bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurological Sleep Disorders and Blood Pressure
Authors: Mansukhani Meghna P. , Covassin Naima , Somers Virend K.
Published: September 2019

Hypertension is a major determinant of cardiovascular morbidity and mortality and is highly prevalent in the general population. While the relationship between sleep apnea and increased blood pressure has been well documented, less recognized is emerging evidence linking sleep-related movement disorders such as restless legs syndrome/periodic limb movements of sleep and sleep-related bruxism with blood pressure (BP) dysregulation and hypertension. There is also recent literature linking narcolepsy-cataplexy with elevated BP and altered pressor responses, and there are data suggesting abnormal BP control in rapid eye movement sleep behavior disorder. It is thought that neural circulatory mechanisms, sympathetic activation in particular, comprise the predominant mediator underlying elevated BP in these neurological sleep disorders. There is very limited evidence that treating these sleep disorders may be beneficial in lowering BP primarily because this question has received very little attention. In this review, we discuss the potential pathophysiologic mechanisms underlying elevated BP in restless legs syndrome/periodic limb movements of sleep, sleep-related bruxism, narcolepsy-cataplexy, and rapid eye movement sleep behavior disorder. We also examine the relationship between these sleep disorders and elevated BP and the impact of treatment of these conditions on BP control. Last, we discuss gaps in the literature evaluating the associations between these sleep disorders and elevated BP and identify areas for further research.
A Tale of Two Positivities and the N400: Distinct Neural Signatures Are Evoked by Confirmed and Violated Predictions at Different Levels of Representation
Authors: Kuperberg Gina R. , Brothers Trevor , Wlotko Edward W.
Published: September 2019

It has been proposed that hierarchical prediction is a fundamental computational principle underlying neurocognitive processing. Here, we ask whether the brain engages distinct neurocognitive mechanisms in response to inputs that fulfill versus violate strong predictions at different levels of representation during language comprehension. Participants read three-sentence scenarios in which the third sentence constrained for a broad event structure, for example, {Agent caution animate–Patient}. High constraint contexts additionally constrained for a specific event/lexical item, for example, a two-sentence context about a beach, lifeguards, and sharks constrained for the event, {Lifeguards cautioned Swimmers}, and the specific lexical item swimmers. Low constraint contexts did not constrain for any specific event/lexical item. We measured ERPs on critical nouns that fulfilled and/or violated each of these constraints. We found clear, dissociable effects to fulfilled semantic predictions (a reduced N400), to event/lexical prediction violations (an increased late frontal positivity), and to event structure/animacy prediction violations (an increased late posterior positivity/P600). We argue that the late frontal positivity reflects a large change in activity associated with successfully updating the comprehender's current situation model with new unpredicted information. We suggest that the late posterior positivity/P600 is triggered when the comprehender detects a conflict between the input and her model of the communicator and communicative environment. This leads to an initial failure to incorporate the unpredicted input into the situation model, which may be followed by second-pass attempts to make sense of the discourse through reanalysis, repair, or reinterpretation. Together, these findings provide strong evidence that confirmed and violated predictions at different levels of representation manifest as distinct spatiotemporal neural signatures.
Macrobrachium chainatense sp. nov. (Decapoda: Palaemonidae): a freshwater prawn from Thailand based on morphology and molecular phylogeny
Authors: SAENGPHAN NUKUL , PANIJPAN BHINYO , SENAPIN SAENGCHAN , LAOSINCHAI PARAMES , RUENWONGSA PINTIP , SUKSOMNIT AUAREE , PHIWSAIYA KORNSUNEE
Published: September 2019

Many species of freshwater prawns, large and small, inhabit Southeast Asian countries. In Thailand alone, there have been recent reports of new species in the genus Macrobrachium. Morphological differentiation and, recently, DNA sequence differences have been used to distinguish new species from valid ones. Macrobrachium chainatense (Decapoda: Palaemonidae), a small freshwater prawn found in Thailand, is now established as a new species based on both morphological and genetic criteria. Among Thailand Macrobrachium prawns, M. chainatense has smallest body size, largest egg size, and 3–5 teeth on the cutting edges. The most closely related Macrobrachium species to M. chainatense in terms of COI and 18S DNA sequences is M. niphanae. Their COI sequences differ by 7.3% while their 18S sequences are basically identical in all but one site. Observations of some aspects of this prawn in captivity are also utilized to establish its unique species status. This prawn may be useful as a source of cooked food for human consumption.
The Role of Alfred J. Marrow and the Harwood Manufacturing Corporation in the Advancement of OD
Authors: Burnes Bernard
Published: September 2019

The Harwood Manufacturing Corporation began its life in the garment-trade sweatshops of New York at the end of the 19th century and ended its independent existence in the sweatshops of Honduras and Costa Rica at the end of the 20th century. In between, under the influence of Kurt Lewin and Alfred J. Marrow, it became seen as a beacon of progressive management: the place where the values, tools, and philosophy of the Organization Development (OD) movement were trialed, extended, and established. Harwood laid the foundations of the group-orientated OD that emerged in the 1950s and shaped the more system-wide and integrated approach to OD that came to the fore in the 1970s. As such, it left a lasting legacy that has been institutionalized in current OD practices and values.
Engaging with Popular Music from a Cultural Standpoint: A Concept-Oriented Framework
Authors: Niknafs Nasim
Published: September 2019

The last two decades in the North America have seen a resurgence of scholarly and practitioner activities advocating for integrating more popular music in music classrooms both through repertoire and pedagogy. However, the emphasis has been on Western-oriented popular music practices, neglecting those of other cultures, even though there is a major increase in population diversity occurring in the United States and Canada. This article examines the concept-oriented framework, through which, instead of exploring popular music geographically, one can engage with the wider concept of popular music across cultures. The framework consists of a central concept selected by music teachers and students and is contextualized by various areas of exploration. Popular music can play an influential, transformative, and socially just role in improving numerous situations.
A Return to Amateurism in Music Education
Authors: Kratus John
Published: September 2019

The future of American music education may be found in its past—a time when music teachers instilled lifelong amateur music-making in their students. There are differences between amateur and professional musicianship, and the focus of American music education shifted from amateurism to semiprofessionalism in the mid-twentieth century. An orientation toward semiprofessionalism makes little sense given the limited performance opportunities in large ensembles after high school and college. This article suggests a way back to nurturing amateurism and highlights two obstacles to this goal: the inflexibility of music teacher education and the profession’s reluctance to accept popular music. The article concludes with a narrative of what a world of amateur musicianship looks like.
Popular Music Education: A Call to Action
Authors: Powell Bryan , Smith Gareth Dylan , West Chad , Kratus John
Published: September 2019

This is the editors’ introduction to the Special Focus Issue on Popular Music Education. Also included is a forward from Robert A. Cutietta, editor of the 1991 Music Educators Journal Special Focus Issue on Popular Music Education.
Exploring breast cancer diagnosis and treatment experience among a sample of South African women who access primary health care
Authors: Coetzee Bronwynè , Roomaney Rizwana , Smith Paula , Daniels Jo
Published: September 2019

Despite the known impact of a cancer diagnosis and related treatments on quality of life, and the complexity of patient journeys in low-resource settings, there has been little published research into the relevant issues faced by South African women living with breast cancer. In this study, we aimed to understand the experiences of breast cancer diagnosis and treatment among a sample of South African women who access primary health care. A convenience sample of 12 women between the ages of 48 and 66 years attending a primary health care facility took part in our study. Women undergoing breast cancer treatment were invited to take part in face-to-face interviews. The interviews were semi-structured and guided by an interview schedule. Interviews were analysed thematically using ATLAS.ti v 8 computer software. We identified three important themes that explained how women experience diagnosis and treatment, namely, (1) reactions to the diagnosis experience, (2) the importance of faith, and (3) the value in having a sense of agency. Women’s initial reaction to their cancer diagnosis was one of shock and disbelief. Despite these reactions, faith and agency played an important role in how women in this study made sense of their illness experience and how they coped. Our findings demonstrate that women’s experiences of breast cancer diagnosis and treatment were accompanied by some psychological distress for which they need support. Furthermore, supporting women to make positive choices about coping and valuing the role of religion when appropriate should form part of any therapeutic engagement, medical or otherwise.
Community-Dwelling and Recently Widowed Older Adults: Effects of Spousal Loss on Psychological Well-Being, Perceived Quality of Life, and Health-Care Costs
Authors: van Boekel L. C. , Cloin J. C. M. , Luijkx K. G.
Published: September 2019

This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently ( N = 9,400) at baseline, the majority had not lost their spouse after 12 months ( T12, n = 9,150), but 2.7% ( n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.
In-between Translation, Transformation and Contestation: Studying Human Rights Activism as Politics-as-Ruptures in Violent Social Conflicts
Authors: Georgi F. Richard
Published: September 2019

How can we study the politics of human rights activism in violent social conflicts? International Relations scholarship has long neglected the ambiguous political relationships between human rights activism and violent social conflicts. Addressing this gap requires new research methodologies that place the focus not on the normative or legal dimensions of human rights, but in how their usage constitutes the political. In this article I argue that using post-foundational discourse theory makes visible ‘politics-as-ruptures’ that locate the political function of human rights activism precisely in the resistance to representations of violence in conflict discourses. I analyse this political function by asking how activists translate human rights norms, transform conflict discourses, and thereby contest power relations. As examples, the article presents three types of discursive politics that I studied in Colombia. These examples point out further pathways to pose empirical questions about the roles of human rights activism in transforming social conflicts.
Reversal of Severe Multiorgan Failure Associated With Sickle Cell Crisis Using Plasma Exchange: A Case Series
Authors: Zaidi Gulrukh Z. , Rosentsveyg Juliana A. , Fomani Katayoun F. , Louie James P. , Koenig Seth J.
Published: September 2019

Objective:

Red blood cell exchange (RBCE) is the standard of care for patients with sickle cell disease (SCD) who present with severe vaso-occlusive crisis (VOC). However, subsets of these critically ill patients have progressive multiorgan failure (MOF) despite RBCE therapy. The purpose of this case series is to describe the use of plasma exchange (PLEX) for the treatment of SCD-related MOF that is refractory to RBCE.

Methods:

A retrospective case review of patients with severe MOF from sickle cell crisis unresponsive to RBCE who underwent PLEX in a 14-bed adult medical intensive care unit (ICU) at a tertiary care university hospital over a 4-year time period. Key laboratory data including complete blood count, indices of hemolysis, and markers of organ failure were recorded before and after both RBCE and PLEX.

Results:

Our primary objective is to evaluate the effectiveness of PLEX, in addition to RBCE, on organ dysfunction, laboratory indices, and mortality. Of the 7 patients, 6 survived. Of the patients who survived, all remained hemodynamically stable during PLEX sessions and showed both clinical and laboratory evidences of improvement in hemolysis and organ function. Average time from completion of first PLEX treatment to initial laboratory signs of organ failure reversal for patients who survived was 15.6 hours, the average length of stay in the ICU was 5.6 days, and the average total length of stay in the hospital was 14 days.

Conclusions:

Plasma exchange, in addition to RBCE, may be a novel synergistic treatment option to decrease risk of mortality in patients with refractory VOC and MOF.
Intimate Partner Sexual Violence and Mental Health Indicators Among Chinese Emerging Adults
Authors: Wong Janet Y. H. , Choi Edmond P. H. , Lo Herman H. M. , Wong Wendy , Chio Jasmine H. M. , Choi Anna W. M. , Fong Daniel Y. T.
Published: September 2019

Intimate partner sexual violence (IPSV) among emerging adults, including heterosexuals and sexual minorities in the Chinese population, is poorly understood. Focusing on college students, the objectives of the present study were to estimate the prevalence of IPSV among Chinese emerging adults, examine the association between sexual orientation and IPSV, and evaluate the mental health and quality of life of survivors of IPSV. Data were collected from four university campuses in Hong Kong. A total of 1,015 participants were included in the data analysis. The prevalence of IPSV as identified by Conflict Tactics Scale (CTS)-2 was 12.1%. There was no gender difference in the prevalence of IPSV. Multiple logistic regression found that being older; having experienced childhood sexual abuse and having a smoking habit; and belonging to a sexual minority were factors associated with IPSV. Multiple linear regression found that IPSV survivors were more likely to have higher levels of anxiety and depression, more severe psychosomatic symptoms, and poorer quality of life in three domains: psychological, social relationships, and environment when compared with those without IPSV experience. The documented factors underscored the importance of awareness that men and sexual minorities might incur IPSV, which should receive more attention in IPSV prevention programs. Also, interventions for IPSV survivors should be targeted at improving their mental health and quality of life and sex education should place more emphasis on sexual consent and sexual health in dating relationships.
Is Selection Necessary for Evolution? A Dynamics of Coastal Population of India
Authors: Kapoor A. K. , Saini Monika
Published: September 2019

Nature provides a good opportunity to understand the dynamics of evolution. The country has a huge coastline, which experiences socio-cultural and natural vulnerability. The aim of the paper has been to describe the pattern of selection intensity among the east and west coastal populations of India. Differential fertility and mortality were collected from 2,099 females (mothers) of the western coasts of India, and secondary data were collected from the eastern coast of India for comparison purposes. Selection potential was computed using Crow’s index and Johnston & Kensinger’s index. The data involved a total of 7,512 pregnancies during their reproductive lifespan and the successful outcomes (live births) were 7,073. The total index (It) for eastern coast varied from 0.221 to 1.078. For the west coast, it varied from 0.262 to 0.617. Among the eastern coastal population groups, the mortality component of selection is comparatively higher than its fertility component, while it is just the reverse among the western coastal population groups.
Impact of Dialysis on the Dyadic Relationship Between Male Patients and Their Female Partners
Authors: Moore Currie , Skevington Suzanne , Wearden Alison , Mitra Sandip
Published: September 2019

The objective of this study was to explore the impact of three early phases of renal dialysis, namely pre-dialysis, starting dialysis, and establishing dialysis, on dyadic relationships. Twenty UK-based dyads (20 male patients and their female partners) participated in semi-structured interviews and discussed the effects of dialysis on themselves and their relationship. Dyadic thematic analysis, facilitated by dyadic-level charting, integrated participants’ experiences and enabled identification of patterns across dyads. We found that dialysis had positive and negative influences on identity, social relationships, and mental health, forming the themes: Prioritizing the Patient, Carrying the Burden, and Changing Identities. The final theme, Managing the Relationship, described how dyads prevented dialysis from negatively impacting their relationship. Dyadic-level charting provided a systematic examination of individual and dyadic experiences. These findings indicate that access to informational and support services for dyads as they prepare to start dialysis may minimize negative effects on their relationship.
Characterizing the Financial Value of In-Home Palliative Care for Patients, Payers, and Hospitals
Authors: Akhtar Saad , Srinivasan Vamshek , Weisse Carol , DiSorbo Phil
Published: September 2019

Background:

The holistic and multidisciplinary approach of in-home palliative care (IHPC) is known to offer high-quality and cost-effective care for patients at the end of life. However, the financial benefits of upstream IHPC programs to hospitals, patients, and payers have not been fully characterized for patients with comorbid chronic conditions.

Aim:

To characterize the financial benefits that upstream IHPC offers to patients with multiple chronic conditions.

Methods:

A structured retrospective patient record review was conducted on the number of emergency department (ED) visits, number of inpatient hospitalizations, hospital length of stay (LOS), and payments made to the hospital for all patients (N = 71) enrolled in an IHPC program between January 1, 2016, and June 30, 2016. Discharge history from each patient’s medical record was also assessed. Comparisons were drawn between patients’ LOS on IHPC and an equivalent time period prior to enrollment in IHPC.

Results:

After patients enrolled in IHPC, average ED and inpatient utilization declined significantly by 41% ( P = .01) and 71% ( P < .001), respectively. The payers for health-care services realized a significant decline of US$2,201 ( P < .001) in hospital payments per patient per month. Inpatient LOS was also significantly lower than expected once patients enrolled in the program ( P = .01).

Conclusions:

As the need for chronic disease management continues to grow, managers of health systems, managed care organizations, and home health agencies should be cognizant of the financial value that IHPC has to offer.
Improving Advance Care Planning in a Resident Primary Care Clinic
Authors: Nassikas Nicholas J. , Baird Grayson L. , Duffy Christine M.
Published: September 2019

Introduction:

Two-thirds of chronically ill patients do not have an advance directive. The primary aim of this study was to develop an intervention to increase the documentation of advance directives in elderly adults in an internal medicine resident primary care clinic. The secondary aims were to improve resident confidence in discussing advance care planning and increase the number of discussions.

Methods:

The study was a pre- and postintervention study. The study intervention was a 30-minute educational session on advance care planning. Study participants were patients aged 65 years and older who were seen in an internal medicine residency primary care clinic over a 6-month period and internal medicine residents. Clinic encounters were reviewed for the presence of advance care planning discussions before and after the intervention. Resident confidence was measured on a Likert scale.

Results:

Two hundred ninety-five eligible patients were seen in the clinic from January 1, 2017, to June 30, 2017, and included in the analysis performed between 2017 and 2018. The mean number of documented advance care planning discussions increased from 2.24 (95% confidence interval [CI]: 1.0-4.9) during the preintervention period to 8.94 (95% CI: 5.94-13.24]) during the postintervention period ( P = .0011). Following the intervention, residents overall reported increased confidence in discussing advance care planning.

Conclusion:

A relatively modest intervention to increase advance care planning discussions is feasible in an internal medicine primary care clinic and can improve the confidence of residents with end-of-life discussion.
Socioeconomic Status and Waiting Times for Health Services: Current Evidences and Next Area of Research
Authors: Landi Stefano , Ivaldi Enrico , Testi Angela
Published: September 2019

Waiting times are an issue in many countries, excessive waiting for treatments may deteriorate patient’s health status and reduce treatment effectiveness potentially, becoming a barrier in the access to health care services. Waiting time to be equitable should be related only to the health need, people with the same health need have to wait the same time, without any difference due to socioeconomic status. In the commentary, the results of the extensive literature review and policy implications are discussed.
Pathogenesis and Consequences of Disordered Sleep in PCOS
Authors: Sam Susan , Ehrmann David A
Published: September 2019

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that is characterized by hyperandrogenism and menstrual irregularity. Affected women have a high prevalence of insulin resistance and related metabolic complications. The frequency of sleep disturbances appears to be increased in women with PCOS, although most studies so far have included more severely affected obese women with PCOS who are referred to tertiary care clinics and may not represent the general population of women with PCOS. This article provides an overview of sleep disturbances in PCOS with the focus on obstructive sleep apnea (OSA), the most commonly reported sleep disturbance among these women. The pathogenesis and risk factors for OSA in PCOS and its association with metabolic disorders is discussed in detail.
Contemporary Role of Topical Calcineurin Inhibitors: A Pediatric Dermatology Perspective
Authors: Fiorillo Loretta , Marcoux Danielle , Ramien Michele
Published: September 2019

Atopic dermatitis (AD) is the most common pediatric chronic inflammatory skin disease in North America, often involving complex treatment regimens and impairing the quality of life of affected children and their families. Two topical calcineurin inhibitors (TCIs) have been available for the treatment of AD in pediatric patients for more than 15 years, and they continue to represent an important steroid-sparing option for the management of AD. Despite the large body of evidence and extensive clinical experience with these agents, there remain concerns among parents and clinicians regarding the long-term safety of this class of therapy, particularly with respect to the boxed warning about the potential risk of lymphoma and malignancy associated with TCIs. Concerns about burning or stinging with initial applications are also common. This review examines the literature on the clinical effectiveness of TCIs, with a focus on the pivotal research that supports the efficacy of these agents, and the reassuring body of evidence supporting their long-term safety in pediatric patients. Practical recommendations for maximizing the utility of TCIs in pediatric patients, including discussion points to address with parents, are offered.
Chinese ‘Study Mothers’ in Living Apart Together (LAT) Relationships: Educational Migration, Family Practices, and Gender Roles
Authors: Qiu Shuang
Published: September 2019

Chinese people have a long history of giving great weight to education. Under the one-child policy, Chinese parents usually spare no efforts to devote themselves to their child’s development. This study examines how the gendered experiences of Chinese ‘study mothers’ ( peidu mama) who accompany their children to study while living apart from their partner, has impacted upon their everyday practices of ‘doing’ family in the Chinese social, historical, and cultural contexts. Drawing on data from qualitative interviews, this article examines how family is culturally constructed and practised in order to reclaim conventional forms of family and gender norms in China. For a woman, being a full-time study mother, even when it is at the cost of living separately from her partner and established career development, has been considered as a way to privilege ‘motherhood’ over ‘wifehood’. The dramatically opposite parenting roles reinforce and entrench the existing traditional gendered division of labour and gender hierarchy in contemporary Chinese society, which has a long tradition of patriarchal families within Confucian culture. This research suggests that family practices in the multi-local household setting are often closely implicated with practices of gender, class, mothering, and social norms. By focusing on these often-neglected groups, this study opens a new avenue to examining the diverse strategies employed by people in varied living arrangements, to negotiate gender roles and everyday family practices.
Canadian Rural Youth and Role Tension of the Police: ‘It’s Hard in a Small Town’
Authors: Ricciardelli Rosemary , Adorjan Michael , Spencer Dale
Published: September 2019

This article presents findings from a case study examining youth perceptions of the police in rural areas of Eastern Canada. A total of 20 semistructured focus group discussions were conducted with 60 youth from Canadian rural Atlantic areas, who were purposively recruited, with groups stratified by age and gender. Discussions centered on role tension regarding the police’s role, that is, along a continuum between law enforcement and public protection versus community policing and crime prevention. Our discussions highlight the arguably ironic view that it is harder to maintain trust when there are strong personal relations with the police. Discussions highlight the ‘pros and cons’ of informal familiarity with police officers, especially the presence of school resource officers and policing in the context of monitoring youth on modes of transportation germane to rural Atlantic Canada (i.e. skidoos). Implications from this study suggest that when dealing with youth, identifying and addressing youth perceptions of the police role can help improve police–youth interactions.
Patient-Specific Rehearsal Feasibility Before Endovascular Repair of Ruptured Abdominal Aortic Aneurysm
Authors: Pakeliani David , Bleuler Andrin , Chaykovska Lyubov , Veith Frank J. , Criado Frank J. , Lachat Mario , Pfammatter Thomas , Pecoraro Felice
Published: September 2019

Purpose: To evaluate the feasibility of a patient-specific rehearsal (PsR) before emergency endovascular aneurysm repairs (eEVAR) and its influence on the operation. Materials and Methods: From February 2016 to October 2016, 10 consecutive patients (mean age 75±7.4 years; 9 men) presenting with a ruptured abdominal aortic aneurysm (rAAA) suitable for standard EVAR were enrolled in the study. A 3-dimensional (3D) model of the abdominal aorta was generated on a virtual reality simulator based on the patient’s computed tomography (CT) images. Following the patient-specific simulation setup, PsR was conducted during patient admission or in parallel with the preoperative eEVAR workup. Measured outcomes were PsR feasibility only in the first 4 patients and impact on operative performance thereafter (changes in device selection, the planning process, clinical outcomes, perioperative mortality, and complication rates). Technical metrics and timing of system setup, rehearsal, interval from patient arrival to the actual procedure, and eEVAR were recorded. Results: Mean time for 3D model creation was 21.3±7.8 minutes (range 13–37); there was a significant positive relationship between aortic neck diameter and segmentation time (p=0.003). The overall mean time for simulator setup and PsR was 54±14 minutes (range 37–80); PsR alone was completed in a mean 31±40 minutes (95% confidence interval −60 to −2.2). The actual eEVAR procedure duration was 69±16 minutes (range 45–90). No delay in the actual eEVAR procedure was registered owing to the PsR pathway. In 6 patients, preprocedure rehearsal induced changes in operative strategy, including device selection, main body introduction side, and/or deployment configuration. In 4 cases, rehearsal was performed twice to achieve optimal performance. Conclusion: PsR before eEVAR was feasible in all cases and caused no time delays in the actual eEVAR procedure. PsR optimized eEVAR planning by identifying optimal strategy for stent-graft component selection and deployment.
Minimally Invasive Thoracoscopic Mitral Valve Replacement in Rheumatic Disease With Continuous Suture Technique
Authors: Dat Pham Quoc , Hung Duong Duc , Hoan Duong Thi , Uoc Nguyen Huu , Nissen Alexander P.
Published: September 2019

Minimally invasive mitral valve surgery has become routine in many institutions. Disadvantages of this approach include prolonged aortic cross-clamp and cardiopulmonary bypass times. Mitral valve replacement with a continuous suture technique may reduce operative times. We present a case of a 51-year-old man suffering from severe rheumatic mitral disease to highlight our continuous suture technique for minimally invasive mitral valve replacement. We also report preliminary results from our series of 15 patients suffering various rheumatic mitral pathology treated with this technique.
The role of pembrolizumab in the treatment of PD-L1 expressing gastric and gastroesophageal junction adenocarcinoma
Authors: Brar Gagandeep , Shah Manish A.
Published: September 2019

Gastric cancer is a leading cause of cancer-related death worldwide. Recent evidence suggests that gastric cancer is a complex and heterogenous disease with emerging subtypes shown to affect response to treatment and survival. Immunotherapy is an advancing field and immune checkpoint inhibitors have become standard treatment options in numerous tumor types. In this review, we discuss the current and evolving use of checkpoint blockade, focusing on the anti-PD-1 inhibitor, pembrolizumab, for use in advanced gastric and gastroesophageal cancers.
Morality as Legitimacy under Xi Jinping: The Political Functionality of Traditional Culture for the Chinese Communist Party
Authors: Kubat Aleksandra
Published: September 2019

Taking as an example Xi Jinping's use of the phrase “excellent traditional culture” ([Formula: see text], youxiu chuantong wenhua), this article looks at the construction of a centrally sanctioned narrative of traditional Chinese culture in resources produced within the Party school system. The specific focus of analysis is on how these resources theorise the functionality of traditional culture for the Chinese Communist Party (CCP) as a political organisation, and what culture-based solutions they put forward to tackle the problems with Party theory and ideology, the state governance model, and cadre performance. It is argued that by referencing traditional culture, and, in particular, by drawing on traditional moral virtues, the CCP realigns itself with societal expectations without making concessions over the ideological foundations of the party state.
Variability in Baseball Throwing Metrics During a Structured Long-Toss Program: Does One Size Fit All or Should Programs Be Individualized?
Authors: Leafblad Nels D. , Larson Dirk R. , Fleisig Glenn S. , Conte Stan , Fealy Stephen A. , Dines Joshua S. , D’Angelo John , Camp Christopher L.
Published: September 2019

Background:

The variability of throwing metrics, particularly elbow torque and ball velocity, during structured long-toss programs is unknown.

Hypotheses:

(1) Elbow torque and ball velocity would increase as throwers progressed through a structured long-toss program and (2) intrathrower reliability would be high while interthrower reliability would be variable.

Study Design:

Descriptive laboratory study.

Level of Evidence:

Level 3.

Methods:

Sixty healthy high school and collegiate pitchers participated in a structured long-toss program while wearing a validated inertial measurement unit, which measured arm slot, arm velocity, shoulder rotation, and elbow varus torque. Ball velocity was assessed by radar gun. These metrics were compared within and between all pitchers at 90, 120, 150, and 180 ft and maximum effort mound pitching. Intra- and interthrower reliabilities were calculated for each metric at every stage of the program.

Results:

Ball velocity significantly changed at each progressive throwing distance, but elbow torque did not. Pitching from the mound did not place more torque on the elbow than long-toss throwing from 120 ft and beyond. Intrathrower reliability was excellent (intraclass correlation coefficient >0.75) throughout the progressive long-toss program, especially on the mound. Ninety-one percent of throwers had acceptable interthrower reliability (coefficient of variation <5%) for ball velocity, whereas only 79% of throwers had acceptable interthrower reliability for elbow torque.

Conclusion:

Based on trends in elbow torque, it may be practical to incorporate pitching from the mound earlier in the program (once a player is comfortable throwing from 120 ft). Ball velocity and elbow torque do not necessarily correlate with one another, so a degree of caution should be exercised when using radar guns to estimate elbow torque. Given the variability in elbow torque between throwers, some athletes would likely benefit from an individualized throwing program.

Clinical Relevance:

Increased ball velocity does not necessarily equate to increased elbow torque in long-toss. Some individuals would likely benefit from individualized long-toss programs for rehabilitation.
Assessing concussion knowledge and awareness in faculty and staff in a collegiate setting
Authors: Mokris Rebecca L , Kessler Andrea , Williams Kathleen , Ranney John , Webster Jeffrey , Stauffer Kory
Published: September 2019

Purpose

To examine faculty and academic support staff members’ awareness and knowledge regarding concussions.

Design

Cross-sectional, web-based questionnaire.

Setting

Division II collegiate setting.

Subjects

A total of 123 collegiate faculty, administrative and academic support staff participated in the study. Measure(s): Participants completed the Faculty and Staff Concussion Awareness and Knowledge Survey. Analysis: Descriptive statistics were compiled for demographic information within the survey. Analysis of variance was performed on concussion awareness and concussion knowledge survey questions.

Results

The majority of the sample had teaching responsibilities in the University (75%). There was a significant effect of college departments within the university on individuals’ level of awareness (F (5, 117) = 9.74, p < .001). The Athletics department scored the highest in awareness of concussion symptomology, while the Business department scored the lowest. Females demonstrated significantly more awareness of concussion symptoms than males (F (1, 121) = 10.488, p = .002). University department significantly impacted knowledge of concussion treatments (F (5, 117) = 3.67, p < .004). The Health Sciences department scored the highest in knowledge of concussion treatments, while the Business department scored the lowest. Past experience with academic accommodations was associated with respondents’ knowledge of concussion treatment (F (1, 121) = 4.046, p = .047).

Conclusions

Concussion management in a collegiate setting should include the faculty and academic support staff. Colleges and Universities should consider educational programming regarding etiology and recovery from concussions for effective management when student experience a concussion.
HA-based dermal filler: downstream process comparison, impurity quantitation by validated HPLC-MS analysis, and in vivo residence time study
Authors: Guarise Cristian , Barbera Carlo , Pavan Mauro , Panfilo Susi , Beninatto Riccardo , Galesso Devis
Published: September 2019

The success of hyaluronic acid (HA)-based dermal fillers, with more than 2 million minimally invasive procedures conducted in 2016 in the US alone, is due to their hygroscopic properties of biocompatibility and reversibility. The type and density of HA cross-linkage, as well as the manufacturing technology, may influence not only the in vivo persistence but also the safety profile of dermal fillers. 1,4-Butanediol diglycidyl ether (BDDE) is the cross-linker used in most market-leading HA fillers; 1,4-butanediol di-(propan-2,3-diolyl) ether (BDPE) is the major impurity obtained from the HA–BDDE cross-linking (HBC) process. In this work, a new process to obtain high purity HBC fillers was developed. A new HPLC-MS method was validated for the quantification of BDPE content in HBC dermal fillers. In vitro cytotoxicity of BDPE was evaluated in fibroblasts (IC50 = 0.48 mg/mL). The viscoelasticity was monitored during the shelf-life of the HBC-10% hydrogel and was correlated with in vitro hyaluronidase resistance and in vivo residence time in a rabbit model. This analysis showed that elasticity is the best parameter to predict the in vivo residence time. Finally, a series of parameters were investigated in certain marketed dermal fillers and were compared with the results of the HBC-10% hydrogel.
Cancer immunotherapy and its renal effects
Authors: Mamlouk Omar , Abudayyeh Ala
Published: September 2019

With the advent of the era of immunotherapy, there has been marked increased survival in several cancers such as advanced melanoma, renal cell carcinoma, non-small cell lung cancer, urothelial carcinoma, and head and neck cancers. Harnessing the immune system against tumor by releasing the breaks off the regulators of the immune system, such as cytotoxic T-lymphocyte–associated antigen 4, programmed cell death protein 1, and its ligand, has resulted in also unregulated organ-specific toxicity. In this review, we will discuss the renal toxicities associated with a checkpoint inhibitor from the typical acute tubulointerstitial nephritis to glomerulonephritis and their proposed mechanisms. In addition, we discuss the available data associated with transplant rejection and the use of checkpoint inhibitor.
Molecular endoscopic imaging: the future is bright
Authors: Ahmed Shakil , Galle Peter R. , Neumann Helmut
Published: September 2019

The prediction and final survival rate of gastrointestinal cancers are dependent on the stage of disease. The ideal would be to detect those gastrointestinal lesions at early stage or even premalignant forms which are difficult to detect by conventional endoscopy with white light optical imaging as they show minimum or no changes in morphological characteristics and are thus left untreated. The introduction of molecular imaging has greatly changed the pattern for detecting gastrointestinal lesions from purely macroscopic structural imaging to the molecular level. It allows microscopic examination of the gastrointestinal mucosa with endoscopy after the topical or systemic application of molecular probes. In recent years, major advancements in endoscopic instruments and specific molecular probes have been achieved. This review focuses on the current status of endoscopic imaging and highlights the application of molecular imaging in gastrointestinal and hepatic disease in the context of diagnosis and therapy based on recently published literature in this field. We also discuss the challenges of molecular endoscopic imaging, its future directions and potential that could have a tremendous impact on endoscopic research and clinical practice in future.
The Impact of Federal Personnel Preparation Grants on Special Education Teacher Candidate Recruitment for Rural and Remote Alternative Teaching Pathways
Authors: Jameson J. Matt , Walker Ryan M. , Farrell Michael , Ryan Joanna , Conradi Lyndsey Aiono , McDonnell John
Published: September 2019

This article describes rural and remote teacher training in low incidence (LI) disabilities through an alternative teaching pathway (ATP) and the efforts of one university’s ATP program to address the ongoing critical special education teacher shortage in rural and remote school districts. The impact of the federal investment in recruiting/training teacher candidates in LI disabilities in rural and remote areas is described, and critical features of a distance education ATP programs in LI are discussed. Lessons learned over two decades of distance ATP delivery in LI are shared.
Proposing a Multilevel Approach for the Management of Uncertainties in Exploratory Projects
Authors: Gomes Leonardo Augusto de Vasconcelos , Brasil Vinicius Chagas , de Paula Rafael Augusto Seixas Reis , Facin Ana Lúcia Figueiredo , Gomes Frederico César de Vasconcelos , Salerno Mario Sergio
Published: September 2019

Managers of exploratory projects might face uncertainties over long timeframes at different levels (e.g., project, portfolio, organization, and network). Although literature offers some guidance on how to deal with uncertainties (mainly at the project level), there is a need for more empirical ground and theoretical development of a systemic approach to the management of uncertainties. To fill this gap, this article employs a multiple case approach in two established firms, investigating six exploratory projects. As main contributions, we identified new categories of uncertainties (primitive, structural, and elementary) and aspects related to managing these uncertainties.
Sitagliptin does not reduce the risk of cardiovascular death or hospitalization for heart failure following myocardial infarction in patients with diabetes: observations from TECOS
Authors: Nauck Michael A. , McGuire Darren K. , Pieper Karen S. , Lokhnygina Yuliya , Strandberg Timo E. , Riefflin Axel , Delibasi Tuncay , Peterson Eric D. , White Harvey D. , Scott Russell , Holman Rury R.
Published: September 2019

Background

To examine the effects of the DPP-4i sitagliptin on CV outcomes during and after incident MI in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS).

Methods

TECOS randomized 14,671 participants with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD) to sitagliptin or placebo, in addition to usual care. For those who had a within-trial MI, we analyzed case fatality, and for those with a nonfatal MI, we examined a composite cardiovascular (CV) outcome (CV death or hospitalization for heart failure [hHF]) by treatment group, using Cox proportional hazards models left-censored at the time of the first within-trial MI, without and with adjustment for potential confounders, in intention-to-treat analyses.

Results

During TECOS, 616 participants had ≥ 1 MI (sitagliptin group 300, placebo group 316, HR 0.95, 95% CI 0.81–1.11, P = 0.49), of which 25 were fatal [11 and 14, respectively]). Of the 591 patients with a nonfatal MI, 87 (15%) died subsequently, with 66 (11%) being CV deaths, and 57 (10%) experiencing hHF. The composite outcome occurred in 58 (20.1%; 13.9 per 100 person-years) sitagliptin group participants and 50 (16.6%; 11.7 per 100 person-years) placebo group participants (HR 1.21, 95% CI 0.83–1.77, P = 0.32, adjusted HR 1.23, 95% CI 0.83–1.82, P = 0.31). On-treatment sensitivity analyses also showed no significant between-group differences in post-MI outcomes.

Conclusions

In patients with type 2 diabetes and ASCVD experiencing an MI, sitagliptin did not reduce subsequent risk of CV death or hHF, contrary to expectations derived from preclinical animal models.

Trial registration clinicaltrials.gov no. NCT00790205
Crustal structure and CO2 occurrences in the Brazilian basins
Authors: Ferraz André , Gamboa Luiz , Neto Eugênio Vaz dos Santos , Baptista Rui
Published: September 2019

[Formula: see text] occurrences are common in hydrocarbon reservoirs in different geologic and geotectonic environments. In most of the Brazilian sedimentary basins, carbon dioxide occurs in minimal amounts. However, more recent deepwater exploration in the Santos Basin discovered significant concentrations of [Formula: see text] in some petroleum fields geographically dispersed. Adjacent fields within a very similar geologic context can hold a few percent to 80% of [Formula: see text] creating great scientific challenges for understanding the origin of [Formula: see text] and the identification of the main controls that govern its erratic distribution. That is the case of the Tupi (Lula) field, which has low [Formula: see text] content, and the neighbor Jupiter field, with an abnormal 80% of [Formula: see text] in the gas cap. The origin of this [Formula: see text] from earth’s mantle was already proved by isotopic analyses of noble gases. We have developed some hypotheses to explain this mantle sourced carbon dioxide in hydrocarbon reservoirs of the Santos Basin, namely, regional crustal thinning, deep-seated faults, high fault density, igneous intrusions, among others. The [Formula: see text] is abundant in the mantle, and the continental crust can act as a seal that inhibits these fluids from flowing toward the earth’s surface. The highly stretched continental crust in the Santos Basin allows [Formula: see text]-rich mantle material to intrude the upper levels of the continental crust in some locations. Fault systems associated with these magmatic intrusions can direct the carbon dioxide into the upper sedimentary section in a trajectory toward the surface. Understanding the crustal structure of a sedimentary basin is an important step in the exploratory process for the assessment of [Formula: see text] risk. The integration of geophysical (grav-mag) and geochemical data prove great efficacy in identifying the origin of [Formula: see text] and the most important controls on its distribution in the Santos Basin. Such results strongly suggest this approach as a valuable tool for derisking new exploration projects.