetic analyses of internal transcribed spacer sequences of nuclear ribosomal DNA confirmed it as a new species in genus Russula Pers., subg. Russula Romagn. emend. sect. Polychromae (Maire) Sarnari subsect. Paraintegrinae Sarnari. A comprehensive morphological description, illustrations, and comparisons with morphologically similar and phylogenetically related species are provided in the present study.
Interventions to reduce inappropriate prescribing of antibiotics for acute respiratory tract infections: summary and update of a systematic review
Authors: McDonagh Marian S. , Peterson Kim , Winthrop Kevin , Cantor Amy , Lazur Brittany H. , Buckley David I.
Published: July 2018

Objective

Antibiotic overuse contributes to antibiotic resistance and adverse consequences. Acute respiratory tract infections (RTIs) are the most common reason for antibiotic prescribing in primary care, but such infections often do not require antibiotics. We summarized and updated a previously performed systematic review of interventions to reduce inappropriate use of antibiotics for acute RTIs.

Methods

To update the review, we searched MEDLINE®, the Cochrane Library (until January 2018), and reference lists. Two reviewers selected the studies, extracted the study data, and assessed the quality and strength of evidence.

Results

Twenty-six interventions were evaluated in 95 mostly fair-quality studies. The following four interventions had moderate-strength evidence of improved/reduced antibiotic prescribing and low-strength evidence of no adverse consequences: parent education (21% reduction, no increase return visits), combined patient/clinician education (7% reduction, no change in complications/satisfaction), procalcitonin testing for adults with RTIs of the lower respiratory tract (12%–72% reduction, no increased adverse consequences), and electronic decision support systems (24%–47% improvement in appropriate prescribing, 5%–9% reduction, no increased complications).

Conclusions

The best evidence supports use of specific educational interventions, procalcitonin testing in adults, and electronic decision support to reduce inappropriate antibiotic prescribing for acute RTIs without causing adverse consequences.
Validating Persuasive Experience (PX) Theory: Preliminary Results of a Case Study on a Corporate Wellness Program’s Web-based Learning Interfaces
Authors: Platt Lisa Sundahl , Li Huiyang , Bass Catherine E. , Yu Kaixiang
Published: June 2018

The objective of this study is to gain a clearer understanding of the role Persuasive Experience (PX) may play in wellness-oriented Web Based Learning (WBL) platforms in forming abilities to incite healthier lifestyle (or promoting health behavior) in technology-based systems use. Specifically, individual users’ interactions with a particular corporate wellness WBL platform was examined in relation to their State of Mind and Behavior. The results of this study may assist in better predicting behavior change and sustainable adherence to increased physical activity routines that could reduce risk of behavior sensitive conditions such as cardiovascular disease and its sequelae in U.S. workplaces. The findings of this case study also offer further validation of PX Theory and insight into its potential to aid in developing and implementing more effective persuasive technologies. The hope is that PX might contribute to technological systems design that can measurably and meaningfully assist employees in changing to healthier behaviors to improve their individual health outcomes. The results of this case study also suggest the potential PX driven design for wellness oriented WBL systems may have in improving overall organizational wellbeing and outcomes related to unplanned health insurance expenditures.
Eye-Tracking Study to Enhance Usability of Molecular Diagnostics Reports in Cancer Precision Medicine
Authors: Sharma Vishakha , Fong Allan , Beckman Robert A. , Rao Shruti , Boca Simina M. , McGarvey Peter B. , Ratwani Raj M. , Madhavan Subha
Published: June 2018

Purpose

We conducted usability studies on commercially available molecular diagnostic (MDX) test reports to identify strengths and weaknesses in content and form that drive clinical decision making. Given routine genomic testing in cancer medicine, oncologists must interpret MDX reports as well as evidence concerning clinical utility of biomarkers accurately for treatment or trial selection. This work aims to evaluate effectiveness of MDX reports in facilitating cancer treatment planning.

Methods

Fourteen clinicians at an academic tertiary care medical facility, with a wide range of experience in oncology and in the use of molecular testing, participated in this study. Three commercially available, widely used, Clinical Laboratory Improvement Amendments (CLIA)–certified, College of American Pathologists (CAP)–accredited test reports (labeled Laboratories A, B, and C) were used. Eye tracking, surveys, and think-aloud protocols were used to collect usability data for these MDX reports focusing on ease of comprehension and actionability

Results

Clinicians found two primary areas in molecular diagnostic reports most useful for patient care: therapy options with benefit or lack of benefit to patients, including enrolling clinical trials; and pathogenic tumor molecular anomalies detected. Therapeutic implications and therapy classes such as US Food and Drug Administration–approved off-label, on-label, clinical trials were critical for decision making. However, all reports had usability and comprehension issues in these areas and could be improved.

Conclusion

Focused usability studies can help drive our understanding of the clinical workflow for use of molecular diagnostic tests in cancer care. This in turn can have major effects on quality of care, outcomes, costs, and patient satisfaction. This study demonstrates the use of specific usability techniques (eye tracking and think-aloud protocols) to help clinical laboratories improve MDX report design in a precision oncology treatment setting.
Lower Spine Volumetric Bone Density in Patients With a History of Epidural Steroid Injections
Authors: Liu Yi , Carrino John A , Dash Alexander S , Chukir Tariq , Do Huong , Bockman Richard S , Hughes Alexander P , Press Joel M , Stein Emily M
Published: July 2018

Context

Epidural steroid injections (ESIs) are a common, effective treatment of lumbar radiculopathy and sciatica. Although the negative skeletal effects of oral glucocorticoids are well established, little is known about the impact of ESI on bone quality.

Objective

To investigate the relationship between ESI exposure and volumetric bone mineral density (vBMD) at the lumbar spine (LS) using central quantitative CT.

Design

Retrospective study.

Setting

University hospital outpatient facility.

Patients

All patients had CT scans of the LS between 2011 and 2016. Cases received at least three ESIs prior to the date of CT (n = 121). Controls were matched for age and sex (n = 121).

Main Outcome Measures

Cumulative ESI dose was calculated. vBMD was measured at T12 through L5 using QCT Pro phantomless software (MindWays).

Results

Mean age of subjects was 65 ± 14 years, and 49% were women. Median number of ESIs was 4 (range: 3 to 16). Median cumulative ESI dosage was 340 mg of triamcinolone or equivalent (range: 150 to 1400 mg). Compared with controls, ESI subjects had lower vBMD at each vertebral level. Higher cumulative dose was associated with lower mean vBMD at T12 to L5 (r = –0.22, P = 0.02).

Conclusions

Greater cumulative ESI dose was related to lower vBMD at the LS. To our knowledge, this is the first study to measure vBMD in patients treated with ESIs. Prospective studies are needed to confirm these findings and to help identify the best strategies for preventing bone loss in this population.
Optomotor steering and flight control requires a specific sub-section of the compound eye in the hawkmoth,Manduca sexta
Authors: Copley Sean , Parthasarathy Kalyanasundaram , Willis Mark A.
Published: July 2018

While tracking odor plumes, male hawkmoths use optic flow cues to stabilize their flight movements with respect to their environment. We studied the responses of freely flying moths tracking odor plumes in a laboratory wind tunnel and tethered moths in an optomotor flight simulator to determine the locations on the compound eye on which critical optic flow cues are detected. In these behavioral experiments, we occluded specific regions of the compound eye and systematically examined the moths’ behavior for specific deficits in optic flow processing. Freely flying moths with the dorsal half of the compound eye painted were unable to maintain stable flight and track the wind-borne odor plume. However, the plume tracking performance of moths with the ventral half of their compound eyes painted was the same as unpainted controls. In a matched set of experiments, we presented tethered moths with moving vertically-oriented sinusoidal gratings and found that individuals with their eyes unpainted, ventrally-painted, and medially-painted all responded by attempting optomotor-driven turns in the same proportion. In contrast, individuals with their compound eyes, dorsally-painted, laterally-painted, and totally-painted showed no optomotor turning response. We decreased the contrast of the visual stimulus and found that this relationship was consistent down to a contrast level of 2.5%. We conclude that visual input from the dorso-lateral region of the animal's visual world is critical for successful maintenance of flight stability and that this species’ visual environment must meet or exceed a contrast ratio of 2.5% to support visual flight control.
Transition State Search Using rPM6: Iron- and Manganese-Catalyzed Oxidation Reactions as a Test Case
Authors: Saito Toru , Takano Yu
Published: July 2018

We present a reparameterization of PM6 (rPM6) for Fe in a similar procedure to that for Mn in our previous work [T. Saito, Y. Takano, Chem. Lett. 2017, 46, 1567]. The performance of the spin unrestricted rPM6 (UrPM6) method has been examined on both energy minimization and transition state (TS) search on the basis of the spin unrestricted density functional theory (UDFT) calculations. For energy minimization, the UrPM6 outperforms the original UPM6 on the basis of the UB3LYP/SVP-optimized geometries. The test set for TS search is comprised of 58 TS structures for oxidation reactions catalyzed by a variety of iron and manganese complexes including active sites of cytochrome P450 and soluble methane monooxygenase as well as their biomimetic complexes. The standard UPM6 method can locate only 21 out of 58 TS structures (36%), whereas an overall success rate is 83% (48 out of 58) by means of UrPM6. Furthermore, the UrPM6-optimized structures can be obtained easily (on the order of several minutes) and 94% of those are found to be utilized for the subsequent refinement by UDFT without any modifications of geometrical parameters.
A família, o cuidar e o desenvolvimento da criança autista
Authors: Da Silva Silvio Eder Dias , Dos Santos Arielle Lima , De Sousa Yasmim Martins , Da Cunha Natacha Mariana Farias , Da Costa Joel Lobato , Araújo Jeferson Santos
Published: July 2018

Introdução: O Autismo é considerado como um transtorno global do desenvolvimento que se inicia antes dos três anos de idade. Caracteriza-se como uma síndrome comportamental de etiologias múltiplas que compromete o processo do desenvolvimento infantil. Objetivo: identificar o que se tem produzido na literatura científica sobre o cuidar em famílias de crianças com transtorno invasivo do desenvolvimento. Método: Estudo de descritivo com abordagrm qualitativa, sendo uma revisão integrativa. Resultados: permitiram identificar que as famílias têm grandes dificuldades em manter suas estratégias para o desenvolvimento do autocuidado de crianças com autismo. Foi identificada, neste estudo, a escassez de produção científica sobre autorias de enfermeiro acerca desta temática. Conclusão: A análise de dados aponta para as estratégias adotadas por pais e familiares cuidadores, em busca do desenvolvimento adequado da criança autista.
Evidências do efeito da terapia fotodinâmica sobre a Propionibacterium acnes
Authors: Ramos Rogério Rodrigo , De Paiva Jeferson Leandro , Boer Nagib Pezati , Boer Luis Fernando Ricci , Batigália Fernando , De Godoy José Maria Pereira
Published: July 2018

Introdução: A Propionibacterium acnes é uma bactéria causadora da acne. Devido aos efeitos colaterais ou à falta de resposta ao tratamento da acne, foi proposta a terapia fotodinâmica como um tratamento alternativo para a acne. Objetivo: O objetivo foi evidenciar a ação fotodinâmica do LED vermelho 660 nm e do fotossensibilizador azul de metileno sobre Propionibacterium acnes in vitro. Métodos: Os ensaios foram constituídos por quatro grupos: 1. controle (sem aplicação de luz e sem fotossensibilizador); 2. com aplicação de luz; 3. com fotossensibilizador e sem aplicação de luz; 4. com fotossensibilizador e com aplicação de luz. Os ensaios foram submetidos a aplicação de luz por 4 ciclos de 5 minutos com intervalos de 3 minutos. Resultados: Houve redução estatisticamente significante (p<0,05) nas médias dos grupos 1, 2 e 4, ainda que o grupo 3 não tenha apresentado significância estatística, mas houve redução detectada nas médias. Conclusão: A ação fotodinâmica é eficiente para a destruição do material biológico por irradiação a 660nm atribuída ao processo de fotossensibilização pela presença do fotossensibilizador.
Esclerose lateral amiotrófica: descrição de aspectos clínicos e funcionais de uma série de casos numa região de saúde do nordeste do Brasil
Authors: Silva Leandro Pereira , Gusmão Cristiane Aguiar , Pithon Karla Rocha , Gomes Thaís Bitencourt Peixoto , Pinto Junior Elzo Pereira
Published: July 2018

Introdução: A Esclerose Lateral Amiotrófica (ELA) é uma doença neurodegenerativa que provoca grandes prejuízos na funcionalidade dos indivíduos acometidos. Objetivo: descrever características sociodemográficas, clínicas e funcionais de uma série de casos diagnosticados com Esclerose Lateral Amiotrófica em uma região de saúde do Estado da Bahia. Métodos: trata-se do relato de uma série de casos de ELA, identificados na microrregião de Saúde de Jequié, circunscrita à 13ª Diretoria Regional de Saúde (DIRES) da Bahia. Foram incluídos indivíduos com diagnóstico médico de ELA, comprovado por exame de Eletroneuromiografia, independente do sexo ou idade. Após a identificação dos sujeitos, foram realizadas visitas domiciliares para coleta de dados sociodemográficas, sintomas neurológicos e avaliação funcional. Resultados: A média de idade dos seis participantes da pesquisa foi 52,8 anos (DP ± 6,3 anos), tendo os primeiros sintomas se manifestado a partir dos 46 anos de idade. Os principais sintomas da Esclerose Lateral Amiotrófica foram fraqueza (50,0%) e dor (50,0%) e durante a progressão foi observada a presença de fraqueza (100,0%), seguida de disartria (83,3%), fasciculações (66,7%) e tremor (66,7%). De modo geral, as atividades que os sujeitos referiram realizar com mais frequência foram “vestir-se da cintura para baixo” (100,0%) e alimentação (83,3%). Conclusão: Os achados desta pesquisa apontam a necessidade de ofertar um conjunto de serviços de saúde para os indivíduos com ELA, em uma perspectiva interdisciplinar, que envolve o acompanhamento médico-farmacológico, nutricional, assistência em fisioterapia, fonoaudiologia e terapia ocupacional, além do acompanhamento psicológico para os pacientes e suas famílias.
Circulação do vírus da raiva em animais no município de Natal-RN e profilaxia antirrábica humana de pós-exposição, no período de 2007 a 2016
Authors: Bandeira Elaine Denise , De Brito Filho Álvaro Soares , Santos Emelynne Gabrielly de Oliveira , Barbosa Isabelle Ribeiro
Published: July 2018

Introdução: A raiva, antropozoonose viral de alta letalidade, é considerada um grave problema de saúde pública no Brasil e no mundo. Objetivo: caracterizar o perfil da profilaxia antirrábica humana pós-exposição e identificar as áreas com casos positivos de raiva em animais no município de Natal-RN. Métodos: Trata-se de um estudo epidemiológico. Os dados das fichas de investigação de atendimentos antirrábicos humanos registrados no Sistema de Informação de Agravos de Notificação (Sinan), no período de 2007 a 2016, foram tabulados e calculados os coeficientes anuais de incidência dos atendimentos quanto às variáveis sociodemográficas e específicas. Foi elaborado um mapa no software Q-GIS dos coeficientes de incidência dos atendimentos por 100 mil habitantes por bairro, indicando-se as áreas epizootias por raiva. Resultados: Houve 18.798 atendimentos, com maior incidência no ano de 2015. A faixa etária mais acometida foi de 0-13 anos, em indivíduos do sexo masculino. Na maioria dos casos, a exposição foi pela mordedura e os locais anatômicos mais afetados foram mãos/pés. A espécie canina esteve envolvida na maioria dos casos. Em 64,9% dos tratamentos foi indicado o tratamento com vacinas. Os bairros Lagoa Azul, Potengi, Nossa Senhora da Apresentação, Ponta Negra e Pitimbu registraram os maiores coeficientes de incidência, além da ocorrência da epizootia por raiva em quirópteros. Conclusão: O município de Natal apresenta áreas de elevados riscos para a ocorrência da raiva humana, sendo o cão a espécie mais envolvida em agressões e as crianças e adolescentes os grupos mais vulneráveis.
ΤΟ ΠΡΟΒΛΗΜΑ ΤΗΣ ΜΙΚΡΑΣ ΓΟΝΙΜΟΤΗΤΟΣ ΕΙΣ ΤΗΝ ΙΠΠΟΠΑΡΑΓΩΓΗΝ ΜΑΣ
Authors: ΒΛΑΧΟΣ ΚΩΝΣΤΑΝΤΙΝΟΣ
Published: July 2018

NO ABSTRACT AVAILABLE
ΕΦΑΡΜΟΓΗ ΤΗΣ ΚΑΤΑ LESTRÀDET ΔΟΚΙΜΑΣΙΑΣ ΕΝ ΤΗ, ΔΙΑΓΝΩΣΤΙΚΗ, ΤΗΣ ΚΕΤΩΣΕΩΣ ΤΩΝ ΓΑΛΑΚΤΟΦΟΡΩΝ ΑΓΕΛΑΔΩΝ
Authors: ΚΑΡΔΑΣΗΣ Ι.
Published: July 2018

NO ABSTRACT AVAILABLE
ΓΕΝΙΚΗ ΑΝΑΙΣΘΗΣΙΑ ΚΥΝΟΣ ΔΙΑ ΝΕΜΒΟΥΤΑΛΗΣ
Authors: ΑΣΠΙΩΤΗΣ Ν.
Published: July 2018

NO ABSTRACT AVAILABLE
Η ΤΕΧΝΗΤΗ ΣΠΕΡΜΑΤΕΓΧΥΣΙΣ ΕΙΣ ΤΑ ΜΟΝΟΠΛΑ ΔΙ' ΑΠΟΣΤΟΛΗΣ ΣΥΝΤΕΤΗΡΗΜΕΝΟΥ ΣΠΕΡΜΑΤΟΣ ΕΙΣ ΜΑΚΡΙΝΑΣ ΑΠΟΣΤΑΣΕΙΣ
Authors: ΒΛΑΧΟΣ Κ.
Published: July 2018

NO ABSTRACT AVAILABLE
H ΧΡΟΝΙΑ ΑΝΑΠΝΕΥΣΤΙΚΗ ΝΟΣΟΣ TΩN ΟΡΝΙΘΩΝ EN ΕΛΛΑΔΙ
Authors: ΤΑΡΛΑΤΖΗΣ Κ. , ΑΫΦΑΝΤΗΣ Σ. , ΔΡΑΓΩΝΑΣ Π. , ΠΑΠΑΔΟΠΟΥΛΟΣ Α.
Published: July 2018

NO ABSTRACT AVAILABLE
Η ΧΡΗΣΙΜΟΠΟΙΗΣΙΣ ΤΩΝ ΑΝΤΙΒΙΟΤΙΚΩΝ ΕΝ ΤΗ, ΔΙΑΤΡΟΦΗ, ΤΩΝ ΖΩΩΝ
Authors: BRYANT B.C.
Published: July 2018

NO ABSTRACT AVAILABLE
Backscatter signal model for Irkutsk Incoherent Scatter Radar
Authors: Ташлыков Виктор , Tashlykov Viktor , Медведев Андрей , Medvedev Andrey , Васильев Роман , Vasilyev Roman
Published: June 2018

The paper presents a backscatter signal model for Irkutsk Incoherent Scatter Radar (IISR) and proposes a technique for solving the inverse scattering problem to obtain plasma temperatures from IISR data. This solution is validated by setting up the direct scattering problem and simulating it using the Monte-Carlo method. In addition, we can introduce known systematic error sources into the backscatter signal model. This enables us to determine which approaches can be used to recover temperatures correctly. The major task of this study is to identify and methodically correct the errors that can distort the obtained temperatures. We also report the results of testing of the developed technique for determining temperatures from IISR experimental data. The presented model and IISR experimental data can be used to validate techniques for determining other ionospheric plasma parameters.
Rules, Practices, and Information Technology: A Trifecta of Organizational Regulation
Authors: de Vaujany François-Xavier , Fomin Vladislav V. , Haefliger Stefan , Lyytinen Kalle
Published: July 2018

As information technology (IT)-based regulation has become critical and pervasive for contemporary organizing, information systems research turns mostly a deaf ear to the topic. Current explanations of IT-based regulation fit into received frameworks such as structuration theory, actor-network theory, or neoinstitutional analyses but fail to recognize the unique capacities IT and related IT-based regulatory practices offer as a powerful regulatory means. Any IT-based regulation system is made up of rules, practices, and IT artifacts and their relationships. We propose this trifecta as a promising lens to study IT-based regulation in that it sensitizes scholars into how IT artifacts mediate rules and constitute regulatory processes embracing rules, capacities of IT endowed by the artifact, and organizational practices. We review the concepts of rules and IT-based regulation and identify two gaps in the current research on organizational regulation: (1) the critical role of sensemaking as part of IT-based regulation, and (2) the challenge of temporally coupling rules and their enactment during IT-based regulation. To address these gaps we introduce the concept of regulatory episode as a unit of analysis for studying IT-based regulation. We also formulate a tentative research agenda for IT-based regulation that focuses on tensions triggered by the three key elements of the IT-based regulatory processes.

The online appendix is available at https://doi.org/10.1287/isre.2017.0771 .
Joyce Thompson: reminiscing on life as a chief nursing officer
Authors: Brotherton Hope
Published: July 2018

Just two years before the health service was formed Joyce Thompson began her journey in healthcare as a student nurse at Manchester Royal Infirmary in 1946.
John Rostill reflects on his time in NHS management
Authors: Brotherton Hope
Published: July 2018

In 1964, 16 years after the NHS was formed, John Rostill left his grammar school roots behind and joined the workforce. Before he delved into the world of healthcare, John had ambitions of becoming a PE teacher, but unfortunately – or fortunately for us – he was injured playing rugby, and as a consequence had to rethink his future career prospects.
Planning menus to meet the voluntary guidelines
Authors: Revel Edwina , Leech Georgia
Published: July 2018

The foundation stage includes a requirement for food and drink. We must ensure children are offered a healthy, balanced diet, based on a variety of foods from the four food groups from the Eatwell Guide.
The experience of low back pain in people with incomplete spinal cord injury in the USA, UK and Greece
Authors: Michailidou Christina , Marston Louise , De Souza Lorraine H
Published: July 2018

Aims/Background:

To investigate the prevalence of low back pain in people with incomplete spinal cord injury and compare these characteristics among three countries.

Methods:

A cross-sectional, primarily internet based survey, was conducted in the USA, UK and Greece. The Short Form McGill Pain Questionnaire was the main measure used. In addition, data were collected on the presence, onset, duration and frequency of low back pain.

Findings:

A total of 219 questionnaires were included in the analysis. Anytime low back pain was 74% (95% confidence interval [CI] 67, 79) and current low back pain was 66% (95% CI 59, 72). People with paraplegia were 2.75 times more likely to report low back pain anytime post incomplete spinal cord injury than people with tetraplegia (95% CI 1.38, 5.47). Thirty-three percent of participants reported low back pain onset immediately post incomplete spinal cord injury and 44% reported daily low back pain with people from UK reporting the highest percentage (59%). The more low back pain days felt in a month the worse its quality and intensity. Low back pain is described as ‘discomforting’ with moderate intensity and people from the UK reported the worst low back pain. Finally, people from Greece reported better results for the sensory component of their low back pain.

Conclusions:

Despite some differences in profile and injury characteristics of the groups from the three nations, low back pain presence in incomplete spinal cord injury is reported highly for all people in the countries investigated.
Classifying joint hypermobility: a comparison of three current classification systems
Authors: Armstrong Ross , Greig Matt
Published: July 2018

Background/Aims:

Joint hypermobility is an excessive range of motion in one joint and is related to increased risk of injury and performance adaptations within sports and dance. Joint hypermobility classification lacks consistency across the literature, which may hinder effective management. The aim of the study was to compare the prevalence of joint hypermobility across sex- and sport-specific participation using three different classification systems.

Methods:

Joint hypermobility was assessed in 286 participants consisting of rugby players, netballers, dancers and female and male controls. The Beighton score was used to measure joint hypermobility in the fifth metacarpophalangeal joints, thumbs, elbows, knees and lumbar spine. Scores were subsequently categorised using three different joint hypermobility classifications previously reported by Beighton et al (1973) , Boyle et al (2003) and Stewart and Burden (2004) .

Findings:

The prevalence of ‘not hypermobile’ varied considerably between classifications. This difference was greatest in female netball players and smallest in male rugby players. Within the ‘not hypermobile’ category, an additional 33 females and 5 males were ‘not hypermobile’ with the Beighton et al (1973) and Stewart and Burden (2004) criteria, which may highlight a sex consideration when assessing low Beighton scores. In the ‘distinctly hypermobile’ category, female subjects demonstrated sensitivity to classification system, most prominently dancers.

Conclusions:

There may be a need for separate sex categories. The female dancer classification may require further categorisation to identify extremes of joint hypermobility more effectively, which may aid injury prevention strategies.
Canine hip dysplasia: aetiology and treatment
Authors: Corral Cheryl
Published: July 2018

With a prevalence of over 70% amongst some breeds, hip dysplasia is one of the most common developmental orthopaedic diseases diagnosed in first opinion practice. With a multimodal approach leading to the best form of management of the condition, this two-part article looks at the causes and treatment of the condition, and the role that the veterinary nurse and rehabilitation can play. Part one below focuses on aetiology and treatment.
How to triage
Authors: Covey Elizabeth
Published: July 2018

Triage is the process of organising patients according to the severity of their condition and getting each patient treatment within an appropriate time frame. Good triage should be implemented in every stage of patient care, from the primary phone call to the patient arrival, to ensure each patient receives the care it needs. This article discusses the different triage scoring systems available, communication with the owner over the phone and face to face, and triage of the patient on arrival through assessment of the three major body systems. There is also discussion of the secondary survey to determine the patients that do not have an immediately life-threatening condition, but where there is potential for their condition to worsen rapidly.