bluuebunny/crossref_metadata_2025 huggingface dataset:
High-resolution CT evaluation of bronchial lumen to vertebral body, pulmonary artery to vertebral body and bronchial lumen to pulmonary artery ratios in Dirofilaria immitis-infected cats with and without selamectin administration
Authors: Lee-Fowler Tekla M , Cole Robert C , Dillon A Ray , Graham Shannon , Tillson D Michael , Barney Sharron
Published: October 2017

Objectives

The bronchial lumen to pulmonary artery (BA) ratio is utilized to evaluate pulmonary pathology on CT images. The BA ratio may be unreliable when changes are present in bronchial and pulmonary arteries concurrently. Bronchial lumen to vertebral body (BV) and pulmonary artery to vertebral body (AV) ratios have been established in normal cats and may serve as an alternative. This study aimed to evaluate the BV, AV and BA ratios in cats before and after infection with Dirofilaria immitis, with and without selamectin administration, and to characterize the distribution of disease.

Methods

Archived CT images were reviewed from three groups of cats: D immitis-infected untreated (n = 6); infected pretreated with selamectin (n = 6); and uninfected untreated (n = 5). The BV, AV and BA ratios were calculated for all lung lobes for baseline (D0) and day 240 (D240) postinfection. Ratios and percentage change from baseline were compared between lobes and between groups.

Results

BV and AV ratios were more consistent in identifying abnormalities when disease was present in bronchial and arteries concurrently than BA ratios. Infected untreated cats had significant changes in both BV and AV ratios and percentage change from baseline. Abnormal BV and AV ratios were noted in the infected selamectin group, although less widely distributed.

Conclusions and relevance

The BV and AV ratios more accurately identified bronchial and pulmonary artery abnormalities in D immitis-infected cats. Both bronchial and pulmonary artery changes were present in infected cats, decreasing the diagnostic application of the BA ratio. Pulmonary artery changes were more widely distributed than bronchial changes in the lung. Heartworm-infected cats receiving selamectin had bronchial and pulmonary artery changes but to a lesser extent than untreated heartworm-infected cats. The CT-derived BV and AV ratios are a useful measure to evaluate lung disease of cats.
An investigation of the dynamic characteristics of super high-rise buildings using real-time kinematic–global navigation satellite system technology
Authors: Xiong Chun-Bao , Niu Yan-Bo , Li Zhi
Published: October 2017

This article aims to investigate the dynamic characteristics (e.g. natural frequency and damping ratio) for two super high-rise completed and uncompleted buildings. Real-time kinematic-global navigation satellite system technology is applied to observe the dynamic responses. To improve the positioning accuracy and avoid distortion of the results, a Type 1 Chebyshev high-pass digital filter is used. The natural frequencies and damping ratios of the buildings are determined using the fast Fourier transform analysis and random decrement technique combined with a logarithmic decrement method, respectively. The structural parameters are obtained. The results show that real-time kinematic-global navigation satellite system technology can provide the dynamic responses of super high-rise buildings in an efficient manner and that the dynamic characteristics from field measurements agree well with the results of the numerical simulation.
Stiffness degradation of suspension bridges and refined analysis of aerodynamic torsional divergence
Authors: Wu Changqing , Zhang Zhitian , Chen Zhengqing
Published: October 2017

Based on the mechanism of the aerostatic torsional divergence of suspension bridges, two criteria for stiffness degradation are presented and discussed. Under the action of wind loads, the torsional stiffness of the main cable system would degrade when one cable reaches a softening state, and then only the small portion of torsional stiffness contributed by the bridge deck would remain. After degradation, the structure could be easily overturned since the residual stiffness is generally far from enough to resist the negative aerodynamic stiffness. For a suspension bridge immersed in a wind flow, its stiffness would degrade when the upward vertical motion of either main cable is large enough to unload the vast majority or even all of its tension. For convenience, the vertical displacement at the central point of the main cables can be used as a criterion for stiffness degradation. However, lateral deflections of the main cables and horizontal deflections of the bridge towers could postpone the stiffness degradation; moreover, a suspension bridge generally responds stochastically due to the turbulent nature of the oncoming flow, which disenables a reliable critical vertical displacement for assessing the stiffness degradation. In view of this, another criterion based on the cable length is put forward. The numerical results of the dynamic finite element analysis show that the stiffness degradation and the torsional divergence can be well explained with this criterion. Also, a notable discrepancy is found between the two critical wind speeds obtained respectively from the static and the dynamic finite element simulations, showing that buffeting responses of a long-span suspension bridge are non-negligible in the assessment of its aerostatic torsional instability.
Mesoscale modelling of concrete reinforced with spiral steel fibres under dynamic splitting tension
Authors: Hao Yifei , Huang Xin , Hao Hong
Published: October 2017

The addition of discrete steel fibres into concrete has been widely recognised as an effective measure to enhance the ductility, post-cracking resistance and energy absorption of the matrix subjected to impact loads. Despite useful information from experimental studies that investigate the macro-scale performance of steel fibre–reinforced concrete under dynamically applied loadings, results from a series of tests or from tests by different researchers are often found to be scattered. Besides variations in testing conditions, random variations of size, location and orientation of aggregates and fibres in steel fibre–reinforced concrete are deemed the fundamental reason of the scattering test data. High-fidelity modelling of concrete and steel fibre–reinforced concrete in mesoscale has been widely adopted to understand the influence of each component in the composite material. Numerical studies have been published to discuss the behaviour of steel fibre–reinforced concrete under dynamic splitting tension. Different shapes, for example, circles, ovals and polygons, of coarse aggregates were considered in different studies, and different conclusions were drawn. This study investigates the influence of the shape of aggregates on numerical prediction in mesoscale modelling of steel fibre–reinforced concrete materials with spiral fibres under dynamic splitting tension in terms of the strain distribution, cracking pattern and strength. The numerical model is validated by experimental results. It is found that the shape of aggregates in mesoscale modelling of splitting tensile tests has negligible influence. Furthermore, steel fibre–reinforced concrete specimens with different volume fractions of spiral fibres from 0.5% to 3.0% under various loading rates are simulated. Results from parametric simulations indicate the optimal dosage of spiral fibres in steel fibre–reinforced concrete mix with respect to the construction cost and mechanical property control.
Role of disease and demographic factors as determinants of return migration: A nationwide register-based cohort study
Authors: Handlos Line Neerup , Petersen Jorgen Holm , Bygbjerg Ib Christian , Norredam Marie
Published: October 2017

Aims: A number of aspects of the health status of migrants who return to their country of origin have been explored in the literature; however, a more general description of the incidence of disease and demographic characteristics is lacking. The aim of this research was to contribute such a description. Methods: A nationwide cohort study was conducted of 114,331 migrants who obtained residence in Denmark between 1 January 1993 and 31 December 2010. Demographic characteristics and ten disease groups were included as explanatory variables and hazards ratios for the association between return migration and disease incidence, as well as demographic characteristics, were estimated using Cox regressions. Results: The tendency to return-migrate when ill was not the same among younger and elderly migrants; migrants <55 years of age had a significantly smaller propensity to return-migrate if they had suffered from a disease during the 18 years of follow-up compared with those who had not had a disease, whereas migrants ≥55 years of age were more prone to return if ill. The likelihood of returning decreased with increasing comorbidity in both age groups. Among those who were <55 years of age, the tendency to return increased with age at obtainment of residence; among those who were ≥55 years, more men than women return-migrated. Conclusions: In Denmark, younger migrants are less inclined to return-migrate if they are ill compared with healthy migrants, whereas elderly migrants are more inclined to return if ill. The returnees also differ demographically from non-returnees in various ways.
Changes in sleep habits between 1985 and 2013 among children and adolescents in Sweden
Authors: Norell-Clarke Annika , Hagquist Curt
Published: October 2017

Aims: The aim was to investigate changes in child and adolescent sleep habits in Sweden over time. This had not been done previously. Methods: Cross-sectional questionnaire data over three decades of investigations of the Health Behaviours of School Children study (1985/1986, 2005/2006 and 2013/2014) were used. The sample included 18,682 children and adolescents, aged 11, 13 and 15. Empirically based age-specific sleep duration recommendations were used to operationalise sleep duration. Results: The results showed that, over time, fewer go to bed early and more go to bed late. Regarding sleep duration, there have been decreases in the proportion of children and adolescents that sleep as much as is recommended for their age. Sleep onset difficulties have increased for all ages and increase the odds of sleeping less than recommended as well as having late bedtimes. Boys were more likely than girls to have later bedtimes and to sleep less than recommended. A vocational educational track, not planning to study further or being unsure of which track to choose increased the odds for 15 year olds to have late bedtimes and to sleep less than recommended compared with a college preparatory track. Conclusions: The results indicate that over time, fewer children and adolescents attain sufficient sleep duration. This may have implications for study results, mental health and cognitive abilities.
Journalism as a public good: A Scandinavian perspective
Authors: Allern Sigurd , Pollack Ester
Published: October 2017

The democratic importance of journalism is related to public good aspects of media products, as well as news media’s positive externalities. Journalism of high quality helps ensure we are all better informed and thus benefits democracy. Lack of investigative journalism may incur large social costs. However, journalism as a public good is difficult to fund on a commercial basis. Historically, an economic solution for media companies has been advertising subsidies, plus different types of public and private support. Today, the long-time marriage between news organisations and advertisers is severely weakened, and nothing so far suggests that digital revenues alone can finance a varied, broad and original news production. In the eyes of capitalist investors, news organisations represent the past, not the future. This article discusses, on the basis of Scandinavian media experiences and recent policy reforms, the necessity of a media policy and a funding system that acknowledges quality journalism as societal knowledge production and a public good.
Transmedia or repurposing journalism? News brands in the era of convergence. Compared study of Greek elections coverage by El País (ES), The Guardian (UK), La Repubblica (IT), and Público (PT)
Authors: Costa-Sánchez Carmen , Rodríguez-Vázquez Ana-Isabel , López-García Xosé
Published: October 2017

Journalism is once again facing a context of technological and social changes. The current stage is characterized for being mobile, multi-screen, and visual. Citizens have adopted with ease the new mobile media for content consumption. Transmedia narratives emerge as structures that can help creators to adapt contents to all platforms and to open the door to new audiences. This article analyzes transmedia strategies in the news offered during the coverage of Greek elections (20-S) by four of the most important news media brands in Europe: El País (ES), The Guardian (UK), La Repubblica (IT), and Público (PT). Results show that mobile platforms have been incorporated into the news coverage following a repurposing strategy as regards web content. The increasing number of published stories, the prioritization of their updating, and the multimedia enrichment make the World Wide Web the main platform of the analyzed practices. The patterns for commenting and sharing do not match, but the most commented and disseminated include multimedia contents.
Coffee people in Tehran, Glasgow and Amsterdam
Authors: Shaker Ardekani Reza , Rath Jan
Published: October 2017

Despite the diversity of consumption and class practices of the new urban middle classes within and between societies, they share some qualities. Focusing on the lifestyles and mentalities of regulars of specialty coffee bars in Tehran, Glasgow and Amsterdam, this study explores common characteristics of this group. Our ethnography suggests that through their everyday consumption practices, coffee people share a set of ethical dispositions and cultural practices among which this article focuses on the metropolitan body, cosmopolitanism and environmentalism.
What are you (un)doing with that story?
Authors: Nouvet Elysée , Sinding Christina , Graham Catherine , Vengris Jennie , Fudge Schormans Ann , Fullwood Ailsa , Skeene Melanie
Published: October 2017

This paper contributes to growing inter-disciplinary discussion on what and how arts-informed community-engaged research can add to critical engagements with social inequalities. It is based on workshops facilitated by an inter-disciplinary university research group with the Women’s Housing Planning Collaborative Advisory in Hamilton, a funded housing project and self-advocacy group in a mid-sized Canadian city. In theoretically informed and carefully crafted exercises, workshop participants performed stories they felt compelled to tell in order to secure resources and empathy from social service professionals. These performances made visible the draining nature and practical limitations of interactions between clients and social service professionals in which only particular affective postures and stories of need qualify clients as worthy of concern. The women then used first-person narrative and image theatre to evoke the worlds they are imagining for themselves and others in their advocacy work. Drawing on feminist, post-colonial, anthropological, and performance studies literature, we describe and analyze how the workshops methods of dramatic ‘play’ enable nuanced, powerful, and collectively energizing critical engagements with painful norms of social (mis)recognition.
The value of digital video data for qualitative social work research: A narrative review
Authors: Miller Scarnato Jenn
Published: October 2017

This study evaluates the value of digital video data in qualitative social work research at each stage of the research process. Through an analytic narrative review of the social work literature and related social sciences fields, the article argues that video data are under-utilized in social work research despite great opportunity to enhance the research process and articulate with social work values in the research encounter. The unique contributions of video data in the collection, analysis, and dissemination stages of research are considered, along with a brief discussion of the interactive nature of these stages in participatory action research designs that train participants in media production. The added benefits that video affords research participants as well as the unique challenges and limitations of video-based research design are reviewed and evaluated in relation to the social work profession. Social workers are called upon to embrace video data in qualitative research to produce critical counter narratives that combat harmful misrepresentations of disenfranchised populations and thereby advance the profession’s mission and values.
The treatment of pseudoaneurysms with flow diverters after malignant otitis externa
Authors: Németh Tamás , Szakács László , Bella Zsolt , Majoros Valéria , Barzó Pál , Vörös Erika
Published: October 2017

Background

We report a case of bilateral malignant otitis externa complicated with bilateral petrous internal carotid artery pseudoaneurysms and their successful treatment with a flow diverter.

Case report

A 68-year-old woman with serious complications of type II diabetes mellitus had malignant otitis externa on the right side. She was treated with combined antibiotic therapy and underwent mastoidectomy for mastoiditis. She presented at our hospital with acute hemorrhage from the right external auditory canal. The emergency computed tomography (CT) angiography revealed a multiobulated pseudoaneurysm at the petrous segment of the right internal carotid artery. The pseudoaneurysm was treated with a 5 × 40-mm Surpass flow diverter. Three months later, she developed a malignant external otitis on the left side. As the infection progressed, a left-sided mastoiditis, a brain abscess, and a pseudoaneurysm at the petrous segment of the left internal carotid artery developed. The pseudoaneurysm caused bleeding from the left ear, and was treated with a 5 × 50-mm Surpass flow diverter. No recurrent bleeding was observed. Four months later, a follow-up angiography showed complete occlusion of the pseudoaneurysm on the left side, but a residual aneurysm could be detected on the right side. One year after the first intervention, the follow-up CT and magnetic resonance angiography revealed the complete occlusion of the aneurysms bilaterally.

Conclusion

The use of a flow diverter appears to be an efficient and safe method to occlude carotid pseudoaneurysms even in an inflammatory milieu.
A rare anomalous origin of right vertebral artery with double branch: First case report
Authors: Liu Ya-dong , Li Zhi-qiang , Fu Jing-jing , E Ya-jun
Published: October 2017

Vertebral artery origin anomalies are typically incidental findings during angiography. We present an extremely rare variant in which the right vertebral artery has a double origin from the right subclavian artery and right common carotid artery in association with an aberrant right subclavian artery, which has never been reported before.
Endovascular aneurysm repair in the elderly: First do no harm
Authors: Qureshi Mahim I , Davies Alun H
Published: October 2017

Endovascular aneurysm repair (EVAR) has become the intervention of choice for supra-threshold aortic aneurysms due to the lower 30-day mortality of EVAR as compared with open surgery, despite no long-term longevity gains. Trials such as EVAR-1 that established the current status of endovascular aortic intervention often excluded participants over the age of 80, and specific studies of EVAR in the elderly reveal higher mortality than accepted averages. Analyses of the cost-effectiveness of EVAR have not demonstrated superiority of endovascular intervention over open repair, in particular when considering complications such as endoleak. Post-intervention surveillance and the frequent need for re-intervention following EVAR has a detrimental impact on quality of life. Taking these factors into consideration, combined with an ageing population and the likely increase in octogenarian endovascular intervention, there is a clear clinical need for appropriate risk-stratification of elderly patients with supra-threshold aneurysms to determine who will benefit from endovascular repair.
Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation
Authors: Van Dam Nicholas T. , van Vugt Marieke K. , Vago David R. , Schmalzl Laura , Saron Clifford D. , Olendzki Andrew , Meissner Ted , Lazar Sara W. , Kerr Catherine E. , Gorchov Jolie , Fox Kieran C. R. , Field Brent A. , Britton Willoughby B. , Brefczynski-Lewis Julie A. , Meyer David E.
Published: October 2017

During the past two decades, mindfulness meditation has gone from being a fringe topic of scientific investigation to being an occasional replacement for psychotherapy, tool of corporate well-being, widely implemented educational practice, and “key to building more resilient soldiers.” Yet the mindfulness movement and empirical evidence supporting it have not gone without criticism. Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled, and disappointed. Addressing such concerns, the present article discusses the difficulties of defining mindfulness, delineates the proper scope of research into mindfulness practices, and explicates crucial methodological issues for interpreting results from investigations of mindfulness. For doing so, the authors draw on their diverse areas of expertise to review the present state of mindfulness research, comprehensively summarizing what we do and do not know, while providing a prescriptive agenda for contemplative science, with a particular focus on assessment, mindfulness training, possible adverse effects, and intersection with brain imaging. Our goals are to inform interested scientists, the news media, and the public, to minimize harm, curb poor research practices, and staunch the flow of misinformation about the benefits, costs, and future prospects of mindfulness meditation.
Experimental maneuverability and agility quantification for rotary unmanned aerial vehicle
Authors: Verbeke Jon , Schutter Joris De
Published: October 2017

Multicopters are the most popular rotary type of unmanned aerial vehicles. They are a type of helicopter with three or more, usually fixed-pitch, propellers that lift and control the platform by individually changing their rotational velocities. The main advantages of a multicopter are its compactness, robustness, and low cost to build and repair. However, currently no published research determines objectively, quantitatively, and experimentally, the maneuverability and agility of multicopters. Numerous maneuverability and agility metrics, together with detailed test procedures and minimum requirements, exist for manned aircraft. Nevertheless, some of these are not directly applicable to small-size unmanned aircraft. A new test procedure, derived from manned aircraft industry practices and research, based on a simple open-loop step input maneuver, was developed. It experimentally determines nine maneuverability and agility metrics using only onboard flight controller logs. The test procedure is validated using two different multicopters.
Accuracy and Time Delay of Glucose Measurements of Continuous Glucose Monitoring and Bedside Artificial Pancreas During Hyperglycemic and Euglycemic Hyperinsulinemic Glucose Clamp Study
Authors: Kuroda Akio , Taniguchi Satoshi , Akehi Yuko , Mori Hiroyasu , Tamaki Motoyuki , Suzuki Reiko , Otsuka Yinhua , Matsuhisa Munehide
Published: October 2017

Background:

Glucose values of continuous glucose monitoring (CGM) have time delays compared with plasma glucose (PG) values. The artificial pancreas (STG-55, Nikkiso, Japan) (AP), which measures venous blood glucose directly, also has a time delay because of the long tubing lines from sampling vessel to the glucose sensor. We investigate accuracy and time delay of CGM and AP in comparison with PG values during 2-step glucose clamp study.

Methods:

Seven patients with type 2 diabetes and 2 healthy volunteers were included in this study. CGM (Enlite sensor, Medtronic, Northridge, CA, USA) was attached on the day before the experiment. Hyperglycemic (200 mg/dL) clamp was performed for 90 minutes, followed by euglycemic (100 mg/dL) hyperinsulinemic (100 μU/mL) clamp for 90-120 minutes using AP. CGM sensor glucose was calibrated just before and after the clamp study. AP and CGM values were compared with PG values.

Results:

AP values were significantly lower than PG values at 5, 30 minute during hyperglycemic clamp. In comparison, CGM value at 0 minute was significantly higher, and its following values were almost significantly lower than PG values. The time delay of AP and CGM values to reach maximum glucose levels were 5.0 ± 22.3 (NS) and 28.6 ± 32.5 ( P < .05) min, respectively. Mean absolute rate difference of CGM was significantly higher than AP (24.0 ± 7.6 vs 15.3 ± 4.6, P < .05) during glucose rising period (0-45 min); however, there were no significant differences during other periods.

Conclusions:

Both CGM and AP failed to follow plasma glucose values during nonphysiologically rapid glucose rising, but indicated accurate values during physiological glucose change.
Servant Leadership, Employee Job Crafting, and Citizenship Behaviors: A Cross-Level Investigation
Authors: Bavik Ali , Bavik Yuen Lam , Tang Pok Man
Published: October 2017

While servant leadership is widely recognized as a people-oriented management style, little attention has been directed to understand the positive outcomes of servant leadership on different stakeholders in the hospitality context. This research examines the mediating role of employee job crafting in the relationship between servant leadership and individual employees’ interpersonal citizenship behaviors directed at both internal and external stakeholders. Multisourced survey data collected from 238 hotel employees in 38 teams revealed that the effects of servant leadership on individual employees’ citizenship behaviors directed toward leaders, coworkers, and customers were mediated by employee job crafting.
Economic and Conservation Potential of Bird-Watching Tourism in Postconflict Colombia
Authors: Ocampo-Peñuela Natalia , Winton R. Scott
Published: October 2017

Ongoing conflict resolution in Colombia brings an opportunity for economic development of impoverished communities and a conservation threat of deforestation in newly accessible rural areas. Ecotourism is often proposed as a “win–win” solution for developing countries to meet both economic and conservation needs. With the highest number of bird species of any country, including 443 rare species highly valued by bird-watchers, Colombia has a unique opportunity to develop a lucrative and conservation-friendly bird-watching tourism industry in postconflict areas. Through geospatial analysis of conflict zones, bird distributions, protected areas, forest cover, and bird-watching activity, we identify areas of Colombia with unrealized bird-watching potential that are ripe for the development of synergistic conservation-ecotourism projects. An investment in ecotourism infrastructure and training by the Colombian government may be a conservation-friendly alternative to natural resource extraction that could alleviate poverty without degrading natural capital in postconflict Colombia.
Hyperosmolar Potassium (K+) Treatment Suppresses Osteoarthritic Chondrocyte Catabolic and Inflammatory Protein Production in a 3-Dimensional In Vitro Model
Authors: Erndt-Marino Josh , Trinkle Erik , Hahn Mariah S.
Published: October 2017

Objective

The main goal of this study was to provide a proof-of-concept demonstrating that hyperosmolar K+ solutions can limit production of catabolic and inflammatory mediators in human osteoarthritic chondrocytes (OACs).

Methods

A 3-dimensional in vitro model with poly(ethylene glycol) diacrylate (PEGDA) hydrogels was used. Catabolic and pro-inflammatory protein production from encapsulated OACs was assessed following culture for 1 or 7 days in the presence or absence of 80 mM K+ gluconate, 80 mM sodium (Na+) gluconate, or 160 mM sucrose, each added to culture media (final osmolarity ~490 mOsm).

Results

Relative to untreated controls, OACs treated with hyperosmolar (80 mM Na+ gluconate or 160 mM sucrose) solutions produced lower levels of catabolic and inflammatory mediators in a marker- and time-dependent manner (i.e., MMP-9 after 1 day; MCP-1 after 7 days ( P ≤ 0.015)). In contrast, OAC treatment with 80 mM K+ gluconate reduced catabolic and inflammatory mediators to a greater extent (both the number of markers and degree of suppression) relative to untreated, Na+ gluconate, or sucrose controls (i.e., MMP-3, -9, -13, TIMP-1, MCP-1, and IL-8 after 1 day; MMP-1, -3, -9, -13, TIMP-1, MCP-1, and IL-8 after 7 days ( P ≤ 0.029).

Conclusions

Hyperosmolar K+ solutions are capable of attenuating protein production of catabolic and inflammatory OA markers, providing the proof-of-concept needed for further development of a K+-based intra-articular injection for OA treatment. Moreover, K+ performed significantly better than Na+- or sucrose-based solutions, supporting the application of K+ toward improving irrigation solutions for joint surgery.
Controlled dexamethasone delivery via double-walled microspheres to enhance long-term adipose tissue retention
Authors: Kelmendi-Doko Arta , Rubin J Peter , Klett Katarina , Mahoney Christopher , Wang Sheri , Marra Kacey G
Published: October 2017

Current materials used for adipose tissue reconstruction have critical shortcomings such as suboptimal volume retention, donor-site morbidity, and poor biocompatibility. The aim of this study was to examine a controlled delivery system of dexamethasone to generate stable adipose tissue when mixed with disaggregated human fat in an athymic mouse model for 6 months. The hypothesis that the continued release of dexamethasone from polymeric microspheres would enhance both adipogenesis and angiogenesis more significantly when compared to the single-walled microsphere model, resulting in long-term adipose volume retention, was tested. Dexamethasone was encapsulated within single-walled poly(lactic- co-glycolic acid) microspheres (Dex SW MS) and compared to dexamethasone encapsulated in a poly(lactic- co-glycolic acid) core surrounded by a shell of poly-l-lactide. The double-walled polymer microsphere system in the second model was developed to create a more sustainable drug delivery process. Dexamethasone-loaded poly(lactic- co-glycolic acid) microspheres (Dex SW MS) and dexamethasone-loaded poly(lactic- co-glycolic acid)/poly-l-lactide double-walled microspheres (Dex DW MS) were prepared using single and double emulsion/solvent techniques. In vitro release kinetics were determined. Two doses of each type of microsphere were examined; 50 and 27 mg of Dex MS and Dex DW MS were mixed with 0.3 mL of human lipoaspirate. Additionally, 50 mg of empty MS and lipoaspirate-only controls were examined. Samples were analyzed grossly and histologically after 6 months in vivo. Mass and volume were measured; dexamethasone microsphere-containing samples demonstrated greater adipose tissue retention compared to the control group. Histological analysis, including hematoxylin and eosin and CD31 staining, indicated increased vascularization (p < 0.05) within the Dex MS-containing samples. Controlled delivery of adipogenic factors, such as dexamethasone via polymer microspheres, significantly affects adipose tissue retention by maintaining healthy tissue formation and vascularization. Dex DW MS provide an improved model to former Dex SW MS, resulting in notably longer release time and, consequently, larger volumes of adipose retained in vivo. The use of microspheres, specifically double-walled, as vehicles for controlled drug delivery of adipogenic factors therefore present a clinically relevant model of adipose retention that has the potential to greatly improve soft tissue repair.
The use of fentanyl in pain management in head and neck cancer patients: a narrative review
Authors: Giusti Raffaele , Bossi Paolo , Mazzotta Marco , Filetti Marco , Iacono Daniela , Marchetti Paolo
Published: October 2017

Background:

Head and neck (H&N) cancers account for about 5% of all malignant tumours. Pain is one of the most feared consequences of H&N neoplasms and is experienced by up to 80% of patients and worsens their quality of life inhibiting speaking, eating, drinking or swallowing. Nevertheless, pain is still often underestimated and undertreated.

Objectives:

The role of opioids in cancer pain has been well established but evidences about the role and the relative effectiveness of opioids such as fentanyl in the context of H&N cancer pain remains unclear.

Methods:

A literature review based on the guidance of the Centre for Reviews and Dissemination was conducted. An iterative approach was used starting with an electronic search in the MEDLINE database. The search terms ((‘Neoplasms’[Mesh]) AND ‘Head and Neck Neoplasms’[Mesh]) AND ‘Fentanyl’[Mesh] were used.

Results:

A total of 18 publications were found by the first performed search on PubMed. Other publications concordant with our aim were found by cross-reference. Considering inclusion and exclusion criteria for our review, eight papers resulted eligible for analysis.

Conclusion:

Fentanyl transdermal therapeutic system (TTS) seems to be an important option, thanks to the way of administration, the good safety and tolerability profiles to control baseline pain. For breakthrough cancer pain (BTcP), several formulations of transmucosal fentanyl are available. All the formulations seem to be active and safety but we lack head-to-head studies of fentanyl versus other strong opioids, as well as with different formulation of fentanyl, particularly for BTcP where H&N cancer population is very poorly represented.
Awareness of Hand Hygiene Among Health Care Workers of Chitwan, Nepal
Authors: Khanal Gayatri , Thapa Suman
Published: October 2017

Improper HH by health care workers is responsible for about 40% of nosocomial infections resulting in prolonged illnesses. A cross-sectional study was carried out in three hospitals to identify the knowledge and practice of HH. There was a significant difference in the level of knowledge among the health care workers ( p < .05). There was a positive association ( r = 0.247) between knowledge and practice skill of health care workers. Nearly three quarters of the health care workers (74.2%) had been trained for infection prevention. Soap was the most popular agent (57.5%) for HH. The health care workers had good level of knowledge (77.3%) and practice (91.7%) on HH. However, half of the health care workers were unaware of all of the steps of HH and they were lacking in knowledge and practice skill regarding important components of HH. Therefore, there is an urgent need for continuing medical education for infection prevention, to increase their awareness and compliance toward HH.
Book Review: Sabyasachi Bhattacharya and Rana P. Behal (Eds), The Vernacularization of Labour Politics
Authors: Babu Senthil
Published: October 2017

Sabyasachi Bhattacharya and Rana P. Behal (Eds.), The Vernacularization of Labour Politics. New Delhi: Tulika Books, 2016, 950 INR, pp. 348, ISBN: 9789382381822.
Intra-articular Physeal Fractures of the Distal Femur: A Frequently Missed Diagnosis in Adolescent Athletes
Authors: Pennock Andrew T. , Ellis Henry B. , Willimon Samuel C. , Wyatt Charles , Broida Samuel E. , Dennis M. Morgan , Bastrom Tracey
Published: October 2017

Background:

Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature.

Purpose:

To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications.

Study Design:

Case series; Level of evidence, 4.

Methods:

A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed. Patient demographic and injury data, surgical data, and postoperative outcomes were documented. Radiographs were evaluated for fracture classification (Salter-Harris), location, and displacement. Differences between patients with and without complications were compared by use of analysis of variance or chi-square tests.

Results:

A total of 49 patients, with a mean age of 13.5 years (range, 7-17 years), met the inclusion criteria. The majority of fractures were Salter-Harris type III fractures (84%) involving the medial femoral condyle (88%). Football was responsible for 50% of the injuries. The initial diagnosis was missed in 39% of cases, and advanced imaging showed greater mean displacement (6 mm) compared with radiographs (3 mm). All patients underwent surgery and returned to sport with “good to excellent” results after 2 years. Complications were more common in patients with wide-open growth plates, patients with fractures involving the lateral femoral condyle, and patients who were casted ( P < .05).

Conclusion:

Clinicians evaluating skeletally immature athletes (particularly football players) with acute knee injuries should maintain a high index of suspicion for an intra-articular physeal fracture. These fractures are frequently missed, and advanced imaging may be required to establish the diagnosis. Leg-length discrepancies and angular deformities are not uncommon, and patients should be monitored closely. Surgical outcomes are good when fractures are identified, with high rates of return to sport.
Two distinct CXCR4 antagonists mobilize progenitor cells in mice by different mechanisms
Authors: Redpath Andia N. , François Moïra , Wong Suet-Ping , Bonnet Dominique , Rankin Sara M.
Published: October 2017

Key Points

CXCR4 antagonist AMD3100 but not KRH3955 reverses the CXCL12 chemokine gradient across the bone marrow endothelium. CXCR4 antagonists mobilize stem cells from the bone marrow by distinct mechanisms.
Polyion complex micelle formed from tetraphenylethene containing block copolymer
Authors: Lee Seong Min , Jang Woo-Dong
Published: October 2017

Background

Polymeric micelles attract great attention in drug delivery and therapeutics. Various types of block copolymers have been designed for the application in biomedical fields. If we can introduce additional functional groups to the block copolymers, we can achieve advanced applications. In this regards, we tried to introduce aggregation induced emission enhancement (AIE) unit in the block copolymer.

Methods

The formation of polyion complex micelle was confirmed by dynamic light scattering and transmission electron microscopy. HeLa cells were incubated with polyion complex micelle and broad-band visible light using a halogen lamp (150 W) was irradiated to evaluate photocytotoxicity of polyion complex (PIC) micelle.

Results

For the design of functional polymeric micelle, aggregation induced emission enhancement unit was introduced in the middle of block copolymer. We newly synthesized a new type block copolymer (PEG-TPE-PEI) possessing tetraphenylethene (TPE) group, as an AIE unit, in the middle of polymeric segments of PEG and PEI, which successfully formed PIC micelle with DP. The formation of PIC micelle was confirmed by dynamic light scattering, ζ potential measurement and transmission electron microscopy.

Conclusions

PEG-TPE-PEI successfully formed PIC micelle by mixing with negatively charged dendrimer porphyrin. The PIC micelle exhibited photocytotoxicity upon illumination of broadband visible light.
Functionalization of Ti-40Nb implant material with strontium by reactive sputtering
Authors: Göttlicher Markus , Rohnke Marcus , Moryson Yannik , Thomas Jürgen , Sann Joachim , Lode Anja , Schumacher Matthias , Schmidt Romy , Pilz Stefan , Gebert Annett , Gemming Thomas , Janek Jürgen
Published: October 2017

Background

Surface functionalization of orthopedic implants with pharmaceutically active agents is a modern approach to enhance osseointegration in systemically altered bone. A local release of strontium, a verified bone building therapeutic agent, at the fracture site would diminish side effects, which could occur otherwise by oral administration. Strontium surface functionalization of specially designed titanium-niobium (Ti-40Nb) implant alloy would provide an advanced implant system that is mechanically adapted to altered bone with the ability to stimulate bone formation.

Methods

Strontium-containing coatings were prepared by reactive sputtering of strontium chloride (SrCl
2
) in a self-constructed capacitively coupled radio frequency (RF) plasma reactor. Film morphology, structure and composition were investigated by scanning electron microscopy (SEM), time of flight secondary ion mass spectrometry (ToF-SIMS) and X-ray photoelectron spectroscopy (XPS). High-resolution transmission electron microscopy (HR-TEM) was used for the investigation of thickness and growth direction of the product layer. TEM lamellae were prepared using the focused ion beam (FIB) technique. Bioactivity of the surface coatings was tested by cultivation of primary human osteoblasts and subsequent analysis of cell morphology, viability, proliferation and differentiation. The results are correlated with the amount of strontium that is released from the coating in biomedical buffer solution, quantified by inductively coupled plasma mass spectrometry (ICP-MS).

Results

Dense coatings, consisting of SrO
x
Cl
y
, of more than 100 nm thickness and columnar structure, were prepared. TEM images of cross sections clearly show an incoherent but well-structured interface between coating and substrate without any cracks. Sr
2+
is released from the SrO
x
Cl
y
coating into physiological solution as proven by ICP-MS analysis. Cell culture studies showed excellent biocompatibility of the functionalized alloy.

Conclusions

Ti-40Nb alloy, a potential orthopedic implant material for osteoporosis patients, could be successfully plasma coated with a dense SrO
x
Cl
y
film. The material performed well in in vitro tests. Nevertheless, the Sr
2+
release must be optimized in future work to meet the requirements of an effective drug delivery system.
Pediatric inhalation injury
Authors: Sen Soman
Published: October 2017

Smoke inhalation injury can cause severe physiologic perturbations. In pediatric patients, these perturbations cause profound changes in cardiac and pulmonary physiology. In this review, we examine the pathology, early management options, ventilator strategy, and long-term outcomes in pediatric patients who have suffered a smoke inhalation injury.
Trajectories of Injectable Cancer Drug Costs After Launch in the United States
Authors: Gordon Noa , Stemmer Salomon M. , Greenberg Dan , Goldstein Daniel A.
Published: October 2017

Purpose

Cancer drug prices at launch have increased in recent years. It is unclear how individual drug prices change over time after launch and what market determinants influence these changes. We measured the price trajectories of a cohort of cancer drugs after their launch into the US market and assessed the influence of market structure on price changes.

Methods

We studied the changes in mean monthly costs for a cohort of 24 patented, injectable anticancer drugs that were approved by the US Food and Drug Administration between 1996 and 2012. To account for discounts and rebates, we used the average sales prices published by the Centers for Medicare and Medicaid Services. Costs were adjusted to US general and health-related inflation rates. For each drug, we calculated the cumulative and annual drug cost changes. We then used a multivariable regression model to evaluate the association between market and cost changes over time.

Results

With a mean follow-up period of 8 years, the mean percent change in cost for all drugs was +25% (range, −14% to +96%). After adjusting for inflation, the mean cost change was +18% (range, −16% to +59%). Rituximab and trastuzumab followed a similar pattern in cost increases over time, and the inflation-adjusted monthly costs rose since approval by 49% and 44%, respectively. New supplemental US Food and Drug Administration approvals, new off-label indications, and new competitors did not influence the annual cost change rates.

Conclusion

Anticancer drug costs may change substantially after launch. Regardless of competition or supplemental indications, there is a steady increase in costs of patented anticancer agents over time. New regulations may be needed to prevent additional increases in drug costs after launch.
ASCO Value Framework Highlights the Relative Value of Treatment Options in Ovarian Cancer
Authors: Foote Jonathan , Secord Angeles Alvarez , Liang Margaret , Cohn David E. , Jewell Elizabeth , Havrilesky Laura J.
Published: October 2017

Purpose:

The ASCO value framework allows physicians and patients to compare the relative value of novel treatments. Our aim was to assess the value of three frontline ovarian cancer therapies by using this framework.

Methods:

From phase III, randomized controlled clinical trial (RCT) data, the net health benefits (NHBs) for three frontline ovarian cancer treatment options—dose-dense paclitaxel (Japanese Gynecologic Oncology Group study JGOG 3016), intraperitoneal (IP)/intravenous (IV) chemotherapy (Gynecologic Oncology Group [GOG] study GOG 172), and concurrent plus maintenance bevacizumab (GOG 218 and the Seventh International Collaborative Ovarian Neoplasm study [ICON7])—were calculated. The ASCO value framework calculates the NHB by using six criteria: clinical benefit, toxicity, tail of the curve, symptom palliation, treatment-free interval, and quality of life. Clinical benefit calculation uses ASCO-assigned importance weights for overall survival and progression-free survival. The maximum possible NHB points is 180. NHBs were presented alongside the drug-acquisition cost (DAC) of each therapy. A benefit-cost ratio of NHB points per additional cost was calculated.

Results:

The NHB of dose-dense paclitaxel was 38, at an additional cost of $16 per cycle. IP cisplatin/IV + IP paclitaxel received 29 NHB points, at an additional cost of $1,629 per cycle. Concurrent plus maintenance bevacizumab received 24 NHB points, at an additional cost of $7,581 per cycle (GOG 218) or six NHB points ($3,790 per cycle; ICON7). The ratios of NHB points–to-dollar were as follows: dose-dense paclitaxel, 2.4 (highest); IP chemotherapy, 0.018; and bevacizumab, 0.003 (lowest).

Conclusion:

Using the ASCO value framework, we constructed value snapshots of three major frontline therapeutic options in ovarian cancer. Dose-dense paclitaxel provided the highest additional value when analysis accounted for NHB and cost. However, additional research is needed to include individual patient preferences and provide personalized value assessments.
The African Zika virus MR-766 is more virulent and causes more severe brain damage than current Asian lineage and Dengue virus
Authors: Shao Qiang , Herrlinger Stephanie , Zhu Ya-Nan , Yang Mei , Goodfellow Forrest , Stice Steven L. , Qi Xiao-Peng , Brindley Melinda A. , Chen Jian-Fu
Published: October 2017

The Zika virus (ZIKV) has two lineages, Asian and African, and their impact on developing brains has not been compared. Dengue virus (DENV) is a close family member of ZIKV and co-circulates with ZIKV. Here we performed intracerebral inoculation of embryonic mouse brains with dengue virus 2 (DENV2), and found that DENV2 is sufficient to cause smaller brain size due to increased cell death in neural progenitor cells (NPCs) and neurons. Compared to the currently circulating Asian lineage of ZIKV (MEX1-44), DENV2 grows slower, causes less neuronal death, and fails to cause postnatal animal death. Surprisingly, our side-by-side comparison uncovered that African ZIKV isolate (MR-766) is more potent in causing brain damage and postnatal lethality than MEX1-44. In comparison to MEX1-44, MR-766 grows faster in NPCs and in the developing brain, and causes more pronounced cell death in NPCs and neurons, resulting in more severe neuronal loss. Together, these results reveal that DENV2 is sufficient to cause smaller brain sizes, and suggest that the ZIKV African lineage is more virulent and causes more severe brain damage than the Asian lineage.